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The primary aim of this chapter is to explore stigmatization, stress, and coping among adolescent mothers and to identify positive coping mechanisms that not only resist stigmatization but also generate positive affect.

Fifty-two pregnant and parenting adolescents in an urban county in the Midwestern United States were recruited to participate. A journaling tool was developed and used to allow participants to express their thoughts and concerns in a real-time, reflexive manner. Data were coded at different “nodes” or themes. Concepts, such as stigma, stress, strength, and empowerment were operationalized into key words and “themes” based on previous published literature. Key phrases were used to code the journaling data.

Adolescent mothers used positive reappraisal of life circumstances to create a positive self-image and resist the stress of stigma and parenting. Overcoming stereotypes and success in parenting were reappraised as “strength,” which allowed the young women to feel empowered in their caregiving role.

The chapter also contributes to the sociological literature on positive coping responses to stigma and stress. Indeed, very few studies have employed the sociological imagination of pregnant and parenting adolescents by describing not only their lives but also seeking their understanding and explaining their lives sociologically. This chapter also has direct implications for several health care providers, including nurses and social workers. For example, nurses and social workers are a vital part of the healthcare team for pregnant and parenting adolescents, and they often serve as the link between the adolescent, her family and significant others, and healthcare and social service agencies.

This chapter described the mechanisms that adolescent mothers use to cope with stress with a focus on how caregiving generates positive affect through the voices of these young mothers themselves. This chapter contributed to the sociological literature on stress and coping. In particular, our findings were also in line with the work of sociologist Antonovsky’s Sense of Coherence concept. SOC is a global measure that indicates the availability of, and willingness to use, adaptive coping resources as a key variable in maintaining health.

As the new Patient Protection and Affordable Care Act (ACA) achieves full implementation in 2014–2015, public perceptions regarding improvement in access and quality of care due to the ACA provide a fertile area for sociological research. The aim of this chapter is to determine if race is independently associated with perceptions of quality of care and access to care after ACA implementation. And, secondarily, we examined if such a relationship remained stable after considering SES (education and income) alone and SES with other relevant individual characteristics.

Data come from a telephone survey of a representative sample of Georgia residents aged 18 years or older. For each domain of the dependent variables (quality of care and access to care), three models were fitted with a nested design. The first model included only race. The second model included only race and SES. Model 3 included race, SES, and the following individual characteristics: (1) self-rated health status; (2) sense of coherence (SOC; a construct used to explain why some people are more disposed than others to illness after stressful situations); (3) travel time to doctor’s office; (4) importance of short wait times as doctor’s office; (5) political affiliation; and (6) geographic location (rural/non-rural).

Race was significantly associated with both the quality of care and the access to care. Non-White respondents were more likely to perceive improvements to both as a result of the ACA. Likewise, respondents with either higher education or income were also more likely to perceive improvements in quality and access as a result of the ACA. However, these associations were partly explained by respondents’ self-reported political affiliations.

Results of this study show that public perceptions toward the ACA and its impact on quality and access to care seem to differ based on an individuals’ race, income level and political affiliation. This may be a reflection of the media blitzkrieg that surrounds the ACA rather than a direct consequence of the policy itself. A concerted effort to develop communication strategies and outreach efforts by race and SES that can better educate the general population on the ACA may alleviate some of the reservations that are inherent to any major policy implementation, especially in terms of healthcare quality and access.

The purpose of the present study is to investigate whether family caregivers with a stronger sense of coherence (SOC) who are caring for community dwelling older adults with cognitive impairment are less likely to use mental health services. An adaptation of the Anderson behavioral model of access to health care was employed as a conceptual framework. Data were collected for 304 impaired older adult/family caregiver dyads. Caregiver mental health service use and sense of coherence were measures as well as predisposing factors (age, gender, race, education, type of familial relationship, family size, and co-residence with impaired family member), enabling factors (self-reported awareness of services, travel times to mental health services, social support, and insurance), and need factors (chronic health conditions and distress). The impaired elder’s age, level of physical impairment, and level of memory impairment were also examined. Logistic regression results indicated that caregivers who have a stronger SOC were less likely to use mental health services (OR=0.91, p=0.006). Other significant independent predictors of mental health service use were social support (OR=0.34, p=0.032) and caregivers aiding family members with higher levels of physical impairment (OR=1.14, p=0.033). The results of this study support clinicians and planners developing mental health services that use SOC to mitigate the detrimental effects of caregiving. Future research is needed to target effective measures to positively manipulate this variable.

This paper uses social network principles to explain the sources of and variations in relationships among health care providers and patients. General principles of social networks applied are global structure, structural equivalence, structural conduciveness, and the duality of network linkages. Specific principles employed to understand structural variability in provider interrelationships are structural encapsulation and structural excludability, centrality and integration, subgroups and structural holes, close ties versus weak ties, and the virtual ties created by computersupported social networks (CSSNs). Various ways that social network principles help explain the evolving complexities of interconnectedness among health care providers and patients are demonstrated. Practical advantages of using social network principles to organize and to manage interrelationships among health care providers and patients are discussed.

Improvements to supportive services targeting pregnant and parenting adolescents can enhance maternal and child outcomes (e.g., repeat pregnancy and child well-being). The purpose of this chapter is to advance the medical sociological literature by implementing multifaceted approaches including developing evidence-based media messaging device modalities as a forum to engage pregnant and parenting adolescents in social normative communication, self-reflection, and self-expression so that they can develop a tailored health prototype service model to accommodate their health and social needs.

We utilized a purposeful sample of pregnant adolescents or parenting adolescents (of an infant or toddler) ages 15–19 in a large Metropolitan Area in the Midwest. We employed a qualitative research design using two focus groups (n = 15) and participant observation (n = 8) to identify themes. Content analysis was performed to better understand the study participants’ experiences and perceptions.

Based on the focus group results, the custom journal was found to be the most popular outlet to offer self-expression and social support. Four main themes emerged from the data, including teen pregnancy overall is a problem, but having their own baby was not; strong desire for more health information and health education; perceived stigma from their teachers and parents; and frustration with the existing service programs.

The implications of the chapter are that the teen pregnancy norms fostered stigma and “social disgrace” that the pregnant and parenting adolescents experienced and ultimately thwarted their perceived and actual receipt of services. Future research should better understand the potential influences of internal and external pressures brought on by stigmatization as a contributing barrier to communicating social and health needs by pregnant and parenting adolescents.

This chapter developed, implemented, and evaluated media communication and found that it could structure social relations between pregnant and parenting adolescents and service providers. This chapter also extends development communication techniques, with its intellectual roots in rural sociology, by focusing on communication-oriented solutions and the development of new technologies to provide medical information with greater social equality and integrated support services for pregnant and parenting adolescents.

Older adults with memory problems (especially those diagnosed with dementia) consume a great number of health services. However, little is known about the special needs of memory-impaired, noninstitutionalized older adults who seek treatment from primary care physicians (PCPs) for memory problems. The study outlined in this chapter investigated the interrelationships among level of education, residence, physical and mental status, and the use of PCPs for memory problems. A probability-based (random-digit dialing) survey of households with individuals more than 60 years of age occurred in six Southern states: Alabama, Arkansas, Georgia, Louisiana, Mississippi, and Tennessee (N = 1,368). We developed two multivariate logistic regression models. The first estimated the additive effects of sociodemographic and health status characteristics on the likelihood of service utilization. The second model inserted two multiplicative terms: the “instrumental activities of daily living (IADL)” by “memory impairment” and the “low education” by “memory impairment” interaction terms. Three main findings emerged from the analyses: (1) rural/urban differences in use of PCPs approached statistical significance, (2) for lower educated older adults, the odds of using a PCP declined steadily as their number of memory impairments increased, and (3) as older adults experienced increases in IADL limitations and memory impairments, their likelihood of service use declined. The chapter ends with a discussion on program planning, policy, and practice initiatives in light of the findings.

The objective of this chapter was to advance the medical sociology theoretical literature on health lifestyle behaviors. This study investigated the influence of mid-life adult statuses (gender, marital status, parenthood, presence of children in the home, and employment status) and functional health status (general physical health, general mental health, vitality, and social functioning) on selected health-related behaviors. These behaviors included preventive medicine behaviors (routine physical exams, cholesterol checks, and blood pressure checks), risk-taking behaviors (driving above the speed limit, smoking, and consuming alcohol), health promoting behaviors (exercising, sleeping well, and relaxing), and medication usage (using prescribed medicines, over-the-counter medicines, and herbal supplements). The data were gathered through the Warren County Health Survey, a telephone survey of a randomly selected sample of residents from a county in Kentucky. Logistic regression was used to analyze the data. Results indicated that having children at home, being married, being fifty years old or older, and possessing better mental health and social functioning statuses were associated with a greater likelihood of practicing better health-related behaviors. In contrast, being both male and aged 49 and younger were correlated with a greater likelihood of engaging in poorer health-related behaviors. Based on these results, the authors offered several testable, theoretical propositions for future research to test the relationships between mid-life adult health statuses, functional health statuses, and health-related behaviors in other community-based samples.

The purpose of this chapter is to advance the medical sociology literature on the relationship between social cohesion and SRHS on an individual level. There is little information about how neighborhood social characteristics affect seniors’ SRHS. Guided by tenets of the collective efficacy theory, this chapter hypothesized that older individuals who perceived that their neighborhood has high levels of social cohesion around elderly issues will have better SRHS. A secondary hypothesis investigates whether the relationship was attenuated once their neighbors’ actual, self-reported attitudes toward seniors were taken into account.

Data come from a telephone survey of Indianapolis, Indiana residents, court data, and census information.

Logistic regression analyses indicated that both social cohesion and low income are statistically significant predictors of poor self-rated health status. Although both are statistically significant, the protective association between cohesion and poor SRHS (−0.69 log odds) is of similar magnitude to the risky association between income and poor health (−0.64 log odds).

Consistent with the classic work of Durkheim who found that individuals who were more socially integrated with society had lower rates of suicide, our study found a significant association between social cohesion and SRHS.

Future research is needed to target other health status outcomes in other geographical locations. Even though the body of research exploring the predictors of SRHS among older individuals is quite robust, this chapter adds to a more recent growing body of research, which has articulated the importance of the social environment in which an individual lives, especially community-dwelling older adults, is associated with their health status.