Alexandra C.H. Nowakowski

None of the Above: Strategies for Inclusive Teaching with "Representative" Data.

This conversation explores emerging debates concerning teaching to and about marginalized populations often left out of “representative” data sets. Based on our experiences studying, teaching, and belonging to some of these unrepresented populations, we outline some strategies sociologists may use to transform the limitations of data sets traditionally labeled as representative into tools for delivering core sociological concepts. In so doing, we argue that sociologists may respond to increasing critiques of “representative” data by using these critiques to facilitate critical thinking skills and methodological awareness among students. In closing, we encourage sociologists to consider the challenges and opportunities presented by increasing awareness of unrepresented populations within our classrooms and the broader social world.

Swell Foundations: Fundamental Social Causes and Chronic Inflammation

We assess prior research identifying potential causal links between social disadvantage and chronic inflammation, using Fundamental Social Causes (see Link and Phelan 1995) and gender theory. We use ordinary least-squares regression to investigate how social structure and relationship factors predict C-reactive protein serolevels among participants in the National Social Life, Health, and Aging Project (Waite et al. 2007). Gender predicts chronic inflammation status more strongly and reliably than any other social factor; female participants show significantly higher CRP levels. Other reliable predictors include race, education, and marriage. Black race predicts significantly higher CRP; college education and marriage predict significantly lower CRP. Income predicts CRP inconsistently. Social support and communication variables do not significantly predict CRP in our models. Gender inequalities and pressures may place women at heightened risk for chronic inflammation. Political advocacy and policy action approaches may thus prove more effective than medical interventions for inflammation prevention.

Incident Surveillance in New Jersey Career and Technical Education Programs, 1999 to 2008

Through school-sponsored career and technical education programs in New Jersey, students work part-time during or after school in paid and unpaid structured learning experiences regulated by the New Jersey Department of Education. Schools submit information on “reportable incidents,” injury or illness resulting in physician treatment. Incidents including reported use of personal protective equipment (PPE) were assessed; 1,600 incident reports (1999 to 2008) were received. Attributes such as type and severity, body parts affected, and PPE use for incidents occurring at school among students grades 9 to 12 or labeled as “adults” during school hours (n = 285) were analyzed. Older teens incurred more injuries. PPE use was consistently low across age and gender. Students most frequently experienced knife injuries involving fingers and hands. Results identified potential injury determinants and training and intervention topics such as PPE, and support development of an enhanced reporting form.

Do religiosity and spirituality really matter for social, mental, and physical health?: A tale of two samples

ABSTRACT Some prior research has found that religiosity and spirituality can be related to health. However, the relationships are inconsistent, measures of religiosity and spirituality are often problematic and conflated with the health outcomes they are supposed to predict, and very little research on this topic specifies which aspects of health supposedly benefit from religiosity and spirituality. Using two sets of survey data (Sample 1 N = 347; Sample 2 N = 404), we examined whether religiosity and spirituality had direct or indirect effects on physical, mental, and/or social health. We found that spirituality, when conceptualized as belief and experience of the supernatural, had no direct or indirect effect on physical, mental, or social health. Religiosity had a small but significant direct effect on social health in one sample but not the other. We consider our findings in relation to religious privileging in the United States and how proreligious biases can lead to health inequalities.

Should We Talk about the Pain? Personalizing Sociology in the Medical Sociology Classroom

This article discusses the potential of personalizing sociology curriculum, specifically in Medical Sociology courses, to increase student engagement and sociological awareness. Based on our experiences offering separate Medical Sociology courses at a large public research university and a small private teaching university, respectively, we outline emotional techniques we have each employed—separately and together—in our classes to facilitate student engagement, critical awareness, and medical coming out processes in our classrooms. In so doing, we have both built highly successful and popular Medical Sociology courses where students learn about and engage with the interpersonal and emotional effects of health care systems, structures, and patterned disparities. Throughout this article, we use our experiences as a case for facilitating debate concerning the incorporation of personal and emotional biography into sociological teaching and provide questions that may facilitate such conversation. In closing, we encourage sociologists to reflect upon, consider, and debate the usefulness of incorporating personal and emotional biographies into the curriculum.

Hope is a four-letter word: riding the emotional rollercoaster of illness management

In this autoethnography, I explore the process and emotional experience of trying a new drug to improve my quality of life. In so doing, I synthesise personal history with extant research on chronic illness by analysing ways in which my experiences reflect and reject social norms. I also incorporate perspectives from research on aspirations and attainment, and the mental health consequences of cyclical disappointment. By weaving together lessons from each of these literatures, I articulate an integrative psychosocial understanding of the micro-level processes and experiences involved in illness management as well as the ways that experiences of illness management may require integration of varied sociological insights concerning health. In closing, I draw out theoretical implications for understanding the integration and variation of insights from many areas of health research in the lived experiences of people with chronic conditions. A Virtual Abstract of this article can be seen at: https://youtu.be/5aoaWGItDgM.

Engaging African American women in research: an approach to eliminate health disparities in the African American community

Objective To explore the success of community-based participatory research [CBPR] in engaging African American women to achieve health equity by elucidating community, trust, communication and impact. Recommendations helpful for researchers interested in engaging communities to achieve health equity in the USA are included. Inroduction African American women experience health disparities of multifactorial etiology and are underrepresented in research. CBPR is a collaborative approach that incorporates perspectives, which address the intricate determinants of health and has been reported as an effective means to address health disparities. Yet, the science of CBPR seems elusive to researchers in the medical field. The opportunity exists to better understand and expand the use of the principles of engagement, replication, and sustainability in engaging African American women in health research. Methods A variety of literature regarding engaging African American women in community-based participatory research was reviewed. Results CBPR focused on robust engagement of marginalized groups continues to be validated as a vital approach to the elimination of disparities and improved health for all, especially ethnic and racial minority populations. However, limited evidence of focused engagement of African American women was found. Making specific outreach to African American women must be a community and patient engagement priority to achieve health equity. Conclusions Continued research is needed which specifically focuses on building and sustaining engagement with African American women and their communities. This research can transform healthcare access, experiences and outcomes by yielding actionable information about what African American women need and want to promote wellness for themselves and their communities.

Exploring the Cultural and Social Context of Black Infant Mortality

This community-based participatory research study explores perceptions about infant mortality among Black women in Leon and Gadsden counties of North Florida. It emphasizes engagement and leadership for community organizers and health profession students and partnership building across disciplines. Three focus groups were conducted with Black women (N=20) ages 19 to 68. Participants responded to questions about infant mortality definitions, community impacts, sociocultural causes, prevention strategies, health care access, and racial dynamics. Content analysis with open coding was used to identify key themes. Findings suggest that infant mortality in local Black communities stems from interconnected individual, family, community, health system, and societal factors. These include discrimination, socioeconomic challenges, female burden, stress, cultural taboos, health care access, psychosocial support, educational opportunities, and intergenerational communication. Participants describe community outreach,...

Exploring Black-White Differences in the Relationship Between Inflammation and Timing of Menopause

Understanding the biosocial context of menopausal timing offers insight into social and health inequalities. Prior research on inflammatory chronic conditions suggests that inflammation may predict how early women experience menopause. We explore the ability of black race to moderate the overall relationship between chronic inflammation and timing of menopause. We use data from the National Social Life, Health, and Aging Project on inflammation, age of last menstruation, and race as well as relevant social and medical covariates. We conduct event history modeling to predict age at menopause by inflammatory biomarker levels. Using interaction analysis, we investigate whether being black may shape the overall relationship between inflammation status and menopause timing. Our analyses find no significant statistical interactions between black race and inflammation in predicting menopausal onset. However, we do identify independent correlational relationships between inflammation and black race (r = 0.136) and between menopausal timing and black race (r = −0.129) as well as inflammation (r = −0.138) that emerge as significant in corresponding regression models. We conclude that race probably does not moderate associations between inflammation and menopause. Yet, we also note that the original parameter estimate for black race’s impact on menopausal onset (HR = 1.29, p < 0.05) becomes non-significant in a model that includes inflammation (HR = 1.06, p < 0.01). To translate our findings into policy and practice implications, we present alternate conceptualizations of black-white disparity in the inflammation-menopause relationship and recommend future research using mediation modeling.

Childhood Socioeconomic Status and Stress in Late Adulthood: A Longitudinal Approach to Measuring Allostatic Load:

Objectives: This study examines how the effects of childhood socioeconomic status (SES) may carry on into late adulthood. Methods: We examine how childhood SES affects both perceived stress and allostatic load, which is a cumulative measure of the body’s biologic response to chronic stress. We use the National Social Life, Health, and Aging Project, Waves 1 and 2, and suggest a novel method of incorporating a longitudinal allostatic load measure. Results: Individuals who grew up in low SES households have higher allostatic load scores in late adulthood, and this association is mediated mostly by educational attainment. Discussion: The longitudinal allostatic load measure shows similar results to the singular measures and allows us to include 2 time points into one outcome measure. Incorporating 2 separate time points into one measure is important because allostatic load is a measure of cumulative physiological dysregulation, and longitudinal data provide a more comprehensive measure.