BMC Public Health最新文献

{"title":"Racial disparity in mortality from tuberculosis in the US between states with and without a history of Jim-Crow laws: an analysis of the Global Burden of Disease (GBD) and risk factors study, 1990 to 2019.","authors":"Philimon N Gona, Lorena M Estrada-Martinez, Lingling Zhang, Clara M Gona, Aaloke Mody, Sowmya R Rao, Joseph Cooper, Kibibi Mack-Shelton, Ping Chen, Suzanne G Leveille, Ali H Mokdad","doi":"10.1186/s12889-024-20522-9","DOIUrl":"10.1186/s12889-024-20522-9","url":null,"abstract":"<p><strong>Background: </strong>While TB-related mortality in the US declined four-fold from 1990 to 2019, country-level estimates of TB burden obscure within-state racial heterogeneity and changes in TB burden over time. In sixteen US Southern States and Washington DC, the effects of health inequities engendered by Jim-Crow laws enacted from the late 1800s to the 1960s have not been evaluated for TB-related mortality. We, therefore, sought to compare TB mortality rates and annualized rate of change (AROC) between 1990 and 2019 in former Jim-Crow vs. non-Jim-Crow states to help guide response efforts and inform resource prioritization to improve racial equity.</p><p><strong>Methods: </strong>We evaluated whether TB-related mortality varied over time, from 1990 to 2019, between states that have a history of enacting Jim-Crow laws vs. states with no such history using estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019). TB mortality per 100,000 population and bootstrap 95% uncertainty intervals (UIs) were modeled using the Cause of Death Ensemble model (CODEm) framework with varying combinations of predictive covariates. For changes over time, we present age-standardized AROC as the percent difference in the natural logarithm of the rate in 1990 and 2019 divided by 30 (i.e., 100*[ln(2019 Rate/1990 Rate)/(30)) and the corresponding 95% UIs.</p><p><strong>Results: </strong>TB-related mortality in all US states declined between 1990 and 2019. From 1990 to 2019, most former Jim-Crow states had higher mortality rates than states that did not enact Jim-Crow laws. The most significant decline in TB mortality was in Washington DC, with a six-fold decline from 2.69 (2.46-2.96) per 100,000 population in 1990 to 0.45(0.37-0.55) in 2019, corresponding to an AROC of -0.83% (-0.86;-0.79). The lowest decline was in Iowa, from 0.30 (0.27-0.33) to 0.09 (0.07-0.11) (AROC: -0.70% (-0.76; -0.63)). Eleven of the 16 states and Washington DC in the third tertile of TB mortality rate in 1990 (range 0.81-2.69) had a history of Jim-Crow laws, whereas none of the 17 states in the first tertile (range 0.30-0.51) had such history. Conversely, mortality decreased relatively slowly in former Jim-Crow states than in non-Jim-Crow states.</p><p><strong>Conclusions: </strong>Even though the 1964 Civil Rights Act dismantled Jim-Crow statutes, racial inequities in TB burden experienced by past generations may still be felt in subsequent generations. Understanding the role of structural racism at the intersection of science and medicine shows the complex ways historical laws, such as Jim-Crow laws, continue to negatively impact health outcomes and warn of future dangers, such as COVID-19, to avoid.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11542262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589699","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":"Correction to: Association between BMI and increased time-to-pregnancy in planned pregnancy couples: a cohort study in Guangzhou, China.","authors":"Yuxian Zhang, Dongling Gu, Yanyuan Xie, Bing Li","doi":"10.1186/s12889-024-20528-3","DOIUrl":"10.1186/s12889-024-20528-3","url":null,"abstract":"","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11542225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589624","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":"Interactive association of metals and Life's Essential 8 with mortality in U.S. adults: a prospective cohort study from the NHANES dataset.","authors":"Weipeng Zhang, Weiqiang Chen, Dengqiu Lu, Junfeng Nie, Zhumin Hu, Cuiyao Xian","doi":"10.1186/s12889-024-20580-z","DOIUrl":"10.1186/s12889-024-20580-z","url":null,"abstract":"<p><strong>Background: </strong>Life's Essential 8 (LE8) is a novel assessment of cardiovascular health (CVH) by evaluating lifestyle, and reports of the associations between LE8 and urinary metals on mortality have been very limited. This study aimed to conduct a prospective cohort study and investigate the combined effects of metals and LE8 on mortality in U.S. adults.</p><p><strong>Methods: </strong>This study enrolled participants with complete information on urinary metals, LE8, mortality status, and confounders from the National Health and Nutrition Examination Survey (2005-2018). The Cox regression model, adaptive lasso penalized regression, and restricted cubic spline were used to analyze the individual effects of metals and LE8 on all-cause mortality. The additive and multiplicative interaction scales and quantile g-computation were used to evaluate the interaction and combined effects. Stratified analyses were performed to clarify whether metals and LE8 interacted with other variables to influence all-cause mortality.</p><p><strong>Results: </strong>A total of 8017 participants were included in this study. The concentrations of cadmium, cobalt, lead, antimony, and thorium were greater in the low CVH group than in the high CVH group [median (µg/L): 0.29 vs. 0.19, 0.36 vs. 0.35, 0.48 vs. 0.39, 0.05 vs. 0.04, and 0.07 vs. 0.06]. The interaction between cadmium and LE8 was statistically significant, with a synergy index of 1.169 (95% CI: 1.004, 1.361). The stratified analyses showed that the interaction between age and LE8 had an impact on all-cause mortality (P for interaction = 0.004).</p><p><strong>Conclusions: </strong>In this representative sample of the U.S. population, we found that the combined effect of cadmium, lead, thallium, and LE8 was positively associated with all-cause mortality. Furthermore, the interaction between cadmium and LE8 influenced all-cause mortality. So people should adopt healthy behaviors and reduce heavy metal exposure to minimize the risk of adverse health outcomes.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11542460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589680","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":"Disposal of SARS-CoV-2 corpses: experiences of environmental health officers.","authors":"Edward Wilson Ansah, Jacob Owusu Sarfo, Daniel Apaak, Samuel Maneen, Nkosi Nkosi Botha","doi":"10.1186/s12889-024-20569-8","DOIUrl":"10.1186/s12889-024-20569-8","url":null,"abstract":"<p><strong>Background: </strong>Though the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is no more of a public health emergency, the experiences from burying SARS-CoV-2 infectious dead bodies may remain with the workers. For Environmental Health Officers (EHOs), dealing with decedents during the SARS-CoV-2 outbreak may arouse strong feelings of pity, horror, repulsion, disgust, and anger at the tragedy. Therefore, this study aims to explore the experiences of EHOs in disposing off of confirmed or suspected SARS-CoV-2 fatalities in Ghana.</p><p><strong>Methods: </strong>Using an 18-item interview guide, we gathered data from 27 EHOs from three regions of Ghana. We followed the steps in Descriptive Phenomenology in conducting the data analysis.</p><p><strong>Results: </strong>i. EHOs were confronted with several occupational health and safety (OHS) hazards like physical and chemical injuries, threat of harm, and psychological harm, ii. The officers also faced severe shortage of personal protective equipment (PPE). Unfortunately, they were not provided with any form of psychological support during the period.</p><p><strong>Conclusion: </strong>The SARS-CoV-2 outbreak in Ghana exposed major fault lines in the health and safety/disaster and emergency preparedness of EHOs towards the burial of infectious disease dead bodies. Clearly, the disposal exercise failed to uphold the Sustainable Development Goals (SDGs) 4.4, 8.3, and 8.5, which advocate for the promotion of decent jobs for all.</p><p><strong>Recommendation: </strong>Ghana's Ministries of Health, Local Government, and Sanitation and Water Resources need to attach Clinical Psychologists and security personnel to the disposal teams in future exercises to provide psychological support and security to the team. Though studies on the disposal of infectious bodies in Africa exist, very little is known about the experiences of EHOs in the disposal of SARS-CoV-2 dead bodies during the outbreak.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11539444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589532","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":"Influence of air pollution on the nonaccidental death before and after the outbreak of COVID-19.","authors":"Chaohua Wei, Zhuchao Wu, Xinlan Mao, Zheyue Wang, Qiang Zhang, Weimin Kong, Jianning Xu, Jian Sun, Jianming Wang","doi":"10.1186/s12889-024-20542-5","DOIUrl":"10.1186/s12889-024-20542-5","url":null,"abstract":"<p><strong>Background: </strong>During the COVID-19 pandemic, non-therapeutic interventions (NPIs), such as traffic restrictions, work stoppages, and school suspensions, have led to a sharp decline in the concentration of air pollutants in the epidemic sites. However, few studies focused on the impact of air pollutant changes on the risk of nonaccidental death.</p><p><strong>Method: </strong>We selected Yancheng City, China, as the study site and applied a Generalized Additive Model (GAM) based on the quasi-Poisson distribution to evaluate the impact of atmospheric pollutants exposure on the nonaccidental death of local residents. The time span of this study was set from January 1, 2013, to December 21, 2022, that is, before and after the outbreak of COVID-19.</p><p><strong>Results: </strong>The concentration of some air pollutants has greatly varied after the outbreak of COVID-19, with a significant decline for PM_2.5 (- 43.4%), PM₁₀ (- 38.5%), SO₂ (- 62.9%), and NO₂ (- 22.6%), but an increase for O₃ (+ 4.3%). Comparative analysis showed that PM_2.5 contributed to an increased risk of nonaccidental death after the outbreak of COVID-19. With an increase in PM_2.5 by 10 µg/m³, the excess relative risks (ER) of nonaccidental death of residents increased by 1.01% (95%CI: 0.19%,1.84%). The stratified analysis revealed that air pollutants impacted nonaccidental deaths in both men and women before the outbreak of COVID-19. After the outbreak of COVID-19, PM₁₀ had a significant effect on male nonaccidental deaths. The concentrations of PM_2.5, PM₁₀, and SO₂ increased by 10 µg/m³, the ER of PM_2.5, PM₁₀, and SO₂ on female nonaccidental death increased by 1.52% (0.38%,2.67%), 0.58% (0.02%,1.13%), and 15.09% (5.73%,25.28%), respectively. Before the outbreak of COVID-19, five air pollutants had an impact on the death of residents from cardiovascular disease (CVD). After the outbreak of COVID-19, only PM₁₀ significantly affected the death risk of CVD. In addition, we discovered that PM_2.5, PM₁₀, and SO₂ significantly impacted the risk of death due to respiratory diseases before and after the outbreak of COVID-19.</p><p><strong>Conclusions: </strong>Air pollutants have different effects on nonaccidental deaths before and after the COVID-19 outbreak. A decrease in air pollutant concentration due to the NPIs for COVID-19 had a significant effect on the reduction of the risk of nonaccidental death.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11539445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589674","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":"High anaemia and iron deficiency prevalence among pregnant women living in low groundwater iron areas of Bangladesh.","authors":"Mohammed Imrul Hasan, Shamim Ahmed, Alistair R D McLean, A M Quaiyum Rahman, Mohammad Saiful Alam Bhuiyan, S M Mulk Uddin Tipu, Sabine Braat, Shams El Arifeen, Jena D Hamadani, Sant-Rayn Pasricha, Eliza M Davidson","doi":"10.1186/s12889-024-20480-2","DOIUrl":"10.1186/s12889-024-20480-2","url":null,"abstract":"<p><strong>Background: </strong>Anaemia is a significant public health concern in Bangladesh, yet data on the prevalence of anaemia in pregnancy and the contribution of iron deficiency are limited. Given the reliance on groundwater for drinking, a better understanding of the role of drinking water iron in anaemia aetiology is also required to inform anaemia prevention strategies.</p><p><strong>Methods: </strong>This cross-sectional study enrolled 1500 pregnant women from Narayanganj district, Bangladesh, during their second or third trimester. Anaemia and iron status were described and their relationship with drinking water iron assessed using regression analyses.</p><p><strong>Results: </strong>The prevalence of anaemia was 38% (95% confidence interval, CI: 35%, 40%), with 10% (95% CI: 9%, 12%) experiencing moderate-to-severe anaemia. Iron deficiency affected 48% (95% CI: 45%, 50%) of participants. Although drinking water iron concentrations were generally low (median: 0 mg/L; interquartile range: 0-1), high concentrations (≥ 2 mg/L) were associated with increased ferritin levels but did not significantly impact iron deficiency (95% CI: 0·73, 1·02) or anaemia (95% CI: 0·79, 1·17) prevalence. Iron deficient women had a 1·86 (95% CI: 1·61, 2·15) adjusted prevalence ratio for anaemia and a 4·22 (95% CI: 2·89, 6·17) adjusted prevalence ratio for moderate-to-severe anaemia, compared to iron replete women.</p><p><strong>Conclusions: </strong>Anaemia and iron deficiency are highly prevalent among pregnant women in Narayanganj. These findings challenge the assumption of low iron deficiency prevalence throughout Bangladesh and highlight iron deficiency in pregnancy as a potentially underrecognized public health problem, particularly in regions with low drinking water iron. Further research is needed to clarify the contribution of drinking water iron to iron deficiency and anaemia in Bangladesh.</p><p><strong>Trial registration: </strong>The study is registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12621000982819, registered 26/07/2021).</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11539743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582027","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":"The societal burden associated with adolescent idiopathic scoliosis: a cross-sectional burden-of-disease study.","authors":"Thomáy-Claire Ayala Hoelen, Silvia M A A Evers, Jacobus J Arts, Paul C Willems, Ghislaine A P G van Mastrigt","doi":"10.1186/s12889-024-20423-x","DOIUrl":"10.1186/s12889-024-20423-x","url":null,"abstract":"<p><strong>Background: </strong>In the general population the prevalence of adolescent idiopathic scoliosis (AIS) is 2-3%. There is growing awareness of how AIS affects the quality of life of patients. However, the extent of the societal burden AIS poses remains poorly understood. Therefore, this study aimed to determine the societal burden of AIS.</p><p><strong>Methods: </strong>A cross-sectional burden of disease study was conducted using a bottom-up, prevalence-based approach. Patients with AIS or guardians of a child diagnosed with AIS residing in the Netherlands were eligible for inclusion. The survey was distributed between June - December 2022 and was completed once by each participant. Costs were assessed using the institute for Medical Technology Assessment - Medical Consumption and Productivity Cost Questionnaires. The health-related quality of life (HRQoL) was assessed using the EuroQol 5D-5L/EuroQol 5D Youth and the Scoliosis Research Society-22 revised questionnaires. Costs and HRQoL were identified, measured, and valued.</p><p><strong>Results: </strong>Participants (n = 229) were predominantly female (92%), on average 35 years old, and were employed (65%). The societal cost for a patient with AIS in the Netherlands was €12,275 per year. The largest costs were estimated for the healthcare and productivity losses. The mean utility score for adults was 0.7 (SD 0.20). Severe pain was experienced by 10% of the adult participants and 44% reported to experience moderate pain/discomfort. Statistically significant differences between different age groups were present for the sector costs and HRQoL.</p><p><strong>Conclusions: </strong>AIS negatively impacts societal costs and the HRQoL. Reducing the burden that is posed on the productivity sector by AIS and further improving the HRQoL for AIS patients is needed.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11539827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589788","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":"Ask Your Relative: A mixed method analysis of the Sexual Health and Healthy Relationship Q&As submitted by American Indian Alaska Native young adults.","authors":"Stephanie Craig Rushing, Amanda Gchachu Kakuska, Jane Manthei, Tommy Ghost Dog, Asia Brown, Corey Begay, Celena Ghost Dog, Michelle Singer, Sean Simpson, Kelley Milligan, Allyson Kelley","doi":"10.1186/s12889-024-20550-5","DOIUrl":"10.1186/s12889-024-20550-5","url":null,"abstract":"<p><strong>Background: </strong>Disparities in sexual health outcomes persist among American Indian and Alaska Native (AIAN) youth due to intersectional challenges accessing youth-friendly health services. AIAN youth have an increased prevalence of STIs and teen pregnancy. To address disparities in sexual health outcomes, the Ask Auntie/Ask Your Relative (AYR) Q&A service has been used by AIAN youth and young adults for over seven years as a trusted resource for information on sensitive health topics. There is a continued need to better understand the health-seeking behaviors of AIAN youth, especially those related to healthy relationships and sexual health, to improve the alignment of health resources to their needs.</p><p><strong>Methods: </strong>This mixed-method study began with two phases. Phase 1 involved an analysis of all AYR data using Google Analytics and basic frequency counts. Phase 2 reviewed all questions and answers related to sexual health and healthy relationships (N = 240) using thematic analysis, NVivo 12.0, and intersectionality, guided by the social determinants of health. All AYR answers were coded based on type, name/location, number of times viewed, and examples. The final step of the analytic process was to utilize an intersectional approach and socioecological model (Individual, Community, Tribe/Nation, and World) to create a visual model with results.</p><p><strong>Results: </strong>Phase 1-Since We R Native began tracking AYR data, the service has been utilized by 2.37 M users, with 1.16 M unique pageviews. The average time on the page was 4 min and 46 s. The number of AYR questions submitted varied by year, and were most frequent in 2016, then decreased in subsequent years. In Phase 2, the main themes identified in AYR questions were (1) Reaching Out for Help, (2) Identity and Physical Development, and (3) Healthy Relationships. Analysis of the Q&A answers identified 244 resources, and of these, 100 were Native-specific. The context-specific resources represented 21 uniquely coded health topics, ranging from women's health to behavioral health.</p><p><strong>Conclusions: </strong>The broad range of healthy relationship and sexual health questions submitted to the AYR service reflects the types of health information that AIAN young adults want to know about. Resources provided in response to their questions connected Q&A viewers to a wide variety of organizations and programs designed to support AIAN young adults in their health and wellness journey. Findings from this study may be useful for creating additional culturally tailored resources.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11539771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589596","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":"Suicide attempt survivors' recovery-related agency in the relational context of services: a qualitative analysis.","authors":"Selma Gaily-Luoma, Jukka Valkonen, Juha Holma, Aarno Laitila","doi":"10.1186/s12889-024-20459-z","DOIUrl":"10.1186/s12889-024-20459-z","url":null,"abstract":"<p><strong>Background: </strong>Suicidal persons' contacts with services present a key opportunity for suicide prevention. However, interventions by services are not always effective. A deeper understanding of suicidal service users' agency and its implications may facilitate the provision of meaningful responses to help-seeking during suicidal crises. This abductive study explores the recovery-related agency of suicide attempt survivors and the perceived role of interactions with services in facilitating or hindering it.</p><p><strong>Methods: </strong>Fourteen Finnish suicide attempt survivors were interviewed in-depth on their experiences of interacting with services during a recent suicidal episode. An operationalization of recovery-related agency as the expressed ability to take (mental or physical) action in a direction perceived as aiding recovery from suicidality (i.e., the coupling of recovery-related intentionality and power) was used to explore transcribed interviews through directed content analysis. Data were further categorized based on whether the service context was perceived as helpful or unhelpful to recovery efforts.</p><p><strong>Results: </strong>All participants expressed both agency and non-agency in relation to their recovery process. The relational context provided by services was presented as highly relevant for the achievement and sustainability of recovery-related agency as well as for participants' experience of safety in instances when agency was lacking. The results are presented as a typology of recovery-related agency in its perceived relational context, with the categories of sustained agency, strained agency, contained non-agency and uncontained non-agency.</p><p><strong>Conclusions: </strong>The concept of agency helped capture important aspects of suicidal individuals' recovery-related efforts and the role of services in facilitating or hindering them. The findings illuminate the value of viewing suicidal service users as agents of their own recovery process as well as the potential costs of ignoring this perspective in service delivery and design.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11539742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589772","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":"A study of the enablers and barriers to the collection of sociodemographic data by public health units in Ontario, Canada during the COVID-19 pandemic.","authors":"Menna Komeiha, Gregory Kujbida, Aideen Reynolds, Ikenna Mbagwu, Laurie Dojeiji, Joseph J O'Rourke, Shilpa Raju, Monali Varia, Helen Stylianou, Sydnee Burgess, Oluwasegun Jko Ogundele, Andrew D Pinto","doi":"10.1186/s12889-024-20519-4","DOIUrl":"10.1186/s12889-024-20519-4","url":null,"abstract":"<p><strong>Background: </strong>Collection and use of sociodemographic data (SDD), including race, ethnicity and income, are foundational to understanding health inequities. Ontario's public health units collected SDD as part of COVID-19 case management and vaccination activities. This research aimed to identify enablers and barriers to collecting SDD during COVID-19 case management and vaccination.</p><p><strong>Methods: </strong>As part of a larger mixed-method research study [1], qualitative methods were used to identify enablers and barriers to SDD collection during the COVID-19 pandemic. Purposive sampling was used to recruit participants from Ontario's 34 public health units. Sixteen focus groups and eight interviews were conducted virtually using Zoom. Interview data were transcribed and analyzed using inductive and deductive qualitative description.</p><p><strong>Results: </strong>SDD collection enablers included: legally mandating SDD collection and having dedicated data systems, technological and legal supports, senior management championing SDD collection, establishing rapport and trust between staff and clients, and gaining insight from the experiences from local communities and other jurisdictions. Identified barriers to SDD collection included: provincial data systems being perceived as lacking user-friendliness, SDD collection \"was not a priority,\" time and other constraints on building staff and client rapport, and perceived discomfort with asking and answering personal SDD questions.</p><p><strong>Conclusion: </strong>A combination of provincial and local organizational strategies including supportive data systems, training, and frameworks for data collection and use, are needed to normalize and scale up SDD collection by local health units beyond the context of the COVID-19 pandemic.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11539653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589585","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}