The effect of social roles on mental health: a matter of quantity or quality?

The effect of social roles (partner, parent, worker) on mental health may depend on the total number or the quality of the individual occupied social roles. With longitudinal data from the Netherlands Mental Health Survey and Incidence Study (NEMESIS), the effect of the number and quality of occupied social roles on mental health over three years was examined among 2471 men and women aged 25-55 years without mental disorders at baseline. Mental health was assessed using 3-year change in the SF-36 mental health scale as well as using the 3-year incidence of anxiety and depressive disorders defined by DSM-III criteria. The quality of social roles was assessed by the GQSB (Groningen Questionnaire Social Behavior). The number of social roles had no significant effect on the risk of developing depressive and anxiety disorders, but particularly the partner-role had a significant positive effect on mental health (beta of mental health=1.19, p=0.01; HR of incident disorders=0.75, 95% CI:0.51-1.00, p=0.05). A good quality of each of the three social roles was associated with higher levels of mental health and lower risks of incident disorders over 3 years. More than the number of social roles, knowledge about social role quality might provide opportunities for prevention of depressive and anxiety disorders.     

Mental illness and/or mental health? Investigating axioms of the complete state model of health

A continuous assessment and a categorical diagnosis of the presence (i.e., flourishing) and the absence (i.e., languishing) of mental health were proposed and applied to the Midlife in the United States study data, a nationally representative sample of adults between the ages of 25 and 74 years (N = 3,032). Confirmatory factor analyses supported the hypothesis that measures of mental health (i.e., emotional, psychological, and social well-being) and mental illness (i.e., major depressive episode, generalized anxiety, panic disorder, and alcohol dependence) constitute separate correlated unipolar dimensions. The categorical diagnosis yielded an estimate of 18.0% flourishing and, when cross-tabulated with the mental disorders, an estimate of 16.6% with complete mental health. Completely mentally healthy adults reported the fewest health limitations of activities of daily living, the fewest missed days of work, the fewest half-day work cutbacks, and the healthiest psychosocial functioning (low helplessness, clear life goals, high resilience, and high intimacy).     

Are there particular social determinants of health for the world's poorest countries?

Background

The task of improving Social and Economic Determinants of Health (SEDH) imposes a significant challenge to health policy makers in both rich and poor countries. In recent years, while there has been increasing research interest and evidence on the workings of SEDHs, the vast majority of studies on this issue are from developed countries and emphasizes specific concerns of the developed nations of the world. Importantly, they may not fully explain the underlying causal factors and pathways of health inequality in the world''s poorest countries.

Objective

To explore whether there are specific social determinants of health in the world''s poorest countries, and if so, how they could be better identified and researched in Africa in order to promote and support the effort that is currently being made for realizing a better health for all.

Methods

Extensive literature review of existing papers on the social and economic determinants of health.

Conclusion

Most of the existing studies on the social and economic determinants of health studies may not well provide adequate explanation on the historical and contemporary realties of SEDHs in the world''s poorest countries. As these factors vary from one country to another, it becomes necessary to understand country-specific conditions and design appropriate policies that take due cognisance of these country-specific circumstances. Therefore, to support the global effort to close gaps in health disparities, further research is needed in the world''s poorest countries, especially on African social determinants of health     

Explaining potential antecedents of workplace social support: reciprocity or attractiveness?

Effects of social support are an important topic in occupational stress theories and research, yet little is known about support's potential antecedents. Based on reciprocity theory, the authors hypothesized that the social support received is related to the extent the employee performs organizational citizenship behaviors directed at individuals and to one's social competence; based on the notion of personal attraction, the authors hypothesized that employees' physical attractiveness and sense of humor would be associated with the amount of social support received. In a survey of 123 high school employees and separate ratings of their attractiveness, reciprocity variables were related but attraction variables were not related to social support availability. Further research should examine reciprocity in predicting social support.     

Exploring the potential of the theory of social representations in community-based health research--and vice versa?

This article seeks to demonstrate the importance of developing a dialogue between social representations theory and community approaches to researching issues of health. We show how we have used the theory within our own research to ground our findings at the level of community. The article is divided into three sections: the recognition of competing systems of knowledge; the role of representations in maintaining stigmatizing practices; and the impact of representations on identities. Each section is illustrated with material drawn from Foster's research on mental illness and Dorrer's research on women's representations of healthy eating. We conclude by arguing that, while social representations theory is a valuable tool for community-based health research, the theory would benefit from developing a more participatory methodology.     

Poverty and inequality - but of what - as social determinants of health in Africa?

Background

Many African economies have achieved substantial economic growth over the past recent years, yet several of the Millennium Development Goals (MDGs) including those concerned with health, remain considerably behind target. This paper examines whether progress towards these goals is being hampered by existing levels of poverty and income inequality. It also considers whether the inequality hypothesis of Wilkinson and Pickett¹ applies to population health outcomes in African states.

Methods

Correlation analysis and scatter plots were used to assess graphically the link between variations in health outcomes, level of poverty and income inequality in different countries. Health status outcomes were measured by using four indicators: infant and under-five (child) mortality rates; maternal mortality ratios; and life expectancy at birth. In each of the 52 African nations, the proportion of the population living below the poverty line is used as an indicator of the level of poverty and Gini coefficient as a measure of income inequality. The study used a comprehensive review of secondary and relevant literature that are pertinent in the subject area. The data datasets obtained online from UNICEF² and UNDP³ (2009) used to test the research questions. World Health Organization the three broad dimensions to consider when moving towards better population health outcome through Universal Health Coverage and the Social Determinants of Health framework reviewed to establish the poverty and income inequality link in African countries population health outcomes.

Results

The study shows that poverty is strongly associated with all health outcome differences in Africa (IMR, cc = 0.63; U5MR, cc = 0.64; MMR, cc = 0.49; life expectancy at birth, cc = −0.67); income inequality with only one of the four indicators (IMR, cc = 0.14; U5MR, cc = 0.07; MMR, cc = 0.22; life expectancy at birth, cc = −0.49), whereas income inequality is associated with one of the four indicators.

Conclusion

The study shows that tackling poverty should be the immediate concern in Africaas a means of promoting better health for all. There is a question mark over whether the findings of Wilkinson and Pickett¹ on the relationship between income inequality and health apply to Africa. The reasons for this question mark are discussed. More research is needed to investigate whether the inequality results found in this study are replicated in other studies of African health.     

Does caregiver's social bonding enhance the health of their children?: the association between social capital and child behaviors

Little is known about the association between social capital and child behaviors. This study aims to investigate that association. A complete population-based, cross-sectional survey was conducted for all the caregivers with preschool children in a rural town in Okayama prefecture in Japan. Two dimensions of individual-level social capital and unhealthy child behaviors were reported by parent-administered questionnaire. We analyzed 354 preschool children (57.6% of all children for whom questionnaires were completed). Children whose main caregiver had high cognitive social capital were 89% less likely to miss breakfast (odds ratio [OR]＝0.11;95% confidence interval [CI]:0.01-1.03). Children whose caregiver had high structural social capital were 71% less likely to wake up late (OR＝0.29;95% CI:0.12-0.71) and 78% less likely to skip tooth brushing more than once per day (OR＝0.22;95% CI:0.05-0.93). Both cognitive and structural social capital were negatively associated with unhealthy child behaviors. A further intervention study is needed to confirm the impact of social capital on child behavior.     

Do we need critical health psychology or rather critical health psychologists?

In her article Julie Hepworth discusses the definition of critical health psychology and its position within the field of health psychology. We understand that she is inclined to favour a position of critical health psychology that is separate from and in opposition to mainstream health psychology. In contrast to this, we are convinced that the important concerns of critical health psychology are better served by efforts to help mainstream health psychologists think and work more strongly from a critical perspective.     

Community control or control of the community? the case of the community mental health center

This paper analyzes the powerful professional and social forces arrayed against community control. True community control is seen to be in danger of being compromised and co-opted by the mental health establishment. A radical and untried proposition, the implementation of community control, awaits broader institutional and political reform.     

Teenage night owls or early birds? Chronotype and the mental health of adolescents

Evidence suggests that the timing of sleep (chronotype) impacts mental health in young people, but previous studies have not accounted for sleep duration or school start time in this association, or examined a broad range of mental outcomes. In this study, we investigated the association between chronotype and mental health in a representative sample of adolescents from the 2014 Canadian Health Behaviour in School‐Aged Children survey (29,635 students, 362 schools). We examined positive and negative aspects of mental health, using scores for emotional problems (range 0–33), emotional well‐being (0–22), behavioural problems (0–28) and prosocial behaviours (0–25). We estimated chronotype using the time of mid‐sleep on weekends and examined the associations using multilevel regressions, adjusted for sleep duration, school start time, individual, family and geographic characteristics. The average time of mid‐sleep (chronotype) was 04:11 hr. An hour delay in mid‐sleep time was associated with more emotional problems (0.34 [95% confidence interval 0.23, 0.45] point higher score), more behavioural problems (2.0% [95% confidence interval 1.4%, 2.6%] higher score), less emotional well‐being (0.19 [95% confidence interval 0.09, 0.20] point lower score), and fewer prosocial behaviours (0.18 [95% confidence interval 0.08, 0.29] point lower score). A later chronotype was associated with poorer mental health, independent of sleep duration and school start time, and across internalizing and externalizing mental health domains. Further research is needed to clarify the mechanisms underlying this association. The timing of sleep, and not just its duration, may be an additional consideration for youth mental health.     

Is the health of the long-term unemployed better or worse in high unemployment areas?

Data on 25.6 million adults from the UK 2001 Census were analysed to compare the regional pattern of self-rated health of the long-term unemployed to that of people from different social classes and of those who have never worked. The results show that the health of the long-term unemployed was better in high unemployment regions, and conversely, worse where the local labour market was traditionally stronger. This is the reverse of the regional pattern found-for different social classes and for those who have never worked.     

Collision or collaboration? School-based health services meet managed care

Describes interactions of for-profit managed-care organizations (MCOs) with not-for-profit school mental health programs that are affiliated with school-based health centers (SB-HCs). Discussion focuses on the developments and challenges that emerged between SBHCs and MCOs. While relations between MCOs and more traditional forms of mental health services (e.g., community mental health centers) are becoming established, such relations with SBHCs remain far from established. The example of the pathway Connecticut has taken in the continuing dialogue between SBHCs and MCOs is described in detail. Attention is given to the advocacy groups for child and adolescent mental health that were instrumental in convincing legislatures to enact safeguards to maintain SBHCs as providers of health and mental health care in the era of managed care. Challenges and recommendations are outlined to insure that the mental health needs of underserved, disadvantaged children are met through the provision of school-based mental health services.