Public Health最新文献

{"title":"Seroprevalence of dengue virus infection in people residing in Vietnam: A systematic review and meta-analysis.","authors":"Anh Tuan Le, Huy Trang Pham, Kim-Duy Vu, Cao Minh Khuy, Tran Hoang My Lien, Pham Thi Thanh Duyen, Hong H T C Le, Trinh Manh Hung, Dung Phung, Vu Sinh Nam","doi":"10.1016/j.puhe.2026.106300","DOIUrl":"https://doi.org/10.1016/j.puhe.2026.106300","url":null,"abstract":"<p><strong>Objectives: </strong>To estimate the seroprevalence of anti-DENV antibodies in Vietnam, examining regional variability, demographic differences, and serotype distribution.</p><p><strong>Study design: </strong>Systematic review and meta-analysis.</p><p><strong>Methods: </strong>We systematically searched PubMed, Embase, and Web of Science databases for studies published from January 2000 to June 2024. Eligible studies included observational studies reporting laboratory-confirmed dengue infections via serological assays (IgG, IgM) or molecular methods (RT-PCR). We utilized random-effects models to estimate pooled seroprevalence and assessed heterogeneity through the Inconsistency Index (I²). Publication bias was evaluated using funnel plots and Egger's test.</p><p><strong>Results: </strong>Thirty-four studies involving 28,477 individuals were included. The overall pooled seroprevalence of dengue in Vietnam was 40.98% (95% CI: 30.52-51.43%), with substantial heterogeneity across study populations, geographic regions, and diagnostic methods, demonstrating regional variability ranging from 3.05% to 88.8%. This wide range likely reflects differences in study settings, including community-based populations, outbreak investigations, and clinically selected groups. Seroprevalence was higher among children aged 0-16 years (45.52%, 95% CI: 22.32-68.72%), which may partly reflect studies conducted in high-transmission or outbreak settings. Studies conducted among clinically suspected dengue cases showed seroprevalence of 30.57% (95% CI: 18.00-43.15%), although these estimates may be influenced by selection bias because participants were recruited based on clinical suspicion rather than from the general population. Secondary dengue infections were prevalent, ranging broadly between 26 and 75%. DENV-1 and DENV-2 serotypes were dominant, with DENV-2 becoming more frequent since 2021.</p><p><strong>Conclusions: </strong>This study underscores dengue's endemic nature in Vietnam, highlighting significant heterogeneity in seroprevalence related to geographical and demographic factors. The high prevalence of secondary infections and the predominance of DENV-1 and DENV-2 serotypes emphasize the need for targeted public health strategies, enhanced surveillance, and optimized vaccination programs tailored to regional and age-specific risk profiles.</p>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"256 ","pages":"106300"},"PeriodicalIF":3.2,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857581","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":"Peer victimization as a potential gendered mediator between BMI and depression in adolescents from Jiangsu province, China.","authors":"Linkai Mei, Bin Chen, Jiaqi Xu, Xinyi Cao, Xiyan Zhang, Hui Huang, Zaixiang Tang","doi":"10.1016/j.puhe.2026.106302","DOIUrl":"https://doi.org/10.1016/j.puhe.2026.106302","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to examine whether peer victimization and behavioral factors serve as potential mediators in the association between body mass index (BMI) and depressive symptoms among adolescents in Jiangsu Province, China, with a specific focus on gender-specific and non-linear interactions.</p><p><strong>Study design: </strong>A cross-sectional survey.</p><p><strong>Methods: </strong>Participants were 5187 adolescents (median age = 14.43) from Jiangsu Province, China. BMI was classified per Chinese national standards. Depressive symptoms were assessed using the CES-D-20, and peer victimization was processed using a non-linear weighting scheme (0-1-5) and Principal Component Analysis (PCA) to capture severity. Structural equation modeling (SEM) was employed to evaluate potential mediation pathways, while Response Surface Analysis (RSA) was utilized to decode complex non-linear interactions between BMI and victimization intensity.</p><p><strong>Results: </strong>In the overall sample, peer victimization was a significant potential mediator, accounting for 57.9% of the total association between BMI and depression, primarily through emotional neglect (81.7%) and verbal victimization (53.2%). A stark gender disparity was identified: the potential indirect pathway was strong and consistent in females (accounting for 89.4% of the association) but was absent in males. RSA further revealed distinct risk trajectories: males showed a significant positive curvature for emotional neglect (a₂ = 0.192, P = 0.029), explaining the lack of linear mediation in the male subgroup.</p><p><strong>Conclusions: </strong>Peer victimization, particularly emotional neglect and verbal victimization, is a pivotal potential gendered mediator linking BMI to depression among adolescents in this region. The mental health burden of obesity is shaped by distinctly gendered social experiences and non-linear risk trajectories.</p>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"256 ","pages":"106302"},"PeriodicalIF":3.2,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845164","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 effect of physical activity on postpartum depression: A systematic review and meta-analysis.","authors":"Sumaiya Akter","doi":"10.1016/j.puhe.2026.106296","DOIUrl":"https://doi.org/10.1016/j.puhe.2026.106296","url":null,"abstract":"<p><strong>Objectives: </strong>To examine the relationship between physical activity (PA) and postpartum depression (PPD) among pregnant and postpartum women, and to identify characteristics of PA interventions associated with reductions in depressive symptoms.</p><p><strong>Study design: </strong>Systematic review and meta-analysis.</p><p><strong>Methods: </strong>Following PRISMA guidelines, databases were searched in PubMed, MEDLINE, and Wiley Online Library (2012-2023; updated to October 2024). Randomised controlled trials (RCTs) and prospective cohort studies assessing PA and PPD among women aged 19-44 were included. Depression outcomes were measured using validated tools such as the Edinburgh Postnatal Depression Scale (EPDS) and CES-D. A random-effects meta-analysis synthesised RCT findings, while cohort data and heterogeneous PA characteristics were narratively synthesised.</p><p><strong>Results: </strong>Ten studies met inclusion criteria (seven RCTs; three cohort studies). Five studies reported significant reductions in PPD symptoms following PA, while five reported no significant association. Meta-analysis of seven RCTs showed no significant pooled effect (SMD -0.066; 95% CI -0.388 to 0.256, p = 0.689). Interventions varied in frequency, intensity, duration, type, and delivery format. Structured group-based activities, including aerobic sessions, aquatic exercise, and group gymnastics, showed more consistent improvements. Cohort data suggested that moderate-vigorous PA exceeding ∼90 min per week may be protective.</p><p><strong>Conclusions: </strong>Evidence for the effectiveness of PA in reducing PPD remains mixed. Variation in intervention design, PA dose, adherence, and contextual factors contributed to inconsistent findings. However, structured or group-based PA that supports social engagement and routine adherence may be beneficial. Future research should specify PA dose using frequency, intensity, time, and type, monitor intervention fidelity, and consider psychosocial contributors when evaluating PA and PPD.</p>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"256 ","pages":"106296"},"PeriodicalIF":3.2,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845172","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":"Midlife migration, employment status, and mental health: A Swedish register-based study.","authors":"Deirdre Mullally, Lisa Berg, Mikael Rostila, Andrea Dunlavy","doi":"10.1016/j.puhe.2026.106328","DOIUrl":"https://doi.org/10.1016/j.puhe.2026.106328","url":null,"abstract":"<p><strong>Objectives: </strong>Employment status is a key health determinant that impacts mental health through multiple mechanisms. Individuals who migrate in midlife may face particular labor market integration challenges, yet research on the mental health impacts of unemployment among midlife migrants, and how this varies by origin and gender, remains limited. This study investigates associations between employment status and psychiatric disorders among individuals who migrated after age 40, compared with Swedish-born individuals.</p><p><strong>Study design: </strong>Using Swedish administrative register data from 1997 to 2016, a retrospective cohort study was conducted among individuals who migrated after age 40 (n = 21,154) and an age-matched Swedish-born cohort (n = 1,403,098).</p><p><strong>Methods: </strong>Gender-stratified Cox proportional hazard models estimated hazard ratios (HR) for outpatient and inpatient psychiatric care. Employed, Swedish-born individuals served as the primary reference group.</p><p><strong>Results: </strong>Unemployment was associated with increased risks of psychiatric care across all origin groups (HRs from 1.35 to 3.74). For most migrant groups, risks were comparable to those of the unemployed Swedish-born. Nonetheless, indications of mental health inequalities between unemployed migrants and Swedish-born individuals were evident, most notably by the greater magnitudes of increased risk observed among European women and Nordic men.</p><p><strong>Conclusions: </strong>Among midlife migrants, unemployment was consistently associated with poorer mental health, yet its contribution to migrant-native mental health inequalities was only seen in specific groups. Findings highlight the importance of examining how migration background, together with gender and other social factors, shapes health risks, and promoting the socio-economic integration of midlife migrants to support health in later life.</p>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"256 ","pages":"106328"},"PeriodicalIF":3.2,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822841","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":"Identification of challenges to implementation of infection control guidance in primary care during COVID-19 incidents: Lessons for pandemic planning.","authors":"Lorna J Duncan, Jade Meadows, Jonathan Roberts","doi":"10.1016/j.puhe.2026.106293","DOIUrl":"https://doi.org/10.1016/j.puhe.2026.106293","url":null,"abstract":"<p><strong>Objectives: </strong>Despite service delivery modifications to minimise transmission in primary care during the pandemic, 609 COVID-19 incidents linked to English general practice (GP) were mandatorily reported to the United Kingdom Health Security Agency (UKHSA) between March 2020 and April 2022. This study aimed to identify themes in case management records of GP-linked COVID-19 incidents to inform future infection prevention and control (IPC).</p><p><strong>Study design: </strong>Thematic analysis was undertaken of all GP-linked COVID-19 incidents reported to UKHSA in South West England.</p><p><strong>Methods: </strong>Records were included where at least one confirmed COVID-19 case was linked to a GP setting. Analysis of outbreaks/clusters (at least two cases, with/without an epidemiological link respectively) and single case exposures was undertaken. Cases, contacts and potential transmission routes were evaluated in outbreaks; impacts to health/service provision were analysed for all incidents.</p><p><strong>Results: </strong>42 outbreaks, 10 clusters and 10 single case exposures were included for analysis. Staff comprised 95% of 210 outbreak cases, with six family member cases and one patient case. At least one IPC breach was identified in over 70% of outbreaks, commonly involving inadequate social distancing/personal protective equipment use, or multi-site/symptomatic working. Some breaches indicated guidance impracticability. No deaths, but two hospitalisations, occurred and a single case could necessitate site closure.</p><p><strong>Conclusions: </strong>COVID-19 cases in GP-linked outbreaks in South West England were predominantly identified in staff, impacting service delivery. Some IPC breaches involved implementation challenges. Mitigations span premises/IT adaptations, contingency planning and tailored guidance. This emphasizes the need for specific primary care representation in pandemic planning.</p>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"256 ","pages":"106293"},"PeriodicalIF":3.2,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700294","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":"Global policy review to identify links between climate change and antimicrobial resistance","authors":"Alexander J. Thornton ,&nbsp;Kerry Badger ,&nbsp;Rufus F.S. Robinson ,&nbsp;Kelly Moon ,&nbsp;Bianca Van Bavel ,&nbsp;Jennifer Israelsson ,&nbsp;Aideen Carroll ,&nbsp;Rhiannon Cordiner ,&nbsp;Colin Brown ,&nbsp;Prof Lea Berrang-Ford ,&nbsp;Prof Rebecca King","doi":"10.1016/j.puhe.2026.106159","DOIUrl":"10.1016/j.puhe.2026.106159","url":null,"abstract":"<div><h3>Objectives</h3><div>To identify explicit reference to the interdependence between antimicrobial resistance (AMR) and climate change (CC) within global policy for AMR and CC.</div></div><div><h3>Study design</h3><div>This review uses the principles of systematic searching, qualitative evidence synthesis and framework analysis.</div></div><div><h3>Methods</h3><div>Two searches were conducted: (1) explicit AMR policy searching was conducted via searching country AMR National Action Plans (NAPs) on the World Health Organisation Website; and (2) CC policy searching was conducted by reviewing United Nations Framework Convention on Climate Change (UNFCCC) National Communication (NC) documents. Search and coding processes were conducted independently by two sets of researchers and discussions were held to resolve any discrepancies between findings.</div></div><div><h3>Results</h3><div>155 NCs and 81 NAPs were included in the review. 10 (12 %) NAPs and 19 (12 %) NCs demonstrated reference to a relationship between CC and AMR. In most cases, these were limited to a single mention. The most common connection made was to “shared solutions” to the issues and to “CC driving AMR”. The depth of the interconnection described is largely commentarial, lacking sufficient detail of modalities of interaction.</div></div><div><h3>Conclusions</h3><div>Most CC and AMR global policy documents do not reference interdependence between CC and AMR. Where references occur, these are simplistic and do not detail pathways of interactions. Most references are within descriptive text and lack targeted action. This review highlights inadequate focus within policy on this important intersection. This review should inform future global policy development that focuses on integrated approaches to CC and AMR across the One Health system.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"253 ","pages":"Article 106159"},"PeriodicalIF":3.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146175285","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 associations of maternal exposure to PM1 during pregnancy with emotional and behavioral problems in offspring: The interaction effect of maternal diet","authors":"Mengfan Li ,&nbsp;Guoyu Zhang ,&nbsp;Xuanqing He ,&nbsp;Xiaonan Gu ,&nbsp;Weiyin Zhuang ,&nbsp;Chang Wang ,&nbsp;Yu Liu ,&nbsp;Shun Liu ,&nbsp;Xin Wang ,&nbsp;Zhen Wang ,&nbsp;Li Cai","doi":"10.1016/j.puhe.2026.106195","DOIUrl":"10.1016/j.puhe.2026.106195","url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to examine the association between PM₁ exposure during different stages of pregnancy and emotional and behavioral problems in offspring, and to evaluate whether maternal diet quality interacts with these relationships.</div></div><div><h3>Study design</h3><div>Birth cohort study.</div></div><div><h3>Methods</h3><div>This cohort study included 391 mother-child pairs from Guangzhou, China. Prenatal PM₁ exposure was estimated using a spatiotemporal model. Maternal diet was assessed via a validated food frequency questionnaire and scored using the Chinese Healthy Eating Index (CHEI). At age 5, offspring's emotional and behavioral problems were evaluated with the Strengths and Difficulties Questionnaire, including emotional, conduct, hyperactivity, peer relationship problems, prosocial behavior, and total difficulties. Generalized linear models were used to examine the association.</div></div><div><h3>Results</h3><div>Overall, 15.9% of children exhibited at least one type of emotional and behavioral problem. The mean maternal PM₁ was 17.51 ± 2.38 μg/m³. Each interquartile range (IQR) increase in PM₁ concentration during the first trimester was associated with elevated risk of offspring behavioral problems (<em>OR</em> = 2.25; 95% <em>CI</em>: 1.06∼4.89). Increased PM₁ exposure during both the first (<em>OR</em> = 2.90; 1.07∼8.21) and second trimesters (<em>OR</em> = 4.50; 1.23∼16.76) was linked to higher odds of total difficulties. Higher maternal CHEI scores, particularly the total score and dark vegetable intake component, were associated with weaker PM₁-related associations.</div></div><div><h3>Conclusion</h3><div>Maternal exposure to PM₁ during pregnancy, especially during the first and second trimesters, was associated with an increased risk of emotional and behavioral problems in offspring. A high-quality maternal diet, particularly one rich in vegetables, may mitigate these adverse effects.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"253 ","pages":"Article 106195"},"PeriodicalIF":3.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146175279","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":"Household economic security and medical debt onset: Lessons from the COVID-19 pandemic","authors":"Irina B. Grafova,&nbsp;Sharifa Z. Williams","doi":"10.1016/j.puhe.2026.106173","DOIUrl":"10.1016/j.puhe.2026.106173","url":null,"abstract":"<div><h3>Objectives</h3><div>To examine how household medical debt responds to changes in income and new health events.</div></div><div><h3>Study design</h3><div>Secondary analysis of a panel survey.</div></div><div><h3>Methods</h3><div>We analyzed data from 6,599 households in the 2019–2021 waves of the nationally representative US Panel Study of Income Dynamics (PSID) with no medical debt in 2019. We focus on the onset of unpaid medical bills, classifying debt ≥20 % of annual income as high burden and &lt;20 % as low or medium. Using logistic regression, we estimate the impact of changes in household income and onset of chronic conditions on acquiring medical debt.</div></div><div><h3>Results</h3><div>In our analytic sample, 4.4 % of households experienced the onset of low or medium medical debt, and 1.2 % experienced the onset of high medical debt between the 2019 and 2020 waves of the PSID. Pandemic-related earnings loss increased high medical debt onset by 1.1 percentage points (95 % confidence intervals [95 % CI: 0.2 to 1.9]). The onset of low or medium medical debt rose by 3.4 percentage points (95 % CI: 0.4 to 6.4) among households in which the head or spouse received a new diabetes diagnosis, and by 3.5 percentage points (95 % CI: 1.4 to 5.6) among households with a new arthritis diagnosis. High medical debt onset increased by 1.8 percentage points (95 % CI: 0.2 to 3.3) in households with a new cancer diagnosis.</div></div><div><h3>Conclusions</h3><div>Unexpected earnings losses and new diagnoses of cancer, diabetes, and arthritis significantly increase the risk of medical debt onset.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"253 ","pages":"Article 106173"},"PeriodicalIF":3.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146138115","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":"Priority setting for oncology in South Africa using a burden of disease approach","authors":"Ritika Tiwari ,&nbsp;Usuf Chikte ,&nbsp;Vikash Sewram","doi":"10.1016/j.puhe.2026.106184","DOIUrl":"10.1016/j.puhe.2026.106184","url":null,"abstract":"<div><h3>Objectives</h3><div>To forecast the provincial supply of oncologists in South Africa through 2030 using a health need–based approach grounded in disability-adjusted life years (DALYs), and to identify shortfalls under scenarios aimed at reducing human resources for health (HRH) inequities as highlighted in Disease Control Priorities, Volume 3 (DCP-3).</div></div><div><h3>Study design</h3><div>A retrospective forecasting study employing DALY-driven demand projections for oncology services in each of South Africa's nine provinces, with scenario analyses evaluating horizontal equity in HRH distribution.</div></div><div><h3>Methods</h3><div>Age-standardized provincial DALYs for cancer were obtained from the Institute for Health Metrics and Evaluation Global Burden of Disease (IHME GBD) estimates via the Global Health Data Exchange (GHDx). Mid-year population estimates for 2018 were sourced from Statistics South Africa. Using these metrics, we calculated DALY load per oncologist and projected oncologist requirements for 2020, 2025, and 2030.</div></div><div><h3>Results</h3><div>Under the best guess scenario, South Africa faces a shortfall of 47 oncologists in 2020, increasing to 97 by 2025 and 148 by 2030. The optimistic scenario yields national deficits of 77 (2020), 126 (2025), and 175 (2030). In the aspirational scenario, shortfalls climb to 138 (2020), 184 (2025), and 230 (2030).</div></div><div><h3>Conclusions</h3><div>The Workforce Projection Model offers a replicable framework for low- and middle-income countries to assess oncology workforce needs, optimize HRH allocation, and plan capacity development to enhance equitable access to cancer care.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"253 ","pages":"Article 106184"},"PeriodicalIF":3.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146175280","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":"Association between behavioral-environmental risk patterns and multimorbidity of chronic non-communicable diseases among Chinese adolescents at schools","authors":"Zhiyun Hu ,&nbsp;Xiaodong Sun ,&nbsp;Chunyan Luo ,&nbsp;Wei Du ,&nbsp;Dongling Yang ,&nbsp;Hui Xue ,&nbsp;Fengyun Zhang ,&nbsp;Lijun Fan","doi":"10.1016/j.puhe.2026.106193","DOIUrl":"10.1016/j.puhe.2026.106193","url":null,"abstract":"<div><h3>Objectives</h3><div>Multimorbidity, though traditionally discussed in older populations, is increasingly prevalent among adolescents. However, evidence on how co-occurring behavioral and environmental risks contribute to adolescent multimorbidity remains limited. This study aimed to identify distinct patterns of behavioral-environmental risks among Chinese adolescents and to examine how these patterns are associated with multimorbidity of chronic non-communicable diseases.</div></div><div><h3>Study design</h3><div>This was a cross-sectional study, utilizing data from 15,082 participants enrolled in the 2022 Shanghai “Surveillance for Common Diseases and Health Risk Factors among Students” project.</div></div><div><h3>Methods</h3><div>Participants were selected using a cluster random sampling method. Adolescent multimorbidity was defined as the coexistence of six chronic non-communicable diseases (high blood pressure, high myopia, dental caries, abnormal spinal curvature, obesity, and depressive symptoms). Behavioral-environmental risk dimensions covered individual lifestyle behaviors (i.e., imbalanced diet, unhealthy food, smoking or drinking, excessive screen time, insufficient sleep, and physical inactivity), school-related environmental risks (untimely seat or desk adjustment, low frequency of eye exercises or physical education classes), and family environmental factors (non-nuclear family, low parental education, disadvantaged family economy, and household secondhand smoke exposure). Latent class analysis identified distinct risk patterns, and logistic regression models explored their associations with multimorbidity.</div></div><div><h3>Results</h3><div>The mean age of participants was 14.94 (SD = 1.75), and 47.6% were girls. Three behavioral-environmental patterns emerged: “high behavioral and family-environmental risks (Class 1, 40.9%)”, “high behavioral and school-environmental risks (Class 2, 22.3%)”, and “relatively low behavioral-environmental risks (Class 3, 36.8%)”. Compared with Class 3, adolescents in Class 1 (OR = 1.21–1.27, all <em>p</em> &lt; 0.001) or Class 2 (OR = 1.20–1.28, all <em>p</em> &lt; 0.001) had significantly higher odds of multimorbidity across all adjusted models.</div></div><div><h3>Conclusions</h3><div>School-aged adolescents exhibit distinct behavioral-environmental risk patterns, with differing associations with multimorbidity. Findings underscore the need for integrated health promotion strategies addressing individual behaviors and broader environmental influences to reduce multimorbidity among the youth.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"253 ","pages":"Article 106193"},"PeriodicalIF":3.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146174775","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}