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Social environment and health--a social epidemiological frame of reference.

Growing interest in epidemiological studies and prevention has led to increased awareness of the importance of the social environment to health. In this field of research, which might be designated social epidemiology, there is today extensive research into the possible association between different types of social factors and ill-health in the population. This article presents a social epidemiological frame of reference and some social factors of importance when one is studying the relationships between the social environment and health. Important social factors in the model are social stratification, social network, social support and life-style factors. Two other main categories of social factors in the model are circumstances and events related to social stratification or occupation and social network respectively. These may be factors in the external or internal work environment and variables describing the general activity level of the individual or different types of stressful social network-related life events. Other important factors in the model are physiological and clinical factors and three different types of health indicator. In the field of social epidemiological research, there is an increasing need for the development of theoretical models and frameworks as support in the analysis of social factors and health. These could be based on experience and tradition in both epidemiological research and the social sciences.

Epidemiologic Methods

Pheromonally induced sexual maturation in females: regulation by the social environment of the male.

Social subordination, which suppresses gonadal function in juvenile and adult male house mice, also suppresses the activity of an androgen-dependent urinary pheromone that accelerates the rate of sexual maturation in juvenile females. Pheromone production may also be suppressed by the presence of pregnant or lactating females. This suggests that the social environment may influence the fertility of population females by altering urinary pheromone activity in the male.

Adrenal Glands

Effects of modification of the social environment on young monkey development.

Experiments and observations of the effects of modifications of the social environment on the young primate's relationship with its mother and its social-sexual development have begun to delineate the large number of variables that determine and affect the attachment relationship and that are contingent upon it. Attachment can occur to a number of mother substitutes, including a dog. Early experience has special importance but young monkeys are surprisingly responsive and adaptable to substitute maternal stimuli. The quality of developing social behavior is dependent on both the quantity and quality of an attachment. We have yet to learn what are the critical component stimuli which make up an adequate early social environment for young monkeys and apes.

Animals

A typology of family social environments.

A sample of 100 families measured on ten dimensions of their social environments was subjected to cluster analysis to develop an empirically based taxonomy of families. Six distinctive clusters of families were indentified: Expression-Oriented, Structure-Oriented, Independence-Oriented, Achievement-Oriented, Moral/Religious-Oriented and Conflict-Oriented. The clusters showed systematic differences in background characteristics such as size, ethnic minority composition, drinking patterns, and family disturbance and incongruence. Some evidence that certain clusters of families are composed of different sub-clusters was presented. An empirically derived taxonomy of the social environments of families may help to understand how different family environments are linked to different family outcomes.

Achievement

Plasma steroid tendency, social environment and Eimeria necatrix infection.

Chickens from a line selected for high levels of plasma corticosterone when housed in an environment faciliating considerable social interaction were more resistant to Eimeria necatrix infection than those from a line selected for low levels of plasma corticosterone housed in an environment that minimized social interaction. Individuals in the high steroid group had a more active phagocytic defense and fewer schizonts than those in the low steroid group.

Animals

Institutionalism and schizophrenia 30 years on. Clinical poverty and the social environment in three British mental hospitals in 1960 compared with a fourth in 1990.

In their comparison of chronic schizophrenic patients in three British mental hospitals in 1960, Wing and Brown found a strong association between the poverty of the social environment and the severity of 'clinical poverty' (blunted affect, poverty of speech, and social withdrawal). Between 1960 and 1968 the social environments of all three hospitals improved and a weak causal relationship between social poverty and clinical poverty was reported in a proportion of patients. Using the same assessment instruments as Wing and Brown, the present study re-examined the relationship between social and clinical poverty in the long-stay schizophrenic population of a fourth British mental hospital in 1990. The association found between social and clinical poverty was much weaker than in 1960. Reluctance on the part of patients to be discharged from the institution was unrelated to length of stay. There was no significant difference in severity of illness between the patients in the present study and those in the earlier study. However, patients in the former group spent more time doing nothing than those in the hospital with the most understimulating environment three decades before, with four-fifths doing nothing for over five hours a day, despite a greatly increased ratio of nurses to patients.

Attitude to Health

[Social environment of the puerpera and her attitude towards the child].

The mother's attitude towards the newborn child is influenced considerably as well by the number of children, the respective mother is responsible for, as by other factors of her social environment, by the partners attitude towards mother and child, by the efforts in respect of a conscious planning of the human reproduction. Small birth orders, favourable conditions regarding family and social environment, but nevertheless conscious family planning are in high correlation with a positive attitude of the young mother towards the newborn child.

Adult

Biographical situation of scoliotic children and their relationship to the social environment(author's transl).

Studies were conducted to determine whenther or not scoliosis in childhood affects the behavior and experience of the affected children. Two groups of scoliotic and nonscoliotic children were examined with selected psychological tests. No differences could be found in regard to neuroticism, extraversion, manifest fear or the children's self-image. Differences were found in regard to the social environment which scoliotic children experienced as more demanding and supportive. As a result they were more concerned with achievement in a performance situation and more confident of success. The type and extent of the psychological effects of scoliosis is determined by the position accorded to the children by the social environment. Negative consequences can best be dealt with by educating the parents.

Adolescent

The high-risk infant environment. Part 2. The role of caregiving and the social environment.

Neonatal intensive care units are essential for the successful care of very immature and sick infants. The technology of NICUs has contributed significantly to the reduction of neonatal mortality and improvement of neonatal outcome. While the outcome for high-risk neonates has vastly improved over the past three decades, a number of infants sustain injuries and complications that result in long-term disabilities. It is now clear that some of the long-term problems of high-risk infants are a result of the environment and care practices and are not attributable to the original disease or condition that necessitated intensive care. There is accumulating evidence that environmental factors and care practices can interact with disease processes in ways that can increase morbidity, and possibly mortality. In addition to developmental and behavioral problems, there is growing evidence of effects on visual function and perhaps other sensory systems. Many of the environmental and care factors may cause delay in recovery and increase NICU time or unnecessary discomfort, yet not produce long-term disabilities or problems, as currently assessed. Many of the potential behavioral and developmental problems, as well as many of the potential problems with visual, auditory, and other modes of sensory discrimination, are not included in the usual follow-up assessments. The absence of data or the limitations of existing studies are not a cause for comfort or the assumption that the environment and care practices are safe or not harmful.(ABSTRACT TRUNCATED AT 250 WORDS)

Environment

Behavioral and neurological comparisons of neonates born to mothers of differing social environments.

Sixty newborn infants, 30 born to parents of middle to upper-middle socioeconomic status and 30 born to parents of limited personal-social resources, were assessed on the Neonatal Behavioral Assessment Scale. Although no difference between groups was found in motor and neurological status, data from this study did indicate that the prenatal factors, having no obvious physiological base, associated with the parental social environment, may affect the newborn's behavioral outcome.

Child Behavior

Plasma concentrations of testosterone in the developing ram in different social environments.

Plasma testosterone profiles were determined by taking frequent blood samples at intervals from birth to 21 months of age from rams reared in isolation, in an all-male group and in a mixed-sex group. The testosterone pattern was not modified by these different social environments. The ability of the ram to copulate when first exposed to an oestrous ewe, apparently a maturational process, was also independent of social rearing. At birth plasma testosterone levels were detectable but low, they were higher at 10 and 16 weeks of age and showed a marked rise by 26 weeks, coincident with the time of puberty. Depressive effects of season on testosterone profiles occurred during the 2nd year of life but not the 1st year.

Age Factors

Salience of ethnicity in the spontaneous self-concept as a function of one's ethnic distinctiveness in the social environment.

How likely people are to think of themselves in terms of a given personal characteristic is predicted from the distinctiveness postulate that the person, when confronted by a complex stimulus (such as the self), selectively notices and encodes the stimulus in terms of what is most peculiar about it, since these peculiar characteristics are the most informative in distinguishing it from other stimuli. This partial view of the person as an information-encoding machine (one is conscious of oneself insofar as, and in the ways that, one is different) is used to derive four predictions implying that ethnic identity is salient in children's spontaneous self-concepts to the extent that their ethnic group is in the minority in their social milieu at school. Our measure of salience of ethnicity was its being spontaneously mentioned by the children in response to a nondirective "Tell us about yourself" question. All four predictions were confirmed, though for several of the findings there are plausible alternative explanations.

Adolescent

Social support and the social environment of depressed and normal women.

A brief self-report measure of social support was administered initially to a student population, and then to a sample of hospitalized depressed women. Comparison of the responses of the 32 patients with 35 student women of similar age showed no differences between the groups in number of cohabitants or of casual friends, or in faith in the value of talking over one's problems. Patients were more likely than controls to report having no or few confidants, nobody confiding in them, and little confidence in being liked by others. Training in social skills specific to fostering intimacy is suggested as a therapeutic step, and modifications to the social support measure for future use discussed.

Adjustment Disorders