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This paper examines whether the use of blood pressure medication has an influence on social inequalities in blood pressure levels. In Norway, cardiovascular disease has for decades been associated with high mortality and social inequalities. High blood pressure is an important risk factor in this aspect, and prescription drugs have been established as a standard treatment of hypertension. We have seen population blood pressure levels fall, blood pressure inequality levels remaining stabile, and medication use increase. The paper uses panel data from the Nord-Trøndelag Health Study linked with registry data on education and income. Results from fixed effects regression analyses indicate that blood pressure medication overall has a levelling effect. The traditional social gradient is mainly found among non-users of medication. With blood pressure medication being plausibly at a late stage of its diffusion, these findings give some support to the hierarchical diffusion model, while they also imply the need for equal access to sufficient blood pressure treatment. [ABSTRACT FROM AUTHOR]

The nutritional health and wellbeing of children, and by extension their weight, is a heated topic in contemporary discussions of food and health, particularly for low-income populations. Despite contrary understandings, there remains a dominant societal framing that parents – in particular low-income mothers – are solely responsible for the status of their children's health and wellbeing. In this paper, we examine how low-income mothers are positioned within the academic literature to reveal where responsibility for children's health and well-being is positioned. We present a meta-synthesis of 18 qualitative studies to identify how mothers' food choices and feeding are positioned, and the recommendations that researchers identify for promoting child health within this discursive terrain. We found that low-income mothers faced multiple challenges relating to cost, convenience, concerns about health and wellbeing. However, many of the recommendations made by researchers focused extensively on behavioural interventions aimed at the vulnerable mother rather than structural interventions to support mothers' feeding practices. We argue that discourses of low-income motherhood must recommend structural, and not just individual, change to counteract dominant constructions of the 'vulnerable-empowered mother'. [ABSTRACT FROM AUTHOR]

One of the obstacles to understanding the links between social inequality and mental health distress is the reliance on heterogeneous diagnostic categories. In this paper, it is argued that a solution to this problem is to explore more homogenous experiences of distress. This paper investigates one particular form of distress: paranoia. The relationship between social inequality and paranoia is then examined, focusing on two aspects. Firstly, it is argued that social inequality might affect the experience of paranoia itself since the experience of the surveillance encountered in the everyday use of public space may vary depending on one's location in social categories like gender, 'race' and culture and class (these social categories are, of course, themselves stratified by social inequality). Secondly, mental health service users' locations in these categories may influence the way that the plausibility of ostensibly paranoid claims are evaluated by mental health professionals. Within the discussion of each category, links are drawn between community and clinical samples to understand how the experience of paranoia may be influenced by these social categories. The paper concludes with implications for research and policy. [ABSTRACT FROM AUTHOR]

Suicide is a very contemporary issue in the USA. Despite the social characteristics related with suicide, the discipline of sociology has remained relatively silent on the issue. This paper builds upon Durkheim's approach by using social capital theory as a framework to examine suicide rates across 2688 US counties. Using ordinary least-squared regression modelling, we found that counties with higher rates of social capital, diversity, and population density experienced lower suicide rates. Counties that had higher levels of divorce, unemployment, poverty, education, and median age experienced higher suicide rates. [ABSTRACT FROM AUTHOR]

Australia is rapidly becoming home to an increasing number of Polynesians. While the Maori/Pacific Islander 'economic migrant' may appear fit and healthy, statistically the incidence of diabetes, hypertension and cardiovascular disease is extremely high. When this profile is coupled with family reunion migration of older relatives who are living longer, it represents an escalation of current and future outlay for Australian health services. Qualitative semi-structured interviews were conducted with 67 Polynesian migrants in regard to their perceptions of health and illness, and their experience of health services in Sydney and the Hunter region of New South Wales. Three key respondents, all Polynesian nurses practising in Australia, were also interviewed. The findings indicate a concentration of disadvantage concerning educational achievement, skill levels and health literacy that reinforce the process whereby social disadvantage impacts on health outcomes. This study also reveals a nexus of issues around cultural behaviours and poverty that contribute to the incidence of obesity-related illness and limit compliance with recommended preventative measures and treatments. This paper includes a discussion of the socio-political context of health delivery to Maori and Pacific Islander migrants and how the contraction of services under neoliberal 'belt tightening' undermines potential capacity to treat culturally and linguistically diverse (CALD) populations effectively. As Australian scholarship has traditionally concentrated on Melanesia, there is very little research on Polynesians who are one of our burgeoning migrant groups. This study therefore makes a timely contribution to redressing the lack of literature on Polynesian health, cultural practices and socio-economic positioning in this country. [ABSTRACT FROM AUTHOR]

The increased use of information technology in health care allows researchers to generate data on rates of medication use among population groups, raising questions as to whether these rates are too high or too low. This paper presents findings from a study of records of all prescription medication dispensed in one New Zealand region (Te Tāirawhiti) over a one year period. The study examined patterns of psychotropic medication use amongst older people, by age, gender, ethnicity and socio-economic position. It concludes that the chances of being defined as needing psychotropic medication, that is, of being 'medicalised', are not evenly spread through the elderly population. Gender, age and ethnicity impacted significantly on whether prescriptions were received. Our results suggest the need for a nuanced understanding of the medicalisation of unhappiness and deviant behaviour amongst the elderly which takes into account barriers to treatment for some social groups. [ABSTRACT FROM AUTHOR]

Many western countries have experienced increased rates of youth suicide over recent years. This has been an issue of particular concern in New Zealand, since it had the highest rate of youth suicide among OECD countries in the mid-1990s. However, while attention is drawn to the now declining youth suicide rate by politicians and policy-makers, what is obscured is a cohort effect. In this paper we will argue that a cohort effect is clearly visible; suicide rates among 15-24 year olds came to the fore in the mid-1980s, peaking 10 years later, and were displaced by that among 25-35 year olds by the late-1990s. Further, this century has been characterised by the rise of suicide rates among 35-44 year olds. This effect correlates with a dramatic downturn in the New Zealand economy in a five-year period bracketing 1970. We argue for an increased focus on social and economic factors underlying suicide. [ABSTRACT FROM AUTHOR]

This study examines the association between educational attainment, relative to that of an intimate partner, and all-cause mortality for men and women in different-sex relationships. Research suggests some health benefits for partnered adults that arise from economic benefits and improved access to health-promoting tools. One way these benefits could be gained is through the pairing of the highly educated. While high individual educational attainment lowers mortality risk, less is known about the risks of mortality associated with one's education, relative to their partner's education. Using National Health Interview Survey Linked Mortality Files (NHIS-LMF) for the years 1999–2014 with prospective mortality follow-up through December 2015 (N = 347,994), we document the association between relative educational attainment and mortality for men and women with different-sex partners in the United States. Fully adjusted Cox proportional hazard models revealed a higher risk of all-cause mortality for men and women who have more education than their partner, relative to those having the same education as their partner. For women only, having less education than their male partner was associated with a lower risk of all-cause mortality. A better understanding of relative status within different-sex partnerships provides insights into partnered adult's mortality risks. [ABSTRACT FROM AUTHOR]

Households are important health contexts, providing social, emotional, financial and material support, but little is known about the role of household composition in the social etiology of Indigenous health. Our research is framed by an Indigenous standpoint, using eight waves of data from the Longitudinal Study of Indigenous Children. We investigated whether household composition and change in household composition were associated with the self-reported general health of Indigenous children and their mothers, adjusting for socioeconomic, household structure and social support factors. Our measure of household composition comprised eight groups differentiating lone and couple parents, living with and without other children and adults. Study children in couple households with other children and adults were 16% less likely to have excellent health and mothers in these same households were 7% less likely to report excellent health than children and mothers in couple households. We find little evidence that mothers in lone parent households have poorer health than mothers in couple households, after adjustment for covariates. Change in household composition was positively associated with health for both children and mothers. The results caution against presuming a direct translatability of research findings from non-Indigenous to Indigenous Peoples. [ABSTRACT FROM AUTHOR]

Over the last two decades, childhood obesity has emerged as a major public health issue in Switzerland. Health professionals and public health organisations now frame this condition as a disease that requires medical intervention. In this article, I report the findings of an ethnographic study conducted in a Swiss hospital program for the management of childhood obesity. The study explored the impact of the medical treatment of childhood obesity on children's lives. Using a Bourdieusian approach to guide my analysis, I found that the experience of the therapy varies substantially according to children's socioeconomic position. Children with a high SES seem to encounter less difficulties in adapting their lifestyle to professionals' recommendations than low SES children, because their habitus facilitates the internalisation of health norms and they have greater access to economic, social and cultural capitals. Therefore, childhood obesity management tends to reproduce health inequalities between children. [ABSTRACT FROM AUTHOR]

Fundamental Cause Theory suggests the replacement of mechanisms that produce the persistent relationship between socioeconomic status and health over time. Understanding how this process operates is central to explaining the reproduction of health inequality. We use data from the Onco-barometer survey (2010) to test a set of hypotheses derived from FCT, Diffusion Of Innovations theory and the intersection between these theories to examine how socioeconomic inequality emerges and evolves across the cycle of diffusion of six relevant preventive practices in Spain: faecal occult blood tests, prostate-specific antigen tests, Papanicolaou tests, mammograms, cholesterol readings and blood-pressure checks. Because these preventive measures are characterised by differing rates of spontaneous knowledge and use amongst the Spanish population, we assume that they are at different stages in the diffusion cycle. Results suggest that SES has a dynamic influence according to the diffusion stage of each preventive measure. We argue that the conjunction of these theories offers a dynamic 'imagery' that can help to explain the generation and diminishment of inequalities. Moreover, this integration has the potential to bring 'social change' back into the study of health inequalities, which is essential to understanding equitable (and inequitable) returns produced by preventive innovations. [ABSTRACT FROM AUTHOR]

Although an increasing number of studies emphasise migrants' knowledge about their healthcare rights as crucial for their healthcare usage, almost none examine the conditions under which migrants acquire this knowledge. This study contributes to the literature by studying the main determinants of migrants' knowledge about their healthcare rights: Self-interest and necessity, human capital, and social capital. I use unique data collected through the project Migrants' Welfare State Attitudes (MIFARE), where we surveyed 10 different migrant groups within Denmark, the Netherlands, and Germany on their relation to the welfare state, including healthcare. Analysing a total sample of 6,864 migrants using multinomial logistic regression analyses I find that migrants' knowledge about their healthcare rights depends mainly on their education and language skills. Both factors enable migrants to grasp health-related information and to become informed about their healthcare rights. I also observe a network effect since healthcare experiences of family members contribute to migrants' healthcare knowledge. Social ties to the co-ethnic community, however, do not explain why some migrants know more about their healthcare rights than others. Lastly, I find large differences between migrant groups, which remain even after controlling for all relevant factors. [ABSTRACT FROM AUTHOR]

It is widely acknowledged that people with higher socioeconomic positions and women smoke less, avoid alcohol abuse, and eat more healthily. Yet far less is known about the interaction of socioeconomic status with gender, especially in the Italian context. Here we address this issue by employing Abel’s adaptation of Bourdieu’s cultural capital theory and Courtenay’s theory of gender construction and health. Using 2012 data from the Multipurpose survey on Daily Life, we first show that cultural capital is better than social class in predicting an adult’s compliance with health recommendations, although this does not hold true for alcohol intake. We then look at the interaction of gender with cultural capital measures in order to determine how gendered forms of consumption change with increasing levels of cultural capital. The results show that the gender gap diminishes at higher levels of cultural capital following a twofold pattern: most often men’s marginal benefit increases at a higher rate than that of women; however, we also find evidence that the gap diminishes because women start adopting unhealthy behaviours as their level of cultural resources increases. Overall, these findings indicate that cultural capital plays an important role in reconstructing gender role models. [ABSTRACT FROM AUTHOR]

This article presents an approach to understanding health that acquires an original and autonomous development across different Latin American countries, despite being the result of reading and analysing national and international theoretical contributions from social sciences. The proposal seeks to integrate the epidemiologic perspective with those from the social sciences, sociology, and medical anthropology in particular, raising the need to place health problems in their socio-historic, cultural, political and economic context. From this framework, such aspects must be treated not only as epidemiological variables but, above all, as sociocultural and bio-ecological processes. It suggests to conceptually work from a perspective that investigates health-disease as a social process, an area of life in which most of the meanings, representations and practices that allow the reproduction of daily life are articulated. For that, we place the contributions in the field of Collective Health, present the main criticisms and limitations that have been raised to modern epidemiology and, from there, we develop theoretic-methodological proposals of ethno-epidemiology and sociocultural epidemiology directing the analysis towards the development of a superseding episteme. [ABSTRACT FROM AUTHOR]

In this article we approach socioeconomic inequities in cancer by examining a particular dimension of health care: how health services attending patients with cancer set priorities for their daily activities. By using qualitative ethnographic data, we explore logics underlying how practitioners make priority-setting decisions regarding cancer prevention and care. We found four main types of accounts: accounts based on macro social inequalities, accounts based on patients' social and cultural features, accounts based on characteristics of health services, and accounts based on personal voluntarism. These blurred logics shape the everyday decisions which have an impact not only on the quality of health care in general but on the increasing socioeconomic inequities in cancer care attention. [ABSTRACT FROM AUTHOR]

Informed by Bourdieu and Passeron's theory of reproduction, we investigated relationships between the cultural and economic capitals of South Korean parents and the capitals and self-rated health of their adult children in cross-sectional survey data from the 2006 Korea Welfare Panel Study. Parental education and childhood economic circumstances manifested independent associations with the self-rated health of the adult respondents. Much of the connection between parental capitals and respondent self-rated health was explained by respondent education. Educational attainment and household income but not receipt of monetary inheritance from their parents were significantly associated with the self-rated health of the respondents. Lastly, parental educational attainment was associated with the self-rated health of the women but not the men over and above the capitals held by the respondents themselves. Our study illuminates the importance of the intergenerational transmission of multiple forms of capital in the production of good health for South Korean adults. In particular, we propose that wealthy and well-educated South Korean parents employ their capitals to develop math and linguistics skills in their children that facilitate good performance in the standardised university entrance exams, success in the labour and/or marriage markets and, ultimately, good self-rated health for their adult children. [ABSTRACT FROM AUTHOR]

Using the stress process model with a sample of 475 Louisiana newlyweds, this research explores whether a more legally rigorous form of marriage (covenant marriage) substantially reduces depressive symptom disparities between Black and White spouses. Results suggest that Black and White wives share similar depressive symptom levels in the first few months of their marriage. Black husbands have higher levels of depression than White husbands. Life stressors substantially mediate the race gap in depressive symptoms for husbands, while buffers have little effect. After controlling for stressors, buffers and demographic measures, covenant marriage seems to buffer wives against depressive symptoms, though only weakly. For husbands, covenant marriage has no effect and does not reduce the race gap in depression. Thus, while covenant marriage may either select on wives with better mental health or buffer against depressive symptoms for some wives, covenant marriage does not have advantages for husbands, and especially distressed Black husbands. [ABSTRACT FROM AUTHOR]

Health literacy, which relates to the acquisition, understanding and application of health information, has become an increasingly important public health issue, particularly where parents and children are concerned. Given that the home setting comprises a strong influence on children's diets, this qualitative study explored the concept of health literacy using parents' experiences with health information seeking and food related parenting practices. Semi-structured focus groups and in-depth interviews were conducted with parents, with children aged from birth to 12 years, in a low socio-economic region of South Australia. The results of this study indicated that there were a number of perceived barriers to accessing, understanding and utilising health information related to children's nutrition. These findings contribute to a broader understanding of how parents obtain and process dietary information and the channels through which they appear to be accessible. [ABSTRACT FROM AUTHOR]

Higher income societies have moved from institutional to community-based care for people experiencing mental illness. However, stigma and discrimination persists and undermines help-seeking, recovery and life chances. Mental illness prevalence is higher amongst communities that face multiple prejudices and disadvantages within society, including Black and minority ethnic communities who may experience migration trauma, racism, acculturation and adverse social circumstances. This study examines beliefs, stigma and the effectiveness of existing national mental health campaigns with Pakistani, Indian and Chinese heritage communities in Scotland, UK, using community based participatory research. Community organisers were trained and supported to co-facilitate focus groups with 87 people using a range of languages. Whilst diversity within and between communities was apparent, important trends emerged. People with mental illness experience high levels of stigma from communities. Families experience significant associated stigma. This shame combines with culturally inappropriate services to reduce help-seeking from mental health services, friends and families. Existing anti-stigma campaigns have failed to reach or engage with communities due to a combination of practical issues such as the use of inappropriate language, imagery and media, but also due to assuming western medical concepts of illness. Participants suggested a new model for national campaigns placing greater emphasis upon community development, cultural events, positive contact and dialogue with families, faith leaders and youth groups. National anti-stigma programmes must develop more effective partnerships with communities or risk magnifying existing inequalities. Despite a range of national programmes to address stigma towards people with mental illness, it remains as the major barrier to social inclusion for people with mental illness living in communities. Stigma is particularly severe if people have a mental illness and are also economically disadvantaged or face multiple stigmas. By adopting community based participatory research (CBPR) approaches with three Black and ethnic minority communities in Scotland, this study makes the case that stigma can only be understood and effectively addressed with reference to its socio-cultural context. [ABSTRACT FROM AUTHOR]

This study explored Aboriginal perspectives of child health and wellbeing in an urban area in partnership with Aboriginal people and organisations. In depth interviews were conducted with 25 grandparents, parents, aunties or uncles of Aboriginal children. Interviews were transcribed and thematically analysed. A major conceptual theme was related to social, historical, and political factors seen by participants as influencing urban Aboriginal child health and wellbeing. This theme was called 'Strengths and Challenges: Harder for Koori Kids/Koori Kids Doing Well'. Increased challenges to achieving good health and wellbeing faced by Aboriginal children due to factors in their social, historical and political environment were emphasised. Many of these factors can be related back to historical and contemporary forms of racism. On the other hand, there was also a clear call to recognise and celebrate that many Aboriginal children were doing well in the context of these added challenges. [ABSTRACT FROM AUTHOR]

The study, designed as a pilot, aimed to explore lay perceptions of air quality from participants who were selected to represent three different social categories: age; health status; and geographical location. We compared responses from younger with older participants who held memories of about air quality prior to the Clean Air Act (1956). We also explored possible differences in perception due to health status by including some participants who identified themselves as having asthma. Finally, we compared possible differences in perception between two economically and geographically distinct areas of Greater Nottingham in England. Semi-structured interviews were carried out with 22 participants recruited through schools, church groups and residential homes. Our findings suggest that no air (apart from the seaside) is perceived as automatically safe and therefore healthy. We found that perceptions of 'good' air seem to vary with age and health whereas experiences of air quality are associated with socio-economic status. Perceptions of air are shown to be suffused with historical significance, as well as embodying projections embedded from within the local environment and material context. [ABSTRACT FROM AUTHOR]

The aim of this article is to highlight a link between housing and health that may have been underestimated: the pathway from poor health towards marginal housing in caravan parks. Almost all research on links between housing and health is derived from large-scale surveys and correlational analyses which suggest a causation path from poor housing to poor health. The big picture of such studies may in fact disguise a reality for a smaller group where poor health leads to class 'slide' and reduced housing options. Qualitative data and life histories from interviews probe such 'reverse' links and also flesh out contextual backgrounds. It is argued in this article that evidence from interviews with 10 caravan park managers and 50 residents from 16 parks in outer Melbourne and rural Victoria supports general arguments that poor health appears to be a pathway leading to marginal housing. [ABSTRACT FROM AUTHOR]