Social science & medicine
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Social science & medicine · Jun 2017
Health policy in the concertación era (1990-2010): Reforms the chilean way.
The Chilean health system has experienced important transformations in the last decades with a neoliberal turn to privatization of the health insurance and healthcare market since the Pinochet reforms of the 1980s. During 20 years of center-left political coalition governments several reforms were attempted to regulate and reform such markets. This paper analyzes regulatory policies for the private health insurance and health care delivery market, adopted during the 1990-2010 period. ⋯ In contrast, the healthcare delivery market showed a trend of increasing payers' and consumers' control and the set of implemented reforms partially steered the market toward collective responsibility of access by creating a submarket of guaranteed services (AUGE) with lower copayments and fully funded services. Emerging unintended consequences of the adopted policies and potential explanations are discussed. In sum, attempts to use regulation to improve the collective dimension of the Chilean health system has enabled some progress, but several challenges had persisted.
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Social science & medicine · Jun 2017
Problematic social media use and depressive symptoms among U.S. young adults: A nationally-representative study.
Depression is the leading cause of disability worldwide. The suggested association between social media use (SMU) and depression may be explained by the emerging maladaptive use pattern known as problematic social media use (PSMU), characterized by addictive components. ⋯ PSMU was strongly and independently associated with increased depressive symptoms in this nationally-representative sample of young adults. PSMU largely explained the association between SMU and depressive symptom, suggesting that it may be how we use social media, not how much, that poses a risk. Intervention efforts aimed at reducing depressive symptoms, such as screenings for maladaptive SMU, may be most successful if they address addictive components and frequency-rather than time-of SMU.
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Social science & medicine · Jun 2017
Social identity and support for counteracting tobacco company marketing that targets vulnerable populations.
Tobacco companies use advertising to target vulnerable populations, including youth, racial/ethnic minorities, and sexual minorities. ⋯ Our findings suggest that the public strongly supports advertisements to prevent smoking among teens, but support for similar efforts among other vulnerable populations is comparatively low. Anti-smoking campaigns for vulnerable populations may benefit from a greater understanding of the role of social identity in shaping public support for such campaigns.
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Social science & medicine · May 2017
County-level racial prejudice and the black-white gap in infant health outcomes.
Black mothers are 60 percent more likely than white mothers to have preterm births and twice as likely to have a baby with low birth weight. We examine whether these black-white gaps in birth outcomes are larger in counties with higher levels of racial prejudice. ⋯ The black-white gap in United States' birth outcomes is larger in those counties that have the highest levels of racial prejudice. This is true for both implicit and explicit racial prejudice, though the strength of the relationship is strongest for explicit racial prejudice.
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Social science & medicine · Apr 2017
When high pressure, system constraints, and a social justice mission collide: A socio-structural analysis of emergency department social work services.
The emergency department (ED) can be a critical intervention point for many patients with multifaceted needs. Social workers have long been part of interdisciplinary ED teams. This study aimed to contribute to the limited understanding of social worker-patient interactions and factors influencing social work services in this setting. ⋯ All of these forces were at play in patient-social worker interactions and impacted service provision. Social workers were at times able to successfully navigate these forces, yet at other times these challenges were insurmountable. A conceptual model of ED social work and the influences on the patient-social worker interactions was developed to assist in guiding innovative research and practice models to improve services and outcomes in the complex, fast-paced ED.