Drugs and Substance Abuse/ Related Social Problems


Drug and substance abuse have been cited by different studies as a major social problem world over that mainly spring from socio-cultural and economic woes and have a close and strong correlation with unhealthy lifestyles, poor social relations and personality, and sexual abuse. Most studies have reported close link amongst drug and substance, sexual assault and harassment, rape and conflicts, theft and associated psychological trauma to families, individuals and society. This study attempts to explore the social problems that emanate from drug and substance abuse and investigates the causes, effects and nature of these problems. The study gives a socio-demographic analysis of the relationship between drugs and substance abuse, and the social ills including rape, poverty, sexual abuse and poor interpersonal relationships that have been established by different studies as well as my opinion on the issue.

Background Information

Today, there are several social problems that the members of the society are faced with. A social problem refers to a publicly acknowledged condition that exists in the society though it goes against commonly held values, norms, beliefs and practices of a larger segment of the population who in the process try to eradicate it. One example of a common social problem today that I have witnessed is the drug and substance abuse which has intensified to worrying levels and caused other pertinent issues like sexual abuse, rape, prostitution, poor health, incest, intimate partner violence among others.

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Drug and substance abuse have also led to an upsurge in anti-social behaviours include theft and robbery, damage to property, physical confrontations and fights (Gary, Alan, Farzad, Robert, Adele, & Carl, 2004). Further,  commercial sex workers who “exchange sex for money or drugs” are exposed to various social problems ranging from poverty, lack of shelter, incarceration, substance abuse, risk of catching HIV/AIDs,  physical and sexual partners abuse and long term childhood sexual abuse (El-Bassel, Witte,  Wada,  Gilbert &Wallace, 2001).

Study Hypothesis

The study hypothesis relates to the presumed nature of the social problems that are caused by drugs and substances abuse, including my opinion and observations. These assumptions indicate the expected outcomes of the study that attempts to show the link that exists between drug and substances abuse, as a social problem and the various complications, pain and sufferings that come with the practice.

In this study, it is hypothesized   that;

  • There are widespread cases of sexual abuse, violence and other social problems that result from illicit drugs and substance abuse.
  • It is presupposed that most victims of sexual violence can positively identify their attackers, some who are trusted people and family members yet few come out publicly to report the same
  • Finally, it is also assumed that all people, boys, girls, men and women are exposed to the risks and social problems that are caused by the drug and substances abuse in society.

Statement of the Problem

Drug and substances abuse and addiction are major burdens to the society that needs serious intervention (NIDA, 2008). There are several social problems that can be linked to drugs and substance abuse in society. Some of this problems include paucity and squalid living conditions, imprisonment and confinement in rehabilitation centres, prostitution and high exposure to  HIV/AIDs, sexual abuse by partners abuse, rape, sexual assault and long term childhood sexual abuse. Unfortunately, some of these problems are rarely reported while sometimes due to ignorance or fear of the consequences, most victims choose to remain silent instead of seeking treatment and legal redress.

My observations reveal   that drug and substance abuse is a grave social problem owing to its devastating effects to the society including lower, middle and upper-class people, situation which has led to the ensued   maximum publicity, governments’ interventions and formations of international and special interest bodies like United Nations Office on Drugs and Crimes to fight the vice. As a social problem, drug and substance abuse affect proportionately lager portion of the society either directly or indirectly.  For example, those who use drugs whom I have interacted with experience a lot of trauma, health complications, poor social relations and strange behaviours that may result in mental retardation and death. People under the influence of alcohol have also been reported to further increase social problems as they are normally the perpetrators of rape, sexual assaults, intimate partner violence, and economic woes and anti-social behaviours. At the same time, the cost of drug and substance abuse like crime, loss in productivity in USA is exorbitantly high, more than half a trillion dollars annually (NIDA, 2008). This in my view presents a grave loss to the American economy and highlights the significance of the problem of the study.

Consequently, the study attempts to answer these questions;

  1. What are the major causes, effects and trends of drug and substance abuse?
  2. What are the established relationship between drug and substance abuse, and the pronounced social problems?
  • Though most victims of sexual violence can positively identify their attackers, some who are trusted people and family members, why do only a few come out publicly to report the problem?

Purpose of the Study

Drug and substance abuse have been blamed as causative agent of many social problems that affect nearly every member of the society either directly or indirectly. The purpose of this study is to investigate the stated hypotheses, explore the reasons behind these social problems, their consequences, trends and response, and mitigation mechanisms to ensure that no member of the society is exposed to such risks

Study Methodology

The research involved a study of secondary  data on studies that had been conducted in the field, existing records, my observation of the relationship between  drug and substances and sexual abuse, rape, assault, intimate partner and the domestic violence, and childhood sexual abuse. The detailed data was then gathered, recorded and objectively analyzed based on the findings of other studies, socio-demographics and trends of the problem. A qualitative analysis was also employed in a bid to correlate drug and substances abuse and socioeconomic problems such as poverty, sexual abuse, rape, family valences and social relationship and coping behaviour problems.

Literature Review

  1. Causes of problems

As outlined in the study hypothesis, a number of factors have been identified as the potential causes of drug and substances abuse as well as the associated violent acts, sexual abuse and other social ills. First, poverty and economic hardships has been cited as major contributors to the drugs and substances abuse and drug trafficking. El-Bassel, Witte, Wada, Gilbert &Wallace (2001) stipulate that most commercial sex workers are engaged in the trade as well as drug trafficking “as their main source of income” and they do have “sex in crack houses” with partners who are prone to sexual abuse. Consequently, there is a need for a more proactive action to deal eradicate poverty and ignorance as a matter of priority in addressing this social problem. However, poverty alone cannot be blamed to a major factor that fuel this problem since some drug users are people from well to do families who later commit the offences when under the influence of drugs.

A notable research finding by Ompad et al, carried out in  2005 reveals that poverty, drug abuse and childhood sex abuse is not only present in different societies but also lead to frustrations, child recklessness and unusual behaviours which are later portrayed in adult life in form of intimate partner violence, rape and drug abuse and family abandonment:

“….mean age and age at first injection were 23.7 and 19.6 years, respectively, 307 participants (14.3%) reported childhood sexual abuse. After adjustment for gender, race/ethnicity, non-injection drug uses before first injection drug use, and recruitment sites, childhood sexual abuse was independently associated with younger age at first injection” (Ompad et al, 2005).

However, a 2007 research done by PCAR showed that 61%of homeless girls and 16% of homeless boys cite sexual abuse as a reason for fleeing their homes, and eventually become street dwellers (PCAR, 2007). At the same greed by the drug traffickers and desire to become rich quick has also contributed to the widespread of social problem.

Secondly, the family structure has been cited as a factor which may lead to a high prevalence of certain social problems especially rape. Gary, Alan, Farzad, Robert, Adele, & Carl, (2004) emphasize that family structure may be a major contributor to rape by drug addicts. In their study,   the respondents from single families as compared to those who live with both biological parents revealed that they are more vulnerable to these forms of violence. However, this conclusion does not give a verifiable conclusion that can be tested empirical given that the offenders are normally under the influence of drugs and may not be able to identify their victims based on the family structures.  However, it is imperative to acknowledge the multifaceted nature of the social problem and the role drugs and substances abuse play in enhancement of sexual victimization, anti social behaviors, deplorable socioeconomic status and attempts to commit suicide. Due to the fact that most of the offenders of these atrocities are people who are very close to the victims and are highly trusted, most cases go unreported while some are resolved at family levels.

El-Bassel, Gilbert, Wu, Go & Hill (2005) on the other hand state that social problems like intimate partner violence (IPV), unequal power distribution, vague reasoning may be caused by drug use. Factually, the drug use would be an intervening factor in this process owing to the “overlapping psychopharmacological, economic and gender-related powers”. This also show that drug use may trigger cognitive disruption and limit capacity to establish any social interaction between offender and the victim. At the same time, women whom I have observed, resort to use drugs, when traumatized by the effects and experiences of intimate partner violence as they seek ways of living with the situation.

b).    Trends

My analysis indicates that social problems that are occasioned by drugs and substance abuse are ever-increasing despite the awareness and ability of most victims to identify the culprits. One of such research which evaluated the violent and sexual abuse of women reported that nearly 94% of the 1,243 respondents confided to know their assailant while seven percent reported either physical or sexual violence during pregnancy (Amoro, Fried, Cabral & Zuckerman, 1990).  However, the sample size used may be a point of debate as it may no give a true reflection the entire population. In contrast, based on a survey of 17, 337, a larger population sample size,  victims of child sexual abuse, Dube, Anda, Whitfield, Brown, Felitti, Dong & Giles (2000) on the other hand argue that men and women who were abused in their childhood, as compared those who were not, are at a 40 % risk of marrying an alcoholic.

To put more emphasis on the cause and trend of the social problem, the same group also reports that such victims have 40% to 50% possibility of having other social and family problems in their marriage. Another worrying trend that is rarely reported is that both boys and girls are highly exposed to child sexual abuse, though more attention is normally given to the girl child (Dube, Anda, Whitfield, Brown, Felitti, Dong & Giles, 2000).

The findings of Joyce,   Ruiz, Millman & Langrod, (2004) also show similar trends.  The researchers also argue that the long term effects of child sexual abuse on “multiple health and social problems” are indifferent in terms of gender during adulthood. In contrast, Gary, Alan, Farzad, Robert, Adele, & Carl, (2004) argue that they study revealed that ‘girls are 3.9 times more likely than boys” to be sexually abused. This affirms that though there is need to focus on all the vulnerable groups, a deliberate effort needs to be made to protect the female targets more. At the same time, there are more childhood sexual abuse women today who seek medical assistance on problems related to heavy alcoholism and drug abuse as compared to women in the general society (Wilsnack, Vogeltanz, Klassen, & Harris, 1997).

  1. Effects

Due to the violence and sexually related abuses inflicted on the victims by most drug addicts and substance abusers, several social problems are as a result perpetuated. According to Amoro, Fried, Cabral & Zuckerman (1990), most victims of such social ills, especially the women who are abused during pregnancy, are at a greater “risk of having a history of depression and attempted suicide.”  Secondly, the victims frequently show signs of depression, rarely happy about being pregnant. As a result, owing to low motivation by the victims to report incidences of child sexual abuse, a history of attempted suicide is normally very high, and there is high likely hood of the childhood victims to abuse their partners in adult life.

The other effect of sexual abuse by drug users may be the counterproductive scenario where “the victims in turn become users of such drugs as away of hiding their emotional problems and social humiliation especially if such abuse is known by most members of the social circle. Mullen, Martin, Anderson,  Romans & Herbison (1999)  also identify the repercussions of drug-induced sexual abuse as high occurrence of psychopathology, sexual disorders, low self-esteem, and personal relations challenges. Similarly,  Wilsnack, Vogeltanz, Klassen, & Harris, (1997) argue that the commonly reported results of sexual abuse at early ages, which are mainly attributed to alcohol use,  include anxiety, depression, sexual experience and sexual dysfunction, eating disorders and substances abuse by the victims.

Drugs and substance abuse have also contributed to the spread of HIV /AIDs especially due to rape by carrier who is under the influence of drugs, sharing of injections and engaging in sex in exchange for drug. According to El-Bassel, Witte, Wada, Gilbert &Wallace (2001), due to poverty, some women engage in commercial sex so as to obtain money and drugs and share needles and sex partners including these who are HIV positive. However, the researchers do not recognizes the fact that not every commercial sex worker is economically challenged as some resort to the practice for sexual satisfaction and due to separation with their partners. Apart from the risk of contracting the incurable virus, these women are also normally sexually and physically abused by their partners.

  1. Relationships

There have been several attempts by scholars and researchers as well as clinicians to strongly relate drugs and substance abuse to most social problems. One of such research was conducted by Swatz, Swanson, Hiday, Borum, Wagner & Burns (2001) found out that together with resistance to medical treatment, alcohol and substance abuse problems have a very close relationship with serious violent acts in the society, even with control of variables like socio-demographic and clinical features of the conditions in a study.  On the same note, Mullen, Martin, Anderson,  Romans & Herbison (1999) in their article gives an explicit insight on the relationship that has been observed to exist between physical, emotional and sexual abuse of children and adult life mental health, interpersonal and sexual problems.

There is also a close link between the social problems and family history as well as the environment in which one grows and stays in. Mullen, Martin, Anderson,  Romans & Herbison (1999), in a different approach,  reports that abuse of all types and nature, especially the ones done under the influence of drugs, are more common amongst those who come from disrupted family backgrounds. El-Bassel, Gilbert, Wu, Go & Hill show that there exists a reciprocal relationship between intimate partner violence and drug abuse, as both increase the likely hood of occurrence of another. On the other hand, it is also true that there exists close and empirically verifiable relationship between abuse by a partner, substance abuse by the victim and HIV-related complications, a situation which calls for development of synergistic strategies and polices aimed at preventing and treating  the patients, especially the drug-using female street sex workers.


One of the findings of this research is that there has been increasing incidences of social problems that are related to drugs and substance abuse. Such abuses in my opinion relate more to sexual assault, physical assault, rape, incest, violence, theft and robbery, poor public health, depression and psychological problems and financial hardships. The research also reveals that most of the victims of these abuses not only know their attackers, some who are partners, but also rarely report the ills due to fear of the negative ramifications and occasioned reactions from the society. These indicate that risks of violence are highly increased by the abuse of drug and heavy alcoholism.

Consequently,  sustained childhood sexual abuse and history of drug use in the family and immediate surrounding have negative child development and adult outcomes, and work to increase and reinforce the social problems. Summarily, my findings support the hypotheses of the study as it emerged that there is close relationship between use of drugs and substances abuse and social problems which all the sexes an the society are exposed to. However, the findings are specifically clear that the females as compared to males are more prone to sexual related abuses and violence that spring from drug and substances abuse.


As indicated by different researchers that sexual abuse has   far reaching behavioral, social outcomes and psychological effects if the society, it is crucial that deliberate measures be put in place to “identify and treat all adult, affected by” child sexual abuse, while preventive, security and legal procedures are designed and fully implemented by the relevant stakeholders and policy makers (Dube, Anda, Whitfield, Brown, Felitti, Dong & Giles, 2000).   It is apparent that coupled with the poor treatment strategies, alcohol and drug abuse perpetuate social problems in the society and increase the risk of violent behaviors in the society.

It is recommendable that a careful and non based broad based approach be implemented to address these issues with due weightiness and commitment. Such approaches may include attempts to reach specific groups in the society through a customized approach, holistic community intervention, integrated mental disorder management and manageable substance abuse management (Swatz, Swanson, Hiday, Borum, Wagner & Burns, 2001). It is also crucial that an assessment vulnerability of pregnant women who either or their partners are drug abusers be critically carried out especially during the prenatal care (Amoro, Fried, Cabral & Zuckerman, (1990).


Since the  research  reveal that sustained child hood sexual abuse and history of drug use in the family and immediate surrounding have negative child development and adult outcomes, and work to   increase  and reinforce the social problems, it is my belief that  the family can play a central role in addressing these issues. Due to the multifaceted nature of the factors which lead to drug and  substance abuse and social problems, I believe,  it is  critical that workable and proactive intervention and behavior reinforcement programs, on school student’s protection,  professional teaching and counseling and community based prevention strategies be formulated ( Gary,  Alan, Farzad,  Robert,  Adele,  & Carl, 2004). Such strategies, in my view should address the problem of drug and substance abuse, punishment and rehabilitation of sexual offenders and drug dealers and management of the social tribulations that come with the every problem.

Recommendation for Future Research

It is recommended that future research should explore the possibility of improving the socio-economic status of the drugs and substances abusers as a means of managing social problems that spring from their consumption. I suggest that such a study should not only give a detailed analysis of the demographic and regional trends of the problems but also give specific assessment of the nature of the issues by gender, control strategies, treatment of abusers and their victims and their reconciliation. The triggers of close family sexual assault, childhood sexual abuse and intimate partner violence should also be studied further especially their relationship to drug abuse. Tight control of internal variables as well as study of a larger population sample would also be ideal so as to ensure that the results obtained give a clear reflection of the true picture about this social problem.


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Substance abuse. American Journal of Public Health, Vol.80, Issue 5 575-579: American Public Health Association

APA. (2009).Understanding Child Sexual Abuse Education,

Prevention and Recovery. Accessed, April 8, 2009, from http2//www.apa.org/releases/sexabuse/effects.html

Basile, K. C. (2002). Prevalence of wife rape and other intimate partner sexual coercion in a

Nationally representative sample of women. Violence and Victims, 17(5), 511-524.

Bergen, K.R., Barnhill, E. (208). Marital rape: New Research and Directions. Accessed, April

8, 2009, from http://new.vawnet.org/category/Main_Doc.php?docid=248

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Current state of social scientific knowledge. Aggression and Violent Behavior, 9, 675-691

Dube, S., Anda, R., Whitfield, C, Brown, D., Felitti, V., Dong, M & Giles, W. (2000). Long-

Term Consequences of Childhood Sexual Abuse by gender victim. American Journal of preventive medicine, Volume 28, Issue 5, Pages 430-438.

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El-Bassel, N., Witte, S.S., Wada, T., Gilbert, L& Wallace, J. (2001). AIDS Patient Care and


STDs Correlates of Partner Violence Among Female Street-Based Sex Workers: Substance Abuse, History of Childhood Abuse, and HIV Risks. Accessed April 7, 2009, from www.columbia.edu/cu/ssw/faculty/profiles/witte.html


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Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study.
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Gary, K., Alan, J. Farzad, N., Robert, R. Adele, M. & Carl, L. (2004). Substance Abuse and

Behavioral Correlates of Sexual Assault among South African Adolescents. Elsevier Publishers.

Joyce,  L.,  Ruiz P.,  Millman,R. B. &  Langrod, G. (2004). Substance abuse: a comprehensive

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Running Head: Psychology

























Two studies by  Argyropoulos et al in  2008 and Lyons et al in  2000 to  investigate how a associative reduced risk of schizophrenia in the unaffected cot-win of a discordant pair manifests in other mental disorders such mood and anxiety ones, though had related research methodology have significantly different results. To the researchers and other stakeholders, the results of the two invoke deep reflections regarding the schizophrenia discordant that causes a lot of physical, psychological and mental problems among the victims. The pertinent question is:  suppose you were the person with the schizophrenia condition or taking care of a schizophrenia patient, what measures would you put in place to manage the anxiety and depression that emanate from the condition as well as the “detrimental effects on the quality of life of the sufferers?”

The article by Argyropoulos et al (2008)   summarily, gives an overview about schizophrenia, a medical condition which causes mood swings and fretfulness among the patients, especially twins. The authors used studied “35 non schizophrenia co-twins in a study that, interestingly, concluded that there exists a strong verifiable correlation “between schizophrenia and anxiety and depression.”  The article by Lyons et al (2000, however attempts to establish the relationship, if any, between schizophrenia and mental disorders, in a study whose sample size is 24. In contrast, Lyons et al (2000) found no significant incidence of mood and anxiety disorders in the unaffected co-twin. The evocative outcomes of the studies, despite the limitations of the researches, are very critical especially today where the schizophrenia disorder is on the increase among twins, a condition that is also responsible for mental illness.

Research Designs         

The research question of the study was based on the need to explore the conditions that relate to “the familial co-morbidity of schizophrenia with depression and anxiety“, and how it affects twins.  Through the research question, the researchers sought to verify whether the prevalence of depression and anxiety would go up in “non psychotic co-twins” as well as the variations that may exist among different schizophrenia’s patients. While conducting the study, the population sample used were thirty five twin pairs, with mean age of 35.4 years; 12 being MZ, 14 Being DZ , 20 male and female.  The study was   conducted on the twins discordant for schizophrenia against 131 twins from 69 normal, who acted as control in the experiment, twin pairs, where the groups were mixed MZ/DZ in close proportions (Argyropoulos et al, 2008).

On the other hand, Lyons et al (2000) conducted a comparative study on 24 clinically diagnosed schizophrenia twins and their 24 non-schizophrenic co-twins with twins from normal pairs (n = 3327). The study was conducted to analyze the comparative risk of other mental disorders, specifically positive diagnosis of mood and anxiety disorders – bipolar disorder, major depression, dysthymia, generalized anxiety disorder, panic disorder and PTSD, in schizophrenia discordant twins and normal ones (Lyons et al, 2000).

Research Results

The results of the study  by Argyropoulos et al (2008)  revealed   that non-schizophrenic co-twins of discordant for schizophrenia group, against the normal control group, had significantly higher rates of depression (54.3% vs 26.7%), any anxiety disorder (40% vs 13.7%), and combined depression or any anxiety disorder (65.7% vs 33.6%), Table 2, Appendix. This study, conducted in 2008, demonstrates that co-twins (both MZ/DZ types) of schizophrenic ones are more prone to mood and anxiety disorders than the normal non-schizophrenic population. These findings are very significant in the real life as they point out the gravity of the situation that calls for a proactive intervention. The other notable finding that can be beneficial to other experts is there were no significant differences between the non-schizophrenic co-twins and normal ones in rates of alcohol and drug abuse, mania and individual anxiety disorders, Appendix 2 (Argyropoulos et al, 2008). At the same time, the schizophrenic probands did not demonstrate any significant symptoms of these either (Argyropoulos et al, 2008).

On the other hand,  Lyons et al (2000)  stresses  that Schizophrenia probands have significantly elevated rates of risk for all the disorders under study than the normal pairs (p<0.01), Table 1, Appendix. In contrast, the odds ratio for the co-twins of schizophrenic probands, when compared to the normal, or controls, were higher for each type of disorder but did not attain any statistical significance (Lyons et al, Table 1, p.30, 2000).

This pattern of risk, which deferred form the other study by Argyropoulos et al, 2008, was observed in both DZ and MZ twins (Lyons et al, 2000).  In the study’s findings, both diagnosed schizophrenia twin groups and control groups were similar in other possible variables such as age. There is some indication, as per Table 1, Appendix, that the unaffected co-twins did demonstrate more evidence of mood and anxiety disorders than the controls though, as the researchers state, this increased incidence was statistically not significant.

Need for Further Study   

The study by Argyropoulos et al (2008) clearly demonstrates that there exist empirically verifiable associative genetic risks of schizophrenia in twins (MZ/DZ) that are discordant for the disorder. Bearing in mind that a related study by Lyons et al (2000), gave a different result in relation to the  risks of mental disorders such mood and anxiety and schizophrenia in co-twins, there is need foe more extensive research that not only attempt to investigate the condition but also to establish why the results of the two studies differed significantly. The conclusions made by Lyons et al (2000), that the risk factors for schizophrenia in the discordant co-twins of schizophrenic ones do not pose as much of a probability, or risk, of other disorders such as mood and anxiety ones as the actual pathological manifestation of schizophrenia itself in the schizophrenic twins, was clearly discredited by Argyropoulos et al who made an opposite assertations, hence the need to bridge the discrepancy through further research.

Such a future study may also be aimed at scientifically analyzing the genotypes/phenotypes and associated environmental factors involved in the different psychopathologies of the schizophrenic and unaffected co-twin of a discordant pair. This would be significant since that researchers acknowledge that their results are not only limited to certain research environments but also only give proof “of a shared familial link for schizophrenic and anxiety and depression”, and  attempt to relate the condition to some “common etiological factors”, which cause the complication. The future study should therefore attempt to “separate the genetic from environmental” influences on the condition. Similarly the researchers recommend further research on the intervening factors which enhance the high increase in schizophrenic, by increasing the sample size that would permit a sufficient and reliable “MZ vs. DZ comparison” (Argyropoulos et al, 2008).

By conducting more related studies on larger sample groups of discordant for schizophrenia twin (MZ/DZ) groups, it would be relatively less complicated to ascertain how associative but reduced genetic risk of schizophrenia distributes to the unaffected co-twin and how it may manifest as other disorders such as mood and anxiety ones. Such future studies should also investigate how environmental factors, including sharing of suffering with the schizophrenic twin, may affect the unaffected co-twin. Better methods of diagnosis and intervention may be produced thereby.   This will allow easier diagnosis and intervention for both  Since both schizophrenia and mood and anxiety disorders result in loss of quality of life this exercise will obviously be one in the interest of many who today suffer or are at risk of suffering in future without hope of successful intervention and subsequent cure/alleviation.




Finally, it is clear that there exits some relationships among schizophrenia, the associated risks of schizophrenia in twins and other mental disorders such as mood and anxiety ones. However, the it is notable that findings by Argyropoulos et al which, reveal that the unaffected co-twin is also affected to a large extent compared to controls, differ from another study by Lyons et al as a result a test yourself” question that may be asked is: which research methodology and verification factors might have caused the wide difference in the results of the studies?   The second “test yourself” question is: which probable   yet unknown specific genetic and environmental factors, which the Argyropoulos et al study could not verify may be responsible for schizophrenia and mood and anxiety disorders?



















Table 1:

(Source: Lyons et al, 2000, Table 1, p.30)

Table 2:

(Source: Argyropoulos et al, 2008, Table 1, p.216)










Argyropoulos S.V, Landau S, Kalidindi S, Toulopoulou T, Castle D.J, Murray R.M,

Picchioni M.M. (2008). Twins discordant for schizophrenia: psychopathology of the non-schizophrenic co-twins, Acta Psychiatr Scand, 2008 Sept; 118 (3): 214-219.

Lyons, M.J, Hupper, J., Toomey, R., Harley, R., Goldberg, J., Eisen, S., True, W., Faraone,

V.S. & Tsuang, M.T. (2000).  Lifetime Prevalence of Mood and Anxiety Disorders in Twin Pairs Discordant for Schizophrenia, Twin Research, 2000; 3: 28-32.









Running Head: Time and organizational management

Time and organizational management









Time log (Two weeks)
Activity Report to work Review previous day’s work Receive calls Attend to appointments Departmental meetings Respond to inquiries Visit OPC departments Make appointments Evaluate diary
8.00-8.10 ü                
8.10-8.20 ü                
8.20-8.40   ü              
8.40-9.00   ü              
9.00-9.30   ü                
10.30-11.30     ü            
11.30-12.30     ü            
1.40-2.00         ü        
2.00-3.00           ü      
3.00-3.30               ü  
3.30-4.00                 ü


The activities require proper time management and following of the schedule to the later.

It would also be necessary to include emergency and contingent activities that may not be foreseen but may totally affect the time log and realization of the planned activities.           It is also critical that the time management process factor in the details of the activities in relation to the time frame in which they ought to completed as well as the expected outcomes.

Question 2): The best way to effectively manage the managerial functions would be through proper time management and self discipline. First, it would imperative to recognize time as a valuable resource that in non renewable and uncontrollable though its usage can be managed. Consequently, it would be a basic requirement that the deadlines are not only met but also strictly adhered to through proper time planning that is very clear, productive , systematic flexible and realistic. At the same time, all the activities should be reviewed every day so as to ensure proper assessment and control in the usage of time use. Effective time management would also requite that scheduled activities are prioritized so as to ensure that all the important activities are highlighted and the overlapping ones assigned to other colleagues as stipulated in the organizational management hierarchy and reporting relationships (Betts, 2000).  The manger needs also to be conversant with the task, be proactive in time management, keen to details and tightly structured to ensure meeting of deadlines, and exhibit multitask performance capabilities.

Question 3: In ensuring that the excepted standards of work and behavior that meet the organizational objectives are met, I would employ proactive democratic leadership that allows for active participation of employees in an a\effort to involve all the stakeholders in decision making. I would therefore employ Rensis Likerts system- 4-democratic leadership as the most consultative style in my duties. Through this leadership, the employees will feel part and parcel of the organization, own the standards of work and behavior since they will have input in designing them and team work will be enhanced (Hannigan, 1995). As a result, it will be very clear to the organization-loyal employees that the manager has shrewd confidence and trust in them as this permit them through their team to make non managerial decisions and implement them.

By employing McGregor’s theory Y of management, I would avail the resources necessary to achieve these objectives, ensure suitable environment for employees to develop and grow in their career and direct their skills towards the achievement of organizational goals (Scholl, 2002).  Through this approach, proper backward, upward, horizontal and vertical communication , proper conflict management, allowing employees to make certain quick but critical decisions through contingency management approach  as well as astute management of employees welfare would be ensure.

I would also carry out systematic positive behavior modification activities amongst employees in a bid to ensure that the expected standards and behaviors are achieved. The process would entail time management, adherence to organization codes of practice and conduct, high level of professionalism and diligence, ethical practices and team work. These codes and practices would be designed together with the employees. The positive behavioral practices would be reinforced through motivation and rewards as per the set rules. The behavior modification and reinforcement however, would require me to adopt the transformational; leadership approach that calls for  a constructive, visionary and inspirational leader, in the process of persuading the employees to understand the need for the uniformity in work process and acceptance of the codes of conduct (Scholl, 2002). This approach would ensure that the change process is managed well, and employees are made to feel part of it to void catastrophic outcomes of change resistance.
Question 4:The aim of the health and safety risk will be to meet the overall organizational objectives and goals of the out patient care facility. The related health and safety risks that have been identified are not only multifaceted but also significant enough to negatively affect the overall organizational work and mission to offer quality health care.  The organization is faced with possible legal risks. These risks may spring from legal suits and litigations due to work related injuries, and non adherence and compliance to various law requirements that relate to public health. These risks may also relate to non professional patients care and handling of chemicals and hospital machines, and poor diagnosis that may result to deaths or permanent disability of patients and employees. Owing to these legal risks, the organization and its employees may suffer severe financial problems and reputation damage owing to negative publicity.  The organization is also faced with risks that relate to work place disease outbreak that may result from poor safety standards and wastes management. As a result, the employees may suffer severely due to the diseases outbreak especially the communicable ones like typhoid, TB, and cholera.

The major actions that need to be taken to mitigate these health and safety risks include management of the risks through reduction and elimination strategies, ensuring that all the health and safety requirements are adhered to, ensuring that only professionally qualified staff are employed, proper waste management and disposal, regular appraisal of the out patient care activities and implementation of overall organization evaluation and control. Through established communication channels, all the accidents that occur in the work place would be reported and relevant data documented.

The position of the manager in this case would not be the traditional supervisory role, but the approach in which he/she acts as a figure head in the implementation of the polices through and together a motivated team. These roles include employee motivation, identification of risk areas and suggestion of preventive approaches, ensuring the professionalism at all time, constant follow up  activities and tracking of records of work related injuries and organizational  work safety trainings and workshops. The management would also put up warning sighs at strategic places, encourage employees to read and understand the manufacturers’ directives on use of chemicals and medicine, and ensure that they understand the directives by the medical board on health and safety.























Betts, P.W. (2000). Supervisory Management. 7th Ed., London: longhorn Publishers.

Hannigan, T. (1995) Management Concepts and Practices. London: Pitman Publishing

Scholl, R. W. (2002).Leadership Approaches. Accessed April, 12, 2009, from http://wwvv.cba.uri.edu/Scholl/Notes/Leadership






Title: Emotional Intelligence (Research Proposal)
























There is increasing demand not only for positive interpersonal relationships but also value based interactions among different individuals that is aimed at character formation, critical and creative thinking and environmental conditions responsiveness. Stys and Brown (2004) describe Emotional Intelligence as a form of intelligence that involves ability to monitor one’s own and other’s feeling and emotions, to discriminate among them and use this information to guide one’s thinking and actions, and promotes personal growth”. People who lack emotional intelligences on the other hand cannot comprehend others moods, never keen to details and make erratic decisions resulting into emotional problems and stress to the colleagues.

Statement of the Problem

Many people, including managers, employers and educators sometimes fail to recognize existences of multitude of intelligence that do not necessarily depend on each other, one’s background or inheritance (Smith, 2002). This presupposition has led to various studies which have not only challenged the notion but also shown distinctive strengths and constraints of intelligence. The Gardner’s multiple intelligence theory has also been criticized on the basis of inadequate empirical evidence to support what critics term as intuition based theory. Finally, there has been a lot of controversy as regards to whether women are more emotionally intelligent than men (Stys & Brown, 2004).

Research Questions

  1. i) What are the components of emotional intelligence and there impacts on an individual’s social relations? ii) How can one who is creatively intelligent and inspirational employ his/ her emotional intelligences in managing stress and conflicts, employees’/ subordinates’ strengths ensure positive work/ task psychology, and group cohesion? iii) Is it a valid premise that people have different gifts and talents, if so how can there behaviors be modified to reflect on the realities of emotional intelligence that require sustainable interpersonal relationships?

Research Hypothesis

  • By creating an environment that guarantees peaceful coexistence and social interactions, the forces and models of emotional intelligence positively influence the mental models and mind sets of an individual and/or a group, and promotes learning
  • Through inspirational leadership and involvement of others in a bid to impact emotional intelligence, the individuals are not only able to understand the dynamics of organizational or institution but also to understand the critical impacts and influences, forces of emotional intelligence has in decision making.
  • Emotionally intelligent persons are more empathetic to the (un)fortunate situations of others and learn how to treat people as individuals, each with unique moods and emotional reactions.

Significance of the Study

This study in very crucial as it seeks to assess the various ways in which emotional intelligence can be nurtured by teachers, families, institutions and employers in a bid to positively manage the challenges posed by variations in emotional intelligence.   (Varadan (2007) stipulates that  proper management of emotional and creative  intelligence results into  empowerment at all levels, development of positive work psychology, relating work place with   social reality, acceptance of systematically introduced change  and enhancement of the value of collaboration. Further, emotional intelligence has been cited as major indicator of “life satisfaction, healthy psychological adaptation, positive interactions with peers and family, and higher parental warmth and its effective adoption means hire returns for organizations”, factors which render the study crucial (Stys &  Brown , 2004) .

Area under Investigation

This paper seeks to analyze the components   of emotional intelligence, their roles in enhancing interpersonal development, growth, social interactions, learning, behavior modification and relationships in management, work places, homes and learning environments. Further, the    factors that lead to differences in peoples’ learning capabilities and how differential instruction can be applied both in and out of class room, including after school learning, to ensure quality education and knowledge acquisition. The objectives of the paper are therefore to establish the extent to which the emotional intelligence concept in relation to theories like the Gardner’s multiple intelligence theory can be validly applied to promote mutual understanding and cooperation. The investigation will also tackle emotional intelligences as   applied in self regulation and awareness as assets in the art of handling relationships and tense situations.

Research Methodology

The research will entail study of secondary data from past studies and personal observations. The study findings, based on the literature review will be objectively analyzed and evaluated in a bid to develop an empirically verifiable research outcome.

Theoretical framework

Theoretically, five components of emotional intelligence,   a set of capabilities that are distinct from Intelligent Quotient but essential for accomplishment in life workplace, personal and social   well being have been developed and include (Poonruksa, 2008); a) Self Awareness: it is a type of emotional intelligence characterized by ability to recognize and comprehend one’s emotional status, varying moods, drives, as well as their effect on others. b) Self Regulation: The ability to manage or readdress upsetting impulses and moods exhibited by one’s propensity to make rational judgment before acting. c) Motivation: A passion to work for reasons that go beyond money or status i.e. propensity to pursue goals with energy and persistence. d) Empathy: The ability to understand the emotional makeup of other people including skill in treating people according to their emotional reactions. e) Social Skill: Proficiency in managing relationships and building networks as shown by ability to find common ground and build rapport.

Further, emotional intelligences have been cited as a major factor in enhancing success in education, positive behavior modification and learning process. According to Tomlinson, (Tomlinson, 1999), differentiating instruction is a   teaching  technique that constructively take into consideration multifaceted variables and individual student-unique  factors like  willingness , abilities, interest, and learning styles in lesson  planning , teaching and assessment due to the students’ varying learning styles that need to be addressed  appropriately. Liu (Liu, 2006) describes differentiated instruction as a teaching methodology that focuses on all the students’ success by factoring in   their readiness, skills and abilities and what the school can do to meet the needs of individual child.Differentiating instruction is therefore beneficial as it ensures that students are challenged to work to their personal optimal potential while teachers are actively engaged in the learning process not as the ultimate source of knowledge but as facilitators of the learning process (Tomlinson, 1999).

The types of intelligence identified by Gardner include; linguistic intelligence shown by language’s express and verbal, logical-mathematical intelligence shown by ability to logically analyze problems solve mathematical problems and think deductively; musical intelligence which involve skill in the performance, composition, and appreciation of musical patterns (Smith, 2002).   On the other hand Stys 2004) identifies three models of emotional intelligence as an “a cognitive ability, a mixed intelligence consisting of cognitive ability and personality aspects and finally as a mixed intelligence involving cognitive ability and personality aspects”. Johnson and Thousand, (Johnson & Thousand, 2004) attempted to correlate collaboration, co-teaching, learning process and differentiated instruction. Collaboration, a joint planning, decision making among educational stakeholders that may occur either formally or informally, is crucial in effecting successful differential order in development of emotional intelligence.

Likely Findings

One possible finding is that the measurable hypotheses would indicate that programs with high levels of collaboration and cooperation in a bid to enforce emotional intelligences are more successful than those with limited levels of collaboration. In helping people  with varying levels of intelligence cope with learning and other complex social issues, Theroux  (Theroux 2004) identified  content of the subject , method of delivery, product of learning process( concept mastery)  and  environment as the main  factors  which need to be specifically tested in the  emotional intelligent assessment process.  It is also likely evident that the Gardeners multiple intelligence theory has been widely used by educators in attempts to offer quality education to students with different capabilities and levels of intelligence.






















Liu Y. (2006). Differentiated Instruction Through Flexible Grouping in EFL Classroom.

Retrieved April 20, 2009. Available Online:


Poonruksa,   S. (2008). Emotional Intelligence. Retrieved April 20, 2009. Available



Razmjoo A. (2008). On the Relationship between Multiple Intelligences and

Language Proficiency. Retrieved April 20, 2009. Available

Online :< http://www.readingmatrix.com/articles/razmjoo/article.pdf>

Sala, F. (2001). Do programs designed to increase emotional intelligence at work?


Consortium for Research on Emotional Intelligence in Organizations. Retrieved April 20, 2009. Available Online :< www.eiconsortium.org>

Smith M. (2008).  Howard Gardner, Multiple Intelligences and Education. Retrieved

a.                               April 20, 2009. Available Online

ii.              < http://www.infed.org/thinkers/gardner.htm>

Stys, Y. & Brown, S. (2004) A Review of the Emotional Intelligence Literature and

Implications for Corrections. Ottawa: Research Branch; Correctional services of Canada.

Theroux, P. (2004). Differentiating Instruction: Enhance Learning with Technology.

Retrieved January 22, 2009. Available Online:


Tomlinson, C. and Mctight, J. (2006). Integrating Differentiated Instruction and

Understanding by Design. Alexandria: Association for Supervision and Curriculum Development.

Varadan, M.  (2007). Summing Up. Retrieved April 20, 2009. Available Online:




Running Head: Ethics and Culture

Ethics and Culture























The multifaceted nature of business environment coupled with globalization, intense competition, dynamism, awareness of human rights and uncertainties that characterize business decisions, cultural diversity are some of the critical factors that have necessitated need for creative business decision making that touch specifically on individual employees’ ethics versus organization’s culture. Further the pace at which the business world is changing especially with the development of multicultural organizations, and technology and communication infrastructure requires that all the strategic business decisions are creatively arrived at by factoring in the issue of individual differences   in all the managerial levels and functional departments.

Culture can be described as behavioral patterns of group or society that is widely accepted and practiced in the society. Organizational culture especially in business context  can be described as “ the shared values, norms, and expectations that guide organization members in terms of how to approach their work and deal with each other and their customers” (Jones, 2005).  Ethics on the other hand deals with the moral aspects of organization culture and how the morals configure in achievement of intended goals. Consequently an acceptable organization culture is “a key determinant o staff satisfaction, intention to stay in the staff and a predictor of long term organizational sustainability” (Jones, 2005).

In my organization, a company that operates in automobiles industry, selling new and second hand automobiles and spare parts to different regions in USA and parts of Africa, Europe and Asia, there has been numerous instances when the organizational culture and employees’ ethics have clashed. There are always differences “between the proffered organizational culture and the actual culture profiles” a threatening conflict and discontent: between whit management seeks in terms of values and culture and what” I view as the best operating culture (Jones, 2005). The clashes have been fueled by differentials in the cultures, education and religious backgrounds, business practices, work expectations and company policies.

First, owing to the concern over work place security and the high costs of work place injury benefits as stipulated in the labor laws, it is not only a culture but an expressly stated company policy that employee surveillance systems be installed in every office. However, most employees consider this managerial practice unethical and uncalled for as it infringes personal freedom and makes employees, including my self, to work under pressure. at the same time, I consider the decision to install the CCTV cameras right inside my office, worst still without my knowledge, since I do not consider my self as a security threat to my own employer. By monitoring every movements and actions of employees, it implies that one may be forced to conform to the company cultures, like doing specifically what is related to the work assigned without deviation, and under the camera. Further, the recordings may be used to unethically victimize an employee by focusing just on a given footage.

Secondly, it is the culture at my work place that the employees be checked and frisked after leaving work, their luggage checked, in a bid to avoid what the company refers to as ‘malicious thefts’. This culture however serves to portray the targeted employees as being unethical and would always grab any opportunity to steal from the company. Thirdly, in my work place, it is a culture that all major reforms new business practices as well as codes of practice are proposed by the top level management and implemented by the middle class managers. The contributions of the lower ranking employees are always very mild as they are only consulted during the summative evaluation process, at the end of a year. However, the modern business ethics requires that every organizational stakeholders is proactively involve in every decision making process, including designing of acceptable workplace conducts, employee orientation, suggestion on product improvements and development of new products and services. By failing to realize the importance o the components of creative intelligence in work place like innovation and intuition intelligence, my company has failed to positively use its culture and individual employees’ ethics to enhance output. While the innovation intelligence advocates for fast adaptation in work environment and real productivity per employee, the intuition intelligence requires that diversity in human beings and groups as manifested in distinctive cultures, educational backgrounds and thinking gaps be factored in so as to ensure cooperative and coping attitudes in an organization (Gaynerd, 2008).

My company has a board of governors and a core management team together with specialized well documented rules and regulations implemented through a formal authority that serve to guide employee performances. This bureaucratic type of approach, an entrenched and  established culture has been applied unsympathetically and has served to regulate  employee’s behavior thereby leading to intended  results, limited budgets, planned  performances, for the company as displayed in statistical reports and employee performance records. The work place behaviors have also been characterized by a standards dressing code that is devoid of any religious symbol or suggestion of the same.

However, the rules have not served to enhance employees’ welfare and ethics since any mistake that may result into loss to the company is surcharged in the employees’ compensation. This practice is considered as unethical as it is very rigid and blames every organizational failure on a specific employee, and also affects my dressing code as well as limitations on religious practices; all which I consider sacred and very ethical. Business ethics on the other hand demands that employees’ welfare be looked into by the management and ethical practices be upheld at all time. It should also be characterized by an organization offering its employees a large degree of freedom and chance to exercise their creative intelligences thereby tapping their creativity towards the improvement of both its products and services thereby facilitating voluntary acceptance of positive cultures. In outlying the concept of creative intelligence, Sternberg (2007) argues that a successful intelligence is one that is shown by potential to realize success in life given one’s personal standards, in a specific and familiar socio-cultural context  in order to adjust to, shape and select environments. A creative and intelligent person is therefore one who is able to recognize and capitalize on his/her strengths in a way that offers compensation for the shortcomings through a balance of analytical, creative and practical abilities (Sternberg, 2007).

The top-down managerial culture has also been portrayed in the organizations communication channels where the traditional design that’s characterized by existence of a tall organization structure is employed. Though this “power culture” (Times, 2009), has created certainty in communication and information transmission, it has however resulted into challenges posed by bureaucracies, delay in obtaining feedbacks, and above all failure to properly mange change. Since change is unavoidable part of an organization, it should not be forced or appear to be forced on the implementers since such a process is bound to back fire and be rejected; as the case with my organization\ion. There have been ethical clashes between the mangers and employees over the manner in which such critical changes and readjustments ought to be introduced as the organization culture coupled by the structure’s model does not enable the change initiators to appreciate the need for proper change management by involving all the stakeholders. At the same time, the culture   also contributes to the failure by the same mangers to appreciate the fact that normally, it is the proponent of change and the way it is introduced and not the change itself that culminate into the change resistance.

On the other hand,  the company  has succeed in creating a generally good working environment, in terms of cleanliness and comfort  for all its employees,  some managers who love to minimize costs to the irreducible minimum see this as making the company  loose a considerable proportion of revenue that ‘would have been put into good use elsewhere’. This motivational culture has further served to ensure the health and safety of workers through the implementation of a comprehensive heath protection scheme that ensures that all employees have a comprehensive medical cover. This is based on its cultural belief that healthy workers are more productive and can produce quality work, are regularly present to work since good health reduces the number of accidents and diseases thereby reducing duration of absence; all ethically laudable initiatives. However, the attempts by a few management especially the new board, to cut down these benefits with a view to continuously report high revenues to share holders has been viewed as a very unethical practice

In conclusion, to   address these conflicts issues, our informal groups, that is based in the research and development department has initiated a voluntary brainstorming session with the supervisor in a bid to instill creative intelligence, person culture supportive and cooperative processes in the team. This initiative is aimed at  ensuring  that unifying aspiration that is generated by the inspirational leadership intelligence plays a crucial role in bridging the voids created by diverse creative thinking styles , cultures and ethics in the  entity. Innovation intelligence according to research ensures that the divergent opinions posed by un-matching creative intelligences are positively harnessed in creating a harmonious work environment, functional structure and a culture of innovation (Gaynerd, 2008).



















Gaynerd, J., (2008). Kirton Adaption-Innovation Measure. Retrieved April 22, 2009,

from http://www.syre.com/racine/versionanglaise/KAI.htm

Jones, Q. (2005). Organizational Culture: Establishing what makes an Organization

Retrieved April 22, 2009, from Attractive. http://www.human-synergistics.com.au/content/articles/papers/attractive-quentin-jones-mar-05/Default.asp

Sternberg, R.J (2007) Teaching for Successful Intelligence. Retrieved April 22, 2009,

from http://www.indiana.edu/~futures/sternberg.ppt

Times. (2009). Corporate and organizational culture. Retrieved April 22, 2009, from


Running Head: For Profit Vs Non For Profit

Profit Vs Non For Profit

















Today a major shift has been witnessed in the health care industry with the emergence of more specialized hospitals that are owned by individuals, private organizations, institutions and universities. As a result, two parallel organizations have emerged, profit and not for profit hospitals, a situation which has also occurred in the cancer management. This paper seeks to analyses the relationship between the two entities, arguments for and against and their structures. For profit cancer hospitals refers to the health care institutions which are owned by an individual, group or institutional investors whose main objective is to maximize the net worth of the investors through provision of quality health care and cancer management to the clients.  Examples of these hospitals include the Hospital Corporation of America, and the Tenet.

In contrast, non profit cancer hospitals are driven by the quests of service to humanity and are mainly supported by government institutions, charitable organizations, donors and foundation funds. The proceed s of the non profit cancer management hospitals are never distributed to individuals as the case with the for profit cancer hospitals. Instead, the revenues generated by the facilities are normally reinvested in expansion programs, medical assistance to poor cancer patients, research and development and general service to the community. However since most cancer care services are now been privately offered, and most of cancer clinics “are already private, the issue is should we from not for profit to profit care delivery”( Guyyat, n.d).


Several arguments have been put forward in attempts to justify the existence of , and the major roles  played by both the not and for profit cancer hospitals in the United States as well as other parts of the world. First, the proponents of for profit cancer hospitals initiatives argue that the management of these facilities is normally very professional and devoid of bureaucracies and complexities in management that are common among the public hospitals. As such, these organizations are able to offer superior and customized cancer care services at relatively affordable costs. The argument is reinforced by a belief that the managerial pressures to deliver justifiable results and accountability to the investors ensure efficiency and completive service delivery.  However, this argument is negated by the research finding by Shapoori and Smith (2005)  which indicate that the “hourly rate for all workers in profit hospitals, 19.26 dollars, was  found to be lower than the average hourly rate for all workers in nonprofit hospitals, 20.16 dollars.”

This gives an indication that the incremental benefits and revenues generated by for profit cancer care hospitals go to the investors and not the other stakeholders like employees.  This reality may be catastrophic especially if employees know this fact and may feel disillusioned and equally ill motivated to give quality health care needed in cancer management. at the same time, on average , the  ’for profit have higher mortality among elderly patients’, the major cancer sufferers (Mclellan  & Steiger, 1999).Not for profit cancer care hospitals however  have been praised as  being very responsive to community welfare and do not seek to exploit a situation for financial gains. Consequently, the not profit hospitals management normally “spend all the tax dollars provided to their institutions on health care delivery”,  and not to maximize their profits (Guyyat, n.d).

The for profit cancer care hospitals are believed to have emerged due to the mission by the investors to respond to the market needs and develop their business concepts in line with the profitable product lines.  Since cancer treatment and management is very costly and normally attracts a lot insurance policy contracts, the for profit cancer care hospitals normally invest a lot of resource in this sector in a bid to recoup more returns on investment. This entrepreneurial spirit is fully legal, and allowed by the society, though controversy arises as to whether health conditions and poor health status warrants a business opportunity, ethically and socially. Owing to this fact, the non profit cancer care hospitals have been suggested as the best approach to ensure affordable health care as the costs of treatment of  “cancer can be a tremendous financial burden, on the patients as well as the family ” (Cancer Care, 2008. further, the for profit making hospitals have been castigated as entities which  prefer the lucrative and high returns cancer management as it requires long term management and ease of monitoring  the progress of the patients as compared to less profitable emergency medical services offered by the not for profit institutions.

Both  for profit and not for profit cancer management hospitals have faced a lot of criticisms in one way or the other. For instance, the profit seeking approach employed by the for profit cancer hospitals especially the discriminatory practices to offer services in line with attractiveness of the market niche, has been termed as unethical practice.  Their aim here is to meet the high profit margins, up to 15 % or more, demanded by the share holders (Guyyat, n.d). Critics argue that the for profit hospitals practice disproportionate insurance where they mainly target seemingly healthy clients but avoid patients with acute cancer conditions.   this strategy  that is very commercial oriented is described by Guyyat (n.d ) as “cream skimming” as the hospitals  “take advantage of the fact that not all sick people are equally sick”.

On the contrary, the not for profit cancer hospitals cater for all the patients even those without certain covers and financial capabilities since “besides hospital bills, cancer treatment includes expenses that insurance doesn’t cover such as transport or child care” (Cancer Care, 2008)

The high cancer management costs charged by the for profit hospitals has also been termed as a major disadvantage of the initiatives in comparison to non profit organizations offering the same services. This price discrimination approach has put the institutions under scrutiny under a common understanding that their objective is to ensure maximum benefits at the expense of the patients through price discriminations. At the same time, the controversy has arisen as to what motives of a cancer hospital should be, to make profit or save lives. However, the manner and rate at which for profit cancer care hospitals are growing may imply that there may be underlying fundamental factors that attract the patients to the hospitals. For example, Guyyat argue that the “for profit based US system eats up over 13 % of the GDP”. A dilemma however arises since the medical bills have to be covered to ensure continuity of the services.  As a result, there has been low level agreement by scholars on the relationship between the two types of cancer management entities, especially in relation to funding, costs of health care, supervision, revenue generation, resource mobilization strategies and financial sustainability.

Organization structure and Cancer Management

There exists close and strong correlation in terms of the management of cancer, medical process, management, and the structure of the cancer hospitals. According to Gort and Broekhuis (2004), structure of care is closely related to the processes of care, which in turn relate the outcome through clients’ satisfaction. The for profit cancer hospitals normally are characterized by line and tall organization structure that is headed by a board of directors who appoint the managers and the chief executive officer to run the facility and be accountable to the investors. Most of these hospitals are run like incorporated companies wit h emphasis of stewardship management. The non profit cancer hospitals however are mainly owned by the government, operate under the department of health and have their top management appointed by the state and federal government. Other non profit cancer hospitals are managed by a board of trustees especially the colleges and charity based ones. Most of the cancer hospitals irrespective of status have such departments as finance, public relations, health information management, out and in patients, research and development and specific hematology and medical sections in their structures.

These structures also relate also to the access time, duration it takes from the first appointment and treatment, and the throughout time, the time lag between the appointment and the surgery. This time variation is normally shorter in private for profit hospitals compared to the public non profit hospitals. The main factors responsible for the difference are the way in which the organizations structures are designed.  the for profit organizations are designed in a corporate structure that is result oriented while the non profit government cancer hospitals normally have complex reporting relationships that springs from the department of health and require a lot of recordings and procedural diagnosis. Further, a functional structure is guaranteed through formation of committees, implementation of an oncological policy plan and annual report to ensure adherence to the managerial set guidelines (Gort  &Broekhuis, 2004).

In conclusion, it is evident that non profit cancer care hospitals are better, though they have low pace of responsive and suffer from executive red tape in comparison to for profit ones. It is imperative also to note that factors other than for profit or not for profit may be also major determinants of quality care in the cancer hospitals Mclellan &Steiger, 1999). To ensure quality services delivery certain workable guidelines, laws regarding operations of for profit cancer care centre, flexible structures need to be put in place. Such structures should however have monitoring and control mechanisms like surveillance of the private hospitals by the health department to avoid development of unethical profit oriented motives as opposed to quality cancer management.














Department of Veterans Affairs. (2007). Health Information Management. Retrieved April 27,

2009, from http://www1.va.gov/vhapublications/ViewPublication.asp?pub_ID=1614.

Gort , M. & Broekhuis, M.  (2004).  Developing actionable quality indicators, structures,

process and outcomes in breast cancer care. Retrieved April 27, 2009 from http://www.isqua.org/isquaPages/Conferences/amsterdam/AmsterdamWebFiles/webfiles/CONF20-10-04/Posters/Abstractsam/A13b/A13b-260-Gort-doc.pdf.

Mclellan, M.  &  Steiger, D. (1999). Comparing Hospital Quality at For-Profit and Not-for-

Profit  Hospitals. Retrieved April 27, 2009, from http://ideas.repec.org/p/nbr/nberwo/7324.html

Guyyat, G. Private not for profit or private for profit. Retrieved April 28, 2009, from


Shapoori, K. and Smith, J. (2005 ) Wages In Profit and Non-Profit Hospitals and Universities.

Bureau of Labor Statistics. retrieved April 27, 2009, from http://www.bls.gov/opub/cwc/cm20050624ar01p1.htm


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