Archives of Public Health最新文献

{"title":"Hospital readmission disparity measure for evaluating hospital performance and penalties.","authors":"Yajun Yi, Henry John Domenico, Leta Yi, Wei Xiang, Xiayu Xiang","doi":"10.1186/s13690-025-01726-w","DOIUrl":"https://doi.org/10.1186/s13690-025-01726-w","url":null,"abstract":"<p><strong>Background: </strong>The excess readmission ratio (ERR) is currently used to determine penalties for hospitals with excessive readmission rates. To determine whether the effectiveness of alternative measures, such as the Risk-Standardized Readmission Rate (RSRR), or Excess Days in Acute Care (EDAC), or differences between paired measures, would provide comparable or superior assessments.</p><p><strong>Methods: </strong>A retrospective national study on readmission measures. This study analyzed national readmission data from 3,047 hospitals for the fiscal year (FY) 2022. We measured the agreements and disparity scores in hospital performance assessments, as well as the changes in penalty status between the paired readmission measures.</p><p><strong>Results: </strong>The ERR and RSRR measures showed a significantly high degree of agreement, ranging from 83.5 to 93.8% across the six applicable conditions/procedures. In contrast, marked differences emerged when comparing EDAC with ERR or RSRR, showing varying levels of disparities. If the EDAC measure were adopted, between 15.9 and 25.2% of hospitals would experience a change in their penalty status. Specifically, using EDAC would reduce financial penalties for 11.4-16.6% of small community hospitals and safety-net hospitals for at least one of the targeted conditions.</p><p><strong>Conclusions: </strong>These findings suggest that integrating disparity scores into the current ERR-based measurement system could have significant implications for promoting equity and informing policy decisions. By doing so, the evaluation of individual providers and hospital care quality could become more comprehensive, insightful, accurate, and equitable.</p>","PeriodicalId":48578,"journal":{"name":"Archives of Public Health","volume":"83 1","pages":"241"},"PeriodicalIF":3.2,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276417","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":"Inertia or unanticipated bottlenecks? Exploring stakeholder perspectives on the implementation determinants of the national alcohol policy five years post-enactment in Zambia.","authors":"Adam Silumbwe, Miguel San Sebastian, Joseph Mumba Zulu, Charles Michelo, Klara Johansson","doi":"10.1186/s13690-025-01737-7","DOIUrl":"https://doi.org/10.1186/s13690-025-01737-7","url":null,"abstract":"<p><strong>Background: </strong>Alcohol use accounts for a huge proportion of the global burden of disease, and many countries grapple with its severe negative social and health consequences. In 2018, Zambia adopted a national alcohol policy with the aim to reduce the prevalence and impact of harmful alcohol use. However, five years post-adoption, the policy implementation has been slow. This study sought to explore the implementation determinants of the national alcohol policy five years post-enactment in Zambia. Implementation determinants, a concept from Bullocks theoretical framework, refer to the enabling and inhibiting factors that shape the alcohol policy and related implementation outcomes among implementing agents and teams.</p><p><strong>Methods: </strong>We employed a qualitative case study design using data collected from 25 semi-structured interviews targeting government ministries, civil society, and agencies responsible for enforcing the alcohol policy. We applied both inductive and deductive manifest thematic analysis using Bullock's analytical framework for understanding the determinants of implementing evidence-based policies.</p><p><strong>Results: </strong>The alcohol policy was generally viewed by key stakeholders as comprehensive framework for action, yet its policy directives remained unclear. A restructured policy coordination committee enhanced the organisational capacity to implement joint action for this policy. However, weak collaboration between the council and state police hampered the enforcement of alcohol laws. Implementing agencies faced obstacles such as lack of financial and human resources, absence of rehabilitation services, and misapplication of alcohol selling licences. Further, community inaction and resistance to alcohol control laws affected the policy implementation. The socio-political environment contributed to implementation challenges through framing alcohol as an economic development issue and culturally tolerating harmful alcohol use. Additionally, changes in government affected policy ownership while unregulated illicit alcohol production and the sale of traditional and imported spirits further hampered the implementation of the policy.</p><p><strong>Conclusion: </strong>Overcoming implementation hurdles to the alcohol policy demands comprehensive strategies such as engaging communities, challenging cultural norms, strategically assigning funding, and fostering collaboration among implementing agencies. This may entail leveraging enablers such as stakeholder recognition of the policy framework and the restructured committee for the coordination of the alcohol policy implementation. Key actions should include empowering local government to enforce measures to reduce unregulated alcohol availability and ensure adequate resource allocation for alcohol control activities among implementation agents, including those providing treatment and rehabilitation services.</p>","PeriodicalId":48578,"journal":{"name":"Archives of Public Health","volume":"83 1","pages":"240"},"PeriodicalIF":3.2,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276442","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":"Primary school children exhibit socioeconomic inequalities in their usual beverage consumption: baseline assessment of the DRINK trial.","authors":"Lucille Desbouys, Wassila Assakali, Isabelle Thiébaut, Katia Castetbon","doi":"10.1186/s13690-025-01730-0","DOIUrl":"10.1186/s13690-025-01730-0","url":null,"abstract":"<p><strong>Background: </strong>Promoting favourable beverages to children remains a public health priority, and schools are essential in reducing nutritional disparities. The study aimed to describe the baseline characteristics of schools and children included in the DRINK trial, and to examine disparities in children's usual beverage consumption.</p><p><strong>Methods: </strong>The study is a cross-sectional analysis of data collected at baseline of the DRINK cluster randomised controlled trial. Children aged 8-11 years from 46 French-speaking primary schools in Belgium were invited to complete 4-day diaries and questionnaires during the spring 2021. Usual consumption of total beverages, water, sweetened beverages (SB), and milk was estimated by correcting the data for within-person variation using the Statistical Program to Assess Dietary Exposure (SPADE) and compared between subgroups using bootstrapping to generate 95% CIs.</p><p><strong>Results: </strong>A diverse range of schools and children participated in the trial. Of the 3,631 students, 2,427 completed a valid diary and child questionnaire, including fewer from Brussels than Wallonia. Children usually consumed 1,109 ml/day (95% CI: 1,092-1,132) of total beverages, including 677 ml/day (660-699) of water, and 345 ml/day (331-359) of SB. Socio-economic disparities were observed in all types of beverage consumption, mostly related to the parental education, and most strikingly for the water intake.</p><p><strong>Conclusion: </strong>Despite the challenges of participation, partly due to the Covid-19 pandemic, inclusion in the DRINK trial provided a wide diversity of school populations, which will ultimately be considered when interpreting the trial findings. The overall high consumption of SB and the socio-economic disparities, particularly in water consumption, emphasize the need to reinforce nutrition interventions among disadvantaged children.</p><p><strong>Trial registration: </strong>The DRINK trial was registered on 25 May 2021 in the ISRCTN Registry (ISRCTN99843102).</p>","PeriodicalId":48578,"journal":{"name":"Archives of Public Health","volume":"83 1","pages":"239"},"PeriodicalIF":3.2,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12512255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259658","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":"Impact of COVID-19 among women seeking abortion services in Nepal: results from a longitudinal study.","authors":"Anupama Ale Magar, Mahesh C Puri, Sunita Karki, Dev Chandra Maharjan, Rachel Murro, Diana Greene Foster","doi":"10.1186/s13690-025-01705-1","DOIUrl":"10.1186/s13690-025-01705-1","url":null,"abstract":"<p><strong>Introduction: </strong>The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted health and well-being worldwide, but limited evidence exists on its effects on women seeking reproductive health services. This paper examined the reported prevalence of COVID-19 signs/symptoms among the women who sought abortion services and the impact pandemic had on women who either received or were denied abortion services over a 3.5-year period in Nepal.</p><p><strong>Methods: </strong>This paper draws on data from a longitudinal study involving 1,832 women who sought abortions at 22 health facilities across Nepal between 2019 and 2020. Participants were interviewed at the time of enrollment, then again at 6 weeks, and every 6 months over a three- and a half-year period. For the analysis, data from 1,739 women were used to examine trends in the prevalence of COVID-19 symptoms and assess the broader impact of the pandemic. To evaluate the effects of COVID-19 pandemic over time, the study period was divided into 6-month intervals. Both bivariate analyses and multivariate regressions were employed to assess the pandemic's impact on these women, considering overall trends as well as differences between those who received abortions and those who were denied.</p><p><strong>Results: </strong>Approximately three-quarters of the respondents reported some impact of COVID-19 pandemic between March and August 2020. Following another peak in March-August 2021 (71% reporting impacts), experience of pandemic impacts decreased steadily to 26% by the end of the study period (Mar-Jun 2023). Economic disruptions related to work or business were the most common impact reported followed by impacts on children's education and the inability to access or afford basic food or necessities After adjusting for baseline differences, women who gave birth after being denied an abortion were more affected by the pandemic when it came to affording daily necessities (OR = 1.78, p < .01) and accessing reproductive (OR = 2.59, p < .01) and non-reproductive health services (OR = 3.07, p < .01).</p><p><strong>Conclusion: </strong>The study highlights the increased vulnerability of pregnant women, particularly those seeking abortion care, during the COVID-19 pandemic. The findings emphasize the critical importance of maintaining access to essential reproductive health services, such as abortion, especially during disease outbreaks and humanitarian crises. Ensuring the continuity of these services should be a top priority, and health systems must be strengthened to deliver them without disruption in future emergencies.</p>","PeriodicalId":48578,"journal":{"name":"Archives of Public Health","volume":"83 1","pages":"238"},"PeriodicalIF":3.2,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12506289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253328","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":"Association between older adults' socioeconomic status and their healthcare experiences, preferences, and attitudes towards deprescribing: a cross-sectional study in 14 countries.","authors":"Renata Vidonscky Lüthold, Esther Kleijer-Werkman, Katharina Tabea Jungo, Zsofia Rozsnyai, Limor Adler, Radost Assenova, Eloísa Rogero-Blanco, Markus Bleckwenn, Thomas Frese, Gilles Henrard, Aisling A Jennings, Donata Kurpas, Vanja Lazic, Heidrun Lingner, Stina Mannheimer, Anne Centeno Neelen, Anabela Pereira, Ferdinando Petrazzuoli, Rosalinde K E Poortvliet, Ágnes Szélvári, Dorothea M G Wild, Sven Streit, Enriqueta Vallejo-Yagüe","doi":"10.1186/s13690-025-01700-6","DOIUrl":"10.1186/s13690-025-01700-6","url":null,"abstract":"<p><strong>Background: </strong>Socioeconomic status (SES) can influence health outcomes. Both SES and older age are associated with polypharmacy, health literacy, and quality of care. Understanding how SES influences healthcare experiences of older adults with polypharmacy can serve to inform future interventions aiming at optimising patient care. Therefore, we investigated the association between older patients' SES and their i) attitudes towards deprescribing, ii) satisfaction with medications, iii) self-rated health, iv) health literacy, and v) trust in their general practitioner (GP).</p><p><strong>Methods: </strong>In this cross-sectional study, older patients with polypharmacy from 14 countries completed a survey on their attitudes towards deprescribing, healthcare experiences, and sociodemographic characteristics. We compared patients' responses across high (reference), middle, and low SES groups (defined by education and financial status), and performed multilevel logistic regressions adjusted for clustering at the country level to assess the association between patients' SES and the outcomes.</p><p><strong>Results: </strong>Among 1,320 older adults, compared to those with high SES, patients with low SES were more likely to want a medication deprescribed (OR_lowSES 1.76, 95%CI 1.20-2.57). Those with medium SES were less likely to trust their GP (OR_mediumSES 0.70, 95%CI 0.52-0.94). Both low and medium SES groups were less likely to be satisfied with their current medications (OR_lowSES 0.45, 95%CI 0.29-0.71; OR_mediumSES 0.63, 95%CI 0.44-0.92), less likely to report good health (OR_lowSES 0.22, 95%CI 0.14-0.34; OR_mediumSES 0.49, 95%CI 0.37-0.65), and had lower health literacy (OR_lowSES 0.10, 95%CI 0.07-0.16; OR_mediumSES 0.31, 95%CI 0.24- 0.41).</p><p><strong>Conclusion: </strong>Older adults with lower SES expressed greater interest in deprescribing, lower satisfaction with medications, lower self-rated health, and lower health literacy. Our findings suggest key aspects to consider when optimising care of older adults with low SES.</p>","PeriodicalId":48578,"journal":{"name":"Archives of Public Health","volume":"83 1","pages":"237"},"PeriodicalIF":3.2,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12502375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240195","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":"Association between living environmental quality and body pain in middle-aged and older adults: a national study in China.","authors":"Shuanglong Hou, Xin Zhao, Rui Liu","doi":"10.1186/s13690-025-01732-y","DOIUrl":"10.1186/s13690-025-01732-y","url":null,"abstract":"<p><strong>Background: </strong>Body pain affecting over 30% of China's aging population, imposes significant socioeconomic burdens, yet environmental determinants remain understudied. This national study investigates associations between multidimensional living environments and pain among middle-aged and older adults.</p><p><strong>Methods: </strong>Using 2011-2020 data from the China Health and Retirement Longitudinal Study (CHARLS), eligible participants were included in cross-sectional and longitudinal analyses. Living environmental quality was assessed via five indicators: building types, household temperatures, water sources, energy sources, and outdoor PM2.5 exposure, categorized into favorable, moderate, and unfavorable. Pain outcomes included upper limb, lower limb, trunk, head and neck, and multisite pain. Logistic and Cox regression models were utilized to examine associations between living environment quality and body pain.</p><p><strong>Results: </strong>Cross-sectionally, unfavorable environments were linked to higher prevalence of single-site (e.g., lower limb OR: 2.05, 95% CI: 1.78-2.37) and multisite pain (OR: 2.02, 95% CI: 1.77-2.32) versus suitable environments, with significant dose-response relationships (all P-values for trend < 0.001). In longitudinal analyses, unfavorable environments increased 9-year incident pain risks: upper limb (HR: 1.30, 95% CI: 1.20-1.41), lower limb (HR: 1.39, 95% CI: 1.28-1.50), trunk (HR: 1.18, 95% CI: 1.09-1.28), head and neck (HR: 1.20, 95% CI: 1.10-1.31), and multisite pain (HR: 1.31, 95% CI: 1.21-1.42), with consistent dose-response patterns (all P-values for trend < 0.001). Kaplan-Meier curves demonstrated a significant difference in pain incidence across different living environment groups within the entire cohort (all P-values for log-rank test < 0.001).</p><p><strong>Conclusions: </strong>Cumulative environmental exposures independently predict pain incidence among middle-aged and older adults in China. Targeted upgrades to the living environment could reduce pain burdens, informing healthy aging policies in China and similar settings.</p>","PeriodicalId":48578,"journal":{"name":"Archives of Public Health","volume":"83 1","pages":"236"},"PeriodicalIF":3.2,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12495682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226065","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":"Implementing PTSD interventions for hospital nurses and physicians during COVID-19: A scoping review.","authors":"Deliah Katzmarzyk, Daniela Holle, Martina Roes","doi":"10.1186/s13690-025-01706-0","DOIUrl":"10.1186/s13690-025-01706-0","url":null,"abstract":"<p><strong>Background: </strong>Nurses and physicians in hospitals are particularly affected by the impacts of the COVID-19 pandemic as shown in the high prevalence of post-traumatic stress disorder (PTSD). To handle the urgent and high demand for psychological support, PTSD-related interventions had to be applied rapidly. Thus, interventions that were already evidence-based were adapted to pandemic conditions, or new interventions were developed. To implement these interventions sustainably, and be prepared for future disease outbreaks, we need to identify which strategies are necessary for the successful implementation. From this perspective, four years after the COVID-19 outbreak, we address the following: What are the [1] interventions that address symptoms of post-traumatic stress disorder in hospital-based nurses and physicians during the COVID-19 pandemic? What are the [2] implementation strategies for the identified interventions?</p><p><strong>Methods: </strong>We used a scoping review approach and conducted a literature search from February to April 2023 in PubMed, PsychINFO and CINHAL. Primary studies (protocols) and concept papers focused on PTSD-related interventions for nurses and physicians and their implementation in hospitals during the COVID-19 pandemic, and published between 2020 and 2023 were included. Data extraction and analysis were performed in MaxQDA using deductive content analysis based on the (a) template for intervention description and replication (TIDieR) and the (b) Expert recommendations for implementing change (ERIC) framework.</p><p><strong>Results: </strong>A total of 16 interventions were adapted or developed world wide during the COVID-19 pandemic between 2020 and 2023. Evidence of effectiveness exist in only six of the 16 interventions. Most of them were designed using digital approaches and were primarly delivered through iterative implementation cycles, whereas the implementation of face-to-face interventions focused on interactions with various stakeholders.</p><p><strong>Conclusion: </strong>Our findings can be used to support the implementation of PTSD-related interventions for nurses and physicians in hospitals under pandemic conditions. Future research should focus on evaluating the effectiveness of these interventions and identifying strategies for a beneficial and sustainable implementation.</p>","PeriodicalId":48578,"journal":{"name":"Archives of Public Health","volume":"83 1","pages":"235"},"PeriodicalIF":3.2,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12492515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213981","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":"Access to emergency medical services and associated barriers among war-affected patients evacuated from Gaza: a cross-sectional study.","authors":"Melih Çamcı, Sueda Zaman, Nourhan Hassanien, Muhammed Fatih Baran","doi":"10.1186/s13690-025-01734-w","DOIUrl":"10.1186/s13690-025-01734-w","url":null,"abstract":"<p><strong>Background: </strong>This study aims to evaluate civilians' experiences in accessing emergency medical services (EMS) within the ongoing conflict in Gaza and to identify the structural, systemic, and human rights-related barriers encountered throughout this process. The literature provides extremely limited quantitative field data focusing on the emergency healthcare experiences of war-affected individuals medically evacuated from regions under siege to other countries. In this respect, the study seeks to contribute to the understanding of possible impairments to the right to health, based on patient experinces during an ongoing conflict situation, while also analyzing measurable access-related factors such as comorbidities, evacuation timelines, and infrastructure adequacy.</p><p><strong>Methods: </strong>This cross-sectional study included 81 patients medically evacuated from Gaza to Türkiye for treatment due to the escalation of violence following the events of October 7, 2023. Ethical approval was pre-obtained, and written informed consents were secured from all participants. Structured questionnaires were administered, collecting sociodemographic data, medical history, barriers to access, and responses concerning human rights. Descriptive analyses, Chi-square tests, and Spearman correlation analyses were employed for statistical evaluation.</p><p><strong>Results: </strong>The study included 81 participants, predominantly female (60.5%), with a median age of 26 years. The most frequent conditions were malignancies (35.4%) and extremity trauma (34.1%). A total of 74% reported that healthcare facilities were damaged during the conflict, and 87.6% cited severe equipment shortages in emergency departments. Ambulance services never arrived for 34.5%, and 33.3% could not reach hospital EDs. Patients with comorbidities experienced significantly longer wait times for both ambulance arrival (p = 0.013) and ED access (p = 0.001). Those waiting over 30 min for ambulances had longer ED treatment durations (p = 0.036), whereas delays in reaching the ED were paradoxically associated with shorter in-department stays (p = 0.026).</p><p><strong>Conclusion: </strong>This study identifies measurable weaknesses in Gaza's emergency healthcare system, including ambulance inaccessibility, delays in reaching emergency departments, and widespread shortages of equipment and personnel. These findings, derived from patient-reported data, reflect systemic barriers to effective emergency care. By identifying specific gaps in infrastructure, care delivery, and coordination, the study offers evidence-based insights to inform targeted humanitarian interventions in conflict settings.</p>","PeriodicalId":48578,"journal":{"name":"Archives of Public Health","volume":"83 1","pages":"234"},"PeriodicalIF":3.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207980","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":"Depression and its relationship to physical activity, sedentary behaviour, and body mass index (BMI) in Malaysian adolescents: a cross-sectional study.","authors":"Norhafizah Sahril, Norliza Shamsuddin, Wan Sarifah Ainin Wan Jusoh, Norlaila Hamid, Ahmad Ali Zainuddin, Noor Ani Ahmad","doi":"10.1186/s13690-025-01729-7","DOIUrl":"10.1186/s13690-025-01729-7","url":null,"abstract":"<p><strong>Introduction: </strong>Adolescence signifies a crucial developmental period characterized by heightened susceptibility to prevalent health issues, including obesity and mental health disorders. This research aims to examine the association between Body Mass Index (BMI), physical activity, sedentary behaviour, and depression among adolescents.</p><p><strong>Methods: </strong>Data from the 2022 National Health and Morbidity Survey (NHMS): Adolescent Health Survey was analysed using a nationwide cross-sectional approach with a two-stage stratified random sampling method. The survey included a representative sample of secondary school students. Depression levels were evaluated using the Patient Health Questionnaire (PHQ-9), with a score of 10 or above indicating depression. Body Mass Index (BMI) was assessed using anthropometric measurement (weight and height) and interpreted using WHO 2007 Growth Reference Data for 5-19 years. A total of 33,523 school-attending adolescents participated in the survey, yielding a response rate of 89.4%. For the purpose of this study, however, analysis was limited to data from 33,407 respondents who fully completed all PHQ-9 questions. Descriptive and complex sample logistic regression analyses were performed using SPSS version 26.0.</p><p><strong>Results: </strong>The prevalence of depression among Malaysian adolescents was 26.9%. Multiple logistic regression analysis indicated that female adolescents (AOR: 2.66, 95% CI: 2.46, 2.87) and those in higher age exhibited a higher likelihood of experiencing depression. Conversely, Chinese (AOR: 0.58, 95% CI: 0.48, 0.69) and Indian adolescents (AOR: 0.67, 95% CI: 0.54, 0.82) were less likely to experience depression. Depression was associated with increased sedentary behaviour (AOR: 2.01, 95% CI: 1.85, 2.18) and obesity (AOR: 1.12, 95% CI: 1.01, 1.23).</p><p><strong>Conclusion: </strong>The findings indicate that one in four Malaysian adolescent experiences depression, with significant risk factors including gender, age, high levels of sedentary behavior, and obesity. These findings emphasize the importance of public health strategies that address these critical factors and depression by encouraging active lifestyles, reducing obesity, and incorporating mental health interventions.</p>","PeriodicalId":48578,"journal":{"name":"Archives of Public Health","volume":"83 1","pages":"233"},"PeriodicalIF":3.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208017","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":"Forecasting impact of demographic changes on the expenditures of healthcare and social security in Italy from 2022 to 2060.","authors":"Francesco Conrado, Gianmarco Giacomini, Pietro Marraffa, Federica Golzio, Valeria Tagliabò, Maria Michela Gianino","doi":"10.1186/s13690-025-01719-9","DOIUrl":"10.1186/s13690-025-01719-9","url":null,"abstract":"<p><strong>Background: </strong>Europe's demographic transition has led to an ageing population, posing challenges for healthcare and pension systems. This study aims to forecast healthcare and social security expenditure in Italy over the next four decades, starting from the different population projection scenarios, and to forecast its incidence on the Gross Domestic Product (GDP) in the context of significant demographic changes.</p><p><strong>Methods: </strong>This study utilized annual data from 1988 to 2022. The dataset included the following key variables: GDP per capita, Healthcare Expenditures per capita, Social Security Expenses per capita, Ratio of Social Security Expenses and Healthcare Expenditures to GDP, and Italian Population Demographics. A Bayesian Vector Autoregressive model was employed to analyze the development of these variables in future years; forecasts extended to 2060 under six demographic scenarios provided by Eurostat: Baseline, Low Mortality Rate, Low Fertility Rate, High Migration, Low Migration, and No Migration.</p><p><strong>Results: </strong>All scenarios showed increases in per capita healthcare and social security expenditures over time. The No Migration scenario exhibited the fastest growth in both expenditures, especially after 2050. The High Migration scenario showed the slowest growth. Other scenarios showed intermediate growth. Per capita healthcare expenditure grew by drawing a convex line, while the per capita social expenditure grew faster, following a concave trajectory.</p><p><strong>Conclusions: </strong>Due to demographic changes, social and healthcare expenditure is set to increase. Results suggest that strong and timely measures should be taken to limit the demographic imbalances affecting healthcare and social expenditures.</p>","PeriodicalId":48578,"journal":{"name":"Archives of Public Health","volume":"83 1","pages":"229"},"PeriodicalIF":3.2,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201819","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}