Medicine and Health Commons^™

Predicting Education-Job Mismatch And Its Consequences For A Cohort Of American Workers, Emily J. Orr

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This paper considers the income and health consequences of education-job mismatch for a cohort of workers. Education-job mismatch is common, but there is little research on how it is related to outcomes for workers. This study uses longitudinal data from the U.S. Panel Study of Income Dynamics (PSID) to examine education-job mismatch over a significant portion of the work life course – early career, between ages 25 and 35, and mid-career. Findings suggest that gender, race/ethnicity, and occupational sector are important predictors of experiencing education-job mismatch. Men, African Americans, and workers in office-administrative occupations were more likely to experience mismatch. …

Science And Sex Testing: The Beginnings Of A Female Testing Discourse, Camille M. Croteau

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In the 1960s, the International Olympic Committee (IOC) sanctioned testing to verify the sex of elite female athletes. Sex tests, as they were called, did not extend to male athletes, and they have tended to rely on appearance and performance alone. Now measuring testosterone levels, the Eligibility Regulations for the Female Classification scrutinizes female athletes far more than male athletes. This dissertation contributes to the sex testing literature by investigating three under-explored avenues: the history of the sex testing sports medical literature, a medical discourse analysis of IOC documents based on the implementation of sex testing, and a critical feminist …

The Impact Of Ethnicity And Immigration On Prostate Cancer Mortality In Canada, Noah Stern

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Despite the prevalence of prostate cancer its pathogenesis remains unclear. Marked differences in mortality rates have been observed between countries, however, it is unclear whether the source of the observed differences is driven by underlying genetics, geographic, or social factors. This thesis investigated the impact of ethnicity and immigration on prostate cancer mortality in Canada using the Canadian Census Health and Environment Cohort. South Asian and East Asian men were seen to be at decreased risk of prostate cancer mortality, while no increased risk was observed in black men. These results affirm studies showing lower risks in Asian men; however, …

Pregnancy In Peril: The Impact Of Conflict On Antenatal Care And Skilled Birth Attendant Utilization In The Democratic Republic Of The Congo And Burundi, Bianca R. Ziegler

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As of 2019, over two billion people globally reside in conflict-affected areas, and as a result, face negative health implications. Burundi and the Democratic Republic of the Congo are among those countries classified as fragile and conflict-affected situations, resulting in disproportionally high maternal mortality rates. Grounded in Andersen’s Model of Healthcare Utilization, this thesis employed multivariate binary logistic regressions to examine factors which influence antenatal care and skilled birth attendant usage in these two countries. Findings indicate that women living in high conflict regions were significantly less likely than those in low conflict regions to have their first antenatal care …

Hegemonic Masculinity And The Ideal Male Hockey Player: The Constructions Of Nhl Injuries In Popular Canadian Newspapers, 2016-2017, Rachelle Miele

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This study critically examines the constructions of men’s hockey injuries in five popular Canadian newspapers published during the 2016-2017 NHL season. I draw on feminist theory and social constructionism and conduct a critical discourse analysis of 199 newspaper articles to examine media narratives, understand taken-for-granted assumptions about men’s hockey injuries and masculinities, and capture the role of language in producing, reproducing, and challenging hegemonic masculinity. I argue that the injury discourse, which constructs men’s injuries, the body, and male hockey players, is rooted in hegemonic masculinity. Specifically, I find that these discursive constructions include: the normalization of injuries as part …

In Search Of Psychiatric Kinds: Natural Kinds And Natural Classification In Psychiatry, Nicholas Slothouber

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In recent years both philosophers and scientists have asked whether or not our current kinds of mental disorder—e.g., schizophrenia, depression, bipolar disorder—are natural kinds; and, moreover, whether or not the search for natural kinds of mental disorder is a realistic desideratum for psychiatry. In this dissertation I clarify the sense in which a kind can be said to be “natural” or “real” and argue that, despite a few notable exceptions, kinds of mental disorder cannot be considered natural kinds. Furthermore, I contend that psychopathological phenomena do not cluster together into kinds in the way that paradigmatic natural kinds (e.g., chemical …

The Canadian Urban - Rural Health Disparity: The Role Of Health Lifestyles And An Alternative Explanation For Rurality's Higher Bmi Rates, Matthew J. Stackhouse

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The Canadian urban - rural health disparity is concerning, as rural residents are more likely to experience deleterious health outcomes such as injuries, chronic conditions, obesity, and shorter life expectancy. There are several rural social-structural explanations for the disparity such as an aging population, less education attainment, greater unemployment rates, poorer working conditions, lack of health professionals, greater distance from quality health resource, and poorer health behaviours. Some of these findings have been linked to higher Body Mass Index (BMI) scores in rural areas. However, no study has considered the health lifestyle differences of urban - rural Canadians and how …

Informing Care: Mapping The Social Organization Of Families’ Information Work In An Aging In Place Climate, Nicole K. Dalmer

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Within an institutional ethnography method of inquiry, this dissertation makes visible the information work that permeates the care work of families of people living with dementia who are also aging at home. An institutional ethnography privileges people’s everyday work and acknowledges that local contexts are influenced by translocal, ruling relations. To map out the social organization of family caregivers’ information work, this dissertation details four separate, yet interrelated studies. The first study comprises two sets of interviews: one with 13 family caregivers of older adults to understand their experiences of the information work they do and a second with five …

Oral Health, Dental Insurance Coverage, And Preventive Dental Care Utilization: The Case Of Immigrants In Canada, Yujiro Sano

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Oral health is essential for social, economic, and psychological well-being. Yet, we know very little about oral health among adult immigrants in Canada. Framing oral health as determined by a wide range of social, economic, cultural, and political conditions, three integrated articles in this dissertation aim to understand how some adult immigrants potentially experience disadvantages in accessing optimal oral health, dental insurance coverage, and preventive dental care utilization, due to their vulnerable positions in Canada.

Using the Canadian Community Health Survey (CCHS), the first article examines whether the ‘healthy immigrant effect’ extends to self-rated oral health in Ontario, Canada. Findings …

Cumulative Childhood Adversity And Disparities In Adult Psychological Distress And Educational Attainment, Loanna Heidinger

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Exposure to childhood adversity often does not occur as an isolated experience; rather, adverse childhood circumstances tend to co-occur, resulting in a climate of disadvantage that has detrimental consequences, and contributes to disparities in adult outcomes. Although the enduring impacts of cumulative childhood adversity on adult mental health and attainment outcomes are well documented in the literature, studies have not accounted for the long-term impact of cumulative childhood adversity on trajectories of adult psychological distress. Furthermore, measures of adversity used to predict selection into higher education consistently focus on childhood economic hardship as the sole indicator of adversity and overlook …

The ‘Meanings’ And ‘Enactments’ Of Science And Technology: Ant-Mobilities’ Analysis Of Two Cases, Farrukh Chishtie

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In this work I study two cases involving practices of science and technology in the backdrop of related and recent curricular reforms in both settings. The first case study is based on the 2005 South Asian earthquake in Muzaffarabad, Pakistan which led to massive losses including large scale injuries and disabilities. This led to reforms at many levels ranging from disaster management to action plans on disability, including educational reforms in rehabilitation sciences. Local efforts to deal with this disaster led to innovative approaches such as the formation of a Community Based Rehabilitation (CBR) model by a local NGO, which …

Accessing Healthcare In Ontario: Influences On Utilization Among Asian Immigrant Women, Gwynne Ng

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Previous research on immigrant integration has tended to focus on economic and social integration. As such, the factors shaping health integration are less understood. At the same time, health researchers suggest that immigrants in Canada may underutilize certain health services. For instance, studies have documented the low participation rates of cervical cancer screening among Asian immigrant women in Canada (Xiong, Murphy, Matthews, Gadag, & Wang, 2010; McDonald & Kennedy, 2007; Woltman & Newbold, 2007). This study sheds light on immigrant integration by exploring the experiences of Asian immigrant women with cervical cancer screening and Canadian healthcare services more broadly. Through …

The Impact Of Beauty, Body Image, And Health Discourses On Eating Disorder Risk In South Asian-Canadian Women, Nazia Bhatti

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This study explores socio-cultural influences that impact South Asian women’s self-perceptions and eating behaviours. The findings revealed that cultural gender ideologies played a substantial role in shaping the way women view themselves and their bodies. The analysis of interviews conducted with seven South Asian-Canadian women between the ages of 19-29 years, demonstrate that women’s perceptions of their own physical appearance is framed within the context of their South Asian cultural identity and cultural norms. This study was approached through the lens of post-colonial feminism by examining cultural factors that contribute to South Asian women’s increased risk for developing eating disorders. …

Transnational Engagement And Immigrants’ Well-Being In Canada, Jonathan Anim Amoyaw

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After migration, most immigrants do not dissociate themselves from their relational networks in their homeland. Instead, they nourish, reproduce, and maintain ties with their non-migrant relatives and friends by engaging in various forms of transnational activities. Within the transnational paradigm, remittances are central to maintaining transnational relationships. Immigrants’ demonstration of affection and solidarity in the absence of physical propinquity and intimacy is highly contingent on their remittance transfers. Over the years, the motives, determinants, benefits, and consequences of these financial flows on the well-being of recipients in origin communities have been extensively studied. However, the existing literature is mainly informed …

Visualizing And Interacting With Social Determinants Of Health, Moutasem Zakkar

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Purpose: The purpose of this study is to examine the use of information visualization to represent specific social determinants of health, and to examine the benefits of such representation for health policymaking. Methods: The study developed a prototype for a visualization tool (www.healthvisualization.ca), which represents the conceptual framework for the social determinants of health (CSDH) and new ways to represent related health equity indicators. This tool was used by study participants. The experience of these participants and the usability of the tool were evaluated using qualitative semi-structured interviews. Results: Visualizing the CSDH framework helps to present the social …

Gender And Health Over The Life Course: Temporal, Contextual, And Intersectional Considerations, Nicole Etherington

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Research has continuously demonstrated differences in health between men and women and emphasized a “gender paradox” whereby women live longer than men, but have higher rates of morbidity. Still, relatively little attention has been given to the underlying mechanisms and processes involved within groups of women and men that may provide greater insight into the patterns of health experienced among each group rather than simply between them. Specifically, there has been an over-reliance on cross-sectional and retrospective data; inattention to multiple resources and health conditions; limited consideration of various age ranges and time spans; and an over-emphasis on comparing women …

Children's Mental Health Over The Early Life Course: The Impact Of Economic Resources, Neighborhood Disorder, And Family Processes, Jinette M. Comeau

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Drawing upon a stress process and life course framework, and using data from the Child Supplement of the National Longitudinal Survey of Youth, the three papers presented in this dissertation examine the extent to which economic resources, neighborhood disorder, and family processes influence children’s trajectories of mental health.

In the first paper, I empirically construct six categories that represent children with comparable profiles of family income over time: increasing, decreasing, fluctuating, and stability across low-, medium-, and high-income families. The income categories are incorporated in multiple group latent growth curve models to assess the extent to which they initiate and …

Knowledge Translation And The Governance Of Health Research In Canada: A Critical Discourse Analysis, Kathleen S. Ellis

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Knowledge translation (KT) is a dominant discourse in the governance of health research in Canada. I critically examine the KT discourse of the Canadian Institutes of Health Research (CIHR), Canada’s major health research funder. Informed by a governmentality perspective, I explore how the KT discourse operates to shape the directions of health research and the activities of health researchers using critical discourse analysis with a sample of publicly available CIHR documents.

This KT discourse is constructed through three rationales: a “gap” between knowledge creation and its application; financial and health care accountabilities for public investment in health research; and, the …

Examining Contextual Factors And Resilience In Adolescents Who Faced Adversity As Children, Veronica Zapotoczny

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The subject of mental health has increasingly become a topic of discussion as individuals advocate for recognition of this health issue. Early childhood adversity is often associated with mental health problems amongst adolescents, however, many do not succumb to these experiences and instead have resilient health outcomes. This study utilized data from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) to analyze the relationship between early adversity and adolescent mental health, how social context may mediate this association, and finally, what factors are associated with mental health resilience. It was found that many at risk children had positive health …

Children's Mental Health, Yvonne A. Asare-Bediako

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The study of children’s mental health has largely been the domain of developmental psychologists and psychiatrists. These studies focus on parental mental health, and examine its direct and indirect effects, through a family’s psychosocial environment. Relatively little attention is given to socio-structural factors. By contrast, the sociology of mental health focuses on such structural factors as poverty and income, examining the extent to which stressors and strains may pattern the effects of these factors on children’s psychopathology. Adding to the divergence in research is the use of maternal reports in the assessment of children’s mental health. These reports often reflect …

Risk Factors For Diabetes Mellitus: A Comparative Analysis Of Subpopulation Differences In A Large Canadian Sample, Michael James Taylor

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Objectives: Certain Canadian subpopulations observe numerous modifiable and non-modifiable risk factors for diabetes. This study compares immigrants and Aboriginals (First Nations, Inuit, and Métis) with Canada-born individuals at higher risks for diabetes, and deciphers the determinant differences between them.

Methods: Pooled Canadian Community Health Survey data (2001-2010) were used. Time trends for diabetes within each subsample were calculated using individual survey year prevalence rates; diabetes diagnoses were self-reported (N=33,565). Various risk factors were also examined using logistic regression.

Results: Diabetes prevalence rates significantly increased from 2001 to 2010 for each subpopulation, as well as the total sample: Canada-Born individuals (3.9% …

Exploring Parental Experiences And Decision-Making Processes Following A Fetal Anomaly Diagnosis, Ramona L. Fernandez

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Often the first indication that something may be wrong in a seemingly normal pregnancy occurs during the first detailed ultrasound appointment between 16 and 20 weeks gestation. Even the most tentative suspicions of fetal anomalies is jarring. Parent’s default reality of a normal pregnancy and a ‘perfect child’ changes to one of risk factors and the possibility of an ‘unhealthy child’. This study begins with the realization of this first loss in a series of losses that follow for parents as they grapple with diagnostic information to be able to make informed medical decisions regarding their fetus and pregnancy. The …

Health Implications Of A Delayed Transition Into Adulthood, Lisa K. Zaporzan

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This thesis considers mental and physical health outcomes experienced by young adults who live in their parents’ home during young adulthood. The life course perspective suggests that this “off-time” transition may lead to stigmatization and stress, and subsequently, health problems. This research uses the National Longitudinal Study of Adolescent Health (Add Health), a nationally representative longitudinal sample of adolescents living in the United States. Wave four was primarily used, during which respondents are between 25-34 years of age (N=2776).

Although living with parents did not significantly increase CES-D or BMI, findings suggest CES-D was affected for those who have physical …

"Proving Yourself" In The Canadian Medical Profession: Gender And The Experiences Of Foreign-Trained Doctors In Medical Practices, Vanessa Noelle Dolishny

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In recent years the medical profession has become feminized. Additionally, there has been an increased representation of foreign-trained professionals in the Canadian medical profession; many of which are women. Thus, there is a significant number of female medical practitioners who are foreign-born and foreign-trained. This demographic faces many barriers, which are often characterized as a “double disadvantage”. This paper investigates the experiences of foreign-trained medical professionals once they have gained access to the profession and whether the feminization of medicine has impacted the experiences of these individuals. Immigrant status was found to be highly significant to one’s experiences in the …

A Life Course Investigation Of The Differences In Psychological Distress Of Mothers By Family Structure Trajectories, Jason Novick

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The purpose of this thesis is to examine the relationships between family structure, employment patterns, and mental health among mothers using the life course perspective. The Single Parent Family Data Set conducted in London, Ontario, Canada by Avison et al. (2008) is used for this research. The sample consists of 349 single mothers and 430 married mothers. The Center for Epidemiologic Studies Depression Scale (CES-D) is used as a measure of psychological distress. This thesis reveals significant differences in levels of psychological distress by family structure trajectory. In addition, the employment patterns of single mothers are more likely to be …

Fall-Related Stigma In Older Adulthood: A Mixed Methods Approach To Understanding The Influence Of Stigma On Older Adults' Reported Attitudes And Behaviours Regarding Falls, Heather M. Hanson

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Falls during older adulthood present a major threat to the health and wellbeing of older adults and a challenge to society. While effective fall prevention strategies have been developed to address risk factors for falls, older adults commonly resist participation in such programming and dissociate from the topic of falls in general. After reviewing research findings and the theoretical literature, support was found for approaching falls as a stigmatizing topic for older adults. Three mixed methods experiments were completed to test the influence of stigma on older adults‟ attitudes, opinions, and behaviours. Experiments 1 and 2 tested the labelling aspect …