Thomas W. Mangione

Social Roles, Sex Roles and Psychological Distress: Additive and Interactive Models of Sex Differences

Determinants of sex differences in psychological distress are explored through estimating additive and interactive regression models, The absence of employment or marriage is associated with depression for both men and women. Also, for this measure of distress, an additive model of social-role effects accounts for the observed sex difference, suggesting a structural interpretation of the genderldepression relationship. For the measure of psychophysiologic complaints, the pattern of influences differs. Here, gender and being a parent jointly influence level of symptomatology. Further analysis reveals this effect to be due primarily to sex differences among parents having young children. The pattern offindings for this variable is understood to support formulations pertaining to the stress of family roles for women.

High injury rates among female army trainees: a function of gender?

BACKGROUND Studies suggest that women are at greater risk than men for sports and training injuries. This study investigated the association between gender and risk of exercise-related injuries among Army basic trainees while controlling for physical fitness and demographics. METHODS Eight hundred and sixty-one trainees were followed during their 8-week basic training course. Demographic characteristics, body composition, and physical fitness were measured at the beginning of training. Physical fitness measures were taken again at the end of training. Multivariate logistic regression analysis was used to evaluate the association between gender and risk of injury while controlling for potential confounders. RESULTS Women experienced twice as many injuries as men (relative risk [RR] = 2.1, 1.78-2.5) and experienced serious time-loss injuries almost 2.5 times more often than men (RR = 2.4, 1. 92-3.05). Women entered training at significantly lower levels of physical fitness than men, but made much greater improvements in fitness over the training period.In multivariate analyses, where demographics, body composition, and initial physical fitness were controlled, female gender was no longer a significant predictor of injuries (RR = 1.14, 0.48-2.72). Physical fitness, particularly aerobic fitness, remained significant. CONCLUSIONS The key risk factor for training injuries appears to be physical fitness, particularly cardiovascular fitness. The significant improvement in endurance attained by women suggests that women enter training less physically fit relative to their own fitness potential, as well as to men. Remedial training for less fit soldiers is likely to reduce injuries and decrease the gender differential in risk of injuries.

Why are most drowning victims men ? Sex differences in aquatic skills and behaviors

Men have higher drowning rates than women for most age groups. Data from a 1991 national household survey (n = 3042) on aquatic activities were used to examine hypotheses about differential drowning rates by sex. Men and women were compared by (1) exposure to aquatic environments; (2) frequency of aquatic activities involving or potentially involving, submersion; (3) swimming training and ability; (4) aquatic risk-taking behaviors; and (5) alcohol use on or near the water. Men had elevated risks for exposure, risk taking, and alcohol use. It was concluded that several factors contribute to their relatively high drowning rates, including a possible interaction between overestimation of abilities and heavy alcohol use.

Sunbathing habits and sunscreen use among white adults: results of a national survey.

OBJECTIVES This study assessed current levels of sunbathing and sunscreen use in the United States. METHODS From a general-population telephone survey of aquatic activities among adults in 3042 US households, we examined responses by the 2459 Whites. RESULTS Most adults (59%) reported sunbathing during the past year, and 25% reported frequent sunbathing. Of the subsample who reported sunbathing during the month before the interview, 47% routinely used sunscreen. Of these individuals, almost half did not use sunscreens with a solar protection factor of 15 or higher. CONCLUSIONS About a quarter of US White adults report frequent sunbathing, and only about a quarter of sunbathers use sunscreens at recommended levels. These results should help focus future sun protection educational efforts.

Impact of legislation raising the legal drinking age in Massachusetts from 18 to 20.

On April 16, 1979, Massachusetts raised its legal drinking age from 18 to 20 years. Massachusetts was compared with New York State, exclusive of New York City and Nassau County. New York State retained an 18-year-old drinking age. Random telephone surveys with approximately 1,000 16-19 year olds in each state were undertaken prior to the laws enactment and twice at yearly intervals after the law to assess the laws impact on teenage drinking, driving after drinking, and non-fatal accident involvement. Fatal crash data reported to the US Department of Transportation by each state from April 16, 1976-April 15, 1981 were also analyzed. After the law, although the modes of procuring alcohol changed. No significant changes were observed in Massachusetts relative to New York in the proportion of surveyed teenagers who reported that they drank or in the volume of their consumption. The proportion of teenagers who drove after drinking heavily (six or more drinks at one time) did not decline in Massachusetts relative to New York. However, the frequency that teenagers reported driving after any drinking declined significantly in Massachusetts. Frequency of teenage driving after marijuana use and non-fatal teenage accidents declined at comparable rates in both states. The numbers of teenage nighttime single vehicle fatal accidents declined more in Massachusetts than New York, in the 18-19 year age group. Overall fatal accident trends among 16-19 year olds in the two states were similar.

Collecting Sensitive Data

Results from studies that compare different methods of data collection may be confounded in many instances because of differences in response rates or sampling frames. Two alternatives to in-person interviewing were designed to overcome these confounding factors. One strategy utilized the telephone with in-person interviewing as a back-up when phone numbers were not available. The other strategy was a drop-off/pick-up, self-administered strategy. The telephone/field strategy was shown to be a viable alternative to in-person interviewing. The drop-off/pick-up strategy did not fare as well in comparison. Although response rates and costs were equivalent to in-person interviewing, the process was less enjoyable for respondents, and produced significantly different distributions on several sensitive measures.

Health Promotion versus Health Protection? Employees' Perceptions and Concerns

The “second public health revolution” targets factors in the environment, together with lifestyle, to prevent illness and untimely death. Yet the growth of the “wellness movement” has driven a wedge between public health advocates who argue for environmental solutions and those whose major focus is individual behavior. This tension is nowhere more evident than in the workplace, where the new wellness professionals are at odds with specialists in occupational health and industrial hygiene.This paper reports findings from a cross-sectional survey of a sizeable sample of workers at six New England facilities of a very large American manufacturing firm, assessing their perceptions of risk in the two domains: environmental exposures and lifestyle risks. Multiple regression analyses reveal that both job risks and life risks are associated with a variety of potentially costly and disruptive health problems, even after controlling for demographic and occupational factors. This analysis suggests that wellness programs in the workplace will be more effective if they integrate environmental protection with efforts to reduce lifestyle risk.

Effects of low-dose alcohol exposure on simulated merchant ship piloting by maritime cadets

The US Department of Transportation (DOT) regulates on-the-job alcohol use by operators of certain categories of commercial transport. For aircraft, trains, and commercial vessels, operators are subject to sanctions for having > or = 0.04 g% blood alcohol concentration (BAC). This study examines the effects of alcohol (between 0.04 and 0.05 g% BAC) on simulated merchant ship handling. A two-group randomized factorial design was used to compare beverage alcohol to placebo while controlling for baseline performance on a previous day. The study was conducted in the Maritime Simulation Center at Maine Maritime Academy, Castine, ME. Participants were 38 volunteer deck officer cadets in their junior or senior year, at least 21 years of age, with previous experience on a bridge simulator. Following a baseline trial on Day 1, on Day 2 participants were randomized to receive alcohol (0.6 g/kg for males and 0.5 g/kg for females) or placebo. After allowing time for absorption, participants completed a bridge simulator task. For baseline and performance trials, participants were randomized to one of four bridge simulator scenarios, each representing passage of a fully loaded container vessel through a channel with commercial traffic. The aggregate scenario score given by blinded maritime educators measured performance. A main effect for alcohol was found indicating that performance was significantly impaired by this low dose of alcohol relative to performance in the placebo condition. These findings are consistent with current federal regulations that limit low-dose alcohol exposure for the operators of commercial transport vehicles. Further research is required to determine effects at lower BACs.

TEENAGE DRIVING AFTER USING MARIJUANA OR DRINKING AND TRAFFIC ACCIDENT INVOLVEMENT

Anonymous random digit dialing telephone surveys of nearly 6000 16-19 year old respondents were conducted in Massachusetts and Upstate New York in 1979-1981. These surveys explored frequency of driving after using marijuana, driving after drinking, respondent accident involvement in the year prior to the interview, and a variety of other respondent characteristics. Frequency of driving after using marijuana and after drinking were each associated with greater accident involvement. To isolate the accident risk of driving after marijuana use, respondents who drove after drinking were excluded from a logistic regression analysis. This analysis also controlled for the distance respondents drove and several respondent demographic characteristics. Compared to respondents who did not drive after marijuana use, teenageers who drove after smoking marijuana on at least 6 occasions per month were 2.4 times more likely to be involved in traffic accidents. Those who drove after marijuana use on at least 15 occasions per month were 2.9 times more likely to have an accident.

Evidence for Cohort or Generational Differences in the Drinking Behavior of Older Adults

Data from a survey of 928 older Bostonians show that there is a negative correlation between age and alcohol consumption among older adults: i.e., “old-old” people-those who are seventy-five years old or older—are more likely to abstain and less likely to drink in any quantity than the “younger-old”—those aged sixty-seventy-five years old. Since the study collected only cross-sectional data, it is not clear whether there are developmental trends in alcohol consumption-that people drink less as they grow older—or whether there are cohort or generational effects. However, several retrospective data suggest that there are cohort or generational patterns of drinking behavior by older adults. Very old respondents, who now drink less than their younger counterparts, report consistently different patterns of life-long drinking habits; they report different parental drinking habits, and they have consistently different attitudes toward the effects of alcohol consumption upon health. The survey provides no insight into the nature of the historical factors which account for the differences in alcohol use. However, Prohibition, Repeal, and the Depression are likely to have played important roles.