Social Constructs and Public Health: A closer look at their impact and strategies for change

Social constructs are integral elements of our society that shape our perceptions, behaviors, and interactions. These constructs play a profound role in public health by influencing health disparities, access to healthcare, and health behaviors. They are not tangible entities, but they hold immense power in shaping our lives. They encompass an array of human-made categories and concepts, such as race, gender, socioeconomic status, sexual orientation, and more.

These constructs may seem natural or inherent, but in reality, they are products of our society’s collective beliefs, values, and norms. The influence of these constructs on individuals and communities is undeniable, and their implications on public health are profound.

The Nature of Social Constructs

They are essentially artificial frameworks that have been created and perpetuated by society. They are not fixed or universal, but rather, they emerge from cultural, historical, and societal influences. For instance, the notion of race, which categorizes individuals based on physical attributes, is not a biological reality but a social construct created to differentiate people. Similarly, gender, often considered a binary concept, is a construct that oversimplifies the diverse spectrum of human identity.

The Fluidity of Social Constructs

What makes social constructs particularly interesting is their fluidity. These constructs evolve, responding to changes in societal norms, values, and attitudes. A classic example is the evolving understanding of gender, which is increasingly recognized as a multidimensional and fluid concept. This fluidity implies that public health strategies and healthcare systems must be adaptable, acknowledging and accommodating these changes.

The Impact of Social Constructs on Public Health

1. Health Disparities: Social constructs are key contributors to health disparities, which are systematic differences in health outcomes among specific groups. For example, racial and ethnic minorities often experience higher rates of chronic diseases, limited access to quality healthcare, and unequal treatment within the healthcare system. These disparities, rooted in systemic racism and racial stereotypes, are perpetuated by social constructs.
2. Socioeconomic status. Individuals with lower incomes may struggle to access essential healthcare services, leading to disparities in healthcare quality and health outcomes (McMaughan et al., 2020). Social constructs like social class play a substantial role in determining the opportunities and resources available to individuals and their subsequent health.
3. Health Behaviors: Social constructs are influential in shaping health behaviors. For instance, gender norms can influence expectations regarding physical activity, nutrition, and mental health expression. These norms, whether explicitly or implicitly enforced, can lead to disparities in disease prevalence and the utilization of healthcare services. Recognizing and addressing the impact of social constructs on health behaviors is paramount to the success of public health interventions.

COVID-19 Case Study on Gender and Age on Public Health 

The COVID-19 pandemic exposed and exacerbated health disparities rooted in social constructs as observed below:

• Gender Roles and Vulnerability Social constructs regarding gender roles played a pivotal role in increasing the transmission of COVID-19 in many African countries. Across the continent, traditional gender norms assigned caregiving and household responsibilities predominantly to women who stayed at home. This often-placed men at the forefront of exposure to the virus. For instance, men who worked as healthcare workers, caregivers, or market vendors had increased risks due to close contact with the public [1]. On the other hand, societal expectations could hinder women from seeking healthcare promptly, resulting in delayed treatment and increased virus transmission. Women often prioritized their caregiving duties over their health, thereby facilitating the virus spread.

Gender constructs were instrumental in propagating misinformation, as women often had limited access to accurate health information. Misinformation related to women’s reproductive health, menstruation, and vaccine safety often deterred some women from getting vaccinated.

• Age and Societal Perceptions: Societal perceptions of age significantly contributed to COVID-19 transmission in many African countries. The perception of youth as less vulnerable to severe illness led to riskier behavior among young individuals. In Africa, social constructs created a sense of invincibility among the youth, leading to a disregard for preventive measures such as vaccination [2]. Conversely, older populations often faced stigmatization and marginalization [3]. This hindered their ability to protect themselves effectively. 

What was needed?

• Equitable Vaccine Distribution: Efforts to ensure equitable vaccine distribution were crucial. Targeted outreach to underserved communities, mobile vaccination clinics, and partnerships with community organizations helped increase access to vaccines among racial and ethnic minorities [4].
• Cultural Competency and Anti-Bias Training: Healthcare providers and professionals underwent cultural competency training to understand better the diverse needs of patients from different racial backgrounds. Anti-bias training aimed to reduce discriminatory practices in healthcare delivery [5].
• Community Engagement: Engaging with communities to build trust and understanding was vital. Many social constructs, such as mistrust of the healthcare system due to historical injustices, needed to be addressed through transparent communication and community partnerships [6].

Case Study 2: Gender and Mental Health During the COVID-19 Pandemic

The COVID-19 pandemic also highlighted the impact of social constructs on gender and its implications for mental health.

• Gender Roles and Expectations: Social constructs related to gender often shape expectations and behaviors. During lockdowns and quarantine measures, traditional gender roles came into focus. Women, in particular, were disproportionately affected by increased caregiving responsibilities, which, in many cases, were exacerbated by the closure of schools and daycare facilities [7].
• Mental Health Expression: Men and women may experience mental health concerns differently due to the influence of social constructs. For example, traditional masculine ideals may discourage men from expressing vulnerability or seeking help for mental health issues. These constructs can create barriers to effective mental health support and treatment [8].
• Work-Related Stress: Gendered constructs also played a role in the impact of remote work and job losses. Women were more likely to experience job loss in certain industries, leading to economic and mental health stresses. On the other hand, remote work intensified the work-home boundary for many women, leading to higher stress levels.

What was needed?

• Supportive Policies: Policies such as paid family leave, flexible work arrangements, and affordable childcare are essential to support individuals in balancing caregiving and work responsibilities, irrespective of gender.
• Mental Health Promotion: Public health campaigns aimed at reducing mental health stigma and encouraging help-seeking behaviors must consider the influence of gender constructs. Messages should be tailored to address the unique challenges experienced by individuals of different genders.
• Community Resources: Local community organizations and support networks can play a vital role in providing practical assistance and emotional support for individuals dealing with the gender-related consequences of the pandemic.

Strategies to Address the Impact of Social Constructs on Public Health

1. Cultural Competency in Healthcare: To address the impact of social constructs on public health, healthcare professionals must develop cultural competency. This involves understanding and respecting the cultural backgrounds, beliefs, and values of diverse patient populations. By doing so, healthcare providers can improve healthcare access and reduce disparities in care. Culturally competent care acknowledges that different individuals and communities may have unique health needs, preferences, and challenges.
2. Health Education and Promotion: Public health initiatives must consider the influence of social constructs on health behaviors. Tailoring health education and promotion efforts to specific cultural and social groups can lead to more effective interventions. For example, promoting culturally sensitive messages to encourage vaccination or healthy lifestyles can be more successful in reaching diverse communities.
3. Policy Interventions: Government policies can play a significant role in addressing the impact of social constructs on public health. Expanding Medicaid and improving healthcare access for low-income individuals can mitigate socioeconomic disparities in health outcomes. Anti-discrimination laws and regulations can also help reduce healthcare disparities related to race, gender, and sexual orientation. Public health policies should be designed with a keen awareness of the influence of social constructs on health disparities.

Therefore, social constructs are not abstract or intangible; they are powerful forces that shape our daily lives, including our health and well-being. Acknowledging their impact on public health is the first step toward creating a more equitable and inclusive healthcare system. Strategies such as cultural competency, tailored health promotion, and policy interventions can help address disparities arising from social constructs.

As we continue to evolve as a society, public health efforts must evolve with us, recognizing and respecting the diverse social constructs that define us and our health. Our ability to address these constructs in public health is essential for fostering healthier, more equitable communities.