European Journal of Public Health最新文献

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.

Wastewater-based surveillance (WBS) is increasingly recognized as a valuable tool for monitoring public health at the population level. However, its integration into national public health frameworks across Europe remains uneven. In mid-2024, the EU-WISH Joint Action conducted a system mapping survey across 27 European countries to assess the governance, development, and integration of WBS systems. The survey combined quantitative and qualitative data to evaluate national strategies, legal and financial frameworks, and system capacities. By May 2024, most participating countries had operational WBS systems, primarily targeting SARS-CoV-2. Other monitored targets included influenza and other respiratory viruses, poliovirus, antimicrobial resistance (AMR), emerging pathogens, illicit drugs, and health-related biomarkers. Prioritization in system design was largely based on operational feasibility and perceived public health value. Challenges identified included fragmented governance, lack of sustainable financing, and limited workforce capacity. Integration into public health decision-making varied, and dissemination practices differed significantly across countries and surveillance targets. The EU-WISH survey provides a baseline assessment of WBS implementation across Europe and highlights key enablers and barriers to its institutionalization. The findings support ongoing efforts at national and EU levels to enhance coordination, sustainability, and integration of WBS into routine public health frameworks.

Public stigma toward individuals with mental illness and addiction remains a major barrier to treatment, recovery, and social integration. While previous studies have documented widespread negative attitudes, less is known about the role of recovery narratives in shaping stigma. This study draws on the 2025 Icelandic Stigma Study to examine whether descriptions of recovery reduce preferred social distance from individuals experiencing schizophrenia, alcohol addiction, or heroin addiction. Data were collected using a nationally representative online panel (N = 1755). Respondents were randomly assigned to vignettes describing a character with one of the three conditions, with or without an added description of recovery. Preferred social distance was measured using a scale of eight items, and responses were analyzed with OLS regression models controlling for vignette characteristics and respondent demographics. Results show that descriptions of recovery significantly reduced preferred social distance across all conditions. The effect was strongest for alcohol addiction (33% reduction), followed by heroin addiction (23%) and schizophrenia (8%). Recovery narratives also reversed the relative ordering of conditions: while alcohol addiction was initially more stigmatized than schizophrenia, individuals in recovery from alcohol addiction were viewed more positively than those in recovery from schizophrenia. Female vignette characters elicited less social distance, while respondent characteristics had limited and inconsistent effects. The findings highlight the importance of recovery-oriented narratives in reducing stigma, particularly for addiction. Public campaigns that emphasize successful treatment and recovery may be especially effective in contexts such as Iceland, though condition-specific tailoring remains crucial.

Armed conflicts often expose groups protected under international humanitarian law, such as healthcare workers (HW) and journalists (JN), to disproportionate risks and in the Israel Gaza war it was particularly evident. However, quantitative assessments of their mortality relative to the general population remain limited. Using official data sources, cross-referenced lists from professional associations, and rigorous statistical methods, we estimated higher mortality among HW and JN during the 2023-24 Israel Gaza war. Mortality risks were consistently higher among these protected groups, ranging from 36% to more than sixfold higher for journalists compared with Gaza residents of the same age and sex. Our findings highlight the urgent global need to protect HW and JN in all conflict settings and to ensure accountability for violations of international humanitarian law.