Social science & medicine
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Social science & medicine · Mar 2009
Violence from parents in childhood and obesity in adulthood: using food in response to stress as a mediator of risk.
Guided by a life course perspective and concepts from models of stress and coping, this study tested the extent to which self-reported profiles of physical and psychological violence in childhood from parents were associated with greater odds of obesity in adulthood. This study also examined the extent to which adults' greater use of food in response to stress served as a mediator of potential associations of risk. Multivariate regression models were estimated using data from 1650 respondents in the 1995-2005 National Survey of Midlife in the U. ⋯ Evidence from a sequence of models that tested mediation effects indicated that greater use of food in response to stress among respondents with problematic histories of violence explained, in part, their higher risk of adult obesity. Findings contribute to the growing body of evidence regarding psychosocial predictors of obesity, as well as the physical health consequences of childhood family violence. Results further suggest the importance of addressing particular aspects of life course social relationships-such as violence in childhood from parents-and their implications for psycho-behavioral uses of food within efforts to reduce rates of adult obesity.
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Social science & medicine · Mar 2009
The structuring of occupational stressors in a Post-Fordist work environment. Moving beyond traditional accounts of demand, control and support.
In this study, the traditional components of the Demand-Control-Support-Model are extended with a broad number of occupational stressors, while investigating associations with persistent fatigue, musculoskeletal complaints and emotional well-being. Furthermore, it is assessed how these stressors are structured into distinct dimensions within a population of wage-earners. In a representative cross-sectional sample of 11,099 Flemish (Belgian) employees a range of loglinear techniques is used: logit modelling, latent class analysis and Modified LISREL-modelling. ⋯ These latent dimensions are all significantly related with at least one of the health outcomes - with immaterial demands having the strongest effects. Contemporary work is characterised by a complex combination of stressors, structured within the population into a number of dimensions. More research on the interrelatedness of occupational stressors is needed.
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Social science & medicine · Mar 2009
Gender equity and health sector reform in Colombia: mixed state-market model yields mixed results.
In 1993, Colombia carried out a sweeping health reform that sought to dramatically increase health insurance coverage and reduce state involvement in health provision by creating a unitary state-supervised health system in which private entities are the main insurers and health service providers. Using a quantitative comparison of household survey data and an analysis of the content of the reforms, we evaluate the effects of Colombia's health reforms on gender equity. We find that several aspects of these reforms hold promise for greater gender equity, such as the resulting increase in women's health insurance coverage. However, the reforms have not achieved gender equity due to the persistence of fees which discriminate against women and the introduction of a two-tier health system in which women heads of household and the poor are concentrated in a lower quality health system.
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Social science & medicine · Mar 2009
Chronic catastrophes: exploring the concentration and sustained nature of ambulatory prescription drug expenditures in the population of British Columbia, Canada.
Previous research has shown that a small proportion of the population accounts for a substantial proportion of spending on physician and hospital services. Much less is known about the high-cost users of ambulatory prescription medicines. We investigate the concentration and sustained nature of ambulatory prescription drug expenditures among residents of British Columbia, Canada in 2001 and 2004. ⋯ They were older, more likely to be female, more likely to be of low income, and more likely to be hospitalized and die within the year of study than other pharmaceutical users and non-users. Our results suggest that careful consideration should be given to the long-term financial burdens and access barriers created by pharmaceutical insurance policies that rely heavily on private payments by individuals. Our focus is on costs associated with ambulatory prescription drug use, however, had we included information on the cost of prescription drugs used in hospitals, we would likely have detected an even stronger relationship between high-cost pharmaceutical use and poor health status.