Social Science & Medicine最新文献

{"title":"The role of stress proliferation in linking childhood stressors to accelerated biological aging","authors":"Maleah Fekete ,&nbsp;Gabriele Ciciurkaite","doi":"10.1016/j.socscimed.2025.118567","DOIUrl":"10.1016/j.socscimed.2025.118567","url":null,"abstract":"<div><div>Adverse childhood experiences (ACEs) are linked to negative health outcomes, but research has not examined the extent to which stress proliferation—the tendency of initial stressors to beget subsequent stressors—explains their association with accelerated biological aging. Using data from 2201 adults in the Person-to-Person Health Interview Study (mean age = 50, SD = 18.6; 61% female; 85% White) and second- and third-generation epigenetic clocks (AgeAccelGrim2 and DunedinPACE), we test whether adult stressors mediate the relationship between ACEs and biological aging, distinguishing between stressful life events and chronic financial strain as pathways. Results show that greater exposure to ACEs is associated with accelerated biological aging both directly and indirectly. Causal mediation analyses indicate that chronic financial strain accounts for 50% of the ACEs–AgeAccelGrim2 association and 47% of the ACEs–DunedinPACE association, while discrete events account for 42% of the ACEs–AgeAccelGrim2 association (the pathway through discrete events is not significant for DunedinPACE). Findings suggest that stressors in adulthood, including financial strain as well as acute stressful experiences like getting divorce or being fired, may be an important pathway through which early adversity contributes to physiological aging.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"384 ","pages":"Article 118567"},"PeriodicalIF":5.0,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145049289","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 scoping review of community participation in public health research and action during the COVID-19 pandemic: Exploring approaches on the continuum between utilitarianism and empowerment","authors":"Annika Frahsa ,&nbsp;Harvy Joy Liwanag ,&nbsp;Cristopher Kobler Betancourt ,&nbsp;Aziz Mert Ipekci ,&nbsp;Beatrice Minder ,&nbsp;Diana Schow","doi":"10.1016/j.socscimed.2025.118556","DOIUrl":"10.1016/j.socscimed.2025.118556","url":null,"abstract":"<div><div>Community participation played a crucial role in addressing health inequities during the COVID-19 pandemic, particularly in reaching marginalized populations and fostering resilience. Amid the wide variation of participatory approaches in community health—from information dissemination to co-decision-making—, there remains a lack of comprehensive analysis on their implementation, impact, and effectiveness. This scoping review synthesizes participatory approaches used during the pandemic, addressing three key gaps: (1) the depth and breadth of participation, (2) the types of communities engaged and the public health issues addressed, and (3) the impact of participation on community health.</div><div>Following the Joanna Briggs Institute (JBI) methodology, we systematically searched nine bibliographic databases, identifying 20,672 records. After removing duplicates and screening articles based on predefined inclusion criteria, we included 127 studies. Our analysis included mapping participation depth using Arnstein's ladder, categorizing motivations as utilitarian or emancipatory, and identifying the types of communities engaged and the community health issues addressed. We also examined community health outcomes and developed a conceptual heuristic framework to better characterize participatory approaches.</div><div>Based on our findings, we propose eight key recommendations for improving the implementation and reporting of participatory approaches in community health. These include providing clear definitions of community and community health, ensuring transparency in participation levels and phases, elaborating on participatory methods, avoiding (re)stigmatization, and promoting community-driven research and action. By enhancing participatory practice and evaluation, these recommendations can support more equitable, effective, and sustainable community health interventions in pandemic contexts and beyond.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"385 ","pages":"Article 118556"},"PeriodicalIF":5.0,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145160278","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":"Delivering the script: The educational activities of medical device industry representatives as a knowledge management strategy","authors":"Quinn Grundy","doi":"10.1016/j.socscimed.2025.118565","DOIUrl":"10.1016/j.socscimed.2025.118565","url":null,"abstract":"<div><div>Representatives of the medical device industry are routinely present in hospitals to provide education and support related to their products which, collectively, represent a company's knowledge management strategy. Between 2021 and 2022, I undertook an interpretive, phenomenological qualitative study at a large, urban, academic medical centre in Canada to examine industry's role in practice-based education. I conducted interviews (n = 23) and focus groups (N = 2) with 36 participants working across departments in roles spanning the point-of-care to executive leadership. Drawing on social studies of the co-construction of users and technologies, I examine the implications of involving commercial interests in the acquisition, circulation, and deployment of knowledge needed to practice in concert with medical technologies. Participants described manufacturers as the source of knowledge needed to use and maintain medical products and equipment and technology transfer occurred through in-services, product samples, and trial periods. However, the circulation of knowledge did not always happen freely: industry sought to maintain its position as a key intermediary in these technology transfers by controlling the flow of knowledge needed to practice in concert with technology. Instances of breakdown in access to knowledge meant that commercial interests became apparent to end-users as they conflicted with existing norms, processes, and clinical goals. Analysis of educational activities involving medical device industry representatives provides insight into the industry's strategic knowledge management, but also analysis of new forms of power and resistance to commercial goals that originate in practice and among proximate gatekeepers for technologies to practice settings.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"384 ","pages":"Article 118565"},"PeriodicalIF":5.0,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145019918","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 association of individual food security status with women's political participation, labor-force participation, and reproductive health: A cross-sectional analysis of gendered structural inequality in the League of Arab States","authors":"Wesley Raymond Dean ,&nbsp;Olfat Sheikomar ,&nbsp;Hala Ghattas ,&nbsp;Rola el-Husseini ,&nbsp;Nadine Sahyoun","doi":"10.1016/j.socscimed.2025.118555","DOIUrl":"10.1016/j.socscimed.2025.118555","url":null,"abstract":"<div><div>This article applies a conceptual framework based on multilevel theories of gender inequality to examine individual-level food insecurity (FI) outcomes in the League of Arab States (LAS). We conceptualize FI as an embodied waypoint on a discriminatory cycle incorporating material and cultural practices that function at macro-, situational-, and individual-levels. Using data drawn from the Gallup World Poll representing a sample of non-institutionalized, aged 15 and above respondents, FAO's Food Insecurity Experience Scale, the UNDP's Gender Inequality Index, and the Varieties of Democracy (V-Dem) Project, we provide cross-sectional evaluations of the associations between gender-related variables and individual-level measures of the experience of FI for both women and men for the LAS, and for states stratified by Human Development Index. National measures of gender inequality were significantly associated with FS status for both men and women, including women's reproductive health (adolescent births and maternal mortality), parliamentary representation, and labor force participation. Regression models run separately for each measure had explanatory power, and addition of each level substantially improved Pseudo R²s. This suggests national-level policies on FS should address national-level gender inequalities and broaden women's substantive representation in governance, promising further value in exploring FI as an embodied health disparity among women and men, through the multilevel framework of gendered structural inequality.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"384 ","pages":"Article 118555"},"PeriodicalIF":5.0,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145049283","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":"New forms of expertise and their implications for the system of professions in healthcare: the case of the patient safety specialist role in the English NHS","authors":"Graham P. Martin ,&nbsp;Robert Pralat ,&nbsp;Justin Waring ,&nbsp;M. Farhad Peerally","doi":"10.1016/j.socscimed.2025.118562","DOIUrl":"10.1016/j.socscimed.2025.118562","url":null,"abstract":"<div><div>Contemporary societal shifts are disrupting established professional divisions of labour in healthcare. Some have argued that professionalism itself is being transformed, with professions characterised less by claims to exclusive jurisdiction and more by connectivity and complementarity. This article puts these arguments to the test in a domain traditionally characterised as one of professional conflict: patient safety. Informed by the sociology of expertise, we consider the case of a new role—the patient safety specialist—constructed by some as a profession in the making. Drawing on three qualitative datasets comprising interview and focus group contributions from 71 participants, we find that patient safety specialists struggled to establish the legitimacy of their expertise in organisational environments that were often hostile. By forging alignments with the interests of clinical professionals, however, some advanced their roles in ways that served mutual interests, in line with recent theses on the changing nature of professionalism and the need for expertise that connects increasingly interdependent jurisdictions. The extent to which this advancement offered a solid and durable foundation for a claim to professional status, however, seemed more questionable.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"385 ","pages":"Article 118562"},"PeriodicalIF":5.0,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145160283","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":"Unpaid labour and mental health–the role of perceived fairness and satisfaction in division amongst working-age adults; a longitudinal analysis using 18 waves of panel data","authors":"Jennifer Ervin ,&nbsp;Brendan Churchill ,&nbsp;Leah Ruppanner ,&nbsp;Tania King","doi":"10.1016/j.socscimed.2025.118559","DOIUrl":"10.1016/j.socscimed.2025.118559","url":null,"abstract":"<div><div>Across the globe, the division of unpaid labour remains highly gendered and unequally shared. This has consequences for women's economic security and their ability to participate equally in paid work. Whilst unpaid labour time has been shown to be associated with poorer mental health, understanding how the unequal division of unpaid labour impacts mental health requires further scrutiny. Utilising 18 annual waves (2005–2022) of the HILDA survey, this study employed Mundlak modelling to examine the longitudinal association between perceptions of fairness and satisfaction in the division of key unpaid labour domains (household work and childcare) and mental health in working-age Australians (n = 8734). Mental health was assessed using the MHI-5 scale. All analyses were stratified by gender. Findings demonstrate that the mental health of both men and women is poorer when they are dissatisfied with the division of either domain of unpaid labour and when they perceive that they are doing <em>more</em> or <em>less</em> than one's fair share of both housework and childcare. Importantly, this research tells us that it is not only the objective division of unpaid labour that impacts mental health but also satisfaction and one's perceptions of fairness in that division.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"384 ","pages":"Article 118559"},"PeriodicalIF":5.0,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050079","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":"Home vs. nursing care: Unpacking the impact on health and well-being","authors":"Elena Bassoli ,&nbsp;Mathieu Lefebvre ,&nbsp;Jérôme Schoenmaeckers","doi":"10.1016/j.socscimed.2025.118533","DOIUrl":"10.1016/j.socscimed.2025.118533","url":null,"abstract":"<div><div>In this paper, we present estimates of the effect of different care settings on health and well- being outcomes. We use data from the French CARE Survey, which interviews individuals aged 60 and above, to assess the differential effect of living at home or in a nursing home on mortality, morbidity and well-being indicators. In addition, we differentiate the effect between for-profit and non-profit nursing homes. To do so, we apply a propensity score matching approach that controls for selection on observables by matching people living at home with those living in nursing homes. Our results are threefold. First, we observe a positive effect of being in a nursing home on health outcomes but a negative effect on other well-being indicators such as happiness and nervousness. Second, the ownership status of the nursing home matters and the positive effect is stronger for non-profit and public nursing homes. Third, residents in for-profit nursing homes appear to to be worse off than those in nonprofit institutions. These findings raise important questions for the future organization and the funding of long-term care.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"385 ","pages":"Article 118533"},"PeriodicalIF":5.0,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145160276","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":"Indirect effects of immigration enforcement on health care utilization among lawfully present older Hispanics","authors":"Jordan Herring ,&nbsp;Burt Barnow","doi":"10.1016/j.socscimed.2025.118540","DOIUrl":"10.1016/j.socscimed.2025.118540","url":null,"abstract":"<div><div>Immigration enforcement can indirectly affect U.S. citizens and lawfully present immigrants though “chilling effects,” where immigrants avoid public resources altogether because of ambiguous immigration law, public charge rules, and network effects. Indirect effects have been documented in take-up rates of public assistance programs, but there is a large gap in knowledge on how immigration enforcement could indirectly affect health care seeking behavior. We examined the impact of Secure Communities, an immigration enforcement program that began in 2008, on health care utilization among older lawfully present Hispanic immigrants and citizens. Using restricted geographic data from the Health and Retirement Study (HRS), we employed a staggered difference–in–differences model comparing U.S.–born Hispanic citizens and likely authorized Hispanic immigrants to a reference group of non–Hispanic, U.S.–born citizens. The main outcome was the probability of having an office visit with a health care provider. We estimate that Secure Communities led to a 16.9 % decline in the probability of having a visit with a health care provider for likely authorized Hispanic immigrants relative to non-Hispanic U.S.-born respondents. These declines are not driven by health insurance coverage, and are even larger among individuals with worse health status and less education. The declines in utilization relate to chilling effects and fear of putting others at risk as the respondents in our study are likely not at immediate risk of deportation or other immigration consequences. As immigration enforcement increases, further efforts should be made to protect access to health care.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"384 ","pages":"Article 118540"},"PeriodicalIF":5.0,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145049287","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":"Addressing housing insecurity as a social determinant of health: A systematic review of interventions in healthcare settings","authors":"Han Yan ,&nbsp;Allyson J. Gallant ,&nbsp;Alannah Delahunty-Pike ,&nbsp;Jodi E. Langley ,&nbsp;Alexander Zsager ,&nbsp;Eunice Abaga ,&nbsp;Carolyn Ziegler ,&nbsp;Jeff Karabanow ,&nbsp;Stephen W. Hwang ,&nbsp;Andrew D. Pinto","doi":"10.1016/j.socscimed.2025.118557","DOIUrl":"10.1016/j.socscimed.2025.118557","url":null,"abstract":"<div><h3>Background</h3><div>Stable housing is a key social determinant of health. Those experiencing homelessness or housing insecurity are known to have increased healthcare utilization and yet worse healthcare outcomes compared to securely housed individuals. Housing interventions offered via healthcare settings provide an opportunity to reach this population. We conducted a systematic review to 1) identify interventions which address housing insecurity and engage healthcare settings; 2) determine effectiveness of these interventions; and 3) ascertain common characteristics of effective interventions to inform new ways to address housing insecurity within healthcare.</div></div><div><h3>Methods</h3><div>Twelve databases were searched for relevant studies published from January 1, 1990–January 3, 2025. We included intervention studies aimed at meeting patients’ housing needs as a primary or secondary outcome and initiated by referrals from within the healthcare system. Titles, abstracts and full-text articles were reviewed by two independent reviewers. Data were extracted relevant to study design, population, and intervention details. Quality appraisals were conducted using JBI critical appraisal tools. Discrepancies at each stage were resolved through reviewer or team discussions.</div></div><div><h3>Results</h3><div>We identified 19 studies from 12,483 unique citations. Most were randomized controlled trials and of moderate quality. Studies primarily addressed the housing needs of adults with mental health or substance use issues (n = 9; 47 %). We identified three common characteristics of housing interventions with positively-associated outcomes active community referrals (i.e. connection to a professional social worker or case manager instead of sharing passive information), incorporating multi-component interventions to address housing and additional health needs, and utilizing case management or assertive community treatment approaches.</div></div><div><h3>Conclusions</h3><div>Interventions to address housing insecurity can be successfully situated within healthcare settings, although more research is required to examine the cost-effectiveness of such interventions. The characteristics of the interventions identified can be used to inform new housing interventions in healthcare settings to address this critical social determinant of health.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"384 ","pages":"Article 118557"},"PeriodicalIF":5.0,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050078","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":"Socioeconomic inequalities in developing cardiometabolic diseases and transition to depression: A trajectory analysis of large-scale population-based study","authors":"Han Chen ,&nbsp;Xuemei Wang ,&nbsp;Zhi Cao ,&nbsp;Chenjie Xu","doi":"10.1016/j.socscimed.2025.118542","DOIUrl":"10.1016/j.socscimed.2025.118542","url":null,"abstract":"<div><div>Existing evidence demonstrates a high risk of developing depression in patients with cardiometabolic diseases (CMDs). However, it remains unclear whether socioeconomic inequality exacerbates the progression. We aimed to quantify the role of socioeconomic status (SES) in the progression from healthy to CMDs and their transitions to depression. A total of 376 610 participants (age 37–73 years) free from CMDs of interest, including type 2 diabetes (T2D), coronary heart disease (CHD) and stroke, from the ongoing UK Biobank study between 2006 and 2010 were included at baseline. Potential various SES groups were derived from latent class analysis using family income level, employment status and education attainment. In latent class analysis, three distinctive levels of SES (low, medium, and high) were identified. During the 15-year follow-up, we found significant associations were found between low SES and different progression stages of CMDs. In multivariate models, the hazard ratios (95 % confidence intervals) for low SES vs. high SES were 1.62 (1.53–1.71), 1.23 (1.17–1.29) and 1.25 (1.13–1.38) for transitions from healthy to T2D, CHD and stroke, and 2.17 (2.03–2.30), 1.63 (1.30–2.03), 1.62 (1.30–2.03), 1.70 (1.11–2.60) for risk of transition to depression from healthy, T2D, CHD and stroke, respectively. Socioeconomic inequalities were associated with almost all transition stages from healthy to CMDs, subsequently to depression, with different magnitude of associations. These findings support the need for targeted screening programs for depression in CMD patients, and policy interventions addressing socioeconomic inequalities through improved access to healthcare, education, and economic opportunities for disadvantaged populations.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"384 ","pages":"Article 118542"},"PeriodicalIF":5.0,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042014","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}