Laurie James-Hawkins

Health lifestyles in early childhood.

This study integrates two important developments, the concept of health lifestyles (which has focused on adults and adolescents) and the increased attention to early childhood. We introduce the concept of childrens health lifestyles, identifying differences from adult health lifestyles and articulating intergenerational transmission and socialization processes shaping childrens health lifestyles. Using the nationally representative Early Childhood Longitudinal Study-Birth Cohort (2001-2007; N ≈ 6,150), latent class analyses identify predominant health lifestyles among U.S. preschoolers. Five distinct empirical patterns representing health lifestyles emerge, two capturing low and medium levels of overall risk across domains and three capturing domain-specific risks. Social background predicts childrens health lifestyles, but lower household resources often explain these relationships. Across kindergarten measures of cognition, behavior, and health, preschool health lifestyles predict childrens development even after controlling for social disadvantage and concurrent household resources. Further research on health lifestyles throughout childhood is warranted.

How Resource Dynamics Explain Accumulating Developmental and Health Disparities for Teen Parents’ Children

This study examines the puzzle of disparities experienced by U.S. teen parents’ young children, whose health and development increasingly lag behind those of peers while their parents are simultaneously experiencing socioeconomic improvements. Using the nationally representative Early Childhood Longitudinal Study-Birth Cohort (2001–2007; N ≈ 8,600), we assess four dynamic patterns in socioeconomic resources that might account for these growing developmental and health disparities throughout early childhood and then test them in multilevel growth curve models. Persistently low socioeconomic resources constituted the strongest explanation, given that consistently low income, maternal education, and assets fully or partially account for growth in cognitive, behavioral, and health disparities experienced by teen parents’ children from infancy through kindergarten. That is, although teen parents gained socioeconomic resources over time, those resources remained relatively low, and the duration of exposure to limited resources explains observed growing disparities. Results suggest that policy interventions addressing the time dynamics of low socioeconomic resources in a household, in terms of both duration and developmental timing, are promising for reducing disparities experienced by teen parents’ children.

Women’s agency and its relationship to current contraceptive use in lower- and middle-income countries: A systematic review of the literature

ABSTRACT Research shows a positive relationship between women’s empowerment and reproductive health. Yet we know little about the quantitative relationship between women’s agency and contraceptive use. We conducted a systematic review of peer-reviewed literature assessing the link between women’s decision-making and freedom of movement with their contraceptive use in lower- and middle-income countries. Of 102 articles that met the initial screening criteria, 12 met all inclusion and exclusion criteria. Of the 12 included studies, consistently positive associations with contraceptive use were found in those that measured decision-making and freedom of movement as separate constructs. Composite measures had a less clear relationship with contraceptive use. In conclusion, women’s agency is associated with women’s contraceptive use in lower- and middle-income countries. However, the relationship is sensitive to how agency and its components are measured. Our review suggests the need for consistent validation of scales for women’s agency as well as more rigorous research using standardised and validated scales, when possible. Longitudinal and intervention studies in lower- and middle-income countries will be useful for understanding the causal impact of women’s agency on contraceptive use, and will help to inform policies and programmes to increase contraceptive use in these settings.

Growing Old Behind Bars Health Profiles of the Older Male Inmate Population in the United States

Objective: This study examines patterns of multimorbidity among elderly male inmates across four domains of health (chronic medical conditions, drug- and alcohol-related diseases, impairments, and mental and behavioral health) to understand the complex health care needs of this growing population. Method: We use the 2004 Survey of Inmates in State Correctional Facilities and Latent Class Regression Analysis to examine 22 health problems among 1,026 men aged 50 and older. Results: There are four groups of elderly male inmates: (a) relatively healthy (45.1%), (b) substance users with behavioral health issues (23.4%), (c) chronic unhealthy with impairments and violence/injury (23.6%), and (d) very unhealthy across all domains (7.9%). These groups have unique sociodemographic background and incarceration history characteristics. Conclusion: This study demonstrates the complexity of health for elderly inmates. Prison health should continue to be monitored to aid correctional and community health programs in understanding clinical risks, exposures, and health care needs for this population.

Low-Income Women’s Navigation of Childbearing Norms Throughout the Reproductive Life Course

Shifts in family structure have affected age norms about both teenage childbearing and reproductive sterilization, but we lack research examining how childbearing norms are connected across the reproductive life course. Drawing on interviews from 40 low-income women in Colorado, we explored linkages between early childbearing and the desire for early sterilization. Specifically, we examined two narratives women use to negotiate competing norms throughout the reproductive life course. The low-income women in our study characterized their teenage childbearing experiences negatively and justified them using a “young and dumb” narrative. Women also asserted that reversible contraceptives do not work for them, using a “hyper-fertility” narrative to explain both their early childbearing and their desire for early sterilization. Our results illustrate the influence of mainstream social norms about childbearing timing on low-income women’s lives and provide evidence of how women use narratives to explain and justify their violation of childbearing norms.

The association of attitudes about contraceptives with contraceptive use in a random sample of Colorado women

Abstract Context Research regarding unintended pregnancy often focuses on how women make decisions about whether or not to use contraceptives, and structural barriers to contraception. Less research examines how multidimensional attitudinal characteristics may be associated with effective contraceptive use. Methods In fall 2007, we conducted a random telephone survey of 801 sexually active women in Colorado to assess associations of the attitudinal dimensions of Planning, Partner Communication, and Stigma and Misinformation with contraceptive use. We also examine demographic differences on hypothesized predictors. Results Stigma and Misinformation is higher in Latina women, women on Medicaid or with no insurance, women with less than a college degree, and women living in small towns or rural areas. Partner Communication attitudes are most positive among those with a bachelors degree, and those with less than a high school degree, while they are most negative among those living in small towns and rural areas. In multivariate analysis, planning to use contraceptives is associated with greater likelihood of more effective contraceptive use. Higher levels of planning and partner communication are associated with greater likelihood of any contraceptive use. Discussion In addition to addressing structural barriers to contraception, interventions to address the need to plan for contraception are vital to mitigate the high prevalence of unintended pregnancies in the United States.

Men's perpetration of partner violence in Bangladesh: community gender norms and violence in childhood

Men’s perpetration of intimate partner violence (IPV) is common, but its multilevel determinants are understudied. We leveraged novel data from a probability sample of married junior men (N = 570; age 18 to 34 years) from 50 urban and 62 rural communities who took part in the Bangladesh survey of the 2011 UN Multi-Country Study of Men and Violence. We tested whether lifetime count (or scope) of physical IPV acts perpetrated was negatively associated with more equitable community gender norms among married senior men (N = 938; age 35 to 49 years) and positively associated with greater exposure to childhood violence among junior men. We also tested whether more equitable community gender norms mitigated the association of more violence in childhood with the lifetime scope of physical IPV acts perpetrated. Among younger married men, 50% reportedly ever perpetrated physical IPV, the mean lifetime scope of physical IPV types perpetrated was 1.1 (SD 1.3) out of 5 listed. A majority (64%) reported childhood exposure to violence. In multilevel Poisson models, a man with more childhood exposure to violence had a higher log scope (estimate: 0.31, SE 0.04, p < .001), and a man living amid the most equitable gender norms had a lower log scope (estimate: −0.61, SE 0.17, p < .01) of physical IPV acts perpetrated; however, no significant cross-level interaction was observed. Interventions that address the trauma of childhood violence and that promote more equitable community gender norms may be needed to mitigate IPV perpetration by younger men.

Gender Norms, Violence in Childhood, and Men’s Coercive Control in Marriage: A Multilevel Analysis of Young Men in Bangladesh.

Objective: Coercive control in marriage is common in patriarchal settings, but multilevel determinants are understudied. Method: Using a probability sample of 570 junior men (married, 18–34 years) from the Bangladesh survey of the 2011 UN Multi-Country Study of Men and Violence, we examined how exposure to violence in childhood and community-level gender norms were related to men’s attitudes about gender equity and use of controlling behavior. We tested whether community-level gender norms moderated the relationship between men’s exposure to violence in childhood and our outcomes. Results: According to results from multilevel Poisson regression models, as community gender norms become more equitable by one SD, a junior married man’s expected rate of controlling behavior is lower by 0.11, and his rate of agreement with gender equitable attitudes is higher by 0.27. More gender-equitable community norms were negatively related to a junior married man’s use of controlling behavior. Childhood exposure to violence was not associated with use of controlling behavior. There was a significant cross-level interaction such that exposure to violence had a stronger negative impact on men’s gender equitable attitudes in communities with lower overall gender equity than those with higher overall gender equity. The corresponding cross-level interaction effect was not significant for the controlling behavior outcome. Conclusions: More equitable community gender norms may encourage more gender-equitable attitudes and discourage use of controlling behavior among junior men, suggesting that interventions to change community gender norms may reduce coercive control of women in marriage.

Norms of Masculinity and the Cultural Narrative of Intimate Partner Violence Among Men in Vietnam

Semi-structured interviews with 31 men in Hung Yen Province in Northern Vietnam are used to elucidate a conceptual narrative to understand men’s perceptions and perpetration of intimate partner violence (IPV) in Vietnam. This narrative suggests that cultural definitions of masculinity and changes in women’s participation in the labor force have contributed to status conflicts that normalize IPV as part of masculine superiority. The narratives of both IPV perpetrators and non-perpetrators demonstrate how violence is incorporated into the cultural definition of masculinity and illustrates how men use this definition to minimize their own and other men’s perpetration. We suggest that attempts to reduce IPV in Vietnam must address constructions of masculinity and the socio-historical context of IPV by providing gender-sensitivity training and opportunities for men to evaluate critically how constructions of masculinity in their families and communities contribute to IPV perpetration.

Multilevel Influences on Depressive Symptoms among Men in Bangladesh

Depression is a worldwide problem and is especially prevalent in lower income countries with insufficient resources and widespread poverty, such as Bangladesh. Yet, multilevel determinants of depressive symptoms in men have not been studied in this context. We leverage a novel data set from men in Bangladesh to determine the community- and individual-level influences of masculine dominance strain and financial strain on the frequency of married men’s depressive symptoms in Bangladesh. Data were collected between January and June 2011 as part of the United Nations Multi-Country Study on Men and Violence, conducted by the International Centre for Diarrheal Disease Research, Bangladesh. Masculine dominance strain at both levels was related to the frequency of depressive symptoms. Financial strain only at the individual level was related to the frequency of depressive symptoms. We conclude that community-level economic interventions may not directly influence individual-level depression; however, addressing customary conceptions of masculinity at the community and individual levels and addressing individual-level financial strain are promising joint strategies to improve married men’s mental health in Bangladesh and similar settings.