BMC Public Health最新文献

{"title":"Citywide park renovations and changes in perceived stress: a quasi-experimental study among low-income communities in New York City.","authors":"Rachel L Thompson, Katarzyna E Wyka, Kelly R Evenson, Lorna E Thorpe, Glen D Johnson, Brian T Pavilonis, Terry T-K Huang","doi":"10.1186/s12889-025-23639-7","DOIUrl":"10.1186/s12889-025-23639-7","url":null,"abstract":"<p><strong>Background: </strong>Quality parks have the potential to promote well-being and health equity in urban communities through reduced stress, yet high-quality epidemiological evidence is limited. This quasi-experimental study measured associations between park renovation and changes in perceived stress among low-income adults in New York City.</p><p><strong>Methods: </strong>Pre- and post-renovation data on the Perceived Stress Scale and park use from 162 adults living near (< 0.3 miles) 31 renovated parks and 151 adults living near 21 sociodemographically matched control parks were analyzed. Linear mixed-effects difference-in-difference (DID) regression measured the association between park renovation and change in perceived stress (post-pre) in the overall sample and stratified by baseline sociodemographics. Additional models explored the interaction of post-renovation park use frequency [high (≥ once/week), low (< once/week)] and intervention status on changes in perceived stress.</p><p><strong>Results: </strong>Overall, changes in perceived stress were similar between intervention and control groups [DID = 0.28 (95% CI -1.48, 2.03)]. However, park renovation was associated with a significant decrease in perceived stress among divorced/separated/widowed participants [DID = -4.22 (95% CI -7.92, -0.53)] and middle-aged participants (35-49y) with high park use [DID = -4.46 (95% CI -8.28, -0.64)]. Among intervention but not control participants, those with high park use experienced a significantly larger decrease in perceived stress compared to those with low park use [DID = -2.92 (95% CI -5.36, -0.47)].</p><p><strong>Conclusions: </strong>In one of the first and largest studies on park quality improvement and mental health, park renovation near one's home was associated with decreased perceived stress among divorced/separated/widowed adults and middle-aged frequent park users. Frequent users of renovated parks experienced a larger drop in perceived stress than infrequent users, suggesting that high-quality parks may be an important pre-condition to the benefits of frequent park use on stress reduction.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2515"},"PeriodicalIF":3.5,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144666927","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 altitude might increase risk of incident frailty in older adults: a nationwide longitudinal survey.","authors":"Yongfei Dong, Qianqian Wang, Xichao Wang, Can Liu, Ibrar Hussain, Hongmei Ma, Ke Lu, Zaixiang Tang","doi":"10.1186/s12889-025-23713-0","DOIUrl":"10.1186/s12889-025-23713-0","url":null,"abstract":"<p><strong>Background: </strong>The number of residents at high altitude is high globally, yet few studies have been conducted on the association between altitude and incident frailty. We evaluated the prospective association and dose-response relationship between altitude and frailty among Chinese older adults.</p><p><strong>Methods: </strong>We conducted a prospective cohort study using data from the China Health and Retirement Longitudinal Survey (CHARLS) from 2013 to 2018, enrolling 4065 participants aged ≥ 60 years at baseline. Frailty was assessed using a frailty index (FI) containing 29 health deficit indicators constructed. Cox proportional hazard regression and linear mixed model were used to analyze the association of altitude with frailty. Restricted Cubic Spline regression was used to assess the dose-response relationship between them.</p><p><strong>Results: </strong>After a median follow-up of 61 months, 1076 (26.5%) frailty events were documented, including 137 (32.2%) in the middle and 939 (25.8%) in the low altitude group. The FI in the middle altitude group was higher than that in the low altitude group at three waves (baseline = 2013, wave 1 = 2015, and wave 2 = 2018 years). The risk of incident frailty was increased by 24% (HR = 1.24, 95%CI: 1.03-1.48) in the middle altitude group compared to the low altitude group. The FI increased with increasing altitude. The RCS revealed an increased risk of developing frailty at altitudes above 2,000 m.</p><p><strong>Conclusions: </strong>Exposure to high altitude is associated with an elevated risk of incident frailty. which suggested that early intervention with high-altitude residents can delay frailty.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2513"},"PeriodicalIF":3.5,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144666934","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":"Implementing a chatbot to promote hereditary breast & ovarian cancer genetic screening in women's health: identifying barriers and facilitators to screening adoption.","authors":"Easton N Wollney, Shireen Madani Sims, Luisel J Ricks-Santi, Elizabeth Eddy, Daniel Wiesman, Carla L Fisher","doi":"10.1186/s12889-025-23488-4","DOIUrl":"10.1186/s12889-025-23488-4","url":null,"abstract":"<p><strong>Background: </strong>To promote genetic screening among women at risk for hereditary breast and ovarian cancer (HBOC), the American College of Obstetricians and Gynecologists recommends that risk assessment be integrated into practice. Chatbots like the Genetic Information Assistant (Gia®) are increasingly implemented to expand access to hereditary genetic screening. Factors that impact chatbot implementation for HBOC risk screening and women's uptake are not fully realized. To refine implementation strategies prior to full scale implementation, we sought to identify women's perceived facilitators/barriers to adopting Gia screening in a rural population within a large healthcare system in the southern United States.</p><p><strong>Methods: </strong>We recruited both women who agreed to screen using Gia (and then recommended for genetic testing based on National Comprehensive Cancer Network guidelines) as well as women who opted not to do the screen from three Women's Health clinics (OB/GYN) in a northern rural region of Florida. We conducted in-depth, semi-structured interviews with 17 women (nine adopted the screen, eight did not). We conducted a thematic analysis to identify and further define barriers/facilitators to women's uptake of Gia for HBOC cancer risk screening in obstetrics/gynecology care.</p><p><strong>Results: </strong>Women identified six factors that inhibited and/or facilitated their willingness to use Gia for screening: 1) cancer risk perception, 2) communication with their clinician, 3) feasibility of screening, 4) fiscal and insurance concerns, 5) technology trust/distrust, and 6) previous genetic testing experience. Findings illustrate how each factor functioned as a facilitator and/or barrier in women's uptake (e.g., technology being trusted for accuracy versus concerns for data privacy and security).</p><p><strong>Conclusions: </strong>While chatbots can extend women's cancer risk screening access, particularly in rural regions and with college-educated women, systems-level (cost) and individual-level factors (perceived risk, misconceptions about repeating genetic testing) should be addressed to promote adoption. Women's interaction with a clinician may be a key implementation strategy for addressing these factors to personalize the screening opportunity and promote their chatbot screening adoption.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2516"},"PeriodicalIF":3.5,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12276685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667020","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":"Determinants of inequalities in health care seeking behavior for childhood illness in Bangladesh: a trend analysis.","authors":"Shahrukh Rummana, M A Hafez, Kanchan Kumar Sen, Abul Hasan BakiBillah","doi":"10.1186/s12889-025-22047-1","DOIUrl":"10.1186/s12889-025-22047-1","url":null,"abstract":"<p><strong>Background: </strong>Worldwide, pneumonia and diarrhea are the leading public health problems; they kill more children under five years of age than any other infectious disease. Approximately two-thirds of all deaths occur in 15 developing countries, including Bangladesh. To achieve the targets of childhood mortality, it is essential to reduce the current rate of under-5 mortality. In Bangladesh, healthcare utilization for childhood illnesses has increased in recent years, but not to a desirable level, and disparities among different groups remain a matter of concern. This study explores the determinants contributing to unequal access to healthcare-seeking behavior for childhood illnesses, namely diarrhea and acute respiratory infection (ARI), over the last decade and a half.</p><p><strong>Methods: </strong>This study extracted data from the latest three Bangladesh Multiple Indicator Cluster Surveys (2006, 2012-13, and 2019). Children younger than five years with diarrhea and/or ARI 2 weeks prior to the survey were included in the study. The prevalence and association of care-seeking were investigated through a chi-square test and multivariate logistic model applied to identify the determinants of unequal access to healthcare services.</p><p><strong>Results: </strong>Care seeking for diarrhea and symptoms of acute respiratory infections showed a downward trend from 2006 to 2012-13 (30% vs. 18.5%) and an upward trend from 2012 to 13 to 2019 (18.5% vs. 74.6%). Several socioeconomic and demographic factors such as gender, administrative division, children's age, mother's education, household head's education, wealth, and ethnicity were found to have significant associations with care-seeking behavior for children under 5. Gender, division, and age were significant predictors across the three study periods.</p><p><strong>Conclusion: </strong>This study identified some possible determinants of care-seeking behaviors in childhood illnesses. Based on the findings of this research, policymakers should revise the existing policy to increase the utilization rate and reduce inequality in health care seeking for children under the age of 5. Specifically, counseling slum residents provide a provision for subsidizing or providing free health care benefits to the poorest households and enhancing parents' counseling to remove gender bias.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2506"},"PeriodicalIF":3.5,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144666930","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":"Sex differences in health-related quality of life among adults in the US: results from the medical expenditures panel survey data.","authors":"Monira Alwhaibi, Bander Balkhi","doi":"10.1186/s12889-025-23707-y","DOIUrl":"10.1186/s12889-025-23707-y","url":null,"abstract":"<p><strong>Background: </strong>Sex disparities in health represent a significant challenge for many nations' healthcare systems. Sex disparities in health-related quality of life (HRQoL) remain insufficiently explored at the population level, despite evidence suggesting that women consistently report lower HRQoL than men. Most prior studies have been disease-specific, relied on small samples, or treated sex as a control variable rather than a primary focus. This study aims to address this gap by evaluating sex differences in HRQoL among U.S. adults using nationally representative data, while accounting for a broad range of social, behavioral, and health-related determinants.</p><p><strong>Methods: </strong>A cross-sectional analysis was conducted using data from the Medical Expenditure Panel Survey (MEPS) for 2020-2021, including 8,482 men and 10,235 women aged 18 and 64. HRQoL was measured using the veterans RAND 12 item health survey which has two domains the Physical and Mental Component Summary (PCS & MCS). The relationships between HRQoL and sex were investigated using a linear regression model after the adjustment for covariates.</p><p><strong>Results: </strong>Women reported lower mean HRQoL than men in the physical domain (51.08 vs. 52.05) and the mental domain (50.05 vs. 51.79). After adjusting for covariates in the linear regression analysis, women had a lower HRQOL compared to men in both the physical domain (PCS: β = -0.090, p-value < 0.0001) and the mental domain (MCS: β = -0.643, p-value < 0.0001). Employment, high income, good perceived general health, and being physically active were positively related to HRQoL, while having high education, health insurance, and chronic illnesses were negatively associated with HRQoL. Notably, employment was positively related to the physical domain of HRQoL in men but positively associated with the physical and mental domains of HRQoL in women. Depression was negatively related to the physical and mental domains of HRQoL in women but only associated with mental domains in men.</p><p><strong>Conclusions: </strong>This study's findings reveal significant sex disparities in adult HRQoL, with women reporting lower HRQoL. The variations in socioeconomic and clinical characteristics and aspects of HRQoL between men and women are also highlighted. These findings provide valuable insights and hope for future interventions to enhance HRQoL among women at risk of low HRQoL.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2511"},"PeriodicalIF":3.5,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144666943","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":"'I don't know when it's my turn': reasons for low uptake of cancer-related healthcare services in Germany.","authors":"Ali Zafar, Milena Koch, Luis Weller, Nelli Tschobur, Andreas Ihrig, Till Johannes Bugaj, Gwendolyn Mayer, Franziska Baessler","doi":"10.1186/s12889-025-23656-6","DOIUrl":"10.1186/s12889-025-23656-6","url":null,"abstract":"<p><strong>Background: </strong>Participation rates in early cancer detection and follow-up cancer related healthcare services are lower than anticipated in many high-income countries. Germany also provides a variety of these services free-of-charge under its highly subsidized public healthcare system. This qualitative study aimed to determine the barriers perceived or experienced by service users in Germany against utilizing cancer screenings and treatment services.</p><p><strong>Methods: </strong>A semi-structured interview protocol was developed based on current literature and in consultation with stakeholders in cancer-related professions. The interviews aimed at exploring the underlying reasons for underutilization of cancer prevention or treatment services. Interviews were conducted from a pool of respondents (N = 57) from an earlier phase of the study based on voluntary response sampling. All interviews were transcribed verbatim from audio recordings and transcripts were processed in MAXQDA 2022. Two authors analyzed the qualitative data using hybrid inductive-deductive coding methodology described by Udo Kuckartz.</p><p><strong>Results: </strong>Overall 23 interviews were conducted. The participants included 13 current or former cancer patients and 10 non-patients [male = 14, female = 9; mean age = 58.65 years (SD = 13.79)]. Lack of awareness and absence of reminders emerged as the most common reason for not attending cancer screenings or treatment services. Most participants described lack of information regarding the availability or timing of the recommended screenings as their main reasons. Other predominant barriers against accessing cancer-related healthcare services were associated with time constraints and work responsibilities, unavailability of physicians and appointments, administrative bureaucracy, fear of negative news, pain or side-effects, low personal relevance, norms of gendered behavior, feelings of shame and insecurity, and communication difficulties with practitioners.</p><p><strong>Conclusions: </strong>Most pertinent barriers were rooted in lack of information and awareness about existing cancer-related healthcare services among participants. Our findings suggest that tailored interventions that address systemic, personal and social factors are essential for improving screening uptake. A proactive approach by healthcare personnel and health insurance companies for providing concise and timely information on cancer-related offers to service users is recommended to improve participation rates.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2505"},"PeriodicalIF":3.5,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667018","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":"Indoor tanning is associated with substance use behaviors among adolescents.","authors":"Nathan Shen, Suzanne L Fastner, Xuechen Wang, Ben J Brintz, Chelsey R Schlechter, Yelena P Wu","doi":"10.1186/s12889-025-23630-2","DOIUrl":"10.1186/s12889-025-23630-2","url":null,"abstract":"<p><strong>Introduction: </strong>Adolescents increase their skin cancer risk through exposure to ultraviolet radiation, tanning, and poor use of sun-safety practices. Past studies documented that adolescent indoor tanning is associated with substance use. However, these did not examine e-cigarette use as many were conducted prior to their widespread popularity nor were most studies focused on areas with high environmental risk for skin cancer. The present study examined the current relationship between indoor tanning and substance use, including e-cigarettes, in an area with high skin cancer burden.</p><p><strong>Methods: </strong>Data for the current study stem from a statewide survey of middle and high school students in a high melanoma burden state of the United States (N = 22,141). The survey assessed student's reported indoor tanning, alcohol use, cigarette smoking, and e-cigarette and marijuana usage.</p><p><strong>Results: </strong>Across all student participants, 3.5% reported indoor tanning one or more times in the past 12 months. Weighted chi-square tests revealed statistically significant associations between indoor tanning and other health risk behaviors (p < 0.001). Specifically, higher alcohol consumption, e-cigarette use, marijuana use, and cigarette use were all significantly associated with more frequent indoor tanning. Female and older adolescents were more likely to report indoor tanning.</p><p><strong>Conclusions: </strong>Indoor tanning among adolescents is associated with increased odds of engaging in substance use behaviors, including e-cigarette use. Health interventions for adolescents may benefit from addressing multiple health risk behaviors concurrently and targeting adolescents most in need for health interventions. Future work to better understand the common mechanisms underlying co-occurring health risk behaviors could inform development of such interventions.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2514"},"PeriodicalIF":3.5,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667021","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 impact of 24-h movement behaviors on college students' physical fitness and its isotemporal substitution benefits: a compositional data analysis approach.","authors":"Rongxuan Li, Di Cui, Qingqing Fan, Le Zhao, Ziyao Xia, Tianer Zuo, Ye Qiu, Qing Jiang, Jiasheng Huo, Zuoliang Wang","doi":"10.1186/s12889-025-23715-y","DOIUrl":"10.1186/s12889-025-23715-y","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;This study aimed to provide theoretical and empirical support for promoting physical fitness enhancement and implementing evidence-based behavioral interventions on university campuses. Through a rigorous compositional data analysis framework combined with isotemporal substitution model (ISM), we systematically examined the associations between 24-h movement behaviors and physical fitness among college students.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This study employed a stratified random cluster sampling design to recruit 3,974 participants from the physical education classes at a technological university located in Central South China during the 2022-2023 academic year. Data collection comprised two standardized assessments. The 24-h movement behaviors Questionnaire (24HMBQ) was administered to quantify five critical domains of daily movement patterns: sleep (SLE), sedentary behavior (SED), light physical activity (LPA), moderate physical activity (MPA), and vigorous physical activity (VPA). The participants' physical fitness was assesed against the Chinese National Student Physical Fitness Standards (CNPFSS). Employing compositional isotemporal substitution analysis, this study examined the dose-response relationship between 24-h movement behaviors and physical fitness in college students.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Compositional regression analysis revealed a significant positive correlation between moderate-to-vigorous physical activity (MVPA) and the total physical fitness test score among total students, science students, male students, and male science students (all P &lt; 0.05). MVPA exhibited consistent positive correlations with indicators in sit-and-reach, standing long jump, and pull-up tests among total students, while demonstrating a negative correlation with indicators for 50-m and 800/1000-m run (all P &lt; 0.05). Meanwhile, LPA was found to be positively linked to indicators in vital capacity and 800/100 m run (all P &lt; 0.05). ISM revealed that reallocating 30 min from LPA, sleep, and SED to MVPA significantly enhanced the total physical fitness test scores for science students, male students, and male science students (all P &lt; 0.05). Furthermore, substituting 60 min of MVPA for other activity behaviors led to significant improvements in the total physical fitness test scores for the total students, as well as these three subgroups(all P &lt; 0.05). In the dose-response analysis, a symmetrical pattern emerged when substituting MVPA for other activities, with respect to the total physical fitness test score. For the total student cohort, the substitution duration displayed a positive correlation with the test score, peaking at 50 min within the range of -40 to + 50 min. For science students, male students, and male science students, the peak correlation occurred at 45 min within the range of -40 to + 45 min.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;For students in technological universities, it is imperative to enh","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2507"},"PeriodicalIF":3.5,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667056","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":"Diabetes influences the link between lipid accumulation products and sarcopenia among US adults, as evidenced by NHANES data.","authors":"Jinyan Lan, Chenwei An, Ye Ke, Yuhong Song, Chaohe Chen, Lixu Tang","doi":"10.1186/s12889-025-23714-z","DOIUrl":"10.1186/s12889-025-23714-z","url":null,"abstract":"<p><strong>Background: </strong>The rising rates of obesity and Sarcopenia have attracted considerable academic interest. The Lipid Accumulation Product (LAP) serves as an indicator of abdominal obesity and cardiovascular risk; however, its association with Sarcopenia remains unexplored. The present study explores the relationship between LAP and Sarcopenia, with a focus on the intermediary function of diabetes in this association.</p><p><strong>Methods: </strong>Cross-sectional data from 10,065 adults, collected through NHANES from 1999 to 2018, were analyzed. Multivariate logistic regression models were used to determine the odds ratio (OR) between LAP and Sarcopenia, and mediation analysis assessed diabetes's mediating effect on LAP-related Sarcopenia.</p><p><strong>Results: </strong>This study included a cohort of 10,065 participants aged 20 years and older, among whom 1,153 were diagnosed with Sarcopenia. In a fully adjusted model, the LAP exhibited a positive association with the prevalence of Sarcopenia (OR = 2.57, 95% CI = 1.46-4.50, P < 0.001). When LAP was transformed from a continuous to a categorical variable, higher LAP levels were associated with an increased prevalence of Sarcopenia compared to the lowest LAP quartile (OR = 4.70, 95% CI = 1.81-12.16, P < 0.001). The application of restricted cubic spline analysis revealed a curvilinear relationship between LAP and Sarcopenia prevalence, with a significant inflection point at LAP = 4. Subgroup and sensitivity analyses confirmed the consistent association between LAP and Sarcopenia. Additionally, diabetes mellitus was identified as a partial mediator in this association, accounting for a mediation proportion of 31.1%.</p><p><strong>Conclusion: </strong>The study reveals a significant correlation between elevated levels of LAP and an increased prevalence of Sarcopenia, with diabetes identified as a mediating factor in this association. Further research is required to investigate the underlying mechanisms.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2512"},"PeriodicalIF":3.5,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144666931","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 dynamic equilibrium between population aging and the allocation of elderly medical care resources in the Yellow River Basin.","authors":"Long Hai, Yanghao Cui, Jiawei Zhang, Rui Wang","doi":"10.1186/s12889-025-22984-x","DOIUrl":"10.1186/s12889-025-22984-x","url":null,"abstract":"<p><strong>Background: </strong>Population aging, as a global issue, has garnered significant attention worldwide. The rational allocation of elderly healthcare resources is critical to addressing this challenge. This study investigates the spatiotemporal evolution of population aging in the Yellow River Basin and evaluates the equilibrium between aging demographics and healthcare resource distribution.</p><p><strong>Methods: </strong>This paper uses the Dagum Gini coefficient decomposition method to analyze regional differences and the dynamic evolution process of population aging in various provinces of the Yellow River Basin. The entropy method is employed to evaluate the elderly care and medical resource allocation in the provinces of the Yellow River Basin in 2020. By combining geographical concentration and the inconsistency index, the study investigates the matching relationship and distribution characteristics between aging levels and elderly care medical resource allocation.</p><p><strong>Results: </strong>The level of aging in the provinces of the Yellow River Basin has been deepening, showing a stepwise increase from west to east. The spatial imbalance in aging, as measured by the Dagum Gini coefficient, decreased from 0.126 in 2000 to 0.099 in 2020. However, the contribution rate of intra-regional differences rose from 23.096% to 40.487%, making it the primary source of disparity. The core provinces (Shandong, Henan, Sichuan) had comprehensive scores of 0.946, 0.846, and 0.793, respectively, while the peripheral provinces (Qinghai, Gansu, Ningxia) scored only 0.001, 0.226, and 0.012. A positive correlation was found between the elderly population and elderly healthcare resources, but 55.56% of the provinces exhibited either resource lag (RI > 1) or over-allocation (RI < 0.8), indicating a mismatch.</p><p><strong>Conclusion: </strong>The Yellow River Basin displays marked spatiotemporal heterogeneity in aging and resource distribution. Most provinces exhibit incoordinate matching relationships, characterized by insufficient supply or low utilization efficiency. Provincial authorities should implement region-specific policies, optimizing resource allocation and tailoring strategies to local demographic-geographic conditions.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2510"},"PeriodicalIF":3.5,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667054","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}