European Journal of Public Health最新文献

Alcohol use is associated with a high burden of disease, resulting in economic consequences. In Belgium, 77% of the population over the age of 15 regularly consume alcohol. Therefore, the objective of this study is to provide updated estimates of the annual healthcare costs and productivity losses among the Belgian population. Data from the 2018 Belgian Health Interview Survey (BHIS) were linked with health insurance claims data. Healthcare costs were calculated on individuals' alcohol use patterns (current, former, abstainer). Lost productivity costs were calculated by multiplying the number of absence days by the national average wage cost per day. Univariate and multivariable regression analysis with negative binomial distribution and log link were performed to evaluate the average healthcare costs and indirect costs in relation to alcohol use, sociodemographic characteristics, and (behavioural) risk factors. Data from 10 829 individuals were available, of which 47.7% were men. A total of 76% subjects indicated that they currently drink alcohol. Compared to abstainers, significantly lower costs were found for current drinkers (€-470; P = .002). When looking at former drinkers, a significantly higher cost (€889; P = .02) was found compared with individuals who indicated that they never used alcohol. Taking into account that 7% of the Belgian population were former drinkers in 2018, the national costs for former drinkers equates to €711 288 900. Results of our study show that alcohol use has a large economic impact on the Belgian society. Especially former drinkers have a substantial impact on direct medical costs.

Prior research has shown that high composite biological health scores (BHS, based on the allostatic load theory of multisystem physiological dysregulation) are associated with mortality. However, most of this work remains cross-sectional and does not explore the implications of long-term biological health changes, although this is an essential perspective for a better understanding of ageing and health span. To explore the relationship between BHS-at two time points and longitudinally-and mortality, we analysed waves six (2007-08) and seven (2015-16) of the Tromsø Study linked with all-cause mortality data from the Norwegian Population Registry up to 2022. Using 10 biomarkers from 8117 individuals, we created 2-category (low/high) Tromsø6-BHS, Tromsø7-BHS, and longitudinal BHS measures. Cox proportional hazard regression analysis adjusted for confounders revealed that both higher Tromsø6-BHS and Tromsø7-BHS were significant predictors of mortality 15 and 7 years later, respectively (Tromsø6-BHS: HR = 1.20 [0.99-1.45]; Tromsø7-BHS: HR = 1.26 [1.05-1.52]), and that the 7-year mortality risk was more pronounced for the longitudinal BHS (1.30 [1.09-1.56]). Corresponding sex- and age-adjusted median survival was lowered by 0.71, 1.69, and 1.84 years in participants with a high versus low Tromsø6-BHS, Tromsø7-BHS and longitudinal-BHS, respectively. These results indicate that both historical elevations of BHS and their cumulation over time play a role in determining mortality risk. Our findings underline the importance of monitoring biological health over the life course as a preventive measure and suggest that individuals with high BHS levels may benefit from dynamic monitoring from mid-adulthood to mitigate the risk of premature mortality.

We conducted a secondary analysis of Eurobarometer survey data from 27 European countries, collected in 2017 (n = 28 300) and 2023 (n = 26 358), to assess changes in public support for standardised tobacco packaging. In the pooled analysis, support remained unchanged in the 19 MS without relevant legislation (adjusted Prevalence Ratio [aPR]=0.94, 95% Confidence Interval: 0.86-1.03), whereas the 8 MS that had implemented the policy by 2023 were significantly more likely to experience an increase in support (interaction term: aPR = 1.28, 1.17-1.41). The increase in support offers reassurance to policymakers advocating for tobacco packaging regulations and encourages MS to consider the adoption of similar policies.

Cardiovascular disease (CVD) is a major contributor to disability and the leading cause of global mortality. This study aims to perform a population-based prospective cohort study to examine the combined impact of multiple lifestyle factors on CVD risk and examine the differences in the relationships across sociodemographic groups. We used data from the UK Biobank. Exposures include seven lifestyle behaviors (smoking, physical activity, alcohol consumption, diet, sleep duration, sedentary behavior, and social connection) and combined multiple behaviors. The lifestyle score was subsequently categorized as favorable (5 to 7 healthy lifestyle factors), intermediate (2 to 4 healthy lifestyle factors), and unfavorable (0 to 1 healthy lifestyle factor) lifestyle classes. Cox proportional hazards models were used to estimate hazard ratios (HRs) for incident CVD and its subtypes. This study showed a significant association of favorable lifestyle with incident CVD (HR = 0.58, 95% CI: 0.54-0.63), myocardial infarction (HR = 0.58, 95% CI: 0.54-0.64), and ischemic stroke (HR = 0.56, 95% CI: 0.48-0.65). Similarly, there was a significant association of intermediate lifestyle with incident CVD (HR = 0.69, 95% CI: 0.64-0.75), myocardial infarction (HR = 0.70, 95% CI: 0.64-0.77), and ischemic stroke (HR = 0.66, 95% CI: 0.57-0.77). The protection effect of lifestyle was more pronounced in the midlife group, females, and those individuals with high Townsend deprivation index levels. Adherence to a broad range of healthy lifestyle factors was associated with a significantly lower risk of CVD and subtypes. Lifestyle modification through multifactorial approaches should be prioritized for preventing and delaying onset of CVD.

The objective was to study the prospective associations between psychosocial work factors and mental health service use. The study used data from the national French periodical ESPS survey collected in 2010, 2012, and 2014 and linked to the national health insurance database. Psychosocial work factors included quantitative demands, tensions with the public, low freedom at work, low possibilities for learning new things, low colleague support, low recognition at work, low salary satisfaction, job insecurity, temporary contract, and redundancy plan. The number of exposures to these factors was calculated. Mental health service use from the national health insurance database was measured by visits to office- and hospital-based psychiatrists within the 2-year period following each survey wave. The prospective associations between psychosocial work factors and the 2-year incidence of mental health service use were studied using mixed effects Cox proportional hazards models with adjustment for covariates. The study sample included 8576 working men and women without mental health service use within the 6 months preceding survey wave. High quantitative demands, low freedom at work, and low colleague support were predictive of mental health service use. The higher the number of exposures, the higher the incidence of mental health service use. There was no gender-related interaction. The study brought support for the prospective associations between psychosocial work factors and mental health service use. Preventive measures towards psychosocial work factors, including multiple exposure, may help to reduce mental health service use and improve mental health among the working population.

Background: Public health indicators serve as vital monitoring tools of population's health while assisting policy makers in their leadership role while guiding policy decisions. Standardized indicator development continues to face substantial obstacles regarding their conceptual definition, methodological precision, and national compatibility. The aim of this review was to combine academic and institutional literature to assess the application of quality indicators in public health settings.

Methods: A scoping review of the existing literature on public health quality indicators was conducted. The search was performed in PubMed, EMBASE and CINAHL databases. Eleven publications were included, and the extracted data were organized in a structured table.

Results: Research findings showed that indicators must retain a balance between usefulness, national context adaptability and standardized frameworks. The ECHI, EUHPID and PAHO's frameworks established systematic methods to organize indicators and create measurement systems. Subnational programs highlighted that data quality and coverage remained insufficient.

Conclusions: Public health indicators serve as essential tools for tracking population health status while assisting in policy decisions. The practical application of indicators depends on their methodological soundness, ethical approach and their practical implementation possibilities. Research demonstrates that public health indicators require continuous investment regarding their technical infrastructure and conceptual frameworks. Future research should include indicator policy impact assessment, framework improvement and real-time public health system assessment.