Economic Stress in Lives: Developmental Perspectives

A major task for research on the social costs of economic stress is to trace how macrosocial changes affect increasingly smaller social units and ultimately those microsocial phenomena that directly influence children in their families. In this paper, we specify linkages between macroeconomic change and children's development by tracing deprivational effects through family adaptations in the household economy and in personal relationships. Our findings from research on children and families of the Great Depression are discussed in relation to an interactional model of the process by which families adapt to stressful times.     

A Profile of Middle-Aged and Older Adults Admitted to Nursing Homes: 2000–2008

Middle-aged adults are becoming an increasing share of the nursing home population. Minimum Data Set assessment data for 2000 and 2008 are used to explore similarities and differences in sociodemographic, residential, medical, and psychiatric characteristics of newly admitted middle-aged adults (31–64) compared to their older counterparts (65+). Relative to their share of the state population, Black middle-aged adults are overrepresented in nursing homes across 45 states and the District of Columbia. Chronic conditions, including diabetes, renal failure, chronic obstructive pulmonary disease, asthma, and circulatory/heart disorders, appeared to contribute to the increasing presence of middle-aged adults. There were substantial increases in diagnoses of psychiatric disorders at admission; psychiatric diagnoses were significantly higher among middle-aged adults. Middle-aged adults were also more likely to have residential histories of prior stays in psychiatric facilities relative to older adults. States' rebalancing efforts need to attend to the increasing presence of disability associated with chronic medical and psychiatric conditions among middle-aged adults.     

Generic tobacco use among four ethnic groups in a school age population

The prevalence of overall or "generic" tobacco use among Hispanic, white, Black and Asian youths in grades four, seven, ten and twelve was compared in San Diego, California (n = 4980). Significant differences in generic tobacco use between ethnic groups were found in the 4th, 10th and 12th grades, but were greatest in the 10th grade. Only white youths demonstrated a sharp increase in regular tobacco use (once a month or more) between 7th and 10th grade. Overall, the prevalence of regular use was highest among whites (25.8%), followed by Hispanics (19.7%), Blacks (17.6%) and Asians (12.6%). Marijuana, alcohol, and other drug use explained approximately 40 percent of the variance in tobacco use in each ethnic group. Other predictors varied by ethnicity and included socioeconomic status, happiness of student, strictness of parent, adult tobacco use at home, accessibility to marijuana, and gender.     

The Troubled Families Programme: Learning about policy impact through realist case study research

This article aims to critically explore how qualitative case study research that is founded on realist principles can fundamentally enhance social policy evaluation methodologies and, in turn, provide improved learning for policy makers and practitioners. We suggest that these methodological advantages are accrued through the careful construction of theory-based explanations of “how” policy programmes work thereby addressing the limitations of quasi-experimental methods—namely, a focus on and prioritisation of outcome measures. The paper situates this key argument within wider, long-standing debates about evidence-based policy making and what constitutes “evidence” of impact in social policy. It does so through reflection on the contentious and contradictory knowledge claims that surround the Troubled Families Programme and evaluative claims regarding its efficacy. In conclusion and looking forward, we suggest that there remains much scope to combine “intensive” qualitative case studies with “extensive” quantitative measures within local and national evaluations of complex, multidimensional social policies, such as the Troubled Families Programme.     

Conceptualising ‘The Relationship’ in Intensive Key Worker Support as a Therapeutic Medium

Across various welfare and justice systems, intensive key worker support is a model of working considered effective for individuals and families identified as having multiple and complex needs. The high profile ‘troubled families’ programme in England is the most recent prominent example of such a model. The key worker role is to assess an individual’s needs, carry out support planning, provide and/or co-ordinate the delivery of supportive interventions and complete care plan reviews. This requires the key worker to work on a one-to-one basis with individuals which, in turn, demands the ability to form effective relationships. In this paper and using evidence from a number of studies, I look at how the key worker-client relationship is developed and maintained. I examine the skills, processes and communication strategies that allow key workers to engage clients, build relationships and drive change. I also explore the notion that the key worker-service user relationship is itself a ‘therapeutic’ medium and is therefore a productive practice in its own right. The paper suggests that while key workers might not be trained therapists or counsellors, they might be equipped to address some emotional challenges that individuals with complex needs face and build therapeutic relationships with them.     

Family Influence on Physical Health During the Middle Years: The Case of Onset of Hypertension

Using survival analysis for 367 married women and 340 married men, this article investigates (a) change in hazard rates and survival probabilities with age for the onset of hypertension and (b) the influences of stressful marital and parental relationships on the hazard rates and survival probabilities of hypertension. Hazard and survival plots show that the risk for hypertension increases during the middle years to maximum, then decreases with age for both men and women. Log‐logistic survival models demonstrate that although marital stress significantly increases the likelihood of earlier hypertension among these long‐time married men and women, parental stress increases the likelihood of earlier hypertension only for women. These models control for the effects of stressful work conditions, health behaviors, hostility, and education. Employing a longitudinal research design strengthens confidence in the findings. The findings demonstrate that stressful close relationships may be more important determinants of physical health than is generally assumed.     

Moving,Making and Atmosphere: Routines of Home as Sites for Mundane Improvisation

In this article, we examine how everyday atmospheres of home are made, maintained and improvised through habitual routines of movement, and the implications of this for co-design for energy demand reduction. Drawing on our ethnography of how people experienced and constituted a sensory aesthetic of home, we analyse the example of lighting use in night-time routines. We propose seeing these routines as sites of the possible, where everyday making might be engaged for co-design. Thus suggesting refocusing ethnographic design research beyond what people do in their homes, towards how they move through and make the atmospheres of their homes.     

Challenging Gerontophobia and Ageism Through a Collaborative Intergenerational Art Program

Prejudices against older adults have been shown to reduce effective care delivery and impact long-term health outcomes for older adults. In an effort to combat these prejudices, intergenerational—and often unidirectional—programs focus on challenging ageism. The PALETTE program takes this further to employ collaborative activities as a way to challenge the gerontophobia that often accompanies ageism. Promoting Art for Life Enrichment Through Transgenerational Engagement (PALETTE) is an innovative program for interprofessional undergraduate and graduate students that combines intergenerational arts activities with formal education on aging, ageism, and gerontophobia. Having demonstrated success in changing the attitudes of students, PALETTE serves as a model for an internationally replicable program that has the potential to improve person-centered care while educating future generations of older adults about positive, optimal aging.