Minority Stress and Binge Eating Among Lesbian and Bisexual Women

Previous research demonstrates that lesbian and bisexual (LB) women report more binge eating behaviors compared to heterosexual women although the explanations for this disparity are not well understood. LB women also experience distal (e.g., discrimination) and proximal (e.g., expectations of rejection) minority stressors that are related to negative mental and physical health outcomes. The present study investigated the association between minority stressors and binge eating behaviors in LB women. A sample of 164 LB women completed an online survey that included measures of distal and proximal sexual minority stressors, emotional-focused coping, social isolation, negative affect, and binge eating. The resultant model partially supported both the psychological mediation framework and the affect regulation model. The principal finding was that among LB women, proximal stressors were associated with social isolation and emotion-focused coping, which in turn were associated with negative affect and ultimately binge eating. Overall, the study provides evidence that minority stress is associated with binge eating and may partially explain the disparity in binge eating between LB and heterosexual women.     

Stressors,Coping Resources,Functioning, and Role Limitations Among Older Korean Immigrants: Gender Differences

This study explored the differential impacts of stressors and coping resources on the functioning and roles of 246 older Korean immigrant men and women. Older Korean immigrant women were significantly more likely than men to have acculturation and socioeconomic stressors, physical/social functioning problems, and role limitations. English-language barriers and lack of transportation were significantly related to lower functioning and higher role limitations of older Korean women compared to those of older men. Providing social and health care services with bilingual and transportation services to older Korean immigrant women is recommended to increase their physical/social functioning and role performance.     

Resilience to Discrimination and Rejection Among Young Sexual Minority Males and Transgender Females: A Qualitative Study on Coping With Minority Stress

Sexual minority and transgender status is associated with mental health disparities, which have been empirically and theoretically linked to stressors related to social stigma. Despite exposure to these unique stressors, many sexual minority and transgender individuals will not experience mental health disorders in their lifetime. Little is known about the specific processes that sexual minority and transgender youth use to maintain their wellbeing in the presence of discrimination and rejection. Semistructured interviews were conducted with 10 sexual minority males and transgender females aged 18–22 years, who currently met criteria for an operationalized definition of resilience to depression and anxiety. Data were analyzed qualitatively, yielding information related to a wide variety of problem-solving, support-seeking, and accommodative coping strategies employed by youth in the face of social stigma. Results are discussed in light of their clinical implications.     

Implications of socio-economic differentials in mortality for the health system

The premise of this discussion is that a systematic and continuous monitoring system is required to assemble data on the social indicator "socio-economic differences in mortality." Attention is directed to 5 particular types of data: secular trends; class differentials and age; linearity versus dichotomy; cross-cutting variables; and downward mobility and biological selection. The following 2 basic questions are examined and answered with a qualified "yes:" 1) does the health care system have any relevance to mortality differentials; and 2) can a health care system have any degree of meaninful autonomy from the overall social system. The policy implications of this analysis are reviewed in terms of the value content of medical education, the organization of the health care system, the emphasis on health, and the focus on the community. The concepts of control and power are analyzed as the key to socioeconomic differentials. Emphasis on differential exposures to "stressors" is rejected for what is termed "a sense of coherence" -- a global orientation which emerges, or fails to emerge among the lower classes, against the background of a high level of generalized resistance resources. Essentially the problem is that the constricted, emergency, powerless, and unpredictable character of lower social class existence prevents individuals of lower class and groups from being able to cope with stressors. Ways that the health care system can strengthen the sense of coherence of the lower classes include the following: a formal monitoring system in each society; caution in assuming that technological advances, environmental control, and health education are egalitarian in their consequences; and the need to identify high-risk groups within the lower classes.     

How colonisation determines social justice and Indigenous health—a review of the literature

Disparities in health status persist for Indigenous people in Australia. In the bid to reduce the disparity gap, the concept of achieving social justice is central to advancing the services and systems that can challenge inequitable circumstances within a nation. Colonisation is well known as the underlying factor influencing the social injustices that result in inequitable health for Indigenous people. A literature review was conducted identifying how the colonial impact on social justice is described in the relationships with the health of Indigenous Australians. A comprehensive search strategy was developed, including four broad search terms of ‘Indigenous people’ and ‘health status’ and ‘colonisation’ or ‘social justice’, and applied within five databases. Publications were limited to Australia, dated from 1 January 2000 to 31 December 2014. The literature acknowledging the effect that colonisation has on Indigenous Australians includes evidence from oral and political histories, and social determinants frameworks. There was a general consensus that the impact of colonisation on the health of Indigenous people is highly complex and that the legacies are experienced intra-generationally and inter-generationally. There is paucity in the evidence that examines the associations of colonisation and its impact on social injustice. Because social justice is considered central to equitable practices across all sectors in society (health, education, legal etc.), questions are raised about the magnitude of the effect that colonisation has on health disparities and importantly how the desideratum to tackle disparities that have stemmed from colonisation are adequately addressed.     

Work–Family Conflict,Job Insecurity,and Health Outcomes Among US Workers

Previous scholarship has highlighted how work–family conflict (work-to-family conflict and family-to-work conflict) and job insecurity interfere with health outcomes. Little work, however, considers how these stressors jointly influence health among workers. Informed by the stress process model, the current study examines whether job insecurity moderates the relationships between work-to-family conflict and family-to-work conflict and two health outcomes: self-reported physical health and poor mental health. The analyses also consider whether a greater moderating role is played by work-to-family conflict or family-to-work conflict. Using data from the 2008 National Study of the Changing Workforce, we also examine if patterns diverge by gender. Our results show that work-to-family conflict and family-to-work conflict have direct effects on poor mental and physical health. Additionally, we find that the negative effect of work-to-family conflict on poor mental and physical health is stronger for those with job insecurity, while no such relationship was found for family-to-work conflict. We found no evidence of significant gender differences in how these relationships operate. Overall, we contribute to the literature by testing the combined effects of both forms of work–family conflict and job insecurity on poor mental and physical health. We also deepen the understanding of the stress process model by highlighting the salience of the anticipatory stressor of job insecurity.     

Gender differences in the link between childhood socioeconomic conditions and heart attack risk in adulthood

A growing body of evidence shows that childhood socioeconomic status (SES) is predictive of disease risk in later life, with those from the most disadvantaged backgrounds more likely to experience poor adult-health outcomes. Most of these studies, however are based on middle-aged male populations and pay insufficient attention to the pathways between childhood risks and specific adult disorders. This article examines gender differences in the link between childhood SES and heart attack risk trajectories and the mechanisms by which early environments affect future disease risk. By using methods that model both latent and path-specific influences, we identify heterogeneity in early life conditions and human, social, and health capital in adulthood that contribute to diverse heart attack risk trajectories between and among men and women as they age into their 60s and 70s. We find that key risk factors for heart attack operate differently for men and women. For men, childhood SES does not differentiate those at low, increasing, and high risk for heart attack. In contrast, women who grew up without a father and/or under adverse economic conditions are the most likely to experience elevated risk for heart attack, even after we adjust for the unequal distribution of working and living conditions, social relationships, access to health care, and adult lifestyle behaviors that influence health outcomes.     

Why do women continue to smoke in pregnancy?

Smoking during pregnancy not only impacts on the woman's health but that of her unborn child. Women most likely to continue smoking throughout pregnancy are generally of lower age, socio-economic status, level of education and occupational status. Women who continue to smoke during pregnancy often feel criticized by society. They feel guilt and personal conflict at not quitting. Lack of long-term positive outcomes from anti-smoking campaigns may result form ignorance surrounding socio-economically disadvantaged women's life circumstances. Current interventions often ignore the emotional and psychological stressors associated with pregnancy; they do not address the altered physiological processes that occur during pregnancy. A review of the literature pertaining to women who smoke throughout pregnancy is presented. Women want an individualised approach to smoking cessation advice, with health care workers having knowledge of the woman's social situation and viewpoints. This paper reveals that the woman's perspective has largely been ignored. Indeed health care professionals have attempted to manipulate women to stop smoking rather than engage in mutually respectful dialogue.     

‘It requires something drastic’: Interviews with health care leaders about organisational responses to social disadvantage

ProblemPersisting disparities in maternal and child health outcomes in high income countries require new insights for health service response.BackgroundSignificant social hardship, including factors related to migration, are associated with perinatal morbidity and mortality. The universality of maternity and child health care offers opportunities to reduce health disparities. Process evaluation of health service initiatives to address refugee health inequalities in Melbourne, Australia, is the setting for the study.AimTo explore the views of health service leaders about health system and service capacity to tailor care to address social adversity and reduce disparities in maternal and child health outcomes.MethodsIn-depth interviews with leaders of maternity and maternal and child health services with questions guided by a diagram to promote discussion. Thematic analysis of transcribed interviews.FindingsHealth care leaders recognised the level of social complexity and diversity of their clientele. The analysis revealed three key themes: grappling with the complexity of social disadvantage; ‘clinical risk’ versus ‘social risk’; and taking steps for system change.DiscussionPriority given to clinical requirements and routine practices together with the rising demand for services is limiting service response to families experiencing social hardship and hampering individualised care. System change was considered possible only if health service decision makers engaged with consumer and community perspectives and that of front-line staff.ConclusionAchieving equity in maternal and child health outcomes requires engagement of all key stakeholders (communities, clinicians, managers) to facilitate effective system re-design.     

Effects of Social Networks on Health from a Stress Theoretical Perspective

This paper focuses on the relevance of quantitative and qualitative aspects of social networks in a health context. The study combined a stress theoretical perspective with theories of social support and social capital in order to investigate the mechanisms behind the association of social network size and self-rated health. The main research question in the study is whether social integration affects health by changing stressor appraisal (perceived stressor intensity or anticipated stressor burden). The study used a survey of an Austrian student sample (n = 246) to measure two models of hypothetical exposure to a potentially stressful event. The findings indicate that individuals with larger trust and support networks consider potential stressors to be less threatening, which leads to a reduced level of stress symptoms and a better subjective health condition. The influence of network size on stressor appraisal is fully mediated by the perceived social embeddedness that these ties induce.     

Coming Out Experiences of Hispanic Sexual Minority Young Adults in South Florida

Sexual minority youth and young adults (SMYYA) have higher prevalence of mental and behavioral health problems potentially linked to experiences of discrimination, stigma, and rejection. Among Hispanics, the intersection of stressors related to being an ethnic and sexual minority may result in compounding adverse outcomes. Coming out may play an important role in experiencing discrimination, stigma, and rejection. However, limited research examines coming out among Hispanic SMYYA (HSMYYA). This qualitative study seeks to understand the coming-out experiences of HSMYYA living in South Florida. Twenty participants between 18 and 28 years old were interviewed. Qualitative content analysis generated codes, which were grouped into categories to generate themes. This study presents data highlighting reasons for disclosing and not disclosing sexual orientation and the perceived consequences of those decisions. Additionally, we discuss unique cultural elements that impact HSMYYA’s decisions to reveal sexual orientation.     

Seeking safer sexual spaces: queer and trans young people labeled with intellectual disabilities and the paradoxical risks of restriction

Young lesbian, gay, bisexual, and transgender (LGBT) people labeled with intellectual disabilities have unique sexual health needs that are not being met. Denial by others of their right to pleasure and the exercise of heightened external control over their sexuality are commonplace. Current research indicates that these youth are at heightened risk for compromised sexual health. This study aimed to explore the ways in which social and environmental conditions influence vulnerability to adverse sexual health outcomes for this population. We used a community-based research approach to conduct qualitative interviews and focus groups with 10 young LGBT people (aged 17-26) labeled with intellectual disabilities. Participants reported multiple limitations on their autonomy that resulted in having sex in places where they did not feel comfortable and were unlikely to practice safer sex. Attempts by authority figures to protect youth through limits on their autonomy may be unintentionally leading to negative sexual health outcomes.     

Residential Mobility Across Local Areas in the United States and the Geographic Distribution of the Healthy Population

Determining whether population dynamics provide competing explanations to place effects for observed geographic patterns of population health is critical for understanding health inequality. We focus on the working-age population—the period of adulthood when health disparities are greatest—and analyze detailed data on residential mobility collected for the first time in the 2000 U.S. census. Residential mobility over a five-year period is frequent and selective, with some variation by race and gender. Even so, we found little evidence that mobility biases cross-sectional snapshots of local population health. Areas undergoing large or rapid population growth or decline may be exceptions. Overall, place of residence is an important health indicator; yet, the frequency of residential mobility raises questions of interpretation from etiological or policy perspectives, complicating simple understandings that residential exposures alone explain the association between place and health. Psychosocial stressors related to contingencies of social identity associated with being black, urban, or poor in the United States may also have adverse health impacts that track with structural location even with movement across residential areas.     

Health Implications of Socioeconomic Characteristics,Subjective Social Status,and Perceptions of Inequality: An Empirical Study of China

This study explores how health is associated with socioeconomic status, subjective social status, and perceptions of inequality simultaneously. Two health outcomes (self-reported health and psychological distress) are examined, and the subtlety of their relationships with each of the three dimensions of inequality is probed. Data used come from a nationally representative sample survey conducted in China. Several findings emerge from empirical analyses: (1) Overall, the three dimensions of social inequality are associated with self-reported health and psychological distress net of each other and other control variables; (2) among focal socioeconomic characteristics, income and Chinese Communist Party membership are significantly associated with both health outcomes, education exhibits a robust effect on self-reported health, and rural and migrant statuses are linked to less distress; (3) subjective social status in comparisons with both socially proximal and broad referents is associated with both health outcomes, and the association with downward comparisons is more salient than with upward comparisons; and (4) perceived degree and perceived sources of inequality in society show varying relationships with the two health outcomes. These findings add to our understanding of the multidimensionality and complexity of social inequality in relation to health.     

Mental Health Consequences of International Migration for Vietnamese Americans and the Mediating Effects of Physical Health and Social Networks: Results From a Natural Experiment Approach

Although the existing literature on immigrant mental health is extensive, major substantive and methodological gaps remain. Substantively, there is little population-based research that focuses on the mental health consequences of migration for Vietnamese Americans. More generally, although a wide range of mental health problems among immigrants has been identified, the potential causal or mediating mechanisms underlying these problems remain elusive. This latter substantive shortcoming is related to a key methodological challenge involving the potentially confounding effects of selection on migration-related outcomes. This article addresses these challenges by employing a “natural experiment” design, involving comparisons among three population-based samples of Vietnamese immigrants, never-leavers, and returnees (N  =  709). Data were collected in Ho Chi Minh City and in New Orleans between 2003 and 2005. The study investigates the long-term impact of international migration on Vietnamese mental health, and the potential mediating effects of social networks and physical health on these migration-related outcomes. The results reveal both mental health advantages and disadvantages among Vietnamese immigrants relative to the two groups of Vietnamese nationals. Selection can be ruled out for some of these differences, and both social networks and physical health are found to play important explanatory roles.     

Same-Sex Attracted,Not LGBQ: The Associations of Sexual Identity Labeling on Religiousness,Sexuality, and Health Among Mormons

ABSTRACT

In the Church of Jesus Christ of Latter-Day Saints (LDS church), beliefs about same-sex sexual attraction are carefully differentiated from beliefs about same-sex sexual behavior and identity, leading some to reject a lesbian, gay, bisexual, or queer (LGBQ) identity label in favor of declining a sexual identity or describing themselves as experiencing same-sex attraction (SSA). Using data from 1,128 sexual minority Mormons recruited from both politically conservative and liberal circles, we examined the relationship between rejecting an LGBQ identity and religiousness, attitudes toward sexuality, and health outcomes. We found that Mormons who reject an LGBQ identity were significantly more religious and less content with their sexuality but had similar health outcomes relative to LGBQ Mormons. We posit that these differences are best understood by differences in group affiliation and support, intersectional experiences with minority stressors, and the lack of generalizability of LGBQ constructs to those who reject an LGBQ identity.     

About Cats and Dogs … Reconsidering the Relationship Between Pet Ownership and Health Related Outcomes in Community-Dwelling Elderly

Having a pet has been claimed to have beneficial health effects, but methodologically sound empirical studies are scarce. Small sample sizes and a lack of information about the specific type of pets involved make it difficult to draw unambiguous conclusions. We aimed to shed light on the relationship between pet ownership and several health related outcomes by conducting a survey among a large national sample of community-dwelling elderly in The Netherlands, all suffering from chronic illness or disability. We distinguished several types of pets, focusing on cats and dogs. Pet ownership was associated with a greater chance of using ambulatory mental healthcare, whereas it was not related to self-reported general or mental health. Considering possible mechanisms, associations between pet ownership and the frequency of social contacts or feelings of loneliness were not found. Having a dog increased the likelihood of being healthy active, whereas having a cat showed the opposite. Future research should pay more attention to pet related characteristics, in addition to characteristics of the human sample.     

Social Participation in Poland: Links to Emotional Well-Being and Risky Alcohol Consumption

Social participation has been hypothesised to have both positive and negative impact on health outcomes via a variety of pathways, but previous studies have found few significant effects of social participation, and there is a lack of research from post-communist societies, which are known to be low on social capital. Using cross-sectional data from Poland on 2,970 individuals surveyed in 2009, we investigated the individual-level relationships between formal and informal social participation, emotional well-being, and risky alcohol consumption while controlling for demographic variables, socioeconomic status, employment and partnership status, health, religiosity, and generalised trust. Frequent joint activities with friends and neighbours were related to higher positive affect but also to more risky alcohol consumption. Membership in voluntary organisations was associated with more risky alcohol consumption, especially among younger males and for certain types of organisations. In contrast, volunteer work was related to higher positive affect and fewer depressive symptoms in the whole sample and to less risky alcohol consumption among the younger participants. The findings illustrate that some types of social participation, even if they are not typical of a given context (e.g., volunteering in Poland), may be more beneficial than others.     

From Mothers of the “People's Home” to Biologically Rational Consumers

The aim of the present article is to study how women's alcohol consumption has been defined and contested in the Swedish press from 1955 to 2010 in relation to the development of Swedish society from a social democratic welfare state to a neoliberal competition state. Our material consists of articles published in the largest Swedish national and regional newspapers in 1955, 1965, 1977, 1982, 1995, 2004, and 2010. In the study, we apply Fraser's concepts of recognition and redistribution to analyse how the press contributed to the formation of cultural injustices and counter-claims through its recognition of women's drinking, and how these cultural injustices and counter-claims have conditioned the redistribution of societal resources. Our analysis shows that, during the study period, women were recognized in the Swedish press in limited and stigmatizing subject positions. These dominating representations of drinking women changed over time in an unpredictable way. As collectively shared, widely accepted cultural images, they tended to downplay the possibility of women achieving equal and just participation in cultural interaction, social activities, and healthcare services. In counter-discourses, the possibilities for women to formulate public claims in order to make surrounding structures more “enabling” of their independency, weakened during the study period.