Social Science [?] Medicine (SOC SCI MED )

Publisher: Elsevier

Journal description

Social Science & Medicine provides an international and interdisciplinary forum for the dissemination of research findings, reviews and theory in all areas of common interest to social scientists and health practitioners and policy makers. The journal publishes material relevant to any aspect of health from a wide range of social science disciplines (eg. anthropology, economics, education, ethics, geography, political science, psychology, social policy and sociology), and material relevant to any of the social sciences from any of the professions concerned with physical and mental health, and with health care practice, policy and organisation. It is particularly keen to publish findings or reviews which are of general interest to an international readership.The journal will publish the following types of contribution:1) Original research reports (preferably not more than 8,000 words in length).2) Critical or analytical reviews in any area of theory, policy or research relevant to health and illness (again preferably not more than 8,000 words in length).3) Short research reports or "think pieces" on topical theoretical or empirical issues (not more than 2,000 words).4) Letters relating to materials previously published in Social Science & Medicine, or to topical and internationally relevant issues concerning social science and health.5) Editorials or commentaries commissioned by the Editors.6) Part or whole Special Issues bringing together collections of papers on a particular theme, and usually edited by a guest editor.7) Reviews commissioned by the book review editor, or recently published books or groups of books which are likely to be of general interest to an international readership. Health Abstracts Online Health Abstracts Online is the new online service that has replaced Abstracts Online Social Science & Medicine. This new online service provides full details of the aims and scope, table of content, free abstracts, author lists and keywords of all articles published in Social Science & Medicine and Health & Place from 1995 onwards. Search each individual journal, or across the whole programme, for a particular topic and access the abstracts provided absolutely free of charge. Access is quick and easy for any user. Whether you are a new user or an existing user simply go to the new website at http://www.healthabstractsonline.com/healthab/show/ and you will automatically enter the new site where you can browse the information provided. When you wish to access the free journal abstracts you will be asked to login by providing your name and e-mail address. You will only need to login once, subsequent visits and access to the abstracts will be automatic. Health Abstracts Online will be regularly updated so visit the website and create a bookmark now - make Health Abstracts Online a regular stop for your research needs. http://www.healthabstractsonline.com/healthab/show/ The XVth International Conference on the Social Sciences & Medicine took place on 16-20 October 2000 in Veldhoven (near Eindhoven), The Netherlands. Proposals to host the XVIth International Conference are invited. Arranged as a series of workshops, each led by a discussion leader, the conference addresses key issues relating to the behavioural and social aspects of health and healthcare. For full details visit http://www.elsevier.nl/locate/ssmconf/

Current impact factor: 2.56

Impact Factor Rankings

2015 Impact Factor Available summer 2015
2013 / 2014 Impact Factor 2.558
2012 Impact Factor 2.733
2011 Impact Factor 2.699

Impact factor over time

Impact factor
Year

Additional details

5-year impact 3.69
Cited half-life 8.50
Immediacy index 0.68
Eigenfactor 0.05
Article influence 1.31
Website Social Science & Medicine website
Other titles Social science & medicine (1982), Social science & medicine, Social science and medicine
ISSN 1873-5347
OCLC 7667666
Material type Periodical, Internet resource
Document type Journal / Magazine / Newspaper, Internet Resource

Publisher details

Elsevier

  • Pre-print
    • Author can archive a pre-print version
  • Post-print
    • Author can archive a post-print version
  • Conditions
    • Pre-print allowed on any website or open access repository
    • Voluntary deposit by author of authors post-print allowed on authors' personal website, arXiv.org or institutions open scholarly website including Institutional Repository, without embargo, where there is not a policy or mandate
    • Deposit due to Funding Body, Institutional and Governmental policy or mandate only allowed where separate agreement between repository and the publisher exists.
    • Permitted deposit due to Funding Body, Institutional and Governmental policy or mandate, may be required to comply with embargo periods of 12 months to 48 months .
    • Set statement to accompany deposit
    • Published source must be acknowledged
    • Must link to journal home page or articles' DOI
    • Publisher's version/PDF cannot be used
    • Articles in some journals can be made Open Access on payment of additional charge
    • NIH Authors articles will be submitted to PubMed Central after 12 months
    • Publisher last contacted on 18/10/2013
  • Classification
    ​ green

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Evidence is mounting on the association between the built environment and physical activity (PA) with a call for intervention research. A broader approach which recognizes the role of supportive environments that can make healthy choices easier is required. A systematic review was undertaken to assess the effectiveness of interventions to encourage PA in urban green space. Five databases were searched independently by two reviewers using search terms relating to ‘physical activity’, ‘urban green space’ and ‘intervention’ in July 2014. Eligibility criteria included: (i) intervention to encourage PA in urban green space which involved either a physical change to the urban green space or a PA intervention to promote use of urban green space or a combination of both; and (ii) primary outcome of PA. Of the 2405 studies identified, 12 were included. There was some evidence (4/9 studies showed positive effect) to support built environment only interventions for encouraging use and increasing PA in urban green space. There was more promising evidence (3/3 studies showed positive effect) to support PAprograms or PA programs combined with a physical change to the built environment, for increasing urban green space use and PAof users. Recommendations for future research include the need for longer term follow-up post-intervention, adequate control groups, sufficiently powered studies, and consideration of the social environment, which was identified as a significantly under-utilized resource in this area. Interventions that involve the use of PA programs combined with a physical change to the built environment are likely to have a positive effect on PA. Robust evaluations of such interventions are urgently required. The findings provide a platform to inform the design, implementation and evaluation of future urban green space and PA intervention research.
    Social Science [?] Medicine 01/2015; 124:246-256.
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    ABSTRACT: Patient decision aids are known to positively impact outcomes critical to shared decision making (SDM), such as gist knowledge and decision preparedness. However, research on the potential improvement of these and other important outcomes through cultural targeting and tailoring of decision aids is very limited. This is the case despite extensive evidence supporting use of cultural targeting and tailoring to improve the effectiveness of health communications. Building on prominent psychological theory, we propose a two-stage framework incorporating cultural concepts into the design process for screening and treatment decision aids. The first phase recommends use of cultural constructs, such as collectivism and individualism, to differentially target patients whose cultures are known to vary on these dimensions. Decision aid targeting is operationalized through use of symbols and values that appeal to members of the given culture. Content dimensions within decision aids that appear particularly appropriate for targeting include surface level visual characteristics, language, beliefs, attitudes and values. The second phase of the framework is based on evidence that individuals vary in terms of how strongly cultural norms influence their approach to problem solving and decision making. In particular, the framework hypothesizes that differences in terms of access to cultural mindsets (e.g., access to interdependent versus independent self) can be measured up front and used to tailor decision aids. Thus, the second phase in the framework emphasizes the importance of not only targeting decision aid content, but also tailoring the information to the individual based on measurement of how strongly he/she is connected to dominant cultural mindsets. Overall, the framework provides a theory-based guide for researchers and practitioners who are interested in using cultural targeting and tailoring to develop and test decision aids that move beyond a “one-size fits all” approach and thereby, improve SDM in our multicultural world.
    Social Science [?] Medicine 12/2014;
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    ABSTRACT: Working conditions have changed dramatically over recent decades in all the countries of European Union: permanent full-time employment characterized by job security and a stable salary is replaced more and more by temporary work, apprenticeship contracts, casual jobs and part-time work. The consequences of these changes on the general well-being of workers and their health represent an increasingly important path of inquiry. We add to the debate by answering the question: are Italian workers on temporary contracts more likely to suffer from poor health than those with permanent jobs? Our analysis is based on a sample of men and women aged 16–64 coming from the Italian longitudinal survey 2007–2010 of the European Union Statistics on Income and Living Conditions. We use the method of inverse-probability-of-treatment weights to estimate the causal effect of temporary work on self-rated health, controlling for selection effects. Our major findings can be summarized as follows: firstly, we show a negative association between temporary employment and health that results from a statistical causal effect in the work-to-health direction, and does not trivially derive from a selection of healthier individuals in the group of people who find permanent jobs (selection effect). Secondly, we find that temporary employment becomes particularly negative for the individual's health when it is prolonged over time. Thirdly, whereas temporary employment does not entail significant adverse consequences for men, the link between temporary employment and health is strongly harmful for Italian women.
    Social Science [?] Medicine 11/2014; 124:121-131.
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    ABSTRACT: This article describes and analyzes patterns of lethal violence in Darfur, Sudan, during 2008-09, drawing upon a uniquely detailed dataset generated by the United Nations-African Union hybrid operation in Darfur (UNAMID), combined with data generated through aggregation of reports from open-source venues. These data enable detailed analysis of patterns of perpetrator/victim and belligerent groups over time, and show how violence changed over the four years following the height of armed conflict in 2003-05. During the reference period, violent incidents were sporadic and diverse and included: battles between the major combatants; battles among subgroups of combatant coalitions that were ostensibly allied; inter-tribal conflict; incidents of one-sided violence against civilians by different parties; and incidents of banditry. The conflict as a whole defies easy categorization. The exercise illustrates the limits of existing frameworks for categorizing armed violence and underlines the importance of rigorous microlevel data collection and improved models for understanding the dynamics of collective violence. By analogy with the use of the epidemiological data for infectious diseases to help design emergency health interventions, we argue for improved use of data on lethal violence in the design and implementation of peacekeeping, humanitarian and conflict resolution interventions.
    Social Science [?] Medicine 11/2014;
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    ABSTRACT: This study examines the influence of health conditions experienced during the individual’s first year of life on the incidence of sickness absence during adulthood. Using a sample of close to 9,000 biological siblings from 17 countries of origin and living in Sweden during the time period 1981-1991, sibling fixed effect models are estimated. This approach is combined with the use of an exogenous measurement of early life conditions, operationalized as the infant mortality rate. The link between early life conditions and later life outcomes is examined both with and without intermediary characteristics observed during the individual’s childhood and adulthood, aiming for a better understanding regarding to what extent the effect of exposure to an early life insult can be mediated. The results suggest that exposure to worse health conditions during the first year of life is associated with an elevated risk of experiencing sickness absence during adulthood. An increase in infant mortality rate by ten per thousand is associated with a four percentage point higher probability of experiencing sickness absence. Despite the importance of adulthood socioeconomic status on sickness absence propensity, these factors do not mediate the influence from the health conditions experienced during the first year of life, suggesting that the association from early life conditions on sickness absence in adulthood operates as a direct mechanism. The link between early life conditions and sickness absence is only present for children to parents with primary schooling and not for individuals with more educated parents. These findings suggest that families with more abundant resources have the ability to protect their child from exposure to adverse health conditions during early life, or to cancel out the influence from an early life insult.
    Social Science [?] Medicine 10/2014;
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    ABSTRACT: To quantify the relation between prenatal famine exposure and adult mortality, taking into account mediating effects of intermediary life conditions. Historical follow-up study. The Dutch famine (Hunger Winter) of 1944-1945 which occurred towards the end of WWII in occupied Netherlands. From 408,015 Dutch male births born 1944-1947, examined for military service at age 18, we selected for follow-up all men born at the time of the famine in six affected cities in the Western Netherlands (n = 25,283), and a sample of unexposed time (n = 10,667) and place (n = 9087) controls. These men were traced and followed for mortality through the national population and death record systems. All-cause mortality between ages 18 and 63 years using Cox proportional hazards models adjusted for intermediary life conditions. An increase in mortality was seen after famine exposure in early gestation (HR 1.12; 95% confidence interval (CI): 1.01-1.24) but not late gestation (HR 1.04; 95% CI: 0.96-1.13). Among intermediary life conditions at age 18 years, educational level was inversely associated with mortality and mortality was elevated in men with fathers with manual versus non-manual occupations (HR 1.08; CI: 1.02-1.16) and in men who were declared unfit for military service (HR 1.44; CI: 1.31-1.58). Associations of intermediate factors with mortality were independent of famine exposure in early life and associations between prenatal famine exposure and adult mortality were independent of social class and education at age 18. Timing of exposure in relation to the stage of pregnancy may be of critical importance for later health outcomes independent of intermediary life conditions.
    Social Science [?] Medicine 10/2014; 119:232-239.
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    ABSTRACT: We examine the influences of a set of early life conditions (ELCs) on all-cause and cause-specific mortality among elderly individuals, with special attention to one of the most dramatic early events in a child's, adolescent's, or even young adult's life, the death of a parent. The foremost question is, once controlling for prevailing (and potentially confounding) conditions early in life (family history of longevity, paternal characteristics (SES, age at time of birth, sibship size, and religious affiliation)), is a parental death associated with enduring mortality risks after age 65? The years following parental death may initiate new circumstances through which the adverse effects of paternal death operate. Here we consider the offspring's marital status (whether married; whether and when widowed), adult socioeconomic status, fertility, and later life health status. Adult health status is based on the Charlson Co-Morbidity Index, a construct that summarizes nearly all serious illnesses afflicting older individuals that relies on Medicare data. The data are based on linkages between the Utah Population Database and Medicare claims that hold medical diagnoses data. We show that offspring whose parents died when they were children, but especially when they were adolescents/young adults, have modest but significant mortality risks after age 65. What are striking are the weak mediating influences of later-life comorbidities, marital status, fertility and adult socioeconomic status since controls for these do little to alter the overall association. No beneficial effects of the surviving parent's remarriage were detected. Overall, we show the persistence of the effects of early life loss on later-life mortality and indicate the difficulties in addressing challenges at young ages
    Social Science [?] Medicine 10/2014;
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    ABSTRACT: In recent years, Kenya's capital city Nairobi has experienced an influx of international economic migrants, as well as migrants forced to flee their neighboring countries of origin, or coming from UNHCR-managed refugee camps into the city. Urban migrants regularly face challenges integrating with host communities and consequently face health vulnerabilities. The International Organization for Migration in Kenya was concerned about the potential marginalization of urban migrants from mainstream health programming and a lack of data upon which to base their activities. The purpose of this project was to gain a greater understanding of urban migrants' barriers to accessing healthcare in Nairobi compared with barriers faced by Kenyans living in the same locations. Guiding our work was a conceptual framework for assessing access to healthcare, which defines availability, geographic accessibility, financial accessibility and acceptability as the four dimensions of access. We identified key informants in collaboration with The National Organisation for Peer Educators, and these individuals assisted in identifying communities within Nairobi where large proportions of migrants reside. Four communities were selected for further study. In each, interviews with government officials and service providers were conducted, and focus group discussions were held with both migrants and Kenyans. Verbatim transcripts were content-analyzed using an open coding technique. Common barriers to accessing care that were shared by migrants and Kenyans included waiting times, drug availability, transportation and cost. Barriers unique to migrants were: threat of harassment; cost discrepancies between migrant and Kenyan clients; real or perceived discrimination; documentation requirements and language barriers. Despite articles from the 2010 Constitution of Kenya that assert the right to health for every person in Kenya, migrants continue to experience unique barriers in accessing healthcare. Efforts to eliminate these barriers should address policy-level interventions, strengthened networks and partnerships, improved migrant-sensitive services and especially continued research in migrant health.
    Social Science [?] Medicine 06/2014; 110:1–9.
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    ABSTRACT: We use micro-data to investigate the relationship between unemployment and mortality in the United States using Logistic regression on a sample of over 16,000 individuals. We consider baselines from 1984 to 1993 and investigate mortality up to ten years from the baseline. We show that poor local labor market conditions are associated with higher mortality risk for working-aged men and, specifically, that a one percentage point increase in the unemployment rate increases their probability of dying within one year of baseline by 6%. There is little to no such relationship for people with weaker labor force attachments such as women or the elderly. Our results contribute to a growing body of work that suggests that poor economic conditions pose health risks and illustrate an important contrast with studies based on aggregate data.
    Social Science [?] Medicine 05/2014; 113C:15-22.
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    ABSTRACT: Self-rated health (SRH) trajectories tend to decline over a lifetime. Moreover, the Cumulative Advantage and Disadvantage (CAD) model indicates that SRH trajectories are known to consistently diverge along socioeconomic positions (SEP) over the life course. However, studies of working adults to consider the influence of work and family conflict (WFC) on SRH trajectories are scarce. We test the CAD model and hypothesise that SRH trajectories diverge over time according to socioeconomic positions and WFC trajectories accentuate this divergence. Using longitudinal data from the Swiss Household Panel (N = 2327 working respondents surveyed from 2004 to 2010), we first examine trajectories of SRH and potential divergence over time across age, gender, SEP and family status using latent growth curve analysis. Second, we assess changes in SRH trajectories in relation to changes in WFC trajectories and divergence in SRH trajectories according to gender, SEP and family status using parallel latent growth curve analysis. Three measures of WFC are used: exhaustion after work, difficulty disconnecting from work, and work interference in private family obligations. The results show that SRH trajectories slowly decline over time and that the rate of change is not influenced by age, gender or SEP, a result which does not support the CAD model. SRH trajectories are significantly correlated with exhaustion after work trajectories but not the other two WFC measures. When exhaustion after work trajectories are taken into account, SRH trajectories of higher educated people decline slower compared to less educated people, supporting the CAD hypothesis.
    Social Science [?] Medicine 05/2014; 113C:23-33.
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    ABSTRACT: The Mexican Oportunidades program is designed to increase human capital through investments in education, health, and nutrition for children in extreme poverty. Although the program is not expressly designed to promote a child's cognitive and non-cognitive development, the set of actions carried out by the program could eventually facilitate improvements in these domains. Previous studies on the Oportunidades program have found little impact on children's cognition but have found positive effects on their non-cognitive development. However, the majority of these studies use the average outcome to measure the impact of the program and thus overlook other "non-average" effects. This paper uses stochastic dominance methods to investigate results beyond the mean by comparing cumulative distributions for both children who are and children who are not aided by the program. Four indicators of cognitive development and one indicator of non-cognitive development are analyzed using a sample of 2595 children aged two to six years. The sample was collected in rural communities in Mexico in 2003 as part of the program evaluation. Similar to previous studies, the program is found to positively influence children's non-cognitive abilities: children enrolled in the program manifest fewer behavioral problems compared with children who are not enrolled. In addition, different program effects are found for girls and boys and for indigenous and non-indigenous children. The ranges where the effect is measured cover a large part of the outcome's distribution, and these ranges include a large proportion of the children in the sample. With regard to cognitive development, only one indicator (short-term memory) shows positive effects. Nevertheless, the results for this indicator demonstrate that children with low values of cognitive development benefit from the program, whereas children with high values do not. Overall, the program has positive effects on child development, especially for the most vulnerable, who are at the bottom of the distribution.
    Social Science [?] Medicine 05/2014; 113C:42-49.
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    ABSTRACT: In recent years, liberal democratic societies have struggled with the question of how best to balance expertise and democratic participation in the regulation of emerging technologies. This study aims to explain how national deliberative ethics committees handle the practical tension between scientific expertise, ethical expertise, expert patient input, and lay public input by explaining two institutions' processes for determining the legitimacy or illegitimacy of reasons in public policy decision-making: that of the United Kingdom's Human Fertilisation and Embryology Authority (HFEA) and the United States' American Society for Reproductive Medicine (ASRM). The articulation of these 'methods of legitimation' draws on 13 in-depth interviews with HFEA and ASRM members and staff conducted in January and February 2012 in London and over Skype, as well as observation of an HFEA deliberation. This study finds that these two institutions employ different methods in rendering certain arguments legitimate and others illegitimate: while the HFEA attempts to 'balance' competing reasons but ultimately legitimizes arguments based on health and welfare concerns, the ASRM seeks to 'filter' out arguments that challenge reproductive autonomy. The notably different structures and missions of each institution may explain these divergent approaches, as may what Sheila Jasanoff (2005) terms the distinctive 'civic epistemologies' of the US and the UK. Significantly for policy makers designing such deliberative committees, each method differs substantially from that explicitly or implicitly endorsed by the institution.
    Social Science [?] Medicine 05/2014; 113C:34-41.
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    ABSTRACT: Health worker (HW) performance is a critical issue facing many low- and middle-income countries (LMICs). The aim of this study was to test the effects of factors in the work environment, such as organizational culture and climate, on HW non-task performance in rural health work settings in a LMIC. The data for the study is from a sample of 963 HWs from rural health centres (HCs) in 16 of the 20 provinces in Papua New Guinea. The reliability and validity of measures for organizational citizenship behaviour (OCB), counterproductive work behaviour (CWB) and work climate (WC) were tested. Multilevel linear regression models were used to test the relationship of individual and HC level factors with non-task performance. The survey found that 62 per cent of HCs practised OCB "often to always" and 5 percent practised CWB "often to always". Multilevel analysis revealed that WC had a positive effect on organizational citizenship behaviour (OCB) and a negative effect on CWB. The mediation analyses provided evidence that the relationship between WC and OCB was mediated through CWB. Human resource policies that improve WC in rural health settings would increase positive non-task behaviour and improve the motivation and performance of HWs in rural settings in LMICs.
    Social Science [?] Medicine 05/2014; 113C:1-4.
  • Social Science [?] Medicine 05/2014;
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    ABSTRACT: The possibility of weighting QALYs differently for different groups of patients has been a source of debate. Most recently, this debate has been extended to the relative value of QALYs at the end of life (EoL). The objective of this study is to provide evidence of societal preferences in relation to this topic. Three cross-sectional surveys were conducted amongst Spanish general population (n = 813). Survey 1 compared increases in life expectancy for EoL patients with health gains from temporary health problems. Survey 2 compared health gains for temporary health problems with quality of life gains at the EoL (palliative care). Survey 3 compared increases in life expectancy with quality of life gains, both for EoL patients. Preferences were elicited using Person Trade-Off (PTO) and Willingness to pay (WTP) techniques presenting two different durations of health benefit (6 and 18 months). Health benefits, measured in QALYs, were held constant in all comparisons. In survey 1 mean WTP was higher for life extending treatments than for temporary health problems and the majority of respondents prioritised life extension over temporary health problems in response to the PTO questions. In survey 2 mean WTP was higher for palliative care than for temporary health problems and 83% prioritized palliative care (for both durations) in the PTO questions. In survey 3 WTP values were higher for palliative care than for life extending treatments and more than 60% prioritized palliative care in the PTO questions. Our results suggest that QALYs gained from EoL treatments have a higher social value than QALYs gained from treatments for temporary health problems. Further, we found that people attach greater weight to improvements in quality of life than to life extension at the end of life.
    Social Science [?] Medicine 05/2014; 113C:5-14.
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    ABSTRACT: Breastfeeding rates in the U.S. are socially patterned. Previous research has documented startling racial and socioeconomic disparities in infant feeding practices. However, much of the empirical evidence regarding the effects of breastfeeding on long-term child health and wellbeing does not adequately address the high degree of selection into breastfeeding. To address this important shortcoming, we employ sibling comparisons in conjunction with 25 years of panel data from the National Longitudinal Survey of Youth (NLSY) to approximate a natural experiment and more accurately estimate what a particular child's outcome would be if he/she had been differently fed during infancy. Results from standard multiple regression models suggest that children aged 4 to 14 who were breast- as opposed to bottle-fed did significantly better on 10 of the 11 outcomes studied. Once we restrict analyses to siblings and incorporate within-family fixed effects, estimates of the association between breastfeeding and all but one indicator of child health and wellbeing dramatically decrease and fail to maintain statistical significance. Our results suggest that much of the beneficial long-term effects typically attributed to breastfeeding, per se, may primarily be due to selection pressures into infant feeding practices along key demographic characteristics such as race and socioeconomic status.
    Social Science [?] Medicine 05/2014; 109:55–65.
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    ABSTRACT: This paper presents an overview of Gavin Mooney’s contributions to broadening the evaluative space in health economics. It outlines how Mooney’s ideas have encouraged many, including ourselves, to expand the conventional QALYs/health gain approach and look more broadly at what it is that is of value from health services. We reflect on Mooney’s contributions to debates around cost-effectiveness analysis, Quality Adjusted Life Years (QALYs) and cost-utility analysis as well as his contribution to the development and application of contingent valuation and discrete choice experiments in health economics. We conclude by suggesting important avenues for future research to take forward Mooney’s work. ‘Preferences are preferences – economic theory is not supposed to pass moral judgements about what should be in a utility function’ (Mooney and Lange, 1993)
    Social Science [?] Medicine 05/2014;
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    ABSTRACT: For the last two decades health geography has focused on the dynamics between health and place. Although the social constructivist perspective of much research has provided many insights into the meanings of health and health care arguably, mirroring progress in the parent discipline of human geography, there could be a far more serious engagement with non-representational theory and the ‘taking place’ of health and health care. To showcase the importance and potential of this broadly, the idea of wellbeing is re-approached. The paper reflects on the ways wellbeing has been treated in research primarily as a meaningful and relatively prescribed state of life, to the neglect of process. Based on this critique, a qualitative study then illustrates the most immediate and everyday ways wellbeing might arise through ‘affect’; the pre-personal mobile energies and intensities that result from physical encounters within assemblages of bodies and objects. Indeed, theoretically the findings support the proposition that, at one level, wellbeing might not be taken from environment but instead might emerge as the affective environment. They certainly raise awareness of how much in health might originate at the surface, prior to meaning, within life's infinite spatial doings, and thus they launch some final thoughts on the wider challenges and opportunities for non-representational health geographies.
    Social Science [?] Medicine 05/2014; 108:210–222.
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    ABSTRACT: While a considerable literature has emerged regarding the relationship between the business cycles and mortality rates, relatively little is known regarding how economic fluctuations are related to morbidity. We investigate the relationship between business cycles and heart disease in Mexico using a unique state-level dataset of 512 observations consisting of real GDP and heart disease incidence rates (overall and by age group) from 1995 to 2010. Our study is one of the first to use a state-level panel approach to analyze the relationship between the business cycle and morbidity. Further, the state and year fixed effects employed in our econometric specification reduce possible omitted variable bias. We find a general procyclical, although largely statistically insignificant, contemporaneous relationship. However, an increase in GDP per capita sustained over five years is associated with considerable increases in the incidence rates of ischemic heart disease and hypertension. This procyclical relationship appears strongest in the states with the lowest levels of development and for the oldest age groups. Our results suggest that economic fluctuations may have important lagged effects on heart disease in developing countries.
    Social Science [?] Medicine 05/2014; 109:19–25.