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CRITICAL CONCEPTS FOR REACHING POPULATIONS AT RISK: Howard I. Kushner and Claire E. Sterk The Limits of Social Capital: Durkheim, Suicide, and Social Cohesion Am J Public Health 2005; 95: 1139-1143 [Abstract] [Full text] [PDF]

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Re-thinking social cohesion in the context of LGBT suicidality

Simon J. Craddock Lee, PhD MPH   (8 August 2005)

Re-thinking social cohesion in the context of LGBT suicidality 8 August 2005
Simon J. Craddock Lee, PhD MPH, Cancer Prevention Fellow National Cancer Institute, NIH Send letter to journal: Re: Re-thinking social cohesion in the context of LGBT suicidality leesi{at}mail.nih.gov Simon J. Craddock Lee, PhD MPH	Drs. Kushner and Sterk raise significant questions about the utility of the social cohesion model for suicidality and identify the risks inherent in our reluctance to question an appealing paradigm of sociality and health (1). Their analysis and the work they cite suggest that the demands of social integration, namely gender roles and familial expectations, may play a role in rates of suicidality among women in the most socially integrated societies. Similar factors may be at work in the case of suicidal ideation and rates of attempted suicide among gay, lesbian and other sexual minority individuals, especially adolescents (2,3,4). The pressures to conform to social roles within a hetero-normative familial or broader social environment clearly play a role in the mental health and well-being of youth struggling with emerging sexual identities. The alienation and despair that results from encountering prejudice or hostility from close family members would suggest social integration is not the panacea some perceive it to be. On the other hand, families and communities that provide affirmation and validation with regard to diverse human sexualities reinforce that it is the quality of relationships within those social ties that is critical to the interaction of social cohesion and health. Indeed, “participation alone does not necessarily translate into acceptance, trust, or reciprocity.”(1) A more nuanced application of the social cohesion model would demonstrate that it is context-dependent, much like the concept of “family values.” Applied carefully, both can contribute to advancing the public health of our many heterogeneous communities. Simon J. Craddock Lee, PhD MPH Cancer Prevention Fellow Ethics of prevention and public health References: 1) Kushner HI, Sterk CE.The Limits of Social Capital: Durkheim, Suicide, and Social Cohesion. Am J Public Health 2005; 95: 1139-1143 2) Fitzpatrick KK et al. Gender role, sexual orientation and suicide risk. J Affect Disord, 2005 Jul: 87(1): 35-42 3) Igartua KJ, Gill K, Montoro R. Internalized homophobia: a factor in depression, anxiety, and suicide in the gay and lesbian population.Can J Commun Ment Health. 2003 Fall;22(2):15-30. 4) Savin-Williams RC, Ream GL. Suicide attempts among sexual-minority male youth. J Clin Child Adolesc Psychol. 2003 Dec;32(4):509-22.