Social Science [?] Medicine (SOC SCI MED )

Publisher: Elsevier


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 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. 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

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  • Website
    Social Science & Medicine website
  • Other titles
    Social science & medicine (1982), Social science & medicine, Social science and medicine
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  • Material type
    Periodical, Internet resource
  • Document type
    Journal / Magazine / Newspaper, Internet Resource

Publisher details


  • Pre-print
    • Author can archive a pre-print version
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    • Author can archive a post-print version
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    • Voluntary deposit by author of pre-print allowed on Institutions open scholarly website and pre-print servers
    • Voluntary deposit by author of authors post-print allowed on institutions open scholarly website including Institutional Repository
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    • Articles in some journals can be made Open Access on payment of additional charge
    • NIH Authors articles will be submitted to PMC after 12 months
    • Authors who are required to deposit in subject repositories may also use Sponsorship Option
    • Pre-print can not be deposited for The Lancet
  • Classification
    ​ green

Publications in this journal

  • [Show abstract] [Hide abstract]
    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: 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: 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;
  • Social Science [?] Medicine 05/2014;
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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: 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: Many public health systems in high- and middle-income countries are under increasing financial pressures as a result of ageing populations, a rise in chronic and non-communicable diseases and shrinking public resources. At the same time the rise in patient mobility and concomitant market in medical tourism provides opportunities for additional income. This is especially the case where public sector hospitals have a reputation as global centres of excellence. Yet, this requires public sector entrepreneurship which, given the unique features of the public sector, means a change to professional culture. This paper examines how and under what conditions public sector entrepreneurship develops, drawing on the example of international patients in the UK NHS. It reports on a subset of data from a wider study of UK medical tourism, and explores inward flows and NHS responses through the lens of public entrepreneurship. Interviews in the English NHS were conducted with managers of Foundation Trusts with interest in international patient work. Data is from seven Foundation Trusts, based on indepth, semi-structured interviews with a range of NHS managers, and three other key stakeholders (n = 16). Interviews were analysed using a framework on entrepreneurship developed from academic literature. Empirical findings showed that Trust managers were actively pursuing a strategy of expanding international patient activity. Respondents emphasised that this was in the context of the current financial climate for the NHS. International patients were seen as a possible route to ameliorating pressure on stretched NHS resources. The analysis of interviews revealed that public entrepreneurial behaviour requires an organisational managerial or political context in order to develop, such as currently in the UK. Public sector workers engaged in this process develop entrepreneurship - melding political, commercial and stakeholder insights - as a coping mechanism to health system constraints.
    Social Science [?] Medicine 04/2014;
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    ABSTRACT: Little is known about the effectiveness of school-based health promotion on physical activity inequalities among children from low-income areas. This study compared the two-year change in physical activity among 10-11 year-old children attending schools with and without health promotion programs by activity level, body weight status, and socioeconomic backgrounds to assess whether health promotion programs reduce or exacerbate health inequalities. This was a quasi-experimental trial of a Comprehensive School Health (CSH) program implemented in schools located in socioeconomically disadvantaged neighbourhoods in Edmonton, Alberta, Canada. In the spring of 2009 and 2011, pedometer (7 full days) and demographic data were collected from cross-sectional samples of grade five children from 10 intervention and 20 comparison schools. Socioeconomic status was determined from parent self-report. Low-active, active, and high-active children were defined according to step-count tertiles. Multilevel linear regression methods adjusted for potential confounders were used to assess the relative inequity in physical activity and were compared between groups and over-time. In 2009, a greater proportion of students in the intervention schools were overweight (38% vs. 31% p = 0.03) and were less active (10,827 vs. 12,265 steps/day p < 0.001). Two years later, the relative difference in step-counts between intervention and comparison schools reduced from -15.5% to 0% among low-active students, from -13.4% to 0% among active students, and from -15.1% to -2.7% among high-active students. The relative difference between intervention and comparison schools reduced from -11.1% to -1.6% among normal weight students, from -16.8% to -1.4% among overweight students, and was balanced across socioeconomic subgroups. These findings demonstrate that CSH programs implemented in socioeconomically disadvantaged neighbourhoods reduced inequalities in physical activity. Investments in school-based health promotion are a viable, promising, and important approach to improve physical activity and prevent childhood obesity, and may also reduce inequalities in health.
    Social Science [?] Medicine 04/2014; 112C:80-87.
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    ABSTRACT: When analysing the health behaviours of any group of people, understanding the constraints and possibilities for individual agency as shaped by the broader societal context is critical. In recent decades, our understanding of the ways in which physical and social environments influence health and health behaviours has expanded greatly. The authors of a recent analysis of Australian Aboriginal health data using an economic 'rational choice model,' published in this journal, claim to make a useful contribution to policy discussions relating to Aboriginal health, but neglect context. By doing so, they neglect the very factors that determine the success or failure of policy change. Notwithstanding the technical sophistication of the analyses, by ignoring most relevant determinants of health, the conclusions misrepresent the lives of Aboriginal and Torres Strait Islander people and therefore risk perpetuating harm, rather than improving health.
    Social Science [?] Medicine 04/2014;
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    ABSTRACT: How do governments contribute to the pharmaceuticalization of society? Whilst the pivotal role of industry is extensively documented, this article shows that governments too are accelerating, intensifying and opening up new trajectories of pharmaceuticalization in society. Governments are becoming more deeply invested in pharmaceuticals because their national security strategies now aspire to defend populations against health-based threats like bioterrorism and pandemics. To counter those threats, governments are acquiring and stockpiling a panoply of 'medical countermeasures' such as antivirals, next-generation vaccines, antibiotics and anti-toxins. More than that, governments are actively incentivizing the development of many new medical countermeasures - principally by marshaling the state's unique powers to introduce exceptional measures in the name of protecting national security. At least five extraordinary policy interventions have been introduced by governments with the aim of stimulating the commercial development of novel medical countermeasures: (1) allocating earmarked public funds, (2) granting comprehensive legal protections to pharmaceutical companies against injury compensation claims, (3) introducing bespoke pathways for regulatory approval, (4) instantiating extraordinary emergency use procedures allowing for the use of unapproved medicines, and (5) designing innovative logistical distribution systems for mass drug administration outside of clinical settings. Those combined efforts, the article argues, are spawning a new, government-led and quite exceptional medical countermeasure regime operating beyond the conventional boundaries of pharmaceutical development and regulation. In the first comprehensive analysis of the pharmaceuticalization dynamics at play in national security policy, this article unearths the detailed array of policy interventions through which governments too are becoming more deeply imbricated in the pharmaceuticalization of society.
    Social Science [?] Medicine 04/2014;
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    ABSTRACT: The causes of cross-national differences in population health are subject for intense discussion, often focusing on the role of structural economic factors. Although population health is widely believed to reflect the living conditions in society, surprisingly few comparative studies systematically assess policy impacts of anti-poverty programs. In this paper we estimate the influence of minimum income benefits on mortality using international data on benefit levels in 18 countries 1990-2009. Included are all major non-contributory benefits that low-income households may receive. Our analyses, based on fixed effects pooled time-series regression, show that minimum income benefits improve mortality, measured in terms of age-standardized death rates and life expectancy. The results on country-level links between minimum income benefits and mortality are remarkably robust in terms of measured confounding effects.
    Social Science [?] Medicine 04/2014; 112C:63-71.
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    ABSTRACT: This paper explores how the Gates-funded HIV Initiative in India, known as Avahan, produces sociality. Drawing upon ethnographic research conducted between 2006 and 2012, we illustrate how epidemiological surveillance procedures, undergirded by contemporary managerial and entrepreneurial logics, entwine with and become transformed by the everyday practices of men who have sex with men (many of whom sell sex). The coevolution of epidemiology and sociality, with respect to these communities, is explored in relation to: 1) how individual identities are reproduced in association with standardized units of space and time; 2) how knowledge of mapping and enumeration data is employed in the making up of group membership boundaries, revealing how collective interests come to cohere around the project of epidemic prevention; and 3) how knowledge of epidemiological surveillance and procedures provides a basis on which groups collectively realize and execute local security strategies. While monitoring and evaluation (M&E) specialists continually track and standardize the identities, behaviours and social spaces of local populations (through various mapping, typologization and random sampling procedures, which treat space and time as predictable variables), community members simultaneously retranslate and reroute these standardizing processes into "the local" through everyday spatial management practices for health protection. These grounded epidemiologies, we argue, point to vital sites in the co-creation of scientific knowledge-where the quotidian practices of sex workers reassemble epidemiology, continually altering the very objects that surveillance experts are tracking. We further argue that attention to these re-workings can help us unravel the tremendous successes that have been claimed under Avahan in terms of HIV infections averted.
    Social Science [?] Medicine 04/2014; 112C:51-62.
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    ABSTRACT: Cigarette smoking is a risk factor in a range of serious diseases, including cardiovascular disease, cancer, stroke and type II diabetes. Theory suggests that working long hours will increase smoking propensities among workers. Consequently there is a significant body of evidence on the relationship between working time and smoking. Results, however, are inconsistent and therefore inconclusive. This paper provides new evidence on how working time affects smoking behaviour using nationally representative panel data from Australia (from 2002 to 2011) and the United Kingdom (from 1992 to 2011). We exploit the panel design of the surveys to look at within-person changes in smoking behaviour over time as working time changes. In contrast to most previous studies, this means we control for time invariant aspects of personality and genetic inheritance that may affect both smoking propensities and choice of working hours. We find that working long hours tends to increase the chances that former smokers will relapse, reduce the chances that smokers will quit and increase cigarette consumption among regular smokers, and that these effects tend to become more pronounced for workers who usually work very long hours (50 or more hours a week) compared to those who work moderately long hours (40-49 h a week).
    Social Science [?] Medicine 04/2014; 112C:72-79.
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    ABSTRACT: Suicide rates in Greece (and other European countries) have been on a remarkable upward trend following the global recession of 2008 and the European sovereign debt crisis of 2009. However, recent investigations of the impact on Greek suicide rates from the 2008 financial crisis have restricted themselves to simple descriptive or correlation analyses. Controlling for various socio-economic effects, this study presents a statistically robust model to explain the influence on realised suicidality of the application of fiscal austerity measures and variations in macroeconomic performance over the period 1968-2011. The responsiveness of suicide to levels of fiscal austerity is established as a means of providing policy guidance on the extent of suicide behaviour associated with different fiscal austerity measures. The results suggest (i) significant age and gender specificity in these effects on suicide rates and that (ii) remittances have suicide-reducing effects on the youth and female population. These empirical regularities potentially offer some guidance on the demographic targeting of suicide prevention measures and the case for 'economic' migration.
    Social Science [?] Medicine 04/2014; 112C:39-50.
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    ABSTRACT: This study examines the impact of Child Development Accounts (CDAs)-asset-building accounts created for children at birth-on the depressive symptoms of mothers in a statewide randomized experiment conducted in the United States. The experiment identified the primary caregivers of children born in Oklahoma during 2007, and 2704 of the caregivers completed a baseline interview before random assignment to the treatment (n = 1358) or the control group (n = 1346). To treatment participants, the experiment offered CDAs built on the existing Oklahoma 529 College Savings Plan. The baseline and follow-up surveys measured the participants' depressive symptoms with a shortened version of the Center for Epidemiologic Studies Depression Scale (CES-D). In models that control for baseline CES-D scores, the mean follow-up score of treatment mothers is .17 lower than that of control mothers (p < .05). Findings suggest that CDAs have a greater impact among subsamples that reported lower income or lower education. Although designed as an economic intervention for children, CDAs may improve parents' psychological well-being. Findings also suggest that CDAs' impacts on maternal depressive symptoms may be partially mediated through children's social-emotional development.
    Social Science [?] Medicine 04/2014; 112C:30-38.

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