Women's subjective and objective health over time : the role of psychosocial conditions and physiological stress responses

Today, health problems are likely to have a complex and multifactorial etiology, whereby psychosocial factors interact with behaviour and bodily responses. Women generally report more health problems than men. The present thesis concerns the development of women’s health from a subjective and objective perspective, as related to psychosocial living conditions and physiological stress responses. Both cross-sectional and longitudinal studies were carried out on a representative sample of women. Data analysis was based on a holistic person-oriented approach as well as a variable approach. In Study I, the women’s self-reported symptoms and diseases as well as self-rated general health status were compared to physician-rated health problems and ratings of the general health of the women, based on medical examinations. The findings showed that physicians rated twice as many women as having poor health compared to the ratings of the women themselves. Moreover, the symptom ”a sense of powerlessness” had the highest predictive power for self-rated general health. Study II investigated individual and structural stability in symptom profiles between adolescence and middle-age as related to pubertal timing. There was individual stability in symptom reporting for nearly thirty years, although the effect of pubertal timing on symptom reporting did not extend into middle-age. Study III explored the longitudinal and current influence of socioeconomic and psychosocial factors on women’s self-reported health. Contemporary factors such as job strain, low income, financial worries, and double exposure in terms of high job strain and heavy domestic responsibilities increased the risk for poor self-reported health in middle-aged women. In Study IV, the association between self-reported symptoms and physiological stress responses was investigated. Results revealed that higher levels of medically unexplained symptoms were related to higher levels of cortisol, cholesterol, and heart rate. The empirical findings are discussed in relation to existing models of stress and health, such as the demand-control model, the allostatic load model, the biopsychosocial model, and the multiple role hypothesis. It was concluded that women’s health problems could be reduced if their overall life circumstances were improved. The practical implications of this might include a redesign of the labour market giving women more influence and control over their lives, both at and away from work.

‘Neutral, native-like or authentic’ : Investigating attitudes and beliefs of expanding circle speakers of English

The status of English as the language of international communication is by now well-established. However, in the past 16 years, research has tried to emphasize the fact that the English spoken in international contact situations and between people with other first languages than English has different needs than the English spoken locally amongst native speakers, resulting in the emergence of English as a lingua franca (ELF) as a scholarly field. However, the impact of findings in ELF has so far only led to a moderate shift in English language teaching. Especially in expanding circle countries, where ELF should have the biggest impact, change is only gradually becoming palpable. Accent and pronunciation, as one of the biggest factors on both identity and mutual intelligibility (Jenkins 2000; 2007) are at the root of discussion. The scope of this study is therefore to examine accent choices and the extent to which native speaker ideology informs the preferences of ten speakers of ELF and 27 German natives with experience in international communication. Both ethnographical and sociolinguistic methods, as well as auditory analysis have been applied and conducted. The auditory analysis of six variables in the recorded speech production of the ten speakers suggests that there is no significant preference of one norm-giving variety over the other. Rather, speakers tend to mix-and-match General American- and Standard Southern British English-like features in their pronunciation. When reporting their accent ideals, the idea of a ‘neutral’ English accent is mentioned by four participants. Neutral accents seem to have been understood as ‘unmarked accents’. Expressed beliefs on their own English pronunciation show a comparatively high level of reflection on and confidence in their own production. Results from a rating task and a survey given to 27 German participants reveal attitudes that are more negatively stacked. While Germans reported openness towards NNS (non-native speaker) accents and showed awareness of the priority of intelligibility over accent choice in both their own and others’ pronunciation, they still largely reported NS accent preference. The ratings of the production from ten ELF speakers confirmed this and showed that ‘neutral’ is equated with native-like. In the light of these findings, issues are discussed that ultimately relate to the influence of NS Englishes, identity and the development of English as an international language.