Faculty Bibliography

A decade of research has shown that housing problems are the strongest predictors of the risk of homelessness among families. In a 1988 study conducted for the Human Resources Administration, we found that few families requesting shelter were plagued by serious drug abuse or mental health problems. Instead, they were faced with extremely difficult housing situations. Perhaps most telling, in a recent study of formerly homeless families judged to be at high risk of returning to shelter, the vast majority remained in their own apartments during their first year

Physicians' responses to AIDS at different career stages and in different specialties were studied by surveying house staff (N = 438), faculty (N = 363), and applicants (N = 487) at six residency programs in internal medicine and six in surgery. House staff had more negative outlooks than senior medical students and faculty, reporting greater fear of exposure to AIDS and greater unwillingness to treat AIDS patients. Surgeons were more negative than internists on these dimensions. For all groups, concern about possible negative educational consequences of treating AIDS patients was largely a function of their amount of contact with AIDS patients. Comparing willingness to treat AIDS and nine other conditions, AIDS consistently ranked low, along with Alzheimer's disease, alcoholism, and drug dependency. The findings have practical implications for hospitals and training programs. In addition, they raise issues concerning the impact of training on professional socialization, and call into question physicians' commitment to the professional norm of treating all patients regardless of provider self-interest, patient social characteristics, or medical uncertainty.

This study examines 253 newly hired home attendants to measure the degree to which employment-based health insurance can affect health status and utilization of health care services among a working poor population that has little experience with health insurance and may face other significant barriers to care. Physician contacts increased after benefits were received; attendants who had no coverage during the prior year experienced the greatest average increase. More attendants also reported using emergency rooms. Neither hospitalizations nor health status were affected. These findings indicate that insurance benefits may substantially improve access to care for many working poor persons, regardless of other barriers they may face.

In a study of the link between physical disability and social relationships among the elderly, questions about social network and social support evoked a surprisingly large number of group responses. People mentioned "my grandchildren," "the people in my building," "people at the senior center," and other groups in ways that suggested that the real unit of support was extraindividual and could not be accurately understood by reference to individual people within those groups. This paper describes the frequency of such responses and the circumstances under which they emerged. Definitions of social support and of social network should not be restricted to dyadic relationships between individuals; better understanding of social support processes would derive from consideration of the kinds of social support functions best offered by groups vs. individuals and consideration of differences in the ways in which support is derived from groups and individuals.

This article examines whether the psychological impact of different kinds of social supports varies according to who provides them. Data on 82 older adults' social relationships, measured as social provisions (Weiss, 1974), were used to evaluate whether the relationship between social provisions and emotional well-being varied when kin and, alternatively, nonkin, made the provisions. Findings showed that, although most social provisions were valuable regardless of their source, reassurance of worth was distinctly more beneficial when provided by nonkin than by kin, and reliable alliance, or instrumental assistance, was more strongly related to well-being when provided by kin than by nonkin. Analysis of social network structure showed that "multiplexity" was negatively related to well-being, and having duplicate providers for a given social provision was uniquely important in offsetting negative affect.

In this paper, the health needs and health care utilization patterns of home attendants and their families have been studied as an illustration of those likely to be found among working poor, immigrant women and their children. Despite tremendous growth in the number of immigrants, studies to date provide only limited information regarding the specific health needs and patterns of health care utilization among such women and their children. As part of a longitudinal study on the impact of insurance on health status and health care utilization, 387 female, immigrant home attendants were interviewed. Data were also gathered on 355 of their minor children. These women and children were found to be less likely than other Americans to make use of basic health services, despite the fact that they are more likely to indicate fair or poor health status. This is true even in comparison to poor or uninsured Americans. Immigrant attendants in fair or poor health report an average annual visit rate of 4.1 ambulatory care visits for themselves and 2.2 for their children, as compared to 8.4 for poor adults and 4.4 for poor children in national samples. These findings illustrate the likelihood that poor, immigrant women make limited use of American medical care, and face barriers to health care that appear even greater than those faced by the uninsured and the poor.

The present two studies were conducted to assess the prosocial behaviors (comforting and helping) of preschool children as a function of the race and gender of the subjects and peer confederates. Results indicated that black, preschool-age males demonstrated prosocial behaviors more often than did white males and females. These findings were discussed in terms of the confounding between race of child and father absence; that is, a disproportionate number of black children were living in fatherless homes. It was suggested that single parents may turn to their opposite-sex child for both emotional and physical support and thus the child learns comforting and helping behaviors early in life. Support for this suggestion was derived from the finding that the number of household chores assigned to a child was positively related to helping behavior. The present results also showed that comforting and helping behaviors were negatively related, suggesting that prosocial acts are not a function of a general personality trait but are situationally specific. Finally, it was noted that race and gender of the peer confederate were not factors in determining the prosocial responses of the subjects. © 1988.