Public Health最新文献

{"title":"Understanding hazardous drinking: The role of anxiety sensitivity and mediating drinking motives","authors":"Maragda Puigcerver ,&nbsp;Lucía Hipólito ,&nbsp;Miguel-Ángel Serrano","doi":"10.1016/j.puhe.2025.106104","DOIUrl":"10.1016/j.puhe.2025.106104","url":null,"abstract":"<div><h3>Objectives</h3><div>Anxiety sensitivity (AS)—the tendency to fear anxiety-related sensations—has been consistently associated with risky drinking, yet the motivational mechanisms underlying this link remain unclear. This study examined whether specific drinking motives (DMs) mediate the association between AS and hazardous drinking, and explored the moderating effects of age and gender.</div></div><div><h3>Study design</h3><div>A cross-sectional, survey-based design was used.</div></div><div><h3>Methods</h3><div>Data were collected through an anonymous online questionnaire completed by 372 adults (69 % women; mean age = 25.3 years), including the Alcohol Use Disorders Identification Test (AUDIT), the Anxiety Sensitivity Index-3 (ASI-3), and four single-item DMs assessing social, avoidance, pleasure, and need-related motives. Analyses were restricted to participants with AUDIT &gt;0. Correlation and regression analyses examined associations among AS, age, gender, and alcohol use. Structural equation modelling (SEM) tested AS as a latent construct (ASI-3 subscales as indicators) and the four DMs as parallel mediators of the AS–AUDIT relationship.</div></div><div><h3>Results</h3><div>Higher AS was associated with greater alcohol use, even after controlling for age and gender. SEM confirmed that AS formed a coherent latent factor and that motives operated in parallel. AS was positively linked to avoidance motives; however, this pathway did not mediate the AS–alcohol link. Only the social motive uniquely predicted higher AUDIT scores, while younger age—but not gender—was consistently associated with greater consumption.</div></div><div><h3>Conclusions</h3><div>Hazardous drinking was mainly explained by social motives and younger age. AS contributed indirectly through its influence on drinking motives rather than a direct effect.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"251 ","pages":"Article 106104"},"PeriodicalIF":3.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145791395","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":"Humiliation and sexual violence in medical students: Results from two nationwide studies","authors":"Agnès Trouche ,&nbsp;Nicolas Doudeau ,&nbsp;François Vilain ,&nbsp;Kahina Sadat ,&nbsp;Yannick Morvan ,&nbsp;Ariel Frajerman","doi":"10.1016/j.puhe.2025.106089","DOIUrl":"10.1016/j.puhe.2025.106089","url":null,"abstract":"<div><h3>Objectives</h3><div>Sexual and gender-based violence (SGBV) affects an important part of the population, and medical trainees are no exception. A 2014 meta-analysis on medical students found that 59 % experienced at least one form of harassment or discrimination during their studies. This study aimed to gather data on SGBV among French medical students in 2024 and to compare its evolution since 2021.</div></div><div><h3>Study design</h3><div>Two national online surveys on mental health in medical school students and residents of all specialities were conducted in 2021 and 2024.</div></div><div><h3>Methods</h3><div>In both surveys, the questionnaire included a section on humiliation and sexual violence, using 5 questions from a nationwide survey on Students in France.</div></div><div><h3>Results</h3><div>We included 17,225 subjects: 9960 in 2021 and 7265 in 2024. The prevalence of violence during the medical studies was 27 % and 17 % for humiliation, 29 % and 22 % for sexual harassment, and 5 % and 6 % for sexual assault in 2021 and 2024, respectively. Women were five times more likely to experience sexual harassment than men. Among the victims, 76 % reported experiencing violence in the hospital, 28 % at student parties, and 10 % at the university. Since 2021, there has been a 26 % increase in reported incidents of violence compared to the previous year (19 %).</div></div><div><h3>Conclusions</h3><div>Despite policies implemented following previous surveys, the rate of sexual harassment remains high. The majority of these violent occurrences in hospital settings highlighting the importance of taking specific actions tailored to the structure of medical studies and the healthcare and caregiving system.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"251 ","pages":"Article 106089"},"PeriodicalIF":3.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145738424","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 distribution of healthcare workforces relative to population ill health in England: Repeated cross-sectional analysis of Census data 2001–2021","authors":"A. Clarke ,&nbsp;L. Quinn ,&nbsp;G.M. Peat","doi":"10.1016/j.puhe.2025.106090","DOIUrl":"10.1016/j.puhe.2025.106090","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate inverse and positive care laws for the geographic distribution of different healthcare workforces in England between 2001 and 2021.</div></div><div><h3>Study design</h3><div>Repeated, cross-sectional, ecologic study at the level of Local Authorities (2001, 2011, 2021) and Integrated Care Boards (2021).</div></div><div><h3>Methods</h3><div>Using national Census survey data for England from 2001, 2011, and 2021 we correlated the prevalence of ill health in the resident population with the proportion of different health professional groups employed in the resident working-age population. To explore the previously described Positive Care Law for informal care, we correlated with the prevalence of ill health with the proportion of the resident population providing 50+ hours of unpaid care per week.</div></div><div><h3>Results</h3><div>Across 2001, 2011, and 2021, the distributions of medical professionals and ‘health associates and therapy professionals’ were consistently inversely distributed relative to population ill health. Nursing professionals and informal caregiving were consistently positively correlated. Data available in 2021 on detailed professional groups revealed wide variation in the distribution of different professional groups relative to population ill health: speech and language therapists (r=−0.456), complementary health associate professionals (r=−0.478), and psychotherapists/cognitive behaviour therapists (r=−0.558) showed the strongest inverse correlation with population ill health. Pharmaceutical technicians (0.774), nursing auxiliaries/assistants (0.764), and care workers/home carers (0.746) were among the most positively correlated.</div></div><div><h3>Conclusions</h3><div>Inverse and positive care laws for healthcare workforce distribution in England appear largely unchanged over the past 20 years. Marked variation between different health professions suggests the need for targeted actions to improve equitable distribution.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"251 ","pages":"Article 106090"},"PeriodicalIF":3.2,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145769716","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 of early-life tobacco smoke exposure with chronic gastrointestinal diseases in adulthood and trajectory of chronic gastrointestinal multi-morbidity: A large prospective cohort study","authors":"Haojie Lu ,&nbsp;Jia Zhang ,&nbsp;Zhen Wang ,&nbsp;Jingjing Ni ,&nbsp;Shuaishuai Yang ,&nbsp;Yuting Shi ,&nbsp;Weiyi Chen ,&nbsp;Sijia Zhu ,&nbsp;Zhihao Zhang ,&nbsp;Yuxin Ni ,&nbsp;Shaofa Nie ,&nbsp;Li Liu","doi":"10.1016/j.puhe.2025.106085","DOIUrl":"10.1016/j.puhe.2025.106085","url":null,"abstract":"<div><h3>Objectives</h3><div>Few prospective studies have investigated early-life tobacco smoke's effects on chronic gastrointestinal diseases (CGD) and multi-morbidity (CGM). We examined associations between early-life tobacco exposure and subsequent CGD or CGM development.</div></div><div><h3>Study design</h3><div>This was a prospective cohort study conducted among UK Biobank.</div></div><div><h3>Methods</h3><div>We assessed the association between tobacco exposure in early life and incident CGD using UK Biobank data. We employed Cox models to estimate the risk of CGD, examining the separate and combined impacts of tobacco exposures in early life and pack-years. Multi-state Cox models further analyzed the impact of tobacco smoke on CGM progression.</div></div><div><h3>Results</h3><div>Our analysis involved 294,344 UK Biobank participants, with 61,472 developing CGD over a median observation period of 13.02 years. Prenatal tobacco exposure increased CGD risk by 11 % (HR = 1.11, 95 % CI: 1.09–1.13). Earlier smoking initiation was associated with higher CGD risk: adjusted HRs were 1.09 for adulthood, 1.16 for adolescence, and 1.25 for childhood initiation compared to never smokers (<em>P</em> trend &lt;0.001). Childhood smoking initiation was linked to a 42 % increased risk of CGD in current smokers (HR = 1.42, 95 % CI: 1.31–1.53) and influenced transitions from incident CGD to CGM (HR = 1.30, 95 % CI: 1.12–1.51) and from healthy to CGM (HR = 1.83, 95 % CI: 1.58–2.13). Additionally, childhood smoking significantly raised mortality risk from all states: healthy (HR = 2.53, 95 % CI: 2.21–2.89), incident CGD (HR = 2.30, 95 % CI: 1.79–2.95), and CGM (HR = 1.67, 95 % CI: 1.13–2.46).</div></div><div><h3>Conclusions</h3><div>Exposure to tobacco in early life increases the risk of developing CGD and elevates incidence and progress of CGM.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"250 ","pages":"Article 106085"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145679337","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 implementing colon capsule endoscopy in colorectal cancer screening on participation and sociodemographic inequalities: A parallel group randomised controlled trial","authors":"Ulrik Deding ,&nbsp;Lasse Kaalby ,&nbsp;Benedicte Schelde-Olesen ,&nbsp;Henrik Bøggild ,&nbsp;Thomas Bjørsum-Meyer ,&nbsp;Anastasios Koulaouzidis ,&nbsp;Morten Kobaek-Larsen ,&nbsp;Marianne Kirstine Thygesen ,&nbsp;Jonna Skov Madsen ,&nbsp;Gunnar Baatrup ,&nbsp;on behalf of the CareForColon2015 study group","doi":"10.1016/j.puhe.2025.106056","DOIUrl":"10.1016/j.puhe.2025.106056","url":null,"abstract":"<div><h3>Objectives</h3><div>Significant sociodemographic inequalities in participation in colorectal cancer (CRC) screening programmes across the globe are evident. We aimed to investigate the effect of introducing colon capsule endoscopy (CCE) as a filter test in faecal immunochemical test (FIT)-based CRC screening on overall FIT participation and social inequalities in FIT participation.</div></div><div><h3>Study design</h3><div>We conducted a randomised controlled trial, randomising 368,452 individuals.</div></div><div><h3>Methods</h3><div>Both groups received an invitation to submit a FIT sample, which elicited a follow-up investigation if ≥ 20 μg haemoglobin/g faeces was detected. The control group followed the standard screening pathway and was referred for follow-up colonoscopy. The intervention group were free to choose between colonoscopy and colon capsule endoscopy.</div></div><div><h3>Results</h3><div>The overall FIT participation proportion was significantly lower in the intervention group (63.4 %), compared to the control group (64.9 %). All sociodemographic subgroups in the intervention group had lower participation proportions than their control group counterpart, with an average of 1.4 (range 0.3–2.7) percentage points lower participation. The odds of non-participation, divided by sociodemographic characteristics, were not significantly different between interventions and controls for any subgroup, except for those aged 55–59 in which the odds ratios for non-participation was 1.59 (1.54–1.65) in the control group and 1.48 (1.43–1.53) in the intervention group, comparing them to those aged above 70.</div></div><div><h3>Conclusions</h3><div>Introducing a free choice between colon capsule endoscopy and colonoscopy if FIT positive did not increase FIT participation in CRC screening. Further, it did not affect the pattern of social inequalities in FIT uptake.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"250 ","pages":"Article 106056"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145569986","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":"Preventable deaths related to haemorrhage in England and Wales, 2013–2022: A systematic case series of coroners’ reports","authors":"M. Hey ,&nbsp;H.S. France ,&nbsp;C. Portwood ,&nbsp;K. Song ,&nbsp;J. Jindal ,&nbsp;D. Launer ,&nbsp;G.C. Richards ,&nbsp;F. Dernie","doi":"10.1016/j.puhe.2025.106054","DOIUrl":"10.1016/j.puhe.2025.106054","url":null,"abstract":"<div><h3>Objectives</h3><div>To identify preventable haemorrhage-related deaths, classify coroner concerns and explore organisational responses.</div></div><div><h3>Study design</h3><div>Retrospective systematic case series of coroners’ Prevention of Future Deaths (PFD) reports from 1st July 2013 to 16 November 2022, in England and Wales.</div></div><div><h3>Methods</h3><div>Reports were acquired from the Courts and Tribunals Judiciary website and screened for haemorrhage-related deaths using a reproducible automated computer code. Demographic information, coroners’ concerns, and organisational responses to PFDs were extracted and analysed, including risk factors predisposing to haemorrhage.</div></div><div><h3>Results</h3><div>339 PFDs (8 % of all PFDs) involved a haemorrhage event contributing to death. The average age of death was 78 years, and 57 % were male. The majority of haemorrhages were intracranial (64 %). 31 % of haemorrhage-related PFDs reported the use of anticoagulation, most often warfarin. Coroners reported 942 concerns directly relevant to the haemorrhage event, including failures to follow protocols, guidelines, or risk assessments (17 %), failures in communication or handovers (14 %), and failures in providing appropriate care, including investigations and observations (13 %). Just under half (48 %) of PFDs did not have responses published on the Judiciary website. Of the organisations who responded, 85 % reported plans to initiate new changes to address these concerns. Improvements most frequently focused on improving protocols, pathways and guidance documents, as well as education and training.</div></div><div><h3>Conclusions</h3><div>Coroner PFDs offer unique insights into haemorrhage-related deaths, highlighting the systems and processes which fail in everyday practice. Improving awareness and dissemination of these reports to clinicians and policymakers nationally may improve patient safety and save lives.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"250 ","pages":"Article 106054"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145569987","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":"Effect of cold spells and heatwaves on daily new cases of COVID-19 in the Western Pacific Region: A time series analysis","authors":"Yizhang Xia ,&nbsp;Ahiafor Maxwell ,&nbsp;Yang Li ,&nbsp;Yu Chen ,&nbsp;Wei Huang ,&nbsp;Fanqi Meng ,&nbsp;Haili Ren ,&nbsp;Peijie Jiang ,&nbsp;Xi Chen ,&nbsp;Boda Zhou","doi":"10.1016/j.puhe.2025.106076","DOIUrl":"10.1016/j.puhe.2025.106076","url":null,"abstract":"<div><h3>Objectives</h3><div>The relationship between extreme temperature events and COVID-19 transmission remains a subject of ongoing debate, particularly in the Western Pacific Region (WPR).</div></div><div><h3>Study design</h3><div>An ecological study.</div></div><div><h3>Methods</h3><div>A comprehensive analysis of daily confirmed COVID-19 cases and meteorological data from 18 WPR countries, covering the period from January 1, 2020, to December 31, 2022, was conducted. We developed a Distributed Lag Nonlinear Model (DLNM) that incorporated variables such as climate zones, population density, human development index, and government response stringency.</div></div><div><h3>Results</h3><div>Our analysis of over 180.3 million confirmed cases revealed significant correlations between patterns of extreme temperature fluctuations and COVID-19 transmission in the WPR. Specifically, heatwaves (HWs) that exceeded the 95th percentile of daily mean temperature for more than four days were associated with a significant increase in COVID-19 transmission risk, with the highest susceptibility observed in the tropical zone (cumulative relative risk of 2.226). Similarly, cold spells (CSs) that fell below the 5th percentile for over three days also heightened the risk of COVID-19 transmission, particularly in temperate regions, with a cumulative RR of 4.148. Further analysis indicated that prolonged durations of HWs and CSs significantly amplify their respective impacts.</div></div><div><h3>Conclusions</h3><div>This study underscores the necessity of considering environmental factors in pandemic management and offers valuable insights for the development of targeted public health interventions and early warning systems tailored to specific climatic conditions.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"250 ","pages":"Article 106076"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145684708","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":"Mind the (widening) gap: why public health must engage with AI now","authors":"Paula del Rey Puech ,&nbsp;Rebecca Payne ,&nbsp;Jasjot Saund ,&nbsp;Martin McKee","doi":"10.1016/j.puhe.2025.106047","DOIUrl":"10.1016/j.puhe.2025.106047","url":null,"abstract":"<div><h3>Objectives</h3><div>This commentary aims to highlight the opportunities and challenges that Artificial Intelligence (AI) presents for public health.</div></div><div><h3>Study design</h3><div>Narrative commentary and conceptual analysis.</div></div><div><h3>Methods</h3><div>The commentary draws on material developed for a forthcoming book by the European Observatory on Health Systems and Policies. Sources were selected to highlight both the potential and the limitations of AI integration at population levels, with a focus on equity, governance, and implementation. The analysis is informed by established public health principles: prevention, systems thinking, and the social determinants of health.</div></div><div><h3>Results</h3><div>AI applications in public health go beyond process automation and operational efficiency. By integrating and processing diverse, multi-modal data sources, its implementation presents opportunities to understand the wider determinants of health at a more nuanced level and identify populations at risk with greater precision. Additionally, AI has the potential to help understand and support behaviour change in sophisticated ways, enhance disease surveillance and modelling, and enable more targeted and responsive public communication and engagement strategies. However, there are several barriers to realise AI's potential in public health, including system fragmentation, data access limitations, resource constraints, implementation challenges, workforce readiness gaps, and technological limitations such as bias and generative AI “hallucinations”.</div></div><div><h3>Conclusion</h3><div>Without deliberate engagement, AI risks reinforcing existing inequities. Practical steps for action include embedding AI training in public health education, building multidisciplinary teams, investing in data infrastructure, and ensuring participatory approaches. AI will continue to shape public health systems, whether or not public health professionals engage. We argue that the public health community is both uniquely positioned and ethically obligated to engage proactively with AI.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"250 ","pages":"Article 106047"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145493020","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":"Corrigendum to “Association between trajectories of life-course group sports participation and dementia: A 3-year longitudinal study” [Public Health. 243 (2025) 105721. Doi: 10.1016/j.puhe.2025.03.033]","authors":"Mitsuya Yamakita ,&nbsp;Taishi Tsuji ,&nbsp;Satoru Kanamori ,&nbsp;Junko Saito ,&nbsp;Yuko Kai ,&nbsp;Yukako Tani ,&nbsp;Takeo Fujiwara ,&nbsp;Naoki Kondo ,&nbsp;Katsunori Kondo","doi":"10.1016/j.puhe.2025.106053","DOIUrl":"10.1016/j.puhe.2025.106053","url":null,"abstract":"","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"250 ","pages":"Article 106053"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145642021","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":"Spatial and temporal patterns and determinants of chronic disease multimorbidity among middle-aged and older adults in China: Evidence from two longitudinal cohort studies","authors":"Jiaojiao Lv ,&nbsp;Yanran Huang ,&nbsp;Fan Du,&nbsp;Jiaxuan Wang,&nbsp;Mingxia Jing","doi":"10.1016/j.puhe.2025.106084","DOIUrl":"10.1016/j.puhe.2025.106084","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aims to investigate the spatial and temporal heterogeneity in the evolution and determinants of multimorbidity among middle-aged and elderly populations, thereby providing data support for formulating regionalized prevention and control measures for multimorbidity.</div></div><div><h3>Study design</h3><div>Retrospective analysis of two longitudinal cohort studies.</div></div><div><h3>Methods</h3><div>We utilized longitudinal data from five waves of the China Health and Retirement Longitudinal Study (CHARLS, 2011–2020) and the China Family Panel Study (CFPS, 2012–2020), focusing on individuals aged 45 years and older. Sociodemographic information and chronic disease prevalence were extracted and analyzed using geographic information system (GIS) technology to identify spatial and temporal patterns in the development of multimorbidity and the identification of determinants influencing multimorbidity across different provinces.</div></div><div><h3>Results</h3><div>Between 2011 and 2020, the prevalence of chronic diseases among middle-aged and elderly individuals showed a fluctuating but overall upward trend at both the national level and within the regions of China. A spatial pattern of stepwise increase from east to west emerged, with Henan Province consistently serving as the epicenter of multimorbidity prevalence. Significant spatial autocorrelation was detected in the distribution of multimorbidity. Moreover, the determinants behind multimorbidity exhibited marked spatial heterogeneity, indicating region-specific influences. Alcohol consumption leads to increased risk of multimorbidity, especially in the East China regions. The Northwest region is the primary location where smoking has a negative effect.</div></div><div><h3>Conclusions</h3><div>Multimorbidity among middle-aged and elderly adults in China is not only highly prevalent but also increasing at a rapid pace. The spatial distribution highlights the need for geographically differentiated public health strategies. Particular attention should be paid to the higher prevalence among women, and targeted tobacco and alcohol control policies are especially warranted in northwestern regions of the country.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"250 ","pages":"Article 106084"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145684802","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}