Social Science & Medicine最新文献

{"title":"Monitoring privilege for health equity: building consensus on indicators to monitor socioeconomic advantage through a modified Delphi survey","authors":"Amy Carrad ,&nbsp;Ashley Schram ,&nbsp;Belinda Townsend ,&nbsp;Patrick Harris ,&nbsp;Fran Baum ,&nbsp;Lucie Rychetnik ,&nbsp;Steven Allender ,&nbsp;Melanie Pescud ,&nbsp;Sharon Friel","doi":"10.1016/j.socscimed.2025.118193","DOIUrl":"10.1016/j.socscimed.2025.118193","url":null,"abstract":"<div><div>The World Health Organization's Commission on Social Determinants of Health highlighted the need to measure and monitor the inequitable distribution of power, money, and resources across society. Efforts to monitor health inequity focus on disadvantage rather than advantage or privilege, and on proximal health outcomes rather than distal social and structural determinants of health. This study aimed to identify a comprehensive set of key indicators to measure and monitor socioeconomic advantage. Following a literature review to establish an initial set of indicators (n = 79), we used a three-round, online Delphi survey to build consensus among a panel of participants with diverse disciplinary backgrounds and with expertise related to socioeconomic inequity. Participants rated indicators for relevance to the concept of socioeconomic advantage using a seven-point Likert scale and ranked priority indicators among selected indicator categories. Thirty-one, 21 and 15 experts—predominantly from Australia— participated in the first, second and third round, respectively. Sixty-four of 76 indicators reached consensus, including all indicators within the ‘Wealth’ and ‘Income/wealth inequality’ categories. Priority rankings of economic indicators were clear: gross income and disposable income were the highest ranked income indicators; net wealth was the highest ranked wealth indicator. Ranking of ‘Connections and signalling indicators’ was less distinct; however, elite secondary schooling, and attendance at exclusive events received the highest mean ranks. Monitoring of these socioeconomic advantage indicators is crucial for identifying whether policy and governance is ultimately shifting the dial on equitably distributing resources for improving health equity outcomes.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"379 ","pages":"Article 118193"},"PeriodicalIF":4.9,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144072738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cosmetic gatekeepers: Negotiations of beauty and (re)shaping bodies by medical aesthetic practitioners","authors":"Anne-Mette Hermans ,&nbsp;Rebecca Nash","doi":"10.1016/j.socscimed.2025.118165","DOIUrl":"10.1016/j.socscimed.2025.118165","url":null,"abstract":"<div><div>Aesthetic practitioners who administer (non-)surgical medical cosmetic procedures play a central, and growing, role in the (re)shaping of predominantly women's bodies. This article focuses on how these practitioners negotiate their role as cosmetic gatekeepers – those with the medical and sociocultural skills, knowledge and tools - in (re)shaping the bodies of their client-patients. Adopting a reflexive thematic analysis of interviews conducted with aesthetic practitioners in the UK and the Netherlands, we identify three main themes. The first theme, <em>conceptualizing beauty</em>, describes the different ways in which aesthetic practitioners describe and negotiate the concept of ‘beauty’, including discussions of beauty as both subjective and objective. The second theme, <em>shaping bodies</em>, explores how practitioners consider why and how they (do not) suggest aesthetic procedures and how they (do not) see themselves as significant shapers of bodies and beauty. Finally, the theme of <em>cosmetic gatekeepers</em> examines the ways in which aesthetic practitioners provide boundaries in terms of how, when, why and on whom they (do not) perform procedures. Inherent to these discussions are constructions of the (non-)surgical ‘other’ and tensions between commercialism and ‘medico-cosmetic’ considerations that must be navigated by aesthetic practitioners. This article furthers explorations of how certain aesthetic appearances are (re)produced as desirable in increasingly expansive, diversified and normalized (non-)surgical cosmetic servicescapes.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"380 ","pages":"Article 118165"},"PeriodicalIF":4.9,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144083854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social and mental health pathways to institutional trust: A cohort study","authors":"Vincent Paquin ,&nbsp;Diana Miconi ,&nbsp;Samantha Aversa ,&nbsp;Janique Johnson-Lafleur ,&nbsp;Sylvana Côté ,&nbsp;Marie-Claude Geoffroy ,&nbsp;Sinan Gülöksüz","doi":"10.1016/j.socscimed.2025.118199","DOIUrl":"10.1016/j.socscimed.2025.118199","url":null,"abstract":"<div><h3>Objective</h3><div>Trust in institutions such as the government is lower in the context of mental health problems and socio-economic disadvantage. However, the roles of structural inequality, interpersonal factors, and mental health on institutional trust remain unclear. This study aimed to examine the associations of social and mental health factors, from early life to adulthood, with institutional trust.</div></div><div><h3>Method</h3><div>Participants (n = 1347; 57.2 % female) were from the population-based Québec Longitudinal Study of Child Development (1997–2021). Trust in 13 institutions was self-reported at age 23. Predictors were 20 social and mental health factors during early life, adolescence, and adulthood. Associations were examined with linear regressions corrected for false discovery rate. Pathways were explored using the temporal Peter-Clark algorithm.</div></div><div><h3>Results</h3><div>Early-life factors associated with lower levels of trust were male sex, racialized minority status, low household income, and maternal history of depression and antisocial behaviors. After adjusting for early-life factors, adolescence factors associated with lower levels of trust were internalizing and externalizing problems, bullying exposure, and school difficulties. Independently of early-life or adolescence factors, adulthood factors associated with lower levels of trust were perceived stress, psychotic experiences, suicidal ideas, and seeking professional help, whereas greater social connectedness was associated with greater trust. Temporal Peter-Clark analyses identified social connectedness and psychotic experiences as potential proximal determinants of institutional trust.</div></div><div><h3>Conclusion</h3><div>This study identified factors related to structural inequality, interpersonal relationships, and mental health over development that were associated with institutional trust. Interventions aimed at promoting social connectedness and equity may improve institutional trust and wellbeing.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"379 ","pages":"Article 118199"},"PeriodicalIF":4.9,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144072029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationships between historical redlining, contemporary housing market dynamics, racial composition, and mental health in U.S. urban neighborhoods: A conditional process analysis","authors":"Jenny Wagner ,&nbsp;Noli Brazil ,&nbsp;Shani Buggs ,&nbsp;Michelle Ko","doi":"10.1016/j.socscimed.2025.118180","DOIUrl":"10.1016/j.socscimed.2025.118180","url":null,"abstract":"<div><div>Historical redlining practices have been linked to a wide range of contemporary social, economic, and health outcomes, including poor mental health. Few studies, however, have investigated the contemporary factors which may explain these lasting associations. We examined features of contemporary housing markets—including property values, homeownership rates, and loan denial rates for home purchase—as possible mediators of historical redlining patterns and contemporary prevalence of poor mental health and assessed neighborhood racial composition as a moderator of these associations. Using data from the CDC PLACES Project (2020 release), American Community Survey (2013–2017), Home Mortgage Disclosure Act database (2013–2017), and Historic Redlining Scores Project, we studied 12,047 census tracts in the United States. We found significant indirect effects of historical redlining on contemporary prevalence of poor mental health via neighborhood property values, homeownership rates, and loan denial rates for home purchase. Further, the indirect effect of redlining via relative median property value was conditional on neighborhood racial composition. Our findings suggest properties in historically “A” graded neighborhoods are valued more than those in neighborhoods graded less favorably, and this apparent benefit to property values—and subsequently to residents’ mental health—is greater in neighborhoods where Black residents are underrepresented.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"379 ","pages":"Article 118180"},"PeriodicalIF":4.9,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144067931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How mobility-based exposure measures may mitigate the underestimation of the association between green space exposures and health","authors":"Yang Liu ,&nbsp;Mei-Po Kwan ,&nbsp;Liuyi Song ,&nbsp;Changda Yu ,&nbsp;Yuhan Cui","doi":"10.1016/j.socscimed.2025.118190","DOIUrl":"10.1016/j.socscimed.2025.118190","url":null,"abstract":"<div><div>Recent urban green space research highlighted that mobility-based measures of green space exposure may significantly mitigate a particular type of exposure measurement error (contextual errors) of residence-based measures. In this study, we examined an important manifestation of the contextual errors of residence-based measures: neighborhood effect averaging. We analytically illustrated that the contextual errors of residence-based measures may lead to a considerable underestimation of the associations between green space exposures and human health, and the reduction of such underestimation can be quantified through a mitigating factor. We employed data from a cross-sectional survey to assess the usefulness of our analytics. Based on participants' 7-day GPS trajectories, we derived residence-based and mobility-based measures of participants' exposures to green space using a spatiotemporally weighted approach. Logistic regression was employed to estimate the associations between green space exposures and participants’ overall health. We derived consistent and significant mitigating factors based on our analytics from the magnitudes of the estimated associations or the variances of green space exposure distributions. Our results indicate that mobility-based measures reduced about 20.9 % – 52.3 % of the underestimation of the associations between green space exposure and health, which reflected the considerable influence of exposure measurement errors. Our study sheds light on how contextual errors may obfuscate the association between green space exposures and human health, which may also be true for other mobility-dependent environmental factors. This has crucial implications for a broad range of environmental and public health studies that need accurate estimation of health impacts.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"379 ","pages":"Article 118190"},"PeriodicalIF":4.9,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144067932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Precarious employment in self-employment: A typology and impact on cardiovascular health conditions in Sweden","authors":"J. Gevaert ,&nbsp;L. Mangot-Sala ,&nbsp;M. Almroth ,&nbsp;K. Badarin ,&nbsp;D.L. Elling ,&nbsp;E. Jonsson ,&nbsp;S. Kvart ,&nbsp;F. Lundh ,&nbsp;P. O'Campo ,&nbsp;K. Pan ,&nbsp;E. Thern ,&nbsp;T. Bodin","doi":"10.1016/j.socscimed.2025.118182","DOIUrl":"10.1016/j.socscimed.2025.118182","url":null,"abstract":"<div><h3>Background</h3><div>Research on health in self-employment shows mixed findings, partly due to limited focus on heterogeneity within self-employment, physical health outcomes and reliance on self-reported, cross-sectional data. This study addresses these gaps by identifying self-employment types using the ‘precarious employment framework’ and examining their association with cardiovascular health conditions in Sweden.</div></div><div><h3>Methods</h3><div>Using the Swedish Work, Illness, and Labour Market Participation (SWIP) cohort, we analyzed individuals born between 1948 and 1968, aged 40–60 in 2008, and living in Sweden in 2005. We identified a typology of precarious self-employment in 2008 (N = 281,251), with cardiovascular health conditions tracked between 2009 and 2020. Latent Class Analysis (LCA) was used to categorize self-employment based on six indicators of precarity: business type, prior unemployment, combined employment, number of employees, income, and income volatility. Cox proportional hazards models estimated the association between the self-employment types and cardiovascular health conditions (diagnoses for myocardial infarction and stroke) compared to waged employment, adjusting for covariates.</div></div><div><h3>Results</h3><div>We identified four self-employment types: entrepreneurial employers, precarious solo self-employed, own-account combiners, and small traders. Precarious self-employment among 40-to-60-year-olds was associated with a higher risk of cardiovascular conditions later in life. The ‘precarious employment framework’ effectively captures the heterogeneity of self-employment and highlights its role as a social determinant of cardiovascular health.</div></div><div><h3>Conclusion</h3><div>Our findings suggest that precarious self-employment is linked to increased cardiovascular risk. This underscores the importance of considering employment quality and heterogeneity in future research and public policies addressing self-employed populations.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"379 ","pages":"Article 118182"},"PeriodicalIF":4.9,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144072083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Encounters between fields: Integrating military forces into the health field's epidemiological effort during COVID-19 in Israel","authors":"Liron Inchi ,&nbsp;Baruch Shimoni ,&nbsp;Batia Madjar ,&nbsp;Shiran Bord","doi":"10.1016/j.socscimed.2025.118139","DOIUrl":"10.1016/j.socscimed.2025.118139","url":null,"abstract":"<div><div>In July 2020, the government of Israel mandated cooperation between the Ministry of Health (MOH) and the Israeli Defense Forces (IDF) to address the COVID-19 crisis. Our research aims to reveal the consequences of this cooperation. We examine how the two organizations dealt with COVID-19 investigations and morbidity challenges. The article's theoretical framework is based on Pierre Bourdieu's theory of fields, showing the conflictual relations between the military and the civilian fields during COVID-19 efforts, as reflected in the relations between the IDF and the MOH. Twenty semi-constructed interviews were conducted with MOH and IDF personnel from February to May 2021. Results show cooperation alongside conflicts and demonstrate the military's extensive intrusion into a field outside its natural domain. The MOH acknowledged the potential benefit of the IDF's mobilization yet sensed that the IDF came to \"save the day\" while placing them in an inferior position. According to the IDF's interviewees, the MOH's \"professional approach\" often clashed with their action-based approach. In Bourdieu's terms, while the healthcare system can use human capital in its actions, the IDF system enjoys greater symbolic, social, cultural, and economic capital. This advantage in capital placed the two fields, MOH and IDF, in an unbalanced power relationship, explaining the IDF's taking over. We assumed that the securitization process of health services with alignment of expectations, division of authority, and open communication has the potential to help organizations better manage clashes in national and global crises.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"379 ","pages":"Article 118139"},"PeriodicalIF":4.9,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144067866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perception and sentiment analysis of palliative care in Chinese social media: Qualitative studies based on machine learning","authors":"Qi Zhou ,&nbsp;Yuling Lei ,&nbsp;Luwen Tian ,&nbsp;Shanshan Ai ,&nbsp;Yuting Yang ,&nbsp;Yueli Zhu","doi":"10.1016/j.socscimed.2025.118178","DOIUrl":"10.1016/j.socscimed.2025.118178","url":null,"abstract":"<div><h3>Background</h3><div>Traditional Chinese culture makes death a sensitive and taboo topic, leading patients and family members to refuse to choose palliative care.</div></div><div><h3>Aim</h3><div>To explore the current situation of the public's perception and sentiment towards palliative care and reduce the barriers health-related persons face in providing professional services.</div></div><div><h3>Method</h3><div>The research steps include text acquisition, text cleaning, data standardization, K-Means clustering algorithm, and sentiment analysis algorithm.</div></div><div><h3>Results</h3><div>This study had 9017 comments. The comments increased yearly from 2014 to 2023. K-Means clustering results showed patients' physical condition, disease knowledge, and nursing service. Boson NLP results showed 3264 negative comments, 3451 positive comments, and 2302 neutral objective comments. The dictionary method showed positive and negative emotions such as anger, disgust, fear, sad, surprise, good, and happy. Negative emotions were mainly in Physical and mental condition. Positive emotions were mainly in nursing service and unrelated to disease knowledge.</div></div><div><h3>Conclusion</h3><div>Healthcare professionals should pay attention to the adverse effects of public misperceptions and negative emotions. They provide appropriate measures to enhance positive emotions and perceptions and encourage patients to accept palliative care.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"379 ","pages":"Article 118178"},"PeriodicalIF":4.9,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144067933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The cognitive benefits of ecosystem improvement: Evidence from China's National Key Ecological Function Zones.","authors":"Jia Tang, Chenxu Ni, Shuwei Lu, Jie Xiong, Mingzhe Wang","doi":"10.1016/j.socscimed.2025.118149","DOIUrl":"https://doi.org/10.1016/j.socscimed.2025.118149","url":null,"abstract":"<p><p>Despite growing evidence of a strong correlation between ecosystem changes and human health, the direct impact of ecological improvements on cognitive function remains underexplored. This study examines the impact of China's National Key Ecological Function Zones (NKEFZs) policy on residents' cognitive function, employing a staggered Difference-in-Differences model. Using large-scale longitudinal survey data from 92,825 adults, our findings indicate that NKEFZs implementation is associated with significant improvements in cognitive outcomes, with cognitive scores increasing by 0.0291 standard deviations for vocabulary, 0.0703 for mathematical scores, and 0.0993 for overall cognitive function. Further analysis reveals that these effects are mediated by enhanced objective health status, reduced depression, and increased outdoor exercise frequency. Heterogeneity analysis suggests that the cognitive benefits of NKEFZs implementation vary across demographic groups, with older and lower-income individuals experiencing less pronounced effects. These findings emphasize the broader public health implications of ecosystem improvement.</p>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":" ","pages":"118149"},"PeriodicalIF":4.9,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spoken word poetry in nursing education: A concept analysis","authors":"Sabrina Ali Jamal-Eddine,&nbsp;Sarah Abboud","doi":"10.1016/j.socscimed.2025.118172","DOIUrl":"10.1016/j.socscimed.2025.118172","url":null,"abstract":"<div><h3>Aim</h3><div>To standardize the conceptualization of ‘spoken word poetry’ within nursing contexts through defining attributes, antecedents, and consequences.</div></div><div><h3>Background</h3><div>The growing health inequity gap across marginalized communities and the livelihood of individual marginalized patients require the development of innovative pedagogies within nursing education. Spoken word poetry, a narrative-based performance poetry centering lived experiences of multiply marginalized people, has yet to be explored within nursing.</div></div><div><h3>Design</h3><div>Concept analysis.</div></div><div><h3>Methods</h3><div>Walker and Avant's (2019) methodology following a non-linear, systematic eight-step approach used to elucidate, refine, and standardize conceptualization and communication of a concept for future use in evidence-based research. Steps include selecting the concept, articulating its need for analysis, and identifying its uses, defining attributes, model/borderline/related/contrary cases, antecedents, consequences, and empirical referents.</div></div><div><h3>Results</h3><div>Spoken word poetry is a form of embodied performance poetry rooted in Black culture and characterized by defining attributes of storytelling, spoken voice, active audience participation, critical education, liberation, and cultural identity.</div></div><div><h3>Conclusion</h3><div>Spoken word poetry offers an engaging form of critical narrative pedagogy relevant to nursing education. This pedagogy can promote social change while honing skills in active listening, empathy, critical thinking, advocacy, community-building, and consciousness raising. Research on perceptions, feasibility, and outcomes are needed.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"379 ","pages":"Article 118172"},"PeriodicalIF":4.9,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144067864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}