The Relationship between Civic Engagement and Health among Older Adults

This paper explores the relationship between civic engagement and health among older adults. As the U.S. population ages and people are living longer in the retirement phase, practitioners need to provide programs of growth and development for this population.

Investigating Race and Ethnicity on Data Collection and Analysis

This paper details the research methods an introductory qualitative research class used to both study an issue related to race and identity, and to familiarize themselves with data collection strategies. Throughout the paper the authors attempt to capture the challenges, disagreements, and consensus building that marked this unusual research endeavor.

Children with special health care needs: Comparison of the effects of home care setting, prescribed pediatric extended care setting, and long-term care setting on child and family health outcomes and health care service use

Technological advances during the past 30 years have dramatically improved survival rates for children with life-threatening conditions (preterm births, congenital anomalies, disease, or injury) resulting in children with special health care needs (CSHCN), children who have or are at increased risk for a chronic physical, developmental, behavioral, or emotional condition and who require health and related services beyond that required by children generally. There are approximately 10.2 million of these children in the United States or one in five households with a child with special health care needs. Care for these children is limited to home care, medical day care (Prescribed Pediatric Extended Care; P-PEC) or a long term care (LTC) facility. There is very limited research examining health outcomes of CSHCN and their families. The purpose of this research was to compare the effects of home care settings, P-PEC settings, and LTC settings on child health and functioning, family health and function, and health care service use of families with CSHCN. Eighty four CSHCN ages 2 to 21 years having a medically fragile or complex medical condition that required continual monitoring were enrolled with their parents/guardians. Interviews were conducted monthly for five months using the PedsQL™ Generic Core Module for child health and functioning, PedsQL™ Family Impact Module for family health and functioning, and Access to Care from the NS-CSHCN survey for health care services. Descriptive statistics, chi square, and ANCOVA were conducted to determine differences across care settings. Children in the P-PEC settings had a highest health care quality of life (HRQL) overall including physical and psychosocial functioning. Parents/guardians with CSHCN in LTC had the highest HRQL including having time and energy for a social life and employment. Parents/guardians with CSHCN in home care settings had the poorest HRQL including physical and psychosocial functioning with cognitive difficulties, difficulties with worry, communication, and daily activities. They had the fewest hours of employment and the most hours providing direct care for their children. Overall health care service use was the same across the care settings.

Gender differences in the influence of protective factors, risk factors, and health risk behaviors on HIV risk behaviors among youth in South Florida

Adolescents engage in a range of risk behaviors during their transition from childhood to adulthood. Identifying and understanding interpersonal and socio-environmental factors that may influence risk-taking is imperative in order to meet the Healthy People 2020 goals of reducing the incidence of unintended pregnancies, HIV, and other sexually transmitted infections among youth. The purpose of this study was to investigate gender differences in the predictors of HIV risk behaviors among South Florida youth. More specifically, this study examined how protective factors, risk factors, and health risk behaviors, derived from a guiding framework using the Theory of Problem Behavior and Theory of Gender and Power, were associated with HIV risk behavior. A secondary analysis of 2009 Youth Risk Behavior Survey data sets from Miami-Dade, Broward, and Palm Beach school districts tested hypotheses for factors associated with HIV risk behaviors. The sample consisted of 5,869 high school students (mean age 16.1 years), with 69% identifying as Black or Hispanic. Logistic regression analyses revealed gender differences in the predictors of HIV risk behavior. An increase in the health risk behaviors was related to an increase in the odds that a student would engage in HIV risk behavior. An increase in risk factors was also found to significantly predict an increase in the odds of HIV risk behavior, but only in females. Also, the probability of participation in HIV risk behavior increased with grade level. Post-hoc analyses identified recent sexual activity (past 3 months) as the strongest predictor of condom nonuse and having four or more sexual partners for both genders. The strongest predictors of having sex under the influence of drugs/alcohol were alcohol use in both genders, marijuana use in females, and physical fighting in males. Gender differences in the predictors of unprotected sex, multiple sexual partners, and having sex under the influence were also found. Additional studies are warranted to understand the gender differences in predictors of HIV risk behavior among youth in order to better inform prevention programming and policy, as well as meet the national Healthy People 2020 goals.

Effect of the Supplemental Nutrition Assistance Program (SNAP) and nutrition education on nutrition and health outcomes of HIV+ individuals

Factors associated with and barriers to participation in Supplemental Nutrition Assistance Program (SNAP) and the effect participation has on food security, nutrition status, disease status and quality of life was investigated in a cross-sectional study including 175 HIV infected individuals. In addition, the effect of a targeted nutrition education on nutrition knowledge, readiness to dietary behavior change, nutrition status, disease status and quality of life was also investigated among a subset of the population (N = 45) in a randomized clinical control trial. ^ SNAP participation rate was 70.3%, similar to the State of Florida and national participation rates. SNAP participation was positively and independently associated with being born in the US (P < 0.001), having monthly income less than $1000 (P = 0.006), and receiving antiretroviral treatment (P < 0.001). Participation barriers include denial of participation by program, recent incarceration, living in a shelter where participation is not allowed and unawareness of eligibility status. In regression analyses, SNAP participation was not significantly associated with improved food security, nutrition status, disease status and health related quality of life (HRQOL). Over half (56%) of the population experienced food insecurity and had inadequate intakes of half of the nutrients assessed. Illicit drug, alcohol and cigarette use were high in this population (31%, 55% and 63% respectively), and affected food security, nutrients intake, disease status and HRQOL. The nutrition education intervention resulted in a trend towards improvements nutrition knowledge, self-efficacy, and readiness to change without impacting nutrition status, disease state and quality of life. ^ Food insecurity and other nutrition related issues, with implications for treatment, management and cost of HIV disease, continue to plague infected individuals living in poverty. More resources, including food and nutrition programs, specifically targeted towards this population are needed to address these issues.^

Forgotten Women: Incarceration and Health Concerns of Minority Women

Paper Presentation

Gender Differences in Medical Advice and Health Behavior of Obese African Americans With and Without Type 2 Diabetes

This study examined gender differences in medical advice related to diet and physical activity for obese African American adults (N = 470) with and without diabetes. Data from the 2007-2008 National Health and Nutrition Examination Survey were analyzed using logistic regression analyses. Even after sociodemographic adjustments, men were less likely to report receiving medical advice as compared with women. Both men and women given dietary and physical activity advice were more likely to follow it. Men were less likely to report currently reducing fat or calories, yet men withdiabetes were 5 times more likely to state that they were reducing fat and calories as compared with women with diabetes. Gender- and disease state-specific interventions are needed comparing standard care with enhanced patient education. Moreover, these findings necessitate studies that characterize the role of the health care professional in the diagnosis and treatment of obesity and underscore patient-provider relationships.

Employment status and health in Spain before and after the Great Recession

This article analyzes the relationship between employment status (ES), on one hand, and self-rated health and psychological distress, on the other, in the context of the Great Recession beginning in 2008. For this purpose, it is necessary to move beyond the employment/unemployment dichotomy characteristics of previous theories and research concerning the relationship between the labor market, recession, and health. The authors use data from the Spanish National Health Surveys in 2006 (n = 15,128), before the crisis, and in 2012 (n = 11,124), when its consequences had taken effect. The results of the regression analysis indicate a structural change in the relationship between ES and health. Health inequality patterns changed during the crisis, with increased deterioration in the health of unemployed, especially the long-term unemployed, and self-employed workers. Health inequalities were reduced for temporary workers. The results support the idea that the structure of the association between ES and health varies according to the economic cycle. The association between recession, ES, and health would be directly related to the specific characteristics of the economic and employment contexts under study. In the Spanish case, labor market segmentation processes based on numerical flexibility—a key feature of the Mediterranean Variety of Capitalism—may explain the results obtained.

Discovering complex interrelationships between socioeconomic status and health in Europe: A case study applying Bayesian Networks

Studies assume that socioeconomic status determines individuals’ states of health, but how does health determine socioeconomic status? And how does this association vary depending on contextual differences? To answer this question, our study uses an additive Bayesian Networks model to explain the interrelationships between health and socioeconomic determinants using complex and messy data. This model has been used to find the most probable structure in a network to describe the interdependence of these factors in five European welfare state regimes. The advantage of this study is that it offers a specific picture to describe the complex interrelationship between socioeconomic determinants and health, producing a network that is controlled by socio demographic factors such as gender and age. The present work provides a general framework to describe and understand the complex association between socioeconomic determinants and health.

Always looking on the bright side of life? : Exploring optimism and health in three UK post-industrial urban settings

The survey was jointly funded by NHS Health Scotland and the Glasgow Centre for Population Health.

Join the Union and Be Safe : The Effects of Unionization on Occupational Safety and Health in the European Union

Acknowledgements: Thanks go to the participants of the ‘Health and Work’ Organised Session (2011) of the Scottish Economic Society 2011 Annual Conference, Perth, Scotland, for helpful comments. The authors are also grateful to the editor Franco Peracchi and the referees of this journal for helpful comments and suggestions. The financial support of the European Commission is gratefully acknowledged (HEALTHatWORK Project) — 7th Framework Programme THEME [HEALTH-2007-4.2-3] Grant Agreement No: 200716.

Always looking on the bright side of life? : Exploring optimism and health in three UK post-industrial urban settings

The survey was jointly funded by NHS Health Scotland and the Glasgow Centre for Population Health.

Join the Union and Be Safe : The Effects of Unionization on Occupational Safety and Health in the European Union

Acknowledgements: Thanks go to the participants of the ‘Health and Work’ Organised Session (2011) of the Scottish Economic Society 2011 Annual Conference, Perth, Scotland, for helpful comments. The authors are also grateful to the editor Franco Peracchi and the referees of this journal for helpful comments and suggestions. The financial support of the European Commission is gratefully acknowledged (HEALTHatWORK Project) — 7th Framework Programme THEME [HEALTH-2007-4.2-3] Grant Agreement No: 200716.