Journal of Epidemiology and Community Health最新文献

{"title":"Are there any sociodemographic factors associated with non-uptake of HPV vaccination of girls in high-income countries with school-based vaccination programmes? A systematic review.","authors":"Emily Dema, Roeann Osman, Kate Soldan, Nigel Field, Pam Sonnenberg","doi":"10.1136/jech-2024-222488","DOIUrl":"10.1136/jech-2024-222488","url":null,"abstract":"<p><strong>Background: </strong>Uptake of human papillomavirus (HPV) vaccination is generally high in high-income countries with school-based vaccination programmes; however, lower uptake in certain population subgroups could continue pre-immunisation inequalities in cervical cancer.</p><p><strong>Methods: </strong>Six electronic databases were searched for quantitative articles published between 1 September 2006 and 20 February 2023, which were representative of the general population, with individual-level data on routine school-based vaccination (with >50% coverage) and sociodemographic measures. Titles, abstracts and full-text articles were screened for eligibility criteria and assessed for bias. A second independent reviewer randomly screened 20% of articles at each stage. A narrative synthesis summarised findings.</p><p><strong>Results: </strong>24 studies based in eight countries (Australia, Belgium, Canada, New Zealand, Norway, Sweden, Switzerland, UK) were included. Studies reported vaccination uptake by individual-level and area-level socioeconomic status (SES), parental education, religion, ethnicity and/or country of birth. 19 studies reported that more than 70% were vaccinated (range: 50.7%-93.0%). Minority ethnic groups and migrants were more likely to have lower vaccination uptake than White groups and non-migrants (11/11 studies). Lower SES was also associated with lower uptake of vaccination (11/17 studies). Associations with other sociodemographic characteristics, such as parental education and religion, were less clear.</p><p><strong>Conclusions: </strong>Even in high-income countries with high coverage school-based vaccination programmes, inequalities are seen. The totality of available evidence suggests girls from lower SES and minority ethnic groups tend to be less likely to be vaccinated. Findings could inform targeted approaches to mop-up vaccination and cervical cancer screening amidst changing HPV epidemiology in a vaccine era.</p><p><strong>Trial registration number: </strong>CRD42023399648.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":"388-396"},"PeriodicalIF":4.9,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12015032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883281","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":"Associations between extreme weather events and child undernutrition: evidence from sub-Saharan Africa, 2010-2019.","authors":"Kenneth Petscavage, Martin Kavao Mutua, Abram Luther Wagner, Emily Treleaven","doi":"10.1136/jech-2024-222748","DOIUrl":"10.1136/jech-2024-222748","url":null,"abstract":"<p><strong>Background: </strong>Extreme weather events, or natural disasters, present a large and increasing threat to human health, infrastructure and food security, including in sub-Saharan Africa (SSA), where the burden of undernutrition is high. However, research about associations between natural disasters and undernutrition in early childhood is limited.</p><p><strong>Methods: </strong>We combined anthropometric data of children aged 0-59 months from 51 Demographic and Health Surveys datasets collected from 2010 to 2019 in 30 countries in SSA with information on natural disaster events (flood, drought, other) from the Emergency Events Database database to determine disaster exposure. The analytic sample included 320 479 children. We used generalised estimating equations to predict stunting, wasting and anaemia by disaster exposure and selected covariates.</p><p><strong>Results: </strong>Almost 20% (19.7%) of children under five were exposed to a natural disaster in the preceding year. In adjusted analysis, children exposed to at least one disaster in the preceding year had a relative risk (RR) of wasting 1.17 times higher than unexposed children (95% CI 1.12, 1.22). Adjusted models examining exposure to drought or flood consistently estimated higher risks of wasting post-disaster (drought RR 1.36, 95% CI 1.26, 1.47; flood RR 1.07, 95% CI 1.02, 1.12). RRs increased when using a 3-month exposure period. However, exposure to natural disaster was not consistently associated with significant differences in RR of stunting or anaemia.</p><p><strong>Conclusion: </strong>Natural disasters are prevalent in SSA. Given the high risk of wasting associated with disaster exposure, policymakers should prioritise interventions to address wasting in post-disaster settings.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":"359-365"},"PeriodicalIF":4.9,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857073","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":"SARS-CoV-2 testing, test positivity and vaccination in social housing residents compared with the general population: a retrospective population-based cohort study.","authors":"Gina Agarwal, Homa Keshavarz, Ricardo Angeles, Melissa Pirrie, Francine Marzanek, Francis Nguyen, Jasdeep Brar, J Michael Paterson","doi":"10.1136/jech-2024-222526","DOIUrl":"10.1136/jech-2024-222526","url":null,"abstract":"<p><strong>Background: </strong>The consideration of unique social housing needs has largely been absent from the COVID-19 response, particularly in tailoring strategies to improve access to testing and vaccine uptake among vulnerable and high-risk populations in Ontario. Given the growing population of social housing residents, this study aimed to compare SARS-CoV-2 testing, positivity, and vaccination rates in a social housing population with those in a general population cohort in Ontario, Canada.</p><p><strong>Methods: </strong>This population-based cohort study used administrative health data from Ontario to examine SARS-CoV-2 testing, positivity and vaccination rates in social housing residents compared with the general population from 1 January 2020 to 31 December 2021. All comparisons were unadjusted, stratified by sex and age and evaluated using standardised differences.</p><p><strong>Results: </strong>The rates of SARS-CoV-2 PCR testing were lower among younger age groups and higher among older adults within the social housing cohort, compared with the general population cohort. SARS-CoV-2 test positivity was higher in social housing than in the general population among individuals aged 60-79 years (7.9% vs 5.3%, respectively) and 80 years and older (12.0% vs 7.9%, respectively). Overall, 34.3% of social housing residents were fully vaccinated, compared with 29.6% of the general population cohort. However, a smaller proportion of social housing residents had received a booster vaccine (36.7%) compared with the general population (52.4%).</p><p><strong>Conclusion: </strong>Improved and targeted outreach strategies are needed to increase the uptake of COVID-19 booster vaccines among social housing residents.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":"233-238"},"PeriodicalIF":4.9,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12015039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640261","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":"Insights on health policies from a political philosophy perspective.","authors":"Daniel G Abiétar, Mariacarla Martí-González, Elena Aguiló, Nacho Sánchez-Valdivia","doi":"10.1136/jech-2023-220568","DOIUrl":"10.1136/jech-2023-220568","url":null,"abstract":"<p><p>Health policies play a crucial role in shaping people's well-being. While public health often relies on evidence-based policy to improve health outcomes, many non-scientific factors determine the health policy-making process. This article explores how public health advocacy can be strengthened by examining the relationship between political philosophy and the scientistic aspirations of public health.We begin by critically assessing the deliberative decision-making model, offering insights on policy processes that could inspire new directions in health policy research. To enhance these efforts, we delve into the philosophical critique of scientism, aiming to liberate public health from its technocratic inclinations. Our analysis draws on political philosophy from two angles: first, we revisit Renaissance utopias to highlight the risks of a science-driven society devoid of ethics; second, we introduce modern perspectives on democratic justice, advocating for health policies that resist domination.Ultimately, we argue for a new model of health policy science that positions public health as a key political actor. By focusing on the everyday realities of policy-making, public health can tackle two fundamental questions: How are citizens' interests considered in health policy? And how do we deliberate the goals and means of health policy? By addressing these questions, our proposals aim to enhance public health advocacy, promoting research and actions that lead to more just and inclusive health policies, ensuring the protection of everyone's health.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":"311-315"},"PeriodicalIF":4.9,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632944","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":"Number of children and risk of dementia: a cohort study.","authors":"Katrin Wolfova, Rebecca A Hubbard, Pavla Brennan Kearns, Virginia W Chang, Paul Crane, Andrea Z LaCroix, Eric B Larson, Sarah Tom","doi":"10.1136/jech-2024-222717","DOIUrl":"10.1136/jech-2024-222717","url":null,"abstract":"<p><strong>Background: </strong>Findings on the link between the number of children and dementia risk are inconsistent, mostly studied in females, suggesting pregnancy-related changes may be a key factor in this association.</p><p><strong>Methods: </strong>The Adult Changes in Thought Study is a cohort of adults aged ≥65 years from Kaiser Permanente Washington. The primary exposure was the number of children (0, 1, 2, 3 or ≥4), and the outcome was an incident dementia diagnosis. Cox proportional-hazards models were adjusted for demographic and early-life socioeconomic confounders. Models were then stratified by sex and by birth year <1928 versus ≥1928.</p><p><strong>Results: </strong>Among 4668 participants (average age at enrolment 74.1±SD 6.3 years; 59% female), 967 (21%) had 0 children, 484 (10%) had one child, 1240 (27%) had two children, 968 (21%) had three children and 1009 (22%) had four or more children. We found no association between the number of children and dementia overall or after stratification by birth cohort. When stratified by sex and adjusting for confounders, having ≥4 children compared with two children was associated with a higher rate of dementia in males (HR=1.31, 95% CI 1.01 to 1.71).</p><p><strong>Conclusions: </strong>The number of children was not consistently associated with the risk of dementia. We observed a greater risk of dementia only among males who had ≥4 children, with the lower bound of the 95% CI marginally exceeding 1. These findings suggest that the number of children may influence the risk of dementia through other than pregnancy-related pathways.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":"280-287"},"PeriodicalIF":4.9,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11903176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693451","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":"Would the now shelved congestion tax narrow or widen the health equity gap if brought back to NYC?","authors":"Anthony Amin Milki, Nina Flores, Jeanette Stingone, Mychal Johnson, Stephanie Lovinsky-Desir","doi":"10.1136/jech-2024-223263","DOIUrl":"10.1136/jech-2024-223263","url":null,"abstract":"","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":"316"},"PeriodicalIF":4.9,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669690","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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12015073/pdf/","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":"OA","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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12015071/pdf/","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":"OA","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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12015033/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}