BMC Public Health最新文献

{"title":"Widowed and at risk: increasing HIV prevalence among widowed women in Siaya county, Kenya in the last decade, 2011-2022.","authors":"Jackline A Odhiambo, Ali Mizarzardeh, Moses Otieno, Susan Gachau, Sammy Khagayi, Elizabeth Fair, Angela A Cleveland, Vivienne Kamire, Daniel Kwaro, Rachael H Joseph","doi":"10.1186/s12889-025-24268-w","DOIUrl":"https://doi.org/10.1186/s12889-025-24268-w","url":null,"abstract":"<p><strong>Background: </strong>The majority (66%) of the 1.3 million people living with HIV in Kenya are women. Identification of factors associated with living with HIV, and trends in the burden of HIV among widowed women over time could inform health strategies for this group.</p><p><strong>Methods: </strong>We used serial cross-sectional data collected between 2011 and 2022 among widowed and married women aged 15 + years enrolled in any of five periodic HIV serological and behavioural surveys conducted in Siaya County, Kenya. HIV status was determined either by blood test or evidence of a previous diagnosis. We estimated the weighted HIV prevalence stratified by marital status and age, and assessed factors associated with living with HIV for both married and widowed women using logistic regression.</p><p><strong>Results: </strong>Of 14,445 women, 27.2% (3,930) were ever widowed and 72.8% (10,515) were currently married. Median age among widowed women was 64 years (interquartile range [IQR] 49-76) vs. 32 years (IQR 24-44) among married women. Overall weighted HIV prevalence was 26.2% (95% Confidence Interval [CI]: 25.3-27.0%) among widows and 17.1% (CI:16.6-17.6%) among married women. In 2011-2022, HIV prevalence increased among widowed (21.5-26.2%) and married (15.0-17.1%) women. In the adjusted analysis, the odds of HIV was six-fold higher among widowed than married women (AOR: 5.93, CI: 4.90-7.18). The odds of HIV were higher among younger (< 45 years) than older (60 + years) widowed women (AOR: 5.74, CI:1.94-17.0); among women with younger versus older male sexual partners (AOR 2.19, CI:1.03-4.64 [widowed] and AOR 2.11, CI:1.52-2.95 [married]); and among those who had ever experienced forced sex (AOR 1.75, CI:1.01-3.01 [widowed] and AOR 1.23, CI:1.08-1.41 [married]).</p><p><strong>Conclusion: </strong>From a decade long follow-up, we show a disproportionately high and increasing prevalence of HIV among widowed women in Siaya, Kenya. Among both widowed and married women, there was an association between living with HIV and younger age, 10-year younger sexual partners and experiencing forced sex. Policies that prioritize widowed women could assist in the development of targeted interventions that address the unique challenges of this important subpopulation.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"3305"},"PeriodicalIF":3.6,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211639","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":"Multicomponent exercise intervention for preventing falls and improving physical functioning in older adult nursing home residents: study protocol for a randomised controlled trial.","authors":"Munseef Sadaqa, Wesam A Debes, Zsanett Németh, Zsófia Bera-Baka, Marianna Vachtler-Szepesi, Loretta Nácziné Földes, Viktória Prémusz, Márta Hock","doi":"10.1186/s12889-025-24606-y","DOIUrl":"https://doi.org/10.1186/s12889-025-24606-y","url":null,"abstract":"<p><strong>Background: </strong>Falls are a global problem for older people, as they are among the main reasons for injury and death in this population. Falls incidence is about three times higher among older adults in long-term care facilities than in the community. Globally in the recent decades we witnessed advances in medicine and public health, and that the older population is leading an active and a healthier lifestyle. Yet, ageing is still associated with diminished functional ability, reduced mobility, limited independency, as well as falls. Among the risk factors of these are loss of muscle mass, function, and strength (sarcopenia and dynapenia), in addition to balance and cognitive impairments. Fortunately, these risk factors are modifiable and preventable through exercises. Thus, we aim to evaluate the effect of a multicomponent exercise programme on the number of falls and physical function in nursing homes residents aged 65 years and over. Additionally, we aim to investigate potential risk factors of falls.</p><p><strong>Methods: </strong>A single-blind, parallel randomized controlled trial of 12 weeks will be conducted. Older people aged 65 years and over, will be recruited from nursing homes. Participants will be randomised to either intervention group or control group through stratified randomization, based on age, gender, and baseline values of Short Physical Performance Battery using a random generator, then baseline assessments will be performed to avoid a long interval between participant assessment and the beginning of the interventions. Primary outcome will be number of all falls during the intervention. Secondary outcomes will include Short Physical Performance Battery, Six-minute Walking Test, Timed Up and Go Test, Single Leg Stance Test, and Functional Reach Test. Within groups differences will be analysed using either paired sample t-test, or Wilcoxon test. Poisson Regression to predict number of falls based on baseline data.</p><p><strong>Discussion: </strong>This trial will address the inconsistence and inconclusive evidence about the effect of multicomponent exercise programme on falls in long-term care facility older residents and will investigate the gap in evidence of the effects of exercise at moderate intensity on the residents.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT05835297, registered on 28 April 2023.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"3296"},"PeriodicalIF":3.6,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211664","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":"Changing socioeconomic inequalities in the incidence and case fatality rates of COVID-19 in Germany, March 2020 through May 2022: an ecological study.","authors":"Sarah C Kramer, Laura Andrea Barrero Guevara, Matthias An der Heiden, Benjamin Wachtler, Matthieu Domenech de Cellès","doi":"10.1186/s12889-025-24625-9","DOIUrl":"https://doi.org/10.1186/s12889-025-24625-9","url":null,"abstract":"<p><strong>Background: </strong>Socioeconomic disparities in COVID-19 burden were widely observed during the pandemic's early waves, including in Germany, but studies on whether these inequalities have persisted or changed as the pandemic progressed are lacking.</p><p><strong>Methods: </strong>We used an ecological study design to assess the relationship between a range of demographic, socioeconomic, and healthcare-related predictors and COVID-19 impact in Germany. Specifically, we fit generalized additive models to cumulative, district-level (n = 400) COVID-19 incidence and case fatality rates (CFRs) for each of the first five pandemic waves, which covered the period from March 2020 through May 2022.</p><p><strong>Results: </strong>We find that associations between socioeconomic deprivation and COVID-19 impact evolved over time. Specifically, districts with higher levels of deprivation experienced lower incidence initially, but higher incidence beginning in the second half of wave 1 and persisting through wave 3. Meanwhile, more deprived districts experienced higher CFRs initially as well as during waves 3 through 5, but lower CFRs during the second half of wave 1. Finally, during the first four waves, we find that district-level CFRs scaled superlinearly with incidence, suggesting that the risk of death increased with incidence. This relationship was particularly strong during the first pandemic wave.</p><p><strong>Conclusions: </strong>The association between socioeconomic position and COVID-19 impact in Germany has been complex, with patterns changing in intensity and direction over time. Continued monitoring of socioeconomic inequalities in COVID-19 impact, in particular at the individual level, is needed to better understand if and how inequalities continue to persist. Such monitoring will be instrumental in informing more equitable control strategies.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"3289"},"PeriodicalIF":3.6,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211489","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":"Community's perceptions on health and ecological impacts of climate change and adaptation strategies in rural areas of the central Ethiopian region.","authors":"Isayas Hafebo Lambebo, Kasahun Eba, Gudina Terefe Tucho","doi":"10.1186/s12889-025-24719-4","DOIUrl":"https://doi.org/10.1186/s12889-025-24719-4","url":null,"abstract":"<p><strong>Background: </strong>Ethiopia struggles with floods, droughts, climate-related health issues, lacking sufficient research on community vulnerability, risk perceptions, and adaptation strategies.</p><p><strong>Methods: </strong>Employing a mixed-methods approach including household surveys (N = 845), focus group discussions, and key informant interviews the research captures the socio-economic, ecological, and health dimensions of climate vulnerability in Highland, Midland, and Lowland climatic zones.</p><p><strong>Results: </strong>Findings reveal stark regional disparities: Highland communities face heightened exposure to cold waves and water scarcity exacerbated by aging populations and poor housing; Lowland zones are afflicted by heat-related stressors, institutional collapse, and youth-dominated demographics; while Midland areas suffer from hydrological instability fostering disease transmission. Across all regions, systemic health issues such as food- and water-borne diseases (83%) and malnutrition (80%) emerge as pervasive threats. Statistical analysis via logistic regression identifies educational, income, health insurance access, credit availability, and climate information as significant predictors of adaptation. Notably, higher education boosts adaptive capacity by over 13-fold, while females and larger families show reduced engagement in adaptation practices. Local innovations, including Enset and mixed farming, offer culturally rooted strategies for resilience, though feasibility varies regionally.</p><p><strong>Conclusion: </strong>The study underscores the need for geographically tailored, integrated climate-health interventions supported by inclusive service delivery, climate-aware education, and gender-responsive programming. It also highlights a critical gap between perceived climate risks and scientifically grounded understanding of causes only 14% attribute climate change to human activities pointing to the importance of culturally attuned climate communication.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"3310"},"PeriodicalIF":3.6,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211525","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":"Impact of cut-point methods on classification of physical activity and sedentary behaviour of toddlers.","authors":"Jill Marie Ferry, Joaquin Escribano, Mariona Gispert-LLauradó, Berthold Koletzko, Veit Grote","doi":"10.1186/s12889-025-24636-6","DOIUrl":"https://doi.org/10.1186/s12889-025-24636-6","url":null,"abstract":"<p><strong>Background: </strong>Classification of physical activity (PA) depends on the cut-point method used to allocate PA counts from accelerometer measurements. This study investigates how three validated cut-point methods affect the time spent in various levels of PA and sedentary behaviour (SB), and how they impact toddlers estimated adherence to PA guidelines.</p><p><strong>Methods: </strong>PA was assessed using an ActiGraph wGT3X-BT accelerometer in a cohort of 653 two-year-old children participating in the Toddler Milk Intervention study. Children wearing the ActiGraph for at least four days, with a minimum of six hours wear-time per day, were included. Time spent in SB and different activity levels were estimated according to three cut-point methods and were standardized to individual mean wear-time. We used one cut-point method based on the vertical axis (VA) (Trost VA), with an epoch length of 15 s and two cut-point methods based on either the VA (Costa VA) or on the vector magnitude (VM) (Costa VM) with an epoch length of five seconds. Estimates of SB and PA for each method were compared with repeated measures ANOVA.</p><p><strong>Results: </strong>The time toddlers spent in PA was significantly different depending on the cut-point methods. Costa VM classified on average 62 min (95% CI 61, 64] more per day as SB and 57 min (95% CI -58, -56] less per day as LPA compared to Trost VA (both p < 0.0001). For MVPA, the mean difference between Costa VA and Trost VA was 6.8 min (95% CI -7, -6; p < 0.0001). Concurrently, the proportion of children meeting the WHO recommendation of 180 min of total PA differed between cut-point methods, with 86% according to Costa VM and 97% according to Trost VA.</p><p><strong>Conclusions: </strong>The time toddlers engage in different intensities of PA is significantly determined by the selection of cut-point method. Notably, the use of a different cut-point method leads up to a 10% difference in the estimated time spent in LPA and SB, but only a 1% difference of moderate-vigorous PA. These differences change the estimated adherence to recommendations. Future research is needed to standardize the data processing methods for better comparability between studies analysing toddlers' PA.</p><p><strong>Registry: </strong>ClinicalTrials.gov, TRN: NCT02907502, Registration Date: 31 August 2016.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"3290"},"PeriodicalIF":3.6,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211487","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":"Impact of long-term exposure to PM_2.5 and its components on the risk of chronic lung disease in middle-aged and elderly chinese: evidence from a large Chinese population-based cohort.","authors":"Yu Shi, Di Wu, Yilipa Yilihamu, Yanling Zheng, Liping Zhang","doi":"10.1186/s12889-025-24704-x","DOIUrl":"https://doi.org/10.1186/s12889-025-24704-x","url":null,"abstract":"<p><strong>Background: </strong>Epidemiological evidence indicates a close association between particulate matter with an aerodynamic diameter of fewer than 2.5 μm (PM_2.5) and the occurrence and worsening of chronic lung diseases (CLD), particularly in middle-aged and older adults. Previous studies have explored the effects of PM_2.5 and its components on CLD to a limited extent, and the dynamic trajectories of PM_2.5 and its components over time have not been considered in relation to CLD.</p><p><strong>Methods: </strong>This study used data from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2018 to explore the relationship between long-term exposure to PM_2.5 and its components (sulfate, nitrate, ammonium, organic matter, and black carbon) and CLD based on generalized linear mixed models (GLMM) and group-based trajectory model (GBTM).</p><p><strong>Results: </strong>Results reveal a significant positive correlation between long-term exposure to PM_2.5 and its component concentrations, as well as the rate of decline in these concentrations, with the incidence of CLD. For each 1 µg/m³ increase in PM_2.5, black carbon, organic matter, sulfate, nitrate, and ammonium, there was an increase in the risk of chronic lung disease of 1.005 (95% CI: 1.002, 1.009), 1.177 (95% CI: 1.100, 1.259), 1.027 (95% CI: 1.012, 1.042), 1.037 (95% CI: 1.018, 1.056), 1.021 (95% CI: 1.006, 1.037), and 1.028 (95% CI: 1.005, 1.052). Multivariate pollutant mixture analyses using Weighted Quantile Sum Regression and Quantile g-computation regression analysis found that among PM_2.5 components, black carbon, sulfate, and organic matter are more related to the risk of CLD.</p><p><strong>Conclusion: </strong>This prospective cohort study of middle-aged and older adults in China observed that long-term exposure to various PM_2.5 components increases the risk of CLD. Given the significant role of black carbon, organic matter, and sulfate in their combined harmful effects, stringent controls on the emissions of these components could help mitigate the rising prevalence of CLD among China's rapidly aging population.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"3301"},"PeriodicalIF":3.6,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211515","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":"Adopting the lens of the COM-B behaviour change model to qualitatively explore and understand public health implications of young adults' attitudes towards death-talk.","authors":"Catrin Morgan-Duggan, Joanna Brooks, Lisa Graham-Wisener, Christine Rowland","doi":"10.1186/s12889-025-24519-w","DOIUrl":"https://doi.org/10.1186/s12889-025-24519-w","url":null,"abstract":"<p><strong>Background: </strong>The topic of death and dying holds universal significance, yet societal norms often discourage open discussions, leading to a culture of death-denial. This reluctance can hinder informed decision-making, end-of-life planning, and access to adequate care and grief support. While research has examined death-talk among older adults, clinical populations and healthcare professionals, young adults' perspectives remain underexplored. Understanding their attitudes is crucial, as early engagement with death-talk - framed within a life-course approach - can foster emotional resilience and contribute to developing compassionate communities. This study aims to explore the perceptions and attitudes of a non-clinical sample of young adults (aged 18-34) towards discussing death and dying.</p><p><strong>Methods: </strong>A qualitative approach was employed, involving four focus groups with 33 young adults. Participants were selected using maximum variation sampling to ensure diversity in education, ethnicity, gender, and religious beliefs. Reflexive thematic analysis was performed to identify themes related to attitudes toward death-talk, utilising a critical realist stance. Findings were mapped using the Capabilities, Opportunities, Motivations, and Behaviour (COM-B) model of behaviour change, to identify potentially modifiable barriers and facilitators to engaging in death-talk.</p><p><strong>Results: </strong>The analysis revealed four key themes which collectively illustrate the complex interplay between individual attitudes and broader cultural influences in shaping how young adults perceive and discuss death and dying. The themes highlighted how internal and external factors affect the ability and willingness of young adults to engage in meaningful discussions about death. Factors such as social stigma, fear of causing distress, and a lack of communication skills were identified as significant barriers. Conversely, the recognition of the importance of death-talk, personal experiences with bereavement, and a supportive social environment were found to facilitate these discussions.</p><p><strong>Conclusions: </strong>This study provides valuable insights into the perceptions and experiences of death-talk amongst young adults, including barriers and facilitators. The findings suggest the need for targeted interventions to enhance death literacy among young people, emphasising the importance of normalising these conversations in everyday life. Recommendations are proposed for utilising these insights to inform public health strategies, education, and policy development aimed at fostering a more open dialogue about death and dying within the broader community.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"3307"},"PeriodicalIF":3.6,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211862","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":"Assessing the impact of a social cognitive theory-based educational intervention on ergonomic behaviors: a randomized controlled trial utilizing a learning-by-doing approach.","authors":"Zakieh Sadat Hosseini, Sedigheh Sadat Tavafian, Omran Ahmadi, Reza Maghbouli","doi":"10.1186/s12889-025-24533-y","DOIUrl":"https://doi.org/10.1186/s12889-025-24533-y","url":null,"abstract":"<p><strong>Background: </strong>Work-related musculoskeletal disorders (WMSDs) significantly challenge female assembly line workers due to repetitive tasks, manual force, poor posture, and static muscle contractions. Increased ergonomic preventive behaviors through learning-by-doing (LBD) approach could probably be essential to mitigate these issues. This study investigates the impact of a structured, theory-based educational intervention using the learning-by-doing approach to promote ergonomic behaviors and decease MSDs subsequently.</p><p><strong>Methods: </strong>This randomized controlled trial (RCT) conducted in 2023 investigated the effectiveness of a theory-based ergonomic training program among Iranian women working on electronics assembly lines. Participants were randomly assigned to an intervention group, which received a structured training program based on Social Cognitive Theory (SCT), or to a control group with no intervention. Outcomes were assessed using the Ergonomic Behavior Evaluation Tool (EBET) and the Nordic Musculoskeletal Questionnaire (NMQ) at baseline and at 3, 12, and 24 weeks post-intervention.</p><p><strong>Results: </strong>A total of 80 women participated in the trial, with an average age of 37.87 ± 5.15 years in the experimental group and 37.10 ± 6.81 years in the control group. Although both groups were the same at initial time of the study, there was a significant difference between the two groups in the average scores of all theoretical constructs at 3, 12, and 24 weeks after the intervention, except for the outcome expectancy construct, which was not significant at 24 weeks post-intervention. The experimental group demonstrated a significant improvement in performing ergonomic behaviors compared to the control group. Additionally, women in the experimental group reported a significant reduction in pain in some areas of their bodies.</p><p><strong>Conclusions: </strong>Based on the effect of the educational intervention through LBD approach on and the ergonomic behaviors, it emphasized to apply this training among assembly line workers. however, to further reduce musculoskeletal pain, it is recommended to incorporate other dimensions of ergonomic interventions, supported by macro management levels at the industry level.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov IRCT20220825055792N1. Registered on 23 September 2022 with the IRCTID.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"3304"},"PeriodicalIF":3.6,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211472","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":"Return to work for people with chronic health conditions after medical or vocational rehabilitation during the COVID-19 pandemic: a scoping review.","authors":"Nadine Sänger, Jan Mathis Elling, Christian Hetzel, Betje Schwarz","doi":"10.1186/s12889-025-24769-8","DOIUrl":"https://doi.org/10.1186/s12889-025-24769-8","url":null,"abstract":"","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"3292"},"PeriodicalIF":3.6,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211584","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":"Socioeconomic development index (SDI) gradients and high BMI-Driven pan-cancer burden: a global burden of disease study on mortality, disability, and health inequities (2015-2021).","authors":"Zhuang Ma, Sixuan Zou, Ruoxuan Liu, Song Li, Zhenjiang Li","doi":"10.1186/s12889-025-24531-0","DOIUrl":"https://doi.org/10.1186/s12889-025-24531-0","url":null,"abstract":"<p><strong>Background: </strong>The rising prevalence of high body mass index (BMI) has become a critical driver of global oncologic morbidity and mortality, yet its pan-cancer burden remains poorly characterized across socioeconomic development strata. This study investigates the geographic, temporal, and sex-specific disparities in high BMI-attributable cancer burden, stratified by the Socioeconomic Development Index (SDI), to inform precision public health strategies.</p><p><strong>Methods: </strong>Leveraging the 2021 Global Burden of Disease (GBD) dataset, we analyzed age-standardized mortality, disability-adjusted life years (DALYs), and years of life lost (YLLs) for 17-23 countries across Asia and globally. SDI-stratified analyses evaluated temporal trends (2015-2021) and cancer-type contributions, while multivariable models assessed associations between income inequality (Gini coefficient), healthcare capacity, and metabolic risk exposure.</p><p><strong>Results: </strong>Marked disparities emerged across SDI gradients: high-SDI nations exhibited 6.7-fold higher mortality rates (e.g., Malaysia: 4.40 vs. Bangladesh: 0.65/100,000) and concentrated burdens in colorectal (40.5% DALYs) and breast cancers (27.0% DALYs), contrasting with distributed burdens in low-SDI regions (no cancer > 15.6% DALYs). Gender disparities highlighted male predominance in liver (+ 8.4 DALY difference) and colorectal cancers (+ 5.1), while female-specific malignancies (e.g., uterine cancer) retained consistent burdens across SDI levels. Temporal analyses revealed accelerated DALY reductions in middle-SDI regions (-4.5% annual percent change [APC]) but rising breast cancer burdens in low-SDI settings (+ 1.2% APC). Economic inequality (Gini > 0.40) correlated with elevated mortality (Turkey: 123.1/100,000), independent of GDP, underscoring synergistic impacts of BMI and sociodemographic inequities.</p><p><strong>Conclusion: </strong>High BMI-driven pan-cancer burden is profoundly shaped by SDI gradients, reflecting interactions between metabolic risk, healthcare access, and socioeconomic determinants. Tailored interventions-prioritizing colorectal and breast cancers in high-SDI regions and addressing systemic inequities in low-SDI settings-are critical to mitigating the dual burden of obesity and cancer in transitioning populations.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"3295"},"PeriodicalIF":3.6,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211605","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}