Social science & medicine
-
Social science & medicine · Jul 2013
Illicit and prescription drug problems among urban Aboriginal adults in Canada: the role of traditional culture in protection and resilience.
Illicit and prescription drug use disorders are two to four times more prevalent among Aboriginal peoples in North America than the general population. Research suggests Aboriginal cultural participation may be protective against substance use problems in rural and remote Aboriginal communities. As Aboriginal peoples continue to urbanize rapidly around the globe, the role traditional Aboriginal beliefs and practices may play in reducing or even preventing substance use problems in cities is becoming increasingly relevant, and is the focus of the present study. ⋯ Cultural participation also promoted resilience by reducing the effects of high school incompletion on drug problems. In contrast, mainstream acculturation was not associated with illicit drug problems and served as a risk factor for prescription drug problems in this urban sample. Findings encourage the growth of programs and services that support Aboriginal peoples who strive to maintain their cultural traditions within cities, and further studies that examine how Aboriginal cultural practices and beliefs may promote and protect Aboriginal health in an urban environment.
-
Social science & medicine · May 2013
Structural vulnerability and access to medical care among migrant street-based male sex workers in Germany.
This article discusses health concerns of migrant street-based male sex workers (SMSW) in Germany, a population that remains underexplored by health and social scientists. It is based on five months of ethnographic research in 2011/2012, including 46 semi-structured interviews with physicians, social workers, health department staff, and SMSW from Romania and Bulgaria. This is supplemented with annual reports by organizations providing assistance to this population in eight cities. ⋯ It seeks to move beyond the myopic association between sex work and HIV to contextualize health risks as resultant of macro-level processes associated with migration. Second, the article contributes a summary of primary health concerns for this population. Especially troubling is their lack of access to regular medical services, reflecting a socio-legal position that often resembles that of unauthorized migrants rather than European Union citizens.
-
Social science & medicine · Apr 2013
A large-scale longitudinal study indicating the importance of perceived effectiveness, organizational and management support for innovative culture.
Teams participating in QI collaboratives reportedly enhance innovative culture in long-term care, but we currently lack empirical evidence of the ability of such teams to enhance (determinants of) innovative culture over time. The objectives of our study are therefore to explore innovative cultures in QI teams over time and identify its determinants. The study included QI teams participating between 2006 and 2011 in a national Dutch quality program (Care for Better), using an adapted version of the Breakthrough Method. ⋯ Multilevel analyses showed that perceived effectiveness, organizational support, and management support predicted innovative culture. Our QI teams were not able to improve innovative culture over time, but their innovative culture scores were higher than non-participant professionals. QI interventions require organizational and management support to enhance innovative culture in long-term care settings.
-
Social science & medicine · Apr 2013
Exploration of health risks related to air pollution and temperature in three Latin American cities.
This paper explores whether the health risks related to air pollution and temperature extremes are spatially and socioeconomically differentiated within three Latin American cities: Bogota, Colombia, Mexico City, Mexico, and Santiago, Chile. Based on a theoretical review of three relevant approaches to risk analysis (risk society, environmental justice, and urban vulnerability as impact), we hypothesize that health risks from exposure to air pollution and temperature in these cities do not necessarily depend on socio-economic inequalities. To test this hypothesis, we gathered, validated, and analyzed temperature, air pollution, mortality and socioeconomic vulnerability data from the three study cities. ⋯ The findings suggest that health risks from atmospheric conditions and pollutants exist without boundaries or social distinctions, even exhibiting characteristics of a boomerang effect (i.e., affecting rich and poor alike) on a smaller scale such as areas within urban regions. We used human mortality, a severe impact, to measure health risks from air pollution and extreme temperatures. Public health data of better quality (e.g., morbidity, hospital visits) are needed for future research to advance our understanding of the nature of health risks related to climate hazards.
-
Previous research shows no consensus as to whether and how natural disasters affect suicide rates in their aftermath. Using prefecture-level panel data of natural disasters and suicide in Japan between 1982 and 2010, we estimate both contemporaneous and lagged effects of natural disasters on the suicide rates of various demographic groups. We find that when the damage caused by natural disasters is extremely large, as in the case of the Great Hanshin-Awaji Earthquake in 1995, suicide rates tend to increase in the immediate aftermath of the disaster and several years later. ⋯ We then test the possibility that natural disasters enhance people's willingness to help others in society, an effect that may work as a protective factor against disaster victims' suicidal risks. We find that natural disasters increase the level of social ties in affected communities, which may mitigate some of the adverse consequence of natural disasters, resulting in a decline in suicide rates. Our findings also indicate that when natural disasters are highly destructive and disruptive, such protective features of social connectedness are unlikely to be enough to compensate for the severe negative impact of disasters on health outcomes.