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981.

Problem

Pacific Islanders are disproportionately burdened by poorer maternal health outcomes with higher rates of pre-term births, low birth weight babies, infant mortality, and inadequate or no prenatal care.

Purpose

The purpose of this study was twofold: (1) to explore maternal health care providers’ perceptions and experiences of barriers in providing care to Marshallese women, and (2) providers perceived barriers of access to care among Marshallese women. This is the first paper to explore perceived barriers to maternal health care among a Marshallese community from maternal health care providers’ perspectives in the United States.

Methods

A phenomenological, qualitative design, using a focus group and in-depth interviews with 20 maternal health care providers residing in northwest Arkansas was chosen.

Findings

Several perceived barriers were noted, including transportation, lack of health insurance, communication and language, and socio-cultural barriers that described an incongruence between traditional and Western medical models of care. There was an overall discord between the collectivist cultural identity of Marshallese families and the individualistic maternal health care system that merits further research.

Discussion

Solutions to these barriers, such as increased cultural competency training for maternal health care providers and the incorporation of community health workers are discussed.  相似文献   
982.
A growing body of research has examined how family dynamics shape residential mobility, highlighting the social—as opposed to economic—drivers of mobility. However, few studies have examined kin ties as both push and pull factors in mobility processes or revealed how the influence of kin ties on mobility varies across sociodemographic groups. Using data on local residential moves from the Panel Study of Income Dynamics (PSID) from 1980 to 2013, we find that location of noncoresident kin influences the likelihood of moving out of the current neighborhood and the selection of a new destination neighborhood. Analyses of out-mobility reveal that parents and young adult children living near each other as well as low-income adult children living near parents are especially deterred from moving. Discrete-choice models of neighborhood selection indicate that movers are particularly drawn to neighborhoods close to aging parents, white and higher-income households tend to move close to parents and children, and lower-income households tend to move close to extended family. Our results highlight the social and economic trade-offs that households face when making residential mobility decisions, which have important implications for broader patterns of inequality in residential attainment.  相似文献   
983.
Adult death rates are a critical indicator of population health and well-being. Wealthy countries have high-quality vital registration systems, but poor countries lack this infrastructure and must rely on estimates that are often problematic. In this article, we introduce the network survival method, a new approach for estimating adult death rates. We derive the precise conditions under which it produces consistent and unbiased estimates. Further, we develop an analytical framework for sensitivity analysis. To assess the performance of the network survival method in a realistic setting, we conducted a nationally representative survey experiment in Rwanda (n = 4,669). Network survival estimates were similar to estimates from other methods, even though the network survival estimates were made with substantially smaller samples and are based entirely on data from Rwanda, with no need for model life tables or pooling of data from other countries. Our analytic results demonstrate that the network survival method has attractive properties, and our empirical results show that this method can be used in countries where reliable estimates of adult death rates are sorely needed.  相似文献   
984.
We examine inferences about old-age mortality that arise when researchers use survey data matched to death records. We show that even small rates of failure to match respondents can lead to substantial bias in the measurement of mortality rates at older ages. This type of measurement error is consequential for three strands in the demographic literature: (1) the deceleration in mortality rates at old ages; (2) the black-white mortality crossover; and (3) the relatively low rate of old-age mortality among Hispanics, often called the “Hispanic paradox.” Using the National Longitudinal Survey of Older Men matched to death records in both the U.S. Vital Statistics system and the Social Security Death Index, we demonstrate that even small rates of missing mortality matching plausibly lead to an appearance of mortality deceleration when none exists and can generate a spurious black-white mortality crossover. We confirm these findings using data from the National Health Interview Survey matched to the U.S. Vital Statistics system, a data set known as the “gold standard” (Cowper et al. 2002) for estimating age-specific mortality. Moreover, with these data, we show that the Hispanic paradox is also plausibly explained by a similar undercount.  相似文献   
985.
A large body of literature has demonstrated a positive relationship between education and age at first birth. However, this relationship may be partly spurious because of family background factors that cannot be controlled for in most research designs. We investigate the extent to which education is causally related to later age at first birth in a large sample of female twins from the United Kingdom (N = 2,752). We present novel estimates using within–identical twin and biometric models. Our findings show that one year of additional schooling is associated with about one-half year later age at first birth in ordinary least squares (OLS) models. This estimate reduced to only a 1.5-month later age at first birth for the within–identical twin model controlling for all shared family background factors (genetic and family environmental). Biometric analyses reveal that it is mainly influences of the family environment—not genetic factors—that cause spurious associations between education and age at first birth. Last, using data from the Office for National Statistics, we demonstrate that only 1.9 months of the 2.74 years of fertility postponement for birth cohorts 1944–1967 could be attributed to educational expansion based on these estimates. We conclude that the rise in educational attainment alone cannot explain differences in fertility timing between cohorts.  相似文献   
986.
This review provides a model explicating two related physiologic and behavioral pathways through which the chronic daily stress of the expectation and experience of discrimination exposure can shape life course cardiometabolic risk trajectories: sleep and stress reactivity. We argue that these two pathways work together jointly to shape African American-White disparities in cardiometabolic morbidities. The body’s ongoing anticipation of experiencing racism-related stressors disrupts sleep, a behavior highly responsive to stress reactivity, which is also elevated during stressful conditions. The constant feedback between sleep disruption and the body’s stress response can lead to higher allostatic load and disproportionate exposure to stress-related illness among African Americans earlier in their life course.  相似文献   
987.
The current study assesses ageism and heterosexism relating to older adult sexual activity within long-term care facilities. To assess caregiver reactions, 153 residential care facility staff members read one of three vignettes. Each vignette described a scenario in which a staff member walks in on two residents (male/female, male/male, or female/female) engaging in sexual activity. Although no main effects were discovered for vignette type, exploratory analyses revealed that the facility where participants were employed was significantly related to their ratings of approval. Furthermore, an interaction effect between vignette and facility types was also discovered for caregivers’ approval of sexual activity among residents. Additionally, a strong overall approval rating of older adult sexuality was reported by staff members. The results of this study warrant that further research is necessary regarding older adults’ perception of caregiver bias, as well as further investigation of caregivers’ perceptions of older adults’ sexual activity.  相似文献   
988.
Given the intersection of racial, religious, and sexual identities for Black queer populations, the current study examines sexuality-related religious rhetoric. Twenty Black cisgender queer men were recruited to participate in a qualitative interview. Using thematic analysis, the research team identified four themes: negative religious rhetoric, personal consequences of negative religious rhetoric, social consequences of negative religious rhetoric, and growth from negative religious rhetoric. Participants explained the pervasiveness of negative religious rhetoric within their churches and family structures. Men also conveyed how negative religious rhetoric frames societal ideologies around same-sex behavior, often condoning violence toward queer populations. Although men had negative experiences, participants articulated the importance of using oppression as a platform for growth. Black cisgender queer men are present within religious institutions; however, such negative religious rhetoric may negatively affect their mental and physical health. Researchers, clinicians, and clergy should consider the ways negative religious rhetoric marginalizes queer populations.  相似文献   
989.
Single women of the Baby Boomer generation are often financially disadvantaged in the retirement planning process due to their lower accumulated savings compared to male retirees. This disadvantage impacts significant consumption decisions such as postretirement housing choices. This study uses the theory of planned behavior to examine how certainty in intentions influences preparing and planning for postretirement housing. A typology of single Baby Boomer women is developed based on their financial, demographic, and psychological circumstances. Each segment likely requires different informational strategies and financial services to foster proactive planning for retirement. Significant implications exist for social policy and the financial services sector.  相似文献   
990.
This study is the first to comprehensively examine the effect of state anti-bullying laws (ABLs) on school safety and youth violence. Using existing data from the Youth Risk Behavior Surveys and the Uniform Crime Reports, and newly-collected data on school shootings, we find little evidence that the typical state ABL is effective in improving school safety and student well-being. However, this null finding masks substantial policy heterogeneity. State mandates that require school districts to implement strong, comprehensive anti-bullying policies are associated with a 7 to 13 % reduction in school violence and an 8 to 12 % reduction in bullying. In addition, our results show that strong anti-bullying policy mandates are associated with a reduction in minor teen school shooting deaths and violent crime arrests, suggesting potentially important spillover effects.  相似文献   
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