Racial inequality in active life among adult americans

Is a shorter life with more years lived in poor health a defining attribute of the life cycle of disadvantaged groups? Based on the J990 5% Public Use Microdata Survey, we develop life table models of healthy (or active) life for the major racial groups, by sex, in the United States. The analysis underscores the complexity of the relationship between morbidity and mortality in the population. For Asians, longer life is associated with fewer years lived in poor health. In contrast, Native Americans’ relatively longer lives are accompanied by extended periods of chronic health problems. of all racial groups, blacks live the fewest years, and they live a high proportion of those years with a chronic health problem. Hispanics also live substantially fewer years, yet the period of life they spend with a health problem is relatively compressed. Racial differences in the link between morbidity and mortality point to the importance of investigating how chronic diseases and disease prevention and treatment are related to active life across the population subgroups.     

Social mobility and personal satisfaction: evidence from ten countries

This paper examines survey data relating class mobility to satisfaction and dissatisfaction with seven different domains of everyday life among nationally representative samples of men and women living in ten industrialized nations. The evidence is set against competing pessimistic and optimistic accounts of the mobility experience found in earlier literature. Results show that individuals who move from working-class origins to middle-class destinations are no more likely to be systematically satisfied or dissatisfied with life than are the socially immobile or even those downwardly mobile from advantaged backgrounds into the working class. Indeed, in all nations, the overall association between class experience and satisfaction with life is both weak and uneven across the different life-domains. The study also serves to illustrate an important principle of research methodology more generally.     

Residential segregation of West Indians in the New York/New Jersey metropolitan area: the roles of race and ethnicity

"To assess the relative roles of race and ethnicity in shaping patterns of residential segregation, this article utilizes indices of segregation and a geographic mapping strategy to examine the residential patterns of West Indian blacks in the greater New York City area. The socioeconomic characteristics of neighborhoods occupied by West Indian blacks are also examined and compared to those of areas occupied by African Americans. The results indicate that, on one hand, West Indians are largely denied access to residential areas occupied predominantly by whites and are confined to areas of large black concentrations. On the other hand, West Indians appear to have carved out somewhat separate residential enclaves within these largely black areas...."     

Exposure of medical students to body fluids

Three hundred forty-two students at 3 Florida medical schools were surveyed concerning occupational exposures to blood and body fluids during their 3rd-year clerkship. The 16-item questionnaire was anonymously returned by 150 students, and differences among groups were assessed at p < .05. Most of the students complied with universal precautions guidelines (UVPG); 62 reported 101 exposures, including 9 with HIV-positive blood and body fluids. Most of the exposed students knew about the guidelines but regarded the incidents as irrelevant to their safety or supervision training. Noncompliant students reported significantly more exposures than compliant students. Time constraints, inconvenience of using gloves during procedures, and belief that patients were at low HIV risk discouraged adherence to the guidelines. Common practices following exposure were "no action" or "washed area only" without medical follow-up. Medical students' UVPG adherence should be increased by workload modification, user-friendly safety products, and supervised practice training in clinical exposure settings.     

Psychiatric unit fall event

Patient falls in psychiatric units may have an impact on patient outcomes. Fall risk assessment among psychiatric patients is an important issue. Gait/balance problems and history of falling are important considerations in assessing psychiatric patients for fall risk.     

Paving the road to hell: why change programs ultimately fail

A successful change program must have clearly delineated and honestly defined goals. Change requires conviction, money, and effort and the willingness to invest all three. Change programs fail when any of these requirements are lacking. Many health care executives have the conviction, but are unwilling to spend the money or expend the effort. Some lack conviction, despite having money; the effort is merely spinning wheels with no forward motion. Often all three are lacking, despite an outward appearance to the contrary--the result of management delusions. Employees are quick to see through misleading and insincere schemes. It is much easier to foster trust from the outset than to rebuild it after it has been violated.     

Gender and physician-assisted suicide: an analysis of the Kevorkian cases, 1990-1997

This study examines the seventy-five suicide cases Dr. Jack Kevorkian acknowledged assisting during the period between 1990-1997. Although these cases represent a range of regional and occupational backgrounds, a significant majority are women. Most of these individuals had a disabling, chronic, nonterminal-stage illness. In five female cases, the medical examiner found no evidence of disease whatsoever. About half of the women were between the ages of forty-one and sixty, and another third were older adults. Men's conditions were somewhat less likely than women's to be chronic and nonterminal-stage. The main reasons for the hastened death mentioned by both the person and their significant others were having disabilities, being in pain, and fear of being a burden. The predominance of women among Kevorkian's assisted suicides contrasts with national trends in suicide mortality, where men are a clear majority. It is possible that individuals whose death was hastened by Kevorkian are not representative of physician-assisted suicide cases around the country, because of Kevorkian's unique approach. Alternatively, the preponderance of women among Kevorkian's assisted suicides may represent a real phenomenon. One possibility is that, in the United States, assisted suicide is particularly acceptable for women. Individual, interpersonal, social, economic, and cultural factors encouraging assisted suicide in women are examined.