Social Science & Medicine最新文献

{"title":"White privilege, ethnic disadvantage, and stigmatized linguistic capital: COVID-19 infection rates and lockdown law enforcement in Hong Kong","authors":"","doi":"10.1016/j.socscimed.2024.117323","DOIUrl":"10.1016/j.socscimed.2024.117323","url":null,"abstract":"<div><p>The COVID-19 pandemic has exposed and exacerbated existing disparities in various societies. This study investigates disparities among racial, ethnic, and linguistic groups in Hong Kong's society in COVID-19 infection rates and lockdown enforcement practices that was imposed 545 times from January 2021 to September 2022 and affected 9% of the population. It is found that neighborhoods with more white individuals had lower infection rates than the overall population, while those with more ethnically minoritized groups had higher infection rates. Furthermore, hit rate tests reveal that the government targeted more neighborhoods with a higher share of individuals from linguistically minoritized groups. This novel finding suggests that not only race, but linguistic difference of the same ethnicity can cause bias. The study highlights the positive impact of providing ethnic support services on health outcomes in neighborhoods with a higher share of individuals from ethnically minoritized groups.</p></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142244039","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":"Racism, not race: Quantitative analysis of the use of race and racism in the addiction literature","authors":"","doi":"10.1016/j.socscimed.2024.117325","DOIUrl":"10.1016/j.socscimed.2024.117325","url":null,"abstract":"<div><h3>Rationale</h3><p>Prior research has demonstrated that medical journals rarely mention racism, potentially contributing to an incorrect understanding of and inappropriate interventions for health inequities affecting Black and Brown communities in the US. While this infrequency of mentions of racism has been documented in the general medical literature, it is unknown if this pattern extends to the addiction literature, where some have argued that structural racism has played a specific role in shaping policy and treatment.</p></div><div><h3>Objective</h3><p>To assess how frequently the addiction literature for the last 30 years has mentioned race and racism and if these rates vary with social movements.</p></div><div><h3>Methods</h3><p>We created an algorithm to download and process over 30,000 published articles published from 1990 to 2022 in five major addiction journals: <em>Addiction</em>, <em>Addictive Behaviors, Drug and Alcohol Dependence, Journal of Substance Abuse and Treatment,</em> and <em>International Journal of Drug Policy</em>. Using this data, we reported temporal patterns of mentioning both race and racism across journals and article types. Further, we utilized interrupted time series analysis to identify if the social movements against police violence and the murder of George Floyd in 2020 were associated with significant changes in rates of mentioning racism.</p></div><div><h3>Results</h3><p>While over 30% of the articles in addiction medicine journals included the word race, only 1.5% of articles mentioned racism. Based on an interrupted time series model, after the racial reckoning following the murder of George Floyd in 2020, mentions of racism increased in the addiction literature (OR = 3.21, 95% CI: [2.39, 4.32], <em>P&lt;</em>.001).</p></div><div><h3>Conclusions</h3><p>A large chasm remains between how often authors mention race versus racism in addiction medicine, a field with a unique history intertwined with structural racism. Addressing inequities in addiction outcomes, including burgeoning inequities in overdose deaths, will require acknowledging racism in the scientific literature.</p></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142244037","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":"Funding priorities and health outcomes in Danish medical research","authors":"","doi":"10.1016/j.socscimed.2024.117347","DOIUrl":"10.1016/j.socscimed.2024.117347","url":null,"abstract":"<div><p>External research funding is an essential component of the infrastructure of modern, academic research. Priorities in funding decisions drive what knowledge is generated, and how scientists’ careers are shaped. For health research, it can ultimately have implications for health outcomes. The aim of this paper is to illustrate how funding information can be used to track priorities in health research, linking them to disease burdens and research outputs. Furthermore, funding concentrations are analysed from both researcher and disease perspectives, to estimate the influence of personal Matthew-effects on the distribution of health research funding. Denmark is used as the case, including funding information from all major public and private research foundations in the period 2004–2016. Grant information is linked to research outputs and disability-adjusted life-years (DALY rates), for 34,160 publications linked to 2630 grants, receiving DKK 4.8 billion in funding. Data show poor correlation between funding priorities, research activity and disease burdens, with several diseases receiving disproportionate amounts of funding. A research opportunity index is calculated to identify diseases with the highest potential for future investments from a burden-centred point of view. Funding is highly concentrated, both on people and on specific diseases. High funding concentrations on researchers can be a driving factor behind the observed funding-to-burden imbalances, and may risk knowledge stagnation through monopolisation of the market place of ideas. Results indicate that funders of clinical and translational research, as well as some types of biomedical research, need to supplement traditional considerations of scientific excellence with measures of societal challenges and relevance.</p></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0277953624008013/pdfft?md5=edbbf8f9cb7e01bf832d7ded1276dff3&pid=1-s2.0-S0277953624008013-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142243996","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}

{"title":"Associations of childhood household dysfunction and healthy lifestyle with depressive symptoms in adolescents","authors":"","doi":"10.1016/j.socscimed.2024.117336","DOIUrl":"10.1016/j.socscimed.2024.117336","url":null,"abstract":"<div><h3>Objective</h3><p>Limited understanding exists regarding the cumulative impact of childhood household dysfunction (CHD) on adolescent depressive symptoms in developing countries, as well as the role of lifestyles in this association. This study aims to explore the associations of individual and cumulative CHD indicators with depressive symptoms among Chinese adolescents. Additionally, we investigate potential interactions and joint associations of CHD and lifestyles on depressive symptoms.</p></div><div><h3>Methods</h3><p>In the second phase of the Longitudinal Study of Adolescents’ Mental and Behavioral Well-being Research, data on depressive symptoms, CHD indicators, lifestyle factors, and other covariates were collected from 3106 students (mean [SD] age, 15.16 [1.52] years). Linear and logistic mixed-effects models were employed, with both stratified and joint analyses conducted.</p></div><div><h3>Results</h3><p>Except for parental death, each CHD indicator was associated with an increased risk of depressive symptoms. The accumulation of CHD indicators exhibited a positive, graded association with depressive symptoms scores (β = 3.22, 95% CI: 2.48 to 3.97 for one CHD indicator; β = 5.45, 95% CI: 4.41 to 6.49 for two or more CHD indicators, all <em>P</em> &lt; 0.01). A significant interaction was found between the number of CHD indicators and the healthy lifestyle score (interaction β = −0.40, 95% CI: −0.78 to −0.03, <em>P</em> &lt; 0.05), indicating that healthy lifestyles may mitigate the risk of depressive symptoms in individuals experiencing CHD. For example, the OR for having depressive symptoms among adolescents with favourable lifestyles compared with those with unfavourable lifestyles was 0.21 (95% CI: 0.10 to 0.45, <em>P</em> &lt; 0.01) among those experiencing CHD. Moreover, adolescents with two or more CHD indicators and unfavourable lifestyles faced the highest risk of having depressive symptoms (OR = 8.03, 95% CI: 4.83 to 13.34, <em>P</em> &lt; 0.01) compared with those with no CHD indicator and favourable lifestyles.</p></div><div><h3>Conclusions</h3><p>These findings underscore the importance of promoting comprehensive healthy lifestyles and reducing CHD exposure for the prevention of depressive symptoms in adolescents.</p></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142243997","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 impact of home mechanical ventilation on the time and manner of death for those with Motor neurone disease (MND): A qualitative study of bereaved family members","authors":"","doi":"10.1016/j.socscimed.2024.117345","DOIUrl":"10.1016/j.socscimed.2024.117345","url":null,"abstract":"<div><p>Motor neurone disease (MND) is a progressive neurodegenerative disorder which is ultimately terminal. It causes muscle weakness which can lead to the need for assistance in breathing, for some with the disease. This paper draws on qualitative research using semi-structured interviews with 32 people bereaved by the death of a family member with MND who was dependent on home mechanical ventilation, from across the United Kingdom. Interviews explored how the end-of-life of a person who had used non-invasive ventilation to assist their breathing was experienced by participants, who had cared about, and for them. Four themes are used to examine the impact of dependent ventilation technology on the experience of dying on the part of bereaved family members. Themes are: accompanied dying, planned withdrawal of ventilation, blurred time of death, time post-death. The perception and experience of time was a key component across all four themes. Ventilator technology played a critical role in sustaining life, but it could also contribute to a complex dynamic where the realities of death were mediated or obscured. This raises ethical, emotional, and existential considerations, both for the individuals receiving ventilator support and their families, as well as for healthcare professionals involved in end-of-life care.</p></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0277953624007998/pdfft?md5=ac28606fd4e6110549ac0325bb0ef7f5&pid=1-s2.0-S0277953624007998-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142244040","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}

{"title":"Loneliness and social isolation amongst refugees resettled in high-income countries: A systematic review","authors":"","doi":"10.1016/j.socscimed.2024.117340","DOIUrl":"10.1016/j.socscimed.2024.117340","url":null,"abstract":"<div><p>Refugees encounter multiple psychosocial stressors post-resettlement which increases their risk of developing a mental illness. Loneliness and social isolation are commonly reported in the refugee population and have been demonstrated to be associated with multiple physical and mental health comorbidities in the general population. However, no study to date has systematically reviewed how loneliness and social isolation may affect refugees who have resettled in high-income countries. This systematic review aims to study the prevalence, risk factors, consequences, and interventions for loneliness and social isolation among refugees who have resettled in high-income countries. Systematic searches on five electronic databases yielded 2950 papers, of which 69 were deemed eligible following a double-blinded review by title and abstract then later by full text. From the included studies, it was found that the reported range of prevalence rates of loneliness (15.9–47.7%) and social isolation (9.8–61.2%) were higher than population norms. Risk factors associated with loneliness and social isolation included family separation, acculturative stress, being female or a parent and a current diagnosis of a mental illness. Loneliness and social isolation were found to be associated with depression, post-traumatic stress disorder (PTSD), psychological distress as well as physical health problems. Only three interventions addressing loneliness and social isolation were identified which demonstrates the importance of integrating social support in refugee psycho-social support programs. In summary, loneliness and social isolation were reported by a large proportion of refugees who have resettled in high-income countries. Whilst certain risk factors were pre-migratory and static, most were post-migratory in nature and were found to adversely affect mental and physical health. Thus, interventions focused on reducing loneliness and social isolation that are guided by the needs of refugee communities are urgently required.</p></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0277953624007949/pdfft?md5=dc292dbd3b22c99a94c554dd0049cb37&pid=1-s2.0-S0277953624007949-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142243650","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}

{"title":"Healthcare compassion interventions co-design and feasibility inquiry with clinicians and healthcare leaders in Aotearoa/New Zealand","authors":"","doi":"10.1016/j.socscimed.2024.117327","DOIUrl":"10.1016/j.socscimed.2024.117327","url":null,"abstract":"<div><p>Compassion in healthcare is valued by patients, healthcare professionals (HCPs), and leads to improved outcomes. Notwithstanding reports of systemic failings in the provision of compassionate care, research regarding ways to intervene remains limited. The aim of this study is to clarify compassion intervention needs in a diverse HCP workforce in public secondary healthcare in Aotearoa New Zealand (NZ) by utilising a co-design process. The co-design process involved a series of workshops with clinicians followed by in-depth interviews with healthcare leaders to derive input regarding feasibility and implementation. Reflexive thematic analysis was used to analyze the data. There was a great deal of interest in compassion interventions from healthcare professionals and leaders. However, for compassion interventions to be acceptable, feasible, and effective, compassion interventions design should be reimagined and reflected at each step of interventional design and implementation and span across organizational levels. Namely, the results of the study showed the preference for non-individual focused multi-level interventions to build bridges and connections. The desired compassion intervention components included practising connecting with others' humanity, improving compassion knowledge and relational and reflective skills, and cultural safety and anti-racism training. Experiential training embedded in models of cultural dialogue was the preferred interventional modality. Prioritising leadership as an intervention site was suggested to improve leadership's buy-in of compassion interventions and possibly serve as a starting point for transforming the broader culture, reviving interconnectedness in a healthcare system described as fragmented, disconnected, and alienating with compassion also acting as an equalizer of power.</p></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0277953624007810/pdfft?md5=ba8e2d36e979047b188ed4b70b573ee7&pid=1-s2.0-S0277953624007810-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142244038","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}

{"title":"Social determinants of health analysis makes causal inference and requires analytic epidemiology methods","authors":"","doi":"10.1016/j.socscimed.2024.117344","DOIUrl":"10.1016/j.socscimed.2024.117344","url":null,"abstract":"<div><p>The growing emphasis on reducing health disparities and addressing social determinants of health (SDH) has prompted many national and local health agencies to report population health data by SDH measures. However, many agencies rely on descriptive epidemiology methods for such reports and are susceptible to biased findings due to inadequate confounding control. In this brief analytic essay, using the data presented in an HIV Surveillance Report by the Centers for Disease Control and Prevention (CDC), we demonstrated an example of how reporting health outcomes by SDH with descriptive methods could bias the results and conclusions. SDH are causes of health disparities and SDH analysis requires analytic epidemiology methods to ensure valid research results and effective interventions.</p></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142232083","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 transmission of social inequalities through economic difficulties and lifestyle factors on body mass index: An intersectional mediation analysis in the Swedish population","authors":"","doi":"10.1016/j.socscimed.2024.117314","DOIUrl":"10.1016/j.socscimed.2024.117314","url":null,"abstract":"<div><p>Body mass index (BMI) has increased in Sweden, disproportionally for socially disadvantaged groups, including women, low-educated, and immigrants, who may also face economic constraints, physical inactivity, and poor-quality diets. Intersectional public health research aims to unravel such complex social inequalities, but the intersectional transmission of inequalities to BMI remains unexplored. We aimed to examine intersectional inequalities in BMI mediated by economic strain and health-related lifestyle in the Swedish population. By using the Health on Equal Terms cross-sectional surveys in 2016, 2018, 2020, and 2021 (<em>n</em> = 44,177 inhabitants aged 25 and over), we performed an intersectional mediation analysis to analyze how inequalities across social intersectional strata (by gender, education, and migration status) may be transmitted through economic strain and unhealthy lifestyle (physical inactivity or inadequate fruit/vegetables consumption) to BMI. Our findings showed a sequential transmission that indicates the fact that socially disadvantaged strata (compared with high-educated native men) experienced more economic strain, which in turn led to poorer health-related lifestyles and ultimately to a higher BMI. We also found that certain intersectional strata, such as high-educated women, were more vulnerable to economic strain, despite having lower BMI than high-educated native men. Additionally, the highest BMI and unhealthy lifestyle risk was observed among low- and middle-educated men. In conclusion, not only inequalities in BMI, but also the economic and behavioral pathways underpinning the inequalities, act by intersectional patterns. Public health interventions should provide economic security, particularly for women and migrant population as well as promoting a healthy lifestyle in lower-educated strata, especially among men, to achieve healthy BMI levels.</p></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0277953624007688/pdfft?md5=a4026b0c862c85705602b0d7e1473c4a&pid=1-s2.0-S0277953624007688-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142233914","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}

{"title":"Biopsychosocial pathways model of early childhood appetite self-regulation: Temperament as a key to modulation of interactions among systems","authors":"","doi":"10.1016/j.socscimed.2024.117338","DOIUrl":"10.1016/j.socscimed.2024.117338","url":null,"abstract":"<div><p>The widespread discrimination against individuals with obesity often stems from a simplistic perception of obesity as a mere consequence of personal choices of overeating and insufficient physical activity. This reductionist perception fails to acknowledge the complexity of the epidemic of obesity, which extends beyond diet and exercise decisions. The concept of appetite self-regulation (ASR) has been explored as a crucial element in identifying obesogenic behavioral approaches to food. Although an extensive understanding of ASR in children is essential as an early precursor and modifiable factor influencing obesity, the prevailing view of self-regulation of eating solely as a matter of cognitive and behavioral processing tends to overlook interacting systems of influences. This narrow approach attributes obesity to the lack of voluntary self-control in food consumption while neglecting to account for the biological, psychological, and social influences implicated in the developmental processes of ASR, which may further contribute to the stigmatization of obesity. The current critical analysis provides a comprehensive developmental framework that could guide future studies with testable hypotheses, outlining pathways of interactions among biopsychosocial systems, all of which contribute to the development of ASR in early childhood. Adopting developmental perspectives allows a holistic approach to investigating ASR, which accounts for intricate interactions between biological (B), psychological (P), and social (S) factors influential in the early manifestation of ASR.</p></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0277953624007925/pdfft?md5=85fd4bb1fd2192ac888b3d7d6f82ba1d&pid=1-s2.0-S0277953624007925-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142244043","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}