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Social Science & Medicine

Elizabeth Sweet
The need to more explicitly incorporate political economy and neoliberalism into research on social inequalities in health has been acknowledged across disciplines. This paper explores neoliberalism as it relates to consumer financial debt and internalized feelings of personal responsibility and failure for adults in Boston, Massachusetts. Using data from a mixed-methods study (n = 286), findings show that endorsing a neoliberalized view of personal debt as failure is associated with significantly worse health across a range of measures, including blood pressure, adiposity, self-reported physical and emotional symptoms, depression, anxiety, and perceived stress, even when controlling for several socio-demographic confounders...
July 16, 2018: Social Science & Medicine
Mathilde A Berghout, Lieke Oldenhof, Isabelle N Fabbricotti, Carina G J M Hilders
Physicians are well-known for safeguarding medical professionalism by performing institutional work in their daily practices. However, this study shows how opinion-making physicians in strategic arenas (i.e. national professional bodies, conferences and high-impact journals) advocate to reform medical professionalism by discursively framing physicians as leaders. The aim of this article is to critically investigate the use of leadership discourse by these opinion-making physicians. By performing a discursive analysis of key documents produced in these strategic arenas and additional observations of national conferences, this article investigates how leadership discourse is used and to what purpose...
July 7, 2018: Social Science & Medicine
A Kamenshchikova, P F G Wolffs, C J Hoebe, J Penders, K Horstman
Antimicrobial resistance (AMR) is often presented as a major public health problem globally. Screening for AMR usually takes place in clinical settings. Recent developments in microbiology stimulated a series of studies focusing on AMR in communities, and particularly in travelers (any mobile individual), which was argued to be important for identifying potential public health risks. Against this background, microbiologists have become interested in non-hospitalized refugees as one of the traveler groups. However, this attention to refugees has provoked some professional debates on potential stigmatization of refugees as dangerous "others"...
July 7, 2018: Social Science & Medicine
Matthew K Grace
Support from experientially similar others-individuals who have been through the same life transition or faced a similar set of stressful circumstances-has been shown to be effective for coping with issues ranging from chronic illness to bereavement. Less research has examined how networks comprised of experientially similar others may shape academic outcomes. Using longitudinal egocentric network data collected from early career premedical students at a large research university (n = 268), results indicate that greater experiential homophily in premeds' networks are associated with a lower likelihood of departing from the premedical career track at the end of the academic year...
July 7, 2018: Social Science & Medicine
Ellie Lee, Sally Sheldon, Jan Macvarish
The recent 50th anniversary of the 1967 Abortion Act provides the opportunity to revisit what has been termed the 'remarkable authority' this Act ascribes to doctors. This paper does so using as its starting point a seminal commentary on this question by the renowned medical sociologist Sally Macintyre, published in this journal in 1973 as 'The Medical Profession and the 1967 Abortion Act in Britain'. We revisit themes from that paper through an analysis of the findings of interviews with 14 doctors who, throughout lengthy careers, have provided abortions and led the development of the abortion service in England and Wales...
July 7, 2018: Social Science & Medicine
Chris Degeling, Victoria Brookes, Tess Lea, Michael Ward
Australia is currently canine rabies free; however, the spread of rabies in eastern Indonesia poses an increasing risk to northern Australia. Domestic dogs are numerous in East Arnhem Land (EAL) and the Northern Peninsular Area (NPA), usually unrestrained and living in close relationships with humans. The response to any rabies outbreak on Australian territory will focus on dog vaccination, controlling dog movements and depopulation. A One Health approach to zoonotic disease control should seek to co-promote human and animal health, whilst also seeking to accommodate the preferences of affected communities...
July 5, 2018: Social Science & Medicine
Man-Pui Sally Chan, Kenneth Winneg, Lauren Hawkins, Mohsen Farhadloo, Kathleen Hall Jamieson, Dolores Albarracín
OBJECTIVE: Both legacy media, such as television and newspapers, and online social media are potentially important but incompletely understood sources of information in the face of emerging public health risks. This research aimed to understand media effects on risk perceptions and behaviors concerning the Zika virus in the United States. METHODS: We analyzed a multi-wave nationally representative survey (N = 29,062) and the volume of communications in social and legacy media (i...
July 5, 2018: Social Science & Medicine
Eleanor MacKillop, Sally Sheard
Quality-Adjusted Life-Years (QALYs) are central to healthcare decision-making in Britain and abroad, yet their history is poorly understood. In this paper, we argue that a more in-depth and political history of the QALY is needed to allow a critical evaluation of its current dominance. Exploiting rich data from archives and 44 semi-structured interviews conducted between 2015 and 2018, we employ Multiple Streams Analysis to construct a complex and dynamic picture of how the idea of QALYs emerged and was adopted within UK health policy...
July 3, 2018: Social Science & Medicine
Rosalind Miller, Eleanor Hutchinson, Catherine Goodman
Chain pharmacies are expanding in many low and middle-income countries (LMICs). Historically practices of independent pharmacies in these settings have been poor, and there is a need to understand how these new organisational arrangements are affecting the functioning of pharmacies, and the implications for public health. Drawing on economics literature, we develop a set of hypotheses as to how chains could address the quality failures that typify LMIC retail pharmacy markets, and explore these hypotheses using a set of 38 in-depth interviews, conducted in Bengaluru, India between 2014 and 2015...
July 3, 2018: Social Science & Medicine
Dana L Alden, John Friend, Liana Fraenkel, Maria Jibaja-Weiss
RATIONALE: Do culturally targeted patient decision aids (DAs) better prepare lower-middle and middle-class Hispanic American women for medical decision making compared to DAs designed for the general population? Health promotion evidence indicates that inclusion of cultural values, imagery, linguistics, and health data in a DA will improve ethnic patients' preparation relative to a generic DA; yet, this hypothesis remains untested. METHOD: Four experiments examined consultation preparation effects of culturally targeted versus generic DAs for Hispanic women living in the United States...
July 2, 2018: Social Science & Medicine
Emily Allen Paine
Among LGBTQ people, those who are gender nonconforming (GNC) may be at heightened risk of both discrimination and underutilization of healthcare-yet little is known about what happens during healthcare encounters to compel GNC individuals to continue or avoid seeking future care. This study qualitatively examines the healthcare experiences of a racially diverse sample of 34 adult LGBTQ cis women, transgender men, and nonbinary individuals in a metropolitan area of the United States who do not conform to dominant biomedical schemas of sex and gender...
June 30, 2018: Social Science & Medicine
P Lehoux, D Grimard
While assistive robots receive growing attention as a potential solution to support older adults to live independently, several scholars question the underlying social, ethical and health policy assumptions. One perplexing issue is determining whether assistive robots should be introduced to supplement caregivers or substitute them. Current state of knowledge indicates that users and caregivers consider that robots should not aim to replace humans, but could perform certain tasks. This begs the question of the nature and scope of the tasks that can be delegated to robots and of those that should remain under human responsibility...
June 30, 2018: Social Science & Medicine
Shu Hu, Dhiman Das
Individuals in developing countries often engage in paid and unpaid work till late in life due to low household savings and limited welfare provisions. Yet, physical disabilities associated with aging can limit their ability to work. While work can be beneficial for economic and psychological well-being, this paper investigates whether engagement in paid and unpaid work mediates the impact of physical disabilities on quality of life for older adults. We exploit the different levels of health services and social security in rural and urban China and India to examine the effect of public provisions in the process...
June 30, 2018: Social Science & Medicine
Ian Rivers, Cesar Gonzalez, Nuno Nodin, Elizabeth Peel, Allan Tyler
Evidence suggests that lesbian, gay, bisexual and trans (LGBT) people are more likely to attempt to take their own lives in their youth when compared to heterosexual and/or cisgender people. This study draws on in-depth interviews with 17 LGBT individuals living in England, and explores the narratives used by participants to better understand their perceptions of risk and protective circumstances to explain suicide attempts in youth. Using a Goffman-informed thematic analysis, results identified three key themes that were linked to attempts to end life in youth...
June 30, 2018: Social Science & Medicine
Tine Molendijk
The last decade has witnessed fast-growing scholarly interest in the concept of moral injury, which addresses the link between the ethics of military intervention and deployment-related suffering. However, current research on moral injury, predominantly psychological in nature, tends to approach the phenomenon as an internally contained disorder. Consequently, it medicalizes moral injury and de-contextualizes it from the people who send soldiers to conflict zones and 'welcome' them back. This article addresses the ways in which the experience of moral injury is embedded in and shaped by public debates on military intervention, drawing on relevant literature from the fields of psychology, philosophy, and social sciences, and on in-depth qualitative interviews collected in 2016 and 2017 with 80 Dutch veterans...
June 30, 2018: Social Science & Medicine
Sophie E Roborgh
This article explores the complex position of local physicians at times of political unrest or conflict, conceptualizing local medical voluntarism as a form of collective action. It analyzes the evolving interpretation of medical neutrality among Egyptian physicians who provided medical assistance to injured protesters in the Egyptian uprising (2011-2013). In-depth interviews with 24 medical and non-medical volunteers on their perception of medical neutrality were matched with their mobilization and participation history, showing the extent towards which political considerations influenced their voluntary medical engagement...
June 28, 2018: Social Science & Medicine
Anna P Nieboer, Jane M Cramm
In a time of aging populations and an enormous increase in frailty within them, examination of these populations' ability to achieve well-being has become increasingly important. This study aims to validate a theory-driven instrument for the measurement of well-being in three community-dwelling older populations: (i) a general population, (ii) a frail population, and (iii) Turkish migrants. The short (15-item) version of the Social Production Function Instrument for the Level of Well-being (SPF-ILs) measures whether a person's needs for stimulation, comfort, behavioral confirmation, affection, and status are met...
June 27, 2018: Social Science & Medicine
Graham Moon, Liz Twigg, Kelvyn Jones, Grant Aitken, Joanna Taylor
Small area health data are not always available on a consistent and robust routine basis across nations, necessitating the employment of small area estimation methods to generate local-scale data or the use of proxy measures. Geodemographic indicators are widely marketed as a potential proxy for many health indicators. This paper tests the extent to which the inclusion of geodemographic indicators in small area estimation methodology can enhance small area estimates of limiting long-term illness (LLTI). The paper contributes to international debates on small area estimation methodologies in health research and the relevance of geodemographic indicators to the identification of health care needs...
June 26, 2018: Social Science & Medicine
Laura Sikstrom
Despite access to antiretroviral testing and treatment, high rates of mortality among HIV infected infants and young children persist, often because they are diagnosed too late to benefit from treatment. Most research assumes that treatment delays are a proxy indicator for ongoing HIV-related stigma. My argument is different. Instead I argue that secrecy and truth-telling are socially produced; that is I consider how gendered and intergenerational dynamics regulate how and to whom secrets should be shared. In this article I draw on two years of ethnographic fieldwork (2008-2010) in Northern Malawi with 35 HIV positive children, their primary caregivers, as well as multiple interviews with their extended therapy networks [N = 96] and community stakeholders [N = 72] to examine how social hierarchies influenced the timing of an HIV diagnosis for infected infants...
June 26, 2018: Social Science & Medicine
M Hobbs, C Griffiths, M A Green, A Christensen, J McKenna
The environment may lead to lower body mass index (BMI) and obesity risk by providing opportunities to be physically active. However, while intuitively appealing, associations are often inconsistent in direction and small scale. This longitudinal study examined if change in BMI and obesity was associated with the availability of physical activity (PA) facilities and parks and explored if these associations differed by age. Longitudinal data (n = 8,864, aged 18-86 years) were provided at baseline (wave I: 2010-2012) and follow up (wave II: 2013-2015) of the Yorkshire Health Study...
June 25, 2018: Social Science & Medicine
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