Professor Sara Arber
Professor of Sociology
Qualifications: BSc (LSE), MSc (London), PhD (Surrey), AcSS, FBA, FRSA
Email: s.arber@surrey.ac.uk
Phone: Work: 01483 68 6973
Room no: 34 AD 03
Further information
Biography
SARA ARBER has been Professor of Sociology since 1994 and is Co-Director of the Centre for Research on Ageing and Gender (CRAG). She was Head of the School of Human Sciences (2001-2004) and Head of the Sociology Department (1996-2002). She joined the Sociology Department in 1974, following postgraduate work at the Population Studies Center, University of Michigan. Sara has remained at Surrey throughout her career apart from spending a year on study leave (1979-80) in India and Australia, and as a Visiting Research Fellow at the Australian National University (January to March 2005).
Sara was President of the British Sociological Association (1999-2001) and President of the International Sociological Association Research Committee on Sociology of Aging (RC11) (2006-2010). She was elected as an Academician of the Social Sciences in 2000, a Fellow of the British Academy in 2008 and a Fellow of the Royal Society of Arts in 2012. Sara received the BSG (British Society of Gerontology) Outstanding Achievement Award 2011 for her contribution to the field of ageing and was awarded the status of Fellow of the Gerontological Society of America (GSA) in 2012. She has been actively involved with ESRC and is currently a member of their Grants Assessment Panel. Sara's internationally regarded research has spanned inequalities in health, ageing and gender, and latterly she has pioneered the Sociology of Sleep. Sara is a member of the 2014 REF (Research Excellence Framework) Panel for Sociology.
Research Interests
Sara's research focuses on gender and class inequalities in health, ageing and later life and on sociology of sleep. She was PI on SomnIA, Sleep in Ageing, a multi-disciplinary New Dynamics of Ageing collaborative research programme (2006-2011), and joint PI (with Debra Skene, FHMS) on an EU funded Marie Curie Research Training Network to train European doctoral and post-doctoral researchers in the Sociology of Sleep (2005-2009).
Sara has completed research for the ESRC on 'Negotiating Sleep among Couples' and on 'Older Men'; for the Nuffield Foundation on late life decision-making about life prolongation techniques; for the Health Development Agency on social support, social capital and health, and on older people and falls; for the US National Institute of Aging on a comparative US/UK study of clinical decision-making for older patients; for the EU on a comparative study of 'Sleep in Ageing Women' and a cross-national study of 'Gender, food and later life'; and for Anchor Homes to evaluate their refurbishment and rebuild programme in residential homes. She has recently co-edited Contemporary Grandparenting: changing Family Relationships in Global Contexts (Policy Press, 2012).
Much of Sara's research uses secondary analysis of large-scale datasets. She has conducted comparative research on inequalities in health, comparing Britain with Scandinavia in collaboration with Professor Eero Lahelma from Helsinki. She edited a special issue of Social Science and Medicine on 'Social and economic patterning of women's health in a changing world' (2002, vol. 4, no. 5) with Myriam Khlat, INID, Paris, a Monograph of Current Sociology on 'Gender, Ageing and Power: Changing Dynamics across Western Societies' (2007, vol.55, no.2), and a special issue of Sociological Research Online (12,5) on 'Sleep Across the Lifecourse' (2007).
Professor Arber is frequently invited to speak at international meetings, including Canada, USA, Latvia, Australia, New Zealand, Switzerland, Austria, Ireland, Finland, Germany, Italy, Norway, Czech Republic, Brazil and Belgium since 2005. Her book Connecting Gender and Ageing (co-authored with Jay Ginn) won the 1996 Age Concern prize for the best book on ageing.
Research Groups: Identities, Generation and Everyday Life and Sociology of Sleep
Publications
Journal articles
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(2013) 'Gender differences in approaches to self-management of poor sleep in later life'. Elsevier Social Science and Medicine, 79 (1), pp. 117-123.Full text is available at: http://epubs.surrey.ac.uk/761431/
Abstract
In this paper we seek to understand the influence of gender on the different approaches to managing poor sleep by older men and women through the conceptual framework of existing theoretical debates on medicalization, healthicization and 'personalization'. In-depth interviews undertaken between January and July 2008 with 62 people aged 65-95 who were experiencing poor sleep, revealed that the majority of older men and women resisted the medicalization of poor sleep, as they perceived sleep problems in later life were an inevitable consequence of ageing. However, older men and women engaged differently with the healthicization of poor sleep, with women far more likely than men to explore a range of alternative sleep remedies, such as herbal supplements, and were also much more likely than men to engage in behavioural practices to promote good sleep, and to avoid practices which prevented sleep. Women situated 'sleep' alongside more abstract discussions of 'diet' and health behaviours and drew on the discourses of the media, friends, family and their own experiences to create 'personalized' strategies, drawn from a paradigm of healthicization. Men, however, solely relied on the 'body' to indicate when sleep was needed and gauged their sleep needs largely by how they felt, and were able to function the following day. © 2012 Elsevier Ltd.
- . (2013) 'Effects of night work on sleep, cortisol and mood of female nurses, their husbands and children'. Wiley-Blackwell Sleep and Biological Rhythms, 11 (1), pp. 7-13.
- . (2012) 'Understanding older peoples' decisions about the use of sleeping medication: Issues of control and autonomy'. Wiley Sociology of Health and Illness, 34 (8), pp. 1215-1229.
- . (2012) 'Class, gender and time poverty: a time-use analysis of British workers’ free time resources'. Wiley British Journal of Sociology, 63 (3), pp. 451-471.
- . (2012) 'Rhetoric and reality of daily life in English care homes: The role of organised activities'. Linköping University Electronic Press (LiU E-Press). International Journal of Ageing and Later Life, 7 (1), pp. 53-78.
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(2012) 'Work-family conflicts and subsequent sleep medication among women and men: A longitudinal registry linkage study.'. Elsevier Ltd Social Science and Medicine, 79, pp. 66-75.Full text is available at: http://epubs.surrey.ac.uk/721935/
Abstract
Work and family are two key domains of life among working populations. Conflicts between paid work and family life can be detrimental to sleep and other health-related outcomes. This study examined longitudinally the influence of work–family conflicts on subsequent sleep medication. Questionnaire data were derived from the Helsinki Health Study mail surveys in 2001–2002 (2929 women, 793 men) of employees aged 40–60 years. Data concerning sleep medication were derived from the Finnish Social Insurance Institution’s registers covering all prescribed medication from 1995 to 2007. Four items measured whether job responsibilities interfered with family life (work to family conflicts), and four items measured whether family responsibilities interfered with work (family to work conflicts). Cox proportional hazard models were fitted, adjusting for age, sleep medication five years before baseline, as well as various family- and work-related covariates. During a five-year follow-up, 17% of women and 10% of men had at least one purchase of prescribed sleep medication. Among women, family to work conflicts were associated with sleep medication over the following 5 years after adjustment for age and prior medication. The association remained largely unaffected after adjusting for family-related and work-related covariates. Work to family conflicts were also associated with subsequent sleep medication after adjustment for age and prior medication. The association attenuated after adjustment for work-related factors. No associations could be confirmed among men. Thus reasons for men’s sleep medication likely emerge outside their work and family lives. Concerning individual items, strain-based ones showed stronger associations with sleep medication than more concrete time-based items. In conclusion, in particular family to work conflicts, but also work to family conflicts, are clear determinants of women’s sleep medication.
- . (2012) 'Striking the balance: Night care versus the facilitation of good sleep'. Mark Allen Healthcare British Journal of Nursing, 21 (5), pp. 303-307.
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(2012) 'Understanding sleep among couples: gender and the social patterning of sleep maintenance among younger and older couples'. The Society for Longitudinal and Lifecourse Studies (SLLS). Longitudinal and lifecourse Studies, 3 (1), pp. 66-79.Full text is available at: http://epubs.surrey.ac.uk/217904/
Abstract
Sleep, which is vital for health and wellbeing, is influenced by a complex array of (neuro)biological and social factors. Previous research has suggested that these factors vary across the life course, as well as being affected by transitions, such as parenthood, care-giving and widowhood. This research has also suggested that many of these transitions have a greater affect on women’s sleep. Yet much of this research has focused on women and one-sided reports of partner behaviours. This paper draws on data from Wave 1 of the Understanding Society Survey to examine gender differences in sleep maintenance within younger and older heterosexual couples. Data were collected in 2009 from a representative sample of households in Britain with a response rate of 59%. Sleep maintenance, namely waking on 3 or more nights per week, was included in a self-completion module. A series of logistic regression models are run using sleep maintenance as a dependent variable; i) a two level model for couples where the male is aged 50 or less (n=2452 couples); ii) a two level model for older couples where the male is aged above 50 (n=1972 couples); iii) bivariate models which allow for odds to be calculated separately for male and female partners. Results from the couple level models illustrate how both younger and older women have increased odds of difficulties with sleep maintenance (as compared to their male partners). Poor sleep maintenance is also associated with poor health, own unemployment, dissatisfaction with income, having had a previous cohabiting relationship and having younger children for both men and women. Reports by the husband of frequency of coughing/snoring at night is significantly associated with their wives’ sleep maintenance among younger couples and vice versa; but among older couples there is only a significant association of husband’s snoring on wife’s sleep. Whilst the current analysis is cross-sectional, further understanding of the dynamic relationships of sleep will be revealed through longitudinal analysis as Understanding Society moves through future waves.
- . (2012) 'Understanding older peoples’ decisions about the use of sleeping medication: issues of control and autonomy'. Blackwell Sociology of Health and Illness, 34 (8), pp. 1-15.
- . (2012) 'Gender, marital status and sleep problems in Britain'. Partswowy Zaklad Wydawnictur Lekarskich Przeglad Lekarski / Polish Journal of Social Medicine (English supplement), Poland: 69 (2), pp. 54-60.
- . (2011) 'The Politics of Sleep: Governing (Un)consciousness in the Late Modern Age'. SOCIOLOGY OF HEALTH & ILLNESS, 33, pp. 1112-1113.
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(2011) 'Time spent in bed at night by care-home residents: choice or compromise?'. CAMBRIDGE UNIV PRESS AGEING SOC, 31 (7), pp. 1229-1250.Full text is available at: http://epubs.surrey.ac.uk/15377/
Abstract
This paper examines the amount of time that care-home residents spend in bed at night, focusing on how residents' bedtimes and getting-up times are managed. Using a mixed-methods approach, diary data were collected over 14 days from 125 residents in ten care homes in South East England. The findings indicate that residents spent, on average, nearly 11 hours in bed at night, significantly more time than was spent sleeping. There was greater variance in the amount of time residents who needed assistance spent in bed than there was for independent residents. Detailed investigation of six care homes, each with 8 pm to 8 am night shifts, showed that bedtimes and getting-up times for dependent residents were influenced by the staff's shift patterns. Analysis of qualitative interviews with 38 residents highlighted a lack of resident choice about bedtimes and many compromises by the residents to fit in with the care-home shift and staffing patterns. The social norm of early bedtimes in care homes also influenced the independent residents. It is argued that the current system in care homes of approximately 12-hour night shifts, during which staff ratios are far lower than in the daytime, promotes an overly long ‘night-time’ and curbs residents' choices about the times at which they go to bed and get up, particularly for the most dependent residents.
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(2011) 'Diagnosis and Management of Depression in 3 Countries: Results From a Clinical Vignette Factorial Experiment.'. Physicians Posgraduates Press, Inc. Primary Care Companion CNS Disord, 13 (5)doi: 10.4088/PCC.11m01148Full text is available at: http://epubs.surrey.ac.uk/293560/
Abstract
Objective: International differences in disease prevalence rates are often reported and thought to reflect different lifestyles, genetics, or cultural differences in care-seeking behavior. However, they may also be produced by differences among health care systems. We sought to investigate variation in the diagnosis and management of a "patient" with exactly the same symptoms indicative of depression in 3 different health care systems (Germany, the United Kingdom, and the United States).Method: A factorial experiment was conducted between 2001 and 2006 in which 384 randomly selected primary care physicians viewed a video vignette of a patient presenting with symptoms suggestive of depression. Under the supervision of experienced clinicians, professional actors were trained to realistically portray patients who presented with 7 symptoms of depression: sleep disturbance, decreased interest, guilt, diminished energy, impaired concentration, poor appetite, and psychomotor agitation or retardation.Results: Most physicians listed depression as one of their diagnoses (89.6%), but German physicians were more likely to diagnose depression in women, while British and American physicians were more likely to diagnose depression in men (P = .0251). American physicians were almost twice as likely to prescribe an antidepressant as British physicians (P = .0241). German physicians were significantly more likely to refer the patient to a mental health professional than British or American physicians (P < .0001). German physicians wanted to see the patient in follow-up sooner than British or American physicians (P < .0001).Conclusions: Primary care physicians in different countries diagnose the exact same symptoms of depression differently depending on the patient's gender. There are also significant differences between countries in the management of a patient with symptoms suggestive of depression. International differences in prevalence rates for depression, and perhaps other diseases, may in part result from differences among health care systems in different countries.
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(2011) 'Caregiving at night: Understanding the impact on carers'. Elsevier Journal of Aging Studies, 25 (2), pp. 155-165.Full text is available at: http://epubs.surrey.ac.uk/15376/
Abstract
Caregiving research has rarely examined the nature and impact of care provision at night. This paper analyses indepth interviews with 24 older people in England whose sleep had been adversely affected by providing care at night. A framework is proposed that illustrates how six aspects of caregiving can disrupt carers' sleep quality: first, attending to the night-time physical needs of the care recipient; second, anticipation of their night-time care needs; third, ‘monitoring’ their relative at night; fourth, disruption from relatives who are awake for long periods at night, wandering or shouting; fifth, undertaking emotional support, and worries or anxieties related to their relative; and finally, the legacy of caregiving may continue to disrupt sleep after caring ceases, because of painful images of their relative's suffering or feelings of guilt. Adverse effects on carers' sleep are greatest for co-resident carers, especially when caring for a spouse or relative with a life-limiting illness or dementia.
- . (2011) 'Unen sosiologia: hoiva, sukupuoli ja uniongelmat / Sociology of Sleep: Caregiving, Gender and Sleep Problems'. 48 Edition. Society for Social Medicine in Finland Finnish Journal of Social Medicine, 2, pp. 100-113.
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(2011) 'Identifying the third agers: An analysis of British retirees' leisure pursuits'. Sage Publications Sociological Research Online, 16 (4)doi: 10.5153/sro.2451Full text is available at: http://epubs.surrey.ac.uk/297614/
Abstract
Despite the recent theoretical focus on the emergence of the Third Age as a period of fulfilment and an ongoing engagement with an active leisure lifestyle, there is a dearth of quantitative studies on how older people spend their time. Few studies of later life capitalise on time-use surveys, which constitute the most widely employed and accurate methodology for collecting data on everyday life. This article analyses data from the 2000 UK Time Use Survey in order to operationalise the concept of the Third Age and test theoretical propositions regarding the irrelevance of social divisions in the formation of an active leisure lifestyle after retirement. The analysis focuses on a subsample of 1615 people over the age of 64. An index of active leisure activities is constructed in order to estimate the proportion of third agers amongst British retirees. Logistic regression models are specified to examine the relative influence of socio-demographic characteristics on the probability of a person being a third ager. Strong effects of structural factors and health are found, which do not support arguments suggesting a minor influence of social context in lifestyle choices after retirement. 'Active' ageing appears to be the province of those who are culturally and materially advantaged, and it is the healthy, educated, upper-class and middle-class men that are more likely to engage in a Third Age leisure lifestyle.
- . (2010) 'The Informal Networks in Food Procurement by Older People-A Cross European Comparison'. Springer Verlag Ageing International, 35 (4), pp. 253-275.
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(2010) 'Day-time sleep and active ageing in later life'. Cambridge University Press Ageing and Society, 31 (2), pp. 197-216.Full text is available at: http://epubs.surrey.ac.uk/2993/
Abstract
The concept of ‘active ageing’ has received much attention through strategic policy frameworks such as that initiated by the World Health Organisation, and through government and non-governmental organisation initiatives. The primary goal of these initiatives is to encourage older people to be active and productive, and to enhance quality of life, health and wellbeing. It is well known that with increasing age, night-time sleep deteriorates, which has implications for how older people maintain activity levels, and leads to an increased propensity for day-time sleep. Using data from 62 interviews with people aged 65–95 years living in their own homes who reported poor sleep, this paper explores the meanings of day-time sleep, and how the attitudes and practices of ‘active ageing’ are intricately linked to the management of day-time sleep and bodily changes that arise from the ageing process. The desire to be active in later life led to primarily dichotomous attitudes to day-time sleep; older people either chose to accept sleeping in the day, or resisted it. Those who accepted day-time sleep did so because of recognition of decreasing energy in later life, and an acknowledgement that napping is beneficial in helping to maintain active lives. Those who resisted day-time sleep did so because time spent napping was regarded as being both unproductive and as a negative marker of the ageing process.
- . (2010) 'SOCIO-ECONOMIC PATTERNING OF SLEEP PROBLEMS IN MIDLIFE AND LATER LIFE: THE CONTRIBUTION OF SOCIODEMOGRAPHIC AND HEALTH-RELATED CHARACTERISTICS'. OXFORD UNIV PRESS INC GERONTOLOGIST, 50, pp. 406-406.
- . (2010) 'TRANSITIONS EXPERIENCED BY THE OLDEST OLD LIVING IN ENGLISH CARE HOMES'. OXFORD UNIV PRESS INC GERONTOLOGIST, 50, pp. 214-214.
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(2010) 'Complaints of insomnia among midlife employed people: The contribution of childhood and present socioeconomic circumstances'. Elsevier Ltd Sleep Medicine, 11 (9), pp. 828-836.Full text is available at: http://epubs.surrey.ac.uk/293562/
Abstract
Background Studies using conventional socioeconomic indicators have reported inconsistent evidence on socioeconomic differences in complaints of insomnia. We lack studies using a comprehensive socioeconomic framework over the life course ranging from childhood to adulthood. This study therefore aimed to examine the associations of both past and present socioeconomic circumstances with complaints of insomnia. Methods Data were derived from cross-sectional postal surveys (2000–2002) representative of the staff of the City of Helsinki, Finland (n = 8960, aged 40–60 years). Socioeconomic circumstances were measured by parental education, childhood economic difficulties, own education, occupational class, household income, housing tenure, and current economic difficulties. Complaints of insomnia during the previous month were measured by difficulties initiating and maintaining sleep and non-restorative sleep. Logistic regression analysis was used, adjusting for age and marital status. Results Complaints of insomnia at least once a week were reported by 25% of women and 21% of men. Childhood economic difficulties showed associations with complaints of insomnia among both women (OR 1.52; 95% CI 1.31–1.76) and men (OR 2.25; 95% CI 1.67–3.02) even after full adjustments. Also current economic difficulties remained associated with complaints of insomnia, but only among women (OR 1.65; 95% CI 1.41–1.93). However, education, occupational class, and income showed only limited age-adjusted associations with complaints of insomnia and these associations disappeared after full adjustments. Discussion Past and present economic difficulties were strongly associated with current complaints of insomnia. Supporting both families with children and adults to cope with their economic difficulties might reduce complaints of insomnia in adulthood.
- . (2010) 'Families, Ageing and Social Policy: Intergenerational Solidarity in European Welfare States'. CAMBRIDGE UNIV PRESS J SOC POLICY, 39, pp. 650-651.
- . (2010) 'Sleep complaints in middle-aged women and men: the contribution of working conditions and work-family conflicts'. WILEY-BLACKWELL JOURNAL OF SLEEP RESEARCH, 19 (3), pp. 466-477.
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(2010) 'AN ACTIGRAPHIC STUDY COMPARING COMMUNITY DWELLING POOR SLEEPERS WITH NON-DEMENTED CARE HOME RESIDENTS'. INFORMA HEALTHCARE CHRONOBIOLOGY INTERNATIONAL, 27 (4), pp. 842-854.Full text is available at: http://epubs.surrey.ac.uk/217905/
- . (2010) 'Review of Saraceno, C. (ed.) (2008), Families, Ageing and Social Policy: Intergenerational Solidarity in European Welfare States. Cheltenham: Edward Elgar'. Cambridge University Press Journal of Social Policy, 39 (4), pp. 650-651.
- . (2010) 'It's About Time Physicians' Perceptions of Time Constraints in Primary Care Medical Practice in Three National Healthcare Systems'. LIPPINCOTT WILLIAMS & WILKINS MED CARE, 48 (2), pp. 95-100.
- . (2009) 'CONTINENCE AND SLEEP: NIGHTLIFE IN CARE HOMES FOR OLDER PEOPLE'. GERONTOLOGICAL SOC AMER GERONTOLOGIST, 49, pp. 459-459.
- . (2009) 'A CONCEPTUAL FRAMEWORK OF THE EMOTIONAL LABOUR OF CARE STAFF, WORKING WITH RESIDENTS WITH DEMENTIA'. GERONTOLOGICAL SOC AMER GERONTOLOGIST, 49, pp. 399-400.
- . (2009) 'QUALITATIVE METHODOLOGY IN A MULTI-LINGUAL, MULTI-CULTURAL CONTEXT: THE CHALLENGES AND REWARDS'. GERONTOLOGICAL SOC AMER GERONTOLOGIST, 49, pp. 59-59.
- . (2009) 'REST-ACTIVITY FRAGMENTATION IN OLDER PEOPLE LIVING IN CARE HOMES'. GERONTOLOGICAL SOC AMER GERONTOLOGIST, 49, pp. 206-207.
- . (2009) 'POORER ADHERENCE TO MEDICATIONS AND LIFESTYLE ADVICE IN ADULTS WITH PAEDIATRIC PRESENTATION OF END-STAGE RENAL FAILURE'. SPRINGER PEDIATRIC NEPHROLOGY, 24 (9), pp. 1868-1868.
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(2009) 'Working shifts and mental health - findings from the British Household Panel Survey (1995-2005)'. SCANDINAVIAN JOURNAL WORK ENVIRONMENT & HEALTH SCANDINAVIAN JOURNAL OF WORK ENVIRONMENT & HEALTH, 35 (5), pp. 361-367.Full text is available at: http://epubs.surrey.ac.uk/3000/
- . (2009) 'PAEDIATRIC PRESENTATION OF END-STAGE RENAL FAILURE IS ASSOCIATED WITH POORER SOCIAL AND EDUCATIONAL ACHIEVEMENTS'. SPRINGER PEDIATRIC NEPHROLOGY, 24 (9), pp. 1818-1818.
- . (2009) 'Daily light exposure profiles in older non-resident extreme morning and evening types'. Wiley-Blackwell Publishing Journal of Sleep Research, 18 (4), pp. 466-471.
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(2009) 'Exploring the Interdependence of Couples' Rest-Wake Cycles: An Actigraphic Study'. INFORMA HEALTHCARE CHRONOBIOLOGY INTERNATIONAL, 26 (1) Article number PII 907774277 , pp. 80-92.Full text is available at: http://epubs.surrey.ac.uk/217906/
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(2009) 'Diagnostic Certainty as a Source of Medical Practice Variation in Coronary Heart Disease: Results from a Cross-National Experiment of Clinical Decision Making'. Sage Publications Medical Decision Making, 29 (5), pp. 606-618.Full text is available at: http://epubs.surrey.ac.uk/293563/
Abstract
The authors examined physician diagnostic certainty as one reason for cross-national medical practice variation. Data are from a factorial experiment conducted in the United States, the United Kingdom, and Germany, estimating 384 generalist physicians’ diagnostic and treatment decisions for videotaped vignettes of actor patients depicting a presentation consistent with coronary heart disease (CHD). Despite identical vignette presentations, the authors observed significant differences across health care systems, with US physicians being the most certain and German physicians the least certain (P < 0.0001). Physicians were least certain of a CHD diagnoses when patients were younger and female (P < 0.0086), and there was additional variation by health care system (as represented by country) depending on patient age (P < 0.0100) and race (P < 0.0021). Certainty was positively correlated with several clinical actions, including test ordering, prescriptions, referrals to specialists, and time to follow-up.
- . (2009) 'Review of C.E. Bird and P.P. Rieker (2008) Gender and health: The effects of constrained choices and social policies'. International Journal of Men’s Health, 8 (2), pp. 184-186.
- . (2009) 'Understanding how socio-economic status, gender and marital status influence self-reported sleep problems in Britain'. Social Science and Medicine, 68, pp. 281-289.
- . (2009) 'Lack of sleep, work and the long hours culture: Evidence from the UK Time Use Survey'. Work, Employment and Society, 23 (1), pp. 30-48.
- . (2009) 'Gender and socio-economic patterning of self-reported sleep problems in Britain'. Social Science and Medicine, 68 (2), pp. 281-289.
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(2008) 'Understanding gender differences in older people's attitudes towards life-prolonging medical technologies'. Elsevier Science Inc Journal of Aging Studies, 22 (4), pp. 366-375.Full text is available at: http://epubs.surrey.ac.uk/297615/
Abstract
The power of medical technologies to extend the final stages of life has heightened the need to understand what factors influence older people's wish to use such medical technologies. We analyse gender differences in such views, based on audio-recorded interviews with 33 men and 36 women (aged 65–93) in south-east England. Older women were twice as likely as men to oppose using medical technologies to extend life. More older women voiced ‘other-oriented’ reasons for their opposition, particularly not wanting to be a burden on others. Older men's attitudes were primarily ‘self-oriented’, reflecting a concern to stay alive for as long as possible, with fewer expressing concern about consequences for others. Women's greater life course involvement in caring and empathising with the wishes and concerns of others underlay these gender differences. Thus, women were ‘performing gender’ by putting others before themselves, even at this critical juncture in their lives.
- . (2008) 'GENDER INEQUALITIES IN MATERIAL RESOURCES, SOCIAL CONNECTEDNESS AND ATTITUDES TOWARDS LIFE-PROLONGING MEDICAL TECHNOLOGIES'. GERONTOLOGICAL SOC AMER GERONTOLOGIST, 48, pp. 184-185.
- . (2008) 'THE BODY IN TIME AND SPACE: SLEEP AMONGST CARE HOME RESIDENTS'. GERONTOLOGICAL SOC AMER GERONTOLOGIST, 48, pp. 735-735.
- . (2008) 'FOOD CHOICES AND RESILIENCE: MOTIVATIONS FOR OLDER COMMUNITY DWELLING MEN AND WOMEN TO OPT FOR A "HEALTHY DIET"'. GERONTOLOGICAL SOC AMER GERONTOLOGIST, 48, pp. 675-675.
- . (2008) ''DOING GENDER' AND ATTITUDES TOWARDS LIFE PROLONGATION AMONG OLDER PEOPLE'. GERONTOLOGICAL SOC AMER GERONTOLOGIST, 48, pp. 334-334.
- . (2008) 'IDENTIFYING THE 'THIRD AGERS': A SECONDARY ANALYSIS OF THE LATEST UK TIME USE SURVEYS'. GERONTOLOGICAL SOC AMER GERONTOLOGIST, 48, pp. 447-447.
- . (2008) 'GENDER AND THE IMPACT OF CARE-GIVING ON SLEEP IN ITALY AND THE UK'. GERONTOLOGICAL SOC AMER GERONTOLOGIST, 48, pp. 221-221.
- . (2008) 'Engaging with sleep: male definitions, understandings and attitudes'. Wiley-Blackwell Publishing Sociology of Health and Illness: a journal of medical sociology, 30 (5), pp. 696-710.
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(2008) 'Unruly Bodies and Couples' Sleep'. SAGE PUBLICATIONS LTD BODY & SOCIETY, 14 (4), pp. 75-91.Full text is available at: http://epubs.surrey.ac.uk/217908/
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(2008) 'Women and men with coronary heart disease in three countries; Are they treated differently?'. Elsevier Women’s Health Issues, 18 (3), pp. 191-198.Full text is available at: http://epubs.surrey.ac.uk/729418/
Abstract
Background Nonmedical determinants of medical decision making were investigated in an international research project in the United States, the United Kingdom, and Germany. The key question in this paper is whether and to what extent doctors' diagnostic and therapeutic decisions in coronary heart disease (CHD) are influenced by patient gender. Methods A factorial experiment with a videotaped patient consultation was conducted. Professional actors played the role of patients with symptoms of CHD. Several alternative versions were taped featuring the same script with patient-actors of different gender, age, race, and socioeconomic status. The videotapes were presented to a randomly selected sample of 128 primary care physicians in each country. Using an interview with standardized and open-ended questions, physicians were asked how they would diagnose and treat such a patient after they had seen the video. Results Results show gender differences in the diagnostic strategies of the doctors. Women were asked different questions, CHD was mentioned more often as a possible diagnosis for men than for women, and physicians were less certain about their diagnosis with female patients. Gender differences in management decisions (therapy and lifestyle advice) are less pronounced and less consistent than in diagnostic decisions. Magnitude of gender effect on doctors' decisions varies between countries with smaller influences in the United States. Conclusion Although patients with identical symptoms were presented, primary care doctors' behavior differed by patients' gender in all 3 countries under study. These gender differences suggest that women may be less likely to receive an accurate diagnosis and appropriate treatment than men.
- . (2008) 'Family members' perspectives on potential discussions about life prolongation for their older relatives'. Mortality, 13 (1), pp. 65-81.
- . (2008) 'The fourth shift: exploring the gendered nature of sleep disruption among couples with children'. BLACKWELL PUBLISHING BRITISH JOURNAL OF SOCIOLOGY, 59 (1), pp. 79-98.
- . (2008) 'The organ donor crisis: The missed organ donor potential from the accident and emergency departments'. ELSEVIER SCIENCE INC TRANSPLANTATION PROCEEDINGS, Philadelphia, PA: 40 (4), pp. 1008-1011.
- . (2008) 'The influence of patient and doctor gender on diagnosing Coronary Heart Disease'. Wiley-Blackwell Sociology of Health and Illness, 30 (1), pp. 1-18.
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(2008) 'Country differences in the diagnosis and management of coronary heart disease - a comparison between the US, the UK and Germany'. BIOMED CENTRAL LTD BMC HEALTH SERVICES RESEARCH, 8 Article number ARTN 198 Full text is available at: http://epubs.surrey.ac.uk/1647/
- . (2007) 'Editor's introduction: Gender, sleep and the life course'. SAGE PUBLICATIONS LTD SOCIOLOGICAL RESEARCH ONLINE, 12 (5)
- . (2007) 'Changing approaches to gender and ageing - Introduction'. SAGE PUBLICATIONS LTD CURRENT SOCIOLOGY, 55 (2), pp. 147-153.
- . (2007) 'Aging, globalization and inequality: The new critical gerontology'. AMER SOCIOLOGICAL ASSOC CONTEMPORARY SOCIOLOGY-A JOURNAL OF REVIEWS, 36 (2), pp. 186-188.
- . (2007) 'Caring and sleep disruption among women in Italy'. Sociological Research Online, 12 (5)
- . (2007) 'Gender roles and women's sleep in mid and later life: A quantitative approach'. SAGE PUBLICATIONS LTD SOCIOLOGICAL RESEARCH ONLINE, 12 (5)
- . (2007) 'Patient characteristics and inequalities in doctors' diagnostic and management strategies relating to CHD: A video-simulation experiment'. PERGAMON-ELSEVIER SCIENCE LTD SOCIAL SCIENCE & MEDICINE, 62 (1), pp. 103-115.
- . (2006) 'How do doctors in different countries manage the same patient? Results of a factorial experiment'. BLACKWELL PUBLISHING HEALTH SERVICES RESEARCH, 41 (6), pp. 2182-2200.
- . (2006) 'Dilemmas in decision-making about resuscitation - a focus group study of older people'. PERGAMON-ELSEVIER SCIENCE LTD SOCIAL SCIENCE & MEDICINE, 62 (7), pp. 1579-1593.
- . (2006) 'The influence of patient's age on clinical decision-making about coronary heart disease in the USA and the UK'. CAMBRIDGE UNIV PRESS AGEING & SOCIETY, 26, pp. 303-321.
- . (2006) 'Sleep and health: gender, socioeconomic circumstances, and inequalities in sleep'. OXFORD UNIV PRESS EUROPEAN JOURNAL OF PUBLIC HEALTH, 16, pp. 5-5.
- . (2005) 'Narratives of the night: The use of audio diaries in researching sleep'. SAGE PUBLICATIONS LTD SOCIOLOGICAL RESEARCH ONLINE, 10 (4)
Conference papers
- . (2011) 'RESEARCH AND PRACTICE: ENABLING KNOWLEDGE TRANSFER TO RESIDENTIAL CARE HOMES'. Oxford University Press GERONTOLOGIST, Boston, USA: 64th Annual Scientific Meeting “Lifestyle→Lifespan” 51, pp. 214-214.
- . (2011) 'HOW SOCIAL FACTORS AND CAREGIVING INFLUENCE SLEEP QUALITY IN LATER LIFE'. Oxford University Press GERONTOLOGIST, Boston, USA: 64th Annual Scientific Meeting “Lifestyle→Lifespan” 51, pp. 214-214.
- . (2011) 'USE OF SLEEPING MEDICATION AND SLEEP QUALITY IN LATER LIFE'. GERONTOLOGIST, 51, pp. 331-331.
- . (2011) 'The Role of the Family in Influencing Women's Decision-making About Taking Part in Breast Cancer Clinical Trials'. ELSEVIER SCI LTD EUROPEAN JOURNAL OF CANCER, Stockholm, SWEDEN: European Multidisciplinary Cancer Congress on Integrating Basic and Translational Science, Surgery, Radiotherapy, Medical oncology, Advocacy and Care 47, pp. S309-S309.
- . (2010) 'NIGHTIME URINATION, AGEING AND SLEEP DISTURBANCE: STRATEGIES AND ADJUSTMENTS'. OXFORD UNIV PRESS INC GERONTOLOGIST, 50, pp. 506-506.
- . (2010) 'SOCIAL AND HEALTH INFLUENCES ON THE SLEEP QUALITY OF OLDER ADULTS LIVING IN THE UK'. OXFORD UNIV PRESS INC GERONTOLOGIST, 50, pp. 407-407.
- . (2010) 'SLEEP DISTURBANCE IN LATER LIFE: THE IMPACT OF WORRIES AND ANXIETY'. OXFORD UNIV PRESS INC GERONTOLOGIST, 50, pp. 407-407.
- . (2009) 'MANAGING POOR SLEEP IN LATER LIFE: INTERPRETING OLDER PEOPLES' ATTITUDES TO SLEEP MEDICATION AND SLEEP REMEDIES'. GERONTOLOGICAL SOC AMER GERONTOLOGIST, 49, pp. 157-158.
- . (2009) 'ROUTINISING THE DAY AND NIGHT BEYOND RETIREMENT: CONSEQUENCES FOR POOR SLEEP IN LATER LIFE'. GERONTOLOGICAL SOC AMER GERONTOLOGIST, 49, pp. 239-239.
- . (2008) 'Dawn and dusk: care home sleep routines and participation in activities'. WILEY-BLACKWELL PUBLISHING, INC JOURNAL OF SLEEP RESEARCH, Glasgow, SCOTLAND: 19th Congress of the European-Sleep-Research-Society 17, pp. 247-247.
- . (2008) 'Exploring the determinants of sleep duration: an analysis of time use diaries utilizing multilevel models'. WILEY-BLACKWELL PUBLISHING, INC JOURNAL OF SLEEP RESEARCH, Glasgow, SCOTLAND: 19th Congress of the European-Sleep-Research-Society 17, pp. 232-232.
- . (2008) 'Nurses' night work influences sleep timing for nurses, their partners and children'. WILEY-BLACKWELL PUBLISHING, INC JOURNAL OF SLEEP RESEARCH, Glasgow, SCOTLAND: 19th Congress of the European-Sleep-Research-Society 17, pp. 115-115.
- . (2008) 'Daily light exposure profiles in older extreme morning and evening types'. WILEY-BLACKWELL PUBLISHING, INC JOURNAL OF SLEEP RESEARCH, Glasgow, SCOTLAND: 19th Congress of the European-Sleep-Research-Society 17, pp. 73-73.
- . (2008) 'Understanding quality of sleep in later life: the PSQI and subjective sleep quality'. WILEY-BLACKWELL PUBLISHING, INC JOURNAL OF SLEEP RESEARCH, Glasgow, SCOTLAND: 19th Congress of the European-Sleep-Research-Society 17, pp. 181-181.
- . (2008) 'Working during nights or in evening shifts - does it affect your health?'. WILEY-BLACKWELL PUBLISHING, INC JOURNAL OF SLEEP RESEARCH, Glasgow, SCOTLAND: 19th Congress of the European-Sleep-Research-Society 17, pp. 21-21.
- . (2008) 'The influence of individual and institutional factors on care home residents' sleep'. WILEY-BLACKWELL PUBLISHING, INC JOURNAL OF SLEEP RESEARCH, Glasgow, SCOTLAND: 19th Congress of the European-Sleep-Research-Society 17, pp. 182-183.
- . (2008) 'SLEEP ROUTINES, SLEEP QUALITY AND OLDER PEOPLE'. GERONTOLOGICAL SOC AMER GERONTOLOGIST, 48, pp. 584-584.
- . (2006) 'The effect of caring and family roles on midlife and older women's sleep in Italy'. BLACKWELL PUBLISHING JOURNAL OF SLEEP RESEARCH, Innsbruck, AUSTRIA: 18th Congress of the European-Sleep-Research-Society 15, pp. 130-130.
- . (2006) 'Methods for analysing intra-individual and couple stability and inter-individual and couple variation in dyadic actigraphic data'. BLACKWELL PUBLISHING JOURNAL OF SLEEP RESEARCH, Innsbruck, AUSTRIA: 18th Congress of the European-Sleep-Research-Society 15, pp. 118-118.
- . (2006) 'Demographic, socioeconomic and health determinants of poor quality sleep in the United Kingdom'. BLACKWELL PUBLISHING JOURNAL OF SLEEP RESEARCH, Innsbruck, AUSTRIA: 18th Congress of the European-Sleep-Research-Society 15, pp. 117-117.
- . (2006) 'Diurnal preference in couples: negotiating sleep timing'. BLACKWELL PUBLISHING JOURNAL OF SLEEP RESEARCH, Innsbruck, AUSTRIA: 18th Congress of the European-Sleep-Research-Society 15, pp. 95-95.
- . (2006) 'Sleep, social roles and relationships of health professionals who work at night'. BLACKWELL PUBLISHING JOURNAL OF SLEEP RESEARCH, Innsbruck, AUSTRIA: 18th Congress of the European-Sleep-Research-Society 15, pp. 144-144.
Books
- .
(2012) Contemporary Grandparenting: Changing Family Relationships in Global Contexts. First Edition. Bristol : Policy Press Full text is available at: http://epubs.surrey.ac.uk/749318/
Abstract
Grandparenting in the 21st century is at the heart of profound family and societal changes. It is of increasing social and economic significance yet many dimensions of grandparenting are still poorly understood. Contemporary Grandparenting is the first book to take a sociological approach to grandparenting across diverse country contexts and combines new theorising with up-to-date empirical findings to document the changing nature of grandparenting across global contexts. In this highly original book, leading contributors analyse how grandparenting differs according to the nature of the welfare state and the cultural context, how family breakdown influences grandparenting, and explore men's changing roles as grandfathers. Grandparents today face conflicting norms and expectations about their roles, but act with agency to forge new identities within the context of societal and cultural constraints. Contemporary Grandparenting illuminates key issues relevant to students and researchers from sociology and social policy, including in the fields of family, childhood, ageing and gender studies
- . (2007) The Myth of Generational Conflict: Family and State in Ageing Societies. London : Routledge
Book chapters
- .
(2012) 'Sleep and Society'. in Morin CM, Espie CA (eds.) The Oxford Handbook of Sleep and Sleep Disorders
New York : Oxford University Press Article number 11 , pp. 223-247.Full text is available at: http://epubs.surrey.ac.uk/721936/
Abstract
This chapter demonstrates how sleep is inextricably linked to ‘society’. Part 1 illustrates how sleep and its disorders are historically and culturally divergent and that ‘where’, ‘why’ and ‘how’ we sleep differ depending on the society in which we live. Part 2 focuses in more detail on the ‘private’ nature of Western sleep. Sleep is affected by the social context where it occurs, and is thus influenced by household composition, power, gender, social roles and life course position. Finally, we examine sleep in care-giving and institutional contexts, where sleep is not only ‘observed’, but may be disturbed by those undertaking care or surveillance at night. Sleep is also socially patterned with the socially disadvantaged most likely to report sleep problems.
- . (2011) 'Time use studies: A method for exploring everyday life in the Third Age.'. in Carr D, Komp K (eds.) Gerontology in the Era of the Third Age: Implications and Next Steps New York : Springer Publishing , pp. 127-145.
- . (2011) 'Gender and Ageing'. in Settersten R, Angel J (eds.) Handbook of sociology of aging Springer , pp. 71-82.
- . (2010) 'The Sociology of sleep'. in Cappaccio F, Miller M, Lockley S (eds.) Sleep, Health and Society: From Aetiology to Public Health Oxford : Oxford University Press , pp. 275-299.
- . (2009) 'Gender and food in later life: shifting roles and relationships'. in M Raats , Staveren WV, Groot L (eds.) Food for the Ageing Population Cambridge : Woodhead Publishing , pp. 110-127.
- . (2009) 'Gender, class and income inequalities in later life'. in McDaniel S (ed.) Ageing, Key Issues for the 21st Century Series 3rd Edition. New York : Sage
- . (2008) 'The invisibility of age'. in McDaniel S (ed.) Ageing, Key Issues for the 21st Century Series 1st Edition. New York : Sage
- . (2008) 'Conflicting sleep demands: Parents and young people in UK households'. in Brunt L, Steger B (eds.) Worlds of Sleep: Investigations into the Dormant Third of our Lives Berlin : Frank & Timme , pp. 131-151.
- . (2008) 'Women’s sleep in Italy: The influence of caregiving roles'. in Brunt L, Steger B (eds.) Worlds of Sleep: Investigations into the Dormant Third of our Lives Berlin : Frank & Timme , pp. 131-151.
- . (2008) 'Secondary analysis of survey data'. in Gilbert GN (ed.) Researching Social Life 3rd Edition. London : Sage , pp. 372-393.
Internet publications
- . (2007) Gender roles and women’s sleep in mid and later life: A quantitative approach. Sociological Research Online
Teaching
Sara's recent teaching has been in the area of gender and ageing, and on survey research methodology to undergraduates and M.Sc in Social Research Methods students. She previously taught final year options in Gender and Society and in Sociology of Health and Illness. Sara supervises ten doctoral students in the fields of health, ageing, gender and sociology of sleep, including some students conducting secondary analysis of national datasets. She has supervised 40 students to successful completion of their PhD.
Professional Activities
Sara Arber was President of the British Sociological Association (1999-2001), Treasurer (1988-1990) and is currently a Vice President. She was President of the International Sociological Association Research Committee on Sociology of Aging (RC-11) (2006-2010) and organiser of the ISA RC-11 Inter-Congress Conference on 'Ageing Societies and Ageing Sociology', 7-9 September 2004. She was Vice President of the European Sociological Association (2005-2007) and played a key role in organising the ESA conference in Glasgow, 3-6 September 2007. Sara is an elected Academician of the Social Sciences, and a Fellow of the British Academy. Sara received the BSG (British Society of Gerontology) Outstanding Achievement Award 2011 for her contribution tot he field of ageing. Sara was a consultant on the ONS/ESRC Review of Social Classifications and sits on various advisory committees. She chaired the Sociology Editorial Board (1992-95) and was Treasurer of the British Sociological Association (1988-90). She is a member of the ESRC Grants Assessment Panel (2010-) and previously the ESRC Research Grants Board (2008-10). She was a member of the ESRC Social Affairs Committee (1984-87), and the S.W. Surrey District Health Authority (1981-90). Sara is currently a member of 6 Editorial Boards, including Sociology of Health and Illness, and International Journal of Social Research Methodology, and is an Associate Editor for Social Science and Medicine.
