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This paper contrasts economic and professional models of physician admitting behavior. Economic models emphasize physician convenience and income maximization, while professional models emphasize physician autonomy and independence. The paper examines the relative power of these models to explain two types of admitting decisions made by physicians: which hospitals to begin admitting patients to, and how many patients to admit to a hospital. Analyses of physician admitting patterns over a three-year period suggest that economic considerations outweigh professional considerations in both decisions. Results are interpreted in light of recent changes in the profession of medicine and physician-hospital relationships. [ABSTRACT FROM AUTHOR]

This paper explores alternative explanations for the recent sharp decline in cocaine use among high school seniors, using questionnaire data from annual nationwide surveys conducted from 1976 through 1988. Results show important parallels with earlier analyses of the longer-term decline in marijuana use. Although lifestyle factors (e.g., religious commitment, truancy, evenings out for fun and recreation) show strong links with use of marijuana and cocaine, these factors have not developed trends in ways that can account for the declines in use of either drug. Reported availability of either drug has not been reduced. Instead, increases in perceived risks and disapproval appear to have contributed substantially to the recent declines in use of marijuana and cocaine. The findings provide strong support for the use of realistic information about risks and consequences as an important ingredient in efforts to prevent drug use. Coupled with the findings on availability, the results emphasize the importance of efforts to reduce demand (as opposed to supply). [ABSTRACT FROM AUTHOR]

More than 100 studies have cited M. Harvey Brenner's (1973) claim that fluctuations in the economy increase the onset of mental illness and thus generate increases in mental hospitalization. Published attempts to replicate Brenner, however, have considered only twentieth-century data. One of Brenner's most memorable claims was that a stable inverse relationship between mental illness and the economy could be seen over a 127-year span beginning in the early nineteenth century. Unfortunately, no research since Brenner's has considered nineteenth-century populations. In this paper we analyze the hypothesis that economic change provokes a substantial fraction of first admissions to mental hospitals. We used admissions registers from the three institutions to construct a data base that approximates a psychiatric case register for a nineteenth-century American city from 1881 to 1891. Time-series tests show no support for the "provocation" hypothesis. [ABSTRACT FROM AUTHOR]

This paper probes two aspects of the medical profession in Singapore: its structure and its social position. The first section reviews the relevant concepts concerning the structure and the social position of the professions that may be applied to medicine in Singapore. The second section looks into the structure of the medical profession in Singapore from an historical perspective. The third section deals with the internal organization of the medical profession. The fourth section focuses on its social position. The paper concludes with a summary of the main points and a brief comparison of the situation in Singapore with that in other countries. [ABSTRACT FROM AUTHOR]

This paper presents information on the role and significance of social support for the occurrence of health and birth problems among adolescent mothers and their babies. Pregnant teenagers (N = 268) were interviewed during the course of pregnancy and again approximately four weeks after delivery, and hospital records were abstracted. The significance of family support, friend support, and partner support, assessed during the pregnancy, were examined in relation to infant and mother outcomes assessed at or after the birth. Infant outcome was indexed by birth weight, with gestational age controlled; mother outcome in terms of psychological adaptation was indexed by depressive symptomatology among adolescent mothers. Socioeconomic background was found to influence relationships between social support and both infant and mother outcomes. [ABSTRACT FROM AUTHOR]

This paper is based on ethnographic research in a rural Taiwanese village in which married women with children are a major source of labor for local industry. Responsibility for job and home exposes these women to repeated stressors that can increase their susceptibility to illness. Existing explanatory models linking employment and women's health, however, do not explain adequately the women's response to their wage labor and the consequences of the social aspects of their work on their health. This paper describes women's work and its meaning, and discusses the way in which micro phenomena such as meanings and health states are linked to macro phenomena such as national political-economic processes and the world capitalist system. [ABSTRACT FROM AUTHOR]

This paper presents a critical overview of current concepts and analytic practices in stress research and considers how they can be changed to make the research more consistent with core sociological interests. An overarching concern of the paper is the analytic use of basic information about people's social and institutional affiliations and statuses. It is important that such information be treated not simply as data that need to be controlled statistically; we must examine the bearing of these data on each domain of the stress process: the exposure to and meaning of stressors, access to stress mediators, and the psychological, physical, and behavioral manifestations of stress. The conceptualization and measurement of stressors should move away from their focus on particular events or chronic strains and should seek instead to observe and assess over time constellations of stressors made up of both events and strains. Moreover, the effects of the mediators—coping and social support—are evaluated most fruitfully in terms of their effects in limiting the number, severity, and diffusion of stressors in these constellations. Finally, sociological stress researchers should not be bound to outcomes that better serve the intellectual interests of those who work with biomedical and epidemiological models of stress, nor should the research be committed exclusively to a single outcome. [ABSTRACT FROM AUTHOR]

Emphasis on rural health problems has led to a relative neglect of urban health issues in developing societies. Yet the fact that a large proportion of the limited financial and human resources is allocated to urban health care makes it imperative for researchers and health planners to evaluate the effectiveness of the urban health care system. This paper examines data on health care utilization from a sample survey of 1500 households conducted in three areas of Accra, Ghana in 1982. The factors that influence the use of three types of health care services (clinics, drug vendors, and traditional healers) are examined. Suggestions are made for increasing the effectiveness of the health care system in Accra, with the aim of making medical care more accessible to all families. [ABSTRACT FROM AUTHOR]

When I began my psychiatric residency training in Boston in the late 1950s, sociologists and other social scientists were active members of many major academic departments of psychiatry. Collaboration between psychiatrists and sociologists and anthropologists was widespread and had considerable influence on theory and clinical practice. NIMH had established its Laboratory of Socio-Environmental Studies under the leadership of John Clausen. Sociologists and anthropologists were active in policy-making and research activities at NIMH and at many foundations. The influential works of Stanton and Schwartz (1954), Hollingshead and Redlich (1958), and Greenblatt, Levinson, and Williams (1957) reflect this period of collaboration. Over the subsequent three decades, the relationship between sociology and psychiatry changed considerably. Now relatively few academic departments of psychiatry have social scientists on their full-time faculty. Interaction between psychiatrists and social scientists, in many instances, has become adversarial. This adversarial quality, I believe, is reflected in the paper by Mirowsky and Ross. Their paper illustrates a genre of social science criticism of psychiatry which challenges the scientific validity of the concept of mental illness and raises important issues in measurement. Mirowsky and Ross, however, go beyond the scientific issues; they offer a social criticism of recent changes in psychiatry which they perceive to be the "legacy of nineteenth-century epidemiology and microbiology." Mirowsky and Ross are correct in their perception that significant shifts have occurred within psychiatry over the past decade. Yet their historical reconstruction of those changes and their understanding of the scientific basis for current research and clinical practice are seriously limited; they reflect their ideological commitment more than an appreciation of the increased sophistication of recent theoretical discourse and empirical research in psychiatry. In my commentary I will attempt to correct this imbalance by reconstructing the recent history and by explicating the rationale behind the current approach to psychiatric diagnostic categories. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to examine the effects of political ideology and self-interest on the attitudes of medical students toward national health insurance. Previous empirical studies of the relative importance of ideology and self-interest in explaining attitudes and behavior have been conducted on general population samples. This is the first empirical test of the effects of these factors on the attitudes of professionals in general and of medical students in particular toward a policy issue which is important to their material interests, but which evokes ideological responses at the same time. The findings show that political ideology as well as objective and subjective self-interest are independent dimensions. Both factors are related strongly to medical students' attitudes toward national health insurance. Their relative strength varies considerably with the salience of the issue at hand. Almost uniformly, political ideology has a more pronounced impact on attitudes than does objective self-interest. The differences between the effects of political ideology and of subjective self-interest, however, are not always substantial or significant. [ABSTRACT FROM AUTHOR]

This paper provides a critical review of the social science literature regarding maltreatment of patients in nursing homes. First, two conceptual issues are addressed: problems in defining maltreatment and a rationale for sociological study of the phenomenon. Next, the paper presents a theoretical model of potential causes of patient maltreatment, including exogenous variables, nursing home environment, and staff and patient characteristics. An agenda for research is outlined based on the model. [ABSTRACT FROM AUTHOR]

This paper examines the process of psychiatric diagnosis in a community mental health center walk-in clinic. The results indicate a great deal of conflict and contradiction in the psychiatric evaluation. This is discussed in light of several tensions: (1) mixed agendas surrounding diagnosis; (2) conflict between training and professional practice; (3) conflict created when a public facility is staffed by an elite medical school; (4) conflict between providing mental health services while serving the needs of other public agencies and mandates; and (5) conflict between an ascendant biopsychiatric model and the daily work of clinical therapeutic service. [ABSTRACT FROM AUTHOR]

This paper attempts to explain the higher psychological distress and psychological vulnerability of women and the unmarried as a function of greater exposure to uncontrollable life events (including network events) and perceived lack of control over life circumstances. Panel data on a sample of 1,106 adult heads of household living in Chicago provide measures of relevant variables. Contrary to expectation, event exposure is inconsistently associated with gender and marital status; instead, exposure depends on the types of roles held by individuals. Although group members at higher risk of disturbance perceive less control over their lives, these perceptions neither singly nor jointly with event exposure, explain gender or marital status differences in psychological distress or in vulnerability to negative events in general. In light of these findings, the utilities of a "common stress" and a "unique stress" approach for explaining status differences in symptoms are contrasted. [ABSTRACT FROM AUTHOR]

This paper utilizes a social constructionist perspective to examine the widespread belief among physicians during the early 1980s that an oversupply of doctors was either present or imminent. It was found that the timing and growth of physician beliefs in a "physician glut" during this period could not be adequately explained by net increases in the physician supply, either on an absolute level or relative to the growth of the general population. Rather, this "fact" of a physician surplus was found to be more fruitfully explored as an emergent social phenomenon grounded in the historical evolution of physician-supply themes and the particular clinical practice environment in which physicians found themselves in the late 1970s and early 1980s. [ABSTRACT FROM AUTHOR]

This is a "state of the issue" paper about gender and physical health. It organizes the hypotheses proposed for male-female differences in physical health status, therapeutic health behaviors, and longevity and it summarizes empirical research, especially sociological research, on the topic over the past 10-15 years. Capsule summaries of sex differentials in health and of recent trends in health and morality are also presented for American (U.S.) men and women. The central theoretical viewpoint of this paper is that sex differences in health are principally the outcome of differential risks acquired from roles, stress, life styles, and preventive health practices. Psychosocial factors—how men and women perceive and evaluate symptoms, and their readiness and ability to take therapeutic actions—are important as well, but typically secondary to acquired risks. Other factors such as prior health care, biological risks, health reporting, and caretaker effects (for example, physician sex bias) have even smaller importance. We hypothesize that the relative weight of acquired risks and psychosocial factors varies for different types of health problems as follows: (1) Psychosocial factors have their greatest weight in responses to chronic, nonfatal, or low severity diseases and injuries and (2) gender differences are also greatest in responses to these; that is, men and women differ more in their perception, evaluation, and treatment of prolonged, mild conditions than of acute, life-threatening, or severe ones. The paper suggests some strategies for social science research on male-female health differences in the next decade or two. [ABSTRACT FROM AUTHOR]

This paper reports a study of the premedical student culture at a major university, based on fieldwork and interviews with 30 premedical students. The paper examines the role of stereotypes in the premedical culture; specifically, the common belief in "cut-throats" among premedical students. Cut-throats are described as excessively competitive, selfish, gradehungry students who cheat, steal books and lab reports, and sabotage lab experiments. Despite the widespread belief, our findings suggest cut-throats are a myth. We found more evidence for cooperative than cut-throat behavior. The myth emerges from the competitive and pressured situation of premedical students and the uncertainty of the medical school admission process, and is in part a manifestation of students' collective anxiety. More significantly, it provides cultural explanations for failure and success for premedical students. We discuss its connection to the general premedical stereotype and its relation to pre-medical education. [ABSTRACT FROM AUTHOR]

This paper empirically examines the reliability and validity of three measures of the health of the elderly: an index measuring the ability to perform the activities of daily living without help (Index of Living Skills), an index measuring functional disability (Shanas's Index of Disability), and an index measuring chronic health conditions (the index subsequently used in the U.S. Health Insurance Study). The data involve a random sample of elderly persons living in Manitoba in 1971. The analyses used -- correlational matrices, factor analyses, internal consistency reliability coefficients, and construct validity -- are reported separately for those living in conventional housing in the community, in subsidized housing, and in institutions providing some form of medical care. The results suggest that the Index of Living Skills measures not one but two underlying constructs (heavy and light tasks), Shanas's Index of Disability is reliable and valid when used among those living in the community and in institutions but not among those in subsidized housing, and the index of chronic conditions is relatively unreliable among all three groups of elderly persons. [ABSTRACT FROM AUTHOR]

This paper reports on a prospective longitudinal study in which various aspects of the stress process were examined. Findings indicate that events perceived to be desirable and, therefore, presenting opportunities for gain or mastery were not stressful. Events that were neither desirable nor within control led to distress, symptoms, and physician visits. A longitudinal analysis demonstrated stability of both health and stress and their relationship to one another. While there was an association between stressful events and poorer health, a much weaker relationship was found in regard to change in health. Poorer health resulted in more stress. The stress-illness relationship was not mediated by either expectations of control or effectiveness of social supports. Locus of control predicted baseline levels of distress but showed no relation to change in distress over time or to symptoms. A reciprocal relationship was found between social supports and stressful events. [ABSTRACT FROM AUTHOR]

The proposition that medical treatment decisions can be modified by altering the structural conditions of medical practice has been advanced, but seldom demonstrated empirically. This paper examines the structural conditions under which obstetricians personally opposed to abortion will offer abortion services. Data were obtained in a survey of all private obstetricians practicing in one state during 1975-76. Results of this study indicate that obstetricians with liberal attitudes toward abortion will offer abortion services regardless of the normative structure in which they are located; the treatment decisions of conservative obstetricians, however, are dependent on normative climate. In a practice environment where prevailing professional norms favor abortion, the majority of conservative obstetricians will offer abortion services, despite their personal opposition to this procedure. In an unfavorable climate, however, the behavior of conservative obstetricians is consistent with their attitudes, and relatively few provide abortion services. [ABSTRACT FROM AUTHOR]

The contention that retirement may have an adverse effect on health has become increasingly popular with the recent categorization of this phenomenon as a stressful "life event." The small number of empirical studies examining the health outcomes of retirement, however, appear neither to support nor to refute this hypothesis. Moreover, the serious methodological problems inherent in most of these studies caution against the generalization of findings. o This paper examines the existing research on the health and retirement relationship within the theoretical context of Atchley's process approach to retirement. Recent refinements in the study of life events (e.g., a focus on the timing of the event and the degree of control experienced) are seen as offering important potential contributions both to our understanding of retirement and to the development of more incisive and conceptually sound research in this area. At the same time, the inadequacy of existing life-events scales when applied to an older age group, and the genera/failure to view life changes within a broad sociostructural context are emphasized as weaknesses of the life-events approach that should be taken into account in future research on the complex retirement and health relationship. [ABSTRACT FROM AUTHOR]

This paper examines some major discrepancies in the literature on illness behavior involving psychosocial and organizational factors affecting physician utilization. At issue is why the large-scale multivariate studies find that such factors explain only small amounts of variation, whereas qualitative and more restricted quantitative studies find these predictors to be more influential. Among the factors accounting for discrepancies in results are the interpretation of "illness" measures, differences in concept measurement and data aggregation, and the cross-sectional versus processual analytical approaches to studying this issue. It is suggested that the advantages of both types of studies can be combined, facilitating improved theory and prediction. [ABSTRACT FROM AUTHOR]

By comparing national survey data collected in 1957 and 1976, this paper assesses the stability of relationships between social class and the use of professional help for personal problems, examining the influence of education and income on: (a) problem definition, (b) the decision to seek help, and (c) the choice of a particular help source. In spite of a general increase in "readiness for self-referral" from 1957 to 1976 for the population as a whole, social class differences in defining a problem as relevant for professional help and in adopting a self-help position with regard to potential problems (both reported in 1957) generally persist in 1976. Among those who have identified a personal problem as relevant for help, however, social class differences in the actual use of help, apparent in 1957, have largely disappeared. Despite a marked increase in the use of mental health professionals in all socioeconomic strata, education and income differences in the use of psychiatrists and psychologists found in 1957 also generally persist in 1976, although the gap between high- and low-income groups appears to be narrowing. Although perceived psychological distress is found to play a major role in seeking help, differences in professional help-seeking by socioeconomic status are largely independent of reported symptom levels. These patterns of persistence and change are interpreted as reflecting differential changes in the influence of motivational versus facilitating factors, respectively. [ABSTRACT FROM AUTHOR]

Empirical evidence does not support the claim that task delegation to nonphysicians is greater in large medical organizations than in small office practices. Can the behavior of physicians in these organizations he explained through reference to professional attitudes? This paper reports a study which examined simultaneously two sets of variables as predictors of physicians' delegation behavior: (1) paramedical resources available in the organization, and (2) physicians' professional attitudes. A comparison of multiple regression analyses of delegation behavior in traditional work settings and in modern, formally organized settings is presented. In modern settings, in contrast to traditional settings, physicians' delegation behavior was found to be only weakly related to paramedical resources, and it was unrelated to professional attitudes. [ABSTRACT FROM AUTHOR]

This paper examines the association between psychological distress and persons' perceptions of their physical well-being. Associations between psychological distress and ratings of health status within four diverse data sets are examined, controlling for physical health status as well as for sociodemographic variables. The results indicate that, despite variation in the characteristics of the populations under study, the mode of data collection employed, and the specific questions used to measure psychological distress, distress remains a statistically significant correlate of perceived health status. [ABSTRACT FROM AUTHOR]

This paper examines stability and change in reported subjective stress during one year among 263 wives whose husbands suffered a first myocardial infarction. Patterns of subjective stress scores remained relatively stable over the study year. Level of severity of illness in the husband had some relationship to stress score at particular points in time, although clear-cut findings did not emerge. Some variations in subjective stress levels were also found between women of different educational and ethnic backgrounds. Reported subjective stress is reviewed as part of a more general stress experience, reflected in emotional volatility and marital unhappiness, rather than as a correlate of such variables as illness burdens in the household, employment of wife, age, and socioeconomic status. [ABSTRACT FROM AUTHOR]

This paper attempts to show the importance of including variables relating to providers of care in a full explanation of utilization of ambulatory care services. Data were obtained via interviews in a sample survey of Rhode Island households conducted in 1974. The concept of an affiliation with a medical care provider is developed and the number of affiliations is used as a provider or pattern of care variable to include in a multiple regression equation to explain utilization of ambulatory care services. The two key predictors of utilization are the number of affiliations and the number of conditions. Other important variables are total family income and a dummy variable representing whether or not a person has some form of government aid (such as Medicare or Medicaid) in paying for health costs. As the number of affiliations and number of conditions increases, utilization increases. Having a government-sponsored form of aid also increases utilization. A negative relationship is found between income and utilization. Together the variables included in the regression equation explain 40.4 percent of the variance, thus indicating the importance of including variables relating to affiliations and to how people actually obtain care in future attempts to explain utilization. [ABSTRACT FROM AUTHOR]

This paper focuses on the question of what characteristic of life events is responsible for their link to psychological disorder, is it the readjustment (i.e., change) inherent in such events or is it their undesirable or threatening character? New data on this issue are presented in the context of previous findings from three studies. The combined evidence favors undesirability as the characteristic of life events that should be measured to most accurately assess their stressfulness. This basic conclusion holds up for a variety of different dependent measures, different methods of defining the desirability of events, and varying ways of weighting events. [ABSTRACT FROM AUTHOR]

This paper has two primary purposes. The first involves the empirical assessment of a general framework for theory and research in health service utilization studies, developed as a modification of Aday and Andersen's (1974) causal structure of access to medical care. My analysis of this framework uses multiple regression techniques on data from a regional cross-sectional survey of 487 households conducted in 1972. The data demonstrate support for the general framework. The second purpose centers around the extant findings that health maintenance organization (HMO) subscribers are less satisfied with their health care than are the conventionally insured. Using the general framework to see what health service utilization characteristics were likely to predispose one to join an HMO, I found that would-be joiners are more likely to be high users of preventive services. Because the main purpose of the HMO is to increase the use of preventive services, and assuming a reasonable rate of diminishing returns of such care, then a "ceiling effect" takes place in which the would-be joiner cannot increase use of preventive care very much, and hence is plausibly and expectably less satisfied with the HMO. [ABSTRACT FROM AUTHOR]

This paper presents findings on the relationship between race and mental health extracted from a major five year epidemiologic study conducted in the southeastern United States. Mental health scores on five separate psychiatric scales are compared for blacks and whites. These comparisons are made in two ways. First, simple correlations using Tints and analysis of variance are computed; then the variable race is included with age, sex and socioeconomic status in a stepwise multiple regression equation. The results show that blacks had higher mean scores than whites on all the scales: the differences are statistically significant on every measure. When controlled for the oilier sociodemographic factors, however, the variable black is statistically significant in only two of the equations and in one of these the significance level is quite minimal. Being black is a highly significant variable when scores on a phobia scale are analyzed. In every instance, low socioeconomic status is the most powerful predictor of high mental health scores. The authors conclude that there is no definitive evidence that race alone is a primary etiologic factor in accounting for differences in the rates of mental illness between blacks and whites. [ABSTRACT FROM AUTHOR]

Drawing upon participant observation data from a number of studies of wards instate schools for the "mentally retarded," this paper presents findings dealing with attendants' perspectives. More specifically, it deals with those aspects of attendants' definitions of supervisors, their jobs, and residents that relate to the implementation of "innovative" programs designed by supervisory and professional staff to serve the needs of the residents. [ABSTRACT FROM AUTHOR]

Republicans and conservatives report better self-rated health and well-being compared to Democrats and liberals, yet they are more likely to reside in geographic areas with heavy COVID-19 morbidity and mortality. This harmed health on "both sides" of political divides, occurring in a time of rapid sociopolitical upheaval, warrants the revisiting of psychosocial mechanisms linked to political health differences. Drawing on national Gallup data (early 2021), we find that predicted differences in health or well-being vary substantially by ideology, party, voting behavior, and policy beliefs, with model fit depending on how politics are measured. Differences in self-rated health, psychological distress, happiness, trouble sleeping, and delayed health care tend to reveal worse outcomes for Democrats or liberals. Such differences often are reduced to insignificance by some combination of mastery, meritocratic beliefs, perceived social support, and COVID-19–related exposures and attitudes. Policy beliefs predict health differences most robustly across outcomes and mechanism adjustments. [ABSTRACT FROM AUTHOR]

In early 2020, when COVID-19 began to spread in the United States, many Twitter users called it the "Chinese virus," blaming racial outgroups for the pandemic. I collected tweets containing the "Chinese virus" derivatives posted from March to August 2020 by users within the United States and created a data set with 141,290 tweets published by 50,695 users. I calculated the ratio of users who supported the racist naming of COVID-19 per county and merged Twitter data with the county-level census. Multilevel regression models show that counties with higher COVID-19 mortality or infection rates have more support for the racist naming. Second, the mortality and infection rates effects are stronger in counties with faster minority growth. Moreover, it is mainly in poor counties that minority growth enlarges the effects of infection and mortality rates. These findings relate to the theories on disease-induced xenophobia and the debate between conflict and contact theories. [ABSTRACT FROM AUTHOR]

This paper develops hypotheses regarding the impact of select organizational factors on the distribution of service among applicants to health or welfare agencies. It is hypothesized that agencies with more control over exchange with their environments, i.e. more "boundary control," will under conditions of surplus applicants choose to serve smaller and more homogeneous applicant populations. Also, applicants will tend through referral and rejection processes to flow from agencies with high boundary control to agencies with low boundary control. The extensiveness of agency domains is hypothesized to be directly related to both the size of the applicant populations and the number of applicants serviced. Finally, the size of "domain discrepancy" is seen as directly related to the proportion of applicants rejected and referred. The necessity to relate other organizational characteristics to referral and rejection patterns is stressed. [ABSTRACT FROM AUTHOR]

This paper presents results from an exploratory study of the utilization behavior of lower working-class families in Aberdeen, Scotland. It is shown that, after controlling for such factors as social class, educational level, geographical proximity to, and knowledge of available services, the underutilizers exhibit a different social profile from the utilizers with respect to a number of variables, postulated as being possibly related to utilization behavior. The underutilizers appear to sustain a crisis existence, experiencing lack of permanent accommodation, over-crowding, marital instability, financial difficulties, and frequent sickness in the family. Utilizers appear to avoid most of these problems and to plan for their future lives. The circumstances surrounding the first conception (whether or not it was post-nuptial, on the one hand, or pre-nuptial or illegitimate, on the other), appear to be a main distinguishing variable between the two study groups. [ABSTRACT FROM AUTHOR]

Hypotheses relating family socio-cultural background to behavioral retardation of children are examined in this paper. Data obtained from a stratified-random sample of all Anglo and Mexican-American households in a southern California city of about 100,000 population are used in the research. Generally, the data support the existence of a relationship between family socio-cultural factors of ethnicity, social status, community of origin, and residential mobility and the behavioral retardation of children. When ethnic groups are considered separately, more variance is explained by socio-cultural factors for Mexican-Americans than for Anglos. For both Mexican-Americans and Anglos, the single most important variable explaining families with and without a behaviorally retarded child is mother's education. [ABSTRACT FROM AUTHOR]

Nothing the limited understanding of group dynamics among health reseachers using corrective group, this papers proposes that a number of principles already estalished in the field of small groups might be used facilite the processes of comformity and social control in correctve groups. An exploratory experiment designed to test the effects of several group charactiristics was conducted wth smoking cessation group. The experiment, with smoker wishing to quit, included four conditions: one with experimeter attention; a second with attention and simple group environment; a commitment, and goal interdependence. it was hypothesized that pressures toward comformity and control would increase with the addition of each successive characteristics, and that smoking reduction among the conditions would be ordered along this pressure dimension. The results of the experiment support the hypothesis; smoking reduction increased directly for use in corrective groups are discussed. [ABSTRACT FROM AUTHOR]

This paper evaluates and describes methods for making psychiatric distinctions. It is by means of psychiatric distinctions that individuals are labeled mentally ill or mentally well. Within the mentally ill category, patients are differentially placed according to the severity and type of their mental illness. The placement of individuals into psychiatric categories is an essential prerequisite not only to the clinical treatment of patients but also to any research where the objective is to determine empirical regularities associated with mental illness. Until the patient is categorized, the practitioner has no logical guide for how to perform treatment or even whether he should treat the patient—i.e, the patient may not be a patient. Similarly, unless the psychiatric researcher has categorized his subjects according to some notion of mental illness he has no way of making comparisons or of assessing change, the two essential processes in research. Thus, the logical first step for arty discovery of new knowledge in the field of mental illness is to appraise the reliability and validity of methods for making psychiatric distinctions. No research findings can be more reliable or valid than the psychiatric distinctions used in carrying oat the research. [ABSTRACT FROM AUTHOR]

The reality of hunger in America recurred as a political issue throughout the decade of the 1960's. This paper analyzes an attempt by academicians and other professionals to force the President and the United States Congress to feed starving people. In describing the internal politics and power group pressures that evolved over the issue of hunger, the author analyzes an intervention model of interest to action-oriented social scientists. [ABSTRACT FROM AUTHOR]

Much research has been done in the past fifteen years on the effects of medical education, viewed as professional socialization. Although the significance of social origins, viewed as early sources of socialization, is recognized, there has been little empirical research on the effects of specific background characteristics on specific attitudes, behavior, and careers of professionals. This paper examines the effects of practicing physicians' socioeconomic and religious background on their concern with success values and on their political ideology, including their attitudes toward government participation in medical care. [ABSTRACT FROM AUTHOR]

A four- to six-year follow-up study of a random sample of male schizophrenics is used to assess the relationship between a modified form of Phillips and Zigler's social competence index and prognosis. The results support the finding of Zigler and Phillips of a relationship between the index and hospitalization. Additional analyses are presented indicating that this relationship persists once the effects of differential severity of pathology are controlled and suggesting the relative influence of the various components of the index. A major issue in this paper is the question of how these results should be interpreted. On practical grounds it is contended that the observations can be largely explained on the basis of social system considerations. In terms of theory, it is suggested that the index does not provide a satisfactory operationalization of the concept of competence but rather, like hospitalization, amounts to an outcome measure which is influenced by a series of variables, among them the individual's degree of competence. [ABSTRACT FROM AUTHOR]

The efforts of occupational groups to raise their professional status resembles many of the activities of social movements. In this paper occupational group striving viewed as a social movement is demonstrated as being a significant factor in the development of negative orientations toward impoverished or lower class clients. The research centered on investigations of the orientations and behaviors of three occupational groupings within public health—physicians, nurses and sanitarians. The hypothesis that members of highly striving occupational groups would be significantly more negative in their orientations toward the poor or the lower class client was verified. [ABSTRACT FROM AUTHOR]

This paper proposes a theoretical framework and an empirical example of the relationship between the civic stratification of immigrants in the United States, and their access to healthcare. We use the 2007 Pew Hispanic Center/Robert Wood Johnson Foundation Hispanic Healthcare Survey, a nationally representative survey of U.S. Latinos (N = 2,783 foreign-born respondents) and find that immigrants who are not citizens or legal permanent residents are significantly more likely to be excluded from care in both the United States and across borders. Legal-status differences in cross-border care utilization persisted after controlling for health status, insurance coverage, and other potential demographic and socioeconomic predictors of care. Exclusion from care on both sides of the border was associated with reduced rates of receiving timely preventive services. Civic stratification, and political determinants broadly speaking, should be considered alongside social determinants of population health and health care. [ABSTRACT FROM AUTHOR]

Education has a large and increasing impact on health in America. This paper examines one reason why. Education gives individuals the ability to override the default American lifestyle. The default lifestyle has three elements: displacing human energy with mechanical energy, displacing household food production with industrial food production, and displacing health maintenance with medical dependency. Too little physical activity and too much food produce imperceptibly accumulating pathologies. The medical industry looks for products and services that promise to soften the consequences but do not eliminate the underlying pathologies. This “secondary prevention” creates pharmacologic accumulation: prolonging the use of medications, layering them, and accruing their side effects and interactions. Staying healthy depends on recognizing the risks of the default lifestyle. Overriding it requires insight, knowledge, critical analysis, long-range strategic thinking, personal agency, and self-direction. Education develops that ability directly and indirectly, by way of creative work and a sense of controlling one’s own life. [ABSTRACT FROM AUTHOR]

This paper analyzes data from a nationally representative survey of adults in the United Kingdom (Understanding Society, N = 37,253) to explore the marital status/health nexus (using categories that include a measure of relationship distress) and to assess the role that sleep problems play as a potential mediator. Findings indicate how it is not just the “form” marital status takes but also the absence or presence of relationship distress that is essential to self-rated health. We demonstrate two further findings that: (1) sleep problems act as a mediator of the link between marital status/relationship distress and self-rated health, most notably for those in cohabiting relationships with medium/high distress or who have a history of relationship loss, and (2) the mediating role of sleep problems differs for divorced men and women. [ABSTRACT FROM AUTHOR]

Analyses of the 2008 National Study of the Changing Workforce demonstrate that job pressure is associated with greater anxiety and job dissatisfaction. In this paper we ask, What conditions protect workers? The conventional buffering hypothesis in the Job-Demands Resource (JD-R) model predicts that job resources should attenuate the relationship. We test whether the conventional buffering hypothesis depends on socioeconomic status (SES). Support for conventional buffering is evident only for job dissatisfaction—and that generalizes across SES. When anxiety is assessed, however, we observe an SES contingency: Job resources attenuate the positive association between job pressure and anxiety among workers with lower SES, but exacerbate it among those with higher SES. We discuss the implications of this SES-contingent pattern for theoretical scenarios about “resource reinforcement,” “resource substitution,” and the “stress of higher status.” Future research should consider SES indicators as potential contingencies in the relationship between job conditions and mental health. [ABSTRACT FROM PUBLISHER]

This paper takes a comparative approach to the topic of work time and health, asking whether weekly work hours matter for mental health. We hypothesize that these relationships differ within the United States and Germany, given the more regulated work time environments within Germany and the greater incentives to work long hours in the United States. We further hypothesize that German women will experience greatest penalties to long hours. We use data from the German Socioeconomic Panel and the National Longitudinal Survey of Youth to examine hours effects on mental health score at midlife. The results support our initial hypothesis. In Germany, longer work time is associated with worse mental health, while in the United States, as seen in previous research, the associations are more complex. Our results do not show greater mental health penalties for German women and suggest instead a selection effect into work hours operating by gender. [ABSTRACT FROM AUTHOR]

This article presents information for contributors on the procedure for preparing and submitting research papers and manuscripts for publication.

New evidence on a classic sociological debate allows for a test of the consequences of self-labeling with mental illness. While a medicalized "insight" perspective emphasizes the importance of self-labeling for psychological well-being and recovery, a sociologically informed "outsight" perspective draws from modified labeling, self-labeling, and stigma resistance theories to suggest that self-labeling can generate negative consequences for self-esteem. We engage this debate by examining the effects of mental illness self-labels on a crucial component of psychological well-being for persons with mental health problems—self-esteem—by using longitudinal data that followed 427 sixth-grade youth over two years. Our findings support an outsight perspective whereby adopting a self-label led to decreased self-esteem, while those who dropped a self-label experienced increased self-esteem. This conclusion calls for revisions to prevailing public mental health models that overlook how self-labels can impede rather than enhance psychological well-being and recovery efforts. [ABSTRACT FROM AUTHOR]

Infant health problems are a persistent concern across the United States, disproportionally affecting socioeconomically vulnerable communities. We investigate how inequalities in infant health contribute to differences in interneighborhood commuting mobility and shape neighborhoods' embeddedness in the citywide structure of employment networks in Chicago over a 14-year period. We use the Census Bureau's Longitudinal Employer–Household Dynamics' Origin–Destination Employment Statistics to analyze commuting networks between 2002 and 2015. Results from longitudinal network analyses indicate two main patterns. First, after the Great Recession, a community's infant health problems began to significantly predict isolation from the citywide employment network. Second, pairwise dissimilarity in infant health problems predicts a lower likelihood of mobility ties between communities throughout the entire study period. The findings suggest that infant health problems present a fundamental barrier for communities in equally accessing the full range of jobs and opportunities across the city—compounding existing inequalities. [ABSTRACT FROM AUTHOR]

Faith-based pregnancy centers strive to offer "alternatives to abortion" that supporters claim aid women and critics assert manipulate pregnant people, stigmatize abortion, and potentially delay clients from obtaining medical care. However, scholars know little about the exchanges within appointments and how clients make sense of these experiences. Drawing on ethnographic observations of client appointments in two pregnancy centers in the West and 29 in-depth interviews with clients, this article uses an intersectional framework to analyze client experiences. Clients favorably compared centers to clinical health care providers, emphasizing the unexpectedly attentive emotional care they received. These evaluations stem from clients' reproductive histories, which are shaped by gender, racism, and economic inequalities that configure their access to and interactions within the health system. Emotional care serves to create and maintain pregnancy centers' impression of legitimacy among clients. [ABSTRACT FROM AUTHOR]