Health Status Of Residents Research Articles

Impact of 2022 flood on socio-economic and health status of people residing in flood-stricken areas of Pakistan: a cross-sectional survey.

The events of extreme weather and climate-related disasters such as drought, flood, and heat waves are increasing worldwide. This paper highlights the impact of the 2022 flood in Pakistan on the socio-economic and health status of people residing in flood-stricken areas of Pakistan. A post-flood survey was conducted from three districts of Pakistan with a myriad of questions inquiring about the biopsychosocial aspects of the affected community. Data were collected through a validated questionnaire and was analyzed through SPSS software version 25. Forty percent of people became homeless; the number of individuals with a low income decreased by 9%; and the number of individuals with a moderate income decreased by 22%. Additionally, 48.7% of subjects lost their income due to flooding, 83.4% of subjects reported having some type of illness or disability since the flooding (previously 16.4%), and 92.8% believed that the floods had affected the health and sanitation of their area. Importantly, 22.6% of subjects expressed difficulty in accessing food after flooding compared to before and 59.9% of respondents noted they were unaware of proper pre-flood evacuation protocols in their area. The authors' study indicates that the floods had a significant impact on the socio-economic and health status of residents, particularly those with lower incomes depriving a large proportion of nutrition, health facilities, and property. Without access to necessities and healthcare, individuals are more vulnerable to illnesses, such as chronic respiratory disease, diabetes, and heart disease. The authors stress the importance of providing infrastructural, nutritional, and medical services support to ensure that a community such as Pakistan can recover and thrive post-environmental disaster.

Sex differences in genotype frequency and the risk of polycythemia associated with rs13419896 and rs2790859 among Tibetan highlanders living in Tsarang, Mustang, Nepal

BackgroundTibetan highlanders have adapted to hypoxic environments through genetic mechanisms that avoid hemoglobin concentration increases and prevent polycythemia. Recently, sex differences in hemoglobin dynamics with age have been reported among Tibetan highlanders living in Tsarang. Additionally, concerns have been raised that dietary changes associated with modernization may increase the risk of polycythemia and lifestyle-related diseases among Tibetan highlanders. However, the relationship between genetic polymorphisms and the risk of lifestyle-related diseases in Tibetan highlanders has been investigated in only a few regions. This study aims to elucidate whether polymorphisms in genes related to hypoxic adaptation are associated with the incidence of lifestyle-related diseases and polycythemia and whether these polymorphisms affect hemoglobin dynamics in the residents of Tsarang, Mustang, Nepal.MethodsHealth checkup data from individuals living in Tsarang in Mustang District, Nepal, collected in 2017, were used to determine the prevalence of obesity, hypertension, diabetes, hypoxemia, and polycythemia. DNA was extracted from whole-blood samples, and data for the single-nucleotide polymorphisms (SNPs) rs13419896 (EPAS1), rs12619696 (EPAS1), and rs2790859 (EGLN1) were obtained using real-time PCR. The health checkup data were statistically analyzed to determine the associations of these diseases with polymorphisms in genes related to hypoxic adaptation.ResultsA total of 168 participants, comprising 78 males and 90 females, were included in the final analysis. In terms of the prevalence of each disease, only the prevalence of polycythemia significantly differed between sexes (p < 0.01). Additionally, among the three analyzed SNPs, significant sex differences in genotype frequency were observed for rs13419896 and rs2790859. For rs2790859 in females, Tibetan highlanders with the adaptive genotype had a significantly lower incidence of polycythemia (p < 0.01) and significantly lower hemoglobin concentrations (p < 0.01).ConclusionsThis study revealed that there are sex differences in the genotype frequency of gene-related hypoxic adaptations among the residents of Tsarang. The findings also suggested that the rs2790859 polymorphism might be involved in the recent incidence of polycythemia among Tsarang residents. If the frequency of non-Tibetan genotypes increases due to intermixing with other populations in the Mustang District, polycythemia may emerge as a modern disease. It is essential to continue investigating the health status of Mustang residents to elucidate various aspects of hypoxic adaptation and disease susceptibility.

Clinicopathological Findings of 220 Pediatric, Adolescent, and Young Adult Patients with Thyroid Cancer in Fukushima Medical University Hospital.

Background: Thyroid ultrasound examinations (TUEs), conducted as part of the Fukushima Health Management Survey (FHMS), were initiated to monitor the health status of residents after the Fukushima Daiichi Nuclear Power Plant accident owing to concerns regarding the increased incidence of thyroid cancer among children, as observed after the Chernobyl Nuclear Power Plant accident. This study reported the clinicopathological characteristics of patients with thyroid cancer diagnosed through the FHMS and treated at the Fukushima Medical University Hospital. Methods: Data regarding the clinicopathological characteristics of patients with thyroid cancer were collected and evaluated in this descriptive study. Results: Among the 263 patients diagnosed with thyroid cancer as of September 2021, 220 patients with cytologically diagnosed thyroid cancer were treated as referrals from the FHMS. The median (interquartile range) age at the time of diagnosis was 18.6 (16.2-20.3) years. The median maximum tumor diameter was 13.0 (10.4-18.0) mm. To reduce surgical invasiveness, 199 patients (90.1%) underwent unilateral lobectomy. Pathological findings were suggestive of papillary thyroid carcinomas (PTC) in 216 (98.2%) patients; among them, 205 patients had PTC of the classical type. In addition, 216 (98.2%) patients had stage I disease. Cancer cell extension in the sternothyroid muscle or perithyroidal soft tissues and microscopic lymphovascular invasion were observed in 112 (50.9%) and 123 (55.9%) patients, respectively. No differences were observed between the two age groups (<18.6 years and ≥18.6 years) in terms of the clinical or pathological characteristics of thyroid cancer: risk classification (p = 0.69) and American Thyroid Association pediatric risk level (p = 0.24). Compared with those from previous reports, few surgical complications were observed. Conclusions: Patients with thyroid cancer diagnosed with TUEs underwent safe and minimally invasive operations, and careful postoperative follow-up was provided. The pathological findings of the detected thyroid cancers indicated that the majority were classical papillary carcinomas, and approximately half of the patients had extrathyroidal or lymphovascular invasion. No differences were observed between the two age groups in terms of the clinical or pathological characteristics of thyroid cancer.

Mental health status of Chinese residents and its associated factors in the aftermath of the COVID-19 pandemic: A cross-sectional study

BackgroundDuring the COVID-19 pandemic, numerous studies focused on mental health, but few considered both positive and negative aspects within the dual-factor model of psychological well-being. In China, a highly populous country, limited evidence exists regarding mental health and its associated factors following the surge and decline of COVID-19 cases after the loosening of COVID-19 control measures. This study aims to investigate the mental health status of Chinese residents in the aftermath of the pandemic and factors influencing positive and negative indicators using the System-Based Model of Stress. MethodsA cross-sectional online survey of 1,026 participants was conducted in China from March 2–31, 2023, using quota sampling. Structural equation modeling (SEM) was performed to test the conceptual model, where social support, perceived susceptibility, perceived severity, pandemic-related events, coping style, and concern about COVID-19 were considered as predictors, and psychological distress and subjective well-being as outcomes. ResultsThe results revealed high prevalence rates of psychological distress (23 %) with either of anxiety (15 %) or depression (20 %), and poor subjective well-being (23 %) among Chinese residents after the COVID-19 pandemic. Social support was negatively correlated with psychological distress, and negative coping style, pandemic-related events, and concern about COVID-19 were positively correlated with psychological distress. Moreover, social support was positively correlated with subjective well-being, and negative coping style and pandemic-related events were negatively correlated with subjective well-being. ConclusionsThese findings enhance our understanding of the differing correlates of positive and negative mental health, suggesting targeted psychological interventions for post-pandemic and future public health events.

Current Status of Occupational Health and Safety Education in Engineering Departments of Earth Sciences at Universities

In this study, Occupational Health and Safety (OHS) education in Geological Engineering, Geophysical Engineering, Mineral Processing Engineering and Mining Engineering departments, which are categorised as “earth sciences” departments, is examined. Earth sciences, which is one of the significant industries of our country, is one of the leading business lines that require expertise, experience, knowledge and constant surveillance due to the risks it contains by its nature. The reason why occupational diseases and work accidents are encountered more frequently than in other sectors is that it is a labour-intensive line of work. In adjunct to this, the truth that there is still not sufficient and necessary realisation on OHS and that the significance is not at the level it should be is is also of fundamental relevance in occurence of occupational diseases and accidents. OHS, which is a methodical and scientifically orientated set of studies carried out to protect workers and third parties from conditions that may be harmful to safety and health such as physical, chemical and psychosocial reasons during work in workplaces, has been improving since the beginning of the programme. Although OHS has increasingly become more important in our country in the last few years, there are still deficiencies in OHS education. The demand for qualified human resources in the field of OHS has a tendency to rise further with the entry into force of Law No. 6331. In Earth Sciences Engineering departments, which are in the category of high-risk occupations, a good education is required in order to shape OHS awareness in students in the right way. In this work, the present situation of OHS courses was investigated by analysing the curricula of Mining Engineering in 23 universities, Mineral Processing Engineering in 1 university, Geological Engineering in 33 universities and Geophysical Engineering in 12 universities in Turkey. On the basis of the data acquired, solution suggestions for the improvement of OHS education are presented.

Multivariate analysis of psychological health among hospital infection prevention and control practitioners in Tianjin

Objective: To understand the occupational stress and mental health status of hospital infection prevention and control practitioner (HIPCPs) in medical institutions, and analyze their main influencing factors. Methods: In November 2021, 550 nosocomial infection managers in Tianjin were randomly selected to conduct a questionnaire survey using the Concise Occupational Stress Questionnaire, Depression Screening Scale (PHQ-9) and Self-Rating Anxiety Scale (SAS). 497 valid questionnaires were obtained, and the total recovery efficiency was 90.36%. Single factor analysis and multivariate logistic regression method were used to analyze the main influencing factors of occupational stress and mental health status of psychiatric managers. Results: The detection rate of anxiety and depression among 497 HIPCPs was 22.73% (113/497) and 58.95% (293/497), respectively. Gender and major were the influencing factors of depression (P=0.000, 0.001). Average working hours>52 hours per week and night shift days>1 days per week were the influencing factors of anxiety (P=0.035, 0.014). Average working hours>52 h per week, night shift days >1 d per week and different majors were the influencing factors of occupational stress (P=0.000, 0.025, 0.010). Multivariate logistic regression results showed that the risk of anxiety in those who worked more than 52 hours per week was 1.753 times that of those who worked less than 52 hours per week (P=0.038), and the risk of depression in women was 3.071 times that of men (P=0.006) . Conclusion: Working hours are an important influencing factor for occupational stress and anxiety among HIPCPs. In order to reduce the occurrence of occupational stress and mental health problems, it is necessary to strengthen psychological counseling for HIPCPs and balance work and rest.

Implication of heavy metal(loid)s contamination for human health and preliminary application of water treatment in floodplain area along Mekong River, Lao PDR

Groundwater is widely used for domestic purposes, especially as a reliable source of drinking water in rural areas of the Lao People’s Democratic Republic (Lao PDR). This preliminary study aims to examine heavy metal(loid)s contamination leading to human health risks while also focusing on a method that can improve drinking water quality in floodplain areas along the Mekong River in Lao PDR. Groundwater and surface water samples were collected during the monsoon season in 2022 in Attapeu and Champasak provinces. Heavy metal(loid)s concentrations and human health risks were investigated using inductively coupled plasma mass spectrometry (ICP-MS) and the USEPA method, respectively. A nanofiltration membrane technique was introduced to optimize the quality of groundwater. Results showed that groundwater quality was significantly poor (p < 0.05), particularly in Attapeu province, with high levels of electrical conductivity, total dissolved solids, and manganese, exceeding WHO standards of 400 µS cm−1, 300 mg L−1, and 80 µg L−1, respectively. With the groundwater ingestion pathway, children were found to be more vulnerable to non-carcinogenic risk than adults (Hazard Quotient, Hazard Index >1), but adults had a higher carcinogenic risk (Incremental Lifetime Cancer Risk >1E-04). The removal of fecal bacteria and heavy metal(loid)s was achieved using the nanofiltration membrane, demonstrating its potential as a practical point-of-use technology to provide cleaner water sources and enhance the health status of Lao residents.

What exacerbates and what eases Chinese rural residents’ depression during the COVID-19?

During the COVID-19 pandemic, there has been a growing prevalence of mental disorders, particularly in China, where anti-epidemic measures have been more stringent compared to other countries. This has resulted in a heightened psychological burden on individuals. However, the actual psychological impacts of COVID-19 on Chinese residents have not been clearly established. In this study, we aimed to investigate the effects of various factors, including personal and household characteristics, social networks, and epidemic-related variables (such as rural residents' knowledge of COVID-19 virus transmission and prevention), on rural residents' depression. Using a two-year balanced panel dataset encompassing 152 villages and 676 samples in both 2019 and 2020, we employed the Ordinary Least Squares (OLS) model to estimate the influence of these factors and compare their coefficients to examine the changes in rural residents' depression between the pre-epidemic and during-epidemic periods. Our study highlights significant factors contributing to rural residents' depression during the COVID-19 pandemic, including isolation (2.063, p < 0.01) and concern about COVID-19 infection (0.128, p < 0.05). Conversely, factors such as health status (−0.714, p < 0.01) and the number of friends (−0.017, p < 0.01) were found to significantly alleviate depression among rural residents. Moreover, we identify key moderators that mitigate the negative impact of infection concerns on mental health. Specifically, the health status of rural residents (−0.166, p < 0.01), the size of their family network (−0.036, p < 0.05), and their knowledge of COVID-19 transmission and prevention (−0.184, p < 0.05) significantly moderated the relationship between infection concerns and depression. These findings contribute to a better understanding of the psychological implications of the pandemic and provide valuable insights for the development of targeted interventions to address mental health challenges in rural populations.

Clinically estimated signs of hyposalivation in older adult residents of long-term care.

To assess whether the estimation of clinical signs of hyposalivation is applicable in recognising long-term care facility (LTCF) residents with poor oral health, and which individual characteristics are important in that respect. A common inconvenience among older adults, dry mouth, particularly hyposalivation, can cause many complications, such as greater susceptibility to root caries and oral infections, and it can lead to further deterioration of oral health. However, very little is known about the association of clinically assessed signs of hyposalivation with the oral health status of LTCF residents. The study sample comprised 362 individuals (dentate n = 266, edentate n = 96) aged 65 or older. The examinations included a questionnaire and clinical oral examination. Participants were categorised into three groups based on clinically assessed oral dryness: normal salivation (n = 83, 22.9%), lower salivation (n = 182, 50.3%) and dry mouth (n = 97, 26.8%). The association between signs of dry mouth with aspects to oral health was evaluated and further tested with logistic regression analysis. The signs of oral dryness were observed among females, those with dementia, and those with longer stays in the current facility. Root caries (odds ratio, OR 1.3) and diagnosis of periodontitis (OR 4.1), together with several individual periodontal parameters, as well as having less than ten occluding pairs of natural teeth (OR 3.5) were associated with dry mouth. Edentate participants showed an increased likelihood of having dry mouth with advancing age, and lesions on the lips were associated with dry mouth with OR 3.0. Clinical estimation of signs of oral dryness can be a useful adjunct in evaluating the oral health status of dentate LTCF residents. Poor oral health was a frequent finding, especially among dentate LTCF residents with signs of dry mouth.

Assessment of Occupational Hazards and Health Status (Respiratory and Non-respiratory) Among Sawmillers in Akure Metropolis, Nigeria

Background: Sawmilling exposed workers to diverse occupational mishaps and subsequent health complications. Investigating workplace risk and health status can help mitigate morbidness and death among this group. Objectives: This study aimed to evaluate the occupational hazards and health status of sawmill workers in Akure, Nigeria. Methods: This cross-sectional descriptive survey was conducted on 304 sawmill workers in Akure metropolis selected via multi-stage sampling methodology. Data were collected using a pre-tested, standardized questionnaire. In addition, the body mass index (BMI), blood pressure (mmHg), and respiratory function parameters (spirometry) were measured. Descriptive and inferential statistics (chi-square) were used to evaluate and summarize the data, with a significance level of P &lt; 0.05. Results: The respondents' average age was 42.0 ± 2.8 years. The common reported workplace hazards included noise 273 (89.8%), manual lifting of objects 221 (72.7%), heat 192 (63.2%), and wood dust 192 (63.2%), while common reported injuries were bruises 292 (96.1%), hearing impairment 281 (92.4%), electric shock 250 (82.2%), and fainting attack 232 (76.3%). The common prevalent ailments suffered by respondents in the last month were cough 158 (52.0%), phlegm production 149 (49.0%), chest pain 63 (20.7%), skin problems 100 (32.9%), and eyes irritation 111 (36.5%). The anthropometric measurement showed that most 272 (89.5%) sawmill workers are overweight and obese. Spirometry measurements revealed that one-third of the respondents had a forced expiratory ratio (FER) measurement below 70.00% and an abnormal respiratory rate. The bivariate analysis showed a significant correlation between the respondents' self-reported prior workplace injury, knowledge of workplace dangers, and sociodemographic characteristics (job category and educational level). Conclusions: The results showed that the respondents suffered from impaired respiratory function related to workplace hazard exposure and the non-usage of protective devices during operational activities. In addition, the majority are at risk of developing diverse cardiovascular and respiratory diseases due to workplace exposures.

Pemeriksaan Tekanan Darah, Golongan Darah, Kadar Hemoglobin untuk Mengetahui Kelayakan Donor Darah

Blood donation is the process of distributing blood which is a humanitarian activity. Prospective donors must first undergo a health examination and medical consultation to determine their suitability for blood donation. The aim of this Community Service is to determine the frequency distribution of blood pressure, blood type, hemoglobin levels and the health conditions of residents in Tlogosari Wetan Village, Pedurungan District, Semarang City. Community service activities are carried out through several stages namely the planning, implementation and evaluation stages. At the planning stage, the target audience is determined. The implementation stage is carried out with a flow starting from a blood type examination, hemoglobin examination, body weight and blood pressure measurements. The evaluation stage is carried out after processing data from all examination results to determine the suitability of blood donation. The result is that the majority of residents in Tlogosari Wetan Village, Pedurungan District, Semarang City have blood type O is 29 (58%) people, abnormal hemoglobin levels is 28 (56%) people, appropriate body weight is 45 (90%) people, normal blood pressure is 27 (54%) people, not feasible for blood donation is 35 (70%) people. In the upcoming Community Service activities, it is hoped that blood donation activities can be carried out for community members who meet the requirements as blood donation in order to increase the interest and experience of people who have never donated blood.

Oral Health Status and Treatment Needs Based on Artificial Intelligence (AI) Dental Panoramic Radiograph (DPR) Analysis: A Cross-Sectional Study.

Background: The application of artificial intelligence (AI) is gaining popularity in modern dentistry. AI has been successfully used to interpret dental panoramic radiographs (DPRs) and quickly screen large groups of patients. This cross-sectional study aimed to perform a population-based assessment of the oral health status and treatment needs of the residents of Kielce, Poland, and the surrounding area based on DPR analysis performed by a high-accuracy AI algorithm trained with over 250,000 radiographs. Methods: This study included adults who had a panoramic radiograph performed, regardless of indications. The following diagnoses were used for analysis: (1) dental caries, (2) missing tooth, (3) dental filling, (4) root canal filling, (5) endodontic lesion, (6) implant, (7) implant abutment crown, (8) pontic crown, (9) dental abutment crown, and (10) sound tooth. The study sample included 980 subjects. Results: The patients had an average of 15 sound teeth, with the domination of the lower dental arch over the upper one. The most commonly identified pathology was dental caries, which affected 99% of participants. A total of 67% of patients underwent root canal treatment. Every fifth endodontically treated tooth presented a periapical lesion. Of study group members, 82% lost at least one tooth. Pontics were identified more often (9%) than implants (2%) in replacing missing teeth. Conclusions: DPR assessment by AI has proven to be an efficient method for population analysis. Despite recent improvements in the oral health status of Polish residents, its level is still unsatisfactory and suggests the need to improve oral health. However, due to some limitations of this study, the results should be interpreted with caution.

Knowledge, attitudes, and practices associated with influenza vaccine uptake among healthcare personnel in Israel during three influenza seasons, 2016–2019

IntroductionDespite a longstanding Israel Ministry of Health recommendation that all healthcare personnel (HCP) receive a seasonal influenza vaccine, vaccine uptake among HCP remains below the country’s target of 60% coverage. To understand factors related to vaccine hesitancy, we used data from a prospective three-year (2016–2019) influenza vaccine effectiveness study among Israeli HCP to examine knowledge, attitudes, and practices (KAP) about influenza vaccination and their association with vaccine uptake. MethodsAt the start of each influenza season, all participating HCP completed a questionnaire that included questions about socio-demographic and occupational characteristics, health status, and KAP related to seasonal influenza vaccination. We extracted vaccination history from electronic medical records and employee vaccination registries. We used logistic regression models to identify demographic and occupational factors, and KAP about influenza vaccination, associated with receipt of vaccination. ResultA total of 2,126 HCP were enrolled and had available data on vaccination history. Their median age was 42 years [IQR 35–52], and 73 % self-identified as female. Influenza vaccine uptake in 2016, 2017 and 2018 was 46 %, 48 % and 47 %, respectively. Overall, 36 % of HCP had received an influenza vaccine in ≥ 4 of the eight years prior. HCP aged 35–49 years were less likely to receive influenza vaccine compared to HCP aged ≥ 50 years (OR: 0.81 [95 % CI: 0.67–0.98]). Nurses and allied personnel were less likely to receive influenza vaccine compared to physicians (OR: 0.63 [95 % CI: 0.50–0.78] and OR: 0.53 [95 % CI: 0.40–0.70], respectively). The emotional benefit of vaccination (e.g., anticipating regret if not vaccinated) and the perception of vaccine safety were factors associated with vaccine uptake (OR: 7.60 [95 % CI: 6.27–9.22] and OR: 3.43 [95 % CI:2.91–4.03], respectively). ConclusionAmong HCP at two hospitals in Israel, less than half received an annual influenza vaccine. Older HCP, physicians, and those who reported the emotional benefit of vaccination or agreed that influenza vaccines are safe were more likely to be vaccinated. Future influenza vaccination campaigns could focus on these demographic groups and tailor messages emphasizing the emotional benefits of vaccination and vaccine safety to increase seasonal influenza vaccine uptake among HCP in Israel.

Findings of a Community Health Needs Assessment Survey in Al Najaf Governorate Iraq: A Snapshot of Al Marashda's Health Status.

Community health assessment (CHA) is a well-known method for identifying and analyzing community health needs. This CHA survey aimed to identify and analyze community health needs and assets to prioritize these needs and to plan and act upon significant unmet community health needs. The CHA was planned based on the suggested standard of the North Carolina Guide including eight phases from July to December 2023. The CHA survey was performed among Al-Marashda region residents in the Al-Manathera district. The sample size of our study was 184 interviews of 12536 population. The primary data, which included demographic information, quality of life statements, and community improvement, were collected from the community using a questionnaire through opinion surveys and focus groups, while the secondary data which included the social, health, and economic status of Al-Marashda region residents were obtained from district and governorate sources. Analysis of whole data sources allowed 10 areas of community concern to be identified. Findings from the CHA survey showed that diabetes and high blood pressure, poverty and unemployment, and air pollution were the most common public health problems as priorities. The high-priority problems of Al-Marashda are in common with the noncommunicable diseases (NCDs) priority in Al Najaf. However, poverty and air pollution are specific to the Al-Marashda region. Public health authorities and the city governorate are advised to consider, support, and develop community diagnosis documents to implement appropriate interventions.

Mental COP: Mental Health Cohort Of Police officers in Korea

PurposeThis cohort study addresses the need for comprehensive and longitudinal research on police officers’ mental health, focusing on the relationship between occupational factors, individual characteristics and mental health status or...

Medical insurance benefits and health inequality: evidence from rural China.

Alleviating health inequality among different income groups has become a significant policy goal in China to promote common prosperity. Based on the data from the China Health and Retirement Longitudinal Study (CHARLS) covering the period from 2013 to 2018, this study empirically examines the impact of Integrated Medical Insurance System (URRBMI) on the health and health inequality of older adult rural residents. The following conclusions are drawn: First, URRBMI have elevated the level of medical security, reduced the frailty index of rural residents, and improved the health status of rural residents. Second, China exhibits "pro-rich" health inequality, and URRBMI exacerbates health inequality among rural residents with different incomes. This result remains robust when replacing the frailty index with different health modules. Third, the analysis of influencing mechanisms indicates that the URRBMI exacerbate inequality in the utilization of medical services among rural residents, resulting in a phenomenon of "subsidizing the rich by the poor" and intensifying health inequality. Fourth, in terms of heterogeneity, URRBMI have significantly widened health inequality among the older adult and in regions with a higher proportion of multiple-tiered medical insurance schemes. Finally, it is suggested that China consider establishing a medical financing and benefit assurance system that is related to income and age and separately construct a unified public medical insurance system for the older adult population.

Spatial difference analysis of water and sanitation in China's counties based on a spatial econometric model

Access to safe drinking water and sanitation are preconditions for achieving the Sustainable Development Goals, which is beneficial to promote new urbanization construction accurately. However, the urbanization rate is still less than 25%. Comprehensive governance capacity and carrying capacity are still relatively weak. This study seeks to increase knowledge of spatial differences in water and sanitation in China's counties, which can reveal the living environment and health conditions of residents in different areas. Furthermore, studying the spatial distribution of water and sanitation facilities in different counties can help understand the development differences between urban and rural areas and narrow the gap between urban and rural. Therefore, four indicators of water supply, sewage disposal, garbage disposal, and public toilets as proxy indicators of water and sanitation were selected, and Moran's I was used to test the spatial correlation between county-level sanitation and economic conditions, government fiscal behavior, and social and geographical factors. This study exploited the inverse distance spatial weight matrix to implement the spatial spillover effect of water and sanitation according to the division of the east, middle, and west and four aspects of water supply, sewage disposal, garbage disposal, and public toilets in terms of per capita occupancy. We observed that there was no significant correlation between population density and county-level water, sanitation, and hygiene enhancement. Economic growth can promote the improvement of water and sanitation to a certain extent. The comparison results indicated that the level of urbanization and education had a positive spatial spillover effect on water and sanitation. The water and sanitation of the demonstration county was characterized by siphon, which occupied the water and sanitation development space of neighboring counties. The results of this study are of great significance to improve county-level water and sanitation facilities and narrow the gap between urban and rural.

Association between US Residents’ Health Behavior and Good Health Status at the City Level

ABSTRACT Introduction Poor health behaviors, such as physical inactivity, exacerbate the overall health status of residents. Evidence regarding the impact of personal health behaviors on health status at the city level is lacking. Thus, we aimed to examine the association between health behaviors and good health status of residents of large US cities. Methods Our panel study used 2018 to 2022 American Fitness Index® data measured annually for the 100 most populous US cities. The study outcome was good health status of city residents, and exposures were their health behaviors—exercising, meeting aerobic activity guidelines, meeting both aerobic and strength activity guidelines, bicycling or walking to work, using public transportation to work, consuming two or more fruits or three or more vegetables per day, sleeping 7+ h·d−1, and current smoking habits. We adopted crude and multivariable-adjusted linear mixed and general linear models for our analyses. Results Mean values of the majority of health behavior factors were under 50% between 2018 and 2022. Higher percentages of city residents exercising, meeting aerobic activity guidelines, meeting both aerobic and strength activity guidelines, bicycling/walking to work, and consuming three or more vegetables or two or more fruits per day and lower percentage of residents who currently smoke were associated with higher percentages of good health status. Baseline percentages meeting aerobic activity guidelines, meeting both aerobic and strength activity guidelines, using public transportation, consuming two or more fruits per day, and sleeping 7+ h·d−1 and lower percentage of residents who currently smoke were also significantly associated with change in percentage of residents with good health status over time. Conclusion Our study shows room for improvement in health behaviors in all cities. The findings of our study also suggest that all health behaviors measured were associated with the general health status of residents of the most populous US cities.

Association between Built Environment Policy and Good Health Status

ABSTRACT Introduction/Purpose Access to a high-quality built environment may help improve resident health status. However, city-level evidence regarding the health benefits of community assets is lacking. Thus, we aimed to examine the association between environmental indicators of cities and health statuses of residents. Methods This panel study used the American Fitness Index® data reported annually between 2018 and 2022 for the 100 most populous US cities. The study outcome was self-reported good health status of residents, and exposures were environmental factors: parks per 10,000 residents, percentage of walking distance parks, Walk Score®, air quality index, Bike Score®, Complete Streets policy, park expenditure per resident, and physical education requirement. We applied crude and multivariable-adjusted linear mixed and general models in our analyses. Results Among the 100 largest US cities, 84 increased in percentage of good health status from 2018 to 2022, but the increase was at most 13.1%. Furthermore, the maximum percentage with good health status was only between 60% and 70% in most fit cities, and the gap in good health status between most and least fit cities was approximately 40%. Good health status of residents was significantly (in the positive direction) associated with walking distance parks, Walk Score®, Bike Score®, and Complete Streets policy. The baseline percentage for walking distance parks, Walk Score®, and Complete Streets policy were each significantly associated with higher percentages of good health status of residents over the follow-up period. Conclusion Our study shows room for improvement in environments in all cities. Findings furthermore suggest that environmental factors, such as availability of parks within walking distance, walkability, bikeability, and Complete Streets policy, have the potential to impact the general health status of residents of the largest US cities.

Intrarelationships between suboptimal health status and anxiety symptoms: A network analysis

BackgroundSuboptimal health status is a global public health concern of worldwide academic interest, which is an intermediate health status between health and illness. The purpose of the survey is to investigate the relationship between anxiety statuses and suboptimal health status and to identify the central symptoms and bridge symptoms. MethodsThis study recruited 26,010 participants aged <60 from a cross-sectional study in China in 2022. General Anxiety Disorder-7 (GAD-7) and suboptimal health status short form (SHSQ-9) were used to quantify the levels of anxiety and suboptimal health symptoms, respectively. The network analysis method by the R program was used to judge the central and bridge symptoms. The Network Comparison Test (NCT) was used to investigate the network differences by gender, place of residence, and age in the population. ResultsIn this survey, the prevalence of anxiety symptoms, SHS, and comorbidities was 50.7 %, 54.8 %, and 38.5 %, respectively. “Decreased responsiveness”, “Shortness of breath”, “Uncontrollable worry” were the nodes with the highest expected influence. “Irritable”, “Exhausted” were the two symptom nodes with the highest expected bridge influence in the network. There were significant differences in network structure among different subgroup networks. LimitationsUnable to study the causal relationship and dynamic changes among variables. Anxiety and sub-health were self-rated and may be limited by memory bias. ConclusionsInterventions targeting central symptoms and bridge nodes may be expected to improve suboptimal health status and anxiety in Chinese residents. Researchers can build symptom networks for different populations to capture symptom relationships.