Annals of Epidemiology最新文献

{"title":"Associations between BMI, body size perception, and dropout from upper secondary education: A prospective cohort study of 15–19-year-old adolescents","authors":"Laura Staxen Bruun ,&nbsp;Cecilie Bladt ,&nbsp;Katrine Strandberg-Larsen ,&nbsp;Vibeke Tornhøj Christensen ,&nbsp;Jane Greve ,&nbsp;Elisabeth Reichel Hansen ,&nbsp;Janne S. Tolstrup","doi":"10.1016/j.annepidem.2025.10.010","DOIUrl":"10.1016/j.annepidem.2025.10.010","url":null,"abstract":"<div><h3>Purpose</h3><div>To examine the independent associations of BMI and body size perception with dropout from upper secondary education.</div></div><div><h3>Methods</h3><div>Data from the Danish National Youth Study 2014, including 63,976 students aged 15–19 years, were linked to information on school dropout from the Student Register. Multilevel logistic regressions were employed to examine how BMI and body size perception were each associated with school dropout. Mediation analyses were conducted to assess the role of body size perception in the BMI-dropout association.</div></div><div><h3>Results</h3><div>Both low and high BMI were associated with higher odds of school dropout, following a U-shaped pattern across the BMI continuum. For instance, females with a BMI above 30 kg/m² had an OR of 2.37 (95 % CI: 1.74;3.27), compared to those with a BMI of 18.5–24.9 kg/m². Adjusting for body size perception, ORs attenuated for students with a BMI above the median. Body size perception mediated a substantial proportion of the BMI-dropout association. Students who perceived themselves as too thin or fat also had higher odds of dropout. For instance, females who perceived themselves as ‘much too fat’ had an OR of 2.66 (95 % CI: 2.17;3.25), compared to those who perceived themselves as ‘about right size’. Adjusting for BMI had only minor impact on ORs.</div></div><div><h3>Conclusion</h3><div>Low and high BMI, as well as the perception of not being the right size, were associated with higher odds of dropout from upper secondary education. Adjusted for body size perception, the association between BMI and dropout attenuated, suggesting that body size perception plays a crucial role in this relationship. Body size perception partly explains the BMI-dropout relationship, highlighting a need for more comprehensive approaches focusing adolescents’ perceptions of their bodies alongside actual weight to reduce school dropout.</div></div>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":"111 ","pages":"Pages 129-137"},"PeriodicalIF":3.0,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145269395","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":"Joint spatial modelling of COVID-19 severity among seniors: A Bayesian shared component approach using health administrative data from Ontario, Canada","authors":"Nushrat Nazia,&nbsp;Charmaine Dean","doi":"10.1016/j.annepidem.2025.10.004","DOIUrl":"10.1016/j.annepidem.2025.10.004","url":null,"abstract":"<div><h3>Purpose</h3><div>Jointly monitoring adverse COVID-19 outcomes among seniors is critical for assessing outbreak severity. These outcomes are often influenced by socioeconomic and demographic conditions and may co-occur in space, indicating shared structural risks that inform targeted responses.</div></div><div><h3>Methods</h3><div>We analyzed severe COVID-19 outcomes among adults aged 65 + in Ontario (January 2020–March 2022) using data from the Ontario Health Data Platform supported by ICES. A Bayesian shared component model with Integrated Nested Laplace Approximation at the forward sortation area level included socioeconomic and demographic covariates.</div></div><div><h3>Results</h3><div>The shared component explained ∼75 % of the total modeled spatial variability. High risks clustered in southern Ontario, while lower risks occurred in central and northern regions. Material deprivation was positively associated with death (RR 1.12, 95 % CrI: 1.04–1.21) and multiple hospitalizations (RR 1.20, 95 % CrI: 1.13–1.29). Racialized/newcomer population concentration was positively associated with death (RR 1.25, 95 % CrI: 1.14–1.38) and with single hospitalizations (RR 1.18, 95 % CrI: 1.11–1.24). The percentage of seniors was inversely associated with hospitalization (RR 0.98, 95 % CrI: 0.96–0.99) but not death.</div></div><div><h3>Conclusions</h3><div>Findings highlight structural inequities in pandemic severity and suggest targeted, equity-oriented strategies in guiding pandemic preparedness and response.</div></div>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":"111 ","pages":"Pages 120-128"},"PeriodicalIF":3.0,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259979","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":"Unequal strides to longevity. The extra mile to health equity","authors":"Borja del Pozo Cruz PhD ,&nbsp;Francisco Perales PhD ,&nbsp;Marcin Straczkiewicz PhD ,&nbsp;Marcos Matabuena PhD ,&nbsp;Jesús del Pozo-Cruz PhD ,&nbsp;Rubén López-Bueno PhD","doi":"10.1016/j.annepidem.2025.10.009","DOIUrl":"10.1016/j.annepidem.2025.10.009","url":null,"abstract":"<div><h3>Purpose</h3><div>To examine differences in all-cause mortality risk reductions associated with daily steps across socioeconomic strata.</div></div><div><h3>Methods</h3><div>Prospective cohort study using NHANES data (2011–2014) with a median follow-up of 5.9 years among 7032 U.S. adults aged 18–80 years. Exposure was accelerometer-measured daily steps categorized by socioeconomic status using the Ratio of Family Income to Poverty (RFIP; low &lt;1.30, medium 1.30–1.84, high ≥1.85). Outcome was all-cause mortality determined via linkage to the National Death Index through December 2019. Cox proportional hazards models with restricted cubic splines and Relative Excess Risk due to Interaction (RERI) were applied.</div></div><div><h3>Results</h3><div>Over the follow-up, 452 participants died. Higher daily steps were associated with reduced mortality risk in all socioeconomic groups. However, socioeconomically advantaged individuals experienced greater risk reductions per 1000 daily steps compared to disadvantaged groups (RERI for low vs. high RFIP: –0.115, 95 % CI: –0.189, –0.042). Individuals with low RFIP required 1.2–2.3 times more steps to match the mortality benefits seen in high RFIP groups.</div></div><div><h3>Conclusions</h3><div>Socioeconomically disadvantaged populations may not benefit equally from daily steps. Addressing the factors contributing to this discrepancy will help maximize the health benefits of walking for all, thereby reducing overall health disparities.</div></div>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":"111 ","pages":"Pages 117-119"},"PeriodicalIF":3.0,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145269416","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":"Prenatal depression comorbid with diabetes or hypertension and the risk of adverse neonatal outcomes: A systematic review and meta-analysis","authors":"Biruk Beletew Abate ,&nbsp;Berihun Assefa Dachew ,&nbsp;Getinet Ayano ,&nbsp;Kim Betts ,&nbsp;Rosa Alati","doi":"10.1016/j.annepidem.2025.10.002","DOIUrl":"10.1016/j.annepidem.2025.10.002","url":null,"abstract":"<div><h3>Purpose</h3><div>This systematic review and meta-analysis aim to synthesise evidence on the association between prenatal depression comorbid with diabetes and/or hypertension and adverse birth outcomes.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was conducted across PubMed, Medline, Scopus, Web of Science, Embase, PsycINFO, and Google Scholar. Eligible studies assessed the effect of comorbid prenatal depression and diabetes or hypertension on obstetric or neonatal outcomes. Methodological quality was appraised using the Joanna Briggs Institute tool. Random-effects meta-analyses were conducted using inverse-variance weighting. Subgroup, sensitivity, and publication bias analyses were also performed.</div></div><div><h3>Results</h3><div>Fourteen studies, comprising over 11 million participants, were included. Prenatal depression comorbid with hypertension was significantly associated with increased risks of preterm birth (OR = 2.09; 95 % CI: 1.04–4.19), low birth weight (LBW) (OR = 2.08; 95 % CI: 1.07–4.07), and small for gestational age (SGA)(OR = 1.34; 95 % CI: 1.11–1.60). Additionally, comorbid prenatal depression and diabetes were associated with higher odds of cesarean section (CS) delivery (OR = 1.42; 95 % CI: 1.36–1.47).</div></div><div><h3>Conclusions</h3><div>The findings suggest that prenatal depression comorbid with gestational diabetes or hypertension may increase the risk of adverse birth outcomes, including preterm birth, LBW, SGA, and CS delivery. These findings underscore the need for early identification and targeted management of such comorbidities. Integrated treatment approaches that combine mental and physical healthcare may be essential to improve outcomes for both mothers and infants.</div></div>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":"111 ","pages":"Pages 154-162"},"PeriodicalIF":3.0,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276553","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":"Temporal trends and source attribution of animal-contact related human nontyphoidal Salmonella enterica outbreaks across the United States, 2009–2022","authors":"Hammad Ur Rehman Bajwa ,&nbsp;Suman Bhowmick ,&nbsp;Csaba Varga","doi":"10.1016/j.annepidem.2025.10.008","DOIUrl":"10.1016/j.annepidem.2025.10.008","url":null,"abstract":"<div><h3>Purpose</h3><div>Previous studies have assessed nontyphoidal <em>Salmonella enterica</em> (NTS) outbreaks associated with animal contact over short periods or single exposures. This study longitudinally evaluates the incidence, temporal trends, and all relevant exposure sources of NTS outbreaks attributed to animal contact in the United States (US) from 2009 to 2022.</div></div><div><h3>Methods</h3><div>Surveillance data on animal-contact-related NTS single-state outbreaks in the US, reported to the Centers for Disease Control and Prevention through the National Outbreak Reporting System between 2009 and 2022, were analyzed. First, yearly and state-specific NTS outbreak incidence rates (IRs) per one million population years (1 MPY) were calculated. Next, join point regression models assessed national and state-specific trends in NTS IRs over the study years. Lastly, the proportion of NTS outbreaks attributed to various animal contact sources was described.</div></div><div><h3>Results</h3><div>During the 14 years, 104 NTS outbreaks were reported (0.02 per 1 MPY). The highest outbreak IRs were observed in 2014 (0.0534 per 1 MPY), 2018 (0.0459), and 2009 (0.0389). The join point regression analysis did not identify a significant trend in the national NTS outbreak IRs; however, several states were identified with increasing and/or decreasing trends. Contact with mammals was the main exposure category (n = 37 outbreaks, 35.58 %), followed by birds (n = 31, 29.81 %) and reptiles (n = 24).</div></div><div><h3>Conclusions</h3><div>Continued public health resources to mitigate the health burden of NTS infections are needed. Differences in state-level NTS outbreak IRs call for focused NTS prevention and control programs.</div></div>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":"111 ","pages":"Pages 168-174"},"PeriodicalIF":3.0,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253688","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":"Sexual orientation identity and attraction changes among youth: prospective versus retrospective measurement","authors":"Lynsie R. Ranker PhD, MPH ,&nbsp;Sabra L. Katz-Wise PhD ,&nbsp;Allegra R. Gordon ScD, MPH ,&nbsp;R. Korkodilos ,&nbsp;Ziming Xuan ScD, SM, MA ,&nbsp;Kimberly M. Nelson PhD, MPH","doi":"10.1016/j.annepidem.2025.10.006","DOIUrl":"10.1016/j.annepidem.2025.10.006","url":null,"abstract":"<div><h3>Purpose</h3><div>Prior work has documented sexual orientation change, or fluidity, among youth over time. Some studies measure change via retrospective recall while others assess change prospectively. It is unclear whether retrospective recall and prospective assessment measure change experiences similarly. The current study examines whether prospectively assessed change in sexual orientation identity (SOI) and attractions aligns with change as assessed via retrospective recall of change.</div></div><div><h3>Methods</h3><div>US youth (N = 1235), aged 14–25 years, participated in a longitudinal online cohort. Prospective change in SOI and attraction were determined by comparing self-reported SOI and attraction at baseline and 4-month follow-up. Retrospective recall of SOI and attraction change was assessed at 4-month follow-up. The sensitivity and specificity of retrospective recall of change was assessed in relation to change detected prospectively.</div></div><div><h3>Results</h3><div>Prospectively, 12.8 % of youth changed their reported SOI between baseline and follow-up. Retrospectively, only 5.0 % recalled change for the same period. Prospectively, 21.9 % reported attraction changes between baseline and follow-up. Retrospectively, only 12.4 % recalled attraction changes. Only 17.3 % (95 % CI 11.3, 23.4) who prospectively reported SOI change and 28.7 % (95 % CI 23.3, 34.2) who prospectively reported attraction change also reported change retrospectively.</div></div><div><h3>Conclusions</h3><div>The prevalence of change in SOI and attractions varied substantially by whether change was assessed prospectively or retrospectively. Researchers and clinicians should consider how the method and timing of assessment may influence their ability to detect changes in SOI and attractions within youth populations. Identification of youth experiencing change is critical for allocation of relevant resources and support.</div></div>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":"112 ","pages":"Pages 8-14"},"PeriodicalIF":3.0,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253604","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":"Beyond associations: From theory to interventions in health inequalities research using causal inference","authors":"Maria Gueltzow ,&nbsp;Maarten J. Bijlsma ,&nbsp;Frank J. van Lenthe","doi":"10.1016/j.annepidem.2025.10.001","DOIUrl":"10.1016/j.annepidem.2025.10.001","url":null,"abstract":"<div><div>One of the central goals of public health is not only to improve the health in the population overall, but also to reduce the unequal distribution of health and disease within the population. Even though a large amount of research is directed towards identifying and understanding health inequalities, much of this research is based on associations. This type of research can help to identify what groups in society are at risk of having worse health but cannot tell us how these inequalities may be reduced. In order to move beyond identifying who is at risk, we illustrate how we can combine the existing theoretical foundations with the counterfactual outcomes framework to understand how health inequalities can be tackled. We show how the Commission on Social Determinants of Health (CSDH) framework and the Diderichsen model can be translated into practice through the use of DAGs and notation. This will aid in generating more informative evidence on how certain interventions can reduce inequalities.</div></div>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":"112 ","pages":"Pages 1-7"},"PeriodicalIF":3.0,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253682","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 “The association of preterm birth and small for gestational age with recurrent multisite musculoskeletal pain during early and middle adulthood — The Northern Finland Birth Cohort 1966 Study” [Ann Epidemiol 111 (2025) 9979]","authors":"Sandra-Sofia Nieminen ,&nbsp;Jaro Karppinen ,&nbsp;Eero Kajantie ,&nbsp;Paulo Ferreira ,&nbsp;Eveliina Heikkala","doi":"10.1016/j.annepidem.2025.09.023","DOIUrl":"10.1016/j.annepidem.2025.09.023","url":null,"abstract":"","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":"111 ","pages":"Page 116"},"PeriodicalIF":3.0,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145227783","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":"Predictors of migraine prevalence among different age groups in Hong Kong Chinese women: Machine learning analyses on the MECH-HK cohort.","authors":"Yafei Wu, Harry Qin, Shengnan Wang, Qingling Yang, Yan Zhang, Harry Haoxiang Wang, Yao Jie Xie","doi":"10.1016/j.annepidem.2025.07.017","DOIUrl":"10.1016/j.annepidem.2025.07.017","url":null,"abstract":"<p><strong>Purpose: </strong>To identify age-specific predictors of migraine prevalence among Chinese women.</p><p><strong>Methods: </strong>In this cross-sectional analysis, 54 predictors were collected from the MECH-HK cohort. Migraine was assessed by the ICHD 3rd edition. Machine learning was employed to select a streamlined subset of predictors. Participants were categorised as young and middle age group (<60 years) and old age group (≥60 years) for analysis.</p><p><strong>Results: </strong>The mean age of participants was 54.3 years. Migraine prevalence was higher in women under 60 than in older women (10.7 % vs. 6.0 %, P < 0.001). Lasso selected seven (<60 years) and twelve (≥60 years) predictors, respectively. The top three predictors among women under 60 were fatigue, migraine family history, and PSQI, explaining 6.6 %, 5.0 %, and 4.9 % of variation, respectively. Their ORs (95 % CIs) were 1.61 (1.37-1.89), 3.93 (2.77-5.57), and 1.29 (1.12-1.48), respectively. For older women, the top three predictors were experience of hunger, smartphone usage time, and migraine family history, explaining 2.0 %, 1.8 %, and 1.6 % of variation, respectively, with ORs (95 % CIs) of 2.16 (1.21-3.84), 1.24 (1.03-1.48), and 2.26 (1.16-4.40), respectively.</p><p><strong>Conclusion: </strong>Migraine family history and experience of hunger were shared predictors for migraine prevalence in both ages. Other predictors differentially influence migraine prevalence across ages.</p>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":" ","pages":"34-42"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668908","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":"Leveraging mediation analysis as a tool to study mechanisms underlying health inequities.","authors":"Judith J M Rijnhart, Ryan J Bailey, Jessica Agbodo, Vishakha Agrawal, Valerie M Rodriguez-Olmo, Jason L Salemi","doi":"10.1016/j.annepidem.2025.07.002","DOIUrl":"10.1016/j.annepidem.2025.07.002","url":null,"abstract":"<p><strong>Purpose: </strong>To describe three statistical approaches that help gain a comprehensive understanding of mechanisms underlying health inequities: univariate regression analysis, effect modification analysis, and mediation analysis.</p><p><strong>Methods: </strong>We described how univariate regression analysis, effect modification analysis, and mediation analysis can be used to gain insight into mechanisms underlying health inequities. We demonstrated the application of these approaches using a motivating example from the Health and Retirement Study in which we studied the role of education in ethnic disparities in episodic memory.</p><p><strong>Results: </strong>Univariate regression analysis showed that Hispanic individuals on average had lower episodic memory scores compared to non-Hispanic individuals. Effect modification analysis showed that the beneficial effect of education on episodic memory was less strong in Hispanic individuals compared to non-Hispanic individuals. Mediation analysis showed that the ethnic disparity in episodic memory was not only driven by effect modification, but also by differences in the distribution of education years across ethnic groups.</p><p><strong>Conclusion: </strong>The combined study of effect modification and mediation provides a comprehensive understanding of the mechanisms that cause and sustain health inequities. Insight into these mechanisms is crucial to determine targets for interventions and policies aimed at eliminating health inequities.</p>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":" ","pages":"1-6"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644079","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}