Linda M. Burton - US grants

This proposed research will examine the relationship among socioeconomic context, intergenerational family dynamics, and role transitions in black families with pregnant adolescents. Families from three socioeconomic groups-persistent poor, transient poor, and working/middle class will be compared. The study has three objectives: (1) to identify similarities and differences in social arrangements and family context (including norms) that govern the timing of transitions to parenthood and grandparenthood; (2) to explore the relationship among socioeconomic status, family norms, and patterns of stress and coping exhibited by family members as they experience the role transitions that accompany teenage childbearing (e.g., fatherhood, grandparenthood); and (3) to examine patterns of intergenerational exchanges (monetary and material resources, intergenerational caregiving, household assistance, companionship and advice) among parents, grandparents, and-great-grandparents in response to teenage pregnancy. Personal interviews will be conducted with three- and four-generation black families (50 families per socioeconomic group) residing in a metropolitan community in Pennsylvania. Participants (N-600) from each family unit include the pregnant teenager, her mother, her grandmother, and the father or grandfather of the baby. Families will be recruited through the Department of Public Welfare and local hospitals, clinics, and churches. To capture the effect of role transition, interviews will be conducted with each respondent at two points in time--when the adolescent (age 17 and under) is 5-6 months pregnant and 5-6 months post-partum. This study provides a rare comparative look at adolescent childbearing and interdependent lives in multigeneration black families from three socioeconomic sub-populations of American society. As such, this study will contribute to the formulation of life-course models of family development that recognize sociocultural and socioeconomic diversity and, more specifically, to our understanding of the effects adolescent pregnancy on the life course of kin.

This proposed research will examine the relationship among socioeconomic context, intergenerational family dynamics, and role transitions in black families with pregnant adolescents. Families from three socioeconomic groups-persistent poor, transient poor, and working/middle class will be compared. The study has three objectives: (1) to identify similarities and differences in social arrangements and family context (including norms) that govern the timing of transitions to parenthood and grandparenthood; (2) to explore the relationship among socioeconomic status, family norms, and patterns of stress and coping exhibited by family members as they experience the role transitions that accompany teenage childbearing (e.g., fatherhood, grandparenthood); and (3) to examine patterns of intergenerational exchanges (monetary and material resources, intergenerational caregiving, household assistance, companionship and advice) among parents, grandparents, and-great-grandparents in response to teenage pregnancy. Personal interviews will be conducted with three- and four-generation black families (50 families per socioeconomic group) residing in a metropolitan community in Pennsylvania. Participants (N-600) from each family unit include the pregnant teenager, her mother, her grandmother, and the father or grandfather of the baby. Families will be recruited through the Department of Public Welfare and local hospitals, clinics, and churches. To capture the effect of role transition, interviews will be conducted with each respondent at two points in time--when the adolescent (age 17 and under) is 5-6 months pregnant and 5-6 months post-partum. This study provides a rare comparative look at adolescent childbearing and interdependent lives in multigeneration black families from three socioeconomic sub-populations of American society. As such, this study will contribute to the formulation of life-course models of family development that recognize sociocultural and socioeconomic diversity and, more specifically, to our understanding of the effects adolescent pregnancy on the life course of kin.

DESCRIPTION (Adapted from applicant's abstract): Support is requested for the collaborative work of the Consortium on Diversity, Family Process, and Child and Adolescent Mental Health (FRC III). FRC III emerges from the current Research Consortium on Family Risks and Resilience (FRC II) and involves new members, an expanded organizational structure, and a new focus. This new Consortium is comprised of a twelve member faculty of senior and advanced junior scientists, each of who has a funded program of research on ethnically, socioeconomically and structurally diverse families and child/adolescent health; an advisory board; liaisons from other relevant research networks/consortia; postdoctoral trainees; and research partners from historically minority colleges. FRC III was organized to promote intellectual exchange and collaborative research and training on: (1) the further development of theoretical approaches that are culturally and contextually relevant for study of mental health and families in diverse populations: (2) new advances in research designs, measurement, and statistical methodology that need to be incorporated in research on diversity, family processes and child/adolescent mental health; and, (3) the extension of basic studies on diverse families and mental health to prevention and intervention research. Intellectual exchanges and collaborative research will focus on four highly relevant themes: (1) the impact of families' socioeconomic trajectories on family processes, and development outcomes for children; (3) the prevalence of mental illness among children as it relates to family networks and service utilization; and (4) the role of culture and family structure in developing effective family and child mental health interventions. In addition to collaborative research, FRC III will develop a multisite training program, research training partnerships with historically minority colleges (both to be funded through other mechanisms), and an annual Summer Institute. Products of the FRC III will include: (1) review papers and technical reports; (2) collaborative research projects involving other consortia and research partners; (3) improved research on diverse families and child mental health resulting from the participation of family researchers in the Summer Institutes: (4) a group of well-trained post-doctoral fellows; (5) training partnerships between consortia and historically minority institutions; and (6) handbook(s) on theoretical and methodological approaches to the study of diverse families.

Linda Burton
Stephen Matthews
Debra Skinner
Pennyslvania State University

Using ethnography and Geographic Information Systems (GIS) technology, the investigators will conduct a novel, in- depth, comparative study of resource allocation in low-income families residing in large urban, small town, and rural communities. Resource allocation is defined as the procurement and distribution of material, emotional, and informational resources within and across generations in families. To examine this issue, the PIs (Principal Investigators) will analyze secondary data from two comparably designed ethnographic studies, and supplement on-going data collection in one. The studies are the Welfare, Children, and Families: A Three-City Study and the Family Life Project. The Three-City Study Ethnography was conducted in Boston, Chicago, and San Antonio from June 1999 to August 2003 and comprises a sample of 256 low-income African American, Hispanic, and non- Hispanic white families. The data include over 45,000 pages of fieldnotes and transcripts of participant interviews and observations, 3500 audiotapes, and key tables with life course and spatial resource use information. The Family Life Project, launched in October 2002 and continuing through October 2006, involves a sample of 72 low income African American and non-Hispanic white families. This ethnography is being conducted in Pennsylvania and North Carolina. The grant will support the collection of on-going ethnographic and GIS resource allocation data from families in the Family Life Project. The grant will also allow the investigators to add ten Hispanic families to this ethnography so that the sample is ethnically comparable to the Three-City Study. The specific aims of the proposed study are twofold: (1) to examine the relationship between intergenerational resource allocation, family roles, community resources, and social mobility in urban and rural settings and (2) to integrate ethnographic methods and data on families and communities with GIS technology to inform our understanding of intergenerational resource allocation in urban and rural communities.

The project will advance our knowledge and understanding of family resource allocation. The project takes an interdisciplinary approach, including sociologist, anthropologists, geographers as research team members. Study findings will have a broad appeal to not only disciplines represented by the research team, but to scholars in demography, human development, and life course and family studies as well. More over, the integration of ethnographic and GIS methods and data represents significant innovation in the field that has the potential to lead to new insights and contextually-sensitive understandings of resource allocation among lower-income families.

SES-1030788
Linda Burton
Victor Ray
Duke University

Using original qualitative data this dissertation will examine racial and gender differences in patterns of reintegration for veterans returning from Iraq and Afghanistan. Taking the post- service transition into civilian life as the unit of analysis, this work uses primary data to analyze how race and gender may structure the transition from military service. Prior research in the life course tradition has identified the transition from military service to civilian life as a key ?turning point? in the lives of disadvantaged men. This research will integrate and expand upon life course approaches with theoretical insights from ?racialized social system? and ?intersectional? frameworks to explore the possibility that life course transitions vary by racial and gender statuses. In order to accomplish theses goals data collection will focus on three primary research questions. 1. Are all military benefits created equal? That is, do post-service socio-economic outcomes for women and minorities parallel those of their white counterparts? 2. Is the experience of reintegration color qualitatively different for women and people of than it is for white male veterans? If so, what does this add to our understanding of ?turning points? over the life course? 3. How do institutions, such as the Veteran?s Administration, facilitate reintegration for particular issues facing women and people of color? Data will be derived from two primary sources, 50 in-depth interviews with recently returned veterans and a nine-month ethnographic investigation at a veteran?s center. The research will provide a clearer understanding of veterans? reintegration strategies and the ways in which these strategies are possibly shaped by racial and gender stratification.

Broader Impact. The study offers a major theoretical contribution to studies of the life course by incorporating cutting-edge racial and gender theories of stratification. The research provides a qualitative account of the post-service transition to civilian life in general, and insights into the racial and gender complexities of reintegration. Further, findings from this work may inform service providers on strategies to meet the needs of diverse veterans. Also as the first study of its kind, this work will provide a methodological and theoretical model that essential for understanding the complex process of reintegration.

SES-1131382
Linda Burton
Rose Buckelew
Duke University

Doctoral Dissertation Research: How Problem Gambling is Medicalized

Abstract
This study will provide insight into the mechanisms that shape the medicalization of problem gambling. It will examine how counselors construct racial and gender differences in problem gambling behavior. It will also examine the ways counselors construct and understand race and gender in their everyday discussions of clients and client behavior. Using Conrad's (1992) definition of medicalization, the process by which social problems are redefined as medical problems mandating the intervention and control of licensed medical professionals, this project will demonstrate how social and historical factors shape the construction of illness. And it will bridge the theoretical work on medicalization with research on the "policy making" of street level bureaucrats (Lipsky 1980), and on clinical decision-making processes (Hays et al. 2010, Gushue 2004).

Data collection through participant observation and interviews will address three themes: (1) the types of racial and gender discourses counselors use when discussing clients, (2) the kinds of legitimating evidence counsellors provide in these discourses, and (3) the meanings counselors attach to the differences which have been constructed. Data collection strategies include interviews with counselors and managers of problem gambling programs and a multi-site ethnographic study of gambling addiction training workshops, conferences, and call centers.
Very few qualitative studies closely examine the role of counselors and managers in shaping definitions of mental illness and even fewer seriously examine their subjectivity. Combining interviews and ethnographic approaches, this study will advance understanding of the complex processes of medicalization.

SES-1061591
Linda Burton
Duke University

In the context of America's current changing urban and rural communities, the research team will study the social norms, behavioral expectations, and social experiences that are shaping contemporary U.S. family life. The study will examine the types of social norms, expectations, and experiences that are contributing to the development of sustained families and why they prevail for some in certain urban and rural contexts and not others. The investigators will pay special attention to whether contemporary beliefs and behaviors about marriage lead to establishing long-term committed unions or alternative transient family structures with children. The study will complete a secondary analysis of comprehensive longitudinal team ethnographies of urban and rural families. Data will be analyzed using life history methods with special attention given to how urban and rural cultures influence family structures and behaviors.

Given recent dramatic changes in patterns of marriage, cohabitation, and non-marital childbearing in the U.S., numerous questions about the social norms, expectations, and experiences that shape the lives of contemporary families have become a central concern of social scientists as well as the broader American society. The proposed research will directly address these concerns by conducting a detailed assessment of women's beliefs and behaviors around family and whether they differ in urban and rural communities. The study will also shed light on whether those similarities and differences extend to issues of race by comparing the lives of White, African American, and Latino mothers and their families.

Given the growing diversity of U.S. society, this study promises to provide valuable insights on the contextual and cultural behaviors of different groups relative to family structures. Research findings will contribute to both general and theoretically-based knowledge about a topic of considerable national concern. The project also provides trains undergraduate and graduate students and postdoctorates how to conduct rigorous, detailed scientific investigations of contemporary American family life.

Title: Unpacking Inequality in the Faith-Based and Federal Healthcare Safety Net

The project will explore how the everyday experiences of low-income and uninsured adults shape both the healthcare they have access to and the ways in which they navigate safety-net healthcare organizations in the years following the passage of the Affordable Care Act (ACA). Low-income and uninsured adults in the U.S. are the leading edge in the rising incidence of preventable chronic illness and need high-quality preventive healthcare. However, little progress has been made in understanding the role of healthcare safety-net organizations in the lives of low-income and uninsured adults in an era characterized by significant health and welfare policy changes, neoliberal privatization, and safety net resource fragmentation. This study will analyze multiple data sources centered on the perceptions and experiences of safety net healthcare workers and low-income and uninsured patients who use primary care clinics in a mid-sized city in the southeast region of the U.S. which has become a New Immigrant Destination. Findings will be shared directly with public and private safety-net healthcare organizations to advance the state of current best practices in these settings, with the goals of improving equality in healthcare treatment outcomes among patients and enhancing the coordination of resources provided across safety-net organizations to low-income families.

Research questions will address three specific aims. The first involves a systematic investigation of how life course transitions around health, family, residence, and employment shape when and how low-income and uninsured adults enter healthcare safety net organizations. The second will assess how gendered and racialized features of healthcare systems, welfare systems, and bureaucratic institutions shape the organizational logics of public and private primary care safety-net settings and sanction the efforts of individual workers as they seek to improve their patients' everyday lives. The third seeks to clarify the role of healthcare safety-net organizations in shaping the attitudes, feelings, and health expectations of low-income adults and the kinds of resources available to them. These aims will be addressed through a comparative ethnographic case study of one private primary care setting and one federally qualified health center. The methodology incorporates team-based longitudinal ethnographic methods, qualitative interviews, and patient electronic medical records. The analysis will examine organizational policies, worker attitudes and experiences, and patient attitudes and experiences.