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.

Scholars cite racist political-economic systems as drivers of health inequities in the United States (i.e., racial capitalism). But how does racial capitalism generate health inequities? I address this open question within the historical context of predatory lending during the 2008 financial crisis. Relevant hypotheses are tested with multiple waves of data from Black and White participants of the National Longitudinal Study of Adolescent to Adult Health (N = 8,877). Across socioeconomic strata, I find that Black participants report higher rates of foreclosure, eviction, repossession, delinquent bills, lost income, and new debts in the wake of the financial crisis. Using structural equation and quasi-experimental models, I then show that Black participants also self-report rapid health declines and increases in prescription drug abuse throughout this period, much of which is explained by chronic financial stress. I conclude that racial capitalism can generate health inequities by ensnaring Black Americans in a toxic web of financial exploitation and stress proliferation.

Just a few years after the U.S. government's decision to fully fund the Human Genome Project (HGP) in 1990, an important harbinger of things to come was the publication of the controversial 1994 book The Bell Curve by Richard J. Herrnstein and Charles Murray. The authors' most controversial claim was that human intelligence was at least 60 percent genetic. At that time, the national advisory group to the HGP, the Ethical Legal and Social Implications committee (ELSI) requested that the American Journal of Human Genetics critique and respond to the authors' claim. The editorial board of the journal refused on the grounds that "this book was about behavioral genetics" while the HGP was about human molecular genetics. Members of ELSI committee argued vigorously that this distinction between different forums and platforms used to explain human genetic variation would soon collapse and merge. However, it was only a matter of time before behavioral geneticists would claim the legitimacy of being under the mantle of molecular genetics. In this address, I show just how prescient the ELSI group had been. Much of the answer lies in the reward structure for science publications that strongly favor reductionism versus emergence.

This research adopts an analytical spatial perspective to explain ethno-national health inequality between Palestinians and Jews in Israel. The work identifies the forces that instigated and maintained the spatial segregation of Palestinians and elaborates the role of segregation in generating health gaps between Palestinians and Jews. The analysis suggests a novel conceptualization of two types of segregation: (a) exclusion from the center and confinement to the periphery and (b) segregation within the geographic periphery. Using administrative data on COVID-19 incidence, hospitalization, and death and various health indicators for localities, I devise a decomposition method that evaluates the relative contribution of each type of segregation to the total health gap. The findings indicate that the segregation of Palestinians from the center and their confinement to peripheral regions are crucial determinants of their poor health outcomes and that the segregation of the Palestinian community within the geographic periphery also contributes to poorer health.

Few studies examine how high-achieving Black women navigate chronic reproductive health morbidities. Black women are disproportionately more likely to experience uterine fibroids, with earlier onset and more severe symptoms. This study leverages a national mixed-methods data set of Black women academics to examine how they describe symptomatic fibroids impacting their careers and lives. We find that participants (1) actively coped by engaging in superwoman schema, (2) postponed treatment due to the demands of their tenure-track position, and (3) normalized pain. Our findings suggest a potentially high prevalence of uterine fibroids among Black women faculty, that symptomatic fibroids were an impediment to some women's careers, and that women with symptomatic fibroids often identified expectations of their careers as an impediment to seeking timely treatment. We provide insights for how highly educated, successful Black women cope and navigate career stress coupled with challenges resulting from chronic reproductive health morbidities.