Theodore D. Fuller

Housing, stress, and physical well-being: Evidence from Thailand

The proposition that poor housing and congested living conditions have a detrimental impact on health has been promulgated for at least 150 years. At a minimum, two major causal mechanisms are thought to be involved in the relationship between crowding and physical health. First, high levels of household crowding can produce stress that leads to illness. Second, through shared physical proximity, household congestion contributes to the spread of communicable disease. The outcomes can be exacerbated by poor quality housing. A significant body of research, conducted primarily in affluent countries, has documented the detrimental effects of housing conditions on a variety of illnesses, including various contagious diseases. Poor housing has even been linked to high infant and adult mortality rates. The view that poor housing conditions and household crowding inevitably leads to poor health is challenged, however, by several observers, who question the role played by both crowding and housing quality. Most existing research has been conducted in affluent countries. Little is known, however, about the nature of these relationships within the context of less developed countries, where health status and housing quality are generally much poorer and where levels of household crowding are generally higher. Determination of the effects, if any, of housing quality--including household crowding--on physical health in developing countries is particularly important given the rapid growth of their urban populations and the difficulty of increasing the physical infrastructure fast enough to keep pace with this growth. This paper reports on an investigation of the impact of housing conditions and household crowding in the context of one developing country, Thailand. Using data from a representative sample of households in Bangkok (N = 2017), our results provide reason for some skepticism regarding the influence on housing on health, at least in its objective dimensions. While the skepticism of some is based on a reading of the evidence in Western countries, we likewise find that, in Bangkok, objective indicators of housing quality and household crowding are little related to health. We do find, however, that subjective aspects of housing and of crowding, especially housing satisfaction and a felt lack of privacy, have detrimental effects on health. Furthermore, psychological distress is shown to have a potent influence on the physical health of Bangkokians. Our analyses suggest that all three factors have independent effects on health outcomes bearing on both men and women.

Chronic stress and psychological well-being: Evidence from Thailand on household crowding

This paper examines the effect of one form of chronic stress--household crowding--on psychological well-being, as measured by multiple inverse indicators of psychological well-being. We rely on data from a large (n = 2017) random sample of households in Bangkok, Thailand, a context that has a higher level and broader range of crowding than typically found in the United States. Objective household crowding is found to be detrimental to psychological well-being, controlling for a number of background characteristics. The effect of objective crowding is mediated by subjective crowding, which has strong, consistent and direct detrimental effects on well-being. There is no evidence of a gender effect. Extended family households are not uncommon in Bangkok, but the effects of objective and subjective crowding are similar in both two- and three-generation households, as well as in one- and multiple-couple households. The argument that subjective crowding is an effect, rather than a cause, of psychological well-being is examined and rejected. The findings suggest that crowding, as a chronic source of stress, constitutes a major threat to psychological well-being. Although the empirical analyses are based on data from one city, we frame the issue of household crowding in a historical and theoretical context in order to suggest in which cultural settings household crowding is most likely to have detrimental effects on psychological well-being.

Moderate Alcohol Consumption and the Risk of Mortality

There has been a growing consensus that moderate consumption of alcohol is associated with a lower risk of mortality and that this association is probably causal. However, a recent review article has raised a serious challenge to this consensus. In short, it determined that most prior research in this area committed serious misclassification errors; furthermore, among those studies that were free of these misclassification errors, no support for a protective role of alcohol consumption was found. This article reexamines the issue using prospective data for more than 124,000 persons interviewed in the U.S. National Health Interview Surveys of 1997 through 2000 with mortality follow-up through 2002 using the Linked Mortality File. The study involves about 488,000 person-years. Controlling for a variety of covariates, this study finds that compared with nondrinkers, those who consume a moderate amount of alcohol have lower all-cause and CHD mortality. The fact that the current study has taken care to avoid the pitfalls of some earlier studies and still finds that those who consume a moderate amount of alcohol have lower all-cause mortality and CHD mortality lends credence to the argument that the relationship is causal.

Rural-urban mobility in Thailand: a decision-making approach.

An individual behavioral model of the decision-making process for rural-urban mobility is applied to longitudinal data from an area of Northeast Thailand where circular rural-urban movement dominates. The individual-level variables included in the model are: recent mobility history, urban social contacts, information about urban areas, evaluations of various locations, migration plans, and actual movements in the period subsequent to an initial interview. The empirical results provide relatively strong support for the model. From the standpoint of intervention, information appears to be a key variable in the mobility process.

relationship status, health, and health behavior: an examination of cohabiters and commuters

A large amount of literature on relationship status, health, and health behavior indicates that marriage conveys health benefits. This literature, however, devotes relatively little attention to two theoretically interesting groups: unmarried cohabiters and married people who do not live with their spouse (“commuters”). The author hypothesizes that the health and health behaviors of these two groups will be intermediate between those of married people and unattached single individuals. Selective support is found for the hypothesis that the health behaviors of commuters are intermediate between those of married people and single people, but no support is found for the hypothesis that the health status of commuters is intermediate between that of married people and single people. Contrary to expectation, cohabiting persons tend to have poorer health status and health behavior than both their married and single counterparts. Also, while much previous research indicates that the health benefits of marriage are greater for men than women, the author finds that lacking a live-in partner (i.e., commuting or being single) appears to be more detrimental for women than men.

Female Employment and Marital Instability: Evidence from Thailand.

A link between employment outside the home and instability in the marriages of married women has long been suspected. However two decades of empirical research have produced mixed findings and have yielded few firm conclusions about how wives employment increases marital instability. The present study provides further evidence on the employment-instability linkage examining the direct and indirect effects employment may have. Using data from a study of intact marriages in Bangkok Thailand the analyses indicate that the effects of employment per se and the number of hours worked are class-linked and where present tend to be mediated by various marital processes....The findings in general lend strong support to a process model of marital instability a model previously found to largely account for instability among American couples. (EXCERPT)

Mobility plans and mobility behavior: Convergences and divergences in Thailand

Using Thai data, this paper develops and tests a model of rural-urban mobility behavior in a context dominated by high levels of circular rural-urban mobility. With mobility plans and mobility behavior measured in analogous ways, a close correspondence between mobility plans and mobility behavior is found. In spite of this close correspondence, however, multivariate analysis shows that past mobility behavior—rather than mobility plans—is the most important predictor of subsequent mobility. Where experience with a given type of behavior is abundant, prior behavior may often be the best predictor of subsequent behavior, but where experience with a given type of behavior is scarce, behavioral intentions may be a more relevant explanatory variable.

GENDER DIFFERENCES IN THE PSYCHOLOGICAL WELL-BEING OF MARRIED MEN AND WOMEN: An Asian Case

Using a wide variety of measures of psychological well-being obtained from a representative sample of married men and women in Bangkok, Thailand, we examine gender differences in psychological well-being. We find that, in Bangkok, as in the United States, married men generally enjoy a higher level of psychological well-being than do married women. We find no support for role strain theory, but we do find support for role enhancement theory. We find that social support has little effect on psychological well-being, but that social strain not only has a significant effect on well-being but also largely accounts for gender differences in well-being. The mixed findings suggest the importance of testing theories in different societal contexts, for they may or may not be easily portable from one culture to another.

Migrant-native socioeconomic differentials in Thailand

Recent research has suggested that the position of many urban migrants compares favorably with that of urban natives. This generalization is refined by referring to three key distinctions: migrants from rural versus urban origins, recent versus more experienced cityward migrants, and type of urban destination. In Thailand in the early 1970s, migrants to smaller urban centers, especially the more experienced migrants, are economically more successful than migrants to the large metropolitan centers and in some cases are more successful than urban natives. Reasons for this pattern are discussed.

Why people feel crowded: An examination of objective and subjective crowding

Prior studies have found only a modest relationship between objective and subjective crowding, defying logic and commonsensical notions of why people feel crowded. Using data from a representative sample of Bangkok, Thailand, where the level of household crowding is four times that in western societies, we explore several possibilities of why this is the case. Examining seven different indicators of objective crowding, our analyses suggest that the modest relationship is not an artifact of measurement. Contrary to the assumption of prior investigations, the findings indicate that the objective-subjective crowding relationship is nonlinear and that there is a ceiling effect muting the impact of increased objective crowding. The analyses further suggest that the strength of the relationship is mitigated somewhat, with part of the feeling of being crowded accounted for by household circumstances, such as the degree of control an individual has over the use of household space.