Pathways between education and health: a causal modelling approach

Summary.  The association of poor education and poor health has been consistently observed in many studies and in various countries. Thus far, studies examining the mechanisms underlying this association have looked at only a limited set of potential pathways. This study simultaneously examines six distinctive pathways, which have been hypothesized to link education and health and found support from previous studies. A causal analysis of education and health was performed using structural equation models. Data were used from six phases of the National Child Development Study, which is based on following up an initial sample of 17416 children who were born in 1958. The association between education and health appears to be explained by a combination of mechanisms: adolescent health and adult health behaviours for men and women, adult social class among men and parental social class among women. We conclude that improvements in population educational attainment may not automatically lead to improvements in population health, and that health policies for improving health and reducing health inequalities need to target specific causal pathways.     

Alternative institutional responses to asbestos

The level of asbestos risk varies widely, with insulation workers facing risks many orders of magnitude greater than other groups, such as school children. After a period of regulatory neglect, asbestos risks are now among the mos stringently regulated risks, with costs per case of cancer prevented on the order of $100 million. Asbestos litigation triggered much of the public action against asbestos, as asbestos cases constituted the majority of all product liability cases in the federal courts from 1988 to 1991. The litigation costs have, however, been substantial, almost three times as great as the amounts transferred to asbestos disease victims. Risk communication potentially could promote efficient risk levels and victim compensation.     

Training with o (observing) and T (treatment) teams in live supervision: reflections in the looking glass*

Working with a treatment and observing team at the same time, behind the oneway mirror, offers a variety of ways to: (a) generate multiple realities; (b) work with two different models of family therapy simultaneously; and (c) provide feedback on the teams' own roles, rules and group process. The process that 6 trainees and two supervisors used with T and O teams to examine their own coevolution as a therapeutic system using the Milan model of family therapy and Ericksonian hypnotherapy is described. The article concludes with a discussion of the advantages and pitfalls of this type of dual supervision.     

Socioeconomic, medical care, and public health contexts affecting infant mortality: a study of community-level differentials in Peru

Socioeconomic, medical care, and public health contexts are examined in Peruvian communities for their relationship to infant mortality. A deviant case analysis is used to uncover characteristics important in the social structure of Peruvian communities. Results from fieldwork in two "deviant" communities suggest that economic diversity, income disparity, social class fluidity, and women's autonomy, along with refined measures of medical care and public health resources, are important in understanding differentials in mortality. Attention is drawn to the community context and to the interplay of socioeconomic determinants affecting infant mortality.     

Remittances from labor migration: evaluations,performance and implications

2 evaluative views of worker remittances draw opposite conclusions. The negative one posits that remittances increase dependency, contribute to economic and political stability and development distortion, and lead to economic decline that overshadows a temporary advantage for a fortunate few. The positive view sees remittances as an effective response to market forces, providing a transition to an otherwise unsustainable development. They improve income distribution and quality of life beyond what other available development resources could deliver. The implications are tested for labor supply countries to Europe and the Middle East. The implications of the negative are not supported. Although the dire predictions of the pessimistic view have not materialized, the converse - contributions of remittances to economic performance - should not be overstated due to a lack of data.     

A relation for the covariances of order statistics from n independent and non-identically distributed random variables

We derive a simple relation satisfied by the covariances of order statistics in the i.i.d. case and then generalize it to the case when the variables are independent and non-identically distributed. This relation could be employed successfully either to check the calculations or to reduce the amount of direct computations involved in evaluating the covariances of order statistics from an outlier model.     

The right to life

In this issue is a lengthy, thought-provoking essay on the issues raised by unwanted pregnancy. Written by Robert Wennberg in 1984 for the Christian Scholar's Review (13:4), the article has been edited and condensed for our purposes and is quite relevant, I believe, for the student health population. Any practitioner who cares for students wrestling with these issues should at least acknowledge the moral and philosophical dilemmas presented. As one who has walked both sides of the argument, I find Wennberg's fair-mindedness compelling. In closing his article, the author raises the question of what will happen when it becomes possible to accomplish an "abortion"--or removal of the fetus from the mother--without killing the fetus. Will this procedure be acceptable to the average single college student? The New York Times, in an article on "High Tech Babies" (February 21, 1986), raised ethical questions posed by the technology of frozen embryos. Who decides what is to be done with frozen embryos? To whom do they belong? Do they have rights? The theoretical issues raised by Wennberg are already forcing themselves upon us. Whether we like it or not, the future is now. Regardless of your beliefs on this controversial topic, I urge you to read this article. Dr. Wennberg has also just completed a book on this subject, Life In The Balance.     

A review of research on the happiness measures: A sixty second index of happiness and mental health

Eighteen years of research using the Happiness Measures (HM) is reviewed in relation to the general progress of well-being measurement efforts. The accumulated findings on this remarkably quick instrument, show good reliability, exceptional stability, and a record of convergent, construct, and discriminative validity unparalleled in the field. Because of this, the HM is offered as a potential touchstone of measurement consistency in a field which generally lacks it.     

On "being a prostitute"

The book "On Being a Prostitute" (Perkins & Bennett, 1985) is a valuable contribution to the sociology of deviance and sexual ideologies. However, comprehensive as it is, the book presents certain omissions and flaws, with implications for both is empirical data and theoretical underpinnings. In focusing on male (homoerotic) prostitution, and drawing upon Bennett's (1983) "Twenty-Ten" survey (which forms the main empirical base of that aspect of the book), I argue that certain categories of male prostitutes have been excluded. These omissions, I suggest, were necessary to allow Bennett's hypothesis that most male prostitution derives from economic necessity--a recurrent economic determinism reminiscent of Havelock Ellis (1906/1936), and somewhat contrary to a broader structural approach (see Mathews, 1983).     

Demographics: people and markets

The basics of demography are now basic to us business as well. Demographics combine demographic data with socioeconomic and geographic factors to help business and other managers know the market for their goods and services. This pamphlet explains market, product, and site analyses, discusses data sources and resources, and includes case studies involving major corporations. Post-war population trends have had an enormous impact on consumer and labor markets, bringing home to business the importance of taking advantage of demographic shifts. Advances in computerized access to data describing changes and increased consciousness of their economic significance has spurred the application of demographic knowledge by managers and the growth of the demographics information industry. The pamphlet describes the resources and methods of demographics including the creation and use of demographic data products.