Residential independence among older persons: community and individual factors

The objective of this study is to evaluate an expanded version of the resource model of living arrangements among older persons. This expanded model includes community-level measures of geriatric health services and housing market conditions. We employ the first two waves of the National Survey of Families and Households to test static and longitudinal fixed effects models of residential living arrangements. We find that residing in areas with higher levels of geriatric health care services increases the likelihood of residential independence, net of other contextual factors and individual characteristics. Our results show that housing market conditions are not related to levels of or changes in residential independence when control variables are included in the models. The results for the individual-level resource variables show that persons with greater economic resources, more children, and better functional status are better able to maintain independence and are less likely to die or live in a nursing home. This study shows the utility of expanding on micro-level approaches to understanding community living arrangements among older persons. Future investigations should include measures of the policy environment, transportation constraints and opportunities, and a more complete array of indicators of health and social services oriented toward helping elderly persons maintain their independence.     

Food and population: beyond five billion

The developing countries, with about 3/4 of the world's population, account for less than 1/2 of the production of major food crops. The Third World's per capita food production of 260 kilograms in 1983 was only 1/3 of that in the developed countries. Yet China and India, the most populous countries in the world, have cut fertility rates and moved to food self-sufficiency. An illustration of the food/population dynamic is that although production of food staples in North Africa and the Middle East is projected to expand at about the same rate as that of Asia, about 2.9% annually, owing to a much more rapid rate of population increase, they will achieve only a 0.2% increase in output per person per year, compared with a 1.4% annual growth rate in Asia. In the longer term, higher dietary levels per capita for a world population double that of the present would imply at least a tripling of demand for dietary staples. But more intensive cultivation would place natural resources, many already degraded, under much greater stress. Balancing population, food, and resources for sustained survival is a continual process. The principle cause of hunger and malnutrition is poverty; it is more determinative of nutritional status than aggregate food production.     

A fixed-effects multilevel analysis of how community family structure affects individual mortality in Norway

By using register data for the entire Norwegian population aged 50-89 in the period 1980-1999, during which there were about 720,000 deaths, I estimate how the proportions of persons who were divorced or never married in the municipality affected all-cause mortality, net of individual marital status. The data include individual histories of changes in marital status and places of residence, providing a rare opportunity to enter municipality fixed effects into the model, thereby capturing the time-invariant unobserved factors at that level. The positive health externality of marriage that is suggested in the literature is supported by some of the estimates for women. Other estimates--especially those for men--point in the opposite direction. One possible interpretation of these findings is that social cohesion is perhaps not as beneficial for people's health as often claimed, at least not for both sexes. Alternatively, the results may reflect that marriage perhaps undermines rather than strengthens social cohesion, or that other mechanisms are involved-for example, those that are related to people 's perceptions of their health relative to the health of others. Estimates from models without such municipality fixed effects are markedly different, but these also shed doubt on the notion that a high proportion of unmarried persons generally increases individual mortality.     

HIV risk behavior and drug use among heterosexual male crack users by prostitution involvement

Crack and prostitution, or sex exchange, have been linked to the heterosexual spread of HIV (e.g. Inciardi 1993, 1995). Previous studies have found that among female crack users there are subgroups who do and do not become involved in prostitution (e.g. Logan, Farabee & Leukefeld 1998; Logan & Leukefeld 1998). However, there has been little focus in the literature on subgroups of male heterosexual crack users who are or are not involved in prostitution. The purpose of this study was to examine differences in male heterosexual crack users who reported no involvement in prostitution as clients (n = 4,208), males who reported involvement in prostitution as clients but not in the month preceding the interview (n = 2,774), and males who reported involvement in prostitution as clients the month preceding the interview (n = 2,283) from a multi-site sample of male crack users who participated in the National Institute of Drug Abuse (NIDA) AIDS Cooperative Agreement Project from 20 sites across the nation. Results of the logistic regression indicated that having an STD three or more times and using drugs during sex were associated with ever being involved in prostitution as clients, while using drugs during sex and having 5 or more sexual partners the month preceding the interview were significantly associated with being involved in prostitution as clients at the time of the interview. Implications for interventions are discussed.     

Commitment beyond self and adolescence: The issue of happiness

Is there a link between adolescents' experience of joy and fulfillment and their increased openness and commitment to the world and other human beings? A series of comparative studies was conducted investigating different adolescent samples according to cultural background (American Christians, Israeli Jews, Israeli Arabs), socio-economic status (low, high, disadvantaged), religiosity (observant, secular), and exceptionality (hearing impaired) and at different stages of prosocial involvement (non-involved, registered, and involved volunteers). Over and above group differences, the findings from all samples demonstrated that adolescents who realize positive experiences in greater depth and intensity, are also differentiated by a stronger desire to contribute to society and/or to be devoted to some aim beyond self. Implications for educators in fostering the social responsibility and self-fulfillment of young people from different backgrounds were discussed.     

Population growth and road construction: Looking to traditional indigenous ways

Population growth is linked to road building which is in turn unfortunately linked to what is commonly called sustainable development. The biggest implication of late is that the United Nations' International Conference on Population and Development—as it focused so heavily on feminist agendas, education and economic advancement—did not address a major cause of population growth.Overpopulation in some northern nations, notably the United States, is overlooked due to official neglect of the scientific measurement of carrying capacity, and due to political considerations in discussing immigration even as an environmental issue or component of overpopulation.Traditional indigenous peoples' population sizes and such societies' ethic toward their land are indicated as models of sustainability.     

Prevalence of extradyadic sex in male couples of mixed HIV status and its relationship to psychological distress and relationship quality

This study assessed the prevalence of extradyadic sex and the relationship between such activity and psychological distress and relationship quality in male couples of mixed HIV serostatus. Sixty-three couples were interviewed and had sufficient data for inclusion in all analyses. With regard to sexual activity during the year prior to being interviewed, 19 (30%) couples were monogamous, 18 (29%) described themselves as "open," 13 (21%) kept extradyadic sex a secret from their partners, and in 13 couples there was only partial knowledge of extradyadic sex. Though not statistically significant, monogamous and open couples consistently scored lower numerically on measures of psychological distress and higher on measures of relationship quality, compared to "partial knowledge" and "secretive" couples. When pooled, monogamous and open couples scored significantly higher on measures of dyadic consensus, affectional expression, dyadic satisfaction, and sexual satisfaction compared to the combined subgroup of partial knowledge and secretive couples.     

Looking out, looking in: anti-semitism and racism in lesbian communities

I am a white Jewish lesbian from a Non-English Speaking Background (NESB). This article is based on a speech which I gave at the "Sappho Was A Wog Grrrl" conference organized by the Interlesbian group in Melbourne in 1995. I discuss how racism and anti-Semitism are reflected in lesbian communities, examining issues of privilege, invisibility and exclusion from both personal and community perspectives. I offer alternatives to ignorance and guilt, suggesting some strategies for taking responsibility and moving beyond discrimination. This article is, and remains, a work in progress as I continue to learn and understand more about anti-Semitism and racism.     

Immigration and living arrangements: Moving beyond economic need versus acculturation

Prior research seeking to explain variation in extended family coresidence focused heavily on the potentially competing roles of cultural preferences and socioeconomic and demographic structural constraints. We focus on challenges associated with international immigration as an additional factor driving variation across groups. Using 2000 census data from Mexico and the United States, we compare the prevalence and age patterns of various types of extended family and non-kin living arrangements among Mexican-origin immigrants and nonimmigrants on both sides of the U.S.-Mexico border. Additionally, we use the Survey of Income and Program Participation to examine the stability of extended family living arrangements among Mexican-origin immigrants and natives in the United States. We find that newly arrived immigrants to the United States display unique patterns in the composition and stability of their households relative to nonimmigrants in both Mexico and the United States. Recent immigrants are more likely to reside in an extended family or non-kin household, and among those living with relatives, recent immigrants are more likely to live with extended family from a similar generation (such as siblings and cousins). Further, these households experience high levels of turnover. The results suggest that the high levels of coresidence observed among recently arrived Mexican immigrants represent a departure from “traditional” household/family structures in Mexico and are related to the challenges associated with international migration.     

Breastfeeding women and family planning programs: special needs and opportunities

Although breastfeeding makes a major contribution to fertility control and child spacing in many developing countries, the implications of this are not widely recognized. Terminology may be part of the reason. Contraception may imply something modern, whereas the contraceptive effect of breastfeeding is a natural biological mechanism. Also, many family planning program managers are educated in the West, where breastfeeding is of little contraceptive importance. Regardless of where they were educated, they may consider the pregnancy-postponing effects of breastfeeding as mythology, or may consider breastfeeding as sufficiently effective at the individual level. Breastfeeding as a family planning method cannot be "delivered" to women by family planning methods, and requires an educational approach rather than a clinical or medical approach. A women might use breastfeeding more confidently in avoiding an unplanned pregnancy if she begins using a contraceptive method as soon as she resumes menses, when she begins giving her baby food supplements, or by 6 months post partum--whichever comes first. She can achieve high effectiveness in avoiding pregnancy by keeping the baby nearby and feeding on demand, feeding frequently, sleeping near the baby and maintaining nightfeedings, not giving the baby bottles or pacifiers, and giving the baby only breastmilk for at least 4 months. Breastfeeding can only be used by new mothers and cannot be used to postpone the 1st birth. Nor is it appropriate for women who have attained their desired family size, or who wish to avoid or postpone pregnancy at any cost.     

PrEP Whores and HIV Prevention: The Queer Communication of HIV Pre-Exposure Prophylaxis (PrEP)

ABSTRACT

HIV pre-exposure prophylaxis (PrEP) has been introduced as another biomedical tool in HIV prevention. Whereas other such tools—including post-exposure prophylaxis (PEP) and interruption of perinatal transmission—have been embraced by those impacted by HIV, PrEP has been met with more conflict, especially within the gay community and HIV organizations. The “PrEP whore” has come to designate the social value and personal practices of those taking PrEP. This study examines the “PrEP whore” discourse by using queer theory and quare theory. Within these theoretical vantage points, the study explicates four discursive areas: slut shaming, dirty/clean binaries, mourning the loss of condoms, and reclaiming the inner whore. The study illuminates possible discursive strategies that lie outside of the domains of public health and within the individual and community.     

Sibling rivalry and gender gap: intrahousehold substitution of male and female educational investments from male migration prospects

Improved migration prospects for men could have negative spillover effects on women. We use an exogenous change in an education-based policy for recruiting Nepali men to work in the British Army to examine the effect of new job prospects for men on the human capital of women within the same household. Men who were directly exposed to this change raised their education. These gains came at the expense of their female siblings, who lost 0.12 years of schooling and increased their participation in economic activities. This spillover accounts for a 8% decline in female education and widens the gender gap by 31%. For every additional year of education completed by men, female siblings “lose” 0.394 years of education. This gender spillover is more severe for poor and agricultural households that are more resource constrained.     

The study of intergenerational intimacy in North America: beyond politics and pedophilia

Intergenerational intimacy, social as well as sexual, has been studied in the United States and abroad for some time. In recent years the general trend has been to label such behavior "child sexual abuse." Interest in this type of abuse has generated a considerable amount of more or less scientific literature, some of which seems to have been produced in a "rush to judgment" attempt to build a "professional" literature that supports popular beliefs. This tradition of child-abuse-defined literature, along with the work of investigative and helping agencies which some refer to as a "child abuse industry," has fostered a one-sided, simplistic picture of intergenerational intimacy. A close look at the empirical studies in this tradition reveals flaws associated with two problems: the studies nearly always (1) maintain a narrow focus on sexual contact, and (2) proceed from the related basic assumption that sexual contact in intergenerational relationships by definition constitutes abuse. While sexual abuse certainly occurs, those who apply this assumption to all situations are ignoring empirical findings that show otherwise. Research outside the "child sexual abuse" tradition reveals a broader range of intergenerational relationships outside the family, including a number of aspects which typically are not seen when the focus is on the sexual. Some studies show clearly that even when sexual contact is involved, negative outcomes are not inevitable. This indicates the need for a much broader approach. Further research in North American society and in other cultures would help us to understand more accurately the diversity and possible benefits of intergenerational intimacy.     

Working beyond 65: predictors of late retirement for women and men MBAs

Comparisons of those who planned to continue working after the age of 65 with those who did not were made for 145 women and 414 men working in managerial fields. All received MBA degrees between the years of 1973 and 1982. About 20% definitely wanted to work after age 65. More positive views of work were predictive of wanting to continue working as was having nontraditional gender-role attitudes. Men who planned to continue working were particularly likely to have a spouse wanting to work past the age of 65. Several other factors appeared to operate differently for women and men.     

Looking back moving forward: The history of midwifery in Western Australia

ProblemTo date there is has been very little research into midwifery in Western Australia (WA), therefore this paper addresses a significant gap in the literature. The aim of this paper was to gain insight into the history of midwifery in WA.BackgroundSince the beginning of recorded history midwives have assisted women in childbirth. Midwifery is recognised as one of the oldest professions; midwives are mentioned in ancient Hindu texts, featured on Egyptian papyrus and in The Bible. Up until the seventeenth century childbirth was the responsibility of midwives, but the gradual emergence of barber-surgeons, then man-midwives and obstetricians heralded a shift from women-led and community-supported birth to a patriarchal and medical model. Throughout the twentieth century childbirth practices in the Western World have continued to change, leading to a move from midwifery-led care at home to doctor-led care in the hospital.DiscussionThe first non-Indigenous Australian midwives were not formally trained; they came on ships bringing convicts to Australia and are described as ‘accidental’ midwives, as assistance in childbirth came from whoever was available at the time. This period was followed by what was called the ‘Aunt Rubina’ period where older married women helped younger women in childbirth. Throughout the early 1800s untrained or ‘lay’ midwifery care continued alongside the more formally trained midwives who had arrived with the colonists.From the early 20th century, when birth moved into the hospital, midwives in WA have been incorporated into the hierarchy of the professions with obstetrics as the lead profession and midwifery considered a speciality of nursing. The role of the midwife has been subordinated, initially controlled by medicine and then incorporated into the institutions and nursing. The increase in legislative and training requirements for midwives throughout Australia and the move from home to the hospital, gradually led to the decrease in autonomous midwives working within the community, impacting women’s choice of birth attendant and place of birth.ConclusionThe historical suppression of midwifery in Australia has impacted the understanding of the role of the midwife in the contemporary setting. Understanding the development and evolution of the midwifery profession in Australia can help future directions of the profession.     

Men and not-men: male gender-mixing statuses and homosexuality

Male gender-mixing statuses, such as Native American berdaches, consist of men who assume the cultural, symbolic attributes of women to attain the status of not-men. Remaining distinct from women, not-men are a culturally defined gender status whose indexing features include women's dress and behavior, occupational inversion, and some cultural traits of men. Another indexing feature of not-men is the absence of sexual relations with other not-men, which forces them to seek not-status men or women as sexual partners. The frequent equation of gender-mixing statuses with homosexuality is a misunderstanding: Sex with men is a secondary and derivative characteristic.