Social Science & Medicine最新文献

{"title":"Adolescent loneliness and later-life depressive symptoms: The intersecting roles of gender and socioeconomic status","authors":"Keun Young Kwon ,&nbsp;NaKyung Nam ,&nbsp;Jinho Kim","doi":"10.1016/j.socscimed.2025.118588","DOIUrl":"10.1016/j.socscimed.2025.118588","url":null,"abstract":"<div><h3>Rationale</h3><div>Adolescent loneliness has emerged as a pressing public health issue in many developed countries, drawing increasing attention for its potential long-term psychological consequences.</div></div><div><h3>Objective</h3><div>This study examines the association between adolescent loneliness and depressive symptoms in adulthood and explores how gender and socioeconomic factors, such as college attainment and personal earnings, moderate this relationship.</div></div><div><h3>Methods</h3><div>Using data from the National Longitudinal Study of Adolescent to Adult Health, this study employs sibling fixed effects models to account for unobserved family-level confounding factors. Gender-stratified models and two- and three-way interaction models are used to investigate how gender and socioeconomic factors shape the relationship between adolescent loneliness and adult depressive symptoms.</div></div><div><h3>Results</h3><div>The positive association between adolescent loneliness and depressive symptoms remains significant after accounting for individual- and familial-level covariates, including sibling fixed effects (b = 0.988, p &lt; 0.001). This suggests that the relationship persists independently of unobserved family background characteristics. Gender-specific analyses indicate that college attainment significantly moderates this association for women, but not for men. A three-way interaction between loneliness, college attainment, and gender (b = −1.327, p &lt; 0.05) further supports the gendered moderating role of education. In contrast, personal earnings do not moderate the relationship in either gender.</div></div><div><h3>Conclusion</h3><div>The findings of this study highlight the potential long-term psychological consequences of adolescent loneliness and the importance of interventions across the lifespan. Efforts to support women with lower levels of education may be particularly important in mitigating the heightened psychological effects of loneliness and reducing mental health disparities.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"384 ","pages":"Article 118588"},"PeriodicalIF":5.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145060917","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":"Health in justice or health injustice? Indigenous Māori experiences of primary care following release from New Zealand prisons: a national record study","authors":"Paula Toko King ,&nbsp;Frederieke Sanne Petrović-van der Deen ,&nbsp;Cheryl Davies ,&nbsp;Bridget Robson ,&nbsp;Sue Crengle ,&nbsp;Gabrielle Baker ,&nbsp;Julia Carr ,&nbsp;Natalie Paki Paki ,&nbsp;Tīria Pehi ,&nbsp;Marama Cole ,&nbsp;Bernadette Jones ,&nbsp;Tristram Ingham ,&nbsp;Jeannine Stairmand ,&nbsp;Belinda Tuari-Toma ,&nbsp;Christopher Kemp ,&nbsp;Marshall H. Chin ,&nbsp;Ruth Cunningham","doi":"10.1016/j.socscimed.2025.118543","DOIUrl":"10.1016/j.socscimed.2025.118543","url":null,"abstract":"<div><h3>Background</h3><div>Indigenous Māori experience mass imprisonment in New Zealand secondary to colonisation, coloniality and racism. In addition to high risks of morbidity and mortality, community re-entry from prison presents multiple challenges to accessing healthcare and other critical services. In New Zealand's publicly funded health and disability system, primary care acts as the entry point and gatekeeper to secondary services, facilitating linkages to other supports. Guided by lived experience and using deidentified linked national administrative data, we examined the primary care experiences of Māori over the 12-months post-release from prison.</div></div><div><h3>Results</h3><div>A total of 7398 Māori were released from prisons between June 1, 2021 and May 31, 2022. Over half experienced reimprisonment during the 12-months post-release. Only 76 % were enrolled with a primary health organisation meaning 24 % did not have access to subsidised primary care. Over 12-months, 47 % had accessed primary care consults, 63 % received medication, and 23 % had a community laboratory test. In the 12-months post-release, 26 % presented to an emergency department and 5 % were admitted for ambulatory sensitive hospitalisations.</div></div><div><h3>Conclusions</h3><div>Whilst our findings indicate that Māori released from prisons access primary care, there are financial barriers to access. We also found (across a range of access and quality measures) that primary care services are not meeting their high health needs, demonstrating governmental breach of Indigenous rights to health. High-quality primary care is critical to successful community re-entry and to preventing adverse outcomes. There is an urgent requirement for evidence-informed culturally safe strategies that guarantee equitable access to high-quality primary care, developed and designed in ways that privilege the views of Māori with lived experience of imprisonment, those of their families, and communities.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"384 ","pages":"Article 118543"},"PeriodicalIF":5.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082194","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":"Intersecting social inequalities in prenatal and postnatal care: Examining race, ethnicity, socioeconomic status, and geographic location","authors":"Neema Langa ,&nbsp;Kathryn Freeman Anderson ,&nbsp;Zelma Oyarvide Tuthill ,&nbsp;Annamaria Milazzo ,&nbsp;McClain Sampson ,&nbsp;Elizabeth Gregory ,&nbsp;Kimberly A. Pilkinton ,&nbsp;Regan S. Bennet ,&nbsp;Felicia N. York ,&nbsp;Quenette L. Walton","doi":"10.1016/j.socscimed.2025.118583","DOIUrl":"10.1016/j.socscimed.2025.118583","url":null,"abstract":"<div><div>Existing research document disparities in prenatal and postnatal care utilization. This research introduces a novel approach for examining maternal healthcare disparities by integrating multiple structural factors that inhibit care usage. Principally, we examine intersecting social inequalities to understand how race/ethnicity, socioeconomic status, and geographic location interactively shape obstetric care usage for individuals who give birth. Drawing data from the 2016–2021 Pregnancy Risk Assessment Monitoring System (PRAMS) (N = 177,480), the Gadson conceptual model, and intersectional approach, we examine the racial divide in the effects of documented education status and residence on obstetric care usage in the United States. We found a significantly lower likelihood of both prenatal and postnatal care utilization among marginalized racial/ethnic groups, including non-Latina Black, non-Latina ‘Other’, and Latinas, as compared to non-Latina White individuals. These groups also had lower utilization of adequate, adequate plus prenatal (more than recommended), and post-natal care (for only Latinas), even when highly educated (16 years of education and more). We further documented the rural-urban gaps in the effect of education where rural non-Latina Black individuals with more years of education (16 years and more), rural Latina and rural non-Latina other who are slightly educated (9–11 years of education) had a relatively lower likelihood of using adequate plus prenatal care, as compared to rural non-Latina White with similar education characteristics. We call for reforms in healthcare and other factors affecting health that prioritize inclusivity and equality, and reduce bias and perceptions of bias to improve maternal healthcare and outcomes among vulnerable groups.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"384 ","pages":"Article 118583"},"PeriodicalIF":5.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103121","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 hidden curriculum undermines teaching about health literacy and clear communication, promoting inequities in care.","authors":"Cliff Coleman, Samantha Birk, Katie Stowers, Christine Mullowney, Marie Chisholm-Burns","doi":"10.1016/j.socscimed.2025.118545","DOIUrl":"https://doi.org/10.1016/j.socscimed.2025.118545","url":null,"abstract":"<p><p>Health care professionals (HCPs) use specialized language to communicate with each other. Health professions curricula teach HCPs clear communication skills to use with patients, however, such best practices are under-utilized in clinical practice. The authors hypothesized that the hidden curriculum is largely responsible for this observation, and conducted a narrative literature review, which explores: a) how HCPs learn the specialized language of their field, b) the relationship of this language to professional identity formation, c) the role of the hidden curriculum in undermining clear communication education and practices, d) the inequities in care that result from unnecessarily complex health communication for communities with lower health literacy, and e) a system-oriented \"universal precautions\" approach to reforming communication training for HCPs.</p>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"386 ","pages":"118545"},"PeriodicalIF":5.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145294207","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":"Inequities in eating disorder diagnoses in college students: An intersectional multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA)","authors":"Nicholas K. Andrysiak ,&nbsp;Payal Chakraborty ,&nbsp;Ariel L. Beccia ,&nbsp;Brittany M. Charlton ,&nbsp;Colleen A. Reynolds","doi":"10.1016/j.socscimed.2025.118587","DOIUrl":"10.1016/j.socscimed.2025.118587","url":null,"abstract":"<div><div>Eating disorders contribute significantly to negative health outcomes across a broad range of domains. Despite their often-debilitating effects, they remain understudied, especially with respect to the experiences of people who are marginalized by multiple structural systems of power and oppression. The intersectionality framework highlights the mutually constitutive nature of those systems and the ways by which they uniquely shape lived experiences within and between populations. We used data from the American College Health Association National College Health Assessment III (ACHA-NCHA III), a repeated cross-sectional survey of college students, to estimate the prevalence of eating disorder diagnoses across intersections of gender identity, sexual orientation, race/ethnicity, and parental education via a Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (MAIHDA). Two models were fit, one assessing only stratum-specific variations and another including race/ethnicity, gender identity, sexual orientation, and parental education as main effects. The prevalence of eating disorder diagnoses in the sample was 5.13 %, with stratum-specific prevalence estimates ranging from 0.44 % for Black, straight, cisgender men whose parents have a bachelor's degree to 19.20 % for transfeminine and nonbinary, bisexual/pansexual, Indigenous people whose parents have more than a bachelor's degree. There was a large main effect of gender identity, with strata inclusive of transfeminine and nonbinary individuals having 6.55 times greater odds (95 % CI: 5.70–7.51) of eating disorder diagnoses compared to cisgender men. Intersectional interactions between gender identity, sexual orientation, race/ethnicity, and parental education contributed to 2.66 % excess prevalence among White, bisexual/pansexual, cisgender women whose parents had less than a bachelor's degree, and 2.93 % lower prevalence among White, gay/lesbian, transfeminine and nonbinary people whose parents had less than a bachelor's degree. These findings emphasize the concerning inequities in eating disorder diagnoses among college students, and call attention to the multiple, interlocking systems of power and oppression that shape them.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"384 ","pages":"Article 118587"},"PeriodicalIF":5.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145105752","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":"“Can you bury him before he dies?” Sickle cell disease and social sites of suffering in Malawi and Uganda","authors":"Sarah Svege ,&nbsp;Joseph Rujumba ,&nbsp;Bjarne Robberstad ,&nbsp;Siri Lange","doi":"10.1016/j.socscimed.2025.118591","DOIUrl":"10.1016/j.socscimed.2025.118591","url":null,"abstract":"<div><div>In health-related research, experience of illness is commonly characterised by its physical signs and symptoms. However, the experience of illness also extends past the patients' bodily aches and ailments to influence, and possibly impair, their social interactions. Despite its relational ramifications, the field of medicine has not awarded enough attention towards social dimensions of suffering nor the ways in which chronic disease may change and constrain the tapestries of social life. During everyday encounters, ill individuals are often subjected to the objectifying, evaluative gaze of healthy onlookers, who view them from a detached, third-person perspective. This paper explores interpretations of illness in the context of the genetic blood disorder sickle cell disease in Uganda and Malawi. 11 focus group discussions were held with children above 10 years of age with sickle cell disease, while 18 discussions were performed with caregivers of children with sickle cell disease. Drawing on this data, we describe how social interplay between sickle cell ‘sufferers’, their caregivers, and surrounding ‘spectators’ was coloured by community discourses on death, misconceptions about contagiousness, and attribution of perceived deviance. Beyond clinical features of pain and pathology, sickle cell suffering would take on socially situated forms where the ideas and imageries of ‘observing others’ led to added agony and alienation among affected individuals and their intimates. When addressing the predicament of patients and their families, one should consider how the medical meaning-making and opinions of others may give rise to what we herein refer to as ‘social sites of suffering’.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"385 ","pages":"Article 118591"},"PeriodicalIF":5.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187344","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 protective power of social connectedness: Individual vs. community influences on psychological distress in middle-aged Black adults","authors":"Yu-Tien Hsu,&nbsp;Katelyn Kostakis,&nbsp;Shazel Muhammad,&nbsp;Yusuf Ransome","doi":"10.1016/j.socscimed.2025.118585","DOIUrl":"10.1016/j.socscimed.2025.118585","url":null,"abstract":"<div><h3>Background</h3><div>Social connectedness is a crucial determinant of mental health, yet its effects on Black adults remain understudied, particularly in distinguishing between individual and community-level influences. This study examined cross-sectional and longitudinal associations between social connectedness and psychological distress among Black adults at the individual- and neighborhood (census tract) levels.</div></div><div><h3>Methods</h3><div>Using data from the MIDUS (Midlife in the United States) study, we analyzed 897 Black adults aged 25–74 from an urban setting. Social connectedness was measured across six dimensions: neighborhood social cohesion, social integration, support from family and friends, contribution to the community, and spirituality. After extensive model diagnostics, we employed cluster-robust errors to account for clustering by census tracts. We constructed cross-sectional and longitudinal models using these cluster-robust errors with inverse probability weighting to address attrition, examining individual and census-level effects on psychological distress in immediate and long-term contexts.</div></div><div><h3>Results</h3><div>In 10-year longitudinal analyses, family support (β = −1.95, 95 % CI = −3.01, −0.90) and friend support (β = −1.09, 95 % CI = −1.66, −0.52) showed significant protective effects against psychological distress. Cross-sectional analyses confirmed protective relationships for neighborhood social cohesion (β = −2.19, 95 % CI = −3.10, −1.28), family support (β = −1.97, 95 % CI = −2.77, −1.16), and friend support (β = −0.74, 95 % CI = −1.40, −0.07). Census-level social connectedness measures were not significantly associated with psychological distress in longitudinal models.</div></div><div><h3>Conclusions</h3><div>These findings underscore the primacy of individual-level social connections in protecting against psychological distress among Black adults. Mental health interventions should prioritize strengthening personal and family-centered social support networks while incorporating community engagement components for long-term benefits.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"384 ","pages":"Article 118585"},"PeriodicalIF":5.0,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103125","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":"Can unlocking the potential of peripheral public health workers improve healthcare outcomes? A trial of intervention on enhancing elderly health literacy in China","authors":"Xin Xiang ,&nbsp;Ming Lu ,&nbsp;Xuan Yang ,&nbsp;Yujuan Huang ,&nbsp;Luping Dong ,&nbsp;Hongzhi Wang","doi":"10.1016/j.socscimed.2025.118571","DOIUrl":"10.1016/j.socscimed.2025.118571","url":null,"abstract":"<div><div>Despite increased policy attention and resource allocation by governments worldwide, the mismatch between the supply and demand for healthcare workers continues to worsen. This study broadens the definition of public healthcare personnel by exploring the potential role of peripheral health workers in delivering public health services, aiming to offer a broader perspective for addressing the challenges posed by the healthcare workforce crisis. This study designed and implemented a community intervention trial aimed at evaluating the role of community committee members as peripheral public health workers in enhancing the health literacy of the elderly. A total of 22 urban communities in China were randomly assigned to either the intervention group or the control group. The intervention group received health education training for community committee members, while the control group did not receive any additional interventions. Following the intervention, a survey was conducted to assess the health literacy levels of elderly residents in both groups. The results indicate that elderly participants in the intervention group scored significantly higher across all dimensions and sub-dimensions of health literacy compared to those in the control group. These finding suggest that community committee members, acting as peripheral public health workers, play a significant role in enhancing health literacy within their communities. Our research provides valuable insights for countries and regions facing shortages of healthcare professionals, offering a human resource strategy for enhancing health literacy management and strengthening primary healthcare systems to achieve universal health coverage.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"384 ","pages":"Article 118571"},"PeriodicalIF":5.0,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145049290","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":"A panel data analysis of the impact of government trust on support for universal and air travel vaccine mandates during the COVID-19 pandemic","authors":"Songkhun Nillasithanukroh ,&nbsp;Chul Hyun Park ,&nbsp;Robert Richards ,&nbsp;Alyssa Ghaleb","doi":"10.1016/j.socscimed.2025.118586","DOIUrl":"10.1016/j.socscimed.2025.118586","url":null,"abstract":"<div><div>Does trust in the executive branch of the government influence support for collective public health measures? While previous research has primarily examined how trust in the government influences personal health decisions, such as individual vaccination choices, this article explores the role of trust in shaping support for collective public health measures like vaccine mandates. Unlike individual vaccine acceptance, which focuses on the costs and benefits of personal health decisions, supporting vaccine mandates requires individuals to weigh community health benefits against the potential restriction of others' autonomy. Insufficient support for these measures can undermine a government's ability to achieve its public health objectives. Longitudinal panel data from 2020 to 2023 were used to assess how trust in the President and state governor affects support for universal and air travel COVID-19 vaccine mandates in the U.S. Analyses show that higher trust in the President and state governor correlates with greater support for vaccine mandates. The impact of trust in the President on support varies depending on the severity of the health threat, economic conditions, and political ideology, while the influence of trust in the state governor on support remains consistent regardless of these factors. To garner public support for health mandates that limit citizens' autonomy and achieve public health objectives, both federal and state leaders need to foster public trust. Future research should investigate how trust is developed and maintained, particularly during crises.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"384 ","pages":"Article 118586"},"PeriodicalIF":5.0,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145049288","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 \"natural\" in the artificial: Surrogates’ reproductive literacy in navigating the health care system","authors":"Orit Chorowicz Bar-Am","doi":"10.1016/j.socscimed.2025.118579","DOIUrl":"10.1016/j.socscimed.2025.118579","url":null,"abstract":"<div><div>This study examines how demographic changes among Israeli surrogates have transformed their approaches to medical authority and bodily autonomy within the surrogacy process. We explore the changing medical experiences of second-generation Israeli surrogates, marking a significant new trend that differs from earlier approaches. To this end, we conducted narrative interviews with 47 retired surrogates in Israel between July 2022 and March 2023, employing qualitative methodology and inductive thematic analysis. While first-generation surrogates typically embraced medicalization to create distance between themselves and the pregnancy, our findings demonstrate that contemporary surrogates actively integrate their natural reproductive capabilities into surrogacy protocols. This research suggests that demographic changes—from single mothers with lower socioeconomic status to predominantly middle-class, educated married women—have reshaped surrogate agency. Consequently, we introduce two key concepts: \"repro-tech literacy,\" the specialized knowledge that surrogates acquire to navigate ART along with their embodied knowledge, and \"hybrid model of reproduction,\" where surrogates strategically combine medical advancements with natural capabilities. Contemporary surrogates actively negotiate various medical aspects, including hormonal treatments, embryo transfers, and delivery methods, often challenging standardized protocols that they perceive as unnecessary for IVF patients without reproductive constraints. This research presents new theoretical frameworks that advance our understanding of surrogate agency in reproductive medicine and challenge existing paradigms of medicalization in third-party reproduction. Our findings reflect a broader cultural shift toward selective medicalization and have practical implications for developing more ethical, patient-centered approaches to third-party reproduction.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"384 ","pages":"Article 118579"},"PeriodicalIF":5.0,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087909","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}