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Keep talking about it: HIV/AIDS-related communication and prior HIV testing in Tanzania, Zimbabwe, South Africa, and Thailand.
AIDS and Behavior. 2009 Dec; 13(6):1213-21.Informal, interpersonal communication within a community about HIV and AIDS, or lack of such communication, may influence community members' uptake of voluntary counseling and testing. Drawing from Noelle-Neumann's spiral of silence theory, this study examined the association between communication about HIV/AIDS and prior HIV testing in communities in Tanzania, Zimbabwe, South Africa, and Thailand. Participants (N = 14,818) in 48 communities across five sites throughout the four countries completed a behavioral survey assessing communication, prior voluntary counseling and testing (VCT) uptake, social norms, stigma, and sexual risk. Site-specific logistic regression models demonstrated that frequent conversations about HIV were significantly associated with prior HIV testing at every site. Odds ratios for each site ranged from 1.885 to 3.085, indicating a roughly doubled or tripled chance of past VCT uptake. Results indicate that verbal communication may be an important mechanism for increasing health behaviors and inclusion in future interventions should be considered.
Sexually Transmitted Infections. 2009 Feb; 85(1):65-69.Objectives: To design and assess HIV and homosexuality related stigma scales in a developing world context. Methods: A respondent-driven sampling survey was conducted among 351 men who have sex with men (MSM) in Shenzhen, China. Exploratory and confirmatory factor analyses were used to examine and determine the latent factors of stigma subscales. Results: Factor analyses identified three subscales associated with homosexuality and HIV stigma: public homosexual stigma (10 items), self homosexual stigma (8 items) and public HIV stigma (7 items). There were no items with cross-loadings onto multiple factors, supporting the distinctness of the constructs that these scales were meant to measure. The fit indices in confirmatory factor analysis provide evidence for the hypothesised three-factor structure of associations (the x2/degree ratio=1.84, CFI=0.91, RMSEA=0.05 and SRMR=0.05). Reliability of the three scales was excellent (Cronbach's alpha: 0.78-0.85) and stable across split samples and for the data as a whole. Conclusions: The selection of three latent factors was supported by both psychometric properties and theories of stigmatisation. The scales are brief and suitable for use in developing countries where less time-consuming measurement is preferable.
Indian Journal of Medical Ethics. 2009 Jan-Mar; 6(1):5-6.This editorial examines the issue of male circumcision (MC) in India and discusses doctor's challenges' with the question,"Doesn't the public have the right to know that male circumcision protects against HIV?" It describes the reluctance of the Government of India to disclose this information due to the controversy that may erupt between conservative Hindus and the Muslims in the country in which male circumcision is a marker of religious identity.
A community-based bacteriological study of quality of drinking-water and its feedback to a rural community in western Maharashtra, India.
Journal of Health, Population and Nutrition. 2008 Jun; 26(2):139-150.A longitudinal study of the bacteriological quality of rural water supplies was undertaken for a movement towards self-help against diseases, such as diarrhoea, and improved water management through increased community participation. Three hundred and thirteen water samples from different sources, such as well, tank, community standpost, handpumps, percolation lakes, and streams, and from households were collected from six villages in Maharashtra, India, over a one-year period. Overall, 49.8% of the 313 samples were polluted, whereas 45.9% of the samples from piped water supply were polluted. The quality of groundwater was generally good compared to open wells. Irregular and/or inadequate treatment of water, lack of drainage systems, and domestic washing near the wells led to deterioration in the quality of water. No major diarrhoeal epidemics were recorded during the study, although a few sporadic cases were noted during the rainy season. As a result of a continuous feedback of bacteriological findings to the community, perceptions of the people changed with time. An increased awareness was observed through active participation of the people cutting across age-groups and different socioeconomic strata of the society in village activities. (author's)
Fertility concern in Finland and Russia: Economic thinking and ideal family size in the rhetoric of population polices.
Finnish Yearbook of Population Research. 2008; 43:63-84.This article deals with fertility concern in Russian and Finnish population policies. The article points out that some commonly known discourses are persistently used as arguments in fertility-related population policies. In Finland, these include, for instance, discourses on "ageing nation" and "economic competitiveness". Russian policymakers use a "crisis discourse" that consists of three sub-discourses: "demographic crisis", "reproductive health in crisis" and "family crisis". The Russian government implements pronatalist population policies, whereas Finnish authorities hesitate to use the term "population policy" because of its emphasis on reproductive rights on the one hand, and the negative associations of population policy on the other. Russia has both population and family programs, as well as a new law with a specifically pronatalist emphasis. Conversely, Finland uses family policy as a tool of population policy. (author's)
Indian Journal of Community Medicine. 2006 Jan-Mar; 31(1): p..'Lack of sex education in Indian schools affects mental/ psychological development of children negatively' -- This view is being expressed emphatically nowadays by external experts. The irony of the situation is that Indian experts are agreeing to this without so much of giving it a thought. As Dr. Srivastava, a psychology faculty in an Indian university opines, 'if we consider this advice in context of Indian culture... we can conclude that possibly ... our country at least does not need it (sex education)'. Reportedly, many teachers are opposed to the idea while simultaneously others are strongly advocating it. In view of the controversy pertaining to the subject it is important that various issues pertaining to sex education are clarified. Firstly, it is important to know the aims and objectives of introducing the subject of sex education in school curricula. Very often, people advocate sex education saying that it will help in controlling AIDS and in reducing adolescent pregnancies and the incidents of sexual assaults on women. Such statements are misleading and are based on false assumptions. These false promises (and premises), may lead to frustration in future. Because if it had been so, there would have been no such problem in western countries which have an elaborate system of sex education in schools. We all know that sexual promiscuity and homosexuality is widely prevalent in countries like USA where family as an institution is broken and many experimental family systems exhorting free sex have been tried. Even AIDS originated from there. Thus, sex education is not a proven guarantee against spread of AIDS and should not be promoted with such an aim. (excerpt)
Human Development Legislator. 2001 Aug; 11(7):14-15.The public's perceptions and endorsement of certain issues affect the enactment of proposed policy measures. Therefore, in any advocacy endeavor, efforts are made to influence public opinion. In order to gain public support, it is essential that the public be made aware of how the issue would directly affect their lives. Thus, PLCPD launched Talkpoint Radio in recognition of broadcast media's effectiveness in reaching the public. By informing the public on population and human development issues through Talkpoint Radio, PLCPD aims to raise public awareness and critical thinking on the said issues, and consequently, public support for these areas of advocacy as well. The radio production is part of a three-year communications and research project titled "Involving Legislators in Informing the Public on Reproductive Health Issues," with funding assistance from the Ford Foundation. Talkpoint Radio Talkpoint Radio started broadcast in August 1999 to become the first and only human development, population, and reproductive health-centered radio program in the country. Talkpoint began as a special segment in Womantouch, a daily radio program in DZRM that tackles gender issues. Talkpoint served as a medium for meaningful debate and interactive discussions on reproductive health, population, and human development issues, as well as a source of news on legislative and civil society advocacy efforts. (excerpt)
Comparison of knowledge, attitudes, experience, and opinions between teachers and guardians regarding the emergency contraceptive pill in Chiang Mai, Thailand.
Nursing and Health Sciences. 2006 Mar; 8(1):27-35.Teachers and guardians (parents or authorized persons) are expected to collaborate in educating female students about emergency contraceptive pills (ECPs) but it is unknown whether they have similar perspectives on ECPs. This study aimed to compare their knowledge, attitudes, experience, and opinions regarding ECPs. Questionnaires were distributed to 720 female teachers and guardians of eight randomly selected high schools and vocational schools in Chiang Mai, Thailand. There were significantly more teachers who knew about the existence of ECPs than guardians. More guardians reported some accurate information regarding ECPs than did teachers. More teachers than guardians believed that the use of ECPs was not morally wrong. Both teachers and guardians had similar experience with ECP use and similar agreement in teaching female adolescents about ECPs. The teachers and guardians had some different opinions on teaching barriers. It is suggested that both teachers and guardians are suited to teach female adolescents about ECPs, but they need preparation in different aspects. (author's)
Human Development Legislator. 2000 Oct-Dec; I Spec No(2-3):48-55.This December 2000 Ulat ng Bayan Survey of 1,200 adults ( i.e., 18 years old and above) was conducted to examine the perceptions of Filipinos as regards family planning (FP) and population issues. The examination scheme intended to link such perceptions to the peculiarity of elections in the Philippines and assess the electorate's impression of the electoral candidates' support to population and family planning programs. (excerpt)
Asian Journal of Women's Studies. 2004 Sep 30; 10(3): p..This study seeks to examine the responses of the newspaper media towards two Indian women politicians and the processes of gender construction in political communication. Under a system of universal adult suffrage and the constitutional assurance of social, political and economic equality, Indian women were given rights that were the envy of women in more advanced nation states. Political parties that should play a crucial role in training and encouraging women to enter the public arena are hostile, generally dosing the gates of the upper echelons of party structures to aspiring or deserving women. How are such women viewed by society and how do the media present them? It is within this background that this paper examines the portrayal of two women politicians, that is, Jayalalitha Jayaram and Sushma Swaraj in the Indian English language press in the pre-election period of January and February 1998. Jayalalitha appeared as a calculating, opportunistic, extremely corrupt, and arrogant leader, while Sushma Swaraj was identified with a clean image and one who fulfilled traditional norms and expectations of feminine identity. The particular construction of this frame of `ideal/good woman' and `bad woman' needs to be explored within the discourses of India's colonial and nationalist past, wherein women were perceived as representatives of the `private' and their feminine virtues were perceived to be the essence of the nation. (author's)
Asian Journal of Women's Studies. 1999 Mar 31; 5(1): p..For many centuries, the kitchen has been regarded as the world of women. However, it has gradually become a world of both men and women. Changes in women's roles in the kitchen reflect the transforming social position of women. Accordingly, change in men and women's performance of housework mirrors a shift in the sexual division of labor. This is accompanied by changed attitudes as well. For example, according to one investigation made by the undergraduates of the university where Ms. Wang works, only 28 percent of the women undergraduates agreed with the proposition: "A woman should try her best to be a good wife and mother, whether or not she is successful in her career." This percentage is much lower than that of women of Ms. Wang's generation. Moreover, Ms. Wang's daughter, [Lian Lian], who is much younger than the undergraduates, not only has a great longing for advanced kitchen facilities in the future, but has her own views about cooking and housework. When asked if in the future, she would like to prepare meals for the whole family as her mother has done, Lian Lian replied definitely: "I would not like to." Lian Lian likes to play with one of the boys in her class, and she once told her mother: "If I get married to him in the future, I will be a very lucky girl, because his father is a chef, and I may not have to cook much then." (author's)
SAIS Review. 2004 Summer-Fall; 24(2):9-25.Russia is at the brink of a steep demographic decline--a peacetime population hemorrhage framed by a collapse of the birth rate and a catastrophic surge in the death rate. The following pages will attempt to demonstrate that post-Communist Russia is today beset by what may fairly be characterized as severe, dramatic, and even critical population problems. Russian social conditions, economic potential, military power, and international influence are today all subject to negative demographic constraints--and these constraints stand only to worsen over the years immediately ahead. Altering Russia's demographic trajectory would be a formidable task under any circumstances. Unfortunately, as of yet, neither Russia's political leadership nor the voting public that sustains it have really even begun to address the enormous magnitude of the country's demographic challenges. (author's)
Israel Affairs. 2005 Jan; 11(1):117-136.Analysis of the integration of immigrants from the FSU is complicated from both theoretical and empirical points of view. First, Israel is at a turning point. The current wave of immigration began at a time when the country was undergoing change. Israeli society is less collectivist and more individualistic than in previous decades, less Zionist, less idealistic and more pragmatic. The economy is less rigidly structured. In other words Israel has become socially, culturally and economically diverse. As a result there are more communities and more identities within the territorial and political entity. Second, most paradigms for the integration of immigrants deal with immigrants moving from non-developed countries to developed countries. In contrast, the case of Russian immigration to Israel is in a sense a Brain Drain of educated people from Russia. Third, in most immigration countries the immigrants are a small minority. In Israel Russian immigrants make up 20 per cent of the population. Three factors account for the integration of Russian immigrants in Israeli society: policies, climate of opinion and the immigrants' ability to organize themselves. Analysis of the interplay between the three factors reveals that the different factors are pushing in different directions. The official policies encourage assimilation. The climate of opinion, especially in some sectors of the Israeli society, creates among many immigrants the feeling that they are not welcomed by Israeli society, and the ability of the community to organize itself is pushing, sometimes, towards segregation of the community. The main conclusion of this article is that it is impossible to identify models of integration. We have to try to identify scripts which are more fluid than models. There are four main scripts of integration of Russian immigrants: Assimilation Script, Separation Script, Transnational Script and Hybridity Script. None of these scripts is dominant; they can coexist with one another. (author's)
Connections. 2006 Jan;  p.Public opinion surveys in Russia indicate that a majority of Russians believe more attention should be given to HIV/AIDS and that the media can be an effective vehicle for promoting greater awareness of the issue, according to a July 2005 survey released by Transatlantic Partners Against AIDS (TPAA). The survey, which polled a nationally representative sample of Russian adults aged 18 to 50, also indicates that 84 percent of respondents believe that the number of Russians living with AIDS has increased during the past five years, 70 percent believe that AIDS is not receiving enough public attention, and 78 percent view mass media as an instrumental component in the fight against AIDS. This survey is reflective of official AIDS statistics, which estimate that 800,000 to 1.5 million Russians may be living with HIV/AIDS, according to TPAA. The organization also reports that AIDS has been particularly devastating to younger generations, with men and women under the age of 30 accounting for 80 percent of all registered cases of HIV. This finding is critical because it raises serious health concerns for the future of an already declining Russian population. (excerpt)
Reproductive Health Matters. 2004; 12 Suppl 24:157-166.Discourse on abortion rights inevitably centres on the fetus, and is often framed around the dichotomy of ''pro-life'' vs. ''pro-choice'' positions. This dichotomy is not, however, the only framework to discuss abortion; concerns about the fetus have found varied expression in theological, legal and medical constructs. This article examines discourses on the fetus from the Philippines, Iran and the United States, to show how complex they can be. It examines laws punishing abortion compared to laws punishing the murder of children, and also looks at the effects of ultrasound, amniocentesis and stem cell research on anti-abortion discourse. Although the fetus figures prominently in much legal discourse, it actually figures less prominently in popular discourse, at least in the English and Philippine languages, where terms like ''child'' and ''baby'' are used far more often. Finally, the article highlights the need to examine the experiences and narratives of women who have had abortions, and the implications for public policies and advocacy. It is important to expose the way anti-abortion groups manipulate popular culture and women's experience, driving home their messages through fear and guilt, and to show that pregnant women often decide on abortion in order to defend their family's right to survive. (author's)
Journal of Population and Social Studies. 2003 Jul; 12(1):93-103.This research study focused on male opinions as far as they play an important role in affecting female decision making. This research is a part of the "HIV-Positive Women: Voices and Choices" project. The sample group of this research consisted of a group of males from Bangkok, Northern and Northeastern Thailand between the ages of 20 and 62 years. The main topics of this study are 1) how do men feel about HIV-positive women in general, 2) family planning for HIV-positive females, 3) male opinion of abortion and 4) male opinion of receiving health services and sexual acknowledgement of HIV-positive women. The results: Men feel that HIV-positive women are to be pitied and sympathize with them, however, the level of empathy is lower or nonexistent if that HIV-positive woman is not related to them. The male sample group thinks that HIV-positive women should not have a child or even consider having a child as they are concerned about the child's safety and, most importantly, the significant responsibility of child care and expenses. Lastly, the sample group strongly suggests that an HIV-positive woman should use birth control methods. Nevertheless, health education for HIV-positive women is a need. The sample group believes that HIV-positive women should be treated with the same level of health care services as people without HIV. (author's)
[Application of two-way indicators in evaluation of knowledge about AIDS prevention among the public]
Chinese Journal of Health Education. 2004 Mar; 20(3):199-202.Objective To investigate the value of application of two-way indicators, including the correct answer rate and misunderstanding rate, in evaluation of the knowledge status about AIDS among the public. Methods Health education on AIDS prevention in various forms was carried out for 3 months among about 1700 participants in 2 townships/towns in Guantao County , Hebei Province and about 1300 participants in 2 townships/towns in Shouguang City, Shandong Province, selected by 3-stage stratified randomized sampling. Before and after the health education a questionnaire survey was conducted among the participants to investigate their KAP about AIDS and calculate the correct answer rates and misunderstanding rates. Results The correct answer rates of general AIDS knowledge, transmission routes, and prevention were 74.9%, 81.4%, and 70.6% respectively after health education, all significantly higher than those before health education (46.%, 54.9% , and 41.2 % respectively, all P < 01.1 ). The misunderstanding rates of general AIDS knowledge, transmission routes, and prevention were 18.8%, 15.2%, and 18.5% respectively after health education, all significantly lower than those before health education (19.8%, 18.2%, and 21.4% respectively, all P < 0.05). The correct answer rates were linearly positively correlated with the frequency of receiving relevant information and influenced by all communication channels. However, the misunderstanding rates were not correlated with the frequency of receiving relevant information and influenced by only some of the communication channels. Conclusion Health education shows greater effects on correct answer rates than on misunderstanding rates. The increase of correct answer rate does not accompany the equal degree of decrease of misunderstanding rate. Application of these two contrary indicators is recommended in evaluation of the effects of health education. (author's)
Psychology in the Schools. 2005; 42(3):305-313.China’s one-child policy is now 25 years of age--the officially sanctioned age for marriage by men in the People’s Republic of China. A significant proportion of those now about to enter their child-bearing years are themselves the product of the first generation of one-child homes. This article reviews the history of the single-child policy, with specific regard to the forces that initiated it as a national imperative and which today appear to sustain its widespread acceptance by the Chinese peoples. This article considers the circumstances leading to the implementation of the single-child policy, the development of incentives for compliance and penalties for noncompliance, information reflecting representative data-based analyses of outcomes from the policy, and the present situation and scenarios that might lead to a revisitation of this policy. Impressions and data gathering were conducted through conversation with individuals from all social strata in six locales in the People’s Republic of China and were contrasted with similar exploratory visits from 10 and 15 years ago. (author's)
Population Studies. 1961 Nov; 15(2):102-109.A marked awakening is taking place in Asia to the need and desirability of fertility control. One might even say that a revolution in the public and private attitudes toward family planning has occurred in Asia during the past decade. This paper will describe family planning in the Orient, the term "family planning" being interpreted in a broad sense. It will deal with government policies and with government action in this field, as well as the activities of private associations which are promoting fertility control by voluntary and private efforts. In the terms of this report, Asia includes the countries of Asia and South Asia that extend from Japan to Pakistan. Specific reference will be made only to countries that I have visited during the past six months, namely Japan, the Philippines, Taiwan, the Colony of Hong Kong, the State of Singapore, Indonesia, Thailand, Ceylon, India, and Pakistan. Visits have been made to this region more or less annually since World War II, and my contact with some of these countries dates back to 1939. Recent developments, in contrast to the earlier conditions, will be interpreted; obviously this report covers personal impressions and judgments, without facts and figures to support all the statements. (excerpt)
Population and Development Review. 2005 Jun; 31(2):313-336.After the communist revolution, the population of the People’s Republic of China grew rapidly, increasing by 80 percent between 1950 and 1980 (United Nations 2005). Partly this increase was due to improved social and economic conditions that greatly reduced mortality. Early in the period the Party’s pronatalist exhortations reflected an anti-Malthusian ideology. In the mid-1950s, China’s total fertility rate exceeded 6 children per woman. Although the fertility rate had fallen to less than half that level by the late 1970s, in 1979–80 China introduced its one-child birth planning policy to reduce the country’s rapid population growth. A well-publicized Chinese projection at the time argued that, if the fertility rate stayed at 3, China’s population would be 4.26 billion in 2080, “almost equal to the total  population of the entire world.” he stringent restrictions and coercion associated with the one-child policy aroused international controversy. Some observers viewed it with dismay and disapproval. To this day the policy remains a key impediment to US government contributions to the United Nations Population Fund (US Department of State 2002, 2004). Given the demographic, human rights, and political significance of the policy, it is important to ascertain the attitudes of Chinese citizens to the policy. (excerpt)
BJOG: An International Journal of Obstetrics and Gynaecology. 2005 May; 112:607-611.Objective To assess the impact of the publication of hospital caesarean section rates on the reduction of these rates in South Korea, and explore associated factors contributing to the decrease. Design Observational study. Setting South Korea. Sample Two hundred and sixty-three hospitals in South Korea. Methods The caesarean section rates of 263 hospitals, before and after the release of caesarean section rates to the public, were obtained. The factors influencing the reduction in hospital caesarean section rates were also explored using multiple logistic regression. Main outcome measure Hospital caesarean section rates. Results After the release of information in 2000, the total (clinic and hospital) caesarean section rates in 2000 and 2001 decreased to 38.6% and 39.6%, respectively, from 43.0% in 1999. Caesarean section rates for hospitals were 45.9%, 42.7% and 44.6% in 1999, 2000 and 2001, respectively. Hospitals with the highest baseline caesarean section rates (OR 9.4, 95% CI 4.2- 21.0) and highest number of deliveries (OR 8.1, 95% CI 2.1-31.1) were significant factors contributing independently to a decrease in caesarean section rates. Market share, competition, characteristics of revenue generation and ownership did not significantly influence the change of rates. Conclusion The public release of information on caesarean section rates in Korea has reversed the ever-increasing trend in these rates. Hospitals with pre-existing high caesarean section rates or a larger number of deliveries were influenced by the information release and could be the main targets for interventions to decrease these rates. (author's)
Washington, D.C., USAID, Bureau for Global Health, 2003 Oct. (7)  p. (Success Stories -- HIV / AIDS)NEARLY 4 MILLION PEOPLE IN INDIA are infected with HIV—the second highest figure in the world. Staggering misconceptions about how HIV is transmitted and a reluctance to publicly discuss the disease fuel its spread. But an innovative and aggressive HIV/AIDS education and awareness campaign implemented in 12 major port communities across India is helping to dispel widespread myths surrounding HIV/AIDS and to open channels of communication, enabling those who are at high risk for infection to learn how to steer clear of the disease. The campaign—implemented by Population Services International, with support from the U.S. Agency for International Development—features several components. In Mumbai, it revolves around Balbir Pasha, a fictional character the target audience of young, urban men can relate to, learn from, and empathize with. Balbir is portrayed in a series of identifiable, real-life sexual situations in which he runs the risk of contracting HIV. Scenarios concern the use of alcohol and “forgetting” to use a condom, the mistaken belief that having a regular partner (even a prostitute or casual partner) means one is safe from HIV/AIDS infection, and the misconception that if one’s partner looks healthy, he or she must be free of HIV/AIDS. (excerpt)
Situation analysis of the knowledge, attitudes and behavior of stakeholders and key target groups regarding the family planning program in the Philippines.
[Manila, Philippines], Academy for Educational Development [AED], Social Acceptance Project, 2003 Jan.  p. (Academy for Educational Development, Social Acceptance Project Working Paper)The initiative for this research study came from the Social Acceptance Project of the Academy for Education and Development (AED) which has been launched by USAID as part of the continuing reexamination of the Philippine Population Management Program (PPMP) and in response to the Cairo Declaration calling for fresh initiatives and approaches not only for women but also other key stakeholders such as men and youth. The re-focusing of the country’s population program calls for no less than the creation of a climate of public opinion that supports and encourages couples to practice effective family planning methods in vast enough numbers that will impact the country’s runaway population growth that is considered to be the highest in Southeast Asia. In the light of these social communication issues and concerns, the Social Acceptance Project had come up with the following approaches to “internalize” the small family norm and use of modern contraceptive methods among Filipinos through: a) Increase health literacy and improve the flow of accurate information about family planning; b) Increase dialogue about family planning and the credibility of health providers and the medical profession as sources of information; c) Raise the cultural legitimacy of family planning practice; and d) Build local capacities. This report in turn, was designed to: provide a basic review of the psychological, sociological and cultural factors that may result in the practice or non-practice of family planning; briefly analyze the issues and concerns that explain how communication interventions can lead to behavioral change, client satisfaction, and other desired results for the Social Acceptance Project; come up with a list of recommendations that can be used for future researches and/ or monitoring and evaluation of proposed IEC interventions. (excerpt)
Popular perceptions of emerging influences on mortality and longevity in Bangladesh and West Bengal.
New York, New York, Population Council, Policy Research Division, 2004. 21 p. (Policy Research Division Working Papers No. 186)Although new environmental and pathological threats to human survival and longevity have been documented, relatively little is known about how these threats are perceived in the popular imagination. During fieldwork in rural Bangladesh and West Bengal, India, researching the changing costs of and motivations for reproduction, the authors included survey questions on respondents' perceptions of changing mortality. Child-mortality levels were perceived to have fallen drastically in recent times, but for the middle-aged and the elderly, the past was seen as a better time in terms of health and survival. The decline in adult health is attributed to environmental deterioration and lifestyle changes associated with modernization. This paper explores the objective validity of and subjective reasons for this unexpected world view. References to pesticides and chemical fertilizers as causes of death abound, but mention of other emerging health threats including the HIV/AIDS pandemic, dengue, and toxic levels of arsenic in the water table is conspicuously absent. (author's)
Journal of Health Communication. 2004 Jun; 9 Suppl 1:37-57.Every innovation begins as a deviation from existing social norms. Given the strong effect of social norms and pressure, how can any innovation ever diffuse to the point where it becomes a new social norm? The seeming paradox of how a minority can influence the majority has not been explained well by prevailing social science theory. Computer simulations of the diffusion of a new behavior within the social network of a Bangladesh village led to the discovery of a new principle of social change that resolves this paradox. The results revealed the important but overlooked role played by boundaries that emerge within a social network and how such local boundaries affect the creation of a new social norm. A minority position can become the social norm by means of the process of bounded normative influence. As long as a minority maintains its majority status within its own, locally bounded portion of the network, then it can survive, recruit converts in the near surround, and establish its behavior as the norm for the network as a whole. The process is accelerated when the minority subgroup is centrally located in the network and communicates more frequently and persuasively than the majority. (author's)