Impact of Social Exclusion on Physical and Mental Health

Impact of social exclusion to physical and mental health of Australian children

• Dian Atiqah Binte Lokman O.Mahat

1.0 Introduction

For the purpose of this paper, the various physical and mental health impacts of social exclusion will be discussed, with specific focus on the health of Australian children. The concept of social exclusion has become one of the widely recognised framework for understanding, measuring and addressing poverty and disadvantages in multidimensional level (Harding, McNamara, Daly and Tanton, 2009). Social exclusion is one of the many social factors that contribute to the social determinant of health. Australian children are at risk of child social exclusion with the spatial differences in areas of high social exclusion risk that are common in Australia’s rural and regional balance, and in clusters of outer areas in most of Australia’s capital cities(Harding, McNamara, Daly and Tanton, 2009). Physical and mental health implications resulting from social exclusion will be discussed in relation to social acceptance.

2.0 Social Exclusion as a Determinant of Health for Australian Children

According to the British Social Exclusion Unit, ‘social exclusion is what can happen when people or areas suffer from a combination of linked problems such as unemployment, poor skills, low incomes, poor housing, high crime, poor health and family breakdown’ (Office of the Deputy Prime Minister,2004,p.2). People have a fundamental need for positive and lasting relationships. With the evolution of history, human develops the trait of belonging that enables individuals to gain acceptance and avoid rejection. As belongingness is a core component of human functioning, social exclusion influences many cognitive, emotional, and behavioural outcomes and personality expression. (DeWall, Deckman, Pond & Bonser, 2011)

Social exclusion in the school environment is increasingly being recognised as a form of relational aggression or bullying, in which a child is exposed to harm through the manipulation of their social relationships and status (Edith Cowan University, 2009). There are many form of social exclusion such as experiences being deliberately excluded from a peer group, rumours spread about them, name calling and being purposefully embarrassed. Hence, social exclusion defies a lack of connectedness, participation, alienation or disenfranchisement from certain people within the society.

Based on a Social Policy Research Centre (SPRC) survey results, 1 in 6 children live in households experiencing social exclusion; experiencing four or more of the nine indicators of no week’s holiday away from home each year, children did not participate in school activities and outings, no hobby or leisure activity for children, no medical treatment if needed, no access to a local doctor or hospital, no access to a bulk-billing doctor, does not have $500 in emergency savings, could not raise $2000 in a week in an emergency and lives in a jobless household (Saunders and Naidoo, 2008). Many range of studies done by the Commonwealth of Australia Senate Community Affairs Reference Committee in 2004 shows disadvantaged children in Australia and the impact of poverty on indicators including health education and health, and the social and economic implications of poverty (Harding, McNamara, Daly and Tanton, 2009).

3.0 How Australian Children are affected through social exclusion

Children that experience disadvantages suffer from negative effects throughout their life course (Saunders, Naidoo and Griffiths, 2008). Those who are consistently teased or ostracized, or are always the last ones chosen for the team; people who make fools of themselves in public presentations, or are ridiculed by superiors; and individuals who are put down, criticized, or rejected by relationship partners or because they possess devalued characteristics or social stigmas often experience social evaluative threat (SET), which occurs when the self could be negatively judged by others (Dickerson & Kemeny, 2004). This leads to social pain- the emotional response to the perception that one is being excluded, rejected or devalued by a significant individual or group (MacDonald & Leary, 2005) which produces specific physiological responses, including changes in the cardiovascular, neuroendocrine and immune systems (Dickerson, 2008 ; Dickerson, Grunewald & Kemeny, 2004)

Racial, ethnic, and cultural minority students are at greater risk than others of encountering disadvantages in school (Kaspar, 2013). In Australia and New Zealand, 11-13% of Indigenous youth reported school-based victimization in the Western Australian Aboriginal Child Health Survey (WAACHS; Zubrick et al. 2005), the National Aboriginal and Torres Strait Islander Social Survey (NATSISS; Australian Bureau of Statistics (ABS), 2010), and the Youth 2007 Survey (Clarke et al., 2009). School-based victimization is contemporaneous with, and antecedent to negative peer group conditions, including peer rejection, fewer friendships, poor quality of friendships, and perceptions of peers as hostile, untrustworthy and ill-intentioned (Salmivalli & Isaacs, 2005). Based on an Australian survey, Indigenous youth were more vulnerable to emotional health difficulties due to bullying than were non-Indigenous students bullied (Blair et al., 2005). These social evaluative events that induce social pain are capable of eliciting intense emotional and physiological responses as well.

Accessibility to geographical and workforce supply also contributes to the variation of child health outcome. Inequalities in health arise because of inequalities in the conditions of daily life under which we are born, develop into young children, grow into teenage years and adulthood, and live into old age (Chittleborough, Baum, Taylor & Hiller, 2006; Marmot et al., 2010; WHO, 2008). High social exclusion risk are found in rural, regional areas and clusters in outer areas of Australia’s capital cities (Harding et al, 2009; Tanton et al., 2010). These reduces the opportunity for intervention and prevention of long term consequences of social deprivation on health (WHO, 2008).

4.0 Impacts of Social Exclusion on Physical and Mental Health for Australian Children

The stress of belonging to a socially excluded group can have an adverse affect on mental health. Prolonged stress raises the body’s levels of cortisol and lowers immune system functioning. Chronic stress related to racism and discrimination have been linked to diabetes, cardiovascular and other diseases. Modern evidence indicates that a lack of social connectedness relates to poorer immune system functioning, poor sleep quality, increased total peripheral resistance and increase risk of death (DeWall, Deckman, Pond & Bonser, 2011).

Research suggests that the physical, emotional and mental health of children exposed to social exclusion can be compromised. Children who have been socially excluded influences a variety of outcomes, including lower immune function, reduced sleep quality, reduced ability to calm oneself in times of distress, reduced self-esteem, feelings of anxiety, depression, aggression, self-regulation pro-social behaviour, attentional processes and attitude formation. In extreme events of social exclusion, it causes a period of temporary analgesia, similar to how the body copes with severe physical injury which is both physical and emotional (DeWall, Deckman, Pond & Bonser, 2011).

Social exclusion affect the mental health of an individual that leads to aggression, anti-social behaviour, lack of self-control , negative attitude and need of attention. Social exclusion increased aggressive behaviour and hostile perception of other’s ambiguous actions (DeWall, Twenge, et al., 2009; DeWall, Deckman, Pond & Bonser, 2011). Rejected people usually behave aggressively towards large group of people that could lead to mass violence (Gaertner et al., 2008). However, the aggression drops when they experience a sense of acceptance, social connection or regain a feeling of control with their surroundings (DeWall, Deckman, Pond & Bonser, 2011).Those experiencing social exclusion will also be less willing to engage in pro-social action as they were not driven to behave prosocially without having a sense of belonging and acceptance from others. In a study done by (Baumeister, DeWall,Ciarocco & Twenge, 2005; DeWall, Baumeister, & Vohs, 2008) investigate a link that exist between social exclusion and self- regulation. When people experience social exclusion, the implicit bargain is broken, signalling to the excluded individual that controlling his or her impulses will no longer reap the benefits of acceptance which impairs their self-regulation (DeWall, Deckman, Pond & Bonser, 2011). This could affect their performances when it is not linked with acceptance.

Attitude plays a fundamental aspect in psychological processes. It shapes responses to create agreement with others, further emphasising on the importance of social connection that could not be achieved through social exclusion. Social exclusion also affects patterns of basic, early-in-the-stream cognitive processes that are linked to the desire for renewed affiliation of attention that could act as a building block for more complex social cognition and actions (DeWall, Deckman, Pond & Bonser, 2011).

Repeated or persistent exposure to social exclusion can cause individuals to experience social pain more often for longer duration which leads to more frequent or prolonged activation of the psychological systems which could lead to negative consequences such as increase in cardiovascular, neuroendocrine and immunological parameters.(Dickerson, 2011). These physiological responses maybe an important factor for determining the mechanisms through which social pain could ultimately influence health and disease (Dickerson, 2011).

5.0 Conclusion

It is evident that childhood social exclusion can lead to ongoing intergenerational disadvantage and therefore it is important to identify the risk factors of such experiences and improve the pathways, opportunities and life chances of such children. Dynamic intervention of public policies and support from families are required to address the root causes of social exclusion in order to reverse the effects of social exclusion on the developmental, behavioural, and health outcomes in children.

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6.0 References

Blair, E.M., Zubrick, S.R., Cox, A, H. (2005). The Western Australia Aboriginal child health survery: fidnings to date on adolescents. Medical Journal of Australia, 183(8), 433-435

Chittleborough, C. R., Baum, F. E., Taylor, A. W., & Hiller, J. E. (2006). A life course approach to measuring socioeconomic position in population health surveillance systems, Journal of Epidemiology & Community Health, 60(11), 981-992

Clare, T. C., Robinson, E., Crengle, S., Grant, S,. Galbreath, R. A., & Sykara, J. (2009). Youth’ 07: The health and well-being of secondary school students in New Zealand. Findings on young people and violence. Auckland, New Zealand: The University of Auckland

DeWall, C. N., Baumeister, R. F., & Vohs, K. D. (2008). Satiated with belonginess? Effects of acceptance, rejection, and task framing on self-regulatory performance. Journal of Personality and Social Psychology, 95, 1367-1382

Dewall, C. N., Deckman, T., Pond, R. S., Bonser, I. (2011) Belongingness as a Core Personality Trait: How Social Exclusion Influences Social Functioning and Personality Expression : Journal of Personality, Vol.79(6), pp.1281-1314 [Peer Reviewed Journal]

Dickerson, S.S., Grunewald, T.L., & Kemeny, M. E. (2004). When social self is threatened: Shame, physiology and health. Journal of personality, 72, 1191-1216.

Dickerson, S.S. (2008). Emotional and physiological responses to social-evaluative threat. Social and personality Psychology Compass, 2, 1362-1378.

Dickerson, S. (2011). Physiological responses to experiences of social pain. Social pain: Neuropsychological and health implications of loss and exclusion. , (pp. 79-94). Washington, DC, US: American Psychological Association, x, 258 pp.

Edith Cowan University (2009). Australian Covert Bullying Prevalence Study, CHPRC http://deewr.gov.au/bullying-research-projects

Gaertner, L., Iuzzini, J., & O’Mara, E. M. (2008). When rejection by one fosters aggression against many: Multiple- victim aggression as a consequence of social rejection and perceived groupness. Journal of Experimental Social Psychology, 44, 958-970

Harding, A., McNamara, J., Daly, A., Tanton, R. (2006). Child social exclusion: an updated index from the 2006 Census, Australian Journal of Labour Economics, v.12, no.1, 2009: 41-64 [Peer Reviewed Journal]

Kaspar, V (2013) Mental health of Aboriginal children and adolescents in violent school environments: Protective mediators of violence and psychological / nervous disorders, Social Science and Medicine, Vol.81, pp.70-78 [Peer Reviewed Journal]

Office of the Deputy Prime Minister (2004), The Social Exclusion Unit, Office of the Deputy Prime Minister,London

Salmivalli, C., Issacs, J. (2005). Prospective relations among victimization, rejection, friendliness, and children’s self- and peer- perceptions. Child Development, 76(6), 1161-1171

Saunders, P., Naidoo, Y. (2008), Towards new indicators of disadvantage: deprivation and social exclusion in Australia, Social Policy Research Centre, University of New South Wales.

Tanton, R., Harding, A., McNamara, J., & Yap, M. (2010), Australian Children at risk of social exclusion: a spatial index for gauging relative disadvantage. Population Space and Place, 16(2), 135-150.

WHO, (2008). Closing the gap in a generation: health equity through action on the social determinants of health. Final report. In Commision on the social determinants of health: Geneva: World Health Organisation

Zubrick, S,R., Silburn, S. R., Lawrence, D. M., Mitrou, F. G., Dalby, R. B., Blair, E. M., et al. (2005). Summary report. The Western Australian Aboriginal Child health survey: Forced separation from natural family, relocation from traditional country or homeland, and social and emotional well-being of Aboriginal children and young people. Perth: Curtin University of Technology and Telethon Institute for Children Health Research.

Lokman O.Mahat_Dian Atiqah_ 17289812 HHB 130 Discussion Paper