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The utility of social capital in research on health determinants.

Social capital has become a popular subject in the literature on determinants of health. The concept of social capital has been used in the sociological, political science, and economic development literatures, as well as in the health inequalities literature. Analysis of its use in the health inequalities literature suggests that each theoretical tradition has conceptualized social capital differently. Health researchers have employed a wide range of social capital measures, borrowing from several theoretical traditions. Given the wide variation in these measures and an apparent lack of consistent theoretical or empirical justification for their use, conclusions about the likely role of "social capital" on population health may be overstated or even misleading. Elements of a research agenda are proposed to further elucidate the potential role of factors currently subsumed under the rubric of "social capital."

Community Participation↗

Migrants, refugees and insecurity. Current threats to peace?

Since the early 1980s, international migration has moved beyond humanitarian, economic development, labor market and societal integration concerns, raising complex interactive security implications for governments of migrant sending, receiving and transit countries, as well as for multilateral bodies. This article examines the effects of international migration on varied understandings and perceptions of international security. It discusses why international migration has come to be perceived as a security issue, both in industrialized and developing countries. Questions are raised on the migration-security nexus and the way in which the concepts "security" and "migration" are used. The real and perceived impacts of international migration upon national and regional security, both in industrialized and developing countries, are analyzed. The policies developed by governments and multilateral agencies since the mid-1980s to mitigate the destabilizing effects of certain kinds of international population movement and human displacement are examined. The conclusions stress the need for the establishment of a comprehensive framework of international cooperation among origin and receiving countries and international organizations to address the destabilizing implications of international migration.

Demography↗

What risks are Chinese people concerned about?

The aim of this study is to investigate public perceived risk on various issues in present-day China. Two surveys were conducted in urban China in 1996 and 1998. In the first survey, risk perceptions of different occupational groups are compared. Gender differences within each occupational group are also analyzed. In the second survey, participants with diverse employment status were recruited. The overall risk rankings of both surveys indicate great concern with risks that threaten national stability and economic development, and less concern with high-technology risk such as threat from a nuclear power plant. It is also found that employees from high-profit firms are more concerned about macroscopic catastrophic risks, whereas laid-off workers and employees from money-losing enterprises are more concerned about daily life or self-concerned risks. The importance of actual exposure to risk, mass media coverage, culture, and psychometric dimensions are discussed.

Adult↗

Trends in drinking habits among Finnish youth from 1973 to 1987.

The aim of this study has been to analyze the trends in drinking habits among Finnish youth from 1973 to 1987. The data were collected by questionnaires from representative nationwide samples of 14- to 18-year-olds in 1973, and from 1977, biennially. Response rates varied between 79% (1985) and 88% (1981). The use of alcohol was common among young people in the early 1970s, decreased until the beginning of the 1980s, and then increased again beginning in 1983. The use of alcohol had increased among young people in every sociodemographic group and school type in recent years. However, the increase, per capita, of alcohol consumption in Finland has grown in recent years after a long stable period due to an increase in the availability of alcoholic beverages and better economic conditions. The spending money available to young people for their leisure time activities, including alcohol consumption, increased markedly after 1983. The liberalization of alcohol policies in connection with fast economic development had a special effect on alcohol use among young people in the early 1970s and then again in the 1980s.

Adolescent↗

Sense of coherence among unemployed nurses.

AIMS: This paper reports a study assessing Finnish unemployed nurses' sense of coherence and the factors relating to it. BACKGROUND: During the 1990s, due to the widespread economic downturn in Finland, the nursing profession suffered from a high level of unemployment. Previous research has clearly indicated that unemployment is detrimental to health. It creates stress by disturbing a person's sense of identity and self-esteem and by disrupting social networks. In Finland, many studies have been conducted on the impact of unemployment, but have not examined the sense of coherence of unemployed nurses. METHODS: Data were collected in one Employment and Economic Development Centre area in Finland in 1998. Structured questionnaires were used to collect data among Finnish unemployed nurses (n = 183), and included the General Health Questionnaire, measuring nurses' mental health; socio-demographic questions; and the 13-item version of the Sense of Coherence scale based on Antonovsky's salutogenic model to measure sense of coherence. RESULTS: Although the majority of unemployed nurses had a strong sense of coherence, many felt that during their period of unemployed they did not feel at ease, did not know what to do and had a sense of being unfairly treated. Daily household chores, on the whole, were perceived as meaningful. Income and the state of mental health were positively correlated with nurses' sense of coherence: the better the family income and state of mental health, the stronger was their sense of coherence. Because of the low response rate (less than 50%), the results might be skewed by those whose higher sense of coherence made them more motivated to complete the questionnaires. CONCLUSIONS: Many of the nurses reported low sense of coherence and poor general health. Special interventions should be designed to improve their sense of coherence and high motivation level, and to maintain their professional competence when they return to work. This kind of support may prevent further out-migration and nursing shortages from Finland and other industrialized countries.

Adaptation, Psychological↗

Health and quality of life of ventilator-dependent children.

AIM: This paper reports a qualitative study with ventilator-dependent children and their parents, describing their experiences and meanings concerning the children's health and quality of life. BACKGROUND: Recent medical advances have enabled children to survive premature birth, congenital anomalies, critical illness and accidents with long-term use of mechanical ventilation to support breathing. In economically developed countries, the number of ventilator-dependent children is increasing and many require nurse-led home healthcare services. Debate has been polarized as to whether life on a ventilator is in the best interests of all children. The perspectives of ventilator-dependent children are largely absent in the literature. METHODS: Principles derived from Heideggerian phenomenology were used to describe how children and their parents interpreted and rationalized the quality of the child's 'ventilator-dependent' life and their health. The study had two phases with data collection commencing in 1998 and completed in 2004. RESULTS: The participants were 35 ventilator-dependent children, and 50 mothers and 17 fathers of 53 children. Emergent themes revealed some common features across this heterogeneous group. Ventilation made the children feel better and if they had sufficient breath, they experienced better quality of life. It was not possible to delineate the magnitude of health gain or benefit, especially amongst preverbal children and those with profound sensory impairments. Quality of life equated to quality of life experiences, but some children experienced negative social impacts and low self-esteem. Home healthcare services were not designed to bring about the desired social outcomes that children identified. Parent's accounts showed subtle more negative differences. CONCLUSION: The acceptance of children's dependence on machines to live has brought about the need for nursing, medical, social and biological boundaries to be redefined, especially around children's meanings of their health, what they understand to be good quality of life, and what they need to achieve it. Flexible, high quality child-focused homecare is likely to improve children's outcomes.

Adolescent↗

An overview of the use of anti-tuberculous drugs in Uganda and Hong Kong.

Anti-tuberculous (Anti-TB) chemotherapy in Uganda is outlined. Its pattern of use and the subsequent shortcomings have prompted the need for the present review. A collateral comparison to that of Hong Kong was run to emphasize the correlation of anti-TB chemotherapy with economic development and regional variation in the population of the two areas. Tuberculosis of the central nervous system (CNS) has a high fatality rate. In the search for a more comprehensive anti-TB dosage regimen, the difficulty in treating tuberculosis of the CNS has attracted special attention with emphasis on the fate of anti-TB drugs across the meninges. The choice of a method for drug analysis in routine therapeutic drug monitoring for a country is likewise determined by factors similar to those for the anti-TB regimen. Uganda needs an inexpensive, precise and selective method for TB treatment tailored to its financial and manpower resources.

Child↗

International variations in the incidence of childhood lymphomas.

The International Agency for Research on Cancer has coordinated a worldwide study of childhood cancer incidence, with data provided by contributors from over 50 countries. We present here the results on lymphomas from this study and other sources. Hodgkin's disease had a relatively high incidence in North Africa and West Asia and a low incidence throughout East Asia. In populations of predominantly European origin, the highest rates tended to be in warmer countries of lower latitude. In industrialised Western countries, the incidence increased steeply with age and was low in childhood compared with that in young adults whereas elsewhere the increase in incidence between childhood and adults aged 20-34 was much less marked. The age-distribution of Hodgkin's disease in childhood appears to be related to levels of socio-economic development but the total incidence seems to be determined more by ethnic and environmental factors. The highest incidence of Burkitt's lymphoma occurred in tropical Africa and Papua New Guinea. Elsewhere, Burkitt's lymphoma was rare, though the incidence was higher in Spain, North Africa and the Middle East than in other areas. In most Western countries, a third of all non-Hodgkin lymphomas may be Burkitt's. There was no consistent pattern in the incidence of other non-Hodgkin lymphomas except for a tendency towards higher rates around the Mediterranean and in some Latin American registries.

Adolescent↗

Malaria epidemiology in a rural area of the Mekong Delta: a prospective community-based study.

Over the past 10 years, the Mekong Delta region in Vietnam has experienced fast socio-economic development with subsequent changes in malaria vectors ecology. We conducted a 2-year prospective community-based study in a coastal rural area in the southern Mekong Delta to re-assess the malaria epidemiological situation and the dynamics of transmission. The incidence rate of clinical malaria, established on 558 individuals followed for 23 months by active case detection and biannual cross-sectional surveys, was 2.6/100 person-years. Over the 2-year study period, the parasite rate and malaria seroprevalence (Plasmodium falciparum and P. vivax) decreased significantly from 2.4% to almost 0%. Passive case detection (PCD) of clinical cases and serological follow-up of newborns carried out in a larger population confirmed the low and decreasing trend of malaria transmission. The majority of fever cases were seen in the private sector and most were unnecessarily treated with antimalarials. Training and involvement of the private sector in detection of malaria cases would greatly improve the quality of health care and health information system.

Adolescent↗

Lifestyle effect on total IgE. Lifestyles have a cumulative impact on controlling total IgE levels.

Recent studies have demonstrated an increasing number of cases of allergy in economically developed societies. Many of these allergic reactions are mediated by IgE antibodies whose levels are under genetic control. However, this large increase of allergy prevalence cannot be explained by genetic mutations; comprehensive lifestyles may also play roles in determining total IgE levels. Total IgE levels were determined from serum samples taken from 706 hard metal workers who responded to a questionnaire including 17 items related to physical and mental health practices. Five factors tending to normalize IgE upward and three tending to normalize IgE downward when we keep good lifestyles were extracted using MANOVA analysis. We therefore constructed a Health Practice Index in Allergic reactions (HPIA); eight physical and mental health practices were significantly (P less than 0.05) associated with cumulative elevations or suppressions of total IgE levels when sex, age and environmental factors were controlled for. Multivariate analyses demonstrated a dramatic synergism (Relative Risk greater than 2.0, P less than 0.05) of unhealthy lifestyles determining a bipolar high risk for elevated or suppressed IgE levels which in turn may result in allergic diseases or immuno-suppression. Maintenance of healthy lifestyles may prove beneficial for reducing the prevalence of allergic disorders.

Adolescent↗

Healthy country: healthy people? Exploring the health benefits of indigenous natural resource management.

OBJECTIVE: Decades of health-related research have produced a large body of knowledge describing alarming rates of morbidity, mortality and social/cultural disruption among Indigenous Australians, but have failed to deliver sustainable interventions to arrest the deepening spiral of ill-health. This paper explores the potential of Indigenous natural resource management (NRM) activities to promote and preserve Indigenous health in remote areas of northern Australia. METHOD: A literature review of the health, social science and ecology peer-reviewed journals and secondary literature. CONCLUSIONS AND IMPLICATIONS: Effective interventions in Indigenous health will require trans-disciplinary, holistic approaches that explicitly incorporate Indigenous health beliefs and engage with the social and cultural drivers of health. Aboriginal peoples maintain a strong belief that continued association with and caring for ancestral lands is a key determinant of health. Individual engagement with 'country' provides opportunities for physical activity and improved diet as well as boosting individual autonomy and self-esteem. Internationally, such culturally congruent health promotion activities have been successful in programs targeting substance abuse and chronic diseases. NRM is fundamental to the maintenance of biodiversity of northern Australia. Increased support for Indigenous involvement in land and sea NRM programs would also deliver concrete social benefits for communities including opportunities for sustainable and culturally apt regional employment, applied education and economic development. NRM may also reinvigorate societal/cultural constructs, increasing collective esteem and social cohesion.

Anthropology, Cultural↗

Private production, collective consumption, and regional population structure: the interactions between public and private good provision as determinants of community composition.

"Theories of trade and migration explain the distribution of individuals among regions based on private good productivities. The theory of local public goods (LPG's) uses collective good consumption economies to explain the size and composition of communities. This essay combines the two theories, to explore regional population heterogeneity and stability. Assuming that individuals must consume and produce in the same jurisdiction, the paper examines the nature of efficient allocations, the tensions between the private and public incentives, the nature of the equilibrium (if any) which migration among jurisdictions will generate, and how such equilibrium will depend on tax rules for sharing the costs of the LPG."

Commerce↗

Socio-economic re-structuring and employment: the case of minority ethnic groups.

The consequences of major changes in employment, due to the decline of manufacturing and the growth of the service sector, have not been well-documented, nor theorized, in the sociology of ethnic relations, even in recent studies. For example, Blumer's classic argument that economic development adapts to 'race relations', rather than the reverse as predicted by the modernization school, has not been either empirically resolved or conceptually applied to the UK. By adapting data from the Labour Force Survey and the Census, the paper begins to fill this gap with a detailed account of three main minority ethnic groups, and a separate analysis of male and female employment. It is demonstrated that, contrary to assumptions that members of the minority ethnic groups suffered most from de-industrialization, they actually did rather well, and in some cases did better than the majority population. These findings are re-conceptualized as collective social mobility, as part of a review of a number of conceptual frameworks in the light of the data.

Employment↗

Surnames in Sardinia. I. Fit of frequency distributions for neutral alleles and genetic population structure.

Distributions of surnames were examined using data from about 40 000 individuals from consanguineous marriages (1930-59) in the island of Sardinia. They fit the Karlin-McGregor (1967) distribution for neutral alleles. The logarithmic distribution by Fisher (1943) and the Karlin-McGregor (1967) distribution give practically indistinguishable fits to these data. The two parameters underlying the Fisher distribution, alpha and nu, are fully interdependent, given the sample size N. From the latter and from the number of surnames S, they can be easily and satisfactorily estimated. The quantity nu measures immigration to the area and can be taken as a measure of the richness of the gene pool, being closely related to the quantity theta = Nemu (Ne = effective population size, mu = mutation rate) after the necessary corrections have been taken care of. Surnames behave like genes transmitted by the male line. Differences of female and male migrations require correction for comparison with data from autosomal gene frequencies but there seem to be no important differences between female and male migration in this area, as judged by analysis of pedigrees of consanguineous marriages. It is probable that the migration estimates obtained in this material are lower than real ones, mostly because of a bias characteristic of the particular source of surnames here employed. The distribution of surnames from areas which have very recently undergone economic development is not at equilibrium and is not fitted as well as that of areas which have had less important recent changes. As might be expected, the disturbance is particularly marked in the class most sensitive to effects of recent increases in migration, that of rarest surnames (represented by only one individual). In fact in this material it is noticeable only in this class and correction can be made for it. At equilibrium of migration and drift, the number of surnames in a population sample of given size can give a complete description of the population structure for that sample, in the same sense that the number of alleles is a sufficient statistic for the study of neutral evolution. The study of surnames, given their nature of 'neutral' alleles, the large number of alleles and the ease with which large numbers of individual data can be collected, can be a valuable help in the study of genetic population structure.

Alleles↗

Is greater female longevity a general finding among animals?

(A) There are data showing beyond question a gender gap, with women living longer than men, especially in economically developed societies. There is greater male vulnerability to the major causes of human death. (B) In lower animals there are data suggesting a female survival advantage to adult life in many species, but the observations do not consider longevity or survival to an advanced age. (C) In laboratory rodents kept under controlled conditions the relationship of sex to longevity is variable, with males sometimes showing greater longevity than females and with life span being dependent on factors like breeding and diet. (D) Similar genetic and hormonal processes operate in humans and in non-human mammals including the genetic mechanism of sex determination, the hormonal consequences of sex determination, and the effects of hormones on processes which affect longevity such as cholesterol levels and immune functions. (E) Causes of death in humans and animals are different, and it seems unlikely, therefore, that the same mechanisms could be determinants of longevity in all mammalian species. (F) Human male and female longevity continue to change, and it is likely that the gender gap will narrow, with societal and medical changes in post-industrial societies reducing the male disadvantages in behaviour and in the handling of cholesterol. (G) It remains an important question whether part of the gender gap seen in humans is based on other differences in the basic biology of males and females.

Animal Population Groups↗