Journal of public health (Oxford, England)最新文献

Background: The World Health Organization and the Association of Schools of Public Health in the European Region called for the professionalization of the public health workforce, including the creation of codes of ethics. In this article, the Public Health Ethics and Law Network provides guidance on creating such codes, based on values and principles commonly identified for public health.

Methods: Our interest was in codes addressing public health broadly rather than disciplines within public health. Public Health codes of ethics are typically published on agency and organization websites rather than peer-reviewed literature. We searched several online databases, such as PubMed; United States government websites; Spanish language websites; and English language websites for public health organizations.

Results: We synthesized the principles found into 10 adjectives-such as caring, responsive, and trustworthy-with short elaborations. These terms are practical, for non-philosophers, and provide flexibility for adaptation to country contexts.

Conclusions: The creation of a code of ethics should be followed by the identification and building of ethical competencies and capacity for public health professionals and institutions. There are plans to collaborate with pilot sites in the use and generation of further learning, and additional assistance for competencies and other resources to support a code of ethics and competencies.

Background: Physical activity, sedentary behaviour, and diet synergically coexist (in different ways) within adolescents' lifestyles. Thus, understanding obesogenic behaviour patterns within populations is critical to promoting adolescents' health. This study investigates clustering patterns of adolescents' obesogenic behaviours across South American countries.

Methods: The present work is a harmonized analysis of 10 national representative cross-sectional health surveys investigating adolescents' risk and protective factors for non-communicable diseases. The surveys used questionnaires, and three obesogenic behaviours were analyzed for cluster formation (physical activity, sitting time, and diet). Sociodemographic variables were sex, age, and food insecurity. The Two-step cluster, the Rao-Scott chi-square test, and a meta-analysis were performed for data analysis.

Results: Three to four cluster solutions were identified in each country, and most clusters are unhealthy. The All-day sitters-very poor diet cluster was observed in Paraguay, Peru, Suriname, Chile, Guyana, Argentina, Brazil, Colombia, and Ecuador, with a pooled prevalence of 17.8% (95% CI:15.0; 20.7) amongst South American countries, with the highest prevalence observed in Argentina [26.8% (95% CI: 26.7; 26.9)]. Girls were more likely to belong to the unhealthiest clusters.

Conclusions: The lifestyle behaviours of South American adolescents coexist negatively, and there is a severe obesogenic risk for this population. The synergy between physical inactivity and poor/very poor diet was clustered together in all countries, and our analysis did not reveal any natural healthy clusters. Furthermore, girls are at a disadvantage, given that they are the majority in clusters with unhealthy profiles in South America.

Background: Previous research shows the significant correlation between low education and COVID-19 mortality in underprivileged communities, even when accounting for factors like poverty and race. The exact mechanisms by which low education gives rise to COVID-19 mortality, however, are less clear.

Methods: We propose that low education predicts COVID-19 morality because low education gives rise to a less engaged, less agentic approach to one's own healthcare. We operationalize low engagement and low agentic behavior as four variables that mediate the effect of low education on COVID-19 mortality: (i) vaccination, (ii) distrust of science (Republican vote), (iii) poor health, and (iv) prevention. We model COVID-19 mortality in 3108 counties of the United States, using deaths across 60 fortnights.

Main results: All four indicators of an agentic, engaged approach to health are statistically significant mediators of the relationship between low education and COVID-19 mortality: vaccination [IRR = 1.02; (1.02, 1.03)]; Republican vote [IRR: 1.07; (1.06, 1.09)]; poor health [IRR: 1.01; (1.01, 1.02)]; and prevention [IRR: 1.00, (1.001, 1.003)].

Discussion: These findings suggest that low level of formal education predicts mortality from COVID-19 because low levels of education gives rise to a less engaged and less agentic approach to one's own health.

Background: Alcohol misuse is linked to numerous health and socioeconomic harms. Edutainment and docutainment television programmes can act as health promotion tools, influencing health perceptions and behaviours. Inaccurate portrayals can engender misinformation. Limited research has assessed alcohol-related illnesses and prevention in edutainment/docutainment, with none examining British medical documentaries.

Methods: A quantitative content analysis assessed the portrayal of alcohol-related attendances (ARAs), behaviours, and prevention in the series 24 hours in A&E. Main series episodes broadcast 2011-2022, depicting ARAs, were coded. Descriptive statistics and a Fisher's exact were then undertaken.

Results: ARAs featured 38 patients in 23 episodes (8.3% episodes total). Significantly more ARA episodes were broadcast from 2011 to 2016 than 2017-2022 (P = 0.002). ARAs were mainly portrayed in males (63.2%), young adults (73.7%) and White ethnic groups (78.9%). Binge drinking and pubs/bar/nightclubs/'nights out' were the main behaviours and settings depicted. ARAs encompassed predominantly accidents/injuries (72.7%). Prevention featured infrequently (15.8% patients) and involved secondary (50.0%) or tertiary prevention (50.0%) for alcohol-use disorders (AUDs).

Conclusion: ARAs were under-portrayed. While prevention portrayals and demographics were largely consistent with reality, ethnic minority groups, AUDs and chronic alcohol-related illnesses were underrepresented. Binge drinking and night-time economy settings were over-portrayed. Inaccurate depictions could lead to misperceptions of alcohol-related health harms.

Background: Participation in paid work after childbirth may have important health and socioeconomic impacts on women and their families. We investigated women's employment patterns at six months postpartum and the factors that influence them.

Methods: Using data from a 2018 population-based national maternity survey in England, employment status at six months postpartum was assessed. Logistic regression was used to explore sociodemographic and pregnancy- and birth-related factors associated with being in paid work by six months postpartum. Descriptive analysis was used to explore employment characteristics and motivations of women in paid work.

Results: Of the 4313 participants included, 7.7% were in paid work by six months postpartum. Factors associated with being in paid work were age ≥35 years [(adjusted odd ratios (aOR):1.37, 95% confidence interval (CI):1.02-1.84], not living with a partner (aOR:0.50, 95%CI:0.28-0.90), and pre-term birth (aOR:0.38, 95%CI:0.20-0.69). The most frequently reported motivation was financial need (76%), followed by wanting to work (41%). Financial need was associated with younger age, living in a more socioeconomically disadvantaged area, not living with a partner, and lower education level.

Conclusion: Postpartum employment patterns and motivations for working vary according to sociodemographic characteristics. These findings have important implications for parental leave and childcare policies, which should be equitable across different groups.

Background: This study aimed to explore the Italian population's knowledge and perceptions regarding health data storage and sharing for treatment and research and to identify factors associated with citizens' attitudes toward data storage and sharing.

Methods: A cross-sectional questionnaire, distributed to 1389 participants, collected sociodemographic information, assessed knowledge and gauged attitudes toward sharing data for treatment and research. Descriptive analyses and logistic regressions were performed to examine the associations between sociodemographic factors and knowledge/attitudes about data storage and sharing.

Results: Most respondents wrongly believed that healthcare providers could access personal health-related data across the entire national territory, while 94% expressed willingness to share personal health data nationwide. A substantial percentage of respondents (73%) fully agreed that storing and sharing personal health-related data could improve research and quality of care.Males and younger individuals (<41 years) were likelier to have higher data-sharing knowledge. Lower educational-level respondents exhibited lower positive attitudes towards sharing health data for treatment and research purposes.

Conclusions: The results provide valuable insights for policymakers, healthcare professionals and researchers seeking to improve data management, promote collaboration and leverage the full potential of health data for personalized care and scientific advancements.

Background: The Covid-19 pandemic showed higher infection, severity and death rates among those living in poorer socioeconomic conditions. We use syndemic theory to guide the analyses to investigate the impact of social adversity and multiple long-term conditions (MLTC) on Covid-19 mortality.

Methods: The study sample comprised 154 725 UK Biobank participants. Structural equation modeling was used to investigate pathways between traumatic events, economic deprivation, unhealthy behaviors, MLTC, for Covid-19 mortality. Cox regression analysis was used to investigate MLTC and Covid-19 mortality. We also tested effect modification by traumatic events, economic deprivation and unhealthy behaviors.

Results: Covid-19 mortality (n = 186) was directly explained by overall level of MLTC. Economic deprivation and unhealthy behaviors contributed to Covid-19 death indirectly via their negative impact on MLTC. The risk for Covid-19 mortality grew exponentially for every quintile of predicted scores of MLTC. The presence of traumatic events, economic deprivation or unhealthy behaviors did not modify the impact of MLTC on Covid-19 mortality.

Conclusions: Results suggest a serially causal pathway between economic deprivation and unhealthy behaviors leading to MLTC, which increased the risk of Covid-19 mortality. Policies to tackle the social determinants of health and to mitigate the negative impact of multimorbidity are needed.

Background: Healthcare demand procrastination is a public health concern in Türkiye, with limited research available. This study examines the prevalence of healthcare procrastination and identifies associated factors among patients at Pamukkale University Hospital.

Methods: This cross-sectional study was conducted from 2 to 13 February 2023 in Denizli and involved 503 patients from 15 outpatient clinics. Data on sociodemographic characteristics, healthcare utilization and procrastination behaviors were collected via a structured questionnaire, including the Healthcare Demand Procrastination Scale (HDPS). Descriptive statistics and linear regression were used for analysis.

Results: The participants had a mean age of 41.46 years (±15.34), with 52.9% being female. A significant 77.3% reported delaying healthcare despite needing it. The primary reasons for delays were difficulty in getting appointments (51.5%), long waiting times (21.9%) and COVID-19 concerns (19.9%). The mean HDPS score was 2.29 ± 0.65, indicating moderate procrastination. Regression analysis revealed that younger age (≤35 years) and rural residence significantly predicted higher HDPS scores, whereas receiving health information from professionals was linked to lower procrastination.

Conclusions: Healthcare procrastination is common among patients in Türkiye, particularly among younger individuals and rural residents. Improving healthcare accessibility, reducing wait times and implementing targeted interventions are essential to mitigate this issue and enhance health outcomes.

Background: Nutrient deficiencies during pregnancy may affect offspring development. We aim to examine the association between prenatal vitamin B12 intake and children's cognitive development.

Methods: A total of 5151 mother-child pairs from the Czech part of ELSPAC study were included in the analysis. Dietary information was obtained during pregnancy using food frequency questionnaire. Parents reported on their child's speech and language development at 18 months, 3, 5 and 7 years. Intelligence quotient (IQ) was measured at 8 years in subcohort of 854 children.

Results: Children of mothers with higher vitamin B12 intake demonstrated higher scores in language (B = 0.20, 95% CI 0.06, 0.34) and talking and understanding (B = 2.39, 95% CI 0.97, 3.80) in a fully adjusted model at 18 months. Additionally, they were more likely to get maximum points in the intelligibility test at age 3 (OR = 1.05, 95% CI 1.01, 1.09) in unadjusted model, however, not in fully adjusted model. We found a positive effect of higher vitamin B12 intake on verbal IQ (B = 1.08, 95% CI 0.09, 2.08).

Conclusions: We identified consistent associations between prenatal vitamin B12 intake and children's cognitive development. The results suggest that inadequate vitamin B12 during pregnancy may negatively affect children's cognitive development, particularly in speech and language.

Background: Understanding of the factors influencing oesophageal cancer trends is crucial. Therefore, this cross-sectional cohort study sought to disentangle the age, period and cohort effects on the trends of oesophageal cancer in Kuwait.

Methods: The data on incident oesophageal carcinoma cases diagnosed between January 1, 1980, through December 31, 2019, and reference population were obtained. Age-period-cohort (APC) analysis was conducted using a loglinear Poisson regression model.

Results: A total of 496 oesophageal carcinoma cases in 12.8 million person-years (i.e. squamous-cell carcinoma, 269, 54.23%), adenocarcinoma,147, 29.64% and unspecified cases, 80,16.13%) were diagnosed. The overall age-standardized incidence rate (per 105 person-years) of oesophageal carcinoma during the study period was 10.51 (95% CI: 6.62-14.41). The APC analysis results showed that the age and birth cohort effects were the significant determinants of declining, and subsequently steadying the oesophageal carcinoma incidence rates.

Conclusions: A substantial decline in oesophageal carcinoma incidence rates was recorded, which significantly varied in all three temporal dimensions. The observed birth cohort patterns suggest changing lifestyle and dietary patterns seem to be responsible for decreasing oesophageal carcinoma risk in Kuwait. Future studies may look for the component causes maintaining the endemicity of oesophageal carcinoma risk in this and similar countries in the region.