Thankam S. Sunil

United States' international retirement migration: the reasons for retiring to the environs of Lake Chapala, Mexico

ABSTRACT Most studies of retirement migration in the United States focus at the national level, and there is comparatively little information about the retirees who cross international borders in their search for new homes. Retirement migrants are unusual in that many select destinations in less-developed countries, contrary to the general pattern of migration from poor to rich countries in search of jobs, higher incomes and a better standard of life. This study has examined the reasons for retirement migration from the United States (US) to the Lake Chapala area of the Mexican state of Jalisco. A non-random sample of 211 US retirees was surveyed using a self-completion, semi-structured questionnaire that included items about the decision to move to Mexico, the quality of life at the destination, cultural adaptation, and aspects of personal identity, financial security and health-care. Four major reasons for migrating to Mexico were identified: financial circumstances, the natural environment, a sense of community and friendship, and a better quality of life. While the migrations contradict much taken-for-granted and popular knowledge about migration patterns around the world, they have important implications for the ways of life, social relationships and welfare of the most recent cohort of older people. More in-depth multidisciplinary studies are needed to increase understanding of this evolving phenomenon.

Initiation of and Barriers to Prenatal Care Use Among Low-Income Women in San Antonio, Texas

Abstract Healthy People 2010 goals set a target of 90% of mothers starting prenatal care in the first trimester of pregnancy. While there are questions about the value of prenatal care (PNC), there is much observational evidence of the benefits of PNC including reduction in maternal, fetal, perinatal, and infant deaths. The objective of this study was to understand barriers to PNC as well as factors that impact early initiation of care among low-income women in San Antonio, Texas. A survey study was conducted among low-income women seeking care at selected public health clinics in San Antonio. Interviews were conducted with 444 women. Study results show that women with social barriers, those who were less educated, who were living alone (i.e. without an adult partner or spouse), or who had not planned their pregnancies were more likely to initiate PNC late in their pregnancies. It was also observed that women who enrolled in the WIC program were more likely to initiate PNC early in their pregnancies. Women who initiated PNC late in pregnancy had the highest odds of reporting service-related barriers to receiving care. However, financial and personal barriers created no significant obstacles to women initiating PNC. The majority of women in this study reported that they were aware of the importance of PNC, knew where to go for care during pregnancy, and were able to pay for care through financial assistance, yet some did not initiate early prenatal care. This clearly establishes that the decision making process regarding PNC is complex. It is important that programs consider the complexity of the decision-making process and the priorities women set during pregnancy in planning interventions, particularly those that target low-income women. This could increase the likelihood that these women will seek PNC early in their pregnancies.

An analysis of childhood malnutrition in Kerala and Goa

Improved child health and survival are considered universal humanitarian goals. In this respect, understanding the nutritional status of children has far-reaching implications for the better development of future generations. The present study assessed, first, the nutritional status of children below 5 years using the three anthropometric measures weight-for-age, height-for-age and weight-for-height in two states of India, Kerala and Goa. Secondly, it examined the confounding factors that influence the nutritional status of children in these states. The NFHS-I data for Kerala and Goa were used. The results showed that the relative prevalence of underweight and wasting was high in Kerala, but the prevalence of stunting was medium. In Goa, on the other hand, the relative prevalence of wasting and underweight was very high, and that of stunting was high. Both socioeconomic and family planning variables were significantly associated with malnutrition in these states, but at varied levels. The study recommends more area-specific policies for the development of nutritional intervention programmes.

Religion and selected health behaviors among Latinos in Texas

Though research has shown that religion provides a protective influence with respect to a number of health-related outcomes, little work has examined its influence on patterns of alcohol (especially binge drinking) and tobacco consumption among Latinos in Texas. Thus, we used a probability sample of Texas adults to test this relationship via logistic regression. Our results revealed that clear distinctions emerge on the basis of both denomination and frequency of attendance. Specifically, Protestants who regularly attend religious services are significantly more likely to be abstainers and to have never smoked, while those with no religious affiliation exhibit relatively unfavorable risk profiles. These findings persist despite a range of socio-demographic controls. Our study supports the assertion that religion may serve as an important protective influence on risky health behaviors.

The Fast Food and Obesity Link: Consumption Patterns and Severity of Obesity

BackgroundRates of extreme forms of obesity are rapidly rising, as is the use of bariatric surgery for its treatment. The aim of the present study was to examine selected behavioral factors associated with severity of obesity among preoperative bariatric surgery patients in the San Antonio area, focusing specifically on the effects of fast food consumption.MethodsWe used ordered logistic regression to model behavioral and attitudinal effects on obesity outcomes among 270 patients. These outcomes were based on the severity of obesity and were measured on the basis of body mass index.ResultsOur results indicated that, among the behavioral factors, fast food consumption exerted the largest influence on higher levels of obesity. These remained after controlling for several social and demographic characteristics.ConclusionsOur findings suggest that higher rates of fast food consumption are connected to the increasing rates of severe obesity. Given that morbid and super morbid obesity rates are growing at a more advanced pace than moderate obesity, it is necessary to explore the behavioral characteristics associated with these trends.

Effects of individual and neighborhood factors on maternal care in Cambodia.

This study analyzed data from the 2005 Cambodia Demographic and Health Survey to examine the effects of individual- and community-level factors on the receipt of four or more antenatal care visits, receipt of antenatal care within the first trimester of pregnancy, delivery in a health facility and delivery by trained medical professional. The findings demonstrate that age at birth, parity level, educational attainment, household wealth, occupation, media exposure and counseling about pregnancy complications are significant determinants of pregnancy care. There is also a strong evidence of the impact of community-level factors on the utilization of maternal health services. Programs to improve maternal health outcomes must take into account covariates at multiple levels of influence to better address the needs of women of reproductive age in Cambodia.

Perceived social stress, pregnancy-related anxiety, depression and subjective social status among pregnant Mexican and Mexican American women in south Texas.

Purpose. The purpose of this study was to determine differences in subjective social status, perceived social stress, depressive symptoms, and pregnancy-related anxiety between pregnant Mexican American and Mexican immigrant women. Methods. Three hundred pregnant Mexican immigrant and Mexican American women in South Texas were surveyed for pregnancy-related anxiety, perceived social stress, depressive symptoms, and subjective social status. Results. Pregnant Mexican immigrant women had higher levels of pregnancy-related anxiety and lower levels of depression and perceived social stress than pregnant Mexican American women. Change in these variables among Mexican immigrant women was relatively linear as time of residence in the United States increased. Mexican immigrant and Mexican American women had significantly different correlations between subjective social status, self-esteem and perceived social stress. Conclusions. Results indicate that subjective social status is an important psychosocial variable among pregnant Hispanic women. Results contribute to ongoing efforts to provide culturally responsive prenatal psychosocial support services.

Application of validation data for assessing spatial interpolation methods for 8-h ozone or other sparsely monitored constituents

The adverse health effects of high concentrations of ground-level ozone are well-known, but estimating exposure is difficult due to the sparseness of urban monitoring networks. This sparseness discourages the reservation of a portion of the monitoring stations for validation of interpolation techniques precisely when the risk of overfitting is greatest. In this study, we test a variety of simple spatial interpolation techniques for 8-h ozone with thousands of randomly selected subsets of data from two urban areas with monitoring stations sufficiently numerous to allow for true validation. Results indicate that ordinary kriging with only the range parameter calibrated in an exponential variogram is the generally superior method, and yields reliable confidence intervals. Sparse data sets may contain sufficient information for calibration of the range parameter even if the Moran I p-value is close to unity. R script is made available to apply the methodology to other sparsely monitored constituents.

AIDS Prevention in Zambia: Implications for Social Services

Abstract The incidence of AIDS continues to be higher in the African continent than elsewhere in the world. In Zambia, given the current pace of infection, projections suggest that approximately two million Zambians are likely to die toward the end of this decade. In this paper, we argue that current AIDS educational programs can be substantially reinforced by incorporating the services of family planning agencies in Zambia. Data used for the study come from the Zambia Demographic Health Survey (ZDHS), 1996. We suggest that the social work profession has crucial responsibility for designing AIDS prevention programs. A number of roles that social workers can play based on the values and philosophy of the profession is outlined. Limitations of the study are also discussed.

Do incentives matter? – Evaluation of a family planning program in India

Indian Family Planning programs in the past haveintroduced a number of approaches such as providingmonetary benefits, and motivational programs toimprove contraceptive use among rural illiteratewomen. Under the Ammanpettai family welfare program,the Melatur PHC administered three program typesinvolving a combination of monetary and motivationalapproaches to improve contraceptive use in threetreatment areas. The program was introduced duringJanuary 1989 and was simultaneously discontinued aftera period of two years. The present evaluation wasconducted in 1994. Data from a random sample of 933non-sterilized women at the time of social surveyusing a questionnaire approach is used in this study. The implementation of incentive programs in asocio-economically homogenous population has resultedin an increase in the likelihood of current ofcontraceptive use. The results of this study suggestthat motivational programs are more likely to improvelong term use of temporary family planning methodsthan cash incentive programs. One implication of ourfinding is that motivational programs should provide peer based family planning education and training incommunity work to contact persons who make door todoor visits to promote family planning programs.