Journal of Epidemiology and Community Health最新文献

{"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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066246/pdf/","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":"OA","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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12015012/pdf/","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":"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}

{"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}