Psychosocial outcomes and peer influences among multiracial adolescents in the United States.

Objective: To examine racial and ethnic self-identification among adolescents and explore psychosocial outcomes and peer treatment for multiracial adolescents in the United States. Methods: Data are from the 2014 Child Development Supplement, a subsample of the Panel Study of Income Dynamics. Data were weighted to be nationally representative. Descriptive statistics were used to describe the population and to explore family and parent demographics. Multivariable regressions tested for differences in psychosocial outcomes and peer treatment and group behaviors for multiracial youth in comparison to their single race peers. Results: Black multiracial youth had significantly lower scores on the children's depression index compared to single race Black youth, and White multiracial youth reported significantly higher rates of peer mistreatment in comparison to White single race youth. Black multiracial and White multiracial adolescents reported similar positive and negative peer group behaviors. Conclusions: Complex patterns emerge when examining the psychosocial and peer treatment variables presented in this analysis for multiracial adolescents and their single-race peers. The findings regarding depressive symptoms and peer bullying point to signs of different relationships between multiracial groups. White multiracial adolescents report worse outcomes than their White single-race peers, but Black multiracial adolescents reporting better outcomes than their Black single-race peers.

Social Constructions of Rape at Columbia University and Barnard College, 1955-90.

Sex on college campuses has fascinated scholars, reporters, and the public since the advent of coeducational higher education in the middle of the nineteenth century. But the emergence of rape on campus as a public problem is relatively recent. This article reveals the changing social constructions of campus rape as a public problem through a detailed examination of newspaper reporting on this issue as it unfolded at Columbia University and Barnard College between 1955 and 1990. Adapting Joseph R. Gusfield's classic formulation of public problem construction, we show the ways police and other judicial and law enforcement authorities, feminists, university faculty, student groups, university administrators, and health professionals and institutions have struggled over ownership of how the problem should be defined and described, attribution of responsibility for addressing the problem, and prescriptions for what is to be done. Our findings show how beginning in the late 1960s and early 1970s, the simultaneous swelling of the women's liberation movement and the exponential integration of women into previously male-dominated institutions of higher education and medicine catalyzed the creation of new kinds of knowledge, institutions, and expertise to address rape and sexual violence more broadly on college campuses. New actors-feminists and health professionals-layered frames of gender and health over those of crime and punishment to fundamentally transform how we understand rape on campus, and beyond.

Crisis and Change: The Making of a French FDA.

Policy Points: Introducing a recent special issue of The Lancet on the health system in France, Horton and Ceschia observe that "the dominance of English as the language of science and, increasingly, global health too often closes the door on the history and experiences of others."1 In that spirit, this manuscript presents a detailed case study of public health policy transformation in France in the early 1990s. It casts light on processes of policy change in a political and cultural environment very different from that of the United States, showing how the public health policy process is shaped by multiple contingencies of history, ideology, and politics. More specifically, we describe the transformation of a disease catastrophe into a political crisis and the deployment of that crisis to precipitate reform of the French public health system. CONTEXT: Until the last decade of the 20th century, France had no equivalent to the US Food and Drug Administration. In this paper we describe and interpret the complex series of events that led to the passage by the French Parliament in December 1992 of a law incorporating such an agency, the Agence du Médicament (literally, "medicines agency"). The broad aim of this project was to learn how public health policy change comes about by detailed analysis of a specific instance. More specifically, we aimed to better understand the circumstances under which public health crisis leads to significant public health policy reform. METHODS: This paper is based on detailed analysis of primary documents (eg, archived French health ministry papers, recorded parliamentary debates, government reports, newspaper articles) and oral history interviews covering a period from 1988 to 1993. Thematic analysis of these materials was initially grounded in theories of organizational change, moving to constructs that emerged from the data themselves. FINDINGS: Policy entrepreneurs positioned to frame adverse events and seize opportunities are key to public health policy reform. However, whether these entrepreneurs will have the requisite institutional power is contingent both on political structure and on the power of competing institutional actors. Health crises may catalyze institutional reform, but our analysis suggests that whether reform occurs, or even whether adverse episodes are labeled as crises, is highly contingent on circumstances of history, political structure, and political ideology and is extremely difficult to predict or control. CONCLUSIONS: Actors positioned to shape public health policy need to have a detailed understanding of the circumstances that facilitate or impede policy reform. Health crises are now more often global than not. Comparative, theoretically grounded, cross-national research that looks in detail at how different countries respond to similar health crises would be extremely valuable in informing both policymakers and researchers.

Comfortably, Safely, and Without Shame: Defining Menstrual Hygiene Management as a Public Health Issue.

In recent years, the menstrual hygiene management challenges facing schoolgirls in low-income-country contexts have gained global attention. We applied Gusfield's sociological analysis of the culture of public problems to better understand how this relatively newly recognized public health challenge rose to the level of global public health awareness and action. We similarly applied the conceptualization by Dorfman et al. of the role of public health messaging in changing corporate practice to explore the conceptual frames and the news frames that are being used to shape the perceptions of menstrual hygiene management as an issue of social justice within the context of public health. Important lessons were revealed for getting other public health problems onto the global-, national-, and local-level agendas.

Construction of a policy arena: the case of public health in France.

In this article we examine the transformation over the past two decades of public health as a policy arena in France from a backwater of little interest to politicians, bureaucrats, the media, and the public into a central preoccupation of the state. Recent dramatic health crises (the scandal over HIV-contaminated blood, mad cow disease, etc.) have substantially raised the political profile of (and corresponding state investment in) public health in France, offering opportunities and incentives for political actors not traditionally associated with public health to enter the field and challenging more traditional actors to galvanize themselves and compete for this newly attractive policy terrain. We use the occasion of the passage of a public health law in 2004, labeled by its proponents as the "first" public health law in one hundred years, to show how, in a context of national struggle to contain both risks and costs, "public health" -- chameleonlike -- has taken on various meanings and forms to serve highly conflicting political interests.

"... But then he became my sipa": the implications of relationship fluidity for condom use among women sex workers in Antananarivo, Madagascar.

Increasing evidence indicates that sex workers use condoms less consistently with regular (i.e., nonpaying) partners than with clients. Few studies have examined the extent to which these 2 categories are mutually exclusive. In an ethnographic study of women's sex work in Antananarivo, Madagascar, we examined how the meaning of women sex workers' sexual relationships could shift among 3 different forms of sex work. Condom use was less likely in forms in which the distinction between client and lover (sipa in Malagasy) was fluid. For many sex workers, therefore, relationships they understood to be intimate imparted the greatest health vulnerability. It is important to examine the influence of the meaning of sexual relationships on condom use for HIV prevention. Policy implications for HIV prevention work with sex workers are considered.

Physical women, emotional men: gender and sexual satisfaction in midlife.

In late midlife, heterosexual women report markedly lower levels of sexual satisfaction than heterosexual men. This article explored the social factors contributing to this difference, using data from 1,035 sexually-active heterosexual adults, aged 40-59 years, who participated in the National Health and Social Life Survey (NHSLS). Conducted in 1992, NHSLS interviewed a nationally representative random sample of U.S. adults about diverse aspects of sexual life (Laumann et al., 1994, The social organization of sexuality: Sexual practices in the United States. Chicago: University of Chicago Press). Contrary to gender stereotypes, women's emotional satisfaction was closely associated with bodily sexual practices, whereas men's physical pleasure was linked to relational factors. Lower levels of sexual satisfaction at older ages appeared to stem from differences between the Baby Boom and older generations rather than from aging per se.

Collective actors and corporate targets in tobacco control: a cross-national comparison.

Cross-national comparative analysis of tobacco control strategies can alert health advocates to how opportunities for public health action, types of action, and probabilities for success are shaped by political systems and cultures. This article is based on case studies of tobacco control in the United States, Canada, Britain, and France. Two questions are addressed: (a) To whom were the dangers of smoking attributed? and (b) What was the role of collective action--grassroots level organization--in combating these dangers? Activists in Canada, Britain, and France moved earlier than the United States did to target the tobacco industry and the state. Locally based advocacy centered on passive smoking has been far more important in the United States. The author concludes that U.S.-style advocacy has played a major role in this country's smoking decline but is insufficient in and of itself to change the corporate practices of a wealthy and politically powerful industry.

Parental perceptions of costs and benefits of children as correlates of fertility in Kuwait.

Kuwait is a high fertility country where the average number of desired children still exceeds 5. However, fertility behaviour is beginning to show a noticeable change and the current TFR is about 4.2 children. In order to understand the decline in fertility, the impact of perceived benefits and costs of children on Kuwaiti women's desired and achieved fertility is analysed. Data from a nationally representative survey of Kuwaiti households held in 1999 are used. Bivariate analyses show that the mean desired number of children is significantly higher among those who rank higher on the perceived value of children, and lower among those who are concerned about the cost of raising children. Achieved fertility (children ever born) shows a similar pattern. In the multivariate analysis, however, large family values emerge as the only significant predictor of (higher) desired as well as achieved fertility, net of the respondent's demographic and socioeconomic characteristics. The sociocultural, economic and political contexts that shape the mother's perceptions of the benefits and costs of children are analysed and it is concluded that the need for children as social and national capital is currently the most important driving force behind fertility desires and behaviour.

The skeptic's guide to a movement for universal health insurance.

The social movement has become institutionalized as a form of political action. The aim of this article is to evaluate the possibilities presented by this form as a strategy to bring about universal health insurance in the United States. I draw on the work of social movement theorists, on the substantial body of empirical research on health-related social movements, and on relevant comparative work from Canada to develop a template for this evaluation. Using that template I compare the failed campaign for President Bill Clinton's health insurance plan with a recent, more successful campaign in the state of New York. I conclude that the keys to success are, first, a broad-based coalition that combines an ideologically and/or grievance-motivated grass roots with financially and politically well-endowed mainstream organizations; second, a "master frame" that resonates with the American people; and, third, a political window of opportunity. The prospects for such a conjunction are not hopeless, but they are not high.

The social constructions of sexuality: marital infidelity and sexually transmitted disease-HIV risk in a Mexican migrant community.

OBJECTIVES: This article explores the social context of the migration-related HIV epidemic in western Mexico. METHODS: Data collection involved life histories and participant observation with migrant women in Atlanta and their sisters or sisters-in-law in Mexico. RESULTS: Both younger and older women acknowledged that migrant men's sexual behavior may expose them to HIV and other sexually transmitted diseases.Younger Mexican women in both communities expressed a marital ideal characterized by mutual intimacy, communication, joint decisionmaking, and sexual pleasure, but not by willingness to use condoms as an HIV prevention strategy. CONCLUSIONS: Migrant Mexican women's commitment to an illusion of fidelity will hinder HIV prevention initiatives targeted toward them. Furthermore, the changing meanings of marital sex may make it harder to convince young couples to use condoms as an HIV prevention strategy. If the chain of heterosexual marital HIV transmission is to be interrupted in this community, prevention programs must target men.