Problems in measuring role strains and social functioning in relation to psychological symptoms

The problems that people experience in social roles can be regarded as either causes or consequences of psychological symptoms. To reflect one of these possibilities, Pearlin et al. (1981) developed measures of "role strains" which are considered sources of psychopathology. To reflect the other position, Dohrenwend et al. (1981) constructed measures of "role functioning" which are seen as consequences of psychopathology. We show that the measures developed by these two teams of investigators are similar in content and show substantial empirical overlap despite the different meanings attributed to them. In an effort to understand whether these highly correlated measures assess, "role strain" or "role functioning," we conduct an exploratory analysis of marital and housework role problems, using a small panel sample of New York City residents. Specifically, we use instrumental variables to identify reciprocal effects between psychological distress and each role area. We find that the relationship between housework role problems and distress is more consistent with Pearlin et al.'s interpretation, whereas the relationship between marital problems and distress is more consistent with that of Dohrenwend et al. Investigators interested in measuring either role strain or role functioning must bear in mind the strong possibility of contamination from the other construct.     

THE EFFECTS OF PRESTIGE NAMES IN QUESTION WORDING

Although survey researchers are often warned against using prestigenames in questions (e.g., identifying Contra aid as "PresidentReagan's policy"), prestige names are still commonly used. Tolearn more about the effects of using prestige names, we analyzetwo sets of experiments—on judicial confirmation electionsand on an initiative on tax indexing. The results indicate thatprestige names do more than shift responses in one direction—they eliminate the effect of education on DKs and provide moreof a political basis for the responses.     

Bringing baby home: a comprehensive case management program for obstetrical services

Originally presented to the Society of Home Health Care Management of the American College of Physician Executives at its November 16, 1993, meeting in Tucson, Ariz., the program described in this article was the winner of the College's 1994 Innovations Award in Medical Quality Management, sponsored by Merck Sharp & Dohme. The program shows the potential of case management for both improvement in the quality of care and containment of costs for a managed care population with a substantial Medicaid segment. This article is part of a continuing series on innovative programs in home health care.     

The ethics of health care system reform

The United States is now engaged in a momentous national debate about health care. How can we provide the best care possible while simultaneously containing cost (to promote the general economic integrity of society) and somehow maintain a semblance of a free health care marketplace. This is not just a political question; it is also a question of ethics. It is an ethical consideration because the current debate is not just about designing or promoting health care systems that can best address our concerns for costs, quality, and accessibility. It appears that at least some participants in the debate would not stop at arguing their beliefs as valid; they would make their beliefs law. Some urge the creation of the right to health care as a matter of law. There are significant differences between beliefs and rights, however, and they need to be considered carefully in the ongoing debate over the future of this country's health care delivery and financing system.     

Society,family, and gender in Santa Fe,New Granada,until the end of the colony

The author examines family structure in Santa Fe, the capital of New Granada, a Spanish colony that included Colombia, Ecuador, Panama, and Venezuela. The focus is on the late eighteenth and early nineteenth centuries. He finds that social class structure was closely related to ethnic group and skin color, and that the sex ratio was biased toward women. Women also headed nearly 50% of all households. Data are mainly from the 1801 smallpox census.     

Meeting the change challenge: managing growth in the nonprofit and public human services sectors

The current economic climate has been particularly hard on non-profit and public human services organizations, frequently resulting in managing organizational decline. The authors believe that the dominant concern should be with fostering organizational growth. To this end, they suggest that nonprofit board members and executives, as well as public sector leaders, need to concern themselves with the concurrent management of two agendas: Running the Shop and Meeting the Change Challenge. This can be done effectively through the use of strategic issue management, which is a set of techniques that represents a blend of traditional strategic management and change management approaches.     

Pluralism and ethnic conflict in Tanzania's arid lands: the case of the Maasai and the WaArusha

In Tanzania, the Maasai and Waarusha tribes are experiencing conflict because differences in their modes of productions and economic strategies undermine the peaceful coexistence that they have enjoyed since the 18th century. The Maasai are pastoralists, while the Waarusha are agricultural subsistence farmers who are encroaching on the best pasture lands. A sketch of the history of the two groups shows that the Maasai reached the peak of their land holding in 1880 before the arrival of European colonists who seized land and restricted the Maasai to a semi-arid reserve but allowed the Maasai to remain an autonomous and powerful group. The Waarusha began encroaching on Maasai land after independence due to land and population pressure. While closely tied, each group looks down on the other, and Maasai ascendancy has given way to Waarusha challenges. After independence, the tribal and ethnic rule that was protected by the colonial system was disrupted to allow for increased internal migration and new patterns of settlement. The rights of land ownership were transferred from tribes to the State, allowing privileged groups to benefit. The Waarusha began to engage in illegal land-grabbing and to encroach on the Maasai preserve using legal and illegal means. The Maasai view land as collective property and have had difficulty retaining title of traditional lands in the face of population pressure. This loss of grazing land has forced the Maasai into a mixed economy that depends upon agricultural production as well as livestock production. In the meantime, the Waarusha have deliberately sought political office to gain power to secure their holdings. Immediate action is needed to produce 1) a policy on spontaneous settlement, 2) an immediate adjustment of legal procedures for land acquisition, 3) a land tenure policy that equally emphasizes agricultural and livestock production, and 4) controls on undue expansion of subsistence agriculture into semi-arid rangelands.     

Origins and destinies: Immigration to the United States since World War II

Contemporary immigration to the United States and the formation of new ethnic groups are the complex and unintended social consequences of the expansion of the nation to its post-World War II position of global hegemony. Immigrant communities in the United States today are related to a history of American military, political, economic, and cultural involvement and intervention in the sending countries, especially in Asia and the Caribbean Basin, and to the linkages that are formed in the process that open a variety of legal and illegal migration pathways. The 19.8 million foreign-born persons counted in the 1990 U.S. census formed the largest immigrant population in the world, though in relative terms, only 7.9% of the U.S. population was foreign-born, a lower proportion than earlier in this century. Today's immigrants are extraordinarily diverse, a reflection of polar-opposite types of migrations embedded in very different historical and structural contexts. Also, unlike the expanding economy that absorbed earlier flows from Europe, since the 1970s new immigrants have entered an hourglass economy with reduced opportunities for social mobility, particularly among the less educated, and new waves of refugees have entered a welfare state with expanded opportunities for public assistance. This paper seeks to make sense of the new diversity. A typology of contemporary immigrants is presented, and their patterns of settlement, their distinctive social and economic characteristics compared to major native-born racial-ethnic groups, and their different modes of incorporation in—and consequences for—American society are considered.     

Is the American health care delivery system ready for change?

In October 1992, the American College of Physician Executives sponsored a study tour to Berlin, Germany, and Amsterdam, Holland. Meetings were held with government officials, third-party payers, and providers, and on-site visits were made at hospitals, clinics, and academic centers. The purpose was to study the health care delivery system in those countries and to share some insights with the countries' hosts on the U.S. system. In a series of reports that began in the July issue of the journal, 5 of the 10 study tour participants describe their impressions of the tour and of the health care systems in the countries that were visited. In this final report, the implications of the German and Dutch systems for reform of the U.S. health care system are discussed.