Income under female versus male control: hypotheses from a theory of gender stratification and data from the Third World

This article presents a summary of Blumberg's general theory of gender stratification, which emphasizes relative male/female control of economic resources as a main (although not sole) predictor of a broad array of gender stratification consequences. It also reviews evidence from numerous Third World countries that men and women spend income under their control differently--with women holding back less for themselves and spending more on child nutrition and family basic human needs. Thus the data indicate that when women lose control of income, what is affected is not only their relative marital/familial power (and self-esteem) but also family well-being. Moreover, evidence is presented that planned Third World development projects that rely on female labor but do not provide women with a return to that labor also are likely to suffer: women will attempt to reallocate their efforts to tasks yielding income under their own control. In Africa, where women raise most locally marketed/consumed food and usually have specific familial obligations that require them to have independently controlled income, the bypassing of women farmers and undercutting their returns may be an important--albeit unheralded--factor in the region's food crisis. In sum, the Third World data support both the theory of gender stratification and the relative resources approach to marital power, and point the way to broadening the US marital/family power debate to include male/female spending patterns.     

The contribution of specific causes of death to mortality differences by marital status in the Netherlands

The purpose of this study was to describe the differences inmortality by marital status in the Netherlands in the period1986–1990 for specific causes of death and to estimatethe contribution of each specific cause to the differences intotal mortality. We have used mortality and population datafrom Statistics Netherlands. Poisson regression was used tocalculate relative risks of dying from the specific causes ofdeath. The relative risks and the overall mortality rates wereused to estimate the contribution of the specific causes ofdeath to the differences in total mortality by marital status.For men the general pattern was that the divorced had the highestrisks, followed by the never-married and that the widowed hadrisks closest to married men. For women the general patternwas that the divorced had the highest risks, while widowed andnever-married women alternately had risks closest to marriedwomen. Important exceptions to these risk patterns were foundfor, among others, infectious and parasitic diseases among menand breast cancer among women. External causes of death in particular,contributed more to the excess mortality of the 3 unmarriedgroups of men and women than expected, while the contributionsof malignant neoplasms and diseases of the circulatory systemwere lower than expected on the basis of the percentages ofthese causes of death in mortality in the married population.Since the causes of death that contributed disproportionatelyto the excess mortality of the unmarried almost all have unhealthylifestyles as important risk factors, we argue that the majorityof the mortality differences by marital status can be explainedby social causation (marital status affects health through lifestyledifferences). However, longitudinal data are necessary to ruleout selection effects (effect of health on marital status),preferably controlling for sociodemographic confounders suchas socioeconomic status and taking into account living arrangements.     

Sexual desire and relationship functioning: the effects of marital satisfaction and power

The present study examined the association among marital satisfaction, marital power, and sexual desire in a sample of 60 community couples. We predicted that marital satisfaction would be positively correlated with sexual desire and that this association would be moderated by marital power, such that marital satisfaction would be more strongly correlated with sexual desire among individuals who perceive themselves as having less power in their relationship. Results indicated that marital satisfaction was significantly associated with sexual desire, but there was no evidence for the moderating effects of various forms of marital power.     

Marital status of persons with spinal cord injury

The proposition that persons are selected into and out of marriage on the basis of their health or disability status has often been advanced, but remains untested. This article presents a theoretical rationale for the proposition; provides an initial test of that proposition by comparing the marital status of a sample of persons with spinal cord injury with the marital status of the general public; and elaborates on the proposition by examining the extent to which other factors account for differences in marital status among members of this disabled group. The selected factors were sex, severity of disability (indicated by need for assistance, perceived health, and extent of paralysis), socio-economic status (indicated by adequacy of income and welfare status), current age, and age at onset of disability. A secondary analysis of existing survey data on 251 Oregon residents with spinal cord injury (182 males, 69 females) yielded the following results. The marital selection proposition was supported in that the marital status of this sample differed markedly from that of the general population. The disability exerted a greater effect on the marital status of females than of males. All the selected variables were significantly associated with marital status for one or for both sexes. Discriminant function analyses, employing these variables, identified correctly the marital status of 67.6% of the males, and 75.4% of the females. Profiles of married, formerly married, and single men and women with spinal cord injury are presented. Suggestions are offered for further testing of the marital selection proposition and for elaborating theory linking disability and health status to marital status.     

Psychological distress among Kurdish immigrants in Sweden

AIMS: To analyse whether there is an association between sex and poor self-reported health (SRH) and psychological distress in Kurdish immigrants. METHODS: This cross-sectional study is based on a sample consisting of immigrants, aged 27- 60 years, with self-reported Kurdish ethnicity (n=111, men; n=86, women) in Sweden originating from Iran and Turkey. It is based on data collected in 1996 from the first Swedish National Survey on the living conditions of immigrant groups conducted by Statistics Sweden. The prevalences of reporting poor health, sleeping difficulties, general fatigue and anxiety were estimated by sex. The association between sex and SRH and psychological distress was analysed by an unconditional logistic regression model estimating odds ratios (OR) with 95% confidence intervals. The final model was adjusted for age, marital status, education, housing and employment. Immigrant-specific migration-related variables were used to explore possible reasons for the sex differences. RESULTS: Kurdish men and women had a high prevalence of poor SRH and psychological distress. Age-adjusted odds ratios for anxiety were higher in Kurdish women. Sex differences in anxiety remained even when marital status, education, housing and employment were taken into account. CONCLUSIONS: Kurdish men and women report a high prevalence of poor SRH and indicators of psychological distress. Women had a higher risk for anxiety than men. Negative experiences of pre-migration as well as post-migration experiences, such as economic difficulties, preoccupation with the political situation in the home country, perceived discrimination, and feelings of poor control over one's life, were associated with the outcomes.     

A Logit Analysis of the Likelihood of Leaving Rural Settings for Registered Nurses

This study examined the net effects of individual and community factors on the likelihood of registered nurses leaving current jobs using a logit analysis. Based on data from a survey of 2,509 rural nurses, four separate models were estimated and compared: one for nurses in rural settings as a whole and the other three for nurses in hospitals, skilled nursing facilities, and community/public health agencies. Results of the general model indicated that nurses' marital status, age, position, income, job satisfaction, and satisfaction with the community were significant determinants of the likelihood of leaving current jobs. Job satisfaction was the most significant factor, followed by satisfaction with the community. Findings from the models for three different employment settings were similar to those of the general model. However, the significance of factors and their strength of effect on nurses' decisions to leave or stay in their current jobs differed across the three types of facilities. Based on these findings rural nursing administrators and policy-makers should give priority to retention strategies that focus on improving the job environment. The development of different strategies for different groups of nurses (i.e., by age or marital status) and different types of facilities should increase the benefit/cost ratio. In addition, programs that involve rural health care agencies in community and economic development should be further explored as an avenue to increased nurse retention in rural areas.     

Health behaviours explain part of the differences in self reported health associated with partner/marital status in The Netherlands.

STUDY OBJECTIVE--To describe the differences in health behaviours in disparate marital status groups and to estimate the extent to which these can explain differences in health associated with marital status. DESIGN--Baseline data of a prospective cohort study were used. Directly age standardised percentages of each marital group that engaged in each of the following behaviours--smoking, alcohol consumption, coffee consumption, breakfast, leisure exercise, and body mass index--were computed. Multiple logistic regression models were fitted to estimate the health differences associated with marital status with and without control for differences in health behaviours. SETTING--The population of the city of Eindhoven and surrounding municipalities (mixed urban-rural area) in The Netherlands in March 1991. PARTICIPANTS--There were 16,311 men and women, aged 25-74 years, and of Dutch nationality. MAIN RESULTS--There were differences in relation to marital status for each health behaviour. Married people were more likely to practise positive health behaviours (such as exercise and eating breakfast) and less likely to engage in negative ones (such as smoking or drinking heavily) than the other groups. Control for all six health behaviours could explain an average of 20-36% of the differences in perceived and general health and subjective health complaints. CONCLUSIONS--Differences in health behaviours explained a considerable amount, but not all, of the health differences related to marital status. Longitudinal data are necessary to confirm these findings; to determine whether the differences in health behaviours related to marital status are caused by selection effects or social causation effects; and to learn how social control, social support, and stress inter-relate to reinforce negative or to maintain positive health behaviours.     

Decision‐Making Power,Autonomy, and Communication in Remarried Spouses Compared With First‐Married Spouses*

The current study evaluated differences between remarried and first‐married individuals in communication and standards for autonomy and decision‐making power using self‐report data from 111 remarried and 111 matched first‐married spouses. Remarried spouses endorsed more autonomous standards in childrearing and finances. Also, remarried women endorsed greater autonomy regarding friendships and family. These standards for greater autonomy were not related to marital distress. No differences were found in standards for marital decision‐making power. Remarried spouses did not report more avoidance in communication about marital problems, and avoidance of problem discussion was related to marital distress for both groups.     

Factors associated with cervical cancer screening behavior among Vietnamese women

The purpose of this study was to gather information on the prevalence of pap smear testing among Vietnamese women and to identify predictive factors that influence women to engage in early cervical cancer detection behavior. One hundred and forty-one (141) Vietnamese women ages 18 years and older and living in Western Massachusetts were surveyed by telephone. The overall socioeconomic status of these women was low. Survey results showed that among these women, the use of pap tests was lower than for the U.S. female population in general. Approximately one-half of the respondents reported having had a pap smear. Bivariate and multivariate methods, including logistic regression, were used to analyze the differences between users and nonusers. Bivariate analysis revealed that age, marital status, number of children, religion, regular physician care, and income were significantly related to a prior pap smear experience. The multivariate model for pap test included: age, income, length of residence in the U.S., and marital status. Compared to women who had never had a pap test, women who had were older, married, had higher incomes, and lived in the U.S. longer. It was concluded that this model is useful for screening cancer behavior in Vietnamese women 18 years and older and living in Western Massachusetts, but, in general, should not be used as a cancer screening tool in other populations, at least until similar assessments have been done for these populations.     

Predictors of parenting self‐efficacy in mothers and fathers of toddlers

Background Researchers interested in child developmental outcomes have highlighted the role that parenting self‐efficacy (PSE) plays in psychosocial child adjustment. PSE is a cognitive construct that can be broadly defined as an individual's appraisal of his or her competence in the parental role. PSE has emerged in the literature as an important variable when exploring variance in parenting skills. Despite this, much remains to be learned about PSE. Little is known about the predictors of PSE, with much of the existing research conducted in a piecemeal fashion that lacks a solid theoretical framework. In addition, PSE in fathers has been understudied and relatively little is known about PSE in families with toddler age children. Informed by Belsky's process model of parenting, this study explored similarities and differences in PSE and the predictors of PSE for mothers and fathers of toddlers. Methods A total of 62 cohabiting couples whose first‐born child was 18–36 months old completed self‐report measures of PSE, general self‐efficacy, depression, marital satisfaction, parenting stress, child difficultness and family functioning. Results For fathers, parenting stress and their relational functioning (i.e. marital satisfaction and family functioning) with their spouse predicted PSE scores. For mothers, general self‐efficacy and relational functioning were predictive of PSE. Conclusions and limitations The results of this study support the use of Belsky's process model of parenting to study the predictors of PSE. Important differences were found in the prediction models for mothers and fathers. Future studies need to clarify the nature of parental self‐efficacy beliefs in fathers and continue to use comprehensive theoretical models to identify potentially relevant covariates of PSE. Limitations of the current investigation include reliance on self‐report measures and the homogeneity of the sample.     

The effects of differentiation of self, adult attachment, and sexual communication on sexual and marital satisfaction: a path analysis

This article explores the relations among differentiation of self, adult attachment, sexual communication, sexual satisfaction, and marital satisfaction, in a path analysis model. In a sample of 205 married adults, the path analysis results indicated that (a) differentiation of self had no direct effect on marital or sexual satisfaction, although it was significantly related to sexual communication; (b) adult attachment had a direct effect on marital satisfaction, but not on sexual satisfaction; (c) sexual communication is a mediating variable; (d) sexual communication was positively related to sexual satisfaction and marital satisfaction; and (e) no gender differences existed in the model.     

Path analysis under generalized marital resemblance: evaluation of the assumptions underlying the mixed homogamy model by the Monte Carlo method

Path analysis of nuclear family data has been widely applied to resolve genetic and environmental sources of familial resemblance. Here we report the results of a systematic evaluation of the effects of departures from five modeling assumptions often made when analyzing nuclear family data; i) the observed environmental index is unaffected by the genotype, ii) the basis of marital resemblance is correctly specified in the model, iii) there are no intergenerational differences in either the genetic or cultural heritability, iv) there is no genetic dominance, and v) there is no genotype by family environment interaction. "Deterministic simulations" identified various situations where model misspecification could lead to substantial bias in the estimation of the heritabilities. For these situations, "stochastic simulations" were performed to determine whether the "goodness-of-fit" test used in path analysis would correctly reject the misspecified model. In samples of 500 nuclear families, each comprising two parents and two children, the goodness-of-fit test was found to be sensitive to misspecifications of the source of marital resemblance and the existence of intergenerational differences in heritabilities, although reduced power would make the test less sensitive in smaller samples. The test was largely insensitive to misspecifications of possible genetic effects on the environmental index, and to the existence of multiplicative interaction between the genotype and familial environment. When genetic effects on the index are ignored, the genetic heritability (h2) is underestimated, the cultural heritability (c2) is overestimated, but h2+c2 remains unchanged. Neglecting the interaction was found to result in an overestimate of h2.     

End stage renal disease and the marital dyad: an empirical investigation

The psychological well-being of end stage renal disease (ESRD) patients and spouses was investigated from a dyadic perspective. The responses of patients and spouses from five groups of couples--illustrating different points in the progression and treatment of ESRD--were compared both across ESRD groups and between patients and spouses. Despite the fact that the ESRD groups reflected differences in illness/treatment intrusiveness, no significant differences were found between the ESRD groups, or between patients and spouses, in either marital relations or psychological well-being. However, while for all the participants marital role strain was a significant predictor of psychological well-being, the two dialysis groups evidenced significantly greater correlations between marital role strain and psychological distress than the nondialysis groups. These findings are interpreted as being consistent with a general systems theory approach to the conceptualization and treatment of chronic illness.     

Sex differences in sexuality among medical students: Effects of increasing socioeconomic status

Research has consistently shown that, compared to men, women are more cautious and selective and maintain greater marital aspirations in entering and maintaining sexual relationships. One explanation of this sex difference is that women have traditionally had inferior access to earning power and social status and consequently were forced to acquire socioeconomic status (SES) through their choice of marriage partners. A contrasting view is that this difference is a component of the basic sex difference identified in the Kinsey studies: Men are more likely than women to dissociate coitus from emotional attachment and to desire and seek coitus with a variety of partners. These two explanations were explored in open-ended interviews with matched samples of 20 male and 20 female medical students. The results were more consistent with the perspective of basic sex differences than with the differential resources explanation. Increasing female SES does not appear to eliminate or even substantially reduce this sex difference. Increasing SES tends to enlarge the pool of acceptable, available sexual and marital partners for men while it tends to reduce the pool for women. Increasing SES thus tends to have different effects on men and women and may cause sex differences in the tendency to associate coitus with emotional attachments and marital aspirations to be more, rather than less, apparent. Extensive case data with verbatim quotations are presented to reveal the emotions and desires underlying subjects' overt behavior.     

Does variation in general practitioner (GP) practice matter for the length of sick leave? A multilevel analysis based on Norwegian GP-patient data

In Norway, as in many countries, the national insurance system is under economic stress from demographic change impacting on the pensions versus contributions balance, and an increasing number of disability and sickness benefit claimants. The general practitioner (GP) is responsible for assessing work capacity and issuing certificates for sick leave based on an evaluation of the patient. Although many studies have analyzed certified sickness absence and predictive factors, no studies assess its variation between patients, GPs or geographical areas within a multilevel framework. Using a rich Norwegian matched patient-GP data set and employing a multilevel random intercept model, the study attempts to disentangle patient, GP and municipality-level variation in the certified sickness absence length for Norwegian workers in 2003. We find that most observed patient and GP characteristics are significantly associated with the length of sick leave (LSL) and medical diagnosis is an important observed factor explaining certified sickness durations. However, 98% of the unexplained variation in the LSL is attributed to patient factors rather than influenced by variation in GP practice or differences in municipality-level characteristics. Our findings indicate that GPs practice variation does not matter much for the patients' LSL. Our results are compatible with a high degree of patient involvement in current general practice. Based on this understanding one may infer that GPs play an advocate role for their patients in Norway, where the patients' own wishes are important when decisions are made.     

Antenatal care: a case of the inverse care law?

Abstract: As part of a review of maternity services this study assessed satisfaction with antenatal care among 1193 women who gave birth in Victoria during two weeks of 1989, except for those who had a stillbirth or whose infant died between the birth and the survey. The survey questionnaire was mailed to women eight to nine months after the birth. The response rate, excluding duplicates, women who gave birth outside the survey period and those whose questionnaires were returned because of a change of address was 71.5 per cent. Women attending public hospital clinics were the least satisfied with antenatal care and those attending private obstetricians were the most satisfied, with general practitioners intermediate. These differences by provider accounted for almost all the differences by sociodemographic factors (age, marital status, family income, being of non-English-speaking background and health insurance status). While the majority of women were happy with their antenatal care, an inverse care law still applied: women whose economic and social circumstances meant they were most likely to need ‘care’ from caregivers were more likely to be limited in their choice of caregiver and to be dissatisfied with the care they received.     

Biographical disruption associated with multiple sclerosis: using propensity scoring to assess the impact

Chronic illness such as multiple sclerosis (MS) is often associated with 'biographical disruption', a concept that is derived from qualitative narrative analyses examining how people make sense of their illness in the context of their lives [Bury, M. (1982). Chronic illness as biographical disruption. Sociology of Health and Illness, 4, 167-182]. This paper attempts to operationalise the idea of disruption to one's life trajectory in quantitative analysis by examining the social, economic and emotional disruption associated with MS. A number of studies have suggested that it impacts negatively on employment, income and sexual relationships; however previous research has been based upon samples of people with MS (pwMS), with a dearth of studies comparing pwMS with the general population. This study reports a systematic comparison of MS and non-MS households to enable the impact of MS to be quantified in terms of household composition and marital status; household income; economic activity; and to determine whether biographical disruptions such as relationship breakdown or unemployment are more or less prevalent among those affected by MS compared to the general population. The MS sample came from randomly selected members of the UK MS Society (n=783) and those accessing the MS Society website (n=133). Data for the general population came from the 2001/02 British General Household Survey (GHS). Cases from the MS Society sample were matched using propensity scoring with cases from the GHS. The results of the matched analysis show that both men and women with MS are significantly less likely to be employed than those in the general population and are significantly more likely to have a 'below average' household income, despite the fact that they are in a higher social class and have higher educational levels than people in the general population. Differences between the MS and GHS samples in terms of marital status become non-significant when socio-demographic variables are controlled for using propensity scoring. This study provides robust evidence on how MS impacts on and disrupts the life of the person with MS and their household in terms of income and employment.     

两种模式评估某电网企业职工职业紧张与焦虑症状的关系

目的探讨电网企业职工工作需求-自主(JDC)模式、付出-回报失衡(ERI)模式职业紧张与焦虑症状的相关性及影响因素。方法采用整群随机抽样法,选取广东某电网企业972名职工作为研究对象,采用基本情况调查问卷、工作内容问卷(中文版)、ERI问卷(中文版)、焦虑自评量表对研究对象基本情况、职业紧张和焦虑症状现况进行调查。结果JDC模式职业紧张检出率48.5%,ERI模式职业紧张检出率52.6%。焦虑症状检出率20.2%,不同年龄、婚姻状况、文化程度、工龄及高温高空作业、视屏作业、吸烟、运动、睡眠时间的职工间焦虑症状得分的差异均具有统计学意义(P<0.05)。有焦虑症状者工作需求、外在付出、内在投入得分均高于无焦虑症状者(P<0.05),自主程度、社会支持、回报得分均低于无焦虑症状者(P<0.05)。Logistic回归分析显示,JDC模式中年龄、文化程度、睡眠时间、视屏作业是焦虑症状的影响因素(P<0.05);ERI模式中文化程度、睡眠时间、视屏作业、职业紧张是焦虑症状的影响因素(P<0.05)。结论电网企业职工职业紧张和焦虑症状发生率均较高;文化程度低、睡眠时间短、视屏作业和ERI模式职业紧张均可增加发生焦虑症状的风险。     

Violence between couples]

This article describes variables related to different forms of violence in couples. These variables have been organized in a theoretical model that takes into account cultural factors, sociodemographic and family characteristics, attitudes, and other variables defined as inhibitors and facilitators of violence in conflict situations. For the ACTIVA project, a representative sample consisting of 10,821 people was interviewed in eight cities. For this research on couples, 6,184 of those responses were taken into consideration, from persons who were in a marriage or an unmarried relationship during the year before the interview. The data were obtained from verbal responses to a questionnaire completed in the interviewees' residences. The variables that were clearly associated with couples violence were: socioeconomic level (the fewer the economic resources, the greater the violence), gender (women reported both using and receiving more violence than men did, although the actual level of violence was similar), age (there was more violence between younger people), marital status (there was more violence between unmarried persons), childhood abuse (those most abused in childhood), excessive alcohol consumption (those who have gotten drunk), holding attitudes justifying violence, and having fewer skills to deal with conflicts. Acts of violence, which both men and women commit in relationships, originate in the socialization process, both through the practice of abuse as well as the transmission of values that lead to attitudes justifying violence. A number of things could help markedly reduce the levels of couples violence, including a balance of power between the two persons in the relationship, a modification of attitudes, an improvement in conflict-resolution skills, and a reduction in stress-producing factors.     

中国核电厂操纵人员决策能力的初步探讨

目的 探讨中国核电厂操纵人员的决策能力及其相关性分析。方法 采用整群抽样法,在国内七座核电站随机选取500名操纵人员,应用苏州大学附属第二医院自主研究开发的《中国核电厂操纵人员心理健康和神经行为测评系统2.0版》,对受试者进行心理测试,并记录下决策能力的得分,分析该因子与年龄、工龄、教育程度、婚姻状况等的相关性。结果 本研究中掩饰性因子（Li）得分均小于8分,表明测试结果可信。分析表明,年龄及工龄均可以影响决策能力的均值,而受教育程度和婚姻状况对决策能力的差距无统计学意义。结论 中国核电厂操纵人员决策能力较强,自我管理能力良好,但不同年龄、不同工龄存在明显的差异性（P<0.05）。