Journal of Epidemiology and Community Health最新文献

{"title":"Effect of a multicomponent school-based intervention with parental involvement on socioeconomic inequalities in smoking initiation: equity impact analysis of the TOPAS study.","authors":"Dorien Beeres, Maria Rosaria Galanti, Maria Nilsson, Anni-Maria Pulkki-Brännström","doi":"10.1136/jech-2024-222463","DOIUrl":"https://doi.org/10.1136/jech-2024-222463","url":null,"abstract":"<p><strong>Background: </strong>As prevalence of tobacco use falls, socioeconomic inequalities in tobacco use are increasing in many high-income countries. Evidence is lacking on the effect of preventive interventions on socioeconomic inequalities in smoking initiation among adolescents. We evaluated whether a multicomponent school-based prevention programme with parental involvement has differential effects on smoking initiation across socioeconomic groups and affects the magnitude of socioeconomic inequalities in smoking initiation.</p><p><strong>Methods: </strong>A secondary analysis of data from a 3-year cluster randomised controlled trial, the TOPAS study, conducted in Sweden from 2018 to 2021. Schools were randomised either to the full programme (Tobacco-Free Duo, T-DUO) or minimal intervention (EDU). The analysis was conducted according to intention to treat for the primary outcome, the probability of remaining a non-user of cigarettes at the end of compulsory school (ages 15-16). Parents' educational attainment was the socioeconomic variable. Differential effects were analysed by comparing adolescents exposed to T-DUO with those exposed to EDU within each socioeconomic group. The effect of the intervention on the magnitude of inequalities was analysed by comparing several measures of absolute and relative inequalities between T-DUO and EDU.</p><p><strong>Results: </strong>At the end of follow-up, the full programme had a similar, at most moderate effect on smoking initiation in all socioeconomic groups (relative risk 1.13 (95% CI 1.02 to 1.25) in the middle group). The programme did not significantly affect the magnitude of inequalities (Slope Index of Inequality difference 1.49 (95% CI -15.34 to 18.32)).</p><p><strong>Discussion: </strong>Socioeconomic inequalities in smoking initiation remain substantial. Our results indicate the absence of an effect of the programme T-DUO on these inequalities.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changing relationship between income inequality and mortality.","authors":"Michael Murphy","doi":"10.1136/jech-2024-223088","DOIUrl":"10.1136/jech-2024-223088","url":null,"abstract":"<p><p>The recent paper by Dunn <i>et al</i> showed that the positive relationship between US state-level income inequality and mortality was small in the 1950s, rose to a large value around 1990 but had largely disappeared by 2019. We consider these findings in the context of the mechanisms that have been advanced for reasons why a positive relationship might be expected, and in relation to studies using alternative methods included in systematic reviews that fail to confirm an independent inequality/mortality relationship. Ecological studies, such as by Dunn <i>et al</i>, using subnational data have advantages compared with similar studies using cross-national data, but controls are typically confined to those available from sources such as decennial census, so scope for incorporating lagged effects and life course factors is limited. However, they are often the only studies with the statistical power to identify subnational differentials and time trends so they are complementary to rarely available sources such as high-quality long-term individual-level microdata data required for causal analyses. Income equality can arise not only due to citizens' positive preferences but also to external choices such as economic decline and globalisation, so examining the wider context is important when explaining excess levels of 'deaths of despair' in low-inequality US states. The apparent increasingly strong association between income levels and low mortality with a weakening inequality/mortality relationship has implications for policy recommendations.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":"782-784"},"PeriodicalIF":4.9,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"State-level association between income inequality and mortality in the USA, 1989-2019: ecological study.","authors":"James R Dunn, Gum-Ryeong Park, Robbie Brydon, Michael Veall, Lyndsey A Rolheiser, Michael Wolfson, Arjumand Siddiqi, Nancy A Ross","doi":"10.1136/jech-2024-222262","DOIUrl":"10.1136/jech-2024-222262","url":null,"abstract":"<p><strong>Background: </strong>Prior studies have shown a positive relationship between income inequality and population-level mortality. This study investigates whether the relationship between US state-level income inequality and all-cause mortality persisted from 1989 to 2019 and whether changes in income inequality were correlated with changes in mortality rates.</p><p><strong>Methods: </strong>We perform repeated cross-sectional regressions of mortality on state-level inequality measures (Gini coefficients) at 10-year intervals. We also estimate the correlation between within-state changes in income inequality and changes in mortality rates using two time-series models, one with state- and year-fixed effects and one with a lagged dependent variable. Our primary regressions control for median income and are weighted by population.</p><p><strong>Main outcome measures: </strong>The two primary outcomes are male and female age-adjusted mortality rates for the working-age (25-64) population in each state. The secondary outcome is all-age mortality.</p><p><strong>Results: </strong>There is a strong positive correlation between Gini and mortality in 1989. A 0.01 increase in Gini is associated with more deaths: 9.6/100 000 (95% CI 5.7, 13.5, p<0.01) for working-age females and 29.1 (21.2, 36.9, p<0.01) for working-age males. This correlation disappears or reverses by 2019 when a 0.01 increase in Gini is associated with fewer deaths: -6.7 (-12.2, -1.2, p<0.05) for working-age females and -6.2 (-15.5, 3.1, p>0.1) for working-age males. The correlation between the change in Gini and change in mortality is also negative for all outcomes using either time-series method. These results are generally robust for a range of income inequality measures.</p><p><strong>Conclusion: </strong>The absence or reversal of correlation after 1989 and the presence of an inverse correlation between change in inequality and change in all-cause mortality represents a significant reversal from the findings of a number of other studies. It also raises questions about the conditions under which income inequality may be an important policy target for improving population health.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":"772-778"},"PeriodicalIF":4.9,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socioeconomic status across the early life course predicts gene expression signatures of disease and senescence.","authors":"Cecilia Potente, Julien Bodelet, Hira Himeri, Steve Cole, Kathleen Harris, Michael Shanahan","doi":"10.1136/jech-2023-221812","DOIUrl":"10.1136/jech-2023-221812","url":null,"abstract":"<p><strong>Background: </strong>Socioeconomic status (SES) is associated with many chronic diseases, indicators of senescence and mortality. However, the changing salience of SES in the prediction of adult health is not well understood. Using mRNA-seq abundance data from wave V of the National Longitudinal Study of Adolescent to Adult Health (Add Health), we examine the extent to which SES across the early life course is related to gene expression-based signatures for chronic diseases, senescence and inflammation in the late 30s.</p><p><strong>Methods: </strong>We use Bayesian methods to identify the most likely model of life course epidemiology (critical, sensitive and accumulation models) that characterises the changing importance of parental SES and SES during young (ages 27-30) and mid-adulthood (ages 36-39) in the prediction of the signatures.</p><p><strong>Results: </strong>For most signatures, SES is an important predictor in all periods, although parental SES or SES during young adulthood are often the most predictive. For three signatures (components of diabetes, inflammation and ageing), critical period models involving the exclusive salience of SES in young adulthood (for diabetes) or parental SES (for inflammation and ageing) are most probable. The observed associations are likely mediated by body mass index.</p><p><strong>Conclusion: </strong>Models of life course patterns of SES may inform efforts to identify age-specific mechanisms by which SES is associated with health at different points in life and they also suggest an enhanced approach to prediction models that recognise the changing salience of risk factors.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":"752-758"},"PeriodicalIF":4.9,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does stress from incarceration of family and friends contribute to signs of early vascular ageing in African American women?","authors":"Nicole D Fields, Zachary T Martin, Lori S Hoggard, Christy L Erving, Shivika Udaipuria, Kennedy M Blevins, Jordan E Parker, Jaylah Goodson, Raphiel J Murden, Renee H Moore, Rachel Parker, LaKeia Culler, Bianca Booker, Emma Barinas-Mitchell, Arshed Quyyumi, Viola Vaccarino, Tené T Lewis","doi":"10.1136/jech-2024-222227","DOIUrl":"10.1136/jech-2024-222227","url":null,"abstract":"<p><strong>Background: </strong>Early vascular ageing (EVA) contributes to elevated risk of cardiovascular disease (CVD), which disproportionately affects African American women. Incarceration, an event disproportionately impacting African Americans, may be a stressor contributing to EVA in African American women. Further, the subjective perspective, commonly referred to as appraisal, of incarceration may also be important for health. We hypothesised that having family and/or friends incarcerated and appraising the incarceration as upsetting would be associated with indices of EVA.</p><p><strong>Methods: </strong>In a community-based cohort of African American women aged 30-46 living in Atlanta, Georgia (n=391), participants were asked, at baseline, about family and/or friend incarceration and to appraise how upsetting the incarceration was. Multivariable linear regression examined associations between: (1) family and/or friend incarceration and indices of EVA (pulse wave velocity, augmentation index, central systolic blood pressure (SBP) and pulse pressure amplification) and (2) appraisal of incarceration and EVA indices.</p><p><strong>Results: </strong>45% of participants (n=174) reported having a loved one incarcerated, and 59% (n=102) reported the incarceration as upsetting. Having a loved one incarcerated was associated with a higher central SBP (b=4.30; 95% CI 1.61, 6.99) and augmentation index (b=2.29; 95% CI 0.26, 4.33). Appraisal of incarceration was only associated with central SBP.</p><p><strong>Conclusions: </strong>Family or friend incarceration was highly prevalent in this cohort of African American women and associated with indices of EVA. Mass incarceration of others may affect the physical health of African American women which may contribute to CVD disparities.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":"745-751"},"PeriodicalIF":5.4,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11560605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between socioeconomic disadvantage and severe maternal morbidity and mortality in high-income countries: a systematic review.","authors":"Dorothea Geddes-Barton, Sofia Baldelli, Roshan Karthikappallil, Thomas Bentley, Blessing Omorodion, Lucy Thompson, Nia Wyn Roberts, Raph Goldacre, Marian Knight, Rema Ramakrishnan","doi":"10.1136/jech-2024-222407","DOIUrl":"https://doi.org/10.1136/jech-2024-222407","url":null,"abstract":"<p><strong>Background: </strong>Socioeconomic position (SEP) is among the most important determinants of variations in health outcomes. This systematic review aimed to summarise the association between socioeconomic disadvantage and the risk of severe maternal morbidity (SMM) and maternal mortality (MM) across high-income countries.</p><p><strong>Methods: </strong>A comprehensive search was conducted in the MEDLINE, EMBASE, CINAHL and PsycInfo databases and Google Scholar from January 2000 to June 2023. Peer-reviewed papers from observational studies conducted in Organisation for Economic Co-operation and Development countries were included. Meta-analyses of comparable studies, a narrative summary and a harvest plot were undertaken.The risk of bias was assessed using a modified Newcastle-Ottawa tool.</p><p><strong>Results: </strong>The final review included 52 papers. In the meta-analyses, compared with the least amount of neighbourhood deprivation, neighbourhood income, neighbourhood poverty and years of education, the ORs for SMM in the highest group were 1.45 (95% CI 1.13 to 1.85), 1.48 (95% CI 1.34 to 1.63), 1.61 (95% CI 0.97 to 2.66) and 1.29 (95% CI 1.22 to 1.37), respectively. Similarly, the ORs for MM among least versus highest amount of neighbourhood deprivation, unemployed versus employed, lower versus higher occupational group and years of education were 2.10 (95% CI 1.57 to 2.81), 1.86 (95% CI 0.95 to 3.66), 1.61 (95% CI 1.03 to 2.51) and 1.90 (95% CI 1.29 to 2.79), respectively.</p><p><strong>Discussion: </strong>In high-income countries across the different measures of SEP, socioeconomic disadvantage is associated with increased risk for SMM and MM. There is a need for interventions across multiple societal levels that will be effective in reducing these inequitable outcomes.</p><p><strong>Prospero registration number: </strong>CRD42023399267.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Downstream healthcare use following breast cancer screening: a register-based cohort study.","authors":"Emma Grundtvig Gram, Volkert Siersma, Dagný Rós Nicolaisdóttir, John Brandt Brodersen","doi":"10.1136/jech-2024-222818","DOIUrl":"https://doi.org/10.1136/jech-2024-222818","url":null,"abstract":"<p><strong>Background: </strong>For evaluation of breast cancer screening and informed prioritisation, it is important to examine the downstream healthcare use associated to participation. The objective of this study is to determine the healthcare use among breast cancer screening participants compared with screening-naïve controls.</p><p><strong>Methods: </strong>The study is a register-based cohort study with 14 years of follow-up. We compare healthcare use among women who participated in the initial phase of the stepwise breast cancer screening implementation in Denmark (stratified on screening result: normal, false positive and breast cancer) compared with those invited in subsequent phases.</p><p><strong>Results: </strong>Screening participants, especially those with false-positive results, tended to use primary healthcare services more than the screening-naïve group. Women with breast cancer and false positives received more breast imaging compared with the screening-naïve group. False positives consistently had the highest use of drugs compared with the control group. All screening groups had significantly higher use of outpatient clinic visits in the year of and following screening compared with the screening-naïve group. Screening groups were more likely to receive additional diagnoses in the years following screening than the screening-naïve group. There were no significant differences in medical procedures and days of hospitalisation.</p><p><strong>Conclusions: </strong>The study highlights differences in primary healthcare use among screening groups compared with the screening-naïve group. Since use of primary care services is at the discretion of the women, this implies increased worries about health. Thus, these results indicate increased healthcare-seeking behaviour, especially among women with false-positive results.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Morbidity among resettled refugees at arrival in Ontario, Canada (1994-2017): a controlled interrupted time series study examining the effect of the Immigration Refugee Protection Act, 2002.","authors":"Susitha Wanigaratne, Therese Stukel, Hong Lu, Jun Guan, Michaela Hynie, Natasha Ruth Saunders, Astrid Guttmann","doi":"10.1136/jech-2024-222947","DOIUrl":"https://doi.org/10.1136/jech-2024-222947","url":null,"abstract":"<p><strong>Background: </strong>Immigration inadmissibility on medical grounds is common among high-income countries. In Canada, the Immigrant and Refugee Protection Act (IRPA) became law in 2002. With humanitarian protection as a priority, IRPA removed medical inadmissibility based on exceeding a cost threshold for the projected use of health and social services for resettled refugees. Our objective was to determine whether resettled refugees arriving in Ontario after IRPA became law (2004-2017) were more likely to exceed the cost threshold than those who arrived before (1994-2002).</p><p><strong>Methods: </strong>We linked population-based immigration (1994-2017) and healthcare data (1994-2019) in Ontario, Canada and conducted interrupted and controlled interrupted time series (ITS and CITS, respectively) analyses using segmented regression. We examined morbidity prevalence (a proxy for exceeding the cost threshold), in the pre-IRPA and post-IRPA periods among resettled refugees and three control groups-successful asylum seekers, economic immigrants and other Ontario residents. Morbidity prevalence levels and slopes across years were estimated comparing the post-IRPA to pre-IRPA period within resettled refugees and each control group (ITS), and for resettled refugees relative to each control group comparing the same periods (CITS).</p><p><strong>Results: </strong>Morbidity prevalence levels and slopes did not increase significantly within resettled refugees arriving after compared with before IRPA, nor when compared with control groups. Increasing morbidity prevalence among all immigrant groups post-IRPA suggested that subsequent policy changes linked to excessive demand policies may have impacted morbidity.</p><p><strong>Conclusion: </strong>Evolving medical inadmissibility policies suggest the need to provide a fulsome evaluation, balancing possible implications with the documented contributions immigrants make to Canada.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geographical variability in cancer incidence explained by the socioeconomic environment: an example of lung cancer in northwestern France.","authors":"Pauline Pouchin, Genin Michaël, Bara Simona, Vigneron Nicolas, Guy Launoy, Joséphine Bryère","doi":"10.1136/jech-2024-222704","DOIUrl":"https://doi.org/10.1136/jech-2024-222704","url":null,"abstract":"<p><strong>Background: </strong>The incidence of lung cancer is unequally distributed in France. Although several studies have shown a link between the socioeconomic environment of populations and the incidence of cancer, the contribution has not been quantified. We aimed to analyse the geographical variability of lung cancer incidence in Normandy and calculate the proportion explained by the socioeconomic environment.</p><p><strong>Methods: </strong>We included 7665 lung cancer cases recorded in the General Tumor Registry of Calvados and the Cancer Registry of Manche. A Bayesian model was used to map the spatial variation in the incidence of lung cancer in the territory, and an innovative approach was used to evaluate the influence of geographical variability in the socioeconomic environment on the spatial heterogeneity of lung cancer incidence.</p><p><strong>Results: </strong>The maps of the spatial components showed high contrasts for both genders, and the socioeconomic environment integration in the model made the maps less contrasting. The socioeconomic environment of the population explained one-third of the spatial variation in the incidence of lung cancer in women and one-fifth in men.</p><p><strong>Conclusion: </strong>The results showed that a non-negligible part of the spatial variation in the incidence of lung cancer could be explained by the geographical distribution of the socioeconomic environment.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diverging mental health trends in the postpandemic era: results from the HUNT Study, Norway.","authors":"Daniel Weiss, Christopher Lowenstein, Erik Reidar Sund, Daniel Vethe, Steinar Krokstad","doi":"10.1136/jech-2024-222626","DOIUrl":"https://doi.org/10.1136/jech-2024-222626","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this report is to examine to what extent the COVID-19 pandemic affected pre-existing trends in mental health, with a focus on subgroup differences across age, gender and socioeconomic status.</p><p><strong>Methods: </strong>Our analysis uses data from two survey periods (HUNT4: 2017-2019 and HUNT-COVID: 2021-2023) from the Trøndelag Health Study in Norway. We estimate overall and stratified (by age, sex and educational attainment) prevalence values for above-threshold (≥8) anxiety and depression scores using the Hospital Anxiety and Depression Scale. For each outcome, we compare prevalences between HUNT-4 and HUNT-Covid within each subgroup.</p><p><strong>Results: </strong>Above-threshold levels of anxiety were higher among women than men, while the opposite was true for depression. Symptoms generally decrease with age. Between HUNT4 and HUNT-COVID, for both women and men, anxiety symptoms decreased (except among women between 18-29 and 30-39) while depression symptoms increased (except for individuals over 80). Anxiety symptoms decreased across education levels between HUNT4 and HUNT-COVID while depression symptoms increased across education levels.</p><p><strong>Conclusion: </strong>The findings illustrate the negative long-term effects of a shock such as a pandemic while also illustrating the potential positive effects of generous welfare benefits on inequalities in mental health.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}