Social Science & Medicine最新文献_第3页

Closing the life expectancy gap: An ecological study of the factors associated with smaller regional health inequalities in post-reunification Germany 缩小预期寿命差距：对统一后德国地区健康不平等缩小相关因素的生态研究。

IF 4.9 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Social Science & Medicine

Pub Date : 2024-10-19 DOI: 10.1016/j.socscimed.2024.117436

Regional health inequalities are rising globally. The case of German reunification offers a unique opportunity to explore how such inequalities can be reduced, or even eliminated: following reunification, a long-standing life expectancy gap between East and West Germany was closed for women and markedly reduced for men in less than 15 years.

We used data from official national statistics covering the period 1994–2020 for 15 regions in East and West Germany. Using fixed-effects models with an interaction term for regions in the East, we investigated whether within-region changes in key hypothesised factors (social security expenditure, healthcare improvements, changes in alcohol consumption, and life satisfaction), have had differential impacts on life expectancy at birth and at 65 years.

Our results show that increases in social security benefits in the East following reunification has been the most important factor for lowering inequalities between the two parts of Germany: for every 10% increase in social security benefits, life expectancy at birth increased by an additional 1.05 [0.68; 1.41] months for males and by 0.57 [0.18; 0.97] months for females in East relative to West Germany. We find the protective effect of social security benefits also for women at 65 years (additional 0.38 [0.06; 0.70] months) but not for men.

Our findings suggest that increasing social security expenditure could be an effective policy tool for reducing health inequalities across regions with different levels of economic development. This provides additional support for the materialist hypothesis and the political economy theory of the root causes of health inequalities.

在全球范围内，地区间的健康不平等正在加剧。德国统一为我们提供了一个独特的机会来探索如何减少甚至消除这种不平等：德国统一后，在不到 15 年的时间里，东西德之间长期存在的女性预期寿命差距被缩小，男性预期寿命差距也明显缩小。我们使用了 1994-2020 年期间东西德 15 个地区的国家官方统计数据。我们使用带有东德地区交互项的固定效应模型，研究了地区内关键假设因素（社会保障支出、医疗保健改善、酒精消费变化和生活满意度）的变化是否对出生时和 65 岁时的预期寿命产生了不同影响。我们的研究结果表明，德国统一后，东部地区社会保障福利的增加是降低德国两部分之间不平等的最重要因素：社会保障福利每增加 10%，东德男性出生时预期寿命比西德增加 1.05 [0.68; 1.41]个月，女性出生时预期寿命增加 0.57 [0.18; 0.97]个月。我们发现社会保障福利对 65 岁的女性也有保护作用（额外增加 0.38 [0.06; 0.70] 个月），但对男性则没有。我们的研究结果表明，增加社会保障支出可能是减少不同经济发展水平地区间健康不平等的有效政策工具。这为关于健康不平等根源的唯物主义假设和政治经济学理论提供了更多支持。

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引用次数: 0

Healthcare providers’ psychological investment in clinical recommendations: Investigating the role of implicit racial attitudes 医疗服务提供者对临床建议的心理投资：调查内隐种族态度的作用。

IF 4.9 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Social Science & Medicine

Pub Date : 2024-10-19 DOI: 10.1016/j.socscimed.2024.117435

Racial disparities in clinical recommendations can result in racial disparities in health. While healthcare providers' implicit racial attitudes (affective component of bias) are theorized to be one major factor contributing to racial disparities in clinical recommendations, empirical evidence to support the link is lacking. This study aimed to bridge this gap by moving beyond the standard approach of operationalizing the quality of clinical recommendations as a guideline-consistent vs. -inconsistent dichotomy. The present secondary study examined the role of provider implicit racial attitudes in the quality of clinical recommendations, operationalized as behaviors reflecting providers’ psychological investment in patient care (i.e., number of words used to describe clinical recommendations, and number of treatment options recommended). Two-hundred-and-ten White medical trainees reviewed a clinical vignette of either a White or Black male patient and provided clinical recommendations. Their implicit racial attitudes were evaluated using the Implicit Association Test. Participants with more biased implicit racial attitudes (i.e., stronger implicit preference for White vs. Black individuals) used fewer words to describe their clinical recommendations and provided fewer clinical recommendations for the Black (vs. White) patient, while there were no significant differences between Black and White patients among participants with less biased implicit racial attitudes. These results illustrate the insidious impact of implicit racial attitudes in healthcare provision and underscore the need for researchers to consider the complex, nuanced ways in which provider implicit racial attitudes might manifest in clinical decision-making.

临床建议中的种族差异会导致健康方面的种族差异。虽然医疗服务提供者的内隐种族态度（偏见的情感成分）被认为是造成临床建议中种族差异的一个主要因素，但缺乏支持这种联系的实证证据。本研究旨在超越将临床建议的质量操作化为符合指南与不符合指南二分法的标准方法，从而弥合这一差距。本二次研究考察了医疗服务提供者的内隐种族态度在临床建议质量中的作用，并将其操作化为反映医疗服务提供者对患者护理的心理投入的行为（即用于描述临床建议的词汇数量和建议的治疗方案数量）。两百一十名白人医学实习生回顾了一名白人或黑人男性患者的临床小故事，并提供了临床建议。他们的内隐种族态度通过内隐关联测试进行评估。内隐种族态度偏向性较强的学员（即对白人与黑人的内隐偏好较强）在描述临床建议时使用的词汇较少，为黑人（与白人）患者提供的临床建议也较少，而内隐种族态度偏向性较小的学员在黑人与白人患者之间没有显著差异。这些结果说明了隐性种族态度在医疗保健服务中的潜移默化的影响，并强调研究人员有必要考虑医疗服务提供者的隐性种族态度在临床决策中可能表现出的复杂、微妙的方式。

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引用次数: 0

Sex-specific co-developmental trajectories of childhood victimization among elementary school students: Relations to social behavior 小学生童年受害的性别共同发展轨迹：与社会行为的关系

IF 4.9 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Social Science & Medicine

Pub Date : 2024-10-19 DOI: 10.1016/j.socscimed.2024.117432

This study aimed to identify sex-specific co-developmental trajectories of multiple forms of childhood victimization: family maltreatment (FM), psychological maltreatment by teachers (PMT), and peer victimization (PV), and their relations to prosocial and delinquent behaviors among elementary school students. A total of 4378 Chinese elementary school students (Mage = 9.93; SD = 0.92; 55.14% boys) participated in assessments on five occasions, using six-month intervals. Parallel process latent class growth model analyses revealed three trajectories for boys: Congruent-low (75.64%), High-PV, Moderate-FM and PMT (14.62%), and Moderate-PV, High-FM and PMT (9.74%). Similarly, girls exhibited three trajectories: Congruent-low (81.11%), Moderate-PMT, High-FM and PV (10.54%), and High-PMT, Moderate-FM and PV (8.35%). The results indicated that boys were more susceptible than girls to three forms of childhood victimization. Furthermore, boys were especially vulnerable to co-occurring FM and PMT. In contrast, girls were more vulnerable to co-occurring FM and PV. Additionally, after experiencing childhood victimization, girls showed a greater hindrance in prosocial behavior development, whereas boys exhibited a more significant increase in delinquent behavior. These findings underscore the importance of considering sex differences in understanding multiple forms of childhood victimization and provide important insights for prevention and intervention efforts.

本研究旨在识别小学生在遭受家庭虐待、教师心理虐待和同伴伤害等多种形式的童年伤害时的性别特异性共同发展轨迹，以及它们与亲社会行为和犯罪行为的关系。共有4378名中国小学生（年龄=9.93；标准差=0.92；男生占55.14%）参加了5次评估，每次评估间隔6个月。平行过程潜类成长模型分析显示了男生的三种成长轨迹：低同质性（75.64%），高 PV、中等 FM 和 PMT（14.62%），以及中等 PV、高 FM 和 PMT（9.74%）。同样，女生表现出三种轨迹：一致性低（81.11%），中等-PMT、高-FM 和 PV（10.54%），以及高-PMT、中等-FM 和 PV（8.35%）。结果表明，男孩比女孩更容易受到三种形式的童年伤害。此外，男孩尤其容易同时受到 FM 和 PMT 的伤害。与此相反，女孩更容易同时出现 FM 和 PV。此外，在经历了童年受害后，女孩的亲社会行为发展会受到更大的阻碍，而男孩的犯罪行为则会有更显著的增加。这些发现强调了在理解多种形式的童年受害行为时考虑性别差异的重要性，并为预防和干预工作提供了重要启示。

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引用次数: 0

The double disadvantage faced by adolescents from low socioeconomic backgrounds with mental health problems affects earnings up to mid-life 来自低社会经济背景、有心理健康问题的青少年所面临的双重劣势影响了他们直到中年的收入。

IF 4.9 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Social Science & Medicine

Pub Date : 2024-10-18 DOI: 10.1016/j.socscimed.2024.117385

Early childhood socioeconomic disadvantage and mental health problems are both important determinants of adult social and economic experiences, but little is known about how they interact in this respect. We aimed to assess whether poor mental health in adolescence exacerbates labour market inequalities originating from low socioeconomic status (SES) in childhood. We use a birth cohort of individuals born in 1958 in England and follow their employment experiences and cumulative earnings up to age 55. We proxy low SES in childhood with father's occupational class at the time the respondent was aged 11, and use caregiver (usually, parent) ratings of the Rutter inventory at age 16 to identify mental health problems in adolescence. We fit ordinary least squares (OLS) models to estimate the effect of growing up in a low-SES family and experiencing mental health problems (conduct or emotional problems) in adolescence on cumulative earnings (log-transformed). We use an interaction term to test whether the association between mental health problems (conduct and emotional separately) and earnings differed by socioeconomic group. Individuals who experienced conduct problems in adolescence had lower cumulative earnings and employment levels up to age of 55. Moreover, the association between mental health problems and cumulative earnings was higher among individuals who also experienced low SES in childhood. Families from a higher socioeconomic group may have more effective means to counteract the adverse impacts of adolescent mental health problems, likely due to broader access to resources, support systems and opportunities. This underscores the role of structural supports in addressing socioeconomic inequalities in mental health outcomes and their long-terms implications.

幼年时期的社会经济劣势和心理健康问题都是成年后社会和经济经历的重要决定因素，但人们对它们在这方面如何相互作用却知之甚少。我们的目的是评估青少年时期不良的心理健康状况是否会加剧源于童年时期社会经济地位低下（SES）的劳动力市场不平等。我们以 1958 年出生于英格兰的人为出生组群，跟踪调查他们的就业经历和累积收入，直至 55 岁。我们用受访者 11 岁时父亲的职业等级来替代童年时期的低社会经济地位，并使用 16 岁时照顾者（通常是父母）对拉特量表的评分来识别青少年时期的心理健康问题。我们利用普通最小二乘法（OLS）模型来估算在低社会经济地位家庭中成长以及青少年时期出现心理健康问题（行为或情绪问题）对累积收入（对数转换）的影响。我们使用交互项来检验心理健康问题（分别为行为问题和情绪问题）与收入之间的关系是否因社会经济群体而异。在青少年时期出现行为问题的人，直到 55 岁时的累计收入和就业水平都较低。此外，在童年社会经济地位较低的人群中，心理健康问题与累计收入之间的关联度更高。社会经济地位较高的家庭可能有更有效的方法来抵消青少年心理健康问题的不利影响，这可能是由于他们可以获得更广泛的资源、支持系统和机会。这强调了结构性支持在解决心理健康结果的社会经济不平等及其长期影响方面的作用。

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引用次数: 0

Trajectories of physiological stress markers over time among Latinx immigrants in the United States: Influences of acculturative stressors and psychosocial resilience 美国拉美裔移民的生理压力指标随时间变化的轨迹：文化适应压力因素和社会心理复原力的影响。

IF 4.9 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Social Science & Medicine

Pub Date : 2024-10-18 DOI: 10.1016/j.socscimed.2024.117429

Aims

Latinx immigrants are exposed to acculturative stressors as they adapt to the U.S. However, little is known about the impact of acculturative stressors and psychosocial resilience on physiological responses and health over time. The purpose of this study was to examine trajectories of physiological stress markers among Latinx adults over time and examine the influence of acculturative stressors and psychosocial resilience factors on these different trajectories.

Methods

A community-based, longitudinal study was conducted with adult Latinx immigrants in North Carolina (N = 391) over a two-year period. Self-reported measures of ten different types of acculturative stressors (e.g., occupational, family, healthcare, discrimination) and psychosocial resilience factors (individual resilience, coping, ethnic pride, familism, and social support) along with urine samples were taken at baseline and 12- and 24-month follow-up periods. Biomarkers of physiological stress (inflammatory cytokines interleukin-6 (IL-6), IL-8 and IL-18 and C-Reactive Protein (CRP)) were measured in urine. Multivariate latent class growth analysis, linear mixed models, and unadjusted bivariate analyses were conducted to address the study aims.

Results

Participants were an average of 39 years of age (SD = 6.94) and mostly women (68.8%) and Spanish speakers (83%). Three latent classes of physiological stress marker trajectories were identified: resilient, rapidly increasing stress, and chronic elevated stress. These latent classes had significant differences in gender, race, coping styles, ethnic pride, and parental acculturative stressors.

Conclusions

The findings from this study identify specific types of acculturative stressors and psychosocial resilience factors that are important targets for health promotion and disease prevention programs for Latinx immigrants.

目的：拉美裔移民在适应美国生活的过程中会面临文化适应压力。然而，随着时间的推移，人们对文化适应压力和社会心理复原力对生理反应和健康的影响知之甚少。本研究的目的是考察拉美裔成年人生理压力指标随时间变化的轨迹，并研究文化适应压力因素和社会心理复原力因素对这些不同轨迹的影响：我们对北卡罗来纳州的拉丁裔成年移民（391 人）进行了一项为期两年的社区纵向研究。在基线、12 个月和 24 个月的随访期间，对 10 种不同类型的文化适应压力源（如职业、家庭、医疗保健、歧视）和社会心理复原因素（个人复原力、应对能力、民族自豪感、家庭主义和社会支持）进行了自我报告测量，并采集了尿液样本。对尿液中的生理压力生物标志物（炎症细胞因子白细胞介素-6（IL-6）、IL-8、IL-18 和 C 反应蛋白（CRP））进行了测量。为达到研究目的，进行了多变量潜类增长分析、线性混合模型和未调整的双变量分析：参与者平均年龄 39 岁（SD = 6.94），大部分为女性（68.8%），讲西班牙语（83%）。研究发现了生理压力标记轨迹的三个潜在类别：复原力、快速增加的压力和慢性升高的压力。这些潜在类别在性别、种族、应对方式、民族自豪感和父母文化适应压力因素方面存在显著差异：本研究的结果确定了特定类型的文化适应压力因素和社会心理复原因素，这些因素是针对拉丁裔移民的健康促进和疾病预防计划的重要目标。

{"title":"Trajectories of physiological stress markers over time among Latinx immigrants in the United States: Influences of acculturative stressors and psychosocial resilience","authors":"","doi":"10.1016/j.socscimed.2024.117429","DOIUrl":"10.1016/j.socscimed.2024.117429","url":null,"abstract":"<div><h3>Aims</h3><div>Latinx immigrants are exposed to acculturative stressors as they adapt to the U.S. However, little is known about the impact of acculturative stressors and psychosocial resilience on physiological responses and health over time. The purpose of this study was to examine trajectories of physiological stress markers among Latinx adults over time and examine the influence of acculturative stressors and psychosocial resilience factors on these different trajectories.</div></div><div><h3>Methods</h3><div>A community-based, longitudinal study was conducted with adult Latinx immigrants in North Carolina (N = 391) over a two-year period. Self-reported measures of ten different types of acculturative stressors (e.g., occupational, family, healthcare, discrimination) and psychosocial resilience factors (individual resilience, coping, ethnic pride, familism, and social support) along with urine samples were taken at baseline and 12- and 24-month follow-up periods. Biomarkers of physiological stress (inflammatory cytokines interleukin-6 (IL-6), IL-8 and IL-18 and C-Reactive Protein (CRP)) were measured in urine. Multivariate latent class growth analysis, linear mixed models, and unadjusted bivariate analyses were conducted to address the study aims.</div></div><div><h3>Results</h3><div>Participants were an average of 39 years of age (<em>SD</em> = 6.94) and mostly women (68.8%) and Spanish speakers (83%). Three latent classes of physiological stress marker trajectories were identified: resilient, rapidly increasing stress, and chronic elevated stress. These latent classes had significant differences in gender, race, coping styles, ethnic pride, and parental acculturative stressors.</div></div><div><h3>Conclusions</h3><div>The findings from this study identify specific types of acculturative stressors and psychosocial resilience factors that are important targets for health promotion and disease prevention programs for Latinx immigrants.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478706","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}

引用次数: 0

One health and social research in disease ecology: A social contextual study of vector-borne diseases in the Yucatan Peninsula, Mexico 疾病生态学中的一项健康和社会研究：墨西哥尤卡坦半岛病媒传播疾病的社会背景研究。

IF 4.9 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Social Science & Medicine

Pub Date : 2024-10-17 DOI: 10.1016/j.socscimed.2024.117415

Although disease ecology recognizes the multiplicity of factors involved in the (re)emergence of vector-borne diseases (VBD), it is necessary to strengthen attention to the social context and the social determinants of health. It is essential to integrate a sociocultural approach to health into the biological analysis of VBD ecology. To implement a coherent One Health approach in the prevention and control of VBD, it is pivotal to first understand the social and ecological interactions of the local context. Between October 2021 and June 2022, a social contextual study was made through surveys, semi-structured interviews and participatory activities in 12 localities with diverse ecological, economic and socio-cultural contexts in the Yucatan Peninsula. Through the perceptions of the populations on health and VBD, specifically mosquitoes, we gained knowledge on socio-cultural dynamics that influence people's relationship with pathogens. Local knowledge, management, and control of vectors; interactions with domestic and wild animals; and health-landscape relationship, were identified as factors that determine health-disease processes. This study contributed to a better understanding of local contexts and therefore, to the design of socially pertinent strategies for the reduction of vector-borne diseases risk scenarios in the study sites with an integrated approach.

尽管疾病生态学认识到病媒传播疾病（VBD）的（再）出现涉及多种因素，但仍有必要加强对社会背景和健康的社会决定因素的关注。必须将健康的社会文化方法纳入病媒生物生态学的生物学分析。要在预防和控制膀胱阴道疾病方面实施协调一致的 "一个健康 "方法，关键是要首先了解当地的社会和生态互动情况。2021 年 10 月至 2022 年 6 月期间，在尤卡坦半岛具有不同生态、经济和社会文化背景的 12 个地方，通过调查、半结构式访谈和参与式活动，开展了一项社会背景研究。通过人们对健康和虫媒传染病（尤其是蚊子）的看法，我们了解了影响人们与病原体关系的社会文化动态。当地对病媒的了解、管理和控制；与家畜和野生动物的互动；以及健康与景观的关系，都被认为是决定健康-疾病过程的因素。这项研究有助于更好地了解当地情况，从而设计出与社会相关的战略，以综合方法降低研究地点的病媒传播疾病风险。

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引用次数: 0

Childhood mental health and educational attainment: Within-family associations in a late 20th Century U.S. birth cohort 儿童心理健康与教育成就：20 世纪晚期美国出生队列中的家庭内部关联。

IF 4.9 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Social Science & Medicine

Pub Date : 2024-10-17 DOI: 10.1016/j.socscimed.2024.117417

Mental health problems during childhood are associated with lowered educational attainment in adulthood. However, it is not clear if these associations hold when controlling for unobserved features of the family environment and if they depend on the socioeconomic status (SES) of parents. We use the Panel Study of Income Dynamics (PSID) Child Development and Transition into Adulthood Supplements (CDS; TAS) to examine these questions. Using linear and logistic regression, we isolate within-family variability in mental health problems among full sibling pairs (n = 958 individuals in 479 pairs). Associations depend on the measure used. Parental reports of problem behaviors and diagnosed problems have the most consistent negative associations with educational attainment (for example, a hyperactivity diagnosis is associated with 0.74 fewer years of schooling). Retrospective self-reports of diagnoses other than depression or anxiety also have a negative association (0.96 fewer years of schooling). But self-reports of depressive symptoms and emotional or psychological well-being during late childhood and adolescence have no significant associations with educational attainment. In addition, there is no significant moderation of these associations by SES.

童年时期的心理健康问题与成年后教育程度的降低有关。然而，目前还不清楚在控制家庭环境中未观察到的特征时，这些关联是否成立，也不清楚这些关联是否取决于父母的社会经济地位（SES）。我们利用《收入动态面板研究》（PSID）的《儿童发展与成年过渡期补编》（CDS；TAS）来研究这些问题。通过线性回归和逻辑回归，我们分离了全兄弟姐妹对（479 对中的 958 人）中心理健康问题的家庭内部变异性。相关性取决于所使用的测量方法。父母报告的问题行为和诊断出的问题与受教育程度的负相关最为一致（例如，多动诊断与受教育年数减少 0.74 年相关）。除抑郁症或焦虑症外，其他诊断的回顾性自我报告也与受教育年限呈负相关（减少 0.96 年）。但是，儿童晚期和青少年时期自我报告的抑郁症状和情绪或心理健康状况与受教育程度没有显著关联。此外，这些关联与社会经济地位也没有明显的调节作用。

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引用次数: 0

Suicide variations between English neighbourhoods over 2017-21: The role of spatial scale 2017-21 年间英国居民区之间自杀率的变化：空间尺度的作用

IF 4.9 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Social Science & Medicine

Pub Date : 2024-10-16 DOI: 10.1016/j.socscimed.2024.117414

Geographic studies of suicide variation typically focus on predictors at the same level as the event rates, and the possible interplay between different spatial scales does not generally figure. In this paper we focus on suicide variations between 6856 small area census units in England, but against a background provided by nine regions, broad urban-rural categories, and 155 local labour markets. Suicide death totals vary considerably between the small areas, with more areas than expected having no deaths, so we apply zero inflated regression. With this framework, we consider the relative contribution of factors at higher and lower spatial scales in explaining small area suicide contrasts, and why some areas have unduly elevated or unduly low suicide rates. We find significantly lower suicide levels in English metropolitan regions, after allowing for neighbourhood influences, but considerable heterogeneity in risks within broader spatial units. Varying incidence in general is associated significantly with all observed neighbourhood risk factors (social fragmentation, socioeconomic status, mental ill-health, ethnic mix), but low fragmentation and low psychiatric morbidity are the only significant influences on unduly low incidence.

自杀变异的地理研究通常侧重于与事件发生率处于同一水平的预测因素，而不同空间尺度之间可能存在的相互作用通常并不突出。在本文中，我们重点研究了英格兰 6856 个小区域人口普查单位之间的自杀变化，但研究背景是九个地区、广泛的城乡类别和 155 个当地劳动力市场。小地区之间的自杀死亡总数差异很大，没有死亡的地区比预期的要多，因此我们采用了零膨胀回归法。在这一框架下，我们考虑了较高和较低空间尺度的因素在解释小地区自杀对比中的相对贡献，以及为什么有些地区的自杀率过高或过低。我们发现，在考虑邻里影响因素后，英国大都会地区的自杀率明显较低，但在更广泛的空间单位内，自杀风险却存在相当大的异质性。一般来说，不同的发病率与所有观察到的邻里风险因素（社会分化、社会经济地位、精神疾病、种族混合）都有显著关联，但低分化和低精神病发病率是对过低发病率的唯一显著影响因素。

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引用次数: 0

Association between husband's participation in household work and the onset of depressive symptoms in married women: A population-based longitudinal study in South Korea 丈夫参与家务劳动与已婚妇女抑郁症状发病之间的关系：韩国一项基于人口的纵向研究。

IF 4.9 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Social Science & Medicine

Pub Date : 2024-10-16 DOI: 10.1016/j.socscimed.2024.117416

An unequal distribution of household work by gender is prevalent. This study explored the association between husbands' participation in household work and the onset of depressive symptoms among married Korean women. A nationwide sample of 7024 married women was repeatedly followed up at 2-year intervals from 2014 to 2022 (20,343 observations). The daily household work hours of both the participants and their husbands were self-reported. Satisfaction with husbands' participation in household work was classified as satisfactory, neutral, or dissatisfactory. Depressive symptoms were assessed using the 10-item version of the Center for Epidemiologic Studies Depression. A generalized estimating equation was employed to determine how household work participation was associated with the onset of depressive symptoms in married women at the 2-year follow-up. The risk ratios (RRs) and 95% confidence intervals (CIs) were calculated. The mean daily hours spent on household work were 2.62 h for married women and 0.35 h for husbands. A 1-h increase in the husbands' daily time spent on household work was negatively associated with the risk of onset of depressive symptoms in married women (RR: 0.88, 95% CI: 0.80–0.98). Compared with individuals with neutral responses, those satisfied with their husband's household work had a lower risk of depressive symptom onset (RR: 0.82, 95% CI: 0.74–0.90), whereas dissatisfaction was linked to increased risk (RR: 1.15, 95% CI: 1.04–1.27). Husbands' participation in household work was associated with a reduced risk of depressive symptom onset among married women. Achieving gender equality in the division of household work is important for women's mental health.

家务劳动按性别分配不均的现象十分普遍。本研究探讨了丈夫参与家务劳动与韩国已婚妇女抑郁症状发病之间的关系。从 2014 年到 2022 年，每隔两年对全国范围内的 7024 名已婚妇女进行了反复跟踪调查（共 20343 个观测点）。参与者及其丈夫每天的家务劳动时间均为自我报告。对丈夫参与家务劳动的满意度分为满意、中性和不满意。抑郁症状采用流行病学研究中心抑郁测试的 10 个项目进行评估。在为期两年的随访中，我们采用了广义估计方程来确定家务劳动的参与与已婚妇女抑郁症状的发生之间的关系。研究计算了风险比 (RR) 和 95% 置信区间 (CI)。已婚妇女每天用于家务劳动的平均时间为 2.62 小时，丈夫为 0.35 小时。丈夫每天花在家务劳动上的时间每增加 1 小时，与已婚妇女出现抑郁症状的风险呈负相关（RR：0.88，95% CI：0.80-0.98）。与持中立态度的人相比，对丈夫家务劳动满意的人抑郁症状发病风险较低（RR：0.82，95% CI：0.74-0.90），而不满意的人发病风险较高（RR：1.15，95% CI：1.04-1.27）。丈夫参与家务劳动与已婚妇女抑郁症状发病风险降低有关。在家务分工方面实现性别平等对妇女的心理健康非常重要。

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引用次数: 0

From risk factors to disease situations: A socio-spatial analysis of COVID-19 experiences in Lima, Peru 从风险因素到疾病状况：对秘鲁利马 COVID-19 经验的社会空间分析。

IF 4.9 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Social Science & Medicine

Pub Date : 2024-10-16 DOI: 10.1016/j.socscimed.2024.117413

The goal of this qualitative research study, part of an interdisciplinary project, was to understand the overlapping geographical distribution of COVID-19 and tuberculosis burden in Lima. Using an ethnographic approach, we applied the concept of disease situations to explore how inhabitants’ social and spatial situatedness affected their capacity to respond to the pandemic. Our results show that for some populations in Lima, the risk to develop COVID-19 did not emerge suddenly; it could be traced back to situations of living under subsistence models, relying on unstable sources of income, facing food insecurity, depending on certain mechanisms of social protection, residing in precarious living environments and lacking access to quality health care. These populations did not only have less resources to adjust to changes in daily life induced by the pandemic; they were also forced to constantly weigh the risk of COVID-19 against other pressing needs and potentially face increased risks when control measures were actually followed. Pre-existing social networks played fundamental roles as sources of emotional and material support. The lens of disease situations can help to identify and explain spatial and social configurations that enhance vulnerability, as well as resilience mechanisms that are in place to deal with crises. This perspective could inform the design of contextualised prevention and response strategies around health risks in cities as diverse as Lima, whilst building on existing resources at local levels.

这项定性研究是跨学科项目的一部分，目的是了解 COVID-19 和结核病在利马的重叠地理分布。我们采用人种学方法，运用疾病状况的概念来探讨居民的社会和空间位置如何影响他们应对大流行病的能力。我们的研究结果表明，对于利马的一些居民来说，罹患 COVID-19 的风险并不是突然出现的；这种风险可以追溯到生活在温饱模式下、依赖不稳定的收入来源、面临粮食不安全、依赖某些社会保护机制、居住在不稳定的生活环境中以及无法获得高质量的医疗保健服务等情况。这些人群不仅没有足够的资源来适应大流行病引起的日常生活变化，而且还被迫不断权衡 COVID-19 的风险与其他迫切需求之间的关系，并可能在实际采取控制措施时面临更大的风险。原有的社会网络作为情感和物质支持的来源发挥了重要作用。从疾病情况的角度看问题，有助于识别和解释加剧脆弱性的空间和社会结构，以及应对危机的复原机制。在利马这样的多元化城市，这一视角可以为制定针对健康风险的因地制宜的预防和应对战略提供信息，同时利用地方层面的现有资源。

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