Public Health最新文献

{"title":"COVID-19 stay-at-home orders impacts on suicide attempts among adolescents in the United States","authors":"Sarah Y.T. Hartzell ,&nbsp;Paul G. Devereux ,&nbsp;Marta Elliott ,&nbsp;Michelle L. Granner ,&nbsp;Minggen Lu ,&nbsp;Sarah A. Friedman","doi":"10.1016/j.puhe.2026.106170","DOIUrl":"10.1016/j.puhe.2026.106170","url":null,"abstract":"<div><h3>Objective</h3><div>Reducing social isolation is a public health priority. The implementation of COVID-19 stay-at-home orders increased social isolation and had detrimental psychiatric health impacts. The study's objective was to examine whether the COVID-19 stay-at-home orders impacted suicide attempts among U.S. adolescents.</div></div><div><h3>Study design</h3><div>Comparative interrupted time series.</div></div><div><h3>Methods</h3><div>We calculated predicted probabilities and marginal effects of the COVID-19 stay-at-home orders on suicide attempts among adolescents. National claims data from the COVID-19 Research Database produced a study cohort of 374,524 unique adolescents in both the pre- (March 2019-January 2020) and post-pandemic periods (March–June 2020). The outcome of interest was suicide attempts, including intentional poisoning. Separate analyses compared states with shorter duration COVID-19 stay-at-home orders (March–May) and states with longer duration COVID-19 stay-at-home orders (three sub-groups were created for COVID-19 stay-at-home orders lasting March–June, March–May, and April–June).</div></div><div><h3>Results</h3><div>Among the states with longer-duration COVID-19 stay-at-home orders lasting from March–June and April–June, post-stay-at-home orders slopes increased more than comparison states without COVID-19 stay-at-home orders (March–June: 0.00016; 95 % CI: 0.00001, 0.00031; April–June: 0.00067, 95 % CI: 0.00022, 0.00112). States with shorter-duration COVID-19 stay-at-home orders did not yield significant results.</div></div><div><h3>Conclusions</h3><div>Longer-duration COVID-19 stay-at-home orders were associated with a small but significant increase in suicide attempts among adolescents. Mitigation strategies such as stakeholders creating and implementing school-based youth suicide prevention programs, and allocating more funding to text-based lines for those in suicidal crisis need to be implemented.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"252 ","pages":"Article 106170"},"PeriodicalIF":3.2,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146044165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of community-based obesity prevention interventions on child and adolescent health-related quality of life: A pooled analysis of six Australian studies","authors":"Kaitlyn McKenna ,&nbsp;Melanie Nichols ,&nbsp;Claudia Strugnell ,&nbsp;Liliana Orellana ,&nbsp;Steven Allender ,&nbsp;Rachel Novotny ,&nbsp;Jane Jacobs ,&nbsp;Vicki Brown","doi":"10.1016/j.puhe.2026.106147","DOIUrl":"10.1016/j.puhe.2026.106147","url":null,"abstract":"<div><h3>Objective</h3><div>To examine whether community-based obesity prevention interventions (CBOPIs) impact health-related quality of life (HRQoL) in children and adolescents compared to control condition, and whether there are differences according to gender, school level (primary or secondary), and/or socioeconomic position (SEP).</div></div><div><h3>Study design</h3><div>Pooled analysis of data from six CBOPI studies.</div></div><div><h3>Methods</h3><div>Data from six Australian CBOPI studies conducted between 2005 and 2022 were harmonised. Studies were included if HRQoL was measured using the Pediatric Quality of Life Inventory (PedsQL™). Multi-level mixed-effect models were used to analyse the impact of the interventions on mean overall, physical and psychosocial HRQoL scores. Adjustments were made for age, gender, area level SEP, study and study duration, and clustering at school and individual level.</div></div><div><h3>Results</h3><div>In total, 20,837 observations of children aged 8–18 years were included. A trend of declining HRQoL was observed over time. Interventions were effective in slowing the decline in HRQoL in intervention compared to control groups for the psychosocial score overall (mean difference (md) = 0.97, p = 0.018), and for psychosocial (md = 2.15, p = 0.006) and total score (md = 1.84, p = 0.009) in primary school-aged children. A significant effect in slowing the decline in physical, psychosocial and total HRQoL in intervention group compared to control group was observed in schools in low SEP areas, but not in medium or high SEP areas.</div></div><div><h3>Conclusion</h3><div>Results suggest CBOPIs may slow the decline in HRQoL among children and adolescents, particularly in younger children and students from low SEP areas. Future research should explore the pathways by which CBOPIs impact HRQoL.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"252 ","pages":"Article 106147"},"PeriodicalIF":3.2,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146044162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlates of paternal anxiety during the perinatal period: Systematic review and meta-analysis","authors":"Małgorzata Sobol ,&nbsp;Elisa Mancinelli ,&nbsp;Agata Błachnio ,&nbsp;Silvia Salcuni","doi":"10.1016/j.puhe.2025.106108","DOIUrl":"10.1016/j.puhe.2025.106108","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to identify and quantify factors associated with paternal perinatal anxiety (PPA) within non-clinical populations.</div></div><div><h3>Study design</h3><div>Systematic review and meta-analysis.</div></div><div><h3>Methods</h3><div>A systematic review and meta-analysis were performed in line with PRISMA guidelines. Searches were conducted in the PsycARTICLES, PubMed, PsycINFO, MEDLINE, and Scopus databases, supplemented by manual searches and citation-tracking. The risk of bias, the level of evidence, the corresponding score points, and the degree of association with PPA were assessed for each study.</div></div><div><h3>Results</h3><div>37 studies were included, with 16 in the meta-analysis. Results showed that high paternal depressive symptoms, low social support, and high maternal anxiety were associated with higher paternal prenatal anxiety. Higher paternal anxiety postnatally was associated with paternal prenatal anxiety, postpartum depression symptoms, negative birth memories, and maternal anxiety.</div></div><div><h3>Conclusion</h3><div>The positive association between prenatal and postnatal anxiety suggests continuity of anxiety within fathers across the perinatal period, while being closely linked with paternal depression symptoms as well as partner's anxiety, perceived social support, and birth experiences. Findings emphasize the need for family-centered interventions and improved psychosocial support for expectant and new fathers. Addressing these factors may improve paternal mental health outcomes and family well-being during the perinatal period.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"252 ","pages":"Article 106108"},"PeriodicalIF":3.2,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146044171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"STD history predicts persistent condom non-use and partner HIV seroconversion in older Chinese adults with HIV: A retrospective cohort mediation analysis","authors":"Chunxing Tao ,&nbsp;Ting Huang ,&nbsp;Qingyi Liu ,&nbsp;Rongye Huang ,&nbsp;Aidan Nong ,&nbsp;Zhiman Yan ,&nbsp;Lijing Huang ,&nbsp;Bingyu Liang","doi":"10.1016/j.puhe.2026.106155","DOIUrl":"10.1016/j.puhe.2026.106155","url":null,"abstract":"<div><h3>Objectives</h3><div>This study assessed the impact of STD history on condom use and partner HIV seroconversion among older adults with HIV in Southwest China.</div></div><div><h3>Study design</h3><div>We conducted a retrospective cohort study using data from the Chinese HIV/AIDS Comprehensive Response Information Management System (CRIMS) across five cities in Southwest China (2003–2023).</div></div><div><h3>Methods</h3><div>Participants included older adults (aged ≥50 years) newly diagnosed with HIV and with documented baseline STD history. Outcomes were inconsistent condom use and partner HIV seroconversion, assessed using longitudinal follow-up records. Logistic regression examined associations, and mediation analysis estimated the indirect effect of condom use on the STD history-seroconversion relationship. Sensitivity analyses stratified participants by sex, marital status, education, and occupation.</div></div><div><h3>Results</h3><div>Among 30,492 included older adults with HIV (median age: 62.28 years; IQR: 56.26–68.74), 7.3 % had a documented STD history at diagnosis. Most participants were male (72.1 %), farmers (79.8 %), and married/cohabitating (67.8 %). Of the 27,313 participants included in the analysis of condom use, 18.2 % reported inconsistent use, while among the 5025 participants in the partner seroconversion analysis, 6.5 % reported partner HIV seroconversion. STD history was significantly associated with inconsistent condom use post-diagnosis (aOR: 2.18; 95 %CI: 1.96–2.41) and increased partner HIV seroconversion risk (aOR: 1.90; 95 %CI: 1.27–2.84). The mediation analysis indicated that inconsistent condom use explained 11.9 % of the total effect of STD history on partner seroconversion, while the residual effect was unexplained and not captured by the measured mediator.</div></div><div><h3>Conclusions</h3><div>Prior STD exposure was associated with persistent sexual risk and elevated partner HIV transmission among older adults, underscoring the need to integrate STD history into risk assessments and long-term monitoring strategies for serodiscordant partnerships in high-burden settings with aging HIV populations.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"252 ","pages":"Article 106155"},"PeriodicalIF":3.2,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146041886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dietary diversity score and associated factors among high school adolescent girls in Galkaio town, Puntland, Somalia, 2023","authors":"Mohyadin Abdullahi Ahmed ,&nbsp;Mohamed Hassan Isse ,&nbsp;Ahmed Mohammed Ibrahim ,&nbsp;Mohamed Mohamud Yusuf","doi":"10.1016/j.puhe.2026.106154","DOIUrl":"10.1016/j.puhe.2026.106154","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to assess the dietary diversity score and associated factors among high school adolescent girls in Galkaio, Puntland, Somalia, 2023.</div></div><div><h3>Study design</h3><div>An institution-based cross-sectional study.</div></div><div><h3>Methods</h3><div>This study was conducted among high school adolescent girls in Galkaio, Puntland, Somalia, in 2023. A systematic random sampling technique was used to select study participants. Data were collected using a self-administered semi-structured questionnaire. For data entry and analysis, the Epi-Data 3.1.0 version and SPSS version 23 were used, respectively. Descriptive statistics were used to summarize the data. Bivariate and multivariate logistic regressions analyses were computed to identify factors associated with dietary diversity score. Variables with a p-value &lt;0.25 on bivariate analysis were entered into the multivariate logistic regression. Results were claimed to be statistically significant when the p-value was less than 0.05.</div></div><div><h3>Results</h3><div>In this study, a total of 580 high school adolescent girls participated with a response rate of 96.5 %. The overall proportion of low dietary diversity scores was 55.3 % (95 % CI: 51.2, 59.3). Maternal education [AOR = 2.122 (95 % CI: (1.147, 3.924)], parental occupation [AOR = 5.816 (95 %: CI: 3.308, 10.224)], low wealth index [AOR = 1.682 (95 % CI: 1.040, 2.720)], eating less than three times per day [AOR = 4.338 (95 % CI: 2.253, 8.352)], eating outside the home [AOR = 1.820 (95 % CI: (1.205, 2.750)] and not getting nutritional education [AOR = 2.359 (95 % CI: 1.550, 3.6)] were associated with a low dietary diversity score.</div></div><div><h3>Conclusions</h3><div>The results of this study indicated that more than half of the high school adolescent girls in Galkaio had a low dietary diversity score which requires policy attention. Maternal education, father's occupation, wealth index, meal frequency, eating outside the home and nutritional education were significantly associated with the low dietary diversity score.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"252 ","pages":"Article 106154"},"PeriodicalIF":3.2,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146031523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive accuracy of the 8- and 12-item versions of the DASS-21 in measuring depression, anxiety and stress in Brazilian university students","authors":"Luiz Menezes-Júnior ,&nbsp;Waléria de Paula ,&nbsp;Bruna Carolina Rafael Barbosa ,&nbsp;Carolina Martins dos Santos Chagas ,&nbsp;Clareci Silva Cardoso ,&nbsp;Eulilian Dias de Freitas ,&nbsp;Fernanda de Carvalho Vidigal ,&nbsp;Helian Nunes de Oliveira ,&nbsp;Luciana Neri Nobre ,&nbsp;Luciana Saraiva da Silva ,&nbsp;Adriana Lúcia Meireles","doi":"10.1016/j.puhe.2026.106150","DOIUrl":"10.1016/j.puhe.2026.106150","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the predictive value of the DASS-8 and DASS-12 scales, derived from the full DASS-21, in assessing mental health among Brazilian university students, highlighting the innovation of validating ultra-brief instruments specifically designed to maintain high psychometric performance while enabling rapid, large-scale mental health screening in resource-constrained academic settings.</div></div><div><h3>Study design</h3><div>Multicenter cross-sectional study.</div></div><div><h3>Methods</h3><div>Study carried out with students at eight public universities in Brazil. Data was collected through a self-completed online questionnaire. Symptoms of depression, anxiety, and stress were assessed using the DASS-21. The concurrent validity of the reduced versions of the DASS-12 and DASS-8 was determined using ROC curve analyses and sensitivity, specificity, and accuracy tests, using the DASS-21 as a reference standard. Regression models evaluated the invariance between sociodemographic and health factors with mental health outcomes in the DASS-21; DASS-12 and DASS-8.</div></div><div><h3>Results</h3><div>A total of 8650 study participants were evaluated, the majority were female (65.7 %) and aged between 18 and 22 (54.2 %). The DASS-21; 12 and 8 had excellent internal consistency (α and ω ≥ 0.91). ROC curve analysis yielded AUC values indicating strong predictive validity, with the DASS-12 reported 0.93, 0.91, and 0.90, while the DASS-8 showed AUCs of 0.92, 0.90, and 0.89 for depression, anxiety, and stress, respectively. Sensitivity ranged from 94 % to 97 % for depression, 84 %–94 % for anxiety, and 87 %–96 % for stress, with high specificity and accuracy across all subscales (&gt;90 %). Factors associated with symptoms across the three subscales by DASS-21 were similar to those identified by DASS-12 and DASS-8.</div></div><div><h3>Conclusion</h3><div>The DASS-8 and DASS-12 scales showed reliability and effectiveness in screening for symptoms of depression, anxiety, and stress in Brazilian university students.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"252 ","pages":"Article 106150"},"PeriodicalIF":3.2,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146013093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical and mental health upon reentry: The importance of social contact in prison for wellbeing during reintegration","authors":"Chantal Fahmy ,&nbsp;Alexander Testa ,&nbsp;Travis J. Meyers","doi":"10.1016/j.puhe.2026.106158","DOIUrl":"10.1016/j.puhe.2026.106158","url":null,"abstract":"<div><h3>Objectives</h3><div>Incarceration is associated with adverse mental and physical health outcomes that are exacerbated during the post-release period. Social contact with loved ones during imprisonment—such as in-person visits, phone calls, and written correspondence—may play a key role in mitigating the health consequences of incarceration and promoting health upon release. The current study assesses how social contact during incarceration may mitigate health issues during the reentry period.</div></div><div><h3>Study design</h3><div>The study uses data from a sample of 475 men incarcerated in Texas prisons interviewed prior to release and again one month into the reentry period.</div></div><div><h3>Methods</h3><div>Ordered logistic regression models of in-prison social contact types (i.e., in-person visitation, sending/receiving mail, and making/receiving phone calls) and four groups of people (i.e., family members, friends, gang associates, and anyone else) who visited the incarcerated person in the last six months before prison release are utilized to predict self-reported physical health and mental health approximately four weeks post-release.</div></div><div><h3>Results</h3><div>Mostly consistent with our hypotheses, findings reveal that in-person visitation during incarceration is positively associated with better physical health following release (odds ratio [OR] = 1.61; 95 % Confidence Interval [CI] = [1.05, 2.47]). Additionally, a closer examination of the in-person visitation groups revealed that visits from family members, but not the other three groups (i.e., friends, gang members, or anyone else), were positively associated with better self-reported physical health (OR = 1.88; 95 % CI = [1.28, 2.75]) and mental health (OR = 1.64; 95 % CI = [1.14, 2.37]).</div></div><div><h3>Conclusions</h3><div>The results affirm and highlight the unique role of familial relationships in promoting wellbeing during reentry. To promote in-person visitation, correctional systems should consider efforts to overcome key barriers and stressors related to family visits. Identifying individuals who lacked positive visitation experiences could inform targeted wraparound practices that prioritize counseling around family reunification and social connections with loved ones.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"252 ","pages":"Article 106158"},"PeriodicalIF":3.2,"publicationDate":"2026-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146004832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of ban and ordinances against indoor smoking on the proportion of smoke-free establishments in restaurants, izakaya, and bars in Japan: Interrupted time-series analysis of restaurant database","authors":"Isao Muraki ,&nbsp;Aoi Kataoka ,&nbsp;Yuri Ito ,&nbsp;Kota Katanoda ,&nbsp;Masakazu Nakamura","doi":"10.1016/j.puhe.2026.106146","DOIUrl":"10.1016/j.puhe.2026.106146","url":null,"abstract":"<div><h3>Objectives</h3><div>To protect workers and individuals from second-hand smoke exposure, Japan's national indoor smoking ban was enforced on April 1, 2020. However, certain exemptions were made for eating and drinking establishments. Local ordinances restricted these exemptions to increase their effectiveness. We aimed to evaluate the 2-year impact of the national ban and local ordinances on indoor smoking policies in eating and drinking establishments over a 2-year period.</div></div><div><h3>Study design</h3><div>Panel data analysis.</div></div><div><h3>Methods</h3><div>From a commercial database of eating and drinking establishments, we used area-level summary data of 320,693 establishments for August 2016 and individual establishment data extracted biannually between January 2020 and December 2022 (n = 329,322 to 403,133). We calculated the category-specific and weighted proportions of smoke-free establishments. We analysed the short-term and trend changes using an interrupted time-series analysis.</div></div><div><h3>Results</h3><div>The proportion of smoke-free establishments increased after the national ban (+5.7 % points). Local ordinances restricting the exemption for the establishments with non-family employees enhanced the impact of the national ban (+7.8 % points). In December 2022, the proportions of smoke-free establishments were 68.3 % in restaurants, 70.2 % in cafés, 32.8 % in izakaya, and 25.0 % in bars.</div></div><div><h3>Conclusions</h3><div>The indoor smoking ban has promoted indoor smoke-free policies in eating and drinking establishments in Japan. However, many establishments, nearly two-thirds of izakaya and bars, remain smoking-allowed, probably owing to exemptions and non-compliance. To effectively reduce second-hand smoke exposure in eating and drinking establishments, it is necessary to minimise exemptions by revising laws or enforcing additional ordinances and promoting compliance with these legislations.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"252 ","pages":"Article 106146"},"PeriodicalIF":3.2,"publicationDate":"2026-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146004811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Persistent income-related inequalities in cancer screening utilisation in South Korea: Evidence from repeated cross-sectional data, 2013–2023","authors":"Soyun An ,&nbsp;Sunghyun Yi ,&nbsp;Jihyung Hong","doi":"10.1016/j.puhe.2026.106157","DOIUrl":"10.1016/j.puhe.2026.106157","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to examine trends in income-related inequalities in cancer screening from 2013 to 2023 and decompose these inequalities into contributing factors.</div></div><div><h3>Study design</h3><div>This is a repeated cross-sectional study.</div></div><div><h3>Methods</h3><div>Data were drawn from the 2013, 2018, and 2023 waves of the nationally representative cross-sectional Korea National Health and Nutrition Examination Survey. Screening uptake was defined as having received any cancer screening within the past two years, reflecting Korea's biennial check-up schedule. Income-related inequality was assessed using the Erreygers concentration index (ECI) and the horizontal inequity index (HIwv). The ECI was decomposed to identify contributing factors.</div></div><div><h3>Results</h3><div>Screening rates increased across all income groups, with overall participation rising from 63.7 % in 2013 to 71.8 % in 2023. However, a widening pro-rich inequality was observed over this period. The ECI rose from 0.127 (standard error [SE]: 0.018) in 2013 to 0.149 (SE: 0.016) in 2023, and the HIwv increased from 0.108 (SE: 0.019) to 0.146 (SE: 0.016). Income and private health insurance (PHI) made the largest contributions. Income's share of inequality nearly doubled from 38.2 % to 71.4 %, while PHI's declined from 35.8 % to 24.9 %.</div></div><div><h3>Conclusions</h3><div>Despite near-universal financial coverage, persistent pro-rich inequalities in cancer screening suggest that eliminating direct screening costs alone is insufficient to achieve equity. Broader strategies addressing structural and social barriers — including post-diagnosis financial concerns, time constraints, and gaps in education and health literacy — are required to ensure equitable access to preventive care.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"252 ","pages":"Article 106157"},"PeriodicalIF":3.2,"publicationDate":"2026-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145999524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heat and its effects on maternal and neonatal health care: Evidence from Burkina Faso","authors":"Seni Kouanda ,&nbsp;Kadidiatou Kadio ,&nbsp;Adama Sana ,&nbsp;Mariam Congo ,&nbsp;Nathalie Roos ,&nbsp;Fiona Scorgie ,&nbsp;Britt Nakstad ,&nbsp;Sari Kovats ,&nbsp;Jeremy J. Hess ,&nbsp;Véronique Filippi","doi":"10.1016/j.puhe.2026.106144","DOIUrl":"10.1016/j.puhe.2026.106144","url":null,"abstract":"<div><h3>Objectives</h3><div>Climate change has a wide range of adverse consequences for human health. The effects of extreme weather on maternal and newborn health, as well as the availability and quality of health services, remain under-researched in the sub-Saharan region. The aim of this study is to examine the effects of heat on pregnant women's use of health services, the health facility working environment and the impact of heat on the quality of care in Burkina Faso, a limited resource country.</div></div><div><h3>Study design</h3><div>We adopted a qualitative approach to address the research objectives.</div></div><div><h3>Methods</h3><div>This study was conducted in the primary health care centers of Wemtenga in Ouagadougou and Delga in Kaya, Burkina Faso, from September 30th to October 30th^, 2020. The study included individual interviews and focus group discussions (FGD) with pregnant women, postpartum women, health providers and community leaders, women of reproductive age, as well as relatives and male spouses of women who recently had given birth. The interviews were transcribed into French and coded using NVivo11 software.</div></div><div><h3>Results</h3><div>Forty pregnant and postpartum women, aged 20–40 years, were interviewed, and 31 women of childbearing age, aged 21–39 years, participated in the FGDs; 29 spouses also participated in the FDGs. Interviews indicated that extreme heat was reported to reduce the attendance and use of health services by pregnant and postpartum women. The women's choice of delivery center depended on the quality of the health centers, notably whether they were equipped with cooling systems, as lack of cooling could adversely affect the care of women and newborns, and the number of managed patients. The conveniences offered by health centers, notably the presence of fans or air conditioners, were important factors influencing women's decisions on where to give birth. All stakeholders agreed that extreme heat affected the relationship between caregivers and patients, especially facilities with inadequate infrastructures, such as the lack of a cooling system and cramped spaces.</div></div><div><h3>Conclusions</h3><div>Extreme ambient heat negatively impacts the use of maternal and child health services, the performance and quality of care provided by health professionals, and the relationship between carer and patient. This is particularly concerning as worsening heat could undermine the progress made in maternal and child health in Burkina Faso and other similar settings. It is crucial for healthcare systems to adapt to the effects of climate change, particularly to extreme heat and heatwaves, which are becoming increasingly intense, frequent and long-lasting.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"252 ","pages":"Article 106144"},"PeriodicalIF":3.2,"publicationDate":"2026-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}