Ning Hsieh

Explaining the Mental Health Disparity by Sexual Orientation: The Importance of Social Resources

This study examines the role of social integration and social support, a significant yet under-investigated factor in mental health disparities by sexual orientation. By analyzing National Health and Nutrition Examination Survey data from a representative sample of the middle-aged U.S. population, the study shows that bisexual-identified individuals have the lowest levels of social resources and the poorest mental health status of all sexual orientation groups. Lesbian/gay-identified individuals and heterosexual-identified individuals with same-sex sexual experience are less socially integrated or perceive less emotional support than the sexual majority but do not report poorer mental health. Moreover, social integration and social support jointly mediate the link between sexual orientation and mental distress: sexual minorities are less socially integrated, which is related to a lower level of social support and, in turn, a higher level of mental distress. Additionally, minority-identified individuals reap more health benefits from confidants and emotional support. These findings suggest that sexual minorities are among those who most need and most benefit from supportive social relationships. The study therefore reveals the importance of social resource interventions in narrowing the mental health gap by sexual orientation.

Sexual Minority Health and Health Risk Factors: Intersection Effects of Gender, Race, and Sexual Identity

INTRODUCTIONnAlthough population studies have documented the poorer health outcomes of sexual minorities, few have taken an intersectionality approach to examine how sexual orientation, gender, and race jointly affect these outcomes. Moreover, little is known about how behavioral risks and healthcare access contribute to health disparities by sexual, gender, and racial identities.nnnMETHODSnUsing ordered and binary logistic regression models in 2015, data from the 2013 and 2014 National Health Interview Surveys (n=62,302) were analyzed to study disparities in self-rated health and functional limitation. This study examined how gender and race interact with sexual identity to create health disparities, and how these disparities are attributable to differential exposure to behavioral risks and access to care.nnnRESULTSnConditional on sociodemographic factors, all sexual, gender, and racial minority groups, except straight white women, gay white men, and bisexual non-white men, reported worse self-rated health than straight white men (p<0.05). Some of these gaps were attributable to differences in behaviors and healthcare access. All female groups, as well as gay non-white men, were more likely to report a functional limitation than straight white men (p<0.05), and these gaps largely remained when behavioral risks and access to care were accounted for. The study also discusses health disparities within sexual, gender, and racial minority groups.nnnCONCLUSIONSnSexual, gender, and racial identities interact with one another in a complex way to affect health experiences. Efforts to improve sexual minority health should consider heterogeneity in health risks and health outcomes among sexual minorities.

Labour Market Activity Of Foreign Spouses In Taiwan: Employment Status And Choice Of Employment Sector

The present study examines the employment status and choice of employment sector of female foreign spouses from Southeast Asia and Mainland China in Taiwan. The conceptual framework is based on the family labour supply model, human and social capital theory, and immigrant assimilation theory. Our findings indicate that in regard to employment status, family background variables, including the presence of small children and husbands characteristics, play a more significant role in determining the employment probability for these foreign spouses than do human capital variables. In particular, for spouses from Southeast Asia, each additional child is correlated with a decrease in working probability of 11.3%, whereas college education has an insignificant effect on their employment probability. Employment assimilation for these marriage immigrants may be confirmed by the finding that the employment probability of foreign spouses rises rapidly with the number of years that have elapsed since migration. As for the choice of employment sector, a strong linkage between the employment sector of the foreign spouses and their husbands employment sector is found in this study.

A Global Perspective on Religious Participation and Suicide

Although sociological research in the Durkheimian tradition has generally accepted that religious involvement protects against suicide, few studies have examined this theoretical proposition outside Western industrialized settings. Using multilevel models to analyze data from the World Health Organization Mortality Database and the World Values Survey (1981–2007) across 42 countries in seven geographical-cultural regions, this study explores whether religious participation is more protective against suicide in some regions than others and, if so, why. Results indicate that while religious participation is protective in Latin America, eastern Europe, northern Europe, and English-speaking countries, it may aggravate the risk of suicide in East Asia, western Europe, and southern Europe. This regional variation is the result of differences in both the degree of integration/regulation of religious communities and suicide underreporting. Overall, the findings support the network perspective of Durkheim’s classical theory and suggest that researchers should be more cautious about suicide underreporting in less industrialized settings.

Economic Security, Social Cohesion, and Depression Disparities in Post-Transition Societies: A Comparison of Older Adults in China and Russia

Although both China and Russia have experienced several decades of market reform, initial evidence suggests that this structural change has compromised mental and physical health among the Russian population but not the Chinese population. Using data from the World Health Organization Study on Global AGEing and Adult Health (2007–2010), this study examines the factors associated with the disparity in depression between older adults in China and their Russian counterparts, all of whom experienced market transition in the prime of their lives (Nu2009= 10,896). Results show that the lower level of depression among Chinese respondents is attributable to higher levels of economic security and social cohesion as well as stronger effects of economic and social resources on depression, while health-rating style is likely a minor factor. The study advances the sociological understanding of global/comparative mental health by considering the effects of macrolevel political, economic, social, and cultural conditions.

Despite Increased Insurance Coverage, Nonwhite Sexual Minorities Still Experience Disparities In Access To Care

Previous studies suggest that members of sexual minority groups have poorer access to health services than heterosexuals. However, few studies have examined how sexual orientation interacts with gender and race to affect health care experience. Moreover, little is known about the role in health care disparities played by economic strains such as unemployment and poverty, which may result from prejudice and discrimination based on sexual orientation. Using data for 2013-15 from the National Health Interview Survey, we found that most members of sexual minority groups no longer have higher uninsurance rates than heterosexuals, but many continue to experience poorer access to high-quality care. Gay nonwhite men, bisexual white women, and bisexual and lesbian nonwhite women are disadvantaged in multiple aspects of access, compared to straight white men. Only some of these disparities are attributable to economic factors, which implies that noneconomic barriers to care are substantial. Our results suggest that the intersection of multiple social identities can reveal important gaps in health care experience. Making culturally sensitive services available may be key to closing the gaps.

A National Dyadic Study of Oral Sex, Relationship Quality, and Well-Being among Older Couples

ObjectivesnWe examine how giving versus receiving oral sex, 2 processes that are linked to relationship quality, are associated with older mens and womens well-being.nnnMethodnWe analyzed 884 heterosexual couples from the National Social Life, Health, and Aging Project (2010-2011). We estimate Actor-Partner Interdependence Models using the SEM approach to assess three well-being outcomes: general happiness, psychological distress, and self-reported mental health.nnnResultsnOlder adults with better relationship quality gave oral sex to their partner more often than those with worse relationship quality; this association was stronger for men than for women. While receiving oral sex was positively related to both mens, and womens perceptions of relationship quality, womens relationship quality was more strongly linked to their partners well-being than mens. Correspondingly, mens giving of oral sex (and thus their female partners receiving of oral sex) was positively related to their own well-being through increasing their female partners perceived relationship quality.nnnDiscussionnGiven the high prevalence of sexual dysfunctions among older adults, oral sex may play an important but overlooked role in maintaining an active sexual life, a high-quality relationship, and psychological vibrancy in late life.

Loneliness in the older adult marriage: Associations with dyadic aversion, indifference, and ambivalence

Marriage protects against loneliness, but not all marriages are equally protective. While marriage is a highly interdependent relationship, loneliness in marital dyads has received very little research attention. Unlike most studies proposing that positive and negative marital qualities independently affect loneliness at the individual level, we used a contextual approach to characterize each partner’s ratings of the marriage as supportive (high support, low strain), ambivalent (high support, high strain), indifferent (low support, low strain), or aversive (low support, high strain) and examined how these qualities associate with own and partner’s loneliness. Using couple data from the Wave II National Social Life, Health and Aging Project (N = 953 couples), we found that more than half of the older adults live in an ambivalent, indifferent, or aversive marriage. Actor–partner interdependence models showed that positive and negative marital qualities synergistically predict couple loneliness. Spouses in aversive marriages are lonelier than their supportively married counterparts (actor effect), and that marital aversion increases the loneliness of their partners (partner effect). In addition, wives (but not husbands) in indifferent marriages are lonelier than their supportively married counterparts. These effects of poor marital quality on loneliness were not ameliorated by good relationships with friends and relatives. Results highlight the prominent role of the marriage relationship for imbuing a sense of connectedness among older adults and underscore the need for additional research to identify strategies to help older adults optimize their marital relationship.

Functional Status, Cognition, and Social Relationships in Dyadic Perspective

OBJECTIVESnHealth limitations can change older adults social relationships and social engagement. Yet, researchers rarely examine how the disability of ones spouse might affect ones social relationships, even though such life strains are often experienced as a couple. This study investigates the association between functional and cognitive limitations and social experience in a dyadic context.nnnMETHODnWe use actor-partner interdependence models to analyze the partner data from 953 heterosexual couples in Wave II (2010-2011) of the National Social Life, Health, and Aging Project.nnnRESULTSnOne spouses functional and cognitive health is associated with the others relationship quality, but the pattern varies by gender. Husbands functional limitations are associated with lower marital support and higher marital strain in wives, but wives functional limitations are related to lower family and friendship strain in husbands. Husbands cognitive impairment also predicts higher family and friend support in wives.nnnDISCUSSIONnFindings support a gendered dyadic relationship between health and social life and highlight womens caregiver role and better connection with family and friends. There are also differences between experiencing cognitive and physical limitations in couples. Finally, mild health impairment sometimes shows stronger effects on social relationships than severe impairment, suggesting adaptation to health transition.