Caring for the carers: Ensuring the provision of quality maternity care during a global pandemic

The COVID-19 pandemic is impacting health systems worldwide. Maternity care providers must continue their core business in caring and supporting women, newborns and their families whilst also adapting to a rapidly changing health system environment. This article provides an overview of important considerations for supporting the emotional, mental and physical health needs of maternity care providers in the context of the unprecedented crisis that COVID-19 presents. Cooperation, planning ahead and adequate availability of PPE is critical. Thinking about the needs of maternity providers to prevent stress and burnout is essential. Emotional and psychological support needs to be available throughout the response. Prioritising food, rest and exercise are important. Healthcare workers are every country’s most valuable resource and maternity providers need to be supported to provide the best quality care they can to women and newborns in exceptionally trying circumstances.     

Light Rail Transit in Hamilton: Health, Environmental and Economic Impact Analysis

Hamilton??s historical roots as an electric, industrial and transportation-oriented city provide it with a high potential for rapid transit, especially when combined with its growing population, developing economy, redeveloping downtown core and its plans for sustainable growth. This paper explores the health, environmental, social and economic impacts of light rail transit, a component of the City of Hamilton??s rapid transit initiative. It performs a comparative analysis with other major North American cities that have successfully implemented this form of mass transit. The analysis concentrates on three main areas: urban development and land values, health and environmental impact and socio-economic factors. The results of the research on light rail transit (LRT) and its possible benefits indicate overwhelming support for the economic, health, environmental and social benefits of LRT, especially when compared to other forms of transit, including rapid bus and local transit schemes. According to the results, LRT in a medium sized, growing city such as Hamilton should be considered a viable and desirable transit option; a catalyst for transit oriented, high density, mixed use development; an economically sound investment opportunity, providing a return on investment to property owners, businesses and the municipality; and a catalyst for social change, improving the health, environment and connectivity of the community.     

Place and Child Health: The Interaction of Population Density and Sanitation in Developing Countries

A long literature in demography has debated the importance of place for health, especially children’s health. In this study, we assess whether the importance of dense settlement for infant mortality and child height is moderated by exposure to local sanitation behavior. Is open defecation (i.e., without a toilet or latrine) worse for infant mortality and child height where population density is greater? Is poor sanitation is an important mechanism by which population density influences child health outcomes? We present two complementary analyses using newly assembled data sets, which represent two points in a trade-off between external and internal validity. First, we concentrate on external validity by studying infant mortality and child height in a large, international child-level data set of 172 Demographic and Health Surveys, matched to census population density data for 1,800 subnational regions. Second, we concentrate on internal validity by studying child height in Bangladeshi districts, using a new data set constructed with GIS techniques that allows us to control for fixed effects at a high level of geographic resolution. We find a statistically robust and quantitatively comparable interaction between sanitation and population density with both approaches: open defecation externalities are more important for child health outcomes where people live more closely together.     

Heterosexuals' use of "fag" and "queer" to deride one another: a contributor to heterosexism and stigma

This paper is on heterosexuals' use of words such as "fag" and "queer" to refer to one another in an insulting manner. This behavior perpetuates heterosexism and the stigmatization of gays. Two hundred and fifty-seven university students (73% Euro-American) served as participants. Males exhibited more anti-gay prejudice and anti-gay behavior than females. Heterosexual males frequently used words such as "fag" and "queer" to put one another down. Anti-homosexual prejudice was predictive of anti-gay behavior. However, approximately half of those who engaged in the behavior were not strongly anti-homosexual. For these individuals, the behavior may win approval from their social group. Awareness campaigns and peer reminders that the derisive use of "fag" and "queer" harms homosexuals may be effective in changing this group. It is more difficult to reduce this behavior in individuals with strong anti-homosexual attitudes. The role of individuals and educational and work organizations in bringing about change is discussed.     

广东流动人口性行为及其影响因素

本研究从不同层面、不同角度调查流动人口性与生殖健康的知识、态度和行为的现状．分析影响该人群性和生殖健康水平以及他们在获取生殖健康服务方面所遇到的障碍。研究提示流动人口婚前性行为相当活跃,婚外性行为相对自由,性满意度较高,性行为的影响因素多,存在一定程度的强迫性行和性压抑。     

Factors associated with advance care planning among older women in Southwest Florida

As the nation's population continues to age, many older women will face care needs that can be anticipated in advance. However, little is known about the advance care plans of older women and the characteristics of those who plan. This study utilized a stratified random sampling design to survey older women (n = 124) in the state of Florida regarding their attitudes toward future care and planning behavior in social-environmental, health, and financial domains. Regression analyses were conducted to determine factors most predictive of attitudes toward future care and planning behavior by domain. Results suggest that advanced age predicts greater planning behavior, while living alone is associated with less advance care planning behavior. Other factors associated with less planning by domains of care needs include income status, chronic health conditions, educational attainment, and religious status. Nonaccepting attitudes toward planning were associated with a decreased likelihood to have advance care planning documents.     

Health, Quality of Life and Population Density: A Preliminary Study on “Contextualized” Quality of Life

Quality of life concerns individual (physical and psychological health), interpersonal (social relationships) and contextual (environment) aspects, which are both subjective and objective. In considering contextual characteristics, empirical findings have demonstrated that people’s relation to their living environment is a key issue for their well-being. However, until now literature has paid little attention to population density as an element affecting quality of life. The present study aimed at assessing the predictive role of population density on the several domains of quality of life, along with socio-demographic characteristics and physical diseases. Participants were 344 subjects living in the Northern Italy area. A questionnaire with WHO Quality of Life Brief Scale, a checklist of chronic diseases and a socio-demographic form was used to collect data. Results showed that population density influences psychological, relational and environmental quality of life. Theoretical and policy implications are discussed.     

A theoretical approach to bathhouse environments

HIV prevention guidelines have aimed primarily at the individual level, although recently the field of public health has begun to focus more on structural level interventions. This paper explores an application of Rudolf Moos' person-environment theory as one model that helps to provide an understanding of the dynamic relationship between bathhouse patrons and the environment within which they engage in sexual activities. Understanding how different dimensions of the environment affect behavior could be instrumental in revealing not just that a bathhouse intervention works, but how it works. Knowing more about how an intervention works would facilitate its application in other settings.     

Factors Associated with Advance Care Planning Among Older Women in Southwest Florida

ABSTRACT

As the nation's population continues to age, many older women will face care needs that can be anticipated in advance. However, little is known about the advance care plans of older women and the characteristics of those who plan. This study utilized a stratified random sampling design to survey older women (n = 124) in the state of Florida regarding their attitudes toward future care and planning behavior in social-environmental, health, and financial domains. Regression analyses were conducted to determine factors most predictive of attitudes toward future care and planning behavior by domain. Results suggest that advanced age predicts greater planning behavior, while living alone is associated with less advance care planning behavior. Other factors associated with less planning by domains of care needs include income status, chronic health conditions, educational attainment, and religious status. Nonaccepting attitudes toward planning were associated with a decreased likelihood to have advance care planning documents.     

Sense of Place and Health in Hamilton, Ontario: A Case Study

The concept of sense of place has received considerable attention by social scientists in recent years. Research has indicated that a person's sense of place is influenced by a number of factors including the built environment, socio-economic status (SES), well-being and health. Relatively few studies have examined sense of place at the neighbourhood level, particularly among communities exhibiting different levels of SES. This article investigates sense of place among three neighbourhood groups in Hamilton, Ontario representing areas of low, mixed and high SES. It analyses data from a 16-point sense of place scale derived from the Hamilton Household Quality of Life Survey carried out in 2010-2011 among 1,002 respondents. The paper found that sense of place was highest among residents of the high SES neighbourhood group as well as among home owners, people residing in single-detached homes, retired residents and those living in their neighbourhood for more than 10?years. From a health perspective, the paper found that a strong association existed between sense of place and self-perceived mental health across the three neighbourhood groups. Furthermore, by way of regression modeling, the paper examined the factors influencing health-related sense of place. Among the sample of respondents, a strong connection was found between housing, particularly home ownership, and high levels of health-related sense of place.     

Young Children’s Developmental Ecologies and Kindergarten Readiness

Children enter the crucial transition to school with sociodemographic disparities firmly established. Domain-specific research (e.g., on poverty and family structure) has shed light on these disparities, but we need broader operationalizations of children’s environments to explain them. Building on existing theory, this study articulates the concept of developmental ecology—those interrelated features of a child’s proximal environment that shape development and health. Developmental ecology links structural and demographic factors with interactional, psychological, and genetic factors. Using the Early Childhood Longitudinal Study, Birth Cohort (ECLS-B), this study conducts latent class analyses to identify how 41 factors from three domains—namely, household resources, health risks, and ecological changes—cluster within children as four overarching developmental ecologies. Because it documents how numerous factors co-occur within children, this method allows an approximation of their lived environments. Findings illuminate powerful relationships between race/ethnicity, parental age, socioeconomic background, and nativity and a child’s developmental ecology, as well as associations between developmental ecology and kindergarten cognition, behavior, and health. Developmental ecology represents a major pathway through which demographic characteristics shape school readiness. Because specific factors have different implications depending on the ecologies in which they are embedded, findings support the usefulness of a broad ecological approach.     

中国老年人临终前 生活自理能力的衰退轨迹

本文以老年人为研究对象,以基本生活自理能力(ADL)为测量指标,使用"中国老年健康长寿影响因素跟踪调查"(CLHLS)数据,分析在1998-2014年期间去世的老年人群临终前的生活自理能力的变化轨迹。作者利用组基轨迹模型对男性和女性老年人的生活自理能力变化过程分别进行拟合,发现老年人在临终前的生活自理能力存在显著差异并归纳出三种变化轨迹:生活自理能力完好型、快速发展型和缓慢下降型。研究发现生命历程早期阶段的经历、所处的社会经济状况、年龄效应和队列效应都会对生活自理能力的衰退轨迹产生显著影响。增龄带来的生活自理能力下降使老年人临终前的失能风险及其持续时间增加,而较晚的出生队列在临终前出现长时间失能的可能性较低。在三类轨迹中,自理能力缓慢下降型轨迹受到各种因素的影响最为显著,而该类型的出现概率是影响失能老年人照料负担的主要因素,由此也证明了除去年龄效应与性别差异之外,由社会经济状况、健康行为习惯、生活环境等因素合力产生的健康保护作用将会在失能老年人照料负担增长过程中发挥主导作用。研究还发现老年女性在临终前会面临更高的失能风险和更长时间的失能存活期,其生活自理能力变化过程受到更多因素的影响。     

生育理性和生育决策与我国低生育水平稳定机制的转变

自改革开放以来 ,我国人口生育率水平出现了迅速的转变 ,特别是 1 992年我国确立了市场经济为目标的经济改革以来 ,生育率水平更是进一步降低到更替水平以下。如果说 ,生育率的迅速转变是在国家计划生育政策干预下启动的 ,那么 ,在 1 990年代生育率的下降应该主要是社会和经济发展的结果。以市场经济为导向的经济改革和经济的迅速发展 ,已经为稳定我国城市地区人口低生育率水平提供了必要的经济条件 ,同时 ,制度、技术和文化等因素的变革已经为我国个人生育决策理性化创造了条件 ,低生育水平的稳定机制已经开始从政策控制为主转向群众自我控制为主的转变     

Long‐Term Trends in Life Expectancy and Active Life Expectancy in the United States

Changes in life expectancy and in active life expectancy may have effects on the fiscal integrity of both the Social Security and Medicare programs. Analysis of the fiscal stability of these programs shows that the most serious problem may be the growth of Medicare expenditures projected to surpass, in about 2024, Social Security costs. This is aggravated by the associated rapid growth of the Medicaid program. To understand how the growth of Medicare, Medicaid, and Social Security might be correlated we present estimates of changes in life expectancy and active life expectancy from 1935 to 1999 and then project those values to 2080. How the correlation of life expectancy and active life expectancy changes over time, and by age, may provide insights into how increased health care expenditures, if effective in changing health in the elderly, could modify the age structure of the labor force and the availability of human capital.     

Aging behind bars:health care for older female inmates

As the numbers of women in prison have increased, so have the number of older women behind bars. These older women present unique problems for institutions trying to meet their health care needs. We report findings from our national pilot study of federal and state prisons for women. Prisons report basic services for physical and mental health care, and most report having hospice services. However, those that house larger percentages or that expect to house larger percentages of older prisoners do not significantly differ in their approaches to assessing and providing health care from their counterparts. By failing to anticipate the increase in older women, prisons may be failing to provide for many of the health needs of this vulnerable population.     

Demographic correlates of group achievement: contrasting patterns of Mexican-Americans and Japanese-Americans

Patterns of family size, family stability, and timing of family formation characteristic of Mexican-Americans are contrasted with those of Japanese-Americans, and consequences of their demographic differences for group achievement are explored. Mexican-Americans are found to have a demographic system marked by young ages at marriage, young ages at beginning of childbearing, high rates of reproduction, and high rates of marital instability. Japanese-Americans display just the opposite pattern of behavior on each of these variables. Using existing research on determinants of individual achievement, reasons are then suggested why the demographic environment encountered by Japanese-American youth is more conducive to educational and economic achievement than is that encountered by Mexican-American youth.     

Preliminary evidence regarding the hypothesis that the sex ratio at sexual maturity may affect longevity in men

In human populations, variation in mate availability has been linked to various biological and social outcomes, but the possible effect of mate availability on health or survival has not been studied. Unbalanced sex ratios are a concern in many parts of the world, and their implications for the health and survival of the constituent individuals warrant careful investigation. We indexed mate availability with contextual sex ratios and investigated the hypothesis that the sex ratio at sexual maturity might be associated with long-term survival for men. Using two unique data sets of 7,683,462 and 4,183 men who were followed for more than 50 years, we found that men who reached their sexual maturity in an environment with higher sex ratios (i. e., higher proportions ofreproductively ready men) appeared to suffer higher long-term mortality risks than those in an environment with lower sex ratios. Mate availability at sexual maturity may be linked via several biological and social mechanisms to long-term survival in men.     

The sanitation environment in urban slums: implications for child health

I examine the effect of improved sanitation on child health in urban Bangladesh to assess the relative importance of household versus neighborhood characteristics and of adult latrine usage versus safe disposal of children’s feces. Using fixed-effects regression, I calculate the change in weight-for-height in 153 children as a function of changes in latrine usage in the surrounding community. The use of longitudinal data allows children to act as their own controls, a stumbling point of many other sanitation evaluation studies using cross-sectional or case–control methods. Results provide strong evidence that children’s toileting matters more than adult toileting behavior in creating a safe, hygienic environment and reducing diarrheal disease. I conclude that investments in sanitation improvements offer important externalities, and that sanitation programs must encourage the safe disposal of children’s feces in order to produce maximum health gains.     

Parents' supportive reactions to sexual orientation disclosure associated with better health: results from a population-based survey of LGB adults in Massachusetts

This study investigated associations between coming out to parents, experiences of parental support, and self-reported health behaviors and conditions among a population-based sample of LGB individuals using data collected via the 2002 Massachusetts Behavioral Risk Factor Surveillance System (BRFSS; N = 177). We explored the following two hypotheses: 1) Lesbian, gay, and bisexual (LGB) individuals who had never disclosed their sexual orientation to a parent would report higher levels of risk behaviors and poorer health conditions than those who had come out; and 2) among LGB respondents who had come out to their parents, the individuals whose parents had reacted unsupportively would report higher levels of risk behaviors and poorer health conditions than those who had come out to parents who were supportive. Approximately two thirds of gay and bisexual (GB) males and lesbian and bisexual (LB) females reported receiving adequate social and emotional support from the parent to whom they first disclosed their sexual orientation. Among LB females, no disclosure of sexual orientation to a parent was associated with significantly elevated levels of past-month illicit drug use (AOR 12.16, 95% CI 2.87-51.54), fair or poor self-reported health status (AOR 5.71, 95% CI 1.45-22.51), and >15 days of depression in the past month (AOR 5.95, 95% CI 1.78-19.90), controlling for potential confounders. However, nondisclosure to a parent by GB males was not associated with greater odds of any of the health indicators assessed. Among GB males, those with unsupportive parents were significantly more likely to report current binge drinking (AOR 6.94, 95% CI 1.70-28.35) and >15 days depression in the past month (AOR 6.08, 95% CI 1.15-32.15), and among LB females, those with unsupportive parents were significantly more likely to report lifetime illicit drug use (AOR 11.43, 95% CI 2.50-52.30), and >15 days depression in the past month (AOR 5.51, 95% CI 1.36-22.36). We conclude that coming out may be associated with better health for LB women, and that parents who react nonsupportively when their children disclose LGB sexual orientation may contribute to children's increased odds of depression and hazardous substance use.     

Perceiving Mortality Decline

In the demographic literature on developing countries, studies of mortality perceptions are conspicuous by their absence. Perhaps it has been assumed that when mortality declines, the decline will be quickly recognized by individuals and will then influence their demographic decisions. The possibility of substantial lags and biases in risk perception, which cause individual perceptions to diverge from the changing empirical realities, has not been much considered. Yet studies in cognitive and social psychology indicate that individual mortality perceptions are likely to be diffuse and may well be biased upward in relation to the declining empirical risks. If individuals are poorly equipped to recognize mortality decline, so too may be social groups—social learning will not necessarily correct individual misapprehensions. This note discusses the perceptual limitations that may delay recognition of mortality decline and examines the implications for demographic behavior in three areas: modern health care, fertility control, and children's schooling.