Journal of Epidemiology and Community Health最新文献

{"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":"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":"242-248"},"PeriodicalIF":4.9,"publicationDate":"2025-03-10","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":"High long-term mortality in ischaemic heart disease accentuated among ethnic minorities in Eastern Europe: findings from a prospective all-comers percutaneous coronary intervention registry in Romania.","authors":"Paul-Adrian Călburean, Paul Grebenișan, Ioana-Andreea Nistor, Ioana Paula Șulea, Anda-Cristina Scurtu, Klara Brinzaniuc, Horatiu Suciu, Marius Harpa, Dan Dobreanu, Laszlo Hadadi","doi":"10.1136/jech-2024-222845","DOIUrl":"10.1136/jech-2024-222845","url":null,"abstract":"<p><strong>Background: </strong>Long-term outcomes in cardiovascular diseases are historically under-reported in Eastern Europe. Our aim was to report long-term survival and to identify survival predictors in a prospective Romanian percutaneous coronary intervention (PCI) registry, with an emphasis on important under-resourced minorities, such as Hungarian and Roma ethnicities.</p><p><strong>Methods: </strong>An all-comers patient population treated by PCI in a tertiary cardiovascular centre that has been included prospectively in the local registry since January 2016 was analysed. Cardiovascular cause and all-cause mortality data were available as of December 2023.</p><p><strong>Results: </strong>A total of 6867 patients with 8442 PCI procedures were included. Romanian group consisted of 5095 (74.2%) patients, the Hungarian group consisted of 1417 (20.6%) patients and the Roma group consisted of 355 (5.1%) patients. During a median follow-up of 3.60 (1.35-5.75) years, a total of 1064 cardiovascular-cause and 1374 all-cause events occurred. Romanian, Hungarian and Roma patients suffered 5.12, 5.89 and 7.71 all-cause deaths per 100 patient-years, respectively. Romanian, Hungarian and Roma patients suffered 3.94, 4.63 and 6.22 cardiovascular-cause deaths per 100 patient-years, respectively. Both Hungarian and Roma patients presented significantly higher all-cause mortality than Romanian patients (adjusted HR (aHR)=1.20 (1.05-1.36), p=0.005 and aHR=1.51 (1.21-1.88), p=0.0001). Similarly, Hungarian and Roma patients presented significantly higher cardiovascular cause mortality than Romanian patients (aHR=1.22 (1.05-1.41), p=0.006 and aHR=1.51 (1.18-1.92), p=0.0008).</p><p><strong>Conclusions: </strong>High long-term cardiovascular and all-cause mortality was observed for the entire included population. Long-term survival was significantly lower in ethnic minorities, such as the Hungarian and Roma minority than in the Romanian population.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":"272-279"},"PeriodicalIF":4.9,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632942","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":"'Renoviction' and health: an emerging research agenda.","authors":"Heather Ross, Gerry McCartney","doi":"10.1136/jech-2024-223090","DOIUrl":"10.1136/jech-2024-223090","url":null,"abstract":"<p><p>Mitigating climate change requires us to rapidly improve the energy efficiency of our existing housing, a process known as 'retrofit'. However, this creates the risk of 'renoviction', whereby tenants are moved or evicted to allow these renovations to take place. Understanding the potential for renoviction to undermine the potential population health benefits of retrofit is an important new area for research.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":"239-241"},"PeriodicalIF":4.9,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632945","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":"Sleep regularity and major adverse cardiovascular events: a device-based prospective study in 72 269 UK adults.","authors":"Jean-Philippe Chaput, Raaj Kishore Biswas, Matthew Ahmadi, Peter A Cistulli, Shantha M W Rajaratnam, Wenxin Bian, Marie-Pierre St-Onge, Emmanuel Stamatakis","doi":"10.1136/jech-2024-222795","DOIUrl":"10.1136/jech-2024-222795","url":null,"abstract":"<p><strong>Background: </strong>This study examines the associations between device-measured sleep regularity and the risk of major adverse cardiovascular events (MACE), and aims to determine whether sufficient sleep duration attenuates or eliminates the effects of irregular sleep on MACE risk.</p><p><strong>Methods: </strong>A prospective cohort study of adults aged 40-79 years from the UK Biobank who wore wrist-attached accelerometers for 7 days was conducted. Sleep Regularity Index (SRI) scores were calculated for each participant using a validated algorithm, and categorised as irregular (SRI <71.6), moderately irregular (SRI between 71.6 and 87.3), and regular (SRI >87.3 (reference group)). Information on MACE and its subtypes (myocardial infarction, heart failure, stroke) was obtained from inpatient hospitalisation and death records.</p><p><strong>Results: </strong>We analysed data from 72 269 individuals followed for 8 years, without a previous history of MACE and without an event in the first year of follow-up. Irregular (HR 1.26, 95% CI 1.16 to 1.37) and moderately irregular sleepers (HR 1.08, 95% CI 1.01 to 1.70) were at higher risk of MACE compared with regular sleepers. Dose-response analyses treating SRI as a continuous measure showed that SRI was associated with MACE risk in a near-linear fashion, with a steeper MACE risk reduction at higher (better) SRI scores. Joint SRI and sleep duration analyses showed that meeting the age-specific sleep duration recommendation offsets MACE risk for moderately irregular sleepers (HR 1.07, 95% CI 0.96 to 1.18), but not for irregular sleepers (HR 1.19, 95% CI 1.06 to 1.35).</p><p><strong>Conclusions: </strong>Irregular sleep was strongly associated with higher MACE risk. Adequate sleep duration was not sufficient to offset these adverse effects among irregular sleepers. This study supports the inclusion of sleep regularity in public health guidelines and clinical practice as a risk factor for cardiovascular disease.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":"257-264"},"PeriodicalIF":4.9,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741223","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":"Coming to terms with climate change: a glossary for climate change impacts on mental health and well-being.","authors":"Claire L Niedzwiedz, Jonathan R Olsen, Jala Rizeq, Tsion Afework, Chiara K V Hill-Harding, Richard J Shaw, Rhian Thomas, Symon M Kariuki, Srinivasa Vittal Katikireddi, Andrew J Weaver, Gina Martin, Hester Parr, Esther K Papies","doi":"10.1136/jech-2024-222716","DOIUrl":"10.1136/jech-2024-222716","url":null,"abstract":"<p><p>Climate change is a major threat to global health. Its effects on physical health are increasingly recognised, but mental health impacts have received less attention. The mental health effects of climate change can be direct (resulting from personal exposure to acute and chronic climatic changes), indirect (via the impact on various socioeconomic, political and environmental determinants of mental health) and overarching (via knowledge, education and awareness of climate change). These impacts are unequally distributed according to long-standing structural inequities which are exacerbated by climate change. We outline key concepts and pathways through which climate change may affect mental health and explore the responses to climate change at different levels, from emotions to politics, to highlight the need for multilevel action. We provide a broad reference to help guide researchers, practitioners and policy-makers in the use and understanding of different terms in this rapidly growing interdisciplinary field.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":"295-301"},"PeriodicalIF":4.9,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857028","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":"Trends in physical fitness among Lithuanian adolescents aged 11-17 years between 1992 and 2022.","authors":"Arunas Emeljanovas, Brigita Mieziene, Tomas Venckunas, Justin J Lang, Grant R Tomkinson","doi":"10.1136/jech-2024-223072","DOIUrl":"10.1136/jech-2024-223072","url":null,"abstract":"<p><strong>Background: </strong>Physical fitness is an excellent marker of general health and performance. We aimed to calculate trends in physical fitness among Lithuanian adolescents between 1992 and 2022.</p><p><strong>Methods: </strong>Using a repeated cross-sectional design, body size and physical fitness data for 17 918 Lithuanian adolescents (50.3% female) aged 11-17 years were collected in 1992, 2002, 2012 and 2022. Body mass index (BMI) was calculated from measured height and body mass, with BMI z-scores (zBMI) calculated using WHO growth curves. Physical fitness was measured using the Eurofit test battery, with results converted to z-scores using European norms. With adjustment for zBMI, trends in mean fitness levels were calculated using general linear models. Trends in distributional characteristics were visually described and calculated as the ratio of SDs.</p><p><strong>Results: </strong>We found significant large declines (standardised effect size (ES) ≥ 0.80) in 20-m shuttle run and bent arm hang performance, and significant small declines (ES=0.20-0.49) in standing broad jump, plate tapping, sit-and-reach and sit-ups performance. In contrast, we found a significant moderate improvement (ES=0.50-0.79) in flamingo balance performance and a significant negligible improvement (ES<0.20) in 10×5-m shuttle run performance. Poorer trends were observed in low performers (below the 20th percentile) compared with high performers (above the 80th percentile).</p><p><strong>Conclusion: </strong>Health-related fitness (ie, cardiorespiratory and musculoskeletal fitness) levels have declined among Lithuanian adolescents since 1992, particularly among those with low fitness. National health promotion policies are required to improve current trends.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":"288-294"},"PeriodicalIF":4.9,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741353","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":"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":"249-256"},"PeriodicalIF":4.9,"publicationDate":"2025-03-10","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":"Applying the health capability profile: an analytical study of leading causes of death in the USA and of pressing public health issues.","authors":"Marion Coste, Jennifer J Prah","doi":"10.1136/jech-2023-220573","DOIUrl":"10.1136/jech-2023-220573","url":null,"abstract":"<p><p>Public health problems are complex; investigating them requires a framework that both accounts for multiple interactions among individuals and their intermediate and broader environment and also integrates equity concerns. Incorporating internal and external influences at the individual level, the health capability profile (HCP)'s 15 different health capabilities address this need.Using a systematic three-step deductive content analysis process, we examine hypothetical case studies representing leading causes of death in the USA (eg, heart disease, cancer and diabetes) as well as pressing public health issues such as COVID-19, alcohol use disorder, stigma and discrimination, intimate partner violence and firearm violence. After reviewing the profile (1), each case study is analysed through the framework of the HCP and developed into a flow diagram, through which we identify shortfalls between the observed and optimal levels of each health capability, as well as detrimental or enabling interactions among capabilities (2). We then determine factors and interventions that could help improve overall health capability (3).The HCP harnesses the multitude of unique individual profiles, and through aggregation and analysis, reveals common vulnerabilities (eg, discriminatory social norms and non-evidence-based information), and strengths. It recommends cross-cutting structural policy and programme reforms for institutions, schools, community resources and for individuals to develop a positive set of norms, knowledge, goals, attitudes and habits to chart the path towards health and well-being for all.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":"302-310"},"PeriodicalIF":4.9,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142924044","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":"Parental employment quality and the mental health and school performance of children and youth.","authors":"Anne E Fuller, Faraz V Shahidi, Jinette Comeau, Li Wang, Gita Wahi, James R Dunn, Harriet MacMillan, Catherine S Birken, Arjumand Siddiqi, Katholiki Georgiades","doi":"10.1136/jech-2024-223366","DOIUrl":"https://doi.org/10.1136/jech-2024-223366","url":null,"abstract":"<p><strong>Background: </strong>Lower-quality employment, characterised by excessive or part-time hours, irregular schedules and inadequate earnings, is a key social determinant of health among adults. Research examining parental employment quality in relation to the mental health and school performance of children is lacking. The study objective was to measure the associations between parental employment quality and child mental health symptoms and school performance.</p><p><strong>Methods: </strong>We conducted a secondary analysis of the cross-sectional 2014 Ontario Child Health Study. Dependent variables were parent-reported child mental health symptoms and school performance. We used latent class analysis (LCA) to characterise employment status, hours, scheduling and earnings of parents. We used linear and multinomial regression to model the associations between parental employment quality, mental health symptoms, and school performance.</p><p><strong>Results: </strong>Our study sample consisted of 9,927 children. The LCA of dual-parent households yielded three classes of parental employment quality, which we labelled 'Dual Parent, High Quality', 'Dual Parent, Primary Earner Model' and 'Dual Parent, Precarious'. The LCA of single-parent households yielded two further classes, which we labelled 'Single Parent, High Quality' and 'Single Parent, Precarious'. Compared with children in the 'Dual Parent, High Quality' group, children in all other groups had higher-level mental health symptoms and lower school performance. Children with 'precarious' parental employment in both groups showed the least favourable outcomes.</p><p><strong>Conclusions: </strong>Lower-quality parental employment was associated with increased mental health symptoms and poorer school performance among children. A clearer understanding of these relationships and their underlying mechanisms can help inform relevant policies and interventions.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558776","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":"Cognitive ability in offspring conscripts and cardiovascular disease risk in extended family members: assessing the impact of modifiable risk factors on familial risk.","authors":"Maria Fernanda Vinueza Veloz, Marte Karoline Råberg Kjøllesdal, Huong Nguyen Thu, David Carslake, Øyvind Erik Næss","doi":"10.1136/jech-2024-222599","DOIUrl":"https://doi.org/10.1136/jech-2024-222599","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have demonstrated an inverse association between cognitive ability (CA) and risk of cardiovascular diseases (CVDs). This study aims to investigate the associations between CA in offspring and CVD mortality in relatives of the parental generation (ie, parents, aunts/uncles (A/U) and the partners of A/U) and assesses the role of modifiable risk factors on these associations.</p><p><strong>Methods: </strong>This longitudinal study included nearly 3 million adults who were followed up from age 45 until death. Data for participants were obtained through the linkage of various Norwegian surveys and registries. HRs for CVD mortality among the parental generation in relation to offspring CA were estimated using Cox proportional hazards regression.</p><p><strong>Results: </strong>One standard deviation increase in CA was associated with a 23%, 17%, 9% and 9% CVD mortality reduction in mothers (HR: 0.77, 95% CI (0.74, 0.81)), fathers (0.83, (0.81, 0.86)), A/U (0.91, (0.87, 0.94)) and A/U partners (0.91, (0.89, 0.94)), respectively. Accounting for modifiable risk factors in the parental generation attenuated the association in mothers from 23% to 9% (0.91, (0.87, 0.96)), fathers from 17% to 7% (0.93, (0.91, 0.96)), A/U from 9% to 1% (0.99, (0.96, 1.03)) and A/U partners from 9% to 2% (0.98, (0.95, 1.01)).</p><p><strong>Conclusions: </strong>We observed an inverse CA-CVD association in all familial relationships including non-genetically related duos (offspring-A/U partners). CA and CVD probably have shared causes such as genetic and environmental components common to the family members. These associations were largely accounted for by modifiable risk factors.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544527","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}