Since Durkheim’s (1897/1979) classic study, sociologists have understood that while suicide appears to be a highly personal and private act, it is also a social act. In 2009, nearly 37,000 Americans died by suicide (American Association of Suicidology, 2012). Experts estimate that every suicide intimately affects at least six individuals, both family members and friends, connected to the suicide decedent (Shneidman, 1969). A central question in the field of suicide bereavement is how suicide grief differs from other types of loss (Jordan, 2001). However, such a focus has restricted suicide grievers studied to next-of-kin relationships, despite emphasis that suicide grievers constitute several populations (SAMSHA, 2010). By investigating suicide loss in peer relationships through a qualitative study, this dissertation serves to diversify scholarly inquiry of suicide grief. Moreover, employing the disenfranchised grief framework (Doka, 1989; 2002) as a theoretical lens emphasizes the sociality of suicide loss, especially in terms of relational status and stigmatized dimensions of death by suicide (Charmaz & Milligan, 2006). Twenty-six peers were identified through chain referral sampling strategies (Berg, 2007) and in-depth, semi-structured, face-to-face and telephone interviews were conducted. Results identify several new variants of disenfranchised grief in terms of stigmatized loss and relational status. A continuum of intrapersonal, intermediary, and group-based or extrinsic coping behaviors was developed to conceptualize and understand participants’ varied re-enfranchisement experiences. In particular, participants’ involvement in suicide prevention advocacy such as fundraising walks and programs contributes insights into the process and meanings of re-enfranchisement among peer suicide grievers. At the macro-level, this impetus towards advocacy for suicide prevention among participants is considered through the lens of the health social movement literature within medical sociology (Brown et al., 2004). Alternatively, at the micro-level, findings suggest that a suicide survivor identity is a collaboratively-based identity whereby group contexts influence how this status is defined, signified, affirmed, and even policed (Schwalbe & Mason-Schrock, 1996). Moreover, the existence of these group-based remedies for suicide grief raise the question of whether recently proposed changes to the upcoming DSM-V medicalizing (Kleinman, 2012) and privatizing grief under a depression diagnosis will indirectly foreclose suicide grievers accessing these resources.

BACKGROUND:Race/ethnicity, gender, and socioeconomic status are the three most prominent factors to predict health outcomes. Despite the fact that persistent health inequalities are found between groups, we know little about how the interrelatedness of these social positions influences the health of older adults.PURPOSE:In this study, we apply a feminist intersectional approach to the study of health inequalities, treating social variables as multiplicative rather than additive to capture the mutually constitutive dimensions of race/ethnicity, gender, and education.METHODS:This paper makes use of data from the National Social Life, Health and Aging Project, a nationally representative sample of 3,005 community-dwelling U.S. adults aged 57 to 85 years old, to explore intersections of race, gender, and education. We use a combination of stratified analysis with an interaction term to test multiplicative effects.RESULTS:First, our findings confirm that Black women with less than a high school education have the poorest self-rated health. Second, at the bivariate level, we find highly educated White men are not the converse of lower educated Black women. Third, at the multivariate level, we find being Black and female has an effect on health beyond those already accounted for by race and gender.CONCLUSION:This research demonstrates the explanatory power of an intersectionality approach to deepen understanding of the overlapping, simultaneous production of health inequalities by race, class, and gender.