BMJ public health最新文献

{"title":"Cross-sectional study exploring the prevalence and associated risk factors for suicidality among apprentices in the Irish construction industry.","authors":"Jack Sweeney, Shane O'Donnell, P J White, Paula Carroll, Michael Harrison, Noel Richardson","doi":"10.1136/bmjph-2025-004497","DOIUrl":"https://doi.org/10.1136/bmjph-2025-004497","url":null,"abstract":"<p><strong>Introduction: </strong>Suicide among male construction workers is reported to be disproportionally high compared with the working age population, with younger construction workers being at particular risk. However, there is limited understanding of the prevalence and associated factors for suicidal ideation, non-suicidal self-injury and suicide attempt among this occupational group globally or among apprentices pursuing this career.</p><p><strong>Methods: </strong>A cross-sectional study was conducted on a sample of male Irish construction-related apprentices in Ireland (n = 651). We investigated the prevalence of suicidal ideation, non-suicidal self-injury and suicide attempts and sociodemographic, occupational and mental health factors associated with these three outcomes. A logistic regression with backward selection of variables was used to explore factors related to suicidal ideation, non-suicidal self-injury and suicide attempt.</p><p><strong>Results: </strong>The prevalence rate for suicidal ideation was 40.5%, 13.3% for non-suicidal self-injury and 9.3% for suicide attempt. Analysis of suicidal ideation showed previous mental health difficulties, levels of depression and low self-esteem remained significant. Analysis of non-suicidal self-injury showed living in rented accommodation, financial worries, previous mental health difficulties, levels of anxiety and depression remained significant factors in the final model. Analysis of suicide attempts showed living in rented accommodation, financial worries, previous mental health difficulties, levels of depression and low self-esteem remained significant.</p><p><strong>Conclusion: </strong>Suicidal ideation, non-suicidal self-injury and suicide attempt are significant issues for apprentices working in the construction industry. Findings highlight a need for support at an earlier stage in their journey. They also highlight the need for the early detection and treatment of generalised anxiety disorder, low self-esteem and depression in order to intervene in, and potentially prevent, suicidality among construction workers.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"4 2","pages":"e004497"},"PeriodicalIF":0.0,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13141244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interactive and joint effects of multiple meteorological and air pollution exposures on hand, foot and mouth disease risk in western China: a time-series analysis.","authors":"Jie Sun, Hui Tang, Gu Jing, Yueqian Wu, Yikun Chang, Jinwei Chen, Wangjian Zhang, Zhicheng Du, Yuantao Hao","doi":"10.1136/bmjph-2025-003452","DOIUrl":"https://doi.org/10.1136/bmjph-2025-003452","url":null,"abstract":"<p><strong>Introduction: </strong>Hand, foot and mouth disease (HFMD) is influenced by meteorological and air pollution factors. However, few studies have evaluated their joint and interactive effects under real-world multi-exposure conditions. This study examined the health impacts of environmental mixtures and identified susceptible populations in western China.</p><p><strong>Methods: </strong>A total of 484 928 HFMD cases in children under 6 years old were collected from western China. Bayesian kernel machine regression was used to estimate the effects of simultaneous exposure to temperature, precipitation, shortwave radiation, pressure, fine particulate matter (PM_2.5) and ozone (O₃). Subgroup analyses were conducted by age, sex and region type.</p><p><strong>Results: </strong>Temperature, precipitation, shortwave radiation, PM_2.5 and O₃ were associated with HFMD risk. Notable non-linear interactions were detected between temperature, shortwave radiation or O₃ and other exposures. For instance, under median temperature conditions, increasing shortwave radiation was associated with a higher HFMD risk, with relative risks (RRs) of 1.20 (95% credible interval (95% CrI) 0.95 to 1.51), 1.91 (1.54 to 2.37) and 3.16 (2.05 to 4.87) at the 25th, 50th and 75th percentiles, respectively. In contrast, O₃ appeared to attenuate the risk, with RRs decreasing from 4.19 (3.06 to 5.73) at the 25th percentile to 1.33 (1.03 to 1.72) at the 75th. Joint exposure analysis further revealed a protective association under low combined exposure levels, with the RR of 0.46 and an elevated risk under high exposure levels, with an RR of 1.62. Subgroup analyses indicated higher susceptibility among boys, children aged 0-2 years and residents of ethnic minority-concentrated regions.</p><p><strong>Conclusion: </strong>This study enhanced understanding of the joint and interactive effects of meteorological and air pollution factors on HFMD risk under real-world conditions and identified vulnerable subgroups, supporting future research and targeted prevention efforts.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"4 2","pages":"e003452"},"PeriodicalIF":0.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13141104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the determinants of sexual and reproductive health knowledge and intentions for safer sexual practice among out-of-school adolescents in northern rural settings in Burundi: a cross-sectional population-based study.","authors":"Nadine Misago, Petronie Nyawenda, Jean Paul Ndayizeye, Yvette Nsabimana, Jean Bosco Ahishakiye, Anne Marie Manga, Gabriel Ndayisaba, Desire Habonimana","doi":"10.1136/bmjph-2025-002906","DOIUrl":"https://doi.org/10.1136/bmjph-2025-002906","url":null,"abstract":"<p><strong>Introduction: </strong>Comprehensive Sexual and Reproductive Health and Rights (SRHR) knowledge is critical for reducing unintended pregnancies and sexually transmitted infections (STIs) among adolescents in low-resource settings. We assessed SRHR knowledge gaps among rural, out-of-school adolescents in Burundi and examined associations with intentions for safer practices (eg, condom use).</p><p><strong>Methods: </strong>We purposively sampled and surveyed 767 out-of-school adolescents aged between 10 and 19 years from the rural settings of Ngozi health district in northern Burundi examining their SRHR knowledge and practice. We employed the Rasch model of the Item Response Theory (IRT) to examine overall SRHR knowledge and by gender, assuming that the test was administered an infinite number of times and supplemented this model with a multiple linear regression to detect factors affecting knowledge. Determinants of intentions for safer sexual practice were investigated using logistic regression.</p><p><strong>Results: </strong>First, although the test drew on basic SRHR skills, it appeared to be difficult for the study population. Indeed, participants needed a minimum underlying competence <i>θ</i>>2.4 on -4 to 4 scale (with <i>θ</i>>2.4 indicating in the IRT model high difficulty while average knowledge corresponds to <i>θ</i>≈0) to succeed the whole exam and <i>θ>0</i> to attempt 14/15 questions. The most challenging topics related to condom use, menstruation versus pregnancy, contraception and STIs. Younger females had slightly better knowledge than males, but this has crossed over past 16 years. Second, SRHR knowledge was higher among adolescents who completed primary education and those whose parents or siblings are educated. Further, the long distance to a youth health centre and the lack of prior SRHR information decrease knowledge. Finally, adolescents who have higher SRHR knowledge are more likely to report intentions for safer sexual health practices.</p><p><strong>Conclusion: </strong>Rural and out-of-school adolescents have lower than expected SRHR knowledge. Those who have never heard about SRHR and those whose parents and/or siblings have lower or no education are worse off. SRHR knowledge determines intentions for sexual health behaviours (eg, condom use, seeking HIV testing). Tailored SRHR programmes for rural adolescents should address misconceptions on condoms/contraception.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"4 2","pages":"e002906"},"PeriodicalIF":0.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13141195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proximity of city schools in Scotland to air quality monitors: an exploratory geomapping study in five Scottish cities.","authors":"Alasdair McFadyen, Calum McPherson, Sarah Bartlett, Tom Fardon, Kerry Flinn, Christopher J Graham, Robert C Hughes, Mark Miller, David E Newby, Terence Quinn, Marion Slater, Stephen W Turner, Andrew Elder, Jill J F Belch","doi":"10.1136/bmjph-2024-001585","DOIUrl":"https://doi.org/10.1136/bmjph-2024-001585","url":null,"abstract":"<p><strong>Introduction: </strong>There are serious and long-term effects of air pollution on children, thus the Royal College of Physicians of Edinburgh, Air Pollution Working Group has evaluated whether air quality was being sufficiently monitored around Scottish city schools.</p><p><strong>Methods: </strong>We undertook a web-based study of school placement and air quality monitors. Data, including location, from the automatic monitors were available on the Scottish Government's air quality webpages and on the UK Government site. These data (for both nitrogen dioxide (NO₂) and particulate matter) were supplemented by the non-automatic NO₂ diffusion tube locations, the geographical locations of which were found on the relevant local council websites. 340 primary schools and 95 secondary schools were mapped between the five city council regions. Using the council maps of schools and maps of monitors, we plotted the positions of the schools and monitors on a single map, and distances between schools and monitors were calculated using Google Earth measurement tools.</p><p><strong>Results: </strong>37% of primary schools and 36% of secondary schools are more than 1000 m away from any form of air pollution monitors and for both school types nearly two-thirds are further than 500 m away from monitors. Four out of five cities have no secondary schools within 50 m of air pollution monitors and greater than 97% of all schools are further than 50 m away from any form of air quality monitoring. The mean distance between the primary schools and air quality monitors is 1051 m and for secondary schools 997 m.</p><p><strong>Conclusion: </strong>We have shown that very few schools are near enough to an air quality monitor to provide accurate local readings. The air safety of our school children at school in five Scottish cities, many of which are on busy city streets, is unknown.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"4 2","pages":"e001585"},"PeriodicalIF":0.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13141219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Partner support, communication and family planning choices among Nigerian women: a qualitative study.","authors":"Damilola Jeremiah Ayowole, Ifeoluwa Ruth Atobatele, Tomilola Pelumi Akingbade, Gbenga Joseph Alabi, Praise Toluwani Ayowole, Omobola Yetunde Ojo","doi":"10.1136/bmjph-2025-004065","DOIUrl":"https://doi.org/10.1136/bmjph-2025-004065","url":null,"abstract":"<p><strong>Introduction: </strong>Partner involvement plays a critical role in shaping women's contraceptive choices, yet evidence on its influence remains limited in Nigeria, where contraceptive prevalence is low. This study explored how partner support and communication affect women's family planning decisions.</p><p><strong>Methods: </strong>A descriptive phenomenological qualitative study was conducted over 6 weeks at the family planning clinic of a tertiary healthcare facility in southwest Nigeria, using in-depth interviews, with data analysed through inductive thematic analysis following Braun and Clarke's six-step framework. Using purposive sampling, 20 women aged 21-42 years were recruited for in-depth interviews. Trustworthiness was ensured through member checking, independent coding and peer debriefing.</p><p><strong>Results: </strong>Participants were mostly married (90%) and had secondary or tertiary education; they showed varied awareness of contraceptive methods, with knowledge gaps mainly around side effects. Partner influence ranged from encouragement and financial or emotional support to neutral acceptance, shaping women's autonomy and method choice. Frequent and open spousal communication facilitated shared decision-making, while cultural expectations for large families and health concerns acted as barriers. Healthcare providers were key sources of information; however, participants emphasised the need for greater male engagement in family planning education.</p><p><strong>Conclusion: </strong>These findings suggest that male partners play an important role in shaping contraceptive decision-making through attitudes, support and communication. Strengthening male engagement and couple-centred approaches may improve family planning uptake in similar settings.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"4 2","pages":"e004065"},"PeriodicalIF":0.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13141218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the changes in household purchases of foods and drinks high in fat, salt and sugar following Bristol's outdoor advertisement restrictions policy: a quasi-experimental study.","authors":"Genevieve Buckland, Carlos Sillero-Rejon, Zoi Toumpakari, Russ Jago, Amy Yau, Steven Cummins, James Nobles, Sarah Kate Harding, Jeremy Horwood, Agnes Nairn, William Hollingworth, Sarah Blake, Frank de Vocht","doi":"10.1136/bmjph-2025-004137","DOIUrl":"https://doi.org/10.1136/bmjph-2025-004137","url":null,"abstract":"<p><strong>Introduction: </strong>In 2021, Bristol (UK) became the first city outside London to introduce a policy restricting advertisements of high fat, salt and sugar (HFSS) products and other unhealthy commodities (alcohol, gambling and payday loans) on council-owned advertisement sites, predominantly bus stops. This research evaluates the impact of this policy on household purchasing of HFSS products specifically.</p><p><strong>Methods: </strong>Take-home purchasing data for food and drink items recorded from October 2020 to May 2023 (74 weeks before and 59 weeks after policy implementation) by 1012 households from Kantar's Worldpanel division were included in the analysis: 217 households from Bristol (intervention) and 795 from Cardiff, Sheffield, Gloucestershire and South Gloucestershire (controls). Controlled interrupted time-series analyses adjusted for confounders were used to estimate the change in average weekly household purchases of energy and nutrients from HFSS products in the post-intervention period (from 1 April 2022) compared with the counterfactual (data from controls and pre-intervention in Bristol).</p><p><strong>Results: </strong>There was no indication of changes in purchasing of HFSS products in Bristol following the policy; mean change in weekly household purchases of energy and nutrients from take-home HFSS products was 897.6 kcal (95% CI -57.7 to 1.853) or 6.1% (95% CI -0.7 to 12.9) for energy, 4.6% (95% CI -2.6 to 11.9) for fat, 6.1% (95% CI -2.9 to 15.0) for sugar and -1.9% (95% CI -17.4 to 13.6) for salt, respectively, compared with the counterfactual. Stratified analyses by household socio-demographics also showed no evidence of changes in energy purchased from HFSS products in Bristol.</p><p><strong>Conclusions: </strong>This study did not observe evidence of changes in purchasing of HFSS products following Bristol's advertising restriction policy. Bristol City Council owns a relatively small part (~30%) of the city's outdoor advertisement estate, so changes in exposure may have been too small to lead to measurable effects. Extending similar policies to cover more outdoor spaces and advertising platforms is probably required to impact purchasing behaviour.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"4 2","pages":"e004137"},"PeriodicalIF":0.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13141093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of social determinants, lifestyle and clinical factors in the development of diabetic peripheral neuropathy among a multiethnic Asian population in Singapore: a retrospective analysis.","authors":"Sher Mein Chew, Sanchi Dua Avinashi, Bee Choo Tai, Kavita Venkataraman","doi":"10.1136/bmjph-2025-004143","DOIUrl":"https://doi.org/10.1136/bmjph-2025-004143","url":null,"abstract":"<p><strong>Introduction: </strong>Diabetic peripheral neuropathy (DPN) is a common, underdiagnosed and irreversible complication of diabetes mellitus. However, limited evidence exists on the drivers of DPN in Asian populations, particularly the role of social and lifestyle factors. This study aimed to identify sociodemographic, lifestyle and clinical predictors of incident DPN in a multiethnic Asian cohort in Singapore.</p><p><strong>Methods: </strong>Data from two ongoing Singaporean cohorts were analysed. Participants included individuals with type 2 diabetes mellitus and no DPN at baseline. DPN was assessed at follow-up using self-report, neurothesiometer testing or monofilament scores. Bivariate and multivariate Cox regression analyses were conducted to examine the association between incident DPN and various sociodemographic, lifestyle and clinical factors.</p><p><strong>Results: </strong>During a median follow-up of 3.69 years, 169 out of 2110 participants developed DPN. Multivariable analysis revealed age (HR 1.06, 95% CI 1.04 to 1.08, p<0.001), sedentary time (HR 1.54, 95% CI 1.06 to 2.26, p=0.018), housing (HR 0.67 for larger flats, 95% CI 0.48 to 0.94, p=0.020), HbA1c (HR 1.23, 95% CI 1.14 to 1.32, p<0.001), diabetes duration (HR 1.03, 95% CI 1.02 to 1.05, p<0.001), body mass index (HR 1.04, 95% CI 1.01 to 1.07, p=0.010), systolic (HR 0.99, 95% CI 0.98 to 1.00, p=0.004) and diastolic blood pressure (HR 1.02, 95% CI 1.01 to 1.03, p=0.002) and cardiovascular disease (HR 2.00, 95% CI 1.37 to 2.93, p =0.009) to be independently associated with incident DPN.</p><p><strong>Conclusions: </strong>This study confirms established risk factors for DPN and highlights housing type and sedentary behaviour as novel, potentially modifiable predictors. These findings underscore the importance of targeting high-risk groups and addressing modifiable risk factors to reduce the burden of DPN in Asian populations.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"4 2","pages":"e004143"},"PeriodicalIF":0.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13141084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between local household income and paediatric visual outcomes: a retrospective cross-sectional study of a mobile school-based eye clinic in Orange County, California.","authors":"Kimia Rezaei, Jainam Shah, John D Hong, Elliot H Choi, Kourosh Shahraki, Kimberly R Walker, Annabelle M Storch, Joseph H Bui, Jennifer Espinoza, Diana Torres, Donny W Suh","doi":"10.1136/bmjph-2025-003768","DOIUrl":"https://doi.org/10.1136/bmjph-2025-003768","url":null,"abstract":"<p><strong>Introduction: </strong>Socio-economic status (SES) influences paediatric visual health by affecting eye care access, refractive error prevalence and spectacle provision. This study examines the link between household income and paediatric vision outcomes in Orange County, California, USA using data from the University of California, Irvine EyeMobile Pediatric Clinic (2021-2024).</p><p><strong>Methods: </strong>Vision screening was conducted on 15 842 children (ages 3-10). Subsequent comprehensive eye examinations were performed on 3350 children who failed initial screening. Socio-economic stratification was based on zip-code-level median household income (MHI), categorised as below-average or above-average for Orange County. A retrospective cross-sectional analysis of examination data compared visual acuity, refractive error and spectacle provision rates between the two SES groups.</p><p><strong>Results: </strong>Children from below-average MHI areas had higher screening failure rates than those from above-average MHI areas (24.6% vs 18.5%) and a higher odds of screening failure (OR 1.44, 95% CI 1.33 to 1.57). They also demonstrated a higher need for spectacles (70.3% vs 64.8%), with an increased odds of requiring spectacles (OR 1.28, 95% CI 1.05 to 1.56). The prevalence of astigmatism was higher among children from areas with below-average MHI (75.3% vs 66.1%), corresponding to a significantly higher odds of astigmatism (OR 1.56, 95% CI 1.36 to 1.79). Best-corrected distance visual acuity improved with the provision of spectacles in both income groups; however, children from lower-income communities were more likely to present with uncorrected visual impairment during screening, consistent with the higher screening failure rates observed.</p><p><strong>Conclusion: </strong>Children from lower-income communities demonstrated higher rates of uncorrected visual impairment and a greater need for vision care services, while children from higher-income communities also faced substantial unmet vision needs. A mobile school-based vision screening programme, such as the EyeMobile, could significantly benefit both groups by promoting equitable access to vision care.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"4 2","pages":"e003768"},"PeriodicalIF":0.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13141178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in obesity prevalence and changes in adiposity across ethnic groups: findings from a population-based prospective cohort study in Amsterdam, the Netherlands (HELIUS study).","authors":"Yaw Kusi-Mensah, Esther M Vriend, Eric Moll van Charante, Henrike Galenkamp, Karien Stronks, Charles Hayfron-Benjamin, Sean Chetty, Didier Collard, Charles Agyemang, Bert-Jan H van den Born","doi":"10.1136/bmjph-2025-003837","DOIUrl":"https://doi.org/10.1136/bmjph-2025-003837","url":null,"abstract":"<p><strong>Background and aim: </strong>Obesity has reached epidemic proportions worldwide, with large differences across regions. European data on obesity trends among ethnic groups is scarce, particularly regarding the influence of age and socioeconomic status on these trends, which is crucial for guiding targeted interventions. In this study, we assessed the prevalence of obesity and changes in body mass index (BMI) and waist circumference (WC) over time and the effects of key sociodemographic factors on these changes using longitudinal data from a large multi-ethnic cohort.</p><p><strong>Methods: </strong>Using baseline and follow-up data from 10 484 participants in the HEalthy Life in an Urban Setting (HELIUS) study, representing Dutch, South-Asian Surinamese, African Surinamese, Ghanaian, Moroccan and Turkish populations; age-adjusted obesity prevalence; BMI and WC changes over an average follow-up of 6.3 (SD 1.2) years were calculated. Linear mixed models were used to assess changes in BMI and WC over time, adjusting for age, sex and socio-economic position. Key analyses were stratified by age (younger <50 years, older ≥50 years).</p><p><strong>Results: </strong>Median age of the baseline population was 48.0 years (IQR 38.0, 56.0), with 56.7% being women. Age-adjusted prevalence of obesity increased from 23.6% at baseline to 28.7% at follow-up, with steeper increases in ethnic minority groups compared with the Dutch origin group. The steepest increase in BMI and WC was observed in younger migrants, especially in those of Ghanaian and African-Surinamese descent. In older participants, only individuals of Ghanaian and Turkish descent showed a further increase in BMI over time.</p><p><strong>Conclusion: </strong>Obesity is increasingly prevalent in ethnic minority groups under 50 years, potentially raising obesity-related health risks and underscoring the need for targeted interventions to prevent further complications.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"4 2","pages":"e003837"},"PeriodicalIF":0.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13140977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regional correlation study of obstetrician maldistribution and its impact on pregnancy loss outcomes in Japan amid declining fertility.","authors":"Ken Kuriki, Eiji Nakatani, Yasuto Sato","doi":"10.1136/bmjph-2025-002636","DOIUrl":"https://doi.org/10.1136/bmjph-2025-002636","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;This study investigates the changing regional disparities in obstetrician distribution across Japan over the past 20 years. As the impact of healthcare resource distribution on pregnancy loss outcomes (miscarriages and stillbirths) remains controversial, understanding this relationship is crucial for ensuring equitable perinatal care. Given Japan's declining birthrate, ageing population and increasing urbanisation, we aim to clarify how the regional distribution of obstetricians has changed in relation to demand and its potential impact on pregnancy loss outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a regional correlation study using publicly available official statistical data. First, we calculated the number of obstetricians per birth within each secondary medical area (SMA) and calculated Gini coefficients to examine changes in the maldistribution of obstetricians over a 20-year period. Subsequently, the 335 SMAs in 2000 were clustered into four groups using a two-dimensional classification based on the median values of the number of obstetricians per birth (0.0079 obstetricians/birth) and population density (759.3/km&lt;sup&gt;2&lt;/sup&gt;) to identify which group they would have belonged to in 2020. Finally, multiple regression analysis was conducted. The objective variable was the 2020 ratio of pregnancy losses to live births, while explanatory variables included healthcare, demographic and socioeconomic factors. Pregnancy losses were calculated as the difference between 2019 notifications and 2020 live births.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Based on Vital Statistics, while the total number of obstetricians nationwide was 11 688 at the baseline, the net increase over the 20-year period was only 629. Despite this overall increase, the Gini coefficient for the number of obstetricians per birth rose from 0.228 to 0.259, indicating that regional maldistribution has worsened relative to the number of births. The number of SMAs in the group with lower than the median number of obstetricians per birth in 2000 decreased from 167 to 57 in 2020; 7 SMAs moved from higher to lower number of obstetricians per birth groups. The number of births decreased by approximately two-thirds over 20 years, resulting in an increase in the number of obstetricians per birth of approximately 1.5 times. Multiple regression analysis showed that the number of obstetricians per birth and the number of childbirth facilities (total facilities and clinics alone) per woman aged 20-44 years were negatively associated with pregnancy loss, with only the number of facilities per woman aged 20-44 years showing a significant difference when the significance level was set at &lt;i&gt;p&lt;/i&gt;&lt;0.05.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Regional maldistribution of obstetricians in Japan has worsened over the past 20 years. Our findings suggest that clinical availability, rather than the absolute number of obstetricians per birth, may be more significantly associat","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"4 2","pages":"e002636"},"PeriodicalIF":0.0,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13140961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}