Health Factors Research Articles

Cancer Mortality Among Women in the European Union: A Comprehensive Analysis of Economic, Social, and Health Factors

This study provides a comprehensive analysis of factors associated with cancer mortality among women in twenty-seven European Union (EU) countries from 2013 to 2021. Using Pooled Ordinary Least Squares and Quantile Regression models, we examine the impact of socioeconomic, health, and lifestyle factors on gender disparities in cancer mortality. Key findings reveal that higher average years of schooling among women is associated with an increase in cancer mortality, while higher Gross National Income per capita is linked to reduced mortality rates. Lifestyle variables, such as regular physical activity and dietary habits, are associated with lower cancer mortality, whereas unmet healthcare needs and certain socio-political factors correlate with increased mortality. The results underscore the importance of addressing healthcare access and gender equity to inform policy interventions aligned with UN Sustainable Development Goals (SDGs) aimed at reducing cancer mortality among women in the EU.

Food insecurity in the community: a cross-sectional study in the Portuguese and immigrant population of Amadora

Introduction: Food insecurity, defined as limited or uncertain access to adequate food, is recognized as a public health problem linked to poor eating habits, chronic diseases, and social inequalities. This study aims to characterize and compare food insecurity status among immigrant and Portuguese populations receiving primary health care in Amadora. Methods: A cross-sectional study was conducted based on interviews with individuals aged 18 and above, living in Amadora for at least one year. Sociodemographic and health status variables were collected, and food insecurity was assessed using a Portuguese adapted version of the US Department of Agriculture Household Food Security Survey Module. Data analysis included binary logistic regression to explore the predictive capacity of variables, with food insecurity as the outcome. Results: The estimated prevalence of household food insecurity was 29.7%, with 10.5% classified as severely food insecure. Single individuals (OR 3.090; IC 1.353-7.059), those with basic education (OR 3.296; IC 1.175-9.247); immigrants (OR 4.358; IC 2.206-8.611), households with three or more members (OR 2.686; IC 1.019-7.079), and incomes below €1100 (OR 7.359; IC 2.613-20.726) were more likely to belong to food insecure households. When Portuguese households were analysed, low income (OR 8.730; IC 2.607-29.232) and smoking habits (OR 3.375; IC 1.345-8.469) were found to be potential determinants of food insecurity. As for immigrant households, being single (OR 6.002; IC 1.404-25.659), having a household with three or more members (OR 13.953; IC 2.119-91.887), and low income (OR 7.110; IC 1.257-40.226) increased the risk of food insecurity. Conclusion: The results of this study show that food insecurity is significantly associated with sociodemographic and health factors, with differences between Portuguese and immigrant populations. Awareness of this problem and the need for monitoring should therefore be raised to prioritize community interventions.

Remembering Nightingale in her turbulent times: Introducing the Theory of Integral Nursing in our turbulent times

AbstractAimTo connect selected examples from Florence Nightingale's life with concerns for the distress nurses are experiencing worldwide.BackgroundWe live in turbulent times of disease, armed conflict, vast climate change, and social injustice—factors exacerbating illness and impacting health—factors Nightingale also addressed throughout her life.Sources of evidenceThe Theory of Integral Nursing (TIN) is introduced with related examples of nursing's problems and solutions seen through integral lenses at the individual, group, grassroots, and global levels. Illustrating these points, relevant Nightingale quotes and life narratives illustrate how she responded, in her time, to the challenges we face in our time.DiscussionLeading reflections focus on changes needed within nursing's culture to encourage proactive innovations and public advocacy for the challenges nurses face—for nurses to be seen and heard.ConclusionNurses are a potentially significant force to bring our trusted caring and compassion for suffering into advocacy for a better world.Implications for nursing practiceNightingale's vision for maintaining excellence in ‘sick‐nursing’ practice is described with a corresponding aim to develop ‘health‐nursing’ practices to address the causes of illness and injury through public advocacy.Implications for nursing and health policyRecommendations connect Nightingale's hope for future policy leadership with recent global policy calls to sustain positive change within nursing's culture and the global healthcare workforce.

Serum Mature and Precursor Brain-Derived Neurotrophic Factors and Their Association with Neurocognitive Function in ART-Naïve Adults Living with HIV in Sub-Saharan Africa.

This study investigates the association between serum mature brain-derived neurotrophic factor (mBDNF), its precursor proBDNF, and neurocognitive function in ART-naïve adults with HIV in sub-Saharan Africa, exploring the distinct roles of these neurotrophic factors in cognitive health. This cross-sectional analysis utilized stored baseline serum samples and neuropsychological test data from participants in the AIDS Clinical Trials Group (ACTG) A5199 study in the Johannesburg and Harare sites. Serum concentrations of mBDNF and proBDNF were quantified using ELISA. Neurocognitive function was assessed via standardized tests, with results adjusted for site-specific demographics. Linear and quantile regression models examined the relationship of mBDNF and proBDNF with a composite cognitive score (NPZ-6), and structural equation modeling (SEM) explored their association with individual cognitive test outcomes. The analysis involved 157 ART-naïve adults with HIV. Increased serum mBDNF levels showed a significant positive association with cognitive performance (β = 1.30, p = 0.02), while elevated proBDNF levels were linked to poorer outcomes, particularly affecting fine motor skills and speed (β = - 0.29 to - 0.38, p ≤ 0.01). Quantile regression analysis highlighted mBDNF's stronger positive impact at higher cognitive performance percentiles (β = 1.04 (0.01, 2.06) at the 75th percentile), while proBDNF showed significant negative association at the 75th percentile (β = - 0.26 (- 0.47, - 0.06)). The study highlights the positive association of mature BDNF and the negative association of proBDNF with cognitive function in HIV. These findings emphasize the need for longitudinal research to understand the temporal dynamics of neurotrophic factors during ART initiation and their potential as targets for neurocognitive interventions in HIV.

Association Between Type 1 Diabetes Mellitus and Dental Caries in Children: A Systematic Review

Background: Diabetes mellitus is one of the diseases with chronic prevalence. Keep going increased, not only in adults but also in children. Diabetes mellitus type 1, the most common, occurs in children. Dental caries is an infection caused by metabolizing bacteria Streptococcus mutans, and Lactobacilli that convert carbohydrates into acid that damages tooth enamel. Diabetes can cause changes in saliva composition and flow. Saliva is vital in guarding a healthy tooth by neutralizing acid and providing minerals for remineralizing tooth enamel. Method: A systematic review was done by reviewing research through English data sources Pub Med, Proquest, Cochran, and Wiley. Four studies were included according to the inclusion criteria. Result: The results of a review of these four journals showed that children aged 6-18 who have type 1 or type 2 diabetes mellitus have a higher risk of developing dental caries or dental diseases. Children with diabetes are predisposed to have more glucose in their saliva. High glucose can become a source of nutrition for bacteria cariogenic, which contributes to the formation of plaque and acids that damage teeth. Conclusion: Diabetes mellitus is a risk factor for oral health. Diabetes Mellitus had a significant correlation with dental caries in children. Keywords: Diabetes Mellitus, Children.

The regulatory effects of bioactive polysaccharides on intestinal function and bile acids: chemical structures, bioactivities, and mechanisms

Polysaccharides are one of the important components of the human diet, offering a wide range of biological activities, especially in improving inflammation in the digestive system and addressing metabolic diseases. Among all the reported bioactivities of polysaccharides, their regulation effects on intestinal function and bile acids (BAs) are gradually attracting the attention of more researchers. Bile acids, the main components of intestinal lipid digestive fluid, are also key signal factors for metabolic homeostasis and impact overall health. Polysaccharides usually interact directly or indirectly with the gut and gut microbiota to participate in the regulation process of reabsorption, metabolism, and excretion of bile acids in humans, thereby exerting their role in the intervention of human diseases. In this review, we comprehensively reviewed the effects of bioactive polysaccharides on the regulation of intestinal function and bile acids. The chemical structures, bioactivities, and potential mechanisms for their activities were also reviewed. This study aimed to provide a comprehensive reference for future research on the activities and mechanisms of polysaccharides, as well as to offer important strategies and insights for the development of bioactive polysaccharides to prevent inflammatory and metabolic diseases.

Effects of early marriage among women married before reaching 18 years old (qualitative study approach)

BackgroundThe consequences of early marriage have become a global concern for young women. The detrimental effects of early marriage disproportionately affect girls. Regarding its effects in poor nations like Ethiopia, there is a dearth of data. As a result, this study offers baseline, first-hand, and updated information for both the nation and the study area.ObjectiveThe purpose of this study was to investigate the effects of early marriage on Guji women who were married before the age of 18.MethodsThis qualitative study used a phenomenological approach and was carried out from January to April 2024. An in-depth interview technique was employed to collect the data. The interviews were conducted in the Oromo language. A purposive sampling technique was applied to choose the study participants. A total of 25 women who met the eligibility criteria were selected. A thematic data analysis approach was employed to analyze the data in this study.ResultsThree themes, 10 subthemes, and more than hundreds of codes were extracted after the interview data were analyzed. The main themes and subthemes of this study were as follows: 1-Precipitators of early marriage (abduction and arranged marriage); 2-Consequences of early marriage (emotional damage, moral damage, early marriage is a risk factor for maternal and child health, early marriage is a major cause for girls to drop out of school, poverty, gender-based violence and divorce, lack of essential life skills); and 3-Attitudes toward early marriage (early marriage is a harmful cultural practice; girls should be protected).ConclusionThe study’s findings illustrated the multidimensional effect of early marriage, necessitating the involvement of numerous sectors and stakeholders. The community, religious leaders, the health, education, and legal sectors, as well as the parents of young girls, should all take an active role in delaying early marriage. This indicates the development of policies that permit cooperation amongst all relevant parties. Creating awareness among girls, families, and the community through community-based education is crucial. Early married women should participate in intervention programs to provide their experience to young girls. Women who are victims of early marriage must receive full support to mitigate its negative consequences.

Mental health, risk behaviors, and social life factors in relation to adolescents' suicide ideation, plans and attempt.

This study investigated differences in mental health and well-being, risk behaviors, and social life factors among adolescents who experienced different forms of suicidality. We examined 18-years-olds in the Danish National Birth Cohort (N = 47,852). Suicidality was defined with mutually exclusive categories ranging from no suicidality, self-reported suicide ideation, plans, and attempt as well as hospital-recorded suicide attempt. The proportion of adolescents with self-reported poor mental health and well-being, risk behaviors, and social life factors were compared across forms of suicidality. Sample weights were applied. Depressive symptoms were reported by 14% (95% CI 13%;14%) of girls with no suicidality, 44% (95% CI 43%;45%) of girls with suicide ideation, and 68% (95% CI 65%;72%) 66% (95% CI 60%;72%) of girls with self-reported suicide attempt or hospital-recorded suicide attempt respectively. Among boys, depressive symptoms were reported by 5% (95% CI 4%;5%) of those with no suicidality, 27% (95% CI 26%;28%) of those with suicide ideation, and 51% (95% CI 45%;57%) and 40% (95% CI 22%;58%) of those with self-reported suicide attempt or hospital-recorded suicide attempt respectively. Likewise, other aspects of poor mental health and well-being gradually increased relative with more severe forms of suicidality, while no notable differences were identified between adolescents with self-reported and hospital-recorded suicide attempt. Similar tendencies were observed for risk behaviors and social life factors. These findings suggest that adolescents with suicidality, including the large proportion with suicide ideation only, faces challenges across several parameters of mental health and well-being, risk behavior, and social life factors. This emphasizes the need for community-based interventions to identify and support the large group of adolescents experiencing both more and less severe forms of suicidality. Clinicians should prioritize comprehensive psychiatric intervention to address the complex needs of suicidal adolescents effectively.

Spiritual Health and Psychological Distress Among Hong Kong Community Lay Leaders

Community lay leaders are critical in connecting professional services and general populations in communities. However, limited studies have explored the potential protective factors for psychological health among this group of people. In addition, based on the complex nature of spiritual health, the inconsistent findings of previous studies also suggested that different domains of spiritual health may shape psychological health differently in different contexts and among different socio-demographic groups. Therefore, we assessed the psychological health of Hong Kong community lay leaders after COVID-19 and examined the effects of different domains of spiritual health on psychological distress after controlling for age and gender. Cross-sectional data from 234 Hong Kong community lay leaders aged 18 to 84 were analyzed using structural equation modeling. The results showed that most Hong Kong community lay leaders reported moderate anxiety. In addition, personal and communal (one domain) and transcendental domains of spiritual health were negatively associated with depression, anxiety, and stress, and the environmental domain of spiritual health was positively associated with depression, anxiety, and stress. These findings imply the importance of considering both the positive and negative effects of spiritual health on psychological distress.

Physical and mental well-being of older adults: examining the impact of financial support from male migrant children on Indian left-behind parents.

Amid high youth out-migration, India's older parents face severe social, economic, psychological, and health crises due to their children's separation. However, remittances from their migrant children alleviate economic hardships, improve healthcare access, and partially compensate for their absence. So, this study examines how adult-child migration affects older parents' physical and mental health and how remittance support helps mitigate these challenges. This study used the 2011 Building a Knowledge Base on Population Ageing in India (BKPAI) dataset, the current study (n = 5122) employs bivariate statistics, logistic regression, and mediation analysis to address the objectives. Logistic regression determines the factors of self-rated health and depression, while mediation analysis is implied to understand the intermediate effect of financial support i.e. remittance on left-behind older adult health. The findings indicate that approximately 43% of the study populations were left behind, meaning they have at least one migrant child. Notably, 20% of these left-behind older adults report poor health conditions, and 17% exhibit depressive symptoms, while the poor health and having depressive symptoms were lower among the non-left-behind older adults i.e., 13% and 12% respectively. The mediation analysis indicates that the likelihood of good self-rated health increased 1.35 times through the effect of remittance, which compensates for around 55% of the total adverse effect of migration. The consistent inflow of remittances serves to alleviate the impact on household finances, ensure food security, and address medical expenses. However, it is crucial to recognize that while remittances contribute significantly to economic stability, they cannot fully replace the physical presence of adult children, especially in terms of caregiving.

The impact of Life's Essentials 8 on sarcopenia prevalence among adults in the United States.

Sarcopenia is closely associated with cardiovascular disease. We aimed to examine the association of Life's Essential 8 (LE8), the recently updated measurement of cardiovascular health (CVH), with the presence of sarcopenia among US adults. This population-based cross-sectional study used data from the National Health and Nutrition Examination Survey in 2005-2006 and 2011-2018, and included adults aged 20 years or older. LE8 score was measured according to American Heart Association definitions. Sarcopenia was measured according to the National Institutes of Health definition, the ratio of appendicular skeletal muscle mass (ASM) to body mass index (BMI). Multivariable logistic and restricted cubic spline models were used to assess the associations between LE8 and sarcopenia. Among the 11,078 participants, 1021 (9.22 %) were diagnosed with sarcopenia. After adjusting for potential confounders, higher LE8, health behavior and health factors scores were associated with reduced odds ratios (OR) of sarcopenia (OR for per 10 scores increase in LE8, 0.65; 95 % CI 0.61-0.70; OR for per 10 scores increase in health behaviors score, 0.90; 95 % CI 0.84-0.97; OR for per 10 scores increase in health factors score, 0.67; 95 % CI 0.63-0.71). A non-linear dose-response relationship was observed between LE8 scores, health factors scores, and sarcopenia. The inversed association between LE8 score and sarcopenia was significantly stronger among males and participants with a high school education or above. LE8 was negatively associated with the prevalence of sarcopenia in a nonlinear fashion. Promoting adherence to optimal CVH levels may benefit to reduce the risk of sarcopenia.

Health-aware battery fast charging technique with zonal battery model using pulsed amplitude-width modulation and multi-step constant current constant voltage

ABSTRACT This article presents an innovative method for rapidly charging batteries while considering health factors. The strategy utilizes a closed-loop control approach based on a mathematical model. Initially, an intricate thermo-electric aging cell model (TEACM) was constructed based on electrochemical aging study. The model’s parameters are continuously updated in real-time by pulling data from the battery pack while it is being charged. The TEACM algorithm analyzes the parameter values and calculates different battery statuses. These estimations are then used to improve the charging process. The charge optimization phase optimizes the precharging and boosts charging processes individually. Several pulse precharging approaches have been analyzed, and by calculating the diffusion coefficient, the most effective precharging method has been identified. The use of multistage constant current technique is utilized to optimize the battery charging process. The optimization is accomplished by implementing the non-linear model predictive controller. Ultimately, the two refined charging methods are combined and sent to the charger. The hypothesis was validated using a cell cycling test bench. The acquired findings were compared with other recognized benchmark charging techniques, demonstrating that the suggested approach charges the cell in half the time compared to the 1C-CCCV charging methodology while also increasing the cycle life by 6.67%.

Risk factors for adverse health in military and law enforcement personnel; an umbrella review

Risk factors for adverse health in military and law enforcement personnel; an umbrella review

Strategies to support mental health within a primary school setting

AbstractThis article explores an insight into different teaching strategies implemented within two educational settings in year 1 classrooms. Since the Coronavirus pandemic, evidence states that children's mental health is declining highlighting the need to teach children how to gain a positive mindset. This article shall reflect on my practice, which used different self‐regulation strategies to improve a child's emotional intelligence and transfer their knowledge into real‐life practice. It shall reflect on the three primary methods I implemented into my year 1 classroom to create a safe learning environment: Self‐regulation, brain breaks and calm corners. These methods were implemented in two different year 1 classrooms across two different academic years. These strategies were embedded and adapted throughout the whole year, yet this article shall reflect on the evidence of the Autumn term in each academic year. The same strategies were implemented in both academic years to compare these strategies in two different educational settings. The Autumn term was chosen as the reflection period due to the transition from EYFS to Year 1 being a key factor in most children's mental health at that age.

The Role of Primary Care in Achieving Life's Essential 8: A Scientific Statement From the American Heart Association.

To reduce morbidity and mortality rates of cardiovascular disease, an urgent need exists to improve cardiovascular health among US adults. In 2022, the American Heart Association issued Life's Essential 8, which identifies and defines 8 health behaviors and factors that, when optimized through a combination of primary prevention, risk factor management, and effective treatments, can promote ideal cardiovascular health. Because of its central role in patient care across the life span, primary care is in a strategic position to promote Life's Essential 8 and improve cardiovascular health in the United States. High-quality primary care is person-centered, team-based, community-aligned, and designed to provide affordable optimized health care. The purpose of this scientific statement from the American Heart Association is to provide evidence-based guidance on how primary care, as a field and practice, can support patients in implementing Life's Essential 8. The scientific statement aims to describe the role and functions of primary care, provide evidence for how primary care can be leveraged to promote Life's Essential 8, examine the role of primary care in providing access to care and mitigating disparities in cardiovascular health, review challenges in primary care, and propose solutions to address challenges in achieving Life's Essential 8.

Anxiety and Associated Factors Among Chinese Preschool Teachers

In China, preschool teachers significantly influence the development of young children aged 3–6 years. Understanding their mental health and its associated factors is imperative to informing policies, optimizing their mental well-being, and supporting their job performance. This study aimed to investigate the factors contributing to anxiety symptoms among preschool teachers. A sample of 393 Chinese preschool teachers (279 women, 114 men), aged 21–56, completed online questionnaires collecting their sociodemographic and work-related information and assessing anxiety symptoms, interpersonal difficulties, personality traits, perceived stress, resilience, and inner strength. Pearson correlation and multiple linear regression analyses identified significant predictors of anxiety symptoms. The prevalence of anxiety symptoms among the studied cohort was found to be 12.2%. Statistically significant factors that positively correlated with anxiety symptoms included objective work-related stress (B = 0.149, p < 0.001), interpersonal difficulties (B = 0.921, p < 0.001), perceived stress (B = 0.108, p = 0.001), and neuroticism (B = 0.071, p = 0.002). These findings highlight the urgent need for measures to reduce work-related stress and anxiety. However, when negative mental health factors were included, the effect of positive psychological factors became nullified. Positive mental health might have a moderating role in a negative mental health outcome such as anxiety. Therefore, further research is required to understand the impact of positive mental health factors more clearly.

Nutritional status and factors associated with gestational weight gain in the city of São Paulo, 2012 to 2020: a retrospective cohort study.

Gestational weight gain (GWG) is a critical issue related to postpartum health in newborns and mothers. In Brazil, pregnant women's public health recommends monitoring GWG. Therefore, the objective of this study is to evaluate gestational weight gain and associated health factors of pregnant women monitored at Unified Health System (SUS) in the city of São Paulo between 2012 and 2020. This is a retrospective cohort study of pregnant women seen from 2012 to 2020 in São Paulo, Brazil. The database used was from the Integrated Health Care Management System related to the Live Birth Information System. Data distribution was assessed using the Kolmogorov-Smirnov test. Comparisons between groups according to weight gain (LWG vs. AWG vs. EWG) were performed using analysis of variance (ANOVA) with Tukey post hoc. Inclusion criteria considered that pregnant women had a recorded initial weight before 13 weeks and up to 15 days before delivery and a single pregnancy. The final database includes 276.220 pregnant women. The frequency of women according to initial body mass index (BMI) was 12.004 (4.4%) underweight, 132.049 (48.3%) normal weight, 78.856 (28.8%) overweight, and 50.660 (18.5%) living with obesity. The population consisted of 59.881 (21.9%), 37.217 (13.6%) and 176.471 (64.5%) women with LWG, AWG and EWG, respectively. Weight gain was associated with initial BMI, type of birth, color/ethnicity, marital status, women's age and antenatal care visits. The proportion of pregnant women with inadequate weight gain is high, relating initial BMI, type of birth, color/ethnicity, marital status, women's age and antenatal care visits. Interventions such as nutritional education should be suggested to help achieve adequate GWG.

Association of life's essential 8 with chronic obstructive pulmonary disease: a population-based analysis of NHANES 2007-2018.

Chronic obstructive pulmonary disease (COPD) is closely linked to cardiovascular diseases. We aimed to investigate the association between Life's Essential 8 (LE8), the newly established measurement to assess cardiovascular health (CVH), and COPD among U.S. general adults. This study extracted the National Health and Nutrition Examination Survey (2007-2018) data. Multivariate logistic regression models were used to examine the associations between LE8 and COPD. A restricted cubic spline regression model was used to explore the dose-response relationships between LE8 scores and COPD. In addition, subgroup and sensitivity analyses were performed to assess the robustness of our results. Our study included 19,774 participants representing 145.2million non-institutionalized U.S. population aged ≥ 20 years. The overall age-adjusted prevalence of COPD was 4.5%. After adjusting for the potential covariates, LE8 was inversely associated with COPD [adjusted odds ratio (AOR) = 0.169, 95% CI: 0.115, 0.249], exhibiting a nonlinear dose-response relationship (P for nonlinearity < 0.05). Similar trends in the associations of health behavior score (AOR = 0.300, 95% CI: 0.223, 0.404) and health factor score (AOR = 0.603, 95% CI: 0.426, 0.852) with COPD were also identified. Furthermore, higher LE8 metric scores of nicotine exposure and sleep health were associated with a lower prevalence of COPD. LE8 was inversely associated with spirometric/self-reported COPD in a nonlinear trend, primarily driven by the nicotine exposure metric of LE8. Adhering to LE8 guidelines, especially smoking cessation, to sustain optimal CVH levels may be beneficial to alleviate the burden of COPD.

Abstract 4121672: Multi-level Factors Mediated the Associations Between Perceived Neighborhood Measures and Type 2 Diabetes: The Midlife in the United States III

Introduction: The determinants of type 2 diabetes (T2D) are multifaceted, encompassing individual, psychosocial, health, and neighborhood factors. While these factors have been explored, the mechanisms underlying perceived neighborhood measures and T2D remain understudied. We aimed to test whether psychosocial, health, and inflammatory factors mediate the association between perceived neighborhoods and T2D among adults. We hypothesized that these factors mediate the relationship between perceived neighborhoods and T2D. Methods: Data from the Midlife in the United States 3 (MIDUS3, 2013-2014; MUDIS3 Biomarker Project, 2017-2022) were used (n=564, mean age: 60.7y, female:53.2%, White adults:95.7%). Higher perceived neighborhood scores (social cohesion, safety, quality) represent favorable neighborhoods. T2D (y/n) was defined as either A1c≥6.5%, FGL≥126mg/dL or self-reported T2D. Physical activity (PA), BMI, depression, stress, and CRP were tested as mediators in the cross-sectional association between perceived neighborhood measures and T2D using linear regression (reported odds ratio [OR]) with bootstrap-generated 95% bias-correct confidence intervals (BC CIs) adjusted for covariates (Table). Results: Higher neighborhood social cohesion was indirectly related to lower odds of T2D by PA (OR: 0.93 [95%BC CI: 0.86, 0.98]), BMI (OR: 0.90 [0.80, 0.99]), depression (OR: 0.86 [0.75, 0.97]), stress (OR: 0.88 [0.78, 0.97]), and CRP (OR: 0.91 [0.82, 0.98]). Higher neighborhood safety was indirectly related to lower odds of T2D by depression (OR: 0.90 [0.79, 0.98]) and stress (OR: 0.89 [0.77, 0.97]). Higher neighborhood quality was indirectly related to lower odds of T2D by PA (OR: 0.90 [0.82, 0.98]), depression (OR: 0.82 [0.68, 0.96]), stress (OR: 0.83 [0.70, 0.96]), and CRP (OR: 0.88 [0.75, 0.98]). Conclusions: Favorable perception of neighborhoods had significant indirect associations with T2D via PA, BMI, depression, stress, and CRP. These mediators could be potential targets for intervention alongside promoting better neighborhoods to improve T2D outcomes. Future studies should replicate this line of research in diverse cohorts to address T2D disparities by socioeconomic status.

Sugar-sweetened beverage consumption in Thailand: Determinants and variation across socioeconomic status

ObjectivesReducing consumption of sugar-sweetened beverages (SSBs) is a primary public health goal in Thailand, but information on the characteristics of SSB consumers remains limited. This study aims to gain knowledge about the characteristics of SSB consumers in Thailand. Study designSecondary analysis of survey data. MethodsThe study used data from the Health Behaviour of Population Survey conducted by Thailand's National Statistics Office between February and May 2021. SSB consumption was sourced from a survey question about the consumption of prepackaged sugar-sweetened non-alcoholic beverages. The influence of demographic, socioeconomic, behavioural, habitual, and health factors on mean daily intake and daily consumption was assessed using a two-part model and logistic regression analysis, respectively. Decomposition analysis was conducted to understand how the impact of these factors affecting SSB consumption varied across socioeconomic groups. ResultsFrequent SSB consumers exhibited various unhealthy behaviours, including smoking, unhealthy food consumption, low physical activity, and making food selections driven by appetitive motivations. Although higher socioeconomic status was associated with greater consumption of SSBs, it stabilised at elevated income levels. Increased SSB consumption in higher socioeconomic groups was linked to mixed eating habits, being overweight, and occasional drinking, while in lower socioeconomic groups, it was associated with unhealthy behaviours like smoking, regular alcohol drinking, appetitive food choices, and low physical activity. ConclusionsSSB consumption in Thailand is multifactorial, varying by socioeconomic status. These insights are crucial for policy formation aimed at reducing SSB consumption in the country. Policymakers should explore interventions that address overall unhealthy behaviours alongside those targeting overconsumption of SSBs.