Limits to social capital: comparing network assistance in two New Orleans neighborhoods devastated by Hurricane Katrina

Sociological research emphasizes that personal networks offer social resources in times of need and that this capacity varies by the social position of those involved. Yet rarely are sociologists able to make direct comparisons of such inequalities. This study overcomes this methodological challenge by examining network activation among residents of two unequal neighborhoods severely devastated by Hurricane Katrina. Results indicate that local network capacities of Lower Ninth Ward residents relative to those of the more affluent Lakeview neighborhood dissipated before, during, and after the disaster to erode the life chances of individual residents and the neighborhood they once constituted.

Is obesity contagious? Social networks vs. environmental factors in the obesity epidemic

This note's aim is to investigate the sensitivity of Christakis and Fowler's claim [Christakis, N., Fowler, J., 2007. The spread of obesity in a large social network over 32 years. The New England Journal of Medicine 357, 370-379] that obesity has spread through social networks. It is well known in the economics literature that failure to include contextual effects can lead to spurious inference on "social network effects." We replicate the NEJM results using their specification and a complementary dataset. We find that point estimates of the "social network effect" are reduced and become statistically indistinguishable from zero once standard econometric techniques are implemented. We further note the presence of estimation bias resulting from use of an incorrectly specified dynamic model.

Income and health inequality across Canadian provinces

This paper uses the aggregate data from the Public Use Microdata Files (PUMF) of Canadian National Population Health Survey to estimate income related health inequalities across the ten Canadian provinces. The unique features of the PUMF allow for a meaningful cross-provincial comparison of health indices and their measured inequalities. It concludes that health inequalities favouring the higher income people do exist in all provinces when health status is either self assessed or measured by the health utility index. Moreover, it finds considerable variations in measured health inequalities across the provinces with consistent rankings for certain provinces.

Low-income employees' choices regarding employment benefits aimed at improving the socioeconomic determinants of health

OBJECTIVES

Socioeconomic factors are associated with reduced health status in low-income populations. We sought to identify affordable employment benefit packages that might ameliorate these socioeconomic factors and would be consonant with employees' priorities.

METHODS

Working in groups (n = 53), low-income employees (n = 408; 62% women, 65% Black) from the Washington, DC, and Baltimore, Md, metropolitan area, participated in a computerized exercise in which they expressed their preference for employment benefit packages intended to address socioeconomic determinants of health. The hypothetical costs of these benefits reflected those of the average US benefit package available to low-income employees. Questionnaires ascertained sociodemographic information and attitudes. Descriptive statistics and logistic regression analysis were used to examine benefit choices.

RESULTS

Groups chose offered benefits in the following descending rank order: health care, retirement, vacation, disability pay, training, job flexibility, family time, dependent care, monetary advice, anxiety assistance, wellness, housing assistance, and nutrition programs. Participants varied in their personal choices, but 78% expressed willingness to abide by their groups' choices.

CONCLUSIONS

It is possible to design employment benefits that ameliorate socioeconomic determinants of health and are acceptable to low-income employees. These benefit packages can be provided at the cost of benefit packages currently available to some low-income employees.

Neighborhood social capital and adult health: an empirical test of a Bourdieu-based model

Drawing upon Bourdieu's [1986. The forms of capital. In: Richardson, J.G. (Ed.), Handbook of Theory and Research for the Sociology of Education. Greenwood, New York, pp. 241-258.] social capital theory, I test a conceptual model of neighborhood conditions and social capital - considering relationships between neighborhood social capital forms (social support, social leverage, informal social control, and neighborhood organization participation) and adult health behaviors (smoking, binge drinking) and perceived health, as well as interactions between neighborhood social capital and individuals' access to that social capital. Analyzing Los Angeles Family and Neighborhood Survey data linked with tract level census data, results suggest that specific social capital forms were directly associated with both positive and negative health outcomes. Additionally, residents' neighborhood attachment moderated relationships between various social capital forms and health. Future studies should consider social capital resources and the role of differential access to such resources for promoting or compromising health.

Are we getting what we pay for?

The British NHS delivers health care free at the point of access to whomever needs it. It is often claimed to be the envy of the world. But does it deliver health? Or could the resource put into the health service be better spent elsewhere? In this article, we discuss the determinants of health in the United Kingdom in the past, the rise of public health and the impact medical technology has had on health. We discuss resource distribution in health care, and apply the principles of health economics to the wider context of the delivery of health, rather than health care. With a background of rising demand for health care and rationing of resources in the UK, combined with inequalities in life expectancy related to position in society, we conclude that wealth redistribution, environmental regulation, improved nutrition and better education must come first in the priorities for achieving a healthy population.

Race, money and medicines

Taking notice of race is both risky and inevitable, in medicine no less than in other endeavors. On the one hand, race can be a useful stand-in for unstudied genetic and environmental factors that yield differences in disease expression and therapeutic response. Attention to race can make a therapeutic difference, to the point of saving lives. On the other hand, racial distinctions have social meanings that are often pejorative or worse, especially when these distinctions are cast as culturally or biologically fixed. I argue in this essay that we should start with a presumption against racial categories in medicine, but permit their use when it might prolong lives or meaningfully improve health. Use of racial categories should be understood as an interim step; follow-up inquiry into the factors that underlie race-correlated clinical differences is important both to improve the efficacy of clinical care and to prevent race in itself from being misunderstood as a biological determinant. If we pursue such inquiry with vigor, the pernicious effects of racial categories on public understanding can be managed. But perverse market and regulatory incentives create the danger that use of race will be "locked-in," once drugs or other therapies are approved. These incentives should be revisited.

Toward a neighborhood resource-based theory of social capital for health: can Bourdieu and sociology help?

Within the past several years, a considerable body of research on social capital has emerged in public health. Although offering the potential for new insights into how community factors impact health and well being, this research has received criticism for being undertheorized and methodologically flawed. In an effort to address some of these limitations, this paper applies Pierre Bourdieu's (1986) [Bourdieu, P. (1986). Handbook of theory and research for the sociology of education (pp. 241-258). New York: Greenwood] social capital theory to create a conceptual model of neighborhood socioeconomic processes, social capital (resources inhered within social networks), and health. After briefly reviewing the social capital conceptualizations of Bourdieu and Putnam, I attempt to integrate these authors' theories to better understand how social capital might operate within neighborhoods or local areas. Next, I describe a conceptual model that incorporates this theoretical integration of social capital into a framework of neighborhood social processes as health determinants. Discussion focuses on the utility of this Bourdieu-based neighborhood social capital theory and model for examining several under-addressed issues of social capital in the neighborhood effects literature and generating specific, empirically testable hypotheses for future research.

The theory of S-curve discontinuity in the medical care field

Confusion reigns supreme in the health are field today. In a previous paper, I described my thoughts about the reasons for this chaos. This article reviews the gradual escalation of health care costs and many of the unsuccessful methods to control them, reiterates the theory of S-Curve discontinuity in health care and develops a "tool" that will enable physician executives to determine whether or not a product or process in health care will succeed in the near and distant future. This new tool can be of value to all health care providers, investors, health planners, politicians involved in evolving health care legislation, and any others who have an investment in the future of health care.

Scientism and economism in the regulation of health care

As health care costs continue their apparently relentless rise, it seems to be universally perceived that the United States and western Europe are gripped by a cost crisis. To resolve the apparent crisis, U.S. and western European governments and third-party payers are turning increasingly to a new positivist discipline, called health services research, for which neoclassical health economics is the dominant discourse. However this discipline may actually reinforce the strength of biomedical positivism and the concomitant technological imperative. Like biomedicine, health services research is technologically driven, dependent on "advances" that generate more comprehensive and therefore more "accurate" data. Accordingly, just as biomedicine causes health care workers and patients to depend on technologies for diagnosis and treatment, health services research instills in the body politic dependence on technocratically conceived solutions for political problems. Moreover, because biomedicine and health services research share positivist epistemic and methodological premises, both objectify the subjects they study, abstract those subjects from context, and thereby ignore the cultural dimensions of the problems at hand. Rather than inculcate an ethic and practice in which medicine focuses on the meaning of illness for a life, a cultural phenomenon, this form of positivism strengthens the tendency to reject meaning in favor of the causes and course of disease and the abstracted probability of its occurrence. Accordingly health services research and the forms of regulation with which it is allied threaten to overwhelm the medical humanities movement. Furthermore this scientism precludes the institutionalization of political forums in which we can deliberate on the meaning of medicine, health, and death in our lives.

Work and reproduction: sociologic context

For nearly all women in the U.S., combining reproduction with employment is a complex juggling act. Reproduction as a social process is defined, followed by a review of the status of women at work, ways in which work influences the experience of reproduction, and various maternity provisions in the workplace.