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Social Class (social + class)
Kinds of Social Class Selected AbstractsAmerican Individualisms: Child Rearing and Social Class in Three Neighborhoods.ETHOS, Issue 1 2010Adrie Kusserow. No abstract is available for this article. [source] Explaining Pro-Immigrant Sentiment in the U.S.: Social Class, Cosmopolitanism, and Perceptions of Immigrants1INTERNATIONAL MIGRATION REVIEW, Issue 3 2006Jeannie Haubert In the U.S., research on attitudes toward immigrants generally focuses on anti-immigrant sentiment. Yet, the 1996 General Social Survey indicates that half the population believes that immigrants favorably impact the U.S. economy and culture. Using these data, we analyze theories of both pro- and anti-immigrant sentiment. While we find some support for two theories of intergroup competition, our most important finding connects a cosmopolitan worldview with favorable perceptions of immigrants. We find that cosmopolitans , people who are highly educated, in white-collar occupations, who have lived abroad, and who reject ethnocentrism , are significantly more pro-immigrant than people without these characteristics. [source] Dental Health Differences by Social Class in Home-Dwelling Seniors of Barcelona, SpainJOURNAL OF PUBLIC HEALTH DENTISTRY, Issue 4 2006Vladimir Pizarro DDS Abstract Background:The aim of this study was to assess dental health differences by social class in home-dwelling seniors in Spain. Methods:A cross-sectional household survey of a cohort of senior residents in Barcelona (Spain) was undertaken. Of 891 survivors (72 years or older), 561 (62.9%) oral examinations were completed according to the DMF Index (Decayed, Missing and Filled teeth). Results:42% of participants were edentate. The individuals of social class IV-V were more likely to be edentate, and to have fewer than 15 teeth compared to those in social class I-II. The DMF Index in dentate individuals (Adjusted mean=16.4) also showed significantly worse dental health for lower social classes (p = 0.001). Conclusions:The results of this study indicate a different level of utilization of dental health services and dental health by social class in home-dwelling seniors. Further research is needed to understand the barriers of access and social inequality. [source] Struggling with Poverty: Implications for Theory and Policy of Increasing Research on Social Class-Based StigmaANALYSES OF SOCIAL ISSUES & PUBLIC POLICY, Issue 1 2009Wendy R. Williams Low-income people are stigmatized in a number of ways, including being negatively stereotyped and discriminated against both interpersonally and institutionally (see Lott & Bullock, 2007 for a comprehensive review). Yet psychologists have not focused much attention on social class in general, nor on social class-based stigma in particular. This article argues that by resolving three main problems in the literature (the achieved/ascribed discrepancy, the complexity of operationalizing social class, and the seeming lack of identification with one's social class), psychologists are in a unique position to use their knowledge to aid practitioners and policymakers in ameliorating the consequences of poverty. Thus, this article focuses on how better to incorporate social class into the stigma literature and how this research can be linked to social policy initiatives. [source] A Comparison of Dental Caries Levels in Two Communities with Different Oral Health Prevention Strategies Stratified in Different Social ClassesJOURNAL OF PUBLIC HEALTH DENTISTRY, Issue 1 2007Darius Sagheri PhD Abstract Objectives: To compare dental caries levels of schoolchildren stratified in different social classes whose domestic water supply had been fluoridated since birth (Dublin) with those living in an area where fluoridated salt was available (Freiburg). Methods: A representative, random sample of twelve-year-old children was examined and dental caries was recorded using World Health Organization criteria. Results: A total of 699 twelve-year-old children were examined, 377 were children in Dublin and 322 in Freiburg. In Dublin the mean decayed, missing, and filled permanent teeth (DMFT) was 0.80 and in Freiburg it was 0.69. An examination of the distribution of the DMFT score revealed that its distribution is highly positively skewed. For this reason this study provides summary analyses based on medians and inter-quartile range and nonparametric rank sum tests. In both cities caries levels of children in social class 1 (highest) were considerably lower when compared with the other social classes regardless of the fluoride intervention model used. The caries levels showed a reduced disparity between children in social class 2 (medium) and 3 (lowest) in Dublin compared with those in social class 2 and 3 in Freiburg. Conclusions: The evidence from this study confirmed that water fluoridation has reduced the gap in dental caries experience between medium and lower social classes in Dublin compared with the greater difference in caries experience between the equivalent social classes in Freiburg. The results from this study established the important role of salt fluoridation where water fluoridation is not feasible. [source] Social class and smoking at age 15: the effect of different definitions of smokingADDICTION, Issue 9 2001Helen Sweeting Aim. To explore whether the association between social class and smoking among teenagers varies according to the definition of smoking adopted. Design, setting and participants. A survey of 2196 15-year-olds in 43 secondary schools in the West of Scotland. Measures. Current smoking status and number of cigarettes smoked, and social class based on the occupation of the head of the household. Findings. 'Current smoker' was the only category not significantly differentiated by class; the ratio of smokers from unskilled compared with professional backgrounds rose with increasingly stringent definitions of smoking. Conclusion. The extent to which teenage smoking is patterned by social class depends on the definition of smoking adopted. [source] Stratification in Higher Education, Choice and Social Inequalities in GreeceHIGHER EDUCATION QUARTERLY, Issue 1 2010Eleni Sianou-Kyrgiou Higher education has expanded to a remarkable extent in many countries in recent decades. Although this has led to high levels of participation, inequalities not only persist but are also strengthened. The persistence of inequalities is partly the result of policies for the widening of participation having been accompanied by institutional stratification with educational choices being unequal and socially defined. There is evidence that with the development of new university departments and the increase in the number of university entrants in Greece, a stratified system of higher education has emerged. This study draws on quantitative data that provides evidence that choice has been driven largely by the students' social class: the close relationship between social class and educational opportunities has remained intact. Furthermore, social inequalities in access and distribution in higher education persist, despite the substantial increase in participation in higher education. Social class is a key factor in the interpretation of choice of study, which, along with the performance in the national level examinations that determines entrance into universities, has also led to the increase in the stratification of higher education institutions. [source] Social class is an important and independent prognostic factor of breast cancer mortalityINTERNATIONAL JOURNAL OF CANCER, Issue 5 2006Christine Bouchardy Abstract Reasons of the important impact of socioeconomic status on breast cancer prognosis are far from established. This study aims to evaluate and explain the social disparities in breast cancer survival in the Swiss canton of Geneva, where healthcare costs and life expectancy are among the highest in the world. This population-based study included all 3,920 female residents of Geneva, who were diagnosed with invasive breast cancer before the age of 70 years between 1980 and 2000. Patients were divided into 4 socioeconomic groups, according to the woman's last occupation. We used Cox multivariate regression analysis to identify reasons for the socioeconomic inequalities in breast cancer survival. Compared to patients of high social class, those of low social class had an increased risk (unadjusted hazard ratio [HR] 2.4, 95% CI: 1.6,3.5) of dying as a result of breast cancer. These women were more often foreigners, less frequently had screen-detected cancer and were at more advanced stage at diagnosis. They less frequently underwent breast-conserving surgery, hormonal therapy, and chemotherapy, in particular, in case of axillary lymph node involvement. When adjusting for all these factors, patients of low social class still had a significantly increased risk of dying of breast cancer (HR 1.8, 95% CI: 1.2,2.6). Overmortality linked to low SES is only partly explained by delayed diagnosis, unfavorable tumor characteristics and suboptimal treatments. Other factors, not measured in this study, also could play a role. While waiting for the outcome of other researches, we should consider socioeconomic status as an independent prognostic factor and provide intensified support and surveillance to women of low social class. © 2006 Wiley-Liss, Inc. [source] The impact of childhood on disabled professionalsCHILDREN & SOCIETY, Issue 3 2004Sonali Shah The impact of childhood on success in adulthood has been much researched. This paper discusses how parental expectations, social class, childhood experiences and gender influenced the career success of disabled people. For respondents with congenital disabilities, disability was perceived as a primary factor influencing parental expectations, but those with acquired disabilities felt it was gender. Social class played a significant part in all respondents' childhood socialisation and parental expectations. Some experienced deprivation and trauma as children, encouraging them to master future life events. The findings highlight the importance of childhood socialisation to the career success of disabled people. [source] Learning from Difference: Considerations for Schools as CommunitiesCURRICULUM INQUIRY, Issue 3 2000Carolyn M. Shields In today's highly complex and heterogeneous public schools, the current notion of schools as homogeneous communities with shared beliefs, norms, and alues is inadequate. Drawing on Barth's (1990) question of how to use ifference as a resource, I take up ideas from feminism, multiculturalism, and inclusive education to consider the development of community in schools. I argue that despite the valuable contributions of these theoretical perspectives, each lso includes the potential for increased fragmentation and polarization. As we consider how to use differences as a foundation for community, it is important ot to reify any particular perspective, thus marginalizing others and erecting new barriers. Explicitly embracing the need to identify and respect difference, being open to new ideas without taking an exclusionary position, and committing to ongoing participation in dialogical processes may help schools to develop as more authentic communities of difference. Among the dominant issues identified in today's climate of turbulent educational reform are concerns about how to restructure schools to ensure equality of student opportunity and excellence of instruction (Elmore, 1990; Lieberman, 1992; Murphy, 1991). Many proposals include modifying present leadership and governance structures, overcoming the hegemony of existing power bases, developing mechanisms for accountability, enhancing professionalism, and co-ordinating community resources. One of the suggestions frequently made to address these issues is to change from a focus on schools as organizations to a recognition of schools as communities (Barth, 1990; Fullan, 1993; Lupart & Webber, 1996; Senge, 1990). However, despite the widespread use of the metaphor of community as an alternative to the generally accepted concept of schools as rational or functional organizations, there seems to be little clarity about the concept of community, what it might look like, how it might be implemented, or what policies might sustain it. Indeed, theories about schools as communities have often drawn from Tönnies (1887/1971) concept of gemeinschaft,a concept which perhaps evokes a more homogeneous and romanticized view of the past than one which could be helpful for improving education in today's dynamic, complex, and heterogeneous context (Beck & Kratzer, 1994; Sergiovanni, 1994a). More recently, several writers (Fine et al., 1997; Furman, 1998; Shields & Seltzer, 1997) have advanced the notion of communities of otherness or difference. These authors have suggested that rather than thinking of schools as communities that exist because of a common affiliation to an established school ethos or tradition, it might be more helpful to explore an alternative concept. A school community founded on difference would be one in which the common centre would not be taken as a given but would be co-constructed from the negotiation of disparate beliefs and values as participants learn to respect, and to listen to, each other. In this concept, bonds among members are not assumed, but forged, and boundaries are not imposed but negotiated. Over the past eight years, as I have visited and worked with a large number of schools trying earnestly to address the needs of their diverse student bodies, I have become increasingly aware of the limitations of the concept of community used in the gemeinschaft sense with its emphasis on shared values, norms, and beliefs, and have begun to reflect on the question framed by Barth (1990): ,How can we make conscious, deliberate use of differences in social class, gender, age, ability, race, and interest as resources for learning?' (p. 514). In this article, I consider how learning from three of these areas of difference: gender, race, and ability, may help us to a better understanding of educational community. This article begins with some illustrations and examples from practice, moves to consider how some theoretical perspectives may illuminate them, and concludes with reflections on how the implications of the combined reflections on practice and theory might actually help to reconceptualize and to improve practice. While it draws heavily on questions and impressions which have arisen out of much of my fieldwork, it is not intended to be an empirical paper, but a conceptual one,one which promotes reflection and discussion on the concept of schools as communities of difference. The examples of life in schools taken from longitudinal research studies in which I have been involved demonstrate several common ways in which difference is dealt with in today's schools and some of the problems inherent in these approaches. Some ideas drawn from alternative perspectives then begin to address Barth's question of how to make deliberate use of diversity as a way of thinking about community. Taken together, I hope that these ideas will be helpful in creating what I have elsewhere called ,schools as communities of difference' (Shields & Seltzer, 1997). [source] Reporting of diabetes on death certificates using data from the UK Prospective Diabetes StudyDIABETIC MEDICINE, Issue 8 2005M. J. Thomason Abstract Aims To study the effect of age at death, sex, ethnic group, date of death, underlying cause of death and social class on the frequency of reporting diabetes on death certificates in known cases of diabetes. Methods Data were extracted from certificates recording 981 deaths which occurred between 1985 and 1999 in people aged 45 years or more who participated in the UK Prospective Diabetes Study, to which 23 English, Scottish and Northern Ireland centres contributed. Diabetes (9th revision of the International Classification of Diseases; ICD-9 250) entered on parts 1A,1C or 2A,2C of the death certificate was considered as reporting diabetes. Logistic regression analyses were used to determine independent factors associated with the reporting of diabetes. Results Diabetes was reported on 42% (419/981) of all death certificates and on 46% (249/546) of those with underlying cardiovascular disease causes. Reporting of diabetes was independently associated on all death certificates with per year of age increase (OR 1.02; 95% CI 1.001,1.04, P = 0.037), underlying cause of death (non-cardiovascular causes OR 0.76; 95% CI 0.59,0.98, P = 0.035) and social class (classes I,II OR 1.00; class III OR 1.35; 95% CI 0.96,1.89, P = 0.084, classes IV,V OR 1.48; 95% CI 1.05,2.10, P = 0.027). Stratification by age, sex, and underlying cause of death also revealed significant differences in the frequency of reporting diabetes over time. Conclusions The rate of reporting of diabetes on cardiovascular disease death certificates remains poor. This may indicate a lack of awareness of the importance of diabetes as a risk factor for cardiovascular disease. [source] GOVERNMENT'S CONSTRUCTION OF THE RELATION BETWEEN PARENTS AND SCHOOLS IN THE UPBRINGING OF CHILDREN IN ENGLAND: 1963,2009EDUCATIONAL THEORY, Issue 3 2010David Bridges In this essay David Bridges argues that since most families choose to realize their responsibility for the major part of their children's education through state schools, then the way in which the state constructs parents' relation with these schools is one of its primary levers on parenting itself. Bridges then examines the way in which parent-school relations have been defined in England through government and quasi-government interventions over the last forty-five years, tracing these through an awakening interest in the relation between social class and unequal school success in the 1960s, passing through the discourse of accountability in the 1970s, marketization in the 1980s and 1990s, performativity extending from this period into the first decade of the twenty-first century, and, most recently, more direct interventions into parenting itself and the regulation of school relations with parents in the interests of safeguarding children. These have not, however, been entirely discrete policy themes, and the positive and pragmatic employment of the discourse of partnership has run throughout this period, albeit with different points of emphasis on the precise terms of such partnership. [source] Changes in environmental tobacco smoke (ETS) exposure over a 20-year period: cross-sectional and longitudinal analysesADDICTION, Issue 3 2009Barbara J. Jefferis ABSTRACT Aims To examine long-term changes in environmental tobacco smoke (ETS) exposure in British men between 1978 and 2000, using serum cotinine. Design Prospective cohort: British Regional Heart Study. Setting General practices in 24 towns in England, Wales and Scotland. Participants Non-smoking men: 2125 studied at baseline [questionnaire (Q1): 1978,80, aged 40,59 years], 3046 studied 20 years later (Q20: 1998,2000, aged 60,79 years) and 1208 studied at both times. Non-smokers were men reporting no current smoking with cotinine < 15 ng/ml at Q1 and/or Q20. Measurements Serum cotinine to assess ETS exposure. Findings In cross-sectional analysis, geometric mean cotinine level declined from 1.36 ng/ml [95% confidence interval (CI): 1.31, 1.42] at Q1 to 0.19 ng/ml (95% CI: 0.18, 0.19) at Q20. The prevalence of cotinine levels , 0.7 ng/ml [associated with low coronary heart disease (CHD) risk] rose from 27.1% at Q1 to 83.3% at Q20. Manual social class and northern region of residence were associated with higher mean cotinine levels both at Q1 and Q20; older age was associated with lower cotinine level at Q20 only. Among 1208 persistent non-smokers, cotinine fell by 1.47 ng/ml (95% CI: 1.37, 1.57), 86% decline. Absolute falls in cotinine were greater in manual occupational groups, in the Midlands and Scotland compared to southern England, although percentage decline was very similar across groups. Conclusions A marked decline in ETS exposure occurred in Britain between 1978 and 2000, which is likely to have reduced ETS-related disease risks appreciably before the introduction of legislation banning smoking in public places. [source] Prevalence of alcohol use disorders and associated factors: a population-based study using AUDIT in southern BrazilADDICTION, Issue 6 2003Raúl A. Mendoza-Sassi ABSTRACT Aims To assess the prevalence of potential alcohol use disorders and associated factors using the Alcohol Use Disorders Identification Test (AUDIT). Design Cross-sectional study. Setting A town in southern Brazil. Participants A representative sample of 1260 people aged 15 and over. Measurements Demographic, socioeconomic, smoking habit and mental health data were collected. Logistic regression was used in the multivariate analysis, and odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Findings Overall prevalence of alcohol use disorder was 7.9%, with 14.5% prevalence among men and 2.4% among women. The risk of alcohol misuse increased across social class (P linear trend = 0.03) and compared with the highest classes (A and B), groups C through E had ORs of 1.48, 1.51 and 2.36, respectively. Males had an OR of 6.89 (CI 3.61,13.16) compared with women. A linear trend was found (P = 0.001) between smoking categories, and smokers (OR 3.27; CI 1.91,5.58) and ex-smokers (OR 1.30; CI 0.56,2.98) were at higher risk than non-smokers. Those with minor psychiatric disorders had a 2.48 OR (CI 1.35,4.56) of presenting a positive test. Conclusions The AUDIT detected a high prevalence of potential alcohol use disorders in the population sampled. Those identified are potential targets for preventive measures implemented through health policies. [source] Social class and smoking at age 15: the effect of different definitions of smokingADDICTION, Issue 9 2001Helen Sweeting Aim. To explore whether the association between social class and smoking among teenagers varies according to the definition of smoking adopted. Design, setting and participants. A survey of 2196 15-year-olds in 43 secondary schools in the West of Scotland. Measures. Current smoking status and number of cigarettes smoked, and social class based on the occupation of the head of the household. Findings. 'Current smoker' was the only category not significantly differentiated by class; the ratio of smokers from unskilled compared with professional backgrounds rose with increasingly stringent definitions of smoking. Conclusion. The extent to which teenage smoking is patterned by social class depends on the definition of smoking adopted. [source] Black Women and White Women: Do Perceptions of Childhood Family Environment Differ?FAMILY PROCESS, Issue 2 2007CASSANDRA M. CLAY M.S.W. Introduction: Few studies have examined racial differences in perceptions of childhood. Little is known about how Blacks perceive their own families, particularly the family environment that they experienced in childhood. Methods: A community sample of 290 women (55% White, 45% Black) from two-parent families, heterogeneous in age and social class, was examined using a self-administered questionnaire, including the Family Environment Scale (FES), followed by a focused interview. Siblings were used as collateral informants. Results: The psychometric properties of the FES showed remarkably little variation by race: The internal scale reliability, correlations between scales, and factor structures were quite similar. Although both White and Black women reported good childhood family environments, Black women when compared with White women rated their families of origin as more cohesive, organized, and expressive, and lower in conflict. Sibling responses corroborated these findings. Discussion: This study addresses a gap in the research literature and provides important evidence of strengths in Black family relationships as reported by a community sample of women. The psychometric properties of the FES, found to be strong for families of both races, lends support to our findings and those of other researchers who have used this measure. [source] Influence of Race on Household Residential UtilityGEOGRAPHICAL ANALYSIS, Issue 3 2000M William Sermons Residential location choice models are an important tool employed by urban geographers, planners, and transportation engineers for understanding household residential location behavior and for predicting future residential location activity. Racial segregation and residential racial preferences have been studied extensively using a variety of analysis techniques in social science research, but racial preferences have generally not been adequately incorporated into residential location choice models. This research develops residential location choice model specifications with a variety of alternative methods of addressing racial preferences in residential location decisions. The research tests whether social class, family structure, and in-group racial preferences are sufficient to explain household sensitivity to neighborhood racial composition. The importance of the interaction between the proportion of in-group race neighbors and other-race neighbors is also evaluated. Models for the San Francisco Bay metropolitan area are estimated and evidence of significant avoidance behavior by households of all races is found. The results suggest that social class differences, family structure differences, and in-group racial preferences alone are not sufficient to explain household residential racial preference and that households of all races practice racial avoidance behavior. Particularly pronounced avoidance of black neighbors by Asian households, Hispanic neighbors by black households, and Asian neighbors by white households are found. Evidence of a decrease in household racial avoidance intensity in neighborhoods with large numbers of own-race neighbors is also found. [source] Predictors and correlates of edentulism in the healthy old people in Edinburgh (HOPE) studyGERODONTOLOGY, Issue 4 2008John M. Starr Objectives:, To determine the extent to which correlates of edentulism are explained by an association between tooth loss and cognitive ability. Methods:, Participants in the Healthy Old People in Edinburgh (HOPE) study aged 70 or more at baseline were assessed and health, cognitive, socio-economic and socio-environmental data collected on four consecutive occasions. It was noted whether the participant had any retained teeth and if not, the age when the last tooth was lost. Prior determinants of edentulism were investigated with binary logistic regression models. At the 9-year follow-up, associations with edentulism were examined using general linear models with edentulism as an independent factor. Results:, 201 participants were adequately tested, of whom 104 (51.7%) were edentulous. A logistic regression model that considered age, sex, education, social class, deprivation index of residence, objective distance from dentist, participant's estimate of distance from dentist and NART-estimated IQ (NARTIQ) found age (p = 0.032), occupational class (p = 0.019) and NARTIQ (p = 0.027) as significant predictors of edentulism. Cox's proportional hazards modelling found only NARTIQ (p = 0.050) to be correlated. Being edentulous was associated with poorer respiratory function but not hand grip strength (p = 0.23). Edentulous participants had lower self esteem scores (p = 0.020) and poorer dietary assessment scores (p = 0.028). Being edentulous was also associated with significantly lower mean scores on all cognitive testing, although these associations became non-significant after adjustment for NARTIQ and age. Conclusions:, In healthy older people, edentulism is associated with relative impairment of cognitive ability, although this association is explained by the fact that lower original intelligence predisposes to edentulism and poorer performance on cognitive tests in old age. Once original intelligence is adjusted for, tooth loss is not related to cognitive ability. Tooth loss is, however, associated with poorer status across a wide range of health measures: physical health, nutrition, disability and self-esteem. Establishing the degree to which these health outcomes are causally related to edentulism could usefully be factored into cost,benefit analyses of programmes designed to prevent tooth loss. [source] Lesbian, gay, bisexual and transgender young people's experiences of distress: resilience, ambivalence and self-destructive behaviourHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 3 2008Jonathan Scourfield BA MA DipSW PhD Abstract The research presented in this paper set out to explore the cultural context of youth suicide and more specifically any connections between sexual identity and self-destructive behaviour, in the light of international evidence about the disproportionate risk of suicidal thoughts and suicide attempts in lesbian, gay, bisexual and transgender (LGBT) young people. The empirical basis for the paper is qualitative research that was carried out in the North West of England and South Wales. Focus groups and interviews were conducted with a total of 69 young people, with a purposive sample to reflect diversity of sexual identity, social class and regional and rural-urban location. The paper presents a thematic analysis of the data specifically relating to the experiences of LGBT young people. A range of strategies that LGBT young people employ in the face of distress are described. These are categorised as resilience, ambivalence and self-destructive behaviour (including self-harm and suicide). The potential implications for health and social care of these strategies include the need for ecological approaches and for sexual cultural competence in practitioners, as well as prioritisation of LGBT risk within suicide prevention policies. [source] Formal support, mental disorders and personal characteristics: a 25-year follow-up study of a total cohort of older peopleHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 2 2003G. Samuelsson PhD Abstract The present study was designed to describe the pattern of long-term formal support received by people with mental disorders, and to investigate the relationship between the medical, psychological and social characteristics of the participants and types of formal support. This study is based on a cohort (n = 192) of people born in 1902 and 1903 in a community in Southern Sweden. The research participants were assessed using interviews, psychological tests and medical examinations. Information was collected about the use of primary healthcare and social services. The first assessment took place when the cohort was aged 67 years, and then on eight further occasions until they were 92. The participation rate ranged from 72% to 100%. During the observation period of 25 years, 53% of people with dementia eventually received both home help and institutional care compared to 34% of people with other psychiatric diagnoses and 12% of people with good mental health. The last group had all physical health problems and/or problems with activities of daily living. However, 35% of the dementia group, 46% with other psychiatric diagnoses and 52% of people with good mental health did not receive any formal support. Males and self-employed people were significantly less likely to use formal support. The institutionalised group reported loneliness significantly more often than the other two groups. In a logistic regression analysis, loneliness, low social class, high blood pressure and low problem-solving ability were predictors of formal support use. People with a mental disorder, including dementia, were significantly more likely to use formal support compared to people with good mental health. Social factors were the main factors predicting formal support. [source] Equality of what in health?HEALTH ECONOMICS, Issue 2 2009Distinguishing between outcome egalitarianism, gain egalitarianism Abstract When deciding how to weigh benefits to different groups, standard economic models assume that people focus on the final distribution of utility, health or whatever. Thus, an egalitarian is assumed to be an egalitarian in the outcome space. But what about egalitarianism in the gains space, such that people focus instead on how equally benefits are distributed? This paper reports on a study in which members of the public were asked to rank a number of health programmes that differed in the distribution of benefits and final outcomes in ways that enabled us to distinguish between different types of egalitarianism. The results suggest that outcome egalitarianism dominates, particularly for differences in health by social class, but a sizeable minority of respondents appear to be gain egalitarians, especially when the health differences are by sex. These results have important implications for how we think about outcome-based social welfare functions in economics. Copyright © 2008 John Wiley & Sons, Ltd. [source] Patients' perceptions of cultural factors affecting the quality of their medical encountersHEALTH EXPECTATIONS, Issue 1 2005Anna M. Nápoles-Springer PhD Abstract Objective, The aim of this study was to identify key domains of cultural competence from the perspective of ethnically and linguistically diverse patients. Design, The study involved one-time focus groups in community settings with 61 African,Americans, 45 Latinos and 55 non-Latino Whites. Participants' mean age was 48 years, 45% were women, and 47% had less than a high school education. Participants in 19 groups were asked the meaning of ,culture' and what cultural factors influenced the quality of their medical encounters. Each text unit (TU or identifiable continuous verbal utterance) of focus group transcripts was content analysed to identify key dimensions using inductive and deductive methods. The proportion of TUs was calculated for each dimension by ethnic group. Results, Definitions of culture common to all three ethnic groups included value systems (25% of TUs), customs (17%), self-identified ethnicity (15%), nationality (11%) and stereotypes (4%). Factors influencing the quality of medical encounters common to all ethnic groups included sensitivity to complementary/alternative medicine (17%), health insurance-based discrimination (12%), social class-based discrimination (9%), ethnic concordance of physician and patient (8%), and age-based discrimination (4%). Physicians' acceptance of the role of spirtuality (2%) and of family (2%), and ethnicity-based discrimination (11%) were cultural factors specific to non-Whites. Language issues (21%) and immigration status (5%) were Latino-specific factors. Conclusions, Providing quality health care to ethnically diverse patients requires cultural flexibility to elicit and respond to cultural factors in medical encounters. Interventions to reduce disparities in health and health care in the USA need to address cultural factors that affect the quality of medical encounters. [source] Public perceptions about low back pain and its management: a gap between expectations and reality?HEALTH EXPECTATIONS, Issue 3 2000Jennifer A. Klaber Moffett PhD MSc MCSP Objective To compare public perceptions and patient perceptions about back pain and its management with current clinical guidelines. Design A survey using a quota sampling technique. Setting On-the-street in South Derbyshire in the UK. Subjects 507 members of the general population aged between 20 and 60 years, including a representative subsample of 40% who had experienced back pain in the previous year. Survey To test knowledge and perceptions of back pain and its best management using statements based on The Back Book which was produced in conjunction with the Royal College of General Practitioners and based on best available evidence. In addition expectations of back pain management and outcome were investigated. Results Forty percent of this sample had experienced back pain during the previous year, more than half of whom had consulted their GP. More than half believed the spine is one of the strongest part of the body, but nearly two thirds incorrectly believed that back pain is often due to a slipped disc or trapped nerve. Two thirds expected a GP to be able to tell them exactly what was wrong with their back, although slightly fewer among those who had consulted. Most expected to have an X-ray, especially if they had consulted. Most recognised that the most important thing a GP can do is offer reassurance and advice. The responses were not related to age, gender or social class. Those who had consulted appeared to have slightly more misconceptions: this could be partly due to people with more severe problems or more misconceptions being more likely to consult, but also suggests either that GPs are still giving inaccurate information or at least failing to correct these misconceptions. Conclusions The problem of managing back pain might be reduced by closing the gap between the public's expectations and what is recommended in the guidelines through the promotion of appropriate health education messages. Further professional education of GPs also appears to be needed to update them in the most effective approach to managing back pain. [source] Stratification in Higher Education, Choice and Social Inequalities in GreeceHIGHER EDUCATION QUARTERLY, Issue 1 2010Eleni Sianou-Kyrgiou Higher education has expanded to a remarkable extent in many countries in recent decades. Although this has led to high levels of participation, inequalities not only persist but are also strengthened. The persistence of inequalities is partly the result of policies for the widening of participation having been accompanied by institutional stratification with educational choices being unequal and socially defined. There is evidence that with the development of new university departments and the increase in the number of university entrants in Greece, a stratified system of higher education has emerged. This study draws on quantitative data that provides evidence that choice has been driven largely by the students' social class: the close relationship between social class and educational opportunities has remained intact. Furthermore, social inequalities in access and distribution in higher education persist, despite the substantial increase in participation in higher education. Social class is a key factor in the interpretation of choice of study, which, along with the performance in the national level examinations that determines entrance into universities, has also led to the increase in the stratification of higher education institutions. [source] Political Partisanship, Voting Abstention and Higher Education: Changing Preferences in a British Youth Cohort in the 1990sHIGHER EDUCATION QUARTERLY, Issue 2 2002Muriel EgertonArticle first published online: 16 DEC 200 This paper focuses on the relationship between education and political partisanship, using the British Household Panel Study (1991,1999). It is known that partisanship has been falling in Britain since the mid,1950s. However, voting abstention rose only gradually until the June 2001 election where the turnout (at 59 per cent) was the lowest since 1918. Partisanship also fell sharply during the 1990s. Although social class and education are associated with turnout in the USA, no relationship has been reported in the UK, and voting seems to have been perceived as a citizen duty. However, in the light of recent changes in voting patterns and educational participation, this paper investigates the role of education, contextualising education effects in social class and gender effects. The preferences of young people are observed in their late teens, before entering the labour market or higher education, and are compared with those of the same young people in their early 20s, after completing higher education courses or gaining labour market experience. The BHPS yielded a sample of about 500 young people with the required data over the time period. It was hypothesised that dissatisfaction with government performance would take different forms for the more and the less educated, with the more educated shifting preferences to minority parties while the less educated shift preferences to voting abstention. The hypothesis was confirmed for young men. Endorsement of abstention was very high for adolescent women who also seemed to be more influenced by their family's social class. However, by early adulthood a lower proportion of young women endorsed abstention than young men. Strong effects of education were still found with more highly educated young women (as with more highly educated young men) being more likely to have party preferences. [source] Social class is an important and independent prognostic factor of breast cancer mortalityINTERNATIONAL JOURNAL OF CANCER, Issue 5 2006Christine Bouchardy Abstract Reasons of the important impact of socioeconomic status on breast cancer prognosis are far from established. This study aims to evaluate and explain the social disparities in breast cancer survival in the Swiss canton of Geneva, where healthcare costs and life expectancy are among the highest in the world. This population-based study included all 3,920 female residents of Geneva, who were diagnosed with invasive breast cancer before the age of 70 years between 1980 and 2000. Patients were divided into 4 socioeconomic groups, according to the woman's last occupation. We used Cox multivariate regression analysis to identify reasons for the socioeconomic inequalities in breast cancer survival. Compared to patients of high social class, those of low social class had an increased risk (unadjusted hazard ratio [HR] 2.4, 95% CI: 1.6,3.5) of dying as a result of breast cancer. These women were more often foreigners, less frequently had screen-detected cancer and were at more advanced stage at diagnosis. They less frequently underwent breast-conserving surgery, hormonal therapy, and chemotherapy, in particular, in case of axillary lymph node involvement. When adjusting for all these factors, patients of low social class still had a significantly increased risk of dying of breast cancer (HR 1.8, 95% CI: 1.2,2.6). Overmortality linked to low SES is only partly explained by delayed diagnosis, unfavorable tumor characteristics and suboptimal treatments. Other factors, not measured in this study, also could play a role. While waiting for the outcome of other researches, we should consider socioeconomic status as an independent prognostic factor and provide intensified support and surveillance to women of low social class. © 2006 Wiley-Liss, Inc. [source] Reaching the population with dementia drugs: what are the challenges?INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 7 2007Fiona E Matthews Abstract Background Systematic evidence became available in the late 1990s on efficacy of cholinesterase inhibitors (CHEIs) for patients with mild to moderate Alzheimer's disease (AD) and they began to be used sporadically. Since January 2001 UK based guidelines indicated that one of three cholinesterase inhibitors (CHEIs) could be prescribed for these patients. Since then the cost of prescription in England and Wales has risen. There has been little investigation of uptake at the population level. Objective To estimate the population uptake of CHEIs in a population based study of dementia spanning this period. Design Using data from a 10-year follow up and a later 12 year interview of the Medical Research Council Cognitive Function and Ageing Study (MRC CFAS), a UK population based longitudinal cohort study of people originally aged 65 years and above, we investigated who was taking CHEIs during the period 2001,2004. We sought information from respondents taking part in the study what medication they were taking on a regular basis. Results Only 12, of the 219 individuals who received a study diagnosis of dementia were prescribed CHEIs [5%, 95% Confidence Intervals (CI) 3%,9%]) in 2001/2003 and none of the 28 individuals with a study diagnosis of dementia (0%, 95% CI 0,18%) in 2004 were prescribed CHEIs. Uptake was biased towards individuals with more education and higher social class. Conclusions These data suggest that any impact on AD progression at the population level will be negligible as prescription of CHEIs and uptake in the age group at highest risk is so limited. There is little evidence that this has changed over time. Copyright © 2006 John Wiley & Sons, Ltd. [source] Class and Congregations: Class and Religious Affiliation at the Congregational Level of AnalysisJOURNAL FOR THE SCIENTIFIC STUDY OF RELIGION, Issue 4 2007SAM REIMER Since Niebuhr's seminal work on the social sources of denominationalism, nearly all research on the relationship between social class and religious affiliation has focused on the denominational (or individual) level of analysis. This research examines the effects of social class at the congregational level,effects that were previously glossed over by a unit of analysis that was too large. After demonstrating the relative strength of social class at the denominational and congregational level, I argue that our theoretical attempts to link class and religious affiliation must include congregational-level explanations. [source] A review of the psychosocial issues for nurses in male genitalia-related careJOURNAL OF CLINICAL NURSING, Issue 8 2008MMed (Cardiovascular Surgery), Yu-Li Zang BMed (Nursing) Aim., This literature review aimed to highlight psychosocial issues for nurses in the practice of male genitalia-related care so as to guide the improvement of the teaching and practice of male genitalia-related care. Background., Male genitalia-related care is common in hospitals and in the community. In several conditions, e.g. incontinence, postradiotherapy or following operation for cancer of genitalia, bladder, colon or rectum, patients will require male genitalia-related care. Patients who require male genitalia-related care may encounter psychosocial and/or sexual dysfunction. In the holistic approach to men's health, nurses are expected to meet patients' psychosocial and sexual needs, while the literature suggests that nurses' perceptions and attitudes in providing certain male genitalia-related care, e.g. genital hygiene, sexual counselling, are negative. Method., Systematic literature review. Conclusion., Issues surrounding male genitalia-related care for nurses are complicated and may be related to privacy, intimacy, sexuality, dirty work and emotional discomfort. Age, gender, race and social class could compound these issues. Relevance to clinical practice., Nurses' negative perceptions, responses and attitudes towards male genitalia-related care may exacerbate patients' conditions under which male genitalia-related care is required. Appropriate strategies should be developed to overcome these problems. [source] Message Effects and Social Determinants of Health: Its Application to Cancer DisparitiesJOURNAL OF COMMUNICATION, Issue 2006K. Viswanath Recent work on message effects theories offers a fruitful way to systematically explore how features, formats, structures of messages may attract audience attention and influence the audience and is of great relevance to public health communications. Much of this work, however, has been pursued primarily at the individual level of analysis. It is our contention that message effects on health outcomes could potentially be moderated and mediated by social contextual factors in public health such as social class, social organizations and neighborhoods among others, leading to differential effects among different audience sub-groups. This essay, through a selective review of literatures in communication and social epidemiology, will explore how major message effects may moderate and mediate the role of social determinants of health on cancer control, specifically cancer-related health disparities. [source] | |||||||||||||||||||||||||||||||||||||||||||