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The importance of social interaction: a new perspective on social epidemiology, social risk factors, and health.

Social epidemiology research has provided persuasive evidence of the link between the social environment--especially socioeconomic status--and health outcomes, but has failed to identify underlying mechanisms that might account for the association. The research may have been limited to date by its reliance on traditional epidemiological methods that emphasize a search for specific causal factor-disease relationships. It is time to take the research evidence and recast it to find practical solutions. We argue that the human development perspective supplies a framework for understanding the critical interaction between elements of social environment and health: Analyzing the social epidemiological research from this perspective can help to explain why and how the most potent factor, socioeconomic status, affects health outcomes. Equally important, this alternative perspective also presents health education practice implications.

Epidemiologic Methods↗

Social influences, social norms, social support, and smoking behavior among adolescent workers.

PURPOSE: To examine the relationships between worksite interpersonal influences and smoking and quitting behavior among adolescent workers. DESIGN: The cross-sectional survey assessed factors influencing tobacco use behavior. SETTING: During the fall of 1998, data were collected from 10 grocery stores in Massachusetts that were owned and managed by the same company. SUBJECTS: Eligible participants included 474 working adolescents ages 15 to 18. Eighty-three percent of workers (n = 379) completed the survey. MEASURES: The self-report questionnaire assessed social influences, social norms, social support, friendship networks, stage of smoking and quitting behavior, employment patterns, and demographic factors. RESULTS: Thirty-five percent of respondents were never smokers, 21% experimental, 5% occasional, 18% regular, and 23% former smokers. Using analysis of variance (ANOVA), results indicate that regular smokers were 30% more likely than experimental or occasional smokers to report coworker encouragement to quit (p = .0002). Compared with regular smokers, never smokers were 15% more likely to report greater nonacceptability of smoking (p = .01). chi 2 tests of association revealed no differences in friendship networks by stage of smoking. CONCLUSIONS: These data provide evidence for the need to further explore social factors inside and outside the work environment that influence smoking and quitting behavior among working teens. Interpretations of the data are limited because of cross-sectional and self-report data collection methods used in one segment of the retail sector.

Adolescent↗

[Study of influences of social support and social networks on participation in periodic health examination of the elderly at home comparison of three regions with different social backgrounds].

PURPOSE: Periodic health examination are presumed to be important with respect to the well-being of aged individuals. The purpose of this study was to analyze the relationships between elderly at home accepting periodic health examination and their social support and social networks. METHOD: The survey was performed targeting so-called young elderly persons living at home in 3 regions in Hokkaido Prefecture, a large city (Sapporo), an ex-coalmining town (Yuubari) and a small farming town (Takasu). The study populations were asked about social support and social networks, and the Mantel-Haenszel method was applied to analyze the data. RESULTS: 1) Both males and females who received periodic health examination within the last one year (participants) were members of various groups, such as neighborhood societies, clubs for the elderly and so on, and were more interested in public magazines and political issues than those who had never received periodic health examination (non-participants). Elderly males who accepted periodic health examination were those who were interested in elections, who had a hobby, and who thought that life was worthwhile. 2) Both elderly males and females who accepted periodic health examination were those who had friends, and elderly males who accepted periodic health examination were those who had close relatives and who lived in a friendly neighborhood. 3) Elderly males who accepted periodic health examination were more likely to both receive and supply instrumental and emotional support in interaction with others.

Aged↗

Reaching higher in community psychology: social problems, social settings, and social change.

Forty years after the founding of community psychology, we have yet to deliver on the full promissory note of our birth, where we were poised to address social problems, social settings, and social change. Despite some success, we are at risk for selling ourselves short, for dying out in the discipline of psychology, and for failing to improve the common good. Given changes in demographics and in the safety net, the problem of entrenched disparities is even more urgent-in perception of the other, in the provision of opportunities for development, and in outcomes. Envisioning and enabling will be critical as we work with unified purpose toward a cumulative science where failure will not be predictable.

Humans↗

Alcohol and social influences: yielding among male social drinkers to social pressure.

Thirty men participated as paid volunteers in an experiment exploring whether alcohol intoxication makes a person more or less likely to yield to social pressure. Subjects were randomly assigned to either a Control, a Placebo, or an Alcohol group. The alcohol dose was 0.8 ml of 100% alcohol/kg body weight. Subjects first estimated the length of a line, then received feedback from either a male or a female reference group (social pressure), and finally made a second estimation. This procedure was repeated 30 times. The analysis indicated that the only effect of intoxication was to become more resistant in terms of number of yieldings to social pressure, provided the feedback came from a male reference group. Locus of control in terms of internality significantly predicted number of yieldings for the Alcohol group, although the analysis indicated no significant differences between groups as to mean locus of control scores.

Adult↗

Women and social security: social policy adjusts to social change.

Women age sixty-five and over now constitute about three fifths of the elderly population. They live longer than men and over time that longevity gap is increasing. Yet their income in later years is woefully inadequate. Poverty status is greater for elderly women than for elderly men; over half of aged women in poverty are widows. This paper describes the social security program, the cornerstone of our retirement income, and the lack of congruence of its provisions with contemporary social roles of women. It analyzes alternative proposals of two-tier, double decker and homemaker benefits, and earnings sharing, and their possible impact on women's economic status. It recommends improvements for this transition period while more basic structural reform is under discussion. Reform based on societal consensus could increase equity of treatment and adequacy of benefits for women. It is an essential prelude to consideration of long range financing needs of social security.

Aged↗

Re-thinking the analysis of intergenerational social mobility: a comment on John W. Fox's "Social class, mental illness, and social mobility".

The method of analyzing social mobility described by Fox (1990) is flawed in its adjustment for between-group differences in destination status when estimating the extent of the mentally ill's mobility as compared with the general population. Use of the recommended model with hypothetical data sets resulted in a significant finding when no overall upward or downward mobility occurred, and a non-significant result when the downward mobility of a psychotic group was contrived to be massive. An alternative model for the test of group differences in mobility is suggested within the framework of log-linear analysis commended by Fox (1990). This method indicated significantly more downward and less upward mobility in mentally ill groups when data from four studies were re-analyzed. We conclude that the weight of evidence from published studies supports the notion of social selection-drift, although this does not imply the inconsequence of social factors in the aetiology of schizophrenia (and other psychoses) or in its prognosis and occupational consequences.

Humans↗

Popular and rejected children's social reasoning: linking social status and social knowledge.

The relationship between children's social status/sex and their moral judgements was examined. Sixty-four second- and third-grade children (33 boys, 31 girls) who were identified as popular or rejected by peer sociometric measures were shown pictures of children engaged in moral and second-order transgressions. The children were asked to rate each event on (a) the degree of seriousness for other and self, (b) the amount of punishment for other and self, and (c) rule alterability. The children were also asked for justification of the transgressions (why they thought the transgressions were wrong). The popular and rejected children differentiated between moral and second-order transgressions based upon criterion ratings and justifications. Differences emerged between the popular and the rejected children's ratings and justifications for moral transgressions, suggesting that children's moral judgements are related to social experiences associated with peer acceptance and rejection.

Child↗

A socially neutral disease? Individual social class, household wealth and mortality from Spanish influenza in two socially contrasting parishes in Kristiania 1918-19.

The Spanish influenza pandemic of 1918-19 was one of the most devastating diseases in history, killing perhaps as many as 50-100 million people worldwide. Much of the literature since 1918 has favored the view that mortality from Spanish influenza was class neutral. This view has prevailed, even though several contemporary surveys showed that there indeed were clear differences between the classes in disease incidence and that case fatality rates from influenza and pneumonia also varied according to socioeconomic status. Furthermore, studies of more recent influenza epidemics have also shown that there can be clear class differentials in mortality in this type of illness--is there any reason to believe that Spanish influenza was different? This paper is the first study in which individual- and household-level data which are unique for the period are utilized to test the conservative hypothesis that Spanish influenza was a socially neutral disease with respect to mortality. Through the use of Cox regressions in an analysis of two socially contrasting parishes in the Norwegian capital city of Kristiania, it is shown that apartment size as an indicator of wealth of a household, in addition to social status of place of residence, were the only socioeconomic variables that had an independent and significant effect on mortality after controlling for age, sex and marital status.

Adolescent↗

Transforming schools of social work into spaces of social action: a critical exploration of Project Interaction, The Gay, Lesbian, Bisexual and Two-Spirit Initiative of McGill University's School of Social Work.

This article examines the question of how universities can be encouraged to address the mental health concerns of GLBT-SQ people and communities from a perspective of solidarity. In so doing, the authors take a case study approach, using Project Interaction: The Gay, Lesbian, Bisexual and Two-Spirit Initiative of McGill University's School of Social Work, to critically reflect upon the challenges arising from the development of an alternative organization within academia. The purpose of this reflection is to highlight how normal operations at work on university campuses, and within health and allied health curriculum, can be disrupted with the goal of providing momentum for the creation of affirmative space, the advancement of educational initiatives, and the building of opportunities for social change.

Bisexuality↗

Social Security Ruling, SSR 99-2p.; titles II and XVI; evaluating cases involving chronic fatigue syndrome (CFS). Social Security Administration. Notice of Social Security ruling.

In accordance with 20 CFR 402.35(b)(1), the Commissioner of Social Security gives notice of Social Security Ruling, SSR 99-2p. This Ruling clarifies disability policy for the evaluation and adjudication of disability claims involving Chronic Fatigue Syndrome (CFS). This Ruling explains that, when it is accompanied by appropriate medical signs or laboratory findings, CFS is a medically determinable impairment that can be the basis for a finding of "disability." This Ruling ensures that all adjudicators will use the same policies and procedures in evaluating disability claims involving CFS, and provides a consolidated statement of these policies and procedures.

Disability Evaluation↗

Short-term responses of plasma norepinephrine, epinephrine, glucocorticoid and testosterone titers to social and non-social stressors in male guinea pigs of different social status.

The short-term effects on norepinephrine (NE), epinephrine (E), glucocorticoid (CS) and testosterone (T) levels of (a) taking blood samples, and (b) an agonistic encounter in an experienced fighter's home cage were examined in 15 male guinea pigs living in large heterosexual colonies for 8 to 19 months. Four tests were performed 1 month apart. In the 1st, 2nd and 3rd test 3 blood samples were taken from each male in a strange room within 30 min (sampling times were designated as 0, 20 and 30 min, respectively). In the 4th test blood samples were taken on the same time schedule, however, the males were given 10 min agonistic encounters 10 min after the initial blood sampling. The main findings were as follows: in response to taking blood samples and fighting CS and NE titers increased significantly, whereas E values did not change in a significant way. T titers decreased 10 min after the agonistic encounter. The % changes of NE, E, CS and T at 20 and 30 min did not differ whether an agonistic encounter took place or only blood samples were taken. According to their behaviors displayed in the colonies the males were divided into high (N = 6) and low (N = 9) ranking individuals. When only blood samples were taken the males' social status was only reflected by a tendency towards higher T levels in high ranking males, however not by NE, E and CS titers. High ranking males showed lower NE titers than low ranking males directly after the agonistic encounter. No further relationships between long-term social status and short-term endocrine responses were found. According to their behaviors displayed during the agonistic encounters the males were divided into fighters (F) (5 out of 6 high and 3 out of 9 low ranking individuals), and non-fighters (NF) (1 high, 6 low ranking individuals). F and NF did not differ in T and CS values, NE titers, however, were significantly higher in NF compared with F before, directly after the encounter as well as 10 min later. E was significantly higher in NF than in F directly after the encounter. One month before the contest prospective NF showed higher NE levels at 0, 20 and 30 min sampling times than prospective F when only blood samples were taken. These findings point to a more important role of catecholamines than CS and T in guinea pig intermale agonistic encounters. NE responsiveness may have predictive value for the behavior in contest situations.

Agonistic Behavior↗

[Social contact behavior of elderly females living alone from the social psychology viewpoint--a survey. IV: Are there factors which determine social contact behavior?].

Some factors, which are important with regard to the contact behaviour of elderly women living alone, are reported and discussed: biographical sign, professional and social status as well as informations on the actual health status. Finally the essential results of the statistical intercorrelation of all involved variables are represented.

Aged↗

Different social network and social support characteristics, nervous problems and insomnia: theoretical and methodological aspects on some results from the population study 'men born in 1914', Malmö, Sweden.

A representative sample of 68-year-old men in the Swedish city of Malmö, were interviewed in detail regarding their social network, social support and social influence as a part of an extensive examination of their health status. Emphasis in this paper is put on the definition and operationalization of different social network, social support and social influence characteristics included in a tentative model. The reliability and validity of the different social network, social support and social influence indices are analyzed and discussed. The relation between the different indices and marital status and social class are analyzed implying that men living alone and men in the lowest social class have the most insufficient social network, social support and social influence. The indices were then used in an analysis of nervous problems and insomnia. Social anchorage, social participation and contact frequency, all subconcepts of social network, had independent associations with mental health in this cross-sectional study. The addition of the social network, social support and social influence indices to social class and marital status gives a more differentiated and thereby a more valid picture of the association between the psychosocial environment and this type of mental health problems.

Aged↗

Social anxiety in childhood: the relationship with self and observer rated social skills.

BACKGROUND: Social anxiety of childhood is a common and pervasive problem. Traditional approaches to treating these difficulties have focused on providing afflicted children with social skills training. This approach has met with some, but not complete success. Recent reconceptualisations of social anxiety in the adult literature have emphasised the role of negative cognition regarding one's own social skills. Experimental evidence has demonstrated that a misperception of social skills, rather than a skills deficit per se, may be most pertinent to the understanding of social anxiety. This study set out to examine the relationship between self and observer ratings of social skill, and social anxiety in children. METHOD: One hundred and ten non-referred schoolchildren aged 8-11 years were asked to give a two-minute speech to a video camera, after which they were asked to rate their performance on a number of social skill dimensions. Neutral observers also watched the videos and rated each child on the same dimensions. RESULTS: There was very little correlation between social anxiety level and observer ratings of children's social skills. Indeed, some very anxious children achieved high observer rated social skill scores. State socially anxious children self-reported that their social skills were poorer than less anxious children. However, other than looking more nervous than less anxious children, the social skills of the high anxious children were indistinguishable from those of their less anxious peers. CONCLUSIONS: Socially anxious children may not necessarily lack social skills. Rather, their deficits may relate to nervousness and appraisals of their skills. Treatment programmes for these children should take care to assess social skills carefully before prescribing social skill remediation, and should consider employing a cognitive element to tackle negative misperceptions of subjective social skill.

Child↗