Social Science & Medicine最新文献

{"title":"Exploring heuristics and assessing their impact in discrete choice experiments: a proof-of-principle","authors":"Stella M. Marceta ,&nbsp;Nicholas V.R. Smeele ,&nbsp;Joffre D. Swait ,&nbsp;Jorien Veldwijk","doi":"10.1016/j.socscimed.2026.119044","DOIUrl":"10.1016/j.socscimed.2026.119044","url":null,"abstract":"<div><h3>Objectives</h3><div>Using Discrete Choice Experiments (DCEs), healthcare researchers can model population, patient, staff or provider preferences and choices. DCEs are rooted in Random Utility Theory (RUT), assuming that respondents are fully rational and process all provided information when choosing the alternative that maximizes their attribute-based utility. However, these behavioral premises do not always reflect observed behavior in choice experiments. The often complex, uncertain, and emotion-laden choice scenarios in health contexts can prompt heuristic-based simplifications, violating RUT assumptions. Although heuristics are recognized as behavioral violations relative to the normative RUT-based perspective, their impact is rarely modeled and limited guidance exists on how to do so.</div></div><div><h3>Methods</h3><div>Using three existing DCE studies, we demonstrate how researchers can identify and assess the impact of common RUT-violating heuristics in applied DCE studies. A structured interview guide and rating instrument were developed to identify heuristics a priori, based on clinician and researcher input. Latent-Class Models with restricted parameters were pre-specified to estimate heuristic impacts vis-à-vis preference heterogeneity.</div></div><div><h3>Results</h3><div>Our sensitivity analyses showed that up to 22% of the respondents likely applied particular heuristics. This impacted study results: For example, accounting for dominant decision-making (i.e., a class in which respondents ignored any attributes other than the risk of side effects), increased respondents’ average willingness-to-pay for antibiotics with a low contribution to antibiotic resistance by 15,63 Euros per treatment.</div></div><div><h3>Conclusions</h3><div>Ignoring heuristics that violate RUT assumptions biases preference estimates, marginal rates of substitution and uptake predictions in DCEs. We recommend assessing the likely presence and impact of heuristics in sensitivity analyses of future DCEs to ensure robustness and accuracy of results.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"394 ","pages":"Article 119044"},"PeriodicalIF":5.0,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158417","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":"Mass incarceration and its spillover effects: a scoping review of incarceration rates and health","authors":"Louisa W. Holaday ,&nbsp;Karenna K. Thomas ,&nbsp;Jaelen I. King ,&nbsp;Alyssa A. Grimshaw ,&nbsp;Jessica T. Simes ,&nbsp;Emily A. Wang","doi":"10.1016/j.socscimed.2026.118964","DOIUrl":"10.1016/j.socscimed.2026.118964","url":null,"abstract":"<div><h3>Objective</h3><div>Evidence suggests that mass incarceration has had negative population health effects not only through those directly impacted, but through “spillover” onto families and more broadly. We scope the literature to synthesize findings across disciplines and health outcomes.</div></div><div><h3>Methods</h3><div>We searched 10 medical databases for quantitative studies published from January 01, 1990 to 04/24/2024 examining the association between incarceration rates and outcomes of physical health, mental health, or social determinants of health. We grouped findings by health outcome and differentiated by geographic level, demographic subgroups, and type of carceral exposure (jail versus prison).</div></div><div><h3>Results</h3><div>We identified 70 studies at geographic levels ranging from census block to country. Sixty found a positive independent association between incarceration rates and poor health outcomes. Evidence was strongest for premature mortality, sexually transmitted infections (STIs), and adverse birth outcomes. Few studies investigated chronic conditions or mechanisms underlying the association between incarceration rates and health. Effect sizes were largest at the neighborhood level. Almost two-thirds of studies were high quality, and quality was primarily limited by data availability.</div></div><div><h3>Conclusions</h3><div>There is substantial evidence that as incarceration rates increase, population health worsens. Strong evidence of spillover to never-incarcerated individuals is demonstrated by significant associations in multilevel models accounting for personal and household incarceration, negative outcomes in babies and children too young to be incarcerated, and stronger effects observed among women, who are far less likely to be incarcerated than men. Reducing incarceration rates may reduce STIs even among those never incarcerated. Further research is needed into chronic conditions and the mechanisms underlying identified associations, which would be facilitated by improved data access.</div></div><div><h3>Policy implications</h3><div>Federal, state, and county actors should make neighborhood-level incarceration and crime data available, carceral facilities should institute opt-out STI testing, and cities should make STI testing easily available in high incarceration neighborhoods.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"394 ","pages":"Article 118964"},"PeriodicalIF":5.0,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158660","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":"Does aggressive policing worsen infant health disparities? Evidence from ‘Stop and Frisk’ in New York City","authors":"Nicole S. Ngo ,&nbsp;James Rising","doi":"10.1016/j.socscimed.2026.118943","DOIUrl":"10.1016/j.socscimed.2026.118943","url":null,"abstract":"<div><div>Racism in the U.S. is considered a major public health threat, yet the impact of racial profiling and aggressive policing on health disparities has received less attention in the public policy literature. The Stop, Question, and Frisk program (SQF) in New York City was ruled unconstitutional in 2013 due to racial biases in policing, specifically toward Black and Hispanic communities. While the original intent was to enhance public safety, there are concerns SQF did the opposite by generating distrust and anxiety in communities where it was viewed as racial profiling. Consequently, we investigate the impacts of police stops on a key indicator of public safety and social welfare: infant health. We use restricted infant health data from September 2006 to the end of 2013 and merge this information with detailed data on a mother's community exposure to police stops at the zip code-birth month-year level in New York City. Results show an increase in community exposure to police stops of 10% is associated with a modest, but robust reduction in birth weight of 1.9 g for non-Hispanic Black mothers. We also find small, negative effects on Apgar 5 scores for all mothers. These results are robust to several checks for selection and omitted variable bias, as well as to alternative specifications and falsification tests. Our findings have important implications for both public safety and reducing the gap in racial health disparities, suggesting that even mothers who do not have direct interactions with police could still be modestly impacted by SQF.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"395 ","pages":"Article 118943"},"PeriodicalIF":5.0,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146193274","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 neuro-fiction of addiction immunizations","authors":"Kristin Kay Barker ,&nbsp;Erin F. Madden ,&nbsp;Preston Lawayne Lowe ,&nbsp;Katherine Rickers","doi":"10.1016/j.socscimed.2026.119059","DOIUrl":"10.1016/j.socscimed.2026.119059","url":null,"abstract":"<div><div>Animal studies demonstrating “proof of concept” for addiction immunizations were first published in the 1970s. As originally theorized, immunization could block the brain's absorption of a drug, eliminate its pleasurable effects, and reduce or extinguish future drug-seeking behavior. Since the publication of this foundational animal research, addiction vaccines for humans have been heralded as potential “game changers” in the treatment of substance use disorders (SUD). Labeled as “novel” and “promising” for fifty years, addiction immunizations are still an imaginary. Drawing on the sociology of expectations framework, we analyze the ongoing failure, novelty and promise of immunizations for SUD. Through an <em>interpretive systematic review</em> of the international peer-reviewed medical literature related to addiction immunization from the 1970s forward, we reveal how this body of R&amp;D is simultaneously riddled with failure, on the verge of game-changing breakthroughs, and guardian of the brain disease model of addiction. We investigate how, why and with what consequences addiction vaccines have remained novel and promising in the context of ongoing failure. Our analysis foregrounds three interrelated promissory dynamics that have animated the hunt for addiction immunizations and the neuro-pharmaceuticalization of addiction for fifty years. We argue that the past, present and future support of the idea of addiction vaccines is in service of the dominant but unsettled understanding of addiction as a brain disease. Addiction immunizations are a <em>neuro-fiction</em>: an imaginary neuro-technological solution to a pressing problem. Although imaginary, they espouse an actuality about addiction with significant real-world implications.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"394 ","pages":"Article 119059"},"PeriodicalIF":5.0,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146167508","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":"Rare diseases, global health, and local contexts","authors":"Małgorzata Rajtar ,&nbsp;Eva-Maria Knoll","doi":"10.1016/j.socscimed.2026.119042","DOIUrl":"10.1016/j.socscimed.2026.119042","url":null,"abstract":"","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"395 ","pages":"Article 119042"},"PeriodicalIF":5.0,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146193053","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 should have been my decision”: A mixed methods investigation of contraceptive coercion among U.S. patients with and without disabilities","authors":"Lindsay M. Cannon ,&nbsp;Tiffany L. Green ,&nbsp;Meaghan E. Bethea ,&nbsp;Laura E.T. Swan","doi":"10.1016/j.socscimed.2026.119058","DOIUrl":"10.1016/j.socscimed.2026.119058","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"394 ","pages":"Article 119058"},"PeriodicalIF":5.0,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158959","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":"Perceived ideological polarization, trust in science and healthcare, and COVID-19 vaccination intention: A four-wave cross-lagged mediation panel analysis","authors":"Andrej Kirbiš,&nbsp;Stefani Branilović","doi":"10.1016/j.socscimed.2026.119057","DOIUrl":"10.1016/j.socscimed.2026.119057","url":null,"abstract":"<div><div>Ideological polarization is often theorized to erode trust in science and healthcare, thereby reducing compliance with health guidelines and vaccine uptake. In this study, we examined the longitudinal relationships between perceived ideological polarization, trust in science and healthcare, and COVID-19 vaccination intention, using a four-wave panel design. We analysed four waves of panel data from a sample of 488 Slovenians, representative by gender, age, and education. Pearson correlations and a random intercept cross-lagged panel model (RI-CLPM) were used to assess both within- and between-person associations, and to test whether trust in science and healthcare mediated the relationship between perceived ideological polarization and vaccination intention over time. Baseline correlations showed a positive association between perceived ideological polarization, trust, and vaccination intention, though these associations weakened and became non-significant in later waves. RI-CLPM results revealed no evidence of causal, within-person effects of perceived ideological polarization on later trust or vaccination intention, and no longitudinal mediation pathways. However, between-person effects indicated that individuals with consistently higher trust in science and healthcare reported higher vaccination intentions across time. These findings challenge the assumption that ideological polarization undermines trust and vaccination intention, suggesting that cross-sectional associations observed in prior research may reflect stable between-person differences rather than dynamic causal processes. By distinguishing cross-sectional from longitudinal evidence, this study underscores institutional trust as the key predictor of vaccination intention and calls for comparative research across political and cultural contexts.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"394 ","pages":"Article 119057"},"PeriodicalIF":5.0,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158723","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":"Sauna culture improves physical and mental wellbeing in the UK through social connection and ritual","authors":"M. Newson ,&nbsp;R. McGrath ,&nbsp;I. Mosina ,&nbsp;G. Reason ,&nbsp;L. Peitz","doi":"10.1016/j.socscimed.2026.119061","DOIUrl":"10.1016/j.socscimed.2026.119061","url":null,"abstract":"<div><div>Sauna culture is experiencing rapid global growth, yet beyond physical health benefits, remains largely understudied within academic research. We investigate both its physical and mental health benefits in the UK using the Social Cure model in conjunction with a ritual lens to understand how feelings of connection grow via sauna. Across three studies (<em>N</em> = 1,907), we explored the role of social identities in shaping wellbeing outcomes among sauna users. Studies 1 and 3 employed longitudinal designs, revealing increases in emotional wellbeing over time, while Study 2 used a cross-sectional approach and showed that stronger sauna identities were associated with self-reported improvements in both physical and emotional wellbeing. Study 3 further demonstrated that perceiving sauna use as a ritual, alongside experiencing emotional synchrony during sauna sessions, was positively linked to stronger sauna identities. Together, these findings suggest that the social and ritual aspects of sauna use may contribute to its wellbeing effects, with potential implications for sauna operators in the UK and beyond.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"394 ","pages":"Article 119061"},"PeriodicalIF":5.0,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146182845","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 gendered landscape of informal caregiving: Cohort effects and socioeconomic inequalities in England","authors":"Maria Petrillo ,&nbsp;Ricardo Rodrigues ,&nbsp;Matt Bennett ,&nbsp;Gwilym Pryce","doi":"10.1016/j.socscimed.2026.119052","DOIUrl":"10.1016/j.socscimed.2026.119052","url":null,"abstract":"<div><div>We provide the first detailed cohort analysis of the gender care gap that examines the association between caregiving provision, individual-level poverty, meso-level deprivation, and individual circumstances. Using data from the UK Household Longitudinal Study, we use (i) multilevel mixed-effects logistic regression to provide a detailed age cohort analysis of the probability of providing informal care by sex; and (ii) Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (MAIHDA) to provide an intersectional examination of informal carers.</div><div>Our results reveal a clear age pattern in caregiving, peaking between ages 60–70 before declining, with earlier-born cohorts showing higher caregiving likelihood at the same ages than later-born cohorts. The gender care gap is most pronounced among middle-born cohorts (1969–1978, 1959–1968, and 1949–1958), particularly between ages 50 and 60. While overall caregiving prevalence is higher among individuals experiencing poverty and living in deprived areas, the gender care gap is larger among individuals above the poverty line and in non-deprived areas. Caregiving is primarily associated with the independent effects of cohort, gender, poverty, and meso-level deprivation, with limited evidence of multiplicative intersectional effects.</div><div>Policy attempts to address the gender care gap need to be mindful of these variations, not least because they potentially elucidate the potential sources of gender inequalities in care.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"393 ","pages":"Article 119052"},"PeriodicalIF":5.0,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146133438","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":"Spatially heterogeneous and neighborhood impacts of deep tubewells on childhood diarrhea in rural Bangladesh","authors":"Varun Goel ,&nbsp;Mark M. Janko ,&nbsp;Katerina EB. Beach ,&nbsp;Md Yunus ,&nbsp;Md Taslim Ali ,&nbsp;Md Al Fazal Khan ,&nbsp;Md Nurul Alam ,&nbsp;A.S.G. Faruque ,&nbsp;Paul L. Delamater ,&nbsp;Marc L. Serre ,&nbsp;Mark D. Sobsey ,&nbsp;Md Sirajul Islam ,&nbsp;Michael Emch","doi":"10.1016/j.socscimed.2026.119043","DOIUrl":"10.1016/j.socscimed.2026.119043","url":null,"abstract":"<div><div>Deep tubewells that procure groundwater from deep arsenic-free aquifers are crucial sources of safe drinking-water in rural Bangladesh. However, their health benefits may be heterogeneous and context dependent: inequitable distribution, long collection distances and continued use of unsafe alternatives may increase microbial contamination and diarrheal disease. We examined whether the association between household deep tubewell use and under-five diarrhea varies across space and how neighborhood context helps explain this variation. Prospective diarrhea surveillance was conducted across 19,203 households with under-five children in Matlab, Bangladesh from March 2018 to October 2019. We fitted hierarchical logistic regression models accounting for spatially varying relationships and neighborhood-level measures of deep tubewell use. In non-spatial models, household deep tubewell use is associated with lower childhood diarrhea (Odds Ratio (OR) 0.81, 95% Uncertainty Interval (UI) 0.68–0.96). Accounting for space suggests spatial confounding and that the effect of household deep tubewell use on diarrhea may change based on location. Additionally, there is evidence of neighborhood effects: households in areas where more than 60% of neighbors used deep tubewells had lower odds of childhood diarrhea than those in neighborhoods with lower deep tubewell use (OR 0.72, 95% UI 0.57–0.92), with strongest protection among households that used deep tubewells. Results suggest that despite positive effects, benefits of deep tubewells are unequally distributed, and increasing deep tubewell density can further reduce childhood diarrheal disease burden in rural Bangladesh. This study highlights the importance of incorporating geographic context in the design and evaluation of drinking-water and other population health interventions.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"393 ","pages":"Article 119043"},"PeriodicalIF":5.0,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146133464","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}