Social Science & Medicine最新文献_第8页

Loneliness predicts mortality risk via the erosion of purpose in life 孤独通过对生活目标的侵蚀来预测死亡风险

IF 5 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Social Science & Medicine

Pub Date : 2026-01-23 DOI: 10.1016/j.socscimed.2026.119008

Páraic S. O'Súilleabháin , Emma M. Kirwan , Milou Fredrix , Martina Luchetti , Damaris Aschwanden , Máire McGeehan , Angelina R. Sutin , Antonio Terracciano , Yannick Stephan , Gráinne McKenna

Loneliness is associated with premature mortality risk. Less is known about the mechanisms that may explain this association. Given its consequential health associations and relation to loneliness, purpose in life may be one such mechanism. In a prospective rotating split-sample design from 2008-2010 to 2012-2014 with 11 years of mortality status follow-up, we tested purpose in life as an indirect pathway between loneliness and future risk of death. Participants were from the Health and Retirement Study in the United States (N = 8351; M[SD] = 67.9 [9.19] years; range: 50–101; 60 % female; n = 1191 deceased). Purpose in life explained an estimated 88 % of the association between loneliness and mortality risk, with the majority of the mediated association appearing to reflect changes in purpose in life over time. These effects were independent of loneliness change during follow-up and initial levels of purpose in life. This indirect path was robust to sensitivity analyses, and further adjustment for conceptually similar constructs, such as depression, social isolation, and neuroticism. A supplemental model that tested purpose in life as the antecedent and loneliness as the indirect pathway indicated substantially smaller effects. Much of loneliness-mortality relation operated through purpose in life. Purpose in life appears to be a critical factor in the context of loneliness. It may prove fruitful to pay particular attention to the individual, community, and broader societal sources of purpose in life when looking to ameliorate the effect of loneliness on health.

孤独与过早死亡风险有关。对于解释这种关联的机制，人们所知甚少。鉴于其对健康的影响以及与孤独的关系，生活目标可能就是这样一种机制。在2008-2010年至2012-2014年的前瞻性旋转分裂样本设计中，我们对11年的死亡率状况进行了随访，我们测试了生活目的作为孤独与未来死亡风险之间的间接途径。参与者来自美国健康与退休研究（N = 8351;M[SD] = 67.9[9.19]岁；范围：50-101；60 %女性；N = 1191例死亡）。生活目标解释了大约88 %的孤独和死亡风险之间的关联，其中大多数中介关联似乎反映了随着时间的推移生活目标的变化。这些影响与孤独感在随访和生活目标初始水平的变化无关。这种间接路径对于敏感性分析和进一步调整概念上相似的结构（如抑郁、社会隔离和神经质）是稳健的。一个补充模型测试了生活中的目标作为前因由和孤独作为间接途径，结果表明影响要小得多。许多孤独与死亡的关系是通过生活的目标来实现的。生活的目标似乎是孤独的一个关键因素。在寻求改善孤独对健康的影响时，特别关注个人、社区和更广泛的社会目标来源可能是富有成效的。

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引用次数: 0

The connections among interactions with nature, diet quality, and sustainable eating: Insights from a mixed methods study 与自然互动、饮食质量和可持续饮食之间的联系：来自混合方法研究的见解

IF 5 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Social Science & Medicine

Pub Date : 2026-01-22 DOI: 10.1016/j.socscimed.2026.119014

Dahlia Stott , Michael Bruneau Jr. , Jonathan M. Deutsch , Rebecca Ippolito , DeAndra Forde , Mara Z. Vitolins , Jennifer A. Nasser , Brandy-Joe Milliron

Interacting with nature, such as spending time in nature and having houseplants, has been associated with positive mental and physical health outcomes and behaviors but limited research has explored dietary behaviors. Therefore, this study examined the relationships among interactions with nature, diet quality, and sustainable dietary patterns. In this explanatory sequential mixed methods study, participants self-reported the frequency and duration of their interactions with nature and completed Diet History Questionnaire II, where Healthy Eating Index-2020 (diet quality) and EAT-Lancet Index (sustainable dietary pattern) scores were calculated. A purposive sample of participants completed an interview. Multiple regression models were used to analyze quantitative data. Qualitative data were thematically analyzed. The data were integrated by connecting and merging. Three hundred adults completed the survey and 30 were interviewed. Positive significant relationships among interactions with nature, diet quality (p < .001), and sustainable dietary patterns (p < .001) were found. Four themes highlighted how interacting with nature may affect dietary intake: engaging with the natural world relaxes the mind, paving the way for healthier eating habits; pursuing health draws us toward nature and positively influences dietary choices; a deep connection to nature sparks a desire to nourish the body with more fruits and vegetables; and thoughtfully participating in the food system promotes healthier choices for personal and planetary health. Integrated findings highlight that mental state moderates and connection to nature mediates the relationships of interest. These results may be used to promote dietary behaviors for personal and planetary health through nature-based interventions.

与自然互动，如花时间在大自然中，种植室内植物，与积极的身心健康结果和行为有关，但对饮食行为的研究有限。因此，本研究考察了与自然的相互作用、饮食质量和可持续饮食模式之间的关系。在这项解释性顺序混合方法研究中，参与者自我报告了他们与自然互动的频率和持续时间，并完成了饮食史问卷II，其中计算了健康饮食指数-2020（饮食质量）和EAT-Lancet指数（可持续饮食模式）得分。有目的的参与者样本完成了一次访谈。采用多元回归模型对定量数据进行分析。对定性数据进行专题分析。数据通过连接和合并进行整合。300名成年人完成了这项调查，其中30人接受了采访。与自然的互动、饮食质量（p < 0.001）和可持续饮食模式（p < 0.001）之间存在显著正相关。四个主题强调了与自然互动如何影响饮食摄入：与自然世界接触可以放松大脑，为养成更健康的饮食习惯铺平道路；对健康的追求将我们引向自然，并对饮食选择产生积极影响；与自然的深层联系激发了用更多水果和蔬菜滋养身体的欲望；深思熟虑地参与食品系统，促进个人和地球健康的更健康选择。综合研究结果强调，精神状态调节兴趣关系，与自然的联系调节兴趣关系。这些结果可用于通过基于自然的干预措施促进个人和地球健康的饮食行为。

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引用次数: 0

Adolescence in social context: Longitudinal associations of 15 social factors with health and well-being 社会背景下的青少年：15个社会因素与健康和幸福的纵向关联。

IF 5 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Social Science & Medicine

Pub Date : 2026-01-22 DOI: 10.1016/j.socscimed.2026.118993

Renae Wilkinson , Eric S. Kim , Ying Chen , Julianne Holt-Lunstad , Tyler J. VanderWeele

Concern is growing that social disconnection poses serious risks to health and well-being, especially for adolescents. Yet without clear evidence on which relational factors (e.g., parent-child, sibling, romantic, and friend relationships; connectedness to families, schools, and neighborhoods) matter most, designing effective, developmentally attuned interventions remains difficult. To address this question, we used data from a large, nationally representative sample of U.S. adolescents (Add Health) and an outcome-wide approach to prospectively test whether one-year changes (between Wave I: 1994–1995 and Wave II: 1996) in 15 social factors, spanning structural, functional, and quality domains, were associated with 34 indicators of health and well-being 11.37 years later (in Wave IV: 2008, N = 11,040) or 20.64 years later (in Wave V: 2016–2018, N = 9003), adjusting for an extensive set of covariates. The outcome-wide framework fits a series of regression models for the relationship between one predictor and a set of outcomes (one outcome analyzed at a time), adjusting for the same set of covariates in each regression model. Six factors (school connectedness, loneliness, emotional support, neighborhood cohesion, religious service attendance, and family cohesion) showed associations with at least one-quarter of outcomes. Associations were most consistent in psychological well-being, mental health, and civic/prosocial domains. Strengthening school connectedness and emotional support, and reducing loneliness, appear especially promising for fostering long-term health.

人们越来越担心，与社会脱节对健康和福祉构成严重威胁，特别是对青少年而言。然而，没有明确的证据表明哪些关系因素（例如，亲子、兄弟姐妹、浪漫和朋友关系；与家庭、学校和社区的联系）最重要，设计有效的、与发展相适应的干预措施仍然很困难。为了解决这个问题，我们使用了来自美国青少年的大型全国代表性样本的数据（添加健康）和结果范围的方法来前瞻性地测试15个社会因素的一年变化（第一波：1994-1995年和第二波：1996年），跨越结构，功能和质量领域，是否与11.37年后（第四波：2008年，N = 11040）或20.64年后（第五波：2008年）的34个健康和福祉指标相关。2016-2018, N = 9003)，调整了广泛的协变量集。结果范围框架适用于一个预测器和一组结果（一次分析一个结果）之间关系的一系列回归模型，并对每个回归模型中的同一组协变量进行调整。六个因素（学校联系、孤独感、情感支持、邻里凝聚力、宗教服务出席率和家庭凝聚力）与至少四分之一的结果相关。关联在心理健康、心理健康和公民/亲社会领域最为一致。加强学校联系和情感支持，减少孤独感，似乎对促进长期健康尤其有希望。

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引用次数: 0

How structural homophobia is spreading HIV-risk sexual behaviours around the world. 结构性的同性恋恐惧症如何在世界范围内传播艾滋病毒风险的性行为。

IF 5 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Social Science & Medicine

Pub Date : 2026-01-21 DOI: 10.1016/j.socscimed.2026.119009

Vincent Leroy, Erik Lamontagne, Bruno Spire, Sean Howell, Sylvie Boyer, Bruno Ventelou

Although discrimination and stigma are recognised determinants of HIV-risk sexual behaviours in the LGBTI population, related data are scarce. In particular, the 'pathways' between these determinants and HIV-risk sexual behaviours are understudied. The main objective of the present study was to fill this knowledge gap by analysing - in a worldwide sample - the relationships between multiple dimensions of homophobia, general propensity to take risks, and HIV-risk sexual behaviours. We used data from UNAIDSs Global LGBTI Happiness survey, which was conducted among 115 000 individuals in 204 countries in 2019/2020. Structural/institutional homophobia is defined at the country level and was measured mainly by assessing the number and type of restrictive institutional laws and homophobic attitudes. Structural equation modelling was performed to identify associations between different dimensions of homophobia and HIV-risk sexual behaviours in participants who self-identified as cisgender, transgender, nonbinary, intersex, gay, bisexual and queer. In our worldwide sample of 69 640 participants, we found that structural homophobia predicted local homophobia (β = 0.040, (95 %CI = 0.027-0.053)), homophobia at work (β = 0.022, (95 %CI = 0.010-0.034)), family homophobia (β = 0.19, (95 %CI = 0.18-0.20)), and HIV-risk sexual behaviours (β = 0.069, (95 %CI = 0.059-0.078)). Results indicate that local homophobia and homophobia at work were directly and positively associated with HIV-risk sexual behaviour (β = 0.088, (95 %CI = 0.072-0.10) and 0.013, (95 %CI = 0.001-0.026), respectively). Institutional (/structural) homophobia was also indirectly associated with general risk-taking and HIV-risk sexual behaviour, mediated by individual homophobia. Our findings suggest that structural homophobia was associated with HIV-risk sexual behaviours through both direct and indirect pathways. In the context of limiting HIV-risk sexual behaviours, within the bigger picture of curbing the HIV epidemic, it is essential to prioritize implementing policies which eradicate homophobic violence, and which defend the rights of sexual and gender diverse people.

尽管歧视和污名被认为是LGBTI人群中艾滋病毒风险性行为的决定因素，但相关数据很少。特别是，这些决定因素与艾滋病毒风险性行为之间的“途径”尚未得到充分研究。本研究的主要目的是通过分析——在世界范围内的样本——同性恋恐惧症的多个维度、冒险倾向和艾滋病毒风险性行为之间的关系来填补这一知识空白。我们使用了联合国艾滋病规划署全球LGBTI幸福调查的数据，该调查于2019/2020年在204个国家的11.5万人中进行。结构性/体制性同性恋恐惧症是在国家一级定义的，主要通过评估限制性体制性法律的数量和类型以及对同性恋的态度来衡量。采用结构方程模型来确定自认为是顺性、跨性别、非双性、双性、同性恋、双性恋和酷儿的参与者的同性恋恐惧症的不同维度与hiv风险性行为之间的关联。在我们的全球69 640名参与者样本中，我们发现结构性同性恋恐惧症预测了当地同性恋恐惧症（β = 0.040, (95% CI = 0.027-0.053)），工作中的同性恋恐惧症（β = 0.022, (95% CI = 0.010-0.034)），家庭同性恋恐惧症（β = 0.19, (95% CI = 0.18-0.20)）和艾滋病毒风险性行为（β = 0.069, (95% CI = 0.059-0.078)）。结果表明，当地同性恋恐惧症和工作场所同性恋恐惧症与hiv风险性行为直接呈正相关（β = 0.088 （95% CI = 0.072-0.10）和0.013 (95% CI = 0.001-0.026)）。制度性（/结构性）同性恋恐惧症也与一般的冒险行为和hiv风险性行为间接相关，由个体同性恋恐惧症介导。我们的研究结果表明，结构性同性恋恐惧症通过直接和间接途径与艾滋病毒风险性行为相关。在限制有艾滋病毒风险的性行为的背景下，在遏制艾滋病毒流行的更大范围内，必须优先执行消除仇视同性恋暴力的政策，以及捍卫性取向和性别不同者权利的政策。

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引用次数: 0

Adverse childhood experiences and all-cause mortality in older Japanese adults: a 6-year prospective cohort study, modified by marital status 日本老年人不良童年经历和全因死亡率：一项受婚姻状况影响的6年前瞻性队列研究

IF 5 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Social Science & Medicine

Pub Date : 2026-01-21 DOI: 10.1016/j.socscimed.2026.119012

Tomoki Kawahara , Yukako Tani , Katsunori Kondo , Takeo Fujiwara

Objectives

Adverse childhood experiences (ACEs) are known to be associated with morbidity and premature death, but the association between ACEs and mortality among older people is unknown in Japan, and whether marital status modifies the associations remains unclear.

Methods

We analyzed data from 12,698 older adults (65+ years) participating in the Japan Gerontological Evaluation Study (JAGES; response rate 70.3 %) in 2013 and were followed for 6 years. ACEs and marital status were assessed at baseline, and mortality was prospectively followed. Cox proportional hazards models were used to assess the association between ACEs and mortality, stratified by sex and marital status adjusted for covariates.

Results

1948 deaths occurred during the follow-up (Men: 1,238, Women: 710). We found no association between ACEs and mortality overall for both sexes. When stratified by marital status, among divorced/unmarried men, those having 3+ ACEs were 4.00 times more likely to die (95 % CI: 1.46–10.95), although there was no association between ACEs and mortality among married men. In contrast, among divorced/unmarried women, having ACEs showed a lower risk of mortality, and married women also showed no association between ACEs and mortality.

Discussion

ACEs were associated with mortality among divorced/unmarried older men, which is not true for married men and all women. Further research is warranted to elucidate the mechanism to prevent the adverse effect of ACEs on mortality among divorced/unmarried men and all women.

目的儿童不良经历（ace）已知与发病率和过早死亡相关，但在日本，ace与老年人死亡率之间的关系尚不清楚，婚姻状况是否会改变这种关联尚不清楚。方法分析2013年参加日本老年学评价研究（JAGES，有效率70.3%）的12698名65岁以上老年人的数据，随访6年。基线时评估ace和婚姻状况，并对死亡率进行前瞻性随访。使用Cox比例风险模型评估ace与死亡率之间的关系，并按性别和婚姻状况分层，调整协变量。结果随访期间死亡1948例（男性1238例，女性710例）。我们没有发现ace与两性总体死亡率之间的联系。当按婚姻状况分层时，在离婚/未婚男性中，有3+ ace的人死亡的可能性是4.00倍（95% CI: 1.46-10.95），尽管在已婚男性中ace和死亡率之间没有关联。相比之下，在离婚/未婚女性中，有ace的死亡风险较低，已婚女性也没有显示ace与死亡率之间的关联。在离异/未婚的老年男性中，ace与死亡率有关，但这并不适用于已婚男性和所有女性。在离婚/未婚男性和所有女性中，需要进一步的研究来阐明预防ace对死亡率不利影响的机制。

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引用次数: 0

Socioeconomic disadvantage explains neighborhood racial inequality in opioid-related mortality 社会经济劣势解释了阿片类药物相关死亡率的社区种族不平等。

IF 5 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Social Science & Medicine

Pub Date : 2026-01-20 DOI: 10.1016/j.socscimed.2026.119007

Karl Vachuska, Michael Topping

The mortality burden imposed by the opioid crisis has only increased in recent years, with particularly high increases among Black Americans, who now die from overdoses at higher rates than their white counterparts. As such, a large body of work has emphasized the adverse impact of racial and socioeconomic segregation as a key mechanism of enduring racial health disparities. Also, nascent research has increasingly sought to use cell phone mobility data to examine neighborhood outcomes. This work bridges these two areas of work to look at opioid overdose rates from Cook County, Illinois – the county with the largest number of Black overdoses in the United States—to explore how neighborhood-level characteristics shape these disparities. We find that a neighborhood's level of disadvantage, as measured by the everyday visitors to the neighborhood, is a focal predictor. Moreover, while neighborhoods with a higher share of Black residents have higher rates of opioid-related mortality, we illustrate that our measure of mobility-based disadvantage mediates 100 % of the relationship. These findings remain consistent throughout the pre-2020 (2016–2019) and post-2020 (2020–2023) period when opioid-related mortality spikes. Sensitivity analyses with a wide assortment of controls and different specifications confirm these findings and suggest that future work examining neighborhood disadvantage should consider mobility-based measures in addition to static ones to best identify how disadvantage shapes mortality risk.

阿片类药物危机造成的死亡率负担近年来只增不增，其中黑人的增幅尤其高，他们现在死于过量服用的比例高于白人。因此，大量工作强调种族和社会经济隔离的不利影响是持久的种族健康差异的关键机制。此外，新兴研究越来越多地寻求使用手机移动数据来检查社区结果。这项工作将这两个工作领域联系起来，研究伊利诺伊州库克县的阿片类药物过量率——美国黑人过量服用人数最多的县——以探索社区水平的特征如何塑造这些差异。我们发现，一个社区的劣势水平是一个焦点预测指标，这是由该社区的日常访客来衡量的。此外，虽然黑人居民比例较高的社区与阿片类药物相关的死亡率较高，但我们表明，我们对基于流动性的劣势的衡量标准介导了这种关系的100%。这些发现在阿片类药物相关死亡率飙升的2020年前（2016-2019年）和2020年后（2020-2023年）期间保持一致。采用多种对照和不同规格进行的敏感性分析证实了这些发现，并建议未来研究社区弱势群体的工作除了考虑静态指标外，还应考虑基于流动性的指标，以最好地确定弱势群体如何影响死亡风险。

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引用次数: 0

The health and wellbeing of incarcerated trans, gender diverse, and non-binary people: An international scoping review 被监禁的跨性别者、多元性别者和非二元性别者的健康和福祉：一项国际范围审查

IF 5 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Social Science & Medicine

Pub Date : 2026-01-20 DOI: 10.1016/j.socscimed.2026.118972

Matthew Maycock , Tarra Excell , Annette Brömdal , Penelope Abbott , Riki Lane , Paul Leslie Simpson

Globally there is a growing visibility of trans, gender diverse, and non-binary people in contact with prison systems, and growing questions raised by stakeholders about the health and wellbeing of these populations under state care. This scoping review aims to map the global evidence on the key health and wellbeing issues of incarcerated trans, gender diverse, and non-binary adults and young people to enhance researchers, community and policy makers' capacity to use international evidence to develop locally relevant policies and care models. The review follows Arksey and O'Malley's (2005) five-stage iterative process and PRISMA-ScR guidelines. Eight academic databases and grey literature were searched in May 2024 and again in June 2025. Articles published in all languages were considered. After screening, 57 articles were included and categorised into four themes: (1) general and gender-affirming healthcare; (2) violence; (3) mental health and wellbeing; (4) sexual health and infectious disease; and (5) gender embodiment. Despite geographic, thematic, methodological, and subpopulation knowledge gaps, there is consistent evidence on restricted access to gender-affirming healthcare, systemic mental health challenges and exposure to violence, sexual health risks and HIV care gaps, and creativity and resilience among trans, gender diverse, and non-binary people in the face of gender-affirming attire and grooming restrictions. These findings highlight the need for clear and consistently implemented prison policies and prison diversion strategies. Policies and interventions must be evidence-based, integrated, culturally responsive, sustainably resourced in the face populist discourse, and involve community experts and incarcerated people in their design and evaluation.

在全球范围内，越来越多的跨性别者、性别多元化者和非二元性别者与监狱系统接触，利益相关者对这些在国家护理下的人群的健康和福祉提出了越来越多的问题。这项范围审查的目的是绘制关于被监禁的跨性别者、性别多样化者和非二元性成年人和年轻人的关键健康和福祉问题的全球证据地图，以增强研究人员、社区和政策制定者利用国际证据制定当地相关政策和护理模式的能力。该审查遵循Arksey和O'Malley（2005）的五阶段迭代过程和PRISMA-ScR指南。在2024年5月和2025年6月分别检索了8个学术数据库和灰色文献。审议了以所有语文出版的文章。经筛选，纳入了57篇文章，并将其分为四个主题：(1)一般和性别肯定医疗；(2)暴力;（三）心理健康和福祉；（四）性健康和传染病；(5)性别体现。尽管存在地理、专题、方法和亚人群方面的知识差距，但有一致的证据表明，在获得性别肯定医疗服务的机会有限、系统性心理健康挑战和遭受暴力、性健康风险和艾滋病毒护理方面存在差距，以及跨性别者、性别多样化者和非二元性别者在面对性别肯定着装和打扮限制时的创造力和复原力。这些调查结果突出了明确和一贯执行监狱政策和监狱转移战略的必要性。政策和干预措施必须是基于证据的、综合的、响应文化的、面对民粹主义话语的可持续资源，并让社区专家和被监禁者参与其设计和评估。

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引用次数: 0

Type of water and sanitation facilities and risk of non-partner sexual violence: A multilevel analysis across 31 low- and middle-income countries 水和卫生设施类型与非伴侣性暴力风险：对31个低收入和中等收入国家的多层次分析

IF 5 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Social Science & Medicine

Pub Date : 2026-01-17 DOI: 10.1016/j.socscimed.2026.119005

Hyejun Chi , Abigail Puno-Balagosa , Anoop Jain , S.V. Subramanian , Rockli Kim

Background

Disadvantaged access to water, sanitation, and hygiene (WASH) is acknowledged as a risk factor for non-partner sexual violence (NPSV), particularly in the context of low- and middle-income countries (LMICs). However, gaps in knowledge regarding the associations between inadequate WASH and NPSV persist.

Methods

Demographic and Health Surveys from 31 low- and middle-income countries (2013–2021) were used for the analysis of 259,208 women aged 15–49 years. For the experience of NPSV in the last 12 months, its associations with source of drinking water (private [reference], public, open source) and type of toilet facilities (private [reference], shared, no facilities) were estimated using three-level logistic regressions.

Results

Overall, 0.5 % had a recent experience of NPSV. After adjusting for sociodemographic characteristics, women who used public (Adjusted odds ratio [AOR] = 1.27, 95 % confidence interval [CI] = 1.06–1.52) or open source for drinking water (AOR = 1.37, 95 % CI = 1.02–1.84) were more likely to experience NPSV. Similarly, women who used shared toilet facilities (AOR = 1.16, 95 % CI = 1.01–1.34) and who had no facilities (AOR = 1.40, 95 % CI = 1.17–1.68) had greater risk for NPSV. The interaction was only marginally significant (p-value = 0.07).

Conclusions

The findings support the need to expand WASH-related programs, which can contribute to the prevention of sexual violence and empowerment of women in LMICs. National and global advocacy is essential to resolve discriminatory climates that condone and facilitate violence against women in water-related contexts.

在获得水、环境卫生和个人卫生（WASH）方面处于不利地位被认为是非伴侣性暴力（NPSV）的一个风险因素，特别是在低收入和中等收入国家（LMICs）。然而，关于不充分的WASH与NPSV之间关系的知识差距仍然存在。方法采用来自31个低收入和中等收入国家（2013-2021年）的人口与健康调查，分析了259,208名年龄在15-49岁之间的妇女。对于过去12个月的NPSV经验，使用三级逻辑回归估计其与饮用水来源（私人[参考]，公共，开源）和厕所设施类型（私人[参考]，共享，无设施）的关联。结果总体而言，0.5%的患者近期有NPSV的经历。在调整社会人口统计学特征后，使用公共饮用水（调整优势比[AOR] = 1.27, 95%可信区间[CI] = 1.06-1.52）或开放水源饮用水（AOR = 1.37, 95% CI = 1.02-1.84）的女性更容易出现NPSV。同样，使用公用厕所设施的妇女（AOR = 1.16, 95% CI = 1.01-1.34）和没有公用厕所设施的妇女（AOR = 1.40, 95% CI = 1.17-1.68）患NPSV的风险更高。交互作用仅为边际显著（p值= 0.07）。结论：研究结果支持有必要扩大与wash相关的项目，这有助于在中低收入国家预防性暴力和赋予妇女权力。国家和全球宣传对于解决在与水有关的情况下纵容和促进暴力侵害妇女行为的歧视性气氛至关重要。

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引用次数: 0

Bordering in Canadian healthcare: How the criminalization of immigrants with precarious status undermines their children's right to health 加拿大医疗保健的边界：对身份不稳定的移民定罪如何损害其子女的健康权

IF 5 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Social Science & Medicine

Pub Date : 2026-01-17 DOI: 10.1016/j.socscimed.2026.119003

Monica D. Gagnon

Increases in migration to Canada have implications for healthcare, as immigration and health policies are intertwined, and most people without permanent status are ineligible for publicly funded health coverage. Among Canadian provinces and territories, Ontario is home to the largest population of people who do not have citizenship or permanent resident status. Babies born in Ontario to people who reside in Ontario are Canadian citizens, eligible for health coverage (OHIP) at birth. However, they are often denied registration due to their parents' status. Such denials present a significant barrier to parents accessing healthcare for their newborns. In these instances, a parent's immigration status becomes an important determinant of their child's health. This paper analyzes denial of registration for health coverage to babies born in Ontario hospitals, theorizing such denial as a set of bordering practices policing access to rights of citizenship for populations deemed less deserving. I present a new typology of bordering, practiced through omission, devolution, obfuscation, and intimidation, and discuss how these mechanisms can be strategically resisted. Together, the four bordering mechanisms facilitate surveillance, discrimination, and racial profiling in Ontario hospitals, with negative effects on families' health. Bordering in health policy and practice normalizes the criminalization of a broad population of non-permanent residents and obstructs access to healthcare, even when children are legally entitled.

移民到加拿大的人数增加对医疗保健有影响，因为移民和卫生政策是相互交织的，大多数没有永久身份的人没有资格享受公共资助的医疗保险。在加拿大的省份和地区中，安大略省是没有公民身份或永久居民身份的人口最多的地方。居住在安大略省的人在安大略省所生的婴儿是加拿大公民，出生时有资格享受健康保险（OHIP）。然而，由于他们父母的身份，他们经常被拒绝注册。这种否认对父母获得新生儿保健服务构成重大障碍。在这些情况下，父母的移民身份成为其子女健康的重要决定因素。本文分析了拒绝在安大略省医院出生的婴儿进行健康保险登记的情况，并将这种拒绝作为一套边境做法进行理论化，以监管那些被认为不太值得享有公民权的人群。我提出了一种新的边界类型，通过省略、权力下放、混淆和恐吓来实践，并讨论了如何从战略上抵制这些机制。这四种相邻机制共同促进了安大略省医院的监督、歧视和种族定性，对家庭健康产生了负面影响。卫生政策和做法的边界化使广泛的非永久居民人口被定为犯罪正常化，并妨碍获得保健，即使儿童在法律上有权获得保健。

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引用次数: 0

Prison healthcare and other paradoxes 监狱医疗和其他矛盾。

IF 5 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Social Science & Medicine

Pub Date : 2026-01-17 DOI: 10.1016/j.socscimed.2026.119004

Harley Pomper , Manu S. Sundaresan

Section 400.4.1 of the Cook County Sheriff's Law Enforcement Manual mandates staff shackle, handcuff, and chain incarcerated patients to medical beds during visits. Section 400.4.3 suggests those same restraints cannot interfere with medical procedures or tests. These fault lines—formed between patient rights and procedural realities—traverse the landscape of prison and jail healthcare in the United States. This article examines three such features of carceral healthcare logic (or anti-logic): i) the legal responsibility to provide healthcare to incarcerated patients, ii) administrative systems designed to discharge that responsibility, and iii) navigation of those systems by staff and patients. In doing so, we draw upon case law, correctional policy, and direct testimony from insiders and activists incarcerated in Cook County Jail and the Illinois Department of Corrections. Scaling our analysis across legal premises, administrative aims, and individual behavior, we shed light on the fragility of prisoners' rights to healthcare, the phenomena of risk management and service rationing, and the inverse relationship between demanding and receiving care inside. We find contradictions are not merely consequent to but constitutive of carceral healthcare. Ultimately, this article asks the following: how do the defining contradictions of prison and jail healthcare impact the incarcerated? As the answer comes into view, we resolve and identify the carceral space as a site of paradox, one fundamentally incompatible with the notion of healthcare.

《库克县警长执法手册》第400.4.1节规定，工作人员在探视期间将被监禁的病人铐在医疗病床上。第400.4.3节规定，这些限制不得干扰医疗程序或检查。这些在病人权利和程序现实之间形成的断层线贯穿了美国监狱和监狱医疗保健的各个方面。本文研究了监狱医疗保健逻辑（或反逻辑）的三个特征：i)为监禁患者提供医疗保健的法律责任，ii)为履行该责任而设计的管理系统，以及iii)工作人员和患者对这些系统的导航。在此过程中，我们借鉴了判例法、惩教政策以及库克县监狱和伊利诺伊州惩教局关押的内部人士和活动人士的直接证词。将我们的分析扩展到法律前提、行政目标和个人行为，我们揭示了囚犯医疗保健权利的脆弱性、风险管理和服务配给现象，以及囚犯内部要求和接受护理之间的反比关系。我们发现矛盾不仅是医疗保健的结果，而且是医疗保健的组成部分。最后，本文提出以下问题：监狱和监狱医疗保健的定义矛盾如何影响被监禁者？随着答案的出现，我们解决并确定了carceral空间作为一个悖论的场所，一个与医疗保健概念根本不相容的场所。

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引用次数: 0