A hygiene experiment in rural Bangladesh

In February 1987, 10 students from the health education department at the National Institute of Preventive and Social Medicine of Bangladesh conducted a before after only health education experiment concerning intestinal worm infestation and sanitation by interviewing at least 160 individuals in a village outside of Dhaka. 74.5% initially believed that the only action to take for intestinal worm infestation was to visit a physician and take medicines. After 30 days of intense health education efforts, a 38% increase in those who gave preventive answers occurred among the lower class and a 52% increase among the middle class. Nevertheless 50% of the poor and 37% of the middle class still believed in curative care. In the pretest, 85% did not know how the worms entered the intestine and, in the posttest, this percent fell to 25%. The pretest showed that the typical village member only had 1 correct answer concerning adverse effects of the worms. After intense health education, the number of correct answers of the typical respondent climbed to 2. Moreover, before the intervention, only 20% reported washing their hands correctly after defecation using either rash or soap. After intervention, 96% did so. On the other hand, no change occurred in water sources (2 public tube wells or dirt storage ponds) or the latrine situation. Financial restraints and/or social class may have been responsible for the lack of changes. For example, a tube well is a status symbol of the rich and it would offend the rich if lesser families used them. Further, even the middle class could not afford a sanitary latrine. Therefore the health education intervention had little effect on 2 major sources of the worm infestation problem.     

Policy and practices relating to the active engagement of older people in the community: a comparison of Sweden and Australia

This article compares policy and practices for engaging older people in community life in Sweden and Australia. Barriers and support for active engagement through paid work, social activism, volunteering and aged services are compared. Both countries face issues of ageing populations, services for rural areas and people with small needs. Issues for Sweden were the absence of age discrimination legislation, availability of funds and lack of recognition of the growing levels of volunteering. Issues for Australia concerned the new managerialist approach to services, with associated complexities of access and limited social activism.     

Caring and the generation of social capital: Two models for a positive relationship

Johansson S, Leonard R, Noonan K. Caring and the generation of social capital: two models for a positive relationship When caring is linked to social capital, it is generally assumed that the nature of the relationship is that social capital is a resource that can be used for care work. When there is inadequate funding of aged care services by the state, then social capital may be seen as a substitute for economic and human capital. Caring, therefore, is seen as a drain on capital. However, this does not have to be the case. Aged care services, if thoughtfully designed, can not only consume social capital, but also generate it. Two models of elder care, one Swedish and one Australian, have been identified which specifically address the generation of social capital. In each case, the services and facilities have been developed by third‐sector organisations with a strong community development focus, often in the face of resistance from state‐run or medically oriented services.     

Neighborhood disadvantage and anger among older adults: social comparisons as effect modifiers

Using data from a sample of 1,136 adults ages 65 and older in the District of Columbia and two adjoining counties in Maryland, we examine the association between neighborhood structural disadvantage and levels of anger. In addition, we test whether subjective financial comparisons with neighbors modify those effects differently for elders at different levels of income. We find that the association between neighborhood disadvantage and anger is positive among lower-income elders who feel financially advantaged relative to their neighbors. In contrast, the association between neighborhood disadvantage and anger is positive among higher-income elders who feel financially disadvantaged relative to their neighbors. Irrespective of income, neighborhood disadvantage is unrelated to anger among people who feel financially similar to their neighbors. We discuss the implications of our findings for the study of neighborhood context and health, underscoring interrelationships among inequality, social comparisons, and the stress process.     

How common is intersex? a response to Anne Fausto-Sterling

Anne Fausto-Sterling s suggestion that the prevalence of intersex might be as high as 1.7% has attracted wide attention in both the scholarly press and the popular media. Many reviewers are not aware that this figure includes conditions which most clinicians do not recognize as intersex, such as Klinefelter syndrome, Turner syndrome, and late-onset adrenal hyperplasia. If the term intersex is to retain any meaning, the term should be restricted to those conditions in which chromosomal sex is inconsistent with phenotypic sex, or in which the phenotype is not classifiable as either male or female. Applying this more precise definition, the true prevalence of intersex is seen to be about 0.018%, almost 100 times lower than Fausto-Sterling s estimate of 1.7%.