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Wildeman C, Goldman AW, Lee H. Health Consequences of Family Member Incarceration for Adults in the Household. Public Health Rep 2019; 134:15S-21S. [PMID: 31059412 DOI: 10.1177/0033354918807974] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Christopher Wildeman
- 1 Department of Policy Analysis and Management, Cornell University, Ithaca, NY, USA
| | | | - Hedwig Lee
- 3 Department of Sociology, Washington University in St Louis, St Louis, MO, USA
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Huang X, Chen H, Li S. The Relationship Between Assistance Satisfaction and Negative Affect in Long-Term Social Assistance Recipients in China: The Moderating Role of Self-Acceptance. Front Psychol 2019; 10:109. [PMID: 30766503 PMCID: PMC6365466 DOI: 10.3389/fpsyg.2019.00109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 01/14/2019] [Indexed: 11/24/2022] Open
Abstract
Public welfare in China is less universal, comprehensive, and generous when compared with other welfare regimes, especially for individuals with occupational disease. The assistance satisfaction of Chinese pneumoconiosis patients, a typical group of long-term social assistance recipients, has been linked to diminished health and psychological well-being. Self-acceptance is theorized to promote well-being, which may buffer the negative consequences of negative emotion on assistance satisfaction. This research was conducted based on the survey data of 1,345 patients in typical mining areas of China. In addition to single-factor analysis of variance, descriptive analysis, and correlation analysis, a cluster analysis was performed to explore the profiles of participants' ratings of assistance satisfaction with five governing subjects: government, employing unit, medical institution, welfare organization, and laborer themselves. The results were as follows: (1) Social assistance satisfaction perceived by Chinese long-term social assistance recipients was at an average level, wherein self-assistance satisfaction perception was the lowest among five dimensions. (2) The overall perception of assistance satisfaction of Chinese long-term social assistance recipients was significantly correlated with educational background and household monthly income; specifically, the participants with higher levels of education and lower levels of income were more likely to have higher assistance satisfaction perception. (3) Cross analysis showed that participants with higher assistance satisfaction were mainly from the low-high group, having a lower level of negative affect, and higher level of self-acceptance. (4) The average negative affect level was above the scale midpoint (3.65) and negatively associated with each of the assistance satisfaction ratings. (5) The analysis yielded three distinct profiles—medium (19.26%), high (40%), and low (40.74%)—according to their degree of assistance satisfaction. Relative to the other profiles, low assistance satisfaction participants reported greater levels of negative affect in their daily life. However, self-acceptance moderated these effects, but no moderating effect was detected for individuals reporting greater levels of assistance satisfactory. Purpose is proved empirically a positive asset for promoting psychological adjustment in the period of receiving social assistance for Chinese long-term social assistance recipients.
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Affiliation(s)
- Xinru Huang
- School of Management, China University of Mining and Technology, Xuzhou, China
| | - Hong Chen
- School of Management, China University of Mining and Technology, Xuzhou, China
| | - Shanshan Li
- School of Management, China University of Mining and Technology, Xuzhou, China
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Vahid Shahidi F, Sod-Erdene O, Ramraj C, Hildebrand V, Siddiqi A. Government social assistance programmes are failing to protect the health of low-income populations: evidence from the USA and Canada (2003–2014). J Epidemiol Community Health 2018; 73:198-205. [DOI: 10.1136/jech-2018-211351] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 09/18/2018] [Accepted: 10/28/2018] [Indexed: 11/04/2022]
Abstract
BackgroundSocial policies that improve the availability and distribution of key socioeconomic resources such as income, wealth and employment are believed to present the most promising avenue for reducing health inequalities. The present study aims to estimate the effect of social assistance recipiency on the health of low-income earners in the USA and Canada.MethodsDrawing on nationally representative survey data (National Health Interview Survey and the Canadian Community Health Survey), we employed propensity score matching to match recipients of social assistance to comparable sets of non-recipient ‘controls’. Using a variety of matching algorithms, we estimated the treatment effect of social assistance recipiency on self-rated health, chronic conditions, hypertension, obesity, smoking, binge drinking and physical inactivity.ResultsAfter accounting for underlying differences in the demographic and socioeconomic characteristics of recipients and non-recipients, we found that social assistance recipiency was associated with worse health status or, at best, the absence of a clear health advantage. This finding was consistent across several different matching strategies and a diverse range of health outcomes.ConclusionsFrom a public health perspective, our findings suggest that interventions are warranted to improve the scope and generosity of existing social assistance programmes. This may include reversing welfare reforms implemented over the past several decades, increasing benefit levels and untethering benefit recipiency from stringent work conditionalities.
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Booshehri LG, Dugan J, Patel F, Bloom S, Chilton M. Trauma-informed Temporary Assistance for Needy Families (TANF): A Randomized Controlled Trial with a Two-Generation Impact. JOURNAL OF CHILD AND FAMILY STUDIES 2018; 27:1594-1604. [PMID: 29657515 PMCID: PMC5886995 DOI: 10.1007/s10826-017-0987-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Temporary Assistance for Needy Families (TANF) has limited success in building self-sufficiency, and rarely addresses exposure to trauma as a barrier to employment. The objective of the Building Wealth and Health Network randomized controlled trial was to test effectiveness of financial empowerment combined with trauma-informed peer support against standard TANF programming. Through the method of single-blind randomization we assigned 103 caregivers of children under age six into three groups: control (standard TANF programming), partial (28-weeks financial education), and full (same as partial with simultaneous 28-weeks of trauma-informed peer support). Participants completed baseline and follow-up surveys every 3 months over 15 months. Group response rates were equivalent throughout. With mixed effects analysis we compared post-program outcomes at months 9, 12, and 15 to baseline. We modeled the impact of amount of participation in group classes on participant outcomes. Despite high exposure to trauma and adversity results demonstrate that, compared to the other groups, caregivers in the full intervention reported improved self-efficacy and depressive symptoms, and reduced economic hardship. Unlike the intervention groups, the control group reported increased developmental risk among their children. Although the control group showed higher levels of employment, the full intervention group reported greater earnings. The partial intervention group showed little to no differences compared with the control group. We conclude that financial empowerment education with trauma-informed peer support is more effective than standard TANF programming at improving behavioral health, reducing hardship, and increasing income. Policymakers may consider adapting TANF to include trauma-informed programming.
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Affiliation(s)
- Layla G. Booshehri
- College of Nursing & Health Professions, Drexel University, 1601 Cherry Street, Philadelphia, PA 19102 USA
| | - Jerome Dugan
- College of Nursing & Health Professions, Drexel University, 1601 Cherry Street, Philadelphia, PA 19102 USA
| | - Falguni Patel
- Dornsife School of Public Health, Drexel University, 3600 Market Street, 7th Floor, Philadelphia, PA 19104 USA
| | - Sandra Bloom
- Dornsife School of Public Health, Drexel University, 3600 Market Street, 7th Floor, Philadelphia, PA 19104 USA
| | - Mariana Chilton
- Dornsife School of Public Health, Drexel University, 3600 Market Street, 7th Floor, Philadelphia, PA 19104 USA
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5
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Whitley DM, Fuller-Thomson E. The Health of the Nation's Custodial Grandfathers and Older Single Fathers: Findings From the Behavior Risk Factor Surveillance System. Am J Mens Health 2017; 11:1614-1626. [PMID: 26669777 PMCID: PMC5675257 DOI: 10.1177/1557988315621604] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Two important parent groups are solo grandfathers and single fathers raising children alone. The health of male caregivers raising children has received little attention by scholars. Investigating the health of single male caregivers raises awareness about their physical vulnerability. This study uses the 2012 Behavioral Risk Factor Surveillance System to compare health characteristics of 82 solo grandfathers with 396 single fathers aged 50 years and older. The findings suggest that grandfathers exhibited a high prevalence for various health conditions, including diabetes (44%), heart attack (27%), chronic obstructive pulmonary disease (23%), and stroke (6%). Almost half of grandfathers rated their health as fair/poor (47%), and nearly two in five had functional limitations (38%). Although older single fathers had better health characteristics than grandfathers, their health profile was poorer than population norms. Logistic regression analysis suggests that solo grandfathers are more at risk for poor health outcomes than older single fathers. Practice interventions to minimize health risks are discussed.
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6
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Narain KD, Katz ML. Experiences with Health Insurance and Health Care in the Context of Welfare Reform. HEALTH & SOCIAL WORK 2016; 41:244-252. [PMID: 29206974 DOI: 10.1093/hsw/hlw038] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 12/03/2015] [Indexed: 06/07/2023]
Abstract
Studies have shown that in the wake of welfare reform there has been a drop in the health insurance coverage and health care utilization of low-income mothers. Using data from 20 telephone interviews, this study explored the health insurance and health care experiences of current and former welfare participants living in Los Angeles County. This study found that half of these women had been uninsured at some point. Many of these lapses in health insurance coverage were linked to employment transitions and lack of knowledge regarding eligibility for different safety net programs. This study also found that satisfaction with access to health care was high among the insured respondents; however, barriers to care remained for many individuals, including appointment scheduling issues, limited scope of health insurance coverage, narrow provider networks, lack of care continuity, and perceived low quality of care. Better linkages between social programs assisting with health insurance coverage and improved knowledge among program clients may reduce health insurance cycling in this group. New rules for Medicaid managed care, currently being considered by the Centers for Medicare and Medicaid Services, have the potential to improve access to health care and the quality of care for these individuals.
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Affiliation(s)
- Kimberly Danae Narain
- Greater Los Angeles Veterans Health Administration, Health Services Research and Development Service Center of Innovation, Implementation & Policy
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7
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Løyland B. The co-occurrence of chronic pain and psychological distress and its associations with salient socio-demographic characteristics among long-term social assistance recipients in Norway. Scand J Pain 2016; 11:65-72. [PMID: 28850472 DOI: 10.1016/j.sjpain.2015.12.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Revised: 12/01/2015] [Accepted: 12/07/2015] [Indexed: 11/25/2022]
Abstract
BACKGROUND While lower socioeconomic status increases individual's risk for chronic conditions, little is known about how long-term social assistance recipients (LTRs) with multiple chronic health problems experience chronic pain and/or psychological distress. Social assistance is the last safety net in the Norwegian welfare system and individuals have a legal right to economic assistance if they are unable to support themselves or are entitled to other types of benefits. The purposes of this study were to determine the co-occurrence of both chronic pain and psychological distress and to evaluate for differences in demographic and social characteristics, as well as health-related quality of life, among LTRs. METHODS This descriptive, cross-sectional study surveyed people receiving long-term social assistance in Norway about their health and social functioning from January-November 2005. The social welfare authority offices in each of 14 municipalities in Norway were responsible to locate the LTRs who met the study's inclusion criteria. The selected municipalities provided geographic variability including both rural and urban municipalities in different parts of the country. LTRs were included in this study if they: had received social assistance as their main source of income for at least 6 of the last 12 months; were between 18 and 60 years of age; and were able to complete the study questionnaire. In this study, 405 LTRs were divided into four groups based on the presence or absence of chronic pain and/or psychological distress. (1) Neither chronic pain nor psychological distress (32%, n=119), (2) only chronic pain (12%, n=44), (3) only psychological distress and (24%, n=87), (4) both chronic pain and psychological distress (32%, n=119). RESULTS Except for age and marital status, no differences were found between groups in demographic characteristics. Significant differences were found among the four groups on all of the items related to childhood difficulties before the age of 16, except the item on sexual abuse. LTRs with both chronic pain and psychological distress were more likely to have experienced economic problems in their childhood home; other types of abuse than sexual abuse; long-term bullying; and had more often dropped out of school than LTRs with neither chronic pain nor psychological distress. LTRs with both chronic pain and psychological distress, reported more alcohol and substance use/illicit drug use, more feelings of loneliness and a lower mental score on SF-12 than LTRs with only chronic pain. CONCLUSIONS AND IMPLICATIONS Co-occurrence of chronic pain and psychological distress is common in LTRs and problems in early life are associated with the co-occurrence of chronic pain and psychological distress in adult life. Although this study cannot assign a clear direction or causality to the association between social and demographic characteristics and chronic pain and psychological distress, the findings when examining LTRs' problems in childhood before the age of 16, indicated that incidents in early life create a probability of chronic pain and psychological distress in the adult life of the individuals. Further studies should use life course studies and longitudinal data in to investigate these important questions in LTRs.
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Affiliation(s)
- Borghild Løyland
- Oslo and Akershus University College of Applied Science, Institute of Nursing and Health Promotion, Oslo, Norway.
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8
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Whitley DM, Fuller-Thomson E, Brennenstuhl S. Health Characteristics of Solo Grandparent Caregivers and Single Parents: A Comparative Profile Using the Behavior Risk Factor Surveillance Survey. Curr Gerontol Geriatr Res 2015; 2015:630717. [PMID: 26448744 PMCID: PMC4581507 DOI: 10.1155/2015/630717] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 08/19/2015] [Indexed: 11/22/2022] Open
Abstract
Objectives. To describe the health characteristics of solo grandparents raising grandchildren compared with single parents. Methods. Using the 2012 Behavioral Risk Factor Surveillance System, respondents identified as a single grandparent raising a grandchild were categorized as a solo grandparent; grandparent responses were compared with single parents. Descriptive analysis compared health characteristics of 925 solo grandparents with 7,786 single parents. Results. Compared to single parents, grandparents have a higher prevalence of physical health problems (e.g., arthritis). Both parent groups have a high prevalence of lifetime depression. A larger share of grandparents actively smoke and did no recreational physical exercise in the last month. However, grandparents appear to have better access to health services in comparison with single parents. Conclusion. Solo grandparents may be at risk for diminished physical capacity and heightened prevalence of depression. Health professionals can be an important resource to increase grandparents' physical and emotional capacities.
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Affiliation(s)
- Deborah M. Whitley
- School of Social Work, Andrew Young School of Policy Studies, Georgia State University, P.O. Box 3993, Atlanta, GA 30302, USA
| | - Esme Fuller-Thomson
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON, Canada M5S 1A1
- Institute for Life Course & Aging, University of Toronto, 263 McCaul Street, Suite 328, Toronto, ON, Canada M5T 1W7
| | - Sarah Brennenstuhl
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON, Canada M5S 1A1
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Synthesizing Marketing, Community Engagement, and Systems Science Approaches for Advancing Translational Research. ANS Adv Nurs Sci 2015; 38:227-40. [PMID: 26244479 DOI: 10.1097/ans.0000000000000080] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The adoption and implementation of evidence-based interventions (EBIs) are the goals of translational research; however, potential end-users' perceptions of an EBI value have contributed to low rates of adoption. In this article, we describe our application of emerging dissemination and implementation science theoretical perspectives, community engagement, and systems science principles to develop a novel EBI dissemination approach. Using consumer-driven, graphics-rich simulation, the approach demonstrates predicted implementation effects on health and employment outcomes for socioeconomically disadvantaged women at the local level and is designed to increase adoption interest of county program managers accountable for improving these outcomes in their communities.
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10
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Ngui EM, Cortright AL, Michalski K. Relationship of Paternity Status, Welfare Reform Period, and Racial/Ethnic Disparities in Infant Mortality. Am J Mens Health 2014; 9:350-9. [DOI: 10.1177/1557988314543906] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The objective of this study was to examine the relationship of paternity status, welfare reform period, and racial/ethnic disparities in infant mortality. The study used retrospective analysis of birth outcomes data from singleton birth/infant death data in Milwaukee, Wisconsin, from 1993 to 2009. Multivariate logistic regression was used to examine the relationship between paternity status, welfare reform period, and infant mortality, adjusting for maternal and infant characteristics. Data consisted of almost 185,000 singleton live births and 1,739 infant deaths. Although unmarried women with no father on record made up about 32% of the live births, they accounted for over two thirds of the infant deaths compared with married women with established paternity who made up 39% of live births but had about a quarter of infant deaths. After adjustments, any form of paternity establishment was protective against infant mortality across all racial/ethnic groups. Unmarried women with no father on record had twice to triple the odds of infant mortality among all racial/ethnic groups. The likelihood of infant mortality was only significantly greater for African American women in the postwelfare (1999-2004; odds ratio = 1.27; 95% confidence interval = 1.10-1.46) period compared with the 1993 to 1998 period. Study findings suggest that any form of paternity establishment may have protective effect against infant mortality. Welfare reform changes may have reduced some of the protection against infant mortality among unmarried African American women that was present before the welfare legislation. Policies and programs that promote or support increased paternal involvement and establishment of paternity may improve birth outcomes and help reduce infant mortality.
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Affiliation(s)
- Emmanuel M. Ngui
- University of Wisconsin–Milwaukee, WI, USA
- Center for Urban Population Health, Milwaukee, WI, USA
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Ayala L, Rodríguez M. Health-related effects of welfare-to-work policies. Soc Sci Med 2013; 93:103-12. [PMID: 23906127 DOI: 10.1016/j.socscimed.2013.05.037] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Revised: 05/29/2013] [Accepted: 05/31/2013] [Indexed: 10/26/2022]
Abstract
Non-health related policies may have consequences for health that are more important than the outcomes they were originally designed to produce. In this paper we evaluate the effects of welfare-to-work programs (WTW) on physical and mental health status and a variety of health behaviors. The paper is based on data from the minimum income program of Madrid's Government (IMI). We match the program's administrative records (39,200 households)--covering the whole history of the program from the second half of 1990 to 2001--with a specific survey of former recipients who took part in different work-related activities conducted in 2001 (2300 households). We perform propensity score matching to find that both health status--including physical and mental health problems--and behaviors outcomes were modestly better for those individuals who had taken part in work-related activities. These results offer support for the contention that welfare-to-work policies may have positive unintended health effects.
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Affiliation(s)
- Luis Ayala
- Facultad de Ciencias Jurídicas y Sociales, Universidad Rey Juan Carlos, Paseo Artilleros s/n, 28032 Madrid, Spain.
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Jongeneel-Grimen B, Droomers M, Stronks K, van Oers JAM, Kunst AE. Migration and geographical inequalities in health in the Netherlands: an investigation of age patterns. Int J Public Health 2013; 58:845-54. [DOI: 10.1007/s00038-013-0459-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2011] [Revised: 02/10/2013] [Accepted: 03/14/2013] [Indexed: 10/27/2022] Open
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Versey HS, Kaplan GA. Mediation and moderation of the association between cynical hostility and systolic blood pressure in low-income women. HEALTH EDUCATION & BEHAVIOR 2011; 39:219-28. [PMID: 22167318 DOI: 10.1177/1090198111414884] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Hostility may be related to risk factors for cardiovascular disease (CVD), such as blood pressure. However, the process by which hostility affects blood pressure is not fully understood. The current study sought to evaluate abdominal obesity (waist-to-hip ratio [WHR]) as a potential mediator and modifier of the relationship between cynical hostility and systolic blood pressure (SBP) in a group of disadvantaged women. Path analysis and multiple regression models were used to identify mediating and moderating pathways in the relationship between cynical hostility and SBP. Results indicate a significant interaction between WHR and cynical hostility. WHR was a partial mediator and significant moderator of the association between hostility and blood pressure. These findings highlight the potential importance of examining abdominal obesity and psychosocial factors as conjunctive determinants of CVD and risk factors for related metabolic conditions.
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Affiliation(s)
- H Shellae Versey
- Department of Psychology, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA.
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Kneipp SM, Kairalla JA, Lutz BJ, Pereira D, Hall AG, Flocks J, Beeber L, Schwartz T. Public health nursing case management for women receiving temporary assistance for needy families: a randomized controlled trial using community-based participatory research. Am J Public Health 2011; 101:1759-68. [PMID: 21778474 PMCID: PMC3154225 DOI: 10.2105/ajph.2011.300210] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2011] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We evaluated the effectiveness of a community-based participatory research-grounded intervention among women receiving Temporary Assistance for Needy Families (TANF) with chronic health conditions in increasing (1) health care visits, (2) Medicaid knowledge and skills, and (3) health and functional status. METHODS We used a randomized controlled trial design to assign 432 women to a public health nurse case management plus Medicaid intervention or a wait-control group. We assessed Medicaid outcomes pre- and posttraining; other outcomes were assessed at 3, 6, and 9 months. RESULTS Medicaid knowledge and skills improved (P < .001 for both). Intervention group participants were more likely to have a new mental health visit (odds ratio [OR] = 1.92; P = .007), and this likelihood increased in higher-risk subgroups (OR = 2.03 and 2.83; P = .04 and .006, respectively). Depression and functional status improved in the intervention group over time (P = .016 for both). No differences were found in routine or preventive care, or general health. CONCLUSIONS Health outcomes among women receiving TANF can be improved with public health interventions. Additional strategies are needed to further reduce health disparities in this population.
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Affiliation(s)
- Shawn M Kneipp
- School of Nursing, University of North Carolina at Chapel Hill, 27599, USA.
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Mendias EP, Clark MC, Guevara EB, Svrcek CY. Low-income Euro-American mothers' perceptions of health and self-care practices. Public Health Nurs 2011; 28:233-42. [PMID: 21535108 DOI: 10.1111/j.1525-1446.2010.00913.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Health promotion activities may decrease preventable diseases and health system overuse. This study examined how low-income Euro-American mothers described their health/wellness, self-care practices (SCP), and SCP benefits, barriers, and interpersonal influences (norms, modeling, and social support) affecting their SCP. DESIGN AND SAMPLE This descriptive qualitative study used a convenience sample of 10 low-income, English-speaking mothers, 25-43 years old, seeking women's/children's health services at a large urban Texas health clinic. MEASURES Data were collected via face-to-face interviews, using a standardized semistructured interview guide; data were analyzed using Miles and Huberman's qualitative research methods. RESULTS All participants primarily described themselves positively and as mothers and workers. Most viewed health and wellness as distinct but typically included physical and emotional well-being. Mothers valued health and SCP for personal and family reasons. All identified SCP benefits. Most identified SCP barriers. Women viewed themselves as vital to family function and well-being, learned SCP primarily from parents during childhood, and described limited support for SCP. CONCLUSIONS The results provide a better understanding of participants' self-care decision making and are useful in designing appropriate clinical health promotions. Reducing health inequities in low-income women requires further study of the underlying causes and development of effective policies and measures to address them.
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Affiliation(s)
- Elnora P Mendias
- School of Nursing, The University of Texas Medical Branch, Galveston, Texas 77555-1029, USA.
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Løyland B, Miaskowski C, Dahl E, Paul SM, Rustøen T. Psychological distress and quality of life in long-term social assistance recipients compared to the Norwegian population. Scand J Public Health 2011; 39:303-11. [PMID: 21406477 DOI: 10.1177/1403494811401475] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIMS Mental disorders are serious public health problems and mental disorders have an impact on individuals' health-related quality of life (HRQoL). Therefore, the aim of this study was to evaluate for differences in psychological distress and HRQoL outcomes between long-term social assistance recipients (LTRs) and the general population in Norway. In addition, differences in HRQoL outcomes were evaluated in LTRs and general population who reported clinically meaningful levels of psychological distress. METHODS In this cross-sectional study, which is part of a larger study that evaluated the health and functional abilities of LTRs in Norway, 393 LTRs were compared to a similar aged group (n = 3919) from the general population. Psychological distress was measured using the Hopkins Symptom Checklist. RESULTS LTRs were significantly younger (p < 0.001), more likely to be male (p = 0.001), more likely to be never married or divorced (p < 0.001), and have less education (p < 0.001) than members of the general population. LTRs reported significantly higher total mean psychological distress scores than the general population. More LTRs (57.0%) than general population (10.1%; p < 0.001) reported clinically meaningful levels of psychological distress. LTRs with a psychological distress score >1.85 reported lower mental component scores on the SF-12 than general population. CONCLUSIONS In the total sample, LTRs experienced more psychological distress and reported poorer HRQoL than the general population. Clinically meaningful levels of psychological distress occurred more frequently in LTRs than general population. The LTRs and the general population with psychological distress rated both the physical and mental components of HRQoL lower than LTRs and general population without psychological distress.
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17
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Løyland B, Miaskowski C, Paul SM, Dahl E, Rustøen T. The relationship between chronic pain and health-related quality of life in long-term social assistance recipients in Norway. Qual Life Res 2010; 19:1457-65. [PMID: 20652418 PMCID: PMC2977061 DOI: 10.1007/s11136-010-9707-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2010] [Indexed: 11/28/2022]
Abstract
PURPOSE The purposes of this study were to compare the health-related quality of life (HRQOL) of long-term social assistance recipients (LTRs) with and without chronic pain and determine the effect of select demographic, social, pain, alcohol, and illicit drug use characteristics on the physical and mental components of their HRQOL. METHODS In this cross-sectional study, which is part of a larger study that evaluated the health and functional abilities of LTRs in Norway, 405 LTRs of which 178 had chronic pain were recruited from 14 of 433 municipalities. RESULTS LTRs with chronic pain were older (P < .001), more often married (P = .002), feeling more lonely, (P = .048), and had more problems with alcohol (P = .035). The final regression model explained 41.2% (P < .001) of the variance in PCS scores and 32.2% (P < .001) of the variance in MCS scores. Being in chronic pain (29.7%), being older (4.7%), and never married (2%) predicted worse PCS scores. Feeling lonely (11.9%), having problems with illicit drug use (5.9%), and being in chronic pain (2.9%) predicted worse MCS scores. CONCLUSION LTRs with chronic pain rated both the physical and mental components of HRQOL lower than LTRs without chronic pain. The MCS score in both groups was negatively effected.
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Affiliation(s)
- Borghild Løyland
- Faculty of Nursing, Oslo University College, Postbox 4, St. Olavs Plass, 0130, Oslo, Norway.
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Prevalence and Characteristics of Chronic Pain Among Long-term Social Assistance Recipients Compared to the General Population in Norway. Clin J Pain 2010; 26:624-30. [DOI: 10.1097/ajp.0b013e3181e0de43] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Atkins R. Self-efficacy and the promotion of health for depressed single mothers. MENTAL HEALTH IN FAMILY MEDICINE 2010; 7:155-68. [PMID: 22477937 PMCID: PMC3018952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Single mothers are a vulnerable population at risk for poor mental and physical health. This paper discusses the mental and physical health of single mothers, as well as the psychosocial and socio-economic risk factors placing single mothers at risk for poor health outcomes. Some of these include, gender, income level, educational status, social support, stress and certain personality characteristics. Theoretical models with the potential to explore ways to promote health in depressed single mothers will also be presented. The paper concludes with the application of these models to primary prevention and the promotion of health for single mothers along with recommendations for future research.
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Affiliation(s)
- Rahshida Atkins
- Family Nurse Practitioner, PhD Candidate, Rutgers The State University of New Jersey, Ewing, NJ, USA
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Environmental conditions, political economy, and rates of injection drug use in large US metropolitan areas 1992-2002. Drug Alcohol Depend 2010; 106:142-53. [PMID: 19748745 PMCID: PMC2815118 DOI: 10.1016/j.drugalcdep.2009.08.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2009] [Revised: 08/17/2009] [Accepted: 08/17/2009] [Indexed: 11/22/2022]
Abstract
City-specific studies have suggested the quality of the local environment and economic circumstances are associated with greater risk of injection drug use (IDU). No studies have assessed the relation among the quality of the local environment, economic circumstances, and IDU over time across US metropolitan areas. Annual numbers of IDUs in the 88 largest US metropolitan statistical areas (MSAs) were estimated by extrapolating, adjusting, and allocating existing estimates using various data sources. Generalized estimating equations were used to assess the relation among the quality of the local environment, metropolitan political economy, and IDU prevalence using lagged models taking into account potential confounders. MSAs with a worse local environment (measured as a one standard deviation difference) had a greater risk of IDU (relative risk [RR]=1.03, 95% confidence interval [CI]: 1.01, 1.06); similarly, a one-percentage point worsening of the political economy for an MSA was associated with greater risk of IDU (RR=1.04-1.10). Final models stratified by region indicated heterogeneity of effect by region whereby the quality of the local environment was associated with IDU strongest in the South (RR=1.12, CI: 1.05, 1.12) followed by the West (RR=1.04, CI: 1.01, 1.07) and Midwest (RR=1.03, CI: 1.00, 1.06), and the metropolitan political economy was associated with IDU in the West (RR=1.03-1.09) and Northeast (RR=1.04-1.12). Our results underscore the importance of sociopolitical factors as determinants of IDU in MSAs. Structural solutions targeted at improving environmental conditions and economic circumstances should be considered as drug use interventions.
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Rice MC, Wicks MN, Martin JC. Health Risk Characteristics of Black Female Informal Caregivers on Welfare. Clin Nurs Res 2008; 17:20-31. [DOI: 10.1177/1054773807311689] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This exploratory study examines differences in health risk characteristics and perceived health by caregiver status in two groups of Black women, 37 informal caregivers and 20 noncaregivers, transitioning from welfare to work. Health risk characteristics were assessed with the Center for Epidemiologic Studies Depression Scale and Healthier People Network Health Risk Appraisal—Version 6. Body mass index (BMI) calculations were based on the standard Centers for Disease Control formula. Perceived health status was assessed using a single-item Cantril ladder. Results show no statistically significant between-group differences in perceived health status, depressive symptoms, frequency of lifestyle behaviors, or BMI. Clinically significant proportions of participants in both groups rated their health as poor or fair; reported mild to severe depressive symptoms; smoked cigarettes; did not perform monthly self-breast exams; were physically inactive, overweight, or obese; and consumed high-fat diets. Black women receiving welfare show increased risk for premature chronic health problems, which warrants development of effective community-based risk-reduction programs.
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Affiliation(s)
| | - Mona N. Wicks
- University of Tennessee Health Science Center, Memphis
| | - Judy C. Martin
- Memphis and Shelby County Health Department, Memphis,
TN
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Graham H, Inskip HM, Francis B, Harman J. Pathways of disadvantage and smoking careers: evidence and policy implications. J Epidemiol Community Health 2007; 60 Suppl 2:7-12. [PMID: 17708005 PMCID: PMC2491894 DOI: 10.1136/jech.2005.045583] [Citation(s) in RCA: 98] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To investigate in older industrialised societies (a) how social disadvantage contributes to smoking risk among women (b) the role of social and economic policies in reducing disadvantage and moderating wider inequalities in life chances and living standards. METHODS Review and analysis of (a) the effects of disadvantage in childhood and into adulthood on women's smoking status in early adulthood (b) policy impacts on the social exposures associated with high smoking risk. MAIN RESULTS (a) Smoking status--ever smoking, current smoking, heavy smoking, and cessation--is influenced not only by current circumstances but by longer term biographies of disadvantage (b) social and economic policies shape key social predictors of women's smoking status, including childhood circumstances, educational levels and adult circumstances, and moderate inequalities in the distribution of these dimensions of life chances and living standards. Together, the two sets of findings argue for a policy toolkit that acts on the distal determinants of smoking, with interventions targeting the conditions in which future and current smokers live. CONCLUSIONS An approach to tobacco control is advocated that combines changing smoking habits with reducing inequalities in the social trajectories in which they are embedded. Policies to level up opportunities and living standards across the lifecourse should be championed as part of an equity oriented approach to reducing the disease burden of cigarette smoking.
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Affiliation(s)
- Hilary Graham
- Department of Health Sciences, University of York, UK.
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Jun HJ, Acevedo-Garcia D. The effect of single motherhood on smoking by socioeconomic status and race/ethnicity. Soc Sci Med 2007; 65:653-66. [PMID: 17493724 DOI: 10.1016/j.socscimed.2007.03.038] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2006] [Indexed: 01/03/2023]
Abstract
We examined the association between parenting young children and smoking among US single women compared with married women, and whether this effect is moderated by socioeconomic status and race/ethnicity. Our main finding is that having children reduces smoking except among single white women, and women with low income. We used the Tobacco Use Supplement of the Current Population Survey, a nationally representative dataset (1995-96, n=70,019). Log-binomial regression analysis was used to estimate the association between parenting responsibility (i.e., presence of children aged 0-4 and 5-17) and daily smoking status, after taking into consideration marital status, income, and race/ethnicity. Single women faced a higher risk of smoking than married women. Parenting was protective against smoking among married women but not among single women. Additionally, among single women, the associations between parenting and smoking varied by income and race/ethnicity. Parenting increased the risk of smoking among single women in the lowest income quartile. Single black and Hispanic women with children had a risk of smoking similar to that of their childless counterparts. However, single white women with children were more likely to smoke than their childless counterparts. Smoking cessation interventions and programs to reduce environmental tobacco smoke should recognize that the co-occurrence of single motherhood, parenting responsibility and low-income may increase the risk of smoking. This is particularly significant given the rapid growth of the single women population, and their concentration in poverty in the USA. The finding that parenting is protective against smoking among single minority women, who presumably experience significant stressors, calls for a more thorough investigation of smoking behavior among minority women, and suggests the importance of stress buffers such as social support.
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Affiliation(s)
- Hee-Jin Jun
- Department of Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, MA 02115, USA.
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