Pub Date : 2025-02-01DOI: 10.1016/j.socscimed.2025.117702
Keun Young Kwon , Jinho Kim
Housing instability is widely recognized as a major environmental factor that significantly shapes both health and overall well-being. This study added to the existing literature by examining the longitudinal relationship between housing-related hardship and self-rated health. Moreover, this study explored health behaviors—specifically substance use and lifestyle behaviors—as potential mediators that link housing hardship to health. Using data from Waves I, III, IV, and V of the National Longitudinal Study of Adolescent to Adult Health (Add Health), this study estimated regression models with lagged dependent variables (LDVs) and conducted Sobel tests to formally assess mediation. In the LDV model, housing hardship in Wave III is longitudinally associated with lower self-rated health in Wave V. This relationship remained significant (p = 0.012), though it was substantially attenuated after adjusting for a comprehensive set of confounders, including personal earnings and educational attainment. Smoking emerged as the most significant mediator, accounting for approximately 26% (p < 0.001) of the association, while unhealthy eating behaviors and marijuana use explained 13% (p < 0.001) and 8% (p = 0.008), respectively. Binge drinking and physical activity did not significantly mediate the association. Collectively, the proposed mediating variables explained 34% (p < 0.001) of the association between housing hardship and self-rated health. These findings highlight the importance of tackling both the material aspects of housing hardship and the unhealthy coping mechanisms it fosters to more effectively improve the well-being of individuals experiencing housing instability.
{"title":"Housing hardship and health: Longitudinal evidence of the mediating role of health behaviors","authors":"Keun Young Kwon , Jinho Kim","doi":"10.1016/j.socscimed.2025.117702","DOIUrl":"10.1016/j.socscimed.2025.117702","url":null,"abstract":"<div><div>Housing instability is widely recognized as a major environmental factor that significantly shapes both health and overall well-being. This study added to the existing literature by examining the longitudinal relationship between housing-related hardship and self-rated health. Moreover, this study explored health behaviors—specifically substance use and lifestyle behaviors—as potential mediators that link housing hardship to health. Using data from Waves I, III, IV, and V of the National Longitudinal Study of Adolescent to Adult Health (Add Health), this study estimated regression models with lagged dependent variables (LDVs) and conducted Sobel tests to formally assess mediation. In the LDV model, housing hardship in Wave III is longitudinally associated with lower self-rated health in Wave V. This relationship remained significant (p = 0.012), though it was substantially attenuated after adjusting for a comprehensive set of confounders, including personal earnings and educational attainment. Smoking emerged as the most significant mediator, accounting for approximately 26% (p < 0.001) of the association, while unhealthy eating behaviors and marijuana use explained 13% (p < 0.001) and 8% (p = 0.008), respectively. Binge drinking and physical activity did not significantly mediate the association. Collectively, the proposed mediating variables explained 34% (p < 0.001) of the association between housing hardship and self-rated health. These findings highlight the importance of tackling both the material aspects of housing hardship and the unhealthy coping mechanisms it fosters to more effectively improve the well-being of individuals experiencing housing instability.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"366 ","pages":"Article 117702"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014499","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 : 2025-02-01DOI: 10.1016/j.socscimed.2024.117661
Sanjana Mitra , Lindsey Richardson , Zishan Cui , Mark Gilbert , M.-J. Milloy , Kanna Hayashi , Thomas Kerr
Background
While marked gender-based differences in drug-related risk and harm between men women who use drugs have been characterized to some extent, the complex relationship between gendered socioeconomic conditions, overdose risk, and drug use patterns and behaviours remains underexplored.
Methods
We conducted gender-stratified repeated measures latent class analyses (RMLCA) with data from two ongoing cohorts of people who use drugs in Vancouver, Canada to identify discrete subgroups based on socioeconomic exposures. Multivariable generalized estimating equations models weighted by the respective posterior membership probabilities were applied to estimate the associations between socioeconomic class membership and non-fatal overdose. Sub-analyses investigated whether these relationships were explained by drug use-related variables.
Results
Between June 2014 and March 2020, 1723 participants provided 12120 observations. At study baseline, 1074 (62.3%) were men and 649 (37.7%) were women. In RMLCA, five distinct profiles of socioeconomic exposures emerged for men, and four emerged for women. Classes were presented in ascending order of socioeconomic disadvantage (i.e., ranging from Class 1 [least disadvantage] to Class 4/Class 5 [most disadvantage]) and were primarily distinguished by variations in income, material and housing in/security, participation in illegal/informal income generation, and criminal justice involvement. In analyses adjusting for demographic characteristics, for both men and women, progressive increases in exposure to multiple dimensions of disadvantage were positively and independently associated with non-fatal overdose when compared to the least socioeconomically disadvantaged subgroup. Subsequent analyses revealed that systematic differences in drug use patterns and behaviours across categories of socioeconomic disadvantage largely accounted for these relationships.
Conclusions
Addressing multiple forms of mutually reinforcing health inequities may offer additional opportunity to mitigate non-fatal overdose in men and women who use drugs.
{"title":"Patterns of socioeconomic marginalization and non-fatal overdose among people who use drugs: A gender-stratified repeated measures latent class analysis","authors":"Sanjana Mitra , Lindsey Richardson , Zishan Cui , Mark Gilbert , M.-J. Milloy , Kanna Hayashi , Thomas Kerr","doi":"10.1016/j.socscimed.2024.117661","DOIUrl":"10.1016/j.socscimed.2024.117661","url":null,"abstract":"<div><h3>Background</h3><div>While marked gender-based differences in drug-related risk and harm between men women who use drugs have been characterized to some extent, the complex relationship between gendered socioeconomic conditions, overdose risk, and drug use patterns and behaviours remains underexplored.</div></div><div><h3>Methods</h3><div>We conducted gender-stratified repeated measures latent class analyses (RMLCA) with data from two ongoing cohorts of people who use drugs in Vancouver, Canada to identify discrete subgroups based on socioeconomic exposures. Multivariable generalized estimating equations models weighted by the respective posterior membership probabilities were applied to estimate the associations between socioeconomic class membership and non-fatal overdose. Sub-analyses investigated whether these relationships were explained by drug use-related variables.</div></div><div><h3>Results</h3><div>Between June 2014 and March 2020, 1723 participants provided 12120 observations. At study baseline, 1074 (62.3%) were men and 649 (37.7%) were women. In RMLCA, five distinct profiles of socioeconomic exposures emerged for men, and four emerged for women. Classes were presented in ascending order of socioeconomic disadvantage (i.e., ranging from Class 1 [least disadvantage] to Class 4/Class 5 [most disadvantage]) and were primarily distinguished by variations in income, material and housing in/security, participation in illegal/informal income generation, and criminal justice involvement. In analyses adjusting for demographic characteristics, for both men and women, progressive increases in exposure to multiple dimensions of disadvantage were positively and independently associated with non-fatal overdose when compared to the least socioeconomically disadvantaged subgroup. Subsequent analyses revealed that systematic differences in drug use patterns and behaviours across categories of socioeconomic disadvantage largely accounted for these relationships.</div></div><div><h3>Conclusions</h3><div>Addressing multiple forms of mutually reinforcing health inequities may offer additional opportunity to mitigate non-fatal overdose in men and women who use drugs.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"366 ","pages":"Article 117661"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014673","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 : 2025-02-01DOI: 10.1016/j.socscimed.2025.117711
Karen Glaser , Giorgio Di Gessa
Despite extensive research on the impact of grandchild care on grandparents' well-being, no studies have examined the frequency of activities that grandparents engage in with their grandchildren or the reasons for care using nationally representative data. We address this gap using waves 8 (2016/2017) and 9 (2018/19) of the English Longitudinal Study of Ageing, a nationally representative study of English older adults. We employ hybrid regression models to distinguish between within- and between-individual effects on grandparents’ subjective wellbeing, as captured by quality of life and depressive symptoms. Our findings show that the mostly positive relationships between frequency of grandparental activities and reasons for care and well-being are largely due to between-grandparent differences rather than within-grandparent changes over time. Within-grandparent analyses show a mostly non-significant impact of increased grandparental activities on well-being, except for a detrimental effect when grandchildren stay overnight or are cared for when sick. The influence of reasons for care are more nuanced. Changes in reasons, such as giving parents a break or allowing them to go out in the evening, are significantly associated with a worsening of elevated depressive symptoms. Conversely, changes such as helping grandchildren develop as people or feeling engaged with young people improve the quality of life for the same grandparents over time. When grandparental care is provided because it is difficult to refuse we find a negative association with well-being between grandparents. Overall, our findings highlight the importance of more detailed information on grandparent-grandchild interactions and reasons for care to better understand well-being outcomes.
{"title":"Grandparental childcare and subjective well-being: The role of activities and reasons for care","authors":"Karen Glaser , Giorgio Di Gessa","doi":"10.1016/j.socscimed.2025.117711","DOIUrl":"10.1016/j.socscimed.2025.117711","url":null,"abstract":"<div><div>Despite extensive research on the impact of grandchild care on grandparents' well-being, no studies have examined the frequency of activities that grandparents engage in with their grandchildren or the reasons for care using nationally representative data. We address this gap using waves 8 (2016/2017) and 9 (2018/19) of the English Longitudinal Study of Ageing, a nationally representative study of English older adults. We employ hybrid regression models to distinguish between within- and between-individual effects on grandparents’ subjective wellbeing, as captured by quality of life and depressive symptoms. Our findings show that the mostly positive relationships between frequency of grandparental activities and reasons for care and well-being are largely due to between-grandparent differences rather than within-grandparent changes over time. Within-grandparent analyses show a mostly non-significant impact of increased grandparental activities on well-being, except for a detrimental effect when grandchildren stay overnight or are cared for when sick. The influence of reasons for care are more nuanced. Changes in reasons, such as giving parents a break or allowing them to go out in the evening, are significantly associated with a worsening of elevated depressive symptoms. Conversely, changes such as helping grandchildren develop as people or feeling engaged with young people improve the quality of life for the same grandparents over time. When grandparental care is provided because it is difficult to refuse we find a negative association with well-being between grandparents. Overall, our findings highlight the importance of more detailed information on grandparent-grandchild interactions and reasons for care to better understand well-being outcomes.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"366 ","pages":"Article 117711"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043003","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 : 2025-02-01DOI: 10.1016/j.socscimed.2025.117687
Marcello Antonini , Mesfin G. Genie , Katie Attwell , Arthur E. Attema , Jeremy K. Ward , Alessia Melegaro , Aleksandra Torbica , Brian Kelly , Chiara Berardi , Ana Rita Sequeira , Neil McGregor , Adrian Kellner , Shuli Brammli-Greenberg , Madeleine Hinwood , Liubovė Murauskienė , Daiga Behmane , Zsolt J. Balogh , Terje P. Hagen , Francesco Paolucci
In vaccination decisions, individuals must weigh the benefits against the risks of remaining unvaccinated and potentially facing social restrictions. Previous studies have focused on individual preferences for vaccine characteristics and societal restrictions separately. This study aims to quantify public preferences and the potential trade-offs between vaccine characteristics and societal restrictions, including lockdowns and vaccine mandates, in the context of a future pandemic. We conducted a discrete choice experiment (DCE) involving 47,114 respondents from 21 countries between July 2022 and June 2023 through an online panel. Participants were presented with choices between two hypothetical vaccination programs and an option to opt-out. A latent class logit model was used to estimate trade-offs among attributes. Despite some level of preference heterogeneity across countries and respondents’ profiles, we consistently identified three classes of respondents: vaccine refusers, vaccine-hesitant, and pro-vaccine individuals. Vaccine attributes were generally deemed more important than societal restriction attributes. We detected strong preferences for the highest levels of vaccine effectiveness and for domestically produced vaccines across most countries. Being fully vaccinated against COVID-19 was the strongest predictor of pro-vaccine class preferences. Women and younger people were more likely to be vaccine refusers compared to men and older individuals. In some countries, vaccine hesitancy and refusal were linked to lower socioeconomic status, whereas in others, individuals with higher education and higher income were more likely to exhibit hesitancy. Our findings emphasize the need for tailored vaccination programs that consider local contexts and demographics. Building trust in national regulatory authorities and international organizations through targeted communication, along with investing in domestic production facilities, can improve vaccine uptake and enhance public health responses in the future.
{"title":"Are we ready for the next pandemic? Public preferences and trade-offs between vaccine characteristics and societal restrictions across 21 countries","authors":"Marcello Antonini , Mesfin G. Genie , Katie Attwell , Arthur E. Attema , Jeremy K. Ward , Alessia Melegaro , Aleksandra Torbica , Brian Kelly , Chiara Berardi , Ana Rita Sequeira , Neil McGregor , Adrian Kellner , Shuli Brammli-Greenberg , Madeleine Hinwood , Liubovė Murauskienė , Daiga Behmane , Zsolt J. Balogh , Terje P. Hagen , Francesco Paolucci","doi":"10.1016/j.socscimed.2025.117687","DOIUrl":"10.1016/j.socscimed.2025.117687","url":null,"abstract":"<div><div>In vaccination decisions, individuals must weigh the benefits against the risks of remaining unvaccinated and potentially facing social restrictions. Previous studies have focused on individual preferences for vaccine characteristics and societal restrictions separately. This study aims to quantify public preferences and the potential trade-offs between vaccine characteristics and societal restrictions, including lockdowns and vaccine mandates, in the context of a future pandemic. We conducted a discrete choice experiment (DCE) involving 47,114 respondents from 21 countries between July 2022 and June 2023 through an online panel. Participants were presented with choices between two hypothetical vaccination programs and an option to opt-out. A latent class logit model was used to estimate trade-offs among attributes. Despite some level of preference heterogeneity across countries and respondents’ profiles, we consistently identified three classes of respondents: vaccine refusers, vaccine-hesitant, and pro-vaccine individuals. Vaccine attributes were generally deemed more important than societal restriction attributes. We detected strong preferences for the highest levels of vaccine effectiveness and for domestically produced vaccines across most countries. Being fully vaccinated against COVID-19 was the strongest predictor of pro-vaccine class preferences. Women and younger people were more likely to be vaccine refusers compared to men and older individuals. In some countries, vaccine hesitancy and refusal were linked to lower socioeconomic status, whereas in others, individuals with higher education and higher income were more likely to exhibit hesitancy. Our findings emphasize the need for tailored vaccination programs that consider local contexts and demographics. Building trust in national regulatory authorities and international organizations through targeted communication, along with investing in domestic production facilities, can improve vaccine uptake and enhance public health responses in the future.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"366 ","pages":"Article 117687"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143100862","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 : 2025-02-01DOI: 10.1016/j.socscimed.2024.117638
Liping Fu , Ruizhen Wang , Chaoying He
This study uses panel data from the 2011, 2013, 2015, 2018, and 2020 China Health and Retirement Longitudinal Study to examine the labor supply effects of spousal disability in later life. Employing a staggered difference-in-differences strategy, we provide causal evidence of gender-specific impacts, with a significant and enduring negative effect on female employment lasting over eight years, in contrast to minimal changes for males. The negative effect on female employment is particularly pronounced among low-educated individuals, those with agricultural hukou, and those influenced by stronger Confucian cultural norms. Mechanism analysis attributes the gender disparity to the caregiving effect and the health effect, with females experiencing increased caregiving responsibilities and health deterioration. We do not find enough evidence to support the added worker effect and the joint leisure effect. Furthermore, following the death of a disabled spouse, both genders exhibit an increased withdrawal from the labor market, with females increasingly assuming grandchild care responsibilities. These findings reveal the persistent gender differences in later life and suggest that policy interventions should prioritize the equitable allocation of social welfare resources to mitigate caregiving burdens faced by older women.
{"title":"Gender differences in later life: Labor supply responses to spousal disability","authors":"Liping Fu , Ruizhen Wang , Chaoying He","doi":"10.1016/j.socscimed.2024.117638","DOIUrl":"10.1016/j.socscimed.2024.117638","url":null,"abstract":"<div><div>This study uses panel data from the 2011, 2013, 2015, 2018, and 2020 China Health and Retirement Longitudinal Study to examine the labor supply effects of spousal disability in later life. Employing a staggered difference-in-differences strategy, we provide causal evidence of gender-specific impacts, with a significant and enduring negative effect on female employment lasting over eight years, in contrast to minimal changes for males. The negative effect on female employment is particularly pronounced among low-educated individuals, those with agricultural <em>hukou</em>, and those influenced by stronger Confucian cultural norms. Mechanism analysis attributes the gender disparity to the caregiving effect and the health effect, with females experiencing increased caregiving responsibilities and health deterioration. We do not find enough evidence to support the added worker effect and the joint leisure effect. Furthermore, following the death of a disabled spouse, both genders exhibit an increased withdrawal from the labor market, with females increasingly assuming grandchild care responsibilities. These findings reveal the persistent gender differences in later life and suggest that policy interventions should prioritize the equitable allocation of social welfare resources to mitigate caregiving burdens faced by older women.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"366 ","pages":"Article 117638"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883254","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 : 2025-02-01DOI: 10.1016/j.socscimed.2024.117640
Soohyeon Ko , Hannah Oh , S.V. Subramanian , Rockli Kim
This study investigates the link between life course social mobility and cognitive function among middle-aged and older adults in India, specifically emphasizing whether upward and downward mobility exerts symmetric associations and potential gender heterogeneity within these associations. Leveraging data from the Longitudinal Aging Study in India 2017–2018, encompassing 64,710 individuals aged 45 years or above, we classified social mobility as ‘consistently high,’ ‘upward mobility,’ ‘downward mobility,’ and ‘consistently low,’ based on socioeconomic position during childhood and late adulthood. Multivariable regression and gender-interaction analyses were employed to assess associations. Overall, 35.69% maintained a consistently high socioeconomic position, whereas 22.87% remained consistently low; 20.05% experienced upward mobility, and 21.39% faced downward mobility. Compared to consistently high socioeconomic position, consistently low socioeconomic position was associated with lower cognitive function (b = −1.47; 95% CI = −1.59, −1.34), followed by downward mobility (b = −0.84; 95% CI = −0.95, −0.72) and upward mobility (b = −0.72; 95% CI = −0.84, −0.61). Notably, the interaction model revealed significant differences by gender, especially between opposite social mobility groups. Among men, upward and downward mobility displayed asymmetric associations, with upward mobility being associated with a higher cognitive function than downward mobility (b = 0.31; 95% CI = 0.13, 0.50), whereas such differences were not observed for women (b = −0.01; 95% CI = −0.20, 0.17). These findings highlight the critical influence of life course social mobility on cognitive health, with implications for interventions tailored to the unique trajectories of social mobility by gender in India.
本研究调查了印度中老年人群一生中社会流动与认知功能之间的联系，特别强调了向上和向下流动是否会产生对称关联，以及这些关联中潜在的性别异质性。利用2017-2018年印度纵向老龄化研究的数据，我们根据儿童和成年后期的社会经济地位，将社会流动性分为“持续高”、“向上流动”、“向下流动”和“持续低”。采用多变量回归和性别相互作用分析来评估相关性。总体而言，35.69%的人保持较高的社会经济地位，22.87%的人保持较低的社会经济地位；20.05%的人向上流动，21.39%的人向下流动。与持续较高的社会经济地位相比，持续较低的社会经济地位与较低的认知功能相关(b = -1.47；95% CI = -1.59, -1.34)，其次是向下流动(b = -0.84；95% CI = -0.95, -0.72)和上进心(b = -0.72;95% ci = -0.84, -0.61)。值得注意的是，互动模型揭示了性别之间的显著差异，特别是在相反的社会流动群体之间。在男性中，向上和向下流动表现出不对称的关联，向上流动比向下流动具有更高的认知功能(b = 0.31；95% CI = 0.13, 0.50)，而在女性中没有观察到这种差异(b = -0.01；95% ci = -0.20, 0.17)。这些发现强调了生命历程中社会流动对认知健康的关键影响，对针对印度按性别划分的独特社会流动轨迹进行干预具有启示意义。
{"title":"Life course social mobility and cognitive function among middle-aged and older adults in India: Exploring heterogeneity by gender","authors":"Soohyeon Ko , Hannah Oh , S.V. Subramanian , Rockli Kim","doi":"10.1016/j.socscimed.2024.117640","DOIUrl":"10.1016/j.socscimed.2024.117640","url":null,"abstract":"<div><div>This study investigates the link between life course social mobility and cognitive function among middle-aged and older adults in India, specifically emphasizing whether upward and downward mobility exerts symmetric associations and potential gender heterogeneity within these associations. Leveraging data from the Longitudinal Aging Study in India 2017–2018, encompassing 64,710 individuals aged 45 years or above, we classified social mobility as ‘consistently high,’ ‘upward mobility,’ ‘downward mobility,’ and ‘consistently low,’ based on socioeconomic position during childhood and late adulthood. Multivariable regression and gender-interaction analyses were employed to assess associations. Overall, 35.69% maintained a consistently high socioeconomic position, whereas 22.87% remained consistently low; 20.05% experienced upward mobility, and 21.39% faced downward mobility. Compared to consistently high socioeconomic position, consistently low socioeconomic position was associated with lower cognitive function (<em>b</em> = −1.47; 95% CI = −1.59, −1.34), followed by downward mobility (<em>b</em> = −0.84; 95% CI = −0.95, −0.72) and upward mobility (<em>b</em> = −0.72; 95% CI = −0.84, −0.61). Notably, the interaction model revealed significant differences by gender, especially between opposite social mobility groups. Among men, upward and downward mobility displayed asymmetric associations, with upward mobility being associated with a higher cognitive function than downward mobility (<em>b</em> = 0.31; 95% CI = 0.13, 0.50), whereas such differences were not observed for women (<em>b</em> = −0.01; 95% CI = −0.20, 0.17). These findings highlight the critical influence of life course social mobility on cognitive health, with implications for interventions tailored to the unique trajectories of social mobility by gender in India.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"366 ","pages":"Article 117640"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883371","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 : 2025-02-01DOI: 10.1016/j.socscimed.2024.117641
Yuan Luo , Yuqian Deng , Yibo Wu , Jiaxin Liu , Haiye Ran , Jie Yuan , Liping Zhao
Background and aims
Internet addiction is one of the most serious behavioral addiction problems affecting the physical and mental health of college students. A model is constructed to reveal the mediating role of anxiety and the moderating role of information cocoons in the relationship between the experiences in close relationship and internet addiction among college students in this article.
Methods
A cross-sectional survey investigated 2946 college students in China who had experienced close romantic relationships. A questionnaire was used to measure the general information, the experiences in close relationship, internet addiction, anxiety, information cocoons among participants.
Results
The poorer experiences in close relationship were directly associated with a higher risk of internet addiction among college students. Anxiety mediated the relationship between the experiences in close relationship and internet addiction. Additionally, the information cocoon was also found to moderate an indirect effect: a higher level of information cocoons diminished the impact of the experiences in close relationship on anxiety, while information cocoons intensified the association between anxiety and internet addiction.
Conclusions
A positive close relationship can alleviate anxiety and thereby help prevent internet addiction. Meanwhile, various interventions should be implemented to avoid falling into the information cocoons to promote mental health and reduce internet addiction among college students.
{"title":"The experiences in close relationship and internet addiction among college Students: A moderated mediation model of anxiety and information cocoon","authors":"Yuan Luo , Yuqian Deng , Yibo Wu , Jiaxin Liu , Haiye Ran , Jie Yuan , Liping Zhao","doi":"10.1016/j.socscimed.2024.117641","DOIUrl":"10.1016/j.socscimed.2024.117641","url":null,"abstract":"<div><h3>Background and aims</h3><div>Internet addiction is one of the most serious behavioral addiction problems affecting the physical and mental health of college students. A model is constructed to reveal the mediating role of anxiety and the moderating role of information cocoons in the relationship between the experiences in close relationship and internet addiction among college students in this article.</div></div><div><h3>Methods</h3><div>A cross-sectional survey investigated 2946 college students in China who had experienced close romantic relationships. A questionnaire was used to measure the general information, the experiences in close relationship, internet addiction, anxiety, information cocoons among participants.</div></div><div><h3>Results</h3><div>The poorer experiences in close relationship were directly associated with a higher risk of internet addiction among college students. Anxiety mediated the relationship between the experiences in close relationship and internet addiction. Additionally, the information cocoon was also found to moderate an indirect effect: a higher level of information cocoons diminished the impact of the experiences in close relationship on anxiety, while information cocoons intensified the association between anxiety and internet addiction.</div></div><div><h3>Conclusions</h3><div>A positive close relationship can alleviate anxiety and thereby help prevent internet addiction. Meanwhile, various interventions should be implemented to avoid falling into the information cocoons to promote mental health and reduce internet addiction among college students.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"366 ","pages":"Article 117641"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883402","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 : 2025-02-01DOI: 10.1016/j.socscimed.2024.117652
Amanda Hylland Spjeldnæs , Livia Wick , Heidi E. Fjeld , Anne Kveim Lie
Increasing rates of antimicrobial resistance has accelerated global efforts to reduce antibiotic use. While antibiotic resistance poses a significant threat, especially in low-income settings, there is a scarcity of research on how people in such environments, including refugee camps, access and use antibiotics. This article explores factors that contribute to the shaping of antibiotic use in Shatila refugee camp in Lebanon. It is based on six months of fieldwork from October 2021 to April 2022 in Shatila, consisting of participant observation, semi-structured interviews and group workshops with 32 camp residents and health workers. Following the onset of the Syrian war in 2011, the number of informal pharmacies and Syrian medicines boomed in Shatila. Aiming to describe and analyze how camp residents access and use antibiotics, we address two main themes: 1) the omnipresence of antibiotics in a context of scarcity, and 2) antibiotics as a panacea – a quick-fix for everyday ailments. Antibiotic consumption patterns in Shatila are formed by a scarcity of quality healthcare services on the one hand, and an omnipresence of antibiotics on the other. We demonstrate that in this loosely regulated context, where pharmaceuticals are bought over-the-counter; there is extensive antibiotic consumption. Camp residents often self-medicate with antibiotics for a wide range of purposes, extending beyond the treatment of infections. The high consumption of antibiotics will increase the level of antimicrobial resistance and pose a risk to the camp residents by disturbing local microbiomes and the amount of resistant genes (the resistome) in the environment, thus leading to new potential health risks. Building on theories of pharmaceuticalization and social suffering, we propose the concept of “antibioticalization.” This distinct form of pharmaceuticalization is characterized by the pervasive and generalized use of antibiotics, especially in contexts of healthcare and resource scarcity.
{"title":"“We use it a lot for everything”: Antibioticalization and everyday life in a refugee camp in Lebanon","authors":"Amanda Hylland Spjeldnæs , Livia Wick , Heidi E. Fjeld , Anne Kveim Lie","doi":"10.1016/j.socscimed.2024.117652","DOIUrl":"10.1016/j.socscimed.2024.117652","url":null,"abstract":"<div><div>Increasing rates of antimicrobial resistance has accelerated global efforts to reduce antibiotic use. While antibiotic resistance poses a significant threat, especially in low-income settings, there is a scarcity of research on how people in such environments, including refugee camps, access and use antibiotics. This article explores factors that contribute to the shaping of antibiotic use in Shatila refugee camp in Lebanon. It is based on six months of fieldwork from October 2021 to April 2022 in Shatila, consisting of participant observation, semi-structured interviews and group workshops with 32 camp residents and health workers. Following the onset of the Syrian war in 2011, the number of informal pharmacies and Syrian medicines boomed in Shatila. Aiming to describe and analyze how camp residents access and use antibiotics, we address two main themes: 1) the omnipresence of antibiotics in a context of scarcity, and 2) antibiotics as a panacea – a quick-fix for everyday ailments. Antibiotic consumption patterns in Shatila are formed by a scarcity of quality healthcare services on the one hand, and an omnipresence of antibiotics on the other. We demonstrate that in this loosely regulated context, where pharmaceuticals are bought over-the-counter; there is extensive antibiotic consumption. Camp residents often self-medicate with antibiotics for a wide range of purposes, extending beyond the treatment of infections. The high consumption of antibiotics will increase the level of antimicrobial resistance and pose a risk to the camp residents by disturbing local microbiomes and the amount of resistant genes (the resistome) in the environment, thus leading to new potential health risks. Building on theories of pharmaceuticalization and social suffering, we propose the concept of “antibioticalization.” This distinct form of pharmaceuticalization is characterized by the pervasive and generalized use of antibiotics, especially in contexts of healthcare and resource scarcity.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"366 ","pages":"Article 117652"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899745","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 : 2025-02-01DOI: 10.1016/j.socscimed.2024.117637
Qingxia Kong , Harwin de Vries , Dursen Deniz Poyraz , Abed Kayyal
Introduction:
After a pandemic outbreak, designing and implementing an effective vaccine supply chain is key. The last-mile vaccine delivery (LMVD) – the last stage of the vaccine supply chain – is of particular importance. LMVD design choices, such as the delivery mode (e.g., mobile team or PODs) and the number and locations of PODs, affect “operational attributes” like travel time and waiting time. This paper aims to understand how operational attributes of LMVD systems impact vaccination preferences across different priority groups, pandemic stages, and countries.
Methods:
Adults in The Netherlands ( in May 2021 and in January 2023), Italy ( in March 2023), and Poland ( in March 2023) completed an online discrete-choice experiment. Participants chose between two hypothetical LMVD systems (and opt-out) with five attributes: appointment flexibility, appointment delay, in-facility waiting time, travel time, and familiarity with personnel. Mixed logit models were used to estimate coefficients, based on which relative importance (RI) and vaccine uptake percentages were calculated.
Results:
Operational attributes have a significant impact on estimated uptake. Travel time was the most important attribute in all four studies. Appointment delay and in-facility waiting consistently ranked second or third. The impact of the choice of an LMVD system on uptake varies over time and by country. In The Netherlands, it was strong in 2023 (23.4%) but moderate in 2021 (12.6%). Similarly, it was strong in Italy 2023 (21.8%) and moderate in Poland 2023 (11.4%). The estimated impact also varied by priority group, and was minor (6.1%) for the elderly with poor health in The Netherlands 2021 study.
Conclusion:
Design choices for the LMVD system significantly impact vaccination preferences. Adapting these systems to different countries, time periods, and population groups is key for their effectiveness.
{"title":"Does delivery matter? Examining pandemic vaccination preferences across time and countries using a discrete choice experiment","authors":"Qingxia Kong , Harwin de Vries , Dursen Deniz Poyraz , Abed Kayyal","doi":"10.1016/j.socscimed.2024.117637","DOIUrl":"10.1016/j.socscimed.2024.117637","url":null,"abstract":"<div><h3>Introduction:</h3><div>After a pandemic outbreak, designing and implementing an effective vaccine supply chain is key. The last-mile vaccine delivery (LMVD) – the last stage of the vaccine supply chain – is of particular importance. LMVD design choices, such as the delivery mode (e.g., mobile team or PODs) and the number and locations of PODs, affect “operational attributes” like travel time and waiting time. This paper aims to understand how operational attributes of LMVD systems impact vaccination preferences across different priority groups, pandemic stages, and countries.</div></div><div><h3>Methods:</h3><div>Adults in The Netherlands (<span><math><mrow><mi>N</mi><mo>=</mo><mn>473</mn></mrow></math></span> in May 2021 and <span><math><mrow><mi>N</mi><mo>=</mo><mn>385</mn></mrow></math></span> in January 2023), Italy (<span><math><mrow><mi>N</mi><mo>=</mo><mn>302</mn></mrow></math></span> in March 2023), and Poland (<span><math><mrow><mi>N</mi><mo>=</mo><mn>303</mn></mrow></math></span> in March 2023) completed an online discrete-choice experiment. Participants chose between two hypothetical LMVD systems (and opt-out) with five attributes: appointment flexibility, appointment delay, in-facility waiting time, travel time, and familiarity with personnel. Mixed logit models were used to estimate coefficients, based on which relative importance (RI) and vaccine uptake percentages were calculated.</div></div><div><h3>Results:</h3><div>Operational attributes have a significant impact on estimated uptake. Travel time was the most important attribute in all four studies. Appointment delay and in-facility waiting consistently ranked second or third. The impact of the choice of an LMVD system on uptake varies over time and by country. In The Netherlands, it was strong in 2023 (23.4%) but moderate in 2021 (12.6%). Similarly, it was strong in Italy 2023 (21.8%) and moderate in Poland 2023 (11.4%). The estimated impact also varied by priority group, and was minor (6.1%) for the elderly with poor health in The Netherlands 2021 study.</div></div><div><h3>Conclusion:</h3><div>Design choices for the LMVD system significantly impact vaccination preferences. Adapting these systems to different countries, time periods, and population groups is key for their effectiveness.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"366 ","pages":"Article 117637"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957591","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 : 2025-02-01DOI: 10.1016/j.socscimed.2025.117726
Gabriel Salgado Ribeiro de Sá
Leading up to the 2020 U.S. presidential elections, the scientific consensus on hydroxychloroquine's ineffectiveness in treating COVID-19 was dismissed by Executive branch scientists, who promoted it as both a therapeutic solution and a political tool. This article examines how experimental pharmaceuticals were rationalized even before the pandemic declaration, aligning with medical advocacy groups linked to Donald Trump, who criticized the crisis management capacity of existing health institutions. Framing the emergency as requiring extraordinary measures, White House researchers advocated for executive unilateralism and eventually sought to securitize public health by replacing key health authorities with operational medicine specialists. The most controversial case involved an attempt of planned pharmaceutical intervention aimed at saving lives and restoring public confidence in the administration's pandemic response before the 2020 election. The article draws on confidential documents released by the 2022 House Select Subcommittee on the Coronavirus Crisis.
{"title":"Populism and medical advocacy: The case of hydroxychloroquine prior the 2020 United States presidential election","authors":"Gabriel Salgado Ribeiro de Sá","doi":"10.1016/j.socscimed.2025.117726","DOIUrl":"10.1016/j.socscimed.2025.117726","url":null,"abstract":"<div><div>Leading up to the 2020 U.S. presidential elections, the scientific consensus on hydroxychloroquine's ineffectiveness in treating COVID-19 was dismissed by Executive branch scientists, who promoted it as both a therapeutic solution and a political tool. This article examines how experimental pharmaceuticals were rationalized even before the pandemic declaration, aligning with medical advocacy groups linked to Donald Trump, who criticized the crisis management capacity of existing health institutions. Framing the emergency as requiring extraordinary measures, White House researchers advocated for executive unilateralism and eventually sought to securitize public health by replacing key health authorities with operational medicine specialists. The most controversial case involved an attempt of planned pharmaceutical intervention aimed at saving lives and restoring public confidence in the administration's pandemic response before the 2020 election. The article draws on confidential documents released by the 2022 House Select Subcommittee on the Coronavirus Crisis.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"367 ","pages":"Article 117726"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061266","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号