Examining the Role of Vocational Rehabilitation on Access to Care and Public Health Outcomes for People Living with HIV/AIDS

The purpose of this study is to examine the role of vocational rehabilitation services in contributing to the goals of the National HIV/AIDS strategy. Three key research questions are addressed: (a) What is the relationship among factors associated with the use of vocational rehabilitation services for people living with HIV/AIDS? (b) Are the factors associated with use of vocational rehabilitation also associated with access to health care, supplemental employment services and reduced risk of HIV transmission? And (c) What unique role does use of vocational rehabilitation services play in access to health care and HIV prevention? Survey research methods were used to collect data from a broad sample of volunteer respondents who represented diverse racial (37% Black, 37% White, 18% Latino, 7% other), gender (65% male, 34% female, 1% transgender) and sexual orientation (48% heterosexual, 44% gay, 8% bisexual) backgrounds. The fit of the final structural equation model was good (root mean square error of approximation = .055, Comparative Fit Index=.953, Tucker Lewis Index=.945). Standardized effects with bootstrap confidence intervals are reported. Overall, the findings support the hypothesis that vocational rehabilitation services can play an important role in health and prevention strategies outlined in the National HIV/AIDS strategy.

The Effect Of Social Support On Health As Moderated By Sex-Role Orientation

Previous research has established a significant association between social support and health; high levels of social support are consistently shown to both directly and indirectly improve health (Cohen, 1998, House et al. 1988, Rook, 2001, Schwarzer & Leppin 1989). Additional research has investigated the role of sex and gender differences in social support, health and the interaction between these variables (Barbee et al. 1993, Burda, Vaux & Schill 1984, Cleary, 1987, Rook, 2001, Shumaker & Hill, 1991). The present study aims to further examine the influence of sex-role orientation on social support and health. Forty-nine female participants completed a three-part survey assessing their sex-role orientation, perceived social support, current stress levels and physical health. Results revealed that both masculinity and femininity relate to social support network size and health outcomes. Masculinity and androgyny were significantly negatively associated with health problems, whereas undifferentiated individuals had higher rates of physical illness. These findings demonstrate the important role of gendered traits in social support and ultimately, physical health.

Health, Justice, and Fairness

In this study I will endeavor to show that the American system of health care violates any conception of distributive justice understood as equality of opportunity. This system fails to provide equal access through a lack of universal insurance, a consumer driven conception of quality, and a system wide focus on cost control, leaving millions of Americans exposed to the ravages of disease. However, if health is understood as an antecedent for one's ability to function across a number of categories that have been objectively deemed as vital to engage in a life that is fully human than the commitment our nation has to the protection of fair equality of opportunity, established by our adoption of a Rawlsian conception of justice, necessitates a revision of our nation's conception of quality to encapsulate health outcomes as well as the advent of a system of universal coverage. Quality care will come to be understood as care that returns to the patient the ability to function across those categories of functioning that illness has jeopardized, and this conception of quality will precipitate system wide reform geared at the creation of positive health outcomes. This paper will articulate this argument by reconstructing and synthesizing precepts from the contemporary philosophical sources and then applying these to the practical workings of our healthcare system, while concurrently demonstrating that a system of distributive justice is compatible with the creation of a universal system of healthcare.