The main aim of this dissertation is to develop a reliable and valid instrument to measure the multidimensional concept of social exclusion (SE) in public health surveys, more specifically as... Show moreThe main aim of this dissertation is to develop a reliable and valid instrument to measure the multidimensional concept of social exclusion (SE) in public health surveys, more specifically as embedded in the Public Health Monitor (PHM) conducted by the GGDs in the Netherlands. SE forms part of the WHO Social Determinants of Health framework, but the concept has been ill defined in health research, a generally accepted measure was lacking and the evidence base was not well developed. A systematic review on the relation between SE and health confirmed the hypotheses derived from theory and practice that SE is associated with poor mental and general health. A 15-item index, the Social Exclusion Index for Health Surveys (SEI-HS), was constructed with 2008 and 2012 PHM data. The SEI-HS was validated in the general population and in major non-Western migrant groups in Amsterdam, Rotterdam, The Hague and Utrecht. A possible application of the SEI-HS in public health was explored using 2016 PHM data. Relative risks and population attributable fractions showed a high-risk/high-need population segment in the four cites in which social problems, low agency and ill health coincide. These findings can be used to guide public health policy and resource allocation. Show less
Bergen, A.P.L. van; Loon, A. van; Hoff, S.J.M.; Wolf, J.R.L.M.; Hemert, A.M. van 2021
Background: Population segmentation and risk stratification are important strategies for allocating resources in public health, health care and social care. Social exclusion, which is defined as... Show moreBackground: Population segmentation and risk stratification are important strategies for allocating resources in public health, health care and social care. Social exclusion, which is defined as the cumulation of disadvantages in social, economic, cultural and political domains, is associated with an increased risk of health problems, low agency, and as a consequence, a higher need for health and social care. The aim of this study is to test social exclusion against traditional social stratifiers to identify high-risk/high-need population segments.Methods: We used data from 33,285 adults from the 2016 Public Health Monitor of four major cities in the Netherlands. To identify at-risk populations for cardiovascular risk, cancer, low self-rated health, anxiety and depression symptoms, and low personal control, we compared relative risks (RR) and population attributable fractions (PAF) for social exclusion, which was measured with the Social Exclusion Index for Health Surveys (SEI-HS), and four traditional social stratifiers, namely, education, income, labour market position and migration background.Results: The analyses showed significant associations of social exclusion with all the health indicators and personal control. Particular strong RRs were found for anxiety and depression symptoms (7.95) and low personal control (6.36), with corresponding PAFs of 42 and 35%, respectively. Social exclusion was significantly better at identifying population segments with high anxiety and depression symptoms and low personal control than were the four traditional stratifiers, while the two approaches were similar at identifying other health problems. The combination of social exclusion with a low labour market position (19.5% of the adult population) captured 67% of the prevalence of anxiety and depression symptoms and 60% of the prevalence of low personal control, as well as substantial proportions of the other health indicators.Conclusions: This study shows that the SEI-HS is a powerful tool for identifying high-risk/high-need population segments in which not only ill health is concentrated, as is the case with traditional social stratifiers, but also a high prevalence of anxiety and depression symptoms and low personal control are present, in addition to an accumulation of social problems. These findings have implications for health care practice, public health and social interventions in large cities. Show less
Experiencing and observing social exclusion and inclusion, as well as prosocial behavior, are important aspects of social relationships in childhood. However, it is currently unknown to what extent... Show moreExperiencing and observing social exclusion and inclusion, as well as prosocial behavior, are important aspects of social relationships in childhood. However, it is currently unknown to what extent these processes and their neural correlates differ in heritability. We investigated influences of genetics and environment on experiencing social exclusion and compensating for social exclusion of others with the Prosocial Cyberball Game using fMRI in a twin sample (aged 7–9; N = 500). Neuroimaging analyses (N = 283) revealed that experiencing possible self-exclusion resulted in activity in inferior frontal gyrus and medial prefrontal cortex, which was influenced by genetics and unique environment. Experiencing self-inclusion was associated with activity in anterior cingulate cortex, insula and striatum, but this was not significantly explained by genetics or shared environment. We found that children show prosocial compensating behavior when observing social exclusion. Prosocial compensating behavior was associated with activity in posterior cingulate cortex/precuneus, and showed unique environmental effects or measurement error at both behavioral and neural level. Together, these findings show that in children neural activation for experiencing possible self-exclusion and self-inclusion, and for displaying prosocial compensating behavior, is accounted for by unique environmental factors and measurement error, with a small genetic effect on possible self-exclusion. Show less
Bergen, A.P.L. van; Hoff, S.J.M.; Schreurs, H.; Loon, A. van; Hemert, A.M. van 2017
In recent years, the debate on access to and social inclusion in higher education has been intense, with university selection and admission standing out as particularly relevant topics. Admissions... Show moreIn recent years, the debate on access to and social inclusion in higher education has been intense, with university selection and admission standing out as particularly relevant topics. Admissions criteria and admissions in themselves are considered ‘technical-political devices’ or ‘social-technical tools’ and, as such, are increasingly interesting for research purposes. The historical tendency observed in the twentieth century is from an admissions system focused on merit to the diversification of criteria, consideration of social identities and use of affirmative action by groups that lack representation. This study is focused on university selection and admissions policies in Chile. At the same time, it also describes the role they play in socioeconomic access inequality in detail. As a result, it provides a comprehensive theoretical approach that helps align said policies with the aim of providing greater social inclusion in higher education. On the basis of the empiric and theoretical evidence presented at this study the author suggests that a series of changes in the selection and admission mechanisms of university students in Chile are needed. The search for social justice - that is to say, the capacity for self-fulfillment within the widest social spectrum - should be one of the main aims of an admissions system. By extrapolation, each university’s contribution to this aim could be evaluated as a result of how their enrollment is made up socioeconomically. The system’s general regulatory structure (criteria used, how places are offered, the number of places available, discounts, etc.) should allow institutions to outline the characteristics they look for in students beyond academic merit. Show less
Children and adolescents who are chronically rejected by their peers suffer from widespread impairments in daily life, ranging from poor academic achievement and dropping out of school, to... Show moreChildren and adolescents who are chronically rejected by their peers suffer from widespread impairments in daily life, ranging from poor academic achievement and dropping out of school, to delinquency and the development of mental health problems. To gain a better understanding of the developmental processes that give rise to such impairments, the research described in this dissertation examined the neurocognitive underpinnings of processes that play a role in the emergence and maintenance of peer group rejection and acceptance. The first part of this dissertation focuses on neurocognitive processes underlying reactions to social exclusion. The second part concentrates on the neurocognitive processes involved in sharing valuable resources, based on the widely established finding that frequent displays of prosocial behaviors, such as cooperating, helping, and sharing, are associated with both gaining and maintaining acceptance among peers. The empirical work in this dissertation demonstrates that a developmental cognitive neuroscience approach provides unique insights into the emotional, regulatory, and socio-cognitive processes thought to play a role in the emergence and maintenance of peer group acceptance and rejection. Show less
As infants are fully dependent on their parents, correct perception and interpretation of infant signals is crucial for infant survival. It is therefore not surprising that specific brain circuits... Show moreAs infants are fully dependent on their parents, correct perception and interpretation of infant signals is crucial for infant survival. It is therefore not surprising that specific brain circuits and neuroendocrine processes have evolved to perceive infant signals correctly and to respond adequately. However, parents vary in their ability to respond to their infants in a sensitive way and several factors may be involved in parental sensitive responsiveness. One important factor influencing parenting behavior is the neuropeptide oxytocin. Of all the hormones involved in parenting and other social behaviors, oxytocin has received the most interest, as evidenced by the high number of scientific studies over the past decade (Bos, Panksepp, Bluthé, & Honk, 2012; Van IJzendoorn & Bakermans-Kranenburg, 2012). Many studies suggest that oxytocin is related to sensitive parenting (Bakermans-Kranenburg & Van IJzendoorn, 2008; Feldman, Weller, Zagoory-Sharon, & Levine, 2007), although the exact mechanism underlying this positive association is not entirely clear yet. Another factor that influences parenting behavior is adult state of mind with respect to attachment (Van IJzendoorn, 1995). In the current dissertation, the role of oxytocin and adult attachment in parenting is examined with a series of functional magnetic resonance imaging experiments. Show less
Moor, B.G.; Guroglu, B.; Macks, Z.A. op de; Rombouts, S.A.R.B.; Molen, M.W. van der; Crone, E.A. 2012
This thesis investigates the highly complex issue of cross-border marriages between Mainland China and Taiwan in the period from early 1990 to 2004. The objectives of this research is to... Show moreThis thesis investigates the highly complex issue of cross-border marriages between Mainland China and Taiwan in the period from early 1990 to 2004. The objectives of this research is to investigate three aspects of cross-border marriage migration: 1) factors and motivations for cross-border marriage, that is, Why do mainland Chinese women choose to leave China and to come to Taiwan and why do Taiwanese men marry mainland Chinese women? 2) formation and justification of borders of exclusion, that is, Why and how are mainland brides constructed as “others”? 3) negotiation of gender and intra-familial relations among members of cross-border families. These questions are answered by looking at the perspectives of different actors and by examining how these perspectives are formed and whether and how they are substantiated. These actors include the state and the media, the marriage brokerage industry, and cross-strait couples and family members. Multiple research methodologies and sources of data are used, including ethnography, discourse analysis of policy and media representation and participant observation. Show less
