Social Science & Medicine最新文献

{"title":"The interembodiment of healing: Holistic transformations in neurological rehabilitation and care","authors":"William A.S. Lucas","doi":"10.1016/j.socscimed.2025.118468","DOIUrl":"10.1016/j.socscimed.2025.118468","url":null,"abstract":"<div><div>While disability literature has largely moved away from rehabilitation settings, critiquing its philosophy as reifying normative ableism, many communities still request accessible treatment options. Those with paralysis (on account of spinal cord injury and traumatic brain injury) are especially surrounded by constant messaging centered on hopes of a cure, with activity-based therapy, a relatively new therapy modality, being situated as providing maximum hope for patients and clients. This paper draws on 10 months of ethnographic research with paralysis patients, their caregivers, and rehabilitation professionals, finding that many tensions between patients and their recovery processes emerge from how consonant these modalities are for patient engagement. However, patient learning is often simultaneously emotional, informational, and bodily; a complex that I argue illustrates how interembodiment is a holistic encounter between patients and their therapists. Deep learning occurs on multiple communicative channels. Using ethnographic vignettes and case studies, this paper illustrates situations of interembodiment where rehabilitation professionals and caregivers assist patients and clients by inciting emotional energy and other social connections in order to aid their transitions towards recovery. Rather than seeing paralysis as an individual condition, this work suggests a method for understanding how immanent (and social) emotions can create a web of motivational energy, sentiments, standards, and care practices that transfer both healing and social attunement across bodies.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"383 ","pages":"Article 118468"},"PeriodicalIF":5.0,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144780074","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":"Discrimination, chronic stress, and cardiovascular health among African American men and women in the Jackson Heart Study: A cross-sectional study","authors":"Amber J. Johnson ,&nbsp;Mario Sims ,&nbsp;Chelsea Okundolor ,&nbsp;Sherman A. James ,&nbsp;Katharine A. Kirby","doi":"10.1016/j.socscimed.2025.118460","DOIUrl":"10.1016/j.socscimed.2025.118460","url":null,"abstract":"<div><div>Optimal cardiovascular health (CVH) reduces cardiovascular disease risk. However, further research should clarify the role of psychosocial factors on CVH among African Americans. The current cross-sectional study sought to examine the relationship between discrimination, chronic stress, and CVH among African Americans in the Jackson Heart Study (<em>n</em> = 4737). The associations between discrimination (i.e., daily, lifetime, and discrimination burden), chronic stress, and achieving ideal CVH and CVH indicators (e.g., smoking, diet, blood pressure) were investigated using multinomial logistic regression analysis. Multivariable linear regression models also examined associations between discrimination, chronic stress, and CVH scores.</div><div>Greater perceived daily discrimination was associated with 11 % lower odds of being in the ideal smoking category (never smoking or quit smoking &gt;12 months ago), whereas greater chronic stress was associated with 5 % lower odds of being in this category. Greater perceived daily, lifetime, and burden of lifetime discrimination was associated with decreased odds of having an ideal BMI (&lt;25.0) by 14 %, 22 %, and 16 %, respectively. Chronic stress modified these associations, slightly increasing odds of having an ideal BMI by 2 %, 3 %, and 8 % for perceived daily, lifetime, and burden of lifetime discrimination. Higher scores on perceived daily discrimination were associated with lower LS7 scores (β = −0.09, −16, −0.01) while higher lifetime discrimination was associated with higher LS7 scores. These complex findings support continued focus on research elucidating the underlying mechanisms linking psychosocial stress and CVH among African Americans.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"383 ","pages":"Article 118460"},"PeriodicalIF":5.0,"publicationDate":"2025-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144780072","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":"Time, diagnosis, and medication: The institutional circuit of billing in community mental health care","authors":"Katerina Melino ,&nbsp;Joanne Olson ,&nbsp;Jude Spiers ,&nbsp;Janet Rankin ,&nbsp;Carla Hilario","doi":"10.1016/j.socscimed.2025.118455","DOIUrl":"10.1016/j.socscimed.2025.118455","url":null,"abstract":"<div><div>This study explored the social organization of Psychiatric Mental Health Nurse Practitioners' (PMHNPs') practice in community mental health care settings. Using institutional ethnography (IE), we examined the everyday work practices of PMHNPs to uncover the ruling relations that govern their work with patients with serious mental illness who live within conditions of poverty, violence, houselessness, and discrimination. Nine PMHNPs from outpatient community mental health clinics in a large California city participated in the study. Data collection included in-depth interviews, clinic observations, and analysis of relevant clinical and organizational texts. The analysis revealed how the mental health system's electronic health record (EHR) organizes PMHNPs' work by time, diagnosis, and medication to align their patient care with billing requirements. The Specialty Mental Health Services Medi-Cal Billing Manual and the DSM-5-TR serve as key governing texts that dictate clinical documentation standards and prioritize diagnosis and medication in the interest of revenue generation. At the same time, only some of the time spent on this work is reimbursable. The EHR organizes an institutional circuit focused on billing, which is often at odds with patients' embodied lives, experiences, and needs. PMHNPs must then mediate between this ruling relation and what they know patients need. This study contributes to the literature on the social organization of mental health care in support of advocating for policy reforms that recognize the comprehensive needs of individuals with serious mental illnesses.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"383 ","pages":"Article 118455"},"PeriodicalIF":5.0,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144772504","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":"Migration-induced subjective social mobility and its associations with self-rated mental and general health: A systematic review and narrative synthesis.","authors":"Maike Platz Pereira, Nora Gottlieb, Maren Hintermeier, Niklas Nutsch, Kayvan Bozorgmehr","doi":"10.1016/j.socscimed.2025.118459","DOIUrl":"https://doi.org/10.1016/j.socscimed.2025.118459","url":null,"abstract":"<p><p>Social mobility affects health, but comprehensive evidence on its health effects in migration contexts is lacking. This systematic review summarizes the global empirical quantitative evidence on the impact of migration-induced subjective social mobility on self-rated health outcomes among first-generation migrants, including internally displaced people, international and internal migrants. A systematic search was performed in three scientific databases, using search terms related to migrants, social status/mobility and health outcomes. Studies were included if migrant populations, quantitative measures of health outcomes and subjective social mobility were reported. In total, 13 records met all criteria, representing five different country contexts and covering international migrants, asylum seekers, refugees, and rural-to-urban migrants. Applying cross-sectional study designs, the main outcomes assessed were general health, subjective wellbeing/life satisfaction and depression. The overall evidence shows that downward subjective social mobility consistently correlates with negative mental health effects, namely depression, while upward social mobility is associated with better mental health outcomes. Similar tendencies were found for general health and life satisfaction. The results indicate that downward subjective social mobility is associated with poorer general health, lower life satisfaction and higher risk of depression across various contexts. Correspondingly, upward subjective social mobility and social mobility belief is associated with better general health, higher life satisfaction and lower risk of depression. These findings highlight the need for policies that support post-migration socioeconomic integration to prevent or mitigate the experience of downward mobility and its adverse health effects. Future research is needed to better understand pathways and interactions between policies, contexts, and individual trajectories influencing migration-induced social mobility.</p>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"383 ","pages":"118459"},"PeriodicalIF":5.0,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805154","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":"Racial inequities in the incidence of major adverse cardiovascular events in ELSA-Brasil cohort: the mediating role of weathering","authors":"Amanda Viana Machado ,&nbsp;Sandhi Maria Barreto ,&nbsp;Rodrigo Citton Padilha dos Reis ,&nbsp;Luana Giatti ,&nbsp;Sheila Maria Alvim Matos ,&nbsp;Ana Luísa Patrão ,&nbsp;Belinda L. Needham ,&nbsp;Lidyane V. Camelo","doi":"10.1016/j.socscimed.2025.118421","DOIUrl":"10.1016/j.socscimed.2025.118421","url":null,"abstract":"<div><h3>Background</h3><div>The weathering hypothesis proposes that chronic exposure to social disadvantage leads to earlier onset of age-related diseases, explaining, in part, greater CVD disadvantages of racialized groups. The investigation of such a hypothesis is incipient in Brazil, a society strongly marked by racism. We investigated whether racism is associated with incidence of major adverse cardiovascular events (MACE) and the extent to which weathering explained this association in Brazilian adults.</div></div><div><h3>Method</h3><div>The study includes 10,983 individuals from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), free from CVD at baseline (2008–2010). We use self-reported race/color (White, Brown, and Black) as a social marker of racism as exposure. Weathering was the mediator, defined as the difference between biological and chronological age (obtained by combining nine biomarkers and the Klemera and Doubal method). MACE incidence (fatal and non-fatal coronary syndrome, coronary revascularization, stroke, and heart failure) was the outcome. Sociodemographic and behavioral factors, depression, and racial discrimination were the confounders. Marginal structural models estimated the total (TE) and the controlled direct (CDE) effects of the exposure on outcome.</div></div><div><h3>Results</h3><div>The mean follow-up period was 4.1 years. Black and Brown individuals showed, on average, greater weathering than White individuals. MACE incidence was 63 % higher among Black than White individuals [TE = HR(95 %CI):1.63(1.01–2.65)]. The CDE indicated that weathering mediates the association after weighting [CDE=HR(95 %CI):1.05(0.61–1.79)]. There was no association among Brown individuals.</div></div><div><h3>Conclusion</h3><div>Our results corroborate the weathering hypothesis by showing that accelerated biological aging is a major driver of racial inequalities in MACE incidence in Brazilian adults.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"383 ","pages":"Article 118421"},"PeriodicalIF":5.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144750701","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 emergence of egg intermediaries in the European fertility landscape: the creation of value in reproductive bioeconomies","authors":"Nicky Hudson ,&nbsp;Christina Weis ,&nbsp;Vincenzo Pavone ,&nbsp;Cathy Herbrand ,&nbsp;Veerle Provoost","doi":"10.1016/j.socscimed.2025.118448","DOIUrl":"10.1016/j.socscimed.2025.118448","url":null,"abstract":"<div><div>With recent growth in both domestic and global private health care markets and increased medical travel by patients, there has been an increase in the existence of medical mediation services. Whilst there is a developing scholarship that considers the brokerage of this travel, less attention has been paid to other forms of medical facilitation. Taking the example of fertility treatment - specifically egg donation - this paper examines how intermediaries develop, how they operate and specifically how they create multiple forms of value within systems of healthcare traditionally based around non-commercial logics. The data come from a large-scale comparative study of egg donation in Europe, designed to explore the new landscape and economy of human eggs in fertility treatment. Data collection included: interviews with key actors in the field (donors, clinic staff, intermediary representatives and other stakeholders, n = 132); analysis of marketing material from clinic and intermediary websites; and discussions at deliberative policy workshops with the project team and stakeholders. We identified three types of intermediaries: egg agencies, egg banks, and online matching platforms; actors that are engaged in a multiplicity of valuation practices which give rise to novel forms of logistical, affective, commercial and circumventional value. We suggest that via these practices egg intermediaries are reconfiguring the relationship between donors, fertility patients and the traditional notion of the fertility clinic, and reshaping normative understandings around reproductive labour, kinship, and biomedicine in the wider fertility landscape.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"383 ","pages":"Article 118448"},"PeriodicalIF":5.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144842801","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":"“It's time … to end everything”: Discontinue medication choices and narratives among elderly HIV-positive Yi women","authors":"Jiaojiao He ,&nbsp;Jian Liu ,&nbsp;Apei Song","doi":"10.1016/j.socscimed.2025.118450","DOIUrl":"10.1016/j.socscimed.2025.118450","url":null,"abstract":"<div><div>Elderly Yi women living with HIV have long been caught between the burdens of family responsibilities and the constraints of local medical management policies, which should be considered. Based on an ethnographic study of these people in a mountainous region of southwestern China, this study employs the <em>narrative disruption</em> approach of <em>Narcofeminism</em> to examine their disease narratives and drug-related decisions—particularly their choice to discontinue medication—within the intersecting contexts of health, family duties, and ethnic medical policies. Our findings note that the decision to stop antiretroviral treatment is largely driven by shifting life meanings and expectancies. Specifically, the completion of family obligations and the intensification of stigma within their villages diminish their sense of future possibilities. In addition, HIV control policies in Yi areas, and the structural distribution of HIV treatment drugs gradually erode their sense of meaning in life. As a result, participants adopt a stance of “frustration and relief” toward their condition, framing the discontinuation of treatment as an autonomous choice rather than a matter of drug adherence and resistance. This study critically reflects on the role of autonomic life visions, especially a sense of the future and meaning, in shaping treatment choices. It expands the discourse on drug choices beyond biomedical frameworks, foregrounding the diverse and autonomous decisions of individuals from a cultural perspective. By centring participant-driven narratives over health-centred scripts, this research also offers recommendations for more contextually informed HIV treatment and drug management policies.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"383 ","pages":"Article 118450"},"PeriodicalIF":4.9,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144711178","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":"Temporal stability of preferences: The case of COVID-19 vaccines in Australia and New Zealand.","authors":"My Tran, Robbie Maris, Stephane Hess, Zack Dorner, Elisabeth Huynh, Kathryn Glass, Emily Lancsar","doi":"10.1016/j.socscimed.2025.118417","DOIUrl":"https://doi.org/10.1016/j.socscimed.2025.118417","url":null,"abstract":"<p><p>This paper introduces a novel two-level Latent Class (LC) structure to investigate the temporal stability of preferences, allowing individuals to switch classes over time. The model is used to investigate the temporal stability of COVID-19 vaccine preferences in Australia (AUS) and New Zealand (NZ) during 2020-2021. Through online experiments on vaccine choices, stated choice data is collected across three waves from the general population in both countries. The LC estimation identifies three distinct preference classes: an \"Impatient\" group, with greater sensitivity to waiting time (AUS: 46%, NZ: 31%), a \"Price Sensitive\" group (AUS: 41%, NZ: 56%), and a \"Vaccine Hesitant\" group (AUS: 13%, NZ: 13%). Across waves, preferences for COVID-19 vaccines remain stable, with the probability of respondents remaining in the same class over three waves being 0.62 for Australia and 0.61 for NZ. Changes in preferences are significantly linked to variations in individuals' socioeconomic status and COVID-19 policy responses during the survey period.</p>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"383 ","pages":"118417"},"PeriodicalIF":5.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818032","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 the impact of day and night urban outdoor environments on women's physiological and psychological states using pedestrian-centric street view images","authors":"Chongxian Chen ,&nbsp;Yongqi Hou ,&nbsp;Xinrui Xiong ,&nbsp;Yuru Hua ,&nbsp;Guangsi Lin ,&nbsp;Mengyun Chen ,&nbsp;Jingyi Liu","doi":"10.1016/j.socscimed.2025.118433","DOIUrl":"10.1016/j.socscimed.2025.118433","url":null,"abstract":"<div><div>The urban environment significantly influences women's health and overall quality of life. However, less attention has been given to how the diurnal differences in these environments affect women's physiological and psychological responses during their experiences within them. This study employed field experiments, questionnaires, pedestrian-centric street view images, and deep learning methods to assess how residential, commercial, and leisure environments impact women's physiological and psychological states during both daytime and nighttime. Spatial autocorrelation analysis and Multiscale Geographically Weighted Regression (MGWR) were utilized to examine spatial patterns and identify key influential environmental factors. The results indicate that women's physiological and psychological states exhibit geographical clustering and are influenced by various outdoor environments during both day and night. Leisure environments during the day are associated with the lowest physiological arousal and the highest positive emotions, while residential environments at night correlate with the highest arousal and the lowest positive emotions. Factors such as \"brightness,\" \"openness,\" \"colorfulness,\" and \"greenness\" affect women's states throughout the day and night. Additionally, \"color saturation\" significantly influences arousal in residential areas during the day, while \"color temperature\" enhances positive emotions in nighttime commercial environments. This study contributes to advancing our understanding of gendered experiences in contemporary urban spaces and supports the development of women-friendly cities by integrating a multidisciplinary perspective.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"383 ","pages":"Article 118433"},"PeriodicalIF":5.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144723162","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":"Family caregivers of people who use drugs in Vietnam: Perceived burden and coping","authors":"Hieu Ngoc Nguyen ,&nbsp;Li Li ,&nbsp;Diep Bich Nguyen ,&nbsp;Thang Hong Pham ,&nbsp;Tuan Anh Nguyen","doi":"10.1016/j.socscimed.2025.118440","DOIUrl":"10.1016/j.socscimed.2025.118440","url":null,"abstract":"<div><h3>Background</h3><div>Understanding the burdens and coping of family caregivers for people who use drugs (PWUD) is essential for developing effective support interventions. This study explores patterns of perceived burden and coping efforts among caregivers in Vietnam and their associations with socio-demographic characteristics.</div></div><div><h3>Methods</h3><div>This study analyzed baseline data from an intervention trial conducted in three Vietnamese provinces in 2024. A latent profile analysis was conducted to identify distinct caregiver burden and coping profiles. Chi-square tests were performed to explore associations between these profiles and socio-demographic characteristics.</div></div><div><h3>Results</h3><div>Among 690 family caregivers, four distinct profiles emerged: (1) High burden–High coping (33.3 %), (2) High burden–Low coping (18.0 %), (3) Low burden–High coping (35.2 %), and (4) Low burden–Low coping (13.5 %). Parents reported the highest levels of perceived burden compared to other caregiver roles. Caregivers with lower education levels (39.5 %) or poor financial status (46.8 %) were more likely to experience high burden and low coping capacity, compared to other profile groups.</div></div><div><h3>Conclusions</h3><div>This study contributes to the literature on caregiver burden and coping by identifying differences in challenges faced by family caregivers of PWUD. Future interventions should be tailored to address caregivers' specific needs based on their burden and coping efforts.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"383 ","pages":"Article 118440"},"PeriodicalIF":4.9,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144711089","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}