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

Background: This study aimed to identify maternity services in England that most consistently reported both higher-than-average and lower-than-average rates of extended perinatal mortality (EPM), including stillbirths and neonatal deaths, throughout the government's decade-long National Maternity Safety Ambition to halve the rate of stillbirths and neonatal deaths.

Methods: We conducted a retrospective study of MBRRACE-UK Perinatal Mortality Surveillance Reports (2015-2024) to compare EPM rates for births occurring in 121 organizations providing maternity services in England between 2013 and 2022. Utilizing MBRRACE-UK definitions and designations, we devised a scoring method to determine which organizations most consistently reported higher-than-average and lower-than-average deaths.

Results: We identified 10 organisations providing maternity services (8.3%) with the five highest scores and 15 (12.4%) with the five lowest scores. A total of 20 organisations (16.5%) reported higher-than-average deaths in ≥80% of MBRRACE-UK reports and/or each of the past five years, and 22 (18.2%) reported lower-than-average deaths. Strong indications of a North-South divide for EPM were evident.

Conclusions: We provide evidence of regional EPM variation over the past decade, building on previous study findings of a North-South mortality divide in England. We propose that shared learning between outlier maternity services has the potential to ameliorate avoidable harm.

Background: Public health messaging during infectious disease outbreaks can influence healthcare demand. The winter 2022 surge in Group A Streptococcus (GAS) in England provided an opportunity to examine the relationship between communications and National Health Service (NHS) activity, informing future strategies for resilience and risk communication.

Methods: This observational study analysed UK Health Security Agency (UKHSA) invasive GAS (iGAS) notifications, NHS 111, General Practice (GP), and emergency department (ED) surveillance data, prescription records, internet searches, and media reports. Temporal associations were assessed descriptively, with weekly differences from winter averages calculated.

Results: Following initial media reports and UKHSA messaging, internet search interest rose sharply (4%-63%). In the subsequent week, there were increases in NHS 111 contacts (fevers +256%, sore throats +953%), acute respiratory infection ED visits (+155%), GP pharyngitis consultations (+356%), and community penicillin prescriptions (+134%) compared to winter averages. Compared to the previous week, consultations for scarlet fever declined.

Conclusions: This is the first study to link outbreak communications with system-wide NHS activity in real time. Messaging likely prompted appropriate care-seeking, but the rapid return to baseline and the low predictive value of consultations for iGAS suggest that many were for self-limiting illness. Findings highlight the need for tailored messaging, interdisciplinary collaboration, and scalable healthcare capacity during outbreaks.

Background: While the adolescent use of traditional substances has shown a decline in recent years, the use of Novel Psychoactive Substances (NPS) is rising in popularity due to affordability and accessibility. Limited research exists on the risk profiles of adolescents who engage in NPS use. This study aimed to identify key predictors of NPS use among adolescents.

Methods: This study included 1605 adolescents from the K cohort of the Longitudinal Study of Australian Children. Adolescent NPS use was measured using self-reported lifetime use of synthetic cannabis and other NPS use. We employed Firth's penalized logistic regression to investigate predictors of NPS use among adolescents.

Results: Among the 1605 adolescents included in the study, 64 (4.0%) reported using NPS. Lower weekday social media use was linked to reduced odds of NPS use. Lower parental monitoring was significantly associated with higher odds of NPS use. Alcohol use was linked to increased odds of NPS use. Additionally, higher externalizing behavior was associated with increased odds of NPS use.

Conclusions: The findings highlight the importance of early identification and intervention to reduce the risks of NPS use, emphasizing the role of positive parenting, adolescent mental health support, and evidence-based prevention policies.

Objectives: This systematic review and meta-analysis aimed to compile and analyze available evidence to estimate the pooled prevalence of undernutrition (underweight, stunting, and wasting) among tribal children in India.

Methods: A comprehensive literature search was done using PubMed and Google Scholar and other web-based searches to find studies reporting the prevalence of undernutrition (underweight, stunting, and wasting) among tribal children of India. Out of 1606 identified studies, 58 met the eligibility criteria. Meta-analysis was performed using the inverse variance method, and the random effect model was used to estimate the pooled prevalence. The heterogeneity across studies was assessed using the I2 statistic.

Results: The meta-analysis revealed that the overall pooled prevalence of underweight among tribal children was 43.78% (95% CI: 38.80%-48.83%). The pooled prevalence of stunting and wasting was 43.16% (95% CI: 39.10%-47.26%) and 29.58% (95% CI: 25.59%-33.73%). The significant heterogeneity observed across studies was likely due to variations in study design, geographic location, and measurement methods.

Conclusion: This systematic review and meta-analysis highlight the alarmingly high burden of undernutrition among tribal children of India, with nearly half of the population being underweight and stunted and a substantial proportion suffering from wasting. These findings highlight the pressing need for tailored public health interventions that tackle the specific challenges encountered by tribal communities, including improving healthcare access, addressing poverty, and overcoming geographical barriers. Targeted interventions focusing on nutrition supplementation, health service accessibility, and socio-economic support are urgently recommended to reduce undernutrition in tribal children.

Background: Scale-up of effective interventions is needed to achieve population health outcomes. Before scaling-up, many assess the potential scalability of interventions using a scalability assessment resource. Given the critical importance of reducing health inequities, understanding how equity is considered in these resources merits investigation. We sought to determine if scalability resources consider equity and, if so, how equity is applied.

Methods: A structured search of the literature identified 28 scalability resources. A deductive content analysis was undertaken by two independent coders to identify key aspects of equity concepts within the resources.

Results: Of the resources identified, only half explicitly mentioned equity or equity-related terms; none provided a clear definition of equity. Of the half that mention equity, only three included an equity-specific step while only two included equity as a guiding principle. Three-quarters highlighted a range of disadvantaged groups for consideration, with race/ethnicity and socio-economic status being most frequently mentioned.

Conclusion: This highlights an important gap in current scalability assessment resources and provides an opportunity to improve the systematic consideration of equity. Without more concerted effort to consider equity in scalability assessments, it may result in disadvantaged and marginalized groups being exposed to increasing inequity even when interventions are scaled-up.

Background: Knowledge on gas stove and adult respiratory health is limited. We studied the association between having a gas stove or not and respiratory health using cross-sectional and cohort designs.

Methods: Information on gas stove and respiratory symptoms (e.g. bronchitis, asthma, cough) was obtained from the Danish Health and Morbidity Survey year 2000 (aged ≥ 16 years, n = 3491). Odds ratios (ORs) of respiratory symptoms were estimated by Logistic regressions. In the cohort study, 3444 asthma-free individuals were followed for up to 18 years, with incident asthma identified via Danish National Registers. Incidence rate ratios (IRRs) were estimated by Poisson regression of incidence rates (IRs).

Results: Overall, 13.9% of participants had a gas stove. Respiratory symptoms ranged from 3.0% (bronchitis) to 12.1% (cough). The odds were significantly higher for bronchitis (OR 1.90; 95% CI, 1.15-3.14), cough (OR 1.46; 95% CI, 1.11-1.91), and shortness of breath (OR 1.89: 95% CI, 1.30-2.77) among participants with gas stoves compared to participants without. In the cohort study the overall IR of asthma was 6.1 per 1000 person-years. The adjusted IRR of asthma was 1.19 (95% CI, 0.78-1.80).

Conclusions: Having a gas stove was associated with higher risk of certain respiratory symptoms and indicated an increased asthma incidence.

Background: The European Health Interview Survey-Physical Activity Questionnaire (EHIS-PAQ) assesses physical activity (PA) as part of the European Health Interview Survey. The aim of this study was to evaluate its predictive value for all-cause mortality.

Methods: A prospective study based on data from the 2014 EHIS in Spain linked to the mortality registry until December 2022. The sample included 21 890 participants ≥15 years of age. The EHIS-PAQ measures occupational PA, transport/commuting PA, aerobic PA ≥ 150 minutes/week, muscle strengthening, and total PA (active in occupational and/or aerobic). We designed Poisson regression models to calculate relative risks (RRs) and standardized mortality rate differences while adjusting for relevant covariates.

Results: Total PA was associated with a reduction in mortality [RR (95% CI) = 0.62 (0.54, 0.71)], estimating -5.39 (-6.72, -4.07) deaths/1000 person-years. Independent of other PA domains, most active individuals in occupational or transport/commuting PA had substantially reduced mortality compared to those least active [RR = 0.67 (0.55, 0.82) and 0.52 (0.44, 0.62)]. Engaging in ≥150 minutes/week of aerobic PA was protective [RR = 0.68 (0.58, 0.79)]. Muscle strengthening PA showed no effect.

Conclusions: The EHIS-PAQ adequately assesses PA in its different dimensions and captures their protective effect. All the indicators, except for muscle strengthening, showed independent predictive value for mortality.

The 'Pit Stop for Health' initiative is a student-led health promotion program providing opportunistic health screenings and behavioral counseling at mass gathering events. This cross-sectional observational study surveyed 369 participants across agricultural fairs, sporting events, and university activities. Structural equation modeling identified multiple pathways influencing satisfaction, health modification, and health behavior's, with the overall model explaining 58.8% of the variance (R2 = 0.588). Satisfaction with the 'Pit Stop for Health' initiative significantly predicted health modification (β = 0.157, SE = 0.068, CR = 2.316, P = .021) and the likelihood of recommending the activity to others (β = 0.812, SE = 0.138, CR = 5.877, P < .001), while follow-up behaviors were strongly associated with future health modification (β = 0.854, SE = 0.116, CR = 7.380, P < .001) and seeking medical advice (β = 0.967, SE = 0.107, CR = 9.050, P < .001). The model demonstrated excellent fit (χ2 = 33.736, df = 24, P = .090), with age negatively correlated with follow-up behaviors (r = -0.137, P = .028), and no significant associations found for gender or self-reported health importance. Findings highlight the public health value of student-led, reciprocal service-learning models in delivering preventive interventions in non-clinical community settings. Such initiatives not only strengthen public engagement with health services but also provide meaningful experiential learning for future health professionals. By addressing preventive health needs in accessible, resource-constrained environments, 'Pit Stop for Health' contributes to population-level health promotion. Further research examining cultural and ethnic influences is warranted to enhance the inclusivity, relevance, and scalability of similar interventions in diverse communities. Contribution to Health Promotion  Promoted health behavior changes by offering opportunistic health screenings and lifestyle modification counseling at mass gathering events.Increased access to preventive healthcare services, especially in resource-limited settings, through a cost-effective student-led initiative.Fostered community engagement in health promotion while simultaneously enriching nursing students' educational experiences.Enhanced public awareness of health importance through innovative, context-sensitive interventions at diverse public events.Supported healthcare systems by addressing preventive health needs and improving follow-up behaviors among participants.

Background: Public health is tasked with preventing harm, promoting health and ensuring equitable access to care. Yet, increasing sociopolitical and economic turmoil is creating barriers to public health delivering its core roles. Whilst moral dilemmas are inherent in public health polycrises and their resultant ongoing impacts has thrust consideration of the moral harms that may be experienced when we are prevented in the delivery of care into discourses about the future priorities of public health. Experiencing moral harms can result in profound impacts for the individual and the delivery and outcomes of care and are emerging as a public health concern. At a time when public health and healthcare are facing interconnected challenges in funding, workforce attrition, erosions in public trust and quality, it is critical we identify the pertinent drivers of moral harms.

Methods: This commentary explores five different perspectives representing varied geographical locations and health infrastructures.

Results: Specifically, we explore the critical roles of economic status, social anthropological considerations, fiscal, organisational and individual factors to outline key drivers to formulate public health policy responses, going forward.

Conclusions: Addressing the moral harms is a public health imperative and associated solutions have a critical role to play in dampening the flames of current turmoil.