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Some authors of the Harlem Renaissance wrote fiction that closely mirrored the reality of their lives, giving a window into the world of gay marriages, drag balls, and an open sexuality. Jamaican-born bisexual writer Claude McKay was among those who wrote about the era, sometimes indicating the ambivalence about homosexuality in Harlem. Real marriage licenses were obtained by masculinizing a first name or having a gay male surrogate apply for a license for the lesbian couple. More recent authors have created works of genealogy and personal history, writing their own lifelines. For example, in the bull-jean stories, poet Sharon Bridgforth weaves a history out of her own desire to know the lives of her 1920s ancestors: "rural/southern working-class Black bulldaggas/who were aunty-momma-sister-friend/pillars of the church. Pulp lesbian novels were larger moneymakers than the gay male pulps because of the crossover audience of heterosexual men. After her singing career, Ma Rainey moved to a home at 805 Fifth Avenue, Columbus, Georgia. Despite this, they still stirred the passions of their readers looking for some validation of their feelings. Strapping young men in skimpy swimsuits modeled for a wide range of publications, which had a significant number of gay male subscribers. These magazines provided a sexual release for their readers, and a connection to a "community" in faraway cities. Yet possession of these "pornographic materials" was a felony under most state laws. In 1960, Smith College professor Newton Arvin was arrested by the state of Massachusetts for having physique magazines and was forced to resign. Gay male pulp fiction also had an audience, among both gay and bisexual men and straight women. The first pulp novel to deal with homosexuality was Men into Beasts by George Sylvester Viereck (New York: Fawcett Publication, 1952). Susan Stryker, Queer Pulp: Perverted Passions from the Golden Age of the Paperback (San Francisco: Chronicle Books, 2001). Forrest, Lesbian Pulp Fiction: the Sexually Intrepid World of Lesbian Paperback Novels 1950-1965 (Cleis Press, 2005). In the post-Stonewall era, Arlington Ridge Park in Arlington, Virginia was a popular place for gay men to meet at night. The park is known colloquially as Iwo Jima Park because it is the site of the United States Marine Corps War Memorial/Iwo Jima Memorial. It has been the location of several crackdowns on gay men in the park, including the arrests of over sixty men in late 1971 that triggered a cold, January 1972 protest by the Gay Activist Alliance. See also Barry Reay, New York Hustlers: Masculinity and Sex in Modern America (Manchester: Manchester University Press, 2010). The school secretly put a dozen male students on trial and then "systematically and persistently tried to ruin their lives. In the armed services, men and women who might have felt Examples of these places include Webster Hall, Wellesley College, Hull House, and the Charleston Museum. Webster Hall and Annex, 119-125 East 11th Street, New York City, New York, famous in the 1910s and 1920s for the lavish masquerade balls held there. Katherine Lee Bates, author of "America the Beautiful," attended Wellesley College and then later returned to teach there. It was at Wellesley that she met her partner of twenty-five years, Katherine Coman. In 1920, Laura Bragg was the first female director of the Charleston Museum, since 1980 located at 360 Meeting Street, Charleston, South Carolina. Bragg lived with her partner, Belle Heyward, near the historic William Gibbes House in Charleston, South Carolina. The sex-segregated nature of the armed forces raised homosexuality closer to the surface for all military personnel. It not only changed the personal lives of countless thousands of individual men and women, it also shifted the role of sexuality in American public life and altered the social geography of urban centers like San Francisco. Lesbians tended to meet in private homes, both for privacy and safety, but also because women generally had less free money to spend going out, and so were unable to sustain large numbers of women-only commercial spaces.

Effects of prenatal poverty on infant health: state earned income tax credits and birth weight. The direct impact of maternity benefits on leave taking: evidence from complete fertility histories. Population Health: Behavioral and Social Science Insights Section I: Demographic and Social Epidemiological Perspectives on Population Health 49 23. Do maternity leave benefits improve mothers health at old age: evidence from 11 European countries during 1960-1010. Incorporating home demands into models of job strain: findings from the Work, Family, & Health Network. An active and socially integrated lifestyle in late life might protect against dementia. The widening gap: why working families are in jeopardy and what can be done about it. Lisa Berkman, PhD, is Director, Harvard Center for Population and Development Studies, and Thomas D. She also is the former head of the Division of Chronic Disease Epidemiology at Yale University. She has devoted much of her work to understanding determinants of population health by comparing European countries with the United States. Labor Policy and Work, Family, and Health in the Twenty-First Century 50 Population Health: Behavioral and Social Science Insights Section I: Demographic and Social Epidemiological Perspectives on Population Health 51 Social and Behavioral Interventions to Improve Health and Reduce Disparities in Health David R. In this chapter, we summarize empirical evidence that suggests that promising interventions exist to address the prominent features of these social inequalities in health in the United States. Studies suggest that investing in early childhood interventions can lead to striking improvements in both socioeconomic and health indicators in adulthood. We consider values affirmation interventions as an example of a race-targeted intervention that is seeking to identify aspects of racial disadvantage that may be missed by interventions that target an overall population. In this chapter, we review research that suggests we can improve health and reduce inequalities in health through interventions that target the underlying social and psychological conditions that drive health. Next, we review research on interventions that have the potential to enhance income, improve Social and Behavioral Interventions to Improve Health and Reduce Disparities in Health 52 neighborhood and housing conditions, early childhood experiences, and psychological factors linked to stigmatized racial status. This review is not exhaustive, but it does seek to showcase research from randomized control trials and other studies that used rigorous evaluation designs. We conclude that there is a pressing need to develop a scientific research agenda for future interventions to reduce social inequalities in health. A similar pattern is evident for multiple health outcomes in which disadvantaged racial groups have markedly earlier onset of disease, greater severity of disease, and poorer survival than their more advantaged counterparts. Age-specific heart disease death rates for 2010 for whites and blacks and black/white ratios Males Age 25-34 35-44 45-54 55-64 65-74 75-84 85+ White (W) Rate* 9. This suggests that individual-level income and education do not fully account for the multiple components of social and economic disadvantage that are linked to minority racial status. Research reveals that income and education are not equivalent across race, with blacks and Hispanics, compared to whites, having lower earnings at each level of education, less wealth at every level of income, and less purchasing power because of higher costs of goods and services in their communities. Minorities live in markedly more health-damaging residential environments than whites and have higher exposure to multiple types of acute and chronic stressors over their life course, including the health-damaging aspects of institutional and interpersonal racism. Heart disease death rates, age-standardized, for blacks and whites aged 25-64, 2001 Females Education Black (B) Rate* 106. Research reveals, for example, that the opportunities and resources that people have to be healthy are strongly patterned by place. Neighborhoods also vary in access to health promoting goods and resources, ranging from the quality of the built environment, public services, commercial resources, and shopping that can promote and sustain health. These include the density of fast food outlets and liquor stores, the concentration of tobacco advertising, higher levels of chemicals and pollutants in air, soil, and water, as well as greater exposure to social disorder, including crime and violence. Interventions to Address Social Inequalities Scientific evidence indicates that reducing economic and social disadvantage, providing infrastructures that promote economic opportunity, and enhancing income to achieve an adequate standard of living can improve the health of disadvantaged populations. Increased Household Income and Health Policy initiatives that provide households with additional income can lead to improved health. This study assessed the impact of the extra income that American Indian households received, due to the opening of a casino, on the health of the youth.

Herbal medicines were taken with conventional medicines by 80% of respondents and 87% of these did not tell their healthcare provider. In the rural community 92% took herbal medicines with conventional medicines, compared with 70% of the urban community. Potential interactions between complementary/alternative products and conventional medicines in a Medicare population. Herbal therapy use in a pediatric emergency department population: expect the unexpected. Potential interactions of drug-natural health products and natural health products-natural health products among children. Nonvitamin, nonmineral supplement use over a 12-month period by adult members of a large health maintenance organization. Complementary/ alternative medicine use in a comprehensive cancer center and the implications for oncology. Women generally live longer than men, and elderly people take more supplements; women tend to be the primary carers for children and the elderly and also purchase most of the everyday remedies used in the home; and women take more weight-loss products than men. In several studies, it is suggested that women are at least twice as likely to take herbal medicines or supplements as men. Some studies suggest that usage is similar across most education levels,10 whereas others have found that college graduates appear to have the highest incidence of herbal use. In a study of caregivers who reported giving their child a herbal product, 88% had at least 1 year of college education. However, 77% of the participants in the study did not believe, or were uncertain, if herbal medicines had any adverse effects; only 27% could name a potential adverse effect and 66% were unsure, or thought that herbal medicines did not interact with other medications. Unfortunately, even if patients do report their use of herbal medicines to the physician or pharmacist, there is no guarantee that accurate information or advice will be available. Physicians usually underestimate the extent to which their patients use these remedies and often do not ask for information from the patient. Worse still, in one survey 51% of doctors believed that herbal medicines have no or only mild adverse effects and 75% admitted that they had little or no knowledge about what they are. Use of nonprescription dietary supplements for weight loss is common among Americans. Consumption of herbal remedies and dietary supplements amongst patients hospitalized in medical wards. Herbal use among cancer patients during palliative or curative chemotherapy treatment in Norway. The practice of polypharmacy involving herbal and prescription medicines in the treatment of diabetes mellitus, hypertension and gastrointestinal disorders in Jamaica. Complementary and alternative medicines versus prescription drugs: perceptions of emergency department patients. Interactions between herbal medicines and conventional drugs An interaction is said to occur when the effects of one drug are changed by the presence of another substance, including herbal medicines, food, drink and environmental chemical agents. This definition is obviously as true for conventional medicines as it is for herbal medicines. The outcome can be harmful if the interaction causes an increase in the toxicity of the drug. A potential example of this is the experimental increase in toxicity seen when amikacin is given with ginkgo, see Ginkgo + Aminoglycosides, page 209. A reduction in efficacy due to an interaction can sometimes be just as harmful as an increase. As with any publication detailing the adverse effects of drug use it would be very easy to conclude after browsing through this publication that it is extremely risky to treat patients with conventional drugs and herbal medicines, but this would be an over-reaction. Patients can apparently tolerate adverse interactions remarkably well, and many interactions can be accommodated for (for example, through natural dose titration), so that the effects may not consciously be recognised as the result of an interaction. One of the reasons that it is often difficult to detect an interaction is that, as already mentioned, patient variability is considerable. We now know many of the predisposing and protective factors that determine whether or not an interaction occurs but in practice it is still very difficult to predict what will happen when an individual patient is given two potentially interacting medicines. This effect is compounded when considering the interactions of herbal medicines because they themselves are subject to a degree of variability. Variability of herbal medicines Botanical extracts differ from conventional medicines in that they are complicated mixtures of many bioactive compounds. This makes it difficult to assess the contribution of each constituent to the activity of the whole, and this includes evaluating their possible interactions with drugs.

He shows how informal sexual exchanges between men from a wide range of race and class backgrounds in Times Square constituted social contact that provided short-term and lasting interpersonal and material benefits. But as Delany also points out, not all of the sexual exchanges were gratis and some involved the exchange of sex for money. One example is along waterfronts-piers, ports, and docks-where numerous economies, be they maritime, industrial, or sexual, have flourished alongside each other. In the 1970s and 1980s, deindustrialization had led to the abandonment of warehouses in the area as well as parts of the piers themselves, which then became active sites of public and commercial sex. The geography of sexual and social communities was often divided not only along lines of commerce, but also race and gender; white gay men Howard, Men Like That. Delany, Times Square Red, Times Square Blue (New York: New York University Press, 1999). Homosexual Identity and the Construction of Sexual Boundaries in the World War One Era," Journal of Social History 19, no. Hanhardt often gathered in the areas at the end of Christopher Street, and transgender people of color gathered north, closer to the Meatpacking District (Figure 5). During this time, a community of transgender women also made a home amongst Figure 5: Morton Street Pier, Greenwich Village, New York City, New York, 1981. The eventual redevelopment of the derelict piers into a public park brought into sharp focus debates between residents (gay and straight, renters and homeowners) and nonresident users of the area, drawn to it for its historic role as a community gathering place, that are still ongoing today. Gordon Brent Ingram, Anne-Marie Bouthillette, and Yolanda Retter (New York: Bay Press, 1997). Here it is worth noting that women sex workers include lesbian and bisexual women, and that the public sites available for sexual exchanges with men are considerably more plentiful. Hanhardt encounters, the usual stares at the freaks, whispered taunts of faggot, lezzie, is that a man or a woman, but we did not care. We were heading to the sun, to our piece of the beach where we could kiss and hug and enjoy looking at each other. Softball was one popular sport; in Oakland, California the group Gente was an all-woman-of-color softball team that included lesbian poet Pat Parker. They organized in part in response to the racism of white lesbian bars, but they also saw softball as a way to affirmatively forge community that might extend far beyond the softball field. Many of these places cannot be recorded in the history of community preservation, but some, especially in the 1970s and 1980s, would begin to formalize in the form of community centers. The Pacific Center for Human Growth in Berkeley, California soon followed in 1973 and was also well known in the area for its therapy services and self-help groups (Figure 7). Some have been held in church basements and municipal recreation halls; others have worked collectively to buy buildings, incorporating as nonprofit (and, even, on occasion forprofit) organizations (Figure 8). Enke maps an impressive variety of formal and informal gathering places in Finding the Movement. In fact, the list is much longer than many would expect, and includes centers in places as diverse as Pocatello, Idaho; Missoula, Montana; White Plains, New York; Wichita, Kansas; Highland, Indiana; and Port St. For a longer history of queer cabaret performance see Shane Vogel, the Scene of Harlem Cabaret (Chicago: University of Chicago Press, 2009). Club Heaven had been located at 19106 Woodward Avenue, Detroit, Michigan and closed by the mid-1990s. The last Different Light Bookstore, at 489 Castro Street, San Francisco, closed in 2011. The Oscar Wilde Bookshop, which was located at 15 Christopher Street, New York City from 1973 through 2009 began as the Oscar Wilde Memorial Bookshop at 291 Mercer Street, New York City in 1967. Outwrite Bookstore and Coffeehouse in Atlanta was located at 991 Piedmont Northeast; opened in November of 1993, it closed in January 2012. As historian Martin Meeker contends, among the earliest ways a unified "gay community" was forged was via the printed word. In 1978, the shop moved to 1009 Valencia Street, where it remained until it closed in 1995. Enszer, "Night Heron Press and Lesbian Print Culture in North Carolina, 1976-1983," Southern Cultures 21, no.

Translational research emerged in an effort to move findings from the lab to clinics more systematically and quickly. This is slightly different from the move to novel models of delivery, but key concepts from translational research are useful in casting the challenge for moving forward. Another area of work closely related to translational research is called Implementation Science ( Sometimes this is characterized as "research to programs" and "research to policy. Community here refers to interventions that can be scaled up perhaps at the level of public health. Vaccinations may be among the most familiar examples to convey the full range from bench and bedside to community in which very basic studies are done. For some of the treatments, the bench part includes studies using animal models. What is accepted as routine and indeed exemplary treatment research involves careful screening of the sample using inclusion and exclusion criteria to recruit clients, development of manuals that specify the treatment, extensive training and supervision of therapists to administer treatment, and so on. Although this is not animal laboratory research, it has a "bench" feature because of the highly controlled, small-scale application. Patients can get better in such trials of course, so the research extends beyond a "proof of concept" demonstration. Yet, the high levels of experimental control when added to the dominant model make the treatment not very applicable beyond the confines of the study. Currently a major research priority is to extend treatment from the highly controlled conditions of the lab to "bedside" (patient care). There may be many reasons why treatment outcome effects drop off when bench-to-bedside extensions are made. Among the likely candidates is the lack of training of the practitioners, dilution of the treatment. Evidence-Based Psychotherapies: Novel Models of Delivering Treatment 320 Bedside to Community Bench-to-bedside remains important and is the incubator of interventions that may include principles and practices that serve as the bases for larger-scale interventions. Now it is critical to attend to the larger community of individuals in need of services and what we can do to deliver available treatments or draw on new ones. The move from bedside to community does not merely require scaling up an intervention in the usual way. In treatment, very well trained and supervised therapists are usually part of a clinical trial (bench), and training and supervision are two of the components that fall down in extensions to clinical practice (bedside). Scaling up now involves many more individuals administering treatment, under the most diverse circumstances. This is not a matter of doing more of the same but changing the model of delivery. Problems and challenges to administering treatment effectively are new, different, and formidable when providing an intervention on scale, even when the treatment is really well specified, clear, and not so difficult to administer. It was for this reason that my discussion began by considering the requirements of what is needed to provide a treatment that is to be administered on a large scale. Translational research emphasizes bench, bedside, and community, but the progression need not be unidirectional and move from bench, to bedside, to community. There would be enormous value to beginning in the community with interventions that can be administered on scale and that seem to be working. These interventions can also be moved to the bench to evaluate critical features. General Comments Key concepts of bench, bedside, and community help convey the different levels of interest and our foci. We want laboratory, experimental, and controlled studies (bench), and we want tests of how and whether a treatment is effective when extended to more routine practice settings (clinical work and patient care). It is important to conceptualize critical goals of treatment with the community as an end point of our efforts. It is useful in this conceptualization to begin with identifying the demands of models of delivery that can meet community needs. This does not begin at the bench level but rather looks at community needs, resources, and options. The ability of the model to scale up treatment, bring treatment to those in need, expand the workforce, and address other dimensions mentioned previously. Not only do we need different models of delivery, we also need a different mindset in our research efforts.