The detection of psychiatric illness by questionnaire

▪ Abstract This paper assesses and synthesizes the cumulative results of a new “neighborhood-effects” literature that examines social processes related to problem behaviors and health-related outcomes. Our review identified over 40 relevant studies published in peer-reviewed journals from the mid-1990s to 2001, the take-off point for an increasing level of interest in neighborhood effects. Moving beyond traditional characteristics such as concentrated poverty, we evaluate the salience of social-interactional and institutional mechanisms hypothesized to account for neighborhood-level variations in a variety of phenomena (e.g., delinquency, violence, depression, high-risk behavior), especially among adolescents. We highlight neighborhood ties, social control, mutual trust, institutional resources, disorder, and routine activity patterns. We also discuss a set of thorny methodological problems that plague the study of neighborhood effects, with special attention to selection bias. We conclude with promising ...

ASSESSING "NEIGHBORHOOD EFFECTS": Social Processes and New Directions in Research

This article provides a comprehensive review of research on the effects of neighborhood residence on child and adolescent well-being. The first section reviews key methodological issues. The following section considers links between neighborhood characteristics and child outcomes and suggests the importance of high socioeconomic status (SES) for achievement and low SES and residential instability for behavioral/emotional outcomes. The third section identifies 3 pathways (institutional resources, relationships, and norms/collective efficacy) through which neighborhoods might influence development, and which represent an extension of models identified by C. Jencks and S. Mayer (1990) and R. J. Sampson (1992). The models provide a theoretical base for studying neighborhood mechanisms and specify different levels (individual, family, school, peer, community) at which processes may operate. Implications for an emerging developmental framework for research on neighborhoods are discussed. Social science concerns about the effects of residence in a poor neighborhood on children and youth date back more than 50 years to the publication of Shaw and McKay's (1942) Juvenile Delinquency and Urban Areas. Historical accounts of the effects of living in a poor neighborhood date back even further. The current interest in neighborhood effects on, children and youth has multiple origins. First, Wilson's (1987) documentation of increasingly concentrated poverty in urban areas at the neighborhood level during the 1970s and 1980s served to reorient discussions of poverty from the individual to the neighborhood level. Second, and related to the work of Wilson, was the rejuvenated interest among sociologists and urban scholars in community social disorganization theory (Shaw & McKay, 1942) as an explanatory model for delinquency and crime, as well as other problem behaviors encountered in many poor urban neighborhoods (see, e.g., Bursik, 1988; Kornhauser, 1978; Sampson, 1992; Sampson & Groves, 1989; see Sampson & Morenoff, 1997, for a review). Social disorganization theory posits that neighborhood structural factors, such as poverty, residential instability, single parenthood, and ethnic heterogeneity, are of prime importance in explaining behavior through their ability to thwart or promote neighborhood organization (formal and informal institutions), which maintains public order. Other scholars, although not necessarily focusing on child wellbeing, drew attention to residential (or spacial) patterns as sources

/pdf/the-neighborhoods-they-live-in-the-effects-of-neighborhood-1ws5nup3j3.pdf

The neighborhoods they live in: the effects of neighborhood residence on child and adolescent outcomes.

The human stress response has been characterized, both physiologically and behaviorally, as "fight-or-flight." Although fight-or-flight may characterize the primary physiological responses to stress for both males and females, we propose that, behaviorally, females' responses are more marked by a pattern of "tend-and-befriend." Tending involves nurturant activities designed to protect the self and offspring that promote safety and reduce distress; befriending is the creation and maintenance of social networks that may aid in this process. The biobehavioral mechanism that underlies the tend-and-befriend pattern appears to draw on the attachment-caregiving system, and neuroendocrine evidence from animal and human studies suggests that oxytocin, in conjunction with female reproductive hormones and endogenous opioid peptide mechanisms, may be at its core. This previously unexplored stress regulatory system has manifold implications for the study of stress.

/pdf/biobehavioral-responses-to-stress-in-females-tend-and-2yimakv5ai.pdf

Biobehavioral responses to stress in females: tend-and-befriend, not fight-or-flight.

Health systems rely on commercial prediction algorithms to identify and help patients with complex health needs. We show that a widely used algorithm, typical of this industry-wide approach and affecting millions of patients, exhibits significant racial bias: At a given risk score, Black patients are considerably sicker than White patients, as evidenced by signs of uncontrolled illnesses. Remedying this disparity would increase the percentage of Black patients receiving additional help from 17.7 to 46.5%. The bias arises because the algorithm predicts health care costs rather than illness, but unequal access to care means that we spend less money caring for Black patients than for White patients. Thus, despite health care cost appearing to be an effective proxy for health by some measures of predictive accuracy, large racial biases arise. We suggest that the choice of convenient, seemingly effective proxies for ground truth can be an important source of algorithmic bias in many contexts.

/pdf/dissecting-racial-bias-in-an-algorithm-used-to-manage-the-3w9n49km45.pdf

Dissecting racial bias in an algorithm used to manage the health of populations

Socioeconomic status (SES) underlies three major determinants of health: health care, environmental exposure, and health behavior. In addition, chronic stress associated with lower SES may also increase morbidity and mortality. Reducing SES disparities in health will require policy initiatives addressing the components of socioeconomic status (income, education, and occupation) as well as the pathways by which these affect health. Lessons for U.S. policy approaches are taken from the Acheson Commission in England, which was charged with reducing health disparities in that country.

Socioeconomic Disparities In Health: Pathways And Policies

No Shame in My Game: The Working Poor in the Inner City

▪ Abstract In what follows we critically assess a selection of the works on urban poverty that followed the publication of WJ Wilson's The Truly Disadvantaged (1987), with a particular focus on the family, the neighborhood, and culture. We frame our discussion by assessing the broad explanations of the increased concentration of poverty in urban neighborhoods characteristic of the 1970s and 1980s. Then, in the section on the family, we address the rising out-of-wedlock and disproportionately high teenage birthrates of poor urban women. Next, we critique the literature on neighborhood effects. Finally, in the discussion of culture, we examine critically the new efforts at complementing structural explanations with cultural accounts. We conclude by calling for more comparative, cross-regional, and historical studies, broader conceptions of urban poverty, and a greater focus on Latinos and other ethnic groups.

https://scholar.harvard.edu/files/mariosmall/files/2678613.pdf

URBAN POVERTY AFTER THE TRULY DISADVANTAGED : The Rediscovery of the Family, the Neighborhood, and Culture

In the last decade, school shootings have decimated communities and terrified parents, teachers, and children in even the most "family friendly" American towns and suburbs. These tragedies appear to be the spontaneous acts of disconnected teens, but this important book argues that the roots of violence are deeply entwined in the communities themselves. Rampage challenges the "loner theory" of school violence and shows why so many adults and students miss the warning signs that could prevent it.

Katherine S. Newman

Papers

Socioeconomic Disparities In Health: Pathways And Policies

No Shame in My Game: The Working Poor in the Inner City

URBAN POVERTY AFTER THE TRULY DISADVANTAGED : The Rediscovery of the Family, the Neighborhood, and Culture

Rampage: The Social Roots of School Shootings

Falling from Grace: The Experience of Downward Mobility in the American Middle Class