PubMed Health⌕ Search

Biomedical subjects

M Minkler

Publications and source records attributed to M Minkler.

52 records · Page 3Linked to original sources
PubMed1983

Blaming the aged victim: the politics of scapegoating in times of fiscal conservatism.

The ideology and process of victim blaming have undergone profound changes as a consequence of recent sociopolitical developments. This paper examines a newer and more pernicious form of victim blaming, with particular attention to the ways it has been directed at the elderly in American society. Several contexts are presented within which we may view recent budget cuts affecting the elderly in order to analyze the scapegoating of the aged as a primary "cause" of the fiscal crisis. These contexts include the cyclical nature of social problems, which expand or contract in accordance with the dominant needs of the economy; the "fiscal crisis mentality"; the philosophy and tactics of decentralization; and the Reagan Administration's move toward an "ideological definition of reality." Each of these contexts is seen as fitting within the overarching context of the current economic crisis and the intensified class conflict and related outcomes which it has generated. Unlike the victim blaming of the 1960s and early 70s, which defined "the elderly" as a social problem and devised solutions (e.g. expanded Social Security benefits, Medicare and Medicaid) for dealing with that problem, the victim blaming of the 1980s is seen as defining these earlier "solutions" as part of the problem. Not only are the aged problematic, but ameliorative programs are seen as "busting the federal budget" and in need of dismantling and/or shifting to other levels of government and the private sector. Education grounded in political-economic analyses of the "aging problem," aimed in part at overcoming structurally induced divisiveness among oppressed groups, is suggested as an important deterrent to the increased polarization which the current fiscal crisis mentality has nurtured.

Aged↗
PubMed1981

Applications of social support theory to health education: implications for work with the elderly.

The large body of evidence linking social support and health provides an important supplement to earlier theory and research suggesting the more direct role social contacts may play in influencing health behavior. Three major hypotheses have been set forth concerning the precise mechanism of action through which social support may work to maintain health and decrease susceptibility to illness. Each of these theoretical positions is described and its empirical base examined. The particular relevance of social support theory for work with the elderly is discussed. The concept of social marginality, and such network properties as strength of ties, reciprocity and network size are examined in light of their implications for the design of programs aimed in part at fostering social support among the elderly. Several examples of innovative health education programs are used to illustrate the relevance of different theoretical principles in practice settings. Attention finally is focused on the need for looking beyond social networks to the social policy and environmental contexts within which they operate. Facilitating change in those social and institutional policies which mitigate against network development and maintenance among the elderly is suggested as an important task for health education theorists and practitioners.

Aged↗
PubMed1980

Creating critical consciousness in health: applications of Freire's philosophy and methods to the health care setting.

Paulo Freire's philosophy of "education for critical consciousness" takes on special relevance within the context of the health care system. This dialogical approach to change, stressing action based on critical reflection by the people is seen here as importantly supplementing current efforts to deal with the "health care crisis" in the United States and many developing countries. Applications of the Freir approach in a health context of necessity involve the perception of health and medical care within the total oppressive structure of society. Viewed thusly, health "reform" cannot justifiably be envisioned except within the context of broader structural transformations. Two case studies are presented to illustrate the application of the Freire approach within a health context. Successful utilization of the methodology among peasants in rural Honduras and a relatively unsuccessful application among impoverished elderly residents of an urban United States ghetto are described and analyzed. Modifications of the approach to increase its usefulness in a variety of situational contexts are suggested. The potentials and limitations of this approach to radical change in the health field finally are described, along with lessons learned from initial work in the applications of conscientización to the health field.

California↗
PubMed1978

Ethical issues in community organization.

The health educator's role as a community organizer raises a number of ethical dilemmas for the practitioner. Such basic prescriptions given the health educator as "start where the people are" and "change by choice, not by coercion" must be carefully examined in light of the realities which sometimes make strict adherence to these theoretical goals difficult in practice and problematic from an ethical perspective. The importance of avoiding unintentional "victim-blaming" in the selection of targets for community organization and the necessity of acquainting communities with possible negative or unanticipated outcomes of organizing efforts are underscored as critical ethical issues for the health educator engaged in community organization activities.

Attitude to Health↗
PubMed1977

"Thinking the unthinkable": the prospect of compulsory sterilization in India.

The National Population Policy Statement adopted by the Government of India in April 1976 gave states the mandate to adopt coercive and compulsory sterilization measures toward the end of bringing under control the nation's massive population growth. Many states have since adopted stringent measures which penalize couples having three or more children, and four states additionally have proposed legislation for compulsory sterilization. While the demographic impact of compulsory sterilization after the third child is undisputed, the administrative feasibility of such and undertaking has been widely questioned, particularly in light of the inadequacy of India's medical infrastructure in the rural areas. Critics further have raised questions concerning the social and ethical implications of compulsory sterilization and of measures which penalize the poor through means which may have adverse effects on their health and welfare. Finally, opponents of the new sterilization measures have suggested that they divert attention from the need for more basic changes in the nation's economic and social structure. While the need for bringing down India's continued high birth rate is widely recognized, alternative population measures-e.g. increased abortion facilities and an enforcement of the raised age at marriage-have been advocated in lieu of the compulsory sterilization measures currently being proposed.

Adolescent↗
PubMedDate not supplied

Depression in grandparents raising grandchildren: results of a national longitudinal study.

OBJECTIVES: To assess the effect of undertaking custodial care of a grandchild on grandparents' depression levels and to determine what characteristics are associated with higher depression levels among caregiving grandparents. DESIGN: A longitudinal national probability panel study: the National Survey of Families and Households. The first wave of data (n= 13 008) was collected in 1987 and 1988, and the second wave of data (n=10008) was collected from 1992 through 1994. SETTING: The survey was conducted in respondents' households in the coterminous United States. PARTICIPANTS: The subsample for this study was composed of 3111 respondents who reported being grandparents during the 1992-1994 interviews and for whom complete depression information was available. Of these grandparents, 158 were the primary caregivers for their grandchildren in the 1990s. MAIN OUTCOME MEASURES: Depression was measured using a modified version of the Center for Epidemiological Studies Depression Scale. RESULTS: Those who provide primary care for a grandchild are almost twice as likely to have levels of depressive symptoms above the traditional Center for Epidemiological Studies Depression Scale cut point of 16 (25.1% vs 14.5%). Even when controlling for baseline depression and demographic variables known to affect depressive symptoms, undertaking the care of a grandchild was associated significantly with higher depression levels in a multivariate prospective analysis (P<.01). Among caregiving grandparents, those who recently assumed caregiving responsibilities (P<.05) and women (P<.10) were more depressed and older respondents (P<.10) and those in good health (P<.001) were less depressed. CONCLUSIONS: Undertaking the primary care of a grandchild is associated with an increase in levels of depression. Particularly in light of the recent dramatic increase in the prevalence of grandparent caregiving in the United States, physicians need to explore familial role changes with midlife and older patients who have symptoms of depression. Special attention should be paid to the most at-risk subsets of grandparent caregivers: those who are new caregivers, those in poor health, those who are younger, and women.

Aged↗
PubMedDate not supplied

Using Participatory Action Research to build Healthy Communities.

The author contends that community-based Participatory Action Research (PAR) is ideally suited for use in Healthy Communities projects. The article begins by defining PAR and its principles and characteristics, then discusses the philosophical and methodological compatibility of PAR and Healthy Communities. After highlighting the challenges of expanding the Healthy Communities accent on participation to include PAR, the article describes the experiences of two Healthy Communities projects in the US that have successfully used PAR.

California↗
PubMedDate not supplied

Health promotion for older Americans in the 21st century.

OBJECTIVES: To provide a broad overview of the role of the individual, the physical environment, and the social environment on health and functioning in older adults (65 and older), and to highlight interventions and recommendations for action on each of these levels. DATA SOURCES: Published studies and government reports on health and functioning in older Americans and on the individual, social, and physical environmental contributors to health were identified through journal and government documents review and computer library searches of medical and social science data bases for 1980-1999. STUDY SELECTION: Preference was given to published studies and government reports that focused specifically on behavioral and environmental contributors and barriers to health promotion in Americans 65 and older and/or that highlighted creative interventions with relevance to this population. Both review articles and presentations of original research were included, with the latter selected based on soundness of design and execution and/or creativity of intervention described. DATA EXTRACTION: Studies were examined and their findings organized under three major headings: (1) behavioral risk factors and risk reduction, including current government standards for prevention and screening; (2) the role of the physical environment; and (3) the role of the social environment in relation to health promotion of older adults. DATA SYNTHESIS: Although most attention has been paid to the role of behavioral factors in health promotion for older adults, a substantial body of evidence suggests that physical and social environmental factors also play a key role. Similarly, interventions that promote individual behavioral risk reduction and interventions targeting the broader social or physical environment all may contribute to health in the later years. CONCLUSIONS: With the rapid aging of America's population, increased attention must be focused on health promotion for those who are or will soon be older adults. Promising intervention strategies addressing the individual, the physical environment, and the social environment should be identified and tested, and their potential for replication explored, as we work toward a more comprehensive approach to improving the health of older Americans in the 21st century.

Aged↗