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Recent research: six papers with broad social implications – inequality, health insurance, spanking, bullying, and religion

Here are half a dozen recent research papers with broad social implications (all details & abstracts to these studies are given further down this blog posting).  Kay and colleagues publish on "Inequality, discrimination, and the power of the status quo: Direct evidence for a motivation to see the way things are as the way they should be."  They report four studies showing how widely this motivation acts - with political power, public funding, gender demographics, and in attacks on those who are trying to work for change.  There's relevance here to the second paper by Wilper et al on "Health Insurance and Mortality in US Adults" estimating that, even after adjusting for income, education, health status, weight, exercise, smoking and alcohol use, lack of insurance was associated with about 45,000 excess deaths annually in the United States among people aged 18 to 64.  Still in the area of inequality and discrimination, Wexler et al publish on "Resilience and marginalized youth: making a case for personal and collective meaning-making as part of resilience research in public health" arguing that "Public health's study of resilience, then, must consider the ways that individuals understand and, in turn, resist discrimination."

Looking at a still younger age range, a paper at last month's 14th International Conference on Violence, Abuse and Trauma presented startling findings that "Children who are spanked have lower IQs."  In their large study covering children from 32 countries, they found that societies that condoned corporal punishment of children had kids with lower IQ's and this then appeared to lead to poorer national economic development.  Loosely linked is research reported on by Sourander and colleagues on childhood bullying (violence at home and violence at school can be associated).  They studied links between " ... bullying and victimization in childhood and later psychiatric hospital and psychopharmacologic treatment."  And with a rather different social focus, Nicholson et al report on "Association between attendance at religious services and self-reported health in 22 European countries."  This kind of study is complex, but probably underlines the importance for human health of involvement in social groups.    

Kay, A. C., D. Gaucher, et al. (2009). "Inequality, discrimination, and the power of the status quo: Direct evidence for a motivation to see the way things are as the way they should be." J Pers Soc Psychol 97(3): 421-34.  [PubMed]
How powerful is the status quo in determining people's social ideals? The authors propose (a) that people engage in injunctification, that is, a motivated tendency to construe the current status quo as the most desirable and reasonable state of affairs (i.e., as the most representative of how things should be); (b) that this tendency is driven, at least in part, by people's desire to justify their sociopolitical systems; and (c) that injunctification has profound implications for the maintenance of inequality and societal change. Four studies, across a variety of domains, provided supportive evidence. When the motivation to justify the sociopolitical system was experimentally heightened, participants injunctified extant (a) political power (Study 1), (b) public funding policies (Study 2), and (c) unequal gender demographics in the political and business spheres (Studies 3 and 4, respectively). It was also demonstrated that this motivated phenomenon increased derogation of those who act counter to the status quo (Study 4). Theoretical implications for system justification theory, stereotype formation, affirmative action, and the maintenance of inequality are discussed.

Wilper, A. P., S. Woolhandler, et al. (2009). "Health Insurance and Mortality in US Adults." Am J Public Health: AJPH.2008.157685.  [Abstract/Full Text]
Objectives. A 1993 study found a 25% higher risk of death among uninsured compared with privately insured adults. We analyzed the relationship between uninsurance and death with more recent data.  Methods. We conducted a survival analysis with data from the Third National Health and Nutrition Examination Survey. We analyzed participants aged 17 to 64 years to determine whether uninsurance at the time of interview predicted death.  Results. Among all participants, 3.1% (95% confidence interval [CI]=2.5%, 3.7%) died. The hazard ratio for mortality among the uninsured compared with the insured, with adjustment for age and gender only, was 1.80 (95% CI=1.44, 2.26). After additional adjustment for race/ethnicity, income, education, self- and physician-rated health status, body mass index, leisure exercise, smoking, and regular alcohol use, the uninsured were more likely to die (hazard ratio=1.40; 95% CI=1.06, 1.84) than those with insurance.  Conclusions. Uninsurance is associated with mortality (approximately 45,000 excess deaths annually among those aged 18 to 64) . The strength of that association appears similar to that from a study that evaluated data from the mid-1980s, despite changes in medical therapeutics and the demography of the uninsured since that time.

Wexler, L. M., G. DiFluvio, et al. (2009). "Resilience and marginalized youth: making a case for personal and collective meaning-making as part of resilience research in public health." Soc Sci Med 69(4): 565-70.  [PubMed]
The public health research community has long recognized the roles of discrimination, institutional structures, and unfair economic practices in the production and maintenance of health disparities, but it has neglected the ways in which the interpretation of these structures orients people in overcoming them and achieving positive outcomes in their lives. In this call for researchers to pay more - and more nuanced - attention to cultural context, we contend that group identity-as expressed through affiliation with an oppressed group-can itself prompt meaningful role-based action. Public health's study of resilience, then, must consider the ways that individuals understand and, in turn, resist discrimination. In this article, we briefly outline the shortcomings of current perspectives on resilience as they pertain to the study of marginalized youth and then consider the potential protection offered by ideological commitment. To ground our conceptual argument, we use examples from two different groups with whom the authors have worked for many years: indigenous and sexual minority youth. Though these groups are dissimilar in many ways, the processes related to marginalization, identity and resilience are remarkably similar. Specifically, group affiliation can provide a context to reconceptualize personal difficulty as a politicized collective struggle, and through this reading, can create a platform for ideological commitment and resistance.

Straus, M. and M. Paschall (2009). Children who are spanked have lower IQs. 14th International Conference on Violence, Abuse and Trauma. San Diego, Calif.  [Report]
Groundbreaking research suggests children who are spanked have lower IQs than those who are not, and that the difference is large enough to lower national IQ scores in countries where corporal punishment of children is routine.  Murray Straus, PhD, head of the Family Research Laboratory at the University of New Hampshire, Durham, told Medscape Psychiatry that his landmark 32-nation study of corporal punishment by parents and IQ also suggests that recent increases in IQ in many nations may have been partly a result of the worldwide decrease in the use of corporal punishment by parents.  "The longitudinal part of our study showed that children who were spanked the most fell behind the average IQ development curve, and those who were never spanked advanced ahead of the average," Dr. Straus said. He presented his results at the 14th International Conference on Violence, Abuse and Trauma in San Diego, California.  "That suggested to us that nations that use more corporal punishment of children would have more kids falling behind what they could have achieved, which might result in lower average national IQ, and that is what we found when we looked at data from 32 countries," he added.  Economic Implications: The correlation between corporal punishment and IQ has major economic implications, as several studies have shown that gross domestic product is closely related to national average IQ, Dr. Straus said. 

Sourander, A., J. Ronning, et al. (2009). "Childhood Bullying Behavior and Later Psychiatric Hospital and Psychopharmacologic Treatment: Findings From the Finnish 1981 Birth Cohort Study." Arch Gen Psychiatry 66(9): 1005-1012.  [Abstract/Full Text] 
Context No prospective population-based study examining predictive associations between childhood bullying behavior and long-term mental health outcomes in both males and females exists. Objective To study predictive associations between bullying and victimization in childhood and later psychiatric hospital and psychopharmacologic treatment. Design Nationwide birth cohort study from age 8 to 24 years. Participants Five thousand thirty-eight Finnish children born in 1981 with complete information about bullying and victimization at age 8 years from parents, teachers, and self-reports. Main Outcome Measures National register-based lifetime information about psychiatric hospital treatments and psychopharmacologic medication prescriptions. Results When controlled for psychopathology score, frequent victim status at age 8 years among females independently predicted psychiatric hospital treatment and use of antipsychotic, antidepressant, and anxiolytic drugs. Among males, frequent bully-victim and bully-only statuses predicted use of antidepressant and anxiolytic drugs. Frequent bully-victim status among males also predicted psychiatric hospital treatment and use of antipsychotics. However, when the analysis was controlled with total psychopathology score at age 8 years, frequent bully, victim, or bully-victim status did not predict any psychiatric outcomes among males. Conclusions Boys and girls who display frequent bullying behavior should be evaluated for possible psychiatric problems, as bullying behaviors in concert with psychiatric symptoms are early markers of risk of psychiatric outcome. Among females, frequent childhood victimization predicts later psychiatric problems irrespective of psychiatric problems at baseline.

Nicholson, A., R. Rose, et al. (2009). "Association between attendance at religious services and self-reported health in 22 European countries." Soc Sci Med 69(4): 519-28.  [PubMed]
There are consistent reports of protective associations between attendance at religious services and better self-rated health but existing data rarely consider the social or individual context of religious behaviour. This paper investigates whether attendance at religious services is associated with better self-rated health in diverse countries across Europe. It also explores whether the association varies with either individual-level (gender, educational, social contact) or country-level characteristics (overall level of religious practice, corruption, GDP). Cross-sectional data from round 2 of the European Social Survey were used and 18,328 men and 21,373 women from 22 European countries were included in multilevel analyses, with country as higher level. Compared to men who attended religious services at least once a week, men who never attended were almost twice as likely to describe their health as poor, with an age and education adjusted odds ratio of 1.83 [95% CI, 1.49-2.26]. A similar but weaker effect was seen in women, with an age and education adjusted odds ratio of 1.38 [1.19-1.61]. The associations were reduced only marginally in men by controlling for health status, social contact and country-level variables, but weakened in women. The relationships were stronger in people with longstanding illness, less than university education and in more affluent countries with lower levels of corruption and higher levels of religious belief. These analyses confirm that an association between less frequent attendance at religious services and poor health exists across Europe, but emphasise the importance of taking individual and contextual factors into account. It remains unclear to what extent the observed associations reflect reverse causality or are due to differing perceptions of health.


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