Social science & medicine
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Social science & medicine · Apr 2009
Historical ArticleFamine, death, and madness: schizophrenia in early adulthood after prenatal exposure to the Chinese Great Leap Forward Famine.
Using data from large scale, nationally representative sample surveys, we tested the hypothesis that prenatal exposure to famine increases schizophrenia risk at adulthood by studying the Great Leap Forward Famine in China (1959-1961). Our results show that, in the urban population, being conceived and born during the famine increased the risk of developing schizophrenia at early adulthood as compared to both the pre-famine and post-famine cohorts. ⋯ This finding contrasts sharply with previous studies on the Dutch Hunger Winter as well as with smaller scale local studies in China based on hospital records. We offer an explanation for the urban-rural difference in the schizophrenia-famine relationship based on population selection by differential excess mortality and provide supportive evidence through province- and cohort-level ecological analysis.
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Social science & medicine · Apr 2009
Tobacco control policies are egalitarian: a vulnerabilities perspective on clean indoor air laws, cigarette prices, and tobacco use disparities.
This study models independent associations of state or local strong clean indoor air laws and cigarette prices with current smoker status and consumption in a multilevel framework, including interactions with educational attainment, household income and race/ethnicity and the relationships of these policies to vulnerabilities in smoking behavior. Cross sectional survey data are employed from the February 2002 panel of the Tobacco Use Supplement of the Current Population Survey (54,024 individuals representing the US population aged 15-80). Non-linear relationships between both outcome variables and the predictors were modeled. ⋯ The association of cigarette price with reduced smoking participation and consumption was not found to vary with race/ethnicity. Population vulnerability in consumption appears to be structured by non-white race categories, but not at the state and county levels at which the policies we studied were enacted. Clean indoor air laws and price increases appear to benefit all socio-economic and race/ethnic groups in our study equally in terms of reducing smoking participation and consumption.
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Social science & medicine · Apr 2009
ReviewRelationships between health and culture in Polynesia - a review.
This review of journal articles and book chapters discusses the health beliefs characteristic of Polynesia and reveals several themes. These are: commonality in health conceptualisations across the cultures of the region which differ from the conceptualisations of biomedicine; the role of the relational self, traditional living and communalism in understanding health; the place of spirituality and religion in health and illness causation; and pluralism and pragmatism in health-seeking behaviour. Suggestions are made as to how awareness of key ideas might contribute to effective planning of health promotion and intervention activities.
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Social science & medicine · Apr 2009
Comparative StudyPioneers and laggards - is the effect of gender equality on health dependent on context?
This study combines data at individual and area level to examine interactions between equality within couples and gender equality in the municipality in which individuals live. The research question is whether the context impacts on the association between gender equality and health. The material consists of data on 37,423 men and 37,616 women in 279 Swedish municipalities, who had their first child in 1978. ⋯ Traditional mothers in a traditional municipality have the lowest level of sick leave and pioneers the highest. These results show that there are distinct benefits as well as disadvantages to being a gender pioneer and/or a laggard in comparison to your municipality. The associations are markedly different for men and women.
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Social science & medicine · Apr 2009
Case ReportsCommunity-based delivery of maternal care in conflict-affected areas of eastern Burma: perspectives from lay maternal health workers.
In settings where active conflict, resource scarcity, and logistical constraints prevail, provision of maternal health services within health centers and hospitals is unfeasible and alternative community-based strategies are needed. In eastern Burma, such conditions necessitated implementation of the "Mobile Obstetric Maternal Health Worker" (MOM) project, which has employed a community-based approach to increase access to essential maternal health services including emergency obstetric care. Lay Maternal Health Workers (MHWs) are central to the MOM service delivery model and, because they are accessible to both the communities inside Burma and to outside project managers, they serve as key informants for the project. ⋯ They suggest that some emergency obstetric care services that are conventionally delivered only within healthcare settings might be feasible in community or home-based settings when alternatives are not available. This paper provides an opportunity to hear directly from community-based workers in a conflict setting, perspectives seldom documented in the scientific literature. A rights-based approach to service delivery and its suitability in settings where human rights violations are widespread is highlighted.