Violence as Mediating Variable in Mental Health Disparities Associated to Sexual Orientation Among Mexican Youths

ABSTRACT

In this study, we explored the role of sex as an effect-modifying variable in the association between sexual orientation and mental health in Mexican youth. In addition, we tested if violent experiences in the family and the school and attitudes toward homosexuality could act as mediating variables in such association. Data from three representative surveys performed in 2007, 2009, and 2013 among Mexican high school students were analyzed. Two dimensions of sexual orientation were evaluated: romantic partnership and sexual behavior. The outcomes were negative and positive mood, suicidal ideation and intent, self-concept, and self-esteem. There were differences by gender because in males, there were more disparities in mental health associated with sexual orientation (suicidal ideation and attempt, negative and positive mood, negative self-concept, and family-related self-esteem) than in females (suicidal ideation and negative mood). Experiences of school violence were mediators in the relationship between sexual orientation and most health outcomes in males.     

The Association Between the Fear of Crime,and Mental and Physical Wellbeing in New Zealand

Researchers have provided clear evidence that the fear of crime can lead to various mental health-related issues including anxiety and psychological distress. However, studies on the effects of fear of crime on physical health are limited. Adding to and extending this literature, we evaluated the association between fear of crime and mental and physical health outcomes in a new setting (New Zealand) and at a national scale. As an added contribution to the literature, we examined whether the fear of crime is independently associated with mental and physical wellbeing, regardless of neighbourhood crime rates. Using data from the New Zealand General Social Survey, the 2006 census and the New Zealand Police, we fitted linear and two-level hierarchical linear models regression models to assess the impact of fear of crime on mental and physical health, at varying stages of individual and area-level confounder adjustment. Even after adjusting for a number of individual- and area-level factors that are related to social inequalities in health in the country, a significant effect of increased fear of crime on lower mental and physical wellbeing was detected. We did not, however, detect significant independent effects for neighbourhood crime rates for either outcome. Our findings indicate that fear of crime, rather than recorded crime rates, was associated with detrimental mental and physical health outcomes. As such, efforts to not only reduce crime but perceived risk of crime could yield public health and social wellbeing benefits.     

Minority Stress,Parenting Styles,and Mental Health in Brazilian Homosexual Men

ABSTRACT

Homosexual men are constantly exposed to prejudice and violence in Brazil. The aim of this study was to investigate the relationship between minority stress, parenting styles, and indicators of mental health problems in a sample of homosexual men. Method: quantitative, cross-sectional, correlational, and retrospective design. Participants were 101 Brazilian men who selfidentified as homosexuals, aged between 18 and 55 years. Results: concealing sexual identity was a predictor of depression and stress. Parental responsiveness was associated with a lower incidence of enacted stigma and depression. Conclusions: the mental health of homosexual men can be negatively affected by the need to conceal their sexual orientation. Parental responsiveness is a protective factor in terms of experiencing enacted stigma and depression. The results found in the study may be useful for counselors and social workers who are working with LGBT people and their families.     

Health Care Needs and Care Utilization Among Lesbian,Gay, Bisexual,and Transgender Populations in New Jersey

The purpose of this study was to explore prevalent health issues, perceived barriers to seeking health care, and utilization of health care among lesbian, gay, bisexual, and transgender (LGBT) populations in New Jersey. A cross-sectional online survey was administered to 438 self-identified LGBT people. Results identified health needs, which included management of chronic diseases, preventive care for risky behaviors, mental health issues, and issues related to interpersonal violence. Barriers to seeking health care included scarceness of health professionals competent in LGBT health, inadequate health insurance coverage and lack of personal finances, and widely dispersed LGBT inclusive practices making transportation difficult. There is a need for better preparation of health care professionals who care for LGBT patients, to strengthen social services to improve access and for better integration of medical and social services.     

The Mexican Drug War and Early-Life Health: The Impact of Violent Crime on Birth Outcomes

This study examines the relationship between exposure to violent crime in utero and birth weight using longitudinal data from a household survey conducted in Mexico. Controlling for selective migration and fertility, the results suggest that early gestational exposure to the recent escalation of the Mexican Drug War is associated with a substantial decrease in birth weight. This association is especially pronounced among children born to mothers of low socioeconomic status and among children born to mothers who score poorly on a mental health index.     

Student Functioning,Concerns, and Socio-Personal Well-Being

The following study used the Student Quality of Lifeand Satisfaction (SQOLAS) instrument and 467University of Rhode Island undergraduate and graduatestudents as participants in order to examinerelationships among functioning and performancevariables, student concern and importance areas, andmeasures of socio-personal satisfaction andwell-being. Canonical correlational analysis revealedtwo statistically significant canonical correlationsbetween a student functioning/performance variable setand a concern/importance area variable set. A set ofvariables related to increased concern and importanceratings of socio-sexual behavior, and decreasedratings of crime, violence, multicultural, and genderissues was significantly associated with a second setof variables: increased levels of alcohol use andassociated negative consequences, younger age,increased mental health concerns, men more than women,decreased class year, and less positive ratings towarddirection in life. Standard multiple regressionanalysis produced a statistically significant modelwhere positive attitude towards direction in life canbe predicted by higher levels of socio-personalsatisfaction and deep metacognitive processing, andlower levels of alcohol use and associated negativeconsequences, and fewer mental health concerns.Implications of the results are discussed in relationto theories of cognitive behavior, phenomenologicalfunctioning, life meaning, and well-being.     

A Review of Research on Violence in Same-Gender Couples

Abstract

This paper reviews current research that has primarily focused on domestic violence among same-gender couples. Several key issues pertaining to the identification, assessment, and treatment of domestic violence among same-gender couples are examined and outlined to assist clinicians in effectively working with gay and lesbian clients who may be experiencing domestic violence. Resource information is included to help mental health clinicians recognize specific stressors of marginalized individuals as well as assessment and treatment recommendations are made.     

Minority Stress in the Lives of Men Who Have Sex With Men in Cape Town,South Africa

The mental health outcomes of men who have sex with men (MSM) living in sub-Saharan Africa are understudied, despite evidence that discrimination and stigma are widespread. This article examines the occurrence and mental health effects of minority stress in a sample of diverse South African MSM. Twenty-two MSM living in Cape Town took part in exploratory qualitative in-depth interviews and completed mental health questionnaires. Results indicate that the majority of participants experienced minority stress, which affected their sexual relationships and coping strategies. Concealment behaviors and perceived discrimination levels were high and were associated with race, religion, SES, and geographical location.     

Older women's fears of violence: the need for interventions that enable active ageing

Women's fear of violence can impact negatively on their active participation in life. An ageing survey conducted with 2,620 Australian respondents aged 50 to 90 years examined aspects of work, learning, social, spiritual and emotional status, health, vision, home, life events, demographics, and asked an open-ended question about what being actively engaged in life meant. Ordinal regression was carried out on two dependent variables: wanting and needing to learn to discourage violence. Analyses found that as women's age increased, those on lower incomes were more likely than others to say they needed to learn how to discourage violence against them. This paper investigates the variables associated with the findings-transport, finances, news media, home safety, and reduced social interactions. Results highlight the importance of understanding women's fear in the context of personal and social issues, and the need to provide learning opportunities to improve safety and social engagement.     

Volatile Places,Volatile Times: Predicting Revolutionary Situations with Nations’ Governance and Fragility Indicators

In the last decade, Mexico, the second largest economy in Latin America, has seen high poverty, inequality, and increasing homicide rates, which has led to widespread fear of crime. Two important challenges to understand the elevated levels of fear of crime are the lack of agreement on how to measure it and the debate on whether it responds to actual crime or to a general feeling of vulnerability associated with poverty. Moreover there is little research in Mexico examining the complex influence of social context at the municipality level, on the relationship between person-level characteristics and fear of crime. Using Mexico’s 2015 National Survey of Victimization the goal of the study is to estimate a two-level hierarchical regression analysis combining the effects of person-level predictors and municipality level context variables to explain fear of crime in Mexico´s urban population. Our results show that some person level attributes—victimization, incivilities, trust, police effectiveness, and collective organization—are consistently associated with the three domains of fear of crime: feelings of insecurity, perceptions of risk, and avoidance behaviors. The study shows that homicide rates at the municipality level are directly associated with feelings of insecurity and avoidance behaviors. In addition, high multidimensional poverty and inequality at the municipality level amplified the rate by which incivilities affect perceptions of risk. Unexpectedly, collective efficacy at the municipality level and collective organization to solve crime at the individual level were positive and significant predictors for fear of crime in Mexico.     

A Comparison of Mental Health,Substance Use,and Sexual Risk Behaviors Between Rural and Non-Rural Transgender Persons

The aim of this study was to compare the mental health, substance use, and sexual risk behaviors of rural and non-rural transgender persons. Online banner advertisements were used to recruit 1,229 self-identified rural and non-rural transgender adults (18+ years) residing in the United States. Primary findings include significant differences in mental health between rural and non-rural transmen; relatively low levels of binge drinking across groups, although high levels of marijuana use; and high levels of unprotected sex among transwomen. The results confirm that mental and physical health services for transgender persons residing in rural areas are urgently needed.     

Trauma and Mental Health in South Africa

Prior to the first democratic elections, South Africa had experienced severe political violence. In this paper, we describe the effects of this violence on mental health, concentrating mainly on post-traumatic stress disorder (PTSD), and its symptoms, including reliving aspects of the trauma, avoiding situations which remind one of the experience, and heightened irritability. As part of a nationwide survey on health inequalities covering 4000 South African households, questions were put to 3870 respondents aged 16 to 64 years on their mental health status, feelings of powerlessness, exposure to violence and other traumatic situations, symptoms of PTSD and access to health care for these symptoms. Weighted survey results indicate that approximately five million adults (23% of the population aged 16 to 64 years) had been exposed to one or more violent events, for example, being attacked, participating in violence and witnessing one's home being burnt. Just under four-fifths (78%) of those who had experienced at least one traumatic event had one or more symptoms of PTSD. This syndrome was found to be related to feelings of powerlessness, anxiety and depression and fair or poor self-ratings of emotional well-being. The authors concluded that healing the people of South Africa involves revealing the full extent of political violence that was committed during the apartheid era, confronting the effects of this violence, and establishing both professional and community structures to deal with it on a large scale, for example, the training of lay people to give counselling.     

Moving Beyond Salmon Bias: Mexican Return Migration and Health Selection

Despite having lower levels of education and limited access to health care services, Mexican immigrants report better health outcomes than U.S.-born individuals. Research suggests that the Mexican health advantage may be partially attributable to selective return migration among less healthy migrants—often referred to as “salmon bias.” Our study takes advantage of a rare opportunity to observe the health status of Mexican-origin males as they cross the Mexican border. To assess whether unhealthy migrants are disproportionately represented among those who return, we use data from two California-based studies: the California Health Interview Survey; and the Migrante Study, a survey that samples Mexican migrants entering and leaving the United States through Tijuana. We pool these data sources to look for evidence of health-related return migration. Results provide mixed support for salmon bias. Although migrants who report health limitations and frequent stress are more likely to return, we find little evidence that chronic conditions and self-reported health are associated with higher probabilities of return. Results also provide some indication that limited health care access increases the likelihood of return among the least healthy. This study provides new theoretical considerations of return migration and further elucidates the relationship between health and migration decisions.     

Honesty and comfort levels in mothers when screened for perinatal depression and anxiety

PurposeTo evaluate the degree of honesty and level of comfort reported by women when questioned about their emotional wellbeing during the perinatal period; to investigate if honesty and comfort are associated with perinatal depression or perinatal anxiety; and to examine the reasons why women may not always respond honestly.MethodsQualitative and quantitative data from 1597 women from the cross-sectional perinatal mental health substudy (part of the Australian Longitudinal Study on Women’s Health) were analysed using a mixed methods approach.ResultsWhen questioned by their health practitioner about their emotional wellbeing in the perinatal period, 20.7% of women indicated they had not always responded honestly. Reasons for not being honest reflected four main themes: normalizing of symptoms/coping; negative perceptions (self-and others); fear of adverse repercussions; and fear of involvement of health services (trust and confidentiality). The 38.9% of women who did not feel comfortable when questioned by their health practitioner about their emotional wellbeing were four times more likely to report perinatal depression (odds ratio = 4.09; 95% confidence interval = 2.55, 6.57) and nearly twice as likely to report perinatal anxiety (odds ratio = 1.90; 95% confidence interval = 1.24, 2.94) than other women.ConclusionsWomen who are most likely to need mental health care during the perinatal period are also those least likely to be honest about their mental health. A non-judgemental, open and reassuring approach by clinicians may help to reduce the stigma and fears contributing to lack of honest responses, and improve early diagnosis and treatment of mental health problems.     

Behavioral Risk Disparities in a Random Sample of Self-Identifying Gay and Non-Gay Male University Students

This Internet-based study was designed to compare health risk behaviors of gay and non-gay university students from stratified random cross-sectional samples of undergraduate students. Mean age of the 4,167 male participants was 20.5 (±2.7) years. Of these, 206 (4.9%) self-identified as gay and 3,961 (95.1%) self-identified as heterosexual. After adjusting for selected characteristics and clustering within university, gay men had higher odds of reporting: multiple sexual partners; cigarette smoking; methamphetamine use; gamma-hydroxybutyrate (GHB) use; other illicit drug use within the past 30 days and during lifetime; and intimate partner violence (IPV). Understanding the health risk behaviors of gay and heterosexual men is crucial to identifying associated factors and intervening upon them using appropriate and tailored strategies to reduce behavioral risk disparities and improve health outcomes.     

The experiences of pregnant women during the COVID-19 pandemic in Turkey: A qualitative study

BackgroundDue to spread and impact of COVID-19 in the world and Turkey lead to fear, stress and anxiety in individuals. This trend is increasing more especially in pregnant women at risk as they are concerned about the safety of themselves and the fetus.AimIn our study, concerns, problems and attitudes of pregnant women related to diseases in the pandemic process will be determined by detailed discussions based on their individual experience, and by increasing the awareness of midwives and nurses about what pregnant women experience in this process.MethodsContent analysis is used as qualitative study pattern. Due to the social isolation rules during the coronavirus pandemic, interviews with pregnant women were planned to be held via mobile phone. The study was completed with 15 pregnant women.ResultsAs a result of the content analysis of the interviews, 3 main themes and 11 sub-themes were identified. The identified themes were as following: (1) not understanding the seriousness and fear of the unknown, (2) coronavirus pandemic and disruption of the routine prenatal care (3) disrupted routines and social lives. Each theme was necessarily discussed separately.ConclusionThe results of the study show that coronavirus pandemic has a significant potential for creating anxiety, adversity and fear, which has a negative emotional effect on pregnant people. It will be useful to provide awareness for midwives and nurses not only about the physical health of pregnant women, but also their mental health, and to cooperate with mental health experts if necessary.     

Organized Violence and Institutional Child Delivery: Micro-Level Evidence From Sub-Saharan Africa, 1989–2014

The conditions under which a mother gives birth greatly affect the health risk of both the mother and the child. This article addresses how local exposure to organized violence affects whether women give birth in a health facility. We combine geocoded data on violent events from the Uppsala Conflict Data Program with georeferenced survey data on the use of maternal health care services from the Demographic and Health Surveys. Our sample covers 569,201 births by 390,574 mothers in 31 countries in sub-Saharan Africa. We use a mother fixed-effects analysis to estimate the effect of recent organized violence events within a radius of 50 km of the home of each mother on the likelihood that her child is born in a health facility. The results indicate that geographical and temporal proximity to organized violence significantly reduces the likelihood of institutional births. Although the level of maternal health care overall is lower in rural areas, the negative effect of violence appears to be stronger in urban areas. The study further underscores the importance of household and individual resilience, indicating that the effect of organized violence on institutional child delivery is greater among poor and less-educated mothers.     

A review of research on violence in same-gender couples: a resource for clinicians

This paper reviews current research that has primarily focused on domestic violence among same-gender couples. Several key issues pertaining to the identification, assessment, and treatment of domestic violence among same-gender couples are examined and outlined to assist clinicians in effectively working with gay and lesbian clients who may be experiencing domestic violence. Resource information is included to help mental health clinicians recognize specific stressors of marginalized individuals as well as assessment and treatment recommendations are made.