Brian P. Hinote

The specter of post-communism: Women and alcohol in eight post-Soviet states

Because men have borne the heaviest burden of premature mortality in the former Soviet Union, women have for the most part been overlooked in studies of the health crisis in this part of the world. A considerable body of research points to alcohol consumption among males as a primary lifestyle cause of premature mortality. However, the extent to which alcohol use has penetrated the female population following the collapse of communism and how this consumption is associated with other social factors is less well-understood. Accordingly, this paper investigates alcohol consumption in eight republics of the former USSR - Armenia, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia, and Ukraine using data collected in 2001. More specifically, discussion of gender role transformations and the historical experiences of women during the Soviet era emphasize two potentially important social influences examined in this analysis: psychological distress and Soviet political ideology. Findings suggest that distress is only weakly statistically associated with frequent drinking behavior among women, but results for political ideology show that this factor is statistically and significantly associated with drinking behaviors. Alcohol consumption was not particularly common among women under communism, but trends have been changing. Our discussion suggests that, after the collapse of the Soviet state, women are more able to embrace behavioral practices related to alcohol, and many may do so as an overt rejection of traditional Soviet norms and values. Findings are also discussed within the context of current epidemiological trends and future research directions in these eight republics.

Drinking toward Manhood Masculinity and Alcohol in the Former USSR

Existing research extensively documents the health crisis in Russia and the former Soviet Union. In this article, the authors examine what historical factors set the stage for these trends and, perhaps more importantly, their origins. Specifically, the authors analyze Russian history, culture, and state ideology to explore the connections between masculinities and alcohol and to apply existing sociological theories of gender to this unique social context. The authors employ the concept of hegemonic masculinity to examine the historical dimensions of working-class drinking and its impact on Russian men’s health. The authors also identify one of the important origins of men’s harmful drinking practices by focusing on the historical construction and enactment of masculinities in two prominent social fields—the tavern and the workplace. The authors’ focus upon Russian history and culture emphasizes the sociohistorical factors associated with negative drinking patterns, and consequent health problems, among men in this part of the world.

Psychological distress and dietary patterns in eight post-Soviet republics.

The purpose of this study is to examine the relationship between psychological distress and dietary consumption patterns in the former Soviet Union. Data are cross-sectional and were collected in 2001 from a large representative sample (n = 18,428) of respondents age 18 years and over in eight former Soviet republics. Sociodemographic covariates and psychological distress predictors were analyzed using ordinal logistic regression models to estimate multivariate correlations with the frequency of meat, fish, vegetable, fruit, and animal fat consumption among men and women in these eight regions. Results show that psychological distress exhibits statistically significant, negative associations with all dietary consumption indicators for both men and women. Social class predictors display consistent positive correlations with food consumption outcomes, emphasizing the potential importance of this concept in the dynamic relationship between diet and psychological distress. Higher reported levels of psychological distress are associated with the less frequent consumption of all types of food products in this analysis. Several possible interpretations are discussed, and we explore the probable multidimensional theoretical mechanisms that can help explain the complex relationships among distress, food insecurity, and dietary patterns in these eight republics of the former USSR. The general and practical significance of these findings is also discussed, along with suggested directions for future research and potential dietary intervention strategies.

Health lifestyles in Ukraine

Summary.Objectives: Several studies have identified negative health lifestyles as a primary determinant of the mortality crisis in Europe’s post-communist states, but little is known about Ukraine. In order to address this gap in the literature, this paper provides data on Ukrainian health lifestyles.Methods: Data were collected by face-to-face interviews in the households (N = 2 400) of a random sample of respondents in Ukraine in November, 2001. The sample was selected using multi-stage random sampling with stratification by region and area (urban/rural). Data were analyzed using logistic regression.Results: Male gender was found to be the most powerful single predictor of negative health lifestyles as shown in the results for frequent drinking, heavy vodka use at one occasion, smoking, and diet. Males rated their health status better than females, but over one-third of the males and one-half of the females rated their health status as rather bad or bad.Conclusions: Gender and class differences in health lifestyle practices appear to be key variables, with working-class males showing the most negative practices. The results for health status suggest that the overall level of health in Ukraine is not good.Zusammenfassung.Gesundheitsrelevanter Lebensstil in der UkraineFragestellung: Mehrere Studien haben den negativen gesundheitsrelevanten Lebensstil als wichtigste Determinante der Mortalitätskrise in den europäischen postkommunistischen Ländern ermittelt, jedoch weiss man wenig über die Ukraine. Um dieser Lücke in der Literatur zu begegnen, will dieser Artikel Daten zu gesundheitsrelevanten Lebensstilen in der Ukraine liefern.Methoden: Die Daten wurden durch persönliche Interviews (N = 2 400) in Haushalten einer Zufallsstichprobe in der Ukraine im November 2001 gesammelt. Die Auswahl der Untersuchungsgruppe erfolgte mittels eines mehrstufigen randomisierten Samplingverfahrens, stratifiziert nach Region und geographischer Lage (Stadt/Land). Die Daten wurden mit dem logistischen Regressionsverfahren analysiert.Ergebnisse: Männliches Geschlecht wurde als die stärkste Prädiktorvariable für einen negativen gesundheitsrelevanten Lebensstil gefunden wie anhand der Ergebnisse für regelmässigen Alkoholkonsum, starkes Wodkatrinken während einer Gelegenheit, Rauchen und Ernährungsgewohnheit gezeigt werden kann. Männer stuften ihren Gesundheitsstatus besser ein als Frauen, aber über ein Drittel der Männer und mehr als die Hälfte der Frauen stuften ihn als schlecht bis sehr schlecht ein.Schlussfolgerungen: Geschlechter- und Klassenunterschiede erscheinen als Schlüsselvariablen für gesundheitsrelevante Lebensstil-Praktiken, wobei Männer aus der Arbeiterklasse die negativsten Praktiken aufzeigten. Die Ergebnisse zum Gesundheitsstatus deuten an, dass der allgemeine Gesundheitszustand in der Ukraine nicht gut ist.Résumé.Santé et modes de vie en UkraineObjectifs: Plusieurs études ont identifié des styles de vie négatifs comme déterminants principaux de l’accroissement de la mortalité dans les états post-communistes d’Europe, mais la situation en Ukraine est peu décrite dans la littérature. Afin de combler ce manque, cet article présente des données sur les modes de vie en Ukraine.Méthodes: Les données ont été rassemblées au cours d’entretiens individuels à domicile d’un échantillon aléatoire de répondants en Ukraine (N = 2 400, Novembre 2001). L’échantillon a été choisi au moyen d’un échantillonnage aléatoire en grappe, stratifié selon la région et la zone (urbaine/rurale).Résultats: Etre un homme est le prédicteur unique le plus important d’un mode de vie négatif, comme par exemple la consommation fréquente d’alcool et de grandes quantités de vodka en une fois, le tabagisme et l’alimentation inadéquate; les hommes se sont estimés en meilleure santé que les femmes. Mais plus d’un tiers des hommes et la moitié des femmes ont jugé leur état de santé plutôt mauvais ou mauvais.Conclusions: Le sexe et la classe sociale sont des déterminants importants des pratiques de santé, les ouvriers ayant les pratiques les plus négatives. Les résultats montrent qu’en général l’état de santé de la population ukrainienne n’est pas bon.

Post-Communism and Female Tobacco Consumption in the Former Soviet States

Abstract Existing studies emphasise the important roles played by negative health lifestyle practices in the health situations of the countries constituting the former Soviet Union, and the role of smoking has attracted a considerable body of research. This article analyses female smoking behaviour in eight former Soviet states and seeks to more closely identify the roles of psychological distress and political ideology in relation to tobacco use in these countries. Results suggest that, in these populations, distress and ideology are associated with smoking practices in specific, observable, and sometimes unexpected ways. Findings are discussed within the context of changing gender constructions and dynamics following the post-communist transition.

Reflexive Modernity and the Sociology of Health

The analysis and explanation of increasingly complex social phenomena represents one of the foremost challenges of sociological theory in the twenty-first century. This is particularly important in the sociology of health because definitions of health, mechanisms of disease, the nature of clinical medicine, and the structure of health care delivery in late modernity are all undergoing fundamental transformations. Undoubtedly, scholars will be better positioned to understand these developments if they also consider the broader social changes from which they emanate. Many transformations in health and medicine stem in large part from the way the epidemiological transition has radiated across macro and micro levels of scale. Medical sociologists must not only engage these phenomena in a critical fashion, but in pushing theory and analysis forward (and maintaining a dynamic and relevant sociology of health), we must also match this complexity with equally complex conceptual frameworks that are able to span the micro–macro divide and connect phenomena at multiple levels of analysis. Put another way, explaining, analyzing, and understanding late modern shifts (or fractures) in health, clinical practice, and health care delivery is critical for medical sociology moving forward and the theoretical and conceptual formulations of health sociology are integral to this endeavor.

William C Cockerham: The Contemporary Sociology of Health Lifestyles

In Western societies, lifestyles now represent one of the most significant predictors of health, or conversely, disease. Multiple authors (for example, Omran 1971; Cockerham 2007; Hinote and Wasserman 2013) carefully outline many recent social and epidemiological transformations in these societies, and lifestyles emerge from these shifts with renewed prominence in health matters. Theorists, researchers and practitioners conceptualise the term ‘lifestyle’ in various ways, but health lifestyles are of particular theoretical and empirical significance for medical sociologists and social epidemiologists. However, a comprehensive theoretical framework that specifically articulates the roles and mechanisms of these important health phenomena did not exist until the early twenty-first century, with the work of American medical sociologist William Cockerham (2005). This chapter provides a thorough background, explication and application of Cockerham’s health lifestyles theory, which effectively accounts for the interplay of the individual and their inextricable connections to social structures, and demonstrates the value of critically applying core sociological concepts to the typically individualistic concept of lifestyle.

PAs in a changing society: a sociologic perspective.

18 www.JAAPA.com Volume 28 • Number 8 • August 2015 The medical profession and other health professional occupations in the United States have witnessed considerable change in the last 20 years. These alterations have largely, but not entirely, originated from outside medicine. Physician assistants (PAs) are no exception to the change process as they are buffeted by the same social forces affecting medicine, nursing, and other health-related fi elds. When social and economic conditions change, the medical profession often adapts, and these adaptations can make their way into the organization of medical work. This article applies a sociologic perspective to PAs as an allied occupation within medicine and examines the ways in which change has and will affect the occupation.