BMC Public Health最新文献

{"title":"Anxiety in young university students: the mediating role of sense of coherence and self-esteem.","authors":"Henrique da-Silva-Domingues, Pedro Ángel Palomino-Moral, Rafael Del-Pino-Casado","doi":"10.1186/s12889-025-24646-4","DOIUrl":"https://doi.org/10.1186/s12889-025-24646-4","url":null,"abstract":"<p><strong>Background: </strong>Anxiety is a frequent mental health concern among university students, shaped by psychological, social, academic, and economic influences. While previous studies have linked anxiety to factors such as social support, family functioning, sense of coherence, and self-esteem, the mediating role of sense of coherence and self-esteem remains unclear. This study investigates these relationships, with particular attention to the potential mediating effects. The present study aimed to investigate the relationships between social support, family functioning, sense of coherence, self-esteem, and anxiety, with an emphasis on the mediating role of sense of coherence and self-esteem.</p><p><strong>Methods: </strong>The study included 530 university students from public universities in Andalusia (Spain), selected through stratified multistage cluster sampling. Analyses included descriptive statistics, Pearson correlations, t-tests, and path analysis.</p><p><strong>Results: </strong>The mean age of university students was 20.11 years. The majority of participants in the study were women (56.6%). More than 60% of university students considered themselves anxious. Anxiety was strongly and negatively associated with sense of coherence and self-esteem, and moderately negatively associated with social support and family functioning. Path analysis indicated that the model explained 69% of the variance in anxiety and 49% of self-esteem.</p><p><strong>Conclusions: </strong>Our findings suggest that social support and family functioning influence anxiety levels in university students, with sense of coherence and self-esteem acting as key mediators. Higher levels of both are linked to lower anxiety and better student well-being.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"3240"},"PeriodicalIF":3.6,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211819","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":"Health commitment's associations with health outcomes are independent of health behaviours: insights from a cross-sectional population health survey in Singapore.","authors":"Lixia Ge, Yun Hu, Annie Tan, Cherlyen Teo, Chun Wei Yap, Yeuk Fan Ng","doi":"10.1186/s12889-025-24610-2","DOIUrl":"https://doi.org/10.1186/s12889-025-24610-2","url":null,"abstract":"<p><strong>Background: </strong>An individual's commitment to health is a crucial component of their healthcare engagement. However, research is scarce that has systematically examined the association between commitment and health behaviours as well as health outcomes. We conducted this study to examine their associations in a representative community-dwelling adult population in Singapore.</p><p><strong>Methods: </strong>This cross-sectional study analysed data from the Khoo Teck Puat Hospital and Yishun Community Hospital's Population Health Survey 2022, which interviewed a representative sample of community-dwelling residents aged 18 years and above in Singapore's Northern Region between July and December 2022. Health commitment was assessed using the validated Commitment subscale of the Altarum Consumer Engagement (ACE) Measure™. Assessment of health behaviours encompassed smoking status, alcohol consumption, vegetable and fruit consumption, sleep duration and physical activity. Additionally, various health outcomes spanning physical, mental, and social health domains, as well as healthcare utilisation indicators, were collected. Social-demographic factors associated with commitment were identified via multiple linear regression. Multiple logistic or ordinal logistic regression models were employed to examine the associations between commitment and individual health behaviours and outcomes, adjusting for basic demographic variables.</p><p><strong>Results: </strong>The mean age of the participants was 49.7 years, ranging from 18 to 94 years, with 51% being females, and 68.2% belonging to the Chinese ethnicity. The results identified age group, ethnicity, marital status, housing type, monthly household income, and number of medications as factors associated with commitment. Significant associations were found between health commitment and various health behaviours. Furthermore, higher health commitment was consistently associated with an increased likelihood of subjective health outcomes (odds ratios range:1.17-1.28) and a reduced likelihood of healthcare utilisation (odds ratios range: 0.91-0.93), even after adjusting for health behaviours.</p><p><strong>Conclusions: </strong>These findings underscore the importance of assessing and addressing health commitment in healthcare practice and policy. Strategies to enhance health commitment hold potential for improving health behaviours and health outcomes, thereby contributing to overall well-being. However, it is important to note that the cross-sectional nature of this study does not allow for confirmation of causal pathways. Hence, longitudinal studies are needed to further clarify these relationships and their potential impact on overall well-being.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"3299"},"PeriodicalIF":3.6,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211521","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":"Association between loneliness and self-care in elderly individuals with chronic kidney disease: a structural equation modeling approach.","authors":"Elham Nejadsadeghi, Ahmad Vakili-Basir, Amir Mohamad Moghadasi, Shahab Papi","doi":"10.1186/s12889-025-24659-z","DOIUrl":"https://doi.org/10.1186/s12889-025-24659-z","url":null,"abstract":"","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"3303"},"PeriodicalIF":3.6,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211534","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":"Educational inequalities in trajectories of co-occurring behavioral health risk factors over four years: a latent class growth analysis.","authors":"Sophie Baumann, Andreas Staudt, Maria Zeiser, Jennis Freyer-Adam, Diana Guertler, Henriette Markwart, Anne Moehring, Ulrich John","doi":"10.1186/s12889-025-24663-3","DOIUrl":"https://doi.org/10.1186/s12889-025-24663-3","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to identify unobserved subgroups of persons with similar trajectories of co-occurring behavioral health risk factors (BRFs) over 4 years in an adult general population sample and to examine their relation to education.</p><p><strong>Methods: </strong>Data of 831 control group participants of a randomized controlled trial was analyzed. Participants aged 18-64 years who had consumed alcohol in the past 12 months were recruited at a registry office. Alcohol consumption, tobacco smoking, body mass index, and physical inactivity were assessed at baseline via self-report and 1, 3, and 4 years later. Latent class growth analysis was used to identify BRF trajectories and to test their association with school education, adjusted for sex, age, marital status, and self-rated health.</p><p><strong>Results: </strong>Eight BRF trajectory classes were identified, with the largest class (31% of participants) being characterized by stable low-to-moderate alcohol consumption and an otherwise healthy lifestyle. Higher-educated compared to lower-educated participants were more likely in this class than in other classes, including, among others, a class combining stable alcohol consumption, tobacco smoking, and increasing excess weight (Odds ratio, OR = 7.41, p < 0.001) and a class maintaining absence of BRFs over time (OR = 3.89, p < 0.001).</p><p><strong>Conclusions: </strong>This study demonstrates heterogeneity in BRF trajectories and their relation to education. Although higher-educated persons were more likely in classes with fewer BRFs and favorable BRF changes, alcohol consumption remained a common BRF in several of these trajectories. Trajectories of multiple co-occurring BRFs, particularly those involving tobacco smoking and unfavorable BRF changes, seem to disproportionately affect lower-educated persons.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"3291"},"PeriodicalIF":3.6,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211550","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":"Cardiovascular health behaviour, acrylamide exposure and health risk assessment of adolescents.","authors":"Mehtap Metin Karaaslan, Burhan Basaran","doi":"10.1186/s12889-025-24053-9","DOIUrl":"https://doi.org/10.1186/s12889-025-24053-9","url":null,"abstract":"<p><strong>Background: </strong>The presence of acrylamide at different levels in many foods in our daily diet is a very alarming situation for public health. The aim of this study was to evaluate the acrylamide exposure of adolescents resulting from the consumption of French fries in terms of carcinogenic and non-carcinogenic health risks and to reveal its relationship with heart health.</p><p><strong>Methods: </strong>This study was conducted on adolescents aged 13-15 years living in Türkiye. Firstly, a scale with tested reliability was used to determine the heart health behaviours of adolescents. Then, the acrylamide exposure levels were determined according to the deterministic model by taking the french fries consumption data of the adolescents for a retrospective 24-hour period. Acrylamide exposure level was then evaluated in terms of carcinogenic and non-carcinogenic health risks. Statistical differences between the groups were analysed by independent t test, Mann Whitney U test, Welch Test and Kruskal Wallis Test. Spearman's rho correlation coefficient was used to determine the degree of non-causal relationships.</p><p><strong>Results: </strong>All adolescents showed normal cardiovascular behaviour (63 ± 11). The acrylamide exposure level of all adolescents from French fries consumption ranged between 0-2.60 µg/kg/day. The mean THQ (Target Hazard Quotient) value for all adolescents was 0.11 ± 0.27 and the mean CR (Carcinogenic risk) value was 1.10E-05 ± 2.69E-04. Since the THQ value was lower than the reference value, the consumption of French fries was considered safe for adolescents. However, the CR value indicates the presence of potential carcinogenic health risks. There was no statistical difference between the acrylamide exposure level, THQ and CR values according to the cardiovascular behaviour scores of adolescents, whereas a statistical difference was found only between the BMI (body mass index) subcategories.</p><p><strong>Conclusion: </strong>The acrylamide exposure level calculated for adolescents is relatively high compared to other studies in the literature. Carcinogenic health risks associated with the consumption of French fries have been identified. It is thought that the results of the study will contribute to the studies and strategies to be developed to reduce dietary acrylamide exposure.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"3302"},"PeriodicalIF":3.6,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211563","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":"Loneliness in the Assyrian diaspora: the role of generational factors.","authors":"Shameran Slewa-Younan, Thomas P Nguyen, Iman Hegazi, Andre M N Renzaho","doi":"10.1186/s12889-025-24642-8","DOIUrl":"https://doi.org/10.1186/s12889-025-24642-8","url":null,"abstract":"<p><strong>Background: </strong>Loneliness, a key factor in wellbeing, is under-researched within migrant communities. This study examines loneliness among the Assyrian-Australian diaspora, an ethnoreligious group with a prolonged history of persecution and role of generational differences.</p><p><strong>Methods: </strong>An online survey of 210 Assyrian-Australian adults measured socio-demographic variables and loneliness using the UCLA Loneliness Scale.</p><p><strong>Results: </strong>Findings demonstrated that approximately 65.7% of participants reported moderately high to high degrees of loneliness which was influenced by generation (higher rates of loneliness among second generation) and socio-demographic variables such as age (increased loneliness was noted in the younger participants from second generation and older participants from first generation) and poorer self-reported general health. Participants suggested addressing loneliness through nationalistic activities, mental health education, peer support, and social infrastructure.</p><p><strong>Conclusion: </strong>These findings highlight the importance of understanding the relationship between loneliness in specific Assyrian-Australian subgroups and provides directions to inform the delivery of targeted psychosocial interventions and future research within this community.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"3297"},"PeriodicalIF":3.6,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211626","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":"Individual and area-level factors associated with depression in indonesia: a multilevel analysis using the 2018 national basic health research.","authors":"Sri Idaiani, Muhammad Fiarry Fikaris, Gemala Chairunnisa, Mashita Fajri, Laura Anselmi, Jonathan Gibson, Irmansyah, Budi Anna Keliat, Ida Ayu Mas Amelia Kusumaningtyas, Asri Maharani, Aryana Satrya, Dwidjo Susilo, Matt Sutton, Hasbullah Thabrany, Herni Susanti, Helen Brooks, Penny Bee, Jack Wilkinson","doi":"10.1186/s12889-025-23434-4","DOIUrl":"https://doi.org/10.1186/s12889-025-23434-4","url":null,"abstract":"<p><strong>Background: </strong>Depression has become the leading cause of disease burden in low- and middle-income countries. However, evidence on the determinants of depression in those countries has been limited. This study aims to identify the factors in individual and area levels associated with depression using existing nationally representative data in Indonesia.</p><p><strong>Methods: </strong>Multilevel mixed-effects logistic regression models were performed on various national-scale Indonesian cross-sectional surveys and Indonesian Population Census to estimate those associations. We included adults aged 18 + who participated in the National Basic Health Research 2018 in this study. Depression was measured using the Mini International Neuropsychiatric Interview (MINI). Individual level variables include demographic characteristics, socioeconomic status, history of diseases, health behaviours, healthcare accessibility, and familial history of psychosis. District-level variables include the availability of health providers and professionals, regional gross domestic product, and the happiness index.</p><p><strong>Results: </strong>We found that individual-level factors, i.e., education, occupation, marital status, economic status, comorbidities, health behaviours, and difficulty with healthcare access were associated with the risk of depression. Happiness index as district-level factor, is related to the odds of depression. District-level factors, including the availability of general practitioners and mental health professionals and the density of healthcare providers, had no significant association with depression. The measured variables provided modest explanatory value overall.</p><p><strong>Conclusion: </strong>Individual-level factors are associated with depression among adults in Indonesia. Among the district level factors, only happiness index is related to depression. These results strengthen previous studies which stated determinants at the individual level are an important factor in depression. Therefore, effective prevention programs in mental health need to target both individuals and families.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"3298"},"PeriodicalIF":3.6,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211641","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":"Analyzing the association between heat and utilization of inpatient care: evidence from Dresden University Hospital (Germany).","authors":"J Thiel, A Staudt, S Grummt, M Sedlmayr, E Henke, J Weidner","doi":"10.1186/s12889-025-24804-8","DOIUrl":"https://doi.org/10.1186/s12889-025-24804-8","url":null,"abstract":"<p><strong>Background: </strong>As a result of climate change, temperatures and the burdens on human health are rising. This study investigates the relationship between acute heat and hospitalizations for specific diseases at the University Hospital Carl Gustav Carus in Dresden, Germany.</p><p><strong>Methods: </strong>A statistical analysis was conducted using clinical data from 4,363 patients treated between January 1, 2018, and December 31, 2023. Data included demographic information and heat-related diagnoses categorized by codes from the International Classification of Diseases. Climatic data was sourced from the Dresden-Klotzsche weather station, focusing on days with air temperatures exceeding 23 °C (warm days) and 30 °C (heat days). Correlation analyses were performed to assess the relationship between heat events and hospital admissions on these days.</p><p><strong>Results: </strong>We found a positive correlation between hospital admissions and heat at temperatures ≥ 23 °C for all included diseases combined (p < 0.05). A positive correlation was observed between temperatures ≥ 23 °C and hospitalizations for the diseases dehydration (E86), stroke (I63) and chronic obstructive pulmonary disease (J44) (all p < 0.05). At temperatures of ≥ 30 °C, no statistically significant correlation was identified. We discovered that men, young children and older people were particularly affected by heat-related diseases.</p><p><strong>Conclusions: </strong>The findings based on routine data from one German university hospital indicate that moderate heat can impact hospitalizations for certain diseases, at temperatures above 30 °C, no evidence for a statistically significant association was found, possibly due to a lack of statistical power or behavioural adaptations. This underlines the need for low-threshold preventive measures in response to the health risks associated with rising temperatures.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"3293"},"PeriodicalIF":3.6,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211837","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":"Household income and obesity among older adults: the moderating role of race in a longitudinal analysis.","authors":"Sunkanmi Folorunsho, Victor Ajayi, Munirat Sanmori","doi":"10.1186/s12889-025-22910-1","DOIUrl":"https://doi.org/10.1186/s12889-025-22910-1","url":null,"abstract":"<p><strong>Background: </strong>Obesity among older adults in the United States is a growing public health concern, with rising rates contributing to chronic disease, disability, and premature mortality. While higher income is generally associated with lower obesity risk, this relationship may not hold equally across racial and ethnic groups. This study examines how household income relates to obesity among older adults and whether race moderates this association.</p><p><strong>Methods: </strong>We used longitudinal data from the Health and Retirement Study (2014-2018), a nationally representative panel of U.S. adults aged 50 and older (N = 12,118). Obesity was defined as BMI ≥ 30 using self-reported height and weight. Household income was measured both continuously and in quartiles. We estimated mixed-effects logistic regression models with race-income interaction terms, adjusting for age, gender, nativity, work status, functional limitations, and survey year.</p><p><strong>Results: </strong>Higher income was associated with reduced odds of obesity overall (OR = 0.95 per $10,000, 95% CI: 0.92-0.99), but this protective effect differed by race. Among White older adults, income was strongly protective; among Black adults, income had no significant effect (interaction OR = 1.05, p < 0.05); and among Hispanic adults, the effect was weaker and non-significant. Obesity disparities persisted across income levels, with high-income Black seniors having higher obesity prevalence than low-income Whites.</p><p><strong>Conclusions: </strong>Income-based health advantages do not accrue equally across racial groups. Interventions must go beyond economic measures to address structural barriers, cultural contexts, and life-course disadvantage that shape obesity risk in later life.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"3306"},"PeriodicalIF":3.6,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211473","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":"Exploring stakeholder perceptions and priorities related to reducing tick-related public health risks in natural environments of the United Kingdom.","authors":"Festus A Asaaga, Emmanuel S Tomude, Hermann Kam, Richard M J Hassall, Kayleigh M Hansford, Saudamini Venkatesan, Maya Holding, Dominic P Brass, Caroline Millins, Lucy Gilbert, Jolyon M Medlock, Bethan V Purse","doi":"10.1186/s12889-025-24500-7","DOIUrl":"https://doi.org/10.1186/s12889-025-24500-7","url":null,"abstract":"","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"3300"},"PeriodicalIF":3.6,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211498","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}