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Child stunting, thinness, and their academic performance in Ethiopia: A longitudinal study 埃塞俄比亚儿童发育迟缓、消瘦及其学业表现:一项纵向研究
IF 4.9 2区 医学
Social Science & Medicine Pub Date : 2025-04-03 DOI: 10.1016/j.socscimed.2025.118050
Getenet Dessie , Jinhu Li , Son Nghiem , Tinh Doan
{"title":"Child stunting, thinness, and their academic performance in Ethiopia: A longitudinal study","authors":"Getenet Dessie ,&nbsp;Jinhu Li ,&nbsp;Son Nghiem ,&nbsp;Tinh Doan","doi":"10.1016/j.socscimed.2025.118050","DOIUrl":"10.1016/j.socscimed.2025.118050","url":null,"abstract":"<div><h3>Background</h3><div>The link between stunting, thinness, and academic performance in Ethiopia remains underexplored. The current study analyses a large and longitudinal dataset to estimate the relationship between thinness, stunting, and children's academic performance in Ethiopia.</div></div><div><h3>Method</h3><div>Data from the Young Lives Study, a longitudinal survey conducted from 2002 to 2016 in Ethiopia, were analyzed. We focused on child academic outcomes measured by the Peabody Picture Vocabulary Test (PPVT) and math scores. We used the system Generalized Method of Moments (GMM) as our model in this study.</div></div><div><h3>Result</h3><div>Our system GMM estimates revealed that stunted children had significantly lower PPVT scores by 0.13 units compared to non-stunted peers (β = −0.13, p &lt; 0.01). The lag stunting also had a negative effect on both PPVT and math scores. Children stunted in the previous survey round scored 0.16 units lower on PPVT and 17.89 units lower on math than non-stunted children (β = −0.16, p &lt; 0.01; β = −17.89, p &lt; 0.01). For each additional year of being stunted, math scores decreased by 2.69 points (β = −2.69, p &lt; 0.01) and PPVT scores by 0.03 (β = −0.03, p &lt; 0.01). Children with both malnutritional issues (stunting and thinness) scored 0.09 points lower than their counterparts (β = −0.09, p &lt; 0.05). However, thinness was not significantly associated with either PPVT or math scores.</div></div><div><h3>Conclusion</h3><div>Our findings indicate that stunting is significantly negatively associated with child academic performance (PPVT and math scores), after adjusting for child, household, and parental socio-demographic factors, location, and prior academic performance. To improve the intellectual capabilities and human capital of future generations, policy measures in Ethiopia should prioritize addressing childhood thinness and stunting.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"373 ","pages":"Article 118050"},"PeriodicalIF":4.9,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143783863","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}
引用次数: 0
Impact of retirement transition on health, well-being and health behaviours: critical insights from an overview of reviews 退休过渡对健康、福祉和健康行为的影响:审查概述的重要见解
IF 4.9 2区 医学
Social Science & Medicine Pub Date : 2025-04-03 DOI: 10.1016/j.socscimed.2025.118049
Giacomo Pietro Vigezzi , Chiara Barbati , Elena Maggioni , Sari Stenholm , Anna Odone , the Italian Working Group on Retirement and Health, A. Amerio , C. Ardito , P. Bertuccio , G. Costa , A. d’Errico , L. Gentile , A. Odone , G.P. Vigezzi
{"title":"Impact of retirement transition on health, well-being and health behaviours: critical insights from an overview of reviews","authors":"Giacomo Pietro Vigezzi ,&nbsp;Chiara Barbati ,&nbsp;Elena Maggioni ,&nbsp;Sari Stenholm ,&nbsp;Anna Odone ,&nbsp;the Italian Working Group on Retirement and Health,&nbsp;A. Amerio ,&nbsp;C. Ardito ,&nbsp;P. Bertuccio ,&nbsp;G. Costa ,&nbsp;A. d’Errico ,&nbsp;L. Gentile ,&nbsp;A. Odone ,&nbsp;G.P. Vigezzi","doi":"10.1016/j.socscimed.2025.118049","DOIUrl":"10.1016/j.socscimed.2025.118049","url":null,"abstract":"<div><div>Retirement is a pivotal life course transition wich may have profound implications for health, well-being and health behaviours. Despite extensive research and theoretical debate, the impact of retirement on health remains inconclusive, with studies reporting positive, negative, or no effects.</div><div>This overview of reviews synthesises evidence from 15 systematic reviews (4 meta-analyses) assessing the relationship between retirement and physical and mental health outcomes (including mortality, mental health, cognitive decline and cardiovascular diseases) and health behaviours (including physical activity, diet, smoking and alcohol consumption). The review adheres to PRIOR guidelines and assesses the quality of the literature and existing methodological challenges.</div><div>Findings indicate that retirement's impact varies widely depending on socioeconomic status (SES), job characteristics, and individual lifestyle factors. Retirees with higher SES generally experience improved mental health and increased physical activity, whereas those with lower SES are more prone to declines in physical and mental health, increased sedentary behaviour, and adverse cardiovascular outcomes. Evidence on cognitive decline and mortality remains mixed.</div><div>This review highlights critical methodological issues in the available literature, including inconsistent definitions of retirement, reliance on self-reported health data, and biases like reverse causality and healthy worker effect. Future research should prioritise life course longitudinal designs and cross-country comparisons informed by stronger theoretical grounding to untangle the complex relationship between retirement and health. Policy efforts should target vulnerable groups, particularly those from lower SES, by promoting physical activity, mental well-being, and social engagement during and after the transition to retirement. Tailored interventions across retirement transition could mitigate health disparities and improve overall well-being in later life.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"375 ","pages":"Article 118049"},"PeriodicalIF":4.9,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143838476","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 role of dignity in food assistance: Participant experiences with a free meal kit program 尊严在食品援助中的作用:参与者在免费膳食包计划中的经历
IF 4.9 2区 医学
Social Science & Medicine Pub Date : 2025-04-03 DOI: 10.1016/j.socscimed.2025.118009
Joslyn Brenton , Alyssa Tindall , Karen Glanz , Senbagam Virudachalam
{"title":"The role of dignity in food assistance: Participant experiences with a free meal kit program","authors":"Joslyn Brenton ,&nbsp;Alyssa Tindall ,&nbsp;Karen Glanz ,&nbsp;Senbagam Virudachalam","doi":"10.1016/j.socscimed.2025.118009","DOIUrl":"10.1016/j.socscimed.2025.118009","url":null,"abstract":"<div><div>Federal and private food assistance programs play a crucial role in addressing hunger and nutrition insecurity in the United States. However, using food assistance poses inherent challenges to the construction of food dignity given the longstanding neoliberal stigma surrounding the use of charitable food programs. A human rights approach to food shifts the emphasis from receiving <em>enough</em> food to promoting a food system that values and promotes dignity. Drawing on 116 in-depth interviews with 67 participants during and after their use of a free 4-week meal kit program called Pass the Love, this analysis reveals six components of a high-dignity food experience. These include: (1) unconditional access (2) providing a complete meal (3) fresh and healthy food (4) minimizing access and preparation burden (5) conveying care and generating positive emotional experiences, and (6) honoring diverse foodways and practices. This study contributes to a growing literature on food dignity and suggests that food assistance programs can better achieve their goals by fostering food dignity.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"374 ","pages":"Article 118009"},"PeriodicalIF":4.9,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143808584","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
Navigating healthcare during the pandemic: Experiences of racialized immigrants and racialized non-immigrants in Ontario's Peel Region 在大流行期间导航医疗保健:安大略省皮尔地区种族化移民和种族化非移民的经验
IF 4.9 2区 医学
Social Science & Medicine Pub Date : 2025-04-03 DOI: 10.1016/j.socscimed.2025.118026
Andrea Rishworth , Kathi Wilson , Matthew Adams , Tracey Galloway
{"title":"Navigating healthcare during the pandemic: Experiences of racialized immigrants and racialized non-immigrants in Ontario's Peel Region","authors":"Andrea Rishworth ,&nbsp;Kathi Wilson ,&nbsp;Matthew Adams ,&nbsp;Tracey Galloway","doi":"10.1016/j.socscimed.2025.118026","DOIUrl":"10.1016/j.socscimed.2025.118026","url":null,"abstract":"<div><div>While public health policies implemented during COVID-19, such as prioritizing essential health services and “no visitor” strategies, were important to treat COVID-19 patients and curb disease outbreaks, their potential negative effects on the health of the general population is a growing concern. Research highlights that these policy changes contributed to a near-universal decline in access to all healthcare services and triggered increased morbidity and mortality rates. However, little is known about how health policy changes differentially shaped healthcare access within and between population groups and regions. Few studies qualitatively examine the indirect effects of policy changes on healthcare access among groups disproportionately impacted by COVID-19. This article examines how COVID-19 health policy changes impacted racialized immigrant and racialized non-immigrants’ ability to connect with a provider, navigate telehealth and in-person healthcare, and access specialized healthcare in the Peel Region of Ontario, Canada. Using a Client Centered Framework, findings from in-depth interviews (n = 79) reveal that policy changes generated new (in)abilities for individuals to perceive, seek, reach, pay and engage in healthcare services. Health policy changes created new barriers to reach healthcare, compounding health challenges. While telehealth opened more effective avenues to access healthcare among some people, it created new disparities for individuals with limited English language skills and/or for those experiencing technological inequities. Although individuals recognized their need for specialized healthcare, the prioritization of essential services, gaps in health insurance coverage, and new COVID-19 economic inequities created barriers to specialized healthcare. We close with a discussion of the impacts for policy and practice.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"376 ","pages":"Article 118026"},"PeriodicalIF":4.9,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143864926","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
Provincializing bodyminds, decolonizing disability 将身心地方化,将残疾去殖民化
IF 4.9 2区 医学
Social Science & Medicine Pub Date : 2025-04-02 DOI: 10.1016/j.socscimed.2025.118048
Giorgio Brocco , Laura A. Meek , Jane L. Saffitz
{"title":"Provincializing bodyminds, decolonizing disability","authors":"Giorgio Brocco ,&nbsp;Laura A. Meek ,&nbsp;Jane L. Saffitz","doi":"10.1016/j.socscimed.2025.118048","DOIUrl":"10.1016/j.socscimed.2025.118048","url":null,"abstract":"<div><div>In critical disability studies and crip theory, a key intervention has been to challenge Cartesian dualism by using terms such as bodyminds, body-minds, mind/bodies, and other hybrids. While the concept of \"bodyminds\" integrates physical and cognitive experiences and challenges dualistic thinking, it has been criticized by scholars for prioritizing Eurocentric notions of the mind and subjectivity over other understandings of bodily normality and difference. Drawing on ten years of ethnographic research in Tanzania, this article argues that the concept of \"bodyminds\" remains rooted in a Eurocentric framework that overlooks the relational and communal understandings of disability prevalent in Tanzania. We build on Sylvia Wynter's critique of “the figure of Man” to show how dominant disability discourses and practices often overemphasize secular and biological definitions of disability, marginalizing alternative ways of being human. Our ethnographic research highlights the diverse and relational experiences of disability among our Tanzanian interlocutors by thinking with Swahili concepts like <em>mitandao ya jamii</em>” (social relationships), <em>utofauti</em> (difference), and <em>kawaida</em> (normality). We conclude by urging scholars to expand frameworks of bodily non-normativity beyond Eurocentric models and toward a more inclusive comprehension of ideas and experiences of normality and difference globally.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"376 ","pages":"Article 118048"},"PeriodicalIF":4.9,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143870852","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
Is walkability healthy for all? Using the National Environmental Database to examine equity in the environmental health characteristics of pedestrian-supportive neighborhoods in the U.S. 适宜步行的环境对所有人都健康吗?利用国家环境数据库研究美国步行者支持社区的环境健康特征的公平性。
IF 4.9 2区 医学
Social Science & Medicine Pub Date : 2025-04-01 DOI: 10.1016/j.socscimed.2025.118024
Lindsay M. Braun , Eric H. Fox , Lawrence D. Frank
{"title":"Is walkability healthy for all? Using the National Environmental Database to examine equity in the environmental health characteristics of pedestrian-supportive neighborhoods in the U.S.","authors":"Lindsay M. Braun ,&nbsp;Eric H. Fox ,&nbsp;Lawrence D. Frank","doi":"10.1016/j.socscimed.2025.118024","DOIUrl":"10.1016/j.socscimed.2025.118024","url":null,"abstract":"<div><h3>Background</h3><div>Marginalized populations in the U.S. often live in dense urban areas, which could promote active travel and health. However, while compactness can support walkability, it can also create exposure to pollution, noise, injury risk, and urban heat islands. These exposures may be higher for marginalized groups, creating systematic “walkability-related” risks.</div></div><div><h3>Objectives</h3><div>We evaluated relationships between walkability, health-related environmental exposures, and social vulnerability, asking: (1) How are sociodemographic groups sorted across space with respect to walkability? (2) Do the environmental health correlates of walkability vary by social vulnerability?</div></div><div><h3>Methods</h3><div>We compiled block group-level data for the 30 largest U.S. metropolitan areas. We measured <em>walkability</em> using the National Walkability Index; <em>social vulnerability</em> using indicators of race/ethnicity and socioeconomic status; and <em>environmental exposures</em> using PM<sub>2.5</sub>, pedestrian fatalities, noise, and tree coverage. We used multilevel mixed-effects regressions to predict (1) walkability as a function of vulnerability and (2) each environmental exposure as a function of the cross-tabulation between walkability and vulnerability.</div></div><div><h3>Results</h3><div>Higher walkability was associated with higher vulnerability. Compared to highly walkable block groups with low vulnerability, those with high vulnerability had higher PM<sub>2.5</sub> and noise levels and lower tree coverage. These differences were even more pronounced among block groups with low walkability, suggesting pervasive inequities.</div></div><div><h3>Discussion</h3><div>While marginalized groups often live in more walkable places, the “high” walkability to which they are exposed carries greater environmental risks than for privileged populations. Our findings illustrate the importance of mitigating environmental burdens that could dampen the health benefits of walkability in marginalized communities.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"374 ","pages":"Article 118024"},"PeriodicalIF":4.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143826089","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
Rural-urban migration dynamics and double burden of malnutrition among women across 29 low and middle income countries 29 个中低收入国家的城乡移徙动态与妇女营养不良的双重负担
IF 4.9 2区 医学
Social Science & Medicine Pub Date : 2025-03-31 DOI: 10.1016/j.socscimed.2025.118047
Jinseo Kim , Seung-Ah Choe , Hwa-Young Lee , S.V. Subramanian , Rockli Kim
{"title":"Rural-urban migration dynamics and double burden of malnutrition among women across 29 low and middle income countries","authors":"Jinseo Kim ,&nbsp;Seung-Ah Choe ,&nbsp;Hwa-Young Lee ,&nbsp;S.V. Subramanian ,&nbsp;Rockli Kim","doi":"10.1016/j.socscimed.2025.118047","DOIUrl":"10.1016/j.socscimed.2025.118047","url":null,"abstract":"<div><div>The double burden of malnutrition (DBM) is a significant public health issue in low- and middle-income countries (LMICs), resulting from complex socioeconomic, demographic and nutrition transitions. This study examined the association between internal migration and DBM among women across LMICs, focusing on direction, recency, and age at migration. Using the latest Demographic and Health Survey (2010–2023), data on body mass index, migration status, and covariates were extracted from 232,449 women aged 15–49 years in 29 countries. Migration status was categorised as urban non-migrants, rural non-migrants, urban-to-rural, or rural-to-urban based on prior and current residences. Recency and age at migration were categorised as recent/non-recent (within the last five years or earlier) and childhood/adulthood (before or after age 19). Multinomial multivariable logistic regressions were used to estimate odds ratio for each migrant groups relative to urban and rural non-migrants, respectively. Further analyses examined the association between DBM and recency, and age at migration, among migrants. Overall, 32.1 % of women were overweight/obese while 9.7 % were underweight. Urban-to-rural migrants accounted for 9.5 % of the sample, and rural-to-urban migrants constituted 7.0 %. Rural-to-urban migrants had 21.0 % higher odds of being overweight/obese (95 % CI: 1.15–1.29) compared to rural non-migrants. Urban-to-rural migrants showed 9.0 % lower odds of being underweight (95 % CI: 0.85–0.99) compared to urban non-migrants. Among migrants, recency of migration and age at migration were found to be significantly associated with DBM. This study emphasises the need for targeted public health strategies to enhance immediate and distal determinants of DBM in urban and rural settings in LMICs.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"374 ","pages":"Article 118047"},"PeriodicalIF":4.9,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143824297","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
“There’s no real urgency when it comes to us”: Critical Discourse Analysis of Black Communities’ Lived Experience with Opioid Overdose Response in Indianapolis Area “对我们来说没有真正的紧迫性”:对印第安纳波利斯地区黑人社区阿片类药物过量反应生活经验的批判性话语分析
IF 4.9 2区 医学
Social Science & Medicine Pub Date : 2025-03-29 DOI: 10.1016/j.socscimed.2025.118039
Dong-Chul Seo , Leonardo Alba-Lopez , Naomi Satterfield , Shin Hyung Lee , Charlotte Crabtree , Francesca Williamson
{"title":"“There’s no real urgency when it comes to us”: Critical Discourse Analysis of Black Communities’ Lived Experience with Opioid Overdose Response in Indianapolis Area","authors":"Dong-Chul Seo ,&nbsp;Leonardo Alba-Lopez ,&nbsp;Naomi Satterfield ,&nbsp;Shin Hyung Lee ,&nbsp;Charlotte Crabtree ,&nbsp;Francesca Williamson","doi":"10.1016/j.socscimed.2025.118039","DOIUrl":"10.1016/j.socscimed.2025.118039","url":null,"abstract":"<div><div>This study aims to examine how Black communities construct their discourses about opioid overdose response from lived experiences in the Indianapolis area. We randomly selected and analyzed 20 out of 50 interviews as data saturation was reached. Our analysis was informed by critical discourse analysis (CDA) and intersectionality as an overarching framework for the interpretation process. Each interview lasted about 60 minutes and consisted of ten open-ended questions. Participants were Black residents over 18 years old, who lived in four zip code areas in Indianapolis that had the highest rates of opioid overdose deaths in the city. The interviews revealed complex ways in which Black communities in Indianapolis navigated the opioid overdose crisis. The discourses on opioid overdose response are shaped by the intersectionality of various factors, including institutionalized racism, social discrimination, and fear of mistreatment. Moreover, the normalization of inadequate opioid overdose response is exacerbated by the stereotypes on Black communities, lack of access to resources and information, and historical mistrust in healthcare and law enforcement bodies. Our findings indicate that future intervention to reduce overdose deaths in the Black communities should move away from isolated approaches to holistic ones. These should encompass various intersecting factors, including structural racism, stigma of drug use, fear of mistreatment, lack of resources, and mistrust of law enforcement.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"373 ","pages":"Article 118039"},"PeriodicalIF":4.9,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143777240","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}
引用次数: 0
Complex decision-making of people's use of opioid agonist therapy during pregnancy: Troubling the concept of ‘non-compliance’ 人们在怀孕期间使用阿片类激动剂治疗的复杂决策:困扰“不遵守”的概念
IF 4.9 2区 医学
Social Science & Medicine Pub Date : 2025-03-29 DOI: 10.1016/j.socscimed.2025.118041
Rose A. Schmidt , Amaya Perez-Brumer , Nat Kaminski , Ashley Smoke , Akosua Gyan-Mante , Ningwakwe George , Tara Gomes , Brian Rush , Carol Strike
{"title":"Complex decision-making of people's use of opioid agonist therapy during pregnancy: Troubling the concept of ‘non-compliance’","authors":"Rose A. Schmidt ,&nbsp;Amaya Perez-Brumer ,&nbsp;Nat Kaminski ,&nbsp;Ashley Smoke ,&nbsp;Akosua Gyan-Mante ,&nbsp;Ningwakwe George ,&nbsp;Tara Gomes ,&nbsp;Brian Rush ,&nbsp;Carol Strike","doi":"10.1016/j.socscimed.2025.118041","DOIUrl":"10.1016/j.socscimed.2025.118041","url":null,"abstract":"<div><div>Clinical guidelines strongly recommend that pregnant people with opioid use disorder be offered Opioid Agonist Therapy (OAT); however, access to and retention in substance use services are influenced by a multitude of factors. We conducted 25 semi-structured qualitative interviews with pregnant and recently pregnant people who used opioids or OAT before their pregnancy. Participants were recruited from various health and social services, through social media and by word of mouth. For analysis, we used a voice-centred relational method; each transcript was read four times looking for different levels of influence in participants' stories (i.e., individual, interpersonal, societal). The participant's narratives highlighted how they navigated the expectations of ‘good patient’ and ‘good mother.’ We identified four trajectories of OAT use during pregnancy: two that represent ‘compliance’ and two that represent ‘non-compliance.’ While compliant patients used OAT out of concern for the health of their fetus and because it was medically recommended, the decision to not use OAT occurred in the context of weighing multiple, not only medical risks. Based on past experiences navigating health and social services, some participants made potentially medically risky decisions to avoid negative interactions with health and social care. Our results underscore that health and social service delivery is shaped by paternalistic measures aimed at controlling the behaviour of pregnant people who use drugs and reinforce the need for alternative approaches beyond control to foster more inclusive, supportive, and empathetic support for women who use drugs.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"373 ","pages":"Article 118041"},"PeriodicalIF":4.9,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143777242","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}
引用次数: 0
Is the dual process model of bereavement effective among older bereaved parents in China? An examination of the oscillation process and the effects of overloading 双重过程模式在中国高龄丧亲父母中是否有效?对振荡过程和过载影响的检验
IF 4.9 2区 医学
Social Science & Medicine Pub Date : 2025-03-29 DOI: 10.1016/j.socscimed.2025.118042
Lei Yang , S V Subramanian
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