Social Science & Medicine最新文献_第4页

Effectiveness of 234 interventions to improve life satisfaction: A rapid systematic review 234项干预措施提高生活满意度的有效性：快速系统回顾。

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

Social Science & Medicine

Pub Date : 2025-02-01 DOI: 10.1016/j.socscimed.2024.117662

Katie Tiley , Richard Crellin , Tania Domun , Frances Harkness , Joanna M. Blodgett

This rapid review evaluates interventions aimed at improving life satisfaction and aids policymakers, researchers, and practitioners by identifying research strengths, gaps, and future directions for life satisfaction research. Intervention inclusion criteria were: use of a control group; delivered in high-income OECD country; randomised control trials or quasi-experimental studies; published between Jan 2011–Oct 2023; English language; uses a validated life satisfaction outcome measure. Of 9520 search results across five academic databases and grey literature sources, a total of 189 studies with 234 intervention arms met criteria for inclusion. The six themes (18 total subthemes) identified were: Emotion-based activities (intrapersonal and interpersonal, n = 154); Didactic emotional development (n = 30); Health promotion (n = 31); Social media (n = 4); Music (n = 3); and Multi-component interventions (n = 12). Meta-analyses were possible in six subthemes and examined overall standardised mean differences (SMD) in life satisfaction from pre-to post-intervention between the intervention and control group. The review primarily identified intrapersonal (related to self) emotional activities as generally associated with small improvements in life satisfaction: mindfulness (SMD: 0.28 (95% Confidence Interval: 0.13, 0.42)), gratitude (0.19 (0.11, 0.27)) and therapy (0.33 (0.12, 0.53)). Additionally, meta-analysis revealed a moderate effect of emotional skills development training (SMD 0.50 (0.12, 0.88)) and a small effect of exercise (SMD: 0.33 (0.04, 0.62)) on life satisfaction. Subthemes with mixed evidence (i.e., some interventions were effective while others were not) included: positivity and prosocial activities, emotional regulation and resilience training, health promotion education, ‘other’ intrapersonal emotion-based activities which could not otherwise be categorised, and multi-component interventions. The findings of this rapid review offer comprehensive insight into effective interventions for improving life satisfaction as well as areas for further research.

这篇快速回顾评估了旨在提高生活满意度的干预措施，并通过确定研究优势、差距和生活满意度研究的未来方向，帮助政策制定者、研究人员和实践者。干预纳入标准为：使用对照组；在经合组织高收入国家交付；随机对照试验或准实验研究；2011年1月至2023年10月出版；英语语言;使用有效的生活满意度结果测量。在5个学术数据库和灰色文献来源的9520个搜索结果中，共有189项研究和234个干预组符合纳入标准。确定的六个主题（共18个副主题）是：基于情绪的活动（内省和人际关系，n = 154）；说教式情感发展（n = 30）；促进健康（n = 31）；社交媒体（n = 4）；音乐（n = 3）；多成分干预（n = 12）。对六个子主题进行了荟萃分析，并检查了干预组和对照组之间干预前后生活满意度的总体标准化平均差异（SMD）。本综述主要确定了个人（与自我相关）情绪活动通常与生活满意度的小幅改善有关：正念（SMD: 0.28(95%可信区间：0.13,0.42)），感恩（0.19(0.11,0.27)）和治疗（0.33(0.12,0.53)）。此外，meta分析显示情绪技能发展训练对生活满意度的影响中等（SMD: 0.50(0.12, 0.88)），运动对生活满意度的影响较小（SMD: 0.33(0.04, 0.62)）。证据混杂的次主题（即一些干预措施有效而另一些则无效）包括：积极和亲社会活动、情绪调节和恢复力训练、健康促进教育、“其他”无法分类的基于个人情感的活动，以及多成分干预。这一快速回顾的发现为提高生活满意度的有效干预措施以及进一步研究的领域提供了全面的见解。

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引用次数: 0

Loneliness is positively associated with populist radical right support

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

Social Science & Medicine

Pub Date : 2025-02-01 DOI: 10.1016/j.socscimed.2025.117676

Delaney Peterson , Matthijs Rooduijn , Frederic R. Hopp , Gijs Schumacher , Bert N. Bakker

Objectives

The mental and physical health consequences of loneliness are well documented. However, loneliness's socio-political ramifications have been largely unexplored. We theorize that loneliness, due to its physiologically dysregulating impact on the nervous system, facilitates greater susceptibility towards populist radical right parties.

Methods

We tested our hypothesis in 25 unique tests in four population-based samples (N = 40852), spanning nine countries - the Netherlands (15 tests, 2008–2023), Germany (two samples; 2017, 2018), Austria, Croatia, Denmark, France, Hungary, Sweden, and Switzerland (all in 2017). Logistic regressions were run per year and per country. Two internal meta-analyses were run, the first for the Dutch sample and the second for the cross country dataset.

Results

In the Netherlands, lonelier individuals were more likely to support the populist radical right across 15 tests spanning 15 years of data, with 11 tests reaching statistical significance - odds ratios ranging from 1.1 to 1.38. For the cross country analysis, Denmark reached statistical significance (OR = 1.2, 90% CI = 1.01, 1.42). Due to smaller sample sizes however, the cross country tests were underpowered to reliably detect small effects.

Conclusions

Loneliness is positively associated with support for the populist radical right in the Netherlands. The effect sizes are comparable to common health correlates of loneliness - high blood pressure, heart diseases, and depression – emphasizing their socio-political relevance. Going forward, well-powered cross-national replications are needed.

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引用次数: 0

The genomic promise of cancer as “not-yet-treatable” and the moral burden of “trying”

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

Social Science & Medicine

Pub Date : 2025-02-01 DOI: 10.1016/j.socscimed.2025.117680

Isabel Briz Hernández

Based on fieldwork conducted in China from November 2018 to January 2020 on biomedical innovation with advanced therapies open to foreigners, in this paper I address the question of why parents of children with incurable cancer decide to access experimental treatment on the other side of the world. While work on the “political economy of hope” has already extensively researched the relation between biomedical technology and hope, I delve into other terrains. In this paper, I will discuss the role of “ontological hope” in the moral project of caring for a child with cancer. Drawing on the Anthropology of Ethics, I conclude that in the postgenomic era, when incurable cancers are recategorize as not-yet-treatable, parents’ efforts to access experimental treatment highlight the complex moral work that parents must undergo to imagine a future good life despite their irreparable loss.

引用次数: 0

Whole personhood in medical education: Visual thinking strategy, close reading, and creative practice with a diversity and equity lens 医学教育中的整体人格：视觉思维策略、细读与多元公平视角下的创造性实践。

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

Social Science & Medicine

Pub Date : 2025-02-01 DOI: 10.1016/j.socscimed.2024.117645

Elizabeth Lahti , Natalie Lanocha , Cirila Estela Vasquez Guzman , Pamela Pierce , Candace Chan , Andrew Lee Breidenbach , Lisa Abia-Smith

Purpose

To create and implement a Whole Personhood in Medical Education curriculum including Visual Thinking Strategies (VTS), close reading, and creative practice that features creative works by BIPOC, persons with disability, and/or LGBTQ + individuals that aligns with educational competencies.

Materials and methods

Curriculum design by an interdisciplinary team made up of physician educators, medical sociologist, digital collection librarian, and art museum educators. Prospective single arm intervention study at a single site academic teaching hospital. Utilized pre-post surveys using the Interpersonal Reflexivity Index (IRI) scale on perspective taking, an internally developed ordinal scale survey on arts integration and bias recognition, and open-ended questions for qualitative analysis.

Results

A total of 161 participants responded and showed statistically significant increases in their mean scores in perspective-taking (4.7%), empathic concern (1.8%), the perceived value of art in medical education (15.8%) and recognizing bias (6.1%). In all subscales, non-white students saw bigger increases than white students, and in three of four subscales, females showed higher increases than males. Qualitative analysis of free text responses (n = 308) showed three emergent themes: (1) increased community; (2) recognition of bias in personal, interpersonal, and system levels; and (3) increased awareness of application of empathy and perspective taking in health settings.

Conclusions

Incorporating a required curriculum that features art and written narratives by minoritized groups and utilizes close observation/reading and reflective/creative practice, leads to an enhanced medical education experience. The curriculum leads to statistically significant increase in individuals’ ability to identify bias, recognize perspectives different than their own, and be empathetic toward others.

目的：在医学教育课程中创建和实施一个完整的人格，包括视觉思维策略（VTS）、细读和创造性实践，以BIPOC、残疾人和/或LGBTQ +个人的创造性作品为特色，与教育能力相一致。材料和方法：课程设计由跨学科团队组成的医师教育家，医学社会学家，数字馆藏馆员和艺术博物馆教育家。前瞻性单臂干预研究在单一地点的学术教学医院。采用人际反身性指数（IRI）量表进行前后调查，采用内部开发的顺序量表进行艺术整合和偏见识别，并采用开放式问题进行定性分析。结果：共有161名参与者做出了回应，他们在换位思考（4.7%）、共情关注（1.8%）、医学教育中艺术的感知价值（15.8%）和识别偏见（6.1%）方面的平均得分有统计学上的显著提高。在所有的分量表中，非白人学生的增幅都大于白人学生，在四个分量表中的三个分量表中，女性的增幅高于男性。对自由文本回复的定性分析（n = 308）显示了三个新兴主题：(1)社区增加；(2)识别个人、人际和系统层面的偏见；(3)卫生机构对移情和换位思考应用的认识有所提高。结论：纳入以少数群体的艺术和书面叙述为特色的必修课程，并利用近距离观察/阅读和反思/创造性实践，可以提高医学教育经验。该课程在统计上显著提高了个人识别偏见的能力，认识到与自己不同的观点，并对他人感同身受。

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引用次数: 0

Does women empowerment impact child well-being? Evidence from India

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

Social Science & Medicine

Pub Date : 2025-02-01 DOI: 10.1016/j.socscimed.2025.117686

Sunetra Nath, Gurudas Das

This study intends to examine how women's empowerment directly or indirectly impacts their children's well-being. Since prior research primarily focussed on the effects of maternal empowerment on specific domains of child well-being, such as healthcare or education, this study seeks to explore a more comprehensive understanding of child well-being, where child well-being is quantified using four domains, viz., physical well-being, psycho-social well-being, educational well-being and awareness of safety. For the study, a primary sample of 416 married women who have a child aged between 6 and 18 years was collected using a multistage purposive sampling method from the Barak Valley of Assam, India. Then, exploratory factor analysis is employed to construct two indices, one on women empowerment and the other on child well-being. The index of child well-being was then used as the regressand, and the women empowerment index, along with other children, mother and household characteristics, were used as the regressors in multiple linear regressions. Besides, the moderating role of women's empowerment on child well-being is also studied by creating interactions between the women's empowerment index and other mothers, children, and household characteristics. The study finds that women's empowerment has a strong and positive direct impact on the well-being of children aged 6 to 18. The study also reveals that women's empowerment indirectly impacts child well-being as it moderates between child well-being and other attributes, viz., the mother's working status, child's age, place of residence, and standard of living. A key implication of our study is that maternal empowerment is essential for enhancing child well-being during the early developmental years. We also find that maternal empowerment, when interacted with paid employment, profoundly uplifts their child's well-being.

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引用次数: 0

Between ‘fetal viability’ and the ‘viability of families’: Decision-making for extremely premature infants in Spain

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

Social Science & Medicine

Pub Date : 2025-02-01 DOI: 10.1016/j.socscimed.2025.117760

Paula Martone , Anna Molas , Diana Marre

Neonatal expertise and technologies have been perfected over the last decades, improving preterm infants' survival rates and allowing a gradual reduction in the gestational age limits of fetal viability. Using the concept of viability as a starting point, we analyze decision-making processes regarding extremely preterm newborns at the limits of viability. Drawing on extensive ethnographic fieldwork in a public hospital in Barcelona between March and November 2023, we examine the knowledge forms, rationalities and values that healthcare workers employ when guiding families in decisions about infants' viability. In this respect, we thoroughly analyze the actors involved and the extent of their agency. The findings point out that although neonatal decisions in Spain are embedded in an ethos of “individual responsible choice,” they are in practice collectively produced and shaped by two main (sometimes conflicting) drivers: the perceived means of families to face the challenges posed by infants with high chances of severe sequelae (the ‘viability of families’), and the preterm patients' perceived “will to live” (‘fetal viability’). The study highlights how viability in this context needs to be understood within the structural socioeconomic constraints and struggles to make and raise families in Spain.

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引用次数: 0

The tragedy of promising happiness through overcoming disability

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

Social Science & Medicine

Pub Date : 2025-02-01 DOI: 10.1016/j.socscimed.2025.117769

Olivia Dahl , Merete Monrad

This article explores the often-overlooked tragedy of promising happiness through overcoming disability. It draws on qualitative interviews and focus groups with 36 adults with cerebral palsy to explore how medical discourse shapes the ways in which individuals are encouraged to pursue a good life, leading to unintended consequences. Sara Ahmed's theory of happiness is used to understand the dialectics of pursuing a good life through overcoming disability, revealing how medical interventions and discourse during childhood inadvertently contribute to feelings of inferiority and social alienation. The article highlights the need to reconsider how individuals with disabilities are encouraged to pursue a good life, emphasizing the paradox of disabling effects arising from attempts to minimize and overcome disability.

引用次数: 0

Impact of COVID-19 on medical utilization for psychiatric conditions in Japan

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

Social Science & Medicine

Pub Date : 2025-02-01 DOI: 10.1016/j.socscimed.2025.117763

Kazuhiro Abe , Kouta Suzuki , Atsushi Miyawaki , Ichiro Kawachi

Background

During COVID-19, Japan experienced an increase in suicides, in contrast to many other countries. We sought to examine whether access to outpatient and inpatient care for psychiatric conditions was maintained in Japan during the pandemic.

Methods

Difference-in-differences analysis with Poisson regression comparing psychiatric patient admissions during the pre-pandemic period (January 2015–December 2019) versus the pandemic period (January 2020–December 2020) was performed, using the data from 242 acute-care hospitals in Japan. The Japanese government's emergency declaration in April 2020 was considered an exogenous shock. Primary outcomes included the number of inpatient and outpatient admissions for schizophrenia, mood disorders, anxiety disorders, dementia, and alcohol-related disorders.

Results

During the study period, 79,867 outpatient cases and 2600 hospitalizations were observed. The difference-in-differences analysis showed a decline in the number of outpatient and inpatient admissions except for anxiety disorders after April 2020: incidence-rate ratios (95% confidence intervals), 0·92 (0·83 - 1·02) and 0·71 (0·46 - 1·09) for outpatients and inpatients with schizophrenia, 0·92 (0·85 - 0·99) and 0·87 (0·50 - 1·49) for mood disorders, 1·02 (0·92 - 1·13) and 1·07 (0·69 - 1·65) for anxiety disorders, 0·88 (0·80 - 0·96) and 0·68 (0·38 - 1·22) for dementia, and 0·77 (0·54 - 1·11) and 0·63 (0·43 - 0·90) for alcohol-related disorders.

Conclusion

In Japan, psychiatric admissions decreased overall following the start of the COVID-19 pandemic, with the exception of anxiety disorder cases. The decrease in psychiatric care utilization contrasted with rising suicide rates in the nation, underscoring the need for enhanced psychiatric access during crises.

{"title":"Impact of COVID-19 on medical utilization for psychiatric conditions in Japan","authors":"Kazuhiro Abe , Kouta Suzuki , Atsushi Miyawaki , Ichiro Kawachi","doi":"10.1016/j.socscimed.2025.117763","DOIUrl":"10.1016/j.socscimed.2025.117763","url":null,"abstract":"<div><h3>Background</h3><div>During COVID-19, Japan experienced an increase in suicides, in contrast to many other countries. We sought to examine whether access to outpatient and inpatient care for psychiatric conditions was maintained in Japan during the pandemic.</div></div><div><h3>Methods</h3><div>Difference-in-differences analysis with Poisson regression comparing psychiatric patient admissions during the pre-pandemic period (January 2015–December 2019) versus the pandemic period (January 2020–December 2020) was performed, using the data from 242 acute-care hospitals in Japan. The Japanese government's emergency declaration in April 2020 was considered an exogenous shock. Primary outcomes included the number of inpatient and outpatient admissions for schizophrenia, mood disorders, anxiety disorders, dementia, and alcohol-related disorders.</div></div><div><h3>Results</h3><div>During the study period, 79,867 outpatient cases and 2600 hospitalizations were observed. The difference-in-differences analysis showed a decline in the number of outpatient and inpatient admissions except for anxiety disorders after April 2020: incidence-rate ratios (95% confidence intervals), 0·92 (0·83 - 1·02) and 0·71 (0·46 - 1·09) for outpatients and inpatients with schizophrenia, 0·92 (0·85 - 0·99) and 0·87 (0·50 - 1·49) for mood disorders, 1·02 (0·92 - 1·13) and 1·07 (0·69 - 1·65) for anxiety disorders, 0·88 (0·80 - 0·96) and 0·68 (0·38 - 1·22) for dementia, and 0·77 (0·54 - 1·11) and 0·63 (0·43 - 0·90) for alcohol-related disorders.</div></div><div><h3>Conclusion</h3><div>In Japan, psychiatric admissions decreased overall following the start of the COVID-19 pandemic, with the exception of anxiety disorder cases. The decrease in psychiatric care utilization contrasted with rising suicide rates in the nation, underscoring the need for enhanced psychiatric access during crises.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"367 ","pages":"Article 117763"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076212","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

Navigating bodily disruptions within biolegitimizing institutions: Mastectomy, femininity, and race

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

Social Science & Medicine

Pub Date : 2025-02-01 DOI: 10.1016/j.socscimed.2025.117730

Jessica Poling

There are times when our bodies suddenly change in unexpected or undesirable ways, challenging our sense of self. I posit a framework to study bodily disruptions which attends to the triadic relationship between personal culture, public culture, and the body. First, I explore how public forms of culture shape individuals' experiences of sudden bodily changes. How do these external expectations exacerbate (or alleviate) experiences of disruptions? Moreover, how do these public expectations interact with individuals' own schemas, and in what ways do embodied differences mediate this interaction? Drawing from interviews with therapeutic mastectomy patients and content analysis of online testimonies, I find that healthcare providers' expectations of femininity informed their patient care. Moreover, the compatibility between patients' schematic orientations and these external expectations shaped the extent to which patients' cancer disrupted their sense of self. Patients with hegemonic schemas mostly resonated with these expectations and subsequently felt more at ease with doctors who could realign them with their gendered goals. But not all patients' schemas were so aligned. In these cases, doctors' enforcement of biolegitimacy exacerbated disruptions. Moreover, I argue that the raced and sexualized notions of biolegitimacy posed additional incongruence for patients who felt unable to conform to white, cis-heterosexual norms. These findings expand upon medical sociology's long exploration of “biographical disruptions” and are significant for sociology's continued endeavors to bring the body into cultural studies.

{"title":"Navigating bodily disruptions within biolegitimizing institutions: Mastectomy, femininity, and race","authors":"Jessica Poling","doi":"10.1016/j.socscimed.2025.117730","DOIUrl":"10.1016/j.socscimed.2025.117730","url":null,"abstract":"<div><div>There are times when our bodies suddenly change in unexpected or undesirable ways, challenging our sense of self. I posit a framework to study bodily disruptions which attends to the triadic relationship between personal culture, public culture, and the body. First, I explore how public forms of culture shape individuals' experiences of sudden bodily changes. How do these external expectations exacerbate (or alleviate) experiences of disruptions? Moreover, how do these public expectations <em>interact</em> with individuals' own schemas, and in what ways do embodied differences mediate this interaction? Drawing from interviews with therapeutic mastectomy patients and content analysis of online testimonies, I find that healthcare providers' expectations of femininity informed their patient care. Moreover, the compatibility between patients' schematic orientations and these external expectations shaped the extent to which patients' cancer disrupted their sense of self. Patients with hegemonic schemas mostly resonated with these expectations and subsequently felt more at ease with doctors who could realign them with their gendered goals. But not all patients' schemas were so aligned. In these cases, doctors' enforcement of biolegitimacy exacerbated disruptions. Moreover, I argue that the raced and sexualized notions of biolegitimacy posed additional incongruence for patients who felt unable to conform to white, cis-heterosexual norms. These findings expand upon medical sociology's long exploration of “biographical disruptions” and are significant for sociology's continued endeavors to bring the body into cultural studies.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"367 ","pages":"Article 117730"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081803","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

Carceral heat exposure as harmful design: An integrative model for understanding the health impacts of heat on incarcerated people in the United States

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

Social Science & Medicine

Pub Date : 2025-02-01 DOI: 10.1016/j.socscimed.2025.117679

Karina Brunn, Olivia Toledo, Chelsea Chau Tran, Ashwin Vasudevan, Bharat Jayram Venkat

In an era of climate change-driven weather events, extreme heat has become the most lethal form of “natural disaster” in the United States. However, its negative consequences are unequally distributed. Incarceration exacerbates vulnerability to heat-related illnesses and deaths. This article reviews and synthesizes a range of literature related to carceral heat exposure to characterize the complex biological, social, infrastructural, financial, and legal mechanisms through which incarcerated people experience heat-related illnesses and deaths. These mechanisms include the location, design, and construction of carceral facilities; structural racism and poverty that lead to the overrepresentation of specific populations within the carceral system; comorbid conditions amongst incarcerated people; the use of medication as a form of control; barriers to medical care; institutional neglect; and the weaponization of heat as a tactic of retaliation. This article also reviews the patchwork regulatory apparatus related to carceral heat exposure, legal efforts to improve protections for incarcerated people, and obstacles to implementing those protections.

In reviewing the literature, we find that there is no singular factor that explains how and why incarcerated people are especially vulnerable to the deleterious effects of heat. We offer instead an integrative model for understanding how multiple mechanisms are consolidated by the carceral system, magnifying the vulnerability of incarcerated people to the effects of heat. As social scientists have demonstrated in other contexts, no one dies from a heat wave alone; instead, they experience illness and death as a result of social and infrastructural arrangements that render them vulnerable to the effects of heat. Our aim is to elucidate the specific arrangements through which the carceral system makes people vulnerable to heat. We argue that exposure to debilitating heat and its attendant consequences represent more than a failure of the carceral system – rather, they reveal its fundamentally harmful design.

{"title":"Carceral heat exposure as harmful design: An integrative model for understanding the health impacts of heat on incarcerated people in the United States","authors":"Karina Brunn, Olivia Toledo, Chelsea Chau Tran, Ashwin Vasudevan, Bharat Jayram Venkat","doi":"10.1016/j.socscimed.2025.117679","DOIUrl":"10.1016/j.socscimed.2025.117679","url":null,"abstract":"<div><div>In an era of climate change-driven weather events, extreme heat has become the most lethal form of “natural disaster” in the United States. However, its negative consequences are unequally distributed. Incarceration exacerbates vulnerability to heat-related illnesses and deaths. This article reviews and synthesizes a range of literature related to carceral heat exposure to characterize the complex biological, social, infrastructural, financial, and legal mechanisms through which incarcerated people experience heat-related illnesses and deaths. These mechanisms include the location, design, and construction of carceral facilities; structural racism and poverty that lead to the overrepresentation of specific populations within the carceral system; comorbid conditions amongst incarcerated people; the use of medication as a form of control; barriers to medical care; institutional neglect; and the weaponization of heat as a tactic of retaliation. This article also reviews the patchwork regulatory apparatus related to carceral heat exposure, legal efforts to improve protections for incarcerated people, and obstacles to implementing those protections.</div><div>In reviewing the literature, we find that there is no singular factor that explains how and why incarcerated people are especially vulnerable to the deleterious effects of heat. We offer instead an integrative model for understanding how multiple mechanisms are consolidated by the carceral system, magnifying the vulnerability of incarcerated people to the effects of heat. As social scientists have demonstrated in other contexts, no one dies from a heat wave alone; instead, they experience illness and death as a result of social and infrastructural arrangements that render them vulnerable to the effects of heat. Our aim is to elucidate the specific arrangements through which the carceral system makes people vulnerable to heat. We argue that exposure to debilitating heat and its attendant consequences represent more than a failure of the carceral system – rather, they reveal its fundamentally harmful design.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"367 ","pages":"Article 117679"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143145978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0