Public HealthPub Date : 2025-09-16DOI: 10.1016/j.puhe.2025.105965
Anna Chartres , Jo W.H. Oultram , Alex Royden , Sarah Shanks , John S.P. Tulloch
{"title":"Human fatalities associated with livestock in Great Britain (2010–2023)","authors":"Anna Chartres , Jo W.H. Oultram , Alex Royden , Sarah Shanks , John S.P. Tulloch","doi":"10.1016/j.puhe.2025.105965","DOIUrl":"10.1016/j.puhe.2025.105965","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to describe the incidence, demographics, and context of livestock-related deaths 2010–2023.</div></div><div><h3>Study design</h3><div>A descriptive analysis of the Health and Safety Executive's ‘Fatal injuries in agriculture, forestry and fishing in Great Britain’ annual reports.</div></div><div><h3>Methods</h3><div>Annual incidence of death was calculated. Demographic and contextual information were extracted, and data stratified by whether the victim was a farmer or member of the public. Statistical comparisons were made using Chi<sup>2</sup> tests, Fisher's exact test, and Mann Witney U Tests, where appropriate.</div></div><div><h3>Results</h3><div>Out of 78 livestock-related fatalities, 97 % were caused by domestic cattle and 74.3 % were farmers. Median age of all fatalities was 67 (range: 29–87), and 63.4 % were alone at the point of injury. Farmers were predominantly male and tended to be working with individual animals, often in a contained space. All members of the public were killed in fields and 84.2 % had a dog present with them. They were 250 times more likely to have a dog present than farmers (OR = 250, p < 0.001). A calf or per-parturient cow was more likely to be present when a member of the public was killed (OR = 4.3, p < 0.01).</div></div><div><h3>Conclusions</h3><div>Cattle-related incidents are a concern and further research is required to enable the development and implementation of effective safety interventions. We recommend that a database of livestock-related injuries is created, measures are introduced so farmers can easily temporarily divert public rights of way, and educational programmes for farmers and the public are developed.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"248 ","pages":"Article 105965"},"PeriodicalIF":3.2,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082344","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}
Public HealthPub Date : 2025-09-15DOI: 10.1016/j.puhe.2025.105957
Yingwei Yang , Morgan Payne , Xifan Yang , Mi'Youshi Hopkins , Tasmiah Nuzhath , Heather Love
{"title":"An ecological approach to understanding the multilevel risk factors of youth suicidality in the United States","authors":"Yingwei Yang , Morgan Payne , Xifan Yang , Mi'Youshi Hopkins , Tasmiah Nuzhath , Heather Love","doi":"10.1016/j.puhe.2025.105957","DOIUrl":"10.1016/j.puhe.2025.105957","url":null,"abstract":"<div><h3>Objectives</h3><div>Although suicidality (e.g., suicidal ideation, planning, and attempts) is highly prevalent among adolescents in the United States (U.S.), few studies have explored the interrelationships of societal, community, family, and individual risk factors that collectively contribute to youth suicidality. This study aimed to estimate the complex interplay of multilevel factors associated with youth suicidality in the U.S., stratified by sex.</div></div><div><h3>Study design</h3><div>Population-based cross-sectional study.</div></div><div><h3>Methods</h3><div>Using data collected from a nationally representative sample (N = 17,263, 48.0 % female) in 2023, multigroup structural equation modeling was used to assess the direct effects and indirect pathways of social disadvantage, family adversity, and violence victimization on self-report suicidality (ideation, planning, and attempts) among male and female adolescents.</div></div><div><h3>Results</h3><div>Social disadvantage, family adversity, and violence victimization were intercorrelated and collectively contributed to youth suicidality, with sex-specific patterns. Among males, violence victimization showed the strongest direct and total effects on suicidality. Among females, however, family adversity had the strongest direct effect while social disadvantage showed the strongest total effects on suicidality. The correlation between violence victimization and suicidality was statistically stronger in males, whereas social disadvantage was more strongly correlated with family adversity in females.</div></div><div><h3>Conclusions</h3><div>To address the intercorrelated, multilevel factors associated with youth suicidality, comprehensive strategies and sex-specific protocols are needed. For males, it is recommended to screen for a broad range of violence victimization to facilitate early identification of at-risk groups. For females, addressing the impact of social disadvantage and family adversity is essential to reduce the risk of suicidality.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"248 ","pages":"Article 105957"},"PeriodicalIF":3.2,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145060558","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}
Public HealthPub Date : 2025-09-15DOI: 10.1016/j.puhe.2025.105936
M. Meldgaard , M. Hawkins , R. Osborne , H.T. Maindal
{"title":"Understanding pregnant women's health literacy strengths and challenges: a cluster-based exploration in the Health Literacy in Pregnancy (HeLP) study","authors":"M. Meldgaard , M. Hawkins , R. Osborne , H.T. Maindal","doi":"10.1016/j.puhe.2025.105936","DOIUrl":"10.1016/j.puhe.2025.105936","url":null,"abstract":"<div><h3>Objectives</h3><div>Across populations there is frequently wide variation in the strengths and challenges that people experience regarding their health literacy and their digital health literacy. Given these variations, it is important that tailored care strategies are developed. However, there is limited research about the diversity of health literacy strengths and challenges among pregnant women. Thus, the aim of this observational study was to explore the diversity among pregnant women in Denmark.</div></div><div><h3>Study design</h3><div>This is an observational study, nested in the HeLP cohort and Health Literacy in Pregnancy (HeLP) study.</div></div><div><h3>Methods</h3><div>Hierarchical cluster analysis was used to explore patterns of strengths and challenges among 681 pregnant Danish women. Health literacy was measured using the 44-item Health Literacy Questionnaire (HLQ). Digital health literacy was measured using the eHealth Literacy Questionnaire (eHLQ).</div></div><div><h3>Results</h3><div>Overall, women had average scores above 2.90 for HLQ scales 1 to 5, average scores above 3.70 for HLQ scales 6 to 9, and average scores above 2.80 for the eHLQ. However, cluster analysis-based examination revealed 6 groups of women with large variations in their patterns of health literacy and digital health literacy strengths and challenges. Cluster 1 scored 3.96 on HLQ scale 6: Ability to actively engage with healthcare providers, while cluster 6 scored 2.34 on the same scale. Furthermore, there was considerable diversity in participant characteristics across the groups.</div></div><div><h3>Conclusion</h3><div>This study highlights that although relatively high health literacy and digital health literacy scores suggest a generally skilled population, averages do not fully capture the disparities present among groups. Study findings offer important insights for designing tailored strategies to improve maternal health outcomes in future studies.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"248 ","pages":"Article 105936"},"PeriodicalIF":3.2,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145060557","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}
Public HealthPub Date : 2025-09-12DOI: 10.1016/j.puhe.2025.105937
J. Dunnett, J. Holkham, A. Trebacz, C. Baldasera, C. Francis, L. Dawson, R. Swiers, F. Christie-de-Jong
{"title":"Effectiveness and acceptability of interventions to improve readability of patient healthcare materials: A narrative systematic review","authors":"J. Dunnett, J. Holkham, A. Trebacz, C. Baldasera, C. Francis, L. Dawson, R. Swiers, F. Christie-de-Jong","doi":"10.1016/j.puhe.2025.105937","DOIUrl":"10.1016/j.puhe.2025.105937","url":null,"abstract":"<div><h3>Objectives</h3><div>Reading age is a key component of Health literacy (HL) yet many written healthcare materials in the UK exceed recommended reading levels, making them less accessible to much of the population. Creating barriers to understanding contributes to health inequalities. Simplifying the way information is written and terminology used could be a useful and low-cost approach to support HL, yet effectiveness of such interventions remains unclear. This study aims to systematically review evidence evaluating the effectiveness and acceptability of healthcare material readability interventions in high income countries.</div></div><div><h3>Study design</h3><div>Narrative systematic review.</div></div><div><h3>Methods</h3><div>Searches of CENTRAL, Embase, MEDLINE, CINAHL, ERIC, APA Psych Articles, and Psychology and Behavioral Science, databases from 2014 to 2024 were conducted. Articles title/abstract and full text were double screened. Eligible studies examined tailored or improved written healthcare materials across clinical specialities. Data extraction included study characteristics, and interventions’, impact on patient acceptability, comprehension and health outcomes. The Mixed Methods Appraisal Tool (MMAT) was used for critical appraisal.</div></div><div><h3>Results</h3><div>Thirty studies were included, predominantly from the USA. The majority evaluated interventions using simplified language, structured formatting, or visual enhancements. Findings indicated that simplified content was associated with greater patient understanding and preference. However, evidence on behavioural adherence and direct health outcomes was mixed, with few studies demonstrating statistically significant improvements. Quality of included studies was generally low, with methodological and reporting limitations.</div></div><div><h3>Conclusions</h3><div>Readability interventions can enhance patient comprehension and acceptability, yet their long-term impact on health outcomes remains uncertain. Future research should assess sustained effects and explore routine implementation in healthcare settings to inform best practices.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"248 ","pages":"Article 105937"},"PeriodicalIF":3.2,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145049297","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}
Public HealthPub Date : 2025-09-12DOI: 10.1016/j.puhe.2025.105939
Md. Karimul Islam, Proloy Barua, Md Shakil Ahmed
{"title":"What pushes males to marry underage girls? Demand-side insights of child marriage from northern Bangladesh","authors":"Md. Karimul Islam, Proloy Barua, Md Shakil Ahmed","doi":"10.1016/j.puhe.2025.105939","DOIUrl":"10.1016/j.puhe.2025.105939","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aims to assess the factors that drive males to marry underage girls (i.e., girls below the legal age of marriage), with a specific focus on how individual, household, and contextual characteristics of males relate to the prevalence of child marriage in geographically isolated areas, particularly the riverine islands (<em>chars</em>) of Bangladesh.</div></div><div><h3>Study design</h3><div>This study employs a cross-sectional design, which is appropriate for capturing data at a single point in time. In this case, data were collected between March and April 2024.</div></div><div><h3>Methods</h3><div>With a sample of 5415 individuals, the study applied multilevel mixed-effects Poisson regression to identify factors associated with male preferences for child marriage of girls. Results are reported as incidence rate ratios (IRRs).</div></div><div><h3>Results</h3><div>Younger males had a 29 % higher likelihood of marrying underage girls (IRR = 1.29, 95 % confidence interval [CI] = 1.26, 1.33). Self-employed men were 12 % more likely to engage in child marriage (IRR = 1.14, 95 % CI = 0.99, 1.30). Socioeconomic status influenced risk, with moderately poor (IRR = 1.08, 95 % CI = 1.02, 1.14) and non-poor (IRR = 1.04, 95 % CI = 1.00, 1.08) households showing slightly elevated likelihoods of engaging in child marriage compared to extremely poor households. While the main effect of education alone was not statistically significant (IRR = 0.99, 95 % CI = 0.96, 1.02), among moderately poor households, each additional year of schooling was associated with a reduction in the risk of marrying underage girls (IRR = 0.98, 95 % CI = 0.97, 1.00). This indicates that education may act as a protective factor, especially in certain socioeconomic contexts, by reducing the influence of poverty or informal employment on child marriage decisions.</div></div><div><h3>Conclusions</h3><div>Overall, this study reinforces the notion that, beyond economic status, education plays a critical role in reducing the tendency of men to marry underage girls. Therefore, interventions should focus on promoting male education, engaging younger and self-employed men in awareness programs, and integrating child marriage prevention strategies with broader infrastructure development efforts.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"248 ","pages":"Article 105939"},"PeriodicalIF":3.2,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145049299","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}
Public HealthPub Date : 2025-09-11DOI: 10.1016/j.puhe.2025.105941
Ana Mendez-Lopez , Rebecca Mak
{"title":"Wealth-based inequalities in the coverage of reproductive, maternal, newborn and child health interventions in 19 countries of the Asia-Pacific region, 1994–2022","authors":"Ana Mendez-Lopez , Rebecca Mak","doi":"10.1016/j.puhe.2025.105941","DOIUrl":"10.1016/j.puhe.2025.105941","url":null,"abstract":"<div><h3>Objectives</h3><div>Low- and middle-income countries in the Asia-Pacific region have experienced major health gains in reproductive, maternal, newborn, and child health (RMNCH) since the turn of the millennium. However, some countries and populations remain behind, facing high mortality rates and inadequate access to essential health services. These gaps highlight the urgent need to strengthen service coverage, particularly for unreached and disadvantaged populations. We analyse wealth-based inequalities in RMNCH interventions in this region's low- and middle-income countries and assess coverage gains if such inequalities were eliminated.</div></div><div><h3>Study design</h3><div>Repeated cross-sectional study.</div></div><div><h3>Methods</h3><div>Using data from the WHO Health Inequalities Data Repository derived from Demographic and Health Surveys and Multiple Indicator Cluster Surveys we analysed a composite coverage index (CCI) on eight essential RMNCH interventions, disaggregated data were used to assess the latest situation and time trends of national and wealth quintile-specific coverage rates and inequalities using absolute and relative inequality measures (difference, ratio, and slope and relative index of inequality). We further examined countries’ levels and trends in inequalities against their national RMNCH coverage levels. Finally, we calculated impact measures, including the population attributable risk and fraction, to investigate the potential impact on national coverage levels if wealth-based inequalities were eliminated.</div></div><div><h3>Results</h3><div>Wealth-based inequalities in the RMNCH CCI are prevalent, with the richest quintiles generally having much higher coverage than the poorest. However, countries presented a mixed picture regarding the levels and patterns of wealth-based inequalities. Distinct patterns were observed, including top and bottom inequality distributions and varying trajectories over time, highlighting important country-specific contexts. While countries have seen declines in inequalities over time, in a few countries, gaps in coverage widened. Gains in equality mostly occurred along increased levels of national average coverage. Significant gains in national average CCI could be made by eliminating differences between the coverage in the richest quintile and the rest.</div></div><div><h3>Conclusions</h3><div>Eliminating inequalities could drive substantial gains in coverage of RMNCH services across the Asia-Pacific region. Countries’ wealth-based inequality patterns can guide policy interventions targeted at unreached and disadvantaged populations.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"248 ","pages":"Article 105941"},"PeriodicalIF":3.2,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145049298","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}
Public HealthPub Date : 2025-09-10DOI: 10.1016/j.puhe.2025.105919
Andrew CK. Lee , William Roberts , Simon Dixon
{"title":"Is England's 10 year health plan fit for the future?","authors":"Andrew CK. Lee , William Roberts , Simon Dixon","doi":"10.1016/j.puhe.2025.105919","DOIUrl":"10.1016/j.puhe.2025.105919","url":null,"abstract":"","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"248 ","pages":"Article 105919"},"PeriodicalIF":3.2,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145026450","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}
Public HealthPub Date : 2025-09-10DOI: 10.1016/j.puhe.2025.105934
Yulan Lin , Zhijie Luo , Guangtan Lin , Jianyu Song , Zhiwen Huang , Xiaonan Xu , Roy Rillera Marzo , Li Ping Wong , Changming Huang , Zhijian Hu
{"title":"Diagnostic routes and symptom-to-treatment delays in gastric cancer: Findings from a cross-sectional study in southeastern China","authors":"Yulan Lin , Zhijie Luo , Guangtan Lin , Jianyu Song , Zhiwen Huang , Xiaonan Xu , Roy Rillera Marzo , Li Ping Wong , Changming Huang , Zhijian Hu","doi":"10.1016/j.puhe.2025.105934","DOIUrl":"10.1016/j.puhe.2025.105934","url":null,"abstract":"<div><h3>Objectives</h3><div>Prognosis of gastric cancer is strongly related to stage at diagnosis. Great attention should be given to reducing symptom-to-treatment delays in gastric cancer patients. We mainly aimed to describe diagnostic routes and symptom-to-treatment delays, as well as to explore the predictors of patient delays.</div></div><div><h3>Study design</h3><div>Retrospective cross-sectional study.</div></div><div><h3>Methods</h3><div>Between 1<sup>st</sup> November 2021 and 31<sup>st</sup> October 2022, all eligible consecutive patients with a first diagnosis of gastric cancer were recruited and interviewed at two Grade-A tertiary hospitals in southern China.</div></div><div><h3>Results</h3><div>A total of 533 gastric cancer patients were analyzed. The major diagnostic route was “visit the doctor with symptoms” (82.7 %). The median value was 21.5 days for patient interval, 5.0 days for diagnosis interval, and 10.0 days for treatment interval. About a quarter of patients had a patient delay (24.1 %), diagnosis delay (22.1 %), or treatment delay (28.9 %). Highest household monthly income (OR = 2.12, 95 % CI: 1.13–3.97), high/middle level of life stress (OR = 1.87, 95 % CI: 1.15–3.06), having symptoms of epigastric pain (OR = 2.06, 95 % CI: 1.27–3.35), first presentation to township hospital/county hospitals (OR = 9.49, 95 % CI: 3.29–27.42) or Grade-A tertiary hospital (OR = 13.41, 95 % CI: 4.40–40.84) were positively associated with patient delay. In contrast, ever had gastric cancer screening in the past 5 years (OR = 0.44, 95 % CI: 0.21–0.94), having symptoms of hematemesis/melena (OR = 0.23, 95 % CI: 0.09–0.61) were negatively associated with patient delay.</div></div><div><h3>Conclusions</h3><div>The majority of gastric cancer patients were diagnosed by visiting the doctor with symptoms. Symptom-to-treatment delays were common, highlighting the need to improve symptom appraisal, help-seeking behavior, and diagnostic pathways.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"248 ","pages":"Article 105934"},"PeriodicalIF":3.2,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145026449","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}
Public HealthPub Date : 2025-09-08DOI: 10.1016/j.puhe.2025.105938
H.J. van de Schootbrugge-Vandermeer , L. de Jonge , M.E. van Leerdam , A.J. van Vuuren , E. Dekker , M.C.W. Spaander , I.D. Nagtegaal , F.J. van Kemenade , I. Lansdorp-Vogelaar , E. Toes-Zoutendijk
{"title":"Risk of colorectal cancer and participation in fecal immunochemical test-based screening","authors":"H.J. van de Schootbrugge-Vandermeer , L. de Jonge , M.E. van Leerdam , A.J. van Vuuren , E. Dekker , M.C.W. Spaander , I.D. Nagtegaal , F.J. van Kemenade , I. Lansdorp-Vogelaar , E. Toes-Zoutendijk","doi":"10.1016/j.puhe.2025.105938","DOIUrl":"10.1016/j.puhe.2025.105938","url":null,"abstract":"<div><h3>Objectives</h3><div>Participation rates in fecal immunochemical test (FIT)-based colorectal cancer (CRC) screening differ across socio-demographic subgroups. The largest health gains could be achieved in subgroups with low participation rates and high risk of CRC. We investigated the CRC risk within different socio-demographic subgroups with low participation in the Dutch CRC screening program.</div></div><div><h3>Study design</h3><div>Population-based cohort study.</div></div><div><h3>Methods</h3><div>All individuals invited for the Dutch CRC screening program in 2018 and 2019 were included. Data from a previous study, including screening data and demographic characteristics, were augmented with CRC diagnoses in 2018 and 2019. A multivariable logistic regression was used to assess the association between socio-demographic factors and risk of CRC.</div></div><div><h3>Results</h3><div>Overall participation was 72.3% and age-adjusted CRC incidence was 30.3 per 10,000 individuals. Males showed lower participation (69.7 %) but had a higher-than-average CRC risk (35.1). The difference in CRC risk between males and females was less pronounced among non-participants (OR: 1.28, 95% CI: 1.20–1.36) than participants (OR: 1.41, 95% CI: 1.35–1.47). Lower income groups also had lower participation (down to 60.0 %) and higher risk of CRC (down to 30.7), but the difference in CRC risk between low-income groups and high-income groups was only significant among participants (OR lowest vs highest quintile: 1.22, 95% CI: 1.14–1.32). Conversely, individuals with a Turkish/Moroccan migration background had lower participation (48.7 %), but their CRC risk was also lower (18.8; OR: 0.54, 95% CI: 0.46–0.63).</div></div><div><h3>Conclusions</h3><div>CRC risk varies significantly between low-participation groups in the Dutch CRC screening program. Interventions should prioritize the most vulnerable groups, considering both participation and risk of CRC.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"248 ","pages":"Article 105938"},"PeriodicalIF":3.2,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145019545","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}
Public HealthPub Date : 2025-09-06DOI: 10.1016/j.puhe.2025.105935
Mille Dybdal Bager , Mikkel Porsborg Andersen , Maria Lukács Krogager , Morten Schou , Kristian Hay Kragholm , Emil Loldrup Fosbøl , Lars Køber , Christian Torp-Pedersen
{"title":"Long-term comparative effectiveness of BNT162b2 vaccine on SARS-CoV-2 infection in adolescents: A register-based real-world study from Denmark","authors":"Mille Dybdal Bager , Mikkel Porsborg Andersen , Maria Lukács Krogager , Morten Schou , Kristian Hay Kragholm , Emil Loldrup Fosbøl , Lars Køber , Christian Torp-Pedersen","doi":"10.1016/j.puhe.2025.105935","DOIUrl":"10.1016/j.puhe.2025.105935","url":null,"abstract":"<div><h3>Objectives</h3><div>Contribute to data on the long-term real-world effectiveness of the BNT162b2 vaccine efficacy (VE) in adolescents.</div></div><div><h3>Study design</h3><div>This observational study from July 2021 to June 2022 was designed to emulate a target trial.</div></div><div><h3>Methods</h3><div>Fully vaccinated adolescents 12–15 years of age were matched to unvaccinated adolescents. Outcomes were mild (positive PCR test without hospitalization), moderate (positive PCR test with hospitalization within 30 days), or severe infection (positive PCR test with intensive therapy or death within 30 days). VE was estimated as 1-risk ratio.</div></div><div><h3>Results</h3><div>We compared 235,636 vaccinated adolescents with 235,636 matched unvaccinated adolescents. On mild infection, the estimated VE declined from 42.88 % up to 25 days after full vaccination, to 33.86 %–37.26 % at 100 days and 8.85 %–8.37 % at 320 days. Estimated VE on moderate infection declined from 53.71 % up to 25 days to 22.06 %–22.73 % up to 320 days. A total of 5 events of severe infection among vaccinated, and 14 among unvaccinated individuals was observed.</div></div><div><h3>Conclusions</h3><div>Our estimated VE is limited and rapidly decreasing over 11 months. These findings may be due to the vaccine's effect waning over time, or mutation of the virus.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"248 ","pages":"Article 105935"},"PeriodicalIF":3.2,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145004561","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}