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The broad goal of the approach is to provide a comprehensive analysis of the way in which individual psychology is structured by group life. Moreover, it proposes that when people categorize themselves as members of a group, this gives their behaviour a distinct meaning, in part because it motivates them to positively differentiate their ingroup from comparison outgroups on valued dimensions.
According to this approach, group behaviour is associated with a change in the structure of the self whereby, through a process of depersonalization, the self comes to be perceived as categorically interchangeable with other ingroup members [ 74 ]. So, for example, the more a person identifies with a gym class or exercise group e.
In line with the foregoing arguments, research by Terry and Hogg [ 77 ] found that individuals who identified strongly with a group in which exercise was normative reported greater intentions to engage in regular exercise than those who identified weakly with the group. These findings have subsequently been supported by a large body of experimental research in the broader health domain, which has shown that people are more likely to engage in healthy behaviours if, and to the extent that, these are congruent with the content of a salient social identity [ 78 , 79 ].
Showing too that identity-based intentions translate into identity-congruent behaviour, Strachan et al. Complementing both self-determination theory [ 28 ] and the theory of planned behaviour [ 29 ], these findings reinforce the notion that intentions predict behaviour. Crucially, however, they extend this proposition by demonstrating that this effect is particularly strong when those intentions are structured by internalized social identities. Other research informed by the social identity approach has extended these ideas by highlighting the importance of the structure of exercise environments in fostering identity development.
Across multiple studies, Beauchamp and colleagues [ 81 , 82 ] and Dunlop and Beauchamp [ 83 , 84 ] have shown that people feel more inclined to exercise with others with whom they share membership in a particular social category e. Among other things, these researchers found that age and sex are particularly common markers of shared social identity in exercise settings and that participants who perceived themselves to be similar to other group members in terms of physical characteristics i.
Such findings suggest that people seek out and create ingroups and outgroups in exercise settings [ 85 ] and that the opportunity to exercise with other ingroup rather than outgroup members is therefore an important determinant of their continued engagement in exercise [ 86 ]. They also suggest that people who design exercise programmes need to attend to both 1 the opportunities these provide for emergent social identities and 2 the ways in which the programme allows these identities to be enacted and maintained e.
Supporting these assertions, a recent randomized controlled trial of the Football Fans in Training FFIT programme revealed a significant 4. FFIT is a week programme delivered exclusively to overweight male football fans to improve their diet and physical activity. Crucially, participants share a common social identity as fans of the same team, with interaction between ingroup members assured.
Such interaction is also facilitated within many other recently developed exercise programmes e. These various lines of research all speak to the idea that social identities can have profound implications for participation in, and adherence to, physical activity. However, as yet, the body of research that supports such claims is relatively small.
In an attempt to lend some structure to this effort, we have chosen to focus this editorial on structuring the key premises of the social identity. The impact of these identity processes on health and well-being is explored in the . because the content of social identity is inconsistent with health-enhancing .
Moreover, it is further limited by a predominant focus on healthy, non-clinical populations. Given the additional barriers to participation experienced by clinical populations e. Indeed, such groups would represent a unique challenge to programmes designed to provide opportunities for social identities to emerge and be harnessed. Examination of the benefits of group exercise environments, where multiple individuals undertake the same structured exercise activity, is not new. Indeed, the effectiveness of interventions that involve individual- and group-based exercise environments have been studied extensively, with good evidence that group environments are more effective than individual environments in promoting adherence.
Efforts to develop cohesiveness within exercise groups have proved particularly effective [ 88 ]. Most notably, these benefits include long-term increases in physical activity [ 89 — 91 ] see Estabrooks et al. For example, the influential model by Carron and Spink [ 94 ] proposes that a sense of distinctiveness plays an important role in motivating members of exercise groups to engage in group-relevant activity see also Bruner and Spink [ 95 , 96 ]. Clarifying the causal role of social identification in these outcomes, experimental research that enhanced social identification by providing group t-shirts and encouraging participants to develop a group name found this led to greater subsequent effort in a group task [ 97 ].
Such findings suggest that social identity is a key mechanism that underpins the effectiveness of group-based programmes in exercise settings. Again, though, this hypothesis is yet to be extensively tested. In particular, there is a need for much more empirical research to explore the role that social identities play in the effectiveness of various forms of exercise groups, interventions, and programmes in the world at large e. According to the social identity approach, it is the shift in self-categorization from a personal to a social identity that underpins social collaboration and indeed all forms of group behaviour [ 73 ].
Extending this reasoning, social identity theorizing contends that, when people categorize themselves as members of the same group i. However, at the same time, the capacity for any given individual to exert influence varies as a function of his or her capacity to represent and embody the meaning of the group in a given social context.
Although the efficacy of the social identity approach to leadership has yet to be extensively examined in exercise settings, a vast body of other research supports its applicability to this context. Benefits associated with identity leadership in other mainly organizational contexts include increased satisfaction [ — ], effort [ , ], and support for leaders [ 98 , , ] as well as reduced turnover intentions [ , ] and burnout [ ]. Such findings appear to have clear relevance to exercise settings.
For example, higher levels of burnout have been extensively linked to motivation loss and dropout among sports team players [ — ], emphasizing the value of minimizing the occurrence of burnout in exercise settings. This suggests there would be particular value in exercise leaders 1 taking opportunities to learn about group history, culture, and functioning and 2 attending to collective group values, norms, and goals.
Understanding these nuanced dimensions of group identity will enhance their capacity to be perceived as a prototypical group member and thus engender support e. Again, though, empirical tests of the identity leadership approach in clinical and non-clinical exercise settings are now needed to confirm its seemingly substantial potential and to identify factors that moderate i.
Aspects of the approach may, for example, be less applicable in clinical settings e. However, at the same time, the relative value of leaders helping to create an appropriate identity for such a group e. These nuances await research. Indeed, the research Steffens et al. Nevertheless, Wegge et al. The social identity approach represents a potentially fruitful but greatly under-examined framework for understanding and promoting physical activity.
It also presents a viable alternative to the individualistic treatments that currently dominate the theoretical landscape. In the limited space available here, we have provided three brief illustrations of the ways in which this approach might enrich theory and practice. Our hope is that, though barely sketched out here, the framework we have outlined will serve as the foundation for an exciting new wave of original research into the role that group and identity dynamics play in shaping physical activity behaviours.
Certainly, the clear applicability of the approach to this domain, and the substantial contribution it has already made in others, makes us confident that the approach has the capacity to drive a groundswell of empirical research, and that the advances this would yield would be considerable.
Alexander Haslam and Remco Polman have no conflicts of interest that are relevant to the content of this manuscript. No sources of funding were used in the preparation of this article. National Center for Biotechnology Information , U. Sports Medicine Auckland, N. Published online Mar Steffens , 3 S. Alexander Haslam , 3 and Remco Polman 4. This article has been cited by other articles in PMC. Abstract Against the backdrop of a global physical inactivity crisis, attempts to both understand and positively influence physical activity behaviours are characterized by a focus on individual-level factors e.
Key Points Social factors have a significant impact on physical activity behaviours, and our understanding of their influence will be improved by applying theories of group behaviour to this context. The social identity approach provides a valuable framework from which to explore the impact of social factors on physical activity behaviours.
Through three broad examples, we illustrate how the social identity approach has the potential to enrich both theory and practice in the physical activity domain. Open in a separate window. Introduction In this article, we highlight the potential for a social identity approach to advance understanding and promotion of physical activity behaviours. Physical Activity, Health, and Participation Rates The influence of physical activity on health and well-being is well documented. Current Approaches to Understanding and Promoting Physical Activity Given this physical inactivity pandemic [ 23 , 26 ], considerable effort has been devoted to understanding physical activity behaviours.
Recent Advances in Understanding Behaviour Change Researchers have recently explored new avenues in attempting to advance understanding of behaviour change, including the development of taxonomies of the numerous strategies that have been employed in the context of smoking cessation [ 48 ], alcohol consumption [ 49 ], and healthy eating and physical activity [ 50 , 51 ]. The Social Identity Approach The social identity approach comprises two theories: The Social Identity Approach Applied to Physical Activity Social Identity can be Harnessed to Promote Engagement in Physical Activity In line with the foregoing arguments, research by Terry and Hogg [ 77 ] found that individuals who identified strongly with a group in which exercise was normative reported greater intentions to engage in regular exercise than those who identified weakly with the group.
Social Identity Underpins Exercise Group Behaviour Examination of the benefits of group exercise environments, where multiple individuals undertake the same structured exercise activity, is not new. Social Identity Underpins Effective Leadership in Exercise Settings According to the social identity approach, it is the shift in self-categorization from a personal to a social identity that underpins social collaboration and indeed all forms of group behaviour [ 73 ]. Conclusion The social identity approach represents a potentially fruitful but greatly under-examined framework for understanding and promoting physical activity.
Funding No sources of funding were used in the preparation of this article. Footnotes 1 We consider physical activity in the widest sense, including exercise and sport participation. Physical activity, exercise, and physical fitness: Augoustinos M, De Garis S. Eur J Soc Psychol. Reicher S, Hopkins N. A social identity approach to sport psychology: For example, the more an individual accepts the self-categorization as a group member e.
This has important consequences. Illustrative of this, in a series of studies, Fryberg, Markus, Oyserman, and Stone approached American Indian high school students residing on an Indian reservation and either presented them with stereotypical media representations of their group e. The researchers found that exposure to stereotypical portrayals of the own group not only decreased perceptions that the American Indian community was worthy but also depressed self-esteem compared to the control condition. To better understand results such as these, we argue that group membership—and the social identity related to this group membership—can affect health outcomes in at least two key ways.
First, it has an impact on the way that health conditions and health challenges are appraised, experienced, and understood. Second, it has an impact on the way that people respond to those conditions and challenges. In the following two sections, we discuss each of these processes in turn. In the first instance, social identities have a major bearing on whether individuals perceives that they have a particular health condition or recognize that they face a particular health challenge.
Similarly, and in line with findings from the literature on stereotype threat, research has found that it is only when people define the self in terms of an illness group e. Similar patterns were observed among people with tinnitus and colds in research by St. Claire, Clift, and Dumbelton That is, although people with tinnitus reported more severe tinnitus symptoms than cold symptoms with the opposite being the case for cold sufferers , this pattern was much more marked among those respondents who had been encouraged to self-categorize in terms of a given illness group.
Self-categorization and social identity processes not only affect whether people act in line with expectations associated with a particular health condition but also affect the way that people appraise health challenges. This is a point that Shankar and colleagues explored among participants at the Kumbh Mela, a religious festival in India that attracts millions of pilgrims. Their study examined how these pilgrims appraised the loud and potentially harmful noise to which they were exposed on an ongoing basis at the festival by asking them to listen over headphones to noise that was said to emanate either from the Mela or from the busy world p.
Participants rated the noise more positively, and chose to listen to it longer, when it was thought to have been generated at the Mela. In follow-up research, Pandey, Stevenson, Shankar, Hopkins, and Reicher examined how people participating in the Kumbh Mela coped with exposure to the winter cold, which is another of the health risks to which pilgrims at the festival are exposed. They found that despite the extreme hardship—which involved living for weeks in tented encampments with only limited protection from the intense cold—exposure to these hostile conditions actually served to affirm their pilgrim identity.
Moreover, for this reason, pilgrims were motivated to rise to, and overcome, the unpleasant and physically painful challenges that the conditions presented. For example, a study among bomb disposal experts showed that group identification affected the extent to which negative work features were downplayed. As we outline in greater detail later, this is particularly important when people are in great need of social support to counteract the negative effects of stigma. However, we claim that group memberships can provide psychological resources that go beyond the provision of social support alone.
Importantly, however, it is apparent that these group-based resources are only unlocked when, and to the extent that, individuals identify with the group and therefore self-categorize as group members Jetten et al. The beneficial effects of group membership have been demonstrated in a range of contexts.
More generally, social isolation—reflecting a lack or loss of group memberships—has been associated with reduced physical and mental health Berkman, and enhanced mortality Holt-Lunstad et al. For example, Cruwys and colleagues analyzed the relationship between current and future depression longitudinally over a 4- to 6-year period in a large British sample. They found that people who belonged to a greater number of groups experienced less subsequent depression. Importantly, this longitudinal research found not only that membership in social groups i.
Indeed, the benefits of adding social group memberships were stronger among individuals who were depressed than among those who were not depressed. Self-categorization and social identity also affect the way that people respond to, and cope with, health conditions. For example, Pandey and colleagues showed that sharing social identity with other pilgrims at the Mela led people to engage in forms of mutual support e. Similarly, experimental research by Platow and colleagues showed that participants were able to cope better with the pain induced by a cold pressor task i.
Specifically, participants who were asked to think about more groups showed greater persistence, as indicated by the increased time they held their hand submerged in ice water. As we discuss later, these processes are also at play when people respond to stigma-related stressors. As the findings of Jones and Jetten show, group-based benefits are available even when other group members do not provide explicit social support. Indeed, merely thinking about the groups to which one belongs or being in the presence of others with whom one shares group membership appears to have beneficial health effects.
However, it should be kept in mind that most of the evidence for the processes that we have reviewed so far have focused on group memberships that are not highly stigmatized. This leads to a number of questions. Can group membership also act as a psychological resource when that group is stigmatized? Or is it the case that the beneficial health effects of group identification disappear when the group in question is stigmatized? Also, why would people turn to their minority group to cope with a challenge in this case, discrimination when that group membership is the very reason that they face the challenge in the first place?
As we outline later, the short answer to these questions is that groups continue to be psychological resources for individuals i. This is important because it suggests that even for stigmatized group memberships, group identification is an important means of buffering the negative health effects of exposure to group-based discrimination. The notion that group-based resources provide important buffers for individuals responding to group-based discrimination and stigma underpins research on the rejection—identification model Branscombe et al. This model proposes that although perceptions of prejudice are negatively related to well-being, the harm that is caused by discrimination can be counteracted by increased identification with the minority group, and this in turn has a positive impact on psychological well-being.
In turn, such enhanced group identification has been found to attenuate the negative effects of pervasive discrimination on mental health among African Americans Branscombe et al. Specifically, the latter study found that perceived discrimination was associated with higher levels of anxiety, depression, and psychosomatic symptoms as well as lower general psychological well-being. Relatedly, Giamo, Schmitt, and Outten demonstrated that among a sample of multiracial individuals, perceived discrimination was negatively correlated with well-being measured as life satisfaction.
However, perceived discrimination was also associated with higher identification with other multiracial people measured as stereotyping the self as similar to other multiracial people, perceiving people within the multiracial category as more homogeneous, and expressing solidarity with the multiracial category. In turn, these higher levels of identification were protective of life satisfaction.
Overall, then, results suggest that multiracial identification can have protective properties in providing a collective identity that buffers against the negative effects of discrimination. Similar beneficial effects of identification were also observed in research among people with a stigmatized mental health condition.
Crabtree, Haslam, Postmes, and Haslam found that for these individuals, identification with members of a relevant support group provided a basis for social support and had a positive impact on self-esteem, which served to buffer them from the otherwise negative effects of belonging to a stigmatized group. Paradoxically, then, despite the fact that members of stigmatized groups often face discrimination because of their group membership, there is also evidence that the sense of belonging, identity, and support they derive from their stigmatized group is an important coping resource, helping them to counteract the negative consequences of stigma on health outcomes.
Membership in a stigmatized group and the social identities derived from this thus appear to play an important double-edged role in the relationship between discrimination and health outcomes. On the one hand, they are a basis for threats to health; on the other hand, they provide people with resources that allow them to counteract those threats.
These countervailing forces mean that high levels of identification with a stigmatized group are not necessarily associated with better health outcomes. The meta-analyses conducted by both Schmitt and colleagues and Pascoe and Smart Richman are inconclusive on this point. In their analyses of correlational and longitudinal studies examining group identification in terms of general commitment to the group, Schmitt and colleagues found only weak support for the prediction that higher group identification protects against the harmful effects of discrimination on health.
Moreover, they did not find consistent evidence for a buffering role of social support measured as support from friends, family, and classmates , and they found only weak evidence p. On the other hand, there was evidence that coping strategies indicative of disengagement i. Pascoe and Smart Richman also reported inconsistent effects for the moderating role of group identification. Pascoe and Smart Richman also found that the beneficial effects of social support only emerged under certain conditions e.
In summary, the empirical support for the role of group identification as a moderator, where high levels buffer against the negative effects of discrimination on health, is rather mixed. The question presents itself whether these inconsistent findings are a result of the use of different methodologies or whether it is more systematic. In our view, it may well be the case that methodological considerations are critical for explaining the lack of consistency across findings in the few studies that have tested group identification as a moderator. Indeed, it should be kept in mind that there are some important differences between the formulation of the rejection—identification model and the way that group identification is sometimes examined.
For example, group identification is proposed to be a mediator in the rejection—identification model, but in these meta-analyses, it was examined as a moderator. In addition, the meta-analytic findings examining the moderating role of group identification should be treated with caution because the number of studies examining this relationship is rather small, and group identification has been measured in different ways. Nevertheless, we suspect that methodological variations in how the role of group identification is examined are not the whole story.
Indeed, to understand when there may be a positive impact of group identification, we propose that it is instructive to consider the broader social context in which stigma occurs. Specifically, we argue that researchers need to examine the various ways in which the sociostructural context and intergroup relations shape not only the belief systems of members of stigmatized groups but also the way these belief systems in turn affect responses to negative treatment. Sociostructural Context, Intergroup Relations, and Health. Whether or not group identifications and group memberships act as resources from which individuals can draw strength when responding to discrimination depends on features of the broader social context and the specific nature of intergroup relations that facilitate or block use of these group resources.
On the one hand, they can engage in individual-level strategies through which they aim to physically or psychologically leave the group that is stigmatized consistent with a social mobility belief system. The social identity approach to health suggests that it is only when group members engage in the latter social change strategy, whereby they tackle discrimination collectively, that they will gain the full benefits of the psychological resources associated with group membership for an overview, see Figure Consistent with this, in a sample of people with HIV, Molero, Fuster, Jetten, and Moriano found that perceived group-based discrimination was positively related to identification with others with HIV, and this in turn was positively related to collective action intentions and well-being.
To better illuminate these processes, however, it will be helpful to clarify the nature of social mobility and social change belief systems. The response of groups to stigma and discrimination is largely determined by the availability of appropriate identity management strategies aimed p. Whether individuals engage in individual mobility attempts and are able to leave their devalued and stigmatized group behind has implications for their health behavior Major et al.
The model shows how the sociostructural context affects the belief systems of members of stigmatized groups. When group boundaries are permeable, members of stigmatized groups engage in individual-level strategies through which they aim to physically or psychologically leave the group that is stigmatized consistent with a social mobility belief system. However, when group boundaries are impermeable, they respond collectively captured by a social change belief system by either redefining the meaning of the intergroup comparison when status relations between groups are secure or aiming to change the status quo when status relations between groups are insecure.
These belief systems affect responses to negative treatment and health outcomes. After Tajfel and Turner Research on people suffering from a chronic illness provided evidence that successfully engaging in individual mobility was associated with lower perceived personal discrimination. Limb-lengthening surgery, which is a form of individual mobility, is more common in Spain than in the United States. As a result, people who suffer from skeletal dysplasias in Spain are more likely that their American counterparts to believe that they can move from their stigmatized group—in this case, surgically—and thereby escape at least to some extent the stigma and discrimination they face.
In the United States, however, where boundaries were perceived to be more impermeable because surgery is either not possible or is viewed as undesirable, there was no such correlation between height extent of the stigma and perceived discrimination. Thus, greater impermeability of boundaries led individuals to draw more heavily from the psychological resources group membership had to offer, and this protected them from the negative effects of stigma. For Americans with this stigma, health measured as life satisfaction was enhanced not by abandoning the stigmatized group but, rather, by turning toward it.
Quinn and Crocker found that the more overweight women endorsed an individual mobility ideology in this case, the protestant work ethic , the lower their psychological well-being became. However, for some stigmatized groups, perceptions that boundaries are permeable might be beneficial for health. The perceived permeability of boundaries is also influenced by the perceived pervasiveness of discrimination. Jetten, Schmitt, Branscombe, Garza, and Mewse examined the effects of pervasiveness of discrimination i.
In contrast, when discrimination is viewed as rare—either because it is restricted to a few out-group perpetrators or because it is limited to a few isolated contexts—it is less likely to constrain the lives of members of stigmatized groups. Thus, rare discrimination implies that the boundaries between the groups are traversable, allowing people to believe they can avoid the negative consequences of discrimination by crossing group boundaries. As a result, when people perceive group-based treatment as rare, they are less likely to define themselves in terms of their group membership because this is viewed as largely irrelevant to the outcomes they receive in the world at large.
Prior research involving a range of disadvantaged groups e. These processes are further explored in the next section, in which we focus on the constellation of sociostructural factors that enhance the likelihood that discrimination triggers a collective response. When individual mobility is not possible because the boundaries between the groups are impermeable e. Which strategy they choose depends very much on the perceived security of existing status relations—the degree to which their status and treatment by other groups are viewed as legitimate and stable. Such attempts to achieve social change can take multiple forms—for example, campaigning for legislation to remove barriers for a disadvantaged group as a whole e.
When group members engage in such collective strategies, they may react to discrimination and stigma with increased in-group identification and out-group hostility Branscombe et al.
One important factor that determines whether stigma and discrimination are perceived as legitimate relates to the perceived controllability of the stigma. Because in current society, members of many stigmatized groups e. This may be one reason why this type of stigmatized group membership is negatively related to health Schmitt et al. When mainstream society or dominant groups perceive stigma as relatively legitimate and the stigmatized groups perceive that the status quo is unlikely to change i. What these social creativity strategies all have in common is that they are aimed at diverting attention away from the unfavorable intergroup comparison, changing the connotations of the comparison dimension, or allowing for a positive evaluation of the group in another domain.
We conclude that to understand how group membership and identification with those groups affects the health of those who encounter group-based discrimination, it is important to engage with research that examines perceptions of the broader sociostructural context. These perceptions affect the extent to which individuals will consider individual mobility, social change, or social creativity strategies when they are confronted with discrimination, and this moderates the relationship between perceived group-based discrimination and health.
Although individuals who aim to engage in individual mobility may be able to avoid being the target of discrimination, this strategy may not protect health in the long term. In contrast, those who engage in social change strategies draw heavily from group resources to counter the negative effects of group-based discrimination on health. At times, this may be sufficient to buffer against the negative health consequences of exposure to group-based discrimination. This insight can help explain why, as noted previously, although Schmitt et al.
Importantly, too, and consistent with our analysis, those facing illegitimate forms of discrimination are more likely to respond collectively to group-based discrimination than are those who face more legitimate forms of discrimination Jetten et al. This may be the reason why we find that only for some groups and only under some conditions does remaining with the stigmatized group when one faces discrimination i.
Although important advances have been made in developing an understanding of how social identification and sociostructural factors serve to structure the relationship between stigma and health, much more remains to be learned. For instance, as suggested in Figure There are also important new avenues for future research. In particular, it is only when we start to recognize that there are important social underpinnings to physical health that we can start thinking of ways to manage these factors in order to improve physical health outcomes.
There is a growing body of work testing interventions that focus on strengthening group identification with others often those who face similar treatment and illustrating their importance in counteracting the negative effects of stigma and discrimination on physical health.
For example, in the context of a residential care home, Knight, Haslam, and Haslam found that an intervention that enhanced identification with fellow residents and staff led to improved mental and physical well-being, as assessed by both self-report and care staff ratings. Along slightly different lines, Haslam et al. However, despite there being a clear role for identity processes in protecting and promoting health and well-being, this is rarely a focus for treatment or intervention in responding to stigma and discrimination.
In this vein, there is promising initial evidence of the positive impact of such interventions on those with stigmatized mental illness conditions—conditions that are often associated with significant physical health problems. In particular, in therapy groups for people with depression and anxiety, Cruwys, Haslam, Dingle, Jetten, et al.
Furthermore, in two longitudinal intervention studies one among participants at risk of depression who were helped to join community recreation groups and one among adults with diagnosed depression who joined a clinical psychotherapy group , Cruwys, Dingle, Hornsey, et al. However, there is also initial evidence that stigma can act as a barrier against building social connections and joining new groups. In a sample of homeless individuals, Johnstone, Jetten, Dingle, Parsell, and Walter found that perceived discrimination was associated with a lower likelihood that participants expanded their number of group memberships 3 months later and this negatively impacted well-being.
The capacity for stigma to prevent individuals from seeking out social support to cope with the challenges they face is also apparent from work by Kellizi and Reicher in the aftermath of the Kosovo conflict. Here, the stigma associated with being a rape victim or the shame associated with not being able to protect family members effectively prevented victims from seeking social support from others. Indeed, one of the most toxic effects of stigma can be cutting people off from their connections to groups or the broader social world.
When this occurs, individuals are also cut off from the source of key resources—their membership in social groups—that can protect them against the negative impact of discriminations. To explore these dynamics further, future research should examine the conditions under which stigma is a barrier to joining new groups and to social identification with them.
Such research is essential to better understanding how successful interventions might counteract the negative effects of stigma on mental and physical health. There is compelling evidence that exposure to discrimination has a negative effect on a range of mental and physical health outcomes. In addition, those who suffer from chronic illness often encounter discrimination and stigma, and this may present further challenges to their health and well-being.
In this chapter, we reviewed recent work in the social identity tradition that explores the ways in which social identities are implicated in the relationship between stigmatized group memberships and health. This highlighted the important role that broad sociostructural conditions can play not only in triggering negative health outcomes but also in allowing people to draw from their group memberships to counteract them.
Our concluding message is that although social identity can be a basis for stigma and can therefore play a role in compromising health and well-being, social identities are also resources that can be mobilized to counteract stigma and enhance the health of disadvantaged and vulnerable groups. Although their net impact is highly variable, each of these countervailing impacts has a substantial bearing on the course of mental and physical health. Accordingly, each is becoming an increasingly important focus for interventions aimed at improving health among stigmatized group members.
There is also evidence of consequences — involuntary early retirement appears to increase the prevalence of the common mental disorders, but planned, voluntary retirement appears to reduce them [ 25 , 26 ]. Data from the British National Psychiatric Survey of are very interesting [ 27 , 28 ]. They showed a significant drop in prevalence of the common mental disorders mostly depression, anxiety or both at the age of 65 for men, but not for women.
It is not a cohort effect from analysis of the and surveys together , and no variables explain it statistically other than age. Men who retired early had high rates, indeed higher rates than employed men, until 65, when they suddenly achieved similar low rates. Men still employed after retirement age not only had low rates then, but had relatively low rates in their fifties and early sixties. But the lowest rates were for those who retired at For women, the rates were higher than men at all ages, peaked at age 50—54, then slowly diminished with no large reduction at either age 60 or These are British figures; it would be interesting to have this replicated in other countries, but few have appropriate surveys.
It seems that early retirement is bad for men, but retirement at the age legitimated by society is very good for men. Perhaps legitimation is the secret; at age 65 perhaps, the generality of men can relax, no longer needing to justify themselves as workers; can, perhaps, 'be' more than 'do'. And, perhaps, people like me, who make such a fuss about retirement, are out of step, and need to learn something about personal identity which has nothing to do with being 'something' in work.
Who we are and what we are, are very important questions for all of us, with social, psychological and spiritual dimensions. Without a clear sense of personal identity, it is difficult to have the self-esteem we need to function well as independent people in inter-dependent society. Without a clear sense of personal identity we are vulnerable to psychological injury, at risk of anxiety and depression, and social disengagement.
Without a clear sense of personal identity we cannot easily respond to love with love, to accept forgiveness, to start again after failure. For many people, work, a job, a profession or a trade, provide an important source of personal identity; for some it may be the only significant source. Even for those for whom this is minimal, being a worker is important for the other benefits work mediates. Both before and after retirement age, continuing some work, paid or not, perhaps part-time, but definitely 'work', may be important both for individuals and the community.
And for those with specialist skills and experience, is there not also a moral duty to continue to make a contribution for as long as it is needed and remains appropriate, whether financially rewarded or not? However, work as the source of our identity is fundamentally inadequate, because few of us can claim that identity for ever. Sickness, disability, redundancy, retirement, age, all threaten an identity built upon work. But it is not the only source; we all do have other identities. We are sons and daughters, mothers and fathers, grandmothers and grandfathers and great-aunts, friends and neighbours; identities, built upon personal relationships, and surely more fundamentally important.
Ultimately personal identity and self-esteem are closely bound up together, and derive from a sense of personal value, of personal worth, of being needed, of being loved for what you are, not just for what you do. This is true health and wholeness, and, no doubt, much depends upon our experience of parenting as children. It is also a spiritual issue. Christians, and others of faith, will claim the ultimate value of a human being loved by God and therefore of infinite worth; others will be satisfied with a non-religious belief that each individual human being has intrinsic equal and great value.
Personally, perhaps I should think again about retirement, and accept my rapidly developing identity as a grandfather; and maybe mongongo nuts will grow in the greenhouse. National Center for Biotechnology Information , U. Clin Pract Epidemiol Ment Health. Published online May Received Mar 1; Accepted May This article has been cited by other articles in PMC. Personal introduction Having free-lanced as a public health physician for over a decade, with the inevitable variation in both the avaiIability and type of work, 'retirement' is, perhaps, a vaguer concept than for those with conventional full time jobs.
The work ethic Many 'Western' societies are very work-oriented cultures. Work in society The eminent sociologist Peter Worsley [ 9 ] wrote: Attitudes to work 1. The value of work Our societies have changed substantially in recent decades, and continue to change, not least in attitudes to work, but attitudes are also very varied. Workers to excess There are several types of excessive worker, in all of whom there may be substantial stresses related both to working and to not working. People not in paid work 1. Those who will not work Society exhibits ambivalent attitudes towards the few who are wealthy enough not to work — they are both envied and resented, even though some fill their lives with 'good works' and are highly respected.
Those who are unemployed Those who cannot find work, the unemployed seeking work, are put under increasing pressure. Sickness absence from work The confusion of refusal to work, inability to find work and inability to work is very damaging, because there are many who can't easily work on account of acute illness, long-standing sickness, or serious disability, not all of which is obvious to the casual observer.
People with disabilities Very few people with disabilities cannot work in any way; most, of course, have significant abilities, and want to work as far as they are able. Women I pointed out earlier that most of the literature relating to work applies to men. People who have retired The idea of retirement is relatively modern and is characteristic of industrial societies [ 21 ]. The Meaning of Persons. SCM Press, London; Jessica Kingsley, London; A New Dictionary of Christian Theology. Richardson A, Bowden J, editor. Epworth Press, London; Learning to Grow Old. The Works of John Ruskin, — Cook ET, Wedderburn A, editor.
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The New 'Introducing Sociology'. Penguin Books, London; The Other Side of the Dale. Michael Joseph, London; Social inequalities and the common mental disorders: A systematic literature review of social inequalities in mental health; pp. Statistical Year-Book for Sweden, Ministry of Health, Stockholm; Barham C, Begum N. Work, Personality and Mental health. Psychiatric morbidity anong adults living in private households, Ageing and Modernisation, An Ageing Population.
Carver V, Liddiard P, editor. Susser MW, Watson W. Sociology in Medicine, Oxford, London; Who retires early from the NHS because of ill-health, and what does it cost? Health effects of involuntary job loss among older workers: Retirement and mental health. Decline in common mental disorder prevalence in men during the sixth decade of life.
Social Psychiatry and Psychiatric Epidemiology. The mental health of early retirees — national interview survey in Britain. Support Center Support Center. Please review our privacy policy.