Journal of Health and Social Behavior最新文献

Patient-centered care is widely cited as a component of quality contraceptive health care, but its operationalization in clinical interaction is contested. This article examines patient-centered care as an interactional phenomenon using the case of patient dissatisfaction with side effects of hormonal contraceptive medications. Drawing on transcript data from 109 tape-recorded reproductive health visits, I find that provider responses to treatment dissatisfaction range from patient-centered to relatively authoritarian. Providers typically offer patient-centered responses that validate patient experiences and integrate them into contraceptive counseling and method selection. At the same time, explicit communication about patients' contraceptive priorities is rare. In its absence, providers use patient-centered communication to smooth the interactional path toward uptake of highly effective hormonal methods, mostly ignoring the possibility that some patients may prefer less effective methods. Patient-centered contraceptive care was circumscribed by the clinical goal of pregnancy prevention.

There are competing perspectives on the impact of Hispanic immigrants' social networks on health; the Hispanic health paradox views networks as sources of resilience, whereas the tenuous ties perspective views networks as sources of risk. In this study, I explore the effect of networks on health by examining three network pathways: social capital, social bonding, and network stress. Using egocentric social network data from the VidaSana Study, a survey of 547 Hispanic immigrants in Indiana, I investigate how each network pathway is associated with physical health, mental health, and health care utilization. Results show that networks with greater capital, namely, more network health knowledge, promote physical health and health care access, whereas social bonding, operationalized as close and dense networks, benefits mental health and health care utilization. Network stress contributes to worse mental health yet improved health care access. Implications for social networks and health research among the Hispanics and more broadly are discussed.

With most scholarly attention directed toward understanding the stigma experiences of individuals with mental illness, less attention has been given to associative stigma: an understudied form of social exclusion and devaluation experienced by the social ties of stigmatized individuals. This study advances scholarly understanding of associative stigma by drawing on social network methods to better illuminate how the quantity and quality of social relationships with those dealing with mental illness impact experiences of perceived discrimination. Using a nationally representative sample from the General Social Survey, I find that (1) knowing more people with mental illness, (2) having more core (friends and family members) versus peripheral ties, and (3) having ties who are most at risk of facing public stigma themselves (e.g., stereotype-confirming ties) are associated with greater perceived discrimination experiences. Taken together, these findings shed light on how pervasive associative stigma truly is.

Black Americans experience the death of a parent much earlier in the life course than White Americans on average. However, studies have not considered whether the cardiovascular health consequences of early parental death vary by race. Using data from the National Longitudinal Study of Adolescent to Adult Health, we explore associations between early parental death and cardiovascular disease (CVD) risk in early to mid-adulthood (N = 4,193). We find that the death of a parent during childhood or adolescence (ages 0-17) or the transition to adulthood (ages 18-27) is associated with increased CVD risk for Black Americans, whereas parental death following the transition to adulthood (ages 28+) undermines cardiovascular health for both Black Americans and White Americans. These findings illustrate how a stress and life course perspective can help inform strategies aimed at addressing both the unequal burden of bereavement and high cardiovascular risk faced by Black Americans.