The social epidemiologic concept of fundamental cause

The goal of research in social epidemiology is not simply conceptual clarification or theoretical understanding, but more importantly it is to contribute to, and enhance the health of populations (and so, too, the people who constitute those populations). Undoubtedly, understanding how various individual risk factors such as smoking and obesity affect the health of people does contribute to this goal. However, what is distinctive of much on-going work in social epidemiology is the view that analyses making use of individual-level variables is not enough. In the spirit of Durkheim and Weber, S. Leonard Syme makes this point by writing that just “as bad water and food may be harmful to our health, unhealthful forces in our society may be detrimental to our capacity to make choices and to form opinions” conducive to health and well-being. Advocates of upstream (distal) causes of adverse health outcomes propose to identify the most important of these “unhealthful forces” as the fundamental causes of adverse health outcomes. However, without a clear, theoretically precise and well-grounded understanding of the characteristics of fundamental causes, there is little hope in applying the statistical tools of the health sciences to hypotheses about fundamental causes, their outcomes, and policies intended to enhance the health of populations. This paper begins the process of characterizing the social epidemiological concept of fundamental cause in a theoretically respectable and robust way.

Health information processed under limited attention: is it better to be "hot" or "cool?".

INTRODUCTION: The attentional myopia model (T. Mann & A. Ward, 2004) posits that under conditions of limited attention, individuals will be disproportionately influenced by highly salient cues. The "hot/cool" model (J. Metcalfe & W. Mischel, 1999) suggests that cues designed to activate "hot" emotional systems will typically dominate attention and promote relevant behavior more than cues designed to activate "cool" cognitive systems. METHOD: While under conditions of high or low cognitive load, participants heard information regarding the use of a zinc supplement and reported their intentions to try it. In Study 1, cool message cues that promoted the use of zinc were more salient than hot cues that discouraged its use. In Study 2, hot cues that discouraged the use of zinc were more salient than cool cues that promoted its use. RESULTS: In both studies, the imposition of cognitive load increased the influence of salient cues, regardless of their motivational "temperature." CONCLUSIONS: Consistent with the attentional myopia model, either hot or cool health message cues can exert strong influence over individuals, depending on the relative salience of those cues.     

THE EFFECTS OF CHILDHOOD SEXUAL MESSAGES ON AFRICAN-AMERICAN AND WHITE WOMEN'S ADOLESCENT SEXUAL BEHAVIOR

To clarify the relationship between sexual communication and sexual behavior, multiple components of sexual messages recalled from child hood were examined in a community sample of 248 African-American and White women. Respondents were matched on a predesignated set of demographic variables and were interviewed using the Wyatt Sexual History Questionnaire. We anticipated that women's recollections of messages from parents and television would differ both individually and across ethnicity, and that messages recalled from parents would be multidimensional, varying in tone (positive vs. negative) across time (childhood vs. adolescence) and form (verbal vs. nonverbal). We also expected that the presence and tone of specific types of messages re called would be associated with risk-related sexual behavior. Results confirmed predictions concerning differential interpretations of messages, and ethnicity emerged as a strong mediating variable. The implications of the specific types of parental messages influencing behavior are discussed.     

Interethnic Factors as Predictors of the Subjective Well‐Being of Minority Individuals in a Context of Recent Societal Changes

Our research examined the impact of contextual intergroup variables on the subjective well‐being of ethnic Russians in Estonia (N = 190) who have experienced major social changes with the demise of the Soviet Union. A mediational model was tested where aspects of intergroup relations (i.e., relative deprivation, status legitimization, and temporal comparisons) acted as mediators of the influence of cultural identity and representations of history on subjective well‐being. Preliminary analyses indicated polemical representations of history in which Estonian historical narratives are established around the struggle for independence, and Russian representations of history are consolidated around victory in World War II. Mediation analyses demonstrated that the importance of Russian history increased the perceptions of relative deprivation, status delegitimization, and the frequency of temporal comparisons, which negatively affected life satisfaction. At the same time, the importance of Estonian history led to positive perceptions of the intergroup situation and, in turn, to greater subjective well‐being. The effect of Russian identity on well‐being was mediated by delegitimizing beliefs, but not by relative deprivation and temporal comparisons. Estonian identity did not exert a significant effect on the proposed mediators. The research demonstrates the salience of the effects of contextual intergroup factors on subjective well‐being, and the article discusses implications for the study of intergroup relations and subjective well‐being.     

Can Becoming My Self Influence My Health?: Exploring the Effects of a Eudaimonic-Enhancement Process on Psychological Indicators of Well-Being and Physical Activity

The current study adopts an intervention approach that begins with the assumption that the quality of a person’s lived experience is at the core of well-being and health behavior change. Specifically, the present study used a well-being enhancement process grounded in eudaimonia to explore the connection among eudaimonia, indicators of psychological well-being (i.e., personal growth, subjective vitality, self-determination, and life engagement), and physical activity. Participants in the intervention group engaged in 8 weekly, group eudaimonic well-being enhancement (the Well-Being Way, WBW) sessions with assessments at Weeks 1, 8, and 12 (follow-up), and were compared to a comparison group that did not participate. A series of 2?×?3 (Group by Time) repeated measures ANOVAs along with follow-up paired comparisons t-tests were conducted to compare the WBW and comparison groups across time. Results indicated that the WBW group exhibited significant increases in two indices of psychological well-being (trait subjective vitality and self-determination) and in their physical activity levels. The comparison group showed no changes in any of the variables. The results of an exploratory regression analysis provided some evidence that WBW participants who experienced the greatest gains in life engagement and trait subjective vitality also exhibited significant increases in level of physical activity. Discussion focuses on the implications of the Well-Being Way approach for the enhancement of positive well-being and future possibilities for eudaimonic-based approaches to health behavior change.