Social Science & Medicine最新文献

{"title":"Supporting mental health in farming communities where and when it is needed most: A longitudinal analysis of risk and protective factors","authors":"","doi":"10.1016/j.socscimed.2024.117381","DOIUrl":"10.1016/j.socscimed.2024.117381","url":null,"abstract":"<div><div>The cyclical nature of agriculture exposes farmers to challenges that vary over time, influenced by a myriad of external factors beyond their control. This longitudinal study aimed to examine mental health trajectories for Western Australian farmers over a 12 month period, and determine associations with key risk and protective factors. Farmers and farm residents (<em>N</em> = 125) completed an online survey at three timepoints (baseline, 6 months and 12 months) that assessed anxiety, depression, stress, farming stressors, coping strategies, sense of belonging and social supports. Survey timing coincided with periods of harvest and seeding. Risk factors associated with poorer mental health among farmers included a range of dysfunctional and emotion coping strategies, family/relationship stressors, financial/external stressors and daily stressors. Protective factors included sense of belonging and social support. Stress was found to change over time and family/relationship stressors and financial/external stressors at baseline were found to moderate anxiety and stress at 6 months and 12 months. Addressing factors associated with poor mental health trajectories and bolstering factors that are protective for mental health over time will aid clinical and community services in tailoring their services to meet the needs of farmers.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378460","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":"The built environment and its association with type 2 diabetes mellitus incidence: A systematic review and meta-analysis of longitudinal studies","authors":"","doi":"10.1016/j.socscimed.2024.117372","DOIUrl":"10.1016/j.socscimed.2024.117372","url":null,"abstract":"<div><div>This study aimed to systematically review longitudinal studies examining associations between the incidence of type 2 diabetes mellitus (T2DM) and built environmental factors. This review adhered to the 2020 PRISMA guidelines. Longitudinal studies examining associations between T2DM incidence and built environmental features were eligible. Built environment constructs corresponded to the following themes: 1) Walkability – factors such as sidewalks/footpaths, crosswalks, parks, and density of businesses and services; (2) Green/open space – size, greenness, and type of available public outdoor spaces; (3) Food environment – ratio of healthful food outlets (e.g., greengrocers, butchers, supermarkets, and health food shops) to unhealthful food outlets (e.g., fast-food outlets, sweet food retailers, and convenience stores). Five databases (e.g., Medline) were searched from inception until July 2023. Qualitative and quantitative synthesis were used to summarise key findings, including a meta-analysis of adjusted Hazard Ratios (aHR).</div><div>Of 3,343 articles, 16 longitudinal studies from seven countries, published between 2015 and 2023, involving 13,403,902 baseline participants (median of 83,898), were included. In four of the five studies, unhealthful food environment was significantly associated with higher incident T2DM. Five of seven greenspace studies and two of four walkability studies showed that greater greenery and greater walkability were statistically significantly associated with lesser incident T2DM. In pooled analyses, greater T2DM incidence was associated with unhealthful relative to healthful food environments (pooled HR: 1.21; 95% CI: 1.04, 1.42), and T2DM incidence was inversely associated with green/open space environments (pooled HR: 0.82; 95% CI: 0.74, 0.92). Greater walkability was associated with a slight 2% lesser incidence of T2DM (pooled HR: 0.98; 95% CI: 0.98, 0.99). This review underscores consistency in the nature of associations between built environment features related to T2DM. We observed statistically significant inverse or “protective” associations between T2DM and walkability and healthful food environments. These results support calls for policies and guidelines that promote healthful food environments and walkability.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382148","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 triple trust penalty? The majority-minority gap in subjective wellbeing","authors":"","doi":"10.1016/j.socscimed.2024.117371","DOIUrl":"10.1016/j.socscimed.2024.117371","url":null,"abstract":"<div><div>This study introduces a social capital perspective to the majority-minority gap in wellbeing. We explore the role of social trust and test specifically whether racial and ethnic minorities may experience a triple trust penalty. First is a level penalty, where minorities exhibit lower levels of trust, potentially adversely affecting their wellbeing. Second, there may be a return penalty, where minorities may experience a diminished return from being trustful. Third, there may be a protection penalty, where minorities experience reduced benefits from residing in a high-trust context. Our empirical analyses are based on data from multiple waves of the European Social Survey (Round 4–10, 2008–2020) with over 300,000 individuals from 38 European countries. Our analyses indicate support for the level penalty, but we found no evidence for the return or protection penalties. Specifically, we show that racial and ethnic minorities’ lower levels of trust can have harmful impacts on their happiness and life satisfaction. However, an increase in trust yields greater wellbeing among racial and ethnic minorities, and residing in a high-trust context also appears to have a more substantial impact on the well-being of racial and ethnic minorities as compared to their counterparts. The results suggest that promoting trust can effectively narrow the wellbeing gap among various racial groups.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376214","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":"Sources and processes of social influence on health-related choices: A systematic review based on a social-interdependent choice paradigm","authors":"","doi":"10.1016/j.socscimed.2024.117360","DOIUrl":"10.1016/j.socscimed.2024.117360","url":null,"abstract":"<div><h3>Background</h3><div>Most choices in healthcare are not made in social isolation. However, current econometric models treat patients' preferences as the sole determinants of their choices.</div><div>Through the lens of sociology and medical sociology theories, this paper presents a systematic literature review of identifiable social influences on patients’ choices, serving as a first step in developing a social-interdependent choice paradigm.</div></div><div><h3>Methods</h3><div>Following the PRISMA guideline and using nine databases, we identified the individual agents or groups involved in health-related choices, the functional content through which social relationships influence patients, and the choice constructs affected by these processes. From 9036 screened articles, we selected 208 to develop an analytical framework connecting social relationships with choice constructs.</div></div><div><h3>Results</h3><div>Social influences predominantly come from family, friends, specialized physicians, and general practitioners. We decomposed the functional content of social relationships into functions and contents. Dyadic interactions and expert knowledge were prominent functions, followed by social control. Prescriptive and informational contents were prevalent, followed by instrumental and emotional ones. Expert knowledge and social norms aligned with prescriptive and informational signals, while dyadic interactions provide emotional and instrumental signals. Reference points for social norms included friends, coworkers, and patients. Social relationships primarily impact which alternatives are evaluated, followed by alternative evaluation strategies and goal selection. Distinctions between medical domains and dimensions emerged, highlighting how the medical area conditions the social influence process.</div></div><div><h3>Conclusion</h3><div>This systematic review presents a comprehensive framework that elucidates the social influence process in healthcare patient decision-making. By detailing the functional content of social relationships into functions and contents and linking these components to the elements of the choice process, we created a structured approach to understanding how social relationships impact patient choices. This will facilitate the systematic integration of social relationships into econometric models of patient choice.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378459","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":"Types of genetic determinism in direct-to-consumer genetic testing for health","authors":"","doi":"10.1016/j.socscimed.2024.117376","DOIUrl":"10.1016/j.socscimed.2024.117376","url":null,"abstract":"<div><div>Prior research has challenged genetic determinism by highlighting the complex ways lay people engage with genetics. However, most of these critiques took place prior to the availability of direct-to-consumer (DTC) genetic health testing and were based on reactions to genetic testing administered in a clinical context due to either symptoms or family history. Today, many lay people interact with genetic health information outside of medicine, and often without pre-existing symptoms or family history. This suggests the need to revisit genetic determinism in the context of this new mode of public engagement with genetic information about health. In this paper we examine how a sample of 39 people who had previously taken a DTC genetic test for health make sense of their results. We find genetic determinism is prominent, but takes on several distinct forms, including <em>protective determinism</em>, <em>motivating determinism</em>, and <em>absolute determinism</em>. Considering this, we argue that genetic determinism should not be treated as a singular or fixed concept and cannot be dismissed as insignificant, given its continued salience for DTC genetic test-takers. Our analysis also pays particular attention to how test-takers interpret negative results (i.e., no elevated risks detected), as this is a common outcome of DTC genetic tests but has not been a focus of prior research.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373324","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":"Assessing access: Texting hotline app provides mental health crisis care for economically deprived youth","authors":"","doi":"10.1016/j.socscimed.2024.117369","DOIUrl":"10.1016/j.socscimed.2024.117369","url":null,"abstract":"<div><h3>Background</h3><div>Due to rapidly increasing youth suicides in the U.S state of Utah, the legislature funded creation of a 24/7 texting-based smartphone app in Spanish and English targeting Utah's school aged population. Recent research elsewhere (in the Netherlands) suggests cost inhibits help seeking among the economically disadvantaged. We evaluate the relationship between poverty and app usage during the onset of the COVID-19.</div></div><div><h3>Method</h3><div>Local demographics, social determinants of health and COVID-19 infection rates were modeled using a Bayesian spatio-temporal approach examining usage rates.</div></div><div><h3>Results</h3><div>When controlling for generally researched suicide crisis covariates, app usage is shown to vary depending on economic status of the population, with the largest relative increases in use among disadvantaged youth.</div></div><div><h3>Discussion</h3><div>This bilingual Spanish/English, texting (SMS) based, smart phone app crisis hotline proved effective at providing adolescents from certain populations access to mental health care. The groups discussed are in Census Block Groups (CBGs – neighborhoods) with higher poverty, and/or lower population density (rural areas). The usage of the crisis hotline by these populations increased relative to the overall population as the COVID-19 pandemic unfolded. However, adolescents from areas of higher mobility (our proxy for housing insecure) and those in areas with larger non-White populations had a relative decrease in usage.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382144","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":"Cannabis vaping use in emerging adulthood: Characterizing transitions between stages of vaping among a diverse cohort in Texas","authors":"","doi":"10.1016/j.socscimed.2024.117326","DOIUrl":"10.1016/j.socscimed.2024.117326","url":null,"abstract":"<div><h3>Objective</h3><div>To characterize and compare transitions in cannabis (THC) vaping by sociodemographic and other risk factors among a diverse cohort of youth and young adults observed between Spring 2019 and Fall 2021.</div></div><div><h3>Methods</h3><div>We analyzed six (6) waves of panel data from n = 2605 youth transitioning into young adulthood via the Texas Adolescent Tobacco and Marketing Surveillance (TATAMS) system; participants provided N = 13,974 observations (i.e., completed surveys). The TATAMS sample was 37.7% Hispanic, 31.7% NH-White, 14.5% NH-Black, and 16.1% among NH-Other. We applied a three-state Markov model to estimate cannabis vaping initiation (never→ever), experimentation (never→current), escalation (ever→current), and de-escalation (current→ever). First, we compared transitions in THC vaping by race/ethnicity, with non-Hispanic (NH) Black as the referent. Second, we stratified the Markov models by race/ethnicity to identify common and unique predictors of cannabis vaping transitions, examining differences by: sex, age, alcohol use, depression (PHQ-9), anxiety (GAD-7) and nicotine vaping, across each race/ethnic category.</div></div><div><h3>Results</h3><div>At baseline, 72.7% never vaped cannabis, 12.7% ever vaped cannabis, and 14.5% currently vaped cannabis. Across three years, risk for cannabis vaping experimentation (never → current) was significantly greater among NH-Blacks, relative to Hispanics (aHR: 1.89), NH-Whites (aHR: 2.27), and NH-Other (aHR: 2.01). Stratified models showed that current alcohol use was a common predictor of cannabis vaping experimentation among NH-White (aHR: 5.08), Hispanic (aHR: 2.32), and NH-Black (aHR: 2.91) participants. Depression predicted cannabis vaping initiation among Hispanics (aHR: 1.75) and experimentation among NH-Blacks (aHR: 3.95).</div></div><div><h3>Conclusions</h3><div>Onset of cannabis vaping during youth and young adulthood was most common among NH-Black youth, relative to other race/ethnic categories. Alcohol was a common predictor of cannabis vaping across race/ethnic categories while depression was linked to cannabis vaping transitions among Hispanic and NH-Black youth, only. Future research should investigate the link between alcohol use, mental health, and cannabis vaping among young people.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378457","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":"Applying CFIR to assess multi-level barriers to PrEP delivery in rural South Africa: Processes, gaps and opportunities for service delivery of current and future PrEP modalities","authors":"","doi":"10.1016/j.socscimed.2024.117370","DOIUrl":"10.1016/j.socscimed.2024.117370","url":null,"abstract":"<div><div>Despite established efficacy for oral pre-exposure prophylaxis (PrEP) in reducing HIV incidence, multi-level barriers within the health system, clinics, and the processes that shape practice have hindered service delivery and subsequent population-level effects. We applied the Consolidated Framework for Implementation Research (CFIR) to assess the context of PrEP delivery for adolescent girls and young women (AGYW) in rural South Africa and identify the factors supporting and impeding PrEP implementation to develop strategies to improve PrEP delivery. Between 2021 and 2022, we conducted in-depth interviews with five young women with PrEP use experience and 11 healthcare providers as well as four key informant stakeholder interviews. Tailored interviews organized around the CFIR domains provided multiple perspectives on the inter-connected processes, gaps, and opportunities between health systems, clinics, communities, and PrEP services. Shifts in PrEP policies, funding pressures, and inconsistent communications from the National Department of Health spurred fragmented planning, engagement, execution, and monitoring of PrEP delivery processes within clinics already struggling to address multiple population health needs. Resulting challenges included: conflicting priorities within clinics and across NGO partners, unclear goals and targets, staffing and space constraints, and insufficient community engagement. Individual clinics’ implementation climate and readiness to deliver PrEP varied in terms of operational plans and delivery models. Interviewees reported complexity of initiation procedures and support for PrEP maintenance, with opportunities to improve systems communications and processes to facilitate integrated services and more user-friendly experiences. Applying CFIR identified opportunities to strengthen PrEP delivery across levels within this complex service delivery setting.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376215","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":"Unlocking the night: Exploring the health impacts of night-time walking environments on health outcomes of older adults","authors":"","doi":"10.1016/j.socscimed.2024.117359","DOIUrl":"10.1016/j.socscimed.2024.117359","url":null,"abstract":"<div><div>Walking remains the primary form of physical activity for many older adults in China, and the quality of the walking environment at night may determine the frequency and duration of evening outings. This study reveals how night-time environmental features influence the health outcomes of older adults. Using the medical check-up records of 87,578 older adults from a public health service in the Beilin district of Xi'an city, China, the role of the night-time walking environment in managing chronic conditions was examined. A favorable night-time walking environment reduced the prevalence of chronic conditions and comorbidities among older adults. However, the health effects stemming from the night-time walking environment exhibited heterogeneity, with significant impacts only on metabolic conditions, such as hypertension and diabetes, while the effects on other conditions were not significant. Our findings supplement the theory of healthy aging by highlighting the potential value of the environment in managing chronic conditions, which may serve as a cost-effective health intervention for aging societies.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376217","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 mitigating effect of social protection on undernourishment during economic downturns: A longitudinal study of 46 low- and middle-income countries over the last two decades","authors":"","doi":"10.1016/j.socscimed.2024.117365","DOIUrl":"10.1016/j.socscimed.2024.117365","url":null,"abstract":"<div><h3>Background</h3><div>Low- and middle-income countries (LMICs) are particularly vulnerable to the adverse effects of economic downturns on the Prevalence of Undernourishment (PoU). Our study aimed to evaluate the impact of Social Protection and Labor Programs (SPL) on PoU in 46 LMICs from 2001 to 2019, and to estimate SPL mitigating effects during economic downturns.</div></div><div><h3>Methods</h3><div>This cohort study used a multi-country ecological design with two-ways fixed effects multivariable linear regression models, adjusted for relevant demographic, socioeconomic, and contextual variables. Interaction terms between economic downturns and SPL were used to evaluate SPL mitigating effects.</div></div><div><h3>Findings</h3><div>Our study cohort displayed an average 15.30% PoU and 34.34% SPL coverage in the initial year, contrasting with 8.58% PoU and 43.81% SPL coverage in the final year. A 10% SPL coverage was associated with a 0.51% PoU reduction (95%CI: 0.04–0.99) across all countries and 0.78% reduction within the poorest subgroup. SPL have been able to prevent an estimated 1.01 billion (95% UI: 0.16–1.86) cases of undernourishment over the study period in the 46 LMICs. Economic downturns were associated with a 4.55% PoU increase (95% CI: 1.28–7.81) in all countries, and a 6.06% PoU increase in the poorest subgroup. High SPL coverage during the downturns had significant mitigating effects, reducing an overall 1.17% PoU for every 10% SPL coverage in all countries, and 1.81% PoU in the poorest nations.</div></div><div><h3>Interpretation</h3><div>Amid the ongoing multiple global crises, expanding the coverage of social protection could effectively mitigate the potential increases in undernourishment during economic downturns, contributing to the achievement of nutrition-related Sustainable Development Goals in LMICs.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378461","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}