Unraveling Health Disparities Among Sexual and Gender Minorities: A Commentary on the Persistent Impact of Stigma

ABSTRACT

LGBT (lesbian, gay, bisexual, and transgender) populations experience disparities in health outcomes, both physical and mental, compared to their heterosexual and cisgender peers. This commentary confronts the view held by some researchers that the disparate rates of mental health problems reported among LGBT populations are the consequences of pursuing a particular life trajectory, rather than resulting from the corrosive and persistent impact of stigma. Suggesting that mental health disparities among LGBT populations arise internally, de novo, when individuals express non-heterosexual and non-conforming gender identities ignores the vast body of evidence documenting the destructive impact of socially mediated stigma and systemic discrimination on health outcomes for a number of minorities, including sexual and gender minorities. Furthermore, such thinking is antithetical to widely accepted standards of health and wellbeing because it implies that LGBT persons should adopt and live out identities that contradict or deny their innermost feelings of self.     

Need,well‐being and outcomes: the development of policy‐thinking for children's services 1989–2004

This paper describes how government policy thinking about the well‐being of children and young people developed between the Children Act 1989 and the Children Act 2004. These two Acts are milestone statements about how services to children in England and Wales should be delivered. It is an account informed by the author's own experience as a government adviser on children's social care over much of this period and supporting documentation. It traces the strands of government policy thinking about how to deliver services for children from children in need to the articulation of the five Every Child Matters outcomes. It argues that attempts to achieve coordinated service planning for children and young people played a significant role in the formulation of shared objectives and the articulation of child outcomes. However, it argues that looking at real outcomes exposes how children in the UK do relatively badly compared with other rich nations. It questions whether we can realistically expect our services to deliver significantly improved outcomes given the impact of enduring inequality in our society. This paper is dedicated to the memory of David Lambert CBE, former Assistant Chief Inspector of the Social Services Inspectorate in London, who died suddenly on 7 October 2010. He lent me articles to assist me in writing this paper.     

浙江农村青年创业小额贷款项目在基层的实施效果研究———以乐清市为例

浙江农村青年创业小额贷款项目自推出以来受到浙江基层创业青年广泛关注,该项小额贷款制度申请程序简便、担保形式灵活、政府扶持力度逐年加大,已逐步发展成为基层创业青年融资的主要途径之一.近年来,在浙江“两创”总战略鼓励下,农村青年创业小额贷款项目发展前景广阔、发展势头良好,同时在担保、风险控制、贷款覆盖面等方面也不乏矛盾和困惑     

From Destruction to Reconciliation

SUMMARY

Daniel Johnson discusses how the application of “restorative justice” in his own life and in the life of the victim of his criminal offense contributed to his personal regeneration and healing for his victim. Mr. Johnson challenges criminal justice policy-makers to create conditions where “restorative justice” can be employed in the broadest sense in order to do what contemporary, punitive, retributive criminal justice systems are largely incapable of doing, that is, facilitate lasting offender rehabilitation and healing for crime victims and communities, and to offer opportunities for victim-offender reconciliations.     

Stop the Beat: Quiet Regulation and Cultural Conflict1

This article explores a recent conflict over the youth phenomenon known as “raving” in the City of Chicago. By interviewing participants involved in the conflict, I set out to understand the extent to which the crackdown on raves in Chicago was similar to earlier social reactions to jazz, comic books, rock and roll, and Dead Head culture, as well as to more recent conflicts over punk, rap music, and raves in other cities. While most previous research on cultural conflict has focused on moral crusades, campaigns, and panics, the Chicago conflict represents an example of “quiet regulation.” Opponents refrained from highly visible, morally charged attacks; instead, in the absence of media hype and visible public discourse, public officials justified the crackdown in highly bureaucratic terms—avoiding risk, collecting taxes, enforcing codes. Nonetheless, they also drew on cultural schemas that linked raves and raving with drugs, sex, and deviance. As a result, officials selected a course of regulation that criminalized DJs and discredited the artform. In the absence of a highly visible moral campaign, the rave participants were unable to mobilize and resist the regulation and defend their lifestyle. Sociologists must move beyond highly visible campaigns and crusades and pay greater attention to quiet regulation, both because such regulation is likely to increase in the future and because it has significant consequences for power, cultural expression, and identity.     

‘You Get More Respect,’ Reasons for Sex Among African American High School Youth: A Qualitative Study

ABSTRACT

African American adolescents continue to be disproportionately impacted by HIV, sexually transmitted infections (STIs), and unanticipated pregnancies. In-depth, face-to-face interviews among a convenience sample of 32 African American adolescents (16 male and 16 female) were used to explore the reasons why some adolescents decided to engage in sex while others chose to delay sexual debut. Data were analyzed using a thematic analysis. Among the overall sample, psychological motivations, external pressure, physical pleasure seeking, and relationship-related motivations were the major themes cited for engaging in sex by participants and their friends. External support, motivation to avoid negative consequences, not feeling ready or lacking interest in sex, and having negative views about sex were among the major reasons for delaying sex. Several of the emergent themes showed gender differences. Suggestions for future research include the need for sexual education, and STI/HIV prevention programs that are gender sensitive and flexible enough to accommodate multiple factors related to sexual debut.     

Providing Mental Health Services to Older People Living in Rural Communities

Summary

Rural dwelling elders who experience mental health problems often have difficulty finding help since rural communities often lack adequate mental health service providers. This paper reports on the initial phase of a 5-year, interdisciplinary clinical research study that is testing the effectiveness of providing a home delivered, therapeutic psychosocial intervention, aimed at improving the emotional well-being and the quality of life of medically frail elders who live in rural communities. In the early phases of this study, the clinical research team encountered a number of interesting and often unanticipated challenges as it attempted to recruit study participants and provide services to them. In this article, we examine these challenges and share what we have learned so far about providing mental health services to elderly persons living in rural environments.     

The Making of COBRS 2.0

Abstract

Recently introduced advances in microcomputer technology offer opportunities for improving child welfare agencies' access to powerful case assessment and program evaluation tools. This paper discusses the process of fitting a child behavior outcome measurement system to a menu driven microcomputer program. Traditional strategies for measuring outcome effectiveness, managerial priorities and operational constraints are examined in terms of their bearing on the introduction of new microcomputer technology. The developmental process is traced to show how these factors influenced the addition of a number of user options to the basic program to enhance its adaptability to specific agency needs. Initial user feedback indicated general satisfaction with the basic program and the applicability of its output, little or no experimentation, as yet, in adapting the system, and, a minor need to adjust the sequencing of operator activities to better fit the realities of agency work rhythms.     

'The more things change…': Barriers to community services utilisation in Queensland

Community services are central to the lives of many elderly Australians or Australians with disabilities if they are to remain in the community. Over the past two decades, significant advances have been made in policy and associated programs, significantly improving the standards of service delivery. This research reports on the perceptions of service providers in community services for people with disabilities in six communities in Queensland. It illustrates that significant barriers to service utilisation remain, despite reform. It suggests that continuous efforts to promote service access need to be built in at the program level.