Social Science & Medicine最新文献

{"title":"Introduction to the special issue on bodies, health, environments","authors":"Carly E. Nichols , Sterling Johnson , Allison Hayes-Conroy","doi":"10.1016/j.socscimed.2025.118601","DOIUrl":"10.1016/j.socscimed.2025.118601","url":null,"abstract":"","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"385 ","pages":"Article 118601"},"PeriodicalIF":5.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214086","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":"From hardship to resilience: Childhood financial conditions and adult well-being in WEIRD and less WEIRD countries","authors":"Dorota Weziak-Bialowolska ,&nbsp;Andrzej Cwynar ,&nbsp;Piotr Bialowolski ,&nbsp;Richard G. Cowden ,&nbsp;Renae Wilkinson ,&nbsp;R. Noah Padgett ,&nbsp;Byron R. Johnson ,&nbsp;Tyler J. VanderWeele","doi":"10.1016/j.socscimed.2025.118622","DOIUrl":"10.1016/j.socscimed.2025.118622","url":null,"abstract":"<div><div>This study examines the prospective associations between subjective childhood financial conditions and adult well-being outcomes across 22 countries, with a specific focus on differences between WEIRD and less WEIRD contexts. Using nationally representative cross-sectional data from 202,898 individuals, we analyzed retrospective reports of childhood financial conditions – categorized as “lived comfortably,” “got by,” “found it difficult,” and “found it very difficult” – and their associations with 48 adult well-being indicators across psychological, social, physical health, character strengths, prosocial behaviors, and socioeconomic domains (adjusting for possible sociodemographic characteristics and other retrospectively recalled childhood factors). An outcome-wide analytic approach was used to estimate associations in each country, and meta-analytic methods were employed to pooled effect estimates across the countries. Our meta-analytical findings indicate that more advantageous financial conditions in childhood are associated with more favorable adult well-being outcomes across domains (in 43 out of 48 outcomes). Notably, less WEIRD countries exhibited stronger associations with indicators of life balance, mastery, and social support, whereas WEIRD nations showed more pronounced effects on individual-focused outcomes such as optimism and internal freedom. Additionally, in several less WEIRD settings, adverse financial conditions were paradoxically linked with favorable resilience-related outcomes, suggesting robust adaptive mechanisms in response to early economic adversity. These results confirm prior associations between childhood financial conditions and adult well-being indicators. However, the findings also highlight the need for culturally nuanced policy interventions. Our study contributes novel comparative evidence advocating for expanded research beyond WEIRD contexts to fully understand and address the multifaceted effects of early economic adversity.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"385 ","pages":"Article 118622"},"PeriodicalIF":5.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145160279","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":"Emergency department crowding: How valuable is GPs information?","authors":"Rosella Levaggi, Carmen Marchiori, Michela Marchiori, Raffaele Miniaci","doi":"10.1016/j.socscimed.2025.118600","DOIUrl":"https://doi.org/10.1016/j.socscimed.2025.118600","url":null,"abstract":"<p><p>Can GPs referral reduce the inappropriate use of Emergency Departments (ED)? Our paper allows us to shed some light on this policy relevant issue by exploiting a unique dataset of 38,572 admission records from the province of Trento in 2018. The dataset contains, among other things, specific information on how the decision to visit the ED (i.e., was it the patient's own decision or was the visit based on the advice of their GP) was made. In our data, 10.5 % of the accesses are inappropriate but we find that GP referrals reduce the probability of inappropriate access by 6.5 percentage points on average; the results are robust to changes in parameters and estimation models. From a policy perspective, the analysis suggests that GPs could play a crucial role in reducing overcrowding in EDs and provides quantitative support for the use of fast-tracking GP referrals as a possible management strategy.</p>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"385 ","pages":"118600"},"PeriodicalIF":5.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233925","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 risk of suicide mortality according to income dynamics assessed using health insurance premium data: A nationwide cohort study in Korea","authors":"Kye-Yeung Park ,&nbsp;Kyu-na Lee ,&nbsp;Hwan-Sik Hwang ,&nbsp;Kyungdo Han ,&nbsp;Hoon-Ki Park","doi":"10.1016/j.socscimed.2025.118611","DOIUrl":"10.1016/j.socscimed.2025.118611","url":null,"abstract":"<div><div>Low income is a known risk factor for suicide; however, how changes in income and its fluctuation relate to suicide risk remains unexamined. Using the Korean National Health Insurance Service database, 4,031,867 adults aged 30 years or older who underwent a health checkup in 2012 were followed until the end of 2022. Based on health insurance premiums, income levels and changes between 2008 and 2012 were assessed. Low-income status was defined as the lowest quartile or receiving Medical Aid. Income variability was the standard deviation of the percentage change in income over five years. Hazard ratios (HRs) and 95 % confidence intervals (CIs) for suicide were calculated using multivariable Cox regression. During a 9.2-year follow-up, 10,012 suicide deaths (0.25 %) occurred. Persistent low income for five years was associated with a 48 % increased suicide risk (HR 1.48, 95 % CI 1.38–1.58) compared with those never in low income. Conversely, persistent high income was associated with a decreased suicide risk (HR 0.67, 95 % CI 0.64–0.71). Income decreases resulting in low-income status (HR 1.26, 95 % CI 1.12–1.43) and high variability in income (HR 1.37, 95 % CI 1.29–1.45) were also associated with increased suicide risk. These patterns were consistent regardless of the presence of depression and disability but were more pronounced in males and those under 65. In conclusion, persistent low-income, income decreases, and high variability were all independently associated with increased suicide risks. Suicide prevention strategies should promote income stability while accounting for age and sex.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"385 ","pages":"Article 118611"},"PeriodicalIF":5.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145160282","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":"Beyond partisan rhetoric: Institutional constraints and local COVID-19 policies in Brazil","authors":"Ivan Filipe Fernandes ,&nbsp;Gustavo Andrey de Almeida Lopes Fernandes ,&nbsp;Michael Touchton ,&nbsp;Brian Libgober","doi":"10.1016/j.socscimed.2025.118607","DOIUrl":"10.1016/j.socscimed.2025.118607","url":null,"abstract":"<div><h3>Background</h3><div>Political polarization can influence policy responses, particularly during crises. While institutions aim to counterbalance these effects, their capacity to do so under stress remains underexplored. This study examines whether mayoral partisan ideology affected pandemic policymaking in Brazilian municipalities, a highly polarized context with a severe COVID-19 health burden.</div></div><div><h3>Methods</h3><div>We used a regression discontinuity design in 599 closely contested mayoral elections in 2016 to identify causal effects of partisan ideology on municipal pandemic responses in 2020. The analysis focused on formal policy measures and behavioral outcomes, particularly compliance with social isolation.</div></div><div><h3>Results</h3><div>Mayoral partisan ideology had minimal influence on formal pandemic policymaking at the municipal level, challenging assumptions based on national partisan cues. However, municipalities led by right-wing mayors showed lower compliance with social isolation in the short term, despite no significant differences in formal policies and overall compliance across the first year of the pandemic.</div></div><div><h3>Conclusions</h3><div>These findings highlight the complexity of partisan influence on health policymaking during crises. While national politics may shape public discourse, institutional structures and political and electoral interests can mitigate ideological effects on local policymaking.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"385 ","pages":"Article 118607"},"PeriodicalIF":5.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145222217","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":"Sustained social participation and dementia: evidence from a Japanese longitudinal cohort study with a time-varying exposure analysis","authors":"Yusuke Matsuyama ,&nbsp;Kokoro Shirai ,&nbsp;Jun Aida","doi":"10.1016/j.socscimed.2025.118608","DOIUrl":"10.1016/j.socscimed.2025.118608","url":null,"abstract":"<div><div>Social participation is linked to a reduced risk of cognitive impairment and dementia. However, few studies have considered the bidirectional relationship between social participation and cognitive decline over time. We aimed to estimate the effect of sustained social participation on dementia risk reduction among older Japanese adults, accounting for the bias induced by the bidirectional relationship.</div><div>A longitudinal study was conducted using data from the Japan Gerontological Evaluation Study. A baseline survey was administered in 2013, with dementia onset information up to 2022 obtained from the municipality registry (n = 47,698; median follow-up 9.2 years). Additional questionnaire surveys in 2016 and 2019 collected data on social participation and time-varying confounders. The average treatment effect (ATE) of sustained social participation on dementia onset was estimated using doubly robust targeted minimum loss-based estimation.</div><div>Of the participants, 17.2 % got dementia. Participants with baseline social participation had a lower incidence of dementia (14.7 %) compared to those without social participation (17.8 %). Sustained social participation in any group at least once per week from 2013 to 2019 was associated with a 3.2 percentage point increase in dementia-free survival probability (95 % confidence interval, CI: 1.9, 4.5) compared to never participated. Among specific group types, participation in sports groups (ATE = 4.2; 95 % CI: 2.0, 6.4) and hobby groups (ATE = 5.3; 95 % CI: 2.5, 8.0) was significantly associated with increased dementia-free survival probability.</div><div>Sustained social participation was associated with reduced dementia risk among older Japanese adults.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"385 ","pages":"Article 118608"},"PeriodicalIF":5.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187352","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 effects of parental unemployment on children's wellbeing – results from Switzerland and the United Kingdom","authors":"Claire Mariano ,&nbsp;Christoph Henking ,&nbsp;Dawid Gondek ,&nbsp;Laura Bernardi","doi":"10.1016/j.socscimed.2025.118609","DOIUrl":"10.1016/j.socscimed.2025.118609","url":null,"abstract":"<div><h3>Objective</h3><div>This study uses longitudinal panel data from Switzerland and the United Kingdom to examine how parental unemployment at year T affects children's wellbeing at year T+2 through parental wellbeing at year T+1. We also test the moderating effects of unemployment benefits, wealth, and household composition on parental wellbeing.</div></div><div><h3>Method</h3><div>We used data from the Swiss Household Panel (1999–2021) and Understanding Society (1991–2022). Wellbeing was measured using life satisfaction and worry in Switzerland, and life satisfaction and psychological distress in the UK. We applied linear mixed-effects models to test moderation between unemployment and parental wellbeing and conducted causal mediation analyses to assess indirect effects of unemployment on child wellbeing through parental wellbeing.</div></div><div><h3>Results</h3><div>In Switzerland, household composition and home ownership significantly moderated the relationship between maternal unemployment and life satisfaction. In the UK, unemployment benefits moderated the association between maternal unemployment and psychological distress. Causal mediation analyses using Swiss data revealed that the effect of maternal unemployment on child outcomes was partially mediated by maternal life satisfaction and worry. Paternal unemployment had a direct effect on child life satisfaction. In the UK, results indicated partial mediation through life satisfaction and psychological distress in both mother-child and father-child dyads.</div></div><div><h3>Conclusion</h3><div>Our results suggest that parental employment is associated with child wellbeing, and that this association is partially explained by changes in parental wellbeing. These relationships vary across countries depending on family composition, wealth, and access to unemployment benefits.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"385 ","pages":"Article 118609"},"PeriodicalIF":5.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145160275","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":"Micromobilities: The turn to health, social interaction and inclusivity","authors":"Becky P.Y. Loo","doi":"10.1016/j.socscimed.2025.118602","DOIUrl":"10.1016/j.socscimed.2025.118602","url":null,"abstract":"<div><div>Walking, cycling and other means of micromobility (encompassing lightweight and non-enclosed vehicles like scooters) share common characteristics of not relying on fossil fuels (zero- or low-carbon), non-enclosed (unprotected), and being slower than mechanized transport modes, such as private cars and trains. With less than five years remain for reviewing the 2030 Agenda for Sustainable Development, micromobilities have become more important. First, while traffic injury risk has been the single most important research focus, the much wider interface of slow mobility, environment and health is coming to the forefront. The interface ranges from the negative environmental exposure to health to the more positive environmental exposure to fresh air, greenery and blue assets. Second, micromobilies are important not only for accessibility but also people's desire for mobility, whereby people-to-people interaction and people-environment interaction naturally happen. Third, the special needs of the vulnerable groups in society have become eminent. The need to provide a connected walking, cycling and micromobility infrastructure suitable for use by children and older adults should be prioritized.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"385 ","pages":"Article 118602"},"PeriodicalIF":5.0,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151608","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":"Better health, but growing social and health inequalities among young adults in Germany due to educational expansion? A counterfactual mediation analysis","authors":"Stefanie Sperlich,&nbsp;Batoul Safieddine,&nbsp;Johannes Beller","doi":"10.1016/j.socscimed.2025.118604","DOIUrl":"10.1016/j.socscimed.2025.118604","url":null,"abstract":"<div><h3>Purpose</h3><div>Based on theoretical and empirical work on the significance of school education for health, this study examines the influence of educational expansion on self-rated health (SRH) and the development of social and health inequalities between educational groups among young adults in Germany.</div></div><div><h3>Methods</h3><div>We used data from the German Socio-Economic Panel study from 1995 to 2020, focusing on individuals aged 25–39 years. Health was measured using the single item ‘self-rated health’. Social inequalities between educational groups were examined in terms of professional position, unemployment rates and household income. Logistic regression analyses were applied to examine health trends. The Relative and Slope Index of Inequality (RII/SII) were calculated to examine the development of social and health inequalities. The influence of school education, professional position, unemployment rates and income on the health trends was analysed using causal mediation analysis.</div></div><div><h3>Results</h3><div>We found a beneficial effect of educational expansion on SRH of young adults. At the same time, social and health inequalities have increased between educational groups in terms of relative and absolute measures of inequalities. The deterioration in health of young adults with low education could be partly explained by the increase in low-skilled jobs and low incomes.</div></div><div><h3>Conclusions</h3><div>Our findings suggest that a high educational attainment is becoming increasingly important for success in the labor market and good SRH. Young adults with a low level of education are becoming a smaller but increasingly vulnerable group, which poses challenges for future prevention.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"385 ","pages":"Article 118604"},"PeriodicalIF":5.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145120696","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":"Depression trajectories from mid to late life (50–89 Years): The roles of cohort, multimorbidity status, and national contexts across nine European countries","authors":"Yufei Zhang ,&nbsp;Zhihao Ma","doi":"10.1016/j.socscimed.2025.118605","DOIUrl":"10.1016/j.socscimed.2025.118605","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aims to disentangle the age and cohort effects on depressive symptoms among middle-aged and older adults, while accounting for the role of multimorbidity across nine European countries.</div></div><div><h3>Methods</h3><div>Using longitudinal data from the Survey of Health, Ageing, and Retirement in Europe (SHARE) (2004–2022), with participants aged 50–89 and birth cohorts from 1921 to 1970, we employed Hierarchical Age-Period-Cohort (HAPC)-Growth Curve models to estimate age and cohort effects on depressive symptoms. Interaction effects of multimorbidity and country with cohort and age were also tested. Bounding analysis was used as a robustness check.</div></div><div><h3>Results</h3><div>The age effect revealed a U-shaped trajectory of depressive symptoms, with a decline after age 50, reaching a low point around age 65, followed by a sharp increase after age 70. The cohort effect showed that later-born cohorts experienced higher levels of depression. Bounding analysis confirmed these findings: period effects were near zero, with the exception of Spain. Multimorbidity was positively associated with depression, with significant national differences. Younger cohorts with multimorbidity status in Scandinavian countries show elevated depressive symptoms. For Spain, depressive symptoms are concentrated among earlier-born cohorts. Central European countries showed variability, but Germany's depression trajectory remained stable, with cohort effects being most pronounced.</div></div><div><h3>Discussion</h3><div>Our findings emphasize the need for a life-course perspective to understand depression trajectories. Cohort differences highlight the role of sociohistorical contexts, while multimorbidity requires attention in long-term healthcare policy.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"385 ","pages":"Article 118605"},"PeriodicalIF":5.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145109960","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}