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PubMed1998

Does low socioeconomic status potentiate the effects of heightened cardiovascular responses to stress on the progression of carotid atherosclerosis?

OBJECTIVES: This study examined whether heightened cardiovascular reactivity and low socioeconomic status had synergistic effects on the progression of carotid atherosclerosis in a population of eastern Finnish men. METHODS: Data from the Kuopio Ischemic Heart Disease Risk Factor Study were used to measure 4-year progression of intima-media thickness in 882 men according to cardiovascular reactivity and socioeconomic status. Associations were examined in relation to risk factors and were stratified by baseline levels of atherosclerosis and prevalent ischemic heart disease. RESULTS: The effect of reactivity on atherosclerotic progression depended on socioeconomic status. Men who had heightened cardiovascular responsiveness to stress and were born into poor families, received little education, or had low incomes had the greatest atherosclerotic progression. CONCLUSIONS: An understanding of associations between individual risk factors and disease should be based on etiologic hypotheses that are conceived at the population level and involve fundamental social and economic causes of disease. This study demonstrates how examining the interaction of an individual biological predisposition will low socioeconomic status over the life course is etiologically informative for understanding the progression of atherosclerotic vascular disease.

Arteriosclerosis↗
PubMed1979

Sexual behavior among university students in Nigera.

Sexual behavior patterns among Nigerian university students and factors influencing them were studied. While permarital cohabitation is common, a large percentage (48%) had their first coital experience between the ages of 22 and 27. Religion does not appear to have a strong inhibiting influence on premarital sex, although it does affect the frequency of changing partners. Contraceptives, although known to almost all the respondents, are not widely used. The use of contraceptives had little influence on premarital cohabitation. Oral-genital, male-male, and female-female sexual practices are very uncommon.

Adolescent↗
PubMed1995

Barriers to acceptance of cataract surgery among patients presenting to district hospitals in rural Malawi.

The objective of this research was to assess the barriers to cataract surgical acceptance by blind rural Malawians recognized and referred for surgical correction at district hospitals. Cataract blind recognized and referred for surgery by the ophthalmic assistants in Chikwawa and Nsanje Districts were interviewed 9-12 months after enrolment to determine if they had undergone cataract surgery and to assess factors associated with surgical acceptance. There were significant gender-specific baseline differences between men and women presenting to the ophthalmic assistants. Patients living near the district hospital were also most likely to present to the ophthalmic assistant. Men with lower socioeconomic status were more likely to accept surgery than men with higher socioeconomic status. Men and women who either talked to someone about cataract surgery or knew another aphakic patients were more likely to accept surgery. The best approaches to improving cataract acceptance given existing resources might be to encourage patients undergoing cataract surgery to educate and motivate others to accept surgery and to train existing village level health staff in cataract recognition and referral. Economic barriers and lack of family support are likely to continue to impede improved cataract surgical acceptance, especially among women.

Cataract Extraction↗
PubMed1989

Measuring socioeconomic mortality differentials over time.

Using 1973 Current Population Survey data matched to 1973-1978 Social Security mortality records, this study measures the relationship between the income and education of men and their subsequent mortality. The estimated relationships are compared with socioeconomic mortality differentials found by Kitagawa and Hauser in their study of 1960 census-death certificate matched data. The comparison suggests that there has been no improvement in the relative mortality experience of low socioeconomic status men. More generally, the article discusses how Social Security data could be used to monitor, on a continual basis, our progress toward eradicating significant mortality differentials in the United States.

Data Collection↗
PubMed1997

Comparing inequalities in women's and men's health: Britain in the 1990s.

Data on over 20,000 women and men aged 20-59 are analysed from the British General Household Survey for 1991 and 1992, showing the importance of separately analysing educational qualifications, occupational class and employment status for both women and men. Own occupational class and employment status are the key structural factors associated with limiting long-standing illness, but educational qualifications are particularly good predictors of women's self-assessed health. Class inequalities in health are less pronounced among women who are not in paid work. Women's limiting long-standing illness relates solely to their own labour market characteristics, whereas self-assessed health relates to wider aspects of women's everyday lives, including their household material conditions, and for married women, their partner's occupational class and employment status. Men's unemployment has adverse consequences for the health of their wives, which occurs through the mechanism of the family living in disadvantaged material circumstances. Women's labour market position and role in the family have undergone substantial changes since the 1970s. Approaches to measuring inequalities in women's health need to reflect changes in women's employment participation and changes in marital status and living arrangements.

Adult↗
PubMed1997

Survey of condom-related beliefs, behaviors, and perceived social norms in Mexican migrant laborers.

This study reports findings from a survey of condom-related beliefs, behaviors, and perceived social norms in Mexican migrant laborers that live and work in the United States for extended periods of time. Snowball sampling was used to recruit 501 Mexican migrants from five "sending towns" in Jalisco, Mexico, with historically high rates of out-migration to the United States. Results showed that subjects reported few negative beliefs about condom use and high efficacy to use condoms in challenging sexual situations but social norms sanctioning condoms were limited. Results also revealed mixed knowledge of HIV transmission, poor knowledge of condom use, and higher condom use with occasional versus regular sex partners. Forty-four percent of male migrants reported sex with prostitutes while in the U.S., with married men reporting less condoms use with prostitutes than single men. It was concluded that condom promotion efforts with Mexican migrants should concentrate on men to encourage consistent use with occasional sex partners, including prostitutes. AIDS prevention education should be provided with sensitivity to the language needs, limited education, and extreme social and geographic marginality of this highly underresearched Latino population.

Adult↗
PubMed1984

The buccra-massa and the little man's broker in a Jamaican sugartown: implications for community health education.

In societies that have been historically stratified by class, interclass communication is frequently hampered by behaviors of higher status people that lower status people interpret as denigrating. To escape what they perceive as denigration, lower status people may attempt to avoid interclass interaction, and, when it is unavoidable, adopt such strategies as not making direct eye contact, saying very little except what they think the higher status people want to hear (including flattery), and using a lower status peer as an intermediary. Such behavioral patterns have important implications for the design of health services programs. This paper presents a case study of such interaction difficulties observed during 13 months of anthropological research in a Jamaican town. The lower status people in the town of Haversham (a pseudonym) refer to this avoidance behavior as the 'buccra-massa'. The antonym of buccra-massa is 'buck-the-massa'. 'Buck-the-massa' is characterized by being able to look higher status people in the eye and boldly engage them in conversation. Lower status persons who are known for bucking the massa are frequently used as intermediaries in cross-class interactions. Because Havershamians refer to higher status men as 'big men' and to lower status men as 'little men', the author calls the intermediaries used by lower status people in Haversham, 'little man's brokers'. The author argues that the buccra-massa and buck-the-massa behavioral traditions had their roots in the complex and extreme social inequalities of the slavery period in Jamaica. It is further argued that economic difficulties in Jamaica since the slavery period have contributed to the persistence of these behavioral dynamics to the present day. The buccra-massa/buck-the-massa behavioral complex is often manifested in health care settings in Jamaica. Thus, the author suggests that the little man's broker can be very useful in promoting less threatening, and therefore more effective, interactions between the clients and the staff of health and other human service programs. He notes that while staffmembers often view brokering behavior as trouble making, many of the clients they wish to serve view this same behavior as bucking-the-massa. It is a mistake, according to this analysis, to ignore the little man's broker. As this case of Jamaica shows, accomplished brokers can choose to exert their extensive influence against utilization of services offered by specific programs.(ABSTRACT TRUNCATED AT 400 WORDS)

Communication↗
PubMed1983

Sexual and socioeconomic factors affecting the risk of past infections with herpes simplex virus type 2.

Between November 1978 and May 1980, a cross-sectional survey of 566 females and 391 males, aged 35 to 50 years, living in metropolitan Toronto, was conducted to examine the influence of socioeconomic status and sexual behavior on the occurrence of antibodies to herpes simplex virus type 2. Antibodies to the virus were detected in 17.5% of females and 12.8% of males. Lower socioeconomic status was associated with an increased risk of herpes simplex virus type 2 seropositivity for females but not for males. An increased risk of seropositivity was associated in both sexes with young age at first intercourse, multiple sexual partners, and renting rather than owning their residence. The risk associated with each of these attributes remained when the effects of the other attributes including socioeconomic status and age at interview were controlled. The greatest risk was associated with renting. If the renting effect is real, it suggests that there is some determinant of risk not measured by this study, which is more important than socioeconomic status or sexual behavior.

Adult↗
PubMed1985

Differentials in urban-rural fertility in the countries of the ESCAP region.

Fertility differentials between rural and urban populations are investigated using World Fertility Survey data for Bangladesh, Fiji, Indonesia, Malaysia, Nepal, Pakistan, the Philippines, the Republic of Korea, Sri Lanka, and Thailand. "The fertility measure used in this analysis is the number of children ever born to a woman. An attempt is made first to establish the differential in fertility levels between urban and rural areas after necessary control of the demographic factors..., and then the possible explanation of the differential is sought in terms of socio-economic variables such as education of the respondent, and occupation, work pattern, work status and place of work of the respondent as well as that of the husband." Data concerning the fertility differentials and the associated explanatory variables are presented in tables and charts. "The results tend to show that the countries of Asia are undergoing similar patterns of fertility transition as was experienced in the advanced countries. Perhaps one can graduate the countries in the transition scale as follows: Bangladesh, Indonesia, Nepal, Pakistan and Malaysia are in the initial stage; Fiji, the Philippines, the Republic of Korea, Sri Lanka and Thailand are in the middle stage of transition."

Age Factors↗