The Nexus of Physical and Psychological Pain: Consequences for Mortality and Implications for Medical Sociology

Although physical pain lies at the intersection of biology and social conditions, a sociology of pain is still in its infancy. We seek to show how physical and psychological pain are jointly parts of a common expression of despair, particularly in relation to mortality. Using the 2002–2014 National Health Interview Survey Linked Mortality Files (N = 228,098), we explore sociodemographic differences in the intersection of physical and psychological pain (referred to as the “pain–distress nexus”) and its relationship to mortality among adults ages 25 to 64. Results from regression and event history models reveal that differences are large for the combination of the two, pointing to an overlooked aspect of health disparities. The combination of both high distress and high pain is most prevalent and most strongly predictive of mortality among socioeconomically disadvantaged, non-Hispanic whites. These patterns have several implications that medical sociology is well positioned to address.

Sociodemographic Differences in Care Plans and Time to Treatment Among Children Being Considered for Adenotonsillectomy

Objective To assess sociodemographic differences in care plans and time to evaluation or treatment after otolaryngologic consultation among children with obstructive sleep-disordered breathing (oSDB). Study Design Retrospective cohort study. Setting Single tertiary children’s hospital. Methods We included children aged 2 to 9 years with oSDB seen from June to December 2018 as new otolaryngology clinic patients. Logistic regression was used to examine whether sociodemographic factors were associated with having adenotonsillectomy or polysomnography planned at the end of the visit. Kaplan-Meier analyses and Cox proportional hazards models were used to compare times to these events. Results An overall 1020 children were included, of whom 65% were White and 18% were Black. Approximately 77% were metropolitan residents, 52% were publicly insured, and 88% of caregivers spoke primarily English. Treatment plans included adenotonsillectomy for 62% of patients, polysomnography for 15%, and new medication therapy for 13%. In multivariable analyses, there were no significant differences by child race/ethnicity, metropolitan/nonmetropolitan residence, type of health insurance, or caregiver primary language in the likelihood of having adenotonsillectomy or polysomnography planned. Among children for whom adenotonsillectomy was planned, children from metropolitan areas had greater times to surgery than children from nonmetropolitan areas (hazard ratio, 0.81 [95% CI, 0.66-0.99]; P = .04). This was explained by a difference between Black children from metropolitan areas and White children from nonmetropolitan areas (hazard ratio, 0.65 [95% CI, 0.49-0.86]; P = .003); there were no racial/ethnic differences in time to surgery among metropolitan-residing children ( P = .09). Conclusions After initial otolaryngology consultation, children with oSDB from metropolitan areas have longer times to adenotonsillectomy than those from nonmetropolitan areas.

Social Capital during the First Wave of the COVID-19 Outbreak: The Case of the Island of Menorca

The rapidly evolving coronavirus pandemic has drastically altered the economic and social lives of people throughout the world. Our overall goal is to understand the mechanisms through which social capital shaped the community response to the pandemic on the island of Menorca, Spain, which was under a strict lockdown in 2020. Between April and June 2020, we performed qualitative interviews (n = 25) of permanent residents of the island. From the findings, it is evident that social capital is an important resource with the capacity to organize help and support. However, the dark sides of social capital, with lack of social cohesion and lack of trust, also emerged as an important negative issue. We identified sources of tension that were not resolved, as well as important sociodemographic differences that are primary drivers for health inequalities. The investment in social networks and social capital is a long-term need that should consider sociodemographic vulnerability.

Profile of Parent-Child Well-Being in Immigrant Families

Earlier caregiving research focused on psychological well-being of either caregivers or care recipients, while less is known about the caregiving pattern with optimal outcome for both caregivers and care recipients. Data were from the PINE and PIETY studies, with 804 parent-child dyads. Depressive symptoms were measured by PHQ-9 with a cutoff of 5 distinguishing happy or depressed. Parent-child dyads were divided into four groups: happy-parent-happy-child (HPHC, n=572, 71.1%), depressed-parent-happy-child (DPHC, n=139, 17.3%), happy-parent-depressed-child (HPDC, n=65, 8.1%), and depressed-parent-depressed-child (DPDC, n=28, 3.5%). Multinomial logistic regression was used to compare the sociodemographic differences among the groups. Compared to the HPHC group, the DPHC group had older parents, more mother-child dyads and lower-income children, the HPDC group had more female children. However, there was no significant difference between the HPHC and the DPDC group. Future research could explore the predictors of parent-child well-being to inform intervention strategies.

Third birth intention of the childbearing-age population in mainland China and sociodemographic differences: a cross-sectional survey

Background Global fertility declines have become an inevitable trend, and many countries are adopting policies to drive fertility increases. Fertility intention plays an important role in predicting fertility behavior. The Chinese government has recently issued the ‘three-child’ policy, and there is still little research on the third birth intention of the childbearing-age population. Therefore, the aim of this study is to investigate the prevalence and related reasons of third birth intention in the childbearing-age population in mainland China, and analyze the sociodemographic differences. Method A cross-sectional survey was conducted in mainland China from June to July 2021. A total of 15,332 childbearing-age participants responded and completed the Fertility Intention Questionnaire online through the Wenjuanxing Platform. Data were explored and analyzed by SPSS (version 22.0) software. Descriptive statistics were used to describe the current situation and reasons of third birth intention. Binary logistic regression analysis was applied to assess the influencing factors in the sociodemographic level. Results The mean age of the participants was 32.9 ± 5.94 years. Only 12.2% of participants reported having third birth intention. The subjective norm of having both son and daughter (22.0%) and busy at work (29.2%) accounted for the largest proportion in the reasons of acceptance and rejection, respectively. Age has negative impact on third birth intention (OR = 0.960). Men were 2.209 times more likely to have three children than women (P < 0.001). With the improvement of education and family monthly income, the birth intention shows a downward trend. Compared with Han nationalities, first marriage and city residents, the ethnic minorities, remarriage and rural residents have stronger birth intention (all P < 0.05). And individuals with two existing children are inclined to have the third child (OR = 1.839). Conclusion The third birth intention in the childbearing-age population in China is still low after the announcement of the three-child policy. It is necessary to create a favorable fertility context for childbearing-age group with high level of third birth intention, like younger, male, minority, remarriage, with lower education and family monthly income, living in rural and two existing children. Furthermore, removing barriers for those unintended is also prominent to ensure the impetus of policy.

Confianza en la comunicación de la pandemia. Percepciones de los ciudadanos españoles de la gestión gubernamental de la información sobre la Covid-19

There is global concern regarding how the Covid-19 pandemic was communicated to citizens, given the enormous amount of uncertainty and misinformation surrounding the health situation (Singh et al., 2020). As expected, the government has been the main source of official information in most countries, but the crisis has also affected political communication models and the management of crisis communication and misinformation. In this scenario, the level of trust in the government and political polarization have become crucial variables to understand how citizens perceive and receive communicate about the effects of the pandemic in their daily life. To address these issues in the case of Spain, in November 2020 we conducted the first nationally representative survey to analyze the level of trust that citizens have in public information on Covid-19 provided by the national government. The findings reveal that their perceptions regarding the quality of such information, the media used for its transmission, and the communication management by the Government during the pandemic were rather negative, although some sociodemographic differences are observed. This study, besides broadening knowledge about government communication during the pandemic in Spain, opens new questions such as the effect of trust in government communication on the level of compliance and agreement with health measures. Resumen Existe una preocupación mundial sobre cómo se transmitió o comunicó la pandemia de la Covid-19 a los ciudadanos, dada la enorme incertidumbre y desinformación en torno a la emergencia sanitaria (Singh et al., 2020). Como era de esperar, el Gobierno ha sido la principal fuente de información oficial en la mayoría de los países, pero a su vez esto ha afectado los modelos de comunicación política, la gestión comunicacional de la crisis y la desinformación. En este escenario, el nivel de confianza en el gobierno y la polarización política se han convertido en variables cruciales para entender cómo los ciudadanos perciben y comunican los efectos de la pandemia en su vida diaria. Para abordar estas cuestiones en el caso de España, en noviembre de 2020 realizamos la primera encuesta representativa nacional para analizar el nivel de confianza de la ciudadanía hacia la información pública de la Covid-19 dada por el Gobierno nacional. Nuestros hallazgos revelaron que la percepción sobre la calidad de la información, de los medios utilizados para su transmisión y de la gestión comunicacional del Gobierno durante la pandemia fue más bien negativa, aunque se observaron algunas diferencias sociodemográficas. Este estudio, además de ampliar el conocimiento sobre la comunicación gubernamental durante la pandemia en España, abre nuevos interrogantes, como el efecto de la confianza en la comunicación gubernamental en el nivel de cumplimiento y acuerdo con las medidas sanitarias.

SP4.1.3 The effect of the Covid-19 pandemic on case selection and perioperative outcomes of emergency laparotomies: a UK-based multicentre cohort study

Aims Evaluating the effect of Covid-19 on case selection and perioperative outcomes of emergency laparotomies across South West London (SWL). Methods A retrospective cohort study including all emergency laparotomies performed at three SWL-based NHS hospitals from 01/04/2020-31/12/2020 (i.e., “pandemic” cohort; from the first national lockdown), versus a “pre-pandemic” cohort (01/04/2019-31/12/2019). Data was extracted from the NELA database and hospital records, and analysed by two independent clinicians. Results 414 patients met the inclusion criteria. 17.6% fewer (227 vs. 187) laparotomies were performed during the pandemic period. There were no significant sociodemographic differences between cohorts (mean age 64.5 vs. 62.7 years, p = 0.284; M:F ratio 1:1.154 vs. 1:0.928, p = 0.221). Pre-operative NELA risk scores were higher before the pandemic (mean 13.05% vs. 9.55%, p = 0.020). The commonest indication for laparotomy in both cohorts was small bowel obstruction (32.6% vs. 37.4%), treated most commonly with adhesiolysis. Postoperatively, fewer patients received HDU/ITU care during the pandemic than before (ward-based recovery 4.7% vs. 13.8%, HDU/ITU recovery 93.4% vs. 79.4%, χ2=15.4, p &lt; 0.005). Mean duration of ITU stay was significantly shorter during the pandemic (4.5 vs. 2.7 days, p &lt; 0.005), as was total length of inpatient stay (20.2 vs. 14.3 days, p = 0.0156). Conclusions The overall reduction in emergency laparotomies observed during the pandemic period was potentially secondary to tighter case selection guided by objective risk stratification. Fewer patients were recovered postoperatively on HDU/ITU, and patients were generally discharged from hospital earlier. Such trends in perioperative care served to support organizational prioritization in response to Covid-19 service provision.