Search

This paper explores how social class and race affect the public health policy-making process in an urban area. Ethnographic methods were used to collect and analyze information about HIV/AIDS and tuberculosis policy-making by the Washington, DC Commission of Public Health. Kingdon's conceptual model of policy making was used to analyze and understand the process. The problems of HIV/AIDS and tuberculosis in the district have important social class dimensions that were not always made explicit, but were instead defined in terms of 'race' and 'place'. Social class considerations and racial politics shaped what policies were developed or not developed and implemented successfully or failed. This study, which has national and international implications, concludes that there is a need to improve our understanding of the complex social dimensions of public health problems; there needs to be more consideration of the politics of strategy formulation and how issues of social class and race affect this process; and public health needs to strengthen its constituency in order to build support for the successful development and implementation of policy. Keywords: Social class; Race; Urban health; Health policy; HIV/AIDS; Tuberculosis

This paper examines some shortcomings of self-report questionnaires used to assess alcohol use quantity and frequency and demonstrates the advantages of qualitative interviews to more accurately capture drinking patterns among adolescents. The paper considers alcohol use among two ethnic groups of Black adolescents and discusses variations in rates of alcohol consumption. Qualitative interview data collected from African-American and Haitian adolescents suggest higher rates of alcohol consumption than indicated in previous studies of Black adolescents. Furthermore, qualitative interview data demonstrate greater differences across groups in drinking patterns, including amount and type of alcohol consumed in different cultural contexts than have quantitative-based studies. Strategies are suggested for improving the methodology used to assess drinking patterns among adolescents. Keywords: Alcohol measurement; Qualitative methods; Adolescent drinking patterns; Cultural variation

The paper examines the use of the new measure of social class in the UK, the National Statistics Socio-Economic Classification (NS-SEC) and other socio-economic variables in explaining differences in health between British South Asians and the majority White population. There are a number of hypotheses which try to explain ethnic differences in health and yet there have been relatively few empirical studies which test the explanatory value of these hypotheses. Cross sectional data from the fourth National Survey of Ethnic Minorities (1993-1994) with 2860 white, 1268 Indian and 1771 Pakistani and Bangladeshi adult respondents are analysed. The associations of self-rated health with ethnicity, social class, local area deprivation and standard of living are analysed. Pakistani and Bangladeshi respondents have the poorest self-rated health, followed by Indians. Differences in self-rated health between ethnic groups reduce to non-significance after adjusting for social class, local area deprivation and standard of living. There is some evidence of social class differences in the health of Indians and not much evidence for Pakistanis and Bangladeshis. The NS-SEC is useful in explaining ethnic differences in health. The poorer health of Indians, Pakistanis and Bangladeshis compared to Whites may be largely understood in terms of factors related to occupational social class, material living conditions and local area deprivation. Keywords: Inequalities; Social class; NS-SEC; Ethnicity; British South Asians

In recent years, research on menopausal symptomalogy has focused on identifying symptom groupings experienced by women as they progress from premenopausal to postmenopausal status. However, most of these studies have been conducted among Caucasian women from western cultures. This leaves open the question of whether the findings from these studies can be extended to women of other racial/ethnic groups or cultures. Furthermore, many of the previous studies have been conducted on relatively small samples. This paper addresses the diversity of the menopause experience by comparing symptom reporting in a large cross-sectional survey of women aged 40-55 years among racial/ethnic groups of women in the United States (Caucasian, African-American, Chinese, Japanese, and Hispanic). Evaluation of the extent to which symptoms group together and consistently relate to menopausal status across these five samples provides evidence for or against a universal menopausal syndrome. The specific research questions addressed in this paper are: (1) How does the factor structure of symptoms among mid-aged women compare across racial/ethnic groups? (2) Is symptom reporting related to race/ethnicity or menopausal status? and (3) Does the relation between menopausal status and symptoms vary across racial/ethnic groups? Analyses are based on 14,906 women who participated in the multi-ethnic, multi-race, multi-site study of mid-aged women called the Study of Women's Health Across the Nation (SWAN). Study participants completed a 15-min telephone or in-person interview that contained questions on a variety of health-related topics. Items of interest for these analyses include symptoms, menstrual history (to assess menopausal status), health status, and sociodemographics. Factor analysis results showed that across all five racial/ethnic groups, two consistent factors emerged; one consisting of clearly menopausal symptoms -- hot flashes and night sweats -- and the other consisting of psychological and psychosomatic symptoms. Results of regression analyses showed racial/ethnic differences in symptom reporting, as well as differences by menopausal status. Controlling for age, education, health, and economic strain, Caucasian women reported significantly more psychosomatic symptoms than other racial/ethnic groups. African-American women reported significantly more vasomotor symptoms. Perimenopausal women, hormone users, and women who had a surgical menopause reported significantly more vasomotor symptoms. All of these groups, plus postmenopausal women, reported significantly more vasomotor symptoms than premenopausal women. The pattern of results argues against a universal menopausal syndrome consisting of a variety of vasomotor and psychological symptoms. Keywords: Menopause; Symptoms; Ethnicity; Culture; United States

Previously we have reported population differences in sexual restraint such that, higher socio-economic status > lower socio-economic status, and Mongoloids > Caucasoids > Negroids. This ordering was predicted from a gene-based evolutionary theory of r/K reproductive strategies in which a trade-off occurs between gamete production and social behaviors such as intelligence, law-abidingness, and parental care. Here we consider the implications of these analyses for sexual dysfunction, including susceptibility to AIDS. We conclude that relative to Caucasians, populations of Asian ancestry are inclined to a greater frequency of inhibitory disorders such as low sexual excitement and premature ejaculation and to a lower frequency of sexually transmitted diseases including AIDS, while populations of African ancestry are inclined to a greater frequency of uninhibited disorders such as rape and unintended pregnancy and to more sexually transmitted diseases including AIDS.