Does perceived discrimination affect health? Longitudinal relationships between work discrimination and women's physical and emotional health

This study uses longitudinal data to examine the causal relationships between perceived work discrimination and women's physical and emotional health. Using data on 1,778 employed women in the National Longitudinal Survey of Mature Women, we investigate the structural and individual characteristics that predict later perceptions of discrimination and the effects of those perceptions on subsequent health. We find that perceptions of discrimination are influenced by job attitudes, prior experiences of discrimination, and work contexts, but prior health is not related to later perceptions. However, perceptions of discrimination do impact subsequent health, and these effects remain significant after controlling for prior emotional health, physical health limitations, discrimination, and job characteristics. Overall, the results provide even stronger support for the health impact of workplace discrimination and suggest a need for further longitudinal analyses of causes and consequences of perceived discrimination.     

What encourages community health workers to use mobile technologies for health interventions? Emerging lessons from rural Rwanda

This article explores the determinants of using mobile phone technologies for public health (mHealth) through a quantitative study with community health workers (CHWs) in rural Rwanda. A total of 72 CHWs from two districts in Rwanda who were using the mHealth tool, RapidSMS, were surveyed in June 2014. Using a socio‐technical approach, user, programme and technical characteristics were tested and deemed influential in determining use. Technical characteristics (reminders and alerts) were by far the strongest predicting factors of use. The user characteristic, age, had no influence on utilization, while supports though training and supervision (programme characteristics) revealed mixed findings. These findings illustrate the uniqueness of each context and reiterate the need to consider social and technical factors when implementing mHealth projects.     

How do health shocks influence retirement decisions?

The financial viability of the nation’s Medicare and Social Security programs has come into question as older adult workers, in particular members of the baby-boomer generation, begin to voluntarily retire. Obviously, any deterioration in the health of older adults will inevitably increase pressure on the Medicare system. However, if older adults respond to changes in their health by reducing their labor supply, than this will also increase demand for the Social Security system. Using data on married and employed couples from the Health and Retirement Study (HRS), this paper determines how the labor supply of each member of a married couple is influenced by changes in the health, assets and medical expenditures of the other member of the couple. Therefore, adding to the extant literature as we determine how the labor supply of an individual responds to health shocks visited on their spouse. We find that the labor supply of both males and females is influenced by their own health shocks and health shocks suffered by their spouses.

‘Widening cross-disciplinary research for mental health’: what is missing from the Research Councils UK mental health agenda?

This current issues article is a brief critical examination of the recent Research Councils UK agenda and call for cross-disciplinary research in mental health. Our argument is based on the fact that patient and public involvement (PPI) is the only involvement and influencing strategy for service users and survivors in the agenda. Service user and survivor research as a discipline in itself remains unacknowledged. We conclude that service user and survivor research is distinct and is different to PPI, and should be recognised in any mental health research agenda.     

Does income inequality harm health? New cross-national evidence

The provocative hypothesis that income inequality harms population health has sparked a large body of research, some of which has reported strong associations between income inequality and population health. Cross-national evidence is frequently cited in support of this important hypothesis, but the hypothesis remains controversial, and the cross-national work has been criticized for several methodological shortcomings. This study replicates previous work using a larger sample (692 observations from 115 countries over the 1947-1996 period), a wider range of statistical controls, and fixed-effects models that address heterogeneity bias. The relationship between health and inequality shrinks when controls are included. In fixed-effects models that capture unmeasured heterogeneity, the association between income inequality and health disappears. The null findings hold for two measures of income inequality: the Gini coefficient and the share of income received by the poorest quintile of the population. Analysis of a sample of wealthy countries also fails to support the hypothesis.     

Endangering one’s health to improve performance?

Background: Companies are increasingly applying both goal- and performance-oriented leadership practices. For employees, such indirect control practices make higher self-regulatory demands: They become responsible for their work outcomes and have to bear the consequences of failure just like the self-employed. The current study focuses on the concept of “self-endangering work behaviors” as representing a possible negative effect of indirect control and a possible mediator between work demands and negative outcomes. Method: An online survey was conducted with 607 employees, who reported to work in an indirect control setting. It assessed extension of working hours, intensification of working hours, sickness presenteeism, and faking as possible self-endangering work behaviors together with exhaustion as a subjective well-being measure. The lavaan package was used to test the mediation hypothesis with a structural equation model. Results: Results supported the assumption that self-endangering work behaviors might partly explain the association between work demands and exhaustion. A mediation effect was found for extension of working hours, intensification of working hours, and for faking. However, sickness presenteeism delivered no statistically significant mediation effect in the association between work demands and exhaustion. Discussion: As a mechanism for coping with high work demands, the new concept of self-endangering work behaviors offers one possible explanation for the negative association between high work demands and both subjective well-being and health. The concept needs to be addressed in occupational health prevention initiatives. Such interventions should balance the negative and positive effects of indirect control and take self-endangering work behavior into account.     

Mental health program evaluation: Where you start?

Seduced by the elegance, sophistication and jargon characteristic of new developments in applied research, practicing evaluators are in danger of becoming distracted from achievement of their evaluative goal: that of providing timely, reliable and useful data to program management to facilitate rational data-based decision-making. To avoid such seduction, the author advocates adaptation of simple, inexpensive and efficient evaluative methods tailored to organizational needs and presentation of findings in language readily understood by constituent groups. Likewise, insistance by evaluators upon maintenance of a strict role boundary — that is, limiting role functioning exclusively to those tasks considered evaluation — may be dysfunctional. Rather than detract from accomplishment of his goals, the author maintains that such participation allows development of skills, insights and staff relationships which enhance the evaluator's effective functioning within the organizational context and contribute to organizational acceptance and use of his evaluative results.     

Compounded or confused? Bioidentical hormones and menopausal health

The aim of this article is to focus on compounded bioidentical hormone (BH) formulations for menopausal symptoms and to discuss the impact of these on women's choice of treatment. The practice of compounding BHs for individualized treatment of women with menopausal symptoms has developed in the USA. In spite of claims of superiority, there is no evidence to suggest that these formulations are any more efficacious or safe than conventional hormone replacement therapy (HRT). In fact, there are some concerns about dosing inconsistencies and usefulness of saliva testing that is carried out as part of this type of treatment. While there should be no serious safety issues for women, there is a mismatch between the reality of compounded BH formulations and women's perception of them.     

Private health insurance exchanges and defined contribution health plans: is it déjà vu all over again?

This issue brief examines issues related to private health insurance exchanges, possible structures of an exchange, funding, as well as the pros, cons, and uncertainties to employers of adopting them. A summary of recent surveys on employer attitudes are examined, as are some changes that employers have made to other benefits that might serve as historical precedents for a move to some type of defined contribution health benefits approach.     

Social focus on health and children’s well-being

This special section on children’s health and well-being is an outgrowth of the 2010 International Sociological Association’s (ISA) World Congress in Gothenburg, Sweden. Within the Congress, the Research Committee 53, Sociology of Childhood, organized a panel focused on the health and well-being of children. Together, this collection makes two distinct contributions: first in terms of considering children’s health disparities as an area of concern within sociology, and second by considering children’s health as a factor that shapes other areas of children’s well-being. In addition, these papers offer novel empirical research on children’s health and varied methodological and theoretical orientations. Each paper also makes contributions to social policy, first in the area of infant health affecting later educational outcomes, second in the area of family structure and children’s health, and additionally in understanding type 2 diabetes for children at the individual and structural levels. Finally, these studies highlight the interplay—between the individuals’ health on the one hand and structure and culture on the other—as children’s life chances are shaped.     

Work and health in Gnosjö: a longitudinal study

This study includes women and men born between 1934 and 1953 in the municipality of Gnosj? in the south of Sweden and covers the period 1998 to 2001. Compared with the country, a large proportion of the population of the municipality of Gnosj? works in the manufacturing industry. The aim was to examine associations between physical and psychological stress factors in and outside work, sickness absence and cardiovascular and musculoskeletal diseases, from a gender perspective. Information about working conditions and other aspect of life was collected by a questionnaire in 1998, and register data about sickness absence, cardiovascular diseases and musculoskeletal diseases 1999-2001. The impact on sickness absence consisted mainly of demand and control aspects of the psychosocial working conditions, but also temporary employment and of low sense of coherence. In relation to musculoskeletal health, demand and control was important among women, but not among men. Very few physical factors in the work environment were related to musculoskeletal diseases. Low sense of coherence had an impact also on musculoskeletal diseases. Cardiovascular diseases among women were influenced by demand and control and by life style related factors. We hope that the knowledge gained from our study makes it possible to develop better tools for both the preventive work in Gnosj? and for the rehabilitation of the people already ill. Because of our holistic approach, both public health aspects and working life aspects are covered. The municipality of Gnosj? is small, and therefore foreseeable in a way that many municipalities are not. Still, we do believe that our finding, in this longitudinal study, can be of value also in the public efforts and the efforts to develop adequate and successful rehabilitation approaches.     

The health care Titanic: women and children first?

The plight of people who lack access to health care has captured national attention and led to a number of proposals to remedy the problem. The authors look at three types of proposals being advanced--"pro-competition" plans, "pay-or-play" plans, and a national health care system--and find that they fail to address adequately the pressing needs of two groups of the poor: women of childbearing age and elderly women.     

Role sequencing: does order matter for mental health?

Role sequencing refers to the ordering of social roles. According to the normative order hypothesis, adults who follow a certain sequencing of their social roles will be better adjusted than their peers who follow other life course patterns. The normative order is defined as first entering the paid labor force, getting married, and later having children. This study tests this hypothesis by analyzing retrospective life history data from three subsamples of adults who completed the 1987--1988 National Survey of Families and Households: (1) married, working parents; (2) divorced, working parents; and (3) married, unemployed parents. The findings indicate significant race/ethnic (black/white), gender, and cohort differences in the type of role sequencing patterns that are conducive to positive mental health. For example, African Americans who work first, then have children, and later get married report better mental health than their peers who followed the normative order White men and women seem to benefit from following the normative course of role transitions. Among women, however, the psychological benefits of following typical life course patterns are especially evident among those born during the baby boom.