Social Science & Medicine最新文献

{"title":"Fat shame does not promote health: Attempting weight loss because of weight-based teasing is associated with elevated blood pressure, inflammation, and skipping meals among U.S. youth","authors":"Jennifer M. Cullin ,&nbsp;Kurt E. White","doi":"10.1016/j.socscimed.2025.118636","DOIUrl":"10.1016/j.socscimed.2025.118636","url":null,"abstract":"<div><h3>Objectives</h3><div>Some argue fat shame improves health by motivating weight loss efforts; however, fat stigma has been linked to worsened cardiovascular health, inflammation, and higher allostatic load (AL) in adults. This may be driven by physiological and behavioral responses to fat stigma. Less is known about how weight-based teasing (WBT) is linked to AL, cardiometabolic health, and inflammation in youth. We assessed WBT as a motivation, weight loss strategies, and biomarkers in youth attempting weight loss.</div></div><div><h3>Methods</h3><div>Data from the National Health and Nutrition Examination Survey (2005–2012) included motivations for attempted weight loss and covariates among 957 U.S. youths aged8-15 years. We compared weight loss strategies, AL, and cardiometabolic/immune function markers between U.S. youth who did and did not attempt weight loss because of WBT.</div></div><div><h3>Results</h3><div>Participants citing WBT as motivation were twice as likely to skip meals (OR = 2.01; p = 0.01), had higher diastolic blood pressure (β = 2.67; p = 0.04), and higher C-reactive protein (β = 1.46; p = 0.01) than those citing other motivating factors. AL did not vary statistically significantly between the two groups (β = 0.12; p = 0.06).</div></div><div><h3>Conclusions</h3><div>Motivation from WBT was linked to elevated diastolic blood pressure and C-reactive protein as well as skipping meals, a behavior associated with numerous poor health outcomes. WBT was not associated with AL nor metabolic biomarkers. Longitudinal research will elucidate timing of onset of physiologic dysregulation stemming from WBT. Results suggest WBT does <em>not</em> appear to provide a health benefit. Instead, it is linked to physiological and behavioral responses that may contribute to comorbidities generally associated with high BMI.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"385 ","pages":"Article 118636"},"PeriodicalIF":5.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145222629","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":"Bidirectional, longitudinal associations between finance and health - what comes first? Evidence from middle-aged and older adults in Europe.","authors":"Piotr Bialowolski, Andrzej Cwynar, Dorota Weziak-Bialowolska","doi":"10.1016/j.socscimed.2025.118633","DOIUrl":"https://doi.org/10.1016/j.socscimed.2025.118633","url":null,"abstract":"<p><p>This study examines the bidirectional longitudinal relationship between financial conditions and health among middle-aged and older adults in Europe. Using eight waves (2004-2022) of data from the Survey of Health, Ageing and Retirement in Europe (SHARE), we applied a random intercept cross-lagged panel model (RI-CLPM) to assess reciprocal associations over time between multiple subjective and objective financial and health indicators, while accounting for stable individual differences. Results reveal consistent evidence of mutual influence between financial status and health, though the patterns are asymmetric, with effects from health to financial outcomes generally stronger and more robust. Poor mental and functional health, including depressive symptoms and limitations in daily activities, were associated with deteriorating financial outcomes such as reduced net worth, greater debt, and increased financial strain. Conversely, subjective financial strain, more than income or financial assets, predicted later declines in health, particularly in mental well-being and mobility. Mortgage debt and other liabilities were also consistently associated with poorer outcomes across all health indicators. Policy interventions aiming to improve population health and economic resilience should integrate health support with efforts to reduce perceived financial insecurity. Addressing both domains simultaneously may help break cycles of disadvantage, particularly among older adults vulnerable to financial and health shocks.</p>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"385 ","pages":"118633"},"PeriodicalIF":5.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253348","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 lesser evil’–Abortion and reproductive stigma among Ethiopian university students","authors":"Mulumebet Zenebe ,&nbsp;Marte E.S. Haaland","doi":"10.1016/j.socscimed.2025.118637","DOIUrl":"10.1016/j.socscimed.2025.118637","url":null,"abstract":"<div><div>Since 2005, access to safe and legal abortion services in Ethiopia has significantly improved. Nevertheless, estimates indicate that safety of abortions remains an important public health challenge. Stigma is one of the key barriers young women with unwanted pregnancies encounter. This study explores how different forms of reproductive stigma shape Ethiopian students’ perspectives on and experiences with unwanted pregnancies. Data was collected between September 2016 and June 2018. Drawing on 43 in-depth interviews with students (30) and key stakeholders (13) at Addis Ababa University, supplemented by two focus group discussions, the article thematically analyses how students navigate knowledge, rights, and stigma in situations of unwanted pregnancies. It finds that abortion stigma and stigma towards premarital pregnancies shape how young adults respond to such situations. Building on conceptualizations of stigma as a social process tied to power and differentiation, the article argues that stigma is more than an individual experience, but rather a force that shapes access and constrains reproductive choices. The findings highlight the need to understand how abortion stigma intersects with other forms of stigma and social inequality, and to address the broader social conditions that make both abortion and premarital pregnancies morally and socially contentious.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"385 ","pages":"Article 118637"},"PeriodicalIF":5.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145222630","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":"Education shapes episodic memory measurement via test specifications: Evidence from the China Health and Retirement Longitudinal Study.","authors":"Yizhou Chen, James O'Donnell","doi":"10.1016/j.socscimed.2025.118473","DOIUrl":"10.1016/j.socscimed.2025.118473","url":null,"abstract":"<p><strong>Background: </strong>Many studies have examined how education influences cognitive decline trajectories, often reflected through episodic memory deficits measured by word recall tests. However, little is known about how education affects episodic memory measurement in longitudinal studies where word-list complexity and test form vary. Our study aims to explore whether education influences episodic memory measurement via test specifications in a Chinese context.</p><p><strong>Methods: </strong>23,951 respondents aged over 45 (78,364 person-years) from five waves (2011-2020) of the China Health and Retirement Longitudinal Study (CHARLS) were included. We fitted two random-intercept models-one for immediate and one for delayed test scores-to examine how education influences episodic memory measurement across varying test formats and word list complexities. Based on these results, we applied a hybrid frequency-estimation equating approach to facilitate longitudinal studies in CHARLS, accounting for education's impact when word recall tests use varying specifications.</p><p><strong>Results: </strong>Respondents with higher education scored better on immediate and delayed word recall tests, but all education groups were negatively affected by increased word-list complexity, with lower-educated individuals more vulnerable. Higher-educated respondents also gained more improvement in word recall outcome from extra practice trials when complexity remained constant. After equating, the predicted trajectories reflected more accurate cognitive decline over time, enhancing the measurement's validity.</p><p><strong>Conclusion: </strong>These findings suggest that education strongly influences episodic memory assessment, as test specifications-word-list complexity and test form-interact with participants' education and shape performance gaps between higher- and lower-educated groups. For equating techniques in longitudinal studies, frequency estimation suits waves with similar complexity, whereas equipercentile equating better addresses substantial complexity differences, thereby enhancing measurement validity.</p>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"383 ","pages":"118473"},"PeriodicalIF":5.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805153","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 professionals respond to disruptive effects of artificial intelligence on their jurisdiction: The role of interactive governance","authors":"Qin Chen ,&nbsp;Hongchuan Wang ,&nbsp;Chengcheng Ma ,&nbsp;Peng Ru","doi":"10.1016/j.socscimed.2025.118626","DOIUrl":"10.1016/j.socscimed.2025.118626","url":null,"abstract":"<div><div>The increasing adoption of artificial intelligence (AI) in professional work has disrupted established jurisdiction, frequently eliciting defensive responses from professionals. However, limited research has systematically examined how professionals respond to such disruptions. Based on 86 interviews, 240 hours of non-participatory observation, and 20 documents collected over 47 months of fieldwork in Chinese public hospitals, this article investigates the Intelligent Prescribing Review (IPR) system — an AI tool designed to assist physicians with prescribing and dispensing — in order to analyze professionals’ responses to AI disruption. The study identifies four models of interactive governance employed by professionals: intra-professional division, inter-professional coordination, professional-AI collaboration, and professional-organization consultation. These responses are shown to be shaped by the interplay of the institutional environment, organizational strain, and a relationship-oriented society. By presenting interactive governance as the central mechanism, the analysis moves beyond dichotomous narratives that depict professional responses as mere acceptance or resistance. The findings highlight an important shift in professional jurisdiction, from reliance on individual knowledge-based expertise toward interactive governance through collaborative negotiation.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"386 ","pages":"Article 118626"},"PeriodicalIF":5.0,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145236318","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":"Does intensive parenting come at the expense of parents’ health? Evidence from Sweden","authors":"Anna-Karin Nylin ,&nbsp;Stefanie Mollborn ,&nbsp;Sunnee Billingsley","doi":"10.1016/j.socscimed.2025.118610","DOIUrl":"10.1016/j.socscimed.2025.118610","url":null,"abstract":"<div><div>Given concerns that the intensification of parenting could have negative consequences for well-being, this paper explores whether intensive parenting is associated with parents' self-rated health in the case of Sweden, where extensive parental supports may provide protection. We apply binary logistic regression models to responses from 3400 parents in the nationally representative Swedish Generations and Gender Survey from 2021. Results differ depending on whether we use a variable-centered or person-centered approach to measuring intensive parenting. The variable-centered analysis showed that only certain intensive parenting attitudes, mainly within the challenging dimension, predict negative self-rated health, and this only applies to mothers. Using latent class analysis to group respondents by their overall attitude profiles around intensive parenting, the person-centered approach revealed that associations between intensive parenting attitude profiles and self-rated health differed substantially by gender. Although very few differences were observed according to the strength of intensive parenting attitudes or by agreeing with only certain dimensions, the respondents’ predicted probabilities of rating their own health as good or very good differed for those who reject intensive parenting versus adhering to it at least in part. Mothers who reject intensive parenting have significantly higher probabilities of good health, whereas fathers who reject intensive parenting have significantly lower probabilities of good health.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"385 ","pages":"Article 118610"},"PeriodicalIF":5.0,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207977","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":"Australian health and social service providers’ perspectives on interpersonal and structural forms of reproductive coercion","authors":"Susan Saldanha ,&nbsp;Jessica R. Botfield ,&nbsp;Maryam Moradi ,&nbsp;Jeana Wong ,&nbsp;Danielle Mazza","doi":"10.1016/j.socscimed.2025.118628","DOIUrl":"10.1016/j.socscimed.2025.118628","url":null,"abstract":"<div><div>This study explored how Australian health and social service providers describe both interpersonal and structural forms of reproductive coercion (RC), and how they perceive these forms to interact in practice from their experiences supporting RC victim-survivors. Guided by an adapted socio-ecological framework that helped distinguish interpersonal and structural RC, we conducted semi-structured interviews with 25 general practitioners, nurses, social workers, domestic violence workers, and obstetrician/gynaecologists. Reflexive thematic analysis identified three themes: (1) <em>Conflict and control: being powered by fear</em>, demonstrates how interpersonal coercion emerges when reproductive conflict is coupled with fear and power imbalances, prompting concealment or compliance; (2) <em>The path of ‘shoulds’</em>, captures how explicit and implicit coercion arise from layered interpersonal and structural pressures, including cultural, societal and institutional norms that dictate who should or should not bear a child, with structural conditions often enabling interpersonal control; and (3) <em>Unspoken, unenforced, yet deeply understood pressure</em>, describes tacit coercion, internalised pressures often rooted in cultural and societal expectations that prompt individuals to self-regulate their reproductive choices or make protective decisions within constrained circumstances. Across the three themes, RC was understood as a relational and socially embedded phenomenon, where true freedom from coercion in reproductive decision-making depends not only on the absence of direct interference but also on having the space and supportive structures to make choices freely, safely, and in alignment with one's own values. Future research must centre victim-survivor experiences to deepen this conceptualisation and explore how interpersonal and structural forms of RC intersect in lived realities.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"385 ","pages":"Article 118628"},"PeriodicalIF":5.0,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208010","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":"Chronic pain prevalence and trends in urban, suburban, and rural areas amongAmerican adults aged 55+, 1998–2022","authors":"Yulin Yang ,&nbsp;Feinuo Sun ,&nbsp;Zachary Zimmer ,&nbsp;Anna Zajacova ,&nbsp;Rui Huang ,&nbsp;Hanna Grol-Prokopczyk ,&nbsp;Jacqueline M. Torres","doi":"10.1016/j.socscimed.2025.118625","DOIUrl":"10.1016/j.socscimed.2025.118625","url":null,"abstract":"<div><div>Rural-urban health disparities in the United States are large and persistent, yet most surveillance efforts focus on mortality and disability. Monitoring rural-urban trends in pain, a major but overlooked indicator of population health, remains understudied. Given changes in demographics and resources of urban, suburban, and rural areas since the turn of the 21st century, which may have altered place-based differences in pain prevalence. Using nationally representative data from the Health and Retirement Study of 35,230 adults aged 55 and older (n = 206,600 person-wave observations), we estimated pain prevalence and trends across urban, suburban, and rural areas from 1998 to 2022. We assessed variation by age, sex/gender, race and ethnicity, and census region. Over 24 years, pain prevalence increased by 70 % (Prevalence Ratio [PR] = 1.70, 95 % Confidence Interval [CI]: 1.64, 1.75) and was consistently highest in rural areas and lowest in urban areas. However, pain prevalence rose most sharply in suburbs as compared to both rural and urban areas (suburban and time interaction vs. rural areas: PR = 1.08, 95 % CI: 1.00, 1.17). Suburban pain prevalence was similar to urban levels in 1998 but converged with that of rural levels by 2022. Stratified analyses revealed broadly similar patterns across demographic and regional groups, with particularly rapid increases among suburban populations in the South. These findings highlight nationwide increases in chronic pain, with suburban areas emerging as new “hotspots” alongside rural areas. Given that pain is a leading cause of disability and functional decline, monitoring place-based trends is essential for addressing this growing public health concern.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"385 ","pages":"Article 118625"},"PeriodicalIF":5.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201937","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":"Railways to better minds: The influence of high-speed rail on cognitive health inequalities","authors":"Xu Zong ,&nbsp;Mingming Guan ,&nbsp;Ye Zhang ,&nbsp;Guowei Dong","doi":"10.1016/j.socscimed.2025.118624","DOIUrl":"10.1016/j.socscimed.2025.118624","url":null,"abstract":"<div><div>Cognitive impairment has become a major challenge to health aging all over the world, and evidence shows that transportation infrastructure affects the elderly's cognitive health. However, little is known about the effects of high-speed rail (HSR) on cognitive health. Based on the panel data from 2011 to 2018, this study employs the double machine learning (ML) approach to examine the relationship between HSR and cognitive health among 11,572 middle-aged and aged adults in China. The result shows that the opening of HSR significantly improved global cognition, with an estimated treatment effect coefficient of 0.198 (95 % confidence interval, [0.088, 0.309]). The effect of HSR varies in dimensions of cognitive health, only promoting mental intactness rather than episodic memory. The main result remains robust after conducting a series of robustness tests such as introducing instrumental variables, replacing the HSR measurements and ML method. Further analysis shows that HSR has heterogeneous effects on cognitive health across gender, ages, education levels, rural–urban areas, and geographic regions. For instance, HSR has narrowed the cognitive health inequalities between individuals with elementary or middle school education and those with higher education, but widened the gap between rural and urban residents. Additionally, mediation analysis indicates that HSR may enhance cognitive health by reducing PM2.5 exposure, improving individual earnings, and alleviating depressive symptoms. This study provides beneficial insights for China and other countries to develop transportation infrastructure and promote healthy cognitive aging.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"385 ","pages":"Article 118624"},"PeriodicalIF":5.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214141","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":"Implementing employability interventions for workers with health conditions: A systematic review","authors":"Kevin Daniels,&nbsp;Helen Fitzhugh,&nbsp;Rayhaan Nooraya","doi":"10.1016/j.socscimed.2025.118597","DOIUrl":"10.1016/j.socscimed.2025.118597","url":null,"abstract":"<div><div>Health conditions are a major source of economic inactivity in working age adults. We conducted a systematic review of eight databases to identify factors that influence the implementation of effective interventions for workers with health conditions. We reviewed 55 separate studies of interventions to improve employment and/or health outcomes for workers or those seeking work. Findings were synthesized into evidence-statements (e.g., “Facilitating governance structures are associated with a) efforts at continuation and adaption of interventions and b) learning structures and activities”). The evidence-statements were synthesized into a theory of change to explain the level of implementation of interventions, employment, health, and work performance outcomes. The theory of change considers factors related to: the employing organization's external and internal environment (e.g., labor market legislation), intervention management, intervention features, and a range of stakeholders (e.g., intervention recipients, line managers, health professionals). We identified gaps in the literature, including knowledge of how implementation factors relate to cost-effectiveness and knowledge on how interventions and organizations are adapted to fit with each other. This systematic review is registered on PROSPERO (CRD42024591723).</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"385 ","pages":"Article 118597"},"PeriodicalIF":5.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207959","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}