Social Science & Medicine最新文献

{"title":"Tuberculosis treatment and undernutrition on Daru Island, Papua New Guinea: A qualitative exploration of a local foodscape.","authors":"A Persson, P Jops, J Cowan, M Kupul, R Nake Trumb, S S Majumdar, S Islam, H Nindil, W Pomat, S Bell, G Marks, M Bauri, S M Graham, A Kelly-Hanku","doi":"10.1016/j.socscimed.2024.117631","DOIUrl":"https://doi.org/10.1016/j.socscimed.2024.117631","url":null,"abstract":"<p><p>A substantial proportion of people with tuberculosis (TB)-one of the world's deadliest infectious diseases-live in resource-poor, food insecure settings. It is widely recognised that undernutrition significantly heightens vulnerability to TB, as well as contributes to poor treatment adherence and outcomes. However, more attention is needed to understand what shapes food insecurity and undernutrition in a particular setting. We use the concept of \"foodscapes\" to explore the distinct food environment on Daru Island, a recognised \"hotspot\" for multidrug-resistant TB in the Western Province of Papua New Guinea. Drawing on 128 qualitative interviews and 10 focus groups (conducted July 2019 and July 2020) with people with TB, family members, healthcare providers, community leaders and other stakeholders, we seek to elucidate the critical entwinement of food insecurity, people with TB, and their treatment experiences on Daru Island. We argue that potential solutions need to focus on the social and structural conditions that contribute to undernutrition in the first place, rather than on undernutrition itself.</p>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"365 ","pages":"117631"},"PeriodicalIF":4.9,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866023","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":"A network comparison analysis of socio-ecological protective and risk factors of depression between Chinese urban and rural adolescents.","authors":"Xiaoyu Zhuang, Chun Pong Chan, Xue Yang","doi":"10.1016/j.socscimed.2024.117628","DOIUrl":"https://doi.org/10.1016/j.socscimed.2024.117628","url":null,"abstract":"<p><strong>Background: </strong>Anchoring in the socio-ecological framework and the differential impact theory, the present study pioneered to explore the differential network structures of multilevel risk and protective factors that influence depression among Chinese urban and rural adolescents.</p><p><strong>Method: </strong>A sample of 684 urban adolescents and 1123 rural adolescents completed a battery of self-report questionnaires measuring their depressive symptoms, as well as risk and protective factors at intrapersonal (psychological flexibility, emotion regulation), interpersonal (social support, parental control), and social levels (social capital, stressful life events).</p><p><strong>Results: </strong>Central risk and protective factors in both groups included psychological flexibility, which bridged intrapersonal, interpersonal and social resources, along with social support, social capital, rumination, catastrophizing, and self-blame. Network comparison tests revealed significant differences in the global strength and network structures between the two groups. Rural adolescents showed denser connections between positive refocusing - rumination, positive refocusing - other-blame, refocusing on planning - self-blame, and family support - self-blame, while urban adolescents showed a stronger relationship between rumination - blaming others - depression. Rural adolescents uniquely benefited from a protective loop of reappraisal - social satisfaction - depression.</p><p><strong>Conclusion: </strong>The findings suggest both beneficial and trade-off effects of a denser psychosocial network in adolescents growing up in a high-risk environment. Such results imply that only increasing the number of protective factors (e.g., social resources) may not be sufficient; instead, practical strategies that can neutralize the drawbacks of protective mechanisms may serve as critical strategies in promoting the socio-ecological well-being of adolescents in China and elsewhere.</p>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"365 ","pages":"117628"},"PeriodicalIF":4.9,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856290","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 contribution of childhood adversity to adult socioeconomic gradients in mortality: A Swedish birth cohort analysis.","authors":"Josephine Jackisch, Alyson van Raalte","doi":"10.1016/j.socscimed.2024.117627","DOIUrl":"https://doi.org/10.1016/j.socscimed.2024.117627","url":null,"abstract":"<p><strong>Background: </strong>\"Child maltreatment is a leading cause of health inequality\" according to a leading WHO report. This statement is often assumed, yet, the size of the contribution of childhood adversity to the adult socioeconomic gradient in mortality remains unknown. Inequalities in mortality have mostly been investigated by taking adult conditions as a starting point. The objective of this study is to quantify how much of the socioeconomic gradient in adult life expectancy is associated with childhood adversity.</p><p><strong>Methods: </strong>Drawing on a 1953 birth cohort from Stockholm (n = 14 210), we compared inequalities in adult mortality within the full cohort to a counterfactual scenario where individuals with a history of childhood adversity (indicated by involvement with child welfare services) experienced the mortality rates of those achieving the same adult socioeconomic position, but with no history of childhood adversity. The socioeconomic gradient across education and income quintiles (attained by age 29) is measured by the slope index of inequality of temporary life expectancy (ages 29-67).</p><p><strong>Results: </strong>The counterfactual scenario attenuated the education gradient by 40 percent for men and 54 percent for women. Similarly, inequalities by income were reduced in the counterfactual scenario by 49 percent for men and 47 percent for women.</p><p><strong>Interpretation: </strong>These results support that childhood adversity is an important determinant of inequalities in mortality. The size of their contribution is equivalent to established behavioural risk factors. Taking a life course approach might provide important policy entry points to mitigate health inequalities.</p>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"365 ","pages":"117627"},"PeriodicalIF":4.9,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856292","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":"Age-friendly community environments and the age trajectories of long-term care dependency among Chinese older adults.","authors":"Peng Nie, Qiaoge Li","doi":"10.1016/j.socscimed.2024.117614","DOIUrl":"https://doi.org/10.1016/j.socscimed.2024.117614","url":null,"abstract":"<p><p>In the context of rapid global aging, the importance of age-friendly community environments for promoting healthy aging and \"aging in place\" continues to increase. Using data from the 2011-2020 China Health and Retirement Longitudinal Study, this study investigated the impact of an age-friendly community environment on the age trajectories of late-life long-term care (LTC) dependency among older Chinese adults aged 60+ years. Age-friendly community environments were defined according to three levels (poor, moderate, or good) based on the World Health Organization's age-friendly city and community framework, and LTC dependency was classified as level 1 (high), level 2 (medium), or level 3 (low) according to activities of daily living and instrumental activities of daily living scores. We classified participants into two age trajectory groups according to their level of LTC dependency: early-onset and late-onset groups. We found that an age-friendly community environment, especially a good housing environment, was consistently associated with the probability of having late-onset LTC dependency at any level. Having moderate and good social and employment environments reduced the likelihood of having early-onset level 2 and level 3 LTC dependency. Our mechanism analysis also revealed that age-friendly community environments affect LTC dependency through social participation. Our results may help elucidate the importance of promoting age-friendly community environments to maintain late-life functional ability and support healthy aging.</p>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"365 ","pages":"117614"},"PeriodicalIF":4.9,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866019","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":"Hate crimes and psychiatric emergency department visits among Asian Americans.","authors":"Mandana Masoumirad, Shutong Huo, Abhery Das, Tim A Bruckner","doi":"10.1016/j.socscimed.2024.117624","DOIUrl":"https://doi.org/10.1016/j.socscimed.2024.117624","url":null,"abstract":"<p><strong>Introduction: </strong>Hate crimes against Asian American surged in the United States between 2019 and 2020. Those facing COVID-19 discrimination showed heightened psychological distress. We examined whether increased hate crimes against Asian Americans corresponds positively with psychiatric Emergency Department (ED) visits among Asian Americans in California.</p><p><strong>Methods: </strong>We obtained our outcome variable, psychiatric ED visits, from the University of California Health Data Warehouse (UCHDW) for the period from May 2012 to August 2022. We specified our exposure as a binary indicator for months in which hate crimes against Asian Americans were positive outliers, and we obtained this data from the State of California Department of Justice Criminal Justice Statistics Center. We employed Box-Jenkins time-series methods to control for monthly temporal patterns in ED visits.</p><p><strong>Results: </strong>Increased hate crimes against Asian Americans corresponds with a rise in psychiatric ED visits among this population. After accounting for autocorrelation and controlling for psychiatric ED visits among non-Hispanic whites, our outlier-adjusted analysis shows an increase of 14.13 more psychiatric ED visits per month than expected during high hate crime months (standard error [SE] = 2.81, p < 0.001).</p><p><strong>Conclusions: </strong>Increased racial discrimination and hate crimes at times of conflict may provoke severe mental health crises that require emergency care. Enhancing mental health support systems and providing culturally competent care tailored to the unique experiences of racial minorities remain crucial during such conflicts.</p>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"365 ","pages":"117624"},"PeriodicalIF":4.9,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822658","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":"Similar health emergencies, different commitments: Comparative strategies to end Ebola and COVID-19 in \"post-conflict\" Liberia.","authors":"Florence Wullo Anfaara, Erica S Lawson, Isaac Luginaah","doi":"10.1016/j.socscimed.2024.117609","DOIUrl":"https://doi.org/10.1016/j.socscimed.2024.117609","url":null,"abstract":"<p><p>Liberia, in the face of two consecutive health emergencies - the Ebola epidemic in 2014 and COVID in 2019 - offers a unique, comparative perspective on health crisis management within a fractured healthcare system. In dialogue with a feminist-informed political economy of health in the African context, this paper has two central objectives. First, it examines the strategies employed by community-based women's organisations - many of whom remain invested in peacebuilding after a 14-year civil war (1989-2003)) - to contain the Ebola and COVID-19 disease outbreaks. Second, it explores the implementation strategies under two political administrations, Sirleaf (Ebola) and Weah (COVID-19), at two distinct political moments. Results from five focus group discussions (n = 27) and seven in-depth interviews (n = 7) suggest that, while there was a relative collective effort from the Liberian government, grassroots women's organisations and community members to contain the Ebola epidemic response, the COVID-19 response witnessed an individualistic approach. Overall, participants suggested that lessons learned from the Ebola epidemic did not seem to be transferred to managing the COVID-19 pandemic in Liberia. The study suggests that while local-government-international partnerships are instrumental in ending health emergencies, grassroots community organisations require economic and social resources and sustained political will to effectively build and maintain various health infrastructures in post-conflict countries. This is relevant not just for managing disease outbreaks and health emergencies but also for entrenching public health services to support population health. Here, lessons from Ebola and COVID-19 rooted in everyday experiences of women's reproductive labour can provide an educational foundation for responding to future disease outbreaks in Liberia and other post-conflict contexts.</p>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"365 ","pages":"117609"},"PeriodicalIF":4.9,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856291","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 mortality implications of a unionized career.","authors":"Tom VanHeuvelen, Xiaowen Han, Jane VanHeuvelen","doi":"10.1016/j.socscimed.2024.117620","DOIUrl":"https://doi.org/10.1016/j.socscimed.2024.117620","url":null,"abstract":"<p><p>An emerging literature has documented a wide range of protections and benefits that union membership provides for health and wellbeing. However, this literature primarily focuses on point-in-time associations between unionization and health, whereas the theoretical benefits of union membership should accrue over a long period of time through such mechanisms as predictable upward attainment and greater employment security. Moreover, studies have not examined union membership's association with mortality, a core health outcome in medical research. We build on recent research that examines the contributions of a unionized career to middle- and older-adulthood mortality using data from the Panel Study of Income Dynamics between 1969 and 2019. We track respondents born between 1935 and 1965 and predict mortality using discrete time hazard regression models. We find that more time spent in a union predicts lower rates of mortality, with an additional year as a union member decreasing the odds of mortality by about 1.5%. This magnitude is about half that of consistent attachment to paid employment. Moreover, we find that male, White, and less educated respondents were most protected by unionized careers, while union protection was found between ages 41 and 67. Our findings extend knowledge of the noneconomic consequences of union benefits and point to a source of emerging health disparities among older adults.</p>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"365 ","pages":"117620"},"PeriodicalIF":4.9,"publicationDate":"2024-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830697","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":"Pandemic income support programs and adolescent mental health in the UK, Ireland, and Australia.","authors":"Gabriele Mari","doi":"10.1016/j.socscimed.2024.117612","DOIUrl":"https://doi.org/10.1016/j.socscimed.2024.117612","url":null,"abstract":"<p><p>After cutting social security in recent decades, the UK, Ireland, and Australia expanded income-support programs during the pandemic. Relatively overlooked, this paper investigates policy responses among younger generations, the socioeconomic disparities therein, and whether and which of these policies, now rolled back, were most beneficial. I rely on longitudinal survey data on adolescents and their caregivers. In value-added regressions adjusting for pre-pandemic health reports, I find that children reported better average health in households with access to the relatively generous scheme adopted by Australia. Girls reported better health in households targeted by previous cutbacks, including those with lower incomes (Australia, Ireland) or headed by a single parent (Australia). The more far-reaching programs in Ireland and Australia were associated with better health also among children in well-off households. On the other hand, some children reported worse mental health despite receipt of payments in the UK and Ireland. Further distributional analyses suggest that programs might have reduced adolescent health disparities in Australia, whereas overall effects were negative or mixed in the UK and Ireland. Hence, policy changes during the pandemic did not equally fit the needs of all children. Nonetheless, drawing lessons from that period, changes to existing income-support programs hold some promise to temper distress and associated inequalities across generations.</p>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"365 ","pages":"117612"},"PeriodicalIF":4.9,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830691","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":"Language barriers in emergency ambulance calls for cardiac arrest: Cases of missing vital information.","authors":"Nirukshi Perera, Marine Riou, Tanya Birnie, Austin Whiteside, Stephen Ball, Judith Finn","doi":"10.1016/j.socscimed.2024.117623","DOIUrl":"https://doi.org/10.1016/j.socscimed.2024.117623","url":null,"abstract":"<p><p>In medical emergencies, phoning the ambulance service constitutes a high-stakes interaction. Call-takers rely on callers to provide information about the patient so they can promptly recognise the medical problem and take swift action to remedy it. When a language barrier exists between the call-taker and caller, this can add a further challenge, given that third-party interpreters are rarely engaged, especially for time-critical conditions such as cardiac arrest. Research in cardiac arrest calls has found that language barrier calls experience longer delays to critical points such as recognition of cardiac arrest and commencement of resuscitation. This study aimed to understand, in the absence of interpreters, the interactional challenges that emerged in language barrier emergency calls, as parties worked to communicate the nature of the medical problem. Based on a critical conversation analysis approach, we conducted fine-grained analysis of interactions in audio recordings and transcripts of 33 language barrier calls from an Australian ambulance service in 2019. We found that call takers regularly failed to recognise that the patient had a cardiac arrest. Non-fluent-English callers often provided vital information about the patient, which could have led to cardiac arrest recognition by the call-taker, however such information was missed if it was delivered in an unsolicited or atypical way. Opportunities to recognise cardiac arrest were also missed when call-takers did not probe further after such information was provided or did not provide enough interactional space for callers to complete their turns. We found that the main reason for delays in recognising cardiac arrest was a lack of mutual understanding, which most of the time seemed to remain unbeknownst to participants. The study makes recommendations for emergency medical dispatch centres to cater for language barrier calls, with the goal of fostering a more inclusive prehospital care system and addressing health disparities for non-fluent-English speakers.</p>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"365 ","pages":"117623"},"PeriodicalIF":4.9,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840028","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 psychological impact of reopening after COVID-19 lockdowns in China: Threat perception, affect and moral conflict.","authors":"Qin Duan, Shangyi Chen, Hang Yuan, Yue Zhang, Siyang Luo","doi":"10.1016/j.socscimed.2024.117611","DOIUrl":"https://doi.org/10.1016/j.socscimed.2024.117611","url":null,"abstract":"<p><p>COVID-19 reopening of China in the context of the highly transmissible Omicron variant has resulted in an unprecedented wave of infections, placing significant strain on healthcare systems and giving rise to a range of psychological responses, including perceptions of the pandemic's threat, emotional reactions, and prosocial intentions amid moral conflicts over medical resource scarcity and evolving public health responses. This study employed a comprehensive approach integrating surveys, behavioral experiments, and agent-based modeling (ABM) to examine these psychological impacts of COVID-19 reopening. A total of 1,675 participants from 34 Chinese provinces completed the surveys, with 587 also undertaking the reversal-learning task. The measures employed were primarily designed to assess perceptions of COVID-19 infection risk and medical resources, negative affect, and prosocial intentions in moral conflicts. Results found that the perception of infection risk and associated negative affects remained elevated until the pandemic decline. However, prosocial intentions initially increased, but subsequently decreased. Moreover, the influence of perceived public medical resources and negative affect on prosocial intentions is mediated by distinct pathways. ABM suggested that anxiety might accelerate the pandemic but increase overall fatalities through prosocial actions, while public medical resources perceptions might shape the pandemic by influencing healthcare-seeking behaviors. These findings underscore the crucial role of psychological factors in pandemic management, alongside physical aspects, providing a scientific foundation for future responses.</p>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"365 ","pages":"117611"},"PeriodicalIF":4.9,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830630","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}