Social Science & Medicine最新文献_第2页

An intersectional approach to understanding systolic blood pressure distribution in a large French study: a MAIHDA analysis 在一项大型法国研究中，了解收缩压分布的交叉方法：MAIHDA分析。

IF 5 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Social Science & Medicine

Pub Date : 2026-04-01 Epub Date: 2026-02-01 DOI: 10.1016/j.socscimed.2026.119054

Léna Silberzan , Fé·e Santos , Ainhoa Ugarteche-Perez , Emmanuel Wiernik , Nathalie Bajos , Michelle Kelly-Irving

Inequities in systolic blood pressure (SBP), a widely used biomarker, have been shown to be patterned by age, sex, and socioeconomic position, but few studies have investigated how they combine to result in differential SBP risk. This study brings new insights by simultaneously considering sex, age, education, as well as race/ethnicity - a dimension seldom investigated in French health studies- in an intersectional perspective.

Using data from the CONSTANCES cohort (2012–2021) in the French general population, we applied intersectionality theory and multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA) to examine SBP levels among 150,739 adults, not under BP lowering treatment, nested within 126 intersectional strata.

Our models revealed substantial heterogeneity in SBP across strata, mainly driven by age and sex additive main effects. Older age, male sex, lower education, and Subsaharan African (SSA) and Overseas France (DROMs) groups were associated with increased SBP. SSA and DROMs individuals with fewer years of formal education consistently exhibited among the highest SBP values within each sex-age combination. Although age explained most of the between-strata variance, 25-39-year-old SSA and DROMs with fewer years of formal education displayed higher SBP levels than some 40–59-year-old individuals from other ethnoracial backgrounds, suggesting a premature increase of SBP levels for these strata.

Our results show that SBP varies according to socially structured experiences, to the disadvantage of marginalized social groups. They emphasize the need for more intersectionality-grounded research on a wider range of biomarkers, and advocate for a more systematic inclusion of racism as a major axis of oppression in health inequities studies.

收缩压（SBP）是一种广泛使用的生物标志物，已被证明与年龄、性别和社会经济地位有关，但很少有研究调查这些因素如何共同导致不同的收缩压风险。这项研究从交叉的角度同时考虑了性别、年龄、教育以及种族/民族——这是法国健康研究中很少调查的一个维度——带来了新的见解。使用来自法国普通人群constance队列（2012-2021）的数据，我们应用交叉性理论和个体异质性和歧视准确性的多层次分析（MAIHDA）来检查150,739名成年人的收缩压水平，这些成年人没有接受降血压治疗，嵌套在126个交叉性地层中。我们的模型显示，不同地层的收缩压存在很大的异质性，主要受年龄和性别加性主效应的驱动。年龄较大、男性、受教育程度较低、撒哈拉以南非洲（SSA）和海外法国（DROMs）组与SBP升高有关。正规教育年数较少的SSA和DROMs个体在每个性别年龄组合中始终表现出最高的SBP值。虽然年龄解释了阶层间差异的主要原因，但25-39岁的SSA和受正规教育年限较短的DROMs比40-59岁的其他种族背景的个体显示出更高的收缩压水平，这表明这些阶层的收缩压水平过早升高。我们的研究结果表明，SBP根据社会结构经验而变化，对边缘社会群体不利。他们强调需要对更广泛的生物标志物进行更多基于交叉性的研究，并主张在卫生不平等研究中更系统地将种族主义作为压迫的主要轴心纳入其中。

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引用次数: 0

How do tensions between medical professionalism and financial incentives play out under case-based payment reform in China 在中国基于病例的支付改革下，医疗专业精神和财政激励之间的紧张关系是如何发挥作用的

IF 5 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Social Science & Medicine

Pub Date : 2026-04-01 Epub Date: 2026-02-07 DOI: 10.1016/j.socscimed.2026.119079

Xiaoying Zhu , Daniel Strachan , Tiara Marthias , Ajay Mahal , Shenglan Tang , Barbara McPake

To address rapidly increasing healthcare expenditures of social health insurance, the Chinese government has recently introduced a provider payment reform. While some studies have examined the payment reform effects, findings are mixed, and the deeper mechanisms of how these changes influence physicians’ behaviours remain unclear. Drawing on semi-structured interviews conducted in 2024 with 21 hospital-based physicians from two hospitals with different incentive structures, we examine how they have responded to the new system reform in China and the underlying factors driving these responses. We use thematic analysis on the verbatim transcriptions of digital recordings of face-to-face interviews. We find that physicians simultaneously serve as agents for health insurance authority, hospitals and patients, with their service delivery decisions shaped by awareness of the principles that underpin these priorities. We describe five tensions that physicians perceive as conflicts within their agency relationships: optimal care and cost control pressure; institutional policy and professional autonomy; immediate gains and future sustainability; professional development and financial returns; and information asymmetry and relationship risk. The tensions physicians experience, and their preferred response tendencies are notably shaped by hospital incentive mechanisms. We conclude that designing incentives that align principal and agent objectives and incorporating organizational mediation are needed to improve healthcare efficiency under the new payment reform.

为了解决快速增长的社会医疗保险医疗支出，中国政府最近推出了提供者支付改革。虽然一些研究调查了支付改革的影响，但结果好坏参半，这些变化如何影响医生行为的更深层次机制仍不清楚。我们在2024年对来自两家不同激励结构医院的21名医生进行了半结构化访谈，研究了他们对中国新体制改革的反应以及推动这些反应的潜在因素。我们对面对面访谈的数字录音逐字记录进行专题分析。我们发现，医生同时是健康保险机构、医院和患者的代理人，他们的服务提供决策受到对这些优先事项基础原则的认识的影响。我们描述了医生认为在代理关系中存在冲突的五种紧张关系：最佳护理和成本控制压力；制度政策与专业自主；近期收益和未来可持续性；专业发展和财务回报；信息不对称和关系风险。医院的激励机制显著地塑造了医生所经历的紧张情绪和他们的首选反应倾向。我们的结论是，在新的支付改革下，需要设计使委托人和代理人目标一致的激励措施，并纳入组织调解，以提高医疗保健效率。

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引用次数: 0

Pathways to personalisation: The practice of BRCA stratification 个性化的途径：BRCA分层的实践。

IF 5 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Social Science & Medicine

Pub Date : 2026-04-01 Epub Date: 2026-01-12 DOI: 10.1016/j.socscimed.2026.118973

Clara Felicity Fabian-Therond

Personalised medicine is gathering pace across advanced cancer settings in the UK NHS, and care pathways are becoming increasingly filled with different steps, stages and treatments. One key personalised medicine practice is stratifying patients according to their molecular profile. Nevertheless, understanding how this practice shapes lived experience of cancer patients remains an under-researched area. To shed light on this question this paper focuses on the practice of stratifying patients according to their BRCA gene prior to or at the beginning of a late-stage ovarian cancer personalised medicine pathway. I draw on interviews and observations with 17 ovarian cancer patients, who formed part of a larger comparative ethnographic study, which took place between 2020 and 2021 in a tertiary hospital in the South-East of England. Focus on this one practice made it possible to demonstrate how as well as being a diagnostic tool stratification is an affective technology that cultivates range of feelings including inclusion or exclusion, and novel kinds of ‘biosociality’ (Rabinow, 1999). These findings offer critical insight into the importance to separate and scrutinise its practices on long pathways to understand the lived and felt experience of care.

在英国国家医疗服务体系（NHS）的晚期癌症环境中，个性化医疗正在加快步伐，护理途径越来越多地充满了不同的步骤、阶段和治疗方法。一个关键的个性化医疗实践是根据患者的分子特征对患者进行分层。然而，了解这种做法如何影响癌症患者的生活经历仍然是一个研究不足的领域。为了阐明这个问题，本文着重于在晚期卵巢癌个体化治疗途径之前或开始时根据BRCA基因对患者进行分层的实践。我利用了对17名卵巢癌患者的采访和观察，这些患者是2020年至2021年在英格兰东南部一家三级医院进行的一项更大的比较人种学研究的一部分。关注这一实践，可以证明分层作为一种诊断工具，是一种情感技术，可以培养包括包容或排斥在内的一系列情感，以及新型的“生物社会性”（Rabinow, 1999）。这些发现提供了重要的见解，说明了在长期途径上分离和审查其实践的重要性，以了解护理的生活和感受体验。

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引用次数: 0

Hygiene narratives as public health discourse: Constructing the national body and national identity in wartime China (New China Daily & Liberation Daily, 1937–1945) 卫生叙事作为公共卫生话语：战时中国国家主体与国家认同的建构（《新中国日报》、《解放日报》，1937-1945）。

IF 5 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Social Science & Medicine

Pub Date : 2026-04-01 Epub Date: 2026-01-28 DOI: 10.1016/j.socscimed.2026.119025

Yanyang Ma, Meifang Zhang

During the War of Resistance Against Japan (1937–1945), China faced severe public health crises amid military and political upheaval, making hygiene and epidemic prevention critical to safeguarding public health and national survival. While the Communist Party of China (CPC) newspapers' role in wartime political culture is recognized, systematic research on how their hygiene discourse shaped national identity is scarce. This study adopted qualitative discourse analysis of 586 hygiene-related reports from New China Daily (1937–1941) and Liberation Daily (1941–1945), sourced from databases such as the National Newspaper Index, to explore their identity-construction mechanisms. It found that the newspapers adopted three interrelated strategies: popularizing scientific hygiene knowledge to reshape public perceptions, politicizing health campaigns to turn private practices into patriotic obligations, and embedding hygiene into daily life via education and institutions to consolidate collective consciousness. These narratives not only mobilized public support for the war but also localized Foucault's biopolitics and Douglas's purity and danger theory, redefining hygiene as a patriotic duty and collective resistance, illustrating how public health discourse shapes collective identity and drives public health practice in crises and broadening Western theories' applicability in the Chinese context.

抗日战争时期，中国在军政动荡中面临严重的公共卫生危机，卫生防疫成为保障人民健康和民族生存的关键。虽然中国共产党报纸在战时政治文化中的作用得到了承认，但关于其卫生话语如何塑造国家认同的系统研究却很少。本研究以《新中国日报》（1937-1941）和《解放日报》（1941-1945）的586篇卫生相关报道为研究对象，对其身份建构机制进行定性话语分析。研究发现，报纸采取了三种相互关联的策略：普及科学卫生知识，重塑公众观念；将卫生运动政治化，将私人实践转化为爱国义务；通过教育和机构将卫生融入日常生活，巩固集体意识。这些叙述不仅动员了公众对战争的支持，而且还将福柯的生命政治和道格拉斯的纯洁与危险理论本土化，将卫生重新定义为一种爱国责任和集体抵抗，说明了公共卫生话语如何塑造集体身份，并在危机中推动公共卫生实践，拓宽了西方理论在中国背景下的适用性。

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引用次数: 0

Socioeconomic disadvantage explains neighborhood racial inequality in opioid-related mortality 社会经济劣势解释了阿片类药物相关死亡率的社区种族不平等。

IF 5 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Social Science & Medicine

Pub Date : 2026-04-01 Epub Date: 2026-01-20 DOI: 10.1016/j.socscimed.2026.119007

Karl Vachuska, Michael Topping

The mortality burden imposed by the opioid crisis has only increased in recent years, with particularly high increases among Black Americans, who now die from overdoses at higher rates than their white counterparts. As such, a large body of work has emphasized the adverse impact of racial and socioeconomic segregation as a key mechanism of enduring racial health disparities. Also, nascent research has increasingly sought to use cell phone mobility data to examine neighborhood outcomes. This work bridges these two areas of work to look at opioid overdose rates from Cook County, Illinois – the county with the largest number of Black overdoses in the United States—to explore how neighborhood-level characteristics shape these disparities. We find that a neighborhood's level of disadvantage, as measured by the everyday visitors to the neighborhood, is a focal predictor. Moreover, while neighborhoods with a higher share of Black residents have higher rates of opioid-related mortality, we illustrate that our measure of mobility-based disadvantage mediates 100 % of the relationship. These findings remain consistent throughout the pre-2020 (2016–2019) and post-2020 (2020–2023) period when opioid-related mortality spikes. Sensitivity analyses with a wide assortment of controls and different specifications confirm these findings and suggest that future work examining neighborhood disadvantage should consider mobility-based measures in addition to static ones to best identify how disadvantage shapes mortality risk.

阿片类药物危机造成的死亡率负担近年来只增不增，其中黑人的增幅尤其高，他们现在死于过量服用的比例高于白人。因此，大量工作强调种族和社会经济隔离的不利影响是持久的种族健康差异的关键机制。此外，新兴研究越来越多地寻求使用手机移动数据来检查社区结果。这项工作将这两个工作领域联系起来，研究伊利诺伊州库克县的阿片类药物过量率——美国黑人过量服用人数最多的县——以探索社区水平的特征如何塑造这些差异。我们发现，一个社区的劣势水平是一个焦点预测指标，这是由该社区的日常访客来衡量的。此外，虽然黑人居民比例较高的社区与阿片类药物相关的死亡率较高，但我们表明，我们对基于流动性的劣势的衡量标准介导了这种关系的100%。这些发现在阿片类药物相关死亡率飙升的2020年前（2016-2019年）和2020年后（2020-2023年）期间保持一致。采用多种对照和不同规格进行的敏感性分析证实了这些发现，并建议未来研究社区弱势群体的工作除了考虑静态指标外，还应考虑基于流动性的指标，以最好地确定弱势群体如何影响死亡风险。

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引用次数: 0

Public servants or privileged elites? -Analyzing physician strikes in the Republic of Korea 公务员还是特权精英？——分析韩国医生罢工事件

IF 5 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Social Science & Medicine

Pub Date : 2026-04-01 Epub Date: 2026-02-10 DOI: 10.1016/j.socscimed.2026.119092

Seongwon Choi

The 2024 mass physician strike in Korea highlights a fundamental tension within modern healthcare systems. As a health system operating a hybrid model where health financing and health service organizing are divided into public and private domains, respectively, the Korean health system's conflicts warrant a close analysis to expand our knowledge of health systems. Viewing the event through dialectical materialist perspective, this essay explains that the 2024 strike represents the culmination of irreconcilable contradictions embedded within Korea's healthcare system and the physician profession. The essay offers three considerations for successful reforms: 1) recognizing the fundamental conflict between viewing healthcare as a commodity versus a public good 2) recognizing and contend with the dynamics of class struggle between physicians, other health professionals, and the public, and 3) recognizing the exploitative labor environment that fuels internal contradictions within the profession.

韩国2024年的大规模医生罢工凸显了现代医疗体系内部的根本紧张关系。作为一个将卫生筹资和卫生服务组织分别分为公共和私人领域的混合模式的卫生系统，韩国卫生系统的冲突值得仔细分析，以扩大我们对卫生系统的了解。本文从辩证唯物主义的角度来看待这一事件，解释说，2024年的罢工代表了韩国医疗体系和医生职业内部不可调和的矛盾的高潮。这篇文章为成功的改革提供了三个考虑因素：1)认识到将医疗保健视为商品与公共产品之间的根本冲突；2)认识到医生、其他卫生专业人员和公众之间阶级斗争的动态，并与之抗争；3)认识到助长职业内部矛盾的剥削性劳动环境。

引用次数: 0

Unconditional cash transfers to improve health behaviors among primary care patients: a qualitative sub-study of a randomized clinical trial 无条件现金转移改善初级保健患者的健康行为：随机临床试验的定性子研究

IF 5 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Social Science & Medicine

Pub Date : 2026-04-01 Epub Date: 2026-02-09 DOI: 10.1016/j.socscimed.2026.119068

Laura A. Gibson , Aaron Richterman , Aaliyah Randall , Jonathan Muruako , Beth Uzwiak , Eva Fabian , Harsha Thirumurthy , Christina A. Roberto

Unconditional cash transfers are a popular poverty reduction approach and may influence behavioral risk factors for chronic disease outcomes through economic and psychological pathways. Few studies have used qualitative interviews to identify the mechanisms through which cash transfers delivered in a health care context might influence the health of people living with chronic diseases in the United States. We conducted a pilot randomized controlled trial to identify pathways through which unconditional cash transfers may influence health and assess the acceptability and feasibility of such an intervention among low-income patients receiving treatment for hypertension or diabetes. Inclusion criteria were: ≥1 visit at the Penn Family Care clinic within the six months prior to study start, ≥18 years of age, Pennsylvania Medicaid beneficiary, diagnosis of pre-diabetes or diabetes, and/or hypertension, prescribed ≥1 oral medication for diabetes or hypertension, and no plans to leave the Philadelphia metro area. Participants were randomized to either the standard of care or an unconditional cash transfer intervention, and completed an assessment at enrollment and after 12 weeks of study participation. We enrolled 100 participants from 3/2023-8/2023 and 93 attended the follow-up visit. Thirty-four participants (selected randomly) completed qualitative interviews. The interviews and survey data revealed that cash transfers were primarily used to address basic needs. We identified potential pathways through which cash transfers may improve health, including temporary reductions in stress and anxiety, changes in diet and physical activity, improved medication adherence, and increased healthcare seeking behavior. The intervention itself was viewed as highly acceptable. Participants in the control group were disappointed not to receive the intervention, but felt the process was fair because all participants were economically vulnerable. These findings suggest unconditional cash transfers may improve health for patients with chronic diseases through a variety of pathways that should be measured in future trials.

无条件现金转移是一种流行的减贫方法，可能通过经济和心理途径影响慢性病结局的行为风险因素。很少有研究使用定性访谈来确定在医疗保健背景下提供的现金转移可能影响美国慢性病患者健康的机制。我们进行了一项随机对照试验，以确定无条件现金转移可能影响健康的途径，并评估这种干预在接受高血压或糖尿病治疗的低收入患者中的可接受性和可行性。纳入标准为：研究开始前6个月内≥1次到宾夕法尼亚家庭护理诊所就诊，年龄≥18岁，宾夕法尼亚州医疗补助受益人，诊断为糖尿病前期或糖尿病和/或高血压，处方≥1种口服糖尿病或高血压药物，没有计划离开费城都会区。参与者被随机分配到标准护理组或无条件现金转移干预组，并在入组时和参与研究12周后完成评估。我们从2023年3月至2023年8月招募了100名参与者，其中93人参加了随访。34名参与者（随机选择）完成了定性访谈。访谈和调查数据显示，现金转移主要用于满足基本需求。我们确定了现金转移可能改善健康的潜在途径，包括暂时减轻压力和焦虑，改变饮食和体育活动，改善药物依从性，增加寻求医疗保健的行为。干预本身被认为是高度可接受的。对照组的参与者对没有接受干预感到失望，但觉得这个过程是公平的，因为所有参与者在经济上都很脆弱。这些发现表明，无条件现金转移可能会通过多种途径改善慢性病患者的健康状况，这些途径应该在未来的试验中加以衡量。

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引用次数: 0

“It should have been my decision”: A mixed methods investigation of contraceptive coercion among U.S. patients with and without disabilities “这应该是我的决定”：一项对美国残疾和非残疾患者强制避孕的混合方法调查。

IF 5 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Social Science & Medicine

Pub Date : 2026-04-01 Epub Date: 2026-02-03 DOI: 10.1016/j.socscimed.2026.119058

Lindsay M. Cannon , Tiffany L. Green , Meaghan E. Bethea , Laura E.T. Swan

Background

People with disabilities have long faced threats to their bodily autonomy and reproductive decision-making. One such threat, provider-based contraceptive coercion, occurs when healthcare providers pressure patients to use (upward coercion) or not use (downward coercion) birth control. Yet, modern experiences of contraceptive coercion among people with disabilities remain underexplored.

Methods

In 2023, we surveyed U.S. reproductive-aged people assigned female at birth using Prolific, a national panel of vetted respondents. Participants reported their disability status and contraceptive care experiences. We examined differences in contraceptive coercion by disability status and tested whether self-reported discrimination in contraceptive care mediated this relationship. We also used reflexive thematic analysis to explore contraceptive coercion among people with disabilities.

Results

In our analytic sample (N = 1150), people with disabilities were significantly more likely than those without to report ever experiencing any contraceptive coercion (49.4% vs. 38.9%), including upward coercion (40.1% vs. 31.1%) and downward coercion (23.3% vs. 13.2%). These disparities persisted after adjusting for sociodemographic controls. Self-reported discrimination in contraceptive care mediated the relationship between disability status and contraceptive coercion. Open-ended analysis revealed the complex ways that contraceptive coercion is intertwined with disability status, often involving discriminatory, dismissive, and contradictory contraceptive counseling.

Conclusions

Contraceptive coercion is more common among individuals with disabilities and is explained by self-reported discriminatory care. Understanding these experiences is key to resisting coercive practices and advancing disability-informed reproductive justice.

背景：长期以来，残疾人的身体自主权和生育决策一直面临威胁。其中一种威胁是基于提供者的避孕强制，当医疗保健提供者迫使患者使用（向上强迫）或不使用（向下强迫）节育措施时，就会发生这种威胁。然而，残疾人强制避孕的现代经验仍未得到充分探索。方法：2023年，我们对美国生育年龄的人进行了调查，他们在出生时被指定为女性，这是一个由经过审查的全国性调查小组。参与者报告了他们的残疾状况和避孕护理经历。我们研究了残疾状况对避孕强制的差异，并测试了自我报告的避孕护理歧视是否介导了这种关系。我们还使用反身性专题分析来探讨残疾人的避孕强制措施。结果：在我们的分析样本（N = 1150）中，残疾人比非残疾人更有可能报告曾经经历过任何避孕强迫（49.4%比38.9%），包括向上强迫（40.1%比31.1%）和向下强迫（23.3%比13.2%）。在调整了社会人口控制因素后，这些差异仍然存在。自我报告的避孕护理歧视在残疾状况与避孕强制之间的关系中起中介作用。开放式分析揭示了强制避孕与残疾状况交织在一起的复杂方式，往往涉及歧视性、不屑一顾和相互矛盾的避孕咨询。结论：强迫避孕在残疾人中更为常见，这可以用自我报告的歧视性护理来解释。了解这些经验是抵制强制性做法和推进残障知情生殖司法的关键。

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引用次数: 0

Early versus late entry into parenthood and mental health outcomes in Norway: A Bayesian longitudinal analysis of life satisfaction and depressive tendencies by gender and SES 挪威早期与晚期为人父母与心理健康结果：性别和社会经济地位对生活满意度和抑郁倾向的贝叶斯纵向分析

IF 5 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Social Science & Medicine

Pub Date : 2026-04-01 Epub Date: 2026-01-12 DOI: 10.1016/j.socscimed.2026.118949

Magnus Jørgensen , Bente Wold , Andreas Stenling

Background

Parenthood represents a major life transition with significant implications for mental health, particularly among females and individuals with lower socioeconomic status (SES). As fertility rates continue to decline across countries such as Norway, it has become increasingly important to understand the factors that promote positive parenthood experiences.

Aims

This study examines how parenthood affects mental health and whether these effects vary by timing of parenthood, gender, parental SES, and own SES, while accounting for selection into parenthood.

Methods

Data were drawn from the Norwegian Longitudinal Health Behavior Study (NLHBS), focusing on the 2000, 2007, and 2017 waves. Life satisfaction and depressive tendencies were assessed at ages 30 and 40. Bayesian multigroup structural equation models by gender were estimated to investigate associations between parenthood timing (age 23–30 and age 30–40), own and parental SES, and mental health.

Results

Early parenthood (age 23–30) was associated with higher life satisfaction at age 40 for both genders. Early parenthood was linked to lower depressive tendencies in midlife compared to later parenthood among females, but not among males. Selection effects were evident: higher life satisfaction at age 23 predicted early parenthood for both genders, and females’ own education at age 30 predicted later parenthood.

Conclusion

Parenthood was associated with greater life satisfaction in midlife. Between-gender and SES differences were not credible. Overall, the findings link parenthood to improved adult mental health in a Nordic context and emphasize the importance of preventive and health promotion efforts in addressing health-related selection into parenthood.

为人父母是一个重大的人生转变，对心理健康有着重要的影响，尤其是对女性和社会经济地位较低的个体而言。随着挪威等国家的生育率持续下降，了解促进积极生育经历的因素变得越来越重要。目的：本研究考察了为人父母对心理健康的影响，以及这些影响是否随着为人父母的时间、性别、父母的社会经济地位和自己的社会经济地位而变化，同时考虑了为人父母的选择。方法数据来自挪威纵向健康行为研究（NLHBS），重点关注2000年，2007年和2017年的浪潮。在30岁和40岁时对生活满意度和抑郁倾向进行评估。估计贝叶斯多组结构方程模型按性别调查生育时间（23-30岁和30-40岁），自己和父母的社会经济地位和心理健康之间的关系。结果早为人父母（23-30岁）与40岁时较高的生活满意度相关。与晚育的女性相比，早做父母的女性在中年时抑郁倾向较低，但在男性中则不然。选择效应很明显：23岁时较高的生活满意度预示着男性和女性更早为人父母，而女性在30岁时的受教育程度预示着更晚为人父母。结论为人父母与中年生活满意度相关。性别和社会经济地位的差异是不可信的。总的来说，研究结果将在北欧背景下为人父母与改善成人心理健康联系起来，并强调了预防和健康促进工作在解决与健康有关的选择为人父母方面的重要性。

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引用次数: 0

Social connection among the unhoused in Northern Arizona 北亚利桑那无家可归者之间的社会联系

IF 5 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Social Science & Medicine

Pub Date : 2026-04-01 Epub Date: 2026-02-07 DOI: 10.1016/j.socscimed.2026.119064

Sarah M. Asantewaa , Rea Antoniou , Michelle A. Parsons

Homelessness is a major public health issue in the US. Research shows that unhoused people face numerous challenges including social isolation and loneliness while simultaneously desiring and establishing social connections. We draw on research conducted from 2017 through 2019 at an emergency shelter in Northern Arizona. Methods included participant observation and 14 semi-structured interviews with shelter guests. Interviews explored childhood, social connections, work, and experiences of institutional and interpersonal care. Themes identified include adversity in early relationships, positive relationships, and the complex relationships between unhoused individuals and social service providers. Reciprocal social relations offered these unhoused individuals a sense of worth and recognition. At the same time, some relationships, including those with social service providers, may compromise personal autonomy. Social services can be improved by promoting reciprocal relationships and opportunities for unhoused individuals to be care-givers as well as care-receivers. This study contributes to social theory on reciprocity, autonomy, and loneliness.

在美国，无家可归是一个主要的公共卫生问题。研究表明，无家可归的人在渴望和建立社会联系的同时，面临着许多挑战，包括社会孤立和孤独。我们借鉴了2017年至2019年在亚利桑那州北部的一个紧急避难所 进行的研究。方法包括参与观察和14次半结构化访谈。访谈探讨了童年、社会关系、工作以及机构和人际关怀的经历。确定的主题包括早期关系中的逆境、积极关系以及无家可归者与社会服务提供者之间的复杂关系。互惠的社会关系为这些无家可归的人提供了一种价值感和认同感。与此同时，一些关系，包括与社会服务提供者的关系，可能会损害个人自主权。可以通过促进互惠关系和为无家可归者提供照顾者和接受照顾者的机会来改善社会服务。本研究对互惠、自主和孤独的社会理论有一定的贡献。

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引用次数: 0