Nursing research on the health of low-income women

Cigarette smoking, socioeconomic status, and psychosocial factors: examining a conceptual framework

Inequalities in cigarette smoking prevalence exist, with smokers more likely to be poor and less educated. Higher socioeconomic status (SES) is associated with higher quit rates. The overall relationship between low SES and poor health, as measured by morbidity and mortality, is well established. However, research indicates that inequalities in health are not explained by SES alone; other variables, such as psychosocial factors, may play a significant role. Williams has developed a conceptual framework to examine relationships among SES, psychosocial factors, and medical care related to health outcomes. According to Williams, the interrelationships among these factors have yet to be determined. As such, the pathways among the variables within psychosocial factors are explored and the authors discuss application to public health nursing practice and areas for future research. Further understanding of these relationships in the context of smoking may inform prevention and cessation strategies.

Problems with parsimony in research on socioeconomic determinants of health

Despite growing evidence that social and economic factors are important determinants of health disparities, there is a lack of understanding of how these factors operate in relation to health. This article explores 3 conceptual and methodological issues impeding nursing research in this area: (1) ambiguity surrounding socioeconomic status (SES), both conceptually and as a scientific indicator; (2) the narrow focus on biological and behavioral risks for chronic disease development; and (3) the persistent centrality of individual behavior in studies examining SES-health contextual relationships. A brief overview of emerging approaches for enhancing nursing science in the area of SES and health disparities is presented.

Factors affecting the uptake of community recreation as health promotion for women on low incomes

BACKGROUND

There have been repeated calls for research on the factors that promote the spread of successful local health promotion initiatives from one community to another. We examined the factors that affected the uptake of an initiative designed in one community to improve the health of women living below the poverty line through increased access to community recreation.

METHODS

Workshops were held in three other communities and uptake efforts were tracked for one year through follow-up site visits and telephone interviews with workshop participants.

RESULTS

Making the issue a priority, actively involving the women in planning, pooling resources, sharing responsibility through partnerships, and addressing the structural dimensions of poverty were factors that enabled uptake. Factors that inhibited uptake included an emphasis on revenue generation, professionally led planning, inadequate attention to structural barriers, the undervaluing of certain resources, and an over-reliance on one idea champion.

CONCLUSION

A shift in how municipal recreation departments view their role as partners in community health promotion is required if programs are to promote health and be accessible to under-served populations.

Test of a model of psychosocial resources, stress, and health among undereducated adults

The purpose of this study was to test a model drawn from the modeling and role-modeling theory depicting relationships among psychosocial resources, perceived stress, and health for undereducated adults. A purposive sample of 171 adults enrolled at an urban adult education center completed several self-report measures: Modified Erikson Psychological Stage Inventory, Basic Need Satisfaction Inventory, Perceived Stress, and Positive Health Index. Based on a structural equation modeling analysis, psychosocial development and basic need satisfaction had significant direct effects on health, with the expected positive signs. Psychosocial development had the strongest direct effect on health and also had a strong direct effect on basic need satisfaction and an indirect effect on health. Support for the hypothesized model has important implications for nursing and other community-based care provider interventions regarding health, including strengthening psychosocial resources.

Assessing perceived health promotion needs and interests of low-income older women

This study focuses on an assessment of perceived health promotion needs and interests among predominantly older low-income women (76%) in the state of Pennsylvania. A questionnaire was completed by a convenience sample of 140 individuals attending four senior centers and two nutrition sites. In addition, 14 focus groups with an average of 8 members per group were conducted for a total of 105 people from two of the four senior centers. The health topics of greatest interest to women were exercise (57.6%), making friends (50.9%), nutrition (37.5%), losing weight (33.6%), and home safety (34.6%). Compared with women, men were significantly more interested in exercise and its effect on mood (41.3% versus 24.0%) and love and sex after 60 (44.8% versus 18.2%) and significantly less interested in nutrition (17.2% versus 37.5%). The fitness activities of greatest interest to women were walking (63.1%), back exercises (37.5%), toning to music (22.1%), and self-defense (18.2%), none of which was significantly different from the men in the sample. Results suggest that many of the key health needs perceived by low-income older women could be addressed by a combination of fitness activities and health education, especially if they are also designed to facilitate social interactions. The barriers to participation in such programs most often cited were transportation, scheduling, and cost factors. Fortunately, many communities already have the resources to offer low-cost interventions in the areas of need, such as walking groups, self-defense, and home safety. Communities interested in serving low-income older women should more closely examine the barriers and the unmet needs of this group when designing intervention programs.