Toward a Model of Factors Influencing the Hiring of Women with a History of Breast Cancer

Whether surgical treatment for cancer which results in the removal of an external part of the body is viewed by employers as a medical disability that interferes with the performance of job-related functions, or fits a more stereotypic definition of a physical handicap that might even prevent an employee from being hired, has not been adequately studied. To identify factors which influence employers\u27 decisions to hire women who have had breast cancer, a model of factors influencing the decision to hire was developed. A random sample of personnel directors from an industrialized North Carolina county was surveyed. A majority had personal experience with breast cancer patients and had had mastectomy employees leave work. Five factors were found to explain 69% of the variance in hiring practices: size of company, level of sick leave benefits, company involvement in employees\u27 medical insurance, employers\u27 education and personal experience with breast cancer. Knowledge level about the disease did not predict the hiring decision. Regardless of whether medical personnel made the final decision, the influence of non-medical factors was found to be quite strong in determining whether a former breast cancer patient was actually hired

Structural Approaches to Health Promotion: What Do We Need to Know About Policy and Environmental Change?

Although the public health literature has increasingly called on practitioners to implement changes to social, environmental, and political structures as a means of improving population health, recent research suggests that articles evaluating organization, community, or policy changes are more limited than those focused on programs with individuals or their social networks. Even when these approaches appear promising, we do not fully understand whether they will benefit all population groups or can be successful in the absence of accompanying individually oriented programs. The role of this broad category of approaches, including both policy and environmental changes, in decreasing health disparities is also unclear, often benefiting some communities more than others. Finally, the political nature of policy and environmental change, including the impact on personal autonomy, raises questions about the appropriate role for public health professionals in advancing specific policies and practices that alter the conditions in which people live. This article addresses these issues and ends with a series of questions about the effectiveness and ethical implementation of what we have termed “structural initiatives.

Structural Approaches to Health Promotion: What Do We Need to Know About Policy and Environmental Change?

Although the public health literature has increasingly called on practitioners to implement changes to social, environmental, and political structures as a means of improving population health, recent research suggests that articles evaluating organization, community, or policy changes are more limited than those focused on programs with individuals or their social networks. Even when these approaches appear promising, we do not fully understand whether they will benefit all population groups or can be successful in the absence of accompanying individually oriented programs. The role of this broad category of approaches, including both policy and environmental changes, in decreasing health disparities is also unclear, often benefiting some communities more than others. Finally, the political nature of policy and environmental change, including the impact on personal autonomy, raises questions about the appropriate role for public health professionals in advancing specific policies and practices that alter the conditions in which people live. This article addresses these issues and ends with a series of questions about the effectiveness and ethical implementation of what we have termed “structural initiatives.

Care Transitions in Childhood Cancer Survivorship: Providers' Perspectives

Purpose: Most adolescent and young adult (AYA)-aged childhood cancer survivors develop physical and/or psychosocial sequelae; however, many do not receive long-term follow-up (LTF) critical for screening, prevention, and treatment of late effects. To develop a health services research agenda to optimize care models, we conducted qualitative research with LTF providers examining existing models, and successes and challenges in maintaining survivors' connections to care across their transition to adulthood

Upending the Social Ecological Model to Guide Health Promotion Efforts Toward Policy and Environmental Change

Efforts to change policies and the environments in which people live, work, and play have gained increasing attention over the past several decades. Yet health promotion frameworks that illustrate the complex processes that produce health-enhancing structural changes are limited. Building on the experiences of health educators, community activists, and community-based researchers described in this supplement and elsewhere, as well as several political, social, and behavioral science theories, we propose a new framework to organize our thinking about producing policy, environmental, and other structural changes. We build on the social ecological model, a framework widely employed in public health research and practice, by turning it inside out, placing health-related and other social policies and environments at the center, and conceptualizing the ways in which individuals, their social networks, and organized groups produce a community context that fosters healthy policy and environmental development. We conclude by describing how health promotion practitioners and researchers can foster structural change by (1) conveying the health and social relevance of policy and environmental change initiatives, (2) building partnerships to support them, and (3) promoting more equitable distributions of the resources necessary for people to meet their daily needs, control their lives, and freely participate in the public sphere

Perceived Everyday Racism, Residential Segregation, and HIV Testing Among Patients at a Sexually Transmitted Disease Clinic

Objectives. More than one quarter of HIV-infected people are undiagnosed and therefore unaware of their HIV-positive status. Blacks are disproportionately infected. Although perceived racism influences their attitudes toward HIV prevention, how racism influences their behaviors is unknown. We sought to determine whether perceiving everyday racism and racial segregation influence Black HIV testing behavior

The sexual behavior of married Mexican immigrant men in North Carolina

In the southern United States, North Carolina has attracted an unprecedented influx of Hispanic immigrants in the 1990s. Detailed data on the sexual behavior of these recent immigrants are lacking. This exploratory study used two methods, a survey and qualitative interviews. For both methods, participants were recruited using convenience sampling. All study participants were first-generation Mexican immigrants who had lived in North Carolina for at least six consecutive months. The survey, administered face-to-face, explored the sexual attitudes and behavior of 43 married Mexican men living in North Carolina. The qualitative interviews, conducted with men (n=20) and women (n=19), explored immigrants' perceptions of extramarital sex and sexually transmitted diseases (STDs). The study's results suggest that the sexual behavior of 'unaccompanied' married Mexican immigrant men, living alone in North Carolina, differs, at least in degree if not in kind, from that of 'accompanied' married men, residing in the state with their wives. Unaccompanied men who participated in the survey reported more lifetime sexual partners, more partners in the previous year, more extramarital partners and more contact with prostitutes than accompanied survey respondents. The qualitative interviews suggest that unaccompanied men's peculiar status as 'single' men in North Carolina may provide them with both motive and opportunity to have extramarital sexual relationships and that few married Mexican men and women perceive STDs as relevant to their lives. Overall, the study supports the need for male- and couple-focused STD prevention interventions for Hispanic immigrants.Sexually transmitted diseases Sexual behavior Immigrants Hispanics

Manual ability as a marker of dependency in geriatric women

Little is known about the factors responsible for the institutionalization of the elderly. This study\u27s objective was to discover markers associated with nursing home placement. Fifty-six white ambulatory women over 63 yrs of age were selected from 3 settings encompassing a range of dependency: 20 women from nursing homes; 16 women who lived in their own homes but requiring social assistance and 20 totally independent women. Each woman was examined for factors that might be associated with her state of dependency: age, socioeconomic status, morale, education, strength of social network, number and type of medications, mental status, manual ability, medical problems and abnormalities on physical examination. The time required to perform any of 27 manual skills discriminated the 3 groups better than any other factor (P \u3c 0.0001). Three manual skills predicted group membership with 92% accuracy. Manual ability may be the best marker of dependency in elderly women and should be measured in studies concerned with geriatric health status. © 1982