Frontiers in Public Health最新文献

Introduction: Variation in smoking cessation behaviors and motivators across the United States may contribute to health disparities. This study investigates regional differences over time in two key cessation motivators (quit interest and doctor's advice to quit) and two cessation behaviors (past-year quit attempts and recent successful cessation) across diverse demographic factors.

Methods: Data were analyzed from two releases of the Tobacco Use Supplement to the U.S. Census Bureau's Current Population Survey (TUS-CPS) for the years 2014-15 and 2018-19. The analysis included sex, age, race and ethnicity, education, marital status, employment status, and household income.

Results: Findings from 2018 to 2019 TUS-CPS revealed that quit interest was highest in the Northeast and lowest in the Midwest, while doctor's advice to quit was most prevalent in the Northeast and least in the West. Past-year quit attempts were most common in the Northeast and least in the South. Recent successful cessation (defined as quitting for 6 to 12 months) was highest in the Northeast and Midwest, with the South showing the lowest rates. Compared to the 2014-15 survey, 14 demographic groups (7 in the Midwest, 6 in the South, and 1 in the West) showed decreases in both quit interest and actions to quit. Notably, the Asian non-Hispanic group in the Northeast experienced a significant decrease in quit interest (-17.9%) but an increase in recent successful cessation (+369.2%).

Discussion: Overall, the study indicates that while quit interest was highest in the West, the South exhibited the lowest rates of quit attempts and successful cessation. Significant differences were also noted between age groups. These findings highlight the need for further research into cessation behaviors at more granular levels to inform policies aimed at reducing smoking-related health disparities among populations facing the greatest challenges in cessation.

Introduction: The COVID-19 pandemic led to major disruptions in the lives of university students, which is a population that is already at a greater risk of mental health concerns. Little is known about how the pandemic impacted distress and mental health services utilization among university students across the United States.

Methods: Using survey data from the National College Health Assessment, both before the COVID-19 pandemic (pre-March 2020, n = 88,986) and during the pandemic (Spring 2021, n = 96,489), the present study examined mental health symptoms and utilization of mental health services among undergraduate students attending four-year universities in the United States.

Results: There were notable increases in measures of psychological distress and reductions in well-being from before the pandemic to during the pandemic. However, overall utilization rates of mental health services slightly decreased from pre-pandemic to during the pandemic. Predictors of severe psychological distress included those who experienced loneliness, COVID-19 related stressors, and loss of a loved one from COVID-19. COVID-related stressors and loneliness were associated with higher utilization rates of mental health services, while well-being and resilience were associated with lower utilization rates.

Discussion: Analyses revealed that several demographic groups were at an elevated risk for severe psychological distress, including non-binary, female, and sexual minority students, and especially those who identify as both non-binary and non-heterosexual. Results indicated that students of color, especially female students of color, were less likely to receive mental health services. Future research is needed to increase our understanding of the barriers to mental health service use among high-risk university students.

Background: COVID-19 pandemic had devastating socio-economic and health effects, including mental health. This study examines the intersectionality between gender and mental health outcomes among Kenyan adults in informal settlements of Nairobi, Kisumu, and Kilifi Counties during the COVID-19 crisis. This is necessary to inform mental health response in case of another pandemic.

Methods: We analyzed data collected in a longitudinal survey between July 2020 (fourth round) and February 2021 (fifth round). The data covered COVID-19-related effects on job loss, food insecurity, access to health services, and mental health. Participants were randomly sampled from existing cohorts at the Population Council. The outcomes of interest were depressive and anxiety disorders, combined into a binary composite outcome variable. Descriptive statistics included means for continuous variables and frequencies and proportions for categorical variables. Chi-square tests were used to examine the differences between groups. The relationship between the gendered COVID-19 socio-economic effects and participants' mental health was examined using modified Poisson regression.

Results: A total of 4,050 participants were interviewed, 66% female and median age 38 [interquartile range (IQR): 29-46]. Complete income loss was strongly associated with negative mental health outcomes in multiple intersections with varied magnitudes. The association was larger among older females (≥50 years) (PR = 1.33, 95% CI = 1.17-1.51, p < 0.001) than older males (PR = 1.22, 95% CI = 1.17-1.27, p < 0.001). Partial loss of income was protective against negative mental health outcomes among young males (18-29 years) (PR = 0.81, 95% CI = 0.76-0.87, p < 0.001) but linked to negative outcomes among middle-aged males (30-49 years old) (PR = 1.14, 95% CI = 1.12-1.16, p < 0.001). Skipping meals was associated with negative mental health outcomes for both genders particularly the married (married male: PR = 1.49, 95% CI = 1.22-1.83, p < 0.001; married female: PR = 1.42, 95% CI = 1.26-1.60, p < 0.001).

Conclusion: We observed significant gender differences in the prevalence of depressive symptoms and anxiety disorders during the COVID-19 pandemic, underscoring the importance of socio-economic factors and health services access in shaping mental health outcomes. Interventions targeting pandemic-related mental health issues should be gender-sensitive and address economic vulnerabilities such as job losses and food insecurity. Policies to mitigate these effects, especially for at-risk groups are crucial for reducing mental health burden in future crises.

Background: As individuals age, they commonly experience reduced physical activity and cognitive decline. While evidence, there is limited trajectory research on their concurrent progression and interrelation in individuals over 55 years old.

Methods: The data was collected from 5,765 individuals aged over 55 years who participated in the China Health and Retirement Longitudinal Study (CHARLS) between 2011 and 2020. Physical activity was measured by IPAQ, cognitive function by episodic memory, and mental intactness score. Separate sets of group-based trajectory models were fitted to identify physical activity trajectories and cognitive function trajectories. Multivariate logistic regression was used to estimate the association between baseline characteristics and each set of trajectories. Group-based dual trajectory modeling (GBDTM) was applied to quantify these associations.

Results: GBDTM identified three distinct trajectory groups for physical activity and cognitive outcomes. The physical activity trajectories were classified as "Persistently low physical activity" (74.2%), "Decreasing physical activity" (13.7%), and "Rising physical activity" (12.1%). Similarly, cognitive function trajectories were categorized as "Persistently low cognitive function" (22.2%), "Persistently moderate cognitive function" (37.9%), and "Persistently high cognitive function" (39.9%). Notably, 15.6% of participants followed the trajectories of "Persistently low physical activity" and "Persistently low cognitive function." The presence of a severe decline in physical activity was associated with an increased likelihood of poor cognitive function and vice versa. Age, sex, education, residential status, BMI, and visual impairment were identified as significant predictors for physical activity and cognitive decline.

Conclusion: This study found that the GBDTM can determine the consistent trajectories of physical activity and cognitive function trajectories that persistently decline in individuals over 55 years. Analyses of predictive factors can be instrumental in promoting physical activity and delaying cognitive decline.

The most common source of Radiofrequency Electromagnetic Field (RF-EMF) exposures during sleep includes digital devices, yet there are no studies investigating the impact of multi-night exposure to electromagnetic fields emitted from a baby monitor on sleep under real-world conditions in healthy adults. Given the rise in the number of people reporting to be sensitive to manmade electromagnetic fields, the ubiquitous use of Wi-Fi enabled digital devices and the lack of real-world data, we investigated the effect of 2.45 GHz radiofrequency exposure during sleep on subjective sleep quality, and objective sleep measures, heart rate variability and actigraphy in healthy adults. This pilot study was a 4-week randomised, double-blind, crossover trial of 12 healthy adults. After a one-week run-in period, participants were randomised to exposure from either an active or inactive (sham) baby monitor for 7 nights and then crossed over to the alternate intervention after a one-week washout period. Subjective and objective assessments of sleep included the Pittsburgh Insomnia Rating Scale (PIRS-20), electroencephalography (EEG), actigraphy and heart rate variability (HRV) derived from electrocardiogram. Sleep quality was reduced significantly (p < 0.05) and clinically meaningful during RF-EMF exposure compared to sham-exposure as indicated by the PIRS-20 scores. Furthermore, at higher frequencies (gamma, beta and theta bands), EEG power density significantly increased during the Non-Rapid Eye Movement sleep (p < 0.05). No statistically significant differences in HRV or actigraphy were detected. Our findings suggest that exposure to a 2.45 GHz radiofrequency device (baby monitor) may impact sleep in some people under real-world conditions however further large-scale real-world investigations with specified dosimetry are required to confirm these findings.

Background: This study used data from the Global Burden of Disease Study (GBD) database to systematically assess the magnitude of drug use disorders (DUD) burden between 1990 and 2021.

Methods: This study used GBD data to analyze the trends in ASIR, DALYs and other DUD indicators from 1990 to 2021, and compared them among different regions and countries. The Estimated Annual Percentage Change (EAPC) and its 95% Confidence Interval (CI) were calculated to assess the temporal and geographical disparities. ASIR and DALYs were used to evaluate the burden of DUDs, and socio-demographic index (SDI) was used to measure the socio-economic development level of each country.

Results: The global ASIR of DUDs showed a slight downward trend (EAPC = -0.26). The age-standardized DALY rate (per 100,000) significantly declined from 1990 to 2021 (EAPC = -1.44). Among the regions, the high SDI region exhibited the most substantial increase in ASIR (EAPC = 0.65). On a regional level, the high-income North America region had the highest EAPC for both age-standardized DALYs and ASIR (EAPC = 4.82, 1.02, respectively). Nationally, the United States of America reported the largest increase in age-standardized DALY rates and EAPC for ASIR (EAPC of 4.88, 1.05, respectively), while South Africa had the most significant decrease in EAPC (EAPC of -3.62, -1.52, respectively). In 2021, the highest ASIR was observed in high-income North America at 520.07; Central Asia had the highest age-standardized DALY rate. Globally, age-standardized DALYs and ASIR for DUDs were generally higher in men than in women, and the burden of DUDs decreased with age.

Conclusion: The global burden of DUDs has shown complex and changing trends over the last decades, with large differences in burden between regions and countries. This highlights the need for targeted public health policies and interventions in High income North America region and Eastern Europe.

Studies have shown that the co-infection of Human Immunodeficiency Virus (HIV) and Hepatitis B Virus (HBV) poses a major threat to the public health due to their combined negative impacts on health and increased risk of complications. Even though, some scholars formulated and analyzed the HBV and HIV co-infection model they did not consider the compartment that contains protected individuals against both HBV and HIV infections. They incorporated the optimal control theory and cost-effectiveness analysis simultaneously. With this in mind, we are motivated to formulate and analyze the HBV and HIV co-infection model, considering the protected group and incorporating optimal control theory and cost-effectiveness. In this study, we have theoretically computed all of the models disease-free equilibrium points, all the models effective reproduction numbers and unique endemic equilibrium points. The two sub-models disease-free equilibrium points are locally as well as globally asymptotically stable whenever their associated effective reproduction numbers are less than one. We reformulated the optimal control problem by incorporating five time-dependent control measures and conducted its theoretical analysis by utilizing the Pontryagin's maximum principle. Using the fourth order Runge-Kutta numerical method and MATLAB ODE45, we performed the numerical simulations with various combinations of control efforts to verify the theoretical results and investigate the impacts of the suggested protection and treatment control strategies for both the HBV and HIV diseases. Also, we carried out a cost-effectiveness analysis of the proposed control strategies. Eventually, we compared our model results with other researcher similar model results whenever cost-effectiveness analysis is not carried out the findings of this particular study suggest that implementing each of the proposed control strategies simultaneously has a high potential to reduce and control the spread of HBV and HIV co-infections in the community. According to the cost-effectiveness analysis, implementing the HBV treatment and the HIV and HBV co-infection treatment measures has a high potential effect on reducing and controlling the HBV and HIV co-infection transmission problem in the community.

Background: Adverse socioeconomic conditions at the individual and regional levels are associated with an increased risk of mortality. However, few studies have examined this relationship using multilevel analysis and, if so, only within a single country. This study aimed to examine this relationship using data from several European countries.

Methods: Individual-level data were obtained from Waves 5 to 9 of the Survey of Health, Ageing and Retirement in Europe, while regional-level data were obtained from the Luxembourg Income Study Database. Cox regression analysis with gamma-shared frailty and a random intercept for country of residence was used to examine the association between individual mortality from all causes, cancer, heart attack, and stroke and measures of socioeconomic deprivation at the individual level, including material and social deprivation indices, and at the area level, including the Gini index.

Results: The risk of mortality from all causes was increased for respondents with material deprivation (hazard ratio (HR) = 1.77, 95% CI = [1.60, 1.96]) and social deprivation (HR = 7.63, 95% CI = [6.42, 9.07]) compared with those without. A similar association was observed between individual deprivation and the risk of mortality from cancer, heart attack, or stroke. Regional deprivation had a modest contextual effect on the individual risk of death from all causes and cancer. However, when individual-level deprivation was included in the models, no contextual effects were found.

Conclusion: The results indicate that individual socioeconomic conditions significantly predict causes of death in older European adults, with those with material deprivation and social deprivation having a higher risk of death from all causes, including cancer, heart attack, and stroke, while the Gini index has a minimal effect, although the Gini index reflects regional disparities across Europe.