Self-Rated Health Trajectories among Married Americans: Do Disparities Persist over 20 Years?

The purpose of this study is to understand self-rated health (SRH) trajectories by social location (race/ethnicity by gender by social class) among married individuals in the United States. We estimate multilevel models of SRH using six observations from 1980 to 2000 from a nationally representative panel of married individuals initially aged 25–55 (Marital Instability Over the Life Course Study). Results indicate that gender, race/ethnicity, and social class are associated with initial SRH disparities. Women are less healthy than men; people of color are less healthy than whites; lower educated individuals are less healthy than higher educated individuals. Women’s health declined slower than men’s but did not di@er by race/ethnicity or education. Results from complex intersectional models show that white men with any college had the highest initial SRH. Only women with any college had significantly slower declines in SRH compared to white men with any college. For married individuals of all ages, most initial SRH disparities persist over twenty years. Intersecting statuses show that education provides uneven health benefits across racial/ethnic and gender subgroups

Job Exit Queues: Corporate Mergers and Gender Inequality

Purpose: to explore the experiences of employees in a local bank merger in the United States and examine the concept of job exit queues. We introduce the concept of a job exit queue, which describes how workers position themselves or are positioned by employers to leave jobs and enter new jobs following the announcement of a corporate merger. Design/methodology/approach: Qualitative interviews with mid-level managers, technical specialists and low status workers during the sale and merger process were conducted and coded thematically. We explore: 1) how workers and managers describe the job search as an “opportunity” or as a recurring cycle of low-wage, high-turnover work and 2) how severance packages structure the job exit queue to meet corporate needs. Findings: The role of severance pay is pivotal in understanding women’s and men’s job relations to job exit queues. We conclude that employers create job exit queues, placing low status workers and mid-level women managers with less formal education at a disadvantage in re-employment. Value: This paper contributes a new concept “job exit queue” to the research and theory on workplace diversity, gender inequality, and queuing theories

Associations of Rheumatoid Arthritis and Depressive Symptoms Over Time: Are There Differences by Education, Race/Ethnicity, and Gender?

Objective. To examine associations between changes in rheumatoid arthritis (RA) symptoms and depressive symptoms adjusted for other time-varying characteristics, and to test if these associations differed by education, race/ethnicity, or gender. Methods. Data from the 1988–1998 US National Rheumatoid Arthritis Study were analyzed (n = 854). Time-varying covariates included year of the study, pain, functional ability, household work disability, parental status, marital status, employment status, and social support. The time-invariant covariates included years since diagnosis, education, race/ ethnicity, and gender. Multivariate multilevel-model analyses were used to estimate associations within people over time. Results. Patients with RA experience considerable change in depressive symptoms, pain, functional disability, and household work disability over the study period. Depressive symptoms were driven more by differences between people compared to changes within people over time. Findings show that patients experienced increases in depressive symptoms over the study period. The rate of change in depressive symptoms did not differ by education, race/ethnicity, or gender. Times of worse pain, functional disability, and household disability were associated with worse depressive symptoms. The association of functional disability and depressive symptoms was stronger for men than women. Conclusion. Increases in pain and disability were associated with worse depressive symptoms, adjusted for covariates. It is important to monitor and treat both mental and physical health symptoms. Future research efforts should focus on collecting data reflecting the educational, gender, and racial/ethnic diversity of individuals with RA

Predictors of First Mental Health Service Utilization among Homeless and Runaway Adolescents

Purpose: To describe and explain variations in first mental health service utilization before and after running away from home for homeless adolescents. Methods: Survey interviews were conducted with homeless and runaway youth in several Midwestern locations. The effects of family of origin factors and street experiences on the likelihood of seeing a mental health professional for the first time before running away and after running away for the first time were examined. Bivariate and multivariate logistic regression methods are used to analyze these data. Interactions are tested across race and gender sub-groups. Results: Caretaker education, caretaker rejection, and family transitions increase the probability that an adolescent first sees a mental health professional before running away from home. Post-run intervention is more likely for females, younger runaways, shelter users, youths with social support networks, and youths abused by their caretakers. A gender gap in first service use exists for Whites but not for minority youth. Minority youth who experienced family abuse were less likely than abused Whites to report ever seeing a mental health professional. Conclusions: Analyses indicate homeless youth’s utilization patterns are differentiated by family of origin factors, street experiences, timing of first utilization, and by race and gender interactions. Our findings suggest that youths whose first contact with mental health service use follows running away for the first time may experience higher levels of mental distress compared with other homeless runaways. The significant differences in first service use across race and gender subgroups should be further explored. The racial-ethnic gap in first mental health intervention for abused youths indicates this sub-group is not receiving services that are available to other homeless youths. Our findings suggest that homelessness does not homogenize racial/ethnic differences in first mental health service utilization

The Impact of Monitoring HIV Patients Prior to Treatment in Resource-Poor Settings: Insights from Mathematical Modelling

Using a stochastic model based on data from Africa, Timothy Hallett and colleagues find that starting HIV treatment based on regular CD4 monitoring, rather than on symptoms, would substantially increase survival

Association between fertility and HIV status: what implications for HIV estimates?

Background: Most estimates of HIV prevalence have been based on sentinel surveillance of pregnant women which may either under-estimate or over-estimate the actual prevalence in adult female population. One situation which can lead to either an underestimate or an overestimate of the actual HIV prevalence is where there is a significant difference in fertility rates between HIV-positive and HIV-negative women. Our aim was to compare the fertility rates of HIV-infected and HIV-uninfected women in Cameroon in order to make recommendations on the appropriate adjustments when using antenatal sentinel data to estimate HIV prevalence Methods: Cross-sectional, population-based study using data from 4493 sexually active women aged 15 to 49 years who participated in the 2004 Cameroon Demographic and Health Survey. Results: In the rural area, the age-specific fertility rates in both HIV positive and HIV negative women increased from 15-19 years age bracket to a maximum at 20-24 years and then decreased monotonically till 35-49 years. Similar trends were observed in the urban area. The overall fertility rate for HIV positive women was 118.7 births per 1000 woman-years (95% Confidence Interval [CI] 98.4 to 142.0) compared to 171.3 births per 1000 woman-years (95% CI 164.5 to 178.2) for HIV negative women. The ratio of the fertility rate in HIV positive women to the fertility rate of HIV negative women (called the relative inclusion ratio) was 0.69 (95% CI 0.62 to 0.75). Conclusion: Fertility rates are lower in HIV-positive than HIV-negative women in Cameroon. The findings of this study support the use of summary RIR for the adjustment of HIV prevalence (among adult female population) obtained from sentinel surveillance in antenatal clinics

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

Occupational Racial Composition and Nonfatal Work Injuries

Is there an association between occupational racial composition and nonfatal workplace injuries? Guided by several labor market theories (queuing, social closure, devaluation, poor market position, and human capital), we use occupational data from the U.S. Census and Dictionary of Occupational Titles combined with individual data from the National Longitudinal Survey of Youth to answer this question. Hierarchical generalized linear models of individuals within occupations show that there is an association between occupational racial composition and workplace injuries, but this association is only statistically significant for white men in the model controlling for relevant occupational and individual level characteristics. A 10 percent increase in the occupation percent black is associated with a 28 percent increase in injury risk. Contrary to expectations, white men have the highest adjusted odds of injury; white women and black men have significantly lower odds of injury than white men. Additionally, occupation-level environmental hazards and individual-level education, hours worked per week, jobs with insurance benefits, working in the South, and specific industries are associated with differential injury risk. These findings are consistent with labor market theories that suggest social closure, market position, and individual skills contribute to differential labor market outcomes. We demonstrate that sociological theories of labor market inequality are useful for understanding workplace injury risk, and that workplace injuries should be studied as an outcome of social inequality. Keywords: occupational racial composition, work injury, health, labor markets, and social inequality