BMJ Public Health最新文献

{"title":"Development of an overarching framework for anticipating and assessing adverse and other unintended consequences of public health interventions (CONSEQUENT): a best-fit framework synthesis","authors":"Jan M Stratil, R. Biallas, A. Movsisyan, Kathryn Oliver, Eva Rehfuess","doi":"10.1136/bmjph-2023-000209","DOIUrl":"https://doi.org/10.1136/bmjph-2023-000209","url":null,"abstract":"Despite the best intentions and intended beneficial outcomes, public health (PH) interventions can have adverse effects and other unintended consequences (AUCs). AUCs are rarely systematically examined when developing, evaluating or implementing PH interventions. We, therefore, used a multipronged, evidence-based approach to develop a framework to support researchers and decision-makers in anticipating and assessing AUCs of PH interventions.We employed the ‘best-fit’ synthesis approach, starting with an a priori framework and iteratively revising this based on systematically identified evidence. The a priori framework was designed using key elements of the WHO-INTEGRATE framework and the Behaviour Change Wheel, to root it in global health norms and values, established mechanisms of PH interventions and a complexity perspective. The a priori framework was advanced based on theoretical and conceptual publications and systematic reviews on the topic of AUCs in PH. Thematic analysis was used to revise the framework and identify new themes. To test the framework, it was coded against four systematic reviews of AUCs of PH interventions.The Cosequences of Public Health Interventions (CONSEQUENT) framework includes two components: the first focuses on AUCs and serves to categorise them; the second (supplementary) component highlights the mechanisms through which AUCs may arise. The first component comprises eight domains of consequences: health, health system, human rights, acceptability and adherence, equality, and equity, social and institutional, economic and resources, and the environment.The CONSEQUENT framework is intended to facilitate classification and conceptualisation of AUCs of PH interventions during their development or evaluation to support evidence-informed decision-making.","PeriodicalId":117861,"journal":{"name":"BMJ Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140464752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Home delivery among women who receive antenatal care in Ethiopia, design-based logistic regression analysis","authors":"Y. S. Yimer, Tariku Tesfaye, Awgichew Kifle Zemelak, Solomon Emyu Ferede","doi":"10.1136/bmjph-2023-000399","DOIUrl":"https://doi.org/10.1136/bmjph-2023-000399","url":null,"abstract":"In Ethiopia, a significant proportion of women who receive antenatal care (ANC) deliver at home. This study aims to investigate home delivery among pregnant women who receive ANC during pregnancy in Ethiopia. Increased coverage of ANC is advised to improve institutional delivery, which in turn prevents maternal and neonatal morbidity and mortality.We used data from the Performance Monitoring for Action Ethiopia panel study, which followed pregnant women 1 year through post partum. A total of 1749 women who received ANC during pregnancy were included in this study. To identify risk factors associated with home delivery, a design-based binary logistic regression analysis was used.Of 1749 women who received ANC, 515 (29.4%) gave birth at home. Discussions on place of delivery with partner (adjusted OR (AOR)=0.56, 95% CI=0.35 to 0.90); desire to deliver at home (AOR=3.35, 95% CI=2.15 to 5.22); multiple birth readiness topics during ANC visits (AOR=0.39, 95% CI=0.21 to 0.63); and had ANC by a professional healthcare provider (AOR=0.40, 95% CI=0.23 to 0.70) were found to be significant predictors of home delivery.This study found that one-third of women who received ANC gave birth at home. Discussions on place of delivery with partner, birth readiness topics, women’s desire for place of delivery and type of ANC provider were found to be independent predictors. Our results indicate for special attention to the evaluation and improvement of health extension workers’ competency in ANC delivery, and counselling women on various aspects of birth readiness during ANC visits.","PeriodicalId":117861,"journal":{"name":"BMJ Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140469588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intensive home visiting for adolescent mothers in the Family Nurse Partnership in England 2010–2019: a population-based data linkage cohort study using propensity score matching","authors":"F. Cavallaro, Ruth Gilbert, J. van der Meulen, Sally Kendall, Eilis Kennedy, Katie L. Harron","doi":"10.1136/bmjph-2023-000514","DOIUrl":"https://doi.org/10.1136/bmjph-2023-000514","url":null,"abstract":"We evaluated the effectiveness of the Family Nurse Partnership (FNP), an intensive home visiting programme aiming to improve birth outcomes, child health and development, and to promote economic self-sufficiency among teenage mothers.We created a linked cohort of >130 000 mothers aged 13–19 years with live births between April 2010 and March 2019, using administrative data from health (Hospital Episode Statistics), education and children’s social care (National Pupil Database). Using propensity score matching, we compared indicators of child maltreatment, health and development outcomes, and maternal hospital utilisation and educational outcomes up to 7 years following birth for mothers who did or did not enrol in FNP.We found no evidence of an association between FNP and indicators of child maltreatment, except for an increased rate of unplanned admissions for maltreatment/injury-related diagnoses up to age 2 years for children born to FNP mothers (6.6% vs 5.7%, relative risk (RR) 1.15; 95% CI 1.07, 1.24). There was weak evidence that children born to FNP mothers were more likely to achieve a good level of development at age 5 years (57.5% vs 55.4%, RR 1.05; 95% CI 1.00, 1.09). FNP mothers were less likely to have a subsequent delivery within 18 months of the index birth (8.4% vs 9.3%, RR 0.92; 95% CI 0.88, 0.97).Our study supports findings from previous evaluations of FNP showing no evidence of benefit for child maltreatment or health outcomes measured in administrative data. Bias by indication, and variation in the intervention and usual care, may have limited our ability to detect effects. Future evaluations should capture more information on maternal risk factors and additional outcomes relating to maternal/child well-being.","PeriodicalId":117861,"journal":{"name":"BMJ Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140464893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of a potential Chlamydia vaccine in the USA: mathematical modelling analyses","authors":"Monia Makhoul, H. Ayoub, S. Awad, H. Chemaitelly, L. Abu-Raddad","doi":"10.1136/bmjph-2023-000345","DOIUrl":"https://doi.org/10.1136/bmjph-2023-000345","url":null,"abstract":"Chlamydia trachomatis(CT) infection is a global health challenge. New approaches are needed to control CT disease burden.An age-structured deterministic mathematical model calibrated to nationally representative population-based data was developed to investigate the impact of CT vaccination on the population of the USA if a vaccine becomes available. The model’s parameters were chosen based on current knowledge from the literature on CT’s natural history and epidemiology. The model’s calibration used age-specific CT prevalence data sourced from the biannual rounds of the National Health and Nutrition Examination Surveys. The reported data are based on the outcomes generated by the model’s simulations.Over a 10-year period, vaccinating 80% of individuals aged 15–49 with a vaccine that reduces by 50% susceptibility to infection (VES=50%), infectiousness (VEI=50%) or duration of infection (VEP=50%) resulted, respectively, in 36.3%, 26.5% and 42.1% reduction in CT prevalence, and 38.8%, 28.6% and 24.1% reduction in CT incidence rate. Number of averted infections was 11 346 000, 7 583 000 and 6 012 000, respectively. When efficacies acted together (VES=VEI=VEP=50%), CT prevalence and incidence rate were reduced by 66.3% and 61.0%, respectively. Number of vaccinations needed to avert one infection was 17.7 forVES=50%, 26.5 forVEI=50%, 33.4 forVEP=50%and 12.0 forVES=VEI=VEP=50%. Vaccinating individuals aged 15–19 and at highest risk of infection was most effective, requiring only 7.7 and 1.8 vaccinations to prevent one infection, respectively. Vaccination benefits were larger beyond 10 years.A moderately efficacious CT vaccine can significantly reduce CT disease burden. Targeting specific populations can maximise cost-effectiveness. Additional potential ‘breakthrough’ effects of the vaccine on infectiousness and duration of infection could greatly increase its impact. CT vaccine development and implementation should be a public health priority.","PeriodicalId":117861,"journal":{"name":"BMJ Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140516862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social services utilisation and referrals after seeking help from health services for self-harm: a systematic review and narrative synthesis","authors":"S. Steeg, Faraz Mughal, Nav Kapur, S. Gnani, Catherine Robinson","doi":"10.1136/bmjph-2023-000559","DOIUrl":"https://doi.org/10.1136/bmjph-2023-000559","url":null,"abstract":"Suicide prevention is a major public health challenge. Appropriate aftercare for self-harm is vital due to increased risks of suicide following self-harm. Many antecedents to self-harm involve social factors and there is strong rationale for social services-based self-harm aftercare. We aimed to review evidence for social service utilisation and referrals among people seeking help following self-harm.Systematic review with narrative synthesis.PubMed, PsycINFO, AMED, Social Policy and Practice, EMBASE, Medline, Web of Science, Social Care Online, citation lists of included articles and grey literature.Studies of people of any age in contact with health services following self-harm, with study outcomes including referrals to or utilisation of social workers and social services.Information was extracted from each included study using a proforma and quality was critically assessed by two reviewers. Narrative synthesis was used to review the evidence.From a total of 3414 studies retrieved, 10 reports of 7 studies were included. Study quality was generally high to moderate. All studies were based in emergency departments (EDs) and most were UK based. In studies based solely on ED data, low proportions were referred to social services (in most studies, 1%–4%, though it was up to 44% when social workers were involved in ED assessments). In one study using linked data, 15% (62/427) were referred to social services and 21% (466/2,205) attended social services over the subsequent 3-year period.Overall, few patients were referred to social services after self-harm. Higher reported referral rates may reflect greater service availability, involvement of social workers in psychosocial assessments or better capture of referral activity. Social services-based and integrated approaches for self-harm aftercare are important future directions for suicide prevention. Improved links between social services and health services for people seeking support after self-harm are recommended.","PeriodicalId":117861,"journal":{"name":"BMJ Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138625941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prepandemic inequalities in the burden of disease in Scotland due to multiple deprivation: a retrospective study","authors":"I. Grant, Neil Chalmers, E. Fletcher, F. Lakha, Gerry McCartney, D. Stockton, Grant M. A. Wyper","doi":"10.1136/bmjph-2023-000191","DOIUrl":"https://doi.org/10.1136/bmjph-2023-000191","url":null,"abstract":"Health inequalities in Scotland are well documented, including the contribution of different causes to inequalities in mortality. Our aim was to estimate inequalities within a burden of disease framework, accounting for both premature mortality and the effects of morbidity, to understand the contribution of specific diseases to health inequalities prior to the COVID-19 pandemic.Disability-adjusted life-years (DALYs) for 70 individual causes of disease and injury were sourced from the Scottish Burden of Disease Study. Area-level deprivation was measured using the Scottish Index of Multiple Deprivation. Inequalities were measured by the range, Relative Index of Inequality, Slope Index of Inequality and attributable DALYs were estimated by using the least deprived decile as a reference.The overall disease burden was double that in the most deprived areas (50 305 vs 20 955 DALYS per 100 000), largely driven by inequalities in premature mortality. The rate in the most deprived areas was around 48% higher than the mean population rate (Relative Index of Inequality=0.96), with 35% of DALYs attributed to differences in area-based deprivation. Many leading causes of disease burden in 2019—heart disease, drug use disorders, lung cancer and chronic obstructive pulmonary disease—were also the leading drivers of absolute and relative inequalities in the disease burden.Our study evidences the extent of the stark levels of absolute and relative inequality prior to the COVID-19 pandemic. Given prepandemic stalling of mortality trend improvements and widening health inequalities, and the exacerbation of these caused by COVID-19, urgent policy attention is required to address this.","PeriodicalId":117861,"journal":{"name":"BMJ Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138621592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial and geographical disparities in oesophageal cancer incidence, mortality and county-level risk factors in the state of Mississippi between 2003 and 2019: a descriptive analysis","authors":"Angel Walker, C. Abnet, M.S. Shiels, Wayne R. Lawrence, Tanya Funchess, Deirdre B Rogers, Monica Webb Hooper, Yingxi Chen","doi":"10.1136/bmjph-2023-000316","DOIUrl":"https://doi.org/10.1136/bmjph-2023-000316","url":null,"abstract":"Oesophageal cancer is one of the most aggressive cancers. The aim was to describe the disparities in oesophageal cancer incidence and mortality, and county-level factors in the state of Mississippi from 2003 to 2019 by sex, race, and geolocation.This study used data from the Mississippi Cancer Registry, linked to county-level data from the Behavioral Risk Factor Surveillance System, the American Community Survey, and the Institutes for Health Metrics and Evaluation. We estimated age-standardised incidence (crude ASR) and mortality rates (crude AMR), mortality–incidence rate ratio and average annual percent change (AAPC) in rates by sex, race, and geolocation, using the Joinpoint Software V.5.0. We further calculated relative risks for oesophageal cancer using age-adjusted quasi-Poisson regression for each county-level factor including smoking, obesity, college degree completion, unemployment rate and median household income ranking within the state.Between 2003 and 2019, a total of 2737 oesophageal cancer cases and 2259 oesophageal cancer deaths occurred in Mississippi. Black men had the greatest reduction in oesophageal cancer incidence and mortality despite high rates (crude ASR2019=10.5, crude AMR2019=7.3 per 100 000; AAPCincidence=−3.7%, p<0.001 and AAPCmortality=−4.9%, p<0.001). The reduction was largely driven by decreases in the non-Delta region (AAPCincidence=−4.2%, p<0.001), while incidence rate remained high among Black men in the Delta region (crude ASR2019=15.4 per 100 000, AAPCincidence=−1.8%, p=0.3). The rates among White men were relatively stable (crude ASR2019=8.5, crude AMR2019=7.6 per 100 000; AAPCincidence=0.18%, p=0.7, AAPCmortality=−0.4%, p=0.6). County-level smoking prevalence (in quartile, p=0.02) was significantly associated with oesophageal cancer incidence.This study highlights the importance of targeted interventions to address the persistent high incidence rate of oesophageal cancer among Black men in the Delta region.","PeriodicalId":117861,"journal":{"name":"BMJ Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138625378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health and participation in the Lolland-Falster Health Study: a cohort study","authors":"T. Holmager, G. Napolitano, Neda Esmai­lzadeh Bruun-Rasmu­ssen, R. Jepsen, Søren Lophaven, Elsebeth Lynge","doi":"10.1136/bmjph-2023-000421","DOIUrl":"https://doi.org/10.1136/bmjph-2023-000421","url":null,"abstract":"Lolland-Falster is the area of Denmark with highest mortality. However, clinical measurements from a population-based health survey showed prevalence of disease indicators similar to those in the rest of Denmark. The study aimed to disentangle this paradox.The Lolland-Falster Health Study (LOFUS) took place in 2016–2020. We followed the 53 000 invited persons up for mortality from invitation date to 1 February 2023. Log-binomial regression was used to calculate relative risk (RR) of non-participation versus participation in LOFUS by subgroups of sex, age, municipality, residency group, household composition and economic status. Using Poisson regression, mortality rate ratio (MRR) was calculated between subgroups and within subgroups for non-participants versus participants for all-cause mortality and mortality from cancer, cardiovascular diseases, respiratory diseases, external causes and other diseases.One-third (36%) of persons invited to LOFUS participated. Only modest differences were seen in participation across subgroups; the largest being an RR of 1.37 (95% CI 1.35 to 1.40) for publicly supported versus self-supported persons. However, non-participants had higher mortality than participants (MRR 3.08, 95% CI 2.82 to 3.37). This pattern was consistent across all subgroups and was found for both all-cause and cause-specific mortality.The paradox we observed could partly be attributed to participation differences between subgroups. However, for the lack of population representativeness of the survey data, our study indicated within-group selection, measured by excess mortality of non-participants, to be much more important than between-group selection. One should therefore be cautious in using even weighted health survey data for prioritising health interventions.","PeriodicalId":117861,"journal":{"name":"BMJ Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138625746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health insurance coverage and access to maternal healthcare services by women of reproductive age in Nigeria: a cross-sectional study","authors":"O. Esan, A. Adeomi, O. Afolabi","doi":"10.1136/bmjph-2023-000482","DOIUrl":"https://doi.org/10.1136/bmjph-2023-000482","url":null,"abstract":"Inequitable financial access to maternal healthcare services (MHS) has contributed to maternal deaths, especially in low and middle-income countries. Evidence in the literature on women’s health insurance status and access to MHS in Nigeria is sparse. This study aimed to determine the association between health insurance coverage and access to MHS among Nigerian women of reproductive age.This is a cross-sectional study that used the 2018 Nigeria Demographic and Health Survey (NDHS). A total of 12 935 women who had their last delivery within 2 years before the NDHS were included in the study. Access to MHS was assessed by using the number of antenatal care (ANC) visits and health facility delivery. Adjusted logistic regression models were fit to control for individual, household and community-level factors.Only 18.5% and 40.6% of the women in the study attended ≥8 ANC visits and delivered in a health facility, respectively. About 39.5% of women who had ≥8 ANC visits and 71.8% of those who delivered in health facilities had health insurance coverage. There were statistically significant associations between having health insurance and attendance of ≥8 ANC visits (adjusted OR (AOR) 1.9; 95% CI 1.26–2.95) and women delivering at a health facility (AOR 2.0; 95% CI 1.39–2.82). There were also lower significant odds of accessing ≥8 ANC visits and delivering in health facilities among the rural dwellers, unemployed, those with lower educational status and those in the lower social economic quintiles.There was a low uptake of health insurance programmes among the Nigerian women in this study. Having health insurance coverage was significantly associated with ≥8 ANC visits and women delivering in health facilities. Thus, providing health insurance may be an important way to improve women’s access to MHS in Nigeria.","PeriodicalId":117861,"journal":{"name":"BMJ Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138615147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing health impact of COVID-19 and associated household socioeconomic factors in Papua New Guinea: evidence from the Comprehensive Health and Epidemiological Surveillance System","authors":"B. Pham, Tess Aga, Rebecca Emori, Doris Manong, S. Maraga, Billiam Degemba, Vicky Gabe, Noel Berry, Michael Kobol, Lydia Kue, Nanim Ainui, Ronny Jorry, Vinson D Silas, Norah Abori, Gasowo S Jaukae, Guise Gende, Toan H Ha, A. Okely, William Pomat","doi":"10.1136/bmjph-2023-000563","DOIUrl":"https://doi.org/10.1136/bmjph-2023-000563","url":null,"abstract":"The COVID-19 pandemic had an unprecedented impact on the health and well-being of populations worldwide. Few studies have used household data to explore the health risks associated with COVID-19 in low-income and middle-income countries. This study assessed population vulnerability to COVID-19 by examining household socioeconomic factors related to COVID-19 health risks in Papua New Guinea (PNG).Using household socioeconomic surveillance data from 2020, encompassing 37 880 residents living within the catchment areas of the Comprehensive Health and Epidemiological Surveillance System, the study assessed COVID-19 health risks based on the socioeconomic demographic characteristics of the surveillance population. Multinomial logistic regression analyses were conducted to determine associated factors and to estimate predictors of COVID-19 health risks.Among the surveillance population, more than 9% reported experiencing COVID-19 health risks, including home-based quarantine (9.6%), centre-based quarantine (0.5%), positive COVID-19 test (0.1%), hospitalisation due to COVID-19 (0.3%) and death from COVID-19 (0.3%). People living in semimodern houses (OR 1.47 (95% CI 1.35 to 1.61)) (verse permanent houses), individuals living in houses with 1–2 bedrooms (OR 1.12 (95% CI 1.01 to 1.25)) (verse houses with 4+ bedrooms) and those belonging to the poorest wealth quintile (OR 1.16 (95% CI 1.024 to 1.314)) (verse the richest) were more susceptible to COVID-19 health risks. Protective factors against COVID-19 health risks included urban residence (OR 0.65 (95% CI 0.59 to 0.71)) (verse rurality), aged 0–4 years (OR 0.76 (95% CI 0.64 to 0.91)) (verse aged 55+ years), households with 7–8 members (OR 0.84 (95% CI 0.74 to 0.96)) (verse 10+ members), handwashing with soap (OR 0.3 (95% CI 0.28 to 0.33)) (verse without soap).The study provides insights into the susceptibility to COVID-19 health risks across socioeconomic groups in PNG. These findings have implications for development of public health policies and interventions that can be extrapolated to similar settings for enhancing preparedness for future public health emergencies.","PeriodicalId":117861,"journal":{"name":"BMJ Public Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138611196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}