Examining health literacy disparities in the United States: a third look at the National Assessment of Adult Literacy (NAAL)

BACKGROUND: In the United States, disparities in health literacy parallel disparities in health outcomes. Our research contributes to how diverse indicators of social inequalities (i.e., objective social class, relational social class, and social resources) contribute to understanding disparities in health literacy.

METHODS: We analyze data on respondents 18 years of age and older (N = 14,592) from the 2003 National Assessment of Adult Literacy (NAAL) restricted access data set. A series of weighted Ordinary Least Squares (OLS) regression models estimate the association between respondent's demographic characteristics, socioeconomic status (SES), relational social class, social resources and an Item Response Theory (IRT) based health literacy measure.

RESULTS: Our findings are consistent with previous research on the social and SES determinants of health literacy. However, our findings reveal the importance of relational social status for understanding health literacy disparities in the United States. Objective indicators of social status are persistent and robust indicators of health literacy. Measures of relational social status such as civic engagement (i.e., voting, volunteering, and library use) are associated with higher health literacy levels net of objective resources. Social resources including speaking English and marital status are associated with higher health literacy levels.

CONCLUSIONS: Relational indicators of social class are related to health literacy independent of objective social class indicators. Civic literacy (e.g., voting and volunteering) are predictors of health literacy and offer opportunities for health intervention. Our findings support the notion that health literacy is a social construct and suggest the need to develop a theoretically driven conceptual definition of health literacy that includes a civic literacy component.

The effect of school suspensions and arrests on subsequent adolescent antisocial behavior in Australia and the United States

Purpose: To examine the effect of school suspensions and arrests (i.e., being taken into police custody) on subsequent adolescent antisocial behavior such as violence and crime, after controlling for established risk and protective factors in Victoria, Australia and Washington State, United States (U.S.). Methods: This article reports on analyses of two points of data collected 1 year apart within a cross-national longitudinal study of the development of antisocial behavior, substance use, and related behaviors in approximately 4000 students aged 12 to 16 years in Victoria, Australia and Washington State, U.S. Students completed a modified version of the Communities That Care self-report survey of behavior, as well as risk and protective factors across five domains (individual, family, peer, school, and community). Multivariate logistic regression analyses investigate the effect of school suspensions and arrests on subsequent antisocial behavior, holding constant individual, family, peer, school, and community level influences such as being female, student belief in the moral order, emotional control, and attachment to mother. Results: At the first assessment, school suspensions and arrests were more commonly reported in Washington, and school suspensions significantly increased the likelihood of antisocial behavior 12 months later, after holding constant established risk and protective factors (adjusted odds ratio [OR] 1.5, 95% confidence interval [CI] 1.1–2.1, _p < .05). Predictors of antisocial behavior spanned risk and protective factors across five individual and ecological areas of risk. Risk factors in this study were pre-existing antisocial behavior (OR 3.6, CI 2.7–4.7, _p < .001), association with antisocial peers (OR 1.8, CI 1.4–2.4, _p < .001), academic failure (OR 1.3, CI 1.1–1.5, _p < .01), and perceived availability of drugs in the community (OR 1.3, CI 1.1–1.5, _p < .001). Protective factors included being female (OR 0.7, CI 0.5–0.9, _p < .01), student belief in the moral order (OR 0.8, CI 0.6–1.0, p < .05), student emotional control (OR 0.7, CI 0.6–0.8, _p < .001), and attachment to mother (OR 0.8, CI 0.7–1.0, _p < .05). Conclusions:  School suspensions may increase the likelihood of future antisocial behavior. Further research is required to both replicate this finding and establish the mechanisms by which school suspensions exert their effects.

Public reporting of nursing home quality of care : Lessons from the United States experience for Canadian policy discussion

While the demand for continuing care services in Canada grows, the quality of such services has come under increasing scrutiny. Consideration has been given to the use of public reporting of quality data as a mechanism to stimulate quality improvement and promote public accountability for and transparency in service quality. The recent adoption of the Resident Assessment Instrument (RAI) throughout a number of Canadian jurisdictions means that standardized quality data are available for comparisons among facilities across regions, provinces and nationally. In this paper, we explore current knowledge on public reporting in nursing homes in the United States to identify what lessons may inform policy discussion regarding potential use of public reporting in Canada. Based on these findings, we make recommendations regarding how public reporting should be progressed and managed if Canadian jurisdictions were to implement this strategy.

Positive youth development in the United States: History, efficacy, and links to moral and character education

This paper reviews specific conceptual frameworks and focuses on the evidence from evaluations of program applications delivered prior to age 21 that have the common aim of encouraging Positive Youth Development.

Indigenous blood and ethical regimes in the United States and Australia since the 1960s

Blood samples collected from members of indigenous communities in the mid-20th century by scientists interested in human variation remain frozen today in institutional repositories around the world. This article focuses on two such collections-one established and maintained in the United States and the other in Australia. Through historical and ethnographic analysis, we show how scientific knowledge about the human species and ethical knowledge about human experimentation are coproduced differently in each national context over time. Through a series of vignettes, we trace the attempts of scientists and indigenous people to assemble and reassemble blood samples, ethical regimes, human biological knowledge, and personhood. In including ourselves-a U.S. historian of science and an Australian anthropologist-in the narrative, we show how humanistic and social scientific analysis contributes to ongoing efforts to maintain indigenous samples. [indigenous, biospecimens, science, genomics, postcolonial, ethics, cryopreservation].

Youth alcohol and other drug use in the United States and Australia: a cross-national comparison of three state-wide samples

Although youth drug and alcohol harm minimization policies in Australia are often contrasted with the abstinence and zero tolerance policies adopted in the United States, there has been little research directly comparing youth substance use behaviour in the two countries. Three state representative samples in Victoria, Australia (n = 7898) and in the US states of Oregon (n = 15 224) and Maine (n = 16 245) completed a common cross-sectional student survey. Rates of alcohol use (lifetime alcohol use, recent use in the past 30 days), alcohol use exceeding recommended consumption limits (binge drinking: five or more drinks in a session), other licit drug use (tobacco use), and norm-violating substance use (substance use at school, use in the past 30 days of marijuana or other illicit drug use) were compared for males and females at ages 12-17. Rates were lower (odds ratios 0.5-0.8) for youth in Maine and Oregon compared to Victoria for lifetime and recent alcohol use, binge drinking and daily cigarette smoking. However, rates of recent marijuana use and recent use of other illicit drugs were higher in Maine and Oregon, as were reports of being drunk or high at school. In contradiction of harm minimization objectives, Victoria, relative to the US states of Oregon and Maine, demonstrated higher rates of alcohol use exceeding recommended consumption limits and daily tobacco use. However, findings suggested that aspects of norm-violating substance use (substance use at school, marijuana use and other illicit drug use) were higher in the US states compared to Victoria.

Digital TV in Australia and the USA: a cross-impact analysis of the adoption and diffusion of digital TV in Australia and the United States

The paper examines the adoption and diffusion of Digital Television (DTV) in Australia and the United States, identifying historical, technical, regulatory, marketing, and other commonalities and differences that appear to be most significant to its adoption, as both countries have experienced a 'sluggish' diffusion and adoption of DTV so far. Using library research and borrowing the cross-impact matrix method from futures research, the authors develop J J events related to the various influences and groups of stakeholders that had shaped the policy making and adoption of DTV. We then carry out a comparative analysis between the two countries to make evident their impacts, strengths, and directions of influence. The authors suggest that the implementation of DTV in these two developed countries appears to be nearly identical. Even though Australian and US broadcasting models are fundamentally different, the diffusion process for DTV is primarily affected by the nature of digital technology and globalisation, two trends that may be diminishing the import of the nation-state in the technology adoption process. The paper concludes that these broader economic and technical events may have greater import to DTV's successful diffusion than do traditional, cultural, and nationalistic factors suggested in earlier comparative broadcast studies.

Evaluating a measure of content quality for accounting narratives (with an empirical application to narratives from Australia, Hong Kong, and the United States)

This paper evaluates a texture-based approach developed by Sydserff and Weetman (1999), to examine corporate annual report narratives. This is achieved by using the texture index to evaluate information content (which includes readability) in accounting narratives. Specifically, we examine the letter to shareholders of reports from Australia, Hong Kong and the United States.

We suggest a texture-based evaluation provides a robust measure of narrative quality due to the incorporation of readability and content analysis. The ability to measure content quality assists in promoting accountability, with the aim of improving usefulness of corporate
information and disclosures, and greater investor confidence in capital markets.

This paper also investigates these exploratory results to consider variations in quality between different countries. Considerable differences were found between the countries with Hong Kong reports generally superior. These tentative findings provide a small contribution to the comparative annual report literature and the emerging area of narrative evaluation.

High stakes principalship-sleepless nights, heart attacks and sudden death accountabilities: reading media representations of the United States principal shortage

The possible shortage of applicants for principal positions is news in both Australia and abroad. We subject a corpus of predominantly United states (US) news articles to deconstructive narrative analysis and find that the dominant media representation of principals' work is one of long hours Iow salary high stress and sudden death from high stakes accountabilities. However, reported US policy interventions focus predominantly on professional development for aspirants. We note that this will be insufficient to reverse the lack of applications and suggest that the dominant media picture of completely unattractive principals work, meant to leverage a policy solution, will perhaps paradoxically perpetuate the problem. The dominant media picture is also curiously at odds with research that reports high job satisfaction among principals. We suggest that there is a binary of victim and saviour principal in both media and policy which prevents some strategic re-thinking about how the principalship might be different.

A new era in United States cooperation in international insolvency adminstrations?

Cross-border insolvency laws are increasingly being influenced by the UNCITRAL Model Law on Cross-border Insolvency provisions. The United States has recently enacted domestic legislation based on these provisions by way of Ch 15 of the Bankruptcy Abuse Prevention and Consumer Protection Act 2005, which inserted Ch 15 into USC, Title 11. This article briefly explains the provisions of this United States legislation and draws attention to the important case law commenting and explaining same. It further attempts to alert local practitioners to the changes, benefits and detriments they may encounter when acting pursuant to this legislation.

Prevalence of substance use and delinquent behavior in adolescents from Victoria, Australia and Washington State, United States

This article compares prevalence estimates of substance use and  delinquent behavior in Washington State, United States and Victoria, Australia, two states chosen for their different policy environments around problem behavior. Few comparisons of international differences on rates of multiple problem behavior exist, and most are based on methods that are not matched, raising the question of whether findings are based on  methodological differences rather than actual rate differences. The  International Youth Development Study used standardized methods to recruit and administer an adaptation of the Communities That Care Youth Survey to representative state samples of fifth-, seventh-, and ninth-grade students in each state. Rates of delinquent behavior were generally comparable.  However, striking differences in substance use were noted, with Victoria students reporting higher rates of alcohol use, alcohol misuse, smoking, and inhalant use, whereas Washington State students reported higher rates of marijuana use. Implications for conducting international comparisons are discussed.