European Journal of Public Health最新文献

{"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":"Unleashing the potential of health data: from vision to reality in the HealthData@EU Pilot Project.","authors":"Fulvia Raffaelli, Martin Dorazil, Mélodie Bernaux, Owe Langfeldt, David Asturiol, Jerome De Barros, Irini Kessissoglou, Licinio Kustra Mano, Guillaume Byk","doi":"10.1093/eurpub/ckaf003","DOIUrl":"10.1093/eurpub/ckaf003","url":null,"abstract":"","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":"35 Supplement_3","pages":"iii1-iii2"},"PeriodicalIF":3.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12420903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029196","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":"An index of multiple deprivation in Sweden: measuring area-level socio-economic inequalities.","authors":"Lode van der Velde, Ahmed Nabil Shabaan, Mathias Mattsson, Theo Bodin, Terje A Eikemo, Stefan Swartling Peterson, Anna-Karin Danielsson, Emilie E Agardh","doi":"10.1093/eurpub/ckaf138","DOIUrl":"https://doi.org/10.1093/eurpub/ckaf138","url":null,"abstract":"<p><p>Area-level measures of deprivation in Sweden often rely on limited socio-economic indicators, such as income or education. To address this, we developed the Index of Multiple Deprivation in Sweden (IMDIS) to capture a multitude of explanatory factors for socio-economic inequalities and the distribution across small areas in Sweden. The IMDIS is a compositional index constructed for small areas in Sweden in 2015 and combines 15 indicators across 4 domains (Housing, Employment, Income and Capital, and Education) into an overall deprivation score. Indicators were selected and spatially smoothed to mitigate the effect of small numbers and increase robustness. Domains were constructed using a weighted average of underlying indicators, allowing detailed examination of the significance each domain or indicator has in small areas, and were further combined using explicit weights. All areas were subsequently ranked from the 1st least to 5984th most deprived area. For each area, we generated three key outputs: a score, a rank, and assignment to a deprivation decile. The IMDIS showed high internal consistency and revealed stark geographic inequalities in deprivation. The most deprived areas were concentrated in urban regions, particularly Stockholm, Gothenburg, and Malmö. Housing deprivation was more prominent in urban areas, while educational deprivation was more prevalent in rural and peripheral regions. The IMDIS offers a comprehensive measure of multiple deprivation at the small-area level in Sweden. Its domains and indicators can be used individually or combined to identify inequalities in vulnerable areas and explore geographic patterns, supporting a deeper understanding of social disparities.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144948005","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}

{"title":"The prevalence of multimorbidity with mental and physical health for people who experience homelessness: a systematic review.","authors":"Natasha Chilman, Peter Schofield, Dionne Laporte, Amy Ronaldson, Jayati Das-Munshi","doi":"10.1093/eurpub/ckaf144","DOIUrl":"https://doi.org/10.1093/eurpub/ckaf144","url":null,"abstract":"<p><p>Multimorbidity refers to the co-occurrence of multiple health conditions in a single individual. The objective of this systematic review was to synthesize and evaluate research on the prevalence of multimorbidity (including both mental and physical health conditions) for people who have experienced homelessness. MEDLINE, EMBASE, PsycINFO, Web of Science, and OpenGrey were searched for relevant studies between 1997 and 2025. Studies were included if the sample consisted of adults in high-income countries, where the exposure was current or former homelessness, and the outcome was multimorbidity including both mental and physical conditions. Random-effects meta-analyses were used to calculate pooled prevalence estimates. The studies were narratively synthesized, and quality assessed. The search retrieved 6043 papers, 30 of which were eligible for inclusion in the review. Most studies recruited participants from specialist homelessness services (n = 21). More than half of the study samples were over 75% male (N = 16). When excluding studies which applied non-probability sampling strategies, the pooled prevalence was 45% (95% CI, 25-66) for multimorbidity. There was a 34% (95% CI, 22-48) pooled prevalence for trimorbidity (co-occurring mental, physical, and substance/alcohol use conditions). High heterogeneity was observed across studies (I2 > 99%). To conclude, multimorbidity is highly prevalent for people who experience homelessness. There is a lack of research on multimorbidity for women who are or have been homeless, and for those who are not accessing specialist homelessness services. These findings demonstrate the need for the integration, collaboration, and co-ordination between services to support the multimorbid health needs of people who experience homelessness.</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":"144947962","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":"Temporal trends of key preconception indicators among women in Northern Ireland, UK: an analysis of maternity healthcare data 2011-2021.","authors":"Emma H Cassinelli, Lisa Kent, Kelly-Ann Eastwood, Danielle A J M Schoenaker, Michelle C McKinley, Laura McGowan","doi":"10.1093/eurpub/ckaf141","DOIUrl":"https://doi.org/10.1093/eurpub/ckaf141","url":null,"abstract":"<p><p>Optimizing preconception health offers an opportunity to reverse unfavourable trends in modifiable risk factors and improve reproductive outcomes. This study aims to report the yearly prevalence of key biopsychosocial preconception indicators for over a decade, as reported at antenatal booking appointments in Northern Ireland (UK). The indicators include area-level deprivation, planned pregnancies, and body mass index (BMI) between 2011 and 2021, as well as pre- and early-pregnancy folic acid supplement use between 2015 and 2020. This population-based study was conducted using annual routinely collected maternity data from the Northern Ireland Maternity System (NIMATS). R, accessed via the UK Secure eResearch Platform, was used to calculate yearly proportions. Multinomial regression models explored the relationship between each preconception indicator and year of booking appointment. Patient and Public Involvement and Engagement were integrated throughout the study. Of the 255 117 pregnancies included between 2011 and 2021, 21.4% were from women living in the most deprived quintile and 70.6% from women who reported a planned pregnancy. Obesity rates increased over the study period (e.g. obesity class I: 12.0%-16.1%), and preconception folic acid supplement use remained inadequate, though the use of supplements containing 5 mg of folic acid increased between 2015 and 2020 (400 µg: 34.4%-30.03%; 5 mg: 3.6%-5.0%). Efforts are needed to reverse negative public health consequences of sub-optimal preconception health indicators. Notably, folic acid supplement use was predominantly initiated after conception, suggesting that a renewed focus is needed, particularly supporting women with the greatest need, such as those in the most deprived areas.</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":"144947911","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":"Sickness absence with common mental disorders and antidepressant prescriptions across different employment branches during as compared to before the Covid-19 pandemic-an observational study covering the Swedish population aged 18-65 years.","authors":"Stefanie Kirchner, Katalin Gémes, Pontus Josefsson, Thomas Niederkrotenthaler, Maria Melchior, Josep M Haro, Mireia Félez-Nóbrega, Marit Sijbrandij, Anke B Witteveen, Irwin Hecker, Antonio Lora, Matteo Monzio Compagnoni, Claudia Conflitti, Giulia Caggiu, Jakob Bergström, Ellenor Mittendorfer-Rutz","doi":"10.1093/eurpub/ckaf145","DOIUrl":"https://doi.org/10.1093/eurpub/ckaf145","url":null,"abstract":"<p><p>Few studies have examined the implications of the Covid-19 pandemic on mental health across different employment branches. This study investigated the impact of the pandemic on long-term sickness absence (SA) with common mental disorders (CMDs) and antidepressant prescriptions in different employment branches and age groups in Sweden. Using national registers, we observed the Swedish population (18-65 years) with gainful employment quarterly from 2018 to 2021. An interrupted time-series design was employed to examine changes in trends of incidence rates (IRs) for (i) long-term (>90 days) SA with CMDs and for (ii) antidepressant prescriptions across eight employment branches during versus pre-pandemic. Analyses were stratified by age group. There was no evidence of outcome changes in the entire working age population. However, compared to pre-pandemic levels, the IRs of long-term SA with CMD increased by 5.9% per quarter for those working in the cultural sector [95% confidence interval (CI): 2.2%-9.8%], 3.4% in trade and transportation (95% CI: 0.4%-6.4%), and 5.5% in manufacturing and services (95% CI: 1.5%-9.7%) as well as among individuals aged 56-64. Incident antidepressant prescription rates were marginally higher for workers in construction (1.1% annual increase; 95% CI: 0.1%-2.1%), culture (1.4%; 0.7%-2.0%), and trade and transportation (0.9%; 0.1%-1.7%). While the risk of CMD-related long-term SA or incident antidepressant prescription in Swedish workers did not appear to be impacted by the pandemic, certain employment branches and older individuals were negatively affected in terms of both outcomes. Targeted countermeasures and initiatives to improve well-being are necessary for vulnerable groups.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947895","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":"Advancing public health workforce's professional development: implications for Ukraine.","authors":"Olga Gershuni, Martina Parić, Olga Aleksandrova, Rok Hrzic, Timo Clemens, Genc Burazeri, Nataliia Piven, Matt Commers, Katarzyna Czabanowska","doi":"10.1093/eurpub/ckaf143","DOIUrl":"10.1093/eurpub/ckaf143","url":null,"abstract":"<p><p>Despite many challenges, Ukraine has prioritized the need to develop and professionalize the public health workforce (PHWf) to respond to its transitioning public health (PH) system. This study explores how various PH stakeholders can develop and advance the PHWf professionalization programme in Ukraine using the WHO-ASPHER Roadmap to Professionalize the PHWf in the European region as the theoretical foundation. A mixed-methods qualitative approach was used to (i) document analysis of Ukrainian policy and regulatory documents related to PHWf and (ii) qualitative survey research involving relevant PH stakeholders. Directed and conventional content analysis was applied to analyse data. The document analysis reviews key areas as LoPHS, PH higher education, and continuous professional development. The analysis helped explain the current state of the PHWf and to understand enabling factors for its professionalization. Results from the qualitative survey research suggest several actions to enhance PHS in Ukraine based on three priority areas: (i) PH laws and regulation; (ii) PH education and training; and (iii) financing for the development and professionalization of PHWf. The PHWf professionalization programme for Ukraine resonates with the WHO-ASPHER Roadmap to Professionalizing the PHWf in the European region. It attempts to close the gap between PH legislation, the current state of the PHWf, and international PH practice ambitions. The study suggests the need for a well-coordinated development process across PHS and PHWf domains.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144882503","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 relationship between private import of alcoholic beverages and domestic sales of alcoholic beverages: analyses of Swedish time-series data.","authors":"Håkan Leifman, Thor Norström","doi":"10.1093/eurpub/ckaf139","DOIUrl":"https://doi.org/10.1093/eurpub/ckaf139","url":null,"abstract":"<p><p>Private imports of alcoholic beverages-often referred to as cross-border trade-have long raised concerns in Sweden and other Nordic countries due to their potential impact on national alcohol policies and public health. A key concern is that this trade increases total alcohol consumption and related harms. This study examines the relationship between private alcohol imports and domestic sales in Sweden, with a focus on how cross-border trade influences total alcohol consumption. Using regional and beverage-specific time series data from 2002 to 2023, we applied SARIMA modelling to self-reported import estimates from the Monitor project to assess substitution effects on domestic alcohol sales. Private imports significantly displace domestic alcohol purchases, particularly in southern Sweden across all beverages, though the substitution is partial. For Sweden as a whole, analyses indicate that a 1-litre increase in imports is associated with a 0.456-litre decrease in domestic sales. In central Sweden, only spirits imports show a significant effect (1-litre increase in spirits imports yields a 0.175-litre decrease in domestic sprits sales), while no significant associations are observed in the north. The findings suggest that cross-border trade contributes to higher overall alcohol consumption, especially in border regions. Regional variation underscores the need for differentiated alcohol policy responses. Private imports undermine the effectiveness of domestic alcohol control measures. However, since domestic sales do not influence import levels, policy efforts such as increased excise taxation may reduce total consumption without triggering substantial compensatory imports.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834660","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}