International Journal of Public Health最新文献

[This corrects the article DOI: 10.3389/ijph.2025.1607770.].

Objectives: The objectives were to estimate the prevalence of out-of-home care among school-aged children in Canada by year, gender, age group, and placement type and assess time trends.

Methods: We analyzed data from five cycles of the Health Behaviour in School-aged Children survey. Respondents were students in grades six through ten attending public schools in Canada. Based on a question about the family structure, we derived three types of living arrangements - (1) foster/children's home, (2) kinship home, or (3) living with a parent(s) - and estimated the prevalence of each type.

Results: The pooled sample included 93,720 students; 1.1% reported living in a foster/children's home and 2.1% in a kinship home and in 2018. At the p = 0.05 level (chi-square), there were no observed differences in prevalence by gender or age group. Over time, the prevalence of living in a kinship home increased more than foster/children's home (average percent change per cycle of 18.5% versus 5.0%), to 2.9% and 1.1%, respectively, in 2018.

Conclusions: The prevalence of out-of-home care in Canada was higher that previous estimates based on census and administrative data.

Objectives: To explore the post-earthquake experiences and perspectives of public health specialists, with a particular focus on the delivery of public health services following the 2023 Kahramanmaraş earthquake.

Methods: This qualitative study employed a phenomenological approach, aiming to capture lived experiences and contextual understanding of the situation. In-depth interviews were conducted with 15 public health specialists. Participants were selected through purposive sampling. Data were collected via in-depth interviews and analyzed thematically using multiple coding by the research team.

Results: Public health specialists reported experiencing stress, burnout, and housing difficulties due to increased workloads and suboptimal working conditions, despite also expressing a sense of professional fulfillment in crisis management. Key challenges included problems in temporary housing, infectious disease control, and insufficient coordination in primary healthcare services and community-based approaches. Poor coordination, vague job roles, and inadequate training and resources were cited as significant barriers to effective disaster response.

Conclusion: The main challenges following the earthquake included increased workloads and unclear role definitions. These findings underscore the importance of establishing pre-defined job descriptions and clear lines of authority to improve disaster preparedness and response in the health sector.

Objectives: To examine disability-related disparities in participation in national health screenings in South Korea and to determine how these gaps vary by disability severity, type, and socio-economic factors.

Methods: A trend analysis of screening participation from 2012 to 2020 and multivariable logistic regression for 2019-2020 were conducted using the National Health Insurance Service database, linking eligibility, health screening, and disability registration data. The cohort comprised 10,413,089 adults aged ≥40 years (20% population sample). Annual screening uptake was the outcome; predictors included disability status, severity, type, employment, sex, income, insurance, and region.

Results: Screening uptake rose overall between 2012 and 2020 yet remained lower for people with disabilities, particularly those with severe physical, visual, communication, mental, developmental, epilepsy, and internal disabilities. Age-sex standardization and socio-economic adjustment attenuated but did not remove gaps. Employment narrowed disparities, whereas women with disabilities faced wider gaps than men.

Conclusion: Despite nationwide gains, disability-related inequities in preventive screening persist, amplified by severe impairment, unemployment, and female gender. Policies should prioritize accessible facilities, targeted outreach, and socio-economic support to ensure equitable screening for people with disabilities.

Objectives: This study examined the association between social isolation and mortality outcomes in a large Swedish cohort.

Methods: A cohort study was conducted among 36,490 men and women aged 56-95 years based on linking the Swedish Mammography Cohort (SMC) and the Cohort of Swedish Men (COSM) with Swedish national registers. Cox regression models were used to estimate associations between social isolation and mortality.

Results: Participants with high social isolation had a significantly higher risk of all-cause mortality compared to those with low social isolation (HR 1.17, 95% CI: 1.09-1.27). This association was observed in both women (HR 1.18, 95% CI: 1.02-1.37) and men (HR 1.15, 95% CI: 1.05-1.27). For cause-specific mortality, social isolation was significantly associated with deaths from ischemic heart disease (HR 1.55, 95% CI: 1.12-2.14) and prostate cancer (HR 1.44, 95% CI: 1.02-2.04).

Conclusion: Our study found a significant association between social isolation and both all-cause and cause-specific mortality, such as ischemic heart disease and prostate cancer, among older adults.

Objectives: This meta-analysis examined the association between electronic cigarette (e-cig) use and biomarkers related to lung inflammation and carcinogenesis.

Methods: A systematic review of PubMed, Scopus, Web of Science, EMBASE, and Cochrane Library (2014-April 2024) identified 16 studies including 24,079 adults. Biomarkers from urine, saliva, and plasma-cotinine, NNAL, NAT, and interleukins-were analyzed using one-way ANOVA and Tukey's post-hoc tests. The GRADE framework assessed evidence certainty and risk of bias.

Results: Among participants, 27.2% were smokers, 2.7% e-cig users, 66.0% non-smokers, and 4.1% dual users. E-cig users showed higher salivary cotinine than non-smokers (p = 0.033) but not smokers (p = 0.99). NNAL was significantly elevated in smokers (p = 0.035). E-cig users had increased inflammatory markers (IL-6, TNF-α) compared with non-smokers but lower than smokers. Carcinogenic biomarkers were present in e-cig users at reduced concentrations versus smokers. GRADE indicated low to high certainty with no or moderate bias.

Conclusion: E-cigarette use is associated with biomarker alterations indicating inflammation and potential carcinogenesis, paralleling some effects of traditional smoking. Standardized longitudinal studies are needed to establish causality and long-term risks.

Objective: We examined whether family functioning relates to multisite and chronic musculoskeletal pain in adolescents, a key etiological stage for chronic pain, considering socioeconomic and childhood adversity factors (ACEs).

Methods: Data from 1,473 participants were analyzed using the Luebeck Pain Screening Questionnaire at 18 years. Multisite pain was defined as pain in ≥2 sites; chronic musculoskeletal pain as pain in any musculoskeletal site lasting >3 months. Family functioning was assessed via the Brief Family Relationship Scale and categorized as poor, fair, or good. Socioeconomic indicators were collected at baseline, and ACEs at age 13.

Results: The prevalence of multisite pain was 43%, and chronic pain was 23%. Logistic regression analyses showed that good family functioning was associated with lower odds of multisite pain (OR 0.49; 95% CI 0.37, 0.65) and chronic musculoskeletal pain (OR 0.62; 95% CI 0.45, 0.86). Socioeconomic indicators had limited effects, though higher maternal occupation was linked to greater multisite pain (OR 1.38; 95% CI 1.02, 1.87). Stratified analyses revealed no significant interactions.

Conclusion: Good family functioning was associated with a lower risk of adolescent pain across socioeconomic contexts.

Objectives: In January 2025, federal executive orders introduced sweeping changes to healthcare, public health infrastructure, and research funding. These shifts raised concern within the lung cancer (LC) community, which depends on early detection, timely care, and continued innovation. This study examined community perceptions of these policy changes.

Methods: We conducted a mixed-methods national survey (March 2025) guided by the Social Ecological Model. A 12-item online survey collected responses from individuals with personal or professional ties to LC. Descriptive statistics and inductive thematic analysis were performed.

Results: Among 497 respondents, 239 met inclusion criteria. Most reported a personal (69.5%), professional (20.0%), or combined (10.5%) connection to LC. Over half cited emotional distress, disrupted care, and research-funding concerns. Thematic analysis of 81 responses revealed six themes: fear and uncertainty; reduced access; research loss; and mixed views, with some supporting or opposing the executive orders. Patients and caregivers most often reported fears regarding Medicaid cuts, delayed diagnostics, and stalled innovation.

Conclusion: Findings highlight emotional, operational, and research-related disruptions perceived by LC communities and reinforce the urgency of centering affected voices in health-policy decisions.

Objectives: To investigate the causal relationship between workplace violence and health outcomes among healthcare workers, addressing gaps in evidence on its mechanisms and heterogeneous effects.

Methods: A nationally representative cohort of 4,255 Chinese healthcare workers was surveyed via four-stage stratified sampling. Causal effects were estimated using multiple linear models and ordered logit model, with robustness checks via propensity score matching and instrumental variables to mitigate endogeneity.

Results: Workplace violence reduces the probability of healthcare workers experiencing improved health by 12.9% (p = 0.000), with this effect persisting even after considering endogeneity. Physical violence had the most substantial impact, while psychological and verbal violence also contributed. Professional values mediated the effect. Vulnerable subgroups included women, younger workers, lower-ranking staff, and non-tertiary hospital employees.

Conclusion: This study provides causal evidence that workplace violence undermines the health of healthcare workers, with implications for hospital policies and occupational safety standards. Interventions should prioritize physical violence prevention, support for high-risk groups, and value-based resilience training.

Objectives: The objective of this study was to qualitatively explore the experiences of immigrants in Spain using the internet for health-related purposes, while identifying the barriers, needs, and opportunities within the context of digital health literacy.

Methods: 24 individuals with immigrant backgrounds in Spain participated in semi-structured interviews guided by a participatory framework. Data were analysed using qualitative content analysis.

Results: Immigrants perceive digital health literacy as a valuable tool for empowering them to take a more active role in managing their health. However, socio-economic and cultural barriers such as language limitations and low levels of education were identified. Key needs included improvements in health platforms, particularly regarding access, content and security. Participants advocate for greater involvement from healthcare providers and strategic stakeholders to better adapt services to immigrant communities.

Conclusion: This study provides valuable insights for policymakers, offering evidence-based approaches for inclusive strategies to enhance digital health literacy. It also emphasizes the necessity of policies tailored to the specific health needs of immigrant populations, aiming to reduce health inequalities.