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Social Science & Medicine

Laura Y Cabrera, Marisa Brandt, Rachel McKenzie, Robyn Bluhm
The field of biological psychiatry is controversial, with both academics and members of the public questioning the validity and the responsible use of psychiatric technological interventions. The field of neuroethics provides insight into these controversies by examining key themes that characterize specific topics, attitudes, and reasoning tools that people use to evaluate interventions in the brain and mind. This study offers new empirical neuroethical insights into how the public responds to the use and development of psychiatric technological interventions by comparing how the public evaluates pharmacological and neurosurgical psychiatric interventions, in the context of online comments on news media articles about these topics...
November 12, 2018: Social Science & Medicine
Jennifer A Smith, Minjung Kho, Wei Zhao, Miao Yu, Colter Mitchell, Jessica D Faul
Both social and genetic factors contribute to cognitive impairment and decline, yet genetic factors identified through genome-wide association studies (GWAS) explain only a small portion of trait variability. This "missing heritability" may be due to rare, potentially functional, genetic variants not assessed by GWAS, as well as gene-by-social factor interactions not explicitly modeled. Gene-by-social factor interactions may also operate differently across race/ethnic groups. We selected 39 genes that had significant, replicated associations with cognition, dementia, and related traits in published GWAS...
November 10, 2018: Social Science & Medicine
Lynn McIntyre, Patrick B Patterson, Catherine L Mah
Household food insecurity (HFI), lack of access to adequate food due to financial constraint, has been studied extensively in Canada and is well-recognized for its negative impacts on population health. Despite considerable high-level political recognition, the issue has evoked little substantive policy deliberation. We suggest that Béland and Cox's recently articulated construct of 'valence' may be useful in examining why the idea of HFI has motivated little policy response. Valence is defined as the emotional quality of an idea...
November 10, 2018: Social Science & Medicine
Michelle Pasquale Fillekes, Christina Röcke, Marko Katana, Robert Weibel
In light of novel opportunities to use sensor data to observe individuals' day-to-day mobility in the context of healthy aging research, it is important to understand how meaningful mobility indicators can be extracted from such data and to which degree these sensor-derived indicators are comparable to corresponding self-reports. We used sensor (GPS and accelerometer) and self-reported data from 27 healthy older adults (≥67 years) who participated in the MOASIS project over a 30-day period. Based on sensor data we computed three commonly used daily mobility indicators: life space (LS), travel duration using passive (i...
November 9, 2018: Social Science & Medicine
Ryan S Paquin, Susana Peinado, Megan A Lewis, Barbara B Biesecker, Christine Rini, Myra Roche, Rita M Butterfield, Cynthia M Powell, Jonathan S Berg, Donald B Bailey
Decision aids commonly include values clarification exercises to help people consider which aspects of a choice matter most to them, and to help them make decisions that are congruent with their personal values and preferences. Using a randomized online experiment, we examined the influence of values clarification on parental beliefs and intentions about having genomic sequencing for newborns. We recruited 1186 women and men ages 18-44 who were pregnant or whose partner was pregnant or planning to become pregnant in the next two years...
November 9, 2018: Social Science & Medicine
Björn Högberg, Mattias Strandh, Solveig Petersen, Klara Johansson
Research shows that the school environment is an important social determinant of health among children and adolescents. However, we know virtually nothing of the health consequences of national education systems and policies, for example the stratification of pupils by academic ability. This study aimed to investigate if education system stratification is related to self-reported psychological and somatic health complaints of pupils aged 11 to 15, and social inequalities in such health complaints. Survey data from the Health Behaviors of School-aged Children (HBSC) survey, covering 33 countries and more than 180 000 pupils in primary and lower secondary school, were used...
November 8, 2018: Social Science & Medicine
Sarah Hanson, Duncan Gilbert, Rebecca Landy, Grace Okoli, Cornelia Guell
BACKGROUND: Cancer is a leading cause of premature death in women worldwide, and is associated with socio-economic disadvantage. Yet many interventions designed to reduce risk and improve health fail to reach the most marginalised with the greatest needs. Our study focused on socially marginalised women at two women's centres that provide support and training to women in the judicial system or who have experienced domestic abuse. METHODS: This qualitative study was framed within a sociological rather than behavioural perspective involving thirty participants in individual interviews and focus groups...
November 8, 2018: Social Science & Medicine
H Colin Gallagher, Karen Block, Lisa Gibbs, David Forbes, Dean Lusher, Robyn Molyneaux, John Richardson, Philippa Pattison, Colin MacDougall, Richard A Bryant
Involvement in voluntary associations is a key form of social capital and plays an especially important role following disaster as a venue for coordination and decision-making for the wider community. Yet, relatively little attention has been paid to how group involvement affects mental health, at either the individual or community level. The aim of this study was to assess the impact of involvement in voluntary associations on mental health among residents of bushfire-affected communities. A longitudinal sample of 642 individuals affected by the 2009 Victorian bushfires in south-eastern Australia were surveyed in 2012 and 2014 (3- and 5-years post-disaster)...
November 7, 2018: Social Science & Medicine
Amanda Hughes, Meena Kumari
Lower testosterone levels in men are observationally associated with worse health, but it is unclear whether they contribute to well-established social gradients in health. Mendelian Randomization studies suggest positive testosterone-health associations may not be causal, with some intervention studies suggesting testosterone administration could be harmful. Since testosterone is rarely measured in general population studies, very little is known about how testosterone varies by social position. Differences by education and household income in British men aged 60-64y were recently reported, but it is unclear whether this reflects an influence of socioeconomic position (SEP) on testosterone, influence of testosterone on SEP, or confounding...
November 5, 2018: Social Science & Medicine
K Hauck, A Morton, K Chalkidou, Y-Ling Chi, A Culyer, C Levin, R Meacock, M Over, R Thomas, A Vassall, S Verguet, P C Smith
Health interventions often depend on a complex system of human and capital infrastructure that is shared with other interventions, in the form of service delivery platforms, such as healthcare facilities, hospitals, or community services. Most forms of health system strengthening seek to improve the efficiency or effectiveness of such delivery platforms. This paper presents a typology of ways in which health system strengthening can improve the economic efficiency of health services. Three types of health system strengthening are identified and modelled: (1) investment in the efficiency of an existing shared platform that generates positive benefits across a range of existing interventions; (2) relaxing a capacity constraint of an existing shared platform that inhibits the optimization of existing interventions; (3) providing an entirely new shared platform that supports a number of existing or new interventions...
November 3, 2018: Social Science & Medicine
Colleen Heflin, Irma Arteaga, Leslie Hodges, Jean Felix Ndashiyme, Matthew P Rabbitt
Anecdotal and descriptive evidence has led to the claim that some low-income households may face a "eat or breathe" tradeoff, but quantitative evidence is scarce. We link Medicaid claims data to monthly Supplemental Nutritional Assistance Program (SNAP) participation data from the state of Missouri from 2010 to 2013 to explore monthly patterns in children's emergency room (ER) claims for asthma and to examine whether these patterns are sensitive to the timing and amount of SNAP benefits. This allows us to empirically test whether SNAP households with Medicaid insurance face trade-offs between food and medicine that increases the likelihood that a child in a SNAP and Medicaid household will go to the ER for asthma at the end of the month...
November 2, 2018: Social Science & Medicine
Anagaw D Mebratie, Robert Sparrow, Zelalem Yilma, Degnet Abebaw, Getnet Alemu, Arjun S Bedi
In June 2011, the Government of Ethiopia introduced a pilot Community Based Health Insurance (CBHI) scheme in rural parts of the country. Based on a fixed effects analysis of household panel data, this paper assesses the impact of the scheme on utilization of modern healthcare and the cost of accessing healthcare. It adds to the relatively small body of work that provides a rigorous evaluation of CBHI schemes. We find that in the case of public health facilities, enrolment leads to a 30-41% increase in utilization of outpatient care, a 45-64% increase in the frequency of visits and at least a 56% decline in the cost per visit...
November 2, 2018: Social Science & Medicine
Fadima Bocoum, Michael Grimm, Renate Hartwig, Nathalie Zongo
Community Based Health Insurance Schemes are often confronted to very low uptake. We analyze the impact of a randomized information package on the understanding and adoption of Community Based Health Insurance in Burkina Faso. The sample consists of about 2000 households in the rural community of Ziniaré which we interviewed several times between 2013 and 2016. In contrast to previous studies in the literature, we assess the effects of an intensive information intervention combining tools and repeated interaction instead of only a single event of information provisioning...
November 2, 2018: Social Science & Medicine
Jeremy K Ward, Florian Cafiero, Raphael Fretigny, James Colgrove, Valérie Seror
BACKGROUND: Confronted with a rise in vaccine hesitancy, public health officials increasingly try to involve the public in the policy decision-making process to foster consensus and public acceptability. In public debates and citizen consultations tensions can arise between the principles of science and of democracy. To illustrate this, we analyzed the 2016 citizen consultation on vaccination organized in France. This consultation led to the decision to extend mandatory vaccination. METHODS: The analysis combines qualitative and quantitative methods...
November 2, 2018: Social Science & Medicine
Jennifer A Reich
Despite measurable benefits of childhood vaccines, mothers with high levels of social privilege are increasingly refusing some or all vaccines for their children. These mothers are often clustered geographically or networked socially, providing information, emotional support, and validation for each other. Mothers who reject vaccines may face disapproval from others, criticism in popular culture, negative interactions with healthcare providers, and conflicts with people they know, which serve to stigmatize them...
October 30, 2018: Social Science & Medicine
Nicole Black, David W Johnston, Carol Propper, Michael A Shields
This paper focuses on the long-term impacts of attending a high school with inadequate sports facilities. We use prospective data from the British National Child Development Study, a continuing panel of a cohort of 17,634 children born in Great Britain during a single week of March 1958. Our empirical approach exploits the educational system they were exposed to: children were sorted by educational ability at age 11, but conditional on educational ability, attended their closest school. This produces quasi-random variation in the quality of the school sports facilities across respondents...
October 30, 2018: Social Science & Medicine
Ying Chen, Laura D Kubzansky, Tyler J VanderWeele
OBJECTIVE: This study examined the longitudinal association between parental warmth and offspring flourishing in mid-life. We also considered associations between parental warmth and a number of mental health problems and adverse health behavioral outcomes. METHOD: Longitudinal data from the Midlife in the United States Study (N = 3,929, mean baseline age = 47.4 years) were analyzed using generalized estimating equations. Parental warmth in childhood was recalled at phase I (1995-1996), while flourishing and other outcomes were self-reported at phase II (2004-2006)...
October 30, 2018: Social Science & Medicine
Meredith Van Natta, Nancy J Burke, Irene H Yen, Mark D Fleming, Christoph L Hanssmann, Maryani Palupy Rasidjan, Janet K Shim
Our paper explores how legal status stratification shapes the health and health care of low-income patients with chronic illnesses in the U.S. healthcare safety net. Drawing on data from over two years of ethnographic fieldwork at urban safety-net clinics, we examine efforts by Complex Care Management (CCM) teams to stabilize patients with uncontrolled chronic illnesses through primary care-integrated support. We show that stratified citizenship and geographic variability correspond to different possibilities for health care...
October 27, 2018: Social Science & Medicine
Priya Fielding-Singh
Amidst growing concern about adolescents' diets and dietary health in the United States, this article asks: what does healthy eating mean to adolescents? Using data from in-depth interviews conducted with 74 adolescents across socioeconomic status (SES) in California in 2015-2016, I show how adolescents view healthy eating as a moral, affluent practice and use discussions of healthy eating to assert their own morality and socioeconomic position. Adolescents associate healthy eating with 1) financial privilege and 2) moral superiority...
October 26, 2018: Social Science & Medicine
Alexandra Brewis, Amber Wutich, Margaret V du Bray, Jonathan Maupin, Roseanne C Schuster, Matthew M Gervais
Community sanitation interventions increasingly leverage presumed innate human disgust emotions and desire for social acceptance to change hygiene norms. While often effective at reducing open defecation and encouraging handwashing, there are growing indications from ethnographic studies that this strategy might create collateral damage, such as reinforcing stigmatized identities in ways that can drive social or economic marginalization. To test fundamental ethnographic propositions regarding the connections between hygiene norm violations and stigmatized social identities, we conducted 267 interviews in four distinct global sites (in Guatemala, Fiji, New Zealand, USA) between May 2015 and March 2016...
October 26, 2018: Social Science & Medicine
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