European Journal of Public Health最新文献

Prior research has indicated that residents who perceive their neighborhood as more cohesive have better mental and physical health than those with lower perceived neighborhood social cohesion. However, because most studies are based on cross-sectional data, it remains unclear whether improving the perceptions of social cohesion leads to better health over time. This study applied random effects within-between models to examine the within-individual and between-individual associations of perceived neighborhood social cohesion and poor self-assessed health (SAH) in a cohort of Dutch adults with 17-year follow-up. We also tested whether such associations varied by age, educational level, and gender. The results of pooled analyses indicated that higher perceived neighborhood social cohesion was associated with better SAH [odds ratio (OR): 0.72; 95% confidence interval (CI): 0.65, 0.80], but did not find conclusive evidence that within-individual changes in perceived neighborhood social cohesion were associated with SAH (OR: 0.96; 95% CI: 0.89, 1.04). We also did not observe any moderating effects for age, educational level, or gender. This study provides some evidence that improving social cohesion in neighborhoods may be a beneficial health promotion strategy.

Although the Republic of Moldova had good vaccination rates, anti-vax messages have recently begun to spread, eroding the population's confidence. Vaccination coverage against measles, mumps, and rubella at the target age of 12 months decreased from 95% in 2008 to 83% in 2021. The recent measles outbreak in Romania and three confirmed cases in Moldova, combined with the refugee crisis, have highlighted the importance of vaccination and sparked online conversations on this subject. A mixed-methods study was conducted, involving social listening activities on immunization using the Talkwalker software and qualitative analysis of the identified narratives. Out of 450 identified comments, 30 were selected for further analysis. Over 5 months, a total of 865 results were obtained, with an engagement rate of 6300. The peak in results occurred between 11 and 18 December, driven by the recent measles outbreak in Romania, which saw several confirmed cases and one death, as well as the first cases of measles in Moldova after 3 years. However, no significant increase in the engagement rate was recorded. Comments on immunization tended to reflect distrust in authorities and doctors, political and ideological views, and a lack of knowledge about the risks of vaccine-preventable diseases. The analysed conversations are assessed as having a low risk of spreading, though some employ techniques to influence or manipulate behaviours. The topic of vaccination is used to promote political ideologies through messages issued by the mass media. The information vacuum must be filled with messages designed to produce attitude change regarding vaccination.

Risks to older adults (OA) (aged 65+ years) associated with hot and cold weather in the UK are well-documented. The study aim is to explore OA perception of health risks from high and low temperatures, health-protective measures undertaken, and implications for public health messaging. In 2019/20, Ipsos MORI conducted face-to-face surveys with OA in England (n = 461 cold weather survey, n = 452 hot weather survey). Participants reported temperature-related symptoms, risk perceptions for different groups, and behaviours during hot and cold weather. Analysis involved binomial logistic regression models to assess potential factors (demographics, vulnerability, behaviours) associated with older adults' health risk perception in hot and cold weather. Less than half of OA in both surveys agreed that hot or cold weather posed a risk to their health. OA with higher education, annual income >£25 000 or home ownership were less likely to perceive their health at risk during cold weather and regional differences in hot weather were identified. OA who recognized those the same age or living alone as at an increased risk were more likely to perceive their own health as at risk. OA were more likely to self-identify health risks when reporting those aged 65 yrs+ to be at an increased risk in cold weather. Various temperature-related protective behaviours were associated with older adults' risk perception in hot and cold weather. These findings provide evidence for public health agencies to target high risk individuals, and modify temperature-related public health messaging to protect OA.

Migrant mortality advantage is established in various studies, but there is a lack of evidence on migrant mortality trends in old age. Previous studies have primarily concentrated on all-cause mortality, and few include older age groups. Discussions about the migrant mortality advantage continue due to concerns about data availability and accuracy. Additionally, the mechanisms explaining the migrant mortality advantage remain unclear. This study examines all-cause and cause-specific mortality among older migrant and nonmigrant adults aged 70 and above using Finnish Cause of Death register data (2002-20) and the corresponding risk population. We investigate differences in overall and cause-specific mortality between migrant and Finnish-born population and by geographical region of origin. We calculated direct age-standardized mortality rates and age group-specific death rates followed by Poisson regression to study relative mortality differences. Age at death, sex, income, region of residence, and year of death were controlled for in the regression analysis. We found evidence of migrant mortality advantage across various causes of death, but there was variation by regions of origin groups and sex. Notably, women exhibit the strongest advantage in respiratory and digestive system diseases, while men demonstrated pronounced advantages in external causes and respiratory diseases. Our study challenges the notion of a general diminishing healthy migrant effect in old age. Our findings emphasize the need for nuanced investigations into socioeconomic factors and tailored interventions for older migrants.

Proportion of normal deliveries is decreasing worldwide. This study analysed operative vaginal deliveries (OVD) and Caesarean sections (CS) with some background factors in Estonia and Finland from 1992 to 2016. Data on all deliveries from 1992 to 2016 were obtained from the Finnish Medical Birth Registry (1 481 160 births) and the Estonian Medical Birth Registry (356 063 births). Time trends were analysed by joinpoint regression, and factors associated with OVD and CS by logistic regression. Odds ratios with 95% CIs were calculated, adjusted for year, maternal age, foetal birthweight, and use of epidural/spinal anaesthesia. One out of four deliveries were operative in Estonia and in Finland by 2016. By 2016, the Estonian CS rate had tripled to 20.9% and the OVD rate had increased by nine times to 5.6%. In Finland, the CS rate increased slightly to 16.4% while the OVD rate nearly doubled to 9.4%. In Estonia, the incidence of OVD was 24% lower (aOR 0.76, 95% Cl 0.74-0.78) and the incidence of CS 9% higher (aOR 1.09, 95% Cl 1.07-1.10) than in Finland. Use of epidural/spinal anaesthesia and foetal birthweight increased the risk of OVD in both countries, maternal age increased the risk of CS in both countries. Even if the CS and OVD rates are different, operative delivery rates may be similar in different countries. Combined analysis of operative deliveries together with background factors gives a better understanding of the trends in birthcare than monitoring CS rates alone.

Previous research has suggested an unexpected negative association between smoking and susceptibility to COVID-19. This study, drawing on population-based data from three Nordic countries-Sweden, Norway, and Finland-aims to investigate this association further, capitalizing on diversity introduced by different containment measures. The objective of this research was to examine the association between cigarette smoking and snus (smokeless tobacco) use and the risk of confirmed COVID-19 infection. A pooled analysis integrating original data from 547,685 participants across three countries. We used a multiple imputation approach based on conditional probabilities to impute the systematically missing covariates. The associations between tobacco use and COVID-19 infection were assessed, controlling for potential confounding factors. Current cigarette smokers had a lower risk of a confirmed COVID-19 case, whereas there was an increased risk among snus users. Our sensitivity analysis confirmed that the associations between tobacco use and COVID-19 infection risk are robust, remaining consistent regardless of whether covariate imputation was applied. Findings support a negative association between smoking and SARS-CoV-2 infection, but not the hypothesis that nicotine may be protective against the risk of contracting SARS-CoV-2 infection.

This study aims to investigate the relationship between education and alcohol-related morbidity and the role that low job control and heavy physical workload play in explaining these associations among men and women in Sweden. This register-based cohort study (SWIP cohort) includes over three million individuals registered in Sweden in 2005. Job control and physical workload were measured using a job exposure matrix linked to the index person based on their registered occupation at baseline. Alcohol-related morbidity was measured through diagnoses in the national patient registers between 2006 and 2020. Cox proportional hazards regression models were built to estimate associations between education and alcohol-related morbidity. Reductions in hazard ratios (HRs) were calculated after adjusting for job control, physical workload, and other covariates. Models were also stratified by sex. Lower levels of education predicted a higher risk of alcohol-related morbidity (HR: 2.55 95% confidence interval: 2.49-2.62 for the lowest educated compared to the highest). Low job control and heavy physical workload both played roles in explaining educational differences in alcohol-related morbidity even after accounting for sociodemographic and health factors (15.1% attenuation for job control and 18.3% for physical workload among the lowest educated). Physical workload explained a larger proportion of the associations among men compared to women. Lower levels of education were associated with an increased risk of alcohol-related morbidity and working conditions partly explained these associations beyond what was explained by sociodemographic and health factors. Improving working conditions could therefore prevent some cases of alcohol-related morbidity.

Seventeen percent of people living in the UK are migrants. In high-income countries, migrants have been shown to have better all-cause mortality but worse mortality for some specific causes such as infectious diseases. This observational study aims to quantify the extent to which mortality from coronavirus disease 2019 (COVID-19) differed between migrants and non-migrants for the population of England and Wales, 2020-2021. We use Official National Statistics data to compare mortality from COVID-19 in 2020 and 2021 by country/region of birth, expressed as the standardized mortality ratio with those born in England and Wales as the reference population. Migrants from 17 of 19 countries/regions examined had higher mortality from COVID-19 than non-migrants. The highest mortality was those born in Bangladesh (females SMR = 3.39, 95% CIs 3.09-3.71; males 4.41, 95% CIs 4.09-4.75); Pakistan (females 2.73, 95% CIs 2.59-2.89; males 3.02, 95% CIs 2.89-3.14); and the Caribbean (females 2.03, 95% CIs 1.87-2.20; males 2.48, 95% CIs 2.37-2.60). Migrants born in Antarctica and Oceania (females 0.54, 95% CI 0.42-0.40; males 0.71, 95% CI 0.51-0.88), and North and Central America (females 0.95, 95% CI 0.80-1.11; males 0.85, 95% CI 0.72-0.99) had lower mortality than non-migrants. Most migrant populations had higher mortality from COVID-19 than non-migrants in England and Wales. Policy-makers must work to integrate migration status into routine data collection to inform future research and understand the causes of the inequalities seen.

Knowledge about health literacy challenges among the general population is valuable for initiatives targeting social inequity in health. We investigated health literacy in various population groups and the impact of healthcare-seeking behaviour by analysing the associations between (i) lifestyle, socioeconomics, self-rated health, chronic disease, and health literacy and (ii) symptom burden, contact to general practitioner (GP), and health literacy. In total, 27 488 individuals participated in a population-based survey. Questionnaire data comprised information about symptoms, GP contact, lifestyle, self-rated health, chronic disease, and four aspects of health literacy: feeling understood and supported by healthcare providers, having sufficient information about health, having social support for health, and being able to actively engage with healthcare providers. Socioeconomics were obtained from registers. Descriptive statistics and multivariable linear regression models were applied. Individuals who smoked, lived alone, had different ethnicity than Danish, and low self-rated health had more health literacy challenges reflected in lower scores for all aspects of health literacy. Individuals with high symptom burden and those who had presented a high absolute number of symptoms to their GP were less likely to have sufficient information about health and be able to actively engage, whereas individuals reporting GP contact with a high relative percentage of their symptoms were more likely to feel understood and supported by healthcare providers. Health literacy challenges are related to healthcare-seeking behaviour and several individual factors. To address social inequity in health and society, interventions aimed at both the individual and community-based health literacy are essential.