Public Health最新文献

{"title":"Exploring the syndemic impact of COVID-19 and mental health on health services utilisation among adult Ontario population","authors":"","doi":"10.1016/j.puhe.2024.07.008","DOIUrl":"10.1016/j.puhe.2024.07.008","url":null,"abstract":"<div><h3>Objectives</h3><p>There is a need to consider COVID-19 a syndemic; which calls for a comprehensive approach to tackle the associated interconnected challenges. The objective of this study is to investigate the potential syndemic nature of COVID-19, with a specific focus on understanding how viral infection, mental health (such as anxiety and depression), and pre-existing comorbidities interact and influence each other.</p></div><div><h3>Study Design</h3><p>Retrospective population-based cohort study.</p></div><div><h3>Methods</h3><p>We conducted a population-based retrospective cohort study using linked health administrative data from the Institute for Clinical Evaluative Sciences, Ontario. The study included 2,863,423 Ontario residents from January 2020 to March 2021. We analysed healthcare services utilisation (physician visits, emergency visits, and hospitalisations) for chronic conditions among individuals with both COVID-19 and either anxiety or depression, to understand the syndemic impact of COVID-19 and mental health issues among Ontario population.</p></div><div><h3>Results</h3><p>Multiple regression models were used to explore the study's objective. In the final adjusted regression model for the sample, it was found that the individuals who were COVID-19 positive and had either anxiety or depression were more likely to utilise health services for chronic conditions of interest during the pandemic than those who were COVID-19-negative with mental health issues (odds ratio [OR]:, 1.33; 95% confidence interval [CI]: 1.12–1.58). A higher risk of morbidity was observed among males (OR: 1.28; CI: 1.16–1.41), as well as in individuals with diverse ethnic backgrounds and low socioeconomic status.</p></div><div><h3>Conclusions</h3><p>The impact of COVID-19 on mental health, particularly among vulnerable populations with chronic diseases, can be seen as a syndemic. This complex interaction emphasises the need for integrated public health strategies.</p></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0033350624002889/pdfft?md5=32702e32308775d5cf5beb0bc35cfb77&pid=1-s2.0-S0033350624002889-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142011838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-term effects of air pollutants and meteorological factors on outpatients with allergic airway disease in Ningbo, China, 2015–2021","authors":"","doi":"10.1016/j.puhe.2024.07.020","DOIUrl":"10.1016/j.puhe.2024.07.020","url":null,"abstract":"<div><h3>Objectives</h3><p>The allergic airway disease, such as allergic rhinitis, chronic rhinosinusitis, asthma, is a general term of a range of inflammatory disorders affecting the upper and lower airways and lung parenchyma. This study aimed to investigate the short-term effects of air pollutants and meteorological factors on AAD-related daily outpatient visits.</p></div><div><h3>Study design</h3><p>An ecological study.</p></div><div><h3>Methods</h3><p>Data on outpatient visits due to AAD (n = 4,554,404) were collected from the platform of the Ningbo Health Information from January 1, 2015 to December 31, 2021. A Quasi-Poisson generalized additive regression model was established to analyze the lag effects of air pollution on daily outpatient visits for AAD. Restricted cubic spline functions were used to explore the potential non-linear relationships between air pollutants and meteorological and daily outpatient visits for AAD.</p></div><div><h3>Results</h3><p>PM_2.5, PM₁₀, SO₂, NO₂, or CO were associated with daily outpatient visits for AAD, and there was a significant increasing trend in the cumulative lag effects. SO₂ had the largest effect at Lag07, with a 25.3% (95% CI: 21.6%–29.0%) increase in AAD for every 10 μg/m³ increase in exposure concentration. Subgroup analysis showed that the 0–18 years old age group had the strongest effects, especially for AR, and all effects were stronger in the cold season.</p></div><div><h3>Conclusions</h3><p>Given that patients aged 0–18 are more susceptible to environmental changes, protective measures specifically for children should be taken during dry and cold weather conditions with poor air quality.</p></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009844","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":"Global, regional, and national burden of ischaemic heart disease and its attributable risk factors in youth from 1990 to 2019: a Global Burden of Disease study","authors":"","doi":"10.1016/j.puhe.2024.07.011","DOIUrl":"10.1016/j.puhe.2024.07.011","url":null,"abstract":"<div><h3>Objectives</h3><p>The objective of this study was to analyse the global, regional, and national burdens of ischaemic heart disease (IHD) in adults aged 15–49 years and its attributable risk factors from 1990 to 2019.</p></div><div><h3>Study design</h3><p>Epidemiological study.</p></div><div><h3>Methods</h3><p>Data were obtained from the Global Burden of Disease (GBD) Study 2019. The estimated annual percentage change was used to evaluate temporal trends in incidence, deaths, and disability-adjusted life years (DALYs) of youth IHD. We selected IHD-associated risk factors, including five environmental/occupational factors, 16 behavioural risks, and five metabolic factors. We computed the age-standardised rates and percentage of age-standardised DALY rates attributable to these factors of youth IHD.</p></div><div><h3>Results</h3><p>Globally, there were 2.26 million cases of incidence, 0.63 million deaths, and 30.58 million DALYs in 2019. The age-standardised incidence, death, and DALY rates decreased from 1990 to 2019, whereas the absolute number of incidences, deaths, and DALYs increased significantly. Globally, approximately 94.1% of age-standardised DALY rates from IHD in youths aged 15–49 years are attributable to risk factors listed in the GBD 2019 dataset. The leading global and regional risk factors for youth IHD in 2019 were high low-density lipoprotein cholesterol (68.9%), high systolic blood pressure (51.2%), high body mass index (33.1%), smoking (30.5%), and ambient particulate-matter pollution (25.4%).</p></div><div><h3>Conclusions</h3><p>The burden of IHD among young people is still heavy, and metabolic risk factors are the leading drivers of IHD. Therefore, formulating relevant policies to control and treat cardiovascular risk factors is an effective measure to reduce the IHD burden in youth.</p></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142002103","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":"The association between cognitive decline and exposure to secondhand smoke at work in economically active older adults","authors":"","doi":"10.1016/j.puhe.2024.07.013","DOIUrl":"10.1016/j.puhe.2024.07.013","url":null,"abstract":"<div><h3>Objectives</h3><p>Secondhand smoking may contribute to cognitive decline, but evidence on this subject is limited in the working economically active older adults. This study aimed to investigate the association between cognitive decline and exposure to secondhand smoke at work in economically active adults aged 65 years or above.</p></div><div><h3>Study design</h3><p>Cross-sectional study using nationwide data.</p></div><div><h3>Methods</h3><p>Data were from the 2022 Korea Community Health Survey. Chi-squared test was used to perform descriptive statistics. The association between cognitive decline and exposure to secondhand smoke at work was analysed using multivariable logistic regression analysis. Subgroup analysis was performed based on to exposure status to secondhand smoke at home and diabetes mellitus.</p></div><div><h3>Results</h3><p>Of a total of 28,197 adults, 8767 (28.5%) individuals reported cognitive decline. Compared to individuals without exposure to passive smoking at work, those with such exposure were more likely to report cognitive decline (odds ratio: 1.30, 95% confidence interval: 1.14–1.47). This association was particularly strong in individuals with exposure to passive smoking at both work and home and in those diagnosed with diabetes mellitus.</p></div><div><h3>Conclusions</h3><p>Exposure to secondhand smoking at work is associated with a higher likelihood of cognitive decline in older-aged economically active individuals. The findings infer the importance of monitoring passive smoking and implementing public health measures to reduce workplace secondhand smoke exposure.</p></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141997543","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":"The burden of COVID-19 in Latin American and Caribbean countries: an analysis based on the Global Burden of Disease Study 2021","authors":"","doi":"10.1016/j.puhe.2024.07.006","DOIUrl":"10.1016/j.puhe.2024.07.006","url":null,"abstract":"<div><h3>Objectives</h3><p>The coronavirus disease 2019 (COVID-19) pandemic has had a profound impact on the countries of Latin America and the Caribbean. This study aims to summarise key findings from the Global Burden of Disease (GBD) 2021 in the region. We also explore disparities in burden rates and the relationship with the Socio-demographic Index (SDI).</p></div><div><h3>Study design</h3><p>A cross-sectional analysis of GBD 2021 results was conducted.</p></div><div><h3>Methods</h3><p>We obtained the disability-adjusted life years (DALYs) due to COVID-19 for 20 countries, analysing number- and age-adjusted rates. Spearman's correlation (<span><math><mrow><mi>r</mi><mi>h</mi><mi>o</mi></mrow></math></span>) and 95% confidence intervals (CIs) assessed the SDI–DALY rates relationship.</p></div><div><h3>Results</h3><p>COVID-19 was the leading cause disease burden in the region, with 20,437,321 DALYs in 2020 and 31,525,824 in 2021. Premature mortality (years of life lost) accounted for over 95%. Disparities existed across sexes, age groups, and countries, with Bolivia and Peru having the highest rates. A significant 2021 correlation was found (<span><math><mrow><mi>r</mi><mi>h</mi><mi>o</mi></mrow></math></span> = −0.55, 95% CI: -0.90 to 0.19; <em>P</em> = 0.013) but not in 2020 (<span><math><mrow><mi>r</mi><mi>h</mi><mi>o</mi></mrow></math></span> = −0.40, 95% CI: -0.75 to 0.05; <em>P</em> = 0.078).</p></div><div><h3>Conclusions</h3><p>COVID-19 posed a significant burden in Latin America and the Caribbean, emphasising the need for targeted interventions, especially in socioeconomically disadvantaged regions.</p></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141997542","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":"Performance evaluation of Mexico's health system at the national and subnational level, 1990–2019: an analysis of the Health Access and Quality Index","authors":"","doi":"10.1016/j.puhe.2024.07.009","DOIUrl":"10.1016/j.puhe.2024.07.009","url":null,"abstract":"<div><h3>Objectives</h3><p>This study aimed to comprehensively evaluate Mexico's health system performance from 1990 to 2019 utilising the Health Access and Quality Index (HAQI) as a primary indicator.</p></div><div><h3>Study design</h3><p>A retrospective ecological analysis was performed using data from the Global Burden of Diseases, Injuries and Risk Factors Study (GBD) study and the National Population Council (CONAPO).</p></div><div><h3>Methods</h3><p>HAQI values for 1990, 2000, 2010, 2015, and 2019 were examined for each state in Mexico and three age groups (young, working, and post-working). Additionally, the marginalisation index was employed to assess inequalities in the HAQI distribution across states. The concentration index of the HAQI for each year was estimated, and the efficiency of states in producing the HAQI was evaluated using a data envelopment approach.</p></div><div><h3>Results</h3><p>Through the analysis of national and subnational data, results indicated an overall improvement in healthcare access and quality during the study period. Although differences in the HAQI value related to state marginalisation decreased from 1990 to 2015, by 2019, the inequality had returned to a level comparable to 2000. Efficiency in producing health (HAQI values) exhibited substantial heterogeneity and fluctuations in the ranking order over time. States such as Nuevo León consistently performed well, while others, such as Guerrero, Chihuahua, Mexico City, and Puebla, consistently underperformed.</p></div><div><h3>Conclusions</h3><p>The findings from this study emphasise the necessity for nuanced strategies to address healthcare disparities and enhance the overall system performance. The study provides valuable insights for ongoing discussions about the future of Mexico's healthcare system, aiming to inform evidence-based policy decisions and improve the nationwide delivery of healthcare services.</p></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0033350624002956/pdfft?md5=071077eff3bc4d7adb671ce50ac97ea1&pid=1-s2.0-S0033350624002956-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141997541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is COVID-19 finally just a bad flu? Follow-up study comparing disease severity among COVID-19 and seasonal influenza hospital in-patients across pandemic waves in Ireland","authors":"","doi":"10.1016/j.puhe.2024.07.010","DOIUrl":"10.1016/j.puhe.2024.07.010","url":null,"abstract":"<div><h3>Objectives</h3><p>Coronavirus disease 2019 (COVID-19) was a more severe illness than seasonal influenza in hospitalised cohorts during the early phase of the pandemic. This study's aim was to determine if COVID-19 severity, relative to seasonal influenza, evolved across subsequent disease waves.</p></div><div><h3>Study design</h3><p>Retrospective population-based cohort study.</p></div><div><h3>Methods</h3><p>COVID-19 hospital episodes and seasonal influenza hospital episodes were identified using relevant International Classification of Disease (ICD-10) codes from the Irish national hospitalisation dataset. Descriptive comparative analysis of each group was carried out using Pearson's Chi-squared tests. Length of stay (LOS), intensive care unit (ICU) admission and in-hospital mortality were measured and compared using logistic regression analysis.</p></div><div><h3>Results</h3><p>Compared to influenza episodes, COVID-19 episodes for all ages and all waves combined, had a longer mean LOS (15.8 days, vs 11.4 days, <em>P</em> &lt; 0.001); were more likely to receive ICU care (OR 1.24 95% CI 1.15–1.33, <em>P</em> &lt; 0.001) and were more likely to die in hospital (OR 2.61, 95% CI 2.36-2-88). Despite the reduction in the proportion of patients with an intensive care unit (ICU) stay and dying in hospital in Wave 5 compared to the previous waves, the risk of having an ICU admission or dying in hospital remained higher in patients with COVID-19 in Wave 5 compared to those with influenza diagnosis.</p></div><div><h3>Conclusion</h3><p>While the severity of COVID-19 has reduced with successive pandemic waves, it remains a more severe disease than influenza. Despite changes in strain, population immunity, vaccination and treatment, policymakers and the public must continue to approach COVID-19 as more than ‘just a bad flu’.</p></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141997545","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":"Changes in social inequalities in excess body weight and body dissatisfaction among adolescents in Barcelona, Spain, 2016–2021","authors":"","doi":"10.1016/j.puhe.2024.07.012","DOIUrl":"10.1016/j.puhe.2024.07.012","url":null,"abstract":"<div><h3>Objectives</h3><p>Adolescence is a crucial life stage that can lead to excess weight and body dissatisfaction. Social inequalities in these issues may have been exacerbated by the COVID-19 pandemic. We aimed to analyze the presence of socioeconomic inequalities and their changes in these inequalities stratified by sex in 13- to 19-year-olds in a large Mediterranean city (Barcelona, Spain).</p></div><div><h3>Study design</h3><p>Cross-sectional population-based study.</p></div><div><h3>Methods</h3><p>We used data from the 2016 and 2021 editions of the FRESC survey, which is a representative citywide survey that captures various aspects of adolescent health. Excess weight was determined by objective body mass index measurements. Body dissatisfaction was defined as the discrepancy between perceived and desired body shape. Socioeconomic status was divided into five pseudo-quintiles by using the Family Affluence Scale. We calculated the corresponding prevalence estimates and fitted robust Poisson regression models to estimate both simple and complex measures of inequality, including relative and absolute differences between the two survey years.</p></div><div><h3>Results</h3><p>The overall prevalence of excess weight increased from 25.3% [23.9–26.6] to 29.8% [28.2–31.4] between 2016 and 2021. Similarly, body dissatisfaction increased from 44.2% [42.6–45.8] to 60.4% [58.7–62]. Socioeconomic inequalities in excess weight significantly increased in girls (adjusted ratio of the relative index of inequalities = 1.72 [1.08; 2.74] but not in boys. No significant changes were detected in body dissatisfaction in either girls or boys.</p></div><div><h3>Conclusions</h3><p>Our findings highlight the presence of a sex-specific change in socioeconomic inequalities in adolescent well-being regarding excess weight and body dissatisfaction. These results underscore the need for local public policies to improve social equity in adolescent health.</p></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141997544","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":"Deaths of despair-associated mortality rates globally: a 2000–2019 sex-specific disparities analysis","authors":"","doi":"10.1016/j.puhe.2024.07.015","DOIUrl":"10.1016/j.puhe.2024.07.015","url":null,"abstract":"<div><h3>Objectives</h3><p>The aim of this study was to explore sex-specific disparities in rates of deaths of despair across 183 countries from 2000 to 2019.</p></div><div><h3>Study design</h3><p>Secondary analysis of cross-sectional population-level data.</p></div><div><h3>Methods</h3><p>Data were obtained from the World Health Organization Health Inequality Data Repository. We analysed data on mortality due to alcohol, drug-use disorders, and self-harm (as a proxy for suicide). We calculated the average rate of deaths of despair by year and sex, trends in these rates, and cause-specific mortality trends. We then fitted mixed-effect generalised linear models to compare mortality rates by sex and country.</p></div><div><h3>Results</h3><p>Analyses revealed significant disparities by sex, with a 3.3-fold higher rate among men than among women globally (95% confidence interval: 3.1–3.5, <em>P</em> &lt; 0.001). There was a significant decline in deaths of despair globally and among both sexes during the assessed period (5% per 5 years). Lesotho, Belarus, the US, the Russian Federation, Guyana, and Slovenia ranked among the top 10 countries out of 183 with the highest mortality rates for both sexes. Canada, the Republic of Korea, Belgium, and Finland were countries with the highest mortality rates among women, whereas Ukraine, Lithuania, Mongolia, and Eswatini have the highest rates among men. In the US, 5-year mortality rates increased by 35% for women and 21% for men: drug-use mortality showed a significant increase over time, whereas suicide rates decreased for both sexes in the given country. Additionally, mortality rates from alcohol use decreased among women.</p></div><div><h3>Conclusions</h3><p>This global analysis shed light on health disparities by sex in deaths of despair, especially concerning trends in the US. It identified countries and groups in need of targeted mental health and substance-use programs. Moreover, the disparities by sex revealed in this analysis suggest that mental health and substance-use interventions and programs may need to be more attentive to sex and/or gender, such as inequitable social norms and restrictive forms of masculinities, which have been shown to be contributing factors to deaths of despair.</p></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0033350624003044/pdfft?md5=8080ddf7c60cebf82ac579f85c076294&pid=1-s2.0-S0033350624003044-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global associations between the use of basic drinking water and sanitation services with diarrhoeal disease incidence in 200 countries and territories from 2000 to 2019","authors":"","doi":"10.1016/j.puhe.2024.07.004","DOIUrl":"10.1016/j.puhe.2024.07.004","url":null,"abstract":"<div><h3>Objectives</h3><p>Globally, billions of people do not have access to safely managed drinking water and sanitation services. Interventions to improve drinking water, sanitation and hygiene could reduce the incidence of diarrhoea in low- and middle-income countries. This study aimed to investigate the association between these services and the incidence of diarrhoea.</p></div><div><h3>Study design</h3><p>Worldwide, ecological observational study, utilising cross-sectional data.</p></div><div><h3>Methods</h3><p>Data from the Global Burden of Disease Study 2019 and World Bank were used in this study. Diarrhoeal disease episodes were defined as three or more loose bowel movements within 24 h. Estimated Annual Percentage Change was used to quantify trends in disease incidence over a specific time interval. Quasi-Poisson Generalised Linear Model was introduced to analyse the influence of basic drinking water and sanitation services on the incidence of diarrhoea. Subgroup analyses were carried out to determine potential variations in the incidence of diarrhoeal diseases according to sex, age and sociodemographic index (SDI) region.</p></div><div><h3>Results</h3><p>Between 2000 and 2019, the incidence rate of global diarrhoea remained consistent, with regional variations linked to SDIs. A 1% increase in access to basic drinking water was associated with a 0.41% (95% confidence interval [CI], 0.33%–0.50%) increase in the age-standardised incidence rate of diarrhoea; meanwhile, a 1% increase in sanitation service usage was associated with a 0.47% (95% CI, 0.40%–0.54%) reduction in the age-standardised incidence rate of diarrhoea. The correlation differed across SDI regions. The use of safely managed drinking water was associated with a reduction in diarrhoeal disease rates, but the effect was non-significant in High SDI regions. Higher diarrhoeal disease incidence was seen in younger and older populations. Individuals in the age groups 55–59 years and 10–14 years showed the greatest association of water service usage with diarrhoea, while an increase in sanitation service usage was related to decreased diarrhoea rates in most age groups, excluding children aged 5–14 years.</p></div><div><h3>Conclusions</h3><p>Emphasising initiatives to enhance water quality, elevate the standards of drinking water safety management, and strengthening related infrastructure development in global health policies and development plans could have a positive impact on overall global health. Such comprehensive interventions have the potential to not only prevent waterborne diseases but also elevate the general health status of societies worldwide.</p></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0033350624002828/pdfft?md5=3d592df867f02cdefdf00f318d02de1f&pid=1-s2.0-S0033350624002828-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141993466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}