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Close-to-community (CTC) providers have been identified as a key cadre to progress universal health coverage and address inequities in health service provision due to their embedded position within communities. CTC providers both work within, and are subject to, the gender norms at community level but may also have the potential to alter them. This paper synthesises current evidence on gender and CTC providers and the services they deliver. This study uses a two-stage exploratory approach drawing upon qualitative research from the six countries (Bangladesh, Indonesia, Ethiopia, Kenya, Malawi, Mozambique) that were part of the REACHOUT consortium. This research took place from 2013 to 2014. This was followed by systematic review that took place from January–September 2017, using critical interpretive synthesis methodology. This review included 58 papers from the literature. The resulting findings from both stages informed the development of a conceptual framework. We present the holistic conceptual framework to show how gender roles and relations shape CTC provider experience at the individual, community, and health system levels. The evidence presented highlights the importance of safety and mobility at the community level. At the individual level, influence of family and intra-household dynamics are of importance. Important at the health systems level, are career progression and remuneration. We present suggestions for how the role of a CTC provider can, with the right support, be an empowering experience. Key priorities for policymakers to promote gender equity in this cadre include: safety and well-being, remuneration, and career progression opportunities. Gender roles and relations shape CTC provider experiences across multiple levels of the health system. To strengthen the equity and efficiency of CTC programmes gender dynamics should be considered by policymakers and implementers during both the conceptualisation and implementation of CTC programmes. [ABSTRACT FROM AUTHOR]

Globally, there are 2 billion 'informal' workers, who lack access to social protection while facing profound health risks and socioeconomic exclusions. The informal economy has generated most jobs in Low and Middle-Income Countries (LMICs), but few studies have explored informal workers' complex health vulnerabilities, including in the face of climate change. This paper will discuss recent action-research in Indore (India), Harare, and Masvingo (Zimbabwe) with informal workers like vendors, waste-pickers, and urban farmers. We conducted qualitative interviews (N = 110 in India), focus group discussions (N = 207 in Zimbabwe), and a quantitative survey (N = 418 in Zimbabwe). Many informal workers live in informal settlements ('slums'), and we highlight the interrelated health risks at their homes and workplaces. We explore how climate-related threats—including heatwaves, drought, and floods—negatively affect informal workers' health and livelihoods. These challenges often have gender-inequitable impacts. We also analyse workers' individual and collective responses. We propose a comprehensive framework to reveal the drivers of health in the informal economy, and we complement this holistic approach with a new research agenda. Our framework highlights the socioeconomic, environmental, and political determinants of informal workers' health. We argue that informal workers may face difficult trade-offs, due to competing priorities in the face of climate change and other risks. Future interventions will need to recognise informal workers' array of risks and co-develop multifaceted solutions, thereby helping to avoid such impossible choices. We recommend holistic initiatives to foster health and climate resilience, as well as participatory action-research partnerships and qualitative, intersectional data-collection with informal workers. • Climate change is exacerbating many risks to informal workers' health and livelihoods. • WASH access may foster gender equality and decent work, while tackling heat stress. • Policymakers can partner with informal workers to create inclusive, multi-pronged interventions. [ABSTRACT FROM AUTHOR]

Complex security environments are characterized by violence (including, but not limited to “armed conflict” in the legal sense), poverty, environmental disasters and poor governance. Violence directly affecting health service delivery in complex security environments includes attacks on individuals (e.g. doctors, nurses, administrators, security guards, ambulance drivers and translators), obstructions (e.g. ambulances being stopped at checkpoints), discrimination (e.g. staff being pressured to treat one patient instead of another), attacks on and misappropriation of health facilities and property (e.g. vandalism, theft and ambulance theft by armed groups), and the criminalization of health workers. This paper examines the challenges associated with researching the context, scope and nature of violence directly affecting health service delivery in these environments. With a focus on data collection, it considers how these challenges affect researchers’ ability to analyze the drivers of violence and impact of violence. This paper presents key findings from two research workshops organized in 2014 and 2015 which convened researchers and practitioners in the fields of health and humanitarian aid delivery and policy, and draws upon an analysis of organizational efforts to address violence affecting healthcare delivery and eleven in-depth interviews with representatives of organizations working in complex security environments. Despite the urgency and impact of violence affecting healthcare delivery, there is an overall lack of research that is of health-specific, publically accessible and comparable, as well as a lack of gender-disaggregated data, data on perpetrator motives and an assessment of the ‘knock-on’ effects of violence. These gaps limit analysis and, by extension, the ability of organizations operating in complex security environments to effectively manage the security of their staff and facilities and to deliver health services. Increased research collaboration among aid organizations, researchers and multilateral organizations, such as the WHO, is needed to address these challenges. [ABSTRACT FROM AUTHOR]

Despite impressive global investment in reproductive health programs in West Africa, maternal mortality remains unacceptably high and obstetric care is often inadequate. Fertility is among the highest in the world, while contraceptive prevalence remains among the lowest. This paper explores the social and technical dimensions of this situation. We argue that effective reproductive health programs require analyzing the interfaces between technical programs and the social logics and behaviors of health professionals and client populations. Significant gaps between health programs’ goals and the behaviors of patients and health care professionals have been observed. While public health projects aim to manage reproduction, sexuality, fertility, and professional practices are regulated socially. Such projects may target technical practices, but access to care is greatly influenced by social norms and ethics. This paper shows how an empirical anthropology that investigates the social and technical interfaces of reproduction can contribute to improved global health. [ABSTRACT FROM AUTHOR]

This paper compares three groups of gestational mothers who relied on gametes from donors they did not know. The three groups are women who have conceived with donor sperm and their own eggs, women who have conceived with donor eggs and a partner's sperm, and women who have conceived with embryos composed of both donor eggs and donor sperm. The paper explores three issues. First, it considers whether intending parents select sperm and egg donors for different attributes both when they are chosen as the only donor and when they are chosen as donors contributing to an entire embryo. Second, it examines how women imagine the donor. Finally, it looks at how women conceptualize the donor as an individual who contributes to their child's characteristics. Two significant findings emerged in this analysis of survey data. First, the data show that gametes are gendered with different attributes both when those gametes are separate and even more so when seen as complementary parts of a whole. Second, the data show that women minimize the impact of the egg donor (both when a sole contribution and especially when part of the complementary whole) and thus ignore the influence or impact of the egg donor relative to how they make sense of the influence or impact of the sperm donor. The data for this study comes from an online survey developed by the authors. [ABSTRACT FROM AUTHOR]

In many parts of the world access to adequate water, sanitation and hygiene (WASH) is entwined with gender relations. While there is emerging research on how gender relations intersect with socio-cultural practices and norms to produce gender-based violence in WASH, little is known about how these gender relations are intimately produced, reproduced and embodied in place. Drawing insights from feminist political ecology and gendered geographies of power, this paper uses retrospective narratives of Ghanaian migrants in Canada to advance this scholarship in three significant ways. First, the findings demonstrate how gender relations in WASH produce everyday vulnerabilities differently among women and men. Second, they highlight the complex ways women bargain with patriarchal structures to ensure their safety in WASH spaces. Finally, the findings show how gender relations and roles in WASH transform in transnational spaces in which gendered WASH roles and responsibilities are blurred. The findings draw policy attention to the interconnectedness of WASH and gender equality and the need for policy and practice change to advance gender equity in WASH. • Water, sanitation and hygiene (WASH) security is entwined with gender relations. • Gender relations intersect with socio-cultural practices and norms to (re)produce gender-based violence in WASH. • Women bargain with patriarchal structures to ensure their safety in WASH spaces. • Gender relations and roles in WASH are reconstituted across space and time. [ABSTRACT FROM AUTHOR]

Professionals occupy a position of esteem in society. Doctors and health professionals tend to score especially highly on public opinion surveys of trust. Sexual violence and abuse (SVA) by medical professionals towards their patients is a grave breach of that confidence. This paper uses thematic analysis of a paradigmatic case study of doctor abuse, drawn from a larger sample of semi-structured interviews conducted for an Economic and Social Research Council (ESRC) funded United Kingdom (UK) study 2015–2018 into justice and gender based violence. It explores how professional authority can both facilitate and conceal sexual coercion through building dependency; use of language and authorship of the official record; and by functional complicity and 'data doubling' within intra and inter-professional cultures. While there is an established literature on child sexual abuse, including in institutional contexts, this paper focuses on the lived experience of grooming and sexual violence of an adult survivor of doctor abuse. • Sexual violence and abuse by doctors is a profound breach of trust. • Professional authority and professional cultures can be sexually coercive. • Critical and inter-disciplinary work needed on professional perpetrators. [ABSTRACT FROM AUTHOR]

This paper aims to increase understanding of how mothers diagnosed with breast cancer while in the paid workforce experience and manage their multiple demands of taking care of themselves, their children and their paid work. In-depth, semi-structured interviews were conducted with 32 women who were mothers of dependent children and in the paid workforce at the time of their breast cancer diagnosis. The sample includes women living in urban and rural Australia. The study found that after a breast cancer diagnosis, participants tended to prioritise their health and wellbeing over paid work. Yet dominance of gendered identity meant that they tended to place the needs of family, especially children, above their own health and wellbeing. The key factors that influenced mothers' decisions to continue in, return to, or leave paid work after a breast cancer diagnosis included: a change in perspective regarding what was important in their lives; level of support from the workplace and home; the extent to which participating in paid work was a financial necessity; the extent to which their identity was connected to paid work, and; ongoing level of pain or fatigue. The paper concludes that using the sociological concepts of the fateful moment, boundary maintenance and a feminist ethic of care produces a more nuanced understanding of women's participation in paid work after breast cancer than examining paid workforce participation, or unpaid responsibilities and mothering, separately. The nature of the permeability or malleability of boundaries between work, family and taking care of the self affects women's participation in paid work during and/or after breast cancer treatment. Increased boundary permeability or malleability brought about more by cooperation than conflict facilitated positive experiences of re-negotiating boundaries, whereas increased permeability or malleability brought about more by conflict than cooperation created difficulties for women in finding an acceptable balance between their family, paid work and taking care of their own health after breast cancer. [ABSTRACT FROM AUTHOR]

Abstract: Medical end-of-life decisions, defined as end-of-life practices with a potential or certain life-shortening effect, precede almost 50% of deaths in Western countries, and receive ample medical-ethical attention. This systematic review aims to detect whether there are differences in the prevalence of medical end-of-life decisions in ‘vulnerable’ patient groups. In 2009, five major databases were scrutinized for publications containing original data on the prevalence of euthanasia/physician-assisted suicide, life-ending without explicit patient request, intensified symptom alleviation, non-treatment decisions and palliative sedation by social factors (eg age, gender and SES). Heterogeneous findings were pooled using a random effects model. We identified 6377 papers of which 51 papers were selected, involving over 1.09 million patients. Most publications reported the prevalence of non-treatment decisions. The most studied social factors were age and gender. Among patients older than eighty years, non-treatment decisions occurred more frequently compared with younger patients, while intensified symptom alleviation, palliative sedation, euthanasia/physician-assisted suicide and life-ending without explicit request were practiced less often. Similar patterns of association, although less strong, were found for female patients compared with males and those with lower levels of education versus more highly-educated patients. We conclude that the administration of medication with a potential or certain life-shortening effect seemed generally to be practiced less often among the elderly, females and less well-educated patients compared with younger, male or more educated patients, while decisions that include the withdrawal or withholding of treatments seem to be more common in these groups. Further studies should focus on investigating whether these differences reflect less than optimal end-of-life care for specific patient groups. [Copyright &y& Elsevier]

With its sociocultural, institutional, and demographic contexts, India offers a unique opportunity to study the dynamics and experiences of aging, especially as it is poised to have a large increase in the number of persons aged 60 and above in the next half a century. In this paper, we focus on the concept of productive aging that emphasizes the active participation of older persons in society. We examine the correlates of productive aging in India, drawing on data from the Building Knowledge Base on Population Aging (BKPAI) survey of 9852 men and women aged 60 years and above in seven states of India in 2011. The productive activities that we examine pertain to four domains: work, contribution to household financial matters, grandparenting, and social engagement. The findings highlight the importance of gender, family structure, and socio-economic status in these different aspects of productive aging. Importantly, the findings show that the effect of the correlates is not the same across the different measures of productive aging. We find that women are less likely than men to engage in all productive activities except for grandparenting, and that living with children and adverse health reduce the likelihood of current employment or financial contributions, but not of social engagement or grandparenting. Greater wealth at older ages reduces the likelihood of employment but increases the likelihood of social engagement and ties. The study contributes to the understanding of opportunities and constraints of productive aging in India and has implications for intergenerational relationships, support and dependencies in old age. • We examined economic, care, and social engagement aspects of productive ageing. • Older women engage less than men in productive activities except for grandparenting. • Intergenerational coresidence neither boosts nor harms later life social engagement. • Greater wealth reduces the likelihood of working and increases social engagement. • Functional disability but not chronic ailments adversely affect productive ageing. [ABSTRACT FROM AUTHOR]

Abstract Mobility is fundamental to independent living, but past research on physical function and mobility in older adults has not considered both intersectional social identities and cohort change in tandem. This paper utilizes data on mobility limitations from older adults in multi-ethnic Singapore to test whether cohort change varies simultaneously by gender and ethnicity. Panel data (n = 9334 person-years) collected over six years (2009–2015) were used to estimate aging vector models. Findings show that after adjusting for all covariates, Malay and Indian males in later-born cohorts have an increased number of mobility limitations compared to earlier-born cohorts. While a similar trend was also found for Chinese males and females in unconditional models, these were fully mediated by sociodemographic and health variables. These results highlight the importance of considering cohort change at the intersection of gender and ethnicity, bringing attention to possible inequities between ethnic groups. Highlights • Examines cohort change with lens of intersectionality. • Uses three waves of panel data collected over six years from older Singaporeans. • Cohort trends varied by gender and ethnicity. • Minority males had increased mobility limitations in more recent cohorts. [ABSTRACT FROM AUTHOR]

Abstract: The increased medicalization of different life stages, including menopause, is a subject studied mostly in the Western context. Examining medicalization in the non-Western world advances discussions of body, identity and health. In this paper, I analyze the discourses around postmenopausal osteoporosis in Turkey, focusing on the different constructions of risk in the medical and popular literature. The empirical basis of the paper draws on ethnographic research done in Istanbul, Turkey between June 2006 and March 2007. The research includes participant observation in gynecology clinics, interviews with clinicians and menopausal women and archival research on the representations of menopause in the Turkish media between 1999 and 2006. Referred to as kemik erimesi (melting of the bones) in colloquial Turkish, osteoporosis has been an essential component in the medicalization of menopause in Turkey. I argue that postmenopausal osteoporosis is defined as a combination of embodied risk, which is related to the definition of menopause as a risky period, and lifestyle risk, demonstrated in discussions around “traditional” vs. “modern” clothing and healthcare habits. The Turkish example emphasizes the importance of local conditions in defining medical risk and complicates the embodied vs. lifestyle risk categories. [Copyright &y& Elsevier]

Abstract: This paper responds to the call for culturally-relevant intervention research by introducing a methodology for identifying community norms and resources in order to more effectively implement sustainable interventions strategies. Results of an analysis of community norms, specifically attitudes toward gender equity, are presented from an HIV/STI research and intervention project in a low-income community in Mumbai, India (2008–2012). Community gender norms were explored because of their relevance to sexual risk in settings characterized by high levels of gender inequity. This paper recommends approaches that interventionists and social scientists can take to incorporate cultural insights into formative assessments and project implementation These approaches include how to (1) examine modal beliefs and norms and any patterned variation within the community; (2) identify and assess variation in cultural beliefs and norms among community members (including leaders, social workers, members of civil society and the religious sector); and (3) identify differential needs among sectors of the community and key types of individuals best suited to help formulate and disseminate culturally-relevant intervention messages. Using a multi-method approach that includes the progressive translation of qualitative interviews into a quantitative survey of cultural norms, along with an analysis of community consensus, we outline a means for measuring variation in cultural expectations and beliefs about gender relations in an urban community in Mumbai. Results illustrate how intervention strategies and implementation can benefit from an organic (versus a priori and/or stereotypical) approach to cultural characteristics and analysis of community resources and vulnerabilities. [Copyright &y& Elsevier]

Abstract: The prevalence of child obesity has increased steadily in the recent decades. Drawing on Bourdieu’s theory of lifestyle connecting objective conditions with preferences, values and behaviour, this paper seeks to provide an extension to previous research, which has found child body formation to be correlated with parental socioeconomic background. The paper shows how parental level of capital, especially cultural capital, influences the prevalence of child overweight and parental perceptions of child weight-levels. Parents with higher levels of cultural capital are less likely to have overweight children and more likely to perceive weight-levels in accordance with the BMI categories. The results also demonstrate clear gender differences. Parents have a tendency to overestimate their daughters’ weight-levels while underestimating the weight-levels of their sons compared to the BMI categories. The study is based on Danish survey data from 2007 and uses statistical estimation techniques. [Copyright &y& Elsevier]

Abstract: This paper focuses on a neglected factor in literature on the HIV epidemic in sub-Saharan Africa: the role of the eco-social environment in shaping HIV risk. I argue that the changing ecological environment of Lake Victoria, Africa’s largest freshwater lake, mapping onto a gendered economy, shaped fisherfolk’s sexual relationships and sexual mixing patterns in ways that were consequential for their HIV risk. Specifically, I show how disrupted lake and fish ecology had an impact on fishermen’s sexual, domestic and economic partnerships, as well as how it contributed to the “sex for fish” economy in Nyanza Province, Kenya. I also show the consequences of fishermen’s relative wealth on transactional relationships with school girls and women in lakeside communities. The paper is based on ethnographic fieldwork over a seven month period among the Luo ethnic group, which has the highest HIV rates in Kenya. The study included 74 individual and focus group interviews in communities around Lake Victoria, as well as 20 key informant interviews. Additionally, literature reviews on fishing and sexual economies as well as on ecological research in Lake Victoria are employed. Exploring linkages between these literatures and fieldwork findings forms the basis of this paper. I argue that solely focusing on individual level HIV prevention strategies is limited without taking into account the eco-social context of individual sexual decision making. [Copyright &y& Elsevier]

Abstract: One way of reducing maternal mortality in developing countries is to ensure that women have a referral system at the local level that includes access to emergency obstetric care. Using a 13-month ethnographic study from 2003 to 2005 of women’s social positions and maternal health in a semi-urban community of Hindu-caste women in the Kathmandu Valley, this paper identifies impediments to receiving obstetric care in a context where the infrastructure and services are in place. As birth in Nepal predominantly takes place at home, this paper identifies the following areas for potential improvement in order to avoid the loss of women’s lives during childbirth: the frequency of giving birth unaided, minimal planning for birth or obstetric complications, and delayed responses at the household level to obstetric emergencies. Focusing particularly on the last item, this study concludes that women do not have the power to demand biomedical services or emergency care, and men still viewed birth as the domain of women and remained mostly uninvolved in the process. As the cultural construction of birth shifts from a “natural” phenomenon that did not require human regulation toward one that is located within the domain of biomedical expertise and control, local acceptance of a biomedical model does not necessarily lead to the utilization of services if neither women nor men are in a culturally-defined position to act. [Copyright &y& Elsevier]

Abstract: This paper revisits the concept of medicalisation and considers its value as a framework for understanding the ongoing development of new reproductive technologies, and their impact on women’s reproductive decision-making. This evaluation is drawn from a qualitative discourse analysis of the public debate about the first extended cycle oral contraception (ECOC) to suppress menstruation in the United States of America in 2003/2004, and subsequent interviews with women living in Australia who had already extended their cycles without it being medically approved for widespread practice. Firstly, the debates about menstrual suppression are couched within a discussion of the ongoing usefulness of medicalisation as an analytical tool. It is posited that medicalisation occurs in a particular social and cultural moment, and is a dynamic process where dominant social relations can be both reproduced and challenged. Secondly, qualitative interviews with women about practices of menstrual suppression are used to explore the productive nature of agency in this particular medicalisation contest. Specifically, the ways in which these women engage with the discourses of ‘risk’, ‘choice’ and ‘nature’, as canvassed by menstrual suppression advocates, reveal accommodation and modification as much as resistance and contradiction. This paper suggests that if the concept of medicalisation is to have ongoing traction as a frame of analysis, such a critique must incorporate a generative discussion of agency. [Copyright &y& Elsevier]

Abstract: This paper uses data from the Scottish Health Survey 2003 and the comparable Health Survey for England 2003 to look at whether Scotland''s poor health image and mortality profile is reflected in regional inequalities in prevalence of four risk factors for cardiovascular disease: fruit and vegetable consumption, smoking, obesity and diabetes. It also looks at the “Scottish effect” – how much of any difference between and within Scotland and England remains once socio-demographic factors have been taken in to account. The paper then uses regional analyses to determine the extent to which areas within England and Scotland contribute to their national health advantage and disadvantage. All 2003 strategic health authorities in England and Scottish health boards were compared with Greater Glasgow health board as the reference category. The results showed that significant geographic variation in the risk factors remained once individual economic status was taken into account, but the relationship was complex and varied in strength and direction depending upon risk factor involved and gender of respondent. A small number of areas had significantly lower odds of fruit and vegetable consumption of five portions or more a day in men, compared with Greater Glasgow. In contrast some areas had significantly higher odds of fruit and vegetable consumption for women compared with Greater Glasgow. There was greater geographic variation in the odds of smoking in women than in men. Respondents in the south west and southeast of England (areas which usually show health advantage) did not show significantly lower odds of smoking compared with Greater Glasgow once socio-economic variation, age and urban residence was taken into account. It was respondents from central England that had lower odds of smoking than might be expected. Obesity stood out as the single risk factor that had demonstrated a “Scottish effect” in women only. [Copyright &y& Elsevier]

Abstract: This paper examines young African school children''s understanding of HIV and AIDS. Based on focus group interviews with children aged 7–8 in KwaZulu-Natal province, South Africa, it explores the ways in which gender and sexuality feature in their responses to the disease. Data were collected between 2003 and 2004 through 26 focus groups involving 55 boys and 64 girls. The paper argues that younger children are active agents in giving meaning to the disease. Their agency is negotiated within complex social processes involving sexual violence, highly unequal gender/age inequalities, but also sexual expression. Those expressions are subsumed however under a regime of violence and fear catapulting men, albeit with contestation, as chief vectors in the spread of the disease and a source of girls'' anxieties. Children''s responses to the disease are the effects of material, symbolic and discursive forces effectively constraining the opportunities available to them and creating patterns of vulnerability especially for young girls. Interventions aimed at scaling up efforts to address young children responses to the disease must be situated in parallel efforts to end poverty, sexual violence and pervasive gender inequalities in order to foster more comprehensively the exercise of young children''s agency. [Copyright &y& Elsevier]

Recent research and policy discourse commonly view the limited autonomy of women in developing countries as a key barrier to improvements in their reproductive health. Rarely, however, is the notion of women's autonomy interrogated for its conceptual adequacy or usefulness for understanding the determinants of women's reproductive health, effective policy formulation or program design. Using ethnographic data from 2001, including social mapping exercises, observation of daily life, interviews, case studies and focus group discussions, this paper draws attention to the incongruities between the concept of women's autonomy and the gendered social, cultural, economic and political realities of women's lives in rural Punjab, Pakistan. These inadequacies include: the concept's undue emphasis on women's independent, autonomous action; a lack of attention to men and masculinities; a disregard for the multi-sited constitution of gender relations and gender inequality; an erroneous assumption that uptake of reproductive health services is an indicator of autonomy; and a failure to explore the interplay of other axes of disadvantage such as caste, class or socio-economic position. This paper calls for alternative, more nuanced, theoretical approaches for conceptualizing gender inequalities in order to enhance our understanding of women's reproductive wellbeing in Pakistan. The extent to which our arguments may be relevant to the wider South Asian context, and women's lives in other parts of the world, is also discussed. [Copyright &y& Elsevier]

In this paper, I use a nationally representative sample of adolescents from the United States to examine the association between childhood mistreatment (sexual abuse and physical abuse) and depression during adolescence and young adulthood. Researchers have implicated childhood mistreatment as one of the most important predictors of depression. An alternative mechanism linking childhood mistreatment with adolescent and young adult depression is community and family disadvantage (or other factors) that affect both outcomes. Using data from the restricted version of the U.S. National Longitudinal Study of Adolescent Health (Add Health), this paper outlines several findings of the relationship between mistreatment and depression as well as the gender differences in depression. First, I find very limited evidence that controlling for common environmental factors at the school or neighborhood level explain the relationship between mistreatment and depression. Also, I show that controlling for common family factors decreases the predictive power of childhood mistreatment on depression. Results in this paper generally support previous research that shows the link between childhood mistreatment and depression is most important for females, even within families. Finally, results suggest that the effects of child mistreatment on depression may increase as individuals age. [Copyright &y& Elsevier]

The low rate of help-seeking and high rate of suicide completion among men has prompted public health officials to create suicide prevention campaigns that specifically target men. Drawing from data collected as part of a larger study of fire recovery in a rural county in Northern California, this paper utilizes 68 interviews with fire survivors (24 men and 44 women) and 40 interviews with mental health service providers to examine how rural residents interpret this type of campaign. To track patterns of help-seeking over time, I also draw upon 26 follow-up interviews – 20 with fire survivors (7 men and 13 women) and 6 with service providers – conducted one year after the first wave of interviews. In total, 134 in-depth interviews were conducted. This paper also draws on a secondary data source; I conducted content analysis of an internal Health and Human Services Agency focus group report used in the development of a local male-targeted suicide prevention campaign, Captain Awesome. As I show, male-targeted suicide prevention efforts have little salience in rural communities in which treatment resources are limited and stigma abounds. Perceptions about material conditions – i.e., treatment resources being few and far between – contribute to residents establishing a norm of not seeking help. Rural culture which emphasizes self-sufficiency and independence contributes to a pattern of both men and women repeating a narrative that frames men who seek help as weak. While research has identified women as key drivers for men's physical health maintenance, my research suggests that the same pattern might not hold around mental health maintenance in rural settings. In sum, I argue that male-targeted campaigns have limited resonance and efficacy in rural communities where material conditions and cultural narratives create physical and psychological barriers to accessing to treatment. • Male-targeted suicide prevention campaigns have little salience in rural areas. • Perceptions of limited treatment resources contribute to low rates of help-seeking in rural places. • A rural ethos emphasizing self-sufficiency contributes to low help-seeking. • Both men and women residents of rural places reinforce stigma against help-seeking. • Suicide prevention campaigns need to be developed with regional specificity. [ABSTRACT FROM AUTHOR]

This paper examines whether spending on tobacco crowds out expenditure on basic needs and whether it has implications on nutrition intake and household resource allocation in India. The paper uses a household sample survey from India for the year 1999–2000. A system of quadratic conditional Engel curves was estimated for a set of 10 broad groups of commodities. The results suggest that tobacco consuming households had lower consumption of certain commodities such as milk, education, clean fuels and entertainment which may have more direct bearing on women and children in the household than on men suggesting possible ‘gender effects’ and biases in the allocation of goods and services within the household. Tobacco spending was also found to have negative effects on per capita nutrition intake. The nature of crowding out was found to be similar in low- and high-income households. [Copyright &y& Elsevier]

Abstract: In the context of the contemporary rhetoric of the “obesity epidemic”, the fat body is easily labelled as lazy, self-indulgent and lacking in discipline. Those who become fat often find themselves needing to account for their size in order to refute the suggestion of moral failure that attaches itself easily to the fat body. Drawing on a series of interviews with 35 weight loss surgery patients in England and Scotland, this paper explores the discursive resources and strategies available to those who are, or who have been, very overweight in accounting for their size. The paper argues that the participants drew on three core discourses in order to resist the construction of their fatness as an individual moral failure: (1) the fat-prone body; (2) childhood weight gain; and (3) life events disrupting weight management efforts. [Copyright &y& Elsevier]

Abstract: For researchers interested in understanding men''s health, there are two main literatures to harvest. The first is research on men''s health arising from the study of men and masculinities. The second is the broader study of inequalities in health, including gender inequalities in health. However, these literatures have remained distinct. This paper seeks to develop a model of understanding men''s health from both of these literatures. In order to achieve this integration, this paper argues that studies of men''s health should be based on ‘critical studies on men’ which emerges from feminist theory. Critical studies on men''s health is then integrated into the broader explanatory options identified in the health inequality literature in order to provide a more fulsome account of variance within men''s health and between the health status of men and women. Given the amenability of men''s health issues to interrogation within this resulting framework, it is argued that the inequalities literature should start to include men''s health issues in its work. [Copyright &y& Elsevier]

Abstract: Thalassemia is an inherited blood disorder that has been receiving increasing attention in India. However, prevention of thalassemia in India continues to be difficult despite efforts of public health professionals and the government. Using West Bengal as a case study, this paper attempts to unravel some of the barriers to the prevention campaign and the consequent under utilization of the program. Lack of access, low awareness, low-risk perception and poverty are all important proximate constraints; however, one of the greatest barriers to the program is rooted in cultural notions of blood, marriage, identity, personhood and kinship in Bengali society. Blood is so deeply valued in the Bengali kinship system that this genetic mutation is perceived to be corrupting the blood (rakter dosh). Being a thalassemia carrier (i.e., having thalassemia minor) renders an individual unfit as a suitable marriage partner because of beliefs related to purity of blood, its association with the continuity of the lineage, and subsequent transmission of desirable traits to future generations. The risk of non-marriage affects women disproportionately, and parents are not inclined to test their daughters because of the possibility of not being able to marry them off to eligible suitors. The stigma associated with having thalassemia minor (TMI) is a deterrent to the disclosure of thalassemia status as well as to testing. Using anthropological theories and ethnographic methods, this paper focuses on the gendered process by which the diagnosis of a thalassemia carrier ‘spoils’ identities, thereby creating a disjuncture between the goals of the prevention program and people''s need for social conformity, and ultimately between medical desirability and social desirability. The paper also suggests policies for enhancing the utilization of the program. Finally the conclusions from this study have potential applications for public health prevention programs that confront problems of stigma in program acceptability. [Copyright &y& Elsevier]

Abstract: This paper provides insights into the way gendered assumptions operate within health care interventions for women with eating disorders. A multidisciplinary sample of Australian health care workers were interviewed about their approaches to treatment, and discourse analysis was used to uncover the discursive dynamics and power relations characterising their accounts of intervention. The paper demonstrates a contradictory positioning of anorexic patients in relation to autonomy and control within the two common psychiatric interventions of bed rest intervention and psychotherapy. The paper argues that this is based on gendered assumptions about selfhood and femininity in eating disorders that are reproduced in the therapeutic relationship through the operation of a gendered parent-child dynamic, with the health care worker as father or mother, and the anorexic patient as daughter. One of the main effects of this is to re-inscribe rather than challenge the discursive ‘double bind’ of femininity that has been widely implicated by post-structural feminists in producing eating disorders in the first place. The paper also considers the widely acknowledged problem of resistance to treatment in anorexia as a function of controlling treatments, and discusses psychiatrists’ perspectives on addressing this dilemma. Finally, the paper examines the potential of feminist-informed understandings of eating disorders for overcoming the gendered dilemmas inherent within the dominant psycho-medical treatment paradigm. [Copyright &y& Elsevier]

Recent attention to Millennium Development Goals by the international development community has led to the formation of targets to measure country-level achievements, including achievements on health status indicators such as childhood immunization. Using the example of immunization in India, this paper demonstrates the importance of disaggregating national averages for a better understanding of social disparities in health. Specifically, the paper uses data from the India National Family Health Survey 1992–93 to analyze socioeconomic, gender, urban-rural and regional inequalities in immunization in India for each of the 17 largest states. Results show that, on average, southern states have better immunization levels and lower immunization inequalities than many northern states. Wealth and regional inequalities are correlated with overall levels of immunization in a non-linear fashion. Gender inequalities persist in most states, including in the south, and seem unrelated to overall immunization or the levels of other inequalities measured here. This suggests that the gender differentials reflect deep-seated societal factors rather than health system issues per se. The disaggregated information and analysis used in this paper allows for setting more meaningful targets than country averages. Additionally, it helps policy makers and planners to understand programmatic constraints and needs by identifying disparities between sub-groups of the population, including strong and weak performers at the state and regional levels. [Copyright &y& Elsevier]

Analyses of the psychological sequelae of war-related violence for women tend to rely on the concepts developed in research on male combatants. Post-traumatic stress disorder or varying combinations of its symptoms are identified as the principal outcomes of war-related events for women. By and large, the dominant literature does not examine possible outcomes which could be specified by gender. This paper refers to the war in Mozambique during the 1970s and 1980s as a typical illustration of how women are an integral part of the battlefield. It draws on research on African women and uses testimony of Mozambican women refugees who settled in South Africa to explore how gender is linked to psycho-social outcomes of massive social conflict. The paper argues that a richer understanding of the psycho-social outcomes of war and the needs of survivors is promoted by investigating gender in specific historical situations and how this frames the responses people have to experiences of violence and social destruction. [Copyright &y& Elsevier]

The aim of the paper is to investigate associations between a range of markers of gender inequity, including financial, psychological and physical violence, and two proximal practices in HIV prevention, namely discussion of HIV between partners and the woman suggesting condom use. The paper presents an analysis of data from a cross-sectional study of a representative sample of women from three South African Provinces which was primarily undertaken as an epidemiological study of gender-based violence. A multi-stage sampling design was used with clusters sampled with probability proportional to number of households. Households were randomly selected from within clusters. One randomly selected woman aged 18–49 years was interviewed in each selected home. One thousand three hundred and six women were interviewed (90.3% of eligible women). One thousand one hundred sixty four women had a partner in the previous year and were asked questions related to HIV prevention and gender inequalities in the relationship. The results indicate that discussion of HIV was significantly positively associated with education, living in Mpumalanga Province, the man being a migrant, the woman having multiple partners in the past year and having no confidante. It was significantly negatively associated with living in the Northern Province, the relationship being poor and there being a substantial age difference between partners. The woman suggesting condom use was significantly positively associated with her education, her having multiple partners, domestic violence prior to the past year and financial abuse. It was negatively associated with the relationship being poor. We conclude that this suggests that some indicators of gender inequalities are significantly associated with discussion of HIV and condom use but the direction of association found was both positive and negative. This highlights the need for a more nuanced understanding of gender inequalities and their relationship to HIV risk. Suggestions for key research questions are made. [Copyright &y& Elsevier]

In 2017, the Danish Parliament reclassified the diagnosis used for gender-affirming treatment, officially removing it from the list of psychiatric disorders. This paper examines how trans identity was negotiated and constructed in the political debate during the years leading up to this reclassification. Through the lens of political discourse analysis, it explores how two conflicting discourses emerged in opposition to each other, out of which a liberal rights approach to trans identity gained legitimacy throughout the period in question. We argue that although the two discourses offer different problematizations of trans identity, they both entail a gender essentialist framework. • Historically, trans diagnoses belonged under the category of psychiatric disorders. • In DK, the trans diagnosis was reclassified into being non-psychiatric in 2017. • Two main opposing discourses shaped the debate leading up to the change. • While the development seems progressive, gender essentialism is maintained. [ABSTRACT FROM AUTHOR]

Physical pain is one of the most severe of human experiences. It is thus one of the most important to understand. This paper reports the first cross-country study of the links between physical pain and the state of the economy. A key issue examined is how the level of pain in a society is influenced by the unemployment rate. The study uses pooled cross-sectional Gallup data from 146 countries (total N > 1.3 million). It estimates fixed-effects regression equations that control for personal characteristics. More than a quarter of the world's citizens are in physical pain. Physical pain is lower in an economic boom and greater in an economic downturn. Estimated effect sizes are substantial. Remarkably, increases in pain are borne almost exclusively by women and found principally in rich nations. These findings have paradoxical aspects. The counter-cyclicality of physical pain is not what would be predicted by conventional economic analysis: during an expansion, people typically work harder and longer, and accidents and injuries increase. Nor are the study results due to unemployed citizens experiencing more pain (although they do). Instead, the study's findings are consistent with an important hypothesis proposed recently, using different kinds of evidence, by brain and behavioural-science researchers (e.g., Wiech and Tracey, 2009; Chou et al.; 2016). The hypothesis is that economic worry can create physical pain. This study provides the first cross-country evidence that the level of physical pain in a nation depends on the state of the economy. Pain is high when the unemployment rate is high. That is not because of greater pain among people who lose their jobs — it extends far beyond that into wider society. The increase in physical pain in a downturn is experienced disproportionately by women. • The paper is the first study of physical pain and the state of the economy. • It uses Gallup data from 146 countries. • Pain falls in a boom and rises in a downturn. Pain is high when unemployment is high. • Increases in pain in recessions are borne predominantly by women. [ABSTRACT FROM AUTHOR]

Using nationally representative longitudinal data from 2010 to 2016 in China, this paper aims to systematically investigate the dynamic relationship between socioeconomic status (SES) and obesity in the Chinese adult population. We apply maximum likelihood estimations of dynamic panel models with fixed effects to evaluate the causal directions between SES and obesity, thus providing empirical evidence of the relative importance of the "social determination" hypothesis (SES determines obesity), the "health selection" hypothesis (obesity influences SES) and the "indirect selection" hypothesis (some third factors cause obesity and SES). All analyses were conducted for women and men separately. Our analyses mostly support the contention that after two years, there are no significant causal effects of either lagged SES on Body Mass Index (BMI) or BMI on SES, after controlling for time-invariant unobserved confounders. While there is weak evidence of social determination among men, non-manual workers tend to have a higher BMI than those who are unemployed. We conclude that the indirect selection hypothesis may be the most important explanation in understanding the relationship between SES and obesity in China. • The paper studies the causation between socioeconomic status and BMI in China. • We use maximum likelihood estimation for dynamic panel models with fixed effects. • Neither social determination nor health selection hypothesis is supported. • The association between SES and BMI may be due to earlier unobserved confounders. [ABSTRACT FROM AUTHOR]

This paper explores the multiple ways experiences of pregnancy and early motherhood come to ‘rework’ the biographies of women living with epilepsy. Pregnancy is explored as a temporarily concurrent status alongside the long-term condition of epilepsy. Narrative interviews were conducted with 32 women from across the UK. Analysis of these narratives suggests that biographical disruption and continuity are both useful in the conceptualisation of women's diverse experiences of pregnancy and epilepsy. Such findings challenge the notion that the presence of a condition over a long period of time leads to the normalisation of illness. Participants' narratives demonstrate that, for some, pregnancy and early motherhood may be disruptive and can raise concerns regarding an ever present condition that may previously have been taken for granted. Findings also indicate the need for a greater consideration of gender and care responsibilities, as well explorations of concomitant conditions, in the theorising of biographies and chronic illness. [ABSTRACT FROM AUTHOR]

Increasing food and nutritional inequities are apparent in urban settings across Low- and Middle-Income Countries (LMICs), along with nutrition transition towards ultra-processed diets high in fat, sugar, and salt. In urban informal settlements, characterized by insecurity and inadequate housing and infrastructure, food systems dynamics and their nutritional implications are poorly understood. This paper explores the food system determinants of food and nutrition security in urban informal settlements in LMICs with the goal of identifying effective approaches and entry points for policy and program. Scoping review. Five databases were screened spanning the period 1995 to 2019. A total of 3748 records were assessed for inclusion based on title and abstract followed by 42 full text reviews. At least two reviewers assessed each record. Twenty-four final publications were included, coded, and synthesized. Factors influencing food security and nutrition in urban informal settlements can be organized into three interconnected levels. Macro-level factors include globalization, climate change, transnational food corporations, international treaties and regulations, global and national policies such as SDGs, insufficient social aid programs, and formalization or privatization. Meso-level factors include gender norms, inadequate infrastructure and services, insufficient transportation, informal food retailers, weak municipal policies, marketing strategies, and (lack of) employment. Micro-level factors comprise gender roles, cultural expectations, income, social networks, coping strategies, and food (in) security. Greater policy attention should focus at the meso-level, with priority investments in services and infrastructure within urban informal settlements. The role and engagement of the informal sector is an important consideration in improving the immediate food environment. Gender is also crucial. Women and girls have a central role in food provisioning but are more vulnerable to various forms of malnutrition. Future research should include context-specific studies in LMIC cities as well as promoting policy change using a participatory and gender transformative approach. • Interconnected macro, meso & micro level factors shape inequities in urban food systems. • AcTion is needed to improve the immediate food environment in informal settlements. • The informal food sector is critical to the urban poor with overlooked potential. • Women are key to household food provisioning and need to be supported. [ABSTRACT FROM AUTHOR]

The SARS-CoV2 pandemic led to drastic social restrictions globally. Early data suggest that women in science have been more adversely affected by these lockdowns than men, with relatively fewer scientific articles authored by women. However, these observations test broad populations with many potential causes of disparity. Australia presents a natural experimental condition where several states of similar demographics and disease impact had differing approaches in their social isolation strategies. The state of Victoria experienced 280 days of lockdowns from 2020 to 2021, whereas the comparable state of New South Wales experienced 107 days, most of these in 2021, and other states even fewer restrictions. To assess how the gender balance changed in Australian biomedical publishing with the lockdowns, we created a custom workflow to analyse PubMed data from more than 120,000 published articles submitted in 2019–2021 from Australian authors. Broadly, Australian women have been incredibly resilient to the challenges faced by the lockdowns. There was an increase in the number of published articles submitted in 2020 that was equally due to women as men, including from Victoria. On the other hand, articles specifically addressing COVID-19 were significantly less likely to be authored by women than those on other topics, a finding not likely due to particular gender imbalance in virology or viral epidemiology, since publications on HIV followed similar patterns to previous years. By 2021, this imbalance had reversed, with more COVID-19-related papers authored by women than men. These data suggest women from Victoria were less able to rapidly transition to new research early in the pandemic but had accommodated to the new conditions by 2021. This work indicates we need strategies to support women in science as the pandemic continues and to continue to monitor the situation for its impact on vulnerable groups. • We analyzed PubMed data from >120,000 articles from Australian authors. • COVID-19 pandemic lockdown severity had no gender-specific effect. • Women authored fewer COVID-19 articles than expected in 2020. • Women's publishing of COVID-19 work normalized in 2021. • Women were less able to rapidly transition to new research in the COVID pandemic. [ABSTRACT FROM AUTHOR]

While much previous work linking fertility history with late-life cognition has focused on a narrow set of cognitive measures and/or has used modest sample sizes in the analysis, our paper expands the size and scope of these linkages by analyzing cognitive function across five domains and precisely estimating gendered patterns between men and women. Results point to important gendered associations between parity and cognition: having children is likely associated with better cognitive function for fathers in all five domains. However, mothers show worse cognitive function in some domains (i.e., numeric memory, prospective memory, and fluid intelligence) than childless women. We explore the possibility of confounding in these associations and rule out the effects of genetic cognitive ability on fertility. We also find that adding controls for educational attainment differ by gender—strengthening associations between parity and cognition for men and largely eliminating them for women. The findings support previous work done on how life course contexts may link to the risk of dementia or cognitive impairment, highlighting parity as potential protective or risk factors to parents' cognitive health. The use of five cognitive domains yields variations in results, giving implications on measure selection of cognitive function and calling for replicated work covering more cognitive domains. • For men, having offspring is associated with better cognition in all five domains. • For women, having offspring is associated with worse cognition in three domains. • Education matters to women's fluid intelligence, numeric and prospective memory. • Genetic factors do not explain the association between parity and cognition. [ABSTRACT FROM AUTHOR]

Pandemic preparedness and COVID-19 response indicators focus on public health outcomes (such as infections, case fatalities, and vaccination rates), health system capacity, and/or the effects of the pandemic on the economy, yet this avoids more political questions regarding how responses were mobilized. Pandemic preparedness country rankings have been called into question due to their inability to predict COVID-19 response and outcomes, and COVID-19 response indicators have ignored one of the most well documented secondary effects of the pandemic – its disproportionate effects on women. This paper analyzes pandemic preparedness and response indicators from a feminist perspective to understand how indicators might consider the secondary effects of the pandemic on women and other equity deserving groups. Following a discussion of the tensions that exist between feminist methodologies and the reliance on indicators by policymakers in preparing and responding to health emergencies, we assess the strengths and weakness of current pandemic preparedness and COVID-19 response indicators. The risk with existing pandemic preparedness and response indicators is that they give only limited attention to secondary effects of pandemics and inequities in terms of who is disproportionately affected. There is an urgent need to reconceptualize what 'successful' pandemic preparedness and response entails, moving beyond epidemiological and economic measurements. We suggest how efforts to design COVID response indicators on gender inclusion could inform pandemic preparedness and associated indicators. • A feminist perspective on debates about the use of indicators in global health. • Pandemic preparedness and response indicators consideration of gender is limited. • COVID-19 has led to the development of innovative gender-based approaches. • These can be built upon through greater integration of feminist approaches. [ABSTRACT FROM AUTHOR]

In this paper, we investigate the possibility that genetic variation contributes to self-perceived weight status among adolescents and young adults in the U.S. Using samples of identical and fraternal twins across four waves of the National Longitudinal Study of Adolescent to Adult Health (Add Health) study, we calculate heritability estimates for objective body mass index (BMI) that are in line with previous estimates. We also show that perceived weight status is heritable (h 2 ∼ 0.47) and most importantly that this trait continues to be heritable above and beyond objective BMI (h 2 ∼ 0.25). We then demonstrate significant sex differences in the heritability of weight identity across the four waves of the study, where h 2 women = 0.39, 0.35, 0.40, and 0.50 for each wave, respectively, and h 2 men = 0.10, 0.10, 0.23, and 0.03. These results call for a deeper consideration of both identity and gender in genetics research. [ABSTRACT FROM AUTHOR]

This article shares results from a long-term participatory agroecological research project in northern Malawi. Drawing upon a political ecology of health conceptual framework, the paper explores whether and how participatory agroecological farming can improve food security and nutrition among HIV-affected households. In-depth interviews were conducted with 27 farmers in HIV-affected households in the area near Ekwendeni Trading Centre in northern Malawi. The results show that participatory agroecological farming has a strong potential to meet the food, dietary, labour and income needs of HIV-affected households, whilst helping them to manage natural resources sustainably. As well, the findings reveal that place-based politics, especially gendered power imbalances, are imperative for understanding the human impacts of the HIV/AIDS epidemic. Overall, the study adds valuable insights into the literature on the human-environment dimensions of health. It demonstrates that the onset of disease can radically transform the social relations governing access to and control over resources (e.g., land, labour, and capital), and that these altered social relations in turn affect sustainable disease management. The conclusion highlights how the promotion of sustainable agroecology could help to partly address the socio-ecological challenges associated with HIV/AIDS. [ABSTRACT FROM AUTHOR]

The present paper analysed the directions of associations between individual-level structural social capital, in the form of civic engagement, and depressive symptoms across time from age 16–42 years in Swedish men and women. More specifically, we asked whether civic engagement was related to changes in depressive symptoms, if it was the other way around, or whether the association was bi-directional. This longitudinal study used data from a 26-year prospective cohort material of 1001 individuals in Northern Sweden (482 women and 519 men). Civic engagement was measured by a single-item question reflecting the level of engagement in clubs/organisations. Depressive symptoms were assessed by a composite index. Directions of associations were analysed by means of gender-separate cross-lagged structural equation models. Models were adjusted for parental social class, parental unemployment, parental health, and family type at baseline (age 16). Levels of both civic engagement and depressive symptoms were relatively stable across time. The model with the best fit to data showed that, in men, youth civic engagement was negatively associated with depressive symptoms in adulthood, thus supporting the hypothesis that involvement in social networks promotes health, most likely through provision of social and psychological support, perceived influence, and sense of belonging. Accordingly, interventions to promote civic engagement in young men could be a way to prevent poor mental health for men later on in life. No cross-lagged effects were found among women. We discuss this gender difference in terms of gendered experiences of civic engagement which in turn generate different meanings and consequences for men and women, such as civic engagement not being as positive for women’s mental health as for that of men. We conclude that theories on structural social capital and interventions to facilitate civic engagement for health promoting purposes need to acknowledge gendered life circumstances. [ABSTRACT FROM AUTHOR]

This paper examines gender differentials in survival amongst older people (50+ years) in the Nairobi slums and to the best of our knowledge is the first study of its kind in an urban African setting. The results provide evidence contrary to the expected paradox of poorer self-rated health yet better survival amongst older women. Older women in the Nairobi slums have poorer self-rated health and poorer circumstances across other factors, including disability and socio-economic status. Further, older women in the slums do not have better survival. The conventional female advantage in mortality only becomes apparent after accounting for the cumulative influence of individual characteristics, social networks, health and socio-economic status, suggesting the female advantage in unadjusted old-age mortality does not apply to contexts where women experience significant disadvantage across multiple life domains. This highlights the urgent need to redress the support, status and opportunities available for women across the life course in contexts such as the Nairobi slums. In addition, a greater number of factors differentiate mortality risk amongst men than amongst women, suggesting inequality amongst slum dwelling older men and highlighting the need for gender sensitive interventions which account for the particular needs of both genders in old age. [ABSTRACT FROM AUTHOR]

While a number of studies, based on cross-sectional data for Russia, have documented strong increases in female smoking during the past two decades, the analysis of longer-term trends in smoking prevalence is hampered by the lack of representative data for the Soviet era. In this paper we create life-course smoking histories based on retrospective data from the Russia Longitudinal Monitoring Survey of HSE (RLMS-HSE) and the Global Adult Tobacco Survey (GATS) which allow us to examine the dynamics of smoking patterns over the past 7 decades. We find that smoking rates differ most strongly by gender within all cohorts, but that this differential has decreased over time, driven by increases in female smoking and more recently by decreases in smoking among men. For both genders we observe that the education gradient has become steeper over time, with smoking rates having increased at a higher rate among those with the lowest educational attainment. These findings suggest that the development of smoking in Russia mirrors that described in the model of the tobacco epidemic and observed in Western high-income countries. [ABSTRACT FROM AUTHOR]

Introduction Power imbalances within sexual relationships have significant implications for HIV prevention in sub-Saharan Africa. Little is known about how power influences the quality of a relationship, which could be an important pathway leading to healthy behavior around HIV/AIDS. Methods This paper uses data from 448 heterosexual couples (896 individuals) in rural KwaZulu-Natal, South Africa who completed baseline surveys from 2012 to 2014 as part of a couples-based HIV intervention trial. Using an actor-partner interdependence perspective, we assessed: (1) how both partners' perceptions of power influences their own (i.e., actor effect) and their partner's reports of relationship quality (i.e., partner effect); and (2) whether these associations differed by gender. We examined three constructs related to power (female power, male equitable gender norms, and shared power) and four domains of relationship quality (intimacy, trust, mutually constructive communication, and conflict). Results For actor effects, shared power was strongly and consistently associated with higher relationship quality across all four domains. The effect of shared power on trust, mutually constructive communication, and conflict were stronger for men than women. The findings for female power and male equitable gender norms were more mixed. Female power was positively associated with women's reports of trust and mutually constructive communication, but negatively associated with intimacy. Male equitable gender norms were positively associated with men's reports of mutually constructive communication. For partner effects, male equitable gender norms were positively associated with women's reports of intimacy and negatively associated with women's reports of conflict. Conclusions Research and health interventions aiming to improving HIV-related behaviors should consider sources of shared power within couples and potential leverage points for empowerment at the couple level. Efforts solely focused on empowering women should also take the dyadic environment and men's perspectives into account to ensure positive relationship outcomes. [ABSTRACT FROM AUTHOR]

Given high levels of immigration into Canada and the associated requirement to understand the health needs of new arrivals, an extensive literature has developed over the past decade that has explored immigrant health issues, including the ‘healthy immigrant effect’. Surprisingly, however, issues of disability within the immigrant population have received much less attention. Using data from Statistics Canada, 2006a, 2006b Participation and Activity Limitation Survey (PALS), this paper examines disability and its covariates amongst immigrants relative to non-immigrants in Canada. Compared with their native-born counterparts, recent immigrant arrivals (within the past 10 years) were less likely to report disability and less likely to report a severe disability than the native-born. However, differences in the rates and covariates of disabilities between males and female immigrants were observed, which are partially explained by socioeconomic and sociodemographic effects. The conclusion explores potential reasons why differentials in disability rates are observed, and points to future research directions. [ABSTRACT FROM AUTHOR]

At the start of the twenty-first century, two arms of U.S. immigration policy shape the lives of families and children. The first, enforcement practices, lead to the involuntary separation of parents and children—or the fears of this outcome—when the United States government detains and forcibly removes the parents of U.S. citizen children. The second, the policies which restrict migration to the United States, cause children to experience both long and short term separations when their parents migrate without them. In this paper I use interviews collected between the years of 2003–2006 and 2009–2012 with children and their parents or guardians in both the United States and in Mexico to assess the meanings these two types of separations have for families and the potential impacts for children's well-being. I find that enforcement practices create economic and emotional hardship due to feelings of uncertainty, while restrictive immigration policies lead to resentment among children even post-reunification. [ABSTRACT FROM AUTHOR]

The international migration of parents from the global south raises questions about the health impacts of family separation on those who stay behind. This paper uses data collected in 2008 and 2009 for a project on Child Health and Migrant Parents in South-East Asia (CHAMPSEA) to address a largely neglected research area by investigating the mental health of those who stay behind in Indonesia, Philippines and Vietnam to care for the children of overseas migrants. A mixed-methods research design is employed to answer two questions. First, whether carers in transnational (migrant) households are more likely to suffer mental health problems than those in non-migrant households; and secondly, whether transnational family practices and characteristics of migration are associated with mental health outcomes for stay-behind carers. The Self-Reporting Questionnaire (SRQ-20) was completed by carers in selected communities ( N = 3026) and used to identify likely cases of common mental disorders (CMD). Multivariate logistic regression and thematic analysis of qualitative interviews ( N = 149) reveal a nuanced picture. All stay-behind carers in the Indonesian sample are more likely than carers in non-migrant households to suffer CMD. Across the three study countries, however, it is stay-behind mothers with husbands working overseas who are most likely to experience poor mental health. Moreover, infrequent contact with the migrant, not receiving remittances and migrant destinations in the Middle East are all positively associated with carer CMD, whereas greater educational attainment and greater wealth are protective factors. These findings add new evidence on the ‘costs’ of international labour migration and point to the role of gendered expectations and wider geopolitical structures. Governments and international policy makers need to intervene to encourage transnational family practices that are less detrimental to the mental health of those who stay behind to care for the next generation. [ABSTRACT FROM AUTHOR]

Medicalization is a central topic of concern in the sociology of disability and of health and illness. In this paper, I examine how medicalization is inequitably applied and circulates in the context of schools, specifically in serving students with educational disabilities. My aim is to advance understandings of medicalization through this case. Using a mixed-methods design, I first show, descriptively, how race and gender intersectionally predict educational disability status in a dataset of all Wisconsin public school students. Next, I examine how racial and gender disparities in disability status are produced at the micro level, using interviews with 27 Wisconsin teachers, including in-depth discussions of 73 individual students that were struggling academically or behaviorally. My quantitative findings show variation by race, gender, and disability category: White children have higher probability of special education receipt than comparable children of color for academic difficulties, but lower probability for behavioral difficulties, and girls have lower probability than comparable boys overall. My interview data suggest that these disparate outcomes reflect stratified medicalization processes, in which institutional constraints, status beliefs, and cultural discourses of race and gender shape both stratified noticing of schooling difficulties and stratified interpretation of those difficulties as medicalized conditions. • White children and boys are more likely than comparable peers to receive special education for higher-status disabilities. • Children of color and boys are more likely than comparable peers to receive special education for lower-status disabilities. • These inequalities are explained by stratified definitional processes of medicalization by teachers. • Institutional constraints and cultural discourses of race and gender shape stratified medicalization processes. • These processes include stratified noticing and stratified interpretation of students' difficulties. [ABSTRACT FROM AUTHOR]

A growing body of literature suggests even routine or low-level contact with the criminal justice system impacts health outcomes. In this paper, I examine two mechanisms by which police contact contributes to deleterious health outcomes: system avoidance and social isolation. I use data from 12,016 respondents from the National Longitudinal Study of Adolescent to Adult Health, a longitudinal and nationally representative sample. Findings suggest system avoidance may be an important mechanism by which police stops shape health outcomes. Whether social isolation serves as a mechanism varies based on how it is measured. Results suggest police stops are associated with subjective feelings of loneliness, which in turn explained some of the association between police stops and health outcomes. Notably, women were more likely to exhibit system avoidance and poor health following police contact compared to men. • Contact with the police is associated with worse general health and depression. • Multiple mechanisms connect police contact with deleterious health outcomes. • Mechanisms include the avoidance of formal healthcare and feelings of loneliness. • These influences may be stronger among women than men. [ABSTRACT FROM AUTHOR]

Using innovative data with objective and subjective measures of stress collected from 122 employed men and women, this paper tests the thesis of the Time Bind by asking whether people report lower stress levels at work than at home. The study finds consistent support for the Time Bind hypothesis when examining objective stress data: when participants were at work they had lower values of the stress hormone cortisol than when they were at home. Two variables moderated this association - income and children at home - such that the work as haven effect was stronger for those with lower incomes and no children living at home. Participants also, however, consistently reported higher subjective stress levels on work days than on non-work days, which is in direct contrast to the Time Bind hypothesis. Although our overall findings support Hochschild's hypothesis that stress levels are lower at work, it appears that combining work and home increases people's subjective experience of daily stress. [ABSTRACT FROM AUTHOR]