Social Science & Medicine最新文献

{"title":"When youth record police: Investigating officer intrusion and mental health repercussions among Black youth in Baltimore City, Maryland","authors":"Dylan B. Jackson ,&nbsp;Rebecca L. Fix ,&nbsp;Alexander Testa ,&nbsp;Lindsey Webb ,&nbsp;Tamar Mendelson","doi":"10.1016/j.socscimed.2025.118001","DOIUrl":"10.1016/j.socscimed.2025.118001","url":null,"abstract":"<div><h3>Rationale</h3><div>Recording the police is a high-stakes racial justice issue for minoritized youth and communities. No studies to date have explored youths’ efforts to record police and the mental health impacts of these experiences for youth.</div></div><div><h3>Objective</h3><div>This study examined the features and mental health repercussions of in-person stops where youth attempted to record police.</div></div><div><h3>Methods</h3><div>Data come from the Survey of Police-Adolescent Contact Experiences (SPACE), a cross-sectional survey of a community sample of Black youth ages 12–21 in Baltimore City, Maryland (<em>n</em> = 345), administered from August 2022 to July 2023.</div></div><div><h3>Results</h3><div>Youth commonly attempted to record police during direct stops (33.63%) and in-person witnessed stops (39.18%). Across both types of stops, youths’ attempts to record police were strongly associated with all forms of officer intrusion. Recording the police was also associated with significantly elevated police-initiated post-traumatic stress symptoms (PI-PTSS), even when adjusting for officer intrusion and other covariates. Recording the police was most relevant to PI-PTSS for stops with little to no officer intrusion.</div></div><div><h3>Conclusion</h3><div>In addition to systemic change that eliminates inequities in police violence against minoritized youth and communities, trauma-informed supports may be needed for youth who attempt to record police stops – even when stops feature little to no officer intrusion.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"373 ","pages":"Article 118001"},"PeriodicalIF":4.9,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143760445","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":"Gender affirming medical care access: The role of healthcare stereotype threat and social support in a national probability sample of transgender adults","authors":"Madeline Smith-Johnson,&nbsp;Katherine Alexander","doi":"10.1016/j.socscimed.2025.118014","DOIUrl":"10.1016/j.socscimed.2025.118014","url":null,"abstract":"<div><div>Transgender adults face persistent barriers to gender-affirming medical care (GAC)—medical interventions related to a person's gender expression. Extensive qualitative research suggests that accessing GAC is stressful partly because of anticipated stigma from providers and healthcare systems, but that social support from loved ones helps trans adults persist in seeking care. We know less about how anticipated stigma and social support relate to GAC access at the population level. This study utilizes a nationally representative sample of trans adults who want GAC (N = 204) from the U.S. Transgender Population Health Survey (2016–2018). We ask whether anticipated stigma in healthcare (operationalized as healthcare stereotype threat (HCST), or the worry a person has about being judged, mistreated, or stereotyped by providers because of their gender identity or sexual orientation) and perceived social support are associated with GAC utilization for trans adults. We find a significant positive relationship between GAC utilization and HCST, global social support, and significant other support. We also find a significant interaction between HCST and social support where greater HCST is only associated with greater GAC utilization at high levels of social support. These findings underscore the importance of social relationships like peer advocates and chosen families in supporting necessary medical care for trans adults who want it and the importance of increasing culturally competent care in healthcare settings for gender-diverse people.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"373 ","pages":"Article 118014"},"PeriodicalIF":4.9,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735308","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":"“I get to relate to my patients”: Latinx medical students and residents’ navigational capital in medical education","authors":"Nicole A. Perez ,&nbsp;Sarah Medina-Aguirre ,&nbsp;Pilar Ortega ,&nbsp;Monica Vela ,&nbsp;Laura E. Hirshfield","doi":"10.1016/j.socscimed.2025.118003","DOIUrl":"10.1016/j.socscimed.2025.118003","url":null,"abstract":"<div><div>While the U.S. Latinx population has rapidly increased in the past 30 years, the number of Latinx physicians has not kept pace. Latinx students are often motivated to pursue medicine to serve those in their communities, which benefits Latinx community health outcomes through patient-clinician cultural and linguistic concordance. However, significant barriers often prevent Latinx people from successfully navigating the transition to and through medical school. This study utilized a qualitative, constructivist approach to investigate the transition to and through medical school and residency to further understand and prevent leakages for aspiring Latinx physicians. Using an assets-based framework of Community Cultural Wealth (CCW), we specifically explored navigational capital, to understand how Latinx learners navigate belonging in medicine. Through semi-structured interviews with 20 Latinx medical students and 14 residents, we found that learners understood and created belonging by navigating help-seeking and the imposter phenomenon through their respective pathways in medicine. Findings from this study may be used to develop support systems and resources to reduce the structural inequalities, barriers, and challenges Latinx students and future physicians encounter through medical education pathways.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"372 ","pages":"Article 118003"},"PeriodicalIF":4.9,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143695927","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":"Equity in health care and health: Contributions from health economics","authors":"John Cullinan ,&nbsp;Paula Lorgelly","doi":"10.1016/j.socscimed.2025.117997","DOIUrl":"10.1016/j.socscimed.2025.117997","url":null,"abstract":"","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"372 ","pages":"Article 117997"},"PeriodicalIF":4.9,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697520","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":"“Creating ourselves:” A qualitative analysis of DIY HRT practices in nonbinary adults","authors":"Heather Welty","doi":"10.1016/j.socscimed.2025.117965","DOIUrl":"10.1016/j.socscimed.2025.117965","url":null,"abstract":"<div><div>Engaging in ‘do it yourself’ hormone replacement therapy (DIY HRT), including accessing hormones through non-medical pathways or self-altering one's prescribed dosage, is a common way trans people fulfill their transition-related needs. Although extant research has primarily focused only on binary trans populations, “DIYing” is particularly salient for those who are not seeking a binary transition. This paper shares findings from a qualitative, in-depth interview-based study with nonbinary adults who engage in DIY HRT practices and medical providers who prescribe HRT. Through participant's narratives, DIY HRT emerged as both a mode of knowledge production, a site of communal care, and a practice through which participants could support themselves and their communities and achieve bodily autonomy. These findings indicate that nonbinary trans people may opt to DIY due to systemic disinvestment in the production of knowledge and quality care within trans healthcare, choosing instead to engage with the wealth of knowledge and resources that exist in DIY HRT sites and communal care networks.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"373 ","pages":"Article 117965"},"PeriodicalIF":4.9,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143738520","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 multidimensional tool for quantifying structural racism: Application to adverse pregnancy outcomes in Chicago, Illinois","authors":"Alexa A. Freedman ,&nbsp;Lauren S. Keenan-Devlin ,&nbsp;Britney P. Smart ,&nbsp;Renee M. Odom-Konja ,&nbsp;Shanti U. Gallivan ,&nbsp;Andrew D. Franklin ,&nbsp;Amy H. Crockett ,&nbsp;Linda M. Ernst ,&nbsp;Ann Borders ,&nbsp;Gregory E. Miller","doi":"10.1016/j.socscimed.2025.118013","DOIUrl":"10.1016/j.socscimed.2025.118013","url":null,"abstract":"<div><div>Understanding the relationship between structural racism and health is essential for identifying practice- and policy-based interventions to reduce health inequities. We developed neighborhood-based measures of structural racism and tested their associations with adverse pregnancy outcomes, health outcomes characterized by some of the most pronounced racial inequities. We leveraged electronic health records from 89,410 pregnant patients at six Chicago-area hospitals. Patients were linked with neighborhood exposure to 22 experiences reflective of structural racism based on home address, geocoded to the census tract. Measures were summarized into six domains identified as salient to Black women in the literature: law enforcement, housing, medical, employment, education, and community infrastructure. The primary outcome was preterm birth and models were stratified by race and ethnicity. After adjustment for neighborhood socioeconomic status, Black patients in neighborhoods with unfavorable law enforcement practices and school characteristics were more likely to deliver preterm (law RR: 1.07; 95 % CI: 1.02, 1.12; education RR: 1.08; 95 % CI: 1.03, 1.14). This study developed an approach for quantifying multiple domains of structural racism and illustrated its value in the context of preterm birth risk among Black patients.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"372 ","pages":"Article 118013"},"PeriodicalIF":4.9,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143704419","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":"Structural inequities and provider burnout in maternal health in the United States","authors":"Hyeyoung Oh Nelson,&nbsp;Ashlyn Lange,&nbsp;Maleeha K. Shah,&nbsp;Mercy Kibet","doi":"10.1016/j.socscimed.2025.118010","DOIUrl":"10.1016/j.socscimed.2025.118010","url":null,"abstract":"<div><div>The United States is experiencing a maternal health crisis with one of the highest maternal mortality rates among high income countries and with major access to care issues, including growing maternity care deserts and workforce shortages. These systemic issues have led to a robust social scientific research agenda identifying individual and structural drivers of maternal health inequity, though focus has largely been on the impact these inequities have had on patients. Less attention has been given to the effect of structural inequities on maternal health providers in the US. Drawing from 48 interviews with individuals working in maternal health, conducted from November 2021 through May 2024, we reveal their experiences navigating structural inequities in maternal healthcare systems and the consequences of these experiences for their well-being, specifically through the emergence of burnout. The data reveal that maternal health providers are vulnerable to burnout because they experience triple marginalization. First, maternal health is a marginalized sub-field within medicine, so providers feel unequal access to resources. Second, marginalization occurs among maternal health providers as interprofessional hierarchies stratify clinical and non-clinical individuals working in the field. And third, individuals who hold marginalized identities are at greater risk of enduring difficult working conditions. These experiences of marginalization precipitate burnout, with non-clinical birthworkers and providers of color at greatest risk of experiencing burnout.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"372 ","pages":"Article 118010"},"PeriodicalIF":4.9,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143695924","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":"Understanding the dual role of individual position in multidimensional social support networks and depression levels: Insights from a nomination-driven framework","authors":"Chuyao Peng ,&nbsp;Xiaoya Wang ,&nbsp;Meng Zhang ,&nbsp;Dandan Tong ,&nbsp;Jibo Li ,&nbsp;Tianwei Xu ,&nbsp;Jiang Qiu ,&nbsp;Dongtao Wei","doi":"10.1016/j.socscimed.2025.117968","DOIUrl":"10.1016/j.socscimed.2025.117968","url":null,"abstract":"<div><div>This study aims to investigate the relationship between the structural characteristics (e.g., single dimension friendship networks) and functional characteristics (multi-dimension) of social support networks and depressive symptoms among college students. Data were collected from 1784 students across six Chinese universities using questionnaire surveys and a nomination-based social network analysis approach. Friendship and social support networks (including four dimensions of support: appraisal, belonging, tangible, and self-esteem), were constructed to exploring relationships between network characteristics and depressive symptoms at both individual and class levels. The results indicate that greater integration and active participation in these networks are significantly linked to lower depression risks at both individual and class levels, underscoring the protective role of social connections. Yet, individuals with high betweenness centrality in networks demanding high support face increased depression risks, attributed to the stress of maintaining social cohesion and identity. Multilevel analysis further reveals that class network modularity is positively correlated with depressive symptoms and moderates the relationship between local clustering and depressive symptoms in high-burden social support networks, indicating that individuals in bridge positions or on the periphery of high-modularity networks may face increased risk of depression, potentially due to the lack of strong emotional support and social validation. These findings, by focusing on the characteristics of networks at both individual and group levels, lay a foundation for targeted intervention measures designed to optimize social support systems. They offer insights into mental health policies and practices among college students.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"373 ","pages":"Article 117968"},"PeriodicalIF":4.9,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143738538","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":"Deteriorating care home residents as ‘matter out of place’ in both care homes and hospitals: An ethnographic study","authors":"Fawn Harrad-Hyde ,&nbsp;Chris Williams ,&nbsp;Natalie Armstrong","doi":"10.1016/j.socscimed.2025.118012","DOIUrl":"10.1016/j.socscimed.2025.118012","url":null,"abstract":"<div><div>Older people living in care homes are susceptible to deteriorations in their health. At times of deterioration, care home staff play a crucial role in considering the potential benefits and burdens associated with either caring for the resident in the home or transferring them to hospital. Using data collected through interviews with 30 care home staff and 113 h of ethnographic fieldwork in care homes in England, we consider the ways that care home staff can perceive deteriorating care home residents to be, often simultaneously, vulnerable (or ‘at risk’) and dangerous (or ‘a risk’) in both the hospital and the care home. Drawing on the work of Mary Douglas, we suggest deteriorating care home residents can be considered to be ‘matter out of place’ and can therefore be considered as ‘placeless’ in whichever setting they receive care. Instead of asking whether deteriorating residents are in the ‘right place’ to receive care, we might instead ask whether healthcare services are the ‘right shape’ to support to deteriorating care home residents and their complex needs.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"373 ","pages":"Article 118012"},"PeriodicalIF":4.9,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143716135","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":"Socio-demographic, family, and health-related predictors of maternal mental health trajectories during eight years postpartum in a national cohort of 17,886 mothers in Taiwan","authors":"Yi-Han Chang ,&nbsp;Shu-Sen Chang ,&nbsp;Jui-fen Rachel Lu ,&nbsp;Tung-liang Chiang","doi":"10.1016/j.socscimed.2025.117960","DOIUrl":"10.1016/j.socscimed.2025.117960","url":null,"abstract":"<div><h3>Background</h3><div>Previous studies on maternal postpartum mental health are limited by non-representative samples, a narrow focus on mental illness, and a lack of systematic examination of predictors for diverse mental health trajectories. We investigated maternal mental health trajectories during eight years postpartum and their socio-demographic, family, and health-related predictors in a large cohort of mothers in Taiwan.</div></div><div><h3>Methods</h3><div>Participants were 17,886 mothers drawn from the Taiwan Birth Cohort Study (TBCS), a cohort study of a nationally representative sample of children born in Taiwan in 2005 and their parents. Maternal mental health was assessed at 6, 18, 36, 66, and 96 months postpartum using the Mental Component Summary (MCS) from the 36-item Short-Form Health Survey (SF-36) Taiwan version. We used group-based trajectory modeling to identify trajectory groups of maternal mental health and examined their predictors using multinomial logistic regression.</div></div><div><h3>Results</h3><div>Five postpartum mental health trajectories were identified: persistently poor (6.7%), improving (12.1%), deteriorating (14.3%), persistently moderate (46.7%), and persistently good (20.1%), with the first two groups having the poorest mental health at six months postpartum. Immigrant status and higher household income were associated with favorable (i.e., improving, or persistently moderate or good) mental health trajectories, while low family function and poor general health at six months postpartum were associated with less favorable (i.e., deteriorating or persistently poor) trajectories. Among mothers with poor mental health at six months postpartum, being divorced or separated was additionally associated with persistently poor mental health. Among mothers with moderate mental health at six months postpartum, being a first-time mother was additionally associated with deteriorating mental health.</div></div><div><h3>Conclusion</h3><div>Our findings highlight distinct maternal mental health trajectories over eight years postpartum, with one in five mothers experiencing deteriorating or persistently poor mental health. Socio-demographic factors, family function, and early postpartum health were predictors of these trajectories.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"373 ","pages":"Article 117960"},"PeriodicalIF":4.9,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143716064","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}