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.     

Culture and Organization: The Case of Transmanche-Link

The relationship between culture and organization has often been discussed, but rarely explored directly. This paper implements a cultural values instrument taken from Hofstede together with a behavioural instrument derived from Van de Ven to matched samples of British and French managers working on the Channel Tunnel project. The results largely replicate the findings of Hofstede regarding cultural values, but do not support the predicted implications for behaviour. In essence, the British were found to be more bureaucratic and more team-oriented than their French counterparts, who tended to be more fonceur and competitive. This indicates that the relationship between culture and behaviour might be more complicated than research to date suggests.     

Comparison of Modes of Administration and Response Options in the Assessment of Subjective Health Using the First Question of SF-36

To compare two modes of administration (self-administered; by interviewer) and two response options format (using words; images of “facial-expressions”) of the first question of SF-36 (Q1SF-36), and to test its validity. We included 825 participants (20–90 years). Q1SF-36, using words or images, was included in a global questionnaire interview and at the end participants filled the SF-36. The agreement was tested by weighted kappa coefficients (WKappa). Classification Trees were used in the calibration of Q1SF-36 responses, with the physical (PDSF36) and mental dimensions of SF-36. Polyserial correlation coefficients and areas under the ROC curves (AUC) were used for validation. After categorization, using PDSF36 classification trees, the WKappa were 0.770 (self-administered vs. interviewer), 0.569 (self-administered vs. facial-expressions) and 0.566 (interviewer vs. facial-expressions). The WKappa between the PDSF36 and the modes (self-administered, interviewer and facial-expressions) were 0.784, 0.713 and 0.579 and the corresponding polyserial correlation coefficients were 0.784, 0.713 and 0.579. A good discriminatory power was found comparing the modes with the PDSF36 (AUC = 0.907, 0.923 and 0.827), but not with mental dimension (AUC = 0.538, 0.501 and 0.629). The Q1SF-36, by self-administration or interviewer, may be a valid alternative for assessment of subjective physical health, but not mental health.     

Disruptive Organisation

Organizations are driven by continuous change. Global, socio-economic and technological megatrends – demographic changes and digitalization – are the reasons for transformation. Traditional organization forms are not in line with customers‘ need. Disruptive modes of development and innovations have been intensively discussed elsewhere. The topic of disruptive organization have not been discussed towards internal and external customer relations, although of high relevance. 129 Managers answered on communication ways and the purpose of upcoming meaning for the working place/office. Two new models and five concrete recommendations have been established for upcoming future organization.     

Camera-Related Behaviors during Video Recorded Medical Interactions

Video recording provides an objective record of the content of medical interactions. However, there is concern that cameras may be reactive measurement devices that alter what normally transpires during interactions. This study addressed potential reactivity of cameras in medical interactions. Interactions between 45 patients and 14 medical oncologists were video recorded and coded for camera-related behaviors. Eleven of 45 patients performed none of the behaviors. Among the other patients, camera-related behaviors were infrequent and, on average, constituted about 0.1% (one-tenth of one percent) of total interaction time. Behaviors occurred most often in very early stages of interactions, and when physicians were absent from the room. Seven physicians showed camera-related behaviors, comprising less than 0.1% of the time they were in the interaction. Results suggest video recording can provide nonreactive means of studying medical interactions.

Dual experiences of teenage parenting and homelessness among Native Hawaiian youth: A critical interpretative phenomenological analysis

Teenage parenting is a challenging venture—particularly when parenting while homeless. The present study explores in‐depth through case‐based analysis the lived experiences of three young homeless and parenting teens (one mother and two fathers). It is the first known study of teenage parenting and homelessness among Native Hawaiian youth, a key affected population. Interpretative phenomenological analysis of participants' individual interviews revealed three themes that characterize the experience of parenting as a teen while homeless: (a) They never raised me up (childhood experiences); (b) becoming mommy and daddy (early experiences of teen pregnancy and parenting while homeless); and (c) finding our place (current experiences of teen parenting and perspectives on teen pregnancy and homelessness). Implications for direct practice, social policy, and future research are discussed in the context of this complex reality.     

Cultural Connection Predicts Perceptions of Financial Security for Māori

This paper examines the impact of relative income on income satisfaction with given absolute income. We conducted an experiment in China where participants earned three different levels of income according to their relative performance in a task. While the treatment group was informed about their relative income, the control group only knew their own absolute income. We found that while controlling for absolute income and other factors, information about relative income increases the satisfaction of the high-income group and reduces the satisfaction of the low-income group. Relative income may interact with individual characteristics, such as gender, to affect income satisfaction. We also found that relative income treatment significantly increases income satisfaction inequality, primarily by causing social comparisons among different income groups, which has some welfare implications.     

Living on the margin: disabled Iranians in Belgian society

This paper explores the antecedents, experiences and consequences of marginalization as reported and dealt with by disabled Iranian immigrants in Belgium. This work extends the work of Gallie and colleagues and Siegrist demonstrating that the forces of marginalization applicable to all immigrants are particularly pertinent to disabled immigrants. The research is based on 26 in‐depth, face‐to‐face interviews, focus groups, interviews with government officials and immigration experts, ethnographic work and official government statistics. The findings detail how the combined forces of history, context and reasons for immigration; isolation, vulnerability and perceived loss of control; religion and rejection; lack of reciprocity in social exchanges; problems in obtaining jobs; and difficulties in negotiating an entry into Belgian society combine to sustain marginizalation. As a consequence, disabled immigrants in this group are generally excluded from society and discriminated against in terms of citizenship, education, jobs and general acceptance.