Public Health in Practice最新文献

{"title":"Work and health: We need to focus on people not institutions","authors":"Michelle Black, Paul Crawshaw, Amy Barnes","doi":"10.1016/j.puhip.2024.100561","DOIUrl":"10.1016/j.puhip.2024.100561","url":null,"abstract":"","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"9 ","pages":"Article 100561"},"PeriodicalIF":2.2,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11719403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cesarean delivery and its determining factors: A hospital-based study in Jashore District, Bangladesh","authors":"Md. Sakhawot Hossain ,&nbsp;Suvasish Das Shuvo ,&nbsp;Sharmin Asha ,&nbsp;Md. Raihan Chodhoury ,&nbsp;Md. Toufiq Elahi","doi":"10.1016/j.puhip.2024.100558","DOIUrl":"10.1016/j.puhip.2024.100558","url":null,"abstract":"<div><h3>Background</h3><div>The rising prevalence of cesarean deliveries (CD) is a major public health problem worldwide, especially in Bangladesh. This study aims to investigate the prevalence and factors associated with cesarean deliveries in the Jashore district of Bangladesh.</div></div><div><h3>Study design</h3><div>This cross-sectional study, conducted from December 2022 to February 2023 in Jashore district, Bangladesh, involved face-to-face interviews with 662 mothers during hospital visits.</div></div><div><h3>Methods</h3><div>A pretested, structured, and validated questionnaire was employed to gather information on socioeconomic characteristics, obstetric history, maternal healthcare utilization, and factors influencing the choice of delivery method. Multinomial logistic regression models were employed to assess and predict determining factors influencing cesarean delivery.</div></div><div><h3>Results</h3><div>The study revealed a high cesarean delivery (CD) prevalence of 70.5 %, exceeding the WHO-recommended threshold. Key socioeconomic factors associated with increased CD rates included rural residence, younger maternal age (15–20 years), nuclear family structure, and husbands in business. Additionally, private hospital deliveries, a history of previous CD, maternal self-preference, and doctor's influence were significant predictors of CD. The majority of participants believed CD enhances maternal safety (74.6 %) and alleviates pain (74.8 %).</div></div><div><h3>Conclusion</h3><div>The high rate of cesarean deliveries in Jashore highlights the need for public health interventions that improve access to quality maternal care and promote evidence-based decision-making. Reducing unnecessary cesarean procedures, particularly in private hospitals, and enhancing patient education can significantly improve maternal and neonatal health outcomes.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"8 ","pages":"Article 100558"},"PeriodicalIF":2.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142746657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Born into homelessness: A retrospective observational study","authors":"C. Leahy ,&nbsp;C.A. Murphy ,&nbsp;R. Cullen ,&nbsp;P. Foster ,&nbsp;F.D. Malone ,&nbsp;N. McCallion ,&nbsp;K. Cunningham","doi":"10.1016/j.puhip.2024.100559","DOIUrl":"10.1016/j.puhip.2024.100559","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the differences in the antenatal and neonatal courses of maternal-infant dyads within a homeless population as compared to the general hospital population.</div></div><div><h3>Design</h3><div>This was a retrospective observational study.</div></div><div><h3>Setting</h3><div>A large single tertiary maternity hospital (8500 deliveries/year) in Ireland.</div></div><div><h3>Patients</h3><div>We retrospectively reviewed perinatal outcomes for homeless women who delivered liveborn infants at a tertiary maternity hospital, during the calendar year 2020. Homelessness was defined as either A) A designated homeless accommodation service listed as the home address; or B) Self-identified as homeless with an address other than homeless accommodation. We then compared the study cohort with the general hospital population who delivered liveborn infants in the year 2020.</div></div><div><h3>Outcome measure</h3><div>A set of key clinical variables (maternal, antenatal, birth and postnatal outcomes) were obtained and descriptive statistics were performed and compared to available hospital wide data.</div></div><div><h3>Results</h3><div>A total population of 145 infants born to 143 homeless mothers were included. Compared with the general hospital population, infants born into homelessness were more likely to be born preterm (15 % vs 7 %), with lower median birth weight (3.1 kg vs 3.4 kg) and higher rates of admission to the neonatal unit (35 % vs 14 %). Following discharge, there was a greater incidence of missed appointments to the neonatal clinic (29 % vs 8 %), and lower rates of exclusive breastfeeding (16 % vs 45 %).</div></div><div><h3>Conclusions</h3><div>Addressing societal inequalities starts before birth. Infants born into homelessness are particularly vulnerable to perinatal factors associated with negative long-term outcomes when compared with the general population.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"8 ","pages":"Article 100559"},"PeriodicalIF":2.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of the COVID-19 pandemic on the dispensing of systemic anti-cancer therapy (SACT) in Ireland: A population based study","authors":"Peter M. Barrett ,&nbsp;Fionn P. Daly ,&nbsp;Mengyang Zhang ,&nbsp;Aislinn O'Reilly ,&nbsp;Patricia Heckmann ,&nbsp;Paula Tierney ,&nbsp;Deirdre Murray ,&nbsp;Maeve Mullooly ,&nbsp;Kathleen Bennett","doi":"10.1016/j.puhip.2024.100557","DOIUrl":"10.1016/j.puhip.2024.100557","url":null,"abstract":"<div><h3>Objectives</h3><div>The COVID-19 pandemic had considerable implications for cancer related care. This study aimed to examine its impact on the dispensing of systemic anti-cancer therapy (SACT) in Ireland.</div></div><div><h3>Study design</h3><div>A repeated cross-sectional design was used which involved a quasi-experimental interrupted time series analysis (ITSA), and autoregressive integrated moving average (ARIMA) models.</div></div><div><h3>Methods</h3><div>This nationally representative study utilised monthly pharmacy claims (i.e. dispensing) data from community and hospital schemes. Dispensed items among individuals prescribed any SACT from January 2019 to April 2021 were included.</div></div><div><h3>Results</h3><div>During the study period, 641,273 SACT items were dispensed, including 57,199 chemotherapeutic agents (8.9 %), 15,970 immunotherapeutic agents (2.5 %), 87,813 targeted therapies (13.7 %), and 480,291 (74.9 %) endocrine therapies. There were on average 3.3 and 4.1 fewer immunotherapy and targeted therapy agents, respectively, dispensed per 100,000 population per month post-March 2020 (vs. expected), compared to the level prior to March 2020. For endocrine therapy, there was a significant slowing of the trend post-March 2020 compared to the pre-pandemic period (slope change = −1.72, 95 % CI -2.9 to −0.5; p&lt;0.01).</div></div><div><h3>Conclusion</h3><div>There was a significant level decrease in the dispensing of immunotherapy and targeted therapy during the first year of the pandemic, and a slowing of the trend for endocrine therapies. However, no differences in the dispensing of other SACT were observed.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"8 ","pages":"Article 100557"},"PeriodicalIF":2.2,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142661913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between child marriage and high blood glucose level in women: A birth cohort analysis","authors":"B.K. Datta ,&nbsp;A. Tiwari ,&nbsp;L. Glenn","doi":"10.1016/j.puhip.2024.100556","DOIUrl":"10.1016/j.puhip.2024.100556","url":null,"abstract":"<div><h3>Objectives</h3><div>Child marriage prematurely forces girls (&lt;18 years of age) to perform adult roles prior to physical and psychological maturity. Such precocious transitions to young adulthood can have consequences on their long-term health, however, limited work has examined such relationships to date. As such, this study examines whether child marriage is associated with the risk of having hyperglycemia, or high blood glucose, in adulthood.</div></div><div><h3>Study design</h3><div>Observational study using repeated cross-sectional data.</div></div><div><h3>Methods</h3><div>Using data from the 2015-16 and 2019-21 waves of the India National Family Health Survey, we matched 432,080 and 418,409 women, aged 20–49 years, by birth year and month to create birth cohorts. Fitting multivariable binomial and multinomial logistic models, we compared the odds of having hyperglycemia across groups by marriage age (i.e., before or after age 18 years) within respective birth cohorts.</div></div><div><h3>Results</h3><div>We found that the adjusted odds of having high blood glucose among women married as children were 1.12 (95 % CI: 1.07–1.16) times that of their peers married as adults in the full-sample. The adjusted relative risks of having blood glucose levels higher than normal but lower than diabetic and diabetic ranges were 1.09 (95 % CI: 1.04–1.14) and 1.23 (95 % CI: 1.15–1.31), respectively, in comparison to blood glucose within normal range. These results were persistent across sub-groups of different birth cohorts.</div></div><div><h3>Conclusion</h3><div>Our findings suggest that child marriage was associated with higher risk of having high blood glucose in women, later in life.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"8 ","pages":"Article 100556"},"PeriodicalIF":2.2,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142539827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reaching national Covid-19 vaccination targets whilst decreasing inequalities in vaccine uptake: Public health teams' challenges in supporting disadvantaged populations","authors":"J. Lecouturier ,&nbsp;Michael P. Kelly ,&nbsp;Falko F. Sniehotta","doi":"10.1016/j.puhip.2024.100551","DOIUrl":"10.1016/j.puhip.2024.100551","url":null,"abstract":"<div><h3>Background</h3><div>UK local authority public health teams (LAPHT) supported delivery of the Covid-19 vaccination programme, particularly to disadvantaged populations. We explored the challenges encountered and lessons learnt by LAPHTs in tackling low Covid-19 vaccine uptake. The aim of this study was to understand what works, and how, in addressing local inequalities in relation to uptake of the Covid-19 vaccination with a view to generalising insights to building back fairer after the pandemic and into the future.</div></div><div><h3>Study design</h3><div>Qualitative.</div></div><div><h3>Method</h3><div>We conducted in-depth on-line interviews with Directors of Public Health or their representatives from 21 English local authorities covering a total population of over 8 million people. Data were analysed thematically.</div></div><div><h3>Results</h3><div>Accessing the requisite (and accurate) data, engaging with communities, and working with National Health Service (NHS) organisations presented challenges in delivering initiatives to improve vaccine uptake, particularly for disadvantaged groups. LAPHT's assets beneficial to the programme - in-depth knowledge and experience of their communities and locality - were not considered in the national vaccination programme. Community engagement and relationships with local NHS featured heavily in the majority of LAPHTs responses to improving vaccine uptake rates.</div></div><div><h3>Conclusions</h3><div>Incorporating local public health infrastructure, expertise and existing relationships into national vaccination planning during epidemics or pandemics is crucial. Community engagement and good relationships with NHS staff help to reach and serve disadvantaged populations. How these can be developed and maintained in the longer term without future investment was a concern. Future research should explore the design and implementation of PH and NHS joint service delivery models to tackle health inequalities, informed by experiences of the Covid-19 vaccination programme and with input from community partners.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"8 ","pages":"Article 100551"},"PeriodicalIF":2.2,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142554012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Young, deprived women are more at risk of testing positive for Chlamydia trachomatis: Results from a cross-sectional multicentre study in French health examination centres","authors":"Emilie Labbe-Lobertreau ,&nbsp;Mathieu Oriol ,&nbsp;Luc Goethals ,&nbsp;Isabelle Vincent ,&nbsp;Emmanuel Amsallem","doi":"10.1016/j.puhip.2024.100554","DOIUrl":"10.1016/j.puhip.2024.100554","url":null,"abstract":"<div><h3>Objectives</h3><div>Chlamydia Trachomatis (CT) is the most sexually transmitted infection in France. This study aimed to assess the feasibility of systematic screening for CT among people attending a preventive health examination in Health Examination Centres (HECs) and to compare positive CT cases according to deprivation.</div></div><div><h3>Design</h3><div>A cross-sectional multicentre study in thirteen HECs in France in January 2018.</div></div><div><h3>Methods</h3><div>Self-sampling CT screening was proposed among 18–25 years women and 18–30 years men, who were sexually active and without recent CT treatment. Related data and referred specimens were collected among attendees for the study, including deprivation and health status. CT positivity was estimated by genders. We explored association between CT infection and deprivation by univariate and multivariate modelling.</div></div><div><h3>Results</h3><div>The CT screening was proposed to 1701 eligible young people. 90.1 % [88.6–91.5] accepted and participated with 43.6 % being women, 54.3 % being deprived people. 75.4 % [72.1–78.6] screened women performed self-taken vaginal swabs and others took urinary tests. Screening was conducted in 1486 people. Overall prevalence of CT infection was 4.7 % [3.7%–5.9 %], significantly higher for women than men (6.4 % vs 3.4 %, <em>p=0.009</em>). Among women, being deprived increased the likelihood of CT positivity (aOR 4.95; 95 % CI 2.02 to 12.00) more than it did for men.</div></div><div><h3>Conclusions</h3><div>Individual deprivation was significantly associated with having a CT infection among women. The feasibility of CT screening in HECs was demonstrated, with a high acceptance, and led to the implementation of CT screening in all HECs. Promoting access to CT screening to deprived population might contribute to reduce social inequalities in health.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"8 ","pages":"Article 100554"},"PeriodicalIF":2.2,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142572799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Syndemic geographic patterns of cancer risk in a health-deprived area of England","authors":"Catherine Jones ,&nbsp;Thomas Keegan ,&nbsp;Andy Knox ,&nbsp;Alison Birtle ,&nbsp;Jessica A. Mendes ,&nbsp;Kelly Heys ,&nbsp;Peter M. Atkinson ,&nbsp;Luigi Sedda","doi":"10.1016/j.puhip.2024.100552","DOIUrl":"10.1016/j.puhip.2024.100552","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aims to analyse the geographical co-occurrence of cancers and their individual and shared risk factors in a highly deprived area of the North West of England to aid the identification of potential interventions.</div></div><div><h3>Study design</h3><div>An ecological study design was employed and applied at postcode sector level in the Morecambe Bay region.</div></div><div><h3>Methods</h3><div>A novel spatial joint modelling framework designed to account for large frequencies of left-censored cancer data was employed. Nine cancer types (breast, colorectal, gynaecology, haematology, head and neck, lung, skin, upper gastrointestinal, urology) alongside demographic, behavioural factors and socio-economic variables were included in the model. Explanatory factors were selected by employing an accelerated failure model with lognormal distribution. Post-processing included principal components analysis and hierarchical clustering to delineate geographic areas with similar spatial risk patterns of different cancer types.</div></div><div><h3>Results</h3><div>15,506 cancers were diagnosed from 2017 to 2022, with the highest incidence in skin, breast and urology cancers. Factors such as age, ethnicity, frailty and comorbidities were associated with cancer risk for most of the cancer types. A positive geographical association was found mostly between the colorectal, haematology, upper GI, urology and head and neck cancer types. That is, these cancers had their largest risk in the same areas, similarly to their lowest risk values. The spatial distribution of the risk and cumulative risk of the cancer types revealed regional variations, with five clusters identified based on cancer type risk, demographic and socio-economic characteristics. Rural areas were the least affected by cancer and the urban area of Barrow-in-Furness was the area with the highest cancer risk, three times greater than the risk in the surrounding rural areas.</div></div><div><h3>Conclusions</h3><div>This study emphasizes the utility of joint disease mapping by geographically identifying common or shared factors that, if targeted, could lead to reduced risk of multiple cancers simultaneously. The findings suggest the need for tailored public health interventions, considering specific risk factors and socio-economic disparities. Policymakers can utilize the spatial patterns identified to allocate resources effectively and implement targeted cancer prevention programmes.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"8 ","pages":"Article 100552"},"PeriodicalIF":2.2,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142554013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conducting 24-hour movement behaviour research with preschool children in middle-income countries: Lessons from the SUNRISE pilot study in Mexico","authors":"Gabriela Argumedo ,&nbsp;Deborah Salvo ,&nbsp;Armando G.-Olvera ,&nbsp;Nicolas Aguilar-Farias ,&nbsp;Anthony D. Okely ,&nbsp;Alejandra Jáuregui","doi":"10.1016/j.puhip.2024.100553","DOIUrl":"10.1016/j.puhip.2024.100553","url":null,"abstract":"<div><h3>Objectives</h3><div>Movement behaviour research among preschoolers is nascent in low- and middle-income countries, where levels of physical activity, sleep, and sedentary behaviour in children are largely unknown. This study aimed to adapt and assess the acceptability and feasibility of the International Study of Movement Behaviours in the Early Years (SUNRISE) in Mexico, and report on challenges and solutions while implementing the protocol.</div></div><div><h3>Study design</h3><div>Pilot study of the SUNRISE protocol in Mexico.</div></div><div><h3>Methods</h3><div>Safety, logistic challenges, local dynamics, and population needs were considered to adapt the SUNRISE protocol. A gender-balanced sample of 100 children aged 3–4 years from urban and rural communities were recruited through early childcare and education centres (ECECs). Measures on children's movement behaviours, anthropometry, gross and fine motor skills, and executive functions were collected. Challenges and solutions for implementing the protocol were documented.</div></div><div><h3>Results</h3><div>The protocol was well accepted by the school community (School response rate: 83.3 %). Data were collected from 132 children (response rate: 44.4 %); 88 children had valid accelerometer data (average wear time: 766.8 min/d). Challenges faced included: stringent regulations to access ECECs, low confidence in the research team and protocol, low literacy levels among parents, lack of basic services in rural areas (e.g., electricity, transportation, accommodation), and poor compliance with accelerometer wear time. To overcome them, changes to the protocol considered: adaptions to meet ECECs dynamics, strategies to enhance trust in the research team and protocols (face-to-face communication, demonstrations, and encouraging parental engagement), seeking community leaders to facilitate access to rural areas and ensure the research team's safety and access to basic facilities, and strategies to improve accelerometer adherence.</div></div><div><h3>Conclusions</h3><div>This study demonstrates the feasibility of conducting movement behaviour research among preschool children through ECECs in Mexico and provides relevant lessons learned that may hold relevance for researchers in settings with similar contexts to Mexico.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"9 ","pages":"Article 100553"},"PeriodicalIF":2.2,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11730262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health inequalities and health-related economic inactivity: Why good work needs good health","authors":"Paul Crawshaw ,&nbsp;Joanne Gray ,&nbsp;Catherine Haighton ,&nbsp;Scott Lloyd","doi":"10.1016/j.puhip.2024.100555","DOIUrl":"10.1016/j.puhip.2024.100555","url":null,"abstract":"<div><div>Tackling health inequalities demands whole systems strategies with reach beyond the traditional sphere of influence of health care systems. Practitioners and researchers have long recognised that wider social determinants, where people are born, the communities they live in, their built environment, access to education and resources and, most significantly for this discussion, their relationship to the labour market, profoundly shape health experiences and expectations over the lifecourse. At macro-level, economic structures and systems play a fundamental role in the distribution of good health and incidence of inequalities. Regionally, the health of local labour markets, a phenomenon shaped by macro, national and global economic forces, is a powerful determinant of opportunities to access and remain in work. Simultaneously, health status impacts significantly on ability to participate in paid employment. Absence from the labour market is both a <em>cause</em> and <em>symptom</em> of health inequalities.</div><div>Economic inactivity, where people are both not participating in the labour market, or actively seeking or available for work, is strongly correlated with poor health. In the UK, over one third of the economically inactive experience long-term health problems. The implications for health inequalities, as both cause and symptom are clear. Participation in paid work, where appropriate, can be beneficial both economically and for health and wellbeing. Continued absence from the labour market is directly correlated with ill health. The determinants of health-related economic inactivity are complex and can only be understood using ecological models of public health. This presents significant challenges for politicians and policymakers alike concerned with reducing economic inactivity, delivering economic growth and redressing regional disparities.</div></div>","PeriodicalId":34141,"journal":{"name":"Public Health in Practice","volume":"8 ","pages":"Article 100555"},"PeriodicalIF":2.2,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}