Migration and Pacific Mortality: Estimating Migration Effects on Pacific Mortality Rates Using Bayesian Models

Pacific people living in New Zealand have higher mortality rates than New Zealand residents of European/Other ethnicity. The aim of this paper is to see whether Pacific mortality rates vary by natality and duration of residence. We used linked census-mortality information for 25- to 74-year-olds in the 2001 census followed for up to three years. Hierarchical Bayesian modeling provided a means of handling sparse data. Posterior mortality rates were directly age-standardized. We found little evidence of mortality differences between the overseas-born and the New Zealand–born for all-cause, cancer, and cardiovascular disease (CVD) mortality. However, we found evidence for lower all-cause (and possibly cancer and CVD) mortality rates for Pacific migrants resident in New Zealand for less than 25 years relative to those resident for more than 25 years. This result may arise from a combination of processes operating over time, including health selection effects from variations in New Zealand’s immigration policy, the location of Pacific migrants within the social, political, and cultural environment of the host community, and health impacts of the host culture. We could not determine the relative importance of these processes, but identifying the (modifiable) drivers of the inferred long-term decline in health of the overseas-born Pacific population relative to more-recent Pacific migrants is important to Pacific communities and from a national health and policy perspective.     

A Multilevel Perspective on Gender Differences in the Relationship Between Poverty Status and Depression Among Older Adults in the United States

Despite a large body of literature on depression, previous studies have focused on either intra- or interpersonal factors but not multilevel influences, which potentially could buffer depression in late life. The intent of this study was to identify whether the impact of poverty might be moderated by multilevel factors such as sense of control, social support, and neighborhood environment. The results showed that the elderly poor, especially older women, were more likely to be depressed. Support from friends significantly moderated the association between depression and poverty among older women. Implications for critical feminist gerontology and for practice are discussed.     

An Interagency Comparison of Screening-Level Risk Assessment Approaches

Approaches to risk assessment have been shown to vary among regulatory agencies and across jurisdictional boundaries according to the different assumptions and justifications used. Approaches to screening-level risk assessment from six international agencies were applied to an urban case study focusing on benzo[a]pyrene (B[a]P) exposure and compared in order to provide insight into the differences between agency methods, assumptions, and justifications. Exposure estimates ranged four-fold, with most of the dose stemming from exposure to animal products (8-73%) and plant products (24-88%). Total cancer risk across agencies varied by two orders of magnitude, with exposure to air and plant and animal products contributing most to total cancer risk, while the air contribution showed the greatest variability (1-99%). Variability in cancer risk of 100-fold was attributed to choices of toxicological reference values (TRVs), either based on a combination of epidemiological and animal data, or on animal data. The contribution and importance of the urban exposure pathway for cancer risk varied according to the TRV and, ultimately, according to differences in risk assessment assumptions and guidance. While all agency risk assessment methods are predicated on science, the study results suggest that the largest impact on the differential assessment of risk by international agencies comes from policy and judgment, rather than science.     

POETICS, DRAMATICS, AND TRANSGRESSIVE VALIDITY: The Case of the Skipped Line

This article presents three social-science writing transgressions: writing an in-depth interview as a poem, writing field notes as a drama, and the article, itself, which deploys diverse genres, personal experiences, and critical analyses. Through these examples, I challenge traditional definitions of validity and call for different kinds of science practices. The science practice I model is a feminist-postmodernist one. It blurs genres, probes lived experience, enacts science, creates a female imaginary, breaks down dualisms, inscribes emotional labor and emotional response as valid, deconstructs the myth of an emotion-free social science, and makes a space for partiality, self-reflexivity, tension, and difference.     

A hierarchical model for space–time surveillance data on meningococcal disease incidence

Summary. We describe a model-based approach to analyse space–time surveillance data on meningococcal disease. Such data typically comprise a number of time series of disease counts, each representing a specific geographical area. We propose a hierarchical formulation, where latent parameters capture temporal, seasonal and spatial trends in disease incidence. We then add—for each area—a hidden Markov model to describe potential additional (autoregressive) effects of the number of cases at the previous time point. Different specifications for the functional form of this autoregressive term are compared which involve the number of cases in the same or in neighbouring areas. The two states of the Markov chain can be interpreted as representing an 'endemic' and a 'hyperendemic' state. The methodology is applied to a data set of monthly counts of the incidence of meningococcal disease in the 94 départements of France from 1985 to 1997. Inference is carried out by using Markov chain Monte Carlo simulation techniques in a fully Bayesian framework. We emphasize that a central feature of our model is the possibility of calculating—for each region and each time point—the posterior probability of being in a hyperendemic state, adjusted for global spatial and temporal trends, which we believe is of particular public health interest.     

Development and Evaluation of the Trauma-Informed System Change Instrument: Factorial Validity and Implications for Use

In this paper, we present the process of developing and evaluating an instrument designed to measure the extent to which a complex community system has changed as a result of a community initiative, and for purposes of this research, doing this within the content area of developing local trauma-informed child welfare systems in specific communities in Michigan. The instrument was designed for the Southwest Michigan Children’s Trauma Assessment Center’s (CTAC) Substance Abuse and Mental Health Services Administration (SAMHSA)-funded initiative to bring a trauma-informed perspective to professionals working with children in child welfare. The Trauma Informed System Change Instrument was developed with the input of experts in trauma-informed system change. Two parts of the instrument were analyzed separately using confirmatory factor analysis. A two factor model was fit for Community Characteristics and a three factor model for Individual Characteristics. Although adequate factorial validity was obtained for the instrument, specific items on the instrument that were problematic in fitting the model were identified, and suggestions for revising the instrument for improved functionality are offered, as are other potential uses of the instrument.