September 2003" / Includes bibliographical references. / xxi, 387 leaves : ill. ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / This study showed that a set of social characteristics systematically differed by socioeconomic position. Socioeconomic gradients in personal control, social support, stress and life satisfaction underlie patterns of dental behaviour that are in turn associated with oral health. / Thesis (Ph.D.)--University of Adelaide, Dental School, 2003

This dissertation aims to explore the relationship between social support and social and psychological wellbeing in the adult population of sexual and gender minorities, or Lesbian, Gay, Bisexual, Transgender (LGBT) adults. We apply Antonucci’s (1987) Convoy Model of Social Relations as a lens through which to conceptualize social support across four dimensions: structure, function, quality, and closeness. Chapter One contains an introduction to the LGBT adult population; a description of the Convoy Model of Social Relations and of technology used to exchange social support; and an outline of the specific aims addressed in this dissertation. Chapter Two is an integrative review of literature about social support networks of LGBT older adults age 50 years and older. Chapter Three is a study designed to investigate relationships between LGBT identity, social support characteristics, the use of online social communication, and psychological and social wellbeing. Chapter Four is a qualitative descriptive study that explores LGBT older adults’ attitudes, perceptions, and uses of technology for social connectedness and support during COVID-19. Chapter Five contains a synthesis of all findings in this dissertation; a discussion of the results as they relate to the Convoy Model of Social Relations; and implications for clinical interventions and future research.

This thesis presents the findings of an exploratory study undertaken to investigate the illness experience of fibromyalgia in the context of South Africa. It contains the literature review and conceptual framework that guided the study. The theoretical discussions reflect the approaches to health and illness, illness experience and narrative study, context, diagnosis, prognosis, sickness, illness career, treatment, institutional interactions and social support. Following this, the methodological approaches and tools used in conducting this study are explained. In-depth interviews and diaries were used to collect narratives from 15 participants and one practitioner. Additionally, a brief media content analysis was included in order to assess the public perceptions of fibromyalgia in South African news articles. The themes of legitimacy, credibility, flexibility, and accommodation are continually developed throughout the thesis. The Analysis of Findings chapter presents and discusses the evidence gathered from the investigations undertaken in this study. This chapter shows how the contested and confusing illness experience of fibromyalgia can be understood, by viewing the interactions that patients have with their practitioners, families, peers and colleagues. The meanings ascribed to fibromyalgia as a label, and the uncertain prognosis attached to the diagnosis, as well as infrequently effective treatment options are explored here. The gains found in successful practitioner-patient interactions, and the limitations of medical aid coverage for chronic conditions like fibromyalgia in South Africa are discussed in this chapter. The role of family and peers, as well as workplaces and colleagues in offering support to those living with fibromyalgia is analysed. Finally, the conclusions arising from this study are presented, and recommendations for areas of future engagement and research are offered in order to attain a better understanding of the experience and impact of fibromyalgia in the South African context.

The likelihood of achieving an effective environmental health communications program increases with a knowledge of the target audience's attitudes toward their environmental health concerns, source credibility, preferred channels of communication, and desire to participate in environmental issues. With this in mind, the purpose of this study was threefold: 1) to examine selected personal and social variables that influence attitudes towards environmental health communications; 2) to explore differences in those attitudes between groups that share a common environmental hazard within a defined geographic region; and, 3) to develop a communication needs assessment tool that other public health agencies might be able to use. A stratified random telephone sampling of 407 households was conducted in Idaho's Coeur d'Alene River Basin. Nonparametric statistical methods, Mann-Whitney U and Kruskal-Wallis one-way analysis of ranks, were utilized for the data analysis. The results, showed significant differences in the environmental concerns between the residents of Couer d'Alene and residents of the Silver Valley. Respondents in Coeur d'Alene were more concerned with air pollution, while respondents in the Silver Valley were more concerned with the effects of mining. Secondly, the state government was less negatively received as a source of environmental information than were the local or federal governments. In addition, respondents earning between $50,000 and $75,000 a year have the highest amount of trust in information coming from the federal government. Both TV news and local newspaper were the preferred channels of communication for the majority of respondents in the region. Qualitative data revealed that media sources from Spokane, Washington were a dominant influence in the region. Respondents with a college degree were less likely than respondents from other educational levels to prefer TV news as a source of environmental information. They were, however, more likely to participate in a public meeting than were respondents from other educational levels. Finally, research findings suggest that women, and respondents earning less than $10,000 per year, feel less control over their environmental health than do men and respondents from higher income levels. They are also less likely than either men or respondents earning more than $10,000 per year to feel that a citizen's efforts to protect the environment are usually effective. / Graduation date: 1996

This study addressed the social determinants of health with a specific focus on three factors in the social environment that either individually or collectively have an influence on health status: gender, socioeconomic status (SES), and people's social relationships. The purpose of the study was to examine whether people's social relationships mediate the effects of SES on self-rated health status and to assess whether these effects differ for women and men. The research questions were examined by formulating a theoretical model and evaluating the hypothesized relationships through the use of structural equation modelling. The analyses were conducted using LISREL on data from 1,239 non-First Nations Yukon residents who participated in the Territory's 1993 Health Promotion Survey. The results of this study suggest that household income significantly affected women's and men's health by influencing aspects of their social relationships. A higher overall rating of the quality of one's social relationships was associated with positive health ratings for both women and men while the perception that support would be available if needed significantly affected only women's self-ratings of their health. Received social support was negatively associated with women's health, but not men's, suggesting that the context in which support is received has an important influence on women's health. Relationship strain, as measured by care provided to several sources, was not significantly related to women's or men's health-ratings. The analyses also identify important interrelationships among the dimensions of social relationships studied as well as some gender differences among these relationships. For both women and men, positive evaluations of the importance of social relationships for their health and a greater number of social ties significantly influenced ratings of the overall quality of their social relationships. Having more social ties also positively influenced the perception of availability of social support for both women and men. The quality of their social relationships influenced the perceived availability of social support only for women. Given the focus of provincial and federal governments in seeking reform of their health-care systems, attention to modifiable determinants of health presents an opportunity to contribute to this reform process. The findings of this study contribute to our understanding of the effects of SES on health by providing support for gender interactions in a set of relationships where aspects of people's social relationships mediate the effects of income on health status. These findings provide support for gender-specific mechanisms by which income level influences perceived health status by shaping people's social relationships, the quality of those relationships and the support they offer.

This study addressed the social determinants of health with a specific focus on three factors in the social environment that either individually or collectively have an influence on health status: gender, socioeconomic status (SES), and people's social relationships. The purpose of the study was to examine whether people's social relationships mediate the effects of SES on self-rated health status and to assess whether these effects differ for women and men. The research questions were examined by formulating a theoretical model and evaluating the hypothesized relationships through the use of structural equation modelling. The analyses were conducted using LISREL on data from 1,239 non-First Nations Yukon residents who participated in the Territory's 1993 Health Promotion Survey. The results of this study suggest that household income significantly affected women's and men's health by influencing aspects of their social relationships. A higher overall rating of the quality of one's social relationships was associated with positive health ratings for both women and men while the perception that support would be available if needed significantly affected only women's self-ratings of their health. Received social support was negatively associated with women's health, but not men's, suggesting that the context in which support is received has an important influence on women's health. Relationship strain, as measured by care provided to several sources, was not significantly related to women's or men's health-ratings. The analyses also identify important interrelationships among the dimensions of social relationships studied as well as some gender differences among these relationships. For both women and men, positive evaluations of the importance of social relationships for their health and a greater number of social ties significantly influenced ratings of the overall quality of their social relationships. Having more social ties also positively influenced the perception of availability of social support for both women and men. The quality of their social relationships influenced the perceived availability of social support only for women. Given the focus of provincial and federal governments in seeking reform of their health-care systems, attention to modifiable determinants of health presents an opportunity to contribute to this reform process. The findings of this study contribute to our understanding of the effects of SES on health by providing support for gender interactions in a set of relationships where aspects of people's social relationships mediate the effects of income on health status. These findings provide support for gender-specific mechanisms by which income level influences perceived health status by shaping people's social relationships, the quality of those relationships and the support they offer. / Graduate and Postdoctoral Studies / Graduate

A research report submitted to the Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the award of the Degree of Masters of Arts in the Demography and Population Studies / Although life expectancy has increased in South Africa (RSA), compared with other middle-income countries, health status is poor most especially among the black majority. Coupled with this are the burdens of infectious and non-communicable diseases. RSA has also shown evidence of weak social cohesion through prevalent racial and gender discrimination, income inequalities, and violence. While previous studies on the health status of adults in RSA has only examined its association with other social determinants, the relationship of adult health status and social cohesion, unlike in developed countries, remains under researched in South Africa and other African countries. Using the collective efficacy theory by Sampson and colleagues (1997), this study adds the ‘African perspective’ to the ongoing debate about the health importance of social cohesion. It examined the relationship between social cohesion and the health status of adults in South Africa. The levels and patterns of health across social cohesion and other socio-demographic characteristics were also examined. DATA AND METHODS: Data was drawn from the 2012 South African Social Attitudes Survey, a survey implemented annually by the Human Sciences Research Council. Social cohesion was assessed by drawing from the five measurable items from the work of Sampson and colleagues (1997) which encompass trust, a sense of belonging, shared values and helpless in both cash and kind. These items were subjected to principal component factor analysis with Promax rotation. Cronbach’s alpha (α) for this scale is 0.84. Scores were divided into tertiles of low, medium and high social cohesion. A cumulative stepwise logistic regression model was fitted on a weighted sample of 22,605,550 adults in South Africa aged 18 years or older to examine the nexus between social cohesion and self-rated health status. Sub-group analysis examined if the observed relationship differed by race. The data was analysed using STATA software version 14. All model diagnostics showed that the model fits reasonably for the data. The interpretation of results was made using odds ratios (ORs), and a 95% confidence was used. RESULTS: More than half of adults (54%) in South Africa reported themselves to be in good health while only about 17% reported that they were in poor health. The percentage of adults reporting good health is higher among adults in the highest tertile of social cohesion (59%), compared to 53% among those in the lowest tertile. Controlling for other characteristics, regression analysis showed that adults in lowest tertile [OR:0.70, CI:0.516 - 0.965] and moderate tertile [OR:0.79, CI:0.589 - 1.055] of social cohesion were less likely to report moderate or good health compared to adults in the highest tertile of social cohesion, but the relationship was only statistically significant among adults in the lowest tertile of social cohesion. Sub-group analysis by race showed that among all the racial groups (excluding Indian or Asian adults), black African [OR:0.68, CI:0.472-0.989], coloured [OR:0.63, CI:0.305-1.309], and white [OR:0.67, CI:0.293 1.545] adults residing in the lowest tertile of social cohesion were less likely to be in moderate or good health compared to those in the highest tertile of social cohesion, but the relationship was only statistically significant among black Africans. CONCLUSION AND RECOMMENDATION: The findings from this study demonstrate that social cohesion among adults in South Africa, particularly among black Africans, is important for improvement in health. It is therefore important that the government of South Africa intensifies efforts aimed at increasing social cohesion among adults, particularly among black Africans. This could be achieved through public awareness on the health importance of social cohesion and the need for neighbours to share similar values, trust one another and be willing to help. This is especially important if significant progress is to be made in achieving the sustainable development goals to improve the health of adults in the country by 2030. / XL2018

Rwanda experienced genocide from April to July 1994 during which over 800,000 people were murdered. Among the far-reaching changes that followed this event among individuals and in society overall, the Rwandan Demographic and Health Surveys (DHS) showed that contraceptive prevalence declined from 13% in 1992 to 4% in 2000 among married women of reproductive age. This dissertation has two hypotheses concerning Rwandan women's fertility preferences and behavior following the genocide. It is hypothesized that, first, high levels of conflict reduced women's desire for a child or for additional children and second, that women who experienced relatively high levels of conflict were more likely to act on their wish to not have a child or another child by using modern contraceptives than were women who experienced relatively low levels of conflict. The study's logistic regression dependent (outcome) variables were desire for a or another child and the use of modern contraceptives; the source for these data was the 2000 DHS. Three groups of independent variables were included: socio-demographic variables, also from the 2000 DHS, included age, number of living children, education level, urban/rural residence and socio-economic status; availability of family planning services, assessed using women's perception of distance as a barrier to obtaining health care for themselves, from the 2000 DHS, and quality of health services, assessed with data from the 2001 Service Provision Assessment; and experience of conflict, measured as the percentage of the 1994 commune populations that resided in refugee camps in 1995. Communes were considered `high migration' if 10 percent or more of their populations migrated to camps and `low migration' if less than 10 percent of their populations migrated to camps. Women who lived in high migration communes were considered to have relatively high experience of conflict and those who lived in low migration communes were consider dot have relatively low experience of conflict. Analysis showed that residents of high migration communes were significantly less likely to want a or another child as compared to residents of low migration communes (OR = .74); it appeared that the social environment of high migration had a dampening effect on desire for children. The analysis also showed that residents of high migration communes were significantly less likely to use a modern contraceptive method than were those of low migration communes (OR = .57), even though they were less likely to want a or another child and even when family planning services were reasonably available. The reasons for these results are unclear, and many factors may contribute. The generalized trauma experienced by the population may have had a numbing effect, in which taking action in any domain was difficult. Women may have felt pressured by society to have children as the society emerged from war, despite their own preferences. The population may also have distrusted government health facilities - the only source of services for most - in light of the interactions with officials during and after the genocide. However, another set of reasons specific to women and women's health may also have influenced the findings. There is a pervasive social stigma around reproductive health; these services have generally lagged behind other primary health care components. Moreover, rape was used as a weapon of war in the genocide; these experiences may have reduced women's willingness to seek reproductive health services specifically. Finally, the Rwandan genocide and its preparation were decidedly misogynistic; this pervasive dehumanization may have made it particularly difficult for women to seek care for their sexual and reproductive health needs and desires. This complex personal, social, physical and political context may explain why Rwandan women who may not have wanted a child or additional children nonetheless did not consistently act on their desires in the years following the 1994 genocide. The dissertation includes a series of essays providing the author's personal perspective on working in Rwanda in the 1980s and 1990s and being present in the country at the start of the genocide in April 1994.

This dissertation aims to contextualize the normative and structural constraints on women's bodies, health, and wellbeing in rural Tamil Nadu, India. Using theoretical frameworks by R.W. Connell and Michel Foucault, this qualitative study explores the intersection of gender and power at interpersonal-, institutional-, and community-levels. Findings from this research highlight specific manifestations of the local gender regime that women may need to overcome to better care for their bodies and selves.

"January 2004" / Includes bibliographical references (leaves 252-273) / xxiii, 276, [6] leaves : ill. ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Thesis (Ph.D.)--University of Adelaide, Dept. of Social Inquiry, 2004