Promoting public health through community engagement: Embracing the journey

ABSTRACT

This case study recounts and analyzes the journey that graduate students, enrolled in an experiential, interdisciplinary health promotions course, took with a diverse, urban, Black, Midwest community. Community members, faculty, and graduate students in social work and public health were fellow travelers on this voyage into uncharted territory. A major goal of the journey was to teach students how to recognize community strengths and to facilitate the community in using those strengths. The learner’s stance is used as the guiding principle for this reflective journey that generated serendipitous benefits and challenges. The article concludes with recommendations for interdisciplinary education and curriculum development.     

Acculturation Risk and Protective Factors and Mental Health Symptoms in Immigrant Latino Adolescents

Abstract

The aim of this investigation was to map factors that predicted internalizing, externalizing, social, and total behavioral problems in immigrant Latino adolescents. Interviews were conducted with 100 foreign-born Latino adolescents. Multiple regression analyses revealed two risk factors, perceived discrimination and parent-adolescent conflict, which were significant predictors of adolescent internalizing, externalizing, and total problems. Interaction terms indicated that adolescents who were highly involved in Latino culture and who experienced high parent-adolescent conflict were at risk for internalizing problems. Familism was a protective factor associated with lower levels of internalizing and total problems. However, the effect of familism was mediated by parent-adolescent conflict.     

Filling a critical gap: measuring work policies that affect families globally

Work is a central element in most people's lives, and its adequacy and value cannot be measured by simple figures showing how many people have gained or lost jobs. Current measures of decent work are more comprehensive in terms of what matters to individuals, but deficient in their coverage of work policies that matter to families. In this article, we argue the importance and feasibility of measuring policies and laws that shape work quality, and in particular those that shape how work affects families on a global basis. We make the case that this policy area is especially critical under changing social conditions, and propose a manageable and feasible set of indicators permitting an assessment of the extent to which national labor policies facilitate the ability of working adults to meet the requirements of their jobs as well as the needs of their families. Methods are described and findings mapped for all UN countries in key areas including maternal leave, paternal leave, leave to care for children's health, leave to care for adult family members, and leave to meet other family needs.     

Comorbid mood and adjustment disorders among pathological gamblers seeking treatment in Hong Kong

Research findings on comorbidity and pathological gambling are non–existent in Chinese communities. The objectives of this study were to: (a) determine the prevalence of comorbid mood and adjustment disorders among pathological gamblers seeking treatment in Hong Kong; (b) compare demographic profiles and clinical features in pathological gamblers with and without comorbid mood and adjustment disorders; and (c) explore the association and temporal relationship between pathological gambling and comorbid mood and adjustment disorders. Assessment instruments included demographic data, BSI, SCID-I, ASI and LIFE-RIFT. Results showed that about two-thirds (63.7%; n = 128) of 201 participants reported lifetime comorbid psychiatric disorders. Most common comorbid disorders were mood disorders (29.4%; n = 59) and adjustment disorders (20.9%; n = 42). Pathological gamblers with comorbid mood or adjustment disorders showed more severe levels of psychopathology, impairment in psychosocial functioning and gambling problems. This study is important because it is the first scientific comorbidity study among pathological gamblers in a Chinese context.     

The role of acculturative stress and cultural backgrounds in migrants with pathological gambling

The objective of the present study was to differentiate specific migration-related factors that can account for an increased vulnerability to pathological gambling (PG) among migrants in Germany. One hundred and six gamblers (61 migrants, 45 Germans) with varying degrees of gambling problems participated in the study. We analysed (1) differences between migrants and Germans regarding gambling patterns, severity of gambling problems, motivation and craving; influence of (2) acculturative stress; (3) acceptance and popularity of gambling in the culture of origin on gambling problems; (4) differences between migrants and Germans regarding family gambling and peer gambling; and (5) differences in religiosity and its influence on gambling problems. Results suggest no differences between migrants and Germans regarding gambling patterns and the severity of gambling problems. However, findings indicate that migrants have higher motivation and craving to gamble. Findings further suggest that acculturative stress is associated with more severe gambling problems. In contrast, acceptance and popularity of gambling in the country of origin was not a significant predictor of gambling problems. At the same time, family gambling and peer gambling was significantly more prevalent among migrants, constituting an additional risk factor in the present sample. On the other hand, migrants in the sample benefit more often from a protective influence of religiosity.     

Collaborative Frame Construction in Social Movement Campaigns: Bisphenol-A (BPA) and Scientist–Activist Mobilization

Previous research has explored the definitional features of the processes of scientific expert activism but has been less clear regarding the dynamics of this scientific activism. This paper addresses these gaps in understanding by using an exploration of the state-based efforts and mobilizations to regulate the chemical Bisphenol-A (BPA) to identify and analyze the dynamics of interactions between scientists and activists as they collaborate in pursuit of movement objectives. Drawing primarily from interview data and participant observation, I explore how scientific experts—through collaboration and work with activists—impact the processes of movement framing, and how, in turn, the collaborative dissemination of these frames may contribute to movement goals. I argue that the relationships and coordination that developed between BPA scientists and activists resulted in a collaboratively crafted set of frames that were both scientifically rigorous and highly resonant to a public audience.     

Breaking free from siloes: intersectionality as a collective action frame to address toxic exposures and reproductive health

ABSTRACT

There has been increasing interest in collaborative approaches between the environmental justice (EJ) and reproductive justice (RJ) movements to address the higher burden of toxic exposures and associated reproductive health outcomes in vulnerable communities. This study examined the collective action frames (CAFs) of advocates at the EJ/RJ nexus. CAFs highlight how advocates identify problems and solutions, and motivate action. The use of intersectionality was identified as a main CAF used in three key ways: breaking free from identity-based, issue-based, and movement-based siloes. First, interviewees described breaking free from identity-based siloes by identifying risks of toxic exposures that result from intersecting social locations (e.g. gender, race/ethnicity, income, immigration status) and by equally prioritizing multiple aspects of their identities as they engage in advocacy. Second, they described breaking free from issue-based siloes by developing multi-issue agendas that address a complex web of interrelated problems impacting health. Third, they described breaking free from movement-based siloes by developing cross-movement collaborations to address issues of mutual concern. Among multiple reasons given for cross-movement collaborations, advocates perceived them as valuable in order to disrupt social, political, and economic power imbalances that shape environmental reproductive health inequities, as well as other health and social inequities. Based on these findings, we suggest that intersectionality is a master frame, and thus may be useful to advocates in other social movements addressing intersectional issues. Understanding an intersectionality frame can help to inform advocacy approaches to promote health and health equity, particularly those focused on policies and structural drivers of health.     

Avian Flu and Embodied Global Imagery: A Study of Pandemic Geopolitics in the Media

Avian influenza is caused by viruses adapted to birds. The causative agents can, in rare cases, spread to humans, although no human-to-human transmission has been demonstrated. However, the mere possibility of mutation into a human form allowed for media, states and international organizations to speculate about the meaning of the disease's movement across species and localities. The hypothetical scenarios focused on national preparedness and resilience. Such imageries of elastic and shock absorbing communities offer insights into how diseases are used to contain and border in an age of vanishing boundaries and interconnected global reaches. This study tracks the historical trajectory of public cognitions regarding avian flu as it turned from an ordinary livestock disease into a hyperbolic mutable ‘killer disease’. Excerpts from articles carried in The New York Times and Helsingin Sanomat, a Finnish mainstream daily, are used to map how the disease turned into a register of the hostilities inherent in the world. In the American public cognition, the tangible disease threat was triggered when the dangers of mutation were associated with China. For the small peripheral Finland, the pandemic scare instigated public imaginaries of a resilient and efficient Nordic society.

La influenza aviar es causada por virus adaptados a los pájaros. En casos raros, los agentes causativos pueden propagarse a humanos, aunque no se ha demostrado ninguna transmisión entre humanos. Sin embargo, la simple posibilidad de mutación a una forma humana, permitió a los medios, estados y organizaciones internacionales especular sobre el sentido del movimiento de la enfermedad entre las especies y localidades. Los escenarios hipotéticos se enfocaron en la preparación y resistencia nacionales. Tales imágenes de comunidades elásticas y absorbentes de impactos ayudan a comprender mejor cómo se usan las enfermedades para contener y colindar fronteras en una época que están desapareciendo y de extensa interconexión global. Este estudio sigue la trayectoria histórica de conocimiento público respecto a la gripa aviar cuando pasó de una enfermedad ordinaria de ganado a una ‘enfermedad mortal’ hiperbólica mutable. Extractos de artículos publicados en el New York Times y el Helsinki Sanomat, un diario finlandés predominante, se usaron para representar cómo la enfermedad se convirtió en un registro de las hostilidades inherentes en el mundo. En el conocimiento americano, la amenaza tangible de la enfermedad se desencadenó cuando los peligros de la mutación fueron asociados con China. Para la pequeña Finlandia, el susto pandémico instigó la imaginación pública de una resistente y eficiente sociedad nórdica.

禽流感是由鸟类携带的病毒引起的。尽管目前还未发现人到人传播的案例,但在某些罕见的情况下,这些病原体可以传染给人类。尽管如此,仅仅是能变异为人类病毒的可能性就足以让媒体、国家和国际组织思考这种跨物种和地域的病毒传播的后果。这种假想关注国家的准备情况和应变能力。这种关于具有弹性和能吸收震荡的社会的意象让我们能够洞察,在一个边界正在消失、各领域相互联系的时代中,疾病可以如何被用来阻止国家边界的消失并界定国家边界。禽流感已经从一种普通的家畜疾病变为一种夸张的可变异的致命疾病。本文追踪了这一公众认知变化的历史轨迹。通过刊登在《纽约时报》和芬兰主流日报《赫尔辛基新闻》上的文章节选,本文表明了禽流感是如何变为各国固有敌意的记录器的。在美国的公众认知中,禽流感在中国的变异危险导致了这场有形的疾病威胁。对于处于边缘的小国芬兰而言,这种禽流感大流行的恐慌驱使公众想象一个灵活高效的北欧社会。

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Marital Quality and Health Over 20 Years: A Growth Curve Analysis

Although there is substantial evidence linking marital quality to physical health, few studies have been longitudinal. This study examined data from the Marital Instability Over the Life Course Study; 1,681 married individuals followed for 20 years were included in these analyses. In order to control for life course effects, participants were divided into 2 cohorts: early life and midlife. On the basis of latent growth curve analysis, the results indicated that initial values of marital happiness and marital problems were significantly associated with the initial value of physical health among both cohorts. In addition, the slope of marital happiness was significantly associated with the slope of physical health among the younger cohort, and the slope of marital problems was significantly associated with the slope of physical health among the midlife cohort. These results provide evidence of the significant association between positive and negative dimensions of marital quality and physical health over the life course.     

Challenges of Safe Motherhood: Program and Policy Recommendations

ABSTRACT

This article synthesizes the major findings from research and case studies on safe motherhood and focuses on best practices and changes in public policy. Many factors that negatively influence safe motherhood can be ameliorated—and have been in numerous societies through education, access to resources, public–private partnerships, and grassroots efforts. A model identifying the interrelationship of variable is provided. Policy recommendations are discussed.