Pub Date : 2024-10-12DOI: 10.1016/j.socscimed.2024.117403
Previous studies have reported on the health impact of systemic racism among historically oppressed populations. In fact, there is an emerging body of literature, including systematic reviews, which describe the negative health consequences of systemic racism among racial/ethnic minoritized groups in the US. Less is known, however, about effective intervention strategies to address systemic racism and the resulting health inequities. This scoping review was conducted to synthesize the published literature on U.S.-based interventions designed to improve health equity by addressing systemic racism. The Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping review (PRISMA-ScR) checklist was used to report this review. We searched six databases (MEDLINE, CINAHL, PsycINFO, Sociological Abstracts, Web of Science Core Collection, and Scopus) to examine the intervention studies. A total of 172 articles were included in review. These interventions were classified by typology which included healing-centered approaches, community-based interventions targeting health disparities, diversity, equity, inclusion (DEI) efforts, anti-racism training interventions, and policy interventions. The findings from this review have important implications for the development, testing, and scaling of interventions designed to addressed systemic racism.
以前的研究曾报道过系统性种族主义对历史上受压迫者健康的影响。事实上，包括系统性综述在内的新兴文献描述了系统性种族主义对美国少数种族/族裔群体健康的负面影响。然而，人们对解决系统性种族主义及其导致的健康不平等问题的有效干预策略却知之甚少。本范围界定综述旨在综合已发表的有关美国干预措施的文献，这些干预措施旨在通过解决系统性种族主义问题来改善健康公平状况。本综述采用了系统综述和荟萃分析首选报告项目扩展版（PRISMA-ScR）清单。我们检索了六个数据库（MEDLINE、CINAHL、PsycINFO、Sociological Abstracts、Web of Science Core Collection 和 Scopus）来审查干预研究。共有 172 篇文章被纳入审查范围。这些干预措施按类型分类，包括以治疗为中心的方法、针对健康差异的社区干预措施、多样性、公平、包容（DEI）工作、反种族主义培训干预措施和政策干预措施。本综述的研究结果对旨在解决系统性种族主义问题的干预措施的开发、测试和推广具有重要意义。
{"title":"Interventions addressing systemic racism in the US: A scoping review","authors":"","doi":"10.1016/j.socscimed.2024.117403","DOIUrl":"10.1016/j.socscimed.2024.117403","url":null,"abstract":"<div><div>Previous studies have reported on the health impact of systemic racism among historically oppressed populations. In fact, there is an emerging body of literature, including systematic reviews, which describe the negative health consequences of systemic racism among racial/ethnic minoritized groups in the US. Less is known, however, about effective intervention strategies to address systemic racism and the resulting health inequities. This scoping review was conducted to synthesize the published literature on U.S.-based interventions designed to improve health equity by addressing systemic racism. The Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping review (PRISMA-ScR) checklist was used to report this review. We searched six databases (MEDLINE, CINAHL, PsycINFO, Sociological Abstracts, Web of Science Core Collection, and Scopus) to examine the intervention studies. A total of 172 articles were included in review. These interventions were classified by typology which included healing-centered approaches, community-based interventions targeting health disparities, diversity, equity, inclusion (DEI) efforts, anti-racism training interventions, and policy interventions. The findings from this review have important implications for the development, testing, and scaling of interventions designed to addressed systemic racism.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511366","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}
Pub Date : 2024-10-11DOI: 10.1016/j.socscimed.2024.117412
There is growing recognition of the association between neighbourhood factors and individuals' health. This systematic review examines the associations between urban neighbourhood built and social environment characteristics with different measures of physical functioning among mid- and older-aged adults over 45 years, focusing on cross-sectional and longitudinal study designs. It responds to the increase in publications on this topic following the COVID-19 pandemic. The systematic review included 25 studies written in English from 2018 onwards sourced from 8 databases. Studies were imported into Covidence and reviewed following the ‘Preferred Reporting Items for Systematic Reviews and Meta-Analysis’ (PRISMA) protocols. Findings were assessed according to 13 neighbourhood environment variables: aesthetics, crime safety, greenness and parks, land use mix and destinations, neighbourhood disadvantage, pedestrian/street infrastructure, public transport, residential density, social environment, street connectivity, traffic safety, walkability, and composite variables. Significant associations in the expected direction were found for land use mix and destinations, walkability, crime safety, greenness and parks, social environment, and neighbourhood disadvantage with physical functioning in mid- and older-aged adults. Weaker evidence of expected associations was found for residential density and aesthetics. Future research avenues on this topic include investigating built and social neighbourhood environments in diverse geographies and populations, considering housing status and length of exposure to the neighbourhood environment, using longitudinal surveys over longer time periods and objective measurements.
{"title":"Associations between the urban neighbourhood built and social environment characteristics with physical functioning among mid- and older-aged adults: A systematic review","authors":"","doi":"10.1016/j.socscimed.2024.117412","DOIUrl":"10.1016/j.socscimed.2024.117412","url":null,"abstract":"<div><div>There is growing recognition of the association between neighbourhood factors and individuals' health. This systematic review examines the associations between urban neighbourhood built and social environment characteristics with different measures of physical functioning among mid- and older-aged adults over 45 years, focusing on cross-sectional and longitudinal study designs. It responds to the increase in publications on this topic following the COVID-19 pandemic. The systematic review included 25 studies written in English from 2018 onwards sourced from 8 databases. Studies were imported into Covidence and reviewed following the ‘Preferred Reporting Items for Systematic Reviews and Meta-Analysis’ (PRISMA) protocols. Findings were assessed according to 13 neighbourhood environment variables: aesthetics, crime safety, greenness and parks, land use mix and destinations, neighbourhood disadvantage, pedestrian/street infrastructure, public transport, residential density, social environment, street connectivity, traffic safety, walkability, and composite variables. Significant associations in the expected direction were found for land use mix and destinations, walkability, crime safety, greenness and parks, social environment, and neighbourhood disadvantage with physical functioning in mid- and older-aged adults. Weaker evidence of expected associations was found for residential density and aesthetics. Future research avenues on this topic include investigating built and social neighbourhood environments in diverse geographies and populations, considering housing status and length of exposure to the neighbourhood environment, using longitudinal surveys over longer time periods and objective measurements.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511361","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}
Pub Date : 2024-10-09DOI: 10.1016/j.socscimed.2024.117406
Background
Suicide is a leading cause of death worldwide, with childhood maltreatment identified as a significant risk factor for suicidal behavior in adulthood. The link between childhood maltreatment and suicidality is well-documented; however, the role of complex posttraumatic stress disorder (CPTSD), which includes an additional symptom cluster of disturbances in self-organization (DSO) compared to posttraumatic stress disorder (PTSD), remains underexplored. This study aimed to investigate the association between meeting the criteria for ICD-11 PTSD or CPTSD and suicidality in adults with a history of childhood maltreatment across culturally diverse samples.
Methods
Data were collected across four sites: the United States, the United Kingdom, China, and Malaysia. The Childhood Trauma Questionnaire (CTQ), Suicidal Behaviors Questionnaire-Revised (SBQ-R), and International Trauma Questionnaire (ITQ) were used to assess childhood maltreatment, suicidality, and PTSD or CPTSD, respectively. Linear regressions were conducted to examine the associations, controlling for demographic variables (age, sex, ethnicity, educational level, and subjective socioeconomic status) as well as the severity of maltreatment (CTQ total scores).
Results
Among the 1,324 participants who experienced childhood maltreatment, meeting the criteria for CPTSD was significantly associated with higher suicidality compared to not meeting the criteria for either PTSD or CPTSD (B(SE) = 1.68 (0.30), p < .001), or only meeting the criteria for PTSD (B(SE) = 1.38 (0.43), p < .001). In contrast, meeting the criteria for PTSD alone was not significantly associated with suicidality (B(SE) = 0.35 (0.46), p = .45). These associations remained consistent across different cultural settings.
Conclusion
The study findings highlight the unique association of CPTSD with suicidality in adults with a history of childhood maltreatment, suggesting that the DSO symptom cluster of CPTSD, which distinguish it from PTSD, play a critical role in the development of suicidality in this population. Targeting these symptoms may be essential for effective intervention strategies. Screening for childhood maltreatment and CPTSD in individuals at risk of suicide is crucial for guiding treatment planning.
{"title":"Complex Posttraumatic Stress Disorder (CPTSD) is Uniquely Linked to Suicidality Beyond Posttraumatic Stress Disorder (PTSD) in Adults with Childhood Maltreatment: A Multinational Study Across Four Countries","authors":"","doi":"10.1016/j.socscimed.2024.117406","DOIUrl":"10.1016/j.socscimed.2024.117406","url":null,"abstract":"<div><h3>Background</h3><div>Suicide is a leading cause of death worldwide, with childhood maltreatment identified as a significant risk factor for suicidal behavior in adulthood. The link between childhood maltreatment and suicidality is well-documented; however, the role of complex posttraumatic stress disorder (CPTSD), which includes an additional symptom cluster of disturbances in self-organization (DSO) compared to posttraumatic stress disorder (PTSD), remains underexplored. This study aimed to investigate the association between meeting the criteria for ICD-11 PTSD or CPTSD and suicidality in adults with a history of childhood maltreatment across culturally diverse samples.</div></div><div><h3>Methods</h3><div>Data were collected across four sites: the United States, the United Kingdom, China, and Malaysia. The Childhood Trauma Questionnaire (CTQ), Suicidal Behaviors Questionnaire-Revised (SBQ-R), and International Trauma Questionnaire (ITQ) were used to assess childhood maltreatment, suicidality, and PTSD or CPTSD, respectively. Linear regressions were conducted to examine the associations, controlling for demographic variables (age, sex, ethnicity, educational level, and subjective socioeconomic status) as well as the severity of maltreatment (CTQ total scores).</div></div><div><h3>Results</h3><div>Among the 1,324 participants who experienced childhood maltreatment, meeting the criteria for CPTSD was significantly associated with higher suicidality compared to not meeting the criteria for either PTSD or CPTSD (<em>B(SE)</em> = 1.68 (0.30), <em>p</em> < .001), or only meeting the criteria for PTSD (<em>B(SE)</em> = 1.38 (0.43), <em>p</em> < .001). In contrast, meeting the criteria for PTSD alone was not significantly associated with suicidality (<em>B(SE)</em> = 0.35 (0.46), <em>p</em> = .45). These associations remained consistent across different cultural settings.</div></div><div><h3>Conclusion</h3><div>The study findings highlight the unique association of CPTSD with suicidality in adults with a history of childhood maltreatment, suggesting that the DSO symptom cluster of CPTSD, which distinguish it from PTSD, play a critical role in the development of suicidality in this population. Targeting these symptoms may be essential for effective intervention strategies. Screening for childhood maltreatment and CPTSD in individuals at risk of suicide is crucial for guiding treatment planning.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142417779","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}
Pub Date : 2024-10-09DOI: 10.1016/j.socscimed.2024.117408
This study, conducted in Norway, addresses the issue of inadequate access to toilets in public spaces and transportation systems, particularly concerning individuals with disabilities who have heightened needs of toilets. The study employed in-depth interviews with individuals experiencing various gastrointestinal issues, including bladder-related problems. Utilizing a qualitative approach, interviews were conducted via telephone to accommodate potential travel difficulties. This approach also leveraged previous successes with sensitive topics. A sample size of 10 interviews was chosen based on prior research indicating that key themes typically emerge within this range. Key findings indicate significant barriers to participation in societal activities due to insufficient toilet facilities. For transport in particular, boats and trains emerge as preferred modes over buses, trams and subways due to the presence of onboard toilets. Notably, urban areas and recreational spots like parks and beaches suffer from a lack of restroom facilities. In order to improve these facilities, informants highlighted measures such as provision of open, hygienic toilets with barrier-free access. These measures should be coupled with clear signage and awareness campaigns regarding toilet facilities tailored to individuals with diverse health needs. The study underscores the critical role of toilets in maintaining public health and acknowledges the right to access toilets as recognized by the United Nations. Testimonials from individuals with disabilities underscore the profound impact of toilet accessibility on their daily lives, revealing instances of social isolation and restricted activities due to inadequate facilities. Proposed interventions encompass improved hygiene standards, increased toilet availability, and enhanced staff training to cater to the diverse needs of users. The study advocates for legislative reforms and policy guidelines to address the pressing issue of toilet accessibility, aiming to foster inclusivity and equal participation in public life for individuals with disabilities.
{"title":"The role of toilets in public spaces: An interview study with individuals experiencing gastrointestinal issues","authors":"","doi":"10.1016/j.socscimed.2024.117408","DOIUrl":"10.1016/j.socscimed.2024.117408","url":null,"abstract":"<div><div>This study, conducted in Norway, addresses the issue of inadequate access to toilets in public spaces and transportation systems, particularly concerning individuals with disabilities who have heightened needs of toilets. The study employed in-depth interviews with individuals experiencing various gastrointestinal issues, including bladder-related problems. Utilizing a qualitative approach, interviews were conducted via telephone to accommodate potential travel difficulties. This approach also leveraged previous successes with sensitive topics. A sample size of 10 interviews was chosen based on prior research indicating that key themes typically emerge within this range. Key findings indicate significant barriers to participation in societal activities due to insufficient toilet facilities. For transport in particular, boats and trains emerge as preferred modes over buses, trams and subways due to the presence of onboard toilets. Notably, urban areas and recreational spots like parks and beaches suffer from a lack of restroom facilities. In order to improve these facilities, informants highlighted measures such as provision of open, hygienic toilets with barrier-free access. These measures should be coupled with clear signage and awareness campaigns regarding toilet facilities tailored to individuals with diverse health needs. The study underscores the critical role of toilets in maintaining public health and acknowledges the right to access toilets as recognized by the United Nations. Testimonials from individuals with disabilities underscore the profound impact of toilet accessibility on their daily lives, revealing instances of social isolation and restricted activities due to inadequate facilities. Proposed interventions encompass improved hygiene standards, increased toilet availability, and enhanced staff training to cater to the diverse needs of users. The study advocates for legislative reforms and policy guidelines to address the pressing issue of toilet accessibility, aiming to foster inclusivity and equal participation in public life for individuals with disabilities.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511302","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}
Pub Date : 2024-10-09DOI: 10.1016/j.socscimed.2024.117410
Approximately half of the world's displaced migrant population are women, yet gender-specific analyses are often lacking. Such analyses are crucial for understanding migrant women's unique experiences and informing policies that address their health and broader needs. This paper integrates the concept of structural violence with person-centered ethnography to examine women's physical and mental health in contexts of displacement and migration. Using the triple trauma framework, we offer a holistic, temporal-spatial analysis of the health experiences and exposures faced by asylum-seeking women across three stages: places of origin, travel, and destination. Through the representative case of Anahi, a Honduran woman who fled to the US with her family in 2019, we identify four key themes: the persistence of structural violence and its constraints on health decisions and outcomes, the losses and suffering associated with women's triple roles, the harms of racism and xenophobia, and the health implications of inadequate information on asylum and immigration procedures. We conclude with policy recommendations to reduce health inequities among migrant women. This study advances understanding by providing a comprehensive, gendered analysis of the structural forces shaping health outcomes for migrant women, offering insights that extend beyond a narrow focus on reproductive issues to address their physical, mental, and social well-being.
{"title":"The journey of a living statue: Structural violence and a Honduran migrant woman's pathway toward asylum and wellbeing","authors":"","doi":"10.1016/j.socscimed.2024.117410","DOIUrl":"10.1016/j.socscimed.2024.117410","url":null,"abstract":"<div><div>Approximately half of the world's displaced migrant population are women, yet gender-specific analyses are often lacking. Such analyses are crucial for understanding migrant women's unique experiences and informing policies that address their health and broader needs. This paper integrates the concept of structural violence with person-centered ethnography to examine women's physical and mental health in contexts of displacement and migration. Using the triple trauma framework, we offer a holistic, temporal-spatial analysis of the health experiences and exposures faced by asylum-seeking women across three stages: places of origin, travel, and destination. Through the representative case of Anahi, a Honduran woman who fled to the US with her family in 2019, we identify four key themes: the persistence of structural violence and its constraints on health decisions and outcomes, the losses and suffering associated with women's triple roles, the harms of racism and xenophobia, and the health implications of inadequate information on asylum and immigration procedures. We conclude with policy recommendations to reduce health inequities among migrant women. This study advances understanding by providing a comprehensive, gendered analysis of the structural forces shaping health outcomes for migrant women, offering insights that extend beyond a narrow focus on reproductive issues to address their physical, mental, and social well-being.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592718","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}
Pub Date : 2024-10-09DOI: 10.1016/j.socscimed.2024.117407
Introduction
A syndemic of unhealthy alcohol use, intimate partner violence (IPV), and economic insecurity threatens to derail progress towards UNAIDS 95-95-95 targets in sub-Saharan Africa. We developed a combined economic and relationship-strengthening intervention called Mlambe to reduce unhealthy alcohol use and increase adherence to antiretroviral therapy for couples in Malawi. This study evaluates the additional impact of Mlambe on IPV and relationship dynamics.
Methods
In a pilot randomized controlled trial, 78 married couples (156 individuals) living with HIV and reporting unhealthy alcohol use based on the AUDIT-C (at least one partner) were recruited from HIV care clinics in Zomba, Malawi. The intervention arm (39 couples) received a 10-month program consisting of incentivized savings accounts with financial literacy education, relationship education, and couples counseling sessions to build relationship skills. The control arm (39 couples) received enhanced usual care (EUC) with brief alcohol counseling. We used linear mixed-effects models to assess the effects of Mlambe on relationship quality (e.g., constructive communication, unity, sexual satisfaction) and IPV (physical, sexual, and emotional) by including fixed effects for treatment arm and a random effect for dyad, and tested whether effects on IPV and relationship quality differed by gender.
Results
At 10- and 15-month follow-up visits, couples in the Mlambe arm showed greater increases in couple communication, unity, sexual satisfaction, intimacy, and trust (Cohen’s d ranged from 0.36 to 0.56; p<0.05) as compared to EUC. Couples in the Mlambe arm also showed significant decreases in physical and emotional IPV (Cohen’s d ranged from 0.33 to 0.49; p<0.05) as compared to EUC. Subsequent moderation analyses indicated that women reported significantly greater improvements in relationship quality than men, except for sexual satisfaction (p<0.05), and greater declines in physical IPV than men (p<0.05).
Conclusions
Mlambe resulted in significant improvements in relationship quality and decreased IPV in couples, particularly for women who as a group reported lower relationship quality at baseline. Economic and relationship-strengthening interventions have potential to disrupt harmful syndemics of violence, substance use, and poverty among couples living with HIV.
{"title":"Mlambe economic and relationship-strengthening intervention for alcohol use decreases violence and improves relationship quality in couples living with HIV in Malawi","authors":"","doi":"10.1016/j.socscimed.2024.117407","DOIUrl":"10.1016/j.socscimed.2024.117407","url":null,"abstract":"<div><h3>Introduction</h3><div>A syndemic of unhealthy alcohol use, intimate partner violence (IPV), and economic insecurity threatens to derail progress towards UNAIDS 95-95-95 targets in sub-Saharan Africa. We developed a combined economic and relationship-strengthening intervention called <em>Mlambe</em> to reduce unhealthy alcohol use and increase adherence to antiretroviral therapy for couples in Malawi. This study evaluates the additional impact of <em>Mlambe</em> on IPV and relationship dynamics.</div></div><div><h3>Methods</h3><div>In a pilot randomized controlled trial, 78 married couples (156 individuals) living with HIV and reporting unhealthy alcohol use based on the AUDIT-C (at least one partner) were recruited from HIV care clinics in Zomba, Malawi. The intervention arm (39 couples) received a 10-month program consisting of incentivized savings accounts with financial literacy education, relationship education, and couples counseling sessions to build relationship skills. The control arm (39 couples) received enhanced usual care (EUC) with brief alcohol counseling. We used linear mixed-effects models to assess the effects of <em>Mlambe</em> on relationship quality (e.g., constructive communication, unity, sexual satisfaction) and IPV (physical, sexual, and emotional) by including fixed effects for treatment arm and a random effect for dyad, and tested whether effects on IPV and relationship quality differed by gender.</div></div><div><h3>Results</h3><div>At 10- and 15-month follow-up visits, couples in the <em>Mlambe</em> arm showed greater increases in couple communication, unity, sexual satisfaction, intimacy, and trust (Cohen’s <em>d</em> ranged from 0.36 to 0.56; <em>p</em><0.05) as compared to EUC. Couples in the <em>Mlambe</em> arm also showed significant decreases in physical and emotional IPV (Cohen’s <em>d</em> ranged from 0.33 to 0.49; <em>p</em><0.05) as compared to EUC. Subsequent moderation analyses indicated that women reported significantly greater improvements in relationship quality than men, except for sexual satisfaction (<em>p</em><0.05), and greater declines in physical IPV than men (<em>p</em><0.05).</div></div><div><h3>Conclusions</h3><div><em>Mlambe</em> resulted in significant improvements in relationship quality and decreased IPV in couples, particularly for women who as a group reported lower relationship quality at baseline. Economic and relationship-strengthening interventions have potential to disrupt harmful syndemics of violence, substance use, and poverty among couples living with HIV.</div></div><div><h3>Clinical Trial Number</h3><div>NCT#04906616</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142417777","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}
Pub Date : 2024-10-09DOI: 10.1016/j.socscimed.2024.117402
Background
Abuse and neglect affect over 1.7 billion children worldwide. While the consequences of child maltreatment (CM) across the life course are well understood, there remains ambiguity surrounding the risk factors associated with CM. This exploratory study examined the extent to which a wide range of sociodemographic, prenatal, and postpartum risk factors are associated with CM notifications in an Australian birth cohort.
Methods
This was a prospective longitudinal birth cohort study using data from the Mater-University of Queensland Study of Pregnancy (MUSP) which began in 1981. Child protection data were linked to MUSP records, identifying agency-reported and substantiated CM notifications (including subtypes) up to 16 years of age. A range of sociodemographic and perinatal risk factors were examined.
Results
Children experienced higher odds of any agency-reported CM if their mothers did not have a high school education, had pregnancies at a young age, and were socially isolated postpartum. Similar risk factors were associated with substantiated CM. Female children had increased odds of both agency-reported and substantiated sexual abuse. Children born into large families had increased odds of agency-reported and substantiated neglect. First Nations status was not associated with any form of CM.
Conclusions
Several individual, familial, and social risk factors were associated with CM in this cohort. Notably, different CM subtypes were associated with different risk factors. This research highlights key modifiable factors to support early intervention and prevention of CM.
背景虐待和忽视影响着全球 17 亿多儿童。虽然人们对儿童虐待（CM）在整个生命过程中造成的后果有了充分的了解，但与儿童虐待相关的风险因素仍不明确。这项探索性研究考察了一系列社会人口学、产前和产后风险因素在多大程度上与澳大利亚出生队列中的儿童虐待通报相关。方法这是一项前瞻性纵向出生队列研究，使用的数据来自昆士兰母校-大学妊娠研究（MUSP），该研究始于1981年。儿童保护数据与 MUSP 记录相链接，确定了 16 岁以下机构报告的和经证实的 CM 通知（包括亚型）。对一系列社会人口学和围产期风险因素进行了研究。结果如果儿童的母亲没有受过高等教育、在年轻时怀孕以及产后与社会隔离，那么儿童发生任何机构报告的CM的几率会更高。类似的风险因素也与证实的儿童急诊有关。女性儿童遭受机构报告的性虐待和经证实的性虐待的几率都有所增加。出生在大家庭中的儿童遭受机构报告的忽视和经证实的忽视的几率增加。原住民身份与任何形式的儿童性虐待均无关联。值得注意的是，不同的 CM 亚型与不同的风险因素有关。这项研究强调了支持早期干预和预防儿童手足口病的关键可改变因素。
{"title":"Risk factors associated with child maltreatment in the second generation of a prospective longitudinal Australian birth cohort: A MUSP study","authors":"","doi":"10.1016/j.socscimed.2024.117402","DOIUrl":"10.1016/j.socscimed.2024.117402","url":null,"abstract":"<div><h3>Background</h3><div>Abuse and neglect affect over 1.7 billion children worldwide. While the consequences of child maltreatment (CM) across the life course are well understood, there remains ambiguity surrounding the risk factors associated with CM. This exploratory study examined the extent to which a wide range of sociodemographic, prenatal, and postpartum risk factors are associated with CM notifications in an Australian birth cohort.</div></div><div><h3>Methods</h3><div>This was a prospective longitudinal birth cohort study using data from the Mater-University of Queensland Study of Pregnancy (MUSP) which began in 1981. Child protection data were linked to MUSP records, identifying agency-reported and substantiated CM notifications (including subtypes) up to 16 years of age. A range of sociodemographic and perinatal risk factors were examined.</div></div><div><h3>Results</h3><div>Children experienced higher odds of any agency-reported CM if their mothers did not have a high school education, had pregnancies at a young age, and were socially isolated postpartum. Similar risk factors were associated with substantiated CM. Female children had increased odds of both agency-reported and substantiated sexual abuse. Children born into large families had increased odds of agency-reported and substantiated neglect. First Nations status was not associated with any form of CM.</div></div><div><h3>Conclusions</h3><div>Several individual, familial, and social risk factors were associated with CM in this cohort. Notably, different CM subtypes were associated with different risk factors. This research highlights key modifiable factors to support early intervention and prevention of CM.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142446761","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}
Pub Date : 2024-10-09DOI: 10.1016/j.socscimed.2024.117409
The outbreak of the full-scale war launched by Russia against Ukraine and, following it, significant migrations have not only increased the diversity of the Ukrainian migrant population in Poland, but also added to the complexity of their health needs and strategies. This study seeks to explore Ukrainian migrant women's experiences and practices related to the use of maternity care services. The article is based on fieldwork conducted between February and October 2023 and included 23 semi-structured interviews with Ukrainian migrant women who gave birth in Poland after February 24, 2022. To understand Ukrainian women's pathways to maternity care in Poland and unpack the differences in experiences within this group of migrants, we explore participants' healthcare strategies against the background of existing inequalities in access to quality care in Poland and Ukraine, in particularly the division between private and public services. We consider the role of financial, social and cultural resources and distinguish for this purpose between three groups of permanent, circular and wartime migrants. We show the decisive role of economic resources, nonetheless in articulation with the creation and mobilisation of social networks and time spent in Poland, which play a role in shaping migrant women's capacity to access better maternity care.
{"title":"Ukrainian women's maternity care strategies in Poland after the outbreak of the full-scale war: Understanding unequal access to quality care","authors":"","doi":"10.1016/j.socscimed.2024.117409","DOIUrl":"10.1016/j.socscimed.2024.117409","url":null,"abstract":"<div><div>The outbreak of the full-scale war launched by Russia against Ukraine and, following it, significant migrations have not only increased the diversity of the Ukrainian migrant population in Poland, but also added to the complexity of their health needs and strategies. This study seeks to explore Ukrainian migrant women's experiences and practices related to the use of maternity care services. The article is based on fieldwork conducted between February and October 2023 and included 23 semi-structured interviews with Ukrainian migrant women who gave birth in Poland after February 24, 2022. To understand Ukrainian women's pathways to maternity care in Poland and unpack the differences in experiences within this group of migrants, we explore participants' healthcare strategies against the background of existing inequalities in access to quality care in Poland and Ukraine, in particularly the division between private and public services. We consider the role of financial, social and cultural resources and distinguish for this purpose between three groups of permanent, circular and wartime migrants. We show the decisive role of economic resources, nonetheless in articulation with the creation and mobilisation of social networks and time spent in Poland, which play a role in shaping migrant women's capacity to access better maternity care.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142446760","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}
Pub Date : 2024-10-05DOI: 10.1016/j.socscimed.2024.117384
Infectious diseases exploit niches that are often spatially defined as urban and/or rural. Yet spatial research on infectious diseases often fails to define “urban” and “rural” and how these contexts might influence their epidemiology. We use dengue fever, thought to be mostly an urban disease with rural foci, as a device to explore local definitions of urban and rural spaces and the impact of these spaces on dengue risk in the provinfine urban and rural locales. Interviews conducted from 2019 to 2021 with 71 residents and 23 health personce of Esmeraldas, Ecuador. Ecuador, like many countries, only uses population size and administrative function to denel found that they identified the availability of basic services, extent of their control over their environment, and presence of underbrush and weeds (known in Ecuador as monte and maleza and conceptualized in this paper as natural disorder) as important links to their conceptions of space and dengue risk. This broader conceptualization of space articulated by local residents and professionals reflects a more sophisticated approach to characterizing dengue risk than using categories of urban and rural employed by the national census and government. Rather than this dichotomous category of space, dengue fever can be better framed for health interventions in terms of specific environmental features and assemblages of high-risk spaces. An understanding of how community members perceive risk enhances our ability to collaborate with them to develop optimal mitigation strategies.
{"title":"“Dengue fever is not just urban or rural: Reframing its spatial categorization.”","authors":"","doi":"10.1016/j.socscimed.2024.117384","DOIUrl":"10.1016/j.socscimed.2024.117384","url":null,"abstract":"<div><div>Infectious diseases exploit niches that are often spatially defined as urban and/or rural. Yet spatial research on infectious diseases often fails to define “urban” and “rural” and how these contexts might influence their epidemiology. We use dengue fever, thought to be mostly an urban disease with rural foci, as a device to explore local definitions of urban and rural spaces and the impact of these spaces on dengue risk in the provinfine urban and rural locales. Interviews conducted from 2019 to 2021 with 71 residents and 23 health personce of Esmeraldas, Ecuador. Ecuador, like many countries, only uses population size and administrative function to denel found that they identified the availability of basic services, extent of their control over their environment, and presence of underbrush and weeds (known in Ecuador as <em>monte</em> and <em>maleza</em> and conceptualized in this paper as natural disorder) as important links to their conceptions of space and dengue risk. This broader conceptualization of space articulated by local residents and professionals reflects a more sophisticated approach to characterizing dengue risk than using categories of urban and rural employed by the national census and government. Rather than this dichotomous category of space, dengue fever can be better framed for health interventions in terms of specific environmental features and assemblages of high-risk spaces. An understanding of how community members perceive risk enhances our ability to collaborate with them to develop optimal mitigation strategies.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142407009","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}
Pub Date : 2024-10-05DOI: 10.1016/j.socscimed.2024.117374
{"title":"Corrigendum to “Between loss and restoration: The role of liminality in advancing theories of grief and bereavement [Soc. Sci. Med. 344 (2024) 116616]”","authors":"","doi":"10.1016/j.socscimed.2024.117374","DOIUrl":"10.1016/j.socscimed.2024.117374","url":null,"abstract":"","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":null,"pages":null},"PeriodicalIF":4.9,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382145","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}
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