BMC Public Health最新文献

{"title":"Social contextual factors, social support and accessibility of social services in the health and life satisfaction of family caregivers in Hong Kong.","authors":"Shaolingyun Guo, Qiqi Chen, Ko Ling Chan","doi":"10.1186/s12889-025-23307-w","DOIUrl":"10.1186/s12889-025-23307-w","url":null,"abstract":"<p><strong>Purpose: </strong>Health issues and life satisfaction among family caregivers have attracted significant public and scholarly attention, but research on socio-demographic and social contextual factors contributing to family caregivers' burdens remains limited in scope. This study aims to assess the factors associated with subjective health, mental health and life satisfaction among family caregivers based on a representative community sample of Hong Kong families.</p><p><strong>Methods: </strong>The analysis was performed using the Family Survey, a territory-wide household survey conducted in Hong Kong. The data for the current study included 1,647 family members in either nuclear families or extended households. A three-phase multivariate regression analysis was carried out to investigate the associations between a variety of social contextual factors and physical health, mental health, as well as life satisfaction.</p><p><strong>Results: </strong>Results show that female caregivers experience significant psychological health burdens, older caregivers face physical health burdens, unemployment impacts overall life satisfaction, and lower monthly income and smaller living spaces contribute significantly to physical health and life satisfaction. Additionally, primary caregiving roles are associated with lower life satisfaction, while a higher level of perceived social support leads to better health and a higher level of life satisfaction. No significant relationship was found between caregiving duties and constraints on accessing social services for assistance.</p><p><strong>Conclusion: </strong>The study highlights the importance of enhancing social support and economic assistance for caregivers, particularly for women and the elderly, to alleviate psychological and physical burdens. Future services should focus on improving accessibility to social service resources and developing targeted programs to address these specific needs.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2008"},"PeriodicalIF":3.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12125718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186499","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 effect of the Covid-19 pandemic on the maternal mortality rate and the achievement of the Sustainable Development Goal in Brazil.","authors":"Gabriella Linhares Siqueira, Gabrielle Rossini de Oliveira Fontes, Alanna Gomes da Silva, Cassia Regina Gontijo Gomes, Fernanda Marçal Ferreira, José Paulo de Siqueira Guida, Eunice Francisca Martins, Libni Cosiello Fuillarat Ciaravolo, Maria Cristina Gabrielloni, Marina Cristina Dos Santos Brito, Fernanda Penido Matozinhos, Thales Philipe Rodrigues da Silva","doi":"10.1186/s12889-025-23219-9","DOIUrl":"10.1186/s12889-025-23219-9","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Reducing maternal mortality is a global health priority, as maternal death is an outcome that strongly impacts health services, the economy, and society. In addition to being a serious violation of women's reproductive rights, it is an important health indicator for a certain country, region, or health system. Despite recognition of several preventive measures, reducing maternal mortality is a complex and multifactorial task that involves social, individual, and local health system determinants. Brazil is in a transitional stage, characterized by its broad range of health services and even excessive interventions in childbirth care, such as caesarean sections. The Covid-19 has intensified these challenges, exposing weaknesses in the health system and impacting access to adequate care during pregnancy, childbirth and postpartum. However, inequities in pregnant and postpartum women's health care coexist with the advances, and preventable maternal deaths prevail in the country. This study aims to analyze the effect of the Covid-19 pandemic on the maternal mortality ratio (MMR) in different Brazilian states over a 24-year historical time series, from 2000 to 2023.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This is an epidemiological study with an ecological design carried out with secondary data by the Mortality Information System, selecting direct and indirect causes of maternal mortality in the Brazil, country's five macro-regions in the Brazil (North, Northeast, Midwest, South, and Southeast) and states from 2000 to 2023. Correction factors were applied to calculate the MMR per year. For the time trend analysis, we used the interrupted time series (IST) analysis, conducted through the Prais-Winsten linear regression model for Brazil, by state and for five Brazilian regions, as well as the maternal mortality ratio, stratified by direct and indirect causes. IST is one of the most robust approaches for measuring the effects of sudden political, economic, or natural events when time series data are available. We also calculated the annual percentage change (APC). In this study, 'impact' refers to any measurable change in the maternal mortality ratio (MMR) due to the Covid-19 pandemic. A 'positive impact' indicates an increase in MMR due to the Covid-19 pandemic, while a 'negative impact' reflects a decrease in MMR due to the Covid-19 pandemic. The ITS model was used to detect possible changes in level and trend (slope) after the intervention, enabling a robust analysis of the direct and indirect effects of events, such as the Covid-19 pandemic, on maternal mortality.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;During the period studied, 2021 had the highest maternal mortality ratio (MMR) at 113.14 maternal deaths per 100,000 live births, with significant inequalities across the states and regions of Brazil. The temporal trend analysis of the MMR showed a decreasing trend for Brazil, as well as for the Northeast and South regions. COVID-19 had","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2005"},"PeriodicalIF":3.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186501","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":"Weight-related bullying in schools: a review of school anti-bullying policies.","authors":"Amanda Hughes, Elisabeth Grey, Alice Haigherty, Fayth Shepherd, Fiona Gillison, Georgie MacArthur, Caoimhe Gowran, Rebecca Langford","doi":"10.1186/s12889-025-23170-9","DOIUrl":"10.1186/s12889-025-23170-9","url":null,"abstract":"<p><strong>Introduction: </strong>Weight is reported to be the most common target for bullying at school - far more common than other targets such as ethnicity, religion or sexual orientation. Research suggests weight bias and stigma - including negative beliefs, attitudes and discriminatory behaviours related to a person's weight - is prevalent in educational settings among both pupils and staff. Most schools have anti-bullying policies. Best practice recommendations advise policies should explicitly identify forms of unacceptable behaviour, such as racism or homophobia. We conducted an audit of secondary schools in southwest England to determine if/how they mention weight-related bullying in their policies, and whether this differs by school-level factors.</p><p><strong>Methods: </strong>We obtained lists of all secondary mainstream state, private, and special schools in seven local authorities and downloaded anti-bullying policies from their websites. Policies were searched for key words related to weight and size. We also recorded whether policies mentioned appearance or other key targets for bullying, such as race, religion, sexuality etc. We obtained school level data including size, gender mix, academic performance and quality ratings.</p><p><strong>Results: </strong>From 255 schools with an available bullying or behaviour policy, only 6.7% specifically mentioned weight-related bullying. Just under half (48.6%) mentioned bullying in relation to appearance. Bullying was most often mentioned in relation to race/ethnicity (94.5%), sexual orientation (93.3%), gender (85.9%), religion (84.9%) or gender identity (67.5%). Private schools (N = 40) were more likely to mention weight-related bullying (17.5%) than mainstream state schools (N = 148, 6.1%). No special schools, whether state (N = 41) or private (N = 26), mentioned weight-related bullying in their policies. There was no strong evidence that other school characteristics made a difference, but small numbers limited statistical power of these comparisons.</p><p><strong>Conclusion: </strong>There is a significant mismatch between the prevalence of weight-related bullying in schools and its representation within school anti-bullying policies. Some types of school are more likely than others to mention weight-related bullying in their policies. We recommend that schools explicitly recognise weight-related bullying in their anti-bullying policies and explore how to support staff and pupils to take action.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2006"},"PeriodicalIF":3.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186512","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":"Impact of multi-metal exposure on blood pressure: a mediation analysis through oxidative stress markers in China's Southern Jiangxi Province.","authors":"Fen Yan, Lei Huang, Yuanxiao Jiang, Canyu Jiang, Ya Huang, Jie He, Jie Wang, Gonghua Hu, Lijun Zou, Qi Xu, Xiaokang Zhang, Yanfang Gao","doi":"10.1186/s12889-025-23078-4","DOIUrl":"10.1186/s12889-025-23078-4","url":null,"abstract":"<p><p>Hypertension is a prevalent condition that contributes significantly to the global disease burden. Recent research endeavors have been investigating the potential causal link between metal exposure and the development of hypertension, yet consensus remains elusive. Nevertheless, studies examining the interplay among metal exposure, hypertension, and oxidative stress are relatively limited. This study utilized data from a cross-sectional survey conducted in southern Jiangxi Province, China. We evaluated urinary concentrations of 19 metals, including aluminum and manganese, in conjunction with measurements of systolic and diastolic blood pressures, as well as three oxidative stress biomarkers: glutathione peroxidase (GSH), superoxide dismutase (SOD), and malondialdehyde (MDA). In the monometallic model, chromium, iron, manganese, and molybdenum exhibited positive correlations with blood pressure. These findings were consistent in the mixed exposure model. Conversely, all the aforementioned metals exhibited a negative correlation with GSH and SOD, while demonstrating a positive correlation with MDA. Mediation effect analysis revealed that GSH and SOD mediated the relationships between urinary concentrations of aluminum, iron, manganese, and antimony and blood pressure. In contrast, MDA mediated the associations between urinary silver and antimony and blood pressure. Furthermore, GSH and SOD were identified as mediators in part of the relationship between mixed metal exposure and blood pressure, with mediation rates of 19.09% for GSH and 27.36% for SOD. The results of this study suggest that exposure to both individual and combined metals effects blood pressure levels, which are further associated with changes in oxidative stress levels. Moreover, oxidative stress levels may modulate the changes in blood pressure related to metal exposure, providing a basis for further investigation into the health risks associated with these metal exposures.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2004"},"PeriodicalIF":3.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186496","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":"Understanding the role of the husband in supporting early detection, diagnosis, and treatment for breast cancer patients in Northern Tanzania: a qualitative study.","authors":"Mackenzie N Abraham, Elizabeth F Msoka, Taylor Hollis, Furaha Serventi, Perry M Cyril, Gileard G Masenga, Blandina T Mmbaga, Lily Gutnik","doi":"10.1186/s12889-024-20864-4","DOIUrl":"10.1186/s12889-024-20864-4","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer is a leading cause of cancer related morbidity and mortality in Sub-Saharan Africa with women often being diagnosed at advanced stages of disease. Little is known about how the role of the husband impacts the diagnosis and treatment of women with breast cancer. In this study, we aimed to describe the role of the husband in the experiences of breast cancer patients in Tanzania.</p><p><strong>Methods: </strong>We conducted semi-structured in-depth interviews with breast cancer patients (n = 20), physicians (n = 10), nurses (n = 10), and traditional healers (n = 18) exploring perceptions of breast cancer diagnosis and treatment in Tanzania. Interviews were recorded, transcribed, and subsequently coded by three independent reviewers. Emergent themes were identified using thematic analysis approach.</p><p><strong>Results: </strong>We identified two distinct domains from responses: supportive husbands and unsupportive husbands. Within these domains, 5 supportive and 4 unsupportive themes were identified. Supportive husbands provided financial assistance, encouraged early treatment, adopted a caregiver role, displayed leadership in decision-making, and provided emotional support. Unsupportive husbands displayed stigma and shame, refused financial support, and resorted to rejection and abandonment which ultimately led to delays in diagnosis and treatment.</p><p><strong>Conclusions: </strong>Majority of patients, providers, and traditional healers described unsupportive husbands as a component contributing to the delayed presentation and negative experiences of patients. We inferred that spousal financial concerns and societal stigma often drove husband rejection, which resulted in a lack of emotional and financial support for patients and contributed to delays in diagnosis and treatment. Improvements in husband education and communication may reduce stigma and misconceptions regarding breast cancer and may help increase the number of supportive husbands.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"1998"},"PeriodicalIF":3.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186511","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":"Health risk perception and behavioral decision-making among online-dating MSM in Shandong, China: perspectives on HIV and new psychoactive substances.","authors":"Yuyao Chen, Haiying Yu, Xiaoyan Zhu, Ling Li, Lin Wang, Yangji Zhuoma, Na Zhang, Guoyong Wang, Wei Ma, Meizhen Liao","doi":"10.1186/s12889-025-23153-w","DOIUrl":"10.1186/s12889-025-23153-w","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Online dating has become a dominant channel for men who have sex with men (MSM) to seek sexual partners in China, exacerbating dual public health challenges of HIV transmission and new psychoactive substances (NPS) abuse. This study aims to explore the perceptions of MSM regarding the risks and harms associated with HIV and NPS in the context of online dating.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;From April to July 2023, MSM were recruited from eight cities in Shandong Province using a combination of snowball sampling, venue-based recruitment, and online methods. A questionnaire survey was conducted to collect demographic information, NPS usage, sexual behavior, and online dating activities of the participants. Blood samples were also collected for HIV and syphilis antibody testing. Missing data were imputed using multiple imputation. Two separate multivariate binary logistic regression models were constructed to identify factors associated with two dependent variables: (1) HIV self-perceived risk and (2) NPS harm awareness among online-dating MSM.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 2,785 online-dating MSM were included in the study. Among them, 37.8% (1,052) perceived their risk of HIV infection as low or negligible, while 10.8% (302) believed that using NPS posed little or no harm to their health. Multivariate logistic regression analysis indicated that MSM with a college education or higher (aOR = 1.202, 95%CI: 1.009-1.431), who engaged in anonymous dating (aOR = 1.298, 95%CI: 1.071-1.574), had no pre-sex HIV testing with online partners in the past 6 months (P6M) (aOR = 1.780, 95%CI: 1.489-2.128), consistently used condoms during sex with online partners in the P6M (aOR = 2.004, 95%CI: 1.693-2.371), syphilis positivity (aOR = 1.957, 95%CI: 1.289-2.971), and had used NPS (aOR = 1.989, 95%CI: 1.687-2.344) were more likely to perceive a high risk of HIV infection. Additionally, MSM younger than 25 years (aOR = 1.649, 95%CI: 1.131-2.405), those with an Shandong registration (aOR = 1.997, 95%CI: 1.179-3.382), those with adequate HIV knowledge (aOR = 3.483, 95%CI: 1.723-7.041), those who do not engaged in group sex in the P6M (aOR = 1.531, 95%CI: 1.097-2.138), those who do not engaged in anonymous dating (aOR = 1.733, 95%CI:1.329-2.261), those who reported inconsistent condom use with online partners in the P6M (aOR = 1.554, 95%CI: 1.208-1.998), and those who had not used NPS (aOR = 1.371, 95%CI: 1.071-1.754) were more likely to have a low awareness of NPS harms.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Online-dating MSM in Shandong Province have insufficient HIV self-perception risk and NPS harm awareness, compounded by anonymous partnering and cognitive-behavioral dissonance. It is recommended to implement subpopulation-targeted interventions, increase warning education, promote informed partnering practices, strengthen NPS harm awareness campaigns targeting youth, reinforce online regulation and health education, le","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"1996"},"PeriodicalIF":3.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186495","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 multi-method evaluation of how equity deserving communities were engaged in research.","authors":"Emily Porchak, Ian D Graham, Justin Presseau, Anita Kothari","doi":"10.1186/s12889-025-23149-6","DOIUrl":"10.1186/s12889-025-23149-6","url":null,"abstract":"<p><strong>Background: </strong>We aimed to understand and evaluate the types, experiences and levels of engagement of all groups engaged in the OPTimise research study. The OPTimise study used virtual community engagement to engage equity-deserving populations across three sites to help public health units tailor strategies to improve vaccine uptake during COVID-19. Our evaluation was uniquely conducted at arm's length from the OPTimise researchers who facilitated the virtual engagement with these groups.</p><p><strong>Method: </strong>The community members involved in research (community leaders and citizen partners) were invited to complete the 22-item Patient Engagement in Research Scale (PEIRS-22) survey to understand the nature of engagement. Twenty-three participants were invited to complete the survey and 19 (83%) completed the survey. We conducted individual and focus group interviews with members of all four groups (community leaders, citizen partners, public health unit knowledge user and connectors, and methods researchers) to learn about their engagement experiences with the OPTimise study and research team. Thirty-five participants were invited to join an interview or focus group interview with 22 (63%) completing an interview.</p><p><strong>Results: </strong>OPTimise study members reported \"extremely meaningful\" engagement which is the highest level on the PEIRS-22 scale. The interviews demonstrated that the OPTimise study was designed appropriately across the three sites. Interviews were analyzed based on four topics: relationship management, supporting processes, power sharing, and satisfaction with operations. Qualitative and quantitative data are compared to the Levels of Patient and Researcher Engagement in Health Research framework. Citizen partners and methods researchers reported being engaged at the level of \"lead\" on the framework. Community leaders reported their level of engagement as at the level of \"involve\" throughout the study while connectors and public health knowledge users reported their level of engagement was at the level of \"involve episodically\" throughout the study.</p><p><strong>Conclusions: </strong>This evaluation found that building authentic relationships between the OPTimise research team and participants was key in the early phases of the OPTimise study. Researchers on future projects could benefit from developing working relationships with organizations who can connect with the target audience to facilitate trust building between researchers and engagement participants, especially in virtual environments.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2001"},"PeriodicalIF":3.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186480","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":"Does population density impact maternal and child health? Mediating effects of the Universal Health Coverage Service Coverage Index.","authors":"Xinyan Jiang, Jinpeng Xu, Feier Cheng, Xinhui Zuo, Dongxue Wang, Weixue Yin, Lijuan Cui, Fengzhe Xie, Liuying Wang, Bobkov Artem, Guomei Tian, Zheng Kang","doi":"10.1186/s12889-025-23217-x","DOIUrl":"10.1186/s12889-025-23217-x","url":null,"abstract":"<p><strong>Background: </strong>This article examines the association between population density, maternal mortality, and under-5 mortality in countries throughout the world, as well as the mediating impacts of the Universal Health Coverage Service Coverage Index (UHC-SCI).</p><p><strong>Methods: </strong>The World Health Organization's website provided data on maternal mortality and the Universal Health Coverage Service Coverage Index for the years 2000-2020. The World Bank database included information on population density and under-5 mortality rates for nations between 2000 and 2020. Panel regressions were used to examine the association between population density and maternal and under-5 mortality in each nation, as well as the mediating influence of the Universal Health Coverage Service Coverage Index, while accounting for economic, environmental, and medical factors. Finally, data is divided into regressions based on World Bank member countries' income levels to examine heterogeneity.</p><p><strong>Results: </strong>The study included 175 countries and found a significant negative correlation between population density, maternal mortality, and under-5 mortality (B = -1.015, -1.146, P < 0.05). The Universal Health Coverage Service Coverage Index mediated this relationship (B = -1.044, -1.141, P < 0.05).</p><p><strong>Conclusions: </strong>Increasing population density in countries around the world has helped to reduce maternal and child mortality. As population density has increased, so has the level of the Universal Health Coverage Service Coverage Index, which has proven effective in lowering maternal and under-5 mortality. Governments should plan interventions to build basic health facilities and allocate resources to health services based on population density, level of economic development, and the current state of their health systems, with the goal of stabilizing the rate of change in maternal and under-5 mortality and, eventually, achieving the Sustainable Development Goals.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2002"},"PeriodicalIF":3.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186493","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":"Explainable machine learning models predicting the risk of social isolation in older adults: a prospective cohort study.","authors":"Mingfei Jiang, Xiaoran Li, YongLu","doi":"10.1186/s12889-025-23108-1","DOIUrl":"10.1186/s12889-025-23108-1","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to develop a machine learning system to predict social isolation risk in older adults.</p><p><strong>Methods: </strong>Data from a sample of 6588 older adults in China were analyzed using information from China Health and Retirement Longitudinal Study from 2015 to 2018. We employed the light gradient boosting machine (Lightgbm) algorithm to determine the most common predictors of social isolation among older adults. After identifying these predictors, we trained and optimized 7 models to predict the risk of social isolation among older adults: Lightgbm, logistic regression, decision tree, support vector machine, random forest, gradient boosting decision tree (Gbdt), and Xgboost. In addition, the Shapely additive explanation (SHAP) method was used to show the contribution of each social isolation predictor to the prediction. Statistical analysis was conducted from December 2023 to April 2024.</p><p><strong>Results: </strong>The Gbdt model had the best performance with an accuracy of 0.7247, sensitivity of 0.9207, specificity of 0.6273, F1 score of 0.6894, and Area Under Curve of 0.84. In addition, the SHAP method demonstrated that intergeneration financial support, child visits, age, left-hand grip strength, and loneliness were the most important characteristics.</p><p><strong>Conclusions: </strong>The combination of Gbdt and SHAP provides a clear explanation of the factors contributing to predicting the personalized risk of social isolation for individuals and an intuitive understanding of the impact of key features.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"1999"},"PeriodicalIF":3.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186494","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 cross-sectional analysis of the association between self-employment, racial and ethnic minority status, sex and cardiovascular disease risk factors among a nationally representative sample.","authors":"Kimberly Narain, Daniela Markovic, José J Escarce","doi":"10.1186/s12889-025-22955-2","DOIUrl":"10.1186/s12889-025-22955-2","url":null,"abstract":"<p><strong>Background: </strong>There is a body of evidence that suggest risk factors for cardiovascular disease (CVD) may be linked with self-employment status. Work context varies across race, ethnicity and sex. The objective is to examine the association of self-employment status and CVD risk factors across racial and ethnic minority status as well as sex.</p><p><strong>Methods: </strong>For this observational study, National Health and Nutrition Examination Survey (NHANES) data (1999-2018), a cross-sectional study design, and stratified logistic regression models were used to explore the association between self-employment status (a dichotomous variable) and CVD risk factors (dichotomized measures of elevated cholesterol, hypertension, glucose intolerance, obesity, poor diet, physical inactivity, smoking, binge drinking, sub-optimal sleep duration and poor mental health) across combined racial and ethnic minority status and sex groups, among working, non-pregnant adults(ages 30-62). Statistical models controlled for age, education, marital status, household poverty-to-income ratio, and the number of months working at current job. The coefficient estimates were expressed as predictive margins.</p><p><strong>Results: </strong>The study sample was comprised of 19,395 working adults. Among non-minority women, self-employment was negatively associated with obesity (% diff = -7.4%; p = 0.008), physical inactivity % diff = -7.0%; p = 0.017), and poor sleep duration (% diff = -9.4%; p = 0.004). Among minority women, self-employment was negatively associated with poor diet (% diff = -6.7%; p = 0.024), physical inactivity (% diff =-7.3%; p = 0.013) and poor sleep duration (% diff = -8.1%; p = 0.017). Among non-minority men, self-employment was negatively associated with poor diet (% diff = -6.5%; p = 0.008) and hypertension (% diff = -5.7%; p = 0.013).</p><p><strong>Conclusions: </strong>This study suggests that there may be a relationship between work context and CVD risk factors that varies across race, ethnicity and sex; however, further research is needed to characterize this relationship. Specifically, exploring how autonomy, flexibility, social support and discrimination exposure varies across self-employment status in diverse demographic groups may be important for illuminating the relationship between work and cardiovascular health.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"1786"},"PeriodicalIF":3.5,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180629","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}