Pub Date : 2026-01-12DOI: 10.1016/j.socscimed.2026.118973
Clara Felicity Fabian-Therond
Personalised medicine is gathering pace across advanced cancer settings in the UK NHS, and care pathways are becoming increasingly filled with different steps, stages and treatments. One key personalised medicine practice is stratifying patients according to their molecular profile. Nevertheless, understanding how this practice shapes lived experience of cancer patients remains an under-researched area. To shed light on this question this paper focuses on the practice of stratifying patients according to their BRCA gene prior to or at the beginning of a late-stage ovarian cancer personalised medicine pathway. I draw on interviews and observations with 17 ovarian cancer patients, who formed part of a larger comparative ethnographic study, which took place between 2020 and 2021 in a tertiary hospital in the South-East of England. Focus on this one practice made it possible to demonstrate how as well as being a diagnostic tool stratification is an affective technology that cultivates range of feelings including inclusion or exclusion, and novel kinds of 'biosociality' (Rabinow, 1999). These findings offer critical insight into the importance to separate and scrutinise its practices on long pathways to understand the lived and felt experience of care.
{"title":"Pathways to personalisation: The practice of BRCA stratification.","authors":"Clara Felicity Fabian-Therond","doi":"10.1016/j.socscimed.2026.118973","DOIUrl":"https://doi.org/10.1016/j.socscimed.2026.118973","url":null,"abstract":"<p><p>Personalised medicine is gathering pace across advanced cancer settings in the UK NHS, and care pathways are becoming increasingly filled with different steps, stages and treatments. One key personalised medicine practice is stratifying patients according to their molecular profile. Nevertheless, understanding how this practice shapes lived experience of cancer patients remains an under-researched area. To shed light on this question this paper focuses on the practice of stratifying patients according to their BRCA gene prior to or at the beginning of a late-stage ovarian cancer personalised medicine pathway. I draw on interviews and observations with 17 ovarian cancer patients, who formed part of a larger comparative ethnographic study, which took place between 2020 and 2021 in a tertiary hospital in the South-East of England. Focus on this one practice made it possible to demonstrate how as well as being a diagnostic tool stratification is an affective technology that cultivates range of feelings including inclusion or exclusion, and novel kinds of 'biosociality' (Rabinow, 1999). These findings offer critical insight into the importance to separate and scrutinise its practices on long pathways to understand the lived and felt experience of care.</p>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"394 ","pages":"118973"},"PeriodicalIF":5.0,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146138073","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 : 2026-01-12DOI: 10.1016/j.socscimed.2026.118971
Jessica Finlay , Grace Savard , Desiree Alvarez-McNelis , Mallory Sagehorn , Grace Bowman , Yue Sun , Michael Esposito
While geographic variation in Alzheimer's Disease and Related Dementias (ADRD) rates suggests that environmental factors are important in the development of dementia, understanding of specific neighborhood sites that impact dementia risk is limited, especially in early and mid adulthood. This paper extends Cognability to a life course perspective to conceptualize how neighborhoods may support cognitive health behaviors including physical activity, diet, cognitive stimulation, and socialization across adulthood. The Neighborhoods and Health at All Ages Study employed stationary and mobile interviews (August 2023–March 2024) across the Minneapolis-St. Paul (MN) metropolitan area. Participants were on average 42 years old (range: 23–75). About half (53 %) identified as female, 40 % male, and 7 % nonbinary. Participants reflected diverse racial and ethnic backgrounds, including Asian (22 %), Hispanic (22 %), non-Hispanic White (18 %), Multiracial (17 %), Black/African American (15 %), American Indian/Alaska Native (3 %), and Other/Missing (3 %). Reflexive thematic analysis identified ten neighborhood services and amenities that support cognitive health behaviors: parks and paths, recreation centers, eateries, grocers and food markets, retail stores, civic and social organizations, religious organizations, arts and cultural sites, libraries, and educational sites. The study captured nuanced, intersectional perspectives from adults with varied socioeconomic, racial/ethnic, and gender identities to illuminate how use and salience of neighborhood services and amenities vary across adulthood. As the global dementia burden grows and disparities widen, our results help inform upstream community-level interventions to create more equitable neighborhoods that reduce ADRD risk and support lifelong cognitive health and wellbeing.
{"title":"Cognability across adulthood: A qualitative investigation of neighborhoods and cognitive health behaviors","authors":"Jessica Finlay , Grace Savard , Desiree Alvarez-McNelis , Mallory Sagehorn , Grace Bowman , Yue Sun , Michael Esposito","doi":"10.1016/j.socscimed.2026.118971","DOIUrl":"10.1016/j.socscimed.2026.118971","url":null,"abstract":"<div><div>While geographic variation in Alzheimer's Disease and Related Dementias (ADRD) rates suggests that environmental factors are important in the development of dementia, understanding of <em>specific</em> neighborhood sites that impact dementia risk is limited, especially in early and mid adulthood. This paper extends Cognability to a life course perspective to conceptualize how neighborhoods may support cognitive health behaviors including physical activity, diet, cognitive stimulation, and socialization across adulthood. The <em>Neighborhoods and Health at All Ages Study</em> employed stationary and mobile interviews (August 2023–March 2024) across the Minneapolis-St. Paul (MN) metropolitan area. Participants were on average 42 years old (range: 23–75). About half (53 %) identified as female, 40 % male, and 7 % nonbinary. Participants reflected diverse racial and ethnic backgrounds, including Asian (22 %), Hispanic (22 %), non-Hispanic White (18 %), Multiracial (17 %), Black/African American (15 %), American Indian/Alaska Native (3 %), and Other/Missing (3 %). Reflexive thematic analysis identified ten neighborhood services and amenities that support cognitive health behaviors: parks and paths, recreation centers, eateries, grocers and food markets, retail stores, civic and social organizations, religious organizations, arts and cultural sites, libraries, and educational sites. The study captured nuanced, intersectional perspectives from adults with varied socioeconomic, racial/ethnic, and gender identities to illuminate how use and salience of neighborhood services and amenities vary across adulthood. As the global dementia burden grows and disparities widen, our results help inform upstream community-level interventions to create more equitable neighborhoods that reduce ADRD risk and support lifelong cognitive health and wellbeing.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"392 ","pages":"Article 118971"},"PeriodicalIF":5.0,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145979838","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 : 2026-01-11DOI: 10.1016/j.socscimed.2026.118969
Ricardo Martínez-Flores , Caroline Brand , Gerson Ferrari , Kabir P. Sadarangani , Jorge Cancino-López , Jaime Leppe-Zamora , Carlos Cristi-Montero
Introduction
Sedentary time is associated with adverse health outcomes, and workplace inactivity contributes substantially to overall sedentary behavior. Although effective strategies are needed, evidence comparing guided versus unguided breaks remains limited.
Objective
This study compared the effects of Booster Breaks (B-B) and Computer Prompts (C-P) on sedentary time, body composition, stress perception, and occupational pain among desk-based workers.
Methods
In this quasi-experimental study, 61 desk-based workers were assigned to B-B, C-P, or control groups. B-B consisted of guided 14–16-min active breaks, while C-P involved unguided 2-min hourly breaks, totaling 14–16 min per day for 12 weeks. Body composition was assessed using dual-energy X-ray absorptiometry; stress was measured with the Perceived Stress Scale, and occupational pain with the Nordic Musculoskeletal Questionnaire. Sedentary time and physical activity were monitored via ActiGraph accelerometers. Data were analyzed using ANCOVA, and effect sizes (ES) estimated using Hedges’ g.
Results
The C-P group showed a significant reduction in android fat mass compared to the control group (p = 0.007; ES = −0.867). The B-B group demonstrated significant increases in lean mass (p = 0.029; ES = 0.952) and muscle mass (p = 0.016; ES = 1.025) relative to controls. No significant differences were found for sedentary time, stress, or occupational pain.
Conclusion
Both B-B and C-P interventions positively influenced body composition, with C-P reducing android fat and B-B increasing lean and muscle mass. However, neither intervention affected sedentary time, stress, or pain, highlighting the need for further research to refine workplace health strategies.
引言：久坐时间与不良健康结果相关，工作场所不活动在很大程度上导致了整体久坐行为。虽然需要有效的策略，但比较引导和非引导休息的证据仍然有限。目的：本研究比较了助推器休息（B-B）和电脑提示（C-P）对坐着工作的人久坐时间、身体成分、压力感知和职业性疼痛的影响。方法：在这个准实验研究中，61名办公桌工作人员被分配到B-B组，C-P组和对照组。B-B组包括有指导的14-16分钟主动休息，而C-P组包括无指导的2分钟每小时休息，每天共计14-16分钟，持续12周。采用双能x线吸收仪评估体成分；用感知压力量表测量压力，用北欧肌肉骨骼问卷测量职业性疼痛。通过ActiGraph加速度计监测久坐时间和身体活动。使用ANCOVA分析数据，并使用Hedges' g估计效应量（ES）。结果：与对照组相比，C-P组的android脂肪量显著减少（p = 0.007; ES = -0.867）。与对照组相比，B-B组的瘦肉质量（p = 0.029; ES = 0.952）和肌肉质量（p = 0.016; ES = 1.025）显著增加。在久坐时间、压力或职业性疼痛方面没有发现显著差异。结论：B-B和C-P干预均对体成分产生积极影响，C-P减少脂肪，B-B增加瘦肉和肌肉质量。然而，这两种干预措施都没有影响久坐时间、压力或疼痛，这凸显了进一步研究以完善工作场所健康策略的必要性。
{"title":"Impact of booster breaks and computer prompts on sedentary time, body composition, stress perception, and occupational pain in desk-based workers: A quasi-experimental study – The UP project","authors":"Ricardo Martínez-Flores , Caroline Brand , Gerson Ferrari , Kabir P. Sadarangani , Jorge Cancino-López , Jaime Leppe-Zamora , Carlos Cristi-Montero","doi":"10.1016/j.socscimed.2026.118969","DOIUrl":"10.1016/j.socscimed.2026.118969","url":null,"abstract":"<div><h3>Introduction</h3><div>Sedentary time is associated with adverse health outcomes, and workplace inactivity contributes substantially to overall sedentary behavior. Although effective strategies are needed, evidence comparing guided versus unguided breaks remains limited.</div></div><div><h3>Objective</h3><div>This study compared the effects of Booster Breaks (B-B) and Computer Prompts (C-P) on sedentary time, body composition, stress perception, and occupational pain among desk-based workers.</div></div><div><h3>Methods</h3><div>In this quasi-experimental study, 61 desk-based workers were assigned to B-B, C-P, or control groups. B-B consisted of guided 14–16-min active breaks, while C-P involved unguided 2-min hourly breaks, totaling 14–16 min per day for 12 weeks. Body composition was assessed using dual-energy X-ray absorptiometry; stress was measured with the Perceived Stress Scale, and occupational pain with the Nordic Musculoskeletal Questionnaire. Sedentary time and physical activity were monitored via ActiGraph accelerometers. Data were analyzed using ANCOVA, and effect sizes (ES) estimated using Hedges’ g.</div></div><div><h3>Results</h3><div>The C-P group showed a significant reduction in android fat mass compared to the control group (p = 0.007; ES = −0.867). The B-B group demonstrated significant increases in lean mass (p = 0.029; ES = 0.952) and muscle mass (p = 0.016; ES = 1.025) relative to controls. No significant differences were found for sedentary time, stress, or occupational pain.</div></div><div><h3>Conclusion</h3><div>Both B-B and C-P interventions positively influenced body composition, with C-P reducing android fat and B-B increasing lean and muscle mass. However, neither intervention affected sedentary time, stress, or pain, highlighting the need for further research to refine workplace health strategies.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"392 ","pages":"Article 118969"},"PeriodicalIF":5.0,"publicationDate":"2026-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145999338","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}
Adolescent depression is a major public health concern involving well-documented gender differences that may vary across cultural contexts. In China's academically intensive educational environment, questions regarding when depression risk peaks across adolescence, how behavioral and social factors relate to depression differentially by gender, and how risks cluster into distinct vulnerability profiles remain underexplored. This cross-sectional study analyzed data from a nationwide survey of 414,175 Chinese adolescents. We used generalized additive models and latent profile analysis to examine gender-differentiated age patterns and behavioral-social risk configurations. Results showed that girls reported higher depression scores than boys. Age patterns differed by gender: girls exhibited persistently elevated depression between ages 14-18, whereas boys showed na less pronounced inverted U-shaped pattern with resurgence in late adolescence. Behavioral risks (substance use, screen time) were more strongly associated with depression among girls, whereas physical activity and perceived socioeconomic resources were stronger protective factors for girls. Latent profile analysis identified three subgroups-"Active Advantaged," "Inactive Disadvantaged," and "Screen-Dependent"-with girls in the Screen-Dependent profile (10 %; high screen time, low physical activity) showing markedly higher depression levels. The findings highlight the need for continuous mental health monitoring for girls throughout mid-to-late adolescence (ages 14-18), increased support for boys approaching late adolescence (ages 16-18), and targeted interventions addressing clustered risks in high-screen-use, low-activity subgroups.
{"title":"Who is most at risk, and when? Gender-differentiated patterns and risk heterogeneity of adolescent depression in China: Evidence from a large-scale national study.","authors":"Chengxi Hu, Yiqiao Qi, Wenfei Winnie Wang, Wei Yan, Kaiping Peng","doi":"10.1016/j.socscimed.2026.118938","DOIUrl":"https://doi.org/10.1016/j.socscimed.2026.118938","url":null,"abstract":"<p><p>Adolescent depression is a major public health concern involving well-documented gender differences that may vary across cultural contexts. In China's academically intensive educational environment, questions regarding when depression risk peaks across adolescence, how behavioral and social factors relate to depression differentially by gender, and how risks cluster into distinct vulnerability profiles remain underexplored. This cross-sectional study analyzed data from a nationwide survey of 414,175 Chinese adolescents. We used generalized additive models and latent profile analysis to examine gender-differentiated age patterns and behavioral-social risk configurations. Results showed that girls reported higher depression scores than boys. Age patterns differed by gender: girls exhibited persistently elevated depression between ages 14-18, whereas boys showed na less pronounced inverted U-shaped pattern with resurgence in late adolescence. Behavioral risks (substance use, screen time) were more strongly associated with depression among girls, whereas physical activity and perceived socioeconomic resources were stronger protective factors for girls. Latent profile analysis identified three subgroups-\"Active Advantaged,\" \"Inactive Disadvantaged,\" and \"Screen-Dependent\"-with girls in the Screen-Dependent profile (10 %; high screen time, low physical activity) showing markedly higher depression levels. The findings highlight the need for continuous mental health monitoring for girls throughout mid-to-late adolescence (ages 14-18), increased support for boys approaching late adolescence (ages 16-18), and targeted interventions addressing clustered risks in high-screen-use, low-activity subgroups.</p>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"393 ","pages":"118938"},"PeriodicalIF":5.0,"publicationDate":"2026-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146100638","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 : 2026-01-10DOI: 10.1016/j.socscimed.2025.118796
Harry Taylor , Sarah Stopforth , Dharmi Kapadia , James Nazroo , Chris White , Laia Bécares
Experimental life expectancy estimates calculated by the Office for National Statistics (ONS) for the period 2011 to 2014 show significantly longer life expectancy for minoritised ethnic groups in England and Wales when compared with the white majority. These findings are in contrast to a large body of evidence of poorer health outcomes among certain minoritised ethnic groups (predominately Bangladeshi, Black Caribbean, Gypsy/Traveller and Pakistani groups), and have serious practice and policy implications if taken as definitive. We examine the data and methodology used by the ONS in producing these estimates, and consider the sources of error in that approach. We find that the estimates for minoritised ethnic groups exhibit high sensitivity to error that is not seen in the estimates for the White British population; although we note that even in our largest error scenario, many minoritised ethnic groups still have higher life expectancy than the White British group. Although the results are supported by evidence around the “healthy migrant” effect, and other global research on life expectancy by ethnic group, there is a risk that the ONS’ life expectancy estimates of minoritised ethnic groups may be being inflated due to the large amount of missing data among these groups, and the potential for those missing cohorts to be at higher risk of morbidity and mortality. The ONS’ estimates, while clearly labelled as experimental, have been used in academia, policy and the press without necessary caveats. We remind researchers of the experimental nature of the ONS’ life expectancy by ethnic group estimates, and advise caution in how they are used.
{"title":"Methodological assumptions and limitations of life expectancy estimates for minoritised ethnic groups in the UK: implications for validity, practice, and policy","authors":"Harry Taylor , Sarah Stopforth , Dharmi Kapadia , James Nazroo , Chris White , Laia Bécares","doi":"10.1016/j.socscimed.2025.118796","DOIUrl":"10.1016/j.socscimed.2025.118796","url":null,"abstract":"<div><div>Experimental life expectancy estimates calculated by the Office for National Statistics (ONS) for the period 2011 to 2014 show significantly longer life expectancy for minoritised ethnic groups in England and Wales when compared with the white majority. These findings are in contrast to a large body of evidence of poorer health outcomes among certain minoritised ethnic groups (predominately Bangladeshi, Black Caribbean, Gypsy/Traveller and Pakistani groups), and have serious practice and policy implications if taken as definitive. We examine the data and methodology used by the ONS in producing these estimates, and consider the sources of error in that approach. We find that the estimates for minoritised ethnic groups exhibit high sensitivity to error that is not seen in the estimates for the White British population; although we note that even in our largest error scenario, many minoritised ethnic groups still have higher life expectancy than the White British group. Although the results are supported by evidence around the “healthy migrant” effect, and other global research on life expectancy by ethnic group, there is a risk that the ONS’ life expectancy estimates of minoritised ethnic groups may be being inflated due to the large amount of missing data among these groups, and the potential for those missing cohorts to be at higher risk of morbidity and mortality. The ONS’ estimates, while clearly labelled as experimental, have been used in academia, policy and the press without necessary caveats. We remind researchers of the experimental nature of the ONS’ life expectancy by ethnic group estimates, and advise caution in how they are used.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"390 ","pages":"Article 118796"},"PeriodicalIF":5.0,"publicationDate":"2026-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145939427","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 : 2026-01-10DOI: 10.1016/j.socscimed.2026.118954
Rosamund Greiner
Mothers of disabled children typically fulfil the role of the primary caregiver. For mothers of children with Congenital Zika Syndrome in Colombia, the caregiver role extends far beyond the provision of direct personal care within the private sphere of the home. Their children require specialist interventions, and mothers negotiate access on behalf of their children. In the process, they frequently encounter barriers to timely access to healthcare and welfare for their child. Barriers and facilitators have received significant attention in the literature, but caregivers responses to barriers have been largely overlooked. Drawing on ethnographic research conducted between February 2022 and March 2023 with mothers of children with Congenital Zika Syndrome in Barranquilla, Colombia, I address this gap. In my analysis, I bring together Menéndez’ concept of autoatención (self-management) with Madden's conceptualisation of cultural health capital to explore how mothers respond to barriers and negotiate access to healthcare on behalf of their child. They adopt diverse strategies to draw together formal and informal spaces of attention and care, make use of both biomedical and alternative interventions, and share information about how they manage their child's health with other caregivers. This analysis highlights the essential role of their gendered reproductive labour in ensuring healthcare access and efficacy.
{"title":"“I'm not moving from here until you resolve this for me”: mothers of disabled children overcoming barriers to health care","authors":"Rosamund Greiner","doi":"10.1016/j.socscimed.2026.118954","DOIUrl":"10.1016/j.socscimed.2026.118954","url":null,"abstract":"<div><div>Mothers of disabled children typically fulfil the role of the primary caregiver. For mothers of children with Congenital Zika Syndrome in Colombia, the caregiver role extends far beyond the provision of direct personal care within the private sphere of the home. Their children require specialist interventions, and mothers negotiate access on behalf of their children. In the process, they frequently encounter barriers to timely access to healthcare and welfare for their child. Barriers and facilitators have received significant attention in the literature, but caregivers responses to barriers have been largely overlooked. Drawing on ethnographic research conducted between February 2022 and March 2023 with mothers of children with Congenital Zika Syndrome in Barranquilla, Colombia, I address this gap. In my analysis, I bring together Menéndez’ concept of autoatención (self-management) with Madden's conceptualisation of cultural health capital to explore how mothers respond to barriers and negotiate access to healthcare on behalf of their child. They adopt diverse strategies to draw together formal and informal spaces of attention and care, make use of both biomedical and alternative interventions, and share information about how they manage their child's health with other caregivers. This analysis highlights the essential role of their gendered reproductive labour in ensuring healthcare access and efficacy.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"392 ","pages":"Article 118954"},"PeriodicalIF":5.0,"publicationDate":"2026-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145979731","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 : 2026-01-10DOI: 10.1016/j.socscimed.2026.118967
Michael R. Kramer , Kaitlyn K. Stanhope , Peter J. Joski , Marissa Coloske , Anne L. Dunlop , E. Kathleen Adams
Severe maternal morbidity (SMM) is a composite measure comprising a spectrum of pregnancy-related complications that have substantial implications for short- and long-term maternal health. Existing research focuses primarily on the occurrence of SMM at delivery, but growing evidence points to risks throughout the post-partum period. While racial, ethnic, economic, and geographic disparities in SMM are well documented, the underlying drivers of inequities, particularly the roles of socio-spatial stratification and access to health services, are not well understood. Using a longitudinally-linked cohort of 637,932 hospital deliveries between 2016 and 2022 we examined two questions: (1) Does the race-specific association between neighborhood deprivation (NDI) or the index of concentration at extremes for income (ICE) and SMM vary by time period of SMM (delivery, 3 months after delivery, or up to 12 months postpartum)? (2) Are these associations modified by policy-relevant health service indicators, including payor, proximity to Federally Qualified Health Centers, and availability of OB-GYN's? Half of all SMM events occurred in the postpartum year. NDI was not significantly associated with SMM at delivery for Hispanic, Non-Hispanic White or Black individuals, but was positively associated with SMM between 3 and 12 months for all race/ethnic groups. Living in areas of concentrated affluence was protective against postpartum SMM for non-Hispanic Black individuals while concentrated poverty was associated with higher postpartum SMM risk for Hispanic and non-Hispanic Black women. Place-based structural disadvantage is a key determinant of postpartum SMM and disparities in SMM rates.
{"title":"Postpartum severe maternal morbidity: A longitudinal analysis of the association with economic segregation and neighborhood deprivation in Georgia, USA 2016–2022","authors":"Michael R. Kramer , Kaitlyn K. Stanhope , Peter J. Joski , Marissa Coloske , Anne L. Dunlop , E. Kathleen Adams","doi":"10.1016/j.socscimed.2026.118967","DOIUrl":"10.1016/j.socscimed.2026.118967","url":null,"abstract":"<div><div>Severe maternal morbidity (SMM) is a composite measure comprising a spectrum of pregnancy-related complications that have substantial implications for short- and long-term maternal health. Existing research focuses primarily on the occurrence of SMM at delivery, but growing evidence points to risks throughout the post-partum period. While racial, ethnic, economic, and geographic disparities in SMM are well documented, the underlying drivers of inequities, particularly the roles of socio-spatial stratification and access to health services, are not well understood. Using a longitudinally-linked cohort of 637,932 hospital deliveries between 2016 and 2022 we examined two questions: (1) Does the race-specific association between neighborhood deprivation (NDI) or the index of concentration at extremes for income (ICE) and SMM vary by time period of SMM (delivery, 3 months after delivery, or up to 12 months postpartum)? (2) Are these associations modified by policy-relevant health service indicators, including payor, proximity to Federally Qualified Health Centers, and availability of OB-GYN's? Half of all SMM events occurred in the postpartum year. NDI was not significantly associated with SMM at delivery for Hispanic, Non-Hispanic White or Black individuals, but was positively associated with SMM between 3 and 12 months for all race/ethnic groups. Living in areas of concentrated affluence was protective against postpartum SMM for non-Hispanic Black individuals while concentrated poverty was associated with higher postpartum SMM risk for Hispanic and non-Hispanic Black women. Place-based structural disadvantage is a key determinant of postpartum SMM and disparities in SMM rates.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"392 ","pages":"Article 118967"},"PeriodicalIF":5.0,"publicationDate":"2026-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145979812","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 : 2026-01-10DOI: 10.1016/j.socscimed.2026.118955
Sarah Elshahat , Tina Moffat , K. Bruce Newbold , Asil Samhat , Mafaz Gehani , Yumnah Jafri , Zena Shamli Oghli , Nour Kanaa , Bisma Shafiq , Amna Zaidi , Aniqa Chaudhry , Janna Elshakankiri , Mariam Rahman , Momina Ahmad
There has been growing interest in the concept of resilience for promoting people's health and well-being and to mitigate inequities. There are various definitions of the concept in the literature, yet there have still been repeated calls for a more culturally sensitive, context-oriented conceptualization of resilience. This is particularly critical for racialized populations, given the rise in racism and the ‘othering’ that this group faces. This paper explored resilience and its pathways among Arab Canadians. A collaborative, community-based participatory research and integrated knowledge translation approach was employed in this project. Qualitative interviews and Photovoice sessions were conducted with 50 and 26 participants , respectively, all aged ≥18 years and recruited throughout October 2021-June 2022. This research is guided by a social and cultural ecologies perspective of resilience theory.
Arab Canadian participants conceptualized resilience as resistance to structural barriers and adversities, which operated at both collective and individual levels. Faith and religious practices were major pathways to enable both collective and individual resilience among Arab Canadian participants. Findings from this research also indicated that collective resilience can be developed through culturally responsive and community-based initiatives. This study contributes to the wider theoretical discourse regarding resilience by advancing beyond individual-focused models to consider socio-cultural factors and collective, community-situated dimensions. Findings from our research show that cultural resistance can function as part of a practice of resilience, where diasporic communities transform struggles into collective perseverance under conditions of displacement and oppression. Our theoretical contribution holds practical significance for policy and practice that promote the well-being of Arab diaspora communities and other racialized communities.
{"title":"‘For us, we call it resistance’- conceptualizing resilience and its pathways among Arab Canadians: The CAN-HEAL study","authors":"Sarah Elshahat , Tina Moffat , K. Bruce Newbold , Asil Samhat , Mafaz Gehani , Yumnah Jafri , Zena Shamli Oghli , Nour Kanaa , Bisma Shafiq , Amna Zaidi , Aniqa Chaudhry , Janna Elshakankiri , Mariam Rahman , Momina Ahmad","doi":"10.1016/j.socscimed.2026.118955","DOIUrl":"10.1016/j.socscimed.2026.118955","url":null,"abstract":"<div><div>There has been growing interest in the concept of resilience for promoting people's health and well-being and to mitigate inequities. There are various definitions of the concept in the literature, yet there have still been repeated calls for a more culturally sensitive, context-oriented conceptualization of resilience. This is particularly critical for racialized populations, given the rise in racism and the ‘othering’ that this group faces. This paper explored resilience and its pathways among Arab Canadians. A collaborative, community-based participatory research and integrated knowledge translation approach was employed in this project. Qualitative interviews and Photovoice sessions were conducted with 50 and 26 participants , respectively, all aged ≥18 years and recruited throughout October 2021-June 2022. This research is guided by a social and cultural ecologies perspective of resilience theory.</div><div>Arab Canadian participants conceptualized resilience as resistance to structural barriers and adversities, which operated at both collective and individual levels. Faith and religious practices were major pathways to enable both collective and individual resilience among Arab Canadian participants. Findings from this research also indicated that collective resilience can be developed through culturally responsive and community-based initiatives. This study contributes to the wider theoretical discourse regarding resilience by advancing beyond individual-focused models to consider socio-cultural factors and collective, community-situated dimensions. Findings from our research show that cultural resistance can function as part of a practice of resilience, where diasporic communities transform struggles into collective perseverance under conditions of displacement and oppression. Our theoretical contribution holds practical significance for policy and practice that promote the well-being of Arab diaspora communities and other racialized communities.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"392 ","pages":"Article 118955"},"PeriodicalIF":5.0,"publicationDate":"2026-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145979810","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 : 2026-01-09DOI: 10.1016/j.socscimed.2026.118966
Mónica Serena Perner , Kari Moore , Andrés Trotta , Hal Chen , Mariana Lazo , Olga L. Sarmiento , Daniel Rodriguez , Marcio Alazraqui , Ana V. Diez Roux
Background
The prevalence of obesity has increased worldwide. The association between socioeconomic urban development in the nutritional status of the population in large cities from low and middle-income countries is unclear.
Aim
Analyze how time trends in adult BMI vary across large cities and examine whether city socioeconomic status (SES) is related to adult BMI trends and whether individual level SES modifies this relationship.
Methods
We analyzed different cross-sectional health surveys done between 2000 and 2019, in Argentina, Brazil, Chile, Colombia, and Mexico, compiled as part of the SALURBAL study. Hybrid models adjusted for individual age and education were used to estimate associations of city-level education with differences in BMI, and associations of changes in city-level SES with changes in city BMI (change vs. change). Effect modification by individual-level education was assessed. Models were stratified by sex and country.
Results
We included 285,670 individuals from 201 cities. BMI increased over time in all countries except Brazil (women) and Chile (men), where it was not statistically significant. We did not find consistent evidence that average city education consistently modified trends in BMI. However, within city increases in city education were related to decreases in BMI in women (Chile and Colombia) and in men (Brazil, Chile, and Colombia). These effects were stronger in women with lower education.
Conclusion
In low- and middle-income countries changes over time in city SES impact BMI trends in complex ways. A better understanding of the mechanisms involved may help develop better strategies to prevent increases in obesity.
世界范围内，肥胖症的患病率有所上升。社会经济城市发展与中低收入国家大城市人口营养状况之间的关系尚不清楚。目的分析大城市成人BMI的时间变化趋势，研究城市社会经济地位（SES）是否与成人BMI趋势相关，以及个体社会经济地位是否改变了这种关系。方法：我们分析了2000年至2019年间在阿根廷、巴西、智利、哥伦比亚和墨西哥进行的不同横断面健康调查，这些调查是SALURBAL研究的一部分。采用经个人年龄和受教育程度调整的混合模型估计城市受教育程度与BMI差异的关系，以及城市社会经济地位变化与城市BMI变化的关系（change vs. change）。评估个体教育对效果的影响。模型按性别和国家分层。结果我们纳入了来自201个城市的285670人。除了巴西（女性）和智利（男性）以外，所有国家的BMI都随着时间的推移而增加，这两个国家的BMI在统计上并不显著。我们没有发现一致的证据表明城市平均教育水平能持续改变BMI的趋势。然而，在城市内，城市教育水平的提高与女性（智利和哥伦比亚）和男性（巴西、智利和哥伦比亚）的BMI下降有关。这些影响在受教育程度较低的女性中更为明显。结论在低收入和中等收入国家，城市社会经济地位随时间的变化以复杂的方式影响BMI趋势。更好地了解其中的机制可能有助于制定更好的策略来防止肥胖的增加。
{"title":"Trends in adults body mass index related to changes in socioeconomic status of 201 large Latin American cities","authors":"Mónica Serena Perner , Kari Moore , Andrés Trotta , Hal Chen , Mariana Lazo , Olga L. Sarmiento , Daniel Rodriguez , Marcio Alazraqui , Ana V. Diez Roux","doi":"10.1016/j.socscimed.2026.118966","DOIUrl":"10.1016/j.socscimed.2026.118966","url":null,"abstract":"<div><h3>Background</h3><div>The prevalence of obesity has increased worldwide. The association between socioeconomic urban development in the nutritional status of the population in large cities from low and middle-income countries is unclear.</div></div><div><h3>Aim</h3><div>Analyze how time trends in adult BMI vary across large cities and examine whether city socioeconomic status (SES) is related to adult BMI trends and whether individual level SES modifies this relationship.</div></div><div><h3>Methods</h3><div>We analyzed different cross-sectional health surveys done between 2000 and 2019, in Argentina, Brazil, Chile, Colombia, and Mexico, compiled as part of the SALURBAL study. Hybrid models adjusted for individual age and education were used to estimate associations of city-level education with differences in BMI, and associations of changes in city-level SES with changes in city BMI (change vs. change). Effect modification by individual-level education was assessed. Models were stratified by sex and country.</div></div><div><h3>Results</h3><div>We included 285,670 individuals from 201 cities. BMI increased over time in all countries except Brazil (women) and Chile (men), where it was not statistically significant. We did not find consistent evidence that average city education consistently modified trends in BMI. However, within city increases in city education were related to decreases in BMI in women (Chile and Colombia) and in men (Brazil, Chile, and Colombia). These effects were stronger in women with lower education.</div></div><div><h3>Conclusion</h3><div>In low- and middle-income countries changes over time in city SES impact BMI trends in complex ways. A better understanding of the mechanisms involved may help develop better strategies to prevent increases in obesity.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"392 ","pages":"Article 118966"},"PeriodicalIF":5.0,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145979835","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 : 2026-01-09DOI: 10.1016/j.socscimed.2026.118946
Lindsay A. Pearce , Rebecca R. Shuttleworth , Jesse T. Young , Rohan Borschmann , Stuart A. Kinner
Health outcomes for people released from incarceration are often poor, but it is unclear to what extent these poor outcomes are a result of incarceration or are a consequence of pre-existing morbidity and health risk. We synthesised published evidence regarding the impact of incarceration on physical and mental health. We searched five electronic databases (PsycINFO, CINAHL Complete, Medline, EMBASE, and Campbell Collaboration) for primary research articles measuring at least one health outcome both before and after an episode of incarceration. We screened articles published in any country and placed no restrictions on publication date. We assessed risk of bias using the MethodologicAl STandards for Epidemiological Research (MASTER) scale and conducted a narrative synthesis. Nine studies met the inclusion criteria, seven of which were from the United States. Compared to pre-incarceration, post-incarceration health measures generally indicated reduced substance dependence and increased HIV viral suppression. Changes in mental health-related measures after incarceration were mixed: one study reported an increase in depressive symptoms and another study reported no change in the prevalence of depression, anxiety, psychotic disorders, or personality disorders. The prevalence of physical health conditions did not change substantially from before to after incarceration. The evidence base is sparse, lacks global representation, and is unable to assess causality. Nevertheless, our synthesis of the available evidence suggests that incarceration is associated with both positive and negative health outcomes. Further rigorous and longitudinal research is required, in diverse countries and world regions, to enable causal inference and identify modifiable factors that mediate the impacts of incarceration on specific health outcomes.
{"title":"The impact of incarceration on health: A global systematic review","authors":"Lindsay A. Pearce , Rebecca R. Shuttleworth , Jesse T. Young , Rohan Borschmann , Stuart A. Kinner","doi":"10.1016/j.socscimed.2026.118946","DOIUrl":"10.1016/j.socscimed.2026.118946","url":null,"abstract":"<div><div>Health outcomes for people released from incarceration are often poor, but it is unclear to what extent these poor outcomes are a result of incarceration or are a consequence of pre-existing morbidity and health risk. We synthesised published evidence regarding the impact of incarceration on physical and mental health. We searched five electronic databases (PsycINFO, CINAHL Complete, Medline, EMBASE, and Campbell Collaboration) for primary research articles measuring at least one health outcome both before and after an episode of incarceration. We screened articles published in any country and placed no restrictions on publication date. We assessed risk of bias using the MethodologicAl STandards for Epidemiological Research (MASTER) scale and conducted a narrative synthesis. Nine studies met the inclusion criteria, seven of which were from the United States. Compared to pre-incarceration, post-incarceration health measures generally indicated reduced substance dependence and increased HIV viral suppression. Changes in mental health-related measures after incarceration were mixed: one study reported an increase in depressive symptoms and another study reported no change in the prevalence of depression, anxiety, psychotic disorders, or personality disorders. The prevalence of physical health conditions did not change substantially from before to after incarceration. The evidence base is sparse, lacks global representation, and is unable to assess causality. Nevertheless, our synthesis of the available evidence suggests that incarceration is associated with both positive and negative health outcomes. Further rigorous and longitudinal research is required, in diverse countries and world regions, to enable causal inference and identify modifiable factors that mediate the impacts of incarceration on specific health outcomes.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"393 ","pages":"Article 118946"},"PeriodicalIF":5.0,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146080999","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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