The Common-Sense Model of Illness Representation: Theoretical and Practical Considerations

This article focuses on several areas. After reviewing the most commonly used approaches in the study of health behaviors, (e.g., the medical model, the health belief model, and the theory of reasoned action) the common-sense model is presented as an alternative. By presenting evidence across a wide range of illness domains, we demonstrate the usefulness of the common-sense, self-regulatory approach. We then discuss the importance of the common-sense model for health research among minorities. We conclude the article with examples of the operationalization of illness representations in past research and directions for future research.     

Readers’ Roundtable

Abstract

The Elements of Teaching. James Banner, Jr., and Harold C. Cannon. 1997. New Haven and London: Yale University Press. ISBN: 0-300-06929-4.

American Stories: Collected Scholarship on Minority History from the OAH Magazine of History. 1998. Bloomington, Indiana: Indiana University Press.     

Nineteenth-Century Coastal Slave Trading and the British Abolition Campaign in Sierra Leone

The Sierra Leone Colony was Britain's main base in its campaign to abolish the Atlantic slave trade. Yet, throughout the nineteenth century, slavers supplied external and internal demand by trafficking people along the coast near to and even within the Colony. Although some officials strove to eradicate slaving, others feared that aggressive actions could threaten the Colony's economic and political interests. Administrators debated what constituted trafficking and applied different policies in different treaty zones. Moreover, the expanding commercial system encouraged slave trading, and slavers had the means to evade patrols. Ultimately, officials ended slaving by stopping war and raiding, interdicting traffic and punishing slavers, but enslaved people also contributed by escaping from bondage.     

State capacity: the missing piece in child welfare privatization

Privatization has been used to address the limited capacity of government to achieve positive results in child welfare systems. Privatized systems have not realized better outcomes than their public counterparts, however, and many states continue to struggle with implementation. In order to demonstrate that privatization is in fact an investment on the part of the state, rather than a solution to limited public resources, this article explores the relationship between state capacity and privatization and makes recommendations for more effective partnerships between the public and private sectors.     

Responsible Gambling: General Principles and Minimal Requirements

Many international jurisdictions have introduced responsible gambling programs. These programs intend to minimize negative consequences of excessive gambling, but vary considerably in their aims, focus, and content. Many responsible gambling programs lack a conceptual framework and, in the absence of empirical data, their components are based only on general considerations and impressions. This paper outlines the consensus viewpoint of an international group of researchers suggesting fundamental responsible gambling principles, roles of key stakeholders, and minimal requirements that stakeholders can use to frame and inform responsible gambling programs across jurisdictions. Such a framework does not purport to offer value statements regarding the legal status of gambling or its expansion. Rather, it proposes gambling-related initiatives aimed at government, industry, and individuals to promote responsible gambling and consumer protection. This paper argues that there is a set of basic principles and minimal requirements that should form the basis for every responsible gambling program.     

The impact of minority group status on the projected retirement income of divorced women in the baby boom cohort

Using projections from the Social Security Administration's Modeling Income in the Near Term (MINT1), we examine the characteristics and retirement income of white non-Hispanic, black non-Hispanic, and Hispanic divorced women in the baby boom cohort. Although we find significant differences in retirement income for divorced women of different racial and ethnic groups, the characteristics associated with higher or lower retirement income are very similar. That is, being college educated, owning a home, and having pension and asset income, for example, correspond to increased retirement income for all racial and ethnic groups. However, because black and Hispanic women are less likely than white women to be college educated, to own their home, and to have pension and asset income, their retirement income tends to be lower than that of white women. We conclude the paper by briefly discussing policy options to address the retirement needs of divorced women.     

The Effects of Allostatic Load on Racial/Ethnic Mortality Differences in the United States

This study expands on previous findings of racial/ethnic and allostatic load (AL) associations with mortality by addressing whether differential AL levels by race/ethnicity may explain all-cause mortality differences. This study used data from the third National Health and Nutrition Survey public-use file, gathered between 1988 and 1994, with up to 18 years of mortality follow-up (n = 11,733). AL scores were calculated using a 10-biomarker algorithm based on clinically determined thresholds. Results of discrete-time hazard models suggest that AL is associated with increased mortality risks, independent of other factors, including race/ethnicity and SES. The results also suggest that the AL–mortality association is stronger for non-Hispanic blacks than for non-Hispanic whites, and that at low levels of AL observed mortality differences between non-Hispanic blacks and non-Hispanic whites are non-significant. These findings suggest that mortality differences between non-Hispanic blacks and non-Hispanic whites may be the result of how early life exposure causes premature aging and increased mortality risks. More attention to resource allocation and local environments is needed to understand why non-Hispanic blacks experience premature aging that leads to differential mortality risks compared to non-Hispanic whites.     

Education,race/ethnicity and out-migration from a border city

Through a combination of high immigration rates and differential fertility, communities along the U.S.-Mexico border have become overwhelmingly Hispanic. El Paso, Texas, located across the border from Ciudad Juárez, forms part of the world’s largest urban center on a land border. El Paso ranks among the bottom 10 large U.S. metropolitan areas with the smallest proportion of college-educated adults, causing concerns among policy makers regarding its prospects for economic development. Local discourse suggests that low educational levels result from the out-migration of educated groups that find higher wages or better jobs elsewhere. Two sources of data are used to explore the association between education, race/ethnicity, and out-migration: the five percent 2000 PUMS and a survey conducted among students at the University of Texas at El Paso. We find that between 1995 and 2000 a large net outflow of non-Hispanic whites and blacks of all educational levels took place. Among Mexicans and Mexican Americans, college graduates were more likely to leave compared to high school graduates, but place of birth and language preference influenced these odds. Student data confirmed that non-Hispanics are significantly more likely to plan to leave compared to students of Mexican origin or descent. Among Mexicans and Mexican Americans, those who prefer English and mentioned jobs and lifestyle as the most important factors in choosing a place to live and work were more likely to have plans to leave upon graduation. Policy implications are discussed regarding the future of border communities.     

Social indicators in policy planning: Applying the public marketing model in Yuba city,California

This article is a follow up to a paper appearing in the Spring Issue (4) 1977 of this Journal by the same authors entitled ‘Public Marketing: A Suggested Policy Paradigm for Community Development in the City’. In the earlier article a public marketing model was advanced as a device to order socioeconomic needs for planning and policy making in city government. This article provides an empirical application of the model in an actual city. The results indicate that the model is a workable and useful tool for social indicator construction and policy formulation.     

When the levee breaks: treating adolescents and families in the aftermath of hurricane katrina

Hurricane Katrina brought to the surface serious questions about the capacity of the public health system to respond to community-wide disaster. The storm and its aftermath severed developmentally protective family and community ties; thus its consequences are expected to be particularly acute for vulnerable adolescents. Research confirms that teens are at risk for a range of negative outcomes under conditions of life stress and family disorganization. Specifically, the multiple interacting risk factors for substance abuse in adolescence may be compounded when families and communities have experienced a major trauma. Further, existing service structures and treatments for working with young disaster victims may not address their risk for co-occurring substance abuse and traumatic stress reactions because they tend to be individually or peer group focused, and fail to consider the multi-systemic aspects of disaster recovery. This article proposes an innovative family-based intervention for young disaster victims, based on an empirically supported model for adolescent substance abuse, Multidimensional Family Therapy (MDFT; Liddle, 2002). Outcomes and mechanisms of the model's effects are being investigated in a randomized clinical trial with clinically referred substance-abusing teens in a New Orleans area community impacted by Hurricane Katrina.