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Spatial zero-inflated poisson analysis of homicide mortality in Mexican municipalities, 2020 墨西哥城市凶杀案死亡率空间零膨胀泊松分析，2020

IF 3.2 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health

Pub Date : 2026-01-07 DOI: 10.1016/j.puhe.2025.106107

Emerson Augusto Baptista , Claudio Alberto Dávila Cervantes

Objectives

Homicide remains one of the most pressing public health challenges in Mexico, with mortality rates rising dramatically since 2006 in the context of escalating organized crime and militarized security strategies. Understanding its spatial distribution and structural determinants is essential for designing prevention strategies that address inequality, urbanization, and marginalization.

Study design

We employed a Spatial Zero-Inflated Poisson (S-ZIP) model to analyze homicide mortality across Mexico's municipalities.

Methods

We analyzed homicide mortality across 2469 Mexican municipalities in 2020 using data from the National Institute of Statistics and Geography (ICD-10 codes X85-Y09, Y87.1) and census-derived socioeconomic indicators. To account for excess zeros, overdispersion, and spatial dependence, we applied a Spatial Zero-Inflated Poisson (S-ZIP) model. The explanatory variables included the municipal marginalization index, the proportion of the urban population, and the Gini coefficient of income inequality. Spatial dependence was modeled through Besag-York-Mollié random effects.

Results

Results from the Spatial Zero-Inflated Poisson model showed significant associations between the explanatory variables and homicide mortality, with urbanization and income inequality increasing the risk and reducing the probability of zero homicides. While all covariates were statistically significant, the effect of marginalization partly reflected unmodeled spatial patterns. The model further estimated that nearly one-quarter of Mexican municipalities had a structural zero probability of homicides. Overall, the findings highlight substantial territorial heterogeneity in homicide mortality across the country.

Conclusions

Homicide mortality in Mexico is shaped by structural inequalities and spatial clustering. By framing lethal violence as a public health issue, our findings support geographically targeted policies that reduce inequality, address risks linked to urbanization and strengthen institutional and community resilience.

目标谋杀仍然是墨西哥最紧迫的公共卫生挑战之一，自2006年以来，在有组织犯罪不断升级和军事化安全战略的背景下，死亡率急剧上升。了解其空间分布和结构决定因素对于设计解决不平等、城市化和边缘化问题的预防战略至关重要。研究设计我们采用空间零膨胀泊松（S-ZIP）模型来分析墨西哥各城市的他杀死亡率。方法：我们使用国家统计和地理研究所（ICD-10代码X85-Y09， Y87.1）的数据和人口普查得出的社会经济指标，分析了2020年墨西哥2469个城市的杀人死亡率。为了解释多余的零、过度分散和空间依赖性，我们应用了空间零膨胀泊松（S-ZIP）模型。解释变量包括城市边缘化指数、城市人口比例和收入不平等的基尼系数。空间依赖性通过besag - york - molli随机效应建模。结果空间零膨胀泊松模型的结果显示，解释变量与凶杀死亡率之间存在显著相关性，城市化和收入不平等增加了零凶杀的风险，降低了零凶杀的概率。虽然所有协变量都具有统计学意义，但边缘化的影响部分反映了未建模的空间格局。该模型进一步估计，近四分之一的墨西哥城市发生凶杀案的结构性概率为零。总的来说，研究结果强调了全国各地杀人死亡率的巨大地域差异。结论墨西哥的杀人死亡率受结构不平等和空间聚类的影响。通过将致命暴力视为一个公共卫生问题，我们的研究结果支持有地域针对性的政策，以减少不平等，解决与城市化相关的风险，并加强机构和社区的复原力。

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引用次数: 0

Respiratory syncytial virus (RSV) vaccine choices during pregnancy 妊娠期呼吸道合胞病毒（RSV）疫苗选择

IF 3.2 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health

Pub Date : 2026-01-07 DOI: 10.1016/j.puhe.2025.106114

Bing Wang , Prabha Andraweera , Gang Chen , Jason J. Ong , Zohra Lassi , Helen Marshall

Objectives

Respiratory Syncytial Virus (RSV) is the leading cause of bronchiolitis and pneumonia in infants and can lead to fatal respiratory distress, especially in very young infants. New maternal RSV vaccines and infant monoclonal antibodies are now available. This study aims to understand RSV vaccine attitudes in Australian pregnant women.

Study design

The cross-sectional online survey employed a discrete choice experiment (DCE) design to quantify trade-offs and investigate decision-making patterns among pregnant women regarding the maternal RSV vaccine. A mixed-methods approach was used, with results from focus group discussions informing the development of the DCE survey.

Methods

Any pregnant women aged ≥18 years in Australia were eligible to participate in the survey. During the survey, respondents were asked to choose between hypothetical scenarios, or optout option. Survey data were analysed using mixed logit and latent class models.

Results

In total, 440 pregnant women participated and demonstrated a strong preference for a free RSV maternal vaccine with a lower risk of serious side effects and higher vaccine effectiveness. Latent class analysis revealed two distinct preference groups: “accepters/deliberators” and “rejecters”. Compared to rejecters (31.7 %), accepters/deliberators (68.3 %) were more likely to be older, haver high household income and had received a pertussis vaccine, and were less likely to receive an influenza vaccine. Incentives to encourage vaccination were not supported by either group. Among rejecters, cost did not influence their vaccine preference, but text message reminders were more preferred. In contrast to accepters/deliberators, rejecters expressed a strong dislike for video advertisements. Participants showed a significantly higher preference for RSV maternal vaccination (54.8 %) versus infant monoclonal antibody injection (16.8 %) in a general preference question (p < 0.001).

Conclusions

Maternal RSV vaccination at no cost was generally well received and preferred by pregnant women in this study, though preferences for promotion strategies varied.

呼吸道合胞病毒（RSV）是婴儿毛细支气管炎和肺炎的主要病因，可导致致命的呼吸窘迫，特别是在非常年幼的婴儿中。现在有了新的母体RSV疫苗和婴儿单克隆抗体。本研究旨在了解澳大利亚孕妇对RSV疫苗的态度。研究设计横断面在线调查采用离散选择实验（DCE）设计，量化权衡并调查孕妇对母体RSV疫苗的决策模式。采用了混合方法，焦点小组讨论的结果为DCE调查的发展提供了信息。方法澳大利亚年龄≥18岁的孕妇均可参加本调查。在调查过程中，受访者被要求在假设情景和选择选项之间做出选择。使用混合logit和潜在类别模型分析调查数据。结果共有440名孕妇参与了本次调查，她们对RSV母体免费疫苗表现出强烈的偏好，该疫苗严重副作用的风险较低，疫苗的有效性较高。潜类分析揭示了两个不同的偏好群体：“接受者/审议者”和“拒绝者”。与拒绝者（31.7%）相比，接受者/考虑者（68.3%）更可能年龄较大，家庭收入高，接种过百日咳疫苗，而接种流感疫苗的可能性较小。两组都不支持鼓励接种疫苗的激励措施。在拒绝者中，费用不影响他们对疫苗的偏好，但短信提醒更受欢迎。与接受者/审议者相比，拒绝者对视频广告表达了强烈的厌恶。在一般偏好问题中，参与者对RSV母亲疫苗接种的偏好（54.8%）明显高于婴儿单克隆抗体注射（16.8%）（p < 0.001）。结论在本研究中，尽管孕妇对推广策略的偏好有所不同，但母体免费接种RSV疫苗普遍受到孕妇的欢迎和青睐。

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引用次数: 0

Corrigendum to “Association between trajectories of life-course group sports participation and dementia: A 3-year longitudinal study” [Public Health. 243 (2025) 105721. Doi: 10.1016/j.puhe.2025.03.033] “生命周期团体运动参与轨迹与痴呆之间的关系：一项为期3年的纵向研究”[公共卫生，243(2025)105721]的勘误表。Doi: 10.1016 / j.puhe.2025.03.033]。

IF 3.2 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health

Pub Date : 2026-01-01 DOI: 10.1016/j.puhe.2025.106053

Mitsuya Yamakita , Taishi Tsuji , Satoru Kanamori , Junko Saito , Yuko Kai , Yukako Tani , Takeo Fujiwara , Naoki Kondo , Katsunori Kondo

引用次数: 0

Avoiding corporate amnesia in health systems – the need for organizational memory 避免卫生系统中的集体健忘症——对组织记忆的需求。

IF 3.2 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health

Pub Date : 2026-01-01 DOI: 10.1016/j.puhe.2025.106060

Muslim Abbas Syed , Mohamed Ahmed Syed , Andrew C.K. Lee

Balancing finite resources with rising demand remains a universal challenge for healthcare systems. Organizational decision making is increasingly shaped by cost-efficiency, yet efficiency is often mistakenly equated with effectiveness. Systems may reduce costs and waiting times but still fail to improve individual health outcomes, risking population health in pursuit of financial balance. In England, efforts to curb the ballooning health budget include the dissolution of NHS England and its merger with the Department of Health and Social Care. These reforms, while aimed at streamlining services, risk eroding organizational memory—knowledge embedded in people, processes, and practices. Organizational memory guides current decisions, prevents repetition of failed measures, and supports innovation. Its loss, especially through staff attrition and restructuring, may paradoxically undermine the very improvements these reforms seek to achieve. Singapore's healthcare system offers a counterfactual example, demonstrating how effective use of organizational memory—through electronic health records, regionalized clusters, and preventive care initiatives—can lead to adaptive, efficient, and high-quality care. Gulf Cooperation Council countries, including Qatar, are adopting similar strategies, using rich patient data to inform research and policy. Organizational memory is not an afterthought but a foundational asset. As healthcare systems evolve under financial, technological, and patient-centered pressures, preserving and leveraging organizational memory is essential. Reforms must be designed not only to improve efficiency but also to sustain effectiveness and ensure long-term improvements in patient outcomes.

平衡有限的资源和不断增长的需求仍然是医疗保健系统面临的一个普遍挑战。组织决策越来越受到成本效率的影响，然而效率常常被错误地等同于有效性。系统可以减少成本和等待时间，但仍然不能改善个人健康结果，在追求财务平衡的过程中危及人口健康。在英格兰，遏制不断膨胀的卫生预算的努力包括解散英格兰国民保健服务体系，并将其与卫生和社会保障部合并。这些改革虽然旨在简化服务，但却有可能侵蚀组织的记忆——即嵌入在人员、流程和实践中的知识。组织记忆指导当前的决策，防止失败措施的重复，并支持创新。它的损失，特别是由于工作人员的自然减员和改组而造成的损失，可能自相矛盾地破坏这些改革所力求实现的改善。新加坡的医疗保健系统提供了一个反事实的例子，展示了如何有效地利用组织记忆——通过电子健康记录、区域化集群和预防性护理计划——可以带来适应性强、高效和高质量的护理。包括卡塔尔在内的海湾合作委员会国家正在采取类似的战略，利用丰富的患者数据为研究和政策提供信息。组织记忆不是事后才想到的，而是一项基础资产。随着医疗保健系统在财务、技术和以患者为中心的压力下不断发展，保存和利用组织记忆至关重要。改革的设计不仅要提高效率，而且要保持有效性，并确保长期改善患者的治疗结果。

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引用次数: 0

Establishing the ‘Science of Co-creation’ for public health 为公共卫生建立“共同创造科学”。

IF 3.2 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health

Pub Date : 2026-01-01 DOI: 10.1016/j.puhe.2025.105988

Sebastien Chastin , Maïté Verloigne , Maria Giné-Garriga

引用次数: 0

The impact of colorectal cancer screening on healthcare use: A prospective cohort study with quasi-randomised screening invitation 结直肠癌筛查对医疗保健使用的影响：一项准随机筛选邀请的前瞻性队列研究

IF 3.2 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health

Pub Date : 2025-12-31 DOI: 10.1016/j.puhe.2025.106113

Emma Grundtvig Gram , Volkert Siersma , John Brandt Brodersen , Dagny Ros Nicolaisdottir , Jessica á Rogvi

Objectives

This study examines the association between participation in colorectal cancer screening and subsequent secondary healthcare use.

Study design

A prospective cohort study.

Methods

Exposure was based on a quasi-randomised screening implementation, with a 24-month follow-up. Outcomes included out-of-hospital specialist visits, hospitalisation, outpatient clinic visits, emergency room visits, colonoscopies and sigmoidoscopies, and prescription drugs. We employed a two-step model to estimate the relative risk and incidence-rate ratio of healthcare use, adjusted for baseline healthcare usage over the past decade and relevant socioeconomic factors. The results were stratified by screening results.

Results

Individuals with negative screenings were more likely to consult out-of-hospital specialists compared with a screening-naive control group. All screening groups had higher risk of hospitalisation, higher risk of using outpatient and emergency services, and higher risk of redeeming prescription drugs compared with the control group. Among those that used the respective services, it did not seem that screening groups had more visits or uses compared with the control group.

Conclusions

We observed an increase in healthcare use following colorectal cancer screening, suggesting that screening participants are referred more to secondary healthcare services.

目的本研究探讨参与结直肠癌筛查与随后的二级医疗保健使用之间的关系。研究设计前瞻性队列研究。方法采用准随机筛选方法，随访24个月。结果包括院外专科就诊、住院、门诊就诊、急诊室就诊、结肠镜检查和乙状结肠镜检查以及处方药。我们采用两步模型来估计医疗保健使用的相对风险和发病率，并根据过去十年的基线医疗保健使用情况和相关的社会经济因素进行调整。根据筛选结果对结果进行分层。结果与未接受筛查的对照组相比，筛查结果为阴性的个体更有可能咨询院外专家。与对照组相比，所有筛查组的住院风险、使用门诊和急诊服务的风险以及赎回处方药的风险均较高。在使用各自服务的人中，与对照组相比，筛查组似乎没有更多的访问或使用。结论：我们观察到结直肠癌筛查后的医疗保健使用增加，表明筛查参与者更多地转介到二级医疗保健服务。

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引用次数: 0

Do the associations of sedentary time with colorectal cancer risk differ by physical activity level and vice versa? A cross-sectional study of two large population-based surveys 久坐时间与结直肠癌风险的关联是否因体力活动水平而异，反之亦然？两项大型人口调查的横断面研究

IF 3.2 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health

Pub Date : 2025-12-31 DOI: 10.1016/j.puhe.2025.106115

Yuansen Ma , Xiaomei Wu , Yu Sun , Mouqian Wu , Qihui Tian , Jiahui Tian , Duo Xu , Meixi Gong , Xuanbing Li , Yefu Liu , Bo Zhu

Objectives

Prolonged sedentary behavior increases colorectal cancer (CRC) risk, while physical activity (PA) may reduce it. However, whether PA can mitigate the adverse effects of sedentary time remains unclear. This study examines whether PA modifies the association between sedentary time and CRC risk, and vice versa, and estimates the joint associations of PA and sedentary time with CRC risk using two surveys.

Study design

Cross-sectional study.

Methods

Data were drawn from NHANES and KNHANES. PA and sedentary time were assessed using the Global Physical Activity Questionnaire. Logistic regression with stratified analyses and restricted cubic splines was used to assess associations. Racial subgroup analyses were also performed.

Results

Among 338 CRC cases (NHANES: n = 103, weighted population: 1,282,253; KNHANES: n = 235, weighted population: 190,811), sedentary time greater than 8 h/day (reference 0-<4 h/day) was associated with CRC risk only among those with inactive PA (<600 MET-min/week) (NHANES: OR = 3.37, 95 % CI: 1.03–11.05; KNHANES: OR = 1.47, 95 % CI: 0.82–3.46). Black and Asian individuals with inactive PA showed a higher CRC risk associated with higher sedentary time. Among participants with >8 h sedentary time, higher PA levels (≥2000 MET-min/week) were associated with significantly reduced CRC risk in both datasets (NHANES: 2000–3999 MET-min/week, OR = 0.13, 95 % CI: 0.02–0.77; ≥4000 MET-min/week, OR = 0.08, 95 % CI: 0.01–0.75; KNHANES: 2000–3999 MET-min/week, OR = 0.36, 95 % CI: 0.11–0.98; ≥4000 MET-min/week, OR = 0.33, 95 % CI: 0.04–2.39). Joint analyses showed that individuals with active PA and low sedentary time were associated with reduced CRC risk.

Conclusions

Sedentary time was associated with higher CRC risk but only in individuals with inactive PA (<600 MET-min/week). Higher levels of PA showed greater benefit for CRC risk in those with sedentary time >8 h/day. The combination of active PA and low sedentary time was strongly associated with reduced CRC risk.

长期久坐行为会增加结直肠癌（CRC）的风险，而体育活动（PA）可能会降低这种风险。然而，PA是否能减轻久坐时间的不利影响尚不清楚。本研究考察了PA是否改变了久坐时间与结直肠癌风险之间的关系，反之亦然，并通过两项调查估计了PA和久坐时间与结直肠癌风险的联合关系。研究设计横断面研究。方法数据来源于NHANES和KNHANES。使用全球身体活动问卷评估PA和久坐时间。采用分层分析和限制三次样条的逻辑回归来评估相关性。还进行了种族亚组分析。结果在338例结直肠癌患者中（NHANES: n = 103，加权人群：1,282,253;KNHANES: n = 235，加权人群：190,811），久坐时间大于8小时/天（参考值0- 4小时/天）仅与不活动PA （600 MET-min/周）的结直肠癌风险相关（NHANES: OR = 3.37, 95% CI: 1.03-11.05; KNHANES: OR = 1.47, 95% CI: 0.82-3.46）。非活跃PA的黑人和亚洲人患结直肠癌的风险与久坐时间有关。在久坐8小时的参与者中，较高的PA水平（≥2000 MET-min/week）与两个数据集中CRC风险的显著降低相关（NHANES: 2000 - 3999 MET-min/week, OR = 0.13, 95% CI: 0.02-0.77;≥4000 MET-min/week, OR = 0.08, 95% CI: 0.01-0.75; KNHANES: 2000 - 3999 MET-min/week, OR = 0.36, 95% CI: 0.11-0.98;≥4000 MET-min/week, OR = 0.33, 95% CI: 0.04-2.39）。联合分析表明，PA活跃且久坐时间较短的个体与降低结直肠癌风险相关。结论：久坐时间与较高的结直肠癌风险相关，但仅适用于PA不活跃的个体（<；600 MET-min/周）。高水平的PA对每天久坐8小时的CRC风险有更大的益处。活跃PA和低久坐时间的结合与降低结直肠癌风险密切相关。

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引用次数: 0

Mental health profiles and correlates among Chinese adolescents: A latent profile analysis 中国青少年心理健康状况及其相关因素：一项潜在特征分析。

IF 3.2 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health

Pub Date : 2025-12-29 DOI: 10.1016/j.puhe.2025.106121

Xiang Li , Juntong Li , Sheng Ye , Hui Liu , Yue Yang , Xuelei Lu , Heyue Jin , Li Liu

Objectives

Adolescent mental health issues have become a growing public health concern. This study seeks to identify potential profiles of mental health among Chinese adolescents and to detect high-risk groups for the formulation of targeted intervention strategies based on associated health risk behaviors (HRBs).

Study design

A cross-sectional study.

Methods

This study was based on the Monitoring and Intervention Project for Common Diseases and Health Influencing Factors among Secondary School Students in Nanjing, involving 9,865 secondary school students as participants. Latent profile analysis (LPA) was employed to identify mental health (symptoms of depression, anxiety, and stress, as well as sleep quality); categorical variables were analyzed by the chi-square test or Fisher's exact test, whereas multinomial logistic regression was used to examine associations between HRBs and distinct mental health profiles.

Results

Three profiles of mental health were identified among the adolescents, including “Low-risk Mental Health” (68.03 %), “Moderate-risk Mental Health” (26.19 %), and “High-risk Mental Health” (5.78 %). Compared with the “Low-risk Mental Health” profile, the “Moderate-risk Mental Health” profile was associated with behaviors such as drinking, injury, school bullying, unhealthy diet, internet addiction, physical activity, and outdoor activity time; and the “High-risk Mental Health” profile was associated with smoking, drinking, injury, school bullying, unhealthy diet, internet addiction, and outdoor activity time.

Conclusions

Several HRBs are associated with mental health among Chinese adolescents. Healthcare professionals should target these HRBs and implement comprehensive measures to protect adolescent mental health.

目标：青少年心理健康问题已成为一个日益受到关注的公共卫生问题。本研究旨在确定中国青少年的潜在心理健康状况，并发现高危人群，以制定基于相关健康风险行为（HRBs）的有针对性的干预策略。研究设计：横断面研究。方法：本研究以南京市中学生常见病与健康影响因素监测与干预项目为基础，以9865名中学生为研究对象。使用潜在特征分析（LPA）来确定心理健康（抑郁、焦虑和压力症状以及睡眠质量）；分类变量通过卡方检验或Fisher精确检验进行分析，而多项逻辑回归用于检查HRBs与不同心理健康状况之间的关联。结果：青少年的心理健康状况分为“低危”（68.03%）、“中危”（26.19%）和“高危”（5.78%）三种。与“低风险心理健康”特征相比，“中等风险心理健康”特征与饮酒、伤害、校园欺凌、不健康饮食、网络成瘾、体育锻炼和户外活动时间等行为相关；“高风险心理健康”与吸烟、饮酒、受伤、校园欺凌、不健康饮食、网瘾和户外活动时间有关。结论：几种hrb与中国青少年心理健康相关。卫生保健专业人员应针对这些hrb，并采取综合措施保护青少年心理健康。

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引用次数: 0

Restricted access to GPs had limited effect on consultations for mental health problems in deprived areas during COVID-19: A cohort study 限制获得全科医生对COVID-19期间贫困地区心理健康问题咨询的影响有限：一项队列研究。

IF 3.2 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health

Pub Date : 2025-12-29 DOI: 10.1016/j.puhe.2025.106116

S. Sana , T. Magnée , S. van Pelt , V. Premysl , P.J.E. Bindels , S. Denktaş , E.I.T. de Schepper , P.L. Kocken

Objectives

Stringent COVID-19 lockdown measures with limited access to GP practices raised concerns about the primary mental care access for patients from deprived neighbourhoods. This study investigated the number of mental health GP consultations among patients in deprived neighbourhoods before and during the COVID-19 pandemic.

Study design

Observational study from January 2018 to June 2022.

Methods

Medical records of 379,567 patients were analyzed. We applied segmented time-series Poisson regression analyses to compare monthly mental health consultations in the first lockdown phase (March–May 2020) and the period thereafter with the pre-pandemic period for the total sample and separately for patients in deprived and non-deprived neighbourhoods.

Results

Analysis of 759,863 mental health consultations showed fewer consultations during the first lockdown phase, than pre-pandemic levels (RR = 0·955; 95 % CI = 0·919–0·993). This decrease was only significant among patients in non-deprived neighbourhoods Conversely, a significant increase in consultations during the post-lockdown phase was observed among patients in deprived neighbourhoods (RR = 1·074; 95 % CI = 1·002–1·152), returning to pre-pandemic levels for patients in non-deprived neighbourhoods. For the whole study population, patients had more consultations per month during the first lockdown phase and post-lockdown phase (RR = 1·095; 95 % CI = 1·079–1·111 and RR = 1·064; 95 % CI = 1·051–1·078 respectively).

Conclusions

During the lockdown phase the GP seemed accessible for patients with mental health problems in deprived neighbourhoods. A general decline in consultations during first lockdown phase, only significant in non-deprived neighbourhoods, was followed by increase in deprived neighbourhoods only during post-lockdown. This can be explained by a higher frequency of mental health consultations per patient. Sufficient access to primary health care should be guaranteed to ensure mental health treatment.

目标：严格的COVID-19封锁措施以及对全科医生诊所的限制，引发了人们对贫困社区患者获得初级精神保健的担忧。本研究调查了在COVID-19大流行之前和期间贫困社区患者的心理健康全科医生咨询次数。研究设计：2018年1月至2022年6月的观察性研究。方法：对379,567例患者的病历资料进行分析。我们应用分段时间序列泊松回归分析，将第一个封锁阶段（2020年3月至5月）及其后的时期与大流行前时期的每月心理健康咨询进行比较，并分别对贫困和非贫困社区的患者进行比较。结果：对759,863份心理健康咨询的分析显示，在第一个封锁阶段，咨询人数少于大流行前（RR = 0.955; 95% CI = 0.919 - 0.993）。相反，在封锁后阶段，贫困社区患者的咨询人数显著增加（RR = 1.074; 95% CI = 1.002 - 1.152），非贫困社区患者的咨询人数恢复到大流行前的水平。在整个研究人群中，患者在封城第一阶段和封城后每月就诊次数较多（RR = 1.095; 95% CI = 1.079 - 1.0111; RR = 1.064; 95% CI = 1.051 - 1.078）。结论：在封锁阶段，家庭医生似乎可以为贫困社区的精神健康问题患者提供帮助。在第一个封锁阶段，咨询人数普遍下降，仅在非贫困社区显著下降，随后只有在封锁后，贫困社区的咨询人数才有所增加。这可以解释为每个病人接受心理健康咨询的频率较高。应保证充分获得初级卫生保健，以确保精神卫生治疗。

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引用次数: 0

Epidemiology of child disadvantage and developmental vulnerability in Australia: Insights from linked administrative data 澳大利亚儿童劣势和发育脆弱性的流行病学：来自相关行政数据的见解

IF 3.2 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health

Pub Date : 2025-12-26 DOI: 10.1016/j.puhe.2025.106111

Sarah Gray , Shuaijun Guo , Cindy Pham , Marnie Downes , Katherine Lange , Sue Woolfenden , Gerry Redmond , Naomi Priest , Meredith O'Connor , Hannah Badland , Francisco Azpitarte , Sharon Goldfeld

Objectives

Cross-sectoral linked administrative data provides a powerful tool for population-level evaluations of child disadvantage. We examined individual-and area-level indicators of disadvantage in early childhood in Australia and estimated their associations with children's developmental outcomes at school entry.

Study design

Cross-sectional study.

Methods

We drew on data from the Person Level Integrated Data Asset (PLIDA) involving children born in Australia from 01/01/2012 to 31/07/2013, who commenced full-time schooling in 2018 and participated in the Australian Early Development Census (AEDC) (N = 274,123). Individual-level disadvantage was measured using 22 early childhood indicators across four pre-determined social determinant lenses (sociodemographic, geographic, health conditions, and risk factors). Area-level disadvantage was assessed using the Socio-Economic Indexes for Areas (SEIFA), based on each child's residential address. Teacher-reported poor developmental outcomes were assessed at school entry (4–6 years) in the AEDC.

Results

The percentage of children exposed to different aspects of individual-level disadvantage ranged from 0.2 % (parental death) to 58.8 % (parental mental health issues). There was substantial variation in children's experiences of individual-level disadvantage by geography. The associations between individual-and area-level disadvantage and poor developmental outcomes varied, with the individual-level indicator ‘child not regularly read to at home’ having the strongest association (risk ratio = 4.06, 95 % CI: 4.00 to 4.11). A dose-response relationship was observed, with exposure to an increasing number of child disadvantage indicators associated with poorer developmental outcomes.

Conclusion

Addressing children's experiences of multidimensional disadvantage requires cross-sectoral strategies that combine universal and proportionately targeted supports responsive to both individual-and area-level needs.

目的跨部门关联的行政数据为人口层面的儿童劣势评估提供了强有力的工具。我们检查了澳大利亚儿童早期的个人和地区水平的劣势指标，并估计了它们与儿童入学时发展结果的关系。研究设计横断面研究。方法我们利用来自个人层面综合数据资产（PLIDA）的数据，该数据涉及2012年1月1日至2013年7月31日在澳大利亚出生的儿童，这些儿童于2018年开始全日制教育，并参加了澳大利亚早期发展普查（AEDC）（N = 274,123）。个人水平的劣势是通过22个早期儿童指标在四个预先确定的社会决定因素（社会人口、地理、健康状况和风险因素）中进行测量的。根据每个儿童的居住地址，使用地区社会经济指数（SEIFA）来评估地区一级的劣势。在AEDC中，教师报告的不良发展结果在入学时（4-6年）进行评估。结果暴露于不同个体层面劣势的儿童比例从0.2%（父母死亡）到58.8%（父母心理健康问题）不等。儿童在个人层面上的劣势经历因地域而有很大差异。个体和地区水平的劣势与不良发展结果之间的联系各不相同，个人水平的指标“孩子不经常在家读书”具有最强的关联（风险比= 4.06,95% CI: 4.00至4.11）。观察到一种剂量-反应关系，暴露于越来越多的儿童不利指标与较差的发育结果相关。结论：解决儿童的多维劣势需要跨部门战略，将普遍和按比例有针对性的支持结合起来，满足个人和地区层面的需求。

{"title":"Epidemiology of child disadvantage and developmental vulnerability in Australia: Insights from linked administrative data","authors":"Sarah Gray , Shuaijun Guo , Cindy Pham , Marnie Downes , Katherine Lange , Sue Woolfenden , Gerry Redmond , Naomi Priest , Meredith O'Connor , Hannah Badland , Francisco Azpitarte , Sharon Goldfeld","doi":"10.1016/j.puhe.2025.106111","DOIUrl":"10.1016/j.puhe.2025.106111","url":null,"abstract":"<div><h3>Objectives</h3><div>Cross-sectoral linked administrative data provides a powerful tool for population-level evaluations of child disadvantage. We examined individual-and area-level indicators of disadvantage in early childhood in Australia and estimated their associations with children's developmental outcomes at school entry.</div></div><div><h3>Study design</h3><div>Cross-sectional study.</div></div><div><h3>Methods</h3><div>We drew on data from the Person Level Integrated Data Asset (PLIDA) involving children born in Australia from 01/01/2012 to 31/07/2013, who commenced full-time schooling in 2018 and participated in the Australian Early Development Census (AEDC) (N = 274,123). Individual-level disadvantage was measured using 22 early childhood indicators across four pre-determined social determinant lenses (sociodemographic, geographic, health conditions, and risk factors). Area-level disadvantage was assessed using the Socio-Economic Indexes for Areas (SEIFA), based on each child's residential address. Teacher-reported poor developmental outcomes were assessed at school entry (4–6 years) in the AEDC.</div></div><div><h3>Results</h3><div>The percentage of children exposed to different aspects of individual-level disadvantage ranged from 0.2 % (parental death) to 58.8 % (parental mental health issues). There was substantial variation in children's experiences of individual-level disadvantage by geography. The associations between individual-and area-level disadvantage and poor developmental outcomes varied, with the individual-level indicator ‘child not regularly read to at home’ having the strongest association (risk ratio = 4.06, 95 % CI: 4.00 to 4.11). A dose-response relationship was observed, with exposure to an increasing number of child disadvantage indicators associated with poorer developmental outcomes.</div></div><div><h3>Conclusion</h3><div>Addressing children's experiences of multidimensional disadvantage requires cross-sectoral strategies that combine universal and proportionately targeted supports responsive to both individual-and area-level needs.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"251 ","pages":"Article 106111"},"PeriodicalIF":3.2,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145841366","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}

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