Public Health最新文献

{"title":"The role of loneliness in mediating the relationship between financial strain and mental health: Exploring gender differences in a UK longitudinal study","authors":"Lei Chai ,&nbsp;Senhu Wang ,&nbsp;Zhuofei Lu","doi":"10.1016/j.puhe.2025.03.008","DOIUrl":"10.1016/j.puhe.2025.03.008","url":null,"abstract":"<div><h3>Objectives</h3><div>This study explores the association between financial strain and loneliness over time, investigates loneliness as a mediator in the relationship between financial strain and mental health, and examines the influence of gender.</div></div><div><h3>Study design</h3><div>Longitudinal study.</div></div><div><h3>Methods</h3><div>Using data from six waves (2017–2023) of the UK Household Longitudinal Study (UKHLS), which includes 34,535 participants (154,316 person-years), this study employs fixed-effects regression models.</div></div><div><h3>Results</h3><div>Financial strain is significantly associated with increased loneliness over time (b = .155, <em>p</em> &lt; .001). Loneliness partially mediates the relationship between financial strain and mental health, accounting for approximately 15 % of the effect. Notably, the relationship between loneliness and mental health is moderated by gender (b = .120, <em>p</em> &lt; .001), with women experiencing more severe negative effects.</div></div><div><h3>Conclusions</h3><div>These findings suggest that alleviating financial strain could reduce loneliness and its detrimental effects on mental health. Addressing financial and social stressors is essential for public health strategies. Implementing gender-sensitive approaches is critical for addressing specific vulnerabilities, particularly among women.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"242 ","pages":"Pages 299-303"},"PeriodicalIF":3.9,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143747487","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":"Associations amongst poverty, loneliness, and a defensive symptom cluster characterised by pain, fatigue, and low mood","authors":"Arran J. Davis ,&nbsp;Emma Cohen ,&nbsp;Daniel Nettle","doi":"10.1016/j.puhe.2025.02.037","DOIUrl":"10.1016/j.puhe.2025.02.037","url":null,"abstract":"<div><h3>Objective</h3><div>Perceived social isolation is associated with increased pain, fatigue, and depression. Other research has shown that pain and depression are more common in individuals experiencing low socio-economic status, and that social relationships are especially important for buffering the negative health effects of low socio-economic status.</div></div><div><h3>Study design</h3><div>Cross-sectional.</div></div><div><h3>Methods</h3><div>We used a 20-country, cross-sectional sample of 24,504 respondents to the European Social Survey 7. Multilevel linear regression was used to test for the effects of loneliness, income decile, and their interaction on a symptom cluster variable that was the average of respondent <em>z</em>-scores on self-reported pain, fatigue, and low mood. We hypothesised that loneliness and low income would be interactively associated with higher symptom cluster scores.</div></div><div><h3>Results</h3><div>Those from lower income deciles were much more likely to feel lonely (48.7 % in the lowest income decile; 15.2 % in the highest income decile), despite no differences in reported time spent socialising. Multilevel linear regression indicated statistically significant associations consistent with our hypotheses: (1) lonely individuals score 0.447 <em>SD</em> higher on the symptom cluster, (2) for every increase in income decile, symptom cluster scores decrease by 0.022 <em>SD</em>, and (3) a loneliness by income interaction on the symptom cluster (<em>b</em> = −0.018), with the association between loneliness and the symptom cluster being strongest amongst those in lower income deciles.</div></div><div><h3>Conclusions</h3><div>Both loneliness and low income were associated with higher scores on the symptom cluster, and social relationships were especially strong buffers of the symptom cluster for individuals experiencing poverty. Results inform understandings of social and economic gradients in health.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"242 ","pages":"Pages 272-277"},"PeriodicalIF":3.9,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735057","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":"Associations of socioeconomic status and malnutrition with survival in adults with cancer in the UK Biobank: A prospective cohort study","authors":"X.T. Zheng ,&nbsp;F.Y. Huang ,&nbsp;Y.L. Qi ,&nbsp;W. Sun ,&nbsp;X.R. Zhang ,&nbsp;Y.J. Wang ,&nbsp;Y.J. Zhang ,&nbsp;Q.M. Li ,&nbsp;J.Y. Liu ,&nbsp;C.W. Li ,&nbsp;D.Q. Zheng ,&nbsp;F. Liu","doi":"10.1016/j.puhe.2025.02.039","DOIUrl":"10.1016/j.puhe.2025.02.039","url":null,"abstract":"<div><h3>Objectives</h3><div>Socioeconomic disparities and malnutrition are significant contributors to global health challenges, yet the relationship between socioeconomic status (SES) and malnutrition, and the subsequent risk of mortality in cancer patients remains underexplored. This study aimed to investigate the complex relationships between SES, nutritional status, and both all-cause and cancer-specific mortality in cancer patients.</div></div><div><h3>Study design</h3><div>Prospective cohort study.</div></div><div><h3>Methods</h3><div>Participants from the UK Biobank with a cancer diagnosis within two years prior to baseline assessment were included (n = 4216, 47.3 % male). Latent class analysis (LCA) and the Global Leadership Initiative on Malnutrition (GLIM) criteria were employed to evaluate patients’ SES and nutritional status. Logistic regression was applied to assess the associations between SES and nutritional status. Cox-proportional hazards models, along with mediation, joint association, and interaction analyses, were done to establish the relationship between SES, nutritional status, and both all-cause and cancer-specific mortality.</div></div><div><h3>Results</h3><div>During a median follow-up of 15.14 (IQR: 15.09–15.20) years, 1039 participants died, of which 788 deaths were cancer-specific. Participants with low SES (vs high) had an increased risk of malnutrition (OR 1.60, 95 % CI 1.08–2.39) and all-cause mortality (HR 1.22, 95 % CI 1.03–1.44). Malnutrition accounted for 6.8 % of the association between low SES and all-cause mortality. Compared to well-nourished patients with high SES, those with malnutrition and low SES had the highest risk of all-cause mortality (3.12, 2.26–4.29), while those with malnutrition and high SES faced the highest risk of cancer-specific mortality (2.88, 1.97–4.21).</div></div><div><h3>Conclusions</h3><div>While addressing malnutrition alone may not significantly reduce mortality disparities arising from socioeconomic differences, it remains a crucial strategy for alleviating cancer burden, especially among patients with low SES.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"242 ","pages":"Pages 264-271"},"PeriodicalIF":3.9,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735056","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":"Adverse childhood experiences and trajectories of chronic diseases: A population-base longitudinal study","authors":"Guilan Xie ,&nbsp;Jiajia Li ,&nbsp;Ruiqi Wang ,&nbsp;Lijun Pei ,&nbsp;Xinming Song ,&nbsp;Gong Chen","doi":"10.1016/j.puhe.2025.03.014","DOIUrl":"10.1016/j.puhe.2025.03.014","url":null,"abstract":"<div><h3>Objectives</h3><div>Adverse childhood experiences (ACEs) have far-reaching effects on health outcomes. This study aimed to evaluate the associations of ACEs with trajectories and number of chronic diseases.</div></div><div><h3>Study design</h3><div>Cohort study.</div></div><div><h3>Methods</h3><div>Participants aged 45 years or older of China Health and Retirement Longitudinal Study were included. Ten kinds of ACEs encountered before 17 years old were calculated. Number of chronic diseases were assessed by 14 kinds of self-reported or proxy-reported diagnosed chronic diseases. The associations of specific types and number of ACEs with trajectories and number of chronic diseases were analyzed with latent class trajectory model, multinomial Logistic regression, and general estimating equation.</div></div><div><h3>Results</h3><div>Four trajectories of chronic diseases were identified in 12157 participants. With the reference of low baseline and persistent growth trajectory, those encountered physical abuse, domestic violence, household mental illness, and parental death had higher risks of high baseline and transient growth trajectory, middle baseline and accelerated growth trajectory of chronic diseases (ORs = 1.18–1.65). Compared to those without ACEs, those with 1 and above kinds of ACEs had elevated risks of middle baseline and persistent growth, high baseline and transient growth trajectory, middle baseline and accelerated growth trajectory of chronic diseases (ORs = 1.15–2.71). Physical abuse, domestic violence, bullying, household mental illness, parental death, and exposure of 2 and above kinds of ACEs increased the number of chronic diseases (β = 0.09–0.62). Associations of ACEs with trajectories and number of chronic diseases were more salient in women than men.</div></div><div><h3>Conclusions</h3><div>Different types and number of ACEs were related to trajectories of chronic diseases, especially in women. Early, comprehensive, and joint actions should be taken to prevent chronic diseases from a life-course perspective.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"242 ","pages":"Pages 256-263"},"PeriodicalIF":3.9,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143726173","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":"Can behavioural nudges promote reduced-salt dish orders on meal delivery apps?","authors":"Wenyue Li ,&nbsp;Chao Song ,&nbsp;Ying Cui ,&nbsp;Yue Ma ,&nbsp;Beisi Li ,&nbsp;Zhongdan Chen ,&nbsp;Paige Snider ,&nbsp;Ying Long ,&nbsp;Ailing Liu ,&nbsp;Gauden Galea","doi":"10.1016/j.puhe.2024.12.028","DOIUrl":"10.1016/j.puhe.2024.12.028","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to evaluate the effectiveness of educational health message and menu default options on a Meal Delivery App (MDA) in nudging consumers towards reduced-salt options in restaurants of China.</div></div><div><h3>Study design</h3><div>We conducted a nudge-based intervention trial on an MDA named ELEME in China.</div></div><div><h3>Methods</h3><div>Along with a control group, five intervention groups were formed utilizing different combinations of the three nudging treatments, including setting up a salt submenu for “reduced salt” default, a salt submenu for “regular salt” default, and a conventional educational health message on the ordering page. We recruited 903 restaurants from cities across different geographic regions and assigned them into either the control group or one of the five intervention groups.</div></div><div><h3>Results</h3><div>After analyzing 870,942 meal orders, the results showed that the inclusion of a health message on the restaurants' ordering page was not effective to influence consumers to choose reduced-salt dishes (P &gt; 0.1). A salt submenu that explicitly asked for consumers' preference for “reduced salt” or “regular salt” significantly increased consumers’ likelihoods of choosing reduced-salt dishes in the unadjusted model (P &lt; 0.1).</div></div><div><h3>Conclusions</h3><div>Applying choice architecture changes as nudge-based interventions on MDAs were proven to be effective to promote consumers to order reduced salt dishes, and we consider these findings to have real-world implications for policymakers, researchers, and the private sectors.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"242 ","pages":"Pages 250-255"},"PeriodicalIF":3.9,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143705615","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":"Combined effects of life course maternal psychosocial experiences on perinatal mental health","authors":"Katherine Bowers ,&nbsp;Robert T. Ammerman ,&nbsp;Lili Ding ,&nbsp;Kimberly Yolton ,&nbsp;Jennifer R. Frey ,&nbsp;Alonzo T. Folger","doi":"10.1016/j.puhe.2025.03.005","DOIUrl":"10.1016/j.puhe.2025.03.005","url":null,"abstract":"<div><h3>Objectives</h3><div>Identifying experiences that place women at higher risk for mental health impairment is critical to inform perinatal care. This study's purpose was to identify the individual and combined association between early life adversity, discrimination, and perinatal mental health.</div></div><div><h3>Study design</h3><div>Prospective cohort study.</div></div><div><h3>Methods</h3><div>The Pregnancy and Infant Development Study (PRIDE) is a prospective cohort study that follows pregnant women in Cincinnati, Ohio through 18 months postnatal. Measures of socioeconomic factors, adverse childhood experiences, discrimination, and maternal mental health were collected at home study visits. Multiple linear regression identified associations between psychosocial measures and perinatal mental health.</div></div><div><h3>Results</h3><div>Adjusting for socioeconomic factors, early life adversity, and discrimination were significantly associated with perinatal mental health (β range from 0.20 to 1.64). The strongest association was observed for the association between emotional neglect and depression β = 2.53 (p = 0.006). The joint effect of high early adversity and high discrimination demonstrated the strongest effect.</div></div><div><h3>Conclusion</h3><div>Women who experienced early life trauma, in particular emotional neglect and discrimination, also experienced depression and distress during the perinatal period. Identification of women at risk for mental health problems should be a priority for programs that are positioned to help mitigate future consequences to mothers and their families.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"242 ","pages":"Pages 244-249"},"PeriodicalIF":3.9,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143705616","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":"Shared decision-making tool development for colorectal cancer screening: A co-creative process with general practitioners and underserved people","authors":"Deborah Jael Herrera ,&nbsp;Wessel van de Veerdonk ,&nbsp;Sarah Talboom ,&nbsp;Liesbet Van Bos ,&nbsp;Anthony Verresen ,&nbsp;Marlon van Loo ,&nbsp;Daiane Maria Seibert ,&nbsp;Karen Feyen ,&nbsp;Leen Haesaert ,&nbsp;Guido Van Hal","doi":"10.1016/j.puhe.2025.02.029","DOIUrl":"10.1016/j.puhe.2025.02.029","url":null,"abstract":"<div><h3>Objectives</h3><div>European guidelines stress the importance of informed decision-making in colorectal cancer (CRC) screening. However, tailored tools that facilitate this process among underserved people and general practitioners (GPs) in Flanders are still lacking. This study aimed to co-create a shared decision-making (SDM) tool for CRC screening with both underserved populations and GPs, capturing their needs and preferences for content, design, and delivery.</div></div><div><h3>Study design</h3><div>Qualitative study.</div></div><div><h3>Methods</h3><div>Two rounds of six focus group discussions with underserved people, and five local quality group meetings with GPs were conducted in different areas of Flanders, Belgium. Qualitative data were analyzed using a Modified-Grounded Theory Analytical (M-GTA) approach to identify key themes.</div></div><div><h3>Results</h3><div>Findings revealed four core themes. The first theme, 'Recognizing the Barriers to Screening', identifies challenges such as a lack of time, staff, and tools to facilitate preventive talks, as well as language and literacy barriers for underserved people in CRC screening. The second theme, 'Learning from Existing Tools', highlights successful elements like visuals and simple language and limitations such as low accessibility and poor navigation. The third theme, 'Determining the Content and Design,' reveals that GPs seek user-friendly tools for at-home viewing, while underserved people value personalised and clear information about CRC risk factors and screening costs. The final theme, 'Identifying Strategies for Integration,' stresses the importance of a structured, personalised, collaborative care approach in using the SDM tool for preventive talks in practice.</div></div><div><h3>Conclusion</h3><div>Enhancing the accessibility and relevance of SDM tools, particularly in content and design tailored to both underserved people and GPs, is the key to overcoming barriers such as language and health literacy. Nonetheless, further testing is needed to confirm the effectiveness of the SDM tool in supporting SDM in CRC screening.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"242 ","pages":"Pages 236-243"},"PeriodicalIF":3.9,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681545","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":"Explanation of intention toward influenza vaccination among cardiovascular disease patients: An application of the extended protection motivation theory","authors":"Jiaxue Fan ,&nbsp;Qin Wang ,&nbsp;Ying Deng ,&nbsp;Junyan Liang ,&nbsp;Anita Nyarkoa Walker ,&nbsp;Hua You","doi":"10.1016/j.puhe.2025.03.010","DOIUrl":"10.1016/j.puhe.2025.03.010","url":null,"abstract":"<div><h3>Objective</h3><div>Patients with cardiovascular disease (CVD) are susceptible to influenza virus infection, and influenza vaccination is effective in preventing influenza, but its uptake remains low. This study will investigate the influencing factors affecting patients' intention to receive influenza vaccination based on the extended protection motivation theory (PMT) and explore whether there are differences in this psychological pathway among patients with different levels of illness perception.</div></div><div><h3>Study design</h3><div>Cross-sectional study.</div></div><div><h3>Methods</h3><div>In this study, the extended PMT model was used, which consists of the original construct (threat and coping assessment) and the extended construct (social norms and trust). Based on this, the model used to explain influenza vaccination intentions in CVD patients was constructed. Structural equation modelling was then used to test the extended theory from the overall population, the high-illness-perception and low-illness-perception populations, respectively.</div></div><div><h3>Results</h3><div>Intention toward influenza vaccination was positively correlated with severity (<em>β</em> = .211), vulnerability (<em>β</em> = .154), response efficacy (<em>β</em> = .243), self-efficacy (<em>β</em> = .154), and social norms (<em>β</em> = .179), while being negatively associated with response costs (<em>β</em> = −.244). Social norms influenced intention by mediating response efficacy and self-efficacy, while trust in information sources was mediated by self-efficacy. Extended PMT had higher interpretative efficacy in patients with high illness perception than in patients with low illness perception (75.1 % vs 35.2 %).</div></div><div><h3>Conclusions</h3><div>The study found that the extended PMT is appropriate for explaining the intention toward influenza vaccination of patients with CVD. Patients with different illness perception levels have differences in the paths. It is suggested that patients with different levels of illness perception be subdivided, and intervention strategies should be developed by considering the theoretical models of each subgroup.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"242 ","pages":"Pages 228-235"},"PeriodicalIF":3.9,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681541","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":"A preliminary study on the role of personal history of infectious and parasitic diseases on self-reported health across countries","authors":"Gerit Pfuhl ,&nbsp;Filipe Prazeres ,&nbsp;Marta Kowal ,&nbsp;Toivo Aavik ,&nbsp;Beatriz Abad-Villaverde ,&nbsp;Reza Afhami ,&nbsp;Leonardo Aguilar ,&nbsp;Grace Akello ,&nbsp;Laith Al-Shawaf ,&nbsp;Jan Antfolk ,&nbsp;Chiemezie S. Atama ,&nbsp;Derya Atamturk Duyar ,&nbsp;Roberto Baiocco ,&nbsp;Sercan Balım ,&nbsp;Carlota Batres ,&nbsp;Yakhlef Belkacem ,&nbsp;Théo Besson ,&nbsp;Adam Bode ,&nbsp;Merve Boğa ,&nbsp;Jordane Boudesseul ,&nbsp;Piotr Sorokowski","doi":"10.1016/j.puhe.2025.02.030","DOIUrl":"10.1016/j.puhe.2025.02.030","url":null,"abstract":"<div><h3>Objectives</h3><div>Infectious diseases are often associated with decline in quality of life. The aim of this study is to analyze the relationship between personal history of communicable, i.e., infectious and parasitic diseases and self-rated health.</div></div><div><h3>Study design</h3><div>Secondary analysis of a large dataset multi-country observational study.</div></div><div><h3>Methods</h3><div>We used a four-pronged analysis approach to investigate whether personal history of infectious and parasitic diseases is related to self-reported health, measured with a single item.</div></div><div><h3>Results</h3><div>Three of the four analyses found a small positive effect on self-reported health among those reporting a history of pathogen exposure. The meta-analysis found no support but large heterogeneity that was not reduced by two classifications of countries.</div></div><div><h3>Conclusion</h3><div>Personal history of infectious and parasitic diseases does not reduce self-reported health across a global sample.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"242 ","pages":"Pages 220-227"},"PeriodicalIF":3.9,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681539","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":"Neighborhood characteristics and health literacy: Evidence from the survey of racism and public health","authors":"Jonathan Odumegwu ,&nbsp;Jemar R. Bather ,&nbsp;Adrian Harris ,&nbsp;Marina Mautner Wizentier ,&nbsp;Kimberly A. Kaphingst ,&nbsp;Melody S. Goodman","doi":"10.1016/j.puhe.2025.03.006","DOIUrl":"10.1016/j.puhe.2025.03.006","url":null,"abstract":"<div><h3>Objectives</h3><div>Limited research exists on the relationship between neighborhood characteristics and health literacy. We investigated the potential impacts of neighborhood characteristics on health literacy and explored whether these associations varied across racial/ethnic groups.</div></div><div><h3>Study design</h3><div>The study was a web-based cross-sectional study of adults (18+ years old) residing in areas within the US Health and Human Services Regions 1, 2, or 3.</div></div><div><h3>Methods</h3><div>The 2023 Survey of Racism and Public Health dataset was linked with the 2017–2021 American Community Survey dataset using the respondents' zip codes to obtain measures of residential segregation, neighborhood deprivation, racial and economic polarization, and racial and educational isolation. The Brief Health Literacy Screen was used to assess participants' health literacy. Unadjusted and adjusted models were employed to explore the associations between neighborhood characteristics and limited health literacy.</div></div><div><h3>Results</h3><div>Of 4948 participants, the mean age was 47 (SD = 17) years, 48 % were White, and 42 % had college degrees or higher. Greater neighborhood deprivation was associated with an increased likelihood of limited health literacy (aOR = 1.12, 95 % CI: 1.01, 1.24). Higher racial and economic polarization was associated with decreased odds of limited health literacy (aOR = 0.83, 95 % CI: 0.73, 0.93). Increased racial isolation is associated with increased odds of limited health literacy (aOR = 1.31, 95 % CI:1.14,1.50). These associations did not significantly vary by racialized/ethnic groups.</div></div><div><h3>Conclusions</h3><div>Incorporating neighborhood characteristics in health literacy research helps reveal a possible critical key risk factor; higher neighborhood deprivation increases the likelihood of limited health literacy with no variation across the racial/ethnic groups within the same neighborhood. The findings point policymakers toward the direction for intervention in policy changes that will reduce the maldistribution of health—and economic-promoting resources and risky life-course exposures in communities to improve public health literacy.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"242 ","pages":"Pages 206-213"},"PeriodicalIF":3.9,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681094","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}