Social science & medicine
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Social science & medicine · Apr 2009
Job loss is bad for your health - Swedish evidence on cause-specific hospitalization following involuntary job loss.
This paper examines the impact of job loss on a number of non-fatal health events, which are nonetheless severe enough to require hospital in-patient care. We focus on job loss due only to establishment closures, as this reduces the problem of distinguishing between causation and selection. ⋯ During a subsequent 12-year period, we find that job loss significantly increases the risk of hospitalization due to alcohol-related conditions, among both men and women, and due to traffic accidents and self-harm, among men only. We find no evidence, however, that job loss increased the risk of severe cardiovascular diseases such as myocardial infarction or stroke.
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Social science & medicine · Apr 2009
Comparative StudyPioneers and laggards - is the effect of gender equality on health dependent on context?
This study combines data at individual and area level to examine interactions between equality within couples and gender equality in the municipality in which individuals live. The research question is whether the context impacts on the association between gender equality and health. The material consists of data on 37,423 men and 37,616 women in 279 Swedish municipalities, who had their first child in 1978. ⋯ Traditional mothers in a traditional municipality have the lowest level of sick leave and pioneers the highest. These results show that there are distinct benefits as well as disadvantages to being a gender pioneer and/or a laggard in comparison to your municipality. The associations are markedly different for men and women.
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Social science & medicine · Apr 2009
Writing social determinants into and out of cancer control: an assessment of policy practice.
A large literature concurs that social determinants of health (SDH) are demonstrable, important, and insufficiently attended to in policy and practice. A resulting priority for research should be to determine how the social determinants of health can best be addressed. In this paper we support the more effective transfer of social determinants research into policy by: (1) describing a qualitative analysis of thirty-two cancer control policy documents from six English-speaking OECD countries and two transnational organizations, demonstrating great variability in the treatment of social determinants in these policies; (2) critiquing these various policy practices in relation to their likely impact on social determinants of health; and (3) advancing a tool that policy writers can use to assess the way in which social determinants of health have been addressed in their work. ⋯ These five discourses implied, respectively: that group membership was intrinsically risky; that not enough was known about SDH; that risk arose from choices made by individuals; that groups were constrained by circumstance; or that structural change was necessary. Socio-cultural factors were generally presented negatively, though New Zealand policies modeled a possible alternative. Based on their empirical work, the authors propose a matrix and a set of questions to guide the development and assessment of health policy.
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Social science & medicine · Apr 2009
ReviewRelationships between health and culture in Polynesia - a review.
This review of journal articles and book chapters discusses the health beliefs characteristic of Polynesia and reveals several themes. These are: commonality in health conceptualisations across the cultures of the region which differ from the conceptualisations of biomedicine; the role of the relational self, traditional living and communalism in understanding health; the place of spirituality and religion in health and illness causation; and pluralism and pragmatism in health-seeking behaviour. Suggestions are made as to how awareness of key ideas might contribute to effective planning of health promotion and intervention activities.
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Social science & medicine · Apr 2009
Case ReportsCommunity-based delivery of maternal care in conflict-affected areas of eastern Burma: perspectives from lay maternal health workers.
In settings where active conflict, resource scarcity, and logistical constraints prevail, provision of maternal health services within health centers and hospitals is unfeasible and alternative community-based strategies are needed. In eastern Burma, such conditions necessitated implementation of the "Mobile Obstetric Maternal Health Worker" (MOM) project, which has employed a community-based approach to increase access to essential maternal health services including emergency obstetric care. Lay Maternal Health Workers (MHWs) are central to the MOM service delivery model and, because they are accessible to both the communities inside Burma and to outside project managers, they serve as key informants for the project. ⋯ They suggest that some emergency obstetric care services that are conventionally delivered only within healthcare settings might be feasible in community or home-based settings when alternatives are not available. This paper provides an opportunity to hear directly from community-based workers in a conflict setting, perspectives seldom documented in the scientific literature. A rights-based approach to service delivery and its suitability in settings where human rights violations are widespread is highlighted.