Social Science & Medicine最新文献

{"title":"Early-life access to primary healthcare and educational attainment: Evidence from community health centers in China","authors":"Yucheng Sun ,&nbsp;Jiaolong Li ,&nbsp;Xiuheng Shen ,&nbsp;Zhewen Pan","doi":"10.1016/j.socscimed.2025.118197","DOIUrl":"10.1016/j.socscimed.2025.118197","url":null,"abstract":"<div><div>This paper uses the rollout of community health centers (CHCs) from the 1950s to the 1970s in China to study the long-term effects of early-life access to primary healthcare on educational attainment. By leveraging the variation across birth cohorts and communities in the establishment of CHCs, we find that exposure to CHCs in early life significantly increases children's completed years of education in later life. Event study estimates confirm that the beneficial effects of CHC exposure are concentrated in early life. Mechanism analysis reveals that early-life exposure to CHCs improves birth health and childhood health. The results remain robust after considering a series of robustness checks, such as ruling out confounding factors and placebo tests. Our findings underscore the significance of early-life primary healthcare in building human capital and indicate that the returns on accessing primary healthcare may be significantly underestimated.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"380 ","pages":"Article 118197"},"PeriodicalIF":4.9,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144099871","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":"Heterogeneous associations between early-life religious upbringing and late-life health: Evidence from a machine learning approach","authors":"Xu Zong ,&nbsp;Xiangjiao Meng ,&nbsp;Karri Silventoinen ,&nbsp;Matti Nelimarkka ,&nbsp;Pekka Martikainen","doi":"10.1016/j.socscimed.2025.118210","DOIUrl":"10.1016/j.socscimed.2025.118210","url":null,"abstract":"<div><div>Religious upbringing was common in Europe during the childhood of older adults today. However, studies are still lacking on how early-life religious upbringing is associated with adult health and how this association differs in different population segments. We used cross-national data of 10,346 adults aged 50 or older in Europe. The causal forest approach was applied to capture the complex nonlinear relationships in the data and estimate the average treatment effect (ATE) of early-life religious upbringing on late-life self-rated health and the heterogeneity of this effect across subgroups (early-life circumstances, late-life demographics, and late-life religious involvement) by estimating conditional average treatment effects (CATEs). The results demonstrated that allowing for 19 covariates, early-life religious upbringing was associated with poorer late-life self-rated health with an ATE of −0.10 [95 % confidence interval −0.11, −0.09]. However, the associations varied across different domains of health: religious upbringing was linked to poorer mental health (higher depression levels) and poorer cognitive health (lower numeracy ability) but was associated with better physical health (fewer ADL limitations). CATEs further assess the heterogeneous associations among different subgroups, providing modest evidence that early-life religious upbringing was associated with poorer late-life self-rated health especially among older individuals (65+ years), females, those with low education level, those who were not married or partnered, those who prayed, those who never attended a religious organization, and those with adverse childhood family circumstances. Our results suggest that the association between early-life religious upbringing and late-life health may be modified by both childhood and adulthood social conditions.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"380 ","pages":"Article 118210"},"PeriodicalIF":4.9,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144138659","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":"Simulating social network-based interventions for adolescent cigarette smoking","authors":"Cynthia M. Lakon ,&nbsp;Cheng Wang ,&nbsp;John R. Hipp ,&nbsp;Carter T. Butts","doi":"10.1016/j.socscimed.2025.118196","DOIUrl":"10.1016/j.socscimed.2025.118196","url":null,"abstract":"<div><div>Social network-based adolescent substance use interventions have demonstrated potential for reducing adolescent cigarette smoking. This approach is premised upon leveraging youths’ social networks for the diffusion of peer influence. Determining which adolescents to select in network interventions for reducing smoking is a major consideration. We utilize a simulation approach that first estimates Stochastic Actor-Oriented models (SAOM) of adolescent smoking using data from two of the largest schools from the longitudinal saturation sample of the National Study of Adolescent to Adult Health (Add Health) (n = 3,154). We then conduct Agent-Based Simulation models which mimic the consequences of intervention strategies selecting adolescents in network positions and structures that are salient for smoking and the diffusion of peer influence within school-based networks, and we select adolescents smoking at different levels. Our findings indicate that selecting adolescents occupying central network positions yielded the greatest reductions in the number of smokers in a school, one year post intervention. Moreover, our findings indicate that in the school with the higher smoking prevalence, there was a beneficial network multiplier effect one year later, which resulted in <em>more</em> non-smokers than those smokers initially intervened upon. When examining the effects of varying the magnitude of peer influence, we find that targeting central positions in networks led to even greater decreases in smoking in schools with higher levels of peer influence. Our findings highlight interdependence and sensitivity of peer influence to network position and have implications for informing school-based network interventions for adolescent smoking.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"380 ","pages":"Article 118196"},"PeriodicalIF":4.9,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144169626","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":"Minority stress and bereavement: The impact of social positioning on LGBTQ+ bereavement experiences","authors":"Felicity Johnson ,&nbsp;Kristin Bindley","doi":"10.1016/j.socscimed.2025.118186","DOIUrl":"10.1016/j.socscimed.2025.118186","url":null,"abstract":"<div><div>This scoping review explores how the social positioning of lesbian, gay, bisexual, trans and queer (LGBTQ+) persons impacts their bereavement experiences. Drawing on the key concepts of minority stress and intersectionality, LGBTQ+ bereavement is examined through a social constructionist lens. Arksey and O'Malley's (2005) scoping review method is employed to map the existing research on LGBTQ+ bereavement published between 2003 and 2023, with specific interest in how this research discusses the impact of identity on bereavement. Findings are presented in four themes: (1) Systemic barriers, (2) Complexities of (not) disclosing identity, (3) Minimising of loss, and (4) LGBTQ+ community dis/connection. Employing reflexive thematic analysis to support critical interpretation, findings are explored through the lens of social constructionism, before critiquing the evident lack of intersectional approaches to research in current LGBTQ+ bereavement literature. Findings indicate several gaps in the LGBTQ+ bereavement literature, and the need for further research in this area to be conceptualised and guided by an intersectional approach.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"380 ","pages":"Article 118186"},"PeriodicalIF":4.9,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144138658","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 making of transplant kin","authors":"Tanya Zivkovic","doi":"10.1016/j.socscimed.2025.118173","DOIUrl":"10.1016/j.socscimed.2025.118173","url":null,"abstract":"<div><div>This is a paper about the relational and more-than-human matters of living and dying. Drawing on Australian fieldwork and interviews with bereaved families, I extend anthropological work on bodies and kinship in the context of organ donation and transplantation. Reorienting boundaries between bodies, life, and death, through an expansive category of ‘transplant kin’, I engage feminist science and technology studies (STS) to trouble imaginings of human exceptionalism and biological essentialism. In so doing, I argue that the making of transplant kin is an interembodied act which offers possibilities for recognising mutually constitutive relations with others and the world we live in.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"380 ","pages":"Article 118173"},"PeriodicalIF":4.9,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144170007","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":"Mental well-being trends and school-based protective factors among adolescents in British Columbia (2015–2022): A population-based study","authors":"Eva Oberle ,&nbsp;Xuejun Ryan Ji ,&nbsp;Tonje Molyneux ,&nbsp;Martin Guhn ,&nbsp;Barry Forer ,&nbsp;Kimberly Thomson ,&nbsp;Maram Alkawaja ,&nbsp;Anusha Kassan ,&nbsp;Anne Gadermann","doi":"10.1016/j.socscimed.2025.118201","DOIUrl":"10.1016/j.socscimed.2025.118201","url":null,"abstract":"<div><h3>Background</h3><div>Adolescent mental well-being has declined in the past decade. Much research relies on administrative data and population-based research incorporating youth voices and exploring protective factors for mental well-being is scarce. This study examined trends in adolescent mental well-being from 2015 to 2022 in British Columbia (BC), Canada. We examined sex differences in the trends, the role of protective factors in school, and the relative importance of protective factors for mental well-being.</div></div><div><h3>Methods</h3><div>We drew from self-report data from eight years of implementation (2015–2022) of the Middle Years Development Instrument (MDI) with grade 7 students (N = 69,391; 49 % girls) in schools. Positive (satisfaction with life; SWL) and negative (depressive symptoms) mental well-being indicators were examined over time using a repeated cross-sectional design. Analyses were stratified by sex. The presence of 0–3 protective factors (adult support at school, peer belonging, school connectedness) and SES were covariates.</div></div><div><h3>Results</h3><div>SWL significantly declined and depressive symptoms significantly increased across the study period and for most adjacent study years. Girls had significantly lower well-being and a steeper decline than boys. For the subset of students who scored high on all protective factors, the decline in well-being was attenuated but not eliminated and the sex gap was reduced.</div></div><div><h3>Conclusions</h3><div>The decline in well-being and the protective nature of modifiable protective factors identified in our study highlight the need for population-level mental health strategies that can be implemented in partnership with school districts.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"380 ","pages":"Article 118201"},"PeriodicalIF":4.9,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144099870","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 food (in)security and mental health nexus in high-risk immigrant populations in middle- and high-income countries: A scoping review","authors":"Elizabeth Onyango,&nbsp;Keji Mori,&nbsp;Binita Jirel,&nbsp;Destiny Otoadese","doi":"10.1016/j.socscimed.2025.118185","DOIUrl":"10.1016/j.socscimed.2025.118185","url":null,"abstract":"<div><div>Pre- and post-migration experiences predispose high-risk immigrants and refugees to elevated risk of food insecurity and negative mental health status. With a significant increase in the occurrence of these challenges in high-risk immigrant populations and the evidence for a syndemic interaction, the need for reasonable efforts and evidence-based interventions to effectively address food insecurity and mental health issues. Such studies could focus on exploring the reinforcing connections between food insecurity and mental health trends. As an initial step to filling in this knowledge gap, we conducted a review of existing literature to explore the commonalities in food security and mental health trends in studies of high-risk immigrants. A systematic search in four major databases (MEDLINE-OVID, CINAHL, Academic Plus, and PubMed) identified 22 relevant articles. A synthesis of these articles identified different subgroups of high-risk immigrants including pregnant women, refugee parents, women immigrants and newcomer youth that experience increased risk of mental health and food insecurity challenges, which are associated with the pre- and post-migration contexts. The experiences of political, social and other environmental violence in countries of origin are traumatic experiences embodied by most high-risk immigrants. On arrival in destination countries, immigrants experience systemic and social barriers that also influence their mental health and food security status. However, access to culturally familiar foods is associated with improved health and wellbeing. Among high-risk immigrants, food, particularly culturally familiar foods are viewed as a symbolic vehicle and a representation of home. When culturally familiar foods are accessible, there is improved mental health status reflected in the ability of immigrants to share their cultures and identity while rebuilding their social networks and enhancing a sense of belonging. Efforts to effectively address food insecurity and mental health challenge in high-risk immigrants require a deep appreciation and understanding of the place and community-based factors and the available resources relevant to the unique needs and experiences of the high-risk immigrant populations.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"380 ","pages":"Article 118185"},"PeriodicalIF":4.9,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144105306","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":"Monitoring privilege for health equity: building consensus on indicators to monitor socioeconomic advantage through a modified Delphi survey","authors":"Amy Carrad ,&nbsp;Ashley Schram ,&nbsp;Belinda Townsend ,&nbsp;Patrick Harris ,&nbsp;Fran Baum ,&nbsp;Lucie Rychetnik ,&nbsp;Steven Allender ,&nbsp;Melanie Pescud ,&nbsp;Sharon Friel","doi":"10.1016/j.socscimed.2025.118193","DOIUrl":"10.1016/j.socscimed.2025.118193","url":null,"abstract":"<div><div>The World Health Organization's Commission on Social Determinants of Health highlighted the need to measure and monitor the inequitable distribution of power, money, and resources across society. Efforts to monitor health inequity focus on disadvantage rather than advantage or privilege, and on proximal health outcomes rather than distal social and structural determinants of health. This study aimed to identify a comprehensive set of key indicators to measure and monitor socioeconomic advantage. Following a literature review to establish an initial set of indicators (n = 79), we used a three-round, online Delphi survey to build consensus among a panel of participants with diverse disciplinary backgrounds and with expertise related to socioeconomic inequity. Participants rated indicators for relevance to the concept of socioeconomic advantage using a seven-point Likert scale and ranked priority indicators among selected indicator categories. Thirty-one, 21 and 15 experts—predominantly from Australia— participated in the first, second and third round, respectively. Sixty-four of 76 indicators reached consensus, including all indicators within the ‘Wealth’ and ‘Income/wealth inequality’ categories. Priority rankings of economic indicators were clear: gross income and disposable income were the highest ranked income indicators; net wealth was the highest ranked wealth indicator. Ranking of ‘Connections and signalling indicators’ was less distinct; however, elite secondary schooling, and attendance at exclusive events received the highest mean ranks. Monitoring of these socioeconomic advantage indicators is crucial for identifying whether policy and governance is ultimately shifting the dial on equitably distributing resources for improving health equity outcomes.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"379 ","pages":"Article 118193"},"PeriodicalIF":4.9,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144072738","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":"‘Doctors do not know about Cystic Fibrosis’: Examining structural vulnerability in the management of rare diseases in India","authors":"Sibille Merz ,&nbsp;Ramila Bisht","doi":"10.1016/j.socscimed.2025.118175","DOIUrl":"10.1016/j.socscimed.2025.118175","url":null,"abstract":"<div><div>Individuals living with rare diseases have conventionally been understood as being particularly vulnerable, which often promotes a negative and stigmatising interpretation of vulnerability. In this article, we embrace the framework of structural (health) vulnerability to gain a deeper understanding of the circumstances and factors contributing to adverse outcomes in the specific context of a Global South country, India, and a particular rare disease, Cystic Fibrosis (CF). By drawing on published materials and preliminary data from an evolving ethnographic research project, we contend that it is crucial to examine global power dynamics and the unequal distribution of resources to contextualize the precarious conditions experienced by Indians living with CF. Epistemologically, this stems from pervasive racialised assumptions ingrained in CF knowledge production, constituting a form of hermeneutic injustice, while economically, India's position in the global bioeconomy restricts access to potentially beneficial treatments derived from advanced clinical research. Moreover, reduced investment in healthcare by the Indian Central Government, notably evident in its rare disease policy, leaves CF patients reliant on philanthropy, which is susceptible to shifting interests and priorities. Therefore, we argue that focusing on structural (health) vulnerability is essential for shedding light on the distinct challenges faced by individuals living with CF in India, as well as in other locations in the Global South.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"380 ","pages":"Article 118175"},"PeriodicalIF":4.9,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144169724","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":"Cosmetic gatekeepers: Negotiations of beauty and (re)shaping bodies by medical aesthetic practitioners","authors":"Anne-Mette Hermans ,&nbsp;Rebecca Nash","doi":"10.1016/j.socscimed.2025.118165","DOIUrl":"10.1016/j.socscimed.2025.118165","url":null,"abstract":"<div><div>Aesthetic practitioners who administer (non-)surgical medical cosmetic procedures play a central, and growing, role in the (re)shaping of predominantly women's bodies. This article focuses on how these practitioners negotiate their role as cosmetic gatekeepers – those with the medical and sociocultural skills, knowledge and tools - in (re)shaping the bodies of their client-patients. Adopting a reflexive thematic analysis of interviews conducted with aesthetic practitioners in the UK and the Netherlands, we identify three main themes. The first theme, <em>conceptualizing beauty</em>, describes the different ways in which aesthetic practitioners describe and negotiate the concept of ‘beauty’, including discussions of beauty as both subjective and objective. The second theme, <em>shaping bodies</em>, explores how practitioners consider why and how they (do not) suggest aesthetic procedures and how they (do not) see themselves as significant shapers of bodies and beauty. Finally, the theme of <em>cosmetic gatekeepers</em> examines the ways in which aesthetic practitioners provide boundaries in terms of how, when, why and on whom they (do not) perform procedures. Inherent to these discussions are constructions of the (non-)surgical ‘other’ and tensions between commercialism and ‘medico-cosmetic’ considerations that must be navigated by aesthetic practitioners. This article furthers explorations of how certain aesthetic appearances are (re)produced as desirable in increasingly expansive, diversified and normalized (non-)surgical cosmetic servicescapes.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"380 ","pages":"Article 118165"},"PeriodicalIF":4.9,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144083854","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}