European Journal of Public Health最新文献

{"title":"Areal differences in the utilization of endovascular therapy for acute ischemic stroke.","authors":"Ulla Junttola, Siiri Hietanen, Sanna Lahtinen, Juha-Matti Isokangas, Lasse Raatiniemi, Timo Kaakinen, Merja Vakkala, Janne Liisanantti","doi":"10.1093/eurpub/ckaf154","DOIUrl":"https://doi.org/10.1093/eurpub/ckaf154","url":null,"abstract":"<p><p>Endovascular therapy (EVT) is standard care for acute ischemic stroke due to large vessel occlusion, but its availability is limited in areas with long distances. It has also been demonstrated that there are differences in the utilization of thrombectomy related to socioeconomic factors. The aim of this study is to examine regional differences in the utilization of mechanical thrombectomy and outcome within one comprehensive stroke center district in terms of distance and income. This retrospective single-center study included 352 patients with mechanical thrombectomy in Oulu University Hospital catchment area between the years 2015 and 2019. Socioeconomic status was determined according to the income of residential area. Age-adjusted rate was significantly higher in the highest income areas compared to the lowest and middle third areas; 52.29 (95% CI, 42.85-61.72)/100 000 vs. 34.33 (95% CI, 28.14-40.52) vs. 38.03 (95% CI, 31.14-44.92)/100 000 inhabitants/year. The corresponding rates in rural areas were: 73.37 (95% CI, 53.23-93.51) vs. 37.11 (95% CI, 28.66-45.57) vs. 45.44 (95% CI, 34.72-56.16)/100 000 inhabitants/year. In this study, we found significant differences in the utilization of the EVT within one comprehensive stroke center district. These differences are explained by the income and the rurality of the residential area.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Smoking at football clubs: the Netherlands compared to Germany.","authors":"Anton E Kunst, Rixt A Smit, Emma S E Schlotz, Julia Keijzer, Andrea D Rozema, Mirte A G Kuipers","doi":"10.1093/eurpub/ckaf156","DOIUrl":"https://doi.org/10.1093/eurpub/ckaf156","url":null,"abstract":"<p><p>Ideally, in a smoke-free generation, children could practice sports in a smoke-free setting. This article studied the prevalence of smoking at football clubs in two countries. An audit at 45 German and 116 Dutch clubs measured smoking prevalence at three places. In the Netherlands, smoking was less common at playing fields (at 25% of Dutch clubs versus 64% of German clubs), but more common at terraces (44 versus 19%) and entrances (20 versus 11%). Despite more comprehensive anti-tobacco policies, smoking at clubs in The Netherlands was as common as in Germany, possibly due to displacement of smoking from fields towards other places.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shaping the future EHDS: recommendations for implementation of Health Data Access Bodies in the HealthData@EU infrastructure for secondary use of electronic health data.","authors":"Lise S Svingel, Caroline E Jensen, Gitte F Kjeldsen, Maria H Pedersen, Dipak Kalra, Christian F Christiansen, Katrine H Vad","doi":"10.1093/eurpub/ckaf033","DOIUrl":"10.1093/eurpub/ckaf033","url":null,"abstract":"<p><p>European Union (EU) Member States face challenges in using health data for secondary purposes, constrained by inconsistent digital health systems and limited cross-border sharing. One aim of the European Health Data Space (EHDS) is to facilitate secondary health data use through the HealthData@EU infrastructure and Health Data Access Bodies (HDABs). This article provides recommendations essential for HDAB implementation, informed by the HealthData@EU Pilot project. From October 2022 to December 2024, Work Package 4 gathered insights from the HealthData@EU Pilot project, including from technical work packages and use cases, and complementary insights from the members of the HDABs Community of Practice and the External Advisory Board. Data collection involved workshops, interviews, and questionnaires, with thematic analysis guided by the EHDS user journey and the World Health Organization's National eHealth Strategy Toolkit. Recommendations cover infrastructure, services, and interoperability. Each Member State should designate HDABs to manage secondary health data use and facilitate cross-border access. National infrastructure components deployed by HDABs and National Contact Points and a metadata catalogue compliant with the newly developed HealthDCAT-AP specification are advised to support data discovery, with a common data access application form to streamline the data permit application process. Harmonized validation procedures are recommended for ensuring high data quality and semantic interoperability. Implementation of HDABs within the HealthData@EU infrastructure represents an important step towards accessible health data for secondary use across the EU. Effective implementation requires collaboration at both national and EU level, addressing remaining ambiguities for HDAB functionality within the EHDS framework.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":"35 Supplement_3","pages":"iii32-iii38"},"PeriodicalIF":3.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12420904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Childhood and current socioeconomic position as determinants of sedentary time among young and early midlife employees.","authors":"Eero Kekäläinen, Ossi Rahkonen, Ville Päivärinne, Henriikka Nurminen, Tea Lallukka","doi":"10.1093/eurpub/ckaf152","DOIUrl":"https://doi.org/10.1093/eurpub/ckaf152","url":null,"abstract":"<p><p>Socioeconomic position (SEP) is one of the primary determinants of sedentary behaviour. The study investigated the associations between life-course socioeconomic circumstances and sedentary time (ST) among young and early midlife municipal employees. We used data from the 2017 Helsinki Health Study (N = 4532), which targeted 19- to 39-year-old employees of the City of Helsinki. SEP was assessed through both childhood and current indicators: parental and own educational level, childhood and current economic difficulties, occupational class, income, and wealth. ST was self-reported in minutes per weekday across five behavioural domains. Linear regression models examined differences in STs between socioeconomic groups, with 95% confidence intervals (CIs). All SEP indicators except childhood economic difficulties were associated with total ST. Participants in the highest income quartile reported 76 min (95% CI 60-92) more ST per day than those in the lowest quartile. Similarly, participants with higher education sat 69 min (95% CI 55-84) longer than those with lower education. The largest differences were observed during working hours, with higher education and income associated with more ST. In contrast, lower SEP was associated with more ST spent at home in front of a television/computer and in vehicles. Although individuals with higher SEP often engage in more physical activity and have better health behaviours overall, they are also the most sedentary, especially during work hours. The association between SEP and ST varies across behavioural domains, emphasizing the importance of context-specific interventions.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144946546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of mapping cross-country population coronavirus disease 2019 metrics in a federated design: learnings from a HealthData@EU Pilot use case.","authors":"Charles-Andrew Vande Catsyne, Matilde Slot, Tamara Buble, Katrine Eriksen, Marija Svajda, Emanuel Bradasevic, Jakov Vukovic, Simon Kok Jensen, Helena Ivanković, Persephone Doupi, Christian Fynbo Christiansen, Nienke Schutte","doi":"10.1093/eurpub/ckaf017","DOIUrl":"10.1093/eurpub/ckaf017","url":null,"abstract":"<p><p>The European Health Data Space aims to transform health data management across the EU, supporting both primary and secondary uses of health data while ensuring trust through General Data Protection Regulation compliance. As part of the HealthData@EU Pilot, this study investigates coronavirus disease 2019 (COVID-19) testing, vaccination, and hospitalization metrics across six European countries, with a focus on socioeconomic disparities and challenges in cross-border data access and standardization. This observational, retrospective cohort study used a federated analysis framework across Belgium, Croatia, Denmark, Finland, and France. Data were linked from administrative, social, health, and care records within each country's trusted research environment. A Common Data Model (CDM)-guided data harmonization, enabling nodes to perform independent analyses and share aggregated results. Key data processes (discovery, access, preparation, and analysis) were decentralized, with significant variability in data access procedures, security protocols, and available resources among nodes. The study revealed substantial differences in COVID-19 testing, vaccination, and hospitalization rates across countries. Denmark exhibited notably higher testing and infection rates. However, the study encountered key challenges: complex data access procedures, fragmented and incomplete socioeconomic data, and the need for extensive harmonization. Learnings from this pilot underscore the importance of streamlined, cross-country data access and standardization processes, which the European Health Data Space (EHDS) framework aims to address. The pilot demonstrates the feasibility of federated health data analysis across multiple countries while highlighting limitations in data access and interoperability. The EHDS framework offers a promising path to overcome these barriers, supporting efficient and standardized cross-border health research in the EU.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":"35 Supplement_3","pages":"iii11-iii17"},"PeriodicalIF":3.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12420901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Piloting an infrastructure for the secondary use of health data: learnings from the HealthData@EU Pilot.","authors":"Christian Fynbo Christiansen, Persephone Doupi, Nienke Schutte, Damir Ivanković","doi":"10.1093/eurpub/ckaf073","DOIUrl":"10.1093/eurpub/ckaf073","url":null,"abstract":"","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":"35 Supplement_3","pages":"iii3-iii4"},"PeriodicalIF":3.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12420900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genomic data sharing in research across Europe: legal challenges and upcoming opportunities within the European Health Data Space.","authors":"Romina Royo, Eva Garcia, Irene Schlünder, Christina Hilmarsen, Mette Kielsholm Thomsen, Emilie Cauët, Simon Kok Jensen, Simona Giardina, Aline Hebrant, Gordana Raicevic Toungouz, Marc Van Den Bulcke, Juan Arenas, Christian Fynbo Christiansen, Eivind Hovig, Petr Holub, Alfonso Valencia, Salvador Capella-Gutierrez","doi":"10.1093/eurpub/ckaf070","DOIUrl":"10.1093/eurpub/ckaf070","url":null,"abstract":"<p><p>The European Health Data Space (EHDS) will help researchers use health data across EU Member States (MS). Currently, cross-border research faces heterogeneous data access processes. Using a real-world use case, this paper analyses challenges and opportunities brought by the upcoming implementation of the EHDS, assessing the situation before and after the regulation comes into force. The use case focused on metastatic colorectal cancer, analysing the relations between mutational signatures and clinical trajectories while addressing data access procedures across MS. The regulatory landscape and the challenges that need to be addressed for the EHDS to enable the secondary use of health data, particularly genomic data, are complex and heterogeneous across MS. We describe the pathway from data application to access to pseudonymized data in secure processing environments, emphasizing the legal requirements, including the role of ethics committees. Finally, we analyse the success factors for achieving access to the data and the reasons for access denial to support shaping the upcoming EHDS implementation. Several challenges remain unaddressed for cross-border data use, especially in the context of genomic data, where the complexity and heterogeneity of informed consent can impact or even impede data-sharing efforts. While EHDS can simplify processes across MS, it is crucial to ensure that additional safeguards do not negatively impact or block access to health data and that EHDS infrastructure is ready for effective and affordable processing of large volumes of genomic and other data.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":"35 Supplement_3","pages":"iii25-iii31"},"PeriodicalIF":3.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12420906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"User journeys in cross-European secondary use of health data: insights ahead of the European Health Data Space.","authors":"Rachel B Forster, Eva Garcia Alvarez, Adrian G Zucco, Enrique Bernal-Delgado, Gayo Diallo, Francisco Estupiñán-Romero, Andrea Ganna, Madeleine Gorman-Asal, Christina Hilmarsen, Petr Holub, Klaus Hoeyer, Arti Rawat, Naja H Rod, Anna-Leena Vuorinen, Tibor V Varga","doi":"10.1093/eurpub/ckaf096","DOIUrl":"10.1093/eurpub/ckaf096","url":null,"abstract":"<p><p>The European Health Data Space (EHDS) regulation aims to facilitate cross-border sharing of health data across Europe. However, practical challenges related to data access, interoperability, quality, and interpretive competence remain, particularly when working with health systems across countries. This study aimed to evaluate and report the user journey of researchers accessing and utilizing health data across four European countries for secondary research purposes prior to implementation of EHDS. We conducted a narrative reflection of individual and collective experiences on key aspects of the user journey-discovery, access, use, and finalization. Data were gathered from various structured and unstructured sources, including an online log, prospective questionnaires, regular meetings, and interviews. Researchers faced challenges at different steps of the user journey, which included lack of data quality in national metadata catalogues (discovery stage). Differences in national regulations led to inconsistent timelines for gaining access to data (access stage), with approval times ranging from a few months to over a year. At the use stage, researchers experienced challenges in harmonizing health data due to variations in coding practices and data quality. Issues related to computational capacity caused further delays. Substantial challenges must be addressed for EHDS to succeed. Establishing knowledge hubs, fostering collaborations, and streamlining access processes are essential. Close collaboration with experts will likely be essential for an effective user journey. This analysis underscores the importance of collaboration, analytical reproducibility, and clear documentation to ensure the success and timely delivery of cross-border projects.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":"35 Supplement_3","pages":"iii18-iii24"},"PeriodicalIF":3.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12420902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Which women go for screening?","authors":"Christine Sevilla-Dedieu, Morgane Le Guern, Céline Coquoz, Nathalie Billaudeau, Alain Paraponaris","doi":"10.1093/eurpub/ckaf128","DOIUrl":"https://doi.org/10.1093/eurpub/ckaf128","url":null,"abstract":"<p><p>Cancer accounts for approximately one-third of deaths in developed countries. Preventing cancer, notably by detecting new cases early, is thus crucial. In the European Union (EU), screening rates have been recommended for several types of cancer; however, most EU countries are still not meeting them. Determining how we can improve people's adherence to screening is necessary. This study aimed to explore the characteristics of women associated with being up-to-date on mammograms or Pap smears; notably, we wanted to determine the extent to which women's attitudes towards risk play a role in their adherence to screening. The sample comprised 1411 women who responded to a telephone survey. The survey data, including sociodemographic characteristics, health information, attitudes towards the future, and attitudes towards risk, collected via the Domain-Specific Risk-Taking (DOSPERT) scale, were supplemented by medico-administrative data. The factors associated with undergoing either a mammogram or a Pap smear in a timely manner were similar. Two favourable factors were found: the number of children and a high level of education. In contrast, being older or having a higher DOSPERT score for risk-taking appeared to be negatively associated with timely screening. The fact that women's attitudes towards risk seem to have a strong impact on their adherence to medical recommendations is a finding that should be considered (e.g. by health professionals or in prevention campaigns) regarding increasing women's awareness of the importance of regular cancer screening.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exposome factors associated with multi-morbidity in older adults: a discovery-based cross-sectional analysis in the Longitudinal Aging Study Amsterdam.","authors":"Diana J Mora, Jeroen Lakerveld, Laura A Schaap, Mélanie Bertin, Natasja M van Schoor, Bram J Berntzen","doi":"10.1093/eurpub/ckaf127","DOIUrl":"https://doi.org/10.1093/eurpub/ckaf127","url":null,"abstract":"<p><p>Ageing populations and longer life expectancies challenge healthcare systems due to rising noncommunicable diseases (NCDs) and multi-morbidity. Designing healthier living environments may reduce population risks of NCD onset, but knowledge is needed on environmental factors related to NCDs in older adults. We therefore examined associations between residential neighbourhood built, physico-chemical, and sociodemographic environmental factors and NCD prevalence in the Netherlands among older adults. Cross-sectional data from 1578 older adults from the Longitudinal Aging Study Amsterdam (2008-09) were matched with environmental data from the Dutch Geoscience and Health Cohort Consortium (GECCO). Multivariable logistic regression analyses were conducted to assess the odds of having a single NCD versus no NCD and multi-morbidity versus no NCD, adjusted for sociodemographic factors. Participants had a mean age of 73.2 years, 55% were female, and 77% reported at least one NCD. Multi-morbidity was more common in women, who were also older and had lower education and income. Higher green space density within 500 m was significantly associated with lower odds of single NCD [odds ratio (OR): 0.52, 95% confidence interval (CI): 0.33-0.83]. A higher number of cars in a household also showed lower odds of single NCD (OR: 0.14, 95% CI: 0.04-0.55). No significant associations were observed for physico-chemical exposures. Results were consistent in sensitivity analyses. The findings underscore the need for urban planning and policies that support healthy ageing while embracing a longevity-ready perspective, accounting for the built, physico-chemical, and sociodemographic environments across the life-course.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}