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Social Science & Medicine

Armando H Norman, Andrew J Russell, Claudia Merli
The UK's Quality and Outcomes Framework (QOF) is the largest pay-for-performance scheme in the world. This ethnographic study explored how QOF's monetary logic influences the approach to healthcare in UK general practice. From August 2013 to April 2014, we researched two UK general practice surgeries and one general practice training programme. These environments provided the opportunity for studying various spaces such as QOF meetings, consultation rooms, QOF recoding sessions, and the collection of computer-screen images depicting how patients' biomarkers are evaluated and costed through software systems...
October 11, 2016: Social Science & Medicine
Courtney Boen
Research links Black-White health disparities to racial differences in socioeconomic status (SES), but understanding of the role of SES in racial health gaps has been restricted by reliance on static measures of health and socioeconomic well-being that mask the dynamic quality of these processes and ignore the racialized nature of the SES-health connection. Utilizing twenty-three years of longitudinal data from the Panel Study of Income Dynamics (1984-2007), this study uses multilevel growth curve models to examine how multiple dimensions of socioeconomic well-being-including long-term economic history and differential returns to SES-contribute to the life course patterning of Black-White health disparities across two critical markers of well-being: body mass index (N = 9057) and self-rated health (N = 11,329)...
October 11, 2016: Social Science & Medicine
Amelia Rock, Clare Barrington, Sara Abdoulayi, Maxton Tsoka, Peter Mvula, Sudhanshu Handa
Extensive research documents that social network characteristics affect health, but knowledge of peer networks of youth in Malawi and sub-Saharan Africa is limited. We examine the networks and social participation of youth living in extreme poverty in rural Malawi, using in-depth interviews with 32 youth and caregivers. We describe youth's peer networks and assess how gender and the context of extreme poverty influence their networks and participation, and how their networks influence health. In-school youth had larger, more interactive, and more supportive networks than out-of-school youth, and girls described less social participation and more isolation than boys...
October 8, 2016: Social Science & Medicine
Gillian Fergie, Kate Hunt, Shona Hilton
Social media offer opportunities to both produce and consume content related to health experiences. However, people's social media practices are likely to be influenced by a range of individual, social and environmental factors. The aim of this qualitative study was to explore how engagement with user-generated content can support people with long-term health conditions, and what limits users' adoption of these technologies in the everyday experience of their health condition. Forty semi-structured interviews were conducted with young adults, aged between 18 and 30 years, with experience of diabetes or a common mental health disorder (CMHD)...
October 8, 2016: Social Science & Medicine
Melanie A Martin, Geni Garcia, Hillard S Kaplan, Michael D Gurven
Six months of exclusive breastfeeding (EBF) is considered optimal for infant health, though globally most infants begin complementary feeding (CF) earlier-including among populations that practice prolonged breastfeeding. Two frameworks for understanding patterns of early CF emerge in the literature. In the first, maternal and infant needs trade-off, as "maternal-centric" factors-related to time and energy demands, reproductive investment, cultural influences, and structural barriers- favor supplanting breastfeeding with earlier and increased CF...
October 6, 2016: Social Science & Medicine
Aniruddha Das
OBJECTIVES: This study queried causal direction in linkages of inflammation with psychosocial distress. METHODS: Data were from the 2005-2006 and 2010-2011 waves of the U.S. National Social Life, Health, and Aging Project. Inflammation was indicated by C-reactive protein, and distress by depression, anxiety, as well as stress. Autoregressive cross-lagged panel models were used to examine causal direction. RESULTS: Rather than being an outcome of psychosocial distress, inflammation was a predictor of it...
October 5, 2016: Social Science & Medicine
Sander K R van Zon, Ute Bültmann, Sijmen A Reijneveld, Carlos F Mendes de Leon
OBJECTIVES: The aims of this study are to examine the pattern of pre- and post-retirement changes in functional health and to examine the degree to which socioeconomic position (SEP) modifies pre- and post-retirement changes in functional health. METHOD: This longitudinal study was conducted using data from the Health and Retirement Study from 1992 to 2012. Piecewise linear regression analyses with generalised estimating equations were used to calculate trajectories of limitations in mobility and large muscle functions before and after retirement spanning a time period of 16 years...
October 4, 2016: Social Science & Medicine
Bethany G Everett, Mark L Hatzenbuehler, Tonda L Hughes
RATIONALE: A small but growing body of research documents associations between structural forms of stigma (e.g., same-sex marriage bans) and sexual minority health. These studies, however, have focused on a limited number of outcomes and have not examined whether sociodemographic characteristics, such as race/ethnicity and education, influence the relationship between policy change and health among sexual minorities. OBJECTIVE: To determine the effect of civil union legalization on sexual minority women's perceived discrimination, stigma consciousness, depressive symptoms, and four indicators of hazardous drinking (heavy episodic drinking, intoxication, alcohol dependence symptoms, adverse drinking consequences) and to evaluate whether such effects are moderated by race/ethnicity or education...
October 4, 2016: Social Science & Medicine
Mark Manning, Terrance L Albrecht, Zeynep Yilmaz-Saab, Julie Shultz, Kristen Purrington
RATIONALE: Many states have adopted laws mandating breast density (BD) notification for applicable women; however, very little is known about what women knew or felt about BD and related breast cancer (BC) risk before implementation of BD notification laws. OBJECTIVE: We examined between-race differences in the extent to which having dense breasts was associated with women's related BD cognition and emotion, and with health care providers' communication about BD...
October 4, 2016: Social Science & Medicine
Rosalía Cascón-Pereira, Shiona Chillas, Jerry Hallier
This study examines "identity work" among hybrid doctor-managers (DMs) in the Spanish National Health System to make sense of their managerial roles. In particular, the meanings underlying DMs experience of their hybrid role are investigated using a Grounded Theory methodology, exposing distinctions in role-meanings. Our findings provide evidence that using different social sources of comparison (senior managers or clinicians) to construct the meaning of managerial roles leads to different role-meanings and role identities, which are the source of the two established types of DM in the literature, the reluctant and the enthusiast...
October 3, 2016: Social Science & Medicine
Jay Pan, Hanqing Zhao, Xiuli Wang, Xun Shi
In 2009, the Chinese government launched a new round of healthcare reform, which encourages development of private hospitals. Meanwhile, many public hospitals in China also became increasingly profit-oriented. These trends have led to concerns about social justice and regional disparity. However, there is a lack of empirical scientific analysis to support the debate. We started to fill this gap by conducting a regional-level analysis of spatial variation in spatial access to hospitals in the Sichuan Province...
October 1, 2016: Social Science & Medicine
Amber Wutich, H Russell Bernard
No abstract text is available yet for this article.
September 30, 2016: Social Science & Medicine
Susan Bradley, Christine McCourt, Juliet Rayment, Divya Parmar
The psycho-social elements of labour and delivery are central to any woman's birth experience, but international efforts to reduce maternal mortality in low-income contexts have neglected these aspects and focused on technological birth. In many contexts, maternity care is seen as dehumanised and disrespectful, which can have a negative impact on utilisation of services. We undertook a systematic review and meta-synthesis of the growing literature on women's experiences of facility-based delivery in sub-Saharan Africa to examine the drivers of disrespectful intrapartum care...
September 28, 2016: Social Science & Medicine
Paul Downward, Simona Rasciute
International public policy emphasises the need to increase current low levels of physical activity (WHO, 2010). A large literature examines the reasons for the low levels of physical activity but tends to focus on the correlates of behaviour. This has prompted a call for more causal research to better support policy recommendations to change behaviour (Bauman et al., 2012). Using a large sample of individuals from the British Household Panel Survey (BHPS) between 1996/7 and 2006/7, a dynamic panel data analysis is employed to reveal a causal contemporaneous effect of a household peer's participation in physical activity on an individual's behaviour...
September 28, 2016: Social Science & Medicine
Sarah Hanson, Jane Cross, Andy Jones
Walking groups have known health benefits but may not operate in communities with the greatest health needs, leading to the potential for increasing health inequity. This study examined the process of implementing a new volunteer led walking group scheme in a deprived community in England with poor physical activity, health and socio-economic indicators. Documentary evidence and semi-structured interviews with stakeholders and volunteer walk leaders undertaken at the beginning and end of the funding period were analysed thematically...
September 25, 2016: Social Science & Medicine
John Wildman, Peter McMeekin, Eleanor Grieve, Andrew Briggs
With an ageing population there is a move towards the use of assisted living technologies (ALTs) to provide social care and health care services, and to improve service processes. These technologies are at the forefront of the integration of health and social care. However, economic evaluations of ALTs, and indeed economic evaluations of any interventions providing both health benefits and benefits beyond health are complex. This paper considers the challenges faced by evaluators and presents a method of economic evaluation for use with interventions where traditional methods may not be suitable for informing funders and decision makers...
September 24, 2016: Social Science & Medicine
Kate L Mandeville, Godwin Ulaya, Mylène Lagarde, Adamson S Muula, Titha Dzowela, Kara Hanson
Emigration has contributed to a shortage of doctors in many sub-Saharan African countries. Specialty training is highly valued by doctors and a potential tool for retention. Yet not all types of training may be valued equally. In the first study to examine preferences for postgraduate training in depth, we carried out a discrete choice experiment as part of a cross-sectional survey of all Malawian doctors within seven years of graduation and not yet in specialty training. Over August 2012 to March 2013, 148 doctors took part out of 153 eligible in Malawi...
September 24, 2016: Social Science & Medicine
Jana A Hirsch, Joe Grengs, Amy Schulz, Sara D Adar, Daniel A Rodriguez, Shannon J Brines, Ana V Diez Roux
Investments in neighborhood built environments could increase physical activity and overall health. Disproportionate distribution of these changes in advantaged neighborhoods could inflate health disparities. Little information exists on where changes are occurring. This paper aims to 1) identify changes in the built environment in neighborhoods and 2) investigate associations between high levels of change and sociodemographic characteristics. Using Geographic Information Systems, neighborhood land-use, local destinations (for walking, social engagement, and physical activity), and sociodemographics were characterized in 2000 and 2010 for seven U...
September 23, 2016: Social Science & Medicine
Vincent Lorant, Victoria Soto Rojas, Laia Bécares, Jaana M Kinnunen, Mirte A G Kuipers, Irene Moor, Gaetano Roscillo, Joana Alves, Adeline Grard, Arja Rimpelä, Bruno Federico, Matthias Richter, Julian Perelman, Anton E Kunst
BACKGROUND: Social integration and the health of adolescents with a migration background is a major concern in multicultural societies. The literature, however, has paid little attention to the wider determinants of their health behaviours, including the composition of their social networks. The aim of this study was to describe the composition of adolescents' social networks according to migration background, and to examine how social networks are associated with substance use. METHOD: In 2013, the SILNE study surveyed 11,015 secondary-school adolescents in 50 schools in six European cities in Belgium, Finland, Germany, Italy, the Netherlands, and Portugal, using a social network design...
September 21, 2016: Social Science & Medicine
Anastasia Hudgins, Kristin L Rising
Patients' existential fears of unknowns associated with illness and unusual bodily signs and symptoms are common, but unexamined drivers to the emergency department (ED). This paper examines a May 2015 case study of a 51-year-old low-income, recently insured, African American man in Philadelphia (USA) who had two recent ED visits for evaluation of frequent headaches and described fear of being at risk for a stroke. Through ethnographic methods and anthropological analyses we find that fear of failing to fulfill social roles due to a potentially debilitating illness, and fear of burdening family members with medical bills resulting from doctor's visits affect this man's patterns of health-seeking behaviors...
September 20, 2016: Social Science & Medicine
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