Social Work Commons^™

Ten Year Trends (1992 To 2002) In Sociodemographic Predictors And Indicators Of Alcohol Abuse And Dependence Among Whites, Blacks, And Hispanics In The U.S, Raul Caetano, Jonali Baruah, Karen G. Chartier

Social Work Publications

Background

The objective of this paper is to examine 10-year trends (1992–2002) in the number and type of indicators of DSM-IV abuse and dependence among Whites, Blacks and Hispanics in the U.S.

Methods

Data are from the 1991–1992 National Longitudinal Alcohol Epidemiologic Survey (NLAES; n = 42,862) and the 2001–2002 National Epidemiologic Study on Alcohol and Related Conditions (NESARC; n = 43,093). Both surveys used multistage cluster sample procedures to select respondents 18 years of age and older from the U.S. household population.

Results

Increases in the prevalence of alcohol abuse between 1992 and 2002seem associated to a rise in …

Trends In Alcohol Services Utilization From 1991–1992 To 2001–2002: Ethnic Group Differences In The U.S. Population, Karen G. Chartier, Raul Caetano

Social Work Publications

Background:  During the early 1990s in the United States, changes to the provision and financing of alcohol treatment services included reductions in inpatient treatment services and in private sector spending for treatment. We investigated trends in alcohol services utilization over the 10‐year period from 1991–1992 to 2001–2002 among U.S. whites, blacks, and Hispanics.

Methods:  Data come from 2 household surveys of the U.S. adult population. The 1991 to 1992 National Longitudinal Alcohol Epidemiologic Survey and the 2001 to 2002 National Epidemiologic Survey on Alcohol and Related Conditions conducted face‐to‐face interviews with a multistage cluster sample of individuals 18 years of …

Associations Of Physician Supplies With Colon Cancer Care In Ontario And California, 1996 To 2006, Kevin M. Gorey

Social Work Publications

BACKGROUND: This study examined the differential effects of physician supplies on colon cancer care in Ontario and California. The associations of physician supplies with colon cancer stage at diagnosis, receipt of surgery and adjuvant chemotherapy, and 5-year survival were observed within each country and compared between-country.

METHODS: Random samples of Ontario and California cancer registries provided 2,461 and 2,200 colon cancer cases that were diagnosed between 1996 and 2000, and followed until 2006. Both registries included data on the stage of disease at the time of diagnosis, receipt of cancer-directed surgery, receipt of adjuvant chemotherapy, and survival. Census tract-level data …

Effects Of Socioeconomic Status On Colon Cancer Treatment Accessibility And Survival In Toronto, Ontario, And San Francisco, California, 1996-2006, Kevin M. Gorey, Isaac N. Luginaah, Emma Bartfay, Karen Y. Fung, Eric J. Holowaty, Frances C. Wright, Caroline Hamm, Sindu M. Kanjeekal

Social Work Publications

OBJECTIVES: We examined the differential effects of socioeconomic status on colon cancer care and survival in Toronto, Ontario, Canada, and San Francisco, California.

METHODS: We analyzed registry data for colon cancer patients from Ontario (n = 930) and California (n = 1014), diagnosed between 1996 and 2000 and followed until 2006, on stage, surgery, adjuvant chemotherapy, and survival. We obtained socioeconomic data for individuals' residences from population censuses.

RESULTS: Income was directly associated with lymph node evaluation, chemotherapy, and survival in San Francisco but not in Toronto. High-income persons had better survival rates in San Francisco than in Toronto. After …

Predicting The Use Of Spiritually-Based Interventions With Children And Adolescents: Implications For Social Work Practice, Connie L. Kvarfordt, Michael Sheridan

Social Work Publications

A cross-sectional survey design with disproportionate random sampling was used to gather data from 283 clinical social workers across the United States. Overall, participants had a positive attitude toward the role of religion and spirituality in social work practice and were favorable of social workers helping youth develop spiritually. While practitioners used a wide range of spiritually-derived interventions with this population, the vast majority reported that these issues were rarely, if ever, addressed in their social work education and training. Three attitudinal variables, two practice related variables, and one personal spiritual/religious variable were found to be most predictive of the …

Breast Cancer Care In Canada And The United States: Ecological Comparisons Of Extremely Impoverished And Affluent Urban Neighborhoods, Kevin M. Gorey

Social Work Publications

This study examined the differential effect of extreme impoverishment on breast cancer care in urban Canada and the United States. Ontario and California registry-based samples diagnosed between 1998 and 2000 were followed until 2006. Extremely poor and affluent neighborhoods were compared. Poverty was associated with non-localized disease, surgical and radiation therapy (RT) waits, non-receipt of breast conserving surgery, RT and hormonal therapy, and shorter survival in California, but not in Ontario. Extremely poor Ontario women were consistently advantaged on care indices over their California counterparts. More inclusive health insurance coverage in Canada seems the most plausible explanation for such Canadian …

Income And Long-Term Breast Cancer Survival: Comparisons Of Vulnerable Urban Places In Ontario And California, Kevin M. Gorey

Social Work Publications

Effects of socioeconomic status on the long-term survival of 808 women with node-negative breast cancer in Canada and the United States were observed. Ontario and California samples diagnosed between 1988 and 1990 were followed until 2006. Socioeconomic data were taken from population censuses. Compared with their California counterparts, residents of low-income urban areas in Ontario experienced a significant 15-year survival advantage (RR = 1.66 [95% CI: 1.00, 2.76]). In these and other vulnerable, lower-middle- to working-class neighborhoods, significantly more Ontario residents gained access to adjuvant radiation therapy (RR = 1.75 [1.21, 2.53]) which seemed associated with better long-term survival (RR …

Physician Supply And Breast Cancer Survival, Kevin M. Gorey

Social Work Publications

BACKGROUND: This study tested the hypothesis that physician supply thresholds are associated with breast cancer survival in Ontario.

METHODS: The 5-year survival of 17,820 female breast cancer patients diagnosed between 1995 and 1997 was surveilled until 2003 for all-cause mortality. Physician supply densities in 1991 and 2001 were computed for 49 Ontario regions.

RESULTS: There were independent threshold effects for general practitioners (GP; 7.25 per 10,000) and obstetrician/gynecologists (OB/GYN; 6 per 100,000) at or above which women with breast cancer were more likely to survive for 5 years. The respective risk of living in areas undersupplied with OB/GYN and GP …

Strengthening Family Practices For Latino Families, Karen G. Chartier, Lirio K. Negroni, Michie N. Hesselbrock

Social Work Publications

The study examined the effectiveness of a culturally-adapted Strengthening Families Program (SFP) for Latinos to reduce risks for alcohol and drug use in children. Latino families, predominantly Puerto Rican, with a 9–12 year old child and a parent(s) with a substance abuse problem participated in the study. Pre- and post-tests were conducted with each family. Parental stress, parent-child dysfunctional relations, and child behavior problems were reduced in the families receiving the intervention; family hardiness and family attachment were improved. Findings contribute to the validation of the SFP with Latinos, and can be used to inform social work practice with Puerto …

Ethnicity And Health Disparities In Alcohol Research, Karen G. Chartier, Raul Caetano

Social Work Publications

Recent advances in alcohol research continue to build our understanding of alcohol consumption and related consequences for U.S. ethnic minority groups. National surveys show variations across ethnicities in drinking, alcohol use disorders, alcohol problems, and treatment use. Higher rates of high-risk drinking among ethnic minorities are reported for Native Americans and Hispanics, although within-ethnic group differences (e.g., gender, age-group, and other subpopulations) also are evident for ethnicities. Whites and Native Americans have a greater risk for alcohol use disorders relative to other ethnic groups. However, once alcohol dependence occurs, Blacks and Hispanics experience higher rates than Whites of recurrent or …

Development And Vulnerability Factors In Adolescent Alcohol Use, Karen G. Chartier, Michie N. Hesselbrock, Victor M. Hesselbrock

Social Work Publications

This article provides an overview of the characteristics of adolescent alcohol use, normative and subgroup variations in drinking behavior, and important factors associated with an increased risk for developing alcohol problems in later adolescence and young adulthood. A parental/family history of alcoholism, temperament traits, conduct problems, cognitive functioning, alcohol expectancies, and peer and other social relations are identified as influencing an adolescent’s susceptibility for initiating a variety of alcohol use behaviors. The Deviance Prone Model, proposed by Sher (1991), is presented as an important tool for testing possible relationships among the various risk factors and their sequencing that leads to …

Alcohol Problems In Young Adults Transitioning From Adolescence To Adulthood: The Association With Race And Gender, Karen G. Chartier, Michie N. Hesselbrock, Victor M. Hesselbrock

Social Work Publications

Race and gender may be important considerations for recognizing alcohol related problems in Black and White young adults. This study examined the prevalence and age of onset of individual alcohol problems and alcohol problem severity across race and gender subgroups from a longitudinal study of a community sample of adolescents followed into young adulthood (N = 166; 23–29 yrs. old who were drinkers). All alcohol problems examined first occurred when subjects were in their late teens and early 20s. Drinking in hazardous situations, blackouts, and tolerance were the most common reported alcohol problems. In race and gender comparisons, more …

Breast Cancer Survival In Ontario And California, 1998-2006: Socioeconomic Inequity Remains Much Greater In The United States, Kevin M. Gorey

Social Work Publications

This study re-examined the differential effect of socioeconomic status on the survival of women with breast cancer in Canada and the United States. Ontario and California cancer registries provided 1,913 cases from urban and rural places. Stage-adjusted cohorts (1998-2000) were followed until 2006. Socioeconomic data were taken from population censuses. SES-survival associations were observed in California, but not in Ontario, and Canadian survival advantages in low-income areas were replicated. A better controlled and updated comparison reaffirmed the equity advantage of Canadian health care.

Breast Cancer Survival In Canada And The Usa: Meta-Analytic Evidence Of A Canadian Advantage In Low-Income Areas, Kevin M. Gorey

Social Work Publications

BACKGROUND: This study tested the hypothesis that relatively poor Canadian women with breast cancer have a survival advantage over their counterparts in the USA.

METHODS: Seventy-eight independent retrospective cohort (incidence between 1984 and 2000, followed until 2006) outcomes were synthesized. Fixed effects meta-regression models compared women with breast cancer in low-income areas of Canada and the USA.

RESULTS: Low-income Canadian women were advantaged on survival [rate ratio (RR) = 1.14; 95% confidence interval (CI) 1.13-1.15] and their advantage was even larger among women <65 years of age who are not yet eligible for Medicare coverage in the USA (RR = 1.21, 95% CI 1.18-1.24). Canadian advantages were also larger for node positive breast cancer, which may present with greater clinical and managerial discretion (RR = 1.40, 95% CI 1.30-1.50), and smaller when Hawaii, the state providing the most Canadian-like access, was the US comparator (RR = 1.12, 95% CI 1.01-1.20).

CONCLUSIONS: More inclusive health care insurance coverage in Canada vs the USA, particularly among each country's relatively …

Wait Times For Surgical And Adjuvant Radiation Treatment Of Breast Cancer In Canada And The United States: Greater Socioeconomic Inequity In America, Kevin M. Gorey

Social Work Publications

PURPOSE: The demand for cancer care has increased among aging North American populations as cancer treatment innovations have proliferated. Gaps between supply and demand may be growing. This study examined whether socioeconomic status has a differential effect on waits for surgical and adjuvant radiation treatment (RT) of breast cancer in Canada and the US.

METHODS: Ontario and California cancer registries provided 929 and 984 breast cancer cases diagnosed between 1998 and 2000 in diverse urban and rural places. Residence-based socioeconomic data were taken from censuses. Cancer care variables were reliably abstracted from health records: stage, receipt of surgery and RT, …

Associations Of Physician Supplies With Breast Cancer Stage At Diagnosis And Survival In Ontario, 1988 To 2006, Kevin M. Gorey

Social Work Publications

BACKGROUND: The authors examined whether the supply of primary care physicians had protective effects on breast cancer stage and survival in Ontario and whether supply losses during the 1990s were associated with diminished protection.

METHODS: Random samples of the Ontario Cancer Registry, respectively, provided 879 women and 951 women who were diagnosed with breast cancer between 1988 and 1990 (followed until 1996) and 1998 and 2000 (followed until 2006), respectively. Active physician supply data (1991 and 2001) joined to each woman's census division of residence was taken from the Scott's Medical Database.

RESULTS: Protective thresholds were observed among the earlier …

Increased Racial Differences On Breast Cancer Care And Survival In America: Historical Evidence Consistent With A Health Insurance Hypothesis, 1975-2001, Kevin M. Gorey

Social Work Publications

PURPOSE: This study examined whether race/ethnicity had differential effects on breast cancer care and survival across age strata and cohorts within stages of disease.

METHODS: The Detroit Cancer Registry provided 25,997 breast cancer cases. African American and non-Hispanic white, older Medicare-eligible and younger non-eligible women were compared. Successive historical cohorts (1975-1980 and 1990-1995) were, respectively, followed until 1986 and 2001.

RESULTS: African American disadvantages on survival and treatments increased significantly, particularly among younger women who were much more likely to be uninsured. Within node positive disease all treatment disadvantages among younger African American women disappeared with socioeconomic adjustment.

CONCLUSIONS: Growth …

Welfare-To-Work Programs In America, 1980 To 2005: Meta-Analytic Evidence Of The Importance Of Job And Child Care Availability, Kevin M. Gorey

Social Work Publications

This meta-analysis extended a Campbell Collaboration review of welfare-to-work programs. Its synthesis of 65 randomized trials in America over the past generation replicated a small overall intervention effect. Moreover, it found (1) there was no long-term employment effect of interventions in areas where jobs were relatively unavailable, and (2) programs that provided child care were more effective than those that did not in the short and long term, even in areas of high labor market withdrawal. The availability of jobs as well as such supports as child care that enable their access seem to be key elements of welfare-to-work programs …

Lower Adherence To Screening Mammography Guidelines Among Ethnic Minority Women In America: A Meta-Analytic Review, Rebecca J. Purc-Stephenson, Kevin M. Gorey

Social Work Publications

OBJECTIVE: This study investigates the association between ethnic minority status and receiving a screening mammogram within the past 2 years among American women over 50.

METHOD: The findings from 33 studies identified from interdisciplinary research databases (1980 to 2006) were synthesized. Separate pooled analyses compared white non-Hispanics to African Americans (28 outcomes), Hispanics (18 outcomes), and Asian/Pacific Islanders (10 outcomes).

RESULTS: Using the random effects model, results showed that African Americans were screened less than white non-Hispanics at a marginal level (OR 0.87, 95% CI 0.75, 1.00). Larger and significant discrepancies were observed for Hispanics (OR 0.65, 95% CI 0.50, …

Cancer Survival In Ontario, 1986-2003: Evidence Of Equitable Advances Across Most Diverse Urban And Rural Places, Kevin M. Gorey

Social Work Publications

OBJECTIVES: This study examined whether place and socio-economic status had differential effects on the survival of women diagnosed with breast cancer in Ontario during the 1980s and the 1990s.

METHODS: The Ontario Cancer Registry provided 29,934 primary malignant breast cancer cases. Successive historical cohorts (1986-1988 and 1995-1997) were, respectively, followed until 1994 and 2003. Diverse places were compared: the greater metropolitan Toronto area, other cities, ranging in size from 50,000 to a million people, smaller towns and villages, and rural and remote areas. Socio-economic data for each woman's residence at the time of diagnosis were taken from population censuses.

RESULTS: …

Social Assistance And The Challenges Of Poverty And Inequality In Azerbaijan, A Low-Income Country In Transition Special Issue With Coping With Poverty, Nazim N. Habibov, Lida Fan

Social Work Publications

Although low-income countries in transition are facing the challenges of poverty and inequality, evidence on the performance of safety nets in these countries is scarce. This article uses micro-file data from a nationally representative household budget survey to analyze the existing social assistance programs in Azerbaijan, a low income country in transition, from the perspectives of poverty and inequality reduction. The empirical evidence presented in this paper indicates that the poverty and inequality reduction effectiveness of social assistance programs is inadequate. First, the benefits are very modest and the poor receive only a small proportion of them. Second, some programs …

An International Comparison Of Breast Cancer Survival: Winnipeg, Manitoba And Des Moines, Iowa, Metropolitan Areas, Kevin M. Gorey

Social Work Publications

PURPOSE: Extending previous Canadian-United States cancer survival comparisons in large metropolitan areas, this study compares breast cancer survival in smaller metropolitan areas: Winnipeg, Manitoba and Des Moines, Iowa.

METHODS: Manitoba and Iowa cancer registries, respectively, provided a total of 2,383 and 1,545 women with breast cancer (1984 to 1992, followed until December 31, 1997). Socioeconomic data for each person's residence at the time of diagnosis was taken from population censuses.

RESULTS: Socioeconomic status and breast cancer survival were directly associated in the US cohort, but not in the Canadian cohort. Compared with similar patients in Des Moines, residents of the …

The Effectiveness Of Feminist Social Work Methods: An Integrative Review, Kevin M. Gorey

Social Work Publications

This integrative review of the effectiveness of feminist social work methods compared 35 independent studies of feminist interventions with 44 independent studies of social work practice that were based on other theoretical orientations. Feminist interventions were observed to be more effective than those based on other practice models. And among feminist social work interventions, radical methods seemed to be more effective than liberal methods. These findings are consistent with a theory by target system interaction that was suggested by a previous meta-analysis (Gorey, Thyer, & Pawluck, 1998). While personal theoretical orientations such as cognitive-behavioral modes of practice seem more supportive …

Early Childhood Education: A Meta-Analytic Affirmation Of The Short- And Long-Term Benefits Of Educational Opportunity, Kevin M. Gorey

Social Work Publications

Some scholars who emphasize the heritability of intelligence have suggested that compensatory preschool programs, designed to ameliorate the plight of socioeconomically or otherwise environmentally impoverished children, are wasteful. They have hypothesized that cognitive abilities result primarily from genetic causes and that such environmental manipulations are ineffective. Alternatively, based on the theory that intelligence and related complex human behaviors are probably always determined by myriad complex interactions of genes and environments, the present meta-analytic study is based on the assumption that such behaviors can be both highly heritable and highly malleable. Integrating results across 35 preschool experiments and quasi-experiments, the primary …

An International Comparison Of Cancer Survival: Metropolitan Toronto, Ontario, And Honolulu, Hawaii, Kevin M. Gorey

Social Work Publications

OBJECTIVES: Comparisons of cancer survival in Canadian and US metropolitan areas have shown consistent Canadian advantages. This study tests a health insurance hypothesis by comparing cancer survival in Toronto, Ontario, and Honolulu, Hawaii.

METHODS: Ontario and Hawaii registries provided a total of 9190 and 2895 cancer cases (breast and prostate, 1986-1990, followed until 1996). Socioeconomic data for each person's residence at the time of diagnosis were taken from population censuses.

RESULTS: Socioeconomic status and cancer survival were directly associated in the US cohort, but not in the Canadian cohort. Compared with similar patients in Honolulu, residents of low-income areas in …

Prevalent Low Income Status In Canadian And United States Metropolitan Areas, 1980 And 1990, Kevin M. Gorey

Social Work Publications

As compared to Toronto’s poor people, three to four-fold as many of upstate New York’s poor live in severely impoverished neighborhoods, areas where 40% or more of the residents have annual incomes below the federally established low income or poverty criterion. However, the prevalence of such extremely degraded living conditions increased similarly (two-fold) on both sides of the Canadian-US border during the 1980s. This urban problem, of the concentration of poor people, seems to predominantly be an inner-city problem in the US, whereas it was found to be nearly equivalently extant in the inner-city, mid-suburban and outlying suburban areas of …

Differential Effectiveness Of Prevalent Social Work Practice Models: A Meta-Analysis, Kevin M. Gorey, Bruce A. Thyer, Debra E. Pawluck

Social Work Publications

This meta-analysis of 45 recently published (1990–1994) independent studies of social work's differential effectiveness by prevalent practice models builds on the more general findings of related meta-analyses that have estimated that three-quarters of the clients who participate in social work interventions do better than the average client who does not. It found that the effectiveness of interventions based on different practice models—personal versus systemic-structural—was moderated by their primary focus for change. When the focus for change was clients themselves, personal orientations seemed more effective, whereas systemic-structural models were found to be more effective in supporting the change of other targets, …

The Effectiveness Of Social Work With Older People And Their Families: A Meta-Analysis Of Conference Proceedings, Amanda M. Grenier, Kevin M. Gorey

Social Work Publications

No abstract provided.

Secular Trends In The Incidence Of Anorexia Nervosa: Integrative Review Of Population-Based Studies, Kevin M. Gorey

Social Work Publications

OBJECTIVE AND METHOD: Aggregating across retrospective cohort samples, this integrative review synthesizes the findings of 12 cumulative incidence studies (45 hypotheses) on anorexia nervosa secular trends.

RESULTS: (1) The female/male anorexia incidence rate ratio was estimated to be 8.20, 18.46 versus 2.25 cases per 100,000 per year, p < .05; (2) female teenagers experienced anorexia at a rate fivefold greater than other women, 50.82 versus 10.37 incident cases per 100,000 per year, p < .001; (3) no secular trend or change in the incidence of anorexia was observed among teenagers, while a near threefold increase was observed over the past 40 years among women in their 20s and 30s, 6.28 (1950-1964) versus 17.70 (1980-1992) cases per 100,000 per year, p < .05; and (4) the two cohort characteristics of age, and the age by year interaction accounted for nearly two thirds of the variability among anorexia incidence estimates, R2 = .614, F(2,27) = 21.49, p < .001. After the two factors of age and the Age x Year interaction were accounted for, none of the other study characteristics, including study year(s), were found to be significantly associated with anorexia incidence, that is, a main effect of time was not observed.

DISCUSSION: The integrative evidence across the population-based epidemiologic studies covering 40 years in this field suggests strongly that, overall, the incidence of anorexia nervosa, particularly among those very young women at greatest risk of experiencing it, has not increased significantly. However, the risk does seem to have increased significantly among women in …

Effectiveness Of Case Management With Severely And Persistently Mentally Ill People, Kevin M. Gorey

Social Work Publications

This meta-analytic review synthesizes the findings of 24 published studies dealing with the effectiveness of case management with the severely and persistently mentally ill. Summative findings were: (1) Overall, case management interventions are effective--75% of the clients who participate in them do better than the average client who does not; (2) The estimated preventive fraction (e.g., prevention of re-hospitalization) among clients who experience relatively intense case management service (case loads of 15 or less, 89%) is nearly 30% greater than that estimated among similar clients receiving less intensive service; and (3) Various case management practice models did not differ significantly …