Marital status and bed occupancy in health and social care facilities in the United Kingdom

The purpose of the study was to test the hypothesis that marriage and physical health are positively related.A secondary analysis was performed of census data on all individuals aged 15 y and over occupying beds in general health and social care facilities (excluding mental health) in England and Wales, Scotland, and Northern Ireland in 1971, 1981 and 1991.Using bed occupancy in health and social care facilities as a proxy for ill health, this paper investigates the relationship between marital status and physical health in the United Kingdom. The findings, expressed as the proportion of individuals (excluding staff and visitors) aged 15 y and over within these facilities, suggest that: a) Whether considered separately or together, married men and women are healthier than non-married men and women, as reflected in their much lower use of health and social care beds; b) This positive relationship between marriage and health has increased steadily since the 1970s; c) Within the non-married population, whereas the single are most at risk among men, the widowed are most at risk among women; d) In contrast to the married and widowed, there are some consistent age-specific gender differences among the divorced and single, with men of working age at much higher risk than women of working age.This study confirms research findings elsewhere that marriage and physical health are positively related. Throughout the United Kingdom, not only are married people healthier than non-married people, as reflected in their much lower use of health and social care beds, but this relationship holds irrespective of gender.     

Unemployment,gender and mental health: the role of the gender regime

Existing research suggests that gender differences in the effect of unemployment on mental health are related to the different positions and roles that are available for men and women in society and the family; roles that are connected with their different psychosocial and economic need for employment. The aim of this article is to analyse the role of gender in the relationship between unemployment and mental wellbeing in Sweden, representing a gender regime with a similar need for employment among women and men, and Ireland, representing a gender regime in which the need for employment differs between women and men. The results, based on longitudinal data from the two countries, show that unemployment was more negatively related to mental health among men than among women in Ireland, while men and women were equally affected by unemployment in Sweden. Factors related to the family and economic situation, as well as gendered selection into the unemployment population, explains the difference in mental health between unemployed men and women in Ireland. The overall conclusion is that the context has a major influence on the relationship between unemployment, gender and mental health.     

Gender and health in rural China: evidence from Hebei Province

Gender differences in health and health behavior are well established in Western societies, but little is known about gender health inequalities in rural China. We examine patterns of age-sex differences in health and health behavior of men and women in rural HeBei, People's Republic of China, and consider the extent to which these patterns resemble gender health inequalities observed in North America and Western Europe. The data analyzed were collected from 14,895 individuals residing in 288 villages in the HeBei Province. The results show that gender differences emerged at a later age than generally reported in Western societies. Poorer health among women, as compared with men, becomes observable during young adulthood (25-44) rather than at adolescence, and reached its peak among older adults (45-59) rather than during the productive and reproductive stage of the life course. Among the elderly, the differences between the health and the health behavior of men and women narrowed, similar to many reports in North America and Western Europe. Most importantly, no gender differences in mental health were observed. These findings suggest that the older adult age group (45-59) may be appropriate for interdisciplinary efforts to advance the understanding regarding the relative contributions of nature and nurture to gender differences in health.     

Teenage Kicks: Young Women and their Involvement in Violence and Disorderly Behaviour

The issue of young people's involvement in forms of violence and anti-social behaviour is one that is generating increasing concern across Northern Ireland. Young people are frequently regarded as one of the primary sources of social disorder and are often blamed for provoking fear and a sense of insecurity among elder members of the community. However, in much of the recent writing and in most of the policy responses to problems of anti-social behaviour, there is an inappropriate use of the term “young people”, which effectively functions as a gloss for “young males”. Young women are implicitly included in the concept of “young people as problem” but are effectively excluded from policy considerations, which largely focus on dealing with young men. This paper draws upon research into young people's attitudes to and experiences of violence and disorder in Northern Ireland, but focuses specifically on the views of young women and explores their experiences and knowledge of violence and disorder. The paper considers how far young women's concerns are being acknowledged and questions how far the needs of young women can be accommodated or the risks some of them pose are being addressed by subsuming them within the broader category of “young people”.     

Young Women's Positive and Negative Perceptions of Self in Northern Ireland

This paper represents analysis of one aspect of a larger research project examining the everyday lives and experiences of young women in Northern Ireland. As an introductory exercise within focus groups, 48 young women considered and discussed the good and not so good things about being a young woman in Northern Ireland. Through these accounts many issues emerged, some in direct contrast and contradiction to one another.

The area focused upon for the purpose of this paper is the body, particularly with regard to body image (self-expression versus pressure) and becoming a woman (growing up versus menarche). The aim is to illustrate that what young women cite as being potentially positive aspects of growing up or being a young woman often have negative experiences and implications attached to them. In light of the advancements made by young women in Northern Irish society, an opening of opportunities and their awareness of the persistence of gendered messages regarding their bodies, many young women are of the belief that such messages have less impact upon them today and that gender is a barrier that can be overcome. It is illustrated and argued here, however, that dominant cultural messages regarding women's bodies are more subtle, confusing and perhaps pervasive than they ever have been. As a consequence, this has created more pressure and confusion for young women and tensions exist in terms of young women's beliefs and their actions. In light of these research findings, this paper considers practice implications for those working with and for young women.     

Hard boys, attractive girls: expressions of gender in young people's conversations on smoking in Northern Ireland

Health behaviour and attitudes among young people can be interpreted within the context of personal and social identity. This paper explores ways in which 10- to 11-year-olds in Northern Ireland expressed perceptions of gender ideology while discussing the topic of smoking. The data were gathered by means of in-depth interviews (n=85). Although few had tried smoking, the positive quality of their own gender appeared to be expressed through negative assessment of smokers of the opposite gender, and on different ideas of perceived gender dimensions in adult smoking. In order to deliver successful health promotion interventions, it is crucial to understand and address differences based on gender as it may partly explain differences in smoking experimentation and prevalence.     

Inequalities in mental health in the working population.

Objectives: To analyze inequalities in mental health in the working population by gender and professional qualifications and to identify psychosocial risk factors and employment conditions related to the mental health of this population. Methods: We performed a cross-sectional study using data from the Barcelona Health Survey 2000. The working population aged 16-64 years (2322 men and 1836 women) was included. Mental health was measured with the General Health Questionnaire (GHQ-12). Adjusted odds ratios (aOR) and their 95% confidence intervals (CI) were calculated by means of multivariate logistic regression models separated by job qualifications and gender. Results: The prevalence of poor mental health ranged from 8% among men working in non-manual occupations to 19% in women working in manual jobs. Women were more likely to report poor mental health status than men, although sex differences were greater among manual workers (aOR = 2.26; 95%CI, 1.68-3.05 for women compared to men in the same group). Differences according to qualifications were found among women only (aOR = 1.58 [95%CI, 1.22-2.05] for women working in manual jobs compared to those working in non-manual jobs), while no differences were found among men according to qualifications. Psychosocial risk factors were associated with mental health: demand was associated in all groups, autonomy only in non-manual occupations, and social support only in the most highly qualified working women. Employment conditions such as working a split shift (working day with a long lunch break) or having a temporary contract were associated with mental health in manual occupations only. Conclusions: Mental health among the working population is related to professional qualifications and gender. Women are at greater risk than men, especially those working in manual occupations. Psychosocial occupational factors are related to mental health status, showing different patterns depending on gender and professional qualifications.     

“I Knew I Wasn't Like Anybody Else”: Young Men's Accounts of Coming Out and Being Gay in Northern Ireland

This article is based on 20 one-to-one in-depth interviews conducted with young gay and bisexual men in Northern Ireland between 2000 and 2006. These interviews were conducted during two larger mixed-methods projects: one undertaken by the University of Ulster and the Northern Ireland branch of the Family Planning Association on sexual attitudes and lifestyles of 14–25 year olds, and the other conducted by the Rainbow Project on mental health of same-sex-attracted young men. During the interviews the respondents were asked to recall their experiences of coming out and living as same-sex-attracted people in Northern Ireland. Sociological narrative text–analytical coding techniques are used to identify core categories and themes of the coming-out process experienced by these young people. Firstly, the data are related to a model of gay identity formation. Secondly, Northern Ireland-specific circumstances impacting on gay identity formation are considered and embedded in a wider discussion using available literature.     

Mental health, employment and gender. Cross-sectional evidence in a sample of refugees from Bosnia-Herzegovina living in two Swedish regions

Large regional differences regarding access to employment have been observed amongst persons from Bosnia-Herzegovina coming to Sweden in 1993-1994. This has led to questions about the role of mental health. To explore this further, postal survey questionnaires were distributed to a community sample (N = 650) that was stratified and, within strata, randomly selected from a sampling frame of persons coming to Sweden from Bosnia-Herzegovina in 1993-1994. Four hundred and thirteen persons returned the questionnaire providing a response rate of 63.5%. The aim was to increase knowledge about the relationship between mental health and employment in the chosen population. The main mental health outcome measure was the G?teborg Quality of Life instrument from which 360 respondents were grouped according to low or high symptom levels. Data were cross tabulated (chi2-tested) against background variables such as age, gender and occupational status, and then tested using binary logistic regression. Binary logistic regression revealed unemployed men but not women, and women who had been working for longer periods during 1993-1999, to be associated with high levels of symptoms of poor mental health. Women living in the urban region were also overrepresented in the high symptom group. These findings indicate that, job occupancy is important to the health of men in the study. However, for the women, further understanding is needed, as job occupancy at some level as well as living in the urban region appear to be associated with poor mental health.     

Young men in 'crisis': attending to the language of teenage boys' distress

The last two decades have seen a changing profile of young male mental health in Britain, including increased suicidal and parasuicidal behaviours. For mental health professionals to respond effectively and appropriately to meet these changing needs there needs to be further theorising and development of knowledge of young men's psychological processes and, in particular, how they make sense of their experiences within the cultural context of their lives. By drawing upon contemporary theories of subjectivities, this paper attempts to begin to address some of these issues. It looks in detail at two young men's accounts of their experiences of mental health problems. By using narrative, thematic and discourse analyses, the authors consider the cultural concepts the young men draw upon, and the language they use to voice their distress. The paper focuses on how gender and traditional masculinities constrain and influence the young men's narratives within the context of their individual life-histories and how these may become problematic for their mental health. The analyses provide a contemporary language-sensitive and culturally-sensitive reading of the young men's accounts of mental distress. It highlights how young men may talk about their distress in ways that are not immediately recognisable and extends the knowledge of the contemporary discourses used by young men in British society today. The implications for male subjectivities and mental health and therapeutic engagement are discussed.     

Experience of physical violence and mental health among young men and women: a population-based study in Sweden

Background

In Sweden mental ill-health has increased among the young, especially among young women. Our aim was to investigate the association between experience of physical violence during the past year and self rated psychological health among young men and women.

Methods

The study population consisted of men (n?=?2,624) and women (n?=?3,569) aged 18–34 years who participated in the 2008 public health survey study in Skåne. The survey was a cross-sectional stratified random sample postal questionnaire study with a 54.1% participation rate. Associations were investigated by logistic regression models.

Results

The prevalence of poor psychological health was 18.9% among men and 27.7% among women. One in ten men and one in twenty women had experienced physical violence during the past year. Most men were violated in public places, while women were most often violated at home. Women who had experienced violence during the past year showed more than doubled odds of poor psychological health, odds ratio (OR): 2.66 (95% confidence interval (CI): 2.00, 3.53). Such an association could not be seen in men OR: 1.12 (95% CI: 0.85, 1.47). Adjustment for covariates (i.e. age, country of birth, socioeconomic status, economic stress, alcohol risk consumption, emotional support, instrumental support and generalized trust in other people) did not change the association found among women.

Conclusion

Violated women, but not men, showed nearly doubled odds of poor psychological health after multiple adjustments. There was also a gender difference regarding location of violence. Awareness of gender differences regarding context and mental impact of violence may assist public health workers in reducing the consequences of violence and to design preventive strategies.     

Gender differences in mental and physical illness: the effects of fixed roles and nurturant roles

A decade ago it was widely assumed that there were no gender differences in mental illness/mental health and that any evidence that suggested that women experienced more psychological distress than men was due to women being more willing to admit to psychological distress, being more willing to seek treatment and/or sex bias on the part of clinicians. Furthermore, although it was widely recognized that on most indicators of physical illness women appeared to have higher rates of morbidity, it was generally assumed that the apparent higher rates of women did not reflect real differences in morbidity, but gender differences in illness behavior. A survey of the recent literature, however, shows that there is now a general consensus among social scientists that women experience more psychological distress than men and that this is largely due to aspects of their societal roles. Furthermore, in the last few years the cumulative evidence indicates that women do in fact have higher rates of morbidity than men and that this probably is also largely a consequence of their social roles. The present paper focuses on two aspects of the roles typically occupied by men and women, namely that the roles of men tended to be more structured or 'fixed' than the roles of women, while women are more likely to occupy nurturant roles than men. It is argued that highly structured or 'fixed' roles tend to be causally related to good mental health and low rates of morbidity. In contrast nurturant roles tend to impose a strain and to impair one's ability to effectively adopt a sick role and as a consequence nurturant roles are linked to poor mental health and the higher rates of morbidity. In short, it is suggested that the fixed role-hypothesis and the nurturant role hypothesis complement each other and together partially explain the higher rates of physical illness and psychological distress among women.     

Social inequalities in health: are there gender differences?

Some studies suggest that socio-economic status (SES) inequalities in health are smaller in women than men, but the evidence is inconsistent as to whether this applies across various health measures and life stages. The first aim of this paper was to establish whether the magnitude of social inequality in health differs for men and women during early adulthood, specifically in respect to self rated health, limiting long-standing illness, psychological distress, respiratory symptoms, asthma/wheezing, height and obesity; second, to determine whether explanations for socioeconomic inequality in poor self rated health differ for men and women. Analyses are based on longitudinal data from the British 1958 birth cohort study using information from birth to age 33. When gender differences in inequalities were examined using social class, no significant differences emerged across the seven health measures examined at ages 23 and 33. SES inequalities based on education, however, showed greater inequality among men at age 33 for limiting long-standing illness and respiratory symptoms, but greater inequality among women for poor rated health at age 23 and psychological distress at age 33. Hence, gender differences in the magnitude of health inequality were inconsistent across age and health measures. An analysis of the contribution of explanatory factors to social class differences in self-rated health suggested that causes of inequality were similar for men and women. However, some discrepancies emerged, notably in the greater contribution of job insecurity to class differences for men and in the greater contribution of age at first child for women. The magnitude and explanations for gender differences in SES health inequalities are likely to vary according to life stage and health measure.     

Perceived Discrimination and Health Outcomes: A Gender Comparison Among Asian-Americans Nationwide

ObjectivesWe examined whether similarities and differences exist in the association between perceived discrimination and poor mental and physical health among Asian-American adult women and men. We also tested whether Asian-American women would have a lower perceived discrimination threshold for developing negative health outcomes than Asian-American men.MethodsData were derived from the National Latino and Asian-American Study (2002–2003). A nationally representative sample of Asian-American adults (1,075 women and 972 men) was examined.ResultsThere were more gender similarities than differences in the strong association between discrimination and health. More prominent gender differences were found for the specific level of discrimination and its potential health effects. Specifically, for both Asian women and men, a high level of perceived discrimination showed stronger associations with mental health than with physical health outcomes. And yet, compared with men, the threshold of discrimination was lower for women in affecting mental and physical health status.ConclusionThe findings underscore that a high level of discrimination was associated with negative mental and physical health outcomes for both women and men. However, women had more negative mental and physical health outcomes when exposed to a lower threshold of discrimination than men. These findings suggest that failing to examine women and men separately in discrimination research may no longer be appropriate among the Asian-American population. Future research should focus attention on the biological, social, and political mechanisms that mitigate the adverse health effects of discrimination in order to develop a more comprehensive approach to eliminate disparities in health.     

Mental Health Law Reform: The Impact on Children and Young People in Northern Ireland

The Bamford Review of Mental Health and Learning Disability (Northern Ireland) was established in October 2002 to examine all aspects of the law, policy and provisions that affect people with mental health needs or a learning disability in Northern Ireland. Its report A Comprehensive Legislative Framework, which deals with the reform of law in this area, proposes significant change to mental health law, which is largely welcome. This article outlines some of those key changes and preliminary thoughts regarding the impact of some of the specific proposals on children and young people with mental health problems in Northern Ireland, highlighting those areas that warrant particular attention. Particular comment is made on current legislation and concerns regarding the funding and provision of child and adolescent services in Northern Ireland. Proposals in the Framework for the introduction of capacity legislation and the impact of such on children and young people with mental health problems are examined in light of recent legislative changes in Great Britain. Comment is also made on the need for significant changes in the law and policy regarding the provision of services and support to those children and young people with a personality disorder.     

Gender and health care utilization: the role of mental distress and help-seeking propensity

Many studies report higher levels of health care utilization among women. Understanding how gender influences health care utilization is still unresolved. We developed a model that could explain these gender-related differences. The possible pathways assumed by this model that relate gender to utilization, can be summarized as follows: (1) utilization may be influenced by somatic morbidity, mental distress, perceived symptoms, poor subjective health and propensity to use services; (2) women have higher levels of these variables than men (mediating effect); and (3) the direct effects of some of these variables on utililization are moderated by gender, i.e. they are stronger for women than for men (moderating effect). Data were drawn from a community-based sample of adult enrollees of a sickness fund in the Netherlands, who had responded to a mailed health survey (N = 8698). This survey contained questions on somatic morbidity, mental distress and other mediating variables. Health care utilization was measured prospectively, using data extracted from a claims database held by the sickness fund that covers all types of general health services except general practitioner consultations. The model was tested using structural equation modelling. Women reported more somatic morbidity and mental distress than men did, as well as elevated levels of other mediating variables, which might explain-at least partly-gender related differences in utilization. Differences in propensity to use services were not found. The expected moderating effect of gender could not be demonstrated. That is, we did not find gender related differences in the strength of the relations between mental distress, other mediating variables and utilization. Mental distress is related to utilization in a way that is not gender specific, however, because women report higher levels of mental distress (as well as somatic morbidity), this results in a greater utilization of somatic health care services.     

Gender differences in illhealth in Finland: patterns, magnitude and change

The common wisdom about gender differences in illhealth has been encapsulated in the phrase "women are sicker, but men die quicker". Recently this wisdom has been increasingly questioned. The purpose of this study is first to analyse the patterns and magnitude of gender differences across various indicators of illhealth; second to examine changes over time in these differences and third to assess whether sociodemographic and socioeconomic, family status and social network determinants have any bearing on the differences. The data derive from nationally representative 1986 and 1994 Surveys on Living Conditions in Finland. Women showed poorer health for five out of eight indicators analysed; that is somatic symptoms, mental symptoms, disability among those 50 years or older, long-standing illness and limiting long-standing illness were more prevalent among women than men. Male excess was found for perceived health below good and extremely limiting long-standing illness among those 50 years or older. However, the male excess was statistically significant only for poor perceived health among those 50 years or older. Adjusting for a number of suggested determinants of health had a negligible effect on gender differences. Further analyses showed that gender differences in illhealth remained largely stable over the eight year study period which saw a steep increase of unemployment for both genders. Only in the case of mental and somatic symptoms have gender differences declined, with a simultaneous increase in the prevalence of such symptoms. Otherwise gender differences in illhealth turned out to be resistant to the deep labour market crisis over this relatively short period of time. Although women had poorer health than men for a number of health indicators, we also find gender equality and even male excess for some indicators. Furthermore, the results suggest that a male excess in illhealth is likely to be found with more severe domains of illhealth among elderly people.     

Exploring gender and sexual minority status among street-involved youth

This article compares heterosexual and sexual minority street-involved youth across a number of sociodemographic, risk and current mental health, victimization and delinquency measures with a particular focus on gender differences. The sample consists of 147 homeless and street-involved young men and women aged 16–21 years in Toronto, Ontario, Canada. Bivariate analyses indicate that many of the differences between the heterosexual and sexual minority youth are driven by differences among the young women. Multivariate analyses are then used to test for interactions between gender and sexual minority status alongside controls. The results suggest that gender, sexuality and street involvement intersect to shape outcomes in more complex ways than are acknowledged by the notion of accumulating or multiplying disadvantage common in the literature. The article concludes with a discussion focused on providing a more nuanced view of the experience of youth homelessness at the intersection of gender and sexuality.     

“The L Pack”: Addressing the Sexual Health Needs of Young Lesbians

Concerns about the sexual health of women who identify as other than heterosexual have been highlighted in numerous research reports, yet access to information, advice and services remains limited within Northern Ireland. In response to this, a group of young women have produced a sexual health resource (“The L Pack”) specifically for those who identify as lesbian or bisexual. This article discusses the issue of lesbian sexual health and the rationale for the production of The L Pack. Drawing upon discussions with the young women involved and the various partners, it outlines the participatory process of producing information for young women by young women, the meaning and value of this and the nature of learning for all involved. Illustrating feminist and related principles through practice examples, the article outlines how the project moved from a focus on individual learning to one where the young women involved gained the knowledge, skills and confidence to take their learning to their peers and others.     

Suicide and Young People: The Case of Northern Ireland

Suicides in Northern Ireland are examined in the context of what is known about global and regional trends with respect to gender and age, and change over time. For Northern Ireland, suicide numbers and rates are plotted for 10-24 year olds from 1967 to 2005. Questions are raised about the validity of officially registered suicides in the light of inverse correlations with accidents, and the importance of car crashes as a cause of death for this age group. The increase in suicides during the transition to peace over the past decade is considered in terms of research on mental health and the conflict, and assumptions about the legacies of violence. Among a range of professionals there is a lack of recognition of conflict-related issues and how these impact on children and young people. The article concludes with an agenda for research into self-harm and suicide contagion.