Recent research in medicine and public health highlights differences in health related to race, ethnicity, socioeconomic status, and gender. These inequalities, often labeled "disparities," are pervasive and pertain to the major causes of morbidity, mortality, and lost life years. Often ignored in discussions of health disparities is the complex role of work, including not only occupational exposures and working conditions, but also benefits associated with work, effects of work on families and communities, and policies that determine where and how people work. The authors argue that work should be considered explicitly as a determinant of health disparities. Their conceptual model and empirical evidence, built on previous contributions, describe how work contributes to disparities in health on multiple levels. The examples focus on the United States, but many of the key conceptual features can also be applied to other countries. The model emphasizes behaviors and characteristics of institutions rather than individual workers. This approach avoids a focus on individual responsibility alone, which may lead to victim blaming and failure to emphasize policies and institutional factors that affect large populations and systematically create and maintain racial, gender, and socioeconomic disparities in health.

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According to the sexual script portrayed in romance novels, true love is demonstrated by being "swept away" in passion. To the extent that this traditional romance script influences romance readers' own sexual scripts, readers may express greater reluctance to engage in precautionary sexual health behaviors, such as using condoms. We explored the relationship between women's reading of romance novels and their attitudes toward condom use, reports of past condom use, and intention to use condoms in the future. A systematic content analysis of modem romance novels documented the extremely low incidence of portrayals of condom use in initial sexual encounters.

Background: In the United States, most of the treated sewage sludge (biosolids) is applied to farmland as a soil amendment. Critics suggest that rules regulating sewage sludge treatment and land application may be insufficient to protect public health and the environment. Neighbors of land application sites report illness following land application events.Objectives: We used qualitative research methods to evaluate health and quality of life near land application sites.Methods: We conducted in-depth interviews with neighbors of land application sites and used qualitative analytic software and team-based methods to analyze interview transcripts and identify themes.Results: Thirty-four people in North Carolina, South Carolina, and Virginia responded to interviews. Key themes were health impacts, environmental impacts, and environmental justice. Over half of the respondents attributed physical symptoms to application events. Most noted offensive sludge odors that interfere with daily activities and opportunities to socialize with family and friends. Several questioned the fairness of disposing of urban waste in rural neighborhoods. Although a few respondents were satisfied with the responsiveness of public officials regarding sludge, many reported a lack of public notification about land application in their neighborhoods, as well as difficulty reporting concerns to public officials and influencing decisions about how the practice is conducted where they live.Conclusions: Community members are key witnesses of land application events and their potential impacts on health, quality of life, and the environment. Meaningful involvement of community members in decision making about land application of sewage sludge will strengthen environmental health protections.

We describe an ongoing collaboration that developed as academic investigators responded to a specific request from community members to document health effects on black women of employment in poultry-processing plants in rural North Carolina. Primary outcomes of interest are upper extremity musculoskeletal disorders and function as well as quality of life. Because of concerns of community women and the history of poor labor relations, we decided to conduct this longitudinal study in a manner that did not require involvement of the employer. To provide more detailed insights into the effects of this type of employment, the epidemiologic analyses are supplemented by ethnographic interviews. The resulting approach requires community collaboration. Community-based staff, as paid members of the research team, manage the local project office, recruit and retain participants, conduct interviews, coordinate physical assessments, and participate in outreach. Other community members assisted in the design of the data collection tools and the recruitment of longitudinal study participants and took part in the ethnographic component of the study. This presentation provides an example of one model through which academic researchers and community members can work together productively under challenging circumstances. Notable accomplishments include the recruitment and retention of a cohort of low-income rural black women, often considered hard to reach in research studies. This community-based project includes a number of elements associated with community-based participatory research.

Specialists in rehabilitation are typically called upon to evaluate and render an opinion about whether or not a person can be entrusted to resume driving. And, because driving is an individual privilege to be balanced against the public's right to safety and protection from the dangers of a driver whose residual deficits may impede ability to drive safely, these specialists have developed a number of methods to assess fitness to drive. Unfortunately, many evaluators remain unfamiliar with research used as basis for evaluations or lack understanding of the strengths and weaknesses of tests in use. Therefore, there may be unquestioning trust in tests and methods that leads to errors of significant consequence in decisions about fitness to drive as well as unawareness of expanding risks of litigation that can emanate from inappropriate recommendations. This article intends to draw attention to issues, considerations, and problems underlying the conduct of driver evaluations, including focus on ways in which the legal and medical communities approach question of fitness, legal and medical definitions and terminology, responsibility for assessment as well as tests and methods used in evaluations. Conclusions are drawn from discussion of these matters and recommendations are outlined for addressing identified problems at the interface between medical and legal communities.

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