European Journal of Public Health最新文献

Most European countries have banned flavoured cigarettes. No study has explored whether support for such a ban changes post-implementation. In the UK, a menthol cigarette ban came into force in May 2020. A longitudinal survey in the UK with adult smokers and ex-smokers explored support for the ban in 2019 (N = 3175) and 2022 (N = 3047). Support increased from 2019 (pre-ban) to 2022 (post-ban) for all participants (18.1% to 35.0%), with increased support evident for flavour cigarette smokers (20.7% to 34.5%), non-flavour cigarette smokers (13.5% to 18.1%), and ex-smokers (24.4% to 50.8%). Increased support for tobacco-related policies helps regulators defend policy decisions.

Family screen use rules (FSRs) could plausibly protect against the development of childhood obesity, although the mechanisms underlying these protective effects remain largely unexplored. This research aimed to investigate prospectively the associations between exposure to FSRs at age 24 months, obesogenic behaviours (excessive screen time and short sleep duration) at age 45 months, and obesity at age 54 months. Additionally, a model proposing the mediating role of obesogenic behaviours in the association between FSRs and childhood obesity was tested. Data were obtained from 5733 children and their mothers participating in the 'Growing Up in New Zealand' study. Logistic regressions examined the association between three FSRs (rules on quality, quantity and timing of screen time, and different numbers of FSRs), obesogenic behaviours, and childhood obesity. Structural equation modelling (SEM) was applied to assess the potential mediating roles of obesogenic behaviours in the association between FSRs and zBMI. Neither exposure to individual nor all three FSRs was significantly associated with lower odds of obesity. However, protective effects of FSRs were observed concerning obesogenic behaviours. Exposure to individual or all three FSRs correlated with reduced odds of not meeting screen time and sleep duration recommendations. SEM analysis indicated no direct association between FSRs and zBMI; nevertheless, a significant indirect association was identified through the mediation of obesogenic behaviours. These findings suggest the potential benefits of promoting the adoption of FSRs as a promising population-based strategy to enhance child health behaviours and mitigate the risk of childhood obesity.

Unemployment has been associated with increased risk of cardiovascular disease (CVD) and all-cause mortality. However, factors behind this association remain unsettled. A primary care CVD prevention programme was conducted in two Finnish towns in 2005-07. Of the participants (n = 4450), a cohort of apparently healthy CVD risk subjects belonging to the labour force (n = 1487) was identified. Baseline depressive symptoms were assessed by Beck's Depression Inventory. Data on employment status and mortality were obtained from official statistics. The effect of employment status and depressive symptoms on all-cause mortality after a median follow-up of 15 years was estimated in models adjusted for age, sex, body mass index, non-high-density lipoprotein cholesterol, physical activity, alcohol use, current smoking, glucose metabolism, and hypertension. In comparison to employed non-depressive subjects, fully adjusted hazard ratio (HR) for all-cause mortality was 3.53 (1.90-6.57) in unemployed subjects with increased depressive symptoms, 1.26 (0.68-2.34) in unemployed non-depressive subjects, and 1.09 (0.63-1.90) in employed depressive subjects. Factors independently associated with mortality were unemployment with increased depressive symptoms [HR 3.56 (95% CI 1.92-6.61)], screen-detected diabetes [HR 2.71 (95% CI 1.59-4.63)], current smoking [HR 1.77 (95% CI 1.19-2.65)], and higher age [HR 1.10 (95% CI 1.05-1.15)]. Unemployment in itself was not associated with all-cause mortality. If unemployment was accompanied with increased depressive symptoms, risk of death was significantly elevated.

Declining response proportions in health surveys may lead to increased non-response bias. Multiple reminders are often used to increase response proportions, and, thus, we aimed to determine if the use of reminders decreased the magnitude of non-response bias among web-mode invited in the Danish National Health Survey 2023. In the Danish National Health Survey 2023, a national random sample of 23 467 individuals (aged ≥16 years) with residence in Denmark were invited by a secure electronic mail service. Invited individuals received up to five inquiries: (i) web invitation, (ii) web reminder, (iii) paper invitation including a questionnaire and a prepaid return envelope, (iv) paper reminder, and (v) paper reminder including a questionnaire and a prepaid return envelope. The cumulative response proportions after first-, second-, third-, fourth-, and fifth inquiries were 19.1%, 28.9%, 37.2%, 39.3%, and 42.0%, respectively. In general, third, fourth, and fifth mailing respondents were more often men, at younger ages, with non-Western backgrounds, and unmarried compared to first mailing respondents. Furthermore, third, fourth, and fifth mailing respondents were in general found to have less favorable health behavior than first mailing respondents, but also a lower prevalence of fair or poor self-rated health and long-standing health problems. In conlusion, reminders are an effective way to increase the response proportion. Furthermore, the use of reminders was found to decrease the magnitude of non-response bias; however, the decrease was small due to the low number of individuals responding after fourth and fifth inquiries.

Intimate partner violence against women (IPVAW) is a global problem, and suicidal behaviour is one of its most serious consequences. However, no study has investigated the spatial overlap between the two. The aim of this paper is to analyse whether there is spatial overlap between IPVAW and suicide-related calls in the same neighbourhoods, and to identify common risk factors. Geocoded data on IPVAW (N = 2060) and suicide-related calls (N = 4916) from the city of Valencia, Spain, between 2019 and 2021 were collected from the 112 emergency service and the Spanish National Police Corps. We used two analytical approaches: (i) a Bayesian spatial Poisson regression modelling analysis to identify the risk factors associated with IPVAW and suicide-related calls; (ii) Bayesian joint spatial modelling to examine the common spatial distribution of these outcomes. Relative risk maps are also displayed and analysed. The study revealed a higher incidence of IPVAW and suicide-related calls in neighbourhoods with lower income and population density, and greater residential instability and immigrant concentration. There was a 70% similarity between high- and low-risk areas for these incidents, with a moderate positive correlation of 0.43. Notably, 98% of IPVAW risk variance was explained by shared factors, while 30% applied to suicide-related calls; high IPVAW risk was also found in peripheral areas, while suicide-related calls were concentrated in the city centre. The findings highlight the need to identify areas with shared risk and neighbourhood characteristics for the development of more effective intervention strategies.

The proposal for a regulation on the European Health Data Space (EHDS) contains provisions that would significantly change health data management systems in European member states (MS). This article presents results of a country mapping exercise conducted during the Joint Action 'Towards the European Health Data Space' (TEHDAS) in 2022. It presents the state-of-play of health data management systems in 12 MS and their preparedness to comply with the EHDS provisions. The country mapping exercise consisted of virtual or face-to-face semi-structured interviews to a selection of key stakeholders of the health information systems. A semi-quantitative analysis of the reports was conducted and is presented here, focusing on key aspects related to the user journey through the EHDS. This article reveals a heterogenous picture in countries' readiness to comply with the EHDS provisions. There is a need to improve digitalization and quality of health data at source across most countries. Less than half of the countries visited have or are developing a national datasets catalogue. Although the process to access health data varies, researchers can analyse health data in secure processing environments in all countries visited. Most of the countries use a unique personal identifier for health to facilitate data linkage. The study concluded that the current landscape is heterogeneous, and no member state is fully ready yet to comply with the future regulation. However, there is general political will and ongoing efforts to align health data management systems with the provisions in the EHDS legislative proposal.

During the COVID-19 outbreak the transdisciplinary research project CAVE (Community Engagement and Vulnerability Assessment in Epidemics) investigated perceptions and practicability of public health communication among stakeholders of care and social facilities in Austria. It aimed at finding accurate definitions of vulnerability in the context of epidemics and at developing operational models for engagement of vulnerable groups in co-creating epidemic response mechanisms. Transdisciplinary methods included semi-structured interviews, focus group discussions, and desk reviews as well as spatial analysis and composite indicator-based mapping methods. Informants and participants in the community engagement phase represented clients as well as middle and lower management levels of Austrian care and social facilities for older persons and persons with cognitive impairments, persons depending on mobile healthcare services, homeless people, and socially deprived communities. A narrow definition of vulnerability as well as missing strategies for participation and community engagement limited communication with stakeholders and the implementation of protective measures. An inclusive definition of vulnerability beyond medical and physical indicators should be employed to account for social, psychological, and emotional aspects contributing to a higher risk of being affected by epidemics. The CAVE model provides a multi-level definition of vulnerability that allows for participatory engagement in co-creating adapted crisis response measures. We suggest policymakers and health authorities to consider a broader definition of vulnerability and to commit to pro-active engagement with stakeholders representing these sectors. This requires the establishment and maintenance of communication structures as well as political recognition of civic participation in the creation and implementation of epidemic response measures.

Despite evidence of correlations between low-skilled jobs and poor health, the longitudinal perspective on this research topic has been neglected in Germany for decades. Therefore, we investigate (i) the causal relationship between accumulated employment in low- or medium-skilled jobs on self-rated health and (ii) the selective association of self-rated health on transitions from medium- to low-skilled jobs. About 26 313 dependent employees and persons aged 25-50 from 2010 to 2020 in the German Socio-Economic Panel were included. Linear fixed-effects models were used to analyse the impact of accumulated employment in low- or medium-skilled jobs on self-rated health. Linear probability models with fixed effects were calculated to identify the effect of self-rated health on transitions between low- and medium-skilled jobs. Accumulated employment in low-skilled jobs impacts self-rated health significantly. There is no confirmation for accumulated employment in medium-skilled jobs concerning health. Poor self-rated health increases the probability of transitioning from medium- to low-skilled jobs but does not impact the reverse transition. Poor self-rated health can push employees into low-skilled jobs. Against the background of extended working lives and preserving the labour force potential, there is a need for action and research concerning employees in low-skilled jobs.

Hugely concerning changes to health outcomes have been observed in the UK since the early 2010s, including reductions in life expectancy and widening of inequalities. These have been attributed to UK Government 'austerity' policies which have profoundly affected poorer populations. Studies in mainland Europe have shown associations between austerity and increases in adverse birth outcomes such as low birthweight (LBW). The aim here was to establish whether the period of UK austerity was also associated with higher risks of such outcomes. We analysed all live births in Scotland between 1981 and 2019 (n = 2.3 million), examining outcomes of LBW, preterm birth (PB) and small-for-gestational-age (SGA). Descriptive trend analyses, segmented regression (to identify changes in trends) and logistic regression modelling (to compare risk of outcomes between time periods) were undertaken, stratified by infant sex and quintiles of socioeconomic deprivation. There were marked increases in LBW and PB rates in the austerity period, particularly in the most deprived areas. However, rates of SGA decreased, suggesting prematurity as the main driver of LBW rather than intrauterine growth restriction. The regression analyses confirmed these results: trends in LBW and PB changed within 1-3 years of the period in which austerity was first implemented, and that period was associated with higher risk of such outcomes in adjusted models. The results add to the European evidence base of worsening birth outcomes associated with austerity-related economic adversity. The newly elected UK government needs to understand the causes of these changes, and the future implications for child and adult health.