Social Science & Medicine最新文献

“The system's not getting my grandchild”: A qualitative study of caregiver relationship formation for children born to incarcerated mothers

IF 4.9 2区医学

Social Science & Medicine Pub Date : 2025-02-25 DOI: 10.1016/j.socscimed.2025.117881

Bethany Kotlar , Aisha Yousafzai , Carolyn Sufrin , Monik Jimenez , Henning Tiemeier

{"title":"“The system's not getting my grandchild”: A qualitative study of caregiver relationship formation for children born to incarcerated mothers","authors":"Bethany Kotlar , Aisha Yousafzai , Carolyn Sufrin , Monik Jimenez , Henning Tiemeier","doi":"10.1016/j.socscimed.2025.117881","DOIUrl":"10.1016/j.socscimed.2025.117881","url":null,"abstract":"<div><div>Women who give birth during their incarceration in most states in the US are separated from their newborns, who are placed with non-maternal caregivers. Infants of incarcerated mothers are a highly vulnerable population for which caregiving relationships may be particularly important for their wellbeing. Despite this, incarcerated mothers may be responsible for selecting a caregiver with no formal guidance. However, this process is poorly understood. The goal of this study was to understand how families form caregiving relationships during a mother's incarceration in state prisons in Georgia. Data were drawn from initial interviews from a mixed methods cohort of children exposed prenatally to incarceration. Thirty-six interviews with caregivers and 13 interviews with mothers released from incarceration were analyzed using thematic analysis. Researchers validated data through focus groups with caregivers and nonprofit staff. Caregivers and formerly incarcerated mothers discussed avoiding child welfare custody when making caregiving decisions. Mothers prioritized caregivers who they believed would help them reunify with the child. Caregivers and mothers discussed keeping the child with a family member if possible; mothers overwhelmingly preferred their own parents as caregivers. When mothers choose between several potential caregivers, they prioritized the safety and security of their infant, rejecting those who were substance users, had a history of incarceration, had serious health issues, or who they deemed irresponsible. These factors were frequently brought up when discussing children's fathers as potential caregivers. Thus, choice of caregivers for infants born during incarceration was motivated by family unity and safety and security. Policymakers should target these children and their families for intensive support through social services.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"370 ","pages":"Article 117881"},"PeriodicalIF":4.9,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143511268","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}

引用次数: 0

Natural disaster-induced dementia and cognitive decline: A meta-analysis and systematic review

IF 4.9 2区医学

Social Science & Medicine Pub Date : 2025-02-25 DOI: 10.1016/j.socscimed.2025.117898

Jacob Thompson , Maryam Vasefi

{"title":"Natural disaster-induced dementia and cognitive decline: A meta-analysis and systematic review","authors":"Jacob Thompson , Maryam Vasefi","doi":"10.1016/j.socscimed.2025.117898","DOIUrl":"10.1016/j.socscimed.2025.117898","url":null,"abstract":"<div><div>Recently, some studies have noted a negative cognitive impact on individuals in the aftermath of large-scale natural disasters; however, the causal relationship between disasters and cognitive/neurodegenerative effects remains widely unexplored. This review analyzes the impact of natural disasters on the development of cognitive decline (CD), all-cause dementia, and Alzheimer's disease (AD) in disaster-affected individuals. Studies reported from their inception to August 2023 were obtained via public online databases. All data presented in this review was derived from precalculated study results, data presented within/alongside articles, or statistics calculated using data obtained by contacting the articles' authors for ancillary information. Data from 28 studies, representing 4,606,561 individuals, 158,994 CD events, 179,694 dementia events, and 47,193 AD events was included for analysis. The pooled odds ratio (OR) and 95% confidence interval (CI) estimates showed that natural disasters significantly increased the risk of CD (OR: 1.25, CI: 1.20–1.30), all-cause dementia (OR: 1.07, CI: 1.05–1.08), and AD (OR: 1.07, CI: 1.05–1.10) in disaster victims as opposed to less- or non-impacted individuals. The greatest effects were noted following hurricanes, earthquakes with tsunamis, and heat waves. The findings from this meta-analysis indicate that natural disasters are significantly associated with the development of CD, all-cause dementia, and AD.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"371 ","pages":"Article 117898"},"PeriodicalIF":4.9,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143526727","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}

引用次数: 0

The power paradox of patient-centred care in Chinese community health: Towards a conceptualisation

IF 4.9 2区医学

Social Science & Medicine Pub Date : 2025-02-24 DOI: 10.1016/j.socscimed.2025.117883

Bo Li

{"title":"The power paradox of patient-centred care in Chinese community health: Towards a conceptualisation","authors":"Bo Li","doi":"10.1016/j.socscimed.2025.117883","DOIUrl":"10.1016/j.socscimed.2025.117883","url":null,"abstract":"<div><div>Patient-centred care (PCC) is widely heralded as a transformative healthcare paradigm, designed to prioritise patients' unique needs, preferences, and values in clinical decision-making. By potentially shifting away from the historically provider-centric model, PCC aims to empower patients as autonomous, active participants. However, critical questions remain: Does PCC genuinely dismantle power asymmetries, or does it merely serve as rhetoric subtly reinforcing existing hierarchies under the guise of empowerment? This study examines this power paradox—the disconnect between PCC's rhetorical positioning and its superficial implementation—through Steven Lukes' three dimensions of power, focusing on China's community healthcare system, where patient-centred ideals are strongly advocated. A year-long non-participant observation at a major community health centre in Shenzhen, complemented by semi-structured interviews with 16 general practitioners (GPs) and 18 hypertensive patients (HPs), informed an iterative thematic analysis. The analysis identified three paradoxes that complicate PCC's vision of patient empowerment. First, protective authority demonstrates how GPs' protective intentions manifest as directive behaviours, fostering dependency and limiting patient agency. Second, framing authority reveals how organisational norms, policies, and clinical expectations constrain patient choice, prioritising compliance over autonomy. Lastly, internalised compliance highlights PCC's ideological power, where HPs internalise adherence as integral to their identity as ‘good’ patients, embedding deference to medical authority within their sense of well-being. These findings offer critical insights into PCC's power paradox, questioning its theoretical capacity to redress entrenched provider-patient power imbalances. Addressing these challenges necessitates systemic reforms and shifts in clinical practice to genuinely prioritise patient-centredness.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"371 ","pages":"Article 117883"},"PeriodicalIF":4.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143521260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Disputed and disfavored: Pain, mental illness, and invisible conditions in disability discrimination cases

IF 4.9 2区医学

Social Science & Medicine Pub Date : 2025-02-24 DOI: 10.1016/j.socscimed.2025.117885

Rachel Kahn Best , Yan Fang , Catherine Fisk , Linda Hamilton Krieger , Diana Reddy

{"title":"Disputed and disfavored: Pain, mental illness, and invisible conditions in disability discrimination cases","authors":"Rachel Kahn Best , Yan Fang , Catherine Fisk , Linda Hamilton Krieger , Diana Reddy","doi":"10.1016/j.socscimed.2025.117885","DOIUrl":"10.1016/j.socscimed.2025.117885","url":null,"abstract":"<div><div>When they sue their employers for disability discrimination, do plaintiffs with some types of conditions fare better than others? This paper analyzes legal outcomes for three types of conditions that are potentially disputed (subject to suspicion and doubt) or disfavored (subject to stigma or judgment): mental illnesses, invisible conditions, and subjectively diagnosed pain conditions. Using logistic regression to analyze over 1,100 judicial opinions in the US federal courts, we find that invisible conditions tend to be disputed and mental illnesses tend to be disfavored. We find the strongest and most consistent disadvantages for subjectively diagnosed pain conditions; plaintiffs with these conditions are significantly less likely to be deemed a person with a disability and to win in court. The disadvantages for plaintiffs with difficult-to-document pain conditions persist even if they are deemed to be persons with disabilities, suggesting that skepticism about these conditions pollutes judges’ overall impression of plaintiffs.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"371 ","pages":"Article 117885"},"PeriodicalIF":4.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143512239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effects of emotional expression and platform prompts on patient selection: A multi-method study on online question and answer platforms

IF 4.9 2区医学

Social Science & Medicine Pub Date : 2025-02-21 DOI: 10.1016/j.socscimed.2025.117868

Jiaxin Xue , Zhaohua Deng , Bin Wang

{"title":"Effects of emotional expression and platform prompts on patient selection: A multi-method study on online question and answer platforms","authors":"Jiaxin Xue , Zhaohua Deng , Bin Wang","doi":"10.1016/j.socscimed.2025.117868","DOIUrl":"10.1016/j.socscimed.2025.117868","url":null,"abstract":"<div><div>Patients lacking medical expertise in online health Q&A platforms find it difficult to assess the quality of physician responses. Emotional support provided by doctors and prompts from the platform may influence patient selection.</div><div>We developed a conceptual model based on emotions as social information theory and the Stimulus-Organism-Response framework. The model was validated using a multi-method and multi-study approach. In Study 1, we analyzed platform data using natural language processing and machine learning techniques to explore the impacts of physician expression characteristics on patient selection. In Study 2, we conducted an experiment to explore patient perceptions and influence mechanisms in the process.</div><div>Study 1 showed the effects of empathy, encouragement, and using default responses on patient selection. Study 2 revealed the importance of psychological empowerment and uniqueness neglect on patient decisions. The findings have significant implications for physicians and platforms in designing improved health services and optimizing systems.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"370 ","pages":"Article 117868"},"PeriodicalIF":4.9,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143488350","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}

引用次数: 0

Not/belonging as health promotion: The affective potentialities of human and non-human relationalities in mother-baby-assemblages

IF 4.9 2区医学

Social Science & Medicine Pub Date : 2025-02-21 DOI: 10.1016/j.socscimed.2025.117865

Eva Neely , Michaela Pettie

{"title":"Not/belonging as health promotion: The affective potentialities of human and non-human relationalities in mother-baby-assemblages","authors":"Eva Neely , Michaela Pettie","doi":"10.1016/j.socscimed.2025.117865","DOIUrl":"10.1016/j.socscimed.2025.117865","url":null,"abstract":"<div><div>Motherhood has life-long impacts on health and exacerbates health disparities. Birthing a baby changes life immensely with heightened affectivity and emotions posing risks and opportunities. Identity-focused maternal transition theory and dominant cultural narratives of neoliberal, nuclear, and heterosexual parenting have created a narrow framework within which to understand the responsibilities and challenges of motherhood. In this we paper propose an alternative path to theorising motherhood relationally through the concept of belonging-as-affect in mother-baby-assemblages. To achieve this we plug into posthuman feminism to explore mother-baby-assemblages as relational, embodied and affective sites of fleeting and enduring not/belonging. We develop a creative qualitative reviewing approach and draw on literature that examines motherhood and mothering across place, mobilities, people, bodies and things. We explore how tracing relationalities between human and non-human actants might help us learn about ‘sticky’ sites of not/belonging in mother-baby-assemblages as a more fluid way of understanding the journey into and through mother/parenthood. The sticky-ness of not/belonging as timebound glue offers insights into the vital emergence of maternal health and is articulated as a mode of inquiry for future work in this space. Our orientation to posthuman mothering works through porosity, permeability and vacillation by turning our attention to sites of affectivity, and tracing non/sticky not/belonging emerging in multiple and diverse pathways, embracing openness, and eliciting generosity towards collective parenting. Understanding belonging as emergent co-becoming may allow for hopeful and inclusive motherhoods that are diversely care-ing and care-full.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"371 ","pages":"Article 117865"},"PeriodicalIF":4.9,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143529806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Causally-informative analyses of the effect of job displacement on all-cause and specific-cause mortality from the 1990s Finnish recession until 2020: A population registry study of private sector employees

IF 4.9 2区医学

Social Science & Medicine Pub Date : 2025-02-21 DOI: 10.1016/j.socscimed.2025.117867

Stephanie Zellers , Elissar Azzi , Antti Latvala , Jaakko Kaprio , Terhi Maczulskij

{"title":"Causally-informative analyses of the effect of job displacement on all-cause and specific-cause mortality from the 1990s Finnish recession until 2020: A population registry study of private sector employees","authors":"Stephanie Zellers , Elissar Azzi , Antti Latvala , Jaakko Kaprio , Terhi Maczulskij","doi":"10.1016/j.socscimed.2025.117867","DOIUrl":"10.1016/j.socscimed.2025.117867","url":null,"abstract":"<div><h3>Background</h3><div>Job loss is related to morbidity and mortality, but generation of causal evidence is challenging due to confounding factors. Finland suffered a severe economic recession in the early 1990s with unemployment reaching almost 25%, with many job losses due to mass layoff or company closure. Such job displacements are assumed to be exogenous to the individual and create a natural experiment for causal inference.</div></div><div><h3>Methods and Findings</h3><div>We evaluate the causal relationship between job displacement and mortality using register data from Finland between 1988 and 2020 (N = 590,823 individuals [43.3 % female] aged 25–55 and securely employed by the private sector at baseline, N = 93,199 total deaths by 2020). Job displacement is associated with increased risk of all-cause mortality even after accounting for sex, age, marital status, and education (HR = 1.09 [1.07, 1.11]). Risks of death by suicide, violence, alcohol, accidents, and disease are higher for displaced individuals at all follow-up periods examined. Risks of death from cancer and ischaemic heart disease are higher for displaced individuals only in later follow up periods.</div></div><div><h3>Conclusions</h3><div>Our analyses support the causal influence of job displacement on all-cause and specific-cause mortality, even up to 30 years after the recession; this risk varies by cause of death and by length of follow-up. Future work should evaluate stress and substance use as potential pathways from job displacement to mortality.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"370 ","pages":"Article 117867"},"PeriodicalIF":4.9,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143488351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Diminished returns of maternal education on children's vaccination status for indigenous women in Peru

IF 4.9 2区医学

Social Science & Medicine Pub Date : 2025-02-20 DOI: 10.1016/j.socscimed.2025.117862

Ali Al-kassab-Córdova , Edward Mezones-Holguin , Jay S. Kaufman

{"title":"Diminished returns of maternal education on children's vaccination status for indigenous women in Peru","authors":"Ali Al-kassab-Córdova , Edward Mezones-Holguin , Jay S. Kaufman","doi":"10.1016/j.socscimed.2025.117862","DOIUrl":"10.1016/j.socscimed.2025.117862","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the mediating and moderating roles of maternal education on ethnic disparities in children's vaccination status in Peru.</div></div><div><h3>Methods</h3><div>This was a cross-sectional study based on the secondary analysis of the 2023 Demographic and Health Survey. Children's vaccination status was defined as having completely received BCG; three doses of DPT and polio vaccines; and MMR vaccine by 12 months of age. Linear and Poisson regression models by ethnicity were fitted to assess the effect of maternal education on vaccination status. The 4-way decomposition using interventional analogues of natural effects was performed with the g-formula to assess the mediating and moderating roles of education on the disparity in vaccination status by mother's self-reported ethnicity (Indigenous versus Mestizos).</div></div><div><h3>Results</h3><div>A total of 5,622 Indigenous and 6,939 Mestizo children were included. The proportion of incomplete vaccination was 27.6% in Indigenous children and 21.6% in Mestizo children. Among Indigenous children, secondary and higher maternal education were associated with a 5 and 4 percentage point reduction in incomplete vaccination [-0.05 (95% CI: −0.08,-0.02) and −0.04 (95% CI: −0.07,-0.01), respectively]; while among Mestizo children, the reductions were 8 and 11 percentage points [-0.08 (95% CI: −0.11,-0.06) and −0.11 (95% CI: −0.13,-0.08)], compared to mothers who completed less than secondary education. Poisson models were consistent with the linear model. The mediation analysis showed large negative interaction, representing the reduced benefit of higher educational attainment for Indigenous women.</div></div><div><h3>Conclusion</h3><div>Smaller beneficial effects of maternal education level on children's vaccination status for Indigenous relative to Mestizos. Increasing education levels for all groups would inadvertently amplify existing ethnic gaps.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"370 ","pages":"Article 117862"},"PeriodicalIF":4.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143508272","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}

引用次数: 0

Retirement and health plan choice

IF 4.9 2区医学

Social Science & Medicine Pub Date : 2025-02-20 DOI: 10.1016/j.socscimed.2025.117844

Tobias Müller , Mujaheed Shaikh , Lukas Kauer

引用次数: 0

Understanding the experience of employees in assisted living facilities during the COVID-19 pandemic: A qualitative case study

IF 4.9 2区医学

Social Science & Medicine Pub Date : 2025-02-20 DOI: 10.1016/j.socscimed.2025.117803

Yaqi Yuan

{"title":"Understanding the experience of employees in assisted living facilities during the COVID-19 pandemic: A qualitative case study","authors":"Yaqi Yuan","doi":"10.1016/j.socscimed.2025.117803","DOIUrl":"10.1016/j.socscimed.2025.117803","url":null,"abstract":"<div><div>The COVID-19 pandemic significantly impacted older adults, with assisted living facilities (ALFs) emerging as critical focal points for the spread and management of the virus in the United States. This study examines the challenges faced by workers in assisted living facilities during the pandemic and explores how the state policy impacted their professional and personal lives. The research team conducted semi-structured Zoom and in-person interviews with 29 employees at “Harmony House” in Oregon with the goal of understanding how they balanced federal and state guidelines for COVID-19 with the expectations of residents and their family members. An iterative thematic analysis based on grounded theory was adopted to analyze the transcripts of the 29 audio-recorded interviews. Nearly all participants reported facing a dilemma during the pandemic: they had to police the residents and their families and themselves during the pandemic to ensure the safety of the residents and to comply with the state policies, despite this approach conflicting with their professional training. This role conflict significantly increased their stress, impacting both their professional and personal lives. The findings highlight the complex role dynamics that ALF workers had to navigate, balancing their identity as compassionate caregivers with the unexpected and often distressing role of enforcer. By acknowledging and addressing these dual role demands, ALFs can improve not only the well-being of their staff but also the overall quality of care for their residents, ensuring better outcomes during and beyond public health crises.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"370 ","pages":"Article 117803"},"PeriodicalIF":4.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143479818","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}

引用次数: 0