Migration,ethnicity and psychoses: evidence,models and future directions

There is a large body of research reporting high rates of psychotic disorders among many migrant and minority ethnic groups, particularly in Northern Europe. In the context of increasing migration and consequent cultural diversity in many places worldwide, these findings are a major social and public health concern. In this paper, we take stock of the current state of the art, reviewing evidence on variations in rates of psychoses and putative explanations, including relevant theories and models. We discuss in particular: a) the wide variation in reported rates of psychotic disorders by ethnic group, and b) the evidence implicating social risks to explain this variation, at ecological and individual levels. We go on to set out our proposed socio‐developmental model, that posits greater exposure to systemic social risks over the life course, particularly those involving threat, hostility and violence, to explain high rates of psychoses in some migrant and minority ethnic groups. Based on this analysis, the challenge of addressing this social and public health issue needs to be met at multiple levels, including social policy, community initiatives, and mental health service reform.     

"To open oneself is a poor woman's trouble": embodied inequality and childbirth in South-Central Tanzania

Various theories exist for the ways in which social and material disparities are incorporated within human bodies and then expressed as health outcomes with uneven distributions. From a political economy perspective, one pathway involves processes of social exclusion that take place on articulating local and global fields of power. This study explores such situated processes as they produce and perpetuate embodied inequality at childbirth in the Kilombero Valley of South-Central Tanzania. Ethnographic narratives illustrate how these processes differentially affect the kind of care women seek and receive. Also described are women's complex yet pragmatic responses to potential exclusion in the attempt to secure a safe and otherwise positive outcome. In a culturally constructed world of childbirth, face-to-face claims on entitlement to biomedical services collide with enactments of discrimination at multiple levels, creating a space of contestation for social and material positioning as well as for physical well-being.     

生态系统健康评价的研究进展

生态系统健康评价是环境管理和生态系统监控的基础,生态系统监控可促进生态系统健康评价。首先介绍了生态系统健康概念的产生,发展及其不同的内涵,并着重回顾和讨论了生态系统健康评价指标及其存在的问题,生态系统健康评价指标包括生态指标,物理化学指标,人类健康与社会经济指标3大类,生态指标是反映生态系统特征和状态的生物指标,它分为生态系统,群落和种群与个体等不同层次的指标或指标体系,物理化学指标是检测生态系统的非生物环境的指标。人类健康与社会经济指标着眼于生态系统对人类生存与社会发展的支持作用,采用经济参数和社会发展的环境压力指标等来衡量生态服务的质量与可持续性,根据其敏感程度和功能性,生态系统健康评价指标分为早期预警指标,适宜程度指标和诊断指标3类,一个完整的生态系统评价应包括上述3大类指标或指标体系,但在具体的评价实践中往往因评价目的和对象的不同而有所选择,生态系统健康评价目前有两个亟待解决的问题,如何有效确立评价标准与参照系以及如何正确区分人为压力和自然干扰。     

Improving the dialogue between public health and ecosystem science on antimicrobial resistance

The concept of health has evolved markedly from a bio-medical, mechanistic model to include an interdisciplinary perspective where human, animal and ecosystem health are integrated. One Health, EcoHealth and Planetary Health are examples of approaches to health advocating collaboration and interdisciplinarity at multiple levels. In practice, successful integration has been challenging and in particular, understanding of the ecosystem component of health lags behind the human and animal components. Antimicrobial resistance is an important threat to human health, which develops, is maintained and transmitted at the human–animal–environment interface. While the human and livestock components of resistance are well understood, this is not the case for the ecosystem component. This gap in knowledge leads to a poor representation of the environmental dimension of antimicrobial resistance in key policy documents and in interdisciplinary work around this issue. We interviewed a group of leading researchers in public health and ecology to explore their perceptions on the integration of ecosystem and public health research in the context of antimicrobial resistance. Experts from both fields considered that research on antimicrobial resistance is only beginning to consider ecosystems. They highlighted various barriers that have contributed to limited integration, such as conceptual barriers, and a lack of knowledge translators as facilitators. Better interdisciplinary integration is needed to address the challenge of antimicrobial resistance. Improving the dialogues between the disciplines is a necessary first step in this process. Greater engagement of ecologists is needed to build a more complete understanding of the role of ecosystems in human health, and identify how human interactions with ecosystems can both contribute to, and restrict, the development of antimicrobial resistance.     

Dimensions of health and social structure in the early intermediate period cemetery at Villa El Salvador, Peru

This paper examines relationships between the social structure of a community and the health of its members, based on analysis of human skeletal remains (N = 64) from Villa El Salvador XII (100 BC-AD 100), a prehistoric cemetery located in the lower Lurín Valley, Peru. The ambiguity of social status as conventionally inferred from archaeological context is among the principal complicating factors in such an inquiry. We use multidimensional scaling of skeletal markers to identify the presence of patterned health-based heterogeneity in our sample, without making a priori assumptions about underlying social structure at Villa El Salvador. This procedure situates every skeleton relative to all others in the sample on the basis of multiple health markers, eliciting health groups. Once recognized, the relevance of those groups to social structure can be evaluated by comparison with a broad range of presumptive archaeological status indicators. We test the hypothesis that the distribution of stress indicators in human skeletons covaries with archaeological indicators of social differentiation. Based on multivariate analysis of skeletal indicators, we conclude that the cemetery at Villa El Salvador was utilized by two social groups with different geographic affinities: one of local coastal origin, and the other probably from the upper Lurín Valley or adjacent higher altitudes. These groups differ in skeletal characteristics related to childhood health, probably reflecting systematic contrasts in the growth environments of the studied individuals. This same division is independently supported by the distribution of cranial deformation, a possible marker of ethnicity. We also document some inequality in the distribution of labor among male individuals, as reflected by the relative advancement of degenerative joint disease, and congruent with differences in the number and quality of associated funerary offerings.     

Oxytocin and vasopressin are dysregulated in Williams Syndrome, a genetic disorder affecting social behavior

The molecular and neural mechanisms regulating human social-emotional behaviors are fundamentally important but largely unknown; unraveling these requires a genetic systems neuroscience analysis of human models. Williams Syndrome (WS), a condition caused by deletion of ~28 genes, is associated with a gregarious personality, strong drive to approach strangers, difficult peer interactions, and attraction to music. WS provides a unique opportunity to identify endogenous human gene-behavior mechanisms. Social neuropeptides including oxytocin (OT) and arginine vasopressin (AVP) regulate reproductive and social behaviors in mammals, and we reasoned that these might mediate the features of WS. Here we established blood levels of OT and AVP in WS and controls at baseline, and at multiple timepoints following a positive emotional intervention (music), and a negative physical stressor (cold). We also related these levels to standardized indices of social behavior. Results revealed significantly higher median levels of OT in WS versus controls at baseline, with a less marked increase in AVP. Further, in WS, OT and AVP increased in response to music and to cold, with greater variability and an amplified peak release compared to controls. In WS, baseline OT but not AVP, was correlated positively with approach, but negatively with adaptive social behaviors. These results indicate that WS deleted genes perturb hypothalamic-pituitary release not only of OT but also of AVP, implicating more complex neuropeptide circuitry for WS features and providing evidence for their roles in endogenous regulation of human social behavior. The data suggest a possible biological basis for amygdalar involvement, for increased anxiety, and for the paradox of increased approach but poor social relationships in WS. They also offer insight for translating genetic and neuroendocrine knowledge into treatments for disorders of social behavior.     

Preventing Torture in Nepal: A Public Health and Human Rights Intervention

In this article we address torture in military and police organizations as a public health and human rights challenge that needs to be addressed through multiple levels of intervention. While most mental health approaches focus on treating the harmful effects of such violence on individuals and communities, the goal of the project described here was to develop a primary prevention strategy at the institutional level to prevent torture from occurring in the first place. Such an approach requires understanding and altering the conditions that cause and sustain “atrocity producing situations” (Lifton 2000, 2004). Given the persistence of torture across the world and its profound health consequences, this is an increasingly important issue in global health and human rights.     

Risk Perception and Chronic Exposure to Organochlorine Pesticides in Maya Communities of Mexico

In order to analyze risk perception related to the use and handling of organochlorine pesticides (OCP) in agricultural and livestock activities among Maya communities of Yucatan, Mexico, and to study their impact on public health and the environment, we conducted an analytical study applying 274 semi-structured interviews in 11 municipalities in the zone called “Ring of Cenotes.” The harmful effects of agrochemicals on water supplies, soils, air, and human health were considered, including the indoor use of pesticides to preserve harvest products. Recent studies showed high levels of OCP in groundwater. A generalized low risk perception related to human health and the environment due to pesticide use was found. Likewise, social parameters were analyzed, including the educational level, as well as risk factors related to groundwater karst vulnerability. Pesticides that have been banned by international conventions are still in use. The occurrence of some diseases such as cervical cancer, with a very high prevalence at the national level, and the practice of obtaining drinking water from polluted wells and sinkholes, may be associated with this low risk perception and with poor social conditions. Establishing programs on health education, agro-ecological production alternatives, and water chemical quality monitoring is recommended.     

How race becomes biology: Embodiment of social inequality

The current debate over racial inequalities in health is arguably the most important venue for advancing both scientific and public understanding of race, racism, and human biological variation. In the United States and elsewhere, there are well-defined inequalities between racially defined groups for a range of biological outcomes—cardiovascular disease, diabetes, stroke, certain cancers, low birth weight, preterm delivery, and others. Among biomedical researchers, these patterns are often taken as evidence of fundamental genetic differences between alleged races. However, a growing body of evidence establishes the primacy of social inequalities in the origin and persistence of racial health disparities. Here, I summarize this evidence and argue that the debate over racial inequalities in health presents an opportunity to refine the critique of race in three ways: 1) to reiterate why the race concept is inconsistent with patterns of global human genetic diversity; 2) to refocus attention on the complex, environmental influences on human biology at multiple levels of analysis and across the lifecourse; and 3) to revise the claim that race is a cultural construct and expand research on the sociocultural reality of race and racism. Drawing on recent developments in neighboring disciplines, I present a model for explaining how racial inequality becomes embodied—literally—in the biological well-being of racialized groups and individuals. This model requires a shift in the way we articulate the critique of race as bad biology. Am J Phys Anthropol 2009. © 2009 Wiley-Liss, Inc.     

Integrated analysis of genetic, genomic and proteomic data

The rapid expansion of methods for measuring biological data ranging from DNA sequence variations to mRNA expression and protein abundance presents the opportunity to utilize multiple types of information jointly in the study of human health and disease. Organisms are complex systems that integrate inputs at myriad levels to arrive at an observable phenotype. Therefore, it is essential that questions concerning the etiology of phenotypes as complex as common human diseases take the systemic nature of biology into account, and integrate the information provided by each data type in a manner analogous to the operation of the body itself. While limited in scope, the initial forays into the joint analysis of multiple data types have yielded interesting results that would not have been reached had only one type of data been considered. These early successes, along with the aforementioned theoretical appeal of data integration, provide impetus for the development of methods for the parallel, high-throughput analysis of multiple data types. The idea that the integrated analysis of multiple data types will improve the identification of biomarkers of clinical endpoints, such as disease susceptibility, is presented as a working hypothesis.     

Pesticides,Sexual Development,Reproduction, and Fertility: Current Perspective and Future Direction

Improvements in chemical analytical technology and non-invasive sampling protocols have made it easier to detect pesticides and their metabolites at very low concentrations in human tissues. Monitoring has revealed that pesticides penetrate both maternal and paternal reproductive tissues and organs, thus providing a pathway for initiating harm to their offspring starting before fertilization throughout gestation and lactation. This article explores the literature that addresses the parental pathway of exposure to pesticides. We use DDT/DDE as a model for chemicals that oftentimes upon exposure have no apparent, immediate health impacts, or cause no obvious birth defects, and are seldom linked with cancer. Their health effects are overlooked because they are invisible and not life threatening—but might have significant health, social, and economic impacts at the individual and population levels. The purpose of this article is to demonstrate the necessity to develop new approaches for determining the safety of pesticides and the need for innovative regulatory policy to protect human and environmental health.     

Integrated analysis of genetic,genomic and proteomic data

The rapid expansion of methods for measuring biological data ranging from DNA sequence variations to mRNA expression and protein abundance presents the opportunity to utilize multiple types of information jointly in the study of human health and disease. Organisms are complex systems that integrate inputs at myriad levels to arrive at an observable phenotype. Therefore, it is essential that questions concerning the etiology of phenotypes as complex as common human diseases take the systemic nature of biology into account, and integrate the information provided by each data type in a manner analogous to the operation of the body itself. While limited in scope, the initial forays into the joint analysis of multiple data types have yielded interesting results that would not have been reached had only one type of data been considered. These early successes, along with the aforementioned theoretical appeal of data integration, provide impetus for the development of methods for the parallel, high-throughput analysis of multiple data types. The idea that the integrated analysis of multiple data types will improve the identification of biomarkers of clinical endpoints, such as disease susceptibility, is presented as a working hypothesis.     

Obesity,family instability,and socioemotional health in adolescence

The last two decades have witnessed dramatic increases in obesity and family instability. To the extent that the social stigma of obesity is a risk factor and family instability represents the potential compromise of important protective factors, their convergence may disrupt socioemotional health, especially during periods of heightened social uncertainty. Drawing on data from the National Longitudinal Study of Adolescent Health, this study found that obese youth at the start of high school had higher levels of internalizing symptoms and lower levels of perceived social integration in school only when they had also experienced multiple family transitions since birth. This pattern, however, did not hold for boys, and it did not extend to overweight (as opposed to obese) adolescents of either gender.     

Age of mother and pregnancy outcome in the 1981 Arkansas birth cohort

Higher levels of obstetric risk observed among teenage mothers seem to be an artifact of lower socioeconomic status and inferior access to health care rather than biological immaturity. In a study of matched Arkansas birth-infant death records for 1978, the proxy variables for health access (month care started and number of visits) have the strongest association with each of the dependent variables. The indicators of social status (education, race, and marital status) have a weaker association, and there is virtually no age effect observable once the affects of socioeconomic status and health access have been controlled for. A series of stepwise regression analyses shows that the multiple partial for health access indicators and mortality is 0.036, while the same coefficients for social status indicators and age are 0.001 and 0.006, respectively. Similar results are obtained using the other dependent variables. Health consequences of adolescent pregnancy usually include higher rates of malnutrition and prematurity and lower birth weight. It seems that the elevated morbidity and mortality among newborns delivered by teenagers are not a result of biologic factors. After the effects of lower status and health care access have been removed, the apparent biological disadvantages attributed to teenagers disappear, and, in the case of mortality and birth weight, are replaced by a slight advantage. This advantage is observed through the use of statisitical controls and will not be observed in the population at large unless there are changes in the policies governing access to contraception, abortion, and health care by adolescents, especially those at the youngest ages.     

Charting the history of agricultural experiments

Agricultural experimentation is a world in constant evolution, spanning multiple scientific domains and affecting society at large. Even though the questions underpinning agricultural experiments remain largely the same, the instruments and practices for answering them have changed constantly during the twentieth century with the advent of new disciplines like molecular biology, genomics, statistics, and computing. Charting this evolving reality requires a mapping of the affinities and antinomies at work within the realm of agricultural research, and a consideration of the practices, tools and social and political structures in which agricultural experiments are grounded. Three main questions will be addressed to provide an overview of the complex world of agricultural research investigated by the special issue: What is an agricultural experiment? Who is an experimenter in agriculture? Where do agricultural experiments take place? It will become apparent that agricultural experiments have a wide relevance for human development as they touch upon concerns related to human health and nutrition, contribute to policy discussions, and can affect the social and political structures in which farming is embedded.

     

Circadian rhythm of adrenal glucocorticoid: Its regulation and clinical implications

Glucocorticoid (GC) is an adrenal steroid hormone that controls a variety of physiological processes such as metabolism, immune response, cardiovascular activity, and brain function. In addition to GC induction in response to stress, even in relatively undisturbed states its circulating level is subjected to a robust daily variation with a peak around the onset of the active period of the day. It has long been believed that the synthesis and secretion of GC are primarily regulated by the hypothalamus-pituitary-adrenal (HPA) neuroendocrine axis. However, recent chronobiological research strongly supports the idea that multiple regulatory mechanisms along with the classical HPA neuroendocrine axis underlie the diurnal rhythm of circulating GC. Most notably, recent studies demonstrate that the molecular circadian clockwork is heavily involved in the daily GC rhythm at multiple levels. The daily GC rhythm is implicated in various human diseases accompanied by abnormal GC levels. Patients with such diseases frequently show a blunted GC rhythmicity and, more importantly, circadian rhythm-related symptoms. In this review, we focus on recent advances in the understanding of the circadian regulation of adrenal GC and its implications in human health and disease.     

Successful Aging,Social Support,and Ownership of a Companion Animal

Studies consistently find that higher levels of social support improve the psychological and physiological health of older people, but findings from empirical research are mixed regarding the presence of a “pet effect”— the idea that living with an animal can improve human health, psychological wellbeing, and longevity. We examined the assocations among social support, dog and cat ownership, and successful aging in a panel of 5,688 people between the ages of 50 and 74 years. Utilizing GLM, we tested for the presence of a complement (independent or additive effects) and/or hydraulic (interactive effect) association of pets and human support on four indicators of successful aging (pain, functional ability, chronic illnesses, and subjective successful aging). Supporting the hydraulic hypothesis, we found that having a dog was associated with fewer chronic illnesses, higher functional ability, and higher levels of subjective success when people lack human support. Similarly, having both a dog and a cat was associated with higher functional ability, less pain, and higher levels of subjective success when people lack human support. Supporting the complement hypothesis, we found that having a cat was associated with more chronic illnesses and lower levels of subjective successful aging. Findings carry practical implications for supporting pet ownership of older people, suggesting that dogs have a positive association with successful aging.     

Association between Social Integration and Health among Internal Migrants in ZhongShan,China

Internal migrants are the individuals who migrate between regions in one country. The number of internal migrants were estimated at 245 million in China in 2013. Results were inconsistent in the literature about the relationship between their health statuses and social integration. The main difference exists on how to measure the social integration and whether health statuses of internal migrants improve with years of residence. To complement the existing literature, this study measured social integration more comprehensively and estimated the internal migrants’ health statuses with varying years of residence, and explored the associations between the migrants’ social integration and health. We used the data from 2014 Internal Migrant Dynamic Monitoring Survey of Health and Family Planning in ZhongShan, China. Health status was measured from four aspects: self-reported health, subjective well-being, perception of stress, mental health. We measured social integration through four dimensions: economy, social communication, acculturation, and self-identity. The analyses used multiple linear regressions to examine the associations between self-reported health, subjective well-being, and perception of stress, mental health and social integration. The analytical sample included 1,999 households of the internal migrants and 1,997 local registered households, who were permanent residents in ZhongShan. Among the internal migrants, Adults in the labor force, who were aged 25 to 44 years old, accounted for 91.2% of the internal migrant population, while 74.6% of the registered population were in that age group. Median residential time among migrants was 2.8 (1.3–6.2) years, and 20.2% of them were migrating in the same Guangdong province. Except for mental health, other health statuses among migrants had significant differences compared with local registered population, e.g. self-reported health was better, but subjective well-being was worse. However, these health measurements were improved with more years of residence. Moreover, our results show that two aspects of social integration, economic integration and self-identity, were significantly associated with health status. Subjective feeling of relative social status levels were more associated with health, which prompted the attention to social fairness and the creation of a fair and respectful culture. More interventions could be experimented, such as encouraging internal migrants to participate in community activities more actively, educating local registered residents to treat internal migrants more equally, and developing self-identity among internal migrants. Better social, economic, and cultural environment can benefit internal migrants’ health statuses.     

Climate Change and Health in Sub-Saharan Africa: A Case-Based Perspective

Over the coming decades, sub-Saharan Africa will face profound stresses and challenges from global climate change. Many of these will manifest as adverse health outcomes. This article uses a series of five hypothetical cases to review the climate impacts on the health and well-being of individuals and populations in sub-Saharan Africa. This approach fosters insights into the human dimensions of the risks to health, their interaction with local human ecology, and awareness of the diverse health ramifications of external environmental changes. Each case illustrates the health impact resulting from a specific environmental or social consequence of climate change, including impacts on agriculture and food security, droughts, floods, malaria, and population displacement. Whereas the article focuses on discrete manifestations of climate change, individuals will, in practice, face multiple stresses from climate change (i.e., floods and malaria) concomitant with other non-climate stressors (i.e., HIV/AIDS, globalization, etc.). These multiple sources of vulnerability must be considered when designing climate change and socioeconomic development interventions.     

The dynamics of health and return migration

The increasing importance and complexity of migration globally also implies a global increase in return migration, and thus an increased interest in the health of returning migrants. The health of returning migrants is impacted by the cumulative exposure to social determinants and risk factors of health during the migration process, during the return movement, and following return. Circular migration often occurs among the diaspora, which can result in the transfer of knowledge and skills that contribute to development, including health system strengthening. Migrants with dual nationality often return to countries with better health services than their country of origin when they are sick and can not get care at home. To maintain and improve the health of returning migrants, multi-sectoral policies at global and national levels should facilitate access to appropriate and equitable health services, social services, and continuity of care across and within borders.