International Journal of Public Health最新文献

Objectives: In Pakistan, healthcare utilization is linked to out-of-pocket payments (OOP) which disproportionately affect low-income households. We investigated socioeconomic inequality in OOP and catastrophic health expenditures (CHEs), and the contribution of sociodemographic factors to these inequalities.

Methods: Socioeconomic inequalities were quantified using the concentration index (CI), and the slope (SII) and relative (RII) indices of inequality using data from three rounds of Household Integrated Economic Survey (2007-08, 2011-12, and 2018-19). Decomposition analyses were conducted using the Wagstaff and Erreygers approach.

Results: OOP payments increased from PKR 127 (2007-08) to PKR 250 (2018-19). CHEs in the most deprived quintile (Q1) changed from 8.3% (2007-08) to 13.7% (2018-19), and for the least deprived quintile (Q5) from 5.1% (2007-08) to 8.4% (2018-19). The OOP CI increased from 0.028 to 0.051, while the SII and RII increased from 0.89 to 1.32 and 1.18 to 1.36, respectively. Decomposition analysis showed that household size, composition, employment, and the province of residence explained much of the socioeconomic inequality in CHEs.

Conclusion: Poor households experience high CHE, disproportionately impacting larger families with children and elderly members. Policymakers should implement targeted financial protection strategies to safeguard vulnerable households from the impoverishing effects of healthcare expenses.

[This corrects the article DOI: 10.3389/ijph.2024.1607428.].

Objectives: During the COVID-19 pandemic, online health information search has been shown to influence the public's health beliefs, risk attitudes, and vaccination behavior. This study constructs a conditional process model to explore how online health information search impacts public vaccination behavior, considering critical factors like healthcare system satisfaction, vaccine risk perception, and the perceived usefulness of information.

Methods: Data from the 2021 Chinese General Social Survey (N = 2,547) were analysed. The study utilized logistic regression, path analysis, and the Bootstrap method to test the conditional process model.

Results: Increased online health information search promotes vaccination behavior, while increased vaccine risk perception hinders vaccination behavior. Higher satisfaction with the healthcare system encourages vaccination behavior, but online health information search reduces healthcare system satisfaction. Satisfaction with the healthcare system and vaccine risk perception play a chain mediating role between online health information search and vaccination behavior. Additionally, the perceived usefulness of information has a negative moderating effect on online health information search and healthcare system satisfaction.

Conclusion: The research findings provide new insights for health information dissemination and vaccination interventions.

Objectives: To analyse the consumption of energy drinks (EDs) and the motives for their consumption among physically active adolescents in Poland.

Methods: A nationwide survey study was conducted in 1,530 adolescents (10-14 years old) participating in extracurricular, organised sports activities. A computer-assisted web interview method was applied.

Results: Nearly half (46.4%) of the respondents were ED consumers (significantly more boys than girls: 53.0% vs. 47.0%, p = 0.010). The percentage of ED consumers increased with age, from 27.2% in 10-year-olds to 65.4% in the group of 14-year-olds (p < 0.001). The motives and circumstances of ED consumption varied depending on gender: girls were more likely than boys to drink EDs to improve concentration during studying (17.1% vs. 8.8%, p < 0.001) and to stay awake (22.8% vs. 13.8%, p = 0.002), whereas boys more often than girls reported drinking EDs during physical activity (10.9% vs. 6.0%, p = 0.020).

Conclusion: It is necessary to implement gender-diversified educational campaigns on negative health effects of EDs, targeting children, parents and teachers, as consumption of EDs has been identified as a significant public health problem in Poland.

Objectives: This study investigates how nurse supervisors' Dark Triad personality traits (Machiavellianism, narcissism, psychopathy) influence nurses' task performance, mediated by perceptions of enriched work design (autonomy, task variety, social support, safe work conditions, feedback quality) and psychological safety.

Methods: A multisource approach was used to collect data from 256 manager-nurse dyads across various healthcare settings. Nurses completed surveys assessing their work design and psychological safety. Managers completed a self-assessment of Dark Triad traits and rated their nurse subordinates' task performance. Confirmatory factor analysis and structural equation modeling (SEM) were used for analysis.

Results: Supervisors' Dark Triad traits core component impacted nurses' task performance indirectly, mediated by psychological safety and nurses' perceptions of their enriched work design. Psychopathic traits revealed a significant direct negative effect on nurses' performance, while other Dark Triad traits did not show direct effects.

Conclusion: This study sheds light on key factors influencing nurses' performance, offering insights for healthcare organizations aiming to optimize work environments and improve team effectiveness.

Objectives: During the COVID-19 pandemic, essential health services experienced significant disruptions, impacting preventive and chronic care across the world.

Methods: Utilizing the Pandemic Recovery Survey (PRS), conducted online with Facebook's Active User Base across 21 countries between March and May 2023, this cross-sectional study identifies the magnitude of and key factors associated with unmet preventive and chronic care needs during the late stage of the COVID-19 pandemic.

Results: Approximately 28.2% of respondents reported unmet preventive care needs, and 42.1% experienced unmet chronic care needs, with key determinants including food insecurity (aOR 1.94, 95% CI 1.81-2.07 for preventive services; aOR 1.85, 95% CI 1.68-2.03 for existing conditions) and distrust in health professionals (aOR 1.09, 95% CI 1.03-1.15 for preventive services; aOR 1.53, 95% CI 1.41-1.66 for existing conditions).

Conclusion: The findings underscore a widespread unmet need for health services, highlighting the impact of social determinants and trust in health professionals on service disruption. The results suggest that pandemic recovery efforts should focus on the most affected groups to bridge health disparities and ensure an equitable recovery.

Objective: To determine the prevalence and sociodemographic profiles of mental morbidity and multimorbidity.

Methods: A descriptive analysis was performed with data from 25,269 women and 8,389 men from the French NutriNet-Santé general-population cohort. Participants were split into 8 groups: 1. No mental morbidity; 2. Pure anxiety; 3. Pure insomnia; 4. Pure eating disorders (ED); 5. Comorbid anxiety and insomnia; 6. Comorbid anxiety and ED; 7. Comorbid insomnia and ED; 8. Multimorbid anxiety, insomnia, and ED. Data were weighted using the 2016 French Census and analyzed with Chi² tests.

Results: 40.6% of the participants had ≥1 mental disorder; 2.3% had all 3 disorders. Most pure and comorbid disorders were more common in women than in men. The multimorbidity group had the largest proportions of men who were overweight (52.1%) and current smokers (23.2%). Men with insomnia and ED were the most likely to have obesity (45.8%) and low physical activity (44.3%). Women with ≥2 disorders were the most likely to be current smokers.

Conclusion: The findings could inform research, prevention, and public health guidelines for multimorbidity.

Objectives: We evaluated the impact of polypharmacy on the health of community-dwelling older adults.

Methods: We prospectively analyzed 5,631 individuals from the Moli-sani study (51% men, aged ≥65 years, recruitment 2005-2010, follow-up 2005-2020). Exposure was categorized as chronic polypharmacy therapy (C-PT; ≥5 therapeutic groups and >2 defined daily doses (DDDs)) or non-chronic polypharmacy therapy (NC-PT; polypharmacy but ≤2 DDDs). Hospitalization and mortality were the main outcomes. The mediating role of potentially inappropriate prescriptions (PIP) was examined.

Results: Compared to individuals not on polypharmacy, those in NC-PT and C-PT had higher hazards of mortality [21% (95% CI 7%-37%) and 30% (16%-46%), respectively] and hospitalization [39% (28%-51%) and 61% (49%-75%), respectively]. Similar results were found for cardiovascular outcomes. PIP mediated the association between polypharmacy and outcomes, with mediation effects ranging from 13.6% for mortality to 6.0% for hospitalization. Older adults without multimorbidity experienced the same harm from multiple medications as those with multimorbidity.

Conclusion: Polypharmacy is associated with a higher hazard of mortality and hospitalization, with PIP playing an important role. Addressing "medication without harm" requires assessing the appropriateness of drug prescriptions and monitoring for adverse effects.