Social science & medicine
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Social science & medicine · May 2009
Do biological, sociodemographic, and behavioral characteristics explain racial/ethnic disparities in preterm births?
Many studies find racial/ethnic disparities in a diverse set of birth outcomes. However few empirical studies have examined the existence and possible explanations for racial/ethnic disparities in preterm births using a diverse set of racial/ethnic categories and a nationally representative sample of births. This research fills that gap. ⋯ Results from the full multivariable logistic regression model finds that the only racial/ethnic disparity found in preterm births is observed for infants born to Native American mothers compared to non-Hispanic white mothers, once all variables are controlled for in the model. Race-stratified models indicate that maternal health complications and prenatal care adequacy offer the most potential in explaining remaining racial/ethnic disparities in preterm births. Results from this research support the need to increase access to appropriate and timely prenatal care for women of all races/ethnicities in an effort to reduce racial/ethnic disparities in preterm births.
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Social science & medicine · May 2009
Historical ArticleDo conditions in early life affect old-age mortality directly and indirectly? Evidence from 19th-century rural Sweden.
Previous research has shown that the disease load experienced during the birth year, measured as the infant mortality rate, had a significant influence on old-age mortality in nineteenth-century rural Sweden. We know that children born in years with very high rates of infant mortality, due to outbreaks of smallpox or whooping cough, and who still survived to adulthood and married, faced a life length several years shorter than others. We do not know, however, whether this is a direct effect, caused by permanent physical damage leading to fatal outcomes later in life, or an indirect effect, via its influence on accumulation of wealth and obtained socio-economic status. ⋯ While the result is interesting per se, constituting a debatable issue, it means that the argument that early-life conditions indirectly affect old-age mortality is not supported. Instead, we find support for the conclusion that the effect of the disease load in early-life is direct or, in other words, that physiological damage from severe infections at the start of life leads to higher mortality at older ages. Taking random effects at family level into account did not alter this conclusion.
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Social science & medicine · May 2009
Childhood drowning in Matlab, Bangladesh: an in-depth exploration of community perceptions and practices.
While reductions in infectious disease have resulted in impressive declines in child mortality in Bangladesh, drowning is becoming proportionately more important as a major cause of death, accounting for at least 19% of deaths of children between 1 and 4 years of age in trend analysis since 2000. Little is known about indigenous beliefs and behaviors associated with drowning, which may be critical to preventing child-related drowning deaths. Qualitative research was carried out over 13 months in Matlab, Bangladesh to describe the indigenous explanatory model of drowning and to identify behavioral factors increasing the risk for drowning deaths. ⋯ After the child is removed from the water, traditional practices that have no known benefit are employed. The research identified locally constructed beliefs and practices such as refraining from touching the child that may increase the incidence of drowning deaths. Future efforts are required to address these beliefs and assess the feasibility, cultural acceptability and effectiveness of strategies designed to prevent drowning.
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Social science & medicine · May 2009
Discrimination, work and health in immigrant populations in Spain.
One of the most important social phenomena in the global context is the flow of immigration from developing countries, motivated by economic and employment related issues. Discrimination can be approached as a health risk factor within the immigrant population's working environment, especially for those immigrants at greater risk from social exclusion and marginalisation. The aim of this study is to research perceptions of discrimination and the specific relationship between discrimination in the workplace and health among Spain's immigrant population. ⋯ They also identified political and legal structural barriers related with social institutions. Experiences of discrimination can affect their mental health and are decisive factors regarding access to healthcare services. Our results suggest the need to adopt integration policies in both the countries of origin and the host country, to acknowledge labour and social rights, and to conduct further research into individual and social factors that affect the health of the immigrant populations.