Influence of Posttraumatic Growth on Mental Health and Well-being Across Respondents Severely Affected by War in Post-conflict Sri Lanka

Previous studies have shown that trauma and stressors are negatively correlated with mental health outcomes in post-conflict environments. This paper investigates if posttraumatic growth (positive psychological change due to traumatic experiences) can beneficially influence mental health and well-being in a post-conflict setting. In July 2012, a pilot survey of 150 people and a cross-sectional multistage cluster survey of 3,029 participants were undertaken in the four Sri Lankan districts most severely affected by war. The response rate was 81 % with a total of 2,460 interviewees including people who have experience living in internally displaced person (IDP) camps (n = 1,505) and people who have never lived in IDP camps (n = 955). Results show the impact of posttraumatic growth on mental health and well-being is higher among those people with experience living in IDP camps compared to people who have never lived in IDP camps. Results also show short-term displacement in IDP camps (1 year or less) is positively associated with greater well-being and mental health relative to people in post-conflict areas who have never been in IDP camps. Conversely, longer-term displacement in IDP camps (more than 1 year) is negatively associated with greater well-being and mental health relative to people in post-conflict areas who have never been in IDP camps.     

Educational Attainment and Mortality in the United States: Effects of Degrees,Years of Schooling,and Certification

Researchers have extensively documented a strong and consistent education gradient for mortality, with more highly educated individuals living longer than those with less education. This study contributes to our understanding of the education–mortality relationship by determining the effects of years of education and degree attainment on mortality, and by including non-degree certification, an important but understudied dimension of educational attainment. We use data from the mortality-linked restricted-use files of the Panel Study of Income Dynamics (PSID) sample (N = 9821) and Cox proportional hazards models to estimate mortality risk among U.S. adults. Results indicate that more advanced degrees and additional years of education are associated with reduced mortality risk in separate models, but when included simultaneously, only degrees remain influential. Among individuals who have earned a high school diploma only, additional years of schooling (beyond 12) and vocational school certification (or similar accreditation) are both independently associated with reduced risks of death. Degrees appear to be most important for increasing longevity; the findings also suggest that any educational experience can be beneficial. Future research in health and mortality should consider including educational measures beyond a single variable for educational attainment.     

Left Out? Lesbian,Gay, and Bisexual Poverty in the U.S.

This paper analyzes the risk of poverty for self-identified lesbian, gay, and bisexual (LGB) people from mid-2013 through 2016 in the National Health Interview Survey, a nationally representative survey of households that includes a sexual orientation question based on identity (n = 112,143). The study tests the role of family structure—living with a spouse or partner and having children—on the risk of poverty for LGB and heterosexual respondents. After controlling for education, demographic, and health measures in a probit model, lesbians and gay men are as likely to be poor as similar heterosexuals, but bisexual women and men are significantly more likely to be poor, regardless of relationship status. Single and childless gay men are also more likely to be poor than single heterosexual men. Being in a relationship reduces the likelihood of poverty for people of all sexual orientations, but the data show evidence of a gender composition effect: married male same-sex couples are less likely and unmarried female same-sex couples more likely to be poor than their married counterparts. Marriage reduces gay men’s poverty risk more and children increase their poverty risk less than for heterosexual men.     

Why Do Pacific People with Multiple Ethnic Affiliations Have Poorer Subjective Wellbeing? Negative Ingroup Affect Mediates the Identity Tension Effect

We argue that multi-ethnic affiliation as a member of both the Pacific and majority (European) group creates tension in psychological wellbeing for Pacific peoples of mixed ancestry. Study 1 showed that multi-ethnic Pacific/non-Pacific people were lower in Pacific Familial Wellbeing relative to mono-ethnic Pacific and multi-ethnic Pacific/Pacific people (n = 586). Study 2 replicated this effect in a New Zealand (NZ) national probability sample using a measure of self-esteem (n = 276). Study 2 also modelled the mechanism driving the identity tension effect, and showed that group differences in negative affect toward Pacific peoples fully mediated the effect of ethnic mixed or mono-ethnic group affiliation on self-esteem. This currently affects the one-third of Pacific people who identify as Pacific/non-Pacific in NZ and occurs because multi-ethnic identification promotes the endorsement of negative societal attitudes toward Pacific peoples. Our model indicates that endorsement of such attitudes produces a more negative self-evaluation and generally corrodes subjective wellbeing and family integration. Population projections indicate that this potentially at-risk Pacific/non-Pacific group may increase dramatically in subsequent generations (upwards of 3.3 % of the population by 2026). Implications for the study of Pacific wellbeing, and avenues for applied research targeting this newly-identified emerging social problem are discussed.     

The Benefits of Educational Attainment for U.S. Adult Mortality: Are they Contingent on the Broader Environment?

The growing recognition that educational attainment is one of the strongest preventive factors for adult health and longevity has fueled an interest in educational attainment as a population health strategy. However, less attention has been given to identifying social, economic, and behavioral resources that may moderate the health and longevity benefits of education. We draw on theories of resource substitution and multiplication to examine the extent to which the education–mortality association is contingent on other resources (marriage, employment, income, healthy lifestyles). We use data on adults aged 30–84 in the 1997–2006 National Health Interview Survey Linked Mortality File and estimate discrete-time event history models stratified by gender (N = 146,558; deaths = 10,399). We find that the mortality benefits of education are generally largest for adults—especially women—who have other resources such as employment and marriage, supporting the theory of resource multiplication. Nonetheless, our results also imply that other resources can potentially attenuate the mortality disadvantages (advantages) associated with low (high) levels of education. The findings suggest that efforts to improve population health and longevity by raising education levels should be augmented with strategies that assure widespread access to social, economic, and behavioral resources.     

Adaptation and Dissonance in Quality of Life: A Case Study in Mekelle,Ethiopia

This study aimed to determine predictability of life satisfaction by focusing on social support, substance abuse, socio-demographic factors as well as received health services from medical and traditional centers in the elderly with dementia. The subjects were 1,210 non-institutionalized Malaysian elderly with cognitive problems. In addition, age, ethnicity, sex differences, marital status, educational level, social support, substance abuse and receiving health services were evaluated to predict the risk of falls in samples. Social support was measured by Lubben score. Substance abuse was referred to smoking per day, addiction to alcohol consumption as well as dependency to medications. Health care supports, which were received by individuals included medical and traditional treatments. Life satisfaction was measured by asking in general ‘Are you satisfied with your current life’. The multiple logistic regression analysis was used to determine the effects of contributing variables on life satisfaction in respondents. Approximately 83 % of subjects reported that they were satisfied with their current life. The results of multiple regression analysis showed that marital status (OR = 1.98), traditional treatments (OR = 0.43), social support (OR = 2.28) and educational level (OR = 1.79) significantly affected life satisfaction in samples (p < 0.05). Furthermore, age, ethnicity, sex differences, substance abuse and medical treatments were not significant predictors of life satisfaction (p > 0.05). It was concluded that social support, being married and education increased life satisfaction in subjects but traditional treatments decreased life satisfaction.     

Lifetime risk of pregnancy-related death among Zambian women: district-level estimates from the 2010 census

The aim of this study was to examine district differentials in the lifetime risk of pregnancy-related death among females aged 15–49 in Zambia. We used data on household deaths collected in the 2010 census to estimate the lifetime risk of pregnancy-related death among females in Zambia. Using all-cause age-specific death rates, we generated female life tables for 74 districts and estimated person-years of exposure to all-cause mortality at each age. We then applied age-specific pregnancy-related mortality rates to the person-years of exposure to obtain estimates of adult lifetime risk that took account of competing causes of death. We used the ArcGIS software to analyse clustering and the spatial distribution of risk. A female aged 15 in Zambia had a 3.7 % chance of dying a pregnancy-related death before the age of 50. At district level, the lifetime risk ranged from 1.7 to 7.7 %. The Global Moran’s I was 0.452 (z-score 5.8, p value <0.01), indicating clustering of districts with similar risk levels of pregnancy-related mortality. Clustering of high-risk districts was found in Western province while clustering of low risk districts was found in Lusaka and Muchinga provinces. The level of adult lifetime risk was more positively associated with pregnancy-related mortality than with fertility. Females in Zambia have a high lifetime risk of pregnancy-related death overall but this risk varies greatly across the different districts of the country. The observed diversity is larger than when merely studying differences between provinces and is only weakly linked to differences in fertility levels. The identification of districts with varying levels of risk should enable evidence-based and focused delivery of maternal health services in districts where risk of death from maternal causes is greatest.     

Cigarette Smoking in Same-Sex and Different-Sex Unions: The Role of Socioeconomic and Psychological Factors

Cigarette smoking has long been a target of public health intervention because it substantially contributes to morbidity and mortality. Individuals in different-sex marriages have lower smoking risk (i.e., prevalence and frequency) than different-sex cohabiters. However, little is known about the smoking risk of individuals in same-sex cohabiting unions. We compare the smoking risk of individuals in different-sex marriages, same-sex cohabiting unions, and different-sex cohabiting unions using pooled cross-sectional data from the 1997–2010 National Health Interview Surveys (N = 168,514). We further examine the role of socioeconomic status (SES) and psychological distress in the relationship between union status and smoking. Estimates from multinomial logistic regression models reveal that same-sex and different-sex cohabiters experience similar smoking risk when compared to one another, and higher smoking risk when compared to the different-sex married. Results suggest that SES and psychological distress factors cannot fully explain smoking differences between the different-sex married and same-sex and different-sex cohabiting groups. Moreover, without same-sex cohabiter’s education advantage, same-sex cohabiters would experience even greater smoking risk relative to the different-sex married. Policy recommendations to reduce smoking disparities among same-sex and different-sex cohabiters are discussed.     

The Multi-dimensional Characteristics of Wellbeing: How Different Aspects of Wellbeing Interact and Do Not Interact with Each Other

Because wellbeing is a multi-varied and dynamic phenomenon, social scientists need to better understand how different aspects of people’s wellbeing are tied together and how these ties differ between individuals at one point in time and within individuals over time. The paper outlines a general model that considers the multidimensional structure of wellbeing. We utilize the potential of latent variable modelling on a unique Swedish database: the Panel Survey of Ageing and the Elderly (PSAE). An inclusive and flexible model that considers the interactions between semi-autonomous domains (material resources, health, psychosocial factors, lifestyle, etc.) is developed. Our empirical study is based on cross-sectional PSAE data and focuses on people 55 years or older (N = 5,374). The analysis takes advantage of recent developments in statistical theory in the field of latent variable modelling to bring about a more dynamic and theory confirming analysis of a multifaceted phenomenon such as wellbeing.     

Differences in Child Health Across Rural,Urban, and Slum Areas: Evidence From India

The developing world is rapidly urbanizing, but an understanding of how child health differs across urban and rural areas is lacking. We examine the association between area of residence and child health in India, focusing on composition and selection effects. Simple height-for-age averages show that rural Indian children have the poorest health and urban children have the best, with slum children in between. With wealth or observed health environment held constant, the urban height-for-age advantage disappears, and slum children fare significantly worse than their rural counterparts. Hence, differences in composition across areas mask a substantial negative association between living in slums and height-for-age. This association is more negative for girls than boys. Furthermore, a large number of girls are “missing” in slums; we argue that this implies that the negative association between living in slums and health is even stronger than our estimate. The missing girls also help explain why slum girls appear to have a substantially lower mortality than rural girls, whereas slum boys have a higher mortality risk than rural boys. We estimate that slum conditions (such as overcrowding and open sewers), which the survey does not adequately capture, are associated with 20 % to 37 % of slum children’s stunting risk.     

Age of Onset of Alcohol Consumption and Subsequent Negative Health Outcomes in Gay and Bisexual Men Who Have Sex With Men

ABSTRACT

The correlation between current alcohol use and sexual risk behaviors among men who have sex with men (MSM) is well documented, but little is known about age of drinking onset and current risks among this population. Data from a 2008 Internet survey of 8,452 MSM in the United States were used to assess factors associated with age of onset of alcohol use. In a multivariable model, drinking onset before age 15 was significantly associated with a higher number of lifetime male anal sex partners and being behaviorally bisexual in the past 12 months. Men who reported depressive symptoms in the past two weeks or who screened positive for alcohol abuse in the past 60 days were more likely to have early age of drinking onset. Findings suggest the need for targeting younger adolescents for alcohol screening, particularly sexual minority youth, to prevent risk behaviors in adulthood.     

Contextual Interventions for Controlling Alcohol Drinking

The dynamics of an alcohol drinking population are subject to environment-specific control programs. The stochastic model is developed that includes populations of light, moderate, and heavy drinkers, interacting in two contrasting risk-level drinking environments. For colleges with serious drinking problems, the times to disappearance of serious drinkers show that environment-dependent control programs have lasting efficacy when they are implemented according to the risk level of the environments and not by simply focusing on heavy drinking.     

Religious involvement and U.S. adult mortality

We use recently released, nationally representative data from the National Health Interview Survey-Multiple Cause of Death linked file to model the association of religious attendance and sociodemographic, health, and behavioral correlates with overall and cause-specific mortality. Religious attendance is associated with U.S. adult mortality in a graded fashion: People who never attend exhibit 1.87 times the risk of death in the follow-up period compared with people who attend more than once a week. This translates into a seven-year difference in life expectancy at age 20 between those who never attend and those who attend more than once a week. Health selectivity is responsible for a portion of the religious attendance effect: People who do not attend church or religious services are also more likely to be unhealthy and, consequently, to die. However, religious attendance also works through increased social ties and behavioral factors to decrease the risks of death. And although the magnitude of the association between religious attendance and mortality varies by cause of death, the direction of the association is consistent across causes.     

The Palliative Function of System Justification: Concurrent Benefits Versus Longer-Term Costs to Wellbeing

We examined the extent to which system justification buffered the negative effect of retrospective experiences of active harm from general sources in society on life satisfaction during the same assessment period, and prospectively 1 year later. Results from a nationally representative sample indicated that the retrospective assessment of active harm and quality of life were uncorrelated for people who endorsed system justifying ideology (N = 6,518). Study 2 replicated the concurrent buffering effect of system justification on subjective wellbeing and demonstrated that the effect reversed over time. For people high in system justification beliefs, societal-level harm prospectively predicted lower life satisfaction 1 year later (N = 136 undergraduates). Perceiving the system as fair and legitimate in the face of harm from others in society has opposing short and longer-term effects on wellbeing. We argue that these opposing effects occur because although system justification trumps experiences of harm and buffers life satisfaction in the short-term; the resulting experience-belief conflict engenders a state of ideological dissonance that predicts negative psychological outcomes down the track.     

Changes in Social Exclusion Indicators and Psychological Distress Among Homeless People Over a 2.5-Year Period

Although homelessness is inherently associated with social exclusion, homeless individuals are rarely included in conventional studies on social exclusion. Use of longitudinal survey data from a cohort study on homeless people in four major Dutch cities (n = 378) allowed to examine: changes in indicators of social exclusion among homeless people over a 2.5-year period after reporting to the social relief system, and associations between changes in indicators of social exclusion and changes in psychological distress. Multinomial logistic regression analysis was applied to investigate the associations between changes in indicators of social exclusion and changes in psychological distress. Improvements were found in various indicators of social exclusion, whereas financial debts showed no significant improvement. Changes in unmet care needs, health insurance, social support from family and relatedness to others were related to changes in psychological distress. This study demonstrated improvements in various indicators of social exclusion among homeless people over a period of 2.5 years, and sheds light on the concept of social exclusion in relation to homelessness.     

Make Time for Physical Activity or You May Spend More Time Sick!

This work estimates the association between various types of physical activities and physical health, mental health and health service utilization. Specifically, we consider participation in housework, manual, walking, sports/exercise and total physical activities to a moderate level. We view this as an important contribution given that governments usually recommend a total level of activity that their citizens should achieve to be healthy, rather than a particular activity per se. Our results suggest that participation in any of these activities predicts a lower probability of poor health roughly to the same level. For mental health, our estimates highlight that those who participate in (and do more of) any activity have better mental health when compared to those who do not. The associations are higher for women. The associations are also higher for manual activities and sports/exercise when compared to other activities. The analysis also reveals some lower utilization of in-patient, out-patient visits and GP services among individuals who are moderately physically active.     

Gender differences in the experience of loneliness in U.S. Chinese older adults

This study aimed to explore the gender differences in the experiences of loneliness in the U.S. Chinese older population. The data were drawn from the PINE study, a population-based study of U.S. Chinese adults aged 60 years and older. The Revised–University of California at Los Angeles Loneliness Scale (R-UCLA) was used to measure loneliness. Overall, older Chinese women (28.3%) had a higher rate of loneliness than older men (23.3%, p < .001). In particular, women were more likely to sometimes or often experience a lack of companionship than men (22.9% vs. 17.3%, p < .001). Older women living with fewer people, with lower health status, poorer quality of life, and worsening health changes over the past year were more likely than men to experience any loneliness. This study indicates that gender differences exist in the prevalence, symptoms, and correlates of loneliness. Longitudinal studies should be undertaken to understand gender differences in risk factors and outcomes of loneliness.