Pathways to health : Determinants of health, health behaviour and health inequalities in early adulthood

There is increasing evidence that the origins of poor adult health and health inequalities can be traced back to circumstances preceding current socioeconomic position and living conditions. The life-course approach to examining the determinants of health has emphasised that exposure to adverse social and economic circumstances in earlier life or concurrent adverse circumstances due to unfavourable living conditions in earlier life may lead to poor health, health-damaging behaviour, disease or even premature death in adulthood. There is, however, still a lack of knowledge about the contribution of social and economic circumstances in childhood and youth to adult health and health inequalities, and even less is known about how environmental and behavioural factors in adulthood mediate the effects of earlier adverse experiences. The main purpose of this study was to deepen our understanding of the development of poor health, health-damaging behaviours and health inequalities during the life-course. Its aim was to find out which factors in earlier and current circumstances determine health, the most detrimental indicators of health behaviour (smoking, heavy drinking and obesity as a proxy for the balance between nutrition and exercise), and educational health differences in young adults in Finland. Following the ideas of the social pathway theory, it was assumed that childhood environment affects adult health and its proximal determinants via different pathways, including educational, work and family careers. Early adulthood was studied as a significant phase of life when many behavioural patterns and living conditions relevant to health are established. In addition, socioeconomic health inequalities seem to emerge rapidly when moving into adulthood; they are very small or non-existent in childhood and adolescence, but very marked by early middle age. The data of this study were collected in 2000 2001 as part of the Health 2000 Survey (N = 9,922), a cross-sectional and nationally representative health interview and examination survey. The main subset of data used in this thesis was the one comprising the age group 18 29 years (N = 1,894), which included information collected by standardised structured computer-aided interviews and self-administered questionnaires. The survey had a very high participation rate at almost 90% for the core questions. According to the results of this study, childhood circumstances predict the health of young adults. Almost all the childhood adversities studied were found to be associated with poor self-rated health and psychological distress in early adulthood, although fewer associations were found with the somatic morbidity typical of young adults. These effects seemed to be more or less independent of the young adult s own education. Childhood circumstances also had a strong effect on smoking and heavy drinking, although current circumstances and education in particular, played a role in mediating this effect. Parental smoking and alcohol abuse had an influence on the corresponding behaviours of offspring. Childhood circumstances had a role in the development of obesity and, to a lesser extent, overweight, particularly in women. The findings support the notion that parental education has a strong effect on early adult obesity, even independently of the young adult s own educational level. There were marked educational differences in self-rated health in early adulthood: those in the lowest educational category were most likely to have average or poorer health. Childhood social circumstances seemed to explain a substantial part of these educational differences. In addition, daily smoking and heavy drinking contributed substantially to educational health differences. However, the contribution of childhood circumstances was largely shared with health behaviours adopted by early adulthood. Employment also shared the effects of childhood circumstances on educational health differences. The results indicate that childhood circumstances are important in determining health, health behaviour and health inequalities in early adulthood. Early recognition of childhood adversities followed by relevant support measures may play an important role in preventing the unfortunate pathways leading to the development of poor health, health-damaging behaviour and health inequalities. It is crucially important to recognise the needs of children living in adverse circumstances as well as children of substance abusing parents. In addition, single-parent families would benefit from support. Differences in health and health behaviours between different sub-groups of the population mean that we can expect to see ever greater health differences when today s generation of young adults grows older. This presents a formidable challenge to national health and social policy as well as health promotion. Young adults with no more than primary level education are at greatest risk of poor health. Preventive policies should emphasise the role of low educational level as a key determinant of health-damaging behaviours and poor health. Keywords: health, health behaviour, health inequalities, life-course, socioeconomic position, education, childhood circumstances, self-rated health, psychological distress, somatic morbidity, smoking, heavy drinking, BMI, early adulthood

Social and material deprivation among youth in Finland : causes, consequences, and coping.

Background: Social and material deprivation is associated with poor health, decreased subjective well-being, and limited opportunities for personal development. To date, little is known about the lived experiences of Finnish low-income youths and the general purpose of this study is to fill this gap. Despite the extensive research on socioeconomic income disparities, only a few scholars have addressed the question of how low socioeconomic position is experienced by disadvantaged people themselves. Little is known about the everyday social processes that lead to decreased well-being of economically and socially disadvantaged citizens. Data: The study is based on the data of 65 autobiographical essays written by Finnish low-income youths aged 14-29 (M=23.51, SD=3.95). The research data were originally collected in a Finnish nationwide writing contest “Arkipäivän kokemuksia köyhyydestä” [Everyday Experiences of Poverty] between June and September of 2006. The contest was partaken by 850 Finnish writers. Methods and key concepts: Autobiographical narratives (N=65) of low-income youths were analyzed based on grounded theory methodology (GTM). The analysis was not built on specific pre-conceived categorizations; it was guided by the paradigm model and so-called “sensitizing concepts”. The concepts this study utilized were based on the research literature on socioeconomic inequalities, resilience, and coping. Socioeconomic inequalities refer to unequal distribution of resources, such as income, social status, and health, between social groups. The concept of resilience refers to an individual’s capacity to cope despite existing risk factors and conditions that are harmful to health and well-being. Coping strategies can be understood as ways by which a person tries to cope with psychological stress in a situation where internal or externals demands exceed one’s resources. The ways to cope are cognitive or behavioral efforts by which individual tries to relieve the stress and gain new resources. Lack of material and social resources is associated with increased exposure to health-related stressors during the life-course. Aims: The first aim of this study is to illustrate how youths with low socioeconomic status perceive the causes and consequences of their social and material deprivation. The second aim is to describe what kind of coping strategies youths employ to cope in their everyday life. The third aim is to build an integrative conceptual framework based on the relationships between causes, consequences, and individual coping strategies associated with deprivation. The analysis was carried out through systematic coding and orderly treatment of the data based on the grounded theory methodology. Results: Finnish low-income youths attributed the primary causes of deprivation to their family background, current socioeconomic status, sudden life changes, and contextual factors. Material and social deprivation was associated with various kinds of negative psychological, social, and material consequences. Youths used a variety of coping strategies that were identified as psychological, social, material, and functional-behavioral. Finally, a conceptual framework was formulated to link the findings together. In the discussion, the results were compared and contrasted to the existing research literature. The main references of the study were: Coping: Aldwin (2007); Lazarus & Folkman (1984); Hobfoll (1989, 2001, 2002). Deprivation: Larivaara, Isola, & Mikkonen (2007); Lister (2004); Townsend (1987); Raphael (2007). Health inequalities: Dahlgren & Whitehead (2007); Lynch. et al. (2000); Marmot & Wilkinson (2006); WHO (2008). Methods: Charmaz (2006); Flick (2009); Strauss & Corbin (1990). Resilience: Cutuli & Masten (2009); Luthar (2006).

The Politics of Internet Regulation in Brazil : dynamics, factors, and actors in broadband policy

In May 2010, Brazil joined the roll of nations with a National Broadband Plan. The Decree nº 7,175/2010 had implemented a program that aimed to offer 30 million permanent broadband accesses until 2014 and established its main goals, such as accelerating economic and social development, promoting digital inclusion, reducing social and regional inequalities, promoting a generation of employment and income, and expanding electronic government services. However, the broadband access in Brazil is limited, expensive, and centralized in the main urban centres. Despite the fast growth in the past years due to mobile internet access, the market is still concentrated in the local incumbent operators that currently provide mobile services, landline services and Paid-TV services, resulting in a high level of market verticalization. The following dissertation investigates the constraint of broadband access development, the dynamics, the actors, and the factors that have delayed the roll-out of broadband services in Brazil. The study also promotes reflections about the challenge posed by the media, by costumers associations and by public opinion as critical observers of the policy making process. This research examines on the political influence towards regulation to determine the way policy will benefit interest groups. Many interviews have been conducted in order to understand the forces which have been acting in the telecommunications in Brazil after privatization, in 1998. This study aims to provide a better understanding of telecommunications regulatory process in Brazil, in order to help the country finding an adequate policy which can lead to the implementation of a broadband roll-out. The universal broadband access is the only way to benefit the whole society in Brazil with a satisfactory level of education and create more jobs and economic development regarding the plenty use of Information and Communications Technology (ICT).

Fracasso escolar e adolescentes infratores: a vulnerabiblidade social de adolescentes de baixa escolaridade

O presente trabalho investigou a relação entre a baixa escolaridade e a prática de atos infracionais, procurando entender alguns fatores associados ao fracasso escolar de adolescentes que passaram pela Vara da Infância e da Juventude de Duque de Caxias. Em especial, buscou entender o fenômeno da exclusão social como elemento relevante relacionado ao tema fracasso escolar: em que medida é possível afirmar que a baixa escolaridade coloca estes adolescentes em situação de vulnerabilidade em relação a práticas ilícitas? Os dados da pesquisa foram obtidos por meio de um questionário e de entrevistas aplicados aos adolescentes infratores seus responsáveis. No total, a pesquisa trabalhou com as respostas de 262 adolescentes infratores que tiveram passagem pela Justiça Infanto-Juvenil de Duque de Caxias, no período compreendido entre maio de 2006 e maio de 2008. Esta pesquisa teve por base principal as idéias de Maria Helena Patto, a respeito da construção do fracasso escolar; Miriam Abramovay, com sua contribuição sobre vulnerabilidade social; Aldaíza Spozati e Miguel Arroyo, que alertam para as questões relacionadas ao acesso, permanência, sucesso e não-fracasso na escola; Alex Eduardo Gallo e Lúcia Cavalcanti de Albuquerque Williams, a respeito do perfil dos adolescentes infratores. A pesquisa revelou que a baixa escolaridade coloca os adolescentes em situação de vulnerabilidade social e que a escola pode ser um fator de proteção à criminalidade.

Social and gender analysis report: Barotse Floodplain, Western Province,Zambia

There is increasing awareness that integrating gender into development frameworks is critical for effective implementation of development strategies. In working to alleviate rural poverty, the CGIAR Research Program on Aquatic Agricultural Systems (AAS) recognizes that “business as usual” gender integration approaches will not deliver lasting and widespread improvements in agricultural productivity, poverty reduction and food security. In response, AAS operationalized a gender transformative approach. The approach is informed by conceptual frameworks that explicitly recognize the potent influence of social relations on creating and perpetuating gender inequalities. In this way, AAS aims to address the underlying causes of rural poverty and gender inequality in Zambia’s Barotse Floodplain, where people rely extensively on riverine and wetland ecosystems for food and livelihood security. A central question guiding the research program is “How do social norms and gendered power relations influence agricultural development outcomes?” The findings presented in this report provide insights that help answer this question. The report presents a review of literature relevant to livelihoods, ecosystem services, and gender and social relations in Zambia, with a specific focus on Western Province, where AAS is currently implemented. It also presents a synthesis of findings of a social and gender analysis conducted in 2013 in 10 focal communities situated in and around the Barotse Floodplain.

Use and access to ICT in students of public secondary schools in Chihuahua City, Mexico: inclusion in teaching and digital literacy

This paper addresses the issue of the digital divide in students of public secondary schools at Chihuahua City, Mexico. It seeks to identify potential inequality of opportunities with regards to subjects’ access to information, knowledge and education through the ICT (internet, mobile telephony, broadband and television). The study takes three schools as investigative stage, using the survey as a data collection instrument, identifying patterns of behavior regarding: general knowledge of them, access to computer equipment and internet, and characterization of their use. Other aspects of analysis are the identification of the educational level of parents and access to technology resources available for academic and non-academic purposes in various application areas (home, school and social environment). The proposal concludes, that it is through the recollection of alternatives suggested by the teachers themselves to incorporate ICT for teaching purposes in a systematic and planned fashion, whose greatest reflection manifests in better digital literacy indicators.

Alienation and Digital Labour – a Depth-Hermeneutic Inquiry into Online Commodification and the Unconscious

At the core of this paper is a psychosocial inquiry into the Marxist concept of alienation and its applications to the field of digital labour. Following a brief review of different theoretical works on alienation, it looks into its recent conceptualisations and applications to the study of online social networking sites. Finally, the authors offer suggestions on how to extend and render more complex these recent approaches through in-depth analyses of Facebook posts that exemplify how alienation is experienced, articulated, and expressed online. For this perspective, the article draws on Rahel Jaeggi’s (2005) reassessment of alienation, as well as the depth-hermeneutic method of “scenic understanding” developed by Alfred Lorenzer (e.g. 1970; 1986).

Analysis of the Ethical, Social and Legal Issues Related to the Delivery of the Prenatal Genetic Testing in Argentina

L'introduction de nouvelles biotechnologies dans tout système de soins de santé est un processus complexe qui est étroitement lié aux facteurs économiques, politiques et culturels, et, par conséquent, demande de remettre en cause plusieurs questions sociales et éthiques. Dans la situation particulière de l’Argentine - c’est-à-dire: de grandes inégalités sociales entre les citoyens, la rareté des ressources sanitaires, l’accès limité aux services de base, l’absence de politiques spécifiques - l'introduction de technologies génétiques pose de sérieux défis qui doivent impérativement être abordés par les décideurs politiques. Ce projet examine le cas des tests génétiques prénataux dans le contexte du système de santé argentin pour illustrer comment leur introduction peut être complexe dans une nation où l’accès égale aux services de santé doit encore être amélioré. Il faut également examiner les restrictions légales et les préceptes religieux qui influencent l'utilisation des technologies génétiques, ce qui souligne la nécessite de développer un cadre de référence intégral pour le processus d'évaluation des technologies afin d’appuyer l’élaboration de recommandations pour des politiques cohérentes et novatrices applicables au contexte particulier de l’Argentine.

Relating Fragile States to Social and Human Fragilities

Fragile States is a way of naming this particular category of states that have weak performance, insufficient service delivery, weak administrative and government power, and lack of legal rules. Little consideration is usually made to the fact that their own societies may also be fragile and easily jeopardised by inappropriate economic measures or external events. Poverty traps and social exclusion, unjust inequalities with lack of equity, feelings of insecurity and vulnerability, usually undermine the social fabric. Moreover, the people bear their own internal fragilities, which are based on the lack of capabilities and recognition, and interfere in the relationships between the groups that constitute the society. Therefore, dealing with the issue of fragility requires to consider various decision levels, from the personal one to the State level. Such an approach could allow fragile states to conceive preventive policies that would avoid the surge of a political crisis resulting from the combination of social conflict and individual failure.

The use of social and salience cues in early word learning

This article explores young infants' ability to learn new words in situations providing tightly controlled social and salience cues to their reference. Four experiments investigated whether, given two potential referents, 15-month-olds would attach novel labels to (a) an image toward which a digital recording of a face turned and gazed, (b) a moving image versus a stationary image, (c) a moving image toward which the face gazed, and (d) a gazed-on image versus a moving image. Infants successfully used the recorded gaze cue to form new word-referent associations and also showed learning in the salience condition. However, their behavior in the salience condition and in the experiments that followed suggests that, rather than basing their judgments of the words' reference on the mere presence or absence of the referent's motion, infants were strongly biased to attend to the consistency with which potential referents moved when a word was heard. (c) 2006 Elsevier Inc. All rights reserved.

Sex and socioeconomic inequalities of lung cancer mortality in Barcelona, Spain and Sao Paulo, Brazil

The objective of this paper was to assess sex and socioeconomic inequalities in lung cancer mortality in two major cities of Europe and South America. Official information on mortality and population allowed the estimation of sex- and age-specific death rates for Barcelona, Spain and Sao Paulo, Brazil (1995-2003). Mortality trends and levels were independently assessed for each city and subsequently compared. Rate ratios assessed by Poisson regression analysis addressed hypotheses of association between the outcome and socioeconomic covariates (human development index, unemployment and schooling) at the inner-city area level. Barcelona had a higher mortality in men (76.9/100000 inhabitants) than Sao Paulo (38.2/100 000 inhabitants); although rates were decreasing for the former (-2%/year) and levelled-off for the [after. Mortality in women ranked similarly (9.1 for Barcelona, 11.5 for Sao Paulo); with an increasing trend for women aged 35-64 years (+ 7.7%/year in Barcelona and + 2.4%/year in Sao Paulo). The socioeconomic gradient of mortality in men was negative for Barcelona and positive for Sao Paulo; for women, the socioeconomic gradient was positive in both cities. Negative gradients indicate that deprived areas suffer a higher burden of disease; positive gradients suggest that prosmoking lifestyles may have been more prevalent in more affluent areas during the last decades. Sex and socioeconomic inequalities of lung cancer mortality reinforce the hypothesis that the epidemiologic profile of cancer can be improved by an expanded access to existing technology of healthcare and prevention. The continuous monitoring of inequalities in health may contribute to the concurrent promotion of well-being and social justice.

Постсекулярность и цифровой антиклерикализм в Рунете [Post-Secularity and Digital Anti-Clericalism on Runet]

This article deals with the phenomenon of “digital anti-clericalism” in the Russian-speaking sphere of the Internet (Runet). In the context of post-secularism the claims of Russian clerical and bureaucratic elites to the ideological monopoly in the political and social life face a strong resistance from the champions of religious pluralism and preservation of a secular state. Presented here is a detailed analysis of the topics and the stylistic features of different types of anti-clerical Internet communication – a variety of political folklore (memes, demotivators, photoshopped pictures). Also traced is the connection between the modern anti-clericalism on Runet and the late Soviet counter-culture. Suggested for the first time is a classification of anticlerical and atheist websites that constitute a vital part of the Russian blogosphere.

Sociodemographic vulnerability in the Caribbean: an examination of the social and demographic impediments to equitable development with participatory citizenship in the Caribbean at the dawn of the twenty-first century

Includes bibliography

Digital proficiency and digital inclusion: Comparison between students of computer science, public relations and engineering

New information and communication technologies may be useful for providing more in-depth knowledge to students in many ways, whether through online multimedia educational material, or through online debates with colleagues, teachers and other area professionals in a synchronous or asynchronous manner. This paper focuses on participation in online discussion in e-learning courses for promoting learning. Although an important theoretical aspect, an analysis of literature reveals there are few studies evaluating the personal and social aspects of online course users in a quantitative manner. This paper aims to introduce a method for diagnosing inclusion and digital proficiency and other personal aspects of the student through a case study comparing Information System, Public Relations and Engineering students at a public university in Brazil. Statistical analysis and analysis of variances (ANOVA) were used as the methodology for data analysis in order to understand existing relations between the components of the proposed method. The survey methodology was also used, in its online format, as a research instrument. The method is based on using online questionnaires that diagnose digital proficiency and time management, level of extroversion and social skills of the students. According to the sample studied, there is no strong correlation between digital proficiency and individual characteristics tied to the use of time, level of extroversion and social skills of students. The differences in course grades for some components are partly due to subject 'Introduction to Economics' being offered to freshmen in Public Relations, whereas subject 'Economics in Engineering' is offered in the final semesters of Engineering and Information Systems courses. Therefore, the difference could be more tied to the respondent's age than to the course. Information Systems students were observed to be older, with access to computers and Internet at the workplace, compared to the other students who access the Internet more often from home. This paper presents a pilot study aimed at conducting a diagnosis that permits proposing actions for information and communication technology to contribute towards student education. Three levels of digital inclusion are described as a scale to measure whether information technology increases personal performance and professional knowledge and skills. This study may be useful for other readers interested in themes related to education in engineering. © 2013 IEEE.

Repositório digital como ambiente de inclusão digital e social para usuários idosos

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)