Social science & medicine
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Social science & medicine · Oct 2009
Biography Historical ArticleCrediting his critics' concerns: remaking John Snow's map of Broad Street cholera, 1854.
Few cases in the history of epidemiology and public health are more famous than John Snow's investigation of a neighborhood cholera outbreak in the St. James, Westminster, area of London in 1854. In this study Snow is assumed to have proven that cholera was water rather than airborne through a methodology that became, and to a great extent remains, central to the science and social science of disease studies. ⋯ The answers significantly alter our understanding of this paradigmatic case. It does so in a manner offering insights both into the origins of nineteenth century disease analysis and more generally, the relation of mapping in the investigation of an outbreak of uncertain origin. The result has general relevance-pedagogically and practically-in epidemiology, medical geography, and public health.
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Social science & medicine · Oct 2009
Contextual effects on health care access among immigrants: lessons from three ethnic communities in Hawaii.
Immigrant health care is the product of the dynamic interaction between societal factors and the individual's socio-economic and cultural characteristics. Our knowledge about immigrant health care, however, has been limited to individual characteristics, without paying attention to the social context in which immigrants reside. This paper explores the effects of social contexts on access to health care among recent immigrants. ⋯ While Filipino immigrants do not benefit from state insurance assistance, high levels of health care resources and social capital within the Filipino community enable them to have significantly better health care access than Koreans, who have higher income and educational attainment. Interestingly, the advanced family/kinship networks are associated with better levels of immigrant health care access, while the increase of co-ethnic friend networks is related to lower access to health care. This study implies that restoration of immigrants' eligibility for public health insurance assistance, development of health care resources and social capital within ethnic communities, and mobilization of immigrant networks would be effective starting points to improve health care access among immigrants.
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Social science & medicine · Sep 2009
The good, the bad, and the severely mentally ill: Official and informal labels as organizational resources in community mental health services.
Research on labeling mental illness has focused relatively little attention on practical organizational concerns in the process of labeling in community mental health services. This paper examines this issue through an ethnographic study of two multi-service community mental health services organizations for people labeled severely and persistently mentally ill in the Midwest United States. The findings show that the labeling process is structured by cultural and policy environments in which mental health services are able to provide resources otherwise difficult to obtain. ⋯ Informal organizational labels regarding client mental illness are not tethered to the bureaucratic apparatus granting access to and paying for services. Instead, they reflect workers' real assessments of clients, which can differ from official ones. These informal labels determine how organizations deal with clients when rules and routines are violated.
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Social science & medicine · Sep 2009
Randomized Controlled TrialExperimental emotional disclosure in women undergoing infertility treatment: Are drop outs better off?
So far, the beneficial effects of personal written emotional disclosure have been mainly examined in relation to past or current stressful/traumatic experiences. The anticipation of a medical event has rarely been studied within this paradigm. This randomized-controlled study examined whether written emotional disclosure would reduce emotional distress and increase pregnancy rates in women undergoing in-vitro fertilization treatment. ⋯ The present study did not support the hypotheses that emotional disclosure will reduce infertility-related or general psychological distress and improve pregnancy outcomes in women undergoing in-vitro fertilization treatment. However, women who refused to participate in the study were more likely to get pregnant. Differences in the beneficial effects of emotional disclosure are discussed.