Suchergebnisse

Abstract: We investigated the relationship between living in a household that receives the Brazilian Income Transfer Program (Bolsa Família, in Portuguese - BF), a Brazilian conditional cash transfer program, and aspects of health and whether these relationships are heterogeneous across the 27 Brazilian states. According to data from the 2013 Brazilian National Health Survey, 18% of households participated in BF. Among households with household per capita income below BRL 500, many aspects of health differed between people living in BF and non-BF houses. For example, BF households were less likely to have medical coverage but more likely to have visited the doctor in the last 12 months as well as being more likely to smoke and less likely to do exercise. They ate nearly one less serving of fruits and vegetables a week but were less likely to substitute junk food for a meal. They reported worse self-rated health but did not differ importantly on reporting illnesses. Moderate amounts of heterogeneity in the difference in health characteristics were found for some variables. For instance, medical coverage had an I2 value of 40.7% and the difference in coverage between BF and non-BF households ranged from -0.09 to -0.03. Some illnesses differed qualitatively across states such as high cholesterol, asthma and arthritis. This paper is the first to outline the health profile of people living in households receiving payments from a cash transfer program. It is also the first to find geographic heterogeneity in the relationship between a cash transfer program and health variables. These results suggest the possibility that the effect of cash transfer programs may differ based on the population on which it is implemented.

Advancing methods in social epidemiology / Jay S. Kaufman and J. Michael Oakes -- The measurement of socioeconomic status / J. Michael Oakes and Kate E. Andrade -- Measuring and analyzing 'race', racism, and racial discrimination / Saffron Karlsen and James Yzet Nazroo -- Measuring poverty / David M. Betson and Jennifer L. Warlick -- Health inequalities : measurement and decomposition / Sam Harper and John Lynch -- A conceptual framework for measuring segregation and its association with population outcomes / Sean F. Reardon -- Measures of residential community contexts / Patricia O'Campo Ph.D. and Margaret O'Brien Caughy -- Community-based participatory research : rationale and relevance for social epidemiology / Paula M. Lantz, Barbara A. Israel, Amy J. Schulz, and Angela G. Reyes -- Social network analysis for epidemiology / David A. Shoham and Lynne C. Messer -- Fieldwork with in-depth interviews : how to get strangers in the city to tell you their stories / Melody L. Boyd and Stefanie DeLuca -- Experimental social epidemiology : controlled community trials / Peter J. Hannan -- Propensity score matching for social epidemiology / J. Michael Oakes and Pamela Jo Johnson -- Longitudinal approaches to social epidemiologic research / Magdalena Cerdá and Katherine M. Keyes -- Fixed effects and difference-in-differences / Erin C Strumpf, Sam Harper, and Jay S Kaufman -- Fixed versus random effects models for multilevel and longitudinal data / Ashley Schempf Hirai, and Jay S. Kaufman -- Mediation analysis in social epidemiology / Arijit Nandi and Tyler J. VanderWeele -- A roadmap for estimating and interpreting population intervention parameters / Jennifer Ahern and Alan E. Hubbard -- Natural experiments and instrumental variables analyses in social epidemiology / Maria Glymour, Stefan Walter, and Eric J. Tchetgen -- Using causal diagrams to understand common problems in social epidemiology / M. Maria Glymour

BACKGROUND: Tobacco exposure remains a significant issue for public health, especially for pregnant women. It increases the risk for premature labor, low birth weight and small for gestational age (SGA), among other effects. To reduce these risks, many countries have enacted public policies to curb tobacco exposure. Peru enacted anti-tobacco laws that forbid smoking in public places, require prevention text and images in products and publicity, along with restriction of sales to adults. We evaluated the effect of the implementation of this law on newborn outcomes: birth weight, prematurity and SGA. METHODS: This was a quasi-experimental study that utilized data from the Peruvian Live Birth Registry. Children born to mothers from urban areas were the intervention group, while children born to mothers from rural areas were considered the control group. Only singletons with information on birth weight and gestational age, born to mothers aged 12 to 49 years were included in the study. In addition, newborns with birth weights greater than + 4 standard deviations (SD) or less than − 4 SD from the gestational age-specific mean were excluded. To measure the effect of legislation on birth weight we performed a difference in differences analysis. RESULTS: A total of 2,029,975 births were included in the analysis. After adjusting for characteristics of the mother and the child, and contextual variables, the anti-tobacco law in Peru reduced the incidence of prematurity by 30 cases per 10,000 live births (95% CI: 19 to 42). CONCLUSIONS: The reform had negligible effects on overall birth weights and on the incidence of SGA. This modest result suggests the need for a more aggressive fight against tobacco, prohibiting all types of advertising and promotion of tobacco products, among others measures.

A substantial biomedical literature has accumulated around the question of racial differences in the response to treatment with angiotensin converting enzyme (ACE) inhibitors for hypertension and congestive heart failure. African-origin populations are often asserted to be "low renin", and therefore to have blunted response to agents that interfere with the renin-angiotensin system. Although the US Food and Drug Administration (FDA) rejected a combination of hydralazine and isosorbide dinitrate as a general heart failure treatment in 1997, this literature on Black resistance to ACE-inhibition therapy for heart failure was used to argue for a race-specific approval for this drug. Specifically, a paper by Exner and colleagues published in the New England Journal of Medicine in 2001 reported that ACE-inhibition reduced hospitalization for White patients, but not for Black patients. The Exner et al paper was used to argue for conducting a randomized trial in Black patients only, the successful completion of which led to FDA approval of the hydralazine and isosorbide dinitrate combination (known as BiDil) as a race-specific therapy in 2005. We re-analyze the data in the 2001 Exner et al study, and show that it is not well suited for answering the question of differential response by race. Even so, the published analysis ignored important facets of the data in order to arrive at the stated conclusion of a race-specific response. Black subjects were recruited mostly in a few regions, and were medically distinct from white patients in terms of clinical measures such as hypertension, diabetes and prescription drug history. Overall, Black subjects had a high risk of the outcomes, and the effect of treatment varied widely by clinical center or by region. The stated conclusion by Exner et al of a race-specific response to ACE inhibition is therefore suspect, as is the use of this conclusion to support the notion of race-specific therapies, both in the specific case of BiDil and in general.

AbstractINTRODUCTION: Previous studies have identified a number of demographic characteristics (e.g., age, income, level of education, household composition, and race or ethnicity) that affect hurricane evacuation. However, the magnitude and direction of these associations vary widely, even when the area of landfall or the intensity of the storm is similar. We propose that the associations of demographic characteristics and hurricane evacuation are modified by psychosocial factors such as social cohesion, social capital, and social control. Additional variability may be the result of the changing prevalence of these demographic variables over time or between study locations. METHODS: Ninety census blocks in three eastern North Carolina counties affected by Hurricane Isabel were selected probability proportionate to population and seven interviews were conducted at random locations within each of the selected blocks. Risk differences (RD) and 95% confidence intervals (CI) were produced for stratified data to test for heterogeneity. RESULTS: There was statistical evidence of effect measure modification on the additive scale of the effect of home type, homeownership, age, race, gender, marital status, and having children under age 18 living at home on hurricane evacuation based on Wald p‐values of the interaction terms of ≤ 0.20 and strata‐specific RDs which crossed the null value. Social cohesion, volunteerism, property preparation, church attendance, neighbor's evacuation, and the number of local friends and family modified the RDs for the demographic characteristics. CONCLUSIONS: The associations between demographic characteristics and hurricane evacuation failure are modified by social factors. Effect measure modification on the additive scale may help explain the inconsistency of previously published results and is the appropriate measure for targeted interventions that can increase evacuation among certain groups that are missed when average risks are calculated across the population.

Important differences in evacuation exist across households. This study describes associations between social factors and evacuation from Hurricane Isabel by residents of North Carolina in 2003. Census blocks in three affected counties were stratified by flood zone and 30 census blocks were selected probability proportionate to population size from each flood zone. Within selected blocks, 7 random interview locations were chosen using a geographic information systems-based site selection tool. Risk differences and 95% confidence intervals for evacuation were calculated. High levels of neighborhood social cohesion, markers of territoriality (e.g., no trespassing signs), membership in church or civic organization, volunteerism, neighbors' evacuation, and longer length of residence were associated with reduced hurricane evacuation. Differential levels of social capital, social cohesion, and related social factors contributed to differential rates of evacuation from Hurricane Isabel. Those who reported closer relationships with neighbors and were active volunteers in the community may be more susceptible to evacuation failure and should receive targeted messages regarding evacuation from officials.

This article examines Shiao, Bode, Beyer, and Selvig's (2012) arguments in their article "The Genomic Challenge to the Social Construction of Race" and finds that their claims are based on fundamentally flawed interpretations of current genetic research. We discuss current genomic and genetic knowledge about human biological variation to demonstrate why and how Shiao et al.'s recommendations for future sociological studies and social policy, based on their inadequate understanding of genomic methods and evidence, are similarly flawed and will lead sociology astray.

POLICY POINTS: Historically, reforms that have increased the duration of job‐protected paid parental leave have improved women's economic outcomes. By targeting the period around childbirth, access to paid parental leave also appears to reduce rates of infant mortality, with breastfeeding representing one potential mechanism. The provision of more generous paid leave entitlements in countries that offer unpaid or short durations of paid leave could help families strike a balance between the competing demands of earning income and attending to personal and family well‐being. CONTEXT: Policies legislating paid leave from work for new parents, and to attend to individual and family illness, are common across Organisation for Economic Co‐operation and Development (OECD) countries. However, there exists no comprehensive review of their potential impacts on economic, social, and health outcomes. METHODS: We conducted a systematic review of the peer‐reviewed literature on paid leave and socioeconomic and health outcomes. We reviewed 5,538 abstracts and selected 85 published papers on the impact of parental leave policies, 22 papers on the impact of medical leave policies, and 2 papers that evaluated both types of policies. We synthesized the main findings through a narrative description; a meta‐analysis was precluded by heterogeneity in policy attributes, policy changes, outcomes, and study designs. FINDINGS: We were able to draw several conclusions about the impact of parental leave policies. First, extensions in the duration of paid parental leave to between 6 and 12 months were accompanied by attendant increases in leave‐taking and longer durations of leave. Second, there was little evidence that extending the duration of paid leave had negative employment or economic consequences. Third, unpaid leave does not appear to confer the same benefits as paid leave. Fourth, from a population health perspective, increases in paid parental leave were consistently associated with better infant and child health, particularly ...

The essays in this unique book argue for the inclusion of race as a social construction in the design of large-scale data collection efforts and how scientists must utilize race in the context of specific research questions. This landmark collection concludes on a prescriptive note, providing an arsenal of multidisciplinary, conceptual, and methodological tools for studying race specifically within the context of health inequalities

For decades, the field of bioethics has shaped the way we think about ethical problems in science, technology, and medicine. But its traditional emphasis on individual interests such as doctor-patient relationships, informed consent, and personal autonomy is minimally helpful in confronting the social and political challenges posed by new human biotechnologies such as assisted reproduction, human genetic modification, and DNA forensics. Beyond Bioethics addresses these provocative issues from an emerging standpoint that is attentive to race, gender, class, disability, privacy, and notions of democracy—a ";new biopolitics."; This authoritative volume provides an overview for those grappling with the profound dilemmas posed by these developments. It brings together the work of cutting-edge thinkers from diverse fields of study and public engagement, all of them committed to this new perspective grounded in social justice and public interest values