Social Science & Medicine最新文献_第5页

Awakening the sense of the possible: the Symptoms Clinic as liminal affective technology 唤醒可能的感觉：作为阈限情感技术的症状诊所

IF 4.9 2区医学

Social Science & Medicine Pub Date : 2025-07-11 DOI: 10.1016/j.socscimed.2025.118395

Monica Greco , Vincent Deary , Kate Fryer , Tom Sanders , Christopher Burton

{"title":"Awakening the sense of the possible: the Symptoms Clinic as liminal affective technology","authors":"Monica Greco , Vincent Deary , Kate Fryer , Tom Sanders , Christopher Burton","doi":"10.1016/j.socscimed.2025.118395","DOIUrl":"10.1016/j.socscimed.2025.118395","url":null,"abstract":"<div><div>Persistent (‘medically unexplained’) physical symptoms (PPS) that are disproportionate to detectable disease are common in all clinical settings, with significant impacts in terms of quality of life and cost to health services and society. In the absence of an orthodox biomedical explanation, PPS are often attributed to psychological causes and associated with significant stigma. Emerging neuroscientific approaches to symptom explanation imply causal complexity – involving factors across biological, psychological, and social systems – which exceeds what a conventional diagnostic consultation is designed to address. A successful clinical model needs to be able to open, but also contain, a discursive space for the type of complexity that is relevant to PPS. In this paper we present the Symptoms Clinic Intervention (SCI) as a new model of consultation for patients with PPS. While the SCI was developed in the context of a system broadly organised by the norms of biomedicine we argue that, in its operation, it deviates from such norms in significant and instructive ways. Drawing on causal dispositionalism and on liminality theory, we offer an account of the efficacy of the SCI focused on its ability to shift problematic dispositions. We propose that a carefully crafted experience of liminality can catalyse change by shifting hardened dispositions even in the context of a relatively brief and time-limited intervention such as the SCI. Importantly, this shift refers not only to dispositions in and of the patient, but also to the dispositions of the medical system and of the clinician as its operator and representative.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"383 ","pages":"Article 118395"},"PeriodicalIF":4.9,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144680794","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}

引用次数: 0

Exploring associations between healthy relationships, intimate partner violence, and health at the population level 探索健康关系、亲密伴侣暴力和人口健康之间的联系

IF 4.9 2区医学

Social Science & Medicine Pub Date : 2025-07-10 DOI: 10.1016/j.socscimed.2025.118399

Janet Fanslow , Melissa Reid-Ellis , Pauline Gulliver , Tracey McIntosh

{"title":"Exploring associations between healthy relationships, intimate partner violence, and health at the population level","authors":"Janet Fanslow , Melissa Reid-Ellis , Pauline Gulliver , Tracey McIntosh","doi":"10.1016/j.socscimed.2025.118399","DOIUrl":"10.1016/j.socscimed.2025.118399","url":null,"abstract":"<div><div>This cross-sectional study utilised a population-based sample of 1464 women and 1423 men from the 2019 New Zealand Family Violence Study to investigate associations between healthy relationships, intimate partner violence (IPV), and self-reported physical and mental health. <em>Understandings</em> of healthy relationships were highly prevalent, with over 90 % of women and men agreeing or strongly agreeing with each investigated healthy relationship attribute; however, a greater proportion of women than men endorsed each attribute. <em>Experiences</em> of healthy relationships were also highly prevalent, with over 85 % of participants reporting each healthy relationship indicator, except for asking their partner what they liked during sex. A greater proportion of men reported experiencing most indicators compared to women. For women, experiences of healthy relationships were negatively associated with all IPV types (adjusted odds ratios (AORs) ranged from 0.14 for any IPV to 0.41 for physical IPV), chronic health conditions (AOR = 0.54; 95 % CI: 0.32–0.93) and poor mental health (AOR = 0.58; 95 % CI: 0.34–1.00), and positively associated with positive mental health (AOR = 2.12; 95 % CI: 1.20–3.76). Whereas, for men, experiences of healthy relationships were positively associated with positive mental health only (AOR = 1.89; 95 % CI 1.04–3.44). Health and wellbeing at the population level may be improved by actively empowering people to build and maintain healthy relationships. Community and societal support systems that enable the achievement of individual and community aspirations for healthy relationships may also be beneficial.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"382 ","pages":"Article 118399"},"PeriodicalIF":4.9,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144632249","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}

引用次数: 0

Corrigendum to <"I want to get out … I've got a child at home": Intersubjectivity, reality disjunctures and distress in the care of people living with dementia in the acute hospital> [Soc. Sci. Med. Volume 369, March 2025, 117805]. [Soc.]更正科学。Med. Volume 369, March 2025, 117805]。

IF 4.9 2区医学

Social Science & Medicine Pub Date : 2025-07-10 DOI: 10.1016/j.socscimed.2025.118380

Alison Pilnick, Rebecca O'Brien, Suzanne Beeke, Isabel Windeatt-Harrison, Lauren Bridgstock, Rowan H Harwood

引用次数: 0

Is the quest for efficiency harmful to health equity? An examination of the health efficiency-equity nexus in OECD countries over the past two decades 对效率的追求是否有损于卫生公平？对经合组织国家过去二十年的卫生效率-公平关系的研究

IF 4.9 2区医学

Social Science & Medicine Pub Date : 2025-07-10 DOI: 10.1016/j.socscimed.2025.118379

Marwân-al-Qays Bousmah , Mohammad Abu-Zaineh , Simon Combes , Bruno Ventelou

{"title":"Is the quest for efficiency harmful to health equity? An examination of the health efficiency-equity nexus in OECD countries over the past two decades","authors":"Marwân-al-Qays Bousmah , Mohammad Abu-Zaineh , Simon Combes , Bruno Ventelou","doi":"10.1016/j.socscimed.2025.118379","DOIUrl":"10.1016/j.socscimed.2025.118379","url":null,"abstract":"<div><h3>Background</h3><div>Has the quest for efficiency in OECD health systems impacted the social gradient of health? We examined the cross-dynamics of the health system equity-efficiency nexus among OECD countries in the past two decades.</div></div><div><h3>Methods</h3><div>We used a three-step methodology based on annual macro-level data from 36 OECD countries for the period 2004–2021. First, we estimated the efficiency of health systems using a stochastic frontier analysis. We then assessed the equity of health systems using simple measures of income-related inequality in self-assessed health. Lastly, we estimated the dynamic relationship between health system efficiency and equity using a panel Granger causality analysis. We also stratified the analysis by type of health system: <em>viz</em>. publicly- vs. privately-dominated health service provision.</div></div><div><h3>Findings</h3><div>We find evidence for a bidirectional causality between health system efficiency and equity. An increase in health system efficiency leads to an increase in socioeconomic inequalities in health; a result particularly salient in countries with predominantly private health service provision. Interestingly, decreases in socio-economic inequalities in health are likely to lead to higher health system efficiency, especially in countries where the health system relies predominantly on public provision.</div></div><div><h3>Interpretation</h3><div>The pursuit of efficiency gains in OECD health systems has not been a precondition for socioeconomic equity in health. Adverse effects of efficiency-seeking interventions on health equity are particularly apparent in the private provision of healthcare. However, addressing health inequalities provides a plausible route to enhance efficiency.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"383 ","pages":"Article 118379"},"PeriodicalIF":4.9,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144656675","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}

引用次数: 0

The development, evolution, and maintenance of structural racism for the study of health inequities: An expanded framework for Asian, Black, Hispanic, Indigenous, and White Americans 健康不平等研究中结构性种族主义的发展、演变和维持：亚洲人、黑人、西班牙裔、土著和白人美国人的扩展框架

IF 4.9 2区医学

Social Science & Medicine Pub Date : 2025-07-09 DOI: 10.1016/j.socscimed.2025.118383

Alexis C. Dennis , Rae Anne M. Martinez , Esther O. Chung , Evans K. Lodge , Rachel E. Wilbur

{"title":"The development, evolution, and maintenance of structural racism for the study of health inequities: An expanded framework for Asian, Black, Hispanic, Indigenous, and White Americans","authors":"Alexis C. Dennis , Rae Anne M. Martinez , Esther O. Chung , Evans K. Lodge , Rachel E. Wilbur","doi":"10.1016/j.socscimed.2025.118383","DOIUrl":"10.1016/j.socscimed.2025.118383","url":null,"abstract":"<div><div>Evaluating the relationship between structural racism and health inequity is conceptually and empirically complex. This critical review of policies and events extends a previously published framework for understanding structural racism in health research across ethnoracial groups from 1400 to present. We apply this framework for Asian, Black or African American, Hispanic/Latinx, Native Hawaiian/Pacific Islander, and White groups and reflect on, compare, and contrast the overarching patterns within and across groups. Our findings illustrate the utility of our framework as a tool for conceptualizing and operationalizing structural racism in future health research. We suggest that health scholars can advance the field by: (1) recognizing multiple, reinforcing domains of structural racism; (2) expanding research beyond a Black-White binary to include other ethnoracial groups; (3) emphasizing the role of time and its different manifestations as exposure across the life course and cohorts; (4) highlighting the implications of collective resistance and agency as alternatives to deficit models; and (5) disaggregating data, whenever possible, to avoid rendering smaller ethnoracial groups invisible.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"383 ","pages":"Article 118383"},"PeriodicalIF":4.9,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144713863","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}

引用次数: 0

Mapping risk and protective factors in tuberculosis-related stigma: a scoping review 绘制结核病相关病耻感的风险和保护因素：范围审查

IF 4.9 2区医学

Social Science & Medicine Pub Date : 2025-07-09 DOI: 10.1016/j.socscimed.2025.118396

Mariana Vieira , Pedro Barbosa , João Pedro Ramos , Marta Castro , Dulce Torres , Raquel Duarte

{"title":"Mapping risk and protective factors in tuberculosis-related stigma: a scoping review","authors":"Mariana Vieira , Pedro Barbosa , João Pedro Ramos , Marta Castro , Dulce Torres , Raquel Duarte","doi":"10.1016/j.socscimed.2025.118396","DOIUrl":"10.1016/j.socscimed.2025.118396","url":null,"abstract":"<div><div>Despite global efforts to end tuberculosis (TB), slow declines in incidence and mortality rates persist, partly due to entrenched social and structural challenges. TB-related stigma is a critical barrier to effective TB prevention and treatment. However, existing frameworks often overlook broader structural and intersectional influences, underscoring the need for a comprehensive analysis of the social and structural factors influencing TB-related stigma. We aimed to (1) identify risk and protective factors influencing TB-related stigma and (2) examine how cultural, social, and economic determinants shape stigma experiences among people with TB. A systematic search was conducted across PubMed, SCOPUS, Web of Science, APA PsycInfo, and Sociology Source Ultimate. Studies were included if they (a) involved human participants, (b) were published in the last decade, and (c) reported stigma experiences influenced by social, economic, or environmental determinants. A total of 43 studies were included. Key determinants associated with higher TB-related stigma included lower educational attainment, rural residency, low income, gender, and specific mental health conditions. Cultural perceptions of TB, healthcare system interactions, and the dual stigma associated with HIV co-infection significantly exacerbated TB-related stigma experiences. Factors such as social support, patient-provider communication, and prior TB experience emerged as protective against stigma. Findings underscore TB-related stigma's complex intersection with social and structural determinants, highlighting gaps research, especially concerning standardised conceptual definitions and measurements. Addressing stigma is essential for improving TB care-seeking behaviours and health outcomes, particularly in low-resource settings where TB-related social isolation and discrimination are prevalent.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"383 ","pages":"Article 118396"},"PeriodicalIF":4.9,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144656840","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}

引用次数: 0

‘A bucket in the ocean’: Justice transitions and the emancipatory potential of establishing mental health care in Nepal “大海里的一桶水”：司法转型和在尼泊尔建立精神卫生保健的解放潜力

IF 4.9 2区医学

Social Science & Medicine Pub Date : 2025-07-09 DOI: 10.1016/j.socscimed.2025.118397

Susan Thieme , Sony K.C. , Christine Bigler

{"title":"‘A bucket in the ocean’: Justice transitions and the emancipatory potential of establishing mental health care in Nepal","authors":"Susan Thieme , Sony K.C. , Christine Bigler","doi":"10.1016/j.socscimed.2025.118397","DOIUrl":"10.1016/j.socscimed.2025.118397","url":null,"abstract":"<div><div>This study investigates the perceptions of health workers in Nepal's mental health sector regarding their experiences related to emancipation and justice. The research highlights the mental health gap in general, and that specifically faced by children and adolescents in Nepal. Factors contributing to this gap include a shortage of mental health professionals, societal stigma, and limited awareness of mental health challenges. Through 18 semi-structured, in-depth interviews and two focus group discussions conducted between 2022 and 2023, the study captures the insights of various professionals, including psychiatrists, nurses, and representatives of organizations, about their roles in fostering change within Nepal's mental healthcare landscape. The findings illustrate how these individuals navigate their engagement in a still-evolving field, reflecting on their motivations, challenges, and the relational dynamics at play.</div><div>We apply an emancipatory and justice framework by interlinking the four stages of emancipation with three dimensions of justice, namely the distributive, procedural, and recognitive.</div><div>The research elucidates the interconnectedness of individual experiences with broader structural forces, emphasizing how health workers strive for equity and recognition of mental health in a context marked by social inequalities. The research recognizes the pioneering work of these practitioners, and contributes to providing a nuanced understanding of the transformative potential of mental health workers and their ongoing struggles for justice within the sector.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"383 ","pages":"Article 118397"},"PeriodicalIF":4.9,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144680793","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}

引用次数: 0

Perceptions of the medical school learning environment (MSLE) among racially, ethnically, and socially underrepresented minority (RES-URM) medical students 种族、民族和社会代表性不足的少数族裔医学生对医学院学习环境（MSLE）的看法

IF 4.9 2区医学

Social Science & Medicine Pub Date : 2025-07-09 DOI: 10.1016/j.socscimed.2025.118363

Cirila Estela Vasquez Guzman , Andrew Lee Breidenbach , Anna Ayala , Marissa Song Mayeda , Reem Hasan

{"title":"Perceptions of the medical school learning environment (MSLE) among racially, ethnically, and socially underrepresented minority (RES-URM) medical students","authors":"Cirila Estela Vasquez Guzman , Andrew Lee Breidenbach , Anna Ayala , Marissa Song Mayeda , Reem Hasan","doi":"10.1016/j.socscimed.2025.118363","DOIUrl":"10.1016/j.socscimed.2025.118363","url":null,"abstract":"<div><div>The description of the medical school learning environment (MSLE) is nuanced, complex, and oftentimes fragmented. A large body of literature documents the MSLE among all medical students, but there is a growing interest in the experiences of other describing the MSLE using other frameworks of identities including race, gender, and class. We conducted a medical school-wide assessment of students to illuminate differences between racially, ethnically, <em>and</em> socially underrepresented minority (RES-URM). A single-site survey investigating RES-URM and non-RES-URM students’ perceptions of their MSLE was conducted in 2020 at a medical school in a metro area on the west coast, an academic medical center. All medical students, including dual-degree programs (MD/MPH, MD/PhD) were invited to participate. We combined and used the subscale from the Johns Hopkins Learning Environment Scale (JHLES) and the Medical School Diversity Climate Survey (MSDCS) to describe the MSLE. RES-URM participants rated their overall perception of the MSLE significantly lower than their non-RES-URM peers and were less likely to endorse or recommend the medical school. RES-URM students also reported significantly lower scores in sense of community, peers and inclusion and safety, as well as indicating increased recognition of negative aspects of the campus diversity climate and witnessing discrimination. Medical school institutions can work towards creating learning environments that are more inclusive of <em>all</em> medical students by expanding the definition of diversity and intentionally addressing all aspects of the medical training learning environment. An inclusive MSLE is critical to the retention and graduation of a diverse workforce.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"383 ","pages":"Article 118363"},"PeriodicalIF":4.9,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144696566","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}

引用次数: 0

Spirit of hope: Diminished hopelessness mediates the serial relation between spiritual experiences, reduced stress, and positive affect in transdiagnostic and healthy individuals 希望的精神：在跨诊断和健康个体中，减少的绝望介导了精神体验、减轻的压力和积极影响之间的一系列关系

IF 4.9 2区医学

Social Science & Medicine Pub Date : 2025-07-09 DOI: 10.1016/j.socscimed.2025.118359

L.E. Ptasczynski , E. Haller , A. Küttner , K. Schöniger , R. Herrmann , J. Selle , M. Uhlig , J. Andreev , L. Fleischer , L. Brunner , P. König , E. Zwiky , R. Redlich

{"title":"Spirit of hope: Diminished hopelessness mediates the serial relation between spiritual experiences, reduced stress, and positive affect in transdiagnostic and healthy individuals","authors":"L.E. Ptasczynski , E. Haller , A. Küttner , K. Schöniger , R. Herrmann , J. Selle , M. Uhlig , J. Andreev , L. Fleischer , L. Brunner , P. König , E. Zwiky , R. Redlich","doi":"10.1016/j.socscimed.2025.118359","DOIUrl":"10.1016/j.socscimed.2025.118359","url":null,"abstract":"<div><div>Spirituality and religious practice have again come to the fore of mental health research, where they are considered protective but also risk factors for mental health conditions. While the effect of daily spiritual experiences (DSE) on positive affect, a core indicator of mental health, is consolidated in the current literature, only a few studies inspect its multivariate underpinnings. We here tested three often-discussed mediators that cover affective (stress), cognitive (hopelessness), and psychosocial (social support) aspects in a single serial mediation model to determine their exclusive contribution to this link. Self-report data from a transdiagnostic sample undertaking psychotherapy at the time of testing and a healthy cohort was acquired via online surveys. Results of the mediation analysis indicate a serial relation between DSE, diminished hopelessness, stress reduction, and positive affect. While this serial effect holds not only for the entire sample but also for both subgroups separately, corroborating its generalizability, the serial relation also exists in an additional confirmatory structural equation modelling approach in the transdiagnostic sample. Altogether, our findings have implications for spirituality-based therapeutic practices, and might, prospectively, be considered when assessing coping resources in prevention research.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"382 ","pages":"Article 118359"},"PeriodicalIF":4.9,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144606020","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}

引用次数: 0

Associations between community-based integrated care services and disability trajectories of older adults: Evidence from China 基于社区的综合护理服务与老年人残疾轨迹的关系：来自中国的证据

IF 4.9 2区医学

Social Science & Medicine Pub Date : 2025-07-08 DOI: 10.1016/j.socscimed.2025.118387

Hongwei Hu , Hongwang Guo , Kairan Zhang , Yujia Liu

{"title":"Associations between community-based integrated care services and disability trajectories of older adults: Evidence from China","authors":"Hongwei Hu , Hongwang Guo , Kairan Zhang , Yujia Liu","doi":"10.1016/j.socscimed.2025.118387","DOIUrl":"10.1016/j.socscimed.2025.118387","url":null,"abstract":"<div><div>With the rapid development of community-based integrated care services (CBICSs) globally, many studies have demonstrated their role in improving the health of older adults. However, few studies have focused on associations between CBICSs and disability trajectories of older adults. To this end, using eight waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 1998 to 2018, this study utilized a mortality-adjusted Group-Based Trajectory Model (GBTM) to identify activities of daily living (ADL) and cognitive trajectories among older adults in China, employed multinomial logistic regression to explore associations between CBICSs and disability trajectories, and examined home care and living areas as effect modifiers of these associations. This study identified three ADL trajectories: Group 1 (\"stable throughout life\", 31.89 %), Group 2 (\"risky in later life\", 44.68 %), and Group 3 (\"high-risk\", 23.43 %); and two cognitive trajectories: Group 1 (\"stable throughout life\", 48.36 %) and Group 2 (\"high-risk\", 51.64 %) among older adults. The findings suggested that older adults with CBICSs were more likely to be in the favorable ADL and cognitive trajectories. Heterogeneity analysis identified significant effect modification by home care, but no such effect was observed for living areas. These results provide important implications for policymakers and practitioners to promote the development of CBICSs and improve older adults' health.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"382 ","pages":"Article 118387"},"PeriodicalIF":4.9,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605300","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}

引用次数: 0