Thesis advisor: Diana Pullin / A number of scholars are examining factors hindering student performance. Scholars suggest that understanding these factors is critical knowledge for leaders to cultivate as they work to address elements within their school or district that need to change if student learning is to improve. What is often overlooked in the literature is how educators understand the achievement gap and the impact this understanding has on the learning environment. Exploring how district- and school-level leaders understand disparities in student performance and how these understandings then influence the work of leadership may offer insight into factors hindering student performance. The study was conducted in a small, diverse urban district designated by the state as low performing based on state indicators. Many scholars have explored interactions among leaders as a factor hindering student performance. These researchers indicate the significance of the role that interactions between district- and school-level leaders play in school improvement efforts. Although this is a central focus area in the literature, there is limited scholarship on how those interactions specifically impact leaders' understanding of barriers to students' opportunity to learn. Therefore, analyzing these relations may result in an increased awareness of their impact on the learning environment. This single case study uses document reviews and interview data to analyze leader relations and practice. Findings reveal interactions among leaders resulted in an understanding of barriers in the learning environment; lack of trust hindered some relations but despite this, all leaders engaged in tasks intended to enhance student learning. / Thesis (EdD) — Boston College, 2014. / Submitted to: Boston College. Lynch School of Education. / Discipline: Educational Leadership and Higher Education.

Background: The degree of health variation among social groups is an important indicator of population health and the efficiency of economic and social systems. Previous studies revealed existence of health inequalities across Europe, however recent studies on the contribution of income to such inequalities are scarce. Aim: To investigate differences in self-reported health between the lowest and the highest income groups across Europe. Method: Data from the European Social Survey for 29 countries were examined. The absolute inequalities were calculated as differences in age-adjusted prevalence of poor self-reported health between the lowest and the highest income quintiles. The relative inequalities were measured by odds ratios for reporting poor health in the lowest income group compared to the highest one. Results: Income-related health inequalities were found in all countries. Larger relative inequalities among men were observed in Greece, Kosovo, Ireland, Israel, Iceland, and Slovenia; among women – in Lithuania, Denmark, Norway, Portugal, Cyprus, and Czech Republic. Conslusions: In Europe, income-related health inequalities persist, however, their degree varies across countries. Gender differences in income-related inequalities were observed within certain countries. For a comprehensive description of health situation in a country assessing both the prevalence of poor health and the inequality level is crucial.

Thesis advisor: Rebekah Levine Coley / Theories of upward mobility argue that academic and employment success grant individuals improved health, yet emerging evidence suggests that striving for such mobility in the context of marginalization may actually dysregulate physiological stress responses and compromise health. It is still unclear whether these associations operate as a function of cumulative exposure to risk (including both socioeconomic and racial/ethnic marginalization), or whether they would emerge outside of such collective risk. Further, little is known about how the school context, one of the most central contexts in adolescent development, affects associations between mobility and health, despite evidence that opportunities for socioeconomic comparisons or for discrimination at school may further exacerbate these associations. Drawing on data from the National Longitudinal Study of Adolescent Health, a longitudinal survey of a nationally representative school-based sample of adolescents in the United States (N=14,797), the current study sought to clarify links between achievement and physiological health. Multilevel regression analyses considered prospective associations between achievement and health while attending to potential variation in links across the socioeconomic spectrum and across racial/ethnic groups. Additionally, school-level factors were taken into account and explored as potential augmenting mechanisms in these links. Findings suggested promotive links between achievement and physiological health, but also suggested that such links were not shared broadly by all youth. Although links did not vary across the socioeconomic spectrum, Asian American youth demonstrated some greater health payoffs of achievement compared to their non-Hispanic White peers, while non-Hispanic Black and Mexican American youth largely experienced reversed links. These results suggest additional evidence that striving for academic achievement while experiencing racial/ethnic marginality may engender dysregulation of the stress-response system. Thus, findings are discussed in relation to the social and historical contexts that may contribute to such divergent links. However, the school-level factors considered did not moderate links among achievement, individual characteristics, and physiological health, pointing to the importance of future research considering alternate social and contextual mechanisms in these relationships. / Thesis (PhD) — Boston College, 2017. / Submitted to: Boston College. Lynch School of Education. / Discipline: Counseling, Developmental and Educational Psychology.

This study explored faculty members' perceived importance of family-friendly policies in academia, the extent to which faculty perceive academic institutions as having a social responsibility to make the academy more family-friendly, participants' endorsement of gender-biased norms, and whether the faculty members who participated in this study are considering "opting-out" of academia. Key constructs that were explored include: the ideal worker norm, the motherhood norm, the maternal wall, and bias avoidance. Methodological limitations and the implications for this study were discussed. The participants of this study were 243 female and male tenure-track and tenured faculty members from graduate departments from six nationally accredited, public, U.S. doctoral-granting research universities. The results indicated that although most faculty do not intend to "opt-out" of academia, a substantial proportion reported that they are considering leaving their current institution, or leaving academia entirely. Further, although faculty members' perceptions of whether a family-friendly policy is of personal importance varied, the overwhelming majority of respondents expressed support for such policies. Finally, on average, faculty members did not endorse gender-biased beliefs toward caregiving, with women being less likely to endorse such beliefs.

Black women are disproportionately burdened by type-2 diabetes (Bancks et al., 2017) and their experience of health inequities is negatively shaped by institutionalized racism in the US (Feagin & Bennefield, 2014). Previous research has demonstrated the impact of type-2 diabetes on the Black community, yet fails to adequately capture the complexity of Black women’s experiences navigating the disease (Hurt et al., 2017). This two-phase qualitative dissertation study addresses this gap in the literature. Drawing from critical race theory (Delgado & Stefancic, 2012), feminist theory (Collins, 2002) and popular education (Freire, 1970), photovoice and interview methods were employed to examine how one group of Black women residing in Boston experience type-2 diabetes. Phase I included a photovoice project with 11 Black women between the ages of 36 and 69 recruited from an area diabetes clinic and community agencies. Phase II included one focus group (N=4) with interdisciplinary diabetes providers from an area diabetes clinic and 13 individual interviews with interdisciplinary diabetes providers including: physicians, nurse practitioners, clinical pharmacists, dieticians and social workers from three Boston medical institutions. The researcher explored provider perceptions of the photovoice findings and their implications for provider education and training. The researcher used inductive thematic analysis (Braun & Clark, 2006) to further contextualize the photovoice findings in phase I and to analyze providers’ reactions to the photovoice analysis in phase II. Photovoice participants and providers interpreted the photovoice findings differently. The photovoice participants’ analysis reflected a hopeful, aspirational message despite the complexity of navigating type-2 diabetes and the competing messages about health and wellness many Black women internalize. In contrast, provider reflections were more deficit driven and focused on medical management. Further, providers shared some biased assumptions about Black women’s experiences with type-2 diabetes such as inferring substance use as a concern from one of the photos. This research highlights the transformative power of photovoice methods (Wang & Burris, 1997) to engage Black women to make meaning of their experiences with type-2 diabetes and communicate their health priorities. These findings have important implications for interdisciplinary teaching models and future social work research and practice with Black women and other marginalized groups coping with chronic disease. / 2023-05-07T00:00:00Z

Single parents face many challenges when accessing healthcare for their children and themselves, and have health issues that may go unrecognized, particularly for single fathers. The number of single father households has increased dramatically over the past few decades. There were fewer than 300,000 single father households in 1960, but in 2011 that number increased to more than 2.6 million—a 8.6-fold increase from baseline. Despite this jump in numbers, the literature addressing health-related issues of single fathers is rather scant. In this blog, we disseminate the limited number of studies on the subject and make recommendations for nurses to address the health disparities for this unique segment of population.

Immigrant women are at greater risk for postpartum depression (PPD) compared to non-immigrant women and experience multiple barriers to accessing health services to address their needs. This mixed method study explored the multi-level factors that contribute to the postpartum mental health of immigrant women in Canada and their ability to access requisite health services. In the quantitative phase, data from a longitudinal prospective cohort survey of women were used to examine predictors of PPD over the first postpartum year for a sample of women who delivered at two hospitals in Toronto, Ontario. In the qualitative phase, an interpretive descriptive design shaped by an integrated knowledge translation approach was used to understand the factors immigrant women living in Scarborough, Ontario (a region of Toronto) perceive as contributing to their postpartum emotional health and the factors immigrant women and care providers perceive as influencing access to health services. Across quantitative and qualitative findings, factors contributing to PPD among immigrant women included a lack of social support, individual and community-level challenges faced in terms of the social health determinants, physical health status, and client-provider relationships. Factors contributing to reduced access to health services included: lack of system knowledge, social health determinants, organizational and system barriers, limited access to treatment, and a need for service integration and system navigation support. Immigrant women in Canada experience numerous health inequities that increase their risk for PPD and v prevent them from accessing service supports to address PPD concerns. The Canadian health care system needs to be responsive to individual needs in order to facilitate equitable access and address the health needs of Canadian immigrant women and their families. The diversity and proportion of immigrants in Canada calls for a linguistically and culturally supportive health care system with a strategic approach to enhancing accessibility to address health inequities. / Dissertation / Doctor of Philosophy (PhD) / Immigrant women have a 2-3 times higher risk for postpartum depression (PPD) than native-born women. This study explored the factors that contribute to PPD among immigrant women in Canada and how health services can help them get the care they need, from the perspective of immigrant women and care providers. This study found increased PPD risk when women lacked social support, had physical health issues, and faced challenges such as low income and lack of English language skills. Working with care providers could help address these challenges or make it more difficult to get care. Immigrant women had more difficulty getting services when they lacked knowledge about the health care system, faced social, financial, and language-based barriers to care, and experienced barriers when using available services. The findings from this research can inform the design and delivery of health care to best meet the needs of immigrant women with PPD.

Made available in DSpace on 2014-12-17T14:20:10Z (GMT). No. of bitstreams: 1 MariaSQE.pdf: 568148 bytes, checksum: 9ffdfbb4f54a77c2daaf5a6b3abd2ad4 (MD5) Previous issue date: 2008-07-04 / This issue analises the unevenness in the brazilian system of public health care as an extension of socials inequities. It is a theoretical study based in a historical method, using empirical camp from academic, corporation and institution researchs, along the period 2002-2006. Equality and effectiveness in health systems are analitical basic cathegories grap in the root of the doctrine, principles and organization of the Unique Health System, in which sectorial actions are inserted. Discuss the estructural prodution and determined those inequalities through some social determiners of health system: income, land, food securitiy, nutritional situation, basic sanitation, epidemiological inequities and public management policy. Carry out a thematic review over health social production, it formlation and the goals of social policies, as well as the insertion of the equality principle in the assistance system, in the frame of the running public health regulations. It uses reflections that enlighted the correlation between the process of political-institutional actions and equity on health assistance. Analized the pertinency of sectorial reorganizational strategies on basic attendance, confronting the hipothesis that those strategies reinforce social inequities in health system, because it organize diferential assistance levels over not equal baselines. The results show up that social inequalities, even remaining, have had a small decrease; that the selectiviness of actual public policies and the duplication of the health system, increases the differences within and between the social classes and configures the assistance as inequal. The basic care system has great shortages that also appeares in middle and complex assistance levels. As conclusion, it remarks that the health assintance system, even with it integrality has limits; structural problems on material conditions of living and health system could not be reversed only with institutional legal arragements; by the contrary, in border conditions, these strategies produce policies that reinforce inequities, neglecting the equity principle of the system in which frame, they work. One patina of this tim / Este trabalho teve como objeto de estudo as inquidades no sistema p?blico de sa?de brasileiro como extens?o das desigualdades sociais. Estudo te?rico com base no m?todo hist?rico que se utilizou do campo emp?rico de estudos acad?micos, institucionais e de entidades entre 2003-2006. A equidade e efetividade em sa?de s?o categorias anal?ticas imbricadas ? indissociabilidade dos princ?pios doutrin?rios e organizativos do sistema ?nico de sa?de. Analisa a produ??o estrutural das desisgualdades sociais e as caracteriza pelos determinantes sociais de p?so na quest?o da s?ude: renda, acesso ? terra, seguran?a alimentar, saneamento b?sico, desigualdades epidemiol?gicas e na assist?ncia. Efetua revis?o sobre a produ??o social da sa?de, formula??o, finalidades das pol?ticas sociais e inser??o do princ?pio de equidade no projeto de sa?de publica ancorada em autores que projetaram luzes sobre a corela??o de processos de indu??o pol?tico institucionais com a equidade. Exercita uma an?lise de pertin?ncia sobre a estrat?gia setorial de reorganiza??o da aten??o b?sica com a hip?tese de que esta estrat?gia refor?a as desigualdades sociais ao prestar n?veis assist?nciais diferenciados aos horizontalmente iguais. Os resultados apontam: t?nue redu??o nos diferenciais de distribui??o de renda com manuten??o de elevados n?veis de desigualdades sociais da situa??o alimentar e nutricional, saneamento b?sico e assist?ncia ? sa?de em todos os n?veis; a seletividade dos ajustes neoliberais se esteiam na cultura pol?tica brasileira e na reorganiza??o da assist?ncia de um sistema dual aumentam as dist?ncias intra e entre classes; configuram uma assist?ncia in?qua intra rede; a aten??o b?sica minimalista para pobres tem d?ficits elevados que se extrapolam nos niveis de m?dia e alta complexidade. Conclui pela fr?gil regula??o social na governabilidade setorial cuja retra??o faz avan?ar o bra?o do Estado pelo Judici?rio; em extremas desigualdades a assist?ncia ? sa?de, mesmo integral tem limites; n?o se revertem condi??es materias de vida e de sa?de com arranjos institucionais normativos; ao reverso, arranjos focalistas produzem a??es que refor?am as desigualdades e ferem o princ?pio de equidade do sistema onde elas se inserem. Uma p?tina deste tempo

Although evidence of health inequities abound, why people in lower socio-economic classes have poorer health has not been sufficiently explored. The purpose of this study is to examine day labourers’ pathways to health inequities in a segregated, urban district in Japan. Critical ethnography was employed to investigate day labourers’ social environments and cultural behaviours in order to reveal the ways that social inequalities embedded in mainstream society and the day labourers’ sub-culture produce and sustain day labourers’ disadvantages, leading them into poorer health than the average population. Data were collected through observations of day labourer’s daily activities, events within the district and their interactions with social workers at a hospital. In addition, interviews were conducted with 16 day labourers and 11 professionals and advocates. The study found several components in the pathways to health inequities of day labourers. First, certain people in Japan are ostracized from the social, economic and political mainstream due to an inability to enact traditional Japanese labour practices. Commonly such exclusions make men become day labourers to survive. In a day labourer district, they are exposed to further social inequalities embedded in the work system and their living circumstance. Living and working as a member of the day labour community, they develop collective strategies in order to survive and preserve their social identities as day labourers. However, such strategies do not provide people with opportunities to lead healthy lives. The study also identified several social determinants of health for day labourers, including: 1) employment, 2) working conditions, 3) temporary living, 4) housing quality, 5) social networks and support, 6) marginalized neighbourhood, 7) access to health care, and 8) gender. The findings contribute to a better understanding of social construction of health inequities, which provides insight on the impact of precarious work in the Japanese society at large. Implications of these findings for public health policy and practice are also discussed.

Although evidence of health inequities abound, why people in lower socio-economic classes have poorer health has not been sufficiently explored. The purpose of this study is to examine day labourers’ pathways to health inequities in a segregated, urban district in Japan. Critical ethnography was employed to investigate day labourers’ social environments and cultural behaviours in order to reveal the ways that social inequalities embedded in mainstream society and the day labourers’ sub-culture produce and sustain day labourers’ disadvantages, leading them into poorer health than the average population. Data were collected through observations of day labourer’s daily activities, events within the district and their interactions with social workers at a hospital. In addition, interviews were conducted with 16 day labourers and 11 professionals and advocates. The study found several components in the pathways to health inequities of day labourers. First, certain people in Japan are ostracized from the social, economic and political mainstream due to an inability to enact traditional Japanese labour practices. Commonly such exclusions make men become day labourers to survive. In a day labourer district, they are exposed to further social inequalities embedded in the work system and their living circumstance. Living and working as a member of the day labour community, they develop collective strategies in order to survive and preserve their social identities as day labourers. However, such strategies do not provide people with opportunities to lead healthy lives. The study also identified several social determinants of health for day labourers, including: 1) employment, 2) working conditions, 3) temporary living, 4) housing quality, 5) social networks and support, 6) marginalized neighbourhood, 7) access to health care, and 8) gender. The findings contribute to a better understanding of social construction of health inequities, which provides insight on the impact of precarious work in the Japanese society at large. Implications of these findings for public health policy and practice are also discussed.