Social Science & Medicine最新文献

{"title":"Self-management of everyday female health: The role of self-care agency, patient-centered communication, and technology features in the intention to adopt period-tracking apps","authors":"Qiwei Luna Wu ,&nbsp;Elizabeth Babin Pask","doi":"10.1016/j.socscimed.2025.117851","DOIUrl":"10.1016/j.socscimed.2025.117851","url":null,"abstract":"<div><div>Despite the increasing prevalence of health-related apps, the communication-related mechanisms driving their adoption remain underexplored. Approaching health-related self-tracking from a communication perspective, this study explores how patient-centered communication (PCC), supported by active patient participation, can affect women's intentions to adopt period-tracking apps. Using a cross-sectional survey with 485 women aged 18–49 who had visited a healthcare provider in the past year, our findings showed that individual self-care agency indirectly predicted higher PCC through better patient communication competence. Both communication competence and PCC were associated with increased adoption intentions for period-tracking apps, mediated by perceived ease of app use, app usefulness, and positive attitudes towards the apps. Our findings highlight the intricate interplay between personal communication abilities, healthcare provider interactions, and technology features in shaping health technology adoption. Theoretical and practical implications are discussed, offering insights into enhancing female health self-management through improved communication strategies and supportive technological features.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"370 ","pages":"Article 117851"},"PeriodicalIF":4.9,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143455120","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":"Infrahealth politics: Leveraging bartenders’ expertise in alcohol management - An ethnography","authors":"Alix Boirot,&nbsp;Geraldine Cazorla,&nbsp;Patrizia Carrieri,&nbsp;Marta Lotto","doi":"10.1016/j.socscimed.2025.117731","DOIUrl":"10.1016/j.socscimed.2025.117731","url":null,"abstract":"<div><h3>Background and aims</h3><div>Despite WHO recommendations, the percentage of persons treated for Alcohol Use Disorder (AUD) is still low. The ever-increasing burden of alcohol intoxication cases on emergency services underscores the necessity for innovative approaches to treat individuals with AUD and to improve harm reduction strategies. Bars are often frequented by individuals with AUD who are not under observation by medical or social services. Recognizing that understanding the social contexts surrounding alcohol consumption is essential for harm reduction, this study examined the often overlooked yet important role of bartenders in implementing informal harm reduction strategies.</div></div><div><h3>Methods</h3><div>We conducted an ethnographic study between March and October 2023 in 33 bars in Marseille, France. Combining participant observation with semi-structured interviews, 38 bartenders (23 men and 15 women) were purposively sampled. We investigated the harm reduction strategies employed by bartenders, identified potential barriers to these professionals being able to increase harm reduction efforts, and proposed novel harm reduction strategies that these professionals and healthcare professionals could implement.</div></div><div><h3>Findings</h3><div>Bartenders skillfully manage situations of collective overindulgence to maintain a secure environment for customers. They mediate conflict through acts that sometimes go against the bar's financial interests, including moderating customers' alcohol consumption. Occasionally, they also provide support to patrons beyond commercial obligations (accommodation, finding work). In this multifaceted public health role, they balance hospitality with risk management.</div></div><div><h3>Conclusions</h3><div>Bartenders play an ‘infrahealth role’, reducing risks associated with alcohol consumption outside the formal framework of public health. Their harm reduction intervention ranges from adjusting beverage offerings to preventing conflicts. Acknowledging that grassroots stakeholders such as bartenders contribute to tackling AUD, and strengthening the collaboration of health professionals and local authorities with these stakeholders, could help promote safer and more responsible alcohol consumption practices.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"370 ","pages":"Article 117731"},"PeriodicalIF":4.9,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143455084","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":"(Mis)Informed decision-making: How U.S. healthcare providers use science to influence pregnancy options counseling","authors":"Lucy Tu","doi":"10.1016/j.socscimed.2025.117804","DOIUrl":"10.1016/j.socscimed.2025.117804","url":null,"abstract":"<div><div>The language and authority of science have become central to the U.S. abortion debate. Although the pro-choice movement has traditionally positioned itself as defenders of scientific consensus, pro-life activists have increasingly leveraged scientific claims to advance their policy goals. As a result, scientific expertise now plays a pivotal role in the moral and political struggle over abortion, reshaping the foundations of abortion and pregnancy care. Although previous studies have focused on abortion discourse and scientific claim-making through the macro lens of state politics, legislation, and social movements, this study investigates how these dynamics manifest in the intimate setting of patient-provider interactions. Through in-depth interviews with 54 U.S. healthcare providers, this study explores how providers share scientific expertise during pregnancy options counseling, and how their approaches differ based on their personal attitudes toward abortion. Despite stark differences in the content of the information shared, pro-choice- and pro-life-leaning providers reported using similar strategies to communicate scientific evidence, including deliberating choosing language (e.g., “baby” versus “fetus”) and selectively citing studies to explain abortion's physical and mental health effects. Although both groups claimed to prioritize neutrality and transparency, they also reported using tailored approaches to make their scientific expertise more compelling, credible, and accessible to their patients. Existing clinical guidelines advocate for providers to prioritize scientifically accurate, evidence-based counseling. This study demonstrates how, in practice, providers make value-laden judgments that shape how “informed” decision-making is defined.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"370 ","pages":"Article 117804"},"PeriodicalIF":4.9,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143455122","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":"Children's access to mental healthcare: Parental perceptions and resource constraints","authors":"Nicole Black ,&nbsp;David W. Johnston ,&nbsp;Jemimah Ride","doi":"10.1016/j.socscimed.2025.117853","DOIUrl":"10.1016/j.socscimed.2025.117853","url":null,"abstract":"<div><div>A majority of children with mental health problems do not access mental healthcare. This study examines factors that facilitate access to mental healthcare services and prescription medication when children's mental health deteriorates, focusing on the mother's economic resources and her perceived assessment of her child's emotional problems. Using longitudinal survey data linked to national medical records, we find that the child's self-assessment of emotional problems, rather than the mother's assessment, most strongly predicts future self-harm and suicidal behaviours. However, the mother's assessment more strongly influences whether a child accesses mental healthcare as their emotional health declines. The mother's educational attainment and the child's age and gender, also influence mental healthcare access. We identify factors associated with greater congruence between the child's and mother's assessments of emotional problems, suggesting areas that programs could target to improve children's access to mental healthcare.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"370 ","pages":"Article 117853"},"PeriodicalIF":4.9,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143455121","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":"How hospitals’ goal setting, feedback, and process standardization capacity impact provider payment reforms","authors":"Sian Hsiang-Te Tsuei ,&nbsp;Winnie Chi-Man Yip","doi":"10.1016/j.socscimed.2025.117831","DOIUrl":"10.1016/j.socscimed.2025.117831","url":null,"abstract":"<div><h3>Background</h3><div>Provider payment reforms (PPRs) can improve providers' efficiency, but they often generate mixed results. Since organizations mediate PPR effectiveness, examining hospitals' management capacity's association with PPR effectiveness can be useful. In the context of clear strategies, hospitals' management characteristics related to goal attainment would be key to PPR adaptation. This study examines hospitals' capacity to set goals at appropriate difficulty or specificity, provide feedback, or standardize processes.</div></div><div><h3>Methods</h3><div>We leverage a matched-pair, cluster randomized controlled PPR trial in a low-income Chinese province between 2014 and 2018. The reform aimed to reduce the per admission expenditure of the public insurance New Cooperative Medical Scheme (NCMS) though this may inadvertently trigger higher out-of-pocket (OOP) expenditure. We categorize 52 hospitals’ baseline goal setting, feedback, and process standardization capacities using the World Management Survey and interact these characteristics with the difference-in-difference estimator to examine whether the four management characteristics modified the treatment effect.</div></div><div><h3>Results</h3><div>All four management characteristics were non-statistically significantly associated with lower NCMS expenditure growth, consistent with the PPR incentives. However, their effects were jointly significant. Much of the effect came from goal specificity and feedback. Regarding expenditure shifting to OOP sources, only process standardization amplified such behaviour while goal difficulty showed spillover control in OOP expenditure growth.</div></div><div><h3>Conclusion</h3><div>Management capacity around goal attainment is an important moderator of PPR effectiveness, and future research can further unpack organizational characteristics of PPRs. Policymakers and hospital leaders may use industry peer networks to disseminate high quality goal development approaches and encourage huddles to facilitate feedback. Introducing monitoring and penalties for expenditure shifting—particularly for hospitals that can standardize operations in pursuit of profit—may be helpful.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"370 ","pages":"Article 117831"},"PeriodicalIF":4.9,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143508273","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":"Effects of extended working lives on depressive symptoms, physical, and cognitive health in middle and later life: Evidence from China","authors":"Hengyi Xu ,&nbsp;Zhongmin Zhang ,&nbsp;Xue Yang ,&nbsp;Qin Yang ,&nbsp;Ting Chen","doi":"10.1016/j.socscimed.2025.117833","DOIUrl":"10.1016/j.socscimed.2025.117833","url":null,"abstract":"<div><h3>Introduction</h3><div>Many countries are extending working lives to counteract the shrinking labor force caused by population aging. However, the health implications of this approach for middle-aged and older adults remain unclear, particularly in low- and middle-income countries.</div></div><div><h3>Methods</h3><div>Data were drawn from the 2011–2020 China Health and Retirement Longitudinal Study to analyze the effect of labor force participation on multidimensional health, with a focus on activities of daily living disability, depressive symptoms, and cognitive impairment. A longitudinal g-formula was applied to address the endogeneity associated with long-term employment and simulate the life course of a synthetic cohort aged 45–80 years. The impact of extending working lives to age 63 for men and age 58 for women on health outcomes was estimated.</div></div><div><h3>Results</h3><div>Labor force participation was negatively associated with the onset of activities of daily living disability but positively associated with the onset of depressive symptoms and cognitive impairment among middle-aged and older adults. Extending working life slowed the progression of activities of daily living disability but increased the risk of depressive symptoms and cognitive impairment, especially in women. These effects persisted beyond working years and into postretirement. Higher education levels mitigated the negative impact of extended working lives on cognitive function.</div></div><div><h3>Conclusions</h3><div>While extending working lives may benefit physical functioning, it poses risks to depressive symptoms and cognitive health, particularly for women. National policies promoting longer working lives should incorporate targeted preventive measures to protect the psychological and cognitive health of middle-aged and older adults.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"369 ","pages":"Article 117833"},"PeriodicalIF":4.9,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143420028","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":"Heteronormativity and cisgenderism in medical training: A scoping review of lesbian, gay, bisexual, transgender, queer and plus (LGBTQ+) issues in medical training in Asia","authors":"Yiu Tung Suen ,&nbsp;Eliz Miu Yin Wong ,&nbsp;Randolph C.H. Chan ,&nbsp;Suchon Tepjan ,&nbsp;Peter A. Newman","doi":"10.1016/j.socscimed.2025.117822","DOIUrl":"10.1016/j.socscimed.2025.117822","url":null,"abstract":"<div><div>Lesbian, gay, bisexual, transgender, queer and plus (LGBTQ+) related health concerns in medical training have historically been underrepresented or largely omitted. This review goes beyond the Global North and is one of the first scoping reviews to take a regional approach to understanding LGBTQ+ issues in medical training in Asia, a region that millions of LGBTQ+ people call home. A scoping review of peer-reviewed articles published from 2000 to 2024 on LGBTQ+ issues in medical training (including medical, nursing and dentistry) in Asia was conducted. A diversity of attitudes towards LGBTQ+ issues were found among medical, dental, and nursing students. Negative attitudes, especially pathologization of LGBTQ+ people, were still evident. Despite receiving inadequate training from their medical curriculum, students generally showed a strong eagerness to learn more about LGBTQ+ healthcare to know how to act professionally. Although LGBTQ+ students perceived a supportive environment among their peers, there were constant worries about how they were perceived as doctors by attending physicians and patients. Medical, dental, and nursing educators in the identified studies had minimal knowledge of LGBTQ+ issues and limited experience working with LGBTQ+ patients. Articles found that LGBTQ+ issues were lacking in the formal medical curriculum, with very little consideration beyond strictly biomedical concerns. Importantly, this paper debunks the idea that Asia is uniformly negative and conservative on LGBTQ+ issues, highlights the importance of regionally and culturally specific factors in understanding the medical training environment, and provides suggestions for practice and further research. Altogether, this paper argues that there is an urgent need and a substantial opportunity to make medical training in Asia more LGBTQ+ inclusive.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"370 ","pages":"Article 117822"},"PeriodicalIF":4.9,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143479776","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":"Place-based access to integrated mental health services within substance use disorder treatment facilities in the US","authors":"George Pro ,&nbsp;Harold W. Neighbors ,&nbsp;Brittany Wilkerson ,&nbsp;Tiffany Haynes","doi":"10.1016/j.socscimed.2025.117843","DOIUrl":"10.1016/j.socscimed.2025.117843","url":null,"abstract":"<div><div>The co-occurrence of substance use (SUD) and mental disorders is increasing in the US. Integrating mental health services into SUD treatment facilities improves treatment retention and success, but access to integrated services is lagging behind growing demand. The purpose of this study was to map the locations of SUD treatment facilities that offer integrated mental health services and identify community characteristics associated with whether a treatment facility offers more comprehensive integrated services. We used the Mental health and Addiction Treatment Tracking Repository to identify the location and characteristics of licensed outpatient SUD treatment facilities in the US (2022; N = 8,858). Our focal predictors included the percentage of a census block group that was White, Black, and Hispanic. We used multilevel multiple logistic regression to model whether a facility offered integrated mental health (y/n), adjusted for relevant facility-, county-, and state-level covariates, and defined state as a random effect. The majority of integrated facilities were located in the eastern US, with notable concentrations around large metropolitan areas of Minneapolis, MN, Chicago, IL, Atlanta, GA, and New York, NY. For every 10-percentage point increase in a census block group's Black and Hispanic population, there was a 5% and 7% decrease in the odds of offering integrated services, respectively (aOR_Black = 0.95, 95% CI = 0.91–0.99, p = 0.04; aOR_Hispanic = 0.93, 95% CI = 0.90–0.96, p &lt; 0.0001). We frame our findings around social conditions as fundamental drivers of disease and healthcare access and acknowledge the country's historical disinvestment in nonwhite and rural communities. Racially targeted programs are needed to effectively address growing racial and ethnic inequities in SUD and mental healthcare.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"369 ","pages":"Article 117843"},"PeriodicalIF":4.9,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143454337","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":"Characteristics of geographic environments that support the health and wellbeing of young people with disability: A scoping review","authors":"Amanda Alderton ,&nbsp;Zoe Aitken ,&nbsp;Belinda Hewitt ,&nbsp;Elroy Dearn ,&nbsp;Hannah Badland","doi":"10.1016/j.socscimed.2025.117842","DOIUrl":"10.1016/j.socscimed.2025.117842","url":null,"abstract":"<div><h3>Purpose</h3><div>We aimed to: 1) identify key characteristics of geographic environments relating to the health and wellbeing of young people with disability that have been published in the literature, and 2) determine the coverage of evidence examining these characteristics and current gaps in knowledge of the ways geographic environments support health and wellbeing outcomes for young people with disability.</div></div><div><h3>Methods</h3><div>This scoping review followed Arksey and O'Malley's methodological framework and established reporting guidelines (PRISMA-ScR Checklist). We searched the following databases: Web of Science (Core Collection), PubMed (Medline), Scopus, Proquest Central.</div></div><div><h3>Results</h3><div>We identified 35 studies meeting inclusion criteria, which were mostly from high-income, English-speaking countries. Studies were grouped into ten major themes, which broadly align with place-based social determinants of health (e.g., access to transport, neighbourhood built environments). The largest body of evidence coalesced around neighbourhood social cohesion and related concepts. Notable gaps included a lack of evidence from the Global South, and limited investigation of local employment availability, access to healthcare, leisure and recreation, neighbourhood safety, and transitions into independent living.</div></div><div><h3>Conclusions</h3><div>This scoping review characterised the existing evidence around the key characteristics of geographic environments that support (or hinder) the health and wellbeing of young people with disability, and identified several important gaps and opportunities for future research. This includes developing a better understanding of the place-based experiences, geographic scales, and environmental exposures that are most relevant for young people with disability, including through participatory methods (e.g., participatory mapping).</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"370 ","pages":"Article 117842"},"PeriodicalIF":4.9,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143463814","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":"The impact of China's low-carbon city pilot program on the health of children","authors":"Jiaoli Cai ,&nbsp;Yue Li ,&nbsp;Peter C. Coyte","doi":"10.1016/j.socscimed.2025.117823","DOIUrl":"10.1016/j.socscimed.2025.117823","url":null,"abstract":"<div><div>Global climate change poses a significant threat to public health in general and to the health of children, in particular. In response to this threat, many countries have implemented a series of policies to mitigate climate change, among which China's low-carbon city pilot program has attracted widespread attention. This study used longitudinal data drawn from the China Family Panel Studies between 2012 and 2018 to evaluate the impact of China's low-carbon city pilot program on the health of children. A difference-in-differences model was employed to investigate the effects of the policy, with further exploration of potential impact mechanisms. The results demonstrated that China's low-carbon city pilot program substantially improved the health of children by fostering environmental quality and promoting slow mobility (i.e., travel on foot or by bicycle). The study also showed that the impact of the pilot program on the health of children was proportional to their proximity to school. Our findings are significant not only for the expansion of China's pilot policy, but also generally for low- and middle-income countries in their efforts to combat air pollution and understand the scale of its impact on the health of children.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"369 ","pages":"Article 117823"},"PeriodicalIF":4.9,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143420030","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}