The production of understanding

While there is little doubt that sociological theory and research has had an important impact on the way people think about health and health care, mental health and medical sociologists are often confronted with challenges concerning the utility of the work that they do. Among the doubters are deans, funding agencies and family members. We are challenged by the ascendency of biological interpretations of human behaviors, by the incompatibility between the contextual view we prefer and the very strong individualistic orientation of our culture, and by the fact that we do not have an applied arm that trains the professionals who treat health and mental-health conditions. How do we respond to this challenge? The title of this paper gives a short answer: "The Production of Understanding." I propose that a powerful but under-recognized value of our work is the generation of explanations about health and mental health matters that help people understand the other side of an "us"/"them" divide. We produce understanding in a context in which misunderstanding is regularly constructed by powerful people who offer victim-blaming explanations for the circumstances experienced by people with less power. The production of understanding serves as an important counterbalance to this tendency. Our work shapes the way people think about problems related to health and mental health, limits the power of inaccurate victim-blaming accounts and provides understanding about why health and mental health are mal-distributed among people from different social circumstances.     

Training Intraverbal Naming to Establish Matching-to-Sample Performances

The current study evaluated whether training intraverbal naming would be sufficient to establish visual-visual matching-to-sample (MTS) performances in college students. In the first experiment, we used a multiple-probe design across stimulus sets to assess whether six participants could match arbitrary visual stimuli (AB) after learning to tact their two experimentally defined classes (A’ and B’) and then intraverbally relate their names (i.e., “A’ goes with B’”). All participants matched the stimuli accurately after training, as well as emitted the trained intraverbals. In the second experiment, we used a multiple baseline design across four participants to assess whether the same training would produce bi-directional intraverbals in the form of “B’ goes with A’,” and MTS performance consistent with symmetry (BA). All participants responded accurately during matching and intraverbal tests. Across both experiments, participants stated the trained intraverbals while performing the matching task. Results showed that MTS performance can be established solely by verbal behavior training.     

Cultural Connection Predicts Perceptions of Financial Security for Māori

This paper examines the impact of relative income on income satisfaction with given absolute income. We conducted an experiment in China where participants earned three different levels of income according to their relative performance in a task. While the treatment group was informed about their relative income, the control group only knew their own absolute income. We found that while controlling for absolute income and other factors, information about relative income increases the satisfaction of the high-income group and reduces the satisfaction of the low-income group. Relative income may interact with individual characteristics, such as gender, to affect income satisfaction. We also found that relative income treatment significantly increases income satisfaction inequality, primarily by causing social comparisons among different income groups, which has some welfare implications.     

Work–Family Conflict and Well-Being Across Europe: The Role of Gender Context

This study analysed whether gender context is important to differences in the relationship between work–family conflict (WFC) and well-being across Europe. We hypothesised that in countries that support equality in work life and where norms support women’s employment, the relationship between WFC and low well-being is weaker than in countries with less support for gender equality. Cohabiting men and women aged 18–65 years from 25 European countries were selected from the European Social Survey. A multilevel analysis was conducted to investigate the relationship between well-being and WFC, and two measurements were used to represent gender context: gender equality in work life and norms regarding women’s employment. Contrary to the hypothesis, the results showed that the negative relationship was stronger in countries with high levels of gender equality in work life and support for women’s employment than in countries with a relatively low level of gender equality in work life and support for traditional gender relations. The context in which gender is constructed may be important when studying the relationship between WFC and well-being. In addition, emphasis should be placed on policies that equalise both the labour market and the work performed at home.     

Is Chinese National Health Insurance Effective in the Face of Severe Illness? A Perspective from Health Service Utilization and Economic Burden

Over the past decade, health insurance coverage has expanded dramatically in China. Health insurance benefits, however, remain shallow or ambiguous. This study examines the effect of Chinese national health insurance policy on health service utilization and economic burden in urban settings using the Urban Resident Basic Medical Insurance Household Survey. We employ the Heckman selection model to correct for selection bias among hospital inpatients, and find that compared to individuals without health insurance, those with health insurance are more likely to be admitted to the hospital when their physicians recommended them to enter the hospital as inpatients. Health insurance is also associated with about 45.6 % decrease in out-of-pocket inpatient expenditures. Individuals with urban employee basic medical insurance see the largest decrease in economic burden, followed by individuals with urban resident basic medical Insurance, and those with new rural cooperative medical insurance.     

The Methuselah Effect: The Pernicious Impact of Unreported Deaths on Old-Age Mortality Estimates

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.