Frontiers in Public Health最新文献

Revising public health policy based on new data does not happen automatically. This is acutely relevant to the now undeniable evidence that many diseases develop differently between the sexes and may also be affected by gender. Current health and medical practices across the globe generally fail to cater for sex and gender effects in common diseases. Inadequate policy frameworks to guide the comprehensive inclusion of sex and gender in research jeopardises scientific rigour and ultimately the practices they underpin. To ensure that Australian health and medical research is fit-for-purpose, we realised that potent initiatives would be necessary to expedite strategic reframing of thought and behaviour. Here we report on our innovative engagement of end-users for democratic self-determined policy reform to guide health and medical research, based on robust data. We draw upon our specific study to outline seven key steps that can be adopted to accelerate effective change, across a breadth of evidence-based initiatives to reform health policies.

Introduction: Research on the utilization of outpatient and inpatient medical and health services for residents and the factors influencing them is well established, however, there are fewer relevant studies analyzing the utilization of preventive health check-up services for middle-aged and older adult people in China. In this study, we hope to understand the utilization of preventive health care services and identify the factors that influence such utilization, thereby providing insights for health policy and resource allocation.

Methods: The study uses data from the 2020 CHARLS survey, including 17,200 participants aged 45 and older.

Results: Approximately 47.3% of middle-aged and older adult individuals had at least one health checkup. Utilization was significantly influenced by age, area of residence, education level, social insurance, health insurance, personal income, presence of chronic diseases, and life satisfaction. Older adults, urban residents, and individuals with higher income or chronic conditions were more likely to utilize health checkup services.

Conclusion: There are significant urban-rural disparities in the utilization of health checkup services among middle-aged and older adult people in China. Future health policies should prioritize rural areas and disadvantaged groups to improve equity and accessibility of health services.

Background: Gender-based violence (GBV) poses a significant global threat to human rights, public health and attaining the Sustainable Development Goals. There is a growing emphasis on researching to identify issues and understand the experiences of women relative to GBV. The increasing demand for policymakers and public health practitioners to adopt evidence-based approaches in addressing GBV highlights the need for research prioritization on experiences of GBV among women in resource-limited settings such as sub-Saharan Africa. This paper explored GBV among women in 25 sub-Saharan African (SSA) countries to identify and present key intervention priority areas for addressing GBV in these settings.

Methods: The study involved a cross-sectional analysis of a nationally representative dataset from the Demographic and Health Survey of 25 SSA African countries. Data was analyzed descriptively and inferentially using the Pearson chi-square (X2) at a p < 0.05.

Results: Findings revealed that women aged 25-29, living in rural areas and with primary education were at a significant risk of experiencing GBV across 25 SSA countries. A notable 44.94% of women reported experiencing at least one form of GBV, with the prevalence varying by country. Women in Comoros had the lowest reported prevalence (10.76%), while Sierra Leone women had the highest (60.27%), followed by Uganda (56.92%). Emotional and physical violence were most prevalent in Sierra Leone, while sexual violence was most common in Burundi and the Democratic Republic of Congo.

Discussion: This study highlights the urgent need for targeted interventions for younger women in rural areas and those with limited education. By prioritizing evidence-based approaches, stakeholders can develop more effective, sustainable, and impactful programs to reduce GBV and improve the well-being of women across the SSA region.

Background: Social capital, as a multidimensional social science concept, plays a crucial role in promoting physical activity. Despite numerous studies exploring the relationship between social capital and physical activity, there is still a lack of systematic understanding of how different dimensions of social capital influence physical activity levels. This study aims to systematically review the literature up to 2024 on the relationship between social capital and physical activity, uncover the role of social capital in promoting physical activity, and identify its multidimensional impacts.

Methods: We used a combination of search terms including "social capital" and "physical activity" to search the Web of Science, PubMed, Scopus, SportDiscus, and PsychINFO databases for English literature published up to March 1, 2024.

Results: We identified 2,021 unique articles and reviewed 115 studies that met our inclusion criteria. These studies evaluated various dimensions of social capital, with key dimensions including social participation (34%), social networks (30%), social cohesion (30%), social trust (29%), overall social network (26%), social support (19%), safety (19%), norms of reciprocity (13%), social control (10%), satisfaction with the environment (8%), collective efficacy (4%), norms for physical activity (3%), and voting (1%). In studies exploring the relationship between social capital and physical activity, the majority of positive results in the hypothesized direction were observed in dimensions such as social cohesion, trust, participation, reciprocity, satisfaction with the environment, and overall social networks. In contrast, dimensions such as voting, collective efficacy, safety, control, and physical activity norms predominantly showed null or negative results. The results for social support were mixed, displaying positive, negative, and null outcomes, while findings for social networks were also predominantly mixed.

Conclusion: This study reveals the significant role of social capital in promoting physical activity, particularly in the dimensions of social cohesion, social trust, social participation, norms of reciprocity, satisfaction with environment, and overall social network. When designing public health interventions in the future, it is crucial to tailor strategies to different populations and contexts to better leverage social capital in promoting physical activity.

Purpose: Armed conflicts can lead to devastating psychological health issues within and around conflict zones. Generalized anxiety disorder, associated somatic symptoms, and wellbeing were examined among the Kuwait population during the Gaza Conflict in 2023, in addition to exploring the provoking factors.

Methods: A descriptive, correlational cross-sectional design was used in this study. An online survey was conducted to collect information from people living in Kuwait during the Gaza Conflict. Data were collected between November 20 and November 27, 2023. The generalized anxiety disorder scale (GAD-7), a modified patient health questionnaire (mPHQ-15), and the World Health Organization - Five (WHO-5) were used to examine self-reported anxiety, somatic symptoms, and wellbeing among the study participants. Spearman's correlation and chi-squared tests were used to determine the relationships between anxiety, somatic symptoms, and wellbeing, and to capture the instigating factors.

Results: This study included 1979 participants living in Kuwait during the Gaza conflict period. GAD-7 and mPHQ-5 final scores were moderate (μ = 10.20 ± 4.48; μ = 11.12 ± 6.39), and WHO-5 final score was fair (μ = 53.35 ± 21.82). Spearman's correlation showed a large positive correlation between the GAD-7 and mPHQ-15, r(1977) = 0.52, p < 0.0001, a medium negative correlation between the GAD-7 and WHO-5, r(1977) = -0.36, p < 0.0001, and a medium negative correlation between the mPHQ-15 and WHO-5, r(1977) = -0.27, p < 0.0001. Spearman's correlation showed a small positive correlation between the GAD-7 and current feelings of insecurity, r(1977) = 0.246, p < 0.0001, and medium positive correlation with future fears, r(1979) = 0.292, p < 0.0001.

Conclusion: The Gaza conflict impacted the psychological health of the Kuwait population, who shared geographical, geocultural, and geopolitical factors with those in the conflict zone. A global call to address mental health intervention programs for the public in and around conflict zones is a priority.

Background: The Chinese public health system is grappling with escalating demands, which stemmed from the challenges of preventing chronic and infectious diseases, as well as the aging population. Meanwhile, in the context of restricted public health resources, how to efficiently utilize these resources becomes a paramount concern.

Objective: This study aimed to evaluate the technical efficiency of specialized public health facilities, the major providers of public health services in China, then discuss its temporal and spatial distribution characteristics and finally investigate its influencing factors.

Methods: The super slacks-based measure data envelopment model was constructed to calculate the efficiency of specialized public health facilities of 31 provinces from 2017 to 2019. Stepwise regression was applied to sort out significant independent variables. Then, geographically weighted regression was used to analyze the spatially varying associations between efficiency and independent variables.

Results: On average, the average technical, pure technical and scale efficiencies were 0.6569, 0.7336 and 0.9206, respectively. Notably, a subtle downward trend was observed in the technical efficiency, which declined from 0.6889 in 2017 to 0.6238 in 2019. From the efficiency decomposition, this reduction was mainly caused by the decreasing of scale efficiency. Besides, substantial geographic variations were observed, with the eastern region exhibiting greater levels of technical and pure technical efficiency. Contrarily, the western region appeared to perform better in terms of scale efficiency. Based on the geographically weighted regression, the proportion of public health expenditure had a noticeable negative impact on the technical efficiency, especially in partial central and eastern coastal provinces. On the other side, the ratio of older population, the sex ratio and the Nitrogen Oxides emission volume had positive impacts on technical efficiency with variations in coefficient magnitude across different geographic areas.

Conclusion: The efficiency of specialized public health facilities has not achieved the optimal status, particularly in terms of the pure technical efficiency. Moreover, the geographic variation was a significant issue affecting the sustainable and balanced performance of public health delivery system in China. The spatially heterogeneous associations between macro-regional factors and efficiency provide in-depth insights in assisting local governments to formulate more targeted and effective interventions, thereby contributing to reduce regional disparities.

Background: The social identity model of recovery (SIMOR) posits that adopting a recovery identity is vital for achieving favorable recovery outcomes. Until now, no studies have investigated recovery identity as a dynamic construct, although recent findings suggest it fluctuates from one day to the next. The present study examines the within-person association between recovery identity and sense of meaningfulness-an aspect of holistic recovery wellbeing. Because recovery-focused social contexts exist to support individuals' recovery wellbeing, we assessed the moderating impact of two such contexts (recovery community centers [RCCs] and recovery meetings) as same-day moderators.

Methods and materials: 91 RCC visitors across Pennsylvania completed daily diary surveys for 10 evenings. Daily measures of recovery identity, meaningfulness, recovery meeting and RCC attendance were analyzed in a multilevel Tobit model (to address right-censoring in the outcome data).

Results: Results indicated both day-level recovery identity (b = 0.79, SE = 0.04, p < 0.001) and person-level recovery identity (b = 0.94, SE = 0.11, p < 0.001) were positively associated with daily meaningfulness. Although the day-level interaction with RCC attendance was not significant (b = -0.11, SE = 0.14, p = n.s.), the interaction with recovery meeting attendance was (b = -0.27, SE = 0.13, p = 0.039), suggesting that meeting attendance buffered the effect of recovery identity on meaningfulness. A simple slopes analysis indicated that the relationship of recovery identity with meaningfulness was still statistically significant and positive in both cases (attended: b = 0.56, SE = 0.08, p < 0.001; not attended: b = 0.87, SE = 0.06, p < 0.001).

Conclusion: These results suggest that people reporting stronger recovery identity also reported greater day-to-day meaningfulness. Further, on any given day for an individual, meaningfulness was higher on days recovery identity was stronger than usual for that individual, and lower on days when recovery identity was weaker. Meeting attendance reduced this effect, suggesting that meeting attendance may be especially helpful to recovery on days when recovery identity is low.

Background: Ischemic heart disease (IHD) is a leading cause of death and disability, particularly affecting the older adult population. Extreme temperatures, especially very low and very high temperatures, are known to exacerbate cardiovascular disease burden. With the ongoing global climate change, understanding the impact of non-optimal temperatures on IHD burden becomes increasingly important, especially in vulnerable populations such as the older adult.

Methods: This study used data from the Global Burden of Disease Study 2021 (GBD 2021) to analyze the spatiotemporal trends of low and high temperatures on IHD burden in the older adult population (aged 60 and above) from 1990 to 2021. We used age-standardized rates (ASR), annual percentage change (EAPC), and the Bayesian age-period-cohort (BAPC) model to forecast 2050. Additionally, the geographic differences in IHD burden were analyzed using World Bank regions.

Results: From 1990 to 2021, the IHD burden in the older adult population was mainly attributed to low temperatures. However, it has increased the burden of IHD due to high temperatures, especially in tropical and low-income regions. The analysis of gender difference revealed that men are usually more affected by high temperatures, though generally, women are more sensitive to low temperatures. Forecasts are that in the future, the burden of IHD due to high temperatures will continue to rise, especially in areas with limited adaptive capacity.

Conclusion: Although low temperature remains the most important contributor to IHD burden among the older adult, the burden attributable to high temperature is on the rise, which increases the need to address the extreme temperature fluctuation. That is more so in poor-income and tropical regions where the most vulnerable populations bear a higher risk for health. Thus, there is an urgent need to develop adaptive public health measures against the dual health risks from extreme temperatures. The findings emphasize that targeted interventions are necessary, with adjustments in regional differences and gender-specific risks to effectively address the growing health threats from climate change.

Currently, China has fully entered an aging society. The construction and efficient utilization of community older adult care facilities have become urgent issues that need to be addressed. To explore the differences in the needs of older adult people in the community for older adult care services, this study selected three basic needs: life care, medical security, and cultural and entertainment, as the primary indicators of community older adult care needs. A community older adult care demand indicator system was constructed, which included three primary indicators and 11 secondary indicators. Based on the indicator system, a survey questionnaire was designed, and validity analysis was conducted using Kaiser Meyer Olkin test and Bartlett sphericity test. 490 survey questionnaires were distributed to 22 communities in Wuhan, and 447 valid questionnaires were collected, with a response rate of 91.22%. The results indicated that there were significant differences in the distribution of older adult population in different communities. Different types of residential areas and housing prices affected its construction and use. The demand for home-based older adult care services in communities varied significantly. Through analysis of variance, the type of residential area did not show significant differences in older adult bathing assistance, daytime care, mental comfort, sports activities, etc. (p > 0.05), while there were statistical differences in nighttime care, medical care, rehabilitation care, older adult canteens, chess and card entertainment, artistic activities, etc. (p < 0.05). No significant difference existed in different housing prices for daytime care, nighttime care, mental comfort, and fitness activities (p > 0.05), but there was statistical difference for rehabilitation care, medical care, chess and card entertainment, senior dining halls, and artistic activities (p < 0.05). According to logistic regression analysis, the income level, self-care ability, and education level had obvious impacts on their basic needs for life care, with OR values of 11.68, 2.621, and 1.792, respectively. This study can provide effective reference for building diversified community home-based older adult care service facilities.

Objective: To assess associations between experienced violence and the use of combustible cigarettes, e-cigarettes, and of both products ("dual use") among adolescent students from Mexico.

Methods: Data comes from an online survey among 3,046 adolescents (12-19 years) conducted between September and December 2021. Students reported experiences of neglect, physical, psychological, and sexual violence perpetrated by household members, and digital violence (by anyone) in the previous 12 months, as well as current (last 30 day) use of cigarettes and e-cigarette. In multinomial logistic models, exclusive cigarette use, exclusive e-cigarette use, and dual use (reference = no use) were regressed on experienced violence and covariates.

Results: The prevalence of exclusive use of cigarettes was 1.4%, exclusive e-cigarette use was 6.1, and 2.4% for dual use. Almost half (46.9%) of adolescents reported having been the target of physical violence, followed by psychological violence (42.6%), neglect (34.9%), digital violence (12.3%), and sexual violence (5.2%). In adjusted multinomial models, adolescents who experienced physical violence (Adjusted Relative Risk Ratios: ARRR = 2.28, 95% CI [1.05-4.96]) were more likely to exclusively smoke cigarettes. Adolescents were also more likely to exclusively use e-cigarettes if they had been targeted by psychological or digital violence (ARRR = 1.55, 95% CI [1.05-2.29] and ARRR = 1.69, 95% CI [1.12-2.54], respectively). Experience of physical, digital, neglect, and sexual violence were positively associated with dual use.

Conclusion: Experiences of violence may increase the likelihood of tobacco use, particularly dual use. Prevention programs may need to include the family environment to reduce violence.