Social Science & Medicine最新文献

{"title":"Making and disposing of life's ‘starting materials’: A focus group study of attitudes concerning reproductive scarcity and abundance in in vitro gametogenesis","authors":"Robbin Jeffries Hein ,&nbsp;Anne Le Goff ,&nbsp;Hannah L. Landecker","doi":"10.1016/j.socscimed.2025.118146","DOIUrl":"10.1016/j.socscimed.2025.118146","url":null,"abstract":"<div><div>This paper explores stakeholder attitudes toward gametes and embryos in the context of in vitro gametogenesis (IVG), a new stem cell technology whose future clinical application would entail the production of eggs and sperm in vitro. A key concern raised by the prospect of making gametes from originally non-reproductive body cells has been its potential exacerbation of the issue of “surplus” cryopreserved embryos through the production of unprecedented numbers, with an allied devaluation of human reproductive materials. However, this concern has not been empirically investigated. In this study, focus groups composed of individuals representative of the constituency most likely to be impacted by IVG were asked to respond to scenarios in which the relative abundance and scarcity of gametes and embryos were changed by these new procedures. Respondents who had experienced involuntary childlessness and/or previously accessed in vitro fertilization (IVF) technology drew on these experiences to reason their way through future scenarios in which cells could be more fluidly exchanged over the somatic-reproductive boundary. Unfettered abundance was not found to be a key issue for these respondents. Rather, concerns focused on questions of technological control over outcomes in ARTs, cultural scripts about the preciousness of eggs moderated by concordance between the gender or the donor and the sex of the gamete, and in vitro gametes and embryos as embodiments of the often painful and costly process of attaining them.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"379 ","pages":"Article 118146"},"PeriodicalIF":4.9,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144072084","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 mental and physical health consequences of the U.S. citizenship exam for Rohingya refugees: Implications for policy and practice","authors":"Ifrah Mahamud Magan ,&nbsp;Jessica R. Goodkind","doi":"10.1016/j.socscimed.2025.118138","DOIUrl":"10.1016/j.socscimed.2025.118138","url":null,"abstract":"<div><div>U.S. citizenship is critical for reducing refugees' precarity, securing access to certain rights, healthcare, and social service benefits, and obtaining a U.S. passport. This paper highlights findings from a community-engaged, critical ethnographic study examining the impact of the U.S. citizenship exam on the health of Rohingya refugees from Myanmar. Thirty-one in-depth interviews were conducted with adults who were recruited through a Rohingya-led community center in a U.S. midwestern city and were coupled with participant observations at the community center, and in participants’ homes and neighborhoods. Our study criteria for eligibility included: (1) identifying as ethnically Rohingya, (2) currently living in the Greater [anonymous] area, (3) being at least 13 years of age. We found that Rohingya refugees experience multiple stressors related to the U.S. citizenship exam, which may impact their mental and physical health. These stressors are often exacerbated by their identities as stateless refugees with a longstanding history of trauma and denial of the right to seek formal schooling in their country of origin. Although we also found that community-led initiatives can play an integral role in mitigating some of these stressors, our findings raise critical questions and highlight the importance of considering the ethical and health implications of requiring refugees resettled due to their persecution and exposure to trauma to pass a difficult exam to become U.S. citizens.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"379 ","pages":"Article 118138"},"PeriodicalIF":4.9,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144067868","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":"Excess neonatal mortality among private facility births in rural parts of high-mortality states of India: Demographic analysis of a national survey","authors":"Diane Coffey ,&nbsp;Nikhil Srivastav ,&nbsp;Aditi Priya ,&nbsp;Asmita Verma ,&nbsp;Nathan Franz ,&nbsp;Alok Kumar ,&nbsp;Dean Spears","doi":"10.1016/j.socscimed.2025.118158","DOIUrl":"10.1016/j.socscimed.2025.118158","url":null,"abstract":"<div><div>Almost one-fourth of neonatal deaths occur in India, many of them in the Empowered Action Group (EAG) states. Research has compared facility births with home births, with limited investigation of mortality differences between births at public and private facilities. We ask how early-life mortality in the rural population of the EAG states and the rest of India differs according to the setting of birth. We consider whether quality of care can help explain the differences we find. Using rural births in India's 2019-21 Demographic and Health Survey, we find that in the rural population of EAG states, neonatal mortality among private facility births is 44 per 1000 (95 % CI: 40–48), compared with 29 per 1000 in public facilities (95 % CI: 27–30) and 38 per 1000 for home births (95 % CI: 34–41). Standardization by socioeconomic status increases the public-private gap. These differences persist even stratifying on key predictors of neonatal mortality. The excess mortality among births to the rural population in private facilities, compared with public facilities, accounts for about 43,000 excess neonatal deaths annually in EAG states. Evidence suggests that low-quality care is among the important causes. Most births in India now occur in facilities. Many happen in private facilities run by providers who lack training, resources, and legal permission. The quality of private health facilities serving the rural EAG population appears to be particularly poor.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"379 ","pages":"Article 118158"},"PeriodicalIF":4.9,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144067934","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":"Socioeconomic inequalities in mental health difficulties over childhood: a longitudinal sex-stratified analysis using the UK Millennium Cohort Study","authors":"Yu Wei Chua ,&nbsp;Daniela Schlüter ,&nbsp;Anna Pearce ,&nbsp;Helen Sharp ,&nbsp;David Taylor-Robinson","doi":"10.1016/j.socscimed.2025.118159","DOIUrl":"10.1016/j.socscimed.2025.118159","url":null,"abstract":"<div><div>Stark socioeconomic inequalities in childhood mental health have been widely reported. Understanding whether they vary with age, by type of difficulty or sex can inform public health policies to tackle socioeconomic inequalities. We investigated the effects of early life childhood socioeconomic circumstances (SECs) (maternal education and household income) on developmental trajectories of externalising and internalising difficulties in childhood and adolescence, in males and females from the UK-representative Millennium Cohort Study (N = 15383). We estimated the Slope Index of Inequality (SII) (absolute difference between the most versus least advantaged) using linear mixed-effects regression models, on parent-reported Strengths and Difficulties Questionnaire externalising and internalising difficulties score, at 5, 7, 11, 14, and 17 years(y). The mean externalising score was high at 5y (4.8 [95 %CI: 4.7, 4.9]) and decreased slightly, while mean internalising score increased over childhood, reaching 3.9 [3.8, 4.1] by 17y, with a steeper trend for females in adolescence. Lower maternal education was associated with greater externalising scores at 5y (SII, Male: 3.0 [2.7 to 3.3]; Female: 2.7 [2.4, 3.0]) with inequalities decreasing slightly up to 17y (SII Male: 2.4 [2.0 to 2.7], Female: 2.5 [2.1, 2.8]). Inequalities in internalising scores increased slightly over childhood (SII Female 5y: 1.3 [1.1, 1.6]; 17y: 1.9 [1.5, 2.3]; SII Male 5y = 1.6 [1.3, 1.8], 17y = 1.8 [1.5, 2.2]). Patterns were similar using household income. Disadvantaged SECs are associated with persistently higher levels of parent-reported mental health difficulties up to 17y, with larger effects on externalising than internalising difficulties, but little differences by sex or socioeconomic measure.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"378 ","pages":"Article 118159"},"PeriodicalIF":4.9,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143931438","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":"Racial/ethnic disparities in all-cause and cause-specific death among patients with colorectal cancer in the United States from 1992 to 2021: a registry-based cohort retrospective analysis","authors":"Xiangyuan Qi ,&nbsp;Hongying Wang ,&nbsp;Yutong Wang ,&nbsp;Xiaomei Wu ,&nbsp;Bo Zhu","doi":"10.1016/j.socscimed.2025.118135","DOIUrl":"10.1016/j.socscimed.2025.118135","url":null,"abstract":"<div><h3>Background</h3><div>Inequality in mortality among patients with colorectal cancer in the United States has been documented, but the trends over time and the factors contributing to racial/ethnic disparities in all-cause and cause-specific death are unknown.</div></div><div><h3>Methods</h3><div>This cohort study used the Surveillance, Epidemiology, and End Results (SEER) registry to analyze patients diagnosed with colorectal cancer from 1992 to 2021. We calculated the cumulative incidence of death for all racial/ethnic groups (Black, White, Hispanic, Asian or Pacific Islander [API], and American Indian or Alaska Native [AI/AN]) by diagnostic period and cause of death. We quantified absolute disparities using rate change in 5-year cumulative incidence of death and used discrete-time models to estimate relative racial/ethnic disparities and the contribution of factors to disparities in death.</div></div><div><h3>Results</h3><div>The 5-year cumulative incidence of colorectal cancer and all-cause death among Black patients decreased. AI/AN and Black patients consistently had the highest risk of death between 1992 and 2021. Between Black and White, the adjusted HR for all-cause death difference increased from 1.14 (1.10–1.17) in 1992–1996 to 1.29 (1.23–1.35) in 2017–2021. Adjustment for stage at diagnosis, first course of therapy and socioeconomic status explained 46.5 % of the Black-White disparities and 38.4 % of the AI/AN-White all-cause death disparities.</div></div><div><h3>Conclusion</h3><div>Persistent racial/ethnic disparities in patients with colorectal cancer, especially in AI/AN and Black, call for new interventions to eliminate health disparities. Our study provides vital evidence to address racial/ethnic inequality.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"377 ","pages":"Article 118135"},"PeriodicalIF":4.9,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143906444","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":"Voices from the water(s): Developing a salutogenic trace through swimming","authors":"Ronan Foley","doi":"10.1016/j.socscimed.2025.118129","DOIUrl":"10.1016/j.socscimed.2025.118129","url":null,"abstract":"<div><div>Within geographies of health and wellbeing research, there is ongoing interest in how health-enabling spaces and places are assembled, maintained and reproduced through occupation and practice. Set within a specific blue space practice, swimming, this paper develops the concept of the <em>salutogenic trace</em>, as a new way to consider health and wellbeing in place. Trace is initially introduced as a concept that augments place and space, to consider how relational geographies are understood, using swimmers and the water they swim in, as an empirical example. In the study, swimming traces are also characterised as identifiably salutogenic, a key idea in both health promotion and recent writing on health-enabling spaces and places.</div><div>Salutogenesi<em>s</em> sees health as a braided stream traced across the lifecourse, where ‘upstream’ health is underpinned by a sense of coherence (SOC), with three dimensions, comprehensibility, manageability and meaningfulness. A well-developed SOC in-turn prevents or reduces ill-health ‘downstream’. To better understand how the salutogenic trace works, the three core dimensions of SOC were examined from the point of view of Irish swimmers in three different types of water, river, lake and sea. Each dimension was identified and described as specific components that enabled swimmer's health and wellbeing. While these varied by swimmer and type of water, what emerged were important insights into key health enabling/promoting traces across swimmer’ lives, and how these were enacted and reproduced in blue space. In addition, other key critical components of trace, including flows, blockages and accretion, spoke to the life-course dimensions of salutogenesis.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"378 ","pages":"Article 118129"},"PeriodicalIF":4.9,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143924673","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":"Legal gender recognition and the health of transgender and gender diverse people: A systematic review and meta-analysis","authors":"Ayden I. Scheim ,&nbsp;Arjee J. Restar ,&nbsp;Dougie Zubizarreta ,&nbsp;Ruby Lucas ,&nbsp;S. Wilson Cole ,&nbsp;Avery Everhart ,&nbsp;Kellan E. Baker ,&nbsp;Maria I. Rodriguez","doi":"10.1016/j.socscimed.2025.118147","DOIUrl":"10.1016/j.socscimed.2025.118147","url":null,"abstract":"<div><div>Legal gender recognition (LGR) refers to laws, policies, and administrative procedures that enable transgender and gender diverse (TGD) people to update their legal identity documents (ID) to reflect their self-determined gender. We conducted a systematic review and meta-analysis on the health effects of LGR and a nested scoping review of TGD people's LGR-related values and preferences (PROSPERO CRD42023441769). We searched seven databases through April 19, 2024, and organization websites (for grey literature) through August 2023. The effectiveness review included quantitative studies evaluating the effect of LGR (policies or possession of gender-concordant ID) on seven domains of health and well-being. We conducted random-effects meta-analyses when possible and otherwise used narrative synthesis. Study risk of bias and confidence in the cumulative evidence were assessed using the ROBINS-E and GRADE, respectively. We screened 2748 studies and included 24 in the effectiveness review. In meta-analyses, LGR was associated with less suicidal ideation (OR = 0.75; 95 % CI: 0.56–1.00, <em>I</em>^<em>2</em> = 46 %) and psychological distress (e.g., OR for LGR on all versus no ID = 0.53; 95 % CI: 0.40, 0.70, <em>I</em>^<em>2</em> = 17 %). LGR may reduce anticipated discrimination, increase healthcare utilization, reduce gonadectomies, and improve socio-economic status, but the evidence was very uncertain. We included 31 studies on TGD persons' values and preferences. They perceived well-being benefits of LGR, had diverse personal preferences related to safety, and reported financial and policy barriers to LGR. In conclusion, LGR may improve TGD mental health and is perceived to reduce exposure to stigma and discrimination. Higher-quality effectiveness research is needed on other health and well-being outcomes, as well as research to evaluate specific LGR policy provisions.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"378 ","pages":"Article 118147"},"PeriodicalIF":4.9,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143916199","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":"Silence as a manner within the doctor's epistemic posture during the diagnostic process: A case study in a French hospital","authors":"Antoine Glauzy","doi":"10.1016/j.socscimed.2025.118153","DOIUrl":"10.1016/j.socscimed.2025.118153","url":null,"abstract":"<div><div>The notion of silence often emerges between the lines in studies on diagnosis and the disclosure of bad news to patients. However, silence rarely takes center stage in such studies, risking an underestimation of its significance. This study, conducted through observations and semi-structured interviews in a hospital specializing in liver and pancreatic diseases, centers its analysis on the role of silence. It explores how institutional norms and constraints shape doctors' use of silence during consultations and diagnostic processes. The findings reveal that silence, understood as withholding information or concealing the name of a disease, serves distinct functions: in the pre-diagnostic phase, it helps prepare patients for the possibility of illness while respecting institutional expectations; at the moment of diagnosis, it reinforces doctors' adherence to a scientific framework. This research argues that silence is a central attitude of the doctor's epistemic posture, mediating the complex interplay between institutional demands and patient care.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"378 ","pages":"Article 118153"},"PeriodicalIF":4.9,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143916198","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 everyday ethics in sterilization camps in India","authors":"Eva Fiks","doi":"10.1016/j.socscimed.2025.118150","DOIUrl":"10.1016/j.socscimed.2025.118150","url":null,"abstract":"<div><div>This ethnographic paper examines how various professionals working within sterilization camps in India engage with everyday ethics. While sterilization in India—and its place within India's population control programme historically entrenched in overtly and covertly coercive measures—gathers significant ethical concern in the scholarly and activist circles, extensive ethnographic engagement within sterilization camps in rural Rajasthan in 2012–2013 demonstrates that biomedical and bureaucratic personnel involved in the organisation of the camps are not preoccupied with dramatic ethical considerations during the majority of their time performing various duties in the camps. While they are not preoccupied with a question of ‘Is this ethical?’, they often do see their actions as fundamentally moral. This paper argues that while different ethical reasonings co-exist and clash within the camp, professionals working in sterilization camps view their work as ethical despite the controversial nature of sterilization in the country. Disgust plays a significant role in shaping the moral imperative surrounding sterilization: disgust felt by professionals towards sterilization patients, rooted in caste and class hierarchies, reinforces professionals' belief that they are engaged in humanitarian work by providing services to a population perceived as ‘backward.’ In the context of the impeding climate crisis and the proliferating discourses that return to the question of (over)population, it is important to understand the ethical worlds of professionals who carry out population control programmes.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"377 ","pages":"Article 118150"},"PeriodicalIF":4.9,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143902195","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":"Considerations for the epidemiological evaluation of hyperlocal interventions: A case study of the New York City overdose prevention centers","authors":"Bennett Allen ,&nbsp;Brandi Moore ,&nbsp;Victoria A. Jent ,&nbsp;William C. Goedel ,&nbsp;Khadija Israel ,&nbsp;Alexandra B. Collins ,&nbsp;Brandon D.L. Marshall ,&nbsp;Magdalena Cerdá","doi":"10.1016/j.socscimed.2025.118156","DOIUrl":"10.1016/j.socscimed.2025.118156","url":null,"abstract":"<div><div>To meet the needs of diverse communities, public health authorities are increasingly reliant on hyperlocal interventions targeting specific health issues and distinct populations. To facilitate epidemiological evaluation of hyperlocal interventions on community-level outcomes, we developed a framework of six practice-based considerations for researchers: spatial zone of impact, temporal resolution of impact, outcome of interest, definition of a plausible comparison group, micro vs. macro impacts, and practitioner engagement. We applied this framework to a case study of an impact evaluation of the New York City (NYC) overdose prevention centers (OPCs) on neighborhood-level drug-related arrests. We used drug arrest data from NYC from January 1, 2014, to September 30, 2023 and US Census data to conduct synthetic control modeling, comparing pre- and post-OPC arrests in the neighborhoods surrounding the two NYC OPCs (East Harlem and Washington Heights). We conducted sensitivity analyses to validate our results and compare our findings with those from a prior published study. Our findings indicate no significant change in drug-related arrests following the OPC openings. The mean absolute differences in daily drug-related arrests between the OPCs and their synthetic controls were 0.63 (<em>p</em> = 0.19) in East Harlem and 0.14 (<em>p</em> = 0.22) in Washington Heights. Sensitivity analyses corroborated our main results. Overall, findings demonstrate how our framework can be used to guide future epidemiological evaluations of diverse, hyperlocal public health interventions.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"378 ","pages":"Article 118156"},"PeriodicalIF":4.9,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143931420","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}