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Biomedical subjects

C Muntaner

Publications and source records attributed to C Muntaner.

At least 19 recordsLinked to original sources

Associations between temporary employment and occupational injury: what are the mechanisms?

OBJECTIVE: To determine whether observed higher risks of occupational injury among temporary workers are due to exposure to hazardous working conditions and/or to lack of job experience level. METHODS: Data systematically recorded for 2000 and 2001 by the Spanish Ministry of Labour and Social Affairs on fatal and non-fatal traumatic occupational injuries were examined by type of employment and type of accident, while adjusting for gender, age, occupation, and length of employment in the company. In the study period there were 1500 fatal and 1 806 532 non-fatal traumatic occupational injuries that occurred at the workplace. Incidence rates and rate ratios (RR) were estimated using Poisson regression models. RESULTS: Temporary workers showed a rate ratio of 2.94 for non-fatal occupational injuries (95% CI 2.40 to 3.61) and 2.54 for fatal occupational injuries (95% CI 1.88 to 3.42). When these associations were adjusted by gender, age, occupation, and especially length of employment, they loose statistic significance: 1.05 (95% CI 0.97 to 1.12) for non-fatal and 1.07 (95% CI 0.91 to 1.26) for fatal. CONCLUSIONS: Lower job experience and knowledge of workplace hazards, measured by length of employment, is a possible mechanism to explain the consistent association between temporary workers and occupational injury. The role of working conditions associated with temporary jobs should be assessed more specifically.

Accidents, Occupational↗

Qualitative and quantitative research in social epidemiology: is complementarity the only issue?

Although in recent years there has been a growing acceptance of qualitative research in social epidemiology, the role and scope of its use remain a contested terrain. We sketch some of the issues that have been the focus of the debate between supporters and critics of qualitative research in social epidemiology and adjacent public health disciplines. They include epistemological problems, such as the limitations of survey research to uncover social mechanisms, lack of background among epidemiologists to generate sound hypotheses for specific populations, and ontological problems such the idealism inherent in some of the qualitative research coming from anthropology. Next we review the urban ethnographies of Elliot Liebow's and a decade of population based research in African American and low income neighborhoods in the United States to expose another role for qualitative research in social epidemiology. Thus, we argue that qualitative research has been used in scientific debates that confront egalitarian researchers with institutions or peers with opposing economic interests and ideologies. Qualitative research is often a powerful tool to fuel alternative theoretical frameworks and measures to be included in quantitative population based surveys. We confine this use of qualitative research to the academic world and do not necessarily imply that communities benefit from it as in action research.

Empirical Research↗

Occupational hierarchy, economic sector, and mortality from cardiovascular disease among men and women. Findings from the National Longitudinal Mortality Study.

PURPOSE: Although socioeconomic position has been identified as a determinant of cardiovascular disease among employed men and women in the U.S., the role of economic sector in shaping this relationship has yet to be examined. We sought to estimate the combined effects of economic sector-one of the three major sectors of the economy: finance, government and production-and socioeconomic position on cardiovascular mortality among employed men and women. METHODS: Approximately 375,000 men and women 25 years of age or more were identified from selected Current Population Surveys between 1979 and 1985. These persons were followed for cardiovascular mortality through use of the National Death Index for the years 1979 through 1989. RESULTS: In men, the lowest cardiovascular mortality was found for professionals in the finance sector (76/100,000 person/years). The highest cardiovascular mortality was found among male non-professional workers in the production sector (192/100,000 person years). A different pattern was observed among women. Professional women in the finance sector had the highest rates of cardiovascular mortality (133/100,000 person years). For both men and women, the professional/non-professional gap in cardiovascular mortality was lower in the government sector than in the production and finance sectors. These associations were strong even after adjustment for age, race and income. CONCLUSIONS: Characteristics of government, finance and production work differentially influence the risk of cardiovascular disease mortality. Men, women, professionals and non-professionals experience this risk differently.

Adult↗

Racial/ethnic differences in attitudes toward seeking professional mental health services.

OBJECTIVES: This study examined racial/ethnic differences in attitudes toward seeking mental health services. METHODS: Data from the National Comorbidity Survey, which administered a structured diagnostic interview to a representative sample of the US population (N = 8098), were analyzed. Multiple logistic regression was used, and data were stratified by need for mental health services. RESULTS: African Americans with depression were more likely than Whites with depression to "definitely go" (odds ratio [OR] = 1.8, P < .001) seek mental health services. African Americans with severe psychiatric disorders were less likely to be "somewhat embarrassed if friends knew they sought care" (OR = 0.3, P < .001) than were their White counterparts. CONCLUSIONS: African Americans reported more positive attitudes toward seeking mental health services than did Whites.

Black or African American↗

Health and social security reforms in Latin America: the convergence of the World Health Organization, the World Bank, and transnational corporations.

International financial institutions have played an increasing role in the formation of social policy in Latin American countries over the last two decades, particularly in health and pension programs. World Bank loans and their attached policy conditions have promoted several social security reforms within a neoliberal framework that privileges the role of the market in the provision of health and pensions. Moreover, by endorsing the privatization of health services in Latin America, the World Health Organization has converged with these policies. The privatization of social security has benefited international corporations that become partners with local business elites. Thus the World Health Organization, international financial institutions, and transnational corporations have converged in the neoliberal reforms of social security in Latin America. Overall, the process represents a mechanism of resource transfer from labor to capital and sheds light on one of the ways in which neoliberalism may affect the health of Latin American populations.

Commerce↗

Racial ideology and explanations for health inequalities among middle-class whites.

Middle-class whites' explanations for racial inequalities in health can have a profound impact on the type of questions addressed in epidemiology and public health research. These explanations also constitute a subset of white racial ideology (i.e., racism) that in itself powerfully affects the health of non-whites. This study begins to examine the nature of attributions for racial inequalities in health among university students who by definition are likely to be involved in the research, policy, and service professions (the upper middle class). Investigation of the degree to which middle-class whites attribute racial inequalities in cardiovascular health (between themselves and African Americans, American Indians, or Asian Americans) to biological, social, or lifestyle factors reveals that whites tend to attribute their own health to lifestyle choice and to biology rather than to social factors. These results suggest that contemporary middle-class whites' "self-serving" explanations for racial inequalities in health are comprised of two beliefs: implicit biologism (race is an attribute of organisms rather than a social relation) and liberal belief in self-determination, choice, and individual responsibility--some of the core lay beliefs of the worldview that sustains neoliberal capitalism. Contemporary white middle-class explanations for racial inequalities in health appear to include assumptions that justify class inequality. Liberal approaches to racism in public health are bound to miss a key component of racial ideology that is currently used to justify racial and class inequalities.

Analysis of Variance↗

Social capital, disorganized communities, and the third way: understanding the retreat from structural inequalities in epidemiology and public health.

The construct of social capital has recently captured the interest of researchers in social epidemiology and public health. The authors review current hypotheses on the social capital and health link, and examine the empirical evidence and its implications for health policy. The construct of social capital employed in the public health literature lacks depth compared with its uses in social science. It presents itself as an alternative to materialist structural inequalities (class, gender, and race) and invokes a romanticized view of communities without social conflict that favors an idealist psychology over a psychology connected to material resources and social structure. The evidence on social capital as a determinant of better health is scant or ambiguous. Even if confirmed, such hypotheses call for attention to social determinants beyond the proximal realm of individualized sociopsychological infrastructure. Social capital is used in public health as an alternative to both state-centered economic redistribution and party politics, and represents a potential privatization of both economics and politics. Such uses of social capital mirror recent "third way" policies in Germany, the United Kingdom, and United States. If third way policies lose support in Europe, the prominence of social capital there might be short lived. In the United States, where the working class is less likely to influence social policy, interest in social capital could be longer lived or could drift into academic limbo like other psychosocial constructs once heralded as the next big idea.

Community Health Planning↗

Socioeconomic status and depressive syndrome: the role of inter- and intra-generational mobility, government assistance, and work environment.

This paper assesses the hypothesis that depressive syndrome is associated with socioeconomic status, using longitudinal data from the Baltimore Epidemiologic Catchment Area Followup. Socioeconomic measures include those used in most studies of status attainment, as well as measures of financial dependence, non-job income, and work environment. Analyses include inter- and intra-generational mobility, and replicate the basic aspects of the status attainment process, as well as psychiatric epidemiologic findings regarding gender, family history of depression, life events, and depressive syndrome. But the involvement of depressive syndrome in the process of status attainment, either as cause or consequence, is small and not statistically significant. There are strong effects of financial dependence and work environment on depressive syndrome. The findings shed doubt on the utility of the causation/selection/drift model for depression, to the extent it is based on linear relationships and socioeconomic rank at the macro level, while lending credibility to social-psychologically oriented theories of work environment, poverty, and depression.

Baltimore↗

Racial differences in attitudes toward professional mental health care and in the use of services.

Differences in attitudes toward seeking professional mental health care and in the utilization of mental health services were examined by analyzing the second part of the National Comorbidity Survey. Prior to use of services, African Americans were found to have more positive attitudes than whites toward seeking such services, but less likely to use them. After utilization, their attitudes were found to be less positive than those of whites.

Adolescent↗

Depressive symptoms in rural West Virginia: labor market and health services correlates.

The prevalence and socioeconomic correlates of depressive symptoms in rural West Virginia were assessed. A random-digit-dialed telephone interview was administered to a community-dwelling sample of adults, ages 18 to 64, residing in the 40 rural counties of the Appalachian State of West Virginia. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale (CES-D). Overall rates of depressive symptoms were substantially higher than in the nation as a whole. Gender differences were lower than expected due to a high rate of depressive symptoms among men. Depressive symptoms were inversely associated with higher socioeconomic position. One-third of those who described themselves in "good mental health" reported depressive symptoms. About half who reported depressive symptoms had never seen a mental health professional or a physician for mental health problems. Efforts to increase awareness and access to mental health services are needed to promote the mental health of rural West Virginian populations.

Adult↗