Social Contagion Of Mental Health: Evidence From College Roommates

From a policy standpoint, the spread of health conditions in social networks is important to quantify, because it implies externalities and possible market failures in the consumption of health interventions. Recent studies conclude that happiness and depression may be highly contagious across social ties. The results may be biased, however, because of selection and common shocks. We provide unbiased estimates by using exogenous variation from college roommate assignments. Our findings are consistent with no significant overall contagion of mental health and no more than small contagion effects for specific mental health measures, with no evidence for happiness contagion and modest evidence for anxiety and depression contagion. The weakness of the contagion effects cannot be explained by avoidance of roommates with poor mental health or by generally low social contact among roommates. We also find that similarity of baseline mental health predicts the closeness of roommate relationships, which highlights the potential for selection biases in studies of peer effects that do not have a clearly exogenous source of variation. Overall, our results suggest that mental health contagion is lower, or at least more context specific, than implied by the recent studies in the medical literature. Copyright © 2012 John Wiley & Sons, Ltd.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/99092/1/hec2873.pd

Drug-related stigma and access to care among people who inject drugs in Vietnam.

Introduction and aimsThere are considerable challenges faced by people with a history of injecting drug use (PWID) in Vietnam, including drug-related stigma and lack of access to healthcare. Seeking and utilising healthcare, as well as harm reduction programs for PWID, are often hampered by drug-related stigma. This study aimed to examine the impacts of drug-related stigma on access to care and utilisation of harm reduction programs among PWID in Vietnam.Design and methodsA cross-sectional study was conducted in two provinces in Vietnam, Phú Thọ and Vinh Phúc. The study participants completed the survey by using Audio Computer-Assisted Self-Interview between late 2014 and early 2015. Linear multiple regression models and logistic regression models were used to assess the relationship among drug-related stigma, access to care and utilisation of harm reduction programs, including methadone maintenance treatment (MMT) and needle exchange programs (NEP).ResultsA total of 900 PWID participated in this study. Drug-related stigma was significantly associated with lower level of access to care, but not with utilisation of MMT or NEP. Older age was positively associated with higher levels of access to care. Levels of education were positively correlated with access to care, as well as utilisation of MMT and NEP.Discussion and conclusionsThis study underscores the need for future interventions to reduce drug-related stigma in society and in health-care settings to improve PWID's utilisation of care services. Special attention should be paid to younger PWID and those with lower levels of education

Vocation, Belongingness, and Balance: A Qualitative Study of Veterinary Student Well-Being

An elevated risk for suicide among veterinarians has stimulated research into the mental health of the veterinary profession, and more recently attention has turned to the veterinary student population. This qualitative study sought to explore UK veterinary students' perceptions and experiences of university life, and to consider how these may affect well-being. Semi-structured interviews were conducted with 18 students from a single UK school who were purposively selected to include perspectives from male, female, graduate-entry, standard-entry (straight from high school), and widening participation students across all 5 years of the program. Three main themes were identified: a deep-rooted vocation, navigating belongingness, and finding balance. Participants described a long-standing goal of becoming a veterinarian, with a determination reflected by often circuitous routes to veterinary school and little or no consideration of alternatives. Although some had been motivated by a love of animals, others were intrinsically interested in the scientific and problem-solving challenges of veterinary medicine. Most expressed strong feelings of empathy with animal owners. The issue of belongingness was central to participants' experiences, with accounts reflecting their efforts to negotiate a sense of belongingness both in student and professional communities. Participants also frequently expressed a degree of acceptance of poor balance between work and relaxation, with indications of a belief that this imbalance could be rectified later. This study helps highlight future avenues for research and supports initiatives aiming to nurture a sense of collegiality among veterinary students as they progress through training and into the profession

Essays on Long-Term Care and Aging.

This dissertation contains three empirical papers on important health policy issues. The first paper looks at the effect of changes in levels of Medicare home health care services on the informal care use of disabled, older adults. I estimate two-part models of informal care use, where the key independent variable is a measure of Medicare home health payment restrictiveness. Individuals who lived in states with less Medicare home health care services increased their use of informal care, although this effect is only observed among low-income individuals. The second paper assesses the effects of changes in employment incentives on the supply of informal support from adult children to their disabled, older parents. This study focuses on one specific form of informal support, co-residence with a disabled parent. I compare changes in co-residence patterns between 1990 and 2000 across groups of middle aged women whose co-residence patterns were arguably comparable, and who experienced very different changes in employment incentives. Results from difference-in-difference models provide support to the hypothesis that increasing employment incentives reduces the supply of informal support to disabled parents. The third paper looks at the effect of education on health status. This paper builds on the extensive research literature on this topic by measuring health in terms of the number of Quality-Adjusted Life Years experienced by individuals over an extended period of time. This measure captures overall health status over time, which is arguably a more important measure than point-in-time measures of specific health conditions or longevity alone. I use changes in compulsory schooling laws to identify the causal effect of education on health. Instrumental variables models provide evidence that the health returns to education are both statistically significant and substantial.Ph.D.Health Services Organization & PolicyUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/61743/1/egolber_1.pd

The National Network of Depression Centers: progress through partnership

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/86894/1/20862_ftp.pd

Heterogeneous Relationships between Labor Income and Health by Race/Ethnicity

Objective. To examine the race-stratified relationships between labor income and health among working-age adults in the United States. Data Sources. Data from eight waves of the Panel Study of Income Dynamics from 1999 through 2013 were used for this study. Study Design. The study utilized a retrospective observational longitudinal design with repeated measures of labor income and health measures. System-generalized method of moment and heteroscedasticity-based instrument regressions were used to examine the relationships between labor income and physical and mental health measures, respectively. Dynamic panel models were used to examine the effect of loss in income on health measures. Data Collection/Extraction Methods. We performed secondary data analysis. Principal Findings. Adults in higher labor income quartiles had better self-rated health than those in the lowest quartile regardless of racial group. The relationship between labor income and psychological distress varied by race groups. Reductions in labor income were associated with increases in psychological distress among whites only. Conclusion. These findings suggest heterogeneous relationships between labor income and overall health across racial groups. Our results highlight the need to provide safety nets for adults who experience a decline in income to prevent deterioration in health