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}
Pub Date : 2025-02-01DOI: 10.1016/j.socscimed.2025.117770
Signe K. Bennetsen , Bertina Kreshpaj , Signe Hald Andersen , Tjeerd Rudmer de Vries , Karsten Thielen , Theis Lange , Naja Hulvej Rod , Leonie K. Elsenburg
Background
Childhood adversity has been associated with early school leaving and reliance on social benefits. In this mediation study, we disentangle the contribution of differential likelihood of and differential susceptibility to early school leaving in the association between childhood adversity and long-term use of social benefits in young adulthood.
Methods
We used nationwide register data from the Danish Life Course cohort study on individuals born between Jan 1, 1980, and Oct 2, 1987, who did not die or emigrate before age 16, with complete information on education at age 30 (n = 370,165). Individuals were assigned to one of five trajectory groups based on annual exposure to 12 adversities from age 0–15 across three dimensions. Early school leaving was defined as not completing upper secondary schooling before age 30. Long-term social benefit use was defined as receiving benefits for 52 consecutive weeks between age 30 and 35 years. Using counterfactual mediation analysis, we estimated how differential likelihood of and susceptibility to early school leaving contributed to the association between childhood adversity and long-term use of social benefits.
Results
Childhood adversity was associated with between 31 and 262 additional cases of long-term social benefit use per 1000 individuals. Between 26 % and 31 % of these additional cases were attributed to differential likelihood of early school leaving. The contribution of differential susceptibility to early school leaving ranged from negligible to 27 % across the childhood adversity groups.
Interpretation
A higher likelihood as well as a greater susceptibility to early school leaving among individuals with a history of childhood adversity, explains a substantial proportion of the additional cases of long-term social benefit use observed in these groups. Multifaceted policies and interventions are needed to address the ramifications of childhood adversity, reduce early school leaving, and limit long-term use of social benefits in the population.
{"title":"Childhood adversity, early school leaving and long-term social benefit use: A longitudinal mediation analysis of a population-wide study","authors":"Signe K. Bennetsen , Bertina Kreshpaj , Signe Hald Andersen , Tjeerd Rudmer de Vries , Karsten Thielen , Theis Lange , Naja Hulvej Rod , Leonie K. Elsenburg","doi":"10.1016/j.socscimed.2025.117770","DOIUrl":"10.1016/j.socscimed.2025.117770","url":null,"abstract":"<div><h3>Background</h3><div>Childhood adversity has been associated with early school leaving and reliance on social benefits. In this mediation study, we disentangle the contribution of differential likelihood of and differential susceptibility to early school leaving in the association between childhood adversity and long-term use of social benefits in young adulthood.</div></div><div><h3>Methods</h3><div>We used nationwide register data from the Danish Life Course cohort study on individuals born between Jan 1, 1980, and Oct 2, 1987, who did not die or emigrate before age 16, with complete information on education at age 30 (n = 370,165). Individuals were assigned to one of five trajectory groups based on annual exposure to 12 adversities from age 0–15 across three dimensions. Early school leaving was defined as not completing upper secondary schooling before age 30. Long-term social benefit use was defined as receiving benefits for 52 consecutive weeks between age 30 and 35 years. Using counterfactual mediation analysis, we estimated how differential likelihood of and susceptibility to early school leaving contributed to the association between childhood adversity and long-term use of social benefits.</div></div><div><h3>Results</h3><div>Childhood adversity was associated with between 31 and 262 additional cases of long-term social benefit use per 1000 individuals. Between 26 % and 31 % of these additional cases were attributed to differential likelihood of early school leaving. The contribution of differential susceptibility to early school leaving ranged from negligible to 27 % across the childhood adversity groups.</div></div><div><h3>Interpretation</h3><div>A higher likelihood as well as a greater susceptibility to early school leaving among individuals with a history of childhood adversity, explains a substantial proportion of the additional cases of long-term social benefit use observed in these groups. Multifaceted policies and interventions are needed to address the ramifications of childhood adversity, reduce early school leaving, and limit long-term use of social benefits in the population.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"370 ","pages":"Article 117770"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143479777","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.2024.117248
Simon McNamara , Aki Tsuchiya , John Holmes
{"title":"Corrigendum to ‘Does the UK-public's aversion to inequalities in health differ by group-labelling and health-gain type? A choice-experiment’ [Soc. Sci. Med. Volume 269, January 2021, 113573]","authors":"Simon McNamara , Aki Tsuchiya , John Holmes","doi":"10.1016/j.socscimed.2024.117248","DOIUrl":"10.1016/j.socscimed.2024.117248","url":null,"abstract":"","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"370 ","pages":"Article 117248"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081712","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.2025.117690
Serim Lee
Alcohol is a highly addictive substance, presenting significant global public health concerns, particularly among adolescents. Previous studies have been limited by traditional research methods, making it challenging to encompass diverse risk factors and automate screening or prediction of adolescents’ alcohol use. This study aimed to develop prediction algorithms for adolescent alcohol use in South Korea using machine learning (ML) and deep learning (DL) models, and to identify important features. The study utilized a combination of DL (i.e., Auto-encoder) and ML (i.e., Logistic regression, Ridge, LASSO, Elasticnet, Decision tree, Random forest, AdaBoost, and XGBoost) algorithms to develop the prediction models. It involves 41,239 Korean adolescents and 46 socio-ecological input variables based on cross-sectional data. The analysis revealed that the prediction algorithms had AUC scores ranging from 0.6325 to 0.7214. The feature importance analysis indicates that variables within the domains of sociodemographic characteristics, physical and mental health, behavioral problems, family factors, school factors, and social factors all play significant roles. The developed algorithms enable automatic and early identification of adolescent alcohol use within public health practice settings. By leveraging a comprehensive array of input variables, these methods surpass the limitations of traditional regression approaches, offering novel insights into the critical risk factors associated with alcohol use among Korean adolescents, thereby facilitating early and targeted prevention efforts.
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Pub Date : 2025-02-01DOI: 10.1016/j.socscimed.2025.117786
Mariana Campos Lichtsztejn , Anna Molas Closas , Joan Pujol-Tarrés
The biomedical model of attention focuses on preventive risk assessment to mitigate the apparition of future diseases. In the event of a pregnancy classified “at risk” of preeclampsia, screening undertaken in first-term ultrasound controls determines which patients receive preventive treatment. This article examines women's narratives on the communication dynamics with health professionals by drawing on an eight-month ethnographic fieldwork, between 2022 and 2023, in a Barcelona hospital's obstetrics department and 24 semi-structured interviews with women in the postpartum period. The participants of this study had been classified at high risk of developing preeclampsia, which is determined through a screening undertaken during the first trimester of pregnancy, or had a diagnosis of preeclampsia. The results suggest that risk classification significantly impacts the decision-making process and the technical parameters. As we contend, participants experienced difficulties receiving quality information and communicating with professionals, making shared decision-making challenging. As we conclude, doctor-patient dialogue and shared decisions are increasingly replaced by institutional protocols where patients feel their knowledge and experiences have little room.
{"title":"Risk and decision-making: Communication between health professionals and pregnant women at risk of preeclampsia in Catalonia","authors":"Mariana Campos Lichtsztejn , Anna Molas Closas , Joan Pujol-Tarrés","doi":"10.1016/j.socscimed.2025.117786","DOIUrl":"10.1016/j.socscimed.2025.117786","url":null,"abstract":"<div><div>The biomedical model of attention focuses on preventive risk assessment to mitigate the apparition of future diseases. In the event of a pregnancy classified “at risk” of preeclampsia, screening undertaken in first-term ultrasound controls determines which patients receive preventive treatment. This article examines women's narratives on the communication dynamics with health professionals by drawing on an eight-month ethnographic fieldwork, between 2022 and 2023, in a Barcelona hospital's obstetrics department and 24 semi-structured interviews with women in the postpartum period. The participants of this study had been classified at high risk of developing preeclampsia, which is determined through a screening undertaken during the first trimester of pregnancy, or had a diagnosis of preeclampsia. The results suggest that risk classification significantly impacts the decision-making process and the technical parameters. As we contend, participants experienced difficulties receiving quality information and communicating with professionals, making shared decision-making challenging. As we conclude, doctor-patient dialogue and shared decisions are increasingly replaced by institutional protocols where patients feel their knowledge and experiences have little room.</div></div>","PeriodicalId":49122,"journal":{"name":"Social Science & Medicine","volume":"367 ","pages":"Article 117786"},"PeriodicalIF":4.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123982","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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