Social Science & Medicine最新文献

{"title":"Resilience of the acute sector in recovery from COVID-19 pressures","authors":"Laia Bosque-Mercader ,&nbsp;Simon Conroy ,&nbsp;Daniel Lasserson ,&nbsp;Russell Mannion ,&nbsp;Catia Nicodemo ,&nbsp;Raphael Wittenberg","doi":"10.1016/j.socscimed.2025.118062","DOIUrl":"10.1016/j.socscimed.2025.118062","url":null,"abstract":"<div><div>The COVID-19 pandemic had a profound impact on the management and delivery of acute healthcare. To tackle the pandemic, hospitals redesigned their organisational models to provide a rapid increase in acute care assessment and treatment capacity for patients with COVID-19 whilst also trying to maintain delivery of care for patients with non-COVID-19 healthcare needs. This capacity to adjust and recover after COVID-19 might be shaped by both measures taken by acute hospitals and wider hospital pre-pandemic characteristics. The aim of this study is to examine how hospital characteristics in acute care are associated with recovery of elective activity after the height of the COVID-19 pandemic compared to pre-pandemic levels. Using patient-level data from Hospital Episode Statistics aggregated at monthly-trust level for all English National Health Service (NHS) acute hospital trusts in 2019 and 2021, we estimate the associations between hospital recovery rate and hospital pre-pandemic characteristics by employing linear regressions of the proportional change over time in elective activity against a set of explanatory variables related to supply factors (e.g., hospital size, workforce, type of hospital, regional location), demand factors (e.g., population need, patient case-mix) and time factors. On average, English NHS acute hospital trusts did not fully recover from the COVID-19 pandemic in 2021. The results show that the explanatory variables are not systematically associated with hospital recovery rate, excepting regional differences. Hospital trusts not located in London, especially in the North of England, are associated with a lower recovery (less resilience) of total elective activity and orthopaedic and vascular surgical elective activity. The implication for policy development is that the evolution of hospital recovery rates in elective activity varied across English regions, especially for high-volume and high-risk elective specialties, with better recovery in London than elsewhere.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"375 ","pages":"Article 118062"},"PeriodicalIF":4.9,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834220","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":"Public health and harmful advertising: The nature and extent of children's real-time exposure to unhealthy commodity marketing","authors":"Tom Worters ,&nbsp;Christina McKerchar ,&nbsp;Leah Watkins ,&nbsp;Ryan Gage ,&nbsp;Louise Signal","doi":"10.1016/j.socscimed.2025.118055","DOIUrl":"10.1016/j.socscimed.2025.118055","url":null,"abstract":"<div><div>The consumption of unhealthy commodities (UHCs) – including unhealthy food, alcohol, tobacco and gambling products – contributes to substantial public health harm and significant social and economic costs. Consumption of UHCs is driven, in part, by increasingly sophisticated, persuasive and extensive product marketing. In Aotearoa New Zealand (NZ), UHC marketing is largely self-regulated by industry but varies by individual commodity. This paper aims to identify the nature and extent of children's exposure to UHC marketing in NZ and consider policy implications. Using data collected from wearable cameras, children's brand marketing exposures were analysed to identify their rate of exposure to UHC marketing, as well as ‘Healthy’ (core food/social marketing) and ‘Other’ marketing. Children (N = 90) were exposed to UHC marketing on average 76.2 times per day, nearly 2.5 times their daily exposure to ‘Healthy’ marketing. Children were exposed to UHC marketing through a more diverse range of settings and mediums than core food and social marketing. Over half of children's unhealthy food (54.9 %) and alcohol (51.9 %) marketing exposures were attributed to multinational corporations (MNCs). Children's exposure to each UHC category generally aligned with the level of regulation over that commodity in NZ. Overall, these findings support comprehensive statutory marketing regulation over UHCs, both in NZ and likely internationally given the global nature of UHCs. Statutory marketing regulation would reduce children's exposure to UHC marketing and protect public health. Given the extensive similarities among UHCs, policymakers should consider a joint regulatory approach.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"375 ","pages":"Article 118055"},"PeriodicalIF":4.9,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143848743","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":"Using a novel “Perceived Self-Group Hierarchy” measure to predict White Americans’ health via feelings of “falling behind”","authors":"Jazmin L. Brown-Iannuzzi ,&nbsp;Erin Cooley ,&nbsp;Dylan Vlasak ,&nbsp;Jaclyn A. Lisnek ,&nbsp;Ryan F. Lei ,&nbsp;Camryn Yeager ,&nbsp;Nicholas Elacqua","doi":"10.1016/j.socscimed.2025.118061","DOIUrl":"10.1016/j.socscimed.2025.118061","url":null,"abstract":"<div><div>Previous research finds that White Americans tend to perceive “most White people” to be high-status and see themselves as falling behind their racial group (Cooley et al., 2021). These feelings of low within-group status predict fewer positive emotions which, in turn, predict worse health. However, this previous work is limited by its use of two separate status measures (i.e., “self” and “group”) which are used to infer within-group comparisons via difference scores. To address this limitation, we propose a Perceived Self-Group Hierarchy (PSGH) measure that directly assesses perceptions of <em>within</em>-group status, while also capturing perceptions of <em>between</em>-group status. Using samples of non-Hispanic White Americans with representative quota sampling (<em>N</em>_Total = 1600), we demonstrate that our new measure provides better criterion validity and incremental validity over prior measurement strategies when predicting health (Study 1). Moreover, when combined with latent profile analysis, our measure allows researchers to ask more nuanced questions regarding subjective status and health (Study 2).</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"374 ","pages":"Article 118061"},"PeriodicalIF":4.9,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143829587","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":"Identifying the key predictors of positive self-perceptions of aging using machine learning","authors":"Mohsen Joshanloo","doi":"10.1016/j.socscimed.2025.118060","DOIUrl":"10.1016/j.socscimed.2025.118060","url":null,"abstract":"<div><div>This study aimed to identify key predictors of self-perceptions of aging (SPA) among older adults by examining a comprehensive set of potential predictors across physical, psychological, social, and demographic domains. Data from over 4000 American adults (mean age ≈ 70) from the Health and Retirement Study were used. A machine learning approach using Random Forest regression was employed to assess the relative importance of 49 potential predictors of SPA. The results revealed that health status, age, and psychological resources emerged as the strongest predictors of SPA. The psychological resources included the positive triad of self-esteem, life satisfaction, and optimism, as well as sense of mastery. Emotional tendencies and experiences, financial satisfaction, personality traits, and social factors had substantially lower predictive power. This study provides a comprehensive understanding of the factors that predict SPA and their relative importance, offering insights for both theory and practice. The results highlight the potential for designing targeted, evidence-based interventions that enhance psychological resources, address health and functional well-being, provide tailored support across the lifespan, and incorporate lifestyle changes to foster positive aging perceptions.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"374 ","pages":"Article 118060"},"PeriodicalIF":4.9,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143829585","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":"Momentary health behaviour cues are moderated by educational attainment: Findings from two ecological momentary assessment studies","authors":"Benjamin Schüz ,&nbsp;Mario Wenzel ,&nbsp;Christopher M. Jones","doi":"10.1016/j.socscimed.2025.118057","DOIUrl":"10.1016/j.socscimed.2025.118057","url":null,"abstract":"<div><div>Socioeconomic status (SES), indicated e.g., through educational attainment substantially influences health outcomes through health behaviours. Many health behaviours such as smoking or consuming sugar-sweetened beverages (SSBs) are strongly influenced by momentary environmental and social cues in everyday life. This study examined the moderating role of SES on the relationship between such situational cues and smoking as well as SSB consumption. Data were drawn from two ecological momentary assessment studies with 46 daily smokers (Study 1) and 125 SSB consumers (Study 2) in Germany. Participants provided daily self-reports on behavioral cues and consumption over three weeks. Results revealed that lower educational attainment was associated with increased associations between situational social cues (e.g., observing others engaging in the behavior) and smoking, as well as between situational availability cues (e.g., access to SSBs) and SSB consumption. These findings suggest that individuals with lower educational attainment are both more exposed to and more susceptible to environmental cues promoting health-compromising behaviours. Addressing these disparities may require structural interventions to reduce the density and impact of such cues in disadvantaged environments.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"374 ","pages":"Article 118057"},"PeriodicalIF":4.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143826170","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 social must be stabilised: How are the social needs of young people with social work involvement characterized in their mental health case notes?","authors":"Tessa Morgan ,&nbsp;Francesca Crozier-Roche ,&nbsp;David Graham ,&nbsp;Jack Smith ,&nbsp;Taliah Drayak ,&nbsp;Sophie Mary ,&nbsp;Jeanette Cossar ,&nbsp;Julia Mannes ,&nbsp;Dihini Pilimatalawwe ,&nbsp;Pamela Parker ,&nbsp;Barry Coughlan ,&nbsp;Rick Hood ,&nbsp;Dustin Hutchinson ,&nbsp;Matt Woolgar ,&nbsp;Robbie Duschinsky","doi":"10.1016/j.socscimed.2025.118052","DOIUrl":"10.1016/j.socscimed.2025.118052","url":null,"abstract":"<div><div>In Donzelot's landmark <em>The Policing of Families</em>, he traced the rise of the “social” sector in the 18th century, where institutions like social work, education, and healthcare regulated families, shaping norms of deviance to justify intervention. Social scientists continue to debate the impact of post-2008 austerity measures on the relationship between the social sector and family life in contemporary society. This study aims to contribute to these discussions through a critical discourse analysis of how the social needs of 70 young people with social work involvement have been characterised in their Child and Adolescent Mental Health Service case notes. This analysis was co-produced alongside three experts-by-experience with lived experience of both mental health and social care. Results of this analysis indicate that the social needs of our sample were a) <em>rejected</em> from mental health services for being too social, too chaotic and lacking a stable base; b) <em>accepted but secondary</em> to psychological concerns c) <em>outsourced</em> to other services or to families or young people themselves. Where young people's social needs were sufficiently high risk in the community they were d) <em>contained</em> in mental health facilities or under deprivation of liberty orders by social services. We contend that in the contemporary context, rather than the social comprising an ever-expanding entity designed to govern the conduct of family life, we identified ways in which the social sector was also governing through neglect and containment. This analysis offers important insights into inequalities faced by young people with social care involvement who seek mental health support.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"374 ","pages":"Article 118052"},"PeriodicalIF":4.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143829584","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":"Breaching the professional social contract to drive system innovation: Nurse managers and the emergence of a new professional group","authors":"Charlotte Croft ,&nbsp;Trish Reay","doi":"10.1016/j.socscimed.2025.118054","DOIUrl":"10.1016/j.socscimed.2025.118054","url":null,"abstract":"<div><div>The movement of healthcare professionals into hybrid manager positions is no longer seen as unusual within the course of a career. However, despite a continuing focus on the potential for hybrid managers to drive system level innovation, extant research suggests that potential is limited by the tensions inherent in the role, creating emotional turbulence and a lack of organizational influence. In this paper we explore these tensions as resulting from potentially unavoidable breaches of social contract, which all healthcare professionals becoming hybrid managers must navigate. Drawing on the case of nurse managers, we present findings from 120 h of ethnographic observation and 79 interviews conducted over three years. We identify three types of identity work in response to social contract breach: flipping between ignoring and separating expectations; reframing expectations; and decoupling expectations; and present a model exploring the outcomes and relationship between each of these responses over time. In doing so we give insight into the emergence of a new professional group we call ‘agents of innovation’, who hold the potential to drive system level innovation within healthcare.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"373 ","pages":"Article 118054"},"PeriodicalIF":4.9,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143785268","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":"A qualitative examination of how direct and indirect police violence shapes perceptions of police, sense of safety, and the mental health of Black adults in Chicago","authors":"Katherine G. Quinn ,&nbsp;Melissa L. Neal ,&nbsp;Jesus Valencia ,&nbsp;Jana L. Hirschtick ,&nbsp;DeJuan Washington ,&nbsp;Jacquelyn Jacobs ,&nbsp;Bijou R. Hunt","doi":"10.1016/j.socscimed.2025.118038","DOIUrl":"10.1016/j.socscimed.2025.118038","url":null,"abstract":"<div><div>Police violence remains a significant public health issue, with detrimental effects on the mental health and well-being of Black communities. While public health research documenting the health consequences of police violence has been increasing, there has been considerably less qualitative research in this space. We conducted in-depth phenomenological interviews with 50 Black adults in Chicago to understand the mental health impacts of police violence. Data were analyzed using a team-based approach to thematic analysis. We developed several themes that demonstrate participants’ experiences: 1) direct and indirect exposure to police violence shaped perceptions of policing and feelings of safety; 2) police violence contributed to poor mental health and lack of trust in police; 3) Black women feared for the lives of their Black sons and male loved ones; and 4) individuals identified potential solutions, including racial concordance in policing and reduction or re-allocation of police investments. Overall, this study underscores the increased need for comprehensive police reform to address police violence and diverse representation of police. We also highlight the need for continued research to understand and address the implications of police violence, mental health, and community well-being.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"374 ","pages":"Article 118038"},"PeriodicalIF":4.9,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143808583","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":"Fundamental causation and candidacy: Harnessing explanatory frames to better understand how structural determinants of health inequalities shape disengagement from primary healthcare","authors":"Mhairi Mackenzie ,&nbsp;David Baruffati ,&nbsp;Calum Lindsay ,&nbsp;Kate O'Donnell ,&nbsp;David Ellis ,&nbsp;Sharon Simpson ,&nbsp;Geoffrey Wong ,&nbsp;Michelle Major ,&nbsp;Andrea Williamson","doi":"10.1016/j.socscimed.2025.118043","DOIUrl":"10.1016/j.socscimed.2025.118043","url":null,"abstract":"<div><div>This paper aims to better understand how structural determinants of health inequalities shape disengagement from healthcare for vulnerable groups across a range of social conditions. Using a sub-sample (N = 20) from a qualitative interview UK study of those missing from primary-care, it illuminates how structural drivers of health inequalities operate at organisational and practice levels to weaken engagement with primary-care. Finding ways of better analysing and demonstrating the causal chains between structural determinants and patterns of disengagement is important because previous research has shown that practitioner and policy understanding of structural determination, an important precursor for mitigatory action, is not always sufficient, and research on healthcare utilisation can itself be weak in investigating structures of inequality.</div><div>We address this deductively by testing a novel combination of Link and Phelan's Fundamental Cause Theory and Dixon-Woods and colleagues' Candidacy framework. Combining elements of these frameworks compensates for identified gaps in each. We demonstrate how Candidacy can be strengthened through incorporating more systematic theorisation of structural processes and that the more abstract arguments of fundamental (structural) causes can be made concrete via Candidacy's focus on inequalities in patients' access to, and utilisation of, healthcare. We also argue that both theories are enhanced by including Metzl and Hansen's concept of ‘structural competency’ as a potential mitigatory mechanism operating between fundamental causes and patient engagement.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"374 ","pages":"Article 118043"},"PeriodicalIF":4.9,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143820627","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":"Communication analysis of the COVID-19 infodemic by medical practitioners in China: A mixed methods study","authors":"Teng Zuo ,&nbsp;Lingfeng He ,&nbsp;Yuan Zheng ,&nbsp;Zezheng Lin ,&nbsp;Zelin Xu ,&nbsp;Ning Li","doi":"10.1016/j.socscimed.2025.118051","DOIUrl":"10.1016/j.socscimed.2025.118051","url":null,"abstract":"<div><h3>Background</h3><div>The infodemic during the public health policy transformation in Chinese mainland is known; however, the contributions of medical practitioners have not been evaluated. This study aimed to estimate the role of medical practitioners during the COVID-19 infodemic in Chinese mainland and reveal content structure and spatiotemporal features.</div></div><div><h3>Methods</h3><div>Data from medical practitioner accounts with the highest influence were collected from Sina-Weibo. Original contents were collected from March 1st, 2022 to October 1st, 2023. Misinformation were identified based on cross-validated content analysis. Propagation index, spatiotemporal and network analysis were performed.</div></div><div><h3>Findings</h3><div>A total of 236,775 posts were crawled, with 28,218 posts from 432 accounts filtered through a keyword search and 5825 out of 28,218 (20.6 %) posts from 287 out of 432 (66.4 %) accounts identified as COVID-19-related content. 640 out of 5825 (11.0 %) posts from 112 out of 287 (39.0 %) accounts were identified as misinformation and classified into 5 main types and 6 subtypes. Differences between internal and external accounts were reflected in the distribution of misinformation types. Propagators from various professions had different tendencies in terms of type, and several misinformation repropagation modes were observed. Social network analysis revealed strong correlations among propagators.</div></div><div><h3>Interpretation</h3><div>To our knowledge, this is the first mixed-methods study to examine the characteristics of medical practitioners as propagators in the infodemic in Chinese mainland. Our research suggested that Chinese medical practitioners significantly contributed to the COVID-19 infodemic in social media. This could exacerbate post-pandemic societal distrust in the medical system, potentially having far-reaching public health implications.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"374 ","pages":"Article 118051"},"PeriodicalIF":4.9,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143799386","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}