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Comparison of treatment response among GLB and non-GLB street-living youth
- Authors:
- GRAFSKY Erika L., et al
- Journal article citation:
- Children and Youth Services Review, 33(5), May 2011, pp.569-574.
- Publisher:
- Elsevier
Researchers have found that adolescents who identify as gay, lesbian, or bisexual (GLB) are at a higher risk for increased substance use and mental health symptoms. This study uses secondary analysis of two clinical trials for street-living youth to examine whether self-identification as gay, lesbian, or bisexual (GLB) acts as a moderator of treatment effects. It also examines whether street-living GLB youth respond differently to a therapeutic intervention than non-GLB street-living youth. Comparisons were made of treatment outcomes on two categories of variables (drug use and mental health symptoms) among 244 homeless GLB and non-GLB identified adolescents in Mexico. Overall, GLB and non-GLB adolescents showed similar reductions in drug use and mental health symptoms. However, compared to non-GLB adolescents, GLB adolescents showed greater improvement in reduction of drug use and internalizing and depressive symptom scores. While both groups reported less drug use and fewer mental health symptoms from baseline to post-intervention, GLB youth's scores improved more drastically. Implications of using the identified treatment intervention are discussed.
Family violence and risk of substance use among Mexican adolescents
- Authors:
- CABALLERO Miguel Angel, et al
- Journal article citation:
- Child Abuse and Neglect, 34(8), August 2010, pp.576-584.
- Publisher:
- Elsevier
In this cross-sectional study, 936 students aged between 12 and 16 years in two secondary schools in Mexico City completed self-administered questionnaires to determine the relationship between psychological and physical family violence with risk for consuming alcohol, tobacco and drugs. The majority of adolescents (69.8%) reported living with both parents. Over half of the adolescents reported psychological or physical violence exerted by their parents, and 1 in 10, sexual violence. Violence was exerted, in similar proportions, by both parents toward their children. The proportion of use of alcohol, tobacco and drugs was similar in both sexes. Logistic regression analysis for males showed that psychological violence, exerted by either parent, implied twice the risk for the victims to use tobacco. For males, having suffered sexual violence was associated with increased risk of using drugs. No significant association between family violence and alcohol consumption was found in males. For females, being a victim of multiple forms of violence within the family increased the risk of consuming tobacco, alcohol and drugs, in comparison to non-victims. The authors conclude that treatment programs for young people who have suffered family violence should consider adolescence not only as a stage of vulnerability for substance use but also as a critical time to implement preventive measures. For these measures a joint strategy for both parents and adolescents should be considered to stop the violence and also warn parents of its consequences.
Children home alone unsupervised: Modelling parental decisions and associated factors in Botswana, Mexico, and Vietnam
- Authors:
- RUIZ-CASARES Monica, HEYMANN Jody
- Journal article citation:
- Child Abuse and Neglect, 33(5), May 2009, pp.312-323.
- Publisher:
- Elsevier
This paper examines different child care arrangements utilized by working families in countries undergoing major socio-economic transitions, with a focus on modelling parental decisions to leave children home alone. The study interviewed 537 working caregivers attending government health clinics in Botswana, Mexico, and Vietnam. Analyses involve descriptive statistics, content analysis, and ethnographic decision modelling. Results showed that in one-half of the families in Botswana, over one-third of the families in Mexico, and one-fifth of the families in Vietnam, children are left home alone on a regular or occasional basis. Moreover, 52% of families leaving children home alone relied on other children to help with child care. Parental unavailability and poor working conditions, limited support networks, inability to afford child care, neighbourhood safety, and children's age are critical factors in parents’ decisions to leave children home alone. Children also may remain home alone or without quality supervision when informal child care providers fail to provide care. Seldom their preferred choice, parents identified risks (e.g., increasing unintentional injuries, loneliness, and poor behavioural and developmental consequences) and benefits (e.g., strengthening child independence and sibling relations) of this arrangement. The authors conclude that poverty, social integration, local norms, and child development frame parents’ decisions of care. Insufficient societal support to working families frequently resulted in unsafe child care arrangements and limited parental involvement in child education and health care. Current, comprehensive data on this phenomenon are needed to inform social services and policies in countries undergoing major socio-economic transitions.
Objective and subjective social class gradients for substance use among Mexican adolescents
- Author:
- RITTERMAN Miranda Lucia
- Journal article citation:
- Social Science and Medicine, 68(10), May 2009, pp.1843-1851.
- Publisher:
- Elsevier
This study examines the shape of social class gradients for substance use among Mexican adolescents. Substance use and objective and subjective indicators of social class were assessed in house-to-house surveys conducted with 7614 Mexican adolescents in 2004. The sample was designed to be representative of the poorest urban communities in seven Mexican states. The prevalence of current smoking was 16.8%, alcohol consumption was 30.2%, and drug use was 4.6%. Adolescents who perceived themselves as higher in social status in reference to their local community reported more smoking and drinking. The findings were similar when objective measures of socioeconomic status were used, such as maternal education and total monthly household expenditures per person. In contrast, adolescents who perceived that they had high social standing in reference to Mexican society as a whole were less likely to report being current smokers and drinkers. No significant association between social status and drug use was found. Research into how adolescents perceive themselves in reference to their peer communities may help strengthen programs and policies aimed at promoting health in vulnerable adolescent populations.
Guardians of health: the dimensions of elder caregiving among women in a Mexico City neighborhood
- Authors:
- MENDEZ-LUCK Carolyn, KENNEDY David P., WALLACE Steven P.
- Journal article citation:
- Social Science and Medicine, 68(2), January 2009, pp.228-234.
- Publisher:
- Elsevier
Little is known about the family care of older adults in Mexico and the role of women in this process. To begin to fill this knowledge gap, this paper describes how a small sample of low-income women in one Mexico City neighbourhood conceptualized the caregiver role and identified the forms of assistance they gave to their older relatives on a daily basis. A grounded theory approach was used to collect and analyze the data. Forty-one semi-structured qualitative interviews were conducted with female caregivers. The age of participants was between 19 and 83 years, and care recipients between 56 and 92 years. The relationship of caregiver to care recipient was wife, daughter, daughter-in-law, granddaughter, sibling, and other relative. The mean length of time providing care was 5 years. Most participants were not employed outside the home, and the median monthly household income was 2000 pesos. We found that caregiving was a life-changing event, with 27 of 41 participants viewing themselves as guardians. Caregivers' emphasis was on care recipients' emotional needs in order to provide “the most precious gift” of “time and attention.” Two forms of assistance were ‘keeping company’ and ‘watching out’ as safeguards against poor health or further decline in health. These findings increase the cultural understanding of caregiving in Mexico. Further research is needed to test the caregiving concepts identified in this study.
Paradoxes and asymmetries of transnational networks: a comparative case study of Mexico's community-based AIDS organizations
- Author:
- BARNES Nielan
- Journal article citation:
- Social Science and Medicine, 66(4), February 2008, pp.933-944.
- Publisher:
- Elsevier
This article examines whether transnational networks reconfigure state–civil society relationships in ways that lead to civil society empowerment and increased organizational capacity to address the HIV/AIDS epidemic in Mexico. Using a comparative case study, the author identifies the types of transnational networks and exchanges that both help and hinder community-based HIV/AIDS organizations (CBOs) that provide AIDS prevention and treatment services in Tijuana and Mexico City. Data derive from over 50 formal interviews, organizational documents and archival records, and observation. It is argued that the form and function of transnational networks is shaped by the geo-political context of local organizational fields and that, in turn, transnational networks provide innovative opportunities for civil society–state partnerships that favour some local organizations over others. The author takes apart the prevailing assumption that transnational networks are inherently good, and show how they can (re)produce inter-organizational stratification at the local level. The conclusions of this research are helpful to international health practitioners and social scientists seeking to understand how civil society's participation in transnational networks can both challenge and reproduce existing community-state power regimes and health inequities.
Risk screening, emergency care, and lay concepts of complications during pregnancy in Chiapas, Mexico
- Authors:
- TINOCO-OJANGUREN Rolando, et al
- Journal article citation:
- Social Science and Medicine, 66(5), March 2008, pp.1057-1069.
- Publisher:
- Elsevier
Maternal morbidity and mortality are widespread in Chiapas, Mexico's southernmost state, as in many developing regions. Globally, the utility of three approaches to addressing such problems has been debated: (a) obstetric risk screening (i.e. screening women for risk during pregnancy and channelling those at risk to preventive care); (b) emergency obstetric care (i.e. identifying complications during pregnancy or birth and providing prompt effective treatment); and (c) combined risk screening and emergency care. Unaddressed to date in peer-reviewed journals are the lay perceptions of complications and risk that precede and incite the quest for obstetric care in Mexico. High incidence of maternal mortality in Chiapas, exacerbated by the predominantly rural, highly indigenous, geographically dispersed, and economically marginalized nature of the state's southern Border Region, prompted us to conduct 45 open-ended interviews with a convenience sample of women and their close relative/s, including indigenous and non-indigenous informants in urban and rural areas of four municipalities in this region. Interviews suggest that none of the three approaches is effective in this context, and the reasons why each approach has fallen short are detailed. Specific obstacles identified include that (1) many women do not access adequate prenatal screening care on a regular basis; (2) emergency obstetric care in this region is severely circumscribed; and (3) lay notions of pregnancy-related risk and complications contrast with official clinical criteria, such that neither clinical nor extra-clinical prenatal monitoring encompasses the entire range of physical and social risk factors and danger signs. Findings reported here centre on a rich description of the latter: lay versus clinical criteria for risk of antepartum complication.
Socioeconomic differences in health among older adults in Mexico
- Authors:
- SMITH Kimberly, GOLDMAN Noreen
- Journal article citation:
- Social Science and Medicine, 65(7), October 2007, pp.1372-1385.
- Publisher:
- Elsevier
Although the relationship between socioeconomic status (SES) and health is well-established in Western industrialized countries, few studies have examined this association in developing countries, particularly among older cohorts. We use the Mexican Health and Aging Study (MHAS), a nationally representative survey of Mexicans age 50 and older, to investigate the linkages between three indicators of SES (education, income, and wealth) and a set of health outcomes and behaviours in more and less urban areas of Mexico. We consider three measures of current health (self-rated health and two measures of physical functioning) and three behavioural indicators (obesity, smoking, and alcohol consumption). In urban areas, we find patterns similar to those in industrialized countries: higher SES individuals are more likely to report better health than their lower SES counterparts, regardless of the SES measure considered. In contrast, we find few significant SES–health associations in less urban areas. The results for health behaviours are generally similar between the two areas of residence. One exception is the education–obesity relationship. Our results suggest that education is a protective factor for obesity in urban areas and a risk factor in less urban areas. Contrary to patterns in the industrialized world, income is associated with higher rates of obesity, smoking, and excessive alcohol consumption. We also evaluate age and sex differences in the SES–health relationship among older Mexicans. The results suggest that further economic development in Mexico may lead to a widening of socioeconomic inequalities in health. The study also provides insight into why socioeconomic gradients in health are weak among Mexican-Americans and underscores the importance of understanding health inequalities in Latin America for research on Hispanic health patterns in the US.
Scaling-up a public health innovation: a comparative study of post-abortion care in Bolivia and Mexico
- Authors:
- BILLINGS Deborah L., et al
- Journal article citation:
- Social Science and Medicine, 64(11), June 2007, pp.2210-2222.
- Publisher:
- Elsevier
Post-abortion care (PAC), an innovation for treating women with complications of unsafe abortion, has been introduced in public health systems around the world since the 1994 International Conference on Population and Development (ICPD). This article analyzes the process of scaling-up two of the three key elements of the original PAC model: providing prompt clinical treatment to women with abortion complications and offering post-abortion contraceptive counselling and methods in Bolivia and Mexico. The conceptual framework developed from this comparative analysis includes the environmental context for PAC scale-up; the major influences on start-up, expansion, and institutionalization of PAC; and the health, financial, and social impacts of institutionalization. Start-up in both Bolivia and Mexico was facilitated by innovative leaders or catalyzers who were committed to introducing PAC services into public health care settings, collaboration between international organizations and public health institutions, and financial resources. Important processes for successful PAC expansion included strengthening political commitment to PAC services through research, advocacy, and partnerships; improving health system capacity through training, supervision, and development of service guidelines; and facilitating health system access to essential technologies. Institutionalization of PAC has been more successful in Bolivia than Mexico, as measured by a series of proposed indicators. The positive health and financial impacts of PAC institutionalization have been partially measured in Bolivia and Mexico. Other hypotheses—that scaling-up PAC will significantly reduce maternal mortality and morbidity, decrease abortion-related stigma, and prepare the way for efforts to reform restrictive abortion laws and policies—have yet to be tested.
“Diabetes is my companion”: lifestyle and self-management among good and poor control Mexican diabetic patients
- Authors:
- de ALBA GARCIA Javier Garcia, et al
- Journal article citation:
- Social Science and Medicine, 64(11), June 2007, pp.2223-2235.
- Publisher:
- Elsevier
This paper identifies naturally occurring lifestyle and self-care practices in managing type 2 diabetes mellitus that are associated with good glycemic control. In-depth, qualitative interviews were conducted in Guadalajara, Mexico, with 31 matched pairs of good and poor control diabetic patients (n=62), who were matched on their duration of disease and use of medications. While many themes were listed by both groups, a comparison of the responses indicated that themes of daily exercise with a preference for walking, eating beef and milk rather than chicken and fish, economic issues, and emotional issues distinguished poor-control patients. Good-control patients were more likely to have a negative reaction to their initial diagnosis, take a more comprehensive approach to control, eat only two meals a day (plus snacks), use noncaloric beverages to satisfy desires for more food, and know what their blood sugar levels should be.