European Journal of Public Health最新文献

{"title":"Uptake rates of influenza vaccination in over 65s in Denmark: a comparison between Danish-born and migrant populations, 2015-21.","authors":"Anna Deal, Sally E Hayward, Kristina Langholz Kristensen, Farah Seedat, Jørgen Holm Petersen, Jon S Friedland, Palle Valentiner-Branth, Marie Nørredam, Sally Hargreaves","doi":"10.1093/eurpub/ckaf148","DOIUrl":"https://doi.org/10.1093/eurpub/ckaf148","url":null,"abstract":"<p><p>WHO's Immunization Agenda 2030 has placed renewed focus on life-course vaccination, including among migrants. Despite the availability of a seasonal vaccine, influenza remains a key contributor to winter excess mortality in Northern Europe, yet limited data on influenza vaccination uptake in migrants has been published. We analyzed Danish national registry data to determine influenza vaccine uptake across six flu seasons (2015/16-2020/21) among migrants (asylum-pathway and quota refugees, family reunified migrants) ≥65 years matched 1:6 on age and gender to Danish-born individuals. We used multivariate logistic regression models controlling for migrant status (immigration status, time in Denmark) and other sociodemographic variables (age, gender, nationality, urban/rural residence) to identify factors associated with influenza vaccination uptake. All analyses were done in R v4.2.1. Across all six seasons, overall flu vaccination uptake was 49.3% (Danish-born: 50.9%; migrant cohort: 39.4%). Migrants were less likely [odds ratio (OR): 0.66; 95% confidence interval (CI): 0.64-0.67] to receive an influenza vaccine across all seasons, with this gap widening from 2015/16 (OR: 0.78; 95% CI: 0.74-0.84) to the 2020/21 season (OR: 0.44; 95% CI: 0.42-0.46). Family-reunified migrants were less likely to receive an influenza vaccine across the study period than asylum-pathway and quota refugees and those from the Sub-Saharan Africa region had the lowest uptake in terms of area of origin. This large and unique dataset shows that migrant groups have lower uptake rates for influenza vaccination compared with Danish-born individuals, with the gap widening over time. Going forward, developing tailored interventions, co-developed in collaboration with communities themselves, will be key.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091674","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":"Non-pharmaceutical interventions to prevent community transmission of infectious diseases with pandemic potential-an umbrella review and evidence map.","authors":"Jonas Björk, Gunlög Rasmussen, Susanne Johansson, Jessica Dagerhamn, Hanna Olofsson, Karin Wilbe Ramsay","doi":"10.1093/eurpub/ckaf170","DOIUrl":"https://doi.org/10.1093/eurpub/ckaf170","url":null,"abstract":"<p><p>During the COVID-19 pandemic, most countries implemented non-pharmaceutical interventions (NPIs) to mitigate virus transmission and decrease morbidity and mortality. The aim of this umbrella review was to identify and map systematic reviews on the effectiveness of NPIs to reduce widespread community transmission of infectious diseases with pandemic potential. We searched electronic databases (Medline, Embase, Scopus, INAHTA [International Network of Agencies for Health Technology Asseesment], and World Health Organization COVID-19) and websites (January 2024). Systematic reviews on NPIs during outbreaks, epidemics, or pandemics of COVID-19, severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), influenza, or Ebola were included and organized in an interactive evidence map grouped by type of intervention (individual/population/environmental), disease, risk of bias, and search date. Five of the 132 included reviews were assessed as having low, 43 moderate, and 84 high risk of bias. COVID-19 was targeted in 100 reviews, influenza 66, SARS 39, MERS 34, and Ebola in five reviews. The most frequently investigated NPIs were use of face masks, hand washing, physical distancing, travel restrictions, restrictions on public gatherings, and school closures. The five reviews at low risk of bias concluded at low level of evidence about the effectiveness of most NPIs, with exceptions of hand hygiene and some measures in school settings where low- to moderate-certainty evidence was found. There is substantial lack of evidence regarding the effectiveness of several commonly used NPIs, including restrictions on public gatherings, travel restrictions, and visiting restrictions in long-term care facilities. There is a paucity not only of systematic reviews but also of primary studies at low risk of bias.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091568","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":"Intersectional inequalities in interpersonal discrimination in outpatient care according to sex, history of migration, and income in Germany.","authors":"Olaf von dem Knesebeck, Demet Dingoyan, Anna Makowski, Jens Klein, Daniel Lüdecke","doi":"10.1093/eurpub/ckaf162","DOIUrl":"https://doi.org/10.1093/eurpub/ckaf162","url":null,"abstract":"<p><p>Experiences of interpersonal discrimination in outpatient care (e.g. being treated disrespectfully) are a frequent phenomenon in Germany and in other countries. It can be expected that such experiences contribute to the production and perpetuation of health inequalities. We explored intersectional inequalities in interpersonal discrimination in outpatient care according to sex, history of migration, and income. Analyses were based on an online survey in a random sample of the adult population in Germany (n = 3246). A modified version of the Everyday Discrimination Scale was used to assess frequencies of interpersonal discrimination experiences in outpatient care. Sex, history of migration, and net income were considered as indicators of social inequalities. Intersectional multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA) was conducted. Analyses showed significantly higher frequencies of interpersonal discrimination experiences for females and respondents with a low income while associations with migration history were not significant. Social inequalities in discrimination experiences were attributable to additive (and not multiplicative) effects of sex, migration history, and income, with sex contributing most and migration history least to these inequalities. Analyses across the 18 intersectional strata (combining subgroups of sex, income, and migration history) revealed significant differences in frequencies of discrimination experiences between the most (female second-generation migrants with low income) and least affected strata (men with high income and no migration history). As such discrimination experiences can result in reduced health care engagement and adverse health outcomes, these findings point to an important public health issue.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091501","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":"Inclusion of climate change and planetary health in masters of public health curricula in the UK.","authors":"Ana-Catarina Pinho-Gomes, Cecilia Sorensen, Danielly de Paiva Magalhães, Shakoor Hajat, Harry Rutter","doi":"10.1093/eurpub/ckaf158","DOIUrl":"https://doi.org/10.1093/eurpub/ckaf158","url":null,"abstract":"<p><p>Due to the many health impacts of climate change, it is imperative to equip public health professionals with the skills and knowledge to work on climate mitigation and adaptation. However, it is unclear to what extent Masters of Public Health (MPH) include climate change and related subjects in their curricula. A survey was sent to MPH directors in the UK with questions about inclusion of climate change and related subjects in the curriculum. Russell group universities and those commissioned by NHS England Workforce, Training and Education were invited to take part. A total of 27 MPH courses were included (100% response rate). Climate change and related subjects were included in optional or core modules on other subjects, with health protection and health improvement being the most common. Two MPHs had only one lecture/seminar on climate change and one MPH did not cover these topics in the syllabus. The most common subject included in curricula was climate change (24, 89%). Most MPH directors wanted to increase the inclusion of climate change and planetary health in the curriculum (12, 55%) but could not do so due to lack of space within an already overloaded curriculum (10, 37%). Despite the recognition of the importance of climate change and health education by MPH course directors, the inclusion of those subjects in curricula remains variable and not as thorough as required given the importance of the topic. Addressing barriers is warranted to enable public health professionals to gain the required skills in climate mitigation and adaptation.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091498","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":"The impact of the COVID-19 pandemic on the antibiotic consumption and resistance in Montenegro.","authors":"Gordana Mijovic, Maja Raicevic, Milena Lopicic, Slavica Markovic, Marina Jaksic","doi":"10.1093/eurpub/ckaf167","DOIUrl":"https://doi.org/10.1093/eurpub/ckaf167","url":null,"abstract":"<p><p>Montenegro has been at the top of the European antibiotic (AB) consumption list for a decade. Also, the invasive isolates of significant Gram \"-\" pathogens have one of the highest rates of resistance to key AB in Europe. A COVID-19 pandemic announced in 2020 had a significant impact on AB consumption globally. We analysed the consumption of AB in the pre-COVID (2019) and COVID-19 pandemic (2020, 2021, and 2022) period, and compared it with data on the resistance of Gram \"-\" invasive isolates of important pathogens to key AB. Data on total AB consumption in Montenegro (2011-2022) show that the growth rate in 2021 compared to 2020 was 14.04%, which is a statistically significantly higher value compared to previous years (P < .005, Z-value = 7.43). Additionally, there was a change in the structure of AB consumed, including hospital AB. Resistance of Escherichia coli to the third generation of cephalosporins increased significantly from 38% (9/24) in 2019 to 67% (16/24) in the COVID (2022) year (χ2 = 4.0904, P < .05). The highest rate of Klebsiella pneumoniae resistance to carbapenems was recorded in 2022, 47% (18/38), and was significantly higher compared to 2019 (17% (4/23)) (χ2 = 5.5838, P < .05). The rate of resistance to macrolides of Staphylococcus aureus strains increased significantly from 11% (101/920) in 2019 to 18% (134/735) in 2022 (χ2 = 17 640; P < .001). COVID-19 pandemic altered the resistance map of important pathogens to key antibiotics in Montenegro. A complete national stewardship program must be developed, and the surveillance should be rigorously enhanced and maintained.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091641","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":"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":"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":"The European Health Data Space in communicable diseases surveillance and monitoring of medicines and vaccines: achievements of a pilot project examining the user journey.","authors":"Katharina L Schneider, Luís Alves de Sousa, Ionut Sava, Steffen Heß, Denise Umuhire, Daniel R Morales","doi":"10.1093/eurpub/ckaf115","DOIUrl":"10.1093/eurpub/ckaf115","url":null,"abstract":"<p><p>The future European Health Data Space (EHDS), a network for secure cross-border data use, could be beneficial for public health initiatives. The HealthData@EU pilot project evaluated possibilities of secondary data use based on five use cases and established a pilot IT infrastructure. This article reports overarching experiences from two public health use cases and the IT development. Experiences were reported by the Users' Journey steps (data discovery, application, use, and finalization) elaborated in the context of the European Health Data Space (TEHDAS), the first conceptual EHDS project. The European Medicines Agency's use case analysed coagulopathy-related events in COVID-19 patients, the one led by the European Centre for Disease Prevention and Control assessed the feasibility of HealthData@EU to support antimicrobial resistance surveillance. The IT work package developed the infrastructure for information exchange. The use cases indicated that standardized procedures, wherever available, were considered highly beneficial. In the application phase, node-specific requirements slowed down the progress. A distributed approach in combination with the use of Secure Processing Environments (SPE) was successfully conducted. The IT infrastructure was piloted, tested, and published as open source. It supports data discovery and applications in the future. The HealthData@EU pilot project has achieved major steps regarding data discoverability and accessibility, where a need for more standardized procedures was detected in the use cases. Distributed analyses in combination with SPE use may be possible approaches for the data use phase, which require further investigation in TEHDAS2 and other initiatives.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":"35 Supplement_3","pages":"iii5-iii10"},"PeriodicalIF":3.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12420905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029125","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":"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}