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This study examines chronic illness, disability and social inequality within an exposure-vulnerabilities theoretical framework.

Using the National Survey of Drug Use and Health (NSDUH), a preeminent source of national behavioral health estimates of chronic medical illness, stress and disability, for selected sample years 2005–2014, we construct and analyze two foundational hypotheses underlying the exposure-vulnerabilities model: (1) greater exposure to stressors (i.e., chronic medical illness) among racial/ethnic minority populations yields higher levels of serious psychological distress, which in turn increases the likelihood of medical disability; (2) greater vulnerability among minority populations to stressors such as chronic medical illness exacerbates the impact of these conditions on mental health as well as the impact of mental health on medical disability.

Results of our analyses provided mixed support for the vulnerability (moderator) hypothesis, but not for the exposure (mediation) hypothesis. In the exposure models, while Blacks were more likely than Whites to have a long-term disability, the pathway to disability through chronic illness and serious psychological distress did not emerge. Rather, Whites were more likely than Blacks and Latinx to have a chronic illness and to have experienced severe psychological distress (both of which themselves were related to disability). In the vulnerability models, both Blacks and Latinx with chronic medical illness were more likely than Whites to experience serious psychological distress, although Whites with serious psychological distress were more likely than these groups to have a long-term disability.

Several possibilities for understanding the failure to uncover an exposure dynamic in the model turn on the potential intersectional effects of age and gender, as well as several other covariates that seem to confound the linkages in the model (e.g., issues of stigma, social support, education).

This study (1) extends the racial/ethnic disparities in exposure-vulnerability framework by including factors measuring chronic medical illness and disability which: (2) explicitly test exposure and vulnerability hypotheses in minority populations; (3) develop and test the causal linkages in the hypothesized processes, based on innovations in general structural equation models, and lastly; (4) use national population estimates of these conditions which are rarely, if ever, investigated in this kind of causal framework.

Financial stress has been found to contribute to mental health deterioration associated with job loss. This study examined whether specific types of income support programs (e.g., unemployment benefits and welfare) reduce the negative impacts of job loss on middle-aged women’s mental health in the United States. Two samples of women previously employed before their mental health assessments in their 40s and 50s were selected from the National Longitudinal Survey of Youth 1979 (NLSY79). We conducted regression analysis to predict their mental health scores using employment and income support program status. The model also controlled for baseline health before job loss, socioeconomic status, and demographic and family life characteristics. Compared to their continuously employed counterparts, 50 +  women who had job loss without unemployment benefits had significantly worse mental health. However, those receiving unemployment benefits did not have significantly worse mental health. Unemployment benefits’ ameliorating effect was not found in the 40 +  sample; and welfare programs did not have similar mental health effects. Our findings suggest that certain types of income support policies are beneficial to the mental health of certain cohorts of middle-aged women. For different groups of women, additional and alternative measures are needed to reduce the mental health damage of job loss.

In the late 1990’s, online B2B auctions were proliferating and were being adopted in a wide variety of circumstances. The reverse auction tool has evolved to take advantage of internet technology, and online auctions have been identified by many large organisations as a tool to achieve procurement savings. As companies adopt this technology, it is important for them to understand the implications of this type of procurement. This paper adopts a case study approach to identify the issues for both buyers and sellers using this type of B2B application. It describes the conduct of a reverse auction, from the preliminary steps all the way to the final awarding of the contract. The case study is viewed through the eyes of a supplier, undertaking a reverse auction for the first time. The main outcomes show that the auction vendor and buyer were major winners – with the supplier expending considerable time and effort to participate in the auction, only to realise that the auction places cost above all other factors in awarding the contract. The importance of cost over service delivery, customer support and buyer‐supplier relationship was the “bitter pill” the supplier had to swallow.

This paper aims to explore the links between being lonely and isolated, and increased risks of abuse for adults with care and support needs.

Thematic analysis was used to explore features of loneliness and social isolation present in South Yorkshire Safeguarding Adults Reviews (SARs) published since 2014.

Ten out of fifteen SARs indicated there had been issues of loneliness and/or social isolation for the person who was the subject of the SAR.

The limitations of this paper are that it only included SARs from the South Yorkshire area. Future research should explore national and international perspectives on these issues.

Safeguarding Boards should include actions to address loneliness and social isolation as part of prevention strategies and services to develop approaches that can minimise or prevent abuse before it occurs. Practitioners should routinely explore whether the people they work with feel lonely and/or isolated and support people to take appropriate action to mitigate these risks.

This paper uses the existing body of literature about loneliness and social isolation to explore the risks of abuse and neglect for adults with care and support needs.