Socioeconomic status,psychosocial factors and health in urban Guyana

Individuals of higher socioeconomic status live longer and enjoy better physical and mental health relative to individuals of lower social status. Socioeconomic status differences in health status persist over time. This paper examines the association between socioeconomic status, psychosocial factors, and health in Georgetown, Guyana. The major causes of death are cardiovascular and cerebrovascular disease; life expectancy at birth is 67.3 years for males and 72.3 years for females; and the infant mortality rate is 44 per 1000 live births. Data for the study were drawn from a probability sample of 654 adult residents of Georgetown. A significant inverse association was found between formal education and morbidity for four of the six measures of health status. The authors investigated the extent to which self-concept, health behaviors, stress, and social ties are linked to health status and socioeconomic status, and can explain socioeconomic status differences in health status. Psychosocial factors, especially the self-concept measures of self-esteem and mastery, were found to play a moderate role in accounting for educational differences in health status.     

Diversity Within Diversity

Summary

Asian American elderly form a heterogeneous group with respect to immigration history, ethnic/cultural background, socioeconomic position, and health and mental health status. This paper provides an overview of the internal heterogeneity within the Asian American elderly population and identifies those who experience multiple stressors affecting their quality of life. Then it discusses barriers to formal service utilization as well as strengths and deficits of informal support systems. To better serve Asian American elders with their multiple needs for health, mental health, and social services, increased funding is recommended for research on this group, diversification of social service programs in coethnic communities, and increased cultural competence in non-Asian social service agencies.     

Gambling Participation and Social Support Among Older Adults: A Longitudinal Community Study

The purpose of this preliminary study was to examine associations between leaving home to engage in bingo or gambling activity and indices of physical and mental health and social support among a representative community cohort of 1016 elderly people. Cross-sectional and longitudinal data gathered from a prospective epidemiological study in a rural, low socio-economic status, area of Pennsylvania was employed. The cohort had a mean age of 78.8 (SD = 5.1) (range 71–97) and participated in three consecutive biennial waves of data collection. Nearly half (47.7) of the cohort reported gambling. To predict gambling, the independent variables included age, sex, education, employment, social support, depressive symptoms, self-rated health, alcohol use, cigarette use, and cognitive functioning. In cross-sectional, univariate analyses, gambling was associated with younger age, sex (male), fewer years of education, greater social support, lower depression scores, better self-rated health, alcohol use in the past year, and higher cognitive functioning. In a cross-sectional multiple regression model, younger age, greater social support, and alcohol use in the past year remain strongly and independently associated with gambling activity. Longitudinally, age, sex, social support, alcohol use, and gambling are predictive of future gambling activity. The results revealed that gambling may offer a forum of social support to older adults who are often isolated as they age.     

Women's Status,Fertility Decline,and Women's Health in Developing Countries: Direct and Indirect Influences of Social Status on Health

Abstract In the present three‐wave study of 72 developing countries, we use growth curves to examine how changes in fertility and level of fertility mediate the effect of women's social status on women's health as measured by infant mortality, maternal mortality, and female life expectancy. We find that level of female education, average age at marriage, and the percentage of married women using contraceptives influence attained level of fertility, with controls for economic growth and dependency status. Change in fertility, however, is predicted only by average age at marriage and by level of education. Change in fertility, in turn, predicts improvement in all three women's health indicators, while the level of fertility predicts improvement in maternal mortality and infant mortality. In addition to the mediating effects of fertility, both age at marriage and education contribute directly to reduced level of infant mortality; level of primary education contributes directly to reduced levels of maternal mortality; and use of contraceptives contributes directly to improvement in female life expectancy. These findings provide strong evidence that women's social status makes direct contributions to women's health which cannot be attributed to economic growth, dependency status, and/or the mediating effects of level and change in fertility. The policy implication for developing countries is that greater gains can be made in women's health, particularly maternal health, by improving women's social status, especially in rural areas.     

Late‐Life Migration,Work Status,and Survival: The Case of Older Immigrants from the Former Soviet Union in Israel

This analysis examined mortality among late‐life Soviet Jewish immigrants in Israel, and the contribution of post‐migration work status to their survival. The study linked 1997 survey data to mortality records, seven years hence. The results revealed that mortality was associated with older age, male gender, morbidity, and having less resourceful social networks. More importantly, after controlling for these background variables work status remained a significant correlate. Late‐life immigrants who had never worked in the host country had a significantly greater risk of death than their immigrant counterparts who had ever worked (or were still working).     

Gender, aging, poverty and health: Survival strategies of older men and women in Nairobi slums

This paper is based on data from focus group discussions and in-depth individual interviews carried out in two slum areas, Korogocho and Viwandani in Nairobi, Kenya. It discusses how the division between domestic sphere and public sphere impacts on survival during, and adaptation to old age. Although this paper adopts some of the tenets of the life course approach, it posits that women's participation in the domestic sphere may sometimes give them a ‘gender advantage’ over men in terms of health and adaptation to old age. The paper also discusses the impact of gender roles on the cultivation of social networks and how these networks in turn impact on health and social adjustment as people grow older. It investigates how older people are adjusting and coping with the new challenges they face as a result of high morbidity and mortality among adults in the reproductive age groups.     

An Experiment to Modify Self-Concept and School Performance

Abstract

The joint or combined effects of age level, sex differences, and social factors in fear of crime are systematically investigated using elaboration analysis with 1976 NORC data. Findings reveal that while the elderly are somewhat more likely to report fear of crime when compared with young and middle-aged groups, many more women express apprehension than men at each age level. Fear of being victimized is especially prevalent among those segments of the population that are the most isolated and vulnerable, notably elderly and middle-aged black women, unmarried older women living alone, elderly women in poor health, and women of all ages who had been burglarized.     

The directionality and age selectivity of the health-migration relation: evidence from sequences of disability and mobility in the United States

Evidence regarding the effects of health status on migration are mixed, with some concluding that there is a positive relation while others conclude a negative relation. This study examines the analytical bases for conflicting findings and proposes a model of the health-migration relation which allows for age selectivity, nonlinearities, interactions, and dynamic effects. Often in migration research we focus on migrant-nonmigrant differentials, which helps us to understand the cross-sectional differences between the 2 groups of persons, but it does little to elucidate the complex process by which nonmigrants become migrants. The sequence of migration and health events, from the US National Health Interview Survey from 1979-1980, show that for the population under age 45, there is little temporal connection between migration and health status changes. 2/3 of the younger population with at least 1 health or migration event migrated only, with health status changes neither preceding nor following the migration. Since the migration and health events for these persons are not associated in time, there is little basis for positing strong relations of either direction for the nonelderly. The age groups for which migration and health events are connected in time are those over age 45, and the temporal proximity becomes even more marked for the elderly. Among the elderly, the migrant-only group constituted only 10% of those with at least 1 event. As expected, for the elderly the dominant relation is health deterioration after migration, the pattern displayed by 65% of the elderly with events in the last 5 years. The elderly are also more likely to be in the Destabilized Migrant category, experiencing health status declines both before and after migration. This is also consistent with the theory that the elderly in poor health at the time of migration will be more likely to be stressed by their migration and experience further deteriorations in health. The conditional probabilities indicate that health status declines are unlikely to precipitate immediate migrations, except for those with pre-existing serious conditions or more severe activity limitations.     

Who Is Supporting Homeless Youth? Predictors of Support in Personal Networks

Homeless youth lack the traditional support networks of their housed peers, which increases their risk for poor health outcomes. Using a multilevel dyadic analytic approach, this study identified characteristics of social contacts, relationships, and social networks associated with the provision of tangible and emotional support to homeless youth (N = 419, M age = 20.09, SD = 2.80). Support providers were likely to be family members, sex partners, or non–street‐based contacts. The provision of support was also associated with contacts' employment and homelessness status, frequency of contact, shared risk behaviors, and the number of network members that were homeless and employed. The results provide insights into how homeless youth could be assisted to develop more supportive social networks.     

Ambivalence in Later‐Life Family Networks: Beyond Intergenerational Dyads

In later life, changing conditions related to health, partnership, and economic status may trigger not only support but also conflict and ambivalence, with the consequent renegotiation of family ties. The aim of this study is to investigate both conflict and emotional support in the family networks of older adults, taking the research beyond the level of intergenerational dyads. We used a subsample of 563 elders (aged 65 years and older) from the Swiss Vivre/Leben/Vivere survey. Multiple correspondence analysis and in‐depth case studies were used to identify the key social conditions that relate to the prevalence of conflicted and supportive dyads in family networks. Findings showed that the balance of conflict and emotional support in older adults' family networks varied according to the composition of their family network as well as their age, health, income, and gender.     

Migration,Social Networks,and Child Health in Mexican Families

This paper examines the consequences of parental migratory strategies for children in three types of Mexican families: those living with their migrant parents in the United States, those living with parents who migrated and returned to Mexico, and those living in Mexico with parents who have never migrated. Using data on 804 children from the Health and Migration Survey (HMS), we found significant differences in children's health across the three types of families. Results also revealed robust effects on child health of the size of immediate and extended social networks and migration experience after controlling for potential mediators such as mother's general health, receipt of social support, and child's age and sex. Findings suggest that social networks and migration affect children in complex ways, offering health benefits to those with migrant parents in U.S. households but not to those living with parents who migrated in the past and returned to Mexico.     

Health-related quality of life in older adults: Testing the double jeopardy hypothesis

The double jeopardy hypothesis posits that racial minority elderly suffer a double disadvantage to health due to the interactive effects of age and race. Empirical examinations have found mixed support for the proposition that the aging process heightens the health disadvantage for racial minorities compared to whites. Race-by-age differences are tested using a health-related quality of life measure that has been largely overlooked in previous double jeopardy analyses. The outcome, number of days in poor physical health during the past month, quantifies day-to-day physical well-being in a way not available to standard measures of morbidity and mortality. The data are from the 2003 California Health Interview Survey (CHIS) and were analyzed using negative binomial regression. Results show that the magnitude of differences in the number of physically unhealthy days for African Americans and Hispanics compared to their white counterparts is much larger in the elderly strata than that observed between younger groups. Additionally, social characteristics do not fully explain why racial differences in poor physical health days are greater at older ages. A life course perspective is proposed as one possible explanation for the double jeopardy finding. The results indicate a need to consider health-related quality of life outcomes when examining racial/ethnic health disparities among the elderly population. The appendix presents cross-validation of the 2003 CHIS results with the 2005 CHIS and the findings are replicated.     

The demographic consequences of the accident at the Chernobyl' atomic power station

The author attempts to estimate the demographic effects of the nuclear accident at Chernobyl atomic power station in the Ukraine in April 1986. Topics covered include the resettlement of the population most directly affected; the health status of the population; the impact on sex and age structure, fertility, and mortality; and migration.     

Medical Utilization and Health Expenditure of the Elderly in Taiwan

The present analysis, based upon data from the 1989 Taiwan Labor Force Survey, includes two parts. First, the determinants of physician visits and hospitalization by the elderly are analyzed according to the behavioral systems approach, and, second, variation in health expenditures among the elderly are examined using the Tobit model with sample selection. Findings show that elderly with good or poor health conditions are less likely to use medical services than the frail elderly and that married elders are less likely than the non-married to use medical care. The higher the educational level, the lower the probability of using formal medical services, and elderly who have health insurance are more likely to use formal health care than those who have no health insurance. The elderly who live with their children are less likely to use formal medical services than those who do not live with their children. Finally, among the elderly who have used formal health care, individual health expenditures are influenced primarily by three factors: health condition, health insurance, and residential location. Implications for Taiwan's relatively newly established national health insurance program (effective April 1, 1995) are discussed based upon the findings of this research.     

Primary care for young African American men

Young African American men in the inner city have higher rates of mortality and morbidity from potentially preventable causes than other American men of the same age. They suffer disproportionately high rates of preventable illness from violence, sexually transmitted diseases, and HIV infection. These young men present with problems related to sexual concerns, mental health issues, substance abuse, and violence. They also report substantial risk-taking behaviors, including unprotected sex, substance use, and weapon carrying, as well as exposure to violence. Access to and use of preventive primary care services has been limited for these patients in the past because of financial barriers and competing social issues. Racism and historical oppression have created barriers of mistrust for young men of color. Factors that contribute to their adverse health status, as well as ways to address these problems, are discussed.     

Residence and Income Inequality: Effects on Mortality Among U.S. Counties

Abstract Despite lower average incomes, greater percentages living in poverty, lower levels of health insurance, less preventive health care, and poorer health status, nonmetropolitan residents have been found to experience lower mortality than their metropolitan counterparts. Several pathways through which residence influences mortality have been proposed. The objective of this study is to examine the effects of income inequality on residential differentials in mortality. Using data from the Compressed Mortality File for counties in the coterminous United States for 1990, we estimate weighted least squares models of total mortality for 3,067 counties, and separately for metropolitan and nonmetropolitan counties. Mortality is lower in nonmetropolitan counties than in metropolitan counties, once rates are standardized for age, sex, and race. Moreover, income inequality exerts stronger effects in nonmetro counties, an effect that persists when per capita income, median household size, and racial composition are controlled. The percentage of the population that is black exerts an independent effect on mortality in both metro and non‐metro counties.     

The Right to Aid: Perceptions and Practices of Justice in a Flood-Hazard Context in Jakarta,Indonesia

Regular floods impact negatively on the health and wellbeing of slum dwellers in Jakarta and it is understandable that the victims seek access to justice. Fieldwork in one of Jakarta's most flood-prone neighbourhoods, Bantaran Kali, reveals that riverbank settlers there access what they perceive to be justice by engaging in a number of different social networks that are neither formal nor informal—they feature in between civil society and the state. In this article I explore the network ties that are used by individual slum dwellers to access justice. I will show that in the context of extreme flood risk and related uncertainty, this form of social capital makes a significant difference to the community and to households, and with respect to individuals' resilience. By exploring this particular avenue of access to justice, I show that a sense of justice is achieved not through the formal agencies of government but by means of social networks in a space that fits uneasily in the dichotomy of state and non-state.     

At the intersection of criminal justice involvement and sexual orientation: Dynamic networks and health among a population-based sample of young Black men who have sex with men

Mass incarceration of young Black men has a significant impact on their network composition and stability that, in turn, may have major implications for health and well-being. A sub-group of young Black men with criminal justice involvement (CJI) identify as gay, bisexual or are non-identified men who have sex with men (hereafter MSM). This paper focuses on the potential effects of CJI on the composition of Black MSM social and sexual networks, their stability over time, and concomitant health and social outcomes. We use data from the UConnect study, a population-based cohort of young Black MSM 16–29 years of age (n = 618) selected using respondent-driven sampling in Chicago from 2013 to 2016. Both confidant and sexual network name generators and interpreters were administered at 9-month intervals over three waves of data collection. Ego and dyadic-level data were collected on behaviors prevalent among MSM and including factors associated with network CJI, network stability, and health outcomes. Generalized Structural Equation Models (GSEM) were utilized to determine the relationship between CJI network composition, network stability and behaviors prevalent among young Black MSM and their networks. In the UConnect cohort, 46% had at least once been detained, arrested or spent time in jail or prison. In addition, 20% of participants reported incident CJI over the study period. Respondents with a history of CJI were significantly more likely to have CJI homophily in their confidant and sexual networks. Multivariate analyses demonstrate that the association between one’s history of CJI, housing instability and drug use is partially explained by one’s network CJI. In addition, a higher prevalence of network CJI is associated with increased turnover in the confidant network, and this network instability is also related to important health and social outcomes. This analysis describes the networks of criminal justice involved men among a representative sample of young Black MSM and demonstrates the relationship between CJI network homophily, network stability and their impact on several key health and social outcomes relevant to this population.     

Evidence-based risk factors for adverse health outcomes in older patients after discharge home and assessment tools: a systematic review

The current health care system is discharging elderly patients "quicker" and "sicker" from acute care facilities. Consequently, hospital readmission is common; however, readmission may be only one aspect of adverse outcomes of importance to social work discharge planners. The early recognition of risk factors might ensure a successful transition from the hospital to the home. A systematic review was conducted to identify factors associated with adverse outcomes in older patients discharged from hospital to home. Using a content analysis, factors were characterized in five domains: demographic factors, patient characteristics, medical and biological factors, social factors, and discharge factors. The most frequently reported risks were depression, poor cognition, comorbidities, length of hospital stay, prior hospital admission, functional status, patient age, multiple medications, and lack of social support. A systematic search identified four discharge assessment tools for use with the general population of elderly patients. Practice and research implications are offered.     

A longitudinal perspective on the differentiated valuation of formal education in Brazil in recent decades

The central theme of this article is the relationship between formal education and earnings from a longitudinal perspective, taking into account indicators of social status. Variations in the respective trajectories, in different age cohorts, and in the comparison among different periods are discussed. The empirical material used is based on the microdata files of official statistics. The main techniques put into practice are those that are most focused on measuring the degree of interdependence among variables and those used for means comparison. Our general hypothesis is that the effects of schooling cannot be grasped in terms of education itself but instead in terms of its relationship to status in the social and power structures. One of this paper's principal observations is that of the general declining trend in the economic value of formal education, which varies depending on the level of education and social status. This devaluation is systematic and spans the entire studied universe; however, it focuses much more closely on those of lower social status, particularly for the groups with schooling that is either higher or lower than average.