Natalia Sarkisian

Kin Support among Blacks and Whites: Race and Family Organization

This article addresses two central debates in the scholarship on black families: the disorganization versus superorganization debate and the culture versus structure debate. Focusing on kin support as a measure of family integration and using the National Survey of Families and Households (1992-1994), this article challenges the assumptions about black and white families in both debates. It shows that blacks and whites have different patterns of kin support involvement. Whereas blacks are more involved in practical support (help with transportation, household work, and child care), whites report greater involvement in financial and emotional kin support. This article also shows that gender is crucial for understanding racial differences. Black men and white men are very much alike, whereas there are many significant differences between black women and white women. Furthermore, in understanding kin support, diversity within racial groups appears to matter more than race itself. Social structure explains most of the racial differences in kin support, though cultural differences between whites and blacks do exist and help to explain kin support.

Marriage: The Good, the Bad, and the Greedy

Even good marriages can have some bad side effects, taking people away from other social connections.

Causal Effects of Retirement Timing on Subjective Physical and Emotional Health

OBJECTIVES This article explores the effects of the timing of retirement on subjective physical and emotional health. Using panel data from the Health and Retirement Study (HRS), we test 4 theory-based hypotheses about these effects-that retirements maximize health when they happen earlier, later, anytime, or on time. METHOD We employ fixed and random effects regression models with instrumental variables to estimate the short- and long-term causal effects of retirement timing on self-reported health and depressive symptoms. RESULTS Early retirements--those occurring prior to traditional and legal retirement age--dampen health. DISCUSSION Workers who begin their retirement transition before cultural and institutional timetables experience the worst health outcomes; this finding offers partial support to the psychosocial-materialist approach that emphasizes the benefits of retiring later. Continued employment after traditionally expected retirement age, however, offers no health benefits. In combination, these findings offer some support for the cultural-institutional approach but suggest that we need to modify our understanding of how cultural-institutional forces operate. Retiring too early can be problematic but no disadvantages are associated with late retirements. Raising the retirement age, therefore, could potentially reduce subjective health of retirees by expanding the group of those whose retirements would be considered early.

Analysis of Adverse Events Associated With Adult Moderate Procedural Sedation Outside the Operating Room

Introduction Moderate sedation outside the operating room is performed for a variety of medical and surgical procedures. It involves the administration of different drug combinations by nonanesthesia professionals. Few data exist on risk stratification and patient outcomes in the adult population. Current literature suggests that sedation can be associated with significant adverse outcomes. Objectives The aims of this study were to evaluate the nature of adverse events associated with moderate sedation and to examine their relation to patient characteristics and outcomes. Methods In this retrospective review, 52 cases with moderate sedation safety incidents were identified out of approximately 143,000 cases during an 8-year period at a tertiary care medical center. We describe types of adverse events and the severity of associated harm. We used bivariate and multivariate analyses to examine the links between event types and both patient and procedure characteristics. Results The most common adverse event and unplanned intervention were oversedation leading to apnea (57.7% of cases) and the use of reversal agents (55.8%), respectively. Oversedation, hypoxemia, reversal agent use, and prolonged bag-mask ventilation were most common in cardiology (84.6%, 53.9%, 84.6%, and 38.5% of cases, respectively) and gastroenterology (87.5%, 75%, 87.5%, and 50%) suites. Miscommunication was reported most frequently in the emergency department (83.3%) and on the inpatient floor (69.2%). Higher body mass index was associated with increased rates of hypoxemia and intubation but lower rates of hypotension. Advanced age boosted the rates of oversedation, hypoxemia, and reversal agent use. Women were more likely than men to experience oversedation, hypotension, prolonged bag-mask ventilation, and reversal agent use. Patient harm was associated with age, body mass index, comorbidities, female sex, and procedures in the gastroenterology suite. Conclusions Providers should take into account patient characteristics and procedure types when assessing the risks of harmful sedation-related complications.

Does singlehood isolate or integrate? Examining the link between marital status and ties to kin, friends, and neighbors

This article addresses a debate about the relationship of singlehood and informal ties—singlehood as isolating versus integrative—and evaluates structural explanations for this relationship, focusing on life course characteristics and socioeconomic resources. Using the National Survey of Families and Households (1992–1994) and the General Social Survey (2000, 2004, 2006, 2012), we examine ties to relatives, neighbors, and friends among U.S. adults. We find that single individuals are more likely to frequently stay in touch with, provide help to, and receive help from parents, siblings, neighbors, and friends than the married. These differences between the single and the married are more prominent for the never married than for the previously married, suggesting that marriage extends its reach after it ends. Being single increases the social connections of both women and men. Overall, much of the positive relationship between singlehood and social ties remains even when we take into account structural explanations. We conclude that instead of promoting marriage, policy should acknowledge the social constraints associated with marriage and recognize that single individuals have greater involvement with the broader community.

Affective Interactions in Medical Visits Ethnic Differences Among American Indian Older Adults

Objective: Investigate influence of ethnicity on older American Indian patients’ interpretations of providers’ affective behaviors. Method: Using data from 115 older American Indian patients, random effects ordered logit models related patient ratings of providers’ respect, empathy, and rapport first to separate measures of American Indian and White American ethnicity, then to “ethnic discordance,” or difference between providers’ and patients’ cultural characteristics. Results: In models accounting for patients’ ethnicity only, high scores for American Indian ethnicity were linked to reduced evaluations for providers’ respect; high scores on White ethnicity were associated with elevated ratings for empathy and rapport. In models accounting for provider–patient ethnic discordance, high discordance on either ethnicity scale was associated with reduced ratings for the same behaviors. Discussion: Findings support “orthogonal ethnic identity” theory and extend “cultural health capital” theory, suggesting a pathway by which ethnicity becomes relevant to experience of health care among older adults.

Using a Micro-Level Model to Generate a Macro-Level Model of Productive Successful Aging

PURPOSE OF THE STUDY Aging successfully entails good physical and cognitive health, as well as ongoing participation in social and productive activity. This study hones in on participation in productive activity, a factor that makes an important contribution to successful aging. One conceptual model of productive activity in later life specifies the antecedents and consequences of productivity. This study draws on that micro-level model to develop a corresponding macro-level model and assesses its utility for examining the predictors of and explaining the relationships between one form of productivity (labor force participation rates) and one aspect of well-being (average life expectancy) among males and females. DESIGN AND METHODS Random effects regression models and path analysis were used to analyze cross-national longitudinal data for 24 high-income Organization for Economic Co-operation and Development (OECD) countries at seven time points (1980-2010; 168 observations total). RESULTS OECD countries with higher labor force participation rates among older workers have higher life expectancies. Labor force participation mediates the effects of gross domestic product per capita on male and female life expectancy, and it mediates the effect of self-employment rate for men, but it acts as a suppressor with regard to the effect of public spending on male and female life expectancy. IMPLICATIONS A well-known micro-level model of productive activity can be fruitfully adapted to account for macro-level cross-national variation in productivity and well-being.

Are women less career centric than men? Structure, culture, and identity investments

Some work/family scholars assume that gender differences in career centrality (i.e. the importance of career to ones identity) are a result of differential job characteristics and family demands; others trace these differences to pre-existing cultural orientations. Using the 2010 Generations of Talent data from 9210 employees working in 11 countries for 7 multinational companies, this study verifies the existence of gender differences in career centrality and explores structural and cultural explanations. Gender disparities in career centrality are modest, indicating that womens and mens identification with careers is more similar than is commonly asserted; the most pronounced (but still relatively small) disparities are observed in Japan and China. A large portion of the gender gap is explained by job characteristics, supporting structural explanations. Family demands contribute to explaining the gap as well, but the findings are unexpected: having minor children is associated with higher career centrality for both women and men. In support of cultural explanations, however, traditional gender beliefs are associated with lower career centrality, especially for women, while two job characteristics (job variety and peer relations) have distinct links to career centrality for women and men. Findings challenge the common assumption that family identities compete against work identities.

Economic development, social inequality, and the state: a cross‐national analysis of child mortality in less developed countries

Many cross‐national studies of child and infant mortality emphasize predictors linked to modernization theory, such as economic development level as measured by GNI (gross national income) or GDP (gross domestic product) per capita. However, much less research considers the effects of social inequality on child mortality. This paper relies on four theoretical frameworks. In addition to modernization theory, it assesses the social democratic theory, the class stratification theory, and the gender stratification theory by examining the effects of state commitment to health care, class inequality, and gender inequality on child mortality. The findings demonstrate some support for each of the theories. Along with economic development, state commitment to health care, class inequality, and gender inequality demonstrate significant direct effects on child mortality in LDCs (less developed countries). In addition, economic development has a significant indirect effect on child mortality via state commitment to health care and gender inequality, but not via class inequality. 摘要: ：许多针对儿童死亡率的跨国研究强调经济发展水平对儿童死亡率的作用， 它们依据的是现代化理论， 通常是以人均产值作计量。 人们往往较少考查种种社会不平等因素对儿童死亡率的作用。 本文用结构方程模式的定量分析方法同时对四种相关理论进行评估， 除现代化理论外， 我们考查社会民主理论， 阶级差异理论， 及性别差异理论对儿童死亡率的作用。 我们对137个发展中国家(其中包括中国)的分析结果对以上四种相关理论均提供一定证据。 经济发展水平， 收入不均， 妇女地位， 及政府对医疗保健的投入都对儿童死亡率有着直接的作用。 此外， 经济发展水平通过妇女地位和政府对医疗保健的投入对儿童死亡率有间接的作用。