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Biomedical subjects

M Minkler

Publications and source records attributed to M Minkler.

At least 19 recordsLinked to original sources
PubMed2001

American grandparents providing extensive child care to their grandchildren: prevalence and profile.

PURPOSE: This study sought to determine the prevalence and profile of grandparents providing extensive care for a grandchild (grandparents who provide 30+ hours per week or 90+ nights per year of child care, yet are not the primary caregiver of the grandchild). DESIGN AND METHODS: Secondary analysis of the 3,260 grandparent respondents in the 1992-94 National Survey of Families and Households (NSFH). Extensively caregiving grandparents were compared with custodial grandparents (those with primary responsibility for raising a grandchild for 6+ months), noncaregivers, occasional caregivers (<10 hours per week), and intermediate caregivers using chi-square tests, one-way analysis of variance tests, and logistic regression analyses. RESULTS: Close to 7% of all grandparents provided extensive caregiving, as did 14.9% of those who had provided any grandchild care in the last month. Extensive caregivers most closely resembled custodial caregivers and had least in common with those grandparents who never provided child care. IMPLICATIONS: Areas for future research, policy, and practice are highlighted, including the potential impact of welfare reform legislation on extensively caregiving grandparents.

Aged↗
PubMed2001

Contributions of community involvement to organizational-level empowerment: the federal Healthy Start experience.

This article presents findings of a multisite case study of the experience of nine federal Healthy Start Program sites in using consortia and other community involvement strategies in the fight against infant mortality. Using empowerment theory as a conceptual framework, qualitative data are employed to examine how community involvement in the program through community-based consortia and other means contributed to empowerment at the organizational level. The article concludes with implications of the study findings for practice both within Healthy Start and in the context of other community-based health initiatives.

Community Health Centers↗
PubMed2001

Physical and mental health status of American grandparents providing extensive child care to their grandchildren.

OBJECTIVE: to compare the physical, mental, and functional health status of grandparents providing extensive care to grandchildren (30+ hours per week or 90+ nights per year) with that of custodial grandparents, noncaregivers, and two categories of less intensive care providers. METHODS: Data on a subsample of 3260 respondents to the National Survey of Families and Households who reported being grandparents during the 1992 to 1994 interviews were analyzed. Chi-square tests, 1-way ANOVAs, and multiple regression analyses compared self-reported functional health limitations, depressive symptoms, and change in self-reported health status and depression for extensive caregivers (223), custodial grandparents (173), and 3 other types of grandparents providing less or no child care. RESULTS: Extensive caregivers had levels of depressive symptoms comparable to those of custodial caregivers and significantly higher than those of noncaregivers and less intense care providers. One in 5 extensive caregivers had clinically relevant levels of depressive symptoms. Two out of every 5 extensive caregivers had at least 1 limitation in activities of daily living. CONCLUSIONS: Providing extensive care for a grandchild was associated with elevated levels of depression. Physicians should be alert to family role changes and symptoms of depression in their older patients.

Aged↗
PubMed2000

African American grandparents raising grandchildren: a national profile of demographic and health characteristics.

Social workers are seeing, in health care settings, an increasing number of grandparent caregivers among their clients. A disproportionate number of these are African American. This article compares the demographic and physical and mental health characteristics of African American grandparents who are raising their grandchildren with non-caregiving African American grandparents, using the National Survey of Families and Households (1992-94). Caregivers reported significantly higher levels of limitations in four of five activities of daily living (ADL) and were almost twice as likely as their peers to report clinically relevant levels of depression.

Activities of Daily Living↗
PubMed2000

Second time around parenting: factors predictive of grandparents becoming caregivers for their grandchildren.

More than one in ten American grandparents raise a grandchild for at least six months, with most of these providing care for three years or more. This longitudinal study, utilizing data from the National Survey of Families and Households, identifies the pre-existing personal characteristics and contextual variables which are predictive of individuals becoming primary caregivers for their grandchildren. Contrary to hypothesis, pre-caregiving attitudes concerning intergenerational solidarity bore little relationship to the likelihood of becoming a caregiver. In contrast, being female, younger, African American, and having not completed high school were significantly predictive of becoming a custodial grandparent. Implications of these findings for research, practice, and policy in gerontology, mental health, and related areas are discussed.

Black or African American↗
PubMed1999

Personal responsibility for health? A review of the arguments and the evidence at century's end.

This article examines the continuing controversies regarding personal versus social responsibility for health as they are being played out at the turn of the century. Following a brief examination of the contested meaning of "personal responsibility for health" in recent historical context, attention is focused on the arguments for and against holding the individual to be primarily accountable for his or her health behavior. The paper then makes the case for more balanced, ecological approaches that stress individual responsibility for health within the context of broader social responsibility. The article concludes by briefly summarizing the Canadian approach to health promotion as a useful example of what such a balanced, ecological approach might look like.

Canada↗
PubMed1999

Impacts of welfare reform on California grandparents raising grandchildren: reflections from the field.

Debate over the potential impacts of welfare reform largely has ignored the implications of these changes for the growing number of grandparents who are raising their grandchildren. Results of a qualitative study involving 36 key informants who were intimately involved in the crafting and/or implementation of California's welfare reform plan are presented. Particular attention is focused on time limits on aid, work requirements, and sanctions regarding teenage parenthood as these may impact on grandparent caregivers and their families. Cross-cutting themes also are presented. A case is made for greatly stepping up data collection and evaluative research that may help in determining the actual impacts of the legislation on intergenerational households headed by grandparents.

Adult↗
PubMed1999

The health of grandparents raising grandchildren: results of a national study.

OBJECTIVES: This study sought to compare the functional and self-rated health of grandparents raising grandchildren with that of noncaregiving grandparents. METHODS: A secondary analysis of data from the 1992 to 1994 National Survey of Families and Households was conducted. Bivariate and logistic analyses compared 173 custodial and 3304 noncustodial grandparents in terms of functional health limitations, self-rated health, and satisfaction with health. RESULTS: Custodial grandparents were significantly more likely to have limitations in 4 of the 5 activities of daily living (ADLs) examined, with more than half reporting some limitation in 1 of the 5 ADLs. A logistic regression analysis indicated that caregiving grandparents had 50% higher odds of having an ADL limitation. Caregivers were significantly more likely to report lower satisfaction with health, and a statistical trend indicated that the caregivers had lower self-rated health. CONCLUSIONS: Further research is needed to determine whether the differences observed reflect artifacts or actual differences in functional abilities and other health measures. The need for policies that support rather than penalize grandparents raising grandchildren is stressed.

Activities of Daily Living↗
PubMed1998

Disability theory and public policy: implications for critical gerontology.

Current gerontological theories and aging policy often fail to acknowledge the social and economic consequences of disability in later life, while disability theories and policies tend to focus only on the employment impacts of disability in younger populations. This article attempts to apply a critical gerontology framework to aging and disability issues. The authors review theoretical models of the disablement process, and note the primacy of environmental factors. The production and distribution of disability are assessed, using both social epidemiology and political economy insights. The authors examine the linkage of disability and work impedance and the consequences in disability programming, giving special consideration to inherent age, gender, and racial biases. Some of the historical antecedents of disability stigma in aging populations are also identified. The article concludes by suggesting that analysts and policymakers who wish to address the tremendous social and economic inequities that accompany aging and disability should look to the principles put forth by the independent living movement and to recent work on the moral economy of interdependency over the life course.

Age Factors↗
PubMed1997

A profile of grandparents raising grandchildren in the United States.

This article examines the prevalence of grandparent caregiving in the U.S. and presents a national profile of grandparent caregivers based on current data from the national Survey of Families and Households. More than one in ten grandparents are found to have cared for a grandchild for at least 6 months, with most of these having engaged in a far longer-term commitment. Although custodial grandparenting cuts across gender, class, and ethnic lines, single women, African Americans, and low income persons are disproportionately represented. Multivariate logistic analysis indicates that three groups--women, recently bereaved parents, and African Americans--have approximately twice the odds of becoming caregiving grandparents. Implications for further research, policy, and practice are discussed.

Adult↗
PubMed1997

Impacts of the proposed restructuring of Medicare and Medicaid on the elderly: a conceptual framework and analysis.

The article examines the proposed transformations in U.S. Medicare and Medicaid as these are likely to affect the nation's elderly population. Drawing on political economy, moral economy, and notions of the deserving versus the undeserving poor, the authors develop a broad conceptual framework within which to better understand the current upheavals. Both Republican and Democratic proposals for restructuring Medicare and Medicaid are described and analyzed, and common themes within the various proposals highlighted. After exploring the differential impacts of the restructuring on subgroups within the elderly population, including low-income seniors, the disabled, women, and elders of color, the authors conclude with a discussion of the symbolic importance of the proposed transformations. The latter reflect both accelerated government movement away from its legitimation functions and toward increased capital accumulation, and continuing government attempts to reshape our perceptions of the state economy in ways that permit more radical cutbacks and austerity measures.

Aged↗
PubMed1997

Gender, race, class, and aging: advances and opportunities.

Key debates in social science and health research have centered on how to increase the inclusiveness of such research and hence its relevance for understanding the intersections of race, class, gender, and aging. This article uses gerontology as a case in point, examining the challenges of inclusivity and interlocking oppressions/intersectionality for better apprehending how broad structural factors shape and determine the experience of aging and growing old. The authors discuss alternative hypotheses being used to explore inequalities in the aging experience and the limitations of current concepts and methods. Promising new developments in sociology, epidemiology, and other fields are described in terms of their relevance for better understanding the dynamic interplay of race, class, gender, and aging.

Adaptation, Psychological↗
PubMed1996

Health of grandmothers raising children of the crack cocaine epidemic.

OBJECTIVES: Approximately 3.2 million children live with their grandparents or other relatives-a 40% increase in 10 years. This article presents selected findings from an exploratory study of the experience of 71 African-American women raising their grandchildren because of the crack epidemic. METHODS: The study was designed to describe the caregivers' self-reported physical and emotional health status and health-care-related behaviors through a combination of qualitative and quantitative data collected during two in-home interviews. RESULTS: Most respondents rated their health as good or fair, with little change over the previous year, or since caregiving began. Employed women were more likely not only to rate their health as excellent or good, but also to report that their health had deteriorated over the previous year. Other subgroups showing evidence of deteriorating health were those caring for several grandchildren and great-grandmothers. Caregivers without a confidante reported a positive health change. Although 80% of the sample reported receiving regular health care, one third had not been to the doctor in 3 years. Half reported breaking a medical appointment in the last year, most often because of caregiving demands. CONCLUSIONS: These findings have relevance for physicians and other health-care providers because they suggest that many grandparent caregivers may be or soon become the "hidden patients" of the crack cocaine epidemic.

Adult↗
PubMed1995

Combining research, advocacy, and education: the methods of the Grandparent Caregiver Study.

This article presents a case study of the effective synergy of health education inquiry, community collaboration, and policy advocacy. Using the Grandparent Caregiver Study as the example, the authors focus on key methodological decisions that enabled them to incorporate research, education, and advocacy activities into an ever-growing project on a modest budget. The study itself centered on two in-depth interviews with each of 71 African American grandmothers raising young grandchildren due to the crack cocaine epidemic in Oakland, California. The case study demonstrates ways in which health education research can increase the efficacy of individuals and disenfranchised groups to define problems, voice their concerns, and advocate for more just and healthy public policies. Through discussion of the authors' methods and activities, they suggest strategies through which research participants, service providers, and policymakers can work together to bring a new issue to the policy arena through a collaborative and empowering research process.

Adult↗
PubMed1994

Raising grandchildren from crack-cocaine households: effects on family and friendship ties of African-American women.

Changes in family and friendship networks of 71 African-American grandmothers raising grandchildren as a consequence of the crack-cocaine epidemic are examined. Despite continued strong social ties, many of the women reported decreased contact with family and friends other than confidantes and a decline in marital satisfaction. Implications of the findings for research, policy, and practice are discussed.

Adult↗
PubMed1994

New health promotion movement: a critical examination.

In the last decade, a revolution has been occurring in the field of health promotion. Guided to a large extent by position papers disseminated by the World Health Organization (WHO) Europe Health Promotion Office, and furthered by the Ottawa Charter, the Epp Report in Canada, the Healthy Cities project, as well as by other efforts, this new health promotion movement has introduced new ideas, new language, and new concepts about what constitutes health and how health promotion efforts should be configured to achieve health. Punctuated by the terms like empowerment and community participation, this movement has generated a whole new discourse about the theory and practice of health promotion. This paper explores the multiple meanings that surround these terms, and the implications for practice, by addressing questions like: What does health mean in this new context? What is empowerment? What does participation look like? Has the tyranny of the professional been replaced by the tyranny of the community? Has anything changed about the practice of health promotion other than the language? Finally, it is argued that an acknowledgment of the multidimensionality of these concepts may facilitate their translation from rhetoric into health promotion practice.

Canada↗