Community,Family, and Race/Ethnic Differences in Health Status in Rural Areas1

Abstract Many race-specific differences in health outcomes that have been observed in previous research have been attributed to class and racebased group differences which either facilitate or constrain health opportunities and behaviors. These include such variables as different rates of poverty, health insurance coverage, and access to medical care. However, these relationships have been inadequately examined in rural communities where minority status may be even more detrimental to health than in urban areas, due to various constraints on access to health care. We present an analysis that assesses the effects of community, family structure, sociodemographic, and medical care variables on self-reported health status among Hispanics, Mrican Americans, and non-Hispanic whites in six rural communities in Florida. Community structural characteristics had a significant effect on self-reported health, as did some of the measures of how respondents “experience” community. These relationships held even when other sets of variables were added to the models. Family/household characteristics and sociodemographic and medical care variables were less important in explaining self-reported health status. These findings suggest that community continues to be important in explaining differences in health status in rural areas.     

Informed decision making: the new paradigm

Health care cannot survive in its present form. It is becoming unaffordable for a large share of the country's population. Its quality and effectiveness inexplicably vary between communities and across time. With all these problems, the process of health care can be understood. All that are needed are good, basic data; its access, management, and analysis; and then presentation of facts and observations. Together, these functions describe the translation of data into information--the field of medical informatics. Information about such management concerns as clinical efficiency (which largely is related to appropriateness and cost-effectiveness) and about the realities of day-to-day medical practice can be used to improve the value of health care. Informed decision making is based solely on confidence that, given the right information and understanding, we can all make the right decisions. The right decisions mean better patient acceptance and satisfaction, a sense of value enhancement by payers, and support of the Hippocratic tradition.     

Fitting Hierarchical Holographic Modeling into the Theory of Scenario Structuring and a Resulting Refinement to the Quantitative Definition of Risk

A point of view is suggested from which the Hierarchical Holographic Modeling (HHM) method can be seen as one more method within the Theory of Scenario Structuring (TSS), which is that part of Quantitative Risk Assessment having to do with the task of identifying the set of risk scenarios. Seen in this way, HHM brings strongly to our attention the fact that different methods within TSS can result in different sets of risk scenarios for the same underlying problem. Although this is not a problem practically, it is a bit awkward conceptually from the standpoint of the "set of triplets" definition of risk, in which the scenario set is part of the definition. Accordingly, the present article suggests a refinement to the set of triplets definition, which removes the specific set of scenarios, found by any of the TSS methods, from the definition of risk and casts it, instead, as an approximation to the "true" set of scenarios that is native to the problem at hand and not affected by the TSS method used.     

Outward bound: a treatment modality unexplored by the social work profession.

The Outward Bound Experience has a strong yet time-limited impact on delinquent youths. Social workers could help maintain the impact by establishing community-based followup programs that would reinforce and sustain the positive attitudes and behaviors developed.     

Developing creative solutions to the problems of children and their families: communicative reason and the use of forum theatre

The paper represents a further development of work previously reported in this journal by Spratt & Houston (1999) and Spratt et al. (2000) . The authors have sought to develop ways of understanding current social work with children and families in line with the critical theory of Jurgen Habermas. This analysis has been complemented by an adoption of the methodology of the radical dramatist, Augusto Boal. In synthesizing Habermas's analysis of communicative discourses with the consciousness raising methodology of Boal, the authors have already demonstrated the effectiveness of this hybrid in problem‐solving exercises with social workers. The present paper reports on an application of this developing theory to practice, utilizing the centrepiece of Boal's method, forum theatre. A forum theatre project, concerned with the issue of bullying, is described and evaluated. It is argued that the project provides an exemplar of an innovative, democratizing and effective methodology that might profitably be utilized in social work with children and families. Finally, suggestions are made as to how these ideas could be developed in practice.     

SODA WARS: THE EFFECT OF A SODA TAX ELECTION ON UNIVERSITY BEVERAGE SALES

We examine how soda sales changed due to the campaign attention and election outcome of a local excise tax on sugar‐sweetened beverages. Using panel data of beverage sales from university retailers in Berkeley, California, we estimate that soda purchases relative to control beverages significantly dropped immediately after the election, months before the tax was implemented in the city of Berkeley or on campus. Supplemental scanner data from off‐campus retailers reveal this result is not unique to the university setting. Our findings suggest soda tax media coverage and election outcomes can have larger effects on purchasing behavior than the tax itself. (JEL D12, H20, C23, I38, Q18)     

High school students’ academic causal attributions in the cultural-political context of the Arab school system in Israel

While motivation is commonly interpreted as an individual student’s characteristic, motivational perceptions and beliefs, such as causal attributions of success and failure, are embedded in cultural meanings and contextual practices. The current study aimed to investigate causal attributions among Arab high school students in Israel and to interpret them in the light of their cultural-political context. Two hundred and five 11th-grade Arab students from three different geographic regions in Israel responded to open-ended and closed survey questions about events of success and failure in school. The analysis indicated that students overwhelmingly considered exams when thinking about events of success and failure, reflecting the normative teacher-centred pedagogical practices in schools. The analysis also manifested patterns of a self-serving bias. These findings are interpreted in the light of the cultural-political characteristics of the Arab school system in Israel.