Men Of Lower Socioeconomic Status Research Articles

Penile Pearls and Pearling: Characteristics and Social Identity from the Perspective of Forensic Pathologists.

Penile pearls are artificial implants placed beneath the skin of a penis to provide enhanced sexual experience for the partner or present a stigma of a particular social subgroup (e.g., prisoner, member of a gang). This genital modification is usually encountered in men of low socioeconomic status and prisoners who might (self) implant improvised pearls under poor sanitary conditions. We have only recently started to encounter penile pearls on autopsy, incidentally. The aim of this study was to analyze our autopsy cases with penile pearls to assess the characteristics of these subjects regarding their socioeconomic status, history of imprisonment, substance abuse, as well as the characteristics of implants. Nineteen men were included. Most were born in the 1970s and 1980s, with only elementary/vocational school education (n = 10). Only five men graduated from high school. At least 14 were in prison at some point in life and 13 were unemployed. Ten men were unmarried. In 11 men, regular alcohol consumption was reported. 12 used illicit substances, most with a history of heroin injection. Penile pearls were improvised and made of rigid plastic in 10 men, eight were of soft silicone-like material, and one was of metal. A distinct characteristic was a ribbed contour of some implants. Although this genital modification seems to gain more attention outside of described vulnerable groups, it mostly remains limited to them in our region. It is most likely performed in improvised, non-professional, unsanitary conditions, probably in prisons.

Cannabis, connectivity, and coming of age: Associations between cannabis use and anterior cingulate cortex connectivity during the transition to adulthood.

Cannabis use is common among adolescents and emerging adults and is associated with significant adverse consequences for a subset of users. Rates of use peak between the ages of 18-25, yet the neurobiological consequences for neural systems that are actively developing during this time remain poorly understood. In particular, cannabis exposure may interfere with adaptive development of white matter pathways underlying connectivity of the anterior cingulate cortex, including the cingulum and anterior thalamic radiations (ATR). The current study examined the association between cannabis use during adolescence and emerging adulthood and white matter microstructure of the cingulum and ATR among 158 male subjects enrolled in the Pitt Mother and Child Project, a prospective, longitudinal study of risk and resilience among men of low socioeconomic status. Participants were recruited in infancy, completed follow-up assessments throughout childhood and adolescence, and underwent diffusion imaging at ages 20 and 22. At age 20, moderate cannabis use across adolescence (age 12-19) was associated with higher fractional anisotropy (FA) of the cingulum and ATR, relative to both minimal and heavy adolescent use. Longitudinally, moderate and heavy extended cannabis use (age 12-21) was associated with reduced positive change in FA in the cingulum from age 20 to 22, relative to minimal use. These longitudinal results suggest that cannabis exposure may delay cingulum maturation during the transition to adulthood and potentially impact individuals' functioning later in development.

Racial and Social Determinants of Civilian Gunshot Wounds to the Head.

To assess the clinical, racial, and social characteristics of victims of Gunshot wounds (GSWs) to the head and assess for associations between these factors and outcomes. Previous literature has not focused on the association of race and socioeconomic factors with these specific injuries. We identified patients with GSWs to the head who presented to 2 urban academic medical centers between 1998 and 2020, and extracted patient-level demographic data, information about the clinical and surgical course, and outcomes at discharge and follow-up. The cohort included 250 patients, 90% (n = 226) of whom were male, with a mean age of 28years. Forty-five percent were white (n = 112), 19% Black (n = 48), 18% Latinx (n = 45), with 6% "other" (n = 16), and 12% "unknown" (n = 29). The majority of patients presented with assault-related trauma (n = 153, 61%) as compared to self-inflicted injuries (n = 97, 39%). Across the entire cohort, sex, age, race, and median income by ZIP code were not significant predictors of outcome. Victims of assault by GSW to the head were more likely to be age 18 or younger (OR 5.26, P = 0.01), between the ages of 19 and 33years (OR 4.7, P = 0.001), Black (OR 6.66, P < .001), and Latinx (OR 2.65, P = 0.03). Most patients (n = 155, 63%) had a poor functional outcome (modified Rankin Score 3-6) at discharge. Age, race, and income status were not independent predictors of mortality or functional outcome at discharge in our population. Assault-related GSWs to the head mostly involved young Black or Latinx men of lower socioeconomic status, while self-inflicted injuries were largely seen in older white men.

Analysis of the regional distribution of road traffic mortality and associated factors in Japan

BackgroundRegional differences in road traffic (RT) mortality among municipalities have not been revealed in Japan. Further, the association between RT mortality and regional socioeconomic characteristics has not been investigated. We analyzed geographic differences in RT mortality and its associated factors using the Vital Statistics in Japan.MethodsWe used data on RT mortality by sex and municipality in Japan from 2013 to 2017. We calculated the standardized mortality ratio (SMR) of RT for each municipality by sex using an Empirical Bayes method. The SMRs were mapped onto a map of Japan to show the geographic differences. In addition, an ecological study investigated the municipal characteristics associated with the SMR using demographic socioeconomic, medical, weather, and vehicular characteristics as explanatory variables. The ecological study used a spatial statistical model.ResultsThe mapping revealed that the number of municipalities with a high SMR of RT (SMR > 2) was larger in men than in women. In addition, SMRs of capital areas (Kanagawa and Tokyo prefectures) tended to be low in men and women. The regression analysis revealed that population density was negatively associated with the SMR in men and women, and the degree of the association was the largest among explanatory variables. In contrast, there was a positive association between the proportion of non-Japanese persons and SMR. The proportions of lower educational level (elementary school or junior high school graduates), agriculture, forestry, and fisheries workers, service workers, and blue-collar workers were positively associated with the SMR in men. The proportion of unemployed persons was negatively associated with the SMR in men.ConclusionsSocioeconomic characteristics are associated with geographic differences in RT mortality particularly in men. The results suggested preventive measures targeted at men of low socioeconomic status and non-Japanese persons are needed to decrease RT mortality further.

Socioeconomic inequality in prevalence of cigarette and Water-pipe smoking among Iranian adults: A blinder- Oaxaca decomposition Analysis

Background: To assess the association between socioeconomic inequality and the prevalence of tobacco smoking among Iranian adults in 2010.&#x0D; Methods: Data from the fifth national STEPS survey (WHO STEPwise approach to NCD Surveillance) were analyzed. A Blinder-Oaxaca decomposition method was applied to assess the association between socioeconomic inequality and the prevalence of daily cigarette and water pipe (WP) smoking among Iranian men and women.&#x0D; Results: From 10,615 participants in the survey, 4,203 (39.5%) participants appeared to be in the first and fifth quintiles of socioeconomic status (SES). For men, the prevalence of daily cigarette smoking was higher among those with low SES (23.1%) than those with high SES (11.1%) (P&lt;0.001). The observed difference was mainly attributed to the educational level (8.6%). We found no significant difference in high compared to low SES women for cigarette smoking (P value= 0.881). Although there was no difference between high and low SES men for daily WP smoking, low SES women had a higher prevalence of WP smoking (4.4%) than high SES women (1.3%) (P value=0.027). Education level was the major factor (3.3%) to explain the corresponding difference. The difference in WP smoking in high and low SES men was not statistically significant (P value= 0.199).&#x0D; Conclusion: Cigarette smoking in men and WP smoking in women are associated with SES in Iran. Education was the main factor explaining the differences in the prevalence of cigarette and WP smoking in Iranian men and women. Results from this study must be considered as a pivotal basis for designing a tobacco control program at national and sub-national levels.

Is the Black-White mental health paradox consistent across age, gender, and psychiatric disorders?

Objectives The Black-White mental health epidemiological paradox (i.e. Black Americans’ lower or similar rates of mental disorder relative to Whites) characterizes the literature on race and mental health. Yet, research has generally paid less attention to how such findings may vary across other social statuses that shape mental health. This study assessed whether the Black-White paradox is consistent across gender, age groups, and psychiatric disorders, including lifetime mood, anxiety, and substance use disorders. Method We used data from the National Comorbidity Survey-Replication (NCS-R) and National Survey of American Life (NSAL), 2001–2003 (N = 4,591 African Americans; 6,668 non-Hispanic Whites). Psychiatric disorders were measured with the World Mental Health Survey Initiative version of the WHO Composite International Diagnostic Interview (WMH-CIDI). Binary logistic regression models were conducted to assess racial patterns of lifetime mental disorders across age and gender. Wald tests were performed to assess age and gender group differences in Black-White patterns of mental disorder. Results The Black-White mental health paradox generally extends across lifetime mood, anxiety, and substance use disorders and is consistent across age and gender groups. One exception is middle-aged (45–64 years) Black men, who had higher odds of lifetime substance use disorder relative to their White male middle-aged peers. This difference is no longer statistically significant after accounting for education and employment. We also found more similarity in mental disorders between older Blacks and Whites relative to their younger counterparts, suggesting that Black-White mental health differences are most pronounced among younger age groups. Conclusion Our findings contribute to the broader literature on the Black-White mental health paradox by demonstrating that this epidemiological pattern persists across various mental disorder types and, at times, depends on age group and gender. Given that Black-Whte differences are less pronounced among older adults, future research should consider the ways life course theory might inform our understanding of the paradox. Findings also suggest that substance use services are critical to address the needs of middle-aged Black men of lower socioeconomic status who are disproportionately affected by substance use disorder, yet have relatively lower mental health care utilization rates.

Substance use and non-communicable diseases in India: evidence from National Family Health Survey-4

ABSTRACT Introduction: This study investigated the correlation between substance use and non-communicable diseases according to socioeconomic status in India. Methodology: We analyzed nationally representative data from the fourth round of National Family and Health Survey (NFHS-4), which was conducted in 2015–16, and estimated the prevalence of tobacco and alcohol consumption among 112,122 men aged 15–54 years. A logistic regression analysis was performed to estimate the effect of substance use on non-communicable diseases. Results: It was found that 45% of men in the sample used tobacco in any form and 30% consumed alcohol. Men aged 50–54 years, divorced, separated or deserted, uneducated, belonging to the scheduled tribes and in the poorest wealth quintile consumed significantly higher quantities of substances. The results show that men who consume tobacco and alcohol significantly more likely to have diabetes or heart disease. Correlation of substance use and non-communicable diseases shows that men in the age group of 50 to 54 years, who are married, with higher educational attainments and belonging to the Christian religion are significantly more likely to have diabetes or heart disease. Conclusion: This study concludes that men of low socioeconomic status, who are substance users are at higher risk of developing non-communicable diseases. The study also highlights that men who consume tobacco and alcohol are significantly more likely to develop non-communicable diseases.

Cohort Increases in Sex with Same-Sex Partners: Do Trends Vary by Gender, Race, and Class?

We examine change across U.S. cohorts born between 1920 and 2000 in their probability of having had sex with same-sex partners in the last year and since age 18. Using data from the 1988–2018 General Social Surveys, we explore how trends differ by gender, race, and class background. We find steep increases across birth cohorts in the proportion of women who have had sex with both men and women since age 18, whereas increases for men are less steep. We suggest that the trends reflect an increasingly accepting social climate, and that women’s steeper trend is rooted in a long-term asymmetry in gender change, in which nonconformity to gender norms is more acceptable for women than men. We also find evidence that, among men, the increase in having had sex with both men and women was steeper for black than for white men, and for men of lower socioeconomic status; we speculate that the rise of mass incarceration among less privileged men may have influenced this trend.

6074Cardiorespiratory fitness, socioeconomic status and mortality in middle-aged men: a population-based prospective cohort study

Abstract Background Although both low socioeconomic status (SES) and poor cardiorespiratory fitness (CRF) are associated with increased chronic disease and a heightened risk of death, it remains unclear whether moderate-to-high levels of CRF confer survival benefits in low SES populations. Purpose The present study evaluated the hypothesis that SES and CRF predict all-cause mortality (ACM), cardiovascular disease (CVD) mortality and sudden cardiac death (SCD), and that moderate-to-high levels of CRF may attenuate the associations between low SES and adverse cardiovascular outcomes. Methods This prospective study was based on a population-based sample of 2,368 men aged 42 to 61 years, who were followed in the Kuopio Ischemic Heart Disease cohort. CRF was directly measured by peak oxygen uptake (VO2peak) during progressive exercise testing to volitional fatigue. SES was characterized using self-reported questionnaires via combined measures of income, education, occupation, occupational prestige, material standard of living, and housing conditions. CRF and SES were divided into tertiles, and 4 combined groups (Fit-high SES, Fit-low SES, Unfit-high SES, and Unfit-low SES) based on the median values of CRF and SES. Results During a 25 year median follow-up (interquartile ranges: 18–27 years), 1116 ACM, 512 CVD mortality and 221 SCD events occurred. After adjusting for potential confounders (age, smoking, alcohol, body mass index, systolic blood pressure, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, glucose, diabetes, hypertensive medication, family history of coronary heart disease, and physical activity), the lowest levels of SES were at significantly increased risk for ACM (hazard ratio (HR) 1.49, 95% Confidence Interval (CI): 1.30–1.71), CVD mortality (HR 1.38, 1.13–1.69) and SCD (HR 1.34, 0.97–1.84). In contrast, higher levels of CRF were associated with lower risks of ACM (HR 0.56, 0.46–0.67), CVD mortality (HR 0.53, 0.40–0.71) and SCD (HR 0.53, 0.34–0.83). In combined associations of SES and CRF with mortality, unfit-low SES had significantly higher risks of ACM (HR 2.12, 1.75–2.57), CVD mortality (HR 2.20, 1.64–2.94) and SCD (HR 2.95, 1.79–4.86), but fit-low SES was not associated with a heightened risk of cardiovascular mortality or SCD (CVD mortality, 1.03, 0.73–1.46; SCD, 1.54, 0.87–2.72) as compared with their fit-high SES counterparts (reference). Conclusion Our findings indicate that both SES and CRF are independently associated with the risk of death; however, moderate-to-high levels of CRF appear to attenuate the risk of CVD mortality and SCD in low SES men. These unique data have important implications for public health interventions designed to enhance survival in underserved population cohorts.

Do trends in the prevalence of overweight by socio-economic position differ between India\u2019s most and least economically developed states?

BackgroundIndia’s economic development and urbanisation in recent decades has varied considerably between states. Attempts to assess how overweight (including obesity) varies by socioeconomic position at the national level may mask considerable sub-national heterogeneity. We examined the socioeconomic patterning of overweight among adults in India’s most and least economically developed states between 1998 and 2016.MethodsWe used state representative data from the National Family Health Surveys from 1998 to 99, 2005–06 and 2015–16. We estimated the prevalence of overweight by socioeconomic position in men (15–54 years) and women (15–49 years) from India’s most and least economically developed states using multilevel logistic regressions.ResultsWe observed an increasing trend of overweight prevalence among low socioeconomic position women. Amongst high socioeconomic position women, overweight prevalence either increased to a smaller extent, remained the same or even declined between 1998 and 2016. This was particularly the case in urban areas of the most developed states, where in the main analysis, the prevalence of overweight increased from 19 to 33% among women from the lowest socioeconomic group between 1998 and 2016 compared to no change among women from the highest socioeconomic group. Between 2005 and 2016, the prevalence of overweight increased to similar extents among high and low socioeconomic status men, irrespective of residence.ConclusionsThe converging prevalence of overweight by socioeconomic position in India’s most developed states, particularly amongst urban women, implies that this subpopulation may be the first to exhibit a negative association between socioeconomic position and overweight in India. Programs aiming to reduce the increasing overweight trends may wish to focus on poorer women in India’s most developed states, amongst whom the increasing trend in prevalence has been considerable.

Being a Coptic Man: Masculinity, Class, and Social Change among Egyptian Copts

Inspired by Marcia Inhorn’s work on Arab masculinities, this article looks at changes in masculine ideals and practices among Egyptian middle-class Copts. Based on fieldwork among Copts in the city of Alexandria, Egypt, this article argues that young Coptic men embrace ideals of manhood that highlights conjugal connectivity and involved fatherhood at the expense of other social commitments; that in doing so, they define themselves in opposition to Muslim men of lower socioeconomic status, widely construed as their “masculine others”; and finally that these men ascribe to forms of masculinity that do not seem to reinforce patriarchal power relations, nor lend themselves to hierarchical placement in relation to otherwise dominant forms of masculinity within a predominantly Muslim society. As such, they constitute forms of masculinity that are parallel, but not subordinate to a “hegemonic masculinity,” challenging some of the central premises on which the concept of hegemonic masculinity is commonly based. The case of middle-class Coptic men point to the concept of “emergent masculinities” as a promising starting point for analyzing masculinity in diverse Arab societies.

Clinicopathological profile, diagnosis and treatment of skin cancers at a tertiary care center: a retrospective study

Background: Majority of skin cancers are basal cell carcinoma, Squamous cell carcinoma and Malignant melanoma which account for more than 95% of total skin malignancies. There is an increase in incidence in India over some 10 years of period. This study was done for analysing clinicopathological profile of skin malignancies and association of human papilloma virus (HPV) in skin malignancies in Himalayan Institute of Medical Sciences (HIMS, Uttarakhand, India.Methods: It was a retrospective study done on 101 patients having malignant skin lesions attending the Department of Surgery at HIMS from October 2005 to October 2008 and given their consent.Results: Out of 101 patients, 68 had squamous cell carcinoma, 21 had basal cell carcinoma and 10 had malignant melanoma, prevalence is high in men of lower socioeconomic status (M:F) 1.9:1. The mean age was 54.50 years. Most of the patients were laborers, farmers and factory workers. Ulcers and ulceroproliferative growth were common mode of presentation. Most commonly associated risk factor was exposure to sunlight, the commonest location of skin cancer was face and scalp. Wide local excision was the commonest done procedure with closure of primary defect by SSG, fasciocutaneous or cutaneous flaps. No HPV association was seen.Conclusions: Skin cancers are quite common and their incidence has increased in last few decades, in this study we found that skin cancer were more common in males of lower socioeconomic status, probable cause was increased sun exposure and chemical exposure, in respect to females. Cancer could manifest in many forms but ulcers quite common, Squamous cell carcinoma outnumbered basal cell carcinoma, Wide local excision with skin grafts was main stay of treatment.

Distributions of Subclinical Cardiovascular Disease in a Socioeconomically and Racially Diverse Sample.

Differential subgroup vulnerability to subclinical cardiovascular disease is likely, and yet few, if any, studies have addressed interactive relations of age, sex, race, and socioeconomic status (SES) to these conditions to examine nuances of known health disparities. We examined distributions of carotid atherosclerosis and arterial stiffness in a socioeconomically diverse, biracial, urban sample. Participants (n=2270) in the population-based HANDLS study (Healthy Aging in Neighborhoods of Diversity Across the Life Span; 30-64 years old, 44% men, 57% African American, 39% with household income <125% federal poverty threshold) underwent carotid intimal medial thickness (IMT) and pulse wave velocity assessment. In cross-sectional hierarchical regression analyses, interactive race×SES effects were identified for IMT and pulse wave velocity, such that high SES African Americans had significantly thicker IMTs and faster pulse wave velocities than all other subgroups (ie, low SES African Americans, low SES whites, and high SES whites). A race×sex effect was also identified for IMT, such that the IMT discrepancy between white men and women was more pronounced than the discrepancy between African American men and women. Finally, an SES×sex effect indicated that while IMTs of high SES and low SES men did not significantly differ, high SES women had marginally thicker IMTs than low SES women. High SES African Americans may be particularly vulnerable to subclinical cardiovascular diseases, placing them at enhanced risk for clinical cardiovascular diseases, including stroke. These findings suggest that male sex, low SES, and African American ancestry may represent imprecise generalizations as risk factors for subclinical cardiovascular disease.

Impact of Long Run Exposure to Television on Homicides: Some Evidence from Brazil

This paper focuses on the link between television coverage and violent crime, in particular, homicides in Brazil, a country where crime has grown dramatically in recent decades. Using Census data for the period 1980–2000, the paper finds that people living in areas covered by television signal have significantly lower rates of homicides. The effect is strongest for men of lower socioeconomic status.

Understanding the Relationships between Gender Inequitable Behaviours, Childhood Trauma and Socio-Economic Status in Single and Multiple Perpetrator Rape in Rural South Africa: Structural Equation Modelling.

BackgroundInterventions to prevent rape perpetration must be designed to address its drivers. This paper seeks to extend understanding of drivers of single and multiple perpetrator rape (referred to here as SPR and MPR respectively) and the relationships between socio-economic status, childhood trauma, peer pressure, other masculine behaviours and rape.Method1370 young men aged 15 to 26 were interviewed as part of the randomised controlled trial evaluation of Stepping Stones in the rural Eastern Cape. We used multinomial to compare the characteristics of men who reported rape perpetration at baseline. We used structural equation modelling (SEM) to examine pathways to rape perpetration.Results76.1% of young men had never raped, 10.0% had perpetrated SPR and 13.9% MPR. The factors associated with both MPR and SPR (compared to never having raped) were indicators of socio-economic status (SES), childhood trauma, sexual coercion by a woman, drug and alcohol use, peer pressure susceptibility, having had transactional sex, multiple sexual partners and being physically violent towards a partner. The SEM showed the relationship between SES and rape perpetration to be mediated by gender inequitable masculinity. It was complex as there was a direct path indicating that SES correlated with the masculinity variable directly such that men of higher SES had more gender inequitable masculinities, and indirect path mediated by peer pressure resistance indicated that the former pertained so long as men lacked peer pressure resistance. Having a higher SES conveyed greater resistance for some men. There was also a path mediated through childhood trauma, such that men of lower SES were more likely to have a higher childhood trauma exposure and this correlated with a higher likelihood of having the gender inequitable masculinity (with or without the mediating effect of peer pressure resistance).DiscussionBoth higher and lower socio-economic status were associated with raping. Prevention of rape perpetration must focus on changing men’s gender ideals, entitlements and inequitable practices. Reducing poverty and adverse childhood experiences should also be of benefit.

Family Demographic Mechanisms Linking of Socioeconomic Status to Subjective Physical Health in Rural Bangladesh

Previous literature suggests that lower socioeconomic status (SES) men through higher family sociodemographic pressure and lower capacity of stress control, compared to higher SES men, are more likely to suffer from poorer subjective physical health (SPH). Using a random cross-sectional survey of 1650 young adult men aged 20–50 from rural Bangladesh we examine whether lower SES, compared to middle and higher SES, is significantly associated with poorer SPH, after controlling for family demographic-psychological conditions. Result indicates that lower SES men with higher family sociodemographic pressure, economic hardship, family stress and lower psychological resources in comparison to middle and higher SES men are most likely to suffer from poorer SPH. Further result suggests that SES is significantly associated with both poorer and poor SPH, but when family demographic-psychological conditions are controlled, a significant association of lower education, lower job status with day-laboring and income only with poorer SPH remains constant. This association appears attributable to all family demographic-psychological mechanisms except early marriage.

Becoming a Teenage Father. Having a Baby as a Turning Point in Biographies of Young Men of Low Socioeconomic Status Inhabiting Poverty Enclaves

The paper reflects on the impact of fatherhood on lives of young men, brought up in multiproblem families in poverty enclaves in a post-industrial city, namely Lodz. Empirical grounds of the text are 27 biographical interviews carried out within a research module of the WZLOT project (full project title: “Strengthening Opportunities and Weakening Transmission of Poverty among Inhabitants of Towns of the Lodz Province”) with young men who had become fathers as teenagers. The interviewees had been school dropouts, in conflict with the law, with problems of substance abuse. The paper attempts to reconstruct the process of becoming a father in the case of young men lacking father figures themselves and whose fatherhood was often being questioned because of their low socioeconomic status.

Być nastoletnim ojcem w łódzkiej enklawie biedy. Rodzicielstwo młodych mężczyzn o niskim statusie społeczno-ekonomicznym w świetle koncepcji „nowego ojcostwa”

Współcześnie mamy do czynienia ze zjawiskiem „intensywnego”, „profesjonalizującego” się rodzicielstwa. Fenomen bardzo (jeśli nie nadmiernie) świadomego, traktującego wychowanie dziecka jako „projekt”, wspieranego za pomocą fachowych porad, książek i specjalistów macierzyństwa i ojcostwa wydaje się dotyczyć przede wszystkim rodziców z klasy średniej. Jak obecnie wygląda rodzicielstwo i wychowywanie dzieci wśród najmniej uprzywilejowanych członków naszego społeczeństwa? Na to pytanie postaram się (choć fragmentarycznie) odpowiedzieć, odwołując się do doświadczeń młodych ojców, których pierwsze dzieci urodziły się, kiedy oni sami byli jeszcze nastolatkami. W anglosaskiej literaturze przedmiotu nastoletni rodzice stanowią grupę „paradygmatycznych wykluczonych”, na których funkcjonowanie wpływa często duża liczba skumulowanych niekorzystnych czynników/okoliczności, takich jak wychowanie w rodzinie z wieloma problemami lub placówce opiekuńczo-wychowawczej, wczesne zakończenie kariery szkolnej, brak lub niskie kwalifikacje zawodowe, problemy ze zdrowiem, zamieszkiwanie w przeludnionych i substandardowych lokalach usytuowanych w obszarach dużej koncentracji osób biednych (enklawy, getta biedy). Artykuł opiera się na badaniach o charakterze jakościowym, zrealizowanych w ramach projektu WZLOT („Wzmocnić Szanse i Osłabić Transmisję Biedy wśród Mieszkańców Miast Województwa Łódzkiego”, PO KL, 2008–2010, koordynator prof. Wielisława Warzywoda-Kruszyńska) w module badawczym zatytułowanym „Wczesne rodzicielstwo jako zagrożenie biedą i wykluczeniem społecznym”

Factors driving inequality in prostate cancer survival: a population based study.

PurposeAs cancer control strategies have become more successful, issues around survival have become increasingly important to researchers and policy makers. The aim of this study was to examine the role of a range of clinical and socio-demographic variables in explaining variations in survival after a prostate cancer diagnosis, paying particular attention to the role of healthcare provider(s) i.e. private versus public status.MethodsData were extracted from the National Cancer Registry Ireland, for patients diagnosed with prostate cancer from 1998–2009 (N = 26,183). A series of multivariate Cox and logistic regression models were used to examine the role of healthcare provider and socio-economic status (area-based deprivation) on survival, controlling for age, stage, Gleason grade, marital status and region of residence. Survival was based on all-cause mortality.ResultsOlder individuals who were treated in a private care setting were more likely to have survived than those who had not, when other factors were controlled for. Differences were evident with respect to marital status, region of residence, clinical stage and Gleason grade. The effect of socio-economic status was modified by healthcare provider, such that risk of death was higher in those men of lower socio-economic status treated by public, but not private providers in the Cox models. The logistic models revealed a socio-economic gradient in risk of death overall; the gradient was larger for those treated by public providers compared to those treated by private providers when controlling for a range of other confounding factors.ConclusionThe role of healthcare provider and socio-economic status in survival of men with prostate cancer may give rise to concerns that warrant further investigation.

Is Being Out About Sexual Orientation Uniformly Healthy? The Moderating Role of Socioeconomic Status in a Prospective Study of Gay and Bisexual Men

Stress associated with concealing sexual orientation is a possible mechanism for health disparities among lesbian, gay, bisexual (LGB) individuals. However, disclosing one's sexual orientation might not be uniformly healthy across social contexts. The present study tested whether being out is less healthy for gay and bisexual men of lower socioeconomic status (SES) relative to higher SES men. Using longitudinal data on gay and bisexual men (N = 564, ages 18-72), we examined whether the association between outness and physical health differs by SES. SES significantly moderated associations between outness and physician visits, nonprescription medication use, and physical symptoms. Outness predicted physical health benefits for higher SES men but health problems for lower SES men. The common assumption that disclosing one's sexual orientation is uniformly healthy may be less accurate (or inaccurate) for lower status groups. Future research should explore SES as context for minority stress and LGB health disparities.