Social Science & Medicine最新文献

{"title":"Childhood adversity trajectories and not being in education, employment, or training during early adulthood: The Danish life course cohort (DANLIFE)","authors":"Leonie K. Elsenburg ,&nbsp;Bertina Kreshpaj ,&nbsp;Signe Hald Andersen ,&nbsp;Tjeerd Rudmer de Vries ,&nbsp;Karsten Thielen ,&nbsp;Naja Hulvej Rod","doi":"10.1016/j.socscimed.2025.117841","DOIUrl":"10.1016/j.socscimed.2025.117841","url":null,"abstract":"<div><h3>Background</h3><div>Single and cumulative childhood adversities have been associated with not being in education, employment, or training (NEET) in early adulthood, but associations with more comprehensive childhood adversity measures incorporating clustering of adversities in different dimensions (material, health and family) remain to be examined.</div></div><div><h3>Methods</h3><div>Data from the Danish register-based DANLIFE study are used. Individuals were divided over five groups of childhood adversity from 0 to 15 years. Longer-term NEET in early adulthood (16–29 years) was defined as: 1) being NEET in two consecutive years (n = 1,276,051) and 2) clusters of NEET status over age (n = 576,570) derived through sequence analysis. Relative risks and differences were examined using binomial regressions adjusted for parental origin, maternal age, and birth year.</div></div><div><h3>Results</h3><div>The percentage of individuals in NEET in two consecutive years was 8.2% in the low adversity group, and 16.2% and 23.3% in the early life and persistent material deprivation groups, 18.9% in the loss or threat of loss group, and 44.9% in the high adversity group. Being in any of the childhood adversity groups, compared with the low adversity group, was associated with higher risks of being in longer-term NEET. For example, in the high adversity group, there were 35 additional individuals in NEET in two consecutive years per 100 individuals in adjusted analyses.</div></div><div><h3>Conclusion</h3><div>Childhood adversity is strongly associated with the risk of being longer-term NEET in early adulthood. Interventions are warranted as obtaining educational qualifications or employment in early adulthood is of critical importance for future labor market participation.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"371 ","pages":"Article 117841"},"PeriodicalIF":4.9,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143534404","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":"Effects of extended working lives on depressive symptoms, physical, and cognitive health in middle and later life: Evidence from China","authors":"Hengyi Xu ,&nbsp;Zhongmin Zhang ,&nbsp;Xue Yang ,&nbsp;Qin Yang ,&nbsp;Ting Chen","doi":"10.1016/j.socscimed.2025.117833","DOIUrl":"10.1016/j.socscimed.2025.117833","url":null,"abstract":"<div><h3>Introduction</h3><div>Many countries are extending working lives to counteract the shrinking labor force caused by population aging. However, the health implications of this approach for middle-aged and older adults remain unclear, particularly in low- and middle-income countries.</div></div><div><h3>Methods</h3><div>Data were drawn from the 2011–2020 China Health and Retirement Longitudinal Study to analyze the effect of labor force participation on multidimensional health, with a focus on activities of daily living disability, depressive symptoms, and cognitive impairment. A longitudinal g-formula was applied to address the endogeneity associated with long-term employment and simulate the life course of a synthetic cohort aged 45–80 years. The impact of extending working lives to age 63 for men and age 58 for women on health outcomes was estimated.</div></div><div><h3>Results</h3><div>Labor force participation was negatively associated with the onset of activities of daily living disability but positively associated with the onset of depressive symptoms and cognitive impairment among middle-aged and older adults. Extending working life slowed the progression of activities of daily living disability but increased the risk of depressive symptoms and cognitive impairment, especially in women. These effects persisted beyond working years and into postretirement. Higher education levels mitigated the negative impact of extended working lives on cognitive function.</div></div><div><h3>Conclusions</h3><div>While extending working lives may benefit physical functioning, it poses risks to depressive symptoms and cognitive health, particularly for women. National policies promoting longer working lives should incorporate targeted preventive measures to protect the psychological and cognitive health of middle-aged and older adults.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"369 ","pages":"Article 117833"},"PeriodicalIF":4.9,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143420028","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":"Heteronormativity and cisgenderism in medical training: A scoping review of lesbian, gay, bisexual, transgender, queer and plus (LGBTQ+) issues in medical training in Asia","authors":"Yiu Tung Suen ,&nbsp;Eliz Miu Yin Wong ,&nbsp;Randolph C.H. Chan ,&nbsp;Suchon Tepjan ,&nbsp;Peter A. Newman","doi":"10.1016/j.socscimed.2025.117822","DOIUrl":"10.1016/j.socscimed.2025.117822","url":null,"abstract":"<div><div>Lesbian, gay, bisexual, transgender, queer and plus (LGBTQ+) related health concerns in medical training have historically been underrepresented or largely omitted. This review goes beyond the Global North and is one of the first scoping reviews to take a regional approach to understanding LGBTQ+ issues in medical training in Asia, a region that millions of LGBTQ+ people call home. A scoping review of peer-reviewed articles published from 2000 to 2024 on LGBTQ+ issues in medical training (including medical, nursing and dentistry) in Asia was conducted. A diversity of attitudes towards LGBTQ+ issues were found among medical, dental, and nursing students. Negative attitudes, especially pathologization of LGBTQ+ people, were still evident. Despite receiving inadequate training from their medical curriculum, students generally showed a strong eagerness to learn more about LGBTQ+ healthcare to know how to act professionally. Although LGBTQ+ students perceived a supportive environment among their peers, there were constant worries about how they were perceived as doctors by attending physicians and patients. Medical, dental, and nursing educators in the identified studies had minimal knowledge of LGBTQ+ issues and limited experience working with LGBTQ+ patients. Articles found that LGBTQ+ issues were lacking in the formal medical curriculum, with very little consideration beyond strictly biomedical concerns. Importantly, this paper debunks the idea that Asia is uniformly negative and conservative on LGBTQ+ issues, highlights the importance of regionally and culturally specific factors in understanding the medical training environment, and provides suggestions for practice and further research. Altogether, this paper argues that there is an urgent need and a substantial opportunity to make medical training in Asia more LGBTQ+ inclusive.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"370 ","pages":"Article 117822"},"PeriodicalIF":4.9,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143479776","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}

{"title":"Place-based access to integrated mental health services within substance use disorder treatment facilities in the US","authors":"George Pro ,&nbsp;Harold W. Neighbors ,&nbsp;Brittany Wilkerson ,&nbsp;Tiffany Haynes","doi":"10.1016/j.socscimed.2025.117843","DOIUrl":"10.1016/j.socscimed.2025.117843","url":null,"abstract":"<div><div>The co-occurrence of substance use (SUD) and mental disorders is increasing in the US. Integrating mental health services into SUD treatment facilities improves treatment retention and success, but access to integrated services is lagging behind growing demand. The purpose of this study was to map the locations of SUD treatment facilities that offer integrated mental health services and identify community characteristics associated with whether a treatment facility offers more comprehensive integrated services. We used the Mental health and Addiction Treatment Tracking Repository to identify the location and characteristics of licensed outpatient SUD treatment facilities in the US (2022; N = 8,858). Our focal predictors included the percentage of a census block group that was White, Black, and Hispanic. We used multilevel multiple logistic regression to model whether a facility offered integrated mental health (y/n), adjusted for relevant facility-, county-, and state-level covariates, and defined state as a random effect. The majority of integrated facilities were located in the eastern US, with notable concentrations around large metropolitan areas of Minneapolis, MN, Chicago, IL, Atlanta, GA, and New York, NY. For every 10-percentage point increase in a census block group's Black and Hispanic population, there was a 5% and 7% decrease in the odds of offering integrated services, respectively (aOR_Black = 0.95, 95% CI = 0.91–0.99, p = 0.04; aOR_Hispanic = 0.93, 95% CI = 0.90–0.96, p &lt; 0.0001). We frame our findings around social conditions as fundamental drivers of disease and healthcare access and acknowledge the country's historical disinvestment in nonwhite and rural communities. Racially targeted programs are needed to effectively address growing racial and ethnic inequities in SUD and mental healthcare.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"369 ","pages":"Article 117843"},"PeriodicalIF":4.9,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143454337","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":"Characteristics of geographic environments that support the health and wellbeing of young people with disability: A scoping review","authors":"Amanda Alderton ,&nbsp;Zoe Aitken ,&nbsp;Belinda Hewitt ,&nbsp;Elroy Dearn ,&nbsp;Hannah Badland","doi":"10.1016/j.socscimed.2025.117842","DOIUrl":"10.1016/j.socscimed.2025.117842","url":null,"abstract":"<div><h3>Purpose</h3><div>We aimed to: 1) identify key characteristics of geographic environments relating to the health and wellbeing of young people with disability that have been published in the literature, and 2) determine the coverage of evidence examining these characteristics and current gaps in knowledge of the ways geographic environments support health and wellbeing outcomes for young people with disability.</div></div><div><h3>Methods</h3><div>This scoping review followed Arksey and O'Malley's methodological framework and established reporting guidelines (PRISMA-ScR Checklist). We searched the following databases: Web of Science (Core Collection), PubMed (Medline), Scopus, Proquest Central.</div></div><div><h3>Results</h3><div>We identified 35 studies meeting inclusion criteria, which were mostly from high-income, English-speaking countries. Studies were grouped into ten major themes, which broadly align with place-based social determinants of health (e.g., access to transport, neighbourhood built environments). The largest body of evidence coalesced around neighbourhood social cohesion and related concepts. Notable gaps included a lack of evidence from the Global South, and limited investigation of local employment availability, access to healthcare, leisure and recreation, neighbourhood safety, and transitions into independent living.</div></div><div><h3>Conclusions</h3><div>This scoping review characterised the existing evidence around the key characteristics of geographic environments that support (or hinder) the health and wellbeing of young people with disability, and identified several important gaps and opportunities for future research. This includes developing a better understanding of the place-based experiences, geographic scales, and environmental exposures that are most relevant for young people with disability, including through participatory methods (e.g., participatory mapping).</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"370 ","pages":"Article 117842"},"PeriodicalIF":4.9,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143463814","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}

{"title":"The impact of China's low-carbon city pilot program on the health of children","authors":"Jiaoli Cai ,&nbsp;Yue Li ,&nbsp;Peter C. Coyte","doi":"10.1016/j.socscimed.2025.117823","DOIUrl":"10.1016/j.socscimed.2025.117823","url":null,"abstract":"<div><div>Global climate change poses a significant threat to public health in general and to the health of children, in particular. In response to this threat, many countries have implemented a series of policies to mitigate climate change, among which China's low-carbon city pilot program has attracted widespread attention. This study used longitudinal data drawn from the China Family Panel Studies between 2012 and 2018 to evaluate the impact of China's low-carbon city pilot program on the health of children. A difference-in-differences model was employed to investigate the effects of the policy, with further exploration of potential impact mechanisms. The results demonstrated that China's low-carbon city pilot program substantially improved the health of children by fostering environmental quality and promoting slow mobility (i.e., travel on foot or by bicycle). The study also showed that the impact of the pilot program on the health of children was proportional to their proximity to school. Our findings are significant not only for the expansion of China's pilot policy, but also generally for low- and middle-income countries in their efforts to combat air pollution and understand the scale of its impact on the health of children.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"369 ","pages":"Article 117823"},"PeriodicalIF":4.9,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143420030","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}

{"title":"Dimensions of cisheteronormativity that influence healthcare utilization practices in LGBTQ+ populations: A systematic review","authors":"Mik S. Bartels,&nbsp;Caroline Ng Tseung-Wong,&nbsp;Dimity A. Crisp,&nbsp;Patricia M. Brown","doi":"10.1016/j.socscimed.2025.117818","DOIUrl":"10.1016/j.socscimed.2025.117818","url":null,"abstract":"<div><h3>Introduction</h3><div>Cisheteronormativity in healthcare settings may further exacerbate existing health disparities between LGBTQ+ and non-LGBTQ+ populations. The aim of the current review is to identify dimensions of cisheteronormativity that manifest in healthcare settings to influence healthcare utilization by LGBTQ+ individuals.</div></div><div><h3>Method</h3><div>8148 articles were screened, with 53 remaining for inclusion.</div></div><div><h3>Results</h3><div>Thematic synthesis identified five themes linked to negative healthcare use: 1) Lack of Provider LGBTQ+ Knowledge, 2) Endorsements of Cisheteronormativity, 3) Assumptions of LGBTQ+ experiences and assumptions of non-LGBTQ+ identity, 4) Negation, and 5) Abuse of Power.</div></div><div><h3>Conclusion</h3><div>Findings emphasize the need for provider education regarding LGBTQ+ identities and the dismantling of cisheteronormative structures in healthcare.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"371 ","pages":"Article 117818"},"PeriodicalIF":4.9,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143529803","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}

{"title":"A virtual assistant can persuade you to get vaccinated against the flu. Online dialogue as a tool of social influence in promoting vaccinations","authors":"Agnieszka Kozłowska,&nbsp;Tomasz Grzyb,&nbsp;Dariusz Doliński","doi":"10.1016/j.socscimed.2025.117825","DOIUrl":"10.1016/j.socscimed.2025.117825","url":null,"abstract":"<div><div>Declining acceptance of vaccinations poses a severe challenge to public health. This study delves into the effectiveness of online dialogue in shaping vaccination attitudes amidst this concerning trend. In today's digital age, utilizing the Internet for public health interventions seems crucial. We developed the FLORA application to engage users in health discussions through a conversational agent and tested it in two experiments. The first (N = 903) assessed the impact of online dialogue on vaccine willingness, while the second (N = 870) included a direct vaccination request. The results revealed a noticeable increase in vaccination intention among participants engaged in the interactive dialogue ending with a request. These findings highlight the potential of online dialogue to convey information about vaccines and support healthcare efforts effectively.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"369 ","pages":"Article 117825"},"PeriodicalIF":4.9,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143454336","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":"Examining the association between service coverage of UHC and global disease burden: A cross-country panel analysis","authors":"Tisha Chakma ,&nbsp;Suzana Karim ,&nbsp;Atonu Rabbani","doi":"10.1016/j.socscimed.2025.117832","DOIUrl":"10.1016/j.socscimed.2025.117832","url":null,"abstract":"<div><div>Over the past two decades, numerous countries have enhanced their Universal Health Coverage (UHC), as indicated by the UHC Service Coverage Index (SCI), alongside a global reduction in the disease burden measured by Disability-Adjusted Life Years (DALYs). This paper uses a cross-country panel of 190 countries from 2000 to 2019 to identify the association between UHC SCI and DALYs gain. We find that a one-unit increase in the UHC SCI was associated with a significant decrease in total DALYs. Furthermore, UHC SCI was mostly associated with lowering DALYs from communicable, maternal, neonatal, and nutritional diseases but showed little to no significant association with non-communicable diseases or injuries. These results are robust to various robustness tests. Notable reasons include governments spending more on communicable, maternal, neonatal, and nutritional diseases than on non-communicable diseases and injuries, which is also the case for external aid. Our results also suggest that moving towards UHC helps lower-income countries more than higher-income countries, as developed nation-states have already established a well-functioning health system. Addressing non-communicable diseases and injuries will be essential to improve health outcomes and achieve SDGs in future.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"369 ","pages":"Article 117832"},"PeriodicalIF":4.9,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143454338","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":"Organizational characteristics associated with sustained participation in internal quality improvement: Findings from two waves of a national sample of physician practices in the United States","authors":"Vanessa B. Hurley ,&nbsp;Amanda L. Brewster ,&nbsp;Matthew J. DePuccio ,&nbsp;Dorothy Y. Hung ,&nbsp;A. James O'Malley ,&nbsp;Karen E. Schifferdecker","doi":"10.1016/j.socscimed.2025.117826","DOIUrl":"10.1016/j.socscimed.2025.117826","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Engagement in internal quality improvement (QI) within physician practices is a key avenue by which to deliver evidence-based and patient-centered care, but it can be difficult to sustain such engagement. Consequently, research is needed that identifies organizational factors associated with sustained internal QI. We utilized two waves of a national survey of physician practices to explore whether organizational innovation characteristics including organizational culture, health information technology (HIT) capacity, and Accountable Care Organization (ACO) affiliation distinguish physician practices that sustain their engagement in internal QI from those that do not.</div></div><div><h3>Methods</h3><div>We linked two waves of the National Survey of Healthcare Organizations and Systems (NSHOS) fielded between 2017-2018 and 2022–2023 among physician practices in the United States to assess organizational characteristics associated with sustained engagement in QI (n = 714 practices). Our final regression models incorporate survey and nonresponse weights and control for practice size and ownership.</div></div><div><h3>Results</h3><div>We found that higher innovative culture scores were associated with almost three times the odds of sustained QI (OR = 2.91, p &lt; 0.001). Although high HIT capacity was also associated with greater odds of sustained versus non-sustained QI across both survey waves, this finding was not statistically significant (OR = 1.11, p &gt; 0.05). We did not find statistically significant support for our final hypothesis that ACO affiliation (whether commercial, Medicare, or Medicaid) was associated with sustained internal QI (OR = 1.26, p &gt; 0.05).</div></div><div><h3>Conclusions</h3><div>Our study is the first to our knowledge to underscore the critical importance of innovative organizational culture to sustaining internal QI among physician practices. Although ACO affiliation may signal willingness to participate in QI as a means to advance evidence- and value-based care and HIT capacity may facilitate improvement activities, these characteristics may not assure sustained internal QI engagement without an organizational culture aligned with QI.</div></div><div><h3>Practice implications</h3><div>Policies that advance organizational capacity to develop a learning-oriented innovative culture could enable sustained QI engagement at the physician practice level.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"369 ","pages":"Article 117826"},"PeriodicalIF":4.9,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143420031","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}