Health-related Factors Research Articles

Health status and quality of life before critical illness: Northern Finland Birth Cohort 1966 study.

Previous findings support the claim intensive care unit (ICU) patients have a higher rate of comorbidities and reduction of health- and functional status compared with the normal population. In this prospective observational study, our aim was to determine those health-related factors at the age of 31 years which were associated with a later critical illness among previously un-hospitalized individuals by exploring data obtained from the Northern Finland Birth Cohort 1966 (NFBC1966). NFBC1966 is a Finnish birth cohort, which includes 12,058 live births with expected dates of delivery during 1966. The study was conducted among cohort participants who had not been hospitalized for any reason before the cohort follow-up visit at the age of 31. The study group included NFBC1966 participants who were admitted to the ICU of the Oulu University Hospital. The control group included participants who were treated for any reason in regular hospital wards. The data considering the participants' health status and behavior at the age of 31 were collected from the NFBC1966 database. The gathering of ICU and hospitalization data was concluded on December 31, 2016. 849 NFBC1966 participants met the inclusion criteria: 69 were treated in the ICU (study group) and 780 on regular hospital wards (controls). In the study group, the rate of neurological diseases (26% vs. 16%, 95% CI: -21.8%, -0.2%), malignancy (3% vs. 0.7%, 95% CI: -9.7%, 0.0%), alcohol abuse (4.5% vs. 1%, 95% CI: -11.5%, -0.3%) and smoking (77% vs. 65%, 95% CI: -21.6%, -0.3%) were higher compared with the control group. The patients in the ICU group were also more prone to violent injuries, (17% vs. 7%, 95% CI: -20.2%, -1.9%), practiced less hard physical activity (65% vs. 78%, 95% CI: 2.1%, 25.3%) and had lower maximal muscle strength according to the hand grip test (30 vs. 34 kg, 95% CI: -8.2, 8.6 kg). In this study examining previously un-hospitalized patients, the main factors associated with future critical illness were neurological comorbidities, malignancy, alcohol misuse, smoking, low maximum muscle strength, and less frequent physical exercise compared with those with hospitalization not requiring ICU admission.

Lifestyle related health risk factors regarding non-communicable diseases among adults in Morang District

Introduction: Non-communicable diseases are the leading causes of disease burden worldwide. According to World Health Organization estimates, NCDs are responsible for 74% of all deaths globally, with around 77% of premature deaths from NCDs occurring in low- and middle-income countries. This study aims to assess the lifestyle related health risk factors of non-communicable diseases among adults in Nepal, in which two- third of annual deaths are attributable to non-communicable diseases. Methods: A cross sectional study was conducted among adults in Morang district, Nepal. Data collection involved the assessment of the risk factors of obesity, smoking, alcohol consumption, inadequate fruits and vegetable consumption, inadequate physical activity, are raising blood pressure. Ethnical approval was obtained. Results: Two hundred forty participants participated in the study, of which the most prevalent risk factor was obesity (58.3%). Out of total participants, 41.6% had consumed tobacco, 31.2% had consumed alcohol, 41.6% had consumed inadequate fruits and vegetables, 30.4% had inadequate physical activity, and 29.1% had raised blood pressure. Similarly, education is statistically associated with lifestyle risk factors. Male participants of age above 40 years were found to be statistically associated with current tobacco and alcohol consumption. Conclusion: Health related risk factors are causes of non-communicable disease. Most of the participants had two or more risk factors for non-communicable disease. Education is significantly associated with all the risk factors among the participants.

Food depiction in posts of the most popular Lithuanian influencers on Instagram and Facebook

Abstract Background Considering that content published in social networks might act as risk factor to health, we aimed to assess the prevalence of posts depicting food published by Lithuanian influencers on Facebook and Instagram. Materials and methods All publicly available posts (6425 in total) created by 21 most popular Lithuanian influencers on Facebook and Instagram in 2022 were included. The content analysis of the posts was performed and information about food and other health-related factors was registered. Distribution of the posts depicting food was assessed according to social networks, gender, age, and number of followers of influencers. Results Every fourth (22.6%) post presented foods. Among these posts, fast food was presented in 10.2%, sweets - in 35.5%, vegetables - in 59.5%, fruits and berries - in 40.7%, cereals - in 39.2%, dairy products - in 36.8%, meat - in 26.6%, sea food - in 12.1%. Overall, women, older influencers, influencers with higher number of followers more frequently posted posts depicting vegetables (respectively, 21.0% vs 5.5%, 18.6% vs 6.7%, 18.3% vs 9.3%), fruits and berries (respectively, 14.5% vs 3.8%, 12.0% vs 6.4%, 11.4% vs 8.3%), cereals (respectively, 13.7% vs 4.7%, 12.2% vs 5.6%, 11.2% vs 8.2%), dairy products (respectively, 13.0% vs 3.2%, 11.0% vs 5.0%, 10.8% vs 6.3%), meat (respectively, 8.6% vs 4.1%, 7.9% vs 4.4%). Women and older influencers more frequently depicted sweets (respectively, 13.3% vs 7.1%, 12.6% vs 7.1%), sea food (respectively, 4.4% vs 1.5%, 3.8% vs 2.0%). More posts portraying food in general, fast food, vegetables, milk and dairy products were posted on Instagram (respectively, 27.5% vs 19.8%, 3.4% vs 2.1%, 16.6% vs 13.4%, 10.0% vs 8.3%) (p ≤ 0.05). Conclusions Every fourth post depict food, more frequently on Instagram. Healthy and unhealthy foods are presented with similar frequency. Female influencers, older influencers and influencers with higher number of followers more frequently depict foods. Key messages • Both healthy and unhealthy foods are presented with similar frequency on social networks – this might lead to the overconsumption of unhealthy foods. • Differences in depiction of foods between social networks and influencers with different gender, age and number of followers should be taken into account when implementing public health interventions.

Health disparities continue to report in DEIS schools: Irish COSI Round 6 study

Abstract Background Previous reports have identified clear differences in the prevalence of overweight and obesity among children living with disadvantaged compared to those living in advantaged circumstances. Childhood obesity is influenced by factors in the home environment, including lifestyle behaviours and socio-economic status. The Childhood Obesity Surveillance Initiative (COSI) family survey provides insights into these factors, particularly in children that attend disadvantaged (DEIS) and non-disadvantaged (non-DEIS) schools. Aim This study aims to compare various demographic and socioeconomic factors within the home environment of primary school children across DEIS and non-DEIS schools in Ireland, elucidating the differences in their performance with implications for health policy. Methods Parents of 1st and 2nd class children (mean age 7) from 121 sentinel schools invited to participate in the family survey, returned it by post or online using Lime Survey. Ethical approval was secured for COSI R6, with consent from families. Data on demographics, diet, transportation, activities, and clinical characteristics of children in Ireland were collected, anonymised and analysed in SPSS, comparing children from DEIS (n = 147) and non-DEIS (n = 1014) schools. Results Around 88% of respondents of returned surveys included in the study (n = 1161) were mothers. Significant disparity in families with diabetes diagnosis or treatment observed between DEIS and non-DEIS schools (10.6% vs. 5.4%, p = 0.016). Breastfeeding rates were higher in non-DEIS schools (57.0% vs. 46.9%, p = 0.015). Children consuming at least 3 portions of fruits and vegetables daily were also higher in non-DEIS schools (58.9% vs. 46.0%, p < 0.001). More children in non-DEIS schools engaged in physical activities outside of school hours (93.7% vs. 74.5%, p < 0.001). Conclusions The findings underscore the significant socioeconomic disparities between families whose children attend DEIS and non-DEIS schools in Ireland. Key messages • Irish COSI R6 reveals disparities in health-related factors between disadvantaged and advantaged schools. • Targeted interventions and policies are necessary to address factors influencing child health.

Investigating the role of psychosocial stress factors in back pain patients

Abstract Background In 2022, 27.35 million people in Germany were diagnosed with back pain. This results in a 1-year prevalence of 32.64 percent of the population and 96,8 million days of incapacity to work. Moreover, patients with back pain often suffer from additional mental disorders (e.g. anxiety, depression). This study investigated the influence of other health-related factors such as psychosocial stress in these patients. Methods A randomized controlled study was conducted with 297 gainfully employed participants in a rural rehabilitation center in Germany Bad Zwischenahn who received a 4-week multimodal pain therapy. 150 participants were allocated to the intervention (IG) who received an additional 12-month relapse prevention treatment while 147 were allocated to the control group (CG) who received no such additional treatment. Data was obtained via questionnaire (three measurement points) and claims data. Among other health-related outcomes, the number of sick days was examined. A 10-item subscale of the Patient Health Questionnaire (PHQ) was included to measure common psychosocial stress factors. Results The evaluation of the PHQ (summary) scores revealed a mild stress level at all three dates. Of the ten psychosocial stress factors surveyed, the highest level was reported in the IG and CG on the scale “Worrying about health”. The IG improved significantly (p = .017) compared to the CG after one year reporting decreased health worries. Further analyses carried out by analysis of variance (ANOVA) showed that health worries are significantly associated to a higher number of sick days in the IG (p = .002) and CG (p = .010). Conclusions With regard to psychosocial stressors, the participants were primarily affected by health worries. The results indicate that health concerns are the primary psychosocial stress factor associated with back pain and should be taken into account in the treatment of back pain. Key messages • A 12-month relapse prevention treatment significantly reduced the psychosocial stress experienced by people with back pain after their rehabilitation treatment. • Concerning psychosocial stress factors, the participants of both groups were primarily affected by health worries.

Oral health related cardiovascular disease risk factors: a cross-sectional study

Abstract Background Hypertension, cardiovascular disorders, and hypercholesterolemia represent significant public health concerns. This research presentation examines the impact of various oral health indicators, such as bleeding gums, untreated dental decay, loose teeth, and missing teeth, on these conditions within Hungary. Materials and methods This study utilized data from 5,603 individuals participating in the 2019 Hungarian European Health Interview Survey. Predictor variables were chosen using elastic net regularization and k-fold cross-validation to enhance the performance of weighted logistic regression models. Sensitivity analysis underpinned the robustness of the results. Results Significant associations emerged between deteriorating oral health and the prevalence of various cardiovascular conditions. An increased likelihood of hypertension was observed in individuals with multiple tooth removals, showing an odds ratio (OR) of 1.67 with a 95% confidence interval (CI) of [1.01-2.77]. The use of dental prosthetics presented an OR of 1.45 [1.20-1.75]. Additionally, presence of gum bleeding corresponded to elevated odds for both cardiovascular disease (OR = 1.69 [1.30-2.21]) and hypercholesterolemia (OR = 1.40 [1.09-1.81]). Conclusions enhancing oral health could potentially mitigate chronic cardiac conditions, highlighting the importance of integrating dental care in comprehensive disease management strategies. Key messages • Poor oral health is linked to higher hypertension and heart disease odds. • Dental care is crucial in cardiac disease prevention and management.

A Machine Learning Approach to Identifying Risk Factors for Long COVID-19

Long-term sequelae of coronavirus disease 2019 (COVID-19) infection are common and can have debilitating consequences. There is a need to understand risk factors for Long COVID-19 to give impetus to the development of targeted yet holistic clinical and public health interventions to reduce its associated healthcare and economic burden. Given the large number and variety of predictors implicated spanning health-related and sociodemographic factors, machine learning becomes a valuable tool. As such, this study aims to employ machine learning to produce an algorithm to predict Long COVID-19 risk, and thereby identify key predisposing factors. Longitudinal cohort data were sourced from the UK’s “Understanding Society: COVID-19 Study” (n = 601 participants with past symptomatic COVID-19 infection confirmed by serology testing). The random forest classification algorithm demonstrated good overall performance with 97.4% sensitivity and modest specificity (65.4%). Significant risk factors included early timing of acute COVID-19 infection in the pandemic, greater number of hours worked per week, older age and financial insecurity. Loneliness and having uncommon health conditions were associated with lower risk. Sensitivity analysis suggested that COVID-19 vaccination is also associated with lower risk, and asthma with an increased risk. The results are discussed with emphasis on evaluating the value of machine learning; potential clinical utility; and some benefits and limitations of machine learning for health science researchers given its availability in commonly used statistical software.

The Impact of a 12-Week Workplace Physical Activity Program on the Quality of Life of Sedentary Workers: A Pilot Study

Office workers frequently display behavioral patterns marked by extended periods of sedentary and seated work. In this context, the implementation of a workplace exercise program has been shown to be effective in mitigating health-related risk factors. This study aimed to evaluate the impact of a 12-week workplace exercise program on the quality of life of employees whose primary occupational duties involve prolonged sitting. The final sample comprised 19 participants (6 females and 13 males), aged between 21 and 48 years (M = 32.26; SD = 9.03). Among these participants, 78.9% reported engaging in a hybrid work arrangement, 15.8% followed an on-site work regimen, and 5.3% worked remotely. Furthermore, 84.2% of participants reported sitting for 6 to 8 h per day, while 15.8% reported sitting for between 9 and 12 h daily. The quality of life of participants was assessed using the Medical Outcomes Study 36-Item Short Form Health Survey. A paired samples t-test was employed to examine differences between dependent variables. The results revealed a statistically significant improvement in general health (p < 0.01), vitality (p < 0.01), social functioning (p < 0.05), and the mental health summary measure (p < 0.04). Promoting physical activity through workplace exercise programs offers substantial benefits for workers’ health and quality of life, contributing to the prevention of occupational diseases.

Factors Influencing Health Literacy among South Korean Adults: A Nationwide Study

Abstract Background Health literacy is crucial for health knowledge, behaviors, and outcomes, but research on health literacy has been limited to specific populations and settings in South Korea. This study aimed to identify factors influencing health literacy in a nationally representative sample of South Korean adults to inform public policies. Methods This cross-sectional study utilized data from the 2020 Korea Health Panel survey (10,262 adults aged 18-84 years). Sociodemographic factors (age, gender, education level, monthly household income, employment status, marital status, household characteristics, and region) and health (subjective health status, presence of chronic diseases, depression, and health insurance status) factors were examined. Health literacy was assessed using the 16-item European Health Literacy Survey Questionnaire (HLS-EU-Q16). Linear regression analysis was performed to identify factors associated with health literacy. Results The mean health literacy score was 9.1 (SD 1.60), with significant differences across age groups (p < 0.001). Linear regression analysis (adjusted R2=0.287, F = 322.83, P < 0.001) revealed that higher age, female gender, lower education, lower household income, being single, living outside a metropolitan area, having chronic diseases, lower subjective health, depression, and being uninsured or receiving medical aid were significantly associated with lower health literacy (all p < 0.001). Conclusions This study identified several socio-economic and health-related factors significantly associated with health literacy among South Korean adults. The findings suggest that older individuals, who may require more time to understand and use health information, are particularly vulnerable to low health literacy. These results provide valuable insights for developing targeted interventions and public health policies aimed at promoting health literacy and successful aging in the context of a rapidly aging society. Key messages • Various socio-economic and health-related factors significantly influence health literacy among South Korean adults. • Older individuals are particularly vulnerable to low health literacy, which has implications for successful aging in a rapidly aging society.

Sick-leave trajectories among people sickness absent with stress-related diagnoses; cohort studies

Abstract Background Stress-related disorders are common sickness absence (SA) diagnoses in many Western countries. Knowledge of SA and disability pension (DP) patterns among people with such SA is needed. Thus, the aim was to identify future SADP trajectories among people with a new SA spell due to stress-related diagnosis and to examine sociodemographic and health-related factors associated with identified trajectories. Methods Using microdata from nationwide registers, we included all people living in Sweden with a new SA spell >14 days due to stress-related diagnoses (ICD-10 code F43) in 2011 (N = 32,417) or 2018 (N = 65,511), respectively. These two cohorts were followed prospectively for 13 months from the SA spell start, to identify trajectory groups of mean SA/DP days/month using group-based trajectory modeling. We used multinomial logistic regression to explore associations between sociodemographic and health-related predictors and trajectory membership. Results We identified the following SA/DP trajectories in both cohorts: steep drop (30.6% and 35.9% of all included in 2018 and 2011, respectively); fluctuating (8.7%, 11.2%); fast decrease (25.5%, 24.4%); medium decrease (18.1%, 13.1%); slow decrease (10.8%, 7.3%), and constant high (6.2%, 8.0%). Compared to the steep drop trajectory, individuals in the other trajectories were more likely women, older, and had prior SA/DP or secondary outpatient healthcare visits. Starting the SA spell full-time was the strongest predictor for the slow decrease and constant high trajectory, and previous SA or diagnosis of other mental disorders were predictors of the constant fluctuating and constant high trajectory. Conclusions The similarity of the identified trajectories in the two cohorts is a strength. The results reveal the diversity of future SA/DP in this patient group, indicating the importance of identifying patients at risk of long-term SA who might need further interventions early in the process. Key messages • In two population-wide cohorts with a new sickness absence (SA) spell with stress-related diagnoses, six trajectories of SA/disability pension days were identified during the 13-month follow-up. • Most of those in the cohorts had trajectories that ended with no SA/DP after 13 months, while two trajectories, including 15-19% of individuals, showed high or varying SA/DP days during the follow-up.

Sociodemographic, work- and health-factors predict rejection of vocational rehabilitation in Finland

Abstract Background Vocational rehabilitation (VR) decreases the number of premature retirements. Pension insurance companies operate private sector employees’ VR in Finland. In 2022, some 15,500 individuals received rehabilitation in this earnings-related pension system. However, the rejection rate was 46%. Similar systems exist throughout OECD. VR facilitates finding suitable work despite an illness. A person is eligible if a threat of disability exists within the next few years and non-medical requirements are met. Currently VR is underused. Thus, it is important to understand which sociodemographic, work- and health-related factors predict a VR rejection. Methods We had full application data from a Finnish insurer for 2015-20. Our data cover roughly 40% of the 2.7M person Finnish working population. We excluded applicants with preceding VR and only included under 58-year-old applicants rejected due to ‘no risk for disability’. Our data comprised age, region of residence, salary, doctor’s assessment grades, diagnosis, industry, and data on preceding sickness, unemployment and rehabilitation benefits. For analysis, we used logistic regression. Results After adjustment, younger age and mental disorders showed largest effects on rejection. Features associated with a less severe medical condition as well as decreased employment were significantly connected to rejection. Industry and place of residence showed no effect. Of note, stable employment and higher pay predict entry possibly due to more possible rehabilitation options and better health in general. Interestingly, people with multiple diagnoses are more likely to be rejected. Conclusions The work-ability of aging European populations could benefit from vocational rehabilitation that better suits mental disorders and younger people. Key messages • Vocational rehabilitation (VR) is an underused method to maintain work ability. • Our study identified groups that could benefit from tailored solutions in VR that decrease barriers to entry.

The Norwegian Counties Public Health Survey (NCPHS)

Abstract Effective public health initiatives should be based upon a thorough understanding of important health-related factors. The purpose of The Norwegian Counties Public Health Survey (NCPHS) is to gain insights from the adult population on topics relevant for planning of public health policy, interventions, and action at the county and municipality levels. The survey includes a core questionnaire on public health-related topics such as health behaviour, subjective quality of life, distress, subjective health, social support, social capital, community contexts, and demographics, including indicators of socio-economy, with additional optional questions and scales varying across data collections. Samples are drawn from the Norwegian National Population Register. NCPHS was piloted in three counties in 2015 and in one county in 2018. After some revision of instruments and sampling procedures, surveys have been carried out in most Norwegian counties since 2019. The total number of participants has now passed 400 000. Expedient data analysis and reporting has enabled the Norwegian Institute of Public Health to present comprehensive reports within six weeks after completed data collections. In these, outcome variables are analysed against district (within counties), gender, age, educational attainment, and assessment of household economy. Tables are also made available at the municipality level. The NCPHS represent a valuable addition to existing health registries and regional health surveys, providing critical information for planning purposes for local and regional public health authorities, for assessing trends over time, comparisons across counties and regions, and for evaluation of policies and interventions. The value of such a system during times of crises was demonstrated during the COVID-19 pandemic. At the Lisbon 2024 European Public Health conference, a few selected examples of use of data from the NCPHS system will be presented. Key messages • Large-scale community surveys provide important insights for planning of public health policies and action. • Strong involvement and collaboration with regional and local public health personnell as well as with media and local people is a prerequisite for succeeding.

Person-first and identity-first disability language: Informing client centred care

BackgroundAddressing individuals with a disability can entail the use of person-first (person with a disability) or identity-first language (disabled person). However, there has been debate about use of these terms, yet there is a lack of evidence to inform preference across people with a broad range of health conditions, demographics, or health related factors. MethodsA 42-item survey measuring demographic and health condition factors, implicit and explicit preference for person-first and identity-first language use was open for completion by individuals with a self-reported health condition between July 7, 2021 and November 30, 2021. Recruitment was undertaken via posts on relevant social media sites and through community support and advocacy organisations. ResultsData analysis included responses from 875 valid surveys. Mean age of participants was 39.7 (SD: 13.7) years. There were 89 (10.2%) male, 637 female (72.8%) and 149 (17.0%) non-binary/other participants. When referring to themselves, participants most often reported use of identity first language (n = 335, 42.2%), followed by person-first language (n = 272, 34.1%), then both interchangeably (118, 23.7%). When referring to others, participants most often used person first language (n = 312, 39.4%), followed by both interchangeably (269, 34.0%), then identity-first language (n = 211, 26.6%). Disability language preference varied across health conditions, with participants with neurodevelopmental conditions most likely to use identity-first language and participants with digestive conditions most often preferencing person-first language. Participants who were younger and of non-binary gender preferred use of identity-first language. Appropriate use of identity-first language was rated significantly higher for people with a disability/health condition and family/friends than for third-party representatives, including healthcare professionals, educators, media and the general public. ConclusionFindings highlight the need to understand health condition and disability language preference in a more nuanced way to promote respectful language use when addressing people in the context of their disability/health condition.

Factors influencing sleep duration among middle-aged women in Korea: insights from the community health survey.

This study aimed to investigate the influence of demographic and health-related characteristics on sleep duration among middle-aged women aged 44-64. Utilizing raw data from the 2022 Community Health Survey, a cross-sectional analysis was conducted. The study included middle-aged women who participated in the survey, with data collected through structured interviews. χ2 tests and logistic regression analysis were employed to assess associations between sleep duration and demographic as well as health-related factors. The findings revealed that sleep duration in middle-aged women was significantly associated with multiple factors. Age (p < .001), spouse status (p = .001), occupation (p < .001), self-rated health (p = .004), perceived stress (p < .001), depression (p < .001), cognitive impairment (p = .009), unmet medical needs (p = .034), current cigarette smoking (p = .001), and binge drinking (p = .006) were all identified as important determinants of sleep duration. The results highlight the need for targeted interventions that address both health and psychological risk factors contributing to sleep disturbances among middle-aged women. An integrated approach, considering these factors, is essential to improve sleep health in this vulnerable population.

Associations of Wearable Activity Tracker Use With Physical Activity and Health Outcomes in Patients With Cancer: Findings from a Population-Based Survey Study.

Physical inactivity is a global issue for cancer survivors. Wearable activity trackers are promising to address physical inactivity by providing real-time feedback on physical activity and offering opportunities for self-monitoring and goal setting. Meta-analysis has reported the effects of interventions that incorporate wearable activity trackers on improved physical inactivity and related health outcomes (eg, BMI, anxiety and depression, and self-rated health status). However, wearable activity trackers were often used as an adjunct to physical activity interventions, and the effectiveness of wearable activity trackers alone is unknown. This study aims to determine the association of wearable activity trackers with physical activity and health outcomes in patients with cancer. Data from 957 cancer survivors from the Health Information National Trends Survey-Surveillance, Epidemiology, and End Results (HINTS-SEER) were analyzed. The outcome variables examined were time spent in moderate to vigorous physical activity, weekly frequency of strength training, BMI, anxiety and depression levels, and self-assessed health status. The primary independent variable was whether cancer survivors had used wearable activity trackers within the past 12 months. Design-based linear regression for continuous outcome variables and ordinal logistic regression for ordinal outcome variables were conducted to determine the associations after controlling for sociodemographic, cancer-related, and health-related factors. All data analyses accounted for the complex survey design and sample weights. Only 29% of cancer survivors reported wearable activity tracker use. Bivariate analyses showed that younger age (P<.001), higher education (P=.04), higher income (P<.001), and an employed status (P<.001) were significantly associated with wearable activity tracker use. Wearable activity tracker use was significantly associated with higher time spent in moderate to vigorous physical activity (adjusted =37.94, 95% CI 8.38-67.5; P=.01), more frequent strength training per week (adjusted odds ratio [OR] 1.50, 95% CI 1.09-2.06; P=.01), and better self-rated health status (adjusted OR 1.58, 95% CI 1.09-2.29; P=.01), but not with BMI or anxiety and depression. This study suggests that the uptake of wearable activity trackers is low and highlights the digital divide among patients with cancer. This study has confirmed the associations of wearable activity tracker use with physical activity and self-rated health, supporting using wearable activity trackers as a promising tool to facilitate physical activity promotion.

The Norwegian Counties Public Health Survey (NCPHS): a design study.

Effective public health initiatives should be founded on a comprehensive and robust understanding of health-related factors including societal and community contexts. The Norwegian Counties Public Health Survey (NCPHS) aims for insights into the adult population on topics relevant for planning public health practices at county and municipality levels. The NCPHS includes a core questionnaire on public health-related topics and demographics, including indicators of socio-economy, with additional optional questions and scales varying across data collections. Samples are drawn from the Norwegian National Population Register and 'washed' against the Common Contact Register to retrieve digital contact information and exclude those who cannot be contacted electronically. NCPHS was piloted in 2015 and 2018 (four counties). After some revision of instruments and sampling procedures, surveys have been carried out in most Norwegian counties since 2019. The total number of participants has now passed 400,000. Expedient data analysis has enabled the Norwegian Institute of Public Health to present comprehensive reports within 6 weeks of completed data collections. In these, outcome variables are analysed against district (within counties), gender, age, educational attainment and self-reported sufficiency of household income. Tables are also made available at the municipality level. The NCPHS represents a valuable addition to existing data sources, providing critical information for planning purposes for local and regional public health authorities, for assessing trends over time, comparisons across counties and regions and for evaluation of policies and interventions. The value of such a system during times of crisis was demonstrated during the COVID-19 pandemic.

The interaction between Indigenous identity and rural residency in dementia prevalence among Ecuadorian older adults.

While recognizing the acknowledged difference in dementia prevalence between Indigenous and non-Indigenous populations, most previous studies were conducted in the Global North. This study aims to examine the relationship between Indigenous ethnic identity and dementia status with a special focus on urban-rural differences among older adults in Ecuador. Data came from Ecuador's Survey of Health, Welfare, and Aging (SABE), derived from a probability sample of households in Ecuador. The final sample comprised 4,984 adults aged 60 or older. Dementia status was assessed through three indicators: low scores on a cognitive assessment, the number of difficulties in instrumental activities of daily living (IADL), and self-reported dementia diagnosis. Logistic regression and multivariate decomposition analyses were utilized. Indigenous participants, even after adjusting for sociodemographic and health-related factors, exhibited a higher likelihood of having dementia compared to their non-Indigenous counterparts. Among Indigenous participants, those residing in rural areas had higher likelihood of having dementia status, while there was no significant urban-rural difference observed among non-Indigenous participants. Rural residency and covariates explain 91.0% of the observed difference in dementia prevalence between Indigenous and non-Indigenous older adults. Indigenous older adults who are living in rural areas are at particularly high risk of having dementia largely because they have presently recognized modifiable risk factors. These findings underscore the urgent need to prioritize provisions of appropriate and equitable service related to dementia for Indigenous People living in rural areas outside high-income countries.

Descriptive Representation and Reproductive Health Outcomes: The Role of Women Candidates in Reducing Teen Birth Rates.

Teen birth rates remain a pressing public health issue in the United States, with significant long-term health risks for both mothers and children. Previous research has primarily focused on the impact of women in elected office on reproductive health outcomes, but less is known about the influence of women candidates. This study explores the relationship between the number of women candidates in county-level elections and county-level teen birth rates, highlighting the role of women candidates as visible role models and agents of potential policy change. We utilized a dataset covering county-level elections from 2010 to 2020, along with teen birth rate data from the CDC. We employed a multilevel model to analyze the relationship between the cumulative number of women candidates and teen birth rates, controlling for socioeconomic and health-related factors, such as insurance coverage and social vulnerability. The findings indicate that as the number of women candidates increased, the estimated county-level teen birth rate declined. This effect was observed across different election years, with more substantial impacts in midterm and presidential elections. The analysis also confirmed that socioeconomic conditions, such as a lack of health insurance, contribute to higher teen birth rates. Women candidates, even when not elected, serve as important role models and influence reproductive health outcomes in their communities. Increasing the number of women candidates at the local level may be an effective strategy for reducing teen birth rates and improving public health outcomes.

Rejected sickness cash benefit claims after 180 days of sick leave in the Swedish rehabilitation chain: A nationwide register-based study.

Since a lack of financial security among vulnerable groups could further hamper health and well-being, this study scrutinises factors predicting rejected prolonged sickness cash benefit claims among people on compensated sick leave of more than 180 days with a rejection between days 181 and 365. All 246,872 claims for employed people on sick leave recorded in the Swedish official statistics register between January 2018 and June 2021 were analysed. Claim outcome was evaluated using logistic regression with odds ratios recalculated to relative risks (RR) with 95% confidence intervals (CI), mutually adjusted for sociodemographic, work and health-related factors. Overall, 46,611 (19%) of the claims were rejected, with slightly lower rates among women (RR=0.97; 95% CI 0.95-0.99). Musculoskeletal diseases had the highest rejection rates (RR=1.84; 95% CI 1.75-1.94) followed by injuries (RR=1.57; 95% CI 1.50-1.64) and symptoms (RR=1.51; 95% CI 1.46-1.56). Mental disorders also had above-average rates (RR=1.14; 95% CI 1.09-1.19), whereas the lowest rates were found among pregnancy-related diagnoses (RR=0.13; 95% CI 0.12-0.14) and neoplasms (RR=0.18; 95% CI 0.18-0.18). Higher rates were found among immigrants (RR=1.37; 95% CI 1.34-1.40), those with only primary education (RR=1.09; 95% CI 1.06-1.12) and among blue-collar workers. The regional variation was substantial (RR range 0.41-1.72). High rejection rates were found for complex diagnoses and diagnoses with presupposed work ability in physically lighter occupations and among groups with assumed precarious positions at the labour market. Systematic differences in rates were identified between geographic regions. More studies are warranted to conclude if the differences found could be justified by other factors.

Experiencing Cerebrovascular Diseases like Stroke and Fear of Falling: Longitudinal Results from the Survey of Health, Ageing and Retirement in Europe.

Objective: The aim of this study was to clarify the link between experiencing cerebrovascular diseases (strokes as an explicit example) and fear of falling (FOF) among middle-aged and older adults in Europe. Methods: Longitudinal data were used from wave 5 to wave 7 of the representative Survey of Health, Ageing and Retirement in Europe (SHARE). Self-reported tools were used to quantify the key variables. Fear of falling was similarly assessed using a dichotomous yes or no question, "For the past six months at least, have you been bothered by any of the health conditions on this card", with fear of falling being one of the options. It was adjusted for various sociodemographic and health-related factors. In particular, to account for unobserved heterogeneity, conditional fixed effect regressions (FE) were used. Accordingly, change in an individual's FOF status over the included waves was analysed and correlated with the reported change of all the included time-varying independent variables within the same individual, including experiencing stroke or other cerebrovascular diseases. The final analytical sample equalled n = 22.071 observations. Results: Conditional logistic FE regressions showed that the onset of a stroke or other forms of cerebrovascular disease was not associated with an increased likelihood of experiencing fear of falling (OR = 1.25, p = 0.095). However, stratified by sex, such an association was present in men (OR = 1.79, p = 0.006), though not in women (OR = 0.94, p = 0.732). Conclusions: The onset of a stroke or other cerebrovascular diseases was associated with an increased likelihood of experiencing FOF in men but not women. Efforts are required to assist older men in avoiding FOF after the onset of stroke or other cerebrovascular pathologies.