Communication on health and safety risk control in contemporary society: an interdisciplinary approach

This paper discusses communication as a technology for risk control with health and safety protection and promotion, within the context of a "risk society". As a component of Risk Analysis, risk communication is a technology that appears in risk literature, with well defined objectives, principles and models. These aspects are described and the difficulties are stressed, taking into consideration the multiple rationales related to risks in the culture and the many different aspects of risk regulation and control in the so-called "late modernity". Consideration is also given to the complexity of the communications process, guided by theoretical and methodological discussions in the field. In order to understand the true value of the communications field for risk control with health and safety protection and promotion, this paper also offers an overview of communication theories that support discussions of this matter, proposing a critical approach to models that include the dimensions of power and culture in the context of a capitalist society.     

Hawaiian health practitioners in contemporary society

Hawaiian medical practices in Hawai'i became fragmented and deteriorated following the arrival of Western civilization. With the resurgence of Hawaiian pride, interest has risen to preserve what remains of Hawaiian healing methods. The purpose of this study is to determine the extent to which Hawaiian healing modalities are still in existence and practiced in the 1990s by Hawaiian health practitioners. Twenty-five Hawaiian health practitioners on the island of O'ahu agreed to in-depth interviews on their specific training and current practices of Hawaiian healing. Data collection included demographic characteristics, cultural attributes, training patterns, healing modalities, motivation to practice, spirituality and health, use of Hawaiian medicines, and training of haumana (students). Common practices as well as differences between practitioners and specialties were explored. This study found that a small, but substantive, component of Hawaiian healing is practiced by a growing number of Hawaiian practitioners. Content analyses identified two major components of Hawaiian healing: (1) attributes of Hawaiian culture, and (2) elements of spirituality in health and healing. Three significant modalities remain: ho'olomilomi, massage; la'au lapa'au, herbal medicine; and ho'oponopono, conflict resolution. Seventeen or 68% reported being skilled in more than one healing modality and 56% were training haumana. All practitioners reported apprenticeships under one or more master healers or a recognized elder healer--often a family member. Prior to, and after, the administration of any healing modality, spiritual blessings were administered by all practitioners to initiate the healing process and end the healing session. Hawaiian values--such as lokahi, harmony between man, nature, and the gods--are essential for holistic health. Without lokahi, there is illness. In summary, this study provides data that previously did not exist on contemporary Hawaiian health practitioners. Public health planners and health care professionals may find this information useful in developing culturally competent health programs for Hawaiian clients or patients.     

Work stress and mental health in a changing society

BACKGROUND: The aim of this representative study in the Hungarian population was to analyse the association between work-related factors and self-reported mental and physical health after controlling for negative affect and hostility as personality traits. METHODS: The effects of job related factors on Beck Depression Score, WHO well-being score and self-rated health (SRH) were analysed in a representative sample of 3153 male and 2710 female economically active Hungarians. RESULTS: In both genders negative affect was the most important correlate of depression, well-being and SRH, whereas hostility was closely associated only with depression. Job insecurity, low control and low social support at work, weekend work hours, job-related life events and dissatisfaction with work and with boss were independent mental health risk factors, but there were important gender differences. Job related factors seem to be equally important predictors of mental health as social support from family. CONCLUSION: The results of this large national representative study indicate that independent of negative affect and hostility, a cluster of stressful work-related psychosocial conditions accounts for a substantial part of variation in self-reported mental and physical health of the economically active population in Hungary.     

Security, insecurity and health

An examination of the nexus of security, insecurity and health shows that security is a prerequisite for health. The many and varied ways that armed violence--including threats of armed violence--can affect people's health can be documented by formal studies; however, valuable data also exist in other reports, such as media reports. The health community needs to recognize that people's insecurity is a massive global health issue. The foreign policies of donor governments should incorporate recognition that documentation, analysis and publication of data describing the impact of insecurity on people's health can lead to the creation of policies to enhance people's security.     

Food insecurity and cardiovascular health: Findings from a statewide population health survey in Wisconsin

BackgroundThe social and economic environment has become a major area of interest regarding the determinants of cardiovascular health. Among markers of economic distress, food insecurity has been found associated with metabolic disorders, dyslipidemia, and obesity, but no previous studies have examined its association with overall cardiovascular health.Methods and resultsWe conducted a cross-sectional analysis among 2935 participants in the Survey of the Health of Wisconsin (SHOW), a statewide population-based representative sample. The presence of food insecurity was determined by an affirmative answer to the question “In the last 12 months, have you been concerned about having enough food for you or your family?” Cardiovascular health (CVH) was defined based on the American Heart Association Life's Simple 7 criteria and classified as “poor,” “intermediate,” or “ideal” using previously published criteria. “Good” CVH was defined as having no poor in any of the seven criteria (any amount of intermediate or ideal). Crude and adjusted odds ratios (OR) of good CVH according to presence of food insecurity were calculated using logistic regression models. Overall, food insecurity was associated with a decreased likelihood of good CVH (OR 0.53; 95% Confidence Interval 0.31 to 0.92; p = 0.02). This association persisted in models controlling for age, gender, race, and urbanization.ConclusionsParticipants who were food insecure were significantly less likely to have good CVH compared to participants who were food secure. Even though this study cannot confirm causality, these results suggest that food insecurity might be one of several socio-economic barriers contributing to poor CVH.     

Job insecurity and health.

As employers respond to new competitive pressures of global capitalism through layoffs and the casualization of labor, job insecurity affects a growing number of workers. It appears to harm mental health, but less is known about its effects on physical health and health behaviors and the mechanisms through which it may act. The prevailing individual-centered conceptualization of job insecurity as the perception of a threat to job continuity precludes systematic investigation of the social patterning of its health effects. Analysis of data from a 1994 Canadian national probability sample of adults determined that high levels of job insecurity lowered self-rated health and increased distress and the use of medications, but had no impact on heavy drinking. The findings support one possible mechanism of action whereby job insecurity reduces feelings of control over one's environment and opportunities for positive self-evaluation; these psychological experiences, in turn, have deleterious health consequences. There is little evidence of social patterning of this relationship by gender, education, household income, age, marital status, and social support at work.     

Population aging and health information from the National Household Sample Survey: contemporary demands and challenges. Introduction

This article examines the new demographic and epidemiological reality in Brazil, based on data collected and organized in the Health Supplement of the National Household Sample Survey (PNAD-Health). It highlights the urgency of changes and innovations in health care paradigms for the elderly population with a preventive approach based on comprehensive education and care. As key concepts, the article emphasizes the need to preserve autonomy, participation, care, self-satisfaction, and the possibility of elder citizens being active in various social contexts. It also discusses the contribution by various authors to the discussion forum on Human Aging and the National Household Sample Surveys, coordinated by Cadernos de Saúde Pública/Reports in Public Health, featuring studies on access to and utilization of health services by the elderly, the epidemiological pattern of breast cancer in elderly women, and the validity of using proxy respondents in research on self-perceived health status, concluding that the PNAD data are consistent and can be used by the scientific community.     

Job control, job demands, social support at work and health among adolescent workers

OBJECTIVE: To evaluate physical and psychological dimensions of adolescent labor (such as job demands, job control, and social support in the work environment), and their relation to reported body pain, work injuries, sleep duration and daily working hours. METHODS: A total of 354 adolescents attending evening classes at a public school in Sao Paulo, Brazil, answered questionnaires regarding their living and working conditions (Karasek's Job Content Questionnaire, 1998), and their health status. Data collection took place in April and May 2001. Multiple logistic regression analysis was used to determine relations among variables. RESULTS: Psychological job demands were related to body pain (OR=3.3), higher risk of work injuries (OR=3.0) and reduced sleep duration in weekdays (Monday to Thursday) (p<0.01). Lower decision authority in the workplace (p=0.03) and higher job security (p=0.02) were related to longer daily working hours. CONCLUSIONS: It was concluded that besides physical stressors, psychological factors are to be taken into account when studying adolescent working conditions, as they may be associated with negative job conditions and health effects.     

Labour insecurity and health: an epidemiological study in Zimbabwe

Existing data on health status and health care provision in agricultural labour communities in Zimbabwe indicate that both are poor. In addition, there is evidence that the concentration of capital through increased areas of landholdings, through mechanisation and use of agrochemicals produces a rise in under- and unemployment within the agricultural sector, which increases the risk of ill health. This paper addresses this question in Zimbabwe by examining the nature of developments within the large scale agricultural sector in the last decade, and the consequent effects on employment and income. Rising capital intensity in the private large scale sector is found to be associated with increases in unemployment and underemployment. The impact of this socioeconomic pattern on health is assessed in a longitudinal assessment of 78 permanent labour families and 76 non-permanent (underemployed) labour families in the large scale farming sector. The study shows that while poor social, economic and health conditions exist in all groups, non-permanent labour households suffer greater insecurity of employment and income, poorer health status and lesser participation in sociopolitical structures important for negotiating primary health care gains.     

Employment insecurity and employees' health in Denmark

We use register data for Denmark (IDA) merged with the Danish Work Environment Cohort Survey (1995, 2000, and 2005) to estimate the effect of perceived employment insecurity on perceived health for a sample of Danish employees. We consider two health measures from the SF‐36 Health Survey Instrument: a vitality scale for general well‐being and a mental health scale. We first analyse a summary measure of employment insecurity. Instrumental variables‐fixed effects estimates that use firm workforce changes as a source of exogenous variation show that 1 additional dimension of insecurity causes a shift from the median to the 25th percentile in the mental health scale and to the 30th in that of energy/vitality. It also increases by about 6 percentage points the probability to develop severe mental health problems. Looking at single insecurity dimensions by naïve fixed effects, uncertainty associated with the current job is important for mental health. Employability has a sizeable relationship with health and is the only insecurity dimension that matters for the energy and vitality scale. Danish employees who fear involuntary firm internal mobility experience worse mental health.     

Feeding inequality: food insecurity,social status and college student health

A growing but limited body of research has identified the college student population as one that is particularly vulnerable to food insecurity. Early estimates of food insecurity prevalence among college students range from 14 to 60 per cent. The present study utilises original survey data collected from a random sample (n = 300) of college students enrolled at an urban university in the Midwest region of the United States of America (USA). This study examines the impact of food insecurity on health outcomes and the mediation of this relationship by subjective social status among college students. Ordinary least squares (OLS) and logistic regression analyses find that food insecurity is related to worse self-rated, physical and mental health among college students, and Sobel-Goodman tests find that subjective social status plays a significant mediating role in the relationship between food insecurity and health among college students. The implications of these findings in a university context are discussed using a psychosocial framework and insights from the stress process model. In doing so, I discuss food insecurity among college students with an emphasis on the social significance of food and food insecurity.     

Information and information technology in health: contemporary health kaleidoscope

This essay is based on the assumption that current practices and knowledge of Information and Information Technology in Health are unable to deal with the complexity of the health/disease/care processes and contemporary problems that must be overcome, curbing the expansion of the response capacity of the Brazilian State. It aims to further explore the understanding of the roots and determining factors behind these constraints, analyzing alternatives for confronting them that depend less on location-specific initiatives in the field of information and more - among others - on the adoption of new benchmarks, starting with the meaning and concept of Health. It identifies the existence of an 'information and information technology interfield' that arises from an epistemology based on a transdisciplinary approach, as well as the consolidation of a political and historical process of institutional construction, an area endowed with power and relevance: a political-epistemological interfield. The analysis goes on through an exploratory study of the social, political and epistemological processes found in the historical construction health information networks established by Science and Technology in health, as well as by healthcare systems and services, in addition to social, political and economic information.