Gender differences in health risks and physical symptoms among the homeless

Gender differences in health risks and symptoms are compared for a survey sample of 100 homeless persons and for the general population. Homeless men appear at greater risk of exhibiting symptoms. Nonetheless, homeless women report more symptoms, a result consistent with general population trends. Predisposing illnesses were the most accurate predictors of the number of reported symptoms, but gender explained a significant amount of variation in reported symptoms after other health risks were controlled. The findings inform the debate on the relative importance of biological factors, acquired risks, illness perception and behavior, and reporting bias in explaining why women report more symptoms in survey research. It appears likely that female reporting bias and gender differences in illness perception are underestimated in general population surveys because even under extreme conditions, men are less likely than women to report symptoms.     

A Contradiction in the Health Care Delivery System: Problems of Access*

State-wide sample survey data regarding issues and problems frequently incurred in gaining access to health care delivery systems, as well as reports of illness, are utilized in an analysis covariance. The results indicate that the black population reports receiving more preventive health care services than the white population when controlling for all relevant independent variables. This surprising reversal of the most frequently found relationship between black and white populations, coupled with the reporting by the black population of experiencing more difficulty in gaining access to the system for needed help, presents evidence of a contradiction in the delivery of care.     

Gender, race-ethnicity, and psychosocial barriers to mental health care: an examination of perceptions and attitudes among adults reporting unmet need

Though researchers have described psychosocial barriers to mental health care-seeking, limited research has examined ways in which gender and race-ethnicity are associated with individuals' perceptions and attitudes. This study investigates correlates of psychosocial barriers to mental health care in a population of adults reporting unmet need for mental health care, focusing on gender and race-ethnicity. Data are from the 2002 National Survey on Drug Use and Health. Multivariate analyses show that non-Latino white male status is positively associated with stigma avoidance and mistrust/fear of the mental health care system. Persons of lower income or educational status are less likely to report negative attitudes towards care. Findings imply a need to reconsider the roles of gender race-ethnicity, and socioeconomic status within investigations of psychosocial barriers to care. Future research should examine the relationships among social status, help-seeking behaviors, and attitudes toward mental health care.     

The Use of Humor,Jesting, and Playfulness With Traumatized Elderly

Current statistics indicate that there are a fair proportion of American elderly who have been traumatized in a variety of ways during their lifetime. Social workers and health care workers are likely to encounter this population in a myriad of contexts. This article presents the benefits of humorous interventions in trauma work, guidelines for its use, and case examples when working with the elderly.     

Health Insurance,from a Child Language Broker's Perspective

In the midst of dramatic changes to American health care law there is need to understand the challenges that vulnerable populations encounter in obtaining and managing health insurance. Research has found that child language brokers, children who mediate language and culture for their immigrant families, assist with health‐related matters. We report on focus groups with 17 language brokers living in Central Los Angeles. In this article we detail their experiences language brokering for health insurance and their knowledge of health insurance and policies that apply to their immigrant families. We illuminate some barriers immigrant families face as well as how they navigate them. We conclude with policy implications, particularly in relation to making health insurance more accessible to non‐English speaking and immigrant populations.     

Exploring the Interaction Between Volunteering Status,Paid Job Characteristics and Quality of Volunteers’ Motivation on Mental Health

The literature on the health-promoting effects of community work has primarily dealt with the population in retirement age, yet the vast majority of volunteers are people still in the workforce. The aim of this study is to observe the relationship between volunteering and health within the context of working life, considering paid work conditions and motives to volunteer as moderating variables. We conducted an online survey with a sample of Swiss workers employed in different industries. Results show that volunteers with self-determined motives (but not with controlled motives) report lower levels of stress and burnout than non-volunteers. Moreover, volunteers in general (regardless of the quality of motivation) report higher levels of work engagement and well-being. Analyses further reveal an interaction effect for burnout and stress, where the difference between self-determined volunteers and non-volunteers becomes larger with unfavorable working conditions at their paid job, hinting at potential compensatory effects. Implications for future research and the voluntary sector are discussed.     

Stress,Stigma, and Sexual Minority Status: The Intersectional Ecology Model of LGBTQ Health

One of the four overarching goals of Healthy People 2020 is to achieve health equity, eliminate health disparities, and improve the health of all groups, including the health of lesbian, gay, bisexual, transgender, and questioning (LGBTQ) populations. In 2011, the Institute of Medicine (IOM) released a report that drew attention to the unique health disparities experienced by sexual minorities and underscored the need for a comprehensive approach to sexual minority health research. This article proposes a new model of LGBTQ health to help measure, explore, explain, and predict the impact of sexual minority status on health outcomes. The Intersectional Ecology Model of LGBTQ Health (IEM) demonstrates how the relentless hypervigilance of LGBTQ individuals in a heteronormative society impacts health outcomes through the primary vehicles of stigma and chronic, elevated stress. The purpose of the IEM is to guide future research and enhance public health practice for LGBTQ populations.     

Work-related health factors for female immigrants in Sweden

Work-related health has been a focus of research since the rate of sickness-related absences began to increase in Sweden. The incidence of sickness-related absences and early retirement is higher among female immigrants than among others in the total population. This study is based on a questionnaire survey which was conducted in a municipality in Sweden. The study population consisted of 2 429 native and immigrant female employees. The aim was to study work-related health factors for female immigrants. The results of this study show that about 20% of female immigrants who participate in the survey have temporary employment while the proportion is 8% for native women. The perception of ethnic discrimination among female immigrants was three times as much as among native females. The results also show that 69% of female immigrants report having received no opportunity to discuss their wages with managers, in comparison to 63% of native females. About 40% of female immigrants and 35% of native women report that they do not get opportunities to upgrade their skills. Female immigrants over the age of 50 experience gender and ethnic discrimination and lack of access to skills training programs more often than younger immigrants. They also participate in health-care activities more often.     

Exposure to Client Trauma,Secondary Traumatic Stress,and the Health of Clinical Social Workers: A Mediation Analysis

While it is widely acknowledged that providing services to traumatized populations may negatively impact the mental health of clinicians, little is known about the impact of exposure to traumatized clients and secondary traumatic stress on the physical health status of clinicians. As such, the twofold purpose of this study was to: (1) document the prevalence of STS in a national (US) sample of clinical social workers, and (2) to examine the relationships between exposure to client trauma, STS, and perceived health of clinical social workers. Specifically, we sought to determine if STS mediates the relationship between exposure to client traumas and perceived health. Results indicate clinicians experience intrusion symptoms most frequently, and a significant portion report arousal and avoidance symptoms. Mediation analyses revealed that exposure to traumatized client populations indirectly influenced clinical social workers’ physical health perceptions by way of secondary traumatic stress. Findings call for increased attention toward prevention and amelioration of secondary traumatic stress symptomology among direct service providers, given both its prevalence and potential impact on physical health. Directions for future research are discussed.     

Sex after 40?: Gender,ageism, and sexual partnering in midlife

This article examines the relationship between gender and heterosexual partnering in midlife, using survey data from 1240 women and men aged 40 to 59. Although older ages are associated with lower numbers of sexual partners for both genders, larger proportions of women report having no partners, and at earlier ages than men. Sexual conservatism and non-cohabitation predict lower numbers of partners for both genders, albeit in different ways. Age's differential effects by gender are not reducible to greater conservatism among older cohorts of women or to age-gender patterns in cohabitation, suggesting that ageism and sexism combine to middle-aged women's particular disadvantage.     

Economic Trends,Politics, and Employment Policy for Older Workers

The rising interest among policymakers in developing employment policies for older persons can be traced to several sources. Two of these-concerns about the financing of retirement benefits and fears about possible future labor shortages-are shaping employment policies in ways that have undesirable consequences for older workers who are in poor health and who lack the economic resources to be able to afford retirement. In contrast, employment policies that operate by providing work incentives, rather than retirement disincentives, do not have discriminatory impacts on these subgroups of the older population.     

Residential care for children with intellectual disabilities in the social protection system in Serbia

This paper presents and discusses the characteristics of the social protection of children with intellectual disabilities who are placed in children's homes in Serbia. It draws on a survey that covered the entire population—586 users in all five institutions for children with intellectual disabilities who resided there in 2009. The analysis shows the heterogeneity of users in relation to age and degree of intellectual disability, their long-term stay in homes, the inadequate structural and functional standards, and insufficient health care. Residential care becomes the most common form of permanent rather than temporary care. These findings suggest the need for a number of strategies to be adopted, and the paper concludes by outlining potential ways forward.     

Pachedu‐Zenzele in the Diaspora: Promoting Sexual Health Amongst Zimbabweans in England

Migrants have been found to be at enhanced risk for the Human Immune Deficiency Virus (HIV) in comparison with settled populations. As they migrate, they often bring with them their traditions and cultural values, which may influence the ways they access or make sense of health promotion interventions in the host country. In the diaspora, should they experience compromised citizenship, marked by an unresolved immigration status, some may need to remain invisible and this may include not accessing or presenting late for vital health care interventions. Addressing the needs of such invisible populations is key to health promotion work and paramount to public health interests. This paper describes how ever‐changing “traditions”, in particular the notions of Pachedu and Zenzele, were harnessed to develop ethically grounded sexual health care interventions amongst Zimbabweans in Luton, Bedfordshire, England. These interventions were delivered in mundane settings that formed some of the key everyday networks of this population. The reinvention of “tradition” for the purposes of delivering health and social care interventions has been one of the cornerstones of health promotion interventions in Africa, where the rates of HIV are some of the highest in the world. The concept of Pachedu harnessed confidentiality in the delivery of sexual health interventions with Zenzele calling for communal involvement in such initiatives. A key point that resulted in the success of this intervention was partnership work between statutory providers and the local Zimbabwean population throughout the project’s life span. Rather than being construed as passive recipients of health and social care interventions, local Zimbabweans and their statutory partners were engaged in mutual capacity building initiatives. Local Zimbabweans were also engaged and consulted throughout, from the conceptualization of the project, delivery, monitoring, and dissemination of the findings.     

Examining Associations Between Discrimination,Social Cohesion,and Health among White LGBT versus POC LGBT Chicagoans

Consistent with the minority stress perspective, lesbian/gay, bisexual, and transgender (LGBT) individuals on average report worse health than heterosexual individuals in several domains, for example, general health, mental health, physical health, and healthcare access. Intersectionality-based research shows that LGBT people of color (POC) are, on average, at even greater risk for adverse health outcomes. Discrimination and social cohesion may be two mechanisms underlying these between- and within-group disparities, given that both constructs are frequently reported within marginalized populations, and that both broadly relate to health. This study used data from the Chicago Department of Public Health to examine broad health differences between White LGBT and LGBT POC, and to test specific models in which social cohesion mediated links between discrimination and health. LGBT POC reported experiencing worse general health, lower access to health care, more experiences of discrimination, and lower feelings of social cohesion than did White LGBT individuals. No mediation effects emerged; however, there was a direct effect of experiencing discrimination on mental health distress. Discrimination exposure inversely related to the feelings of social cohesion.     

A survey of Colorado's migrant farmworkers: access to health care

This report utilizes data collected in a 1986 sample survey of 329 adult (18 to 50 years old) migrant farmworkers in Colorado to determine their health needs, health services utilization, and overall access to care. Health needs include selected indices of medical, dental, nutrition, and reproductive health. About 1/4 of the population had no usual source of health care. Upstream states such as Colorado are responsible as the primary providers of health services for those who either have no source of health care at their home base or experience a variety of barriers in their attempts to access services. Women are most likely to have had a medical visit over the past 12 months and are more likely to have experienced hospitalization. Unfortunately, although their contact with medical professionals is more frequent, the family planning needs of women are not being met. A large disparity exists between ideal family size and number of pregnancies and live births. The findings of this survey document the inferior health status of the migrant farmworker population in Colorado. Hunger, poverty, and environmental hazards increase the risk of illness, while at the same time, barriers to care often prevent migrants from accessing needed health services. Recommendations include 1) promoting and funding family planning and reproductive health services for migrant farmworker women and their partners, 2) incorporating trained family planning promoters in the migrant health delivery system, 3) maintaining successful models of restorative dental care for adults, 4) increasing access to services in nontraditional settings, 5) increasing use of ancillary personnel to provide services, especially dental services, 6) maintaining outreach programs in the available food programs, and 7) encouraging migrant health programs to provide leadership in the development of alternative food sources.     

Impact of client suicide on social workers and counselors

Recent studies on the impact of client suicide on mental health professionals focus on psychiatrists and psychologists, while,in the current mental health system in our country, most clients receive services from other clinicians. This research focuses on the impact of client suicide on social workers and counselors as well as organizational responses to client suicide/attempt. Data were collected via interviews and survey of 121 clinicians. Client suicide impacts clinicians adversely in many ways. Many participants felt their agency/practice could have done more to support them during post-suicide management. Data presented in this report have the potential to aid in the creation of needed workforce development initiatives.     

Tobacco, depression, and lifestyle choices in the pivotal early college years

The author explored the correlates of tobacco use among 18- and 19-year-old students at a major midwestern university. A sample of 203 randomly selected freshmen and sophomore students completed a survey that included questions about tobacco use, other drug use, mental health issues, eating disorders, stress, smoking environment, and healthy lifestyles. The prevalence rate for tobacco use was 29% for the past year and 32% for the past month. Multivariate analyses suggested that students with a lifetime diagnosis of depression or treatment for depression were 7 times as likely as other students to use tobacco. In addition, marijuana and alcohol use and weekend exposure to smoke increased the likelihood of being a tobacco user. Stress and diet behaviors were found not to be significantly associated with tobacco use. Implications for health promotion among high school and college populations are drawn from the study findings.