A szorongás, a depresszió, az önértékelés és a társadalmi tőke összefüggései a várandósok egészségmagatartásával = Associations of trait anxiety, depression, self-esteem and social capital with health behaviour in early pregnancy

Elméleti háttér: A várandósság alatti depresszió és szorongás magzatra gyakorolt negatív hatását több kutatás látszik igazolni, míg mások nem találtak ilyen irányú összefüggéseket. Az antenatális depresszió és szorongás részben a fiziológiai, endokrinológiai változásokon, részben az anyai egészségmagatartáson keresztül hathat a magzatra. Cél: Vizsgálatunk célja a szorongás, a depresszió, az önértékelés és a társadalmi tőke várandósok egészségmagatartására gyakorolt hatásának feltárása volt. Az egészségmagatartás elemeit a várandósságra történő felkészülés, a dohányzás, az alkoholfogyasztás, valamint a folsav- és vitaminbevitel alkották. Hipotézisünk az volt, hogy a szorongás és a depresszió, valamint a csökkent önértékelés romló egészségmagatartással jár együtt. Módszerek: Szombathely város tíz védőnői körzetében populációs monitoringot hoztunk létre, ahol 2008. 02. 01. és 2009. 02. 01. között minden terhességi nyilvántartásba kerülő nőről rendszeres adatgyűjtést végeztünk. 307 várandós képezte mintánkat, melyben a depressziót a Rövidített Beck Depresszió Kérdőívvel, a szorongást a Spielberger-féle Vonásszorongás Kérdőívvel, az önértékelést a Rosenberg-skálával mértük. A társadalmi tőkét a közösségi bizalom hiánya, a kölcsönösség és a civil támogatottság 0-tól 3-ig terjedő skáláin mértük. Összefüggéseinket logisztikus regresszió segítségével tártuk fel. Eredmények: A magasabb szintű vonásszorongással jellemezhető válaszadók kisebb eséllyel készültek a várandósságukra (EH = 0,955; 95%MT = 0,923—0,988) és szedtek vitaminokat (EH = 0,954; 95%MT = 0,922—0,987); a több depresszív tünetet mutatók pedig nagyobb eséllyel dohányoztak (EH = 1,106; 95%MT = 1,060—1,154). A társadalmi bizalom hiánya kisebb esélyű folsavbevitellel (EH = 0,648; 95%MT = 0,485—0,867) járt együtt; továbbá a magasabb önértékelésűek kisebb- (EH = 0,943; 95%MT = 0,892—0,997), a nagyobb társas támogatottságúak nagyobb eséllyel (EH = 1,571; 95%MT = 1,144—2,156) fogyasztottak alkoholt. Következtetések: Vizsgálatunkban a szorongás, a depresszió, az alacsony önértékelés és a csökkent társadalmi tőke negatív egészségmagatartási tendenciákkal járt együtt. | Background: The negative effects of antenatal depression and anxiety on neonatal outcomes seem to be proven by several authors; however, others did not reveal similar associations. Antenatal depression and anxiety may act on foetal development through physiological or endocrine changes and maternal health behaviour. Aim: The aim of the present research was to explore the association of antenatal trait anxiety, depression, self-esteem, social capital, and health-behaviour among Hungarian pregnant women. Higher levels of trait anxiety and depression, and lower levels of self-esteem were hypothesized to be associated negatively with health-conscious behaviour. Methods: We have established a population-based monitoring system in 10 districts of health visitors in Szombathely. The system covered every woman who was registered as pregnant between 1st February 2008 and 1st February 2009. Three hundred and seven expectant women in the early stage of their pregnancy were surveyed using the Short Form of Beck Depression Inventory, which enabled the measurement of depressive symptomatology, whereas the Spielberger Trait Anxiety Inventory was used for the measurement of anxiety and Rosenberg’s Self-Esteem Scale for self-esteem. Social capital was measured by lack of social trust, reciprocity between citizens, and help received from civil organizations on a 0 to 3 scale. Associations were established by multivariate binary logistic regression. Results: Higher levels of trait-anxiety corresponded with less preparation for pregnancy (OR = 0.955; 95%CI = 0.923—0.988) and vitamin-intake significantly (OR = 0.954; 95%CI = 0.922—0.987), while higher level of depression was positively associated with smoking (OR = 1.106; 95%CI = 1.060—1.154). Those, who were distrustful of other people, had a lower chance for folate-supplementation (OR = 0.648; 95%CI = 0.485—0.867). Those with higher levels of self-esteem tended to consume less alcohol (OR = 0.943; 95%CI = 0.892—0.997), while those who received higher levels of civil support tended to consume more (OR = 1.571; 95%CI = 1.144—2.156). Conclusions: Trait anxiety, depression, self-esteem and social capital were associated negatively with health-conscious behaviour

Predictors of Routine Medical Care Use among Mexican Immigrants/Mexican-Americans Varying in Legal Status

Background: Immigration has been the focus of intense political debate, with a recurrent theme being the use of public services, including healthcare. Although Latinos are the largest and fastest growing ethnic group in the United States (U.S.), evidence suggests they underutilize healthcare, with Mexican Immigrants and Mexican Americans (MI-MA) living on the U.S.-Mexico border exhibiting the greatest disparities. Objective: This study explored the association of predisposing, enabling and need characteristics, including legal status, with the use of routine medical care (RMC) among 387 MI-MA living on the California-Mexico border. Methods: This cross-sectional study used data collected in 2009 for the San Diego Prevention Research Center (SDPRC) community survey; data analyses were completed in Summer 2012. This study involved multistage sampling and recruitment of Latino adults in 200 census blocks near the California-Mexico border to complete an interview and height and weight measurements. Sequential logistic regressions assessed the relative contribution of predisposing, enabling and need factors to the use of RMC. Results: Predisposing and enabling factors (gender, undocumented status, cost) distinguished between respondents with recent (<1 year) versus limited (≥ 5 years including never) use of RMC, whereas enabling and need factors (insurance, dispositional trust, presence of a chronic illness) adequately differentiated between those with recent versus delayed (≥1 year, but <5 years) use. Undocumented status distinguished between those with delayed versus limited use of RMC. Conclusions: Consideration of different factors, including financial difficulties and legal status, is necessary for promoting use of RMC among MI-MA living in this border region.Contexte : L'immigration est au cœur de débats politiques intenses, dont l'un des thèmes récurrents est l'utilisation des services publics, et notamment des soins de santé. Bien que les Latinos constituent le groupe ethnique le plus important et connaissant la croissance la plus rapide des Etats-Unis, les données semblent indiquer qu'ils sous-utilisent les services de santé, les immigrés mexicains et les Américano-Mexicains (IM-AM) vivant à la frontière américano-mexicaine affichant les plus fortes disparités. Objectif : Cette étude a exploré les liens entre les facteurs prédisposants, favorables et de nécessité, dont le statut juridique, et l'utilisation des soins médicaux courants (SMC) chez 387 IM-AM vivant à la frontière entre la Californie et le Mexique. Méthodes : Cette étude transversale s'est fondée sur les données recueillies en 2009 dans le cadre de l'enquête communautaire du San Diego Prevention Research Center (SDPRC), dont l'analyse s'est achevée à l'été 2012. Cette étude prévoyait un échantillonnage à plusieurs degrés et le recrutement d'adultes latinos dans 200 îlots de recensement situés à proximité de la frontière entre la Californie et le Mexique, afin de les interroger et de relever des mesures de taille et de poids. Des modèles de régression logistique séquentielle ont permis d’évaluer la contribution relative des facteurs prédisposants, favorables et de nécessité à l'utilisation des SMC.  Résultats : Les facteurs prédisposants et favorables (sexe, statut non documenté, coût) faisaient la différence entre les répondants ayant récemment (<1 an) ou peu (≥ 5 ans ou jamais) eu recours aux SMC, tandis que les facteurs favorables et de nécessité (assurance, prédisposition à faire confiance, présence de maladie chronique) distinguaient convenablement ceux qui avaient récemment eu recours aux SMC de ceux qui y avaient eu recours tardivement (≥1 an, mais <5 ans). Le statut non documenté faisait la différence entre ceux qui avaient tardivement ou peu eu recours aux SMC. Conclusions : La prise en compte des différents facteurs, y compris des difficultés financières et du statut légal, est nécessaire pour encourager l'utilisation des SMC chez les IM-AM vivant dans cette région frontalière.Antecedentes: La inmigración es objeto de un intenso debate político en el que uno de los temas recurrentes es el uso de los servicios públicos, entre ellos la atención sanitaria. Aunque los latinos constituyen el grupo étnico más numeroso y de más rápido crecimiento en Estados Unidos, las pruebas indican que no utilizan lo suficiente las instituciones de asistencia sanitaria. Son los inmigrantes mexicanos y los estadounidenses de origen mexicano que viven en la frontera entre Estados Unidos y México los que mayores disparidades muestran al respecto.  Objetivo: Este estudio analizó la asociación existente entre las características de los predisponentes, facilitadores y factores de necesidad, como el estado legal, y el uso de la asistencia médica rutinaria entre 387 estadounidenses de origen mexicano residentes en la frontera de California con México. Métodos: Este estudio transversal utilizó los datos recopilados en 2009 para un estudio comunitario del Centro de Investigación para la Prevención en San Diego (SDPRC), y el análisis de los datos se llevó a cabo en verano de 2012. Se realizaron muestreos en diferentes fases y se reclutaron adultos latinos en bloques censales de 200 cerca de la frontera mexicana con California para completar una entrevista y realizar mediciones de peso y altura. Las regresiones logísticas secuenciales evaluaron la contribución relativa de los predisponentes, facilitadotes y factores de necesidad al uso de la atención médica rutinaria.  Resultados: Los predisponentes y facilitadores (género, situación ilegal o “sin papeles”, coste) variaron entre los participantes entre un uso reciente (<1 año) o limitado (≥ 5 años, o nunca) de la atención médica rutinaria, mientras que los facilitadotes y factores de necesidad (seguro, confianza, presencia de enfermedad crónica) se diferenciaron de forma adecuada entre un uso reciente o retardado (≥1 año, pero <5 años). El estado de indocumentado se diferenció igualmente entre un uso retardado o limitado de la asistencia médica rutinaria. Conclusiones: Es necesario tener en cuenta factores diversos, como las dificultades económicas y la situación jurídica, para promover el uso de la asistencia médica rutinaria entre los estadounidenses de origen mexicano que residen en esta región fronteriza

Small-Scale Urban Nature Parks: Why Should We Care?

Small-scale urban natural parks have the potential to contribute to the health and well-being of urban communities. Although recreation researchers have seldom focused on such areas, recreation research theory can be successfully applied to urban natural parks, especially if augmented by the application of social capital and social networks theory. Social capital and networks theories will aid recreation researchers and policy makers in understanding the processes and benefits associated with urban green space. This understanding may be important relative to low income urban community members who may not participate regularly in nature-based recreation

Family Structure and Family Climate in Relation to Health and Socioeconomic Status for Older Adults: A Longitudinal Moderated Mediation Analysis

Family characteristics are associated with individuals' health and wellbeing. However, the link between family structure (e.g., operationalized via marital status) and health outcomes is ambiguous, and whether family climate mediates the relationship is unclear. This study uses the Biobehavioral Family Model (BBFM) to investigate the association of older adults' family structure with later health, the mediating role of family climate and mental health and how these links vary by socioeconomic status (SES). Using data from n = 29,457 respondents aged over 50 in Waves 4, 5 and 6 (2011, 2013 and 2015) of the Survey of Health, Retirement and Ageing in Europe (SHARE), the BBFM was applied in a longitudinal mediation analysis of family structure and health, including both indicators of mental and physical health. Structural equation modeling was applied, and a multigroup analysis was performed to test the role of SES in a moderated mediation. Family climate and mental health mediated the relationship between family structure and subsequent physical health. Good levels of family climate were found to be consistently associated with improved mental and physical health. These relationships were significantly moderated by SES, showing that the association of family climate and health was weaker for those in low SES positions. Family climate and mental health should be considered as potential mechanisms linking family structure to later physical health outcomes across time; however, these associations are diminished for those with low SES

Is Social Capital Associated with Academic Achievement in Lithuanian High-school Students? A Population-based Study

Th e present study aims to determine the associations between family, neighbourhood, and school social capital with academic achievement among Lithuanian high-school students. Th e study included 1854 high-school students (901 males and 953 females) aged 16-18 years. At the end of the school year, the students’ achievements were measured as an average grade. Family, neighbourhood, and school social capital were identifi ed, indicating trust and understanding perceived from those social settings. Gender, body-mass index, self-perceived socioeconomic status, self-rated health, psychological distress and physical activity were also measured and used as covariates. Academic achievement was associated with family social capital, horizontal school trust and reciprocity at school. Family support, cooperation, and trust between students positively aff ect their achievement. Policies and strategies for a healthy environment for children need to be incorporated, especially within the school system for students’ better progress

Social Capital and Self-Rated Health among Older Adults in China: A Multilevel Analysis

Article on social capital and self-rated health among middle-aged and older adults in China

Social Capital and Self-rated Health: testing association with longitudinal and multilevel methodologies

Since Durkheim’s seminal work over a century ago, research has repeatedly shown that individuals with higher levels of social integration, social networks and social support have better health status. However, the recent introduction of a contextual phenomenon known as social capital to the field of public health has sparked lively debate as to how it may also influence the health of individuals, if at all. Though critics have raised several points of contention regarding reported association between social capital and health over recent years, one outstanding issue remains: the lack of empirical research focusing on causal relationships, due to paucity of adequate longitudinal social capital data. The overall aim of this thesis is to test association between different social capital proxies and self-rated health (SRH), alongside other well-known health determinants, using multilevel and longitudinal data, whilst employing a variety of study designs and methods. All data used in this thesis come from the United Kingdom’s British Household Panel Survey (BHPS) from years 2000, 03, 05, 07 and 08. The underlying premise of this body of work is to investigate temporal (causal) relationships between social capital and health. All four papers of this thesis demonstrate that generalised trust is the most robust of all social capital proxies tested, it maintaining a positive association with SRH over time. Furthermore, results from paper III imply that prior trust levels can predict future SRH, lending weight to the hypothesis that trust is an independent determinant of health. However, debate remains as to whether generalised trust solely captures social capital or other, more tangible aspects of social cohesion

Cross-scale relationships between social capital and women’s participation in decision-making on the farm: a multilevel study in semi-arid Kenya

Social capital develops through relations between people and groups within community social networks. Women in smallholder agrarian communities often draw on social capital to influence their intra-household bargaining positions, with significant implications for their resource access. However, the extent to which women use different types of social capital to increase their participation in agricultural decision-making remain understudied. This research examines the relationships between women’s participation in agricultural decision-making and bonding, bridging, and linking social capital and how broader contextual factors can interact with the pathways through which social capital functions in rural semi-arid Kenya. In 2014, we collected and analyzed quantitative and qualitative data: household (N = 206) and community (n = 127) surveys, key informant interviews (n = 77), twelve focus group discussions, and eight community meetings. Results indicate that women draw on bridging social capital to increase the diversity of their information and training sources. We found that women’s participation in decision-making has a positive association with bonding social capital and a negative association with linking social capital. Multilevel analysis reveals cross-scale interactions between poverty prevalence and social capital on women’s decision-making participation. Findings suggest that advances in regional development have the potential to amplify the stock and usage of social capital for women’s empowerment in smallholder agrarian systems