Ongoing Health Research Articles

Mental health disparities among sexual and gender minority students in higher education

Objective: There has been an ongoing mental health crisis among sexual and gender minority (SGM) populations. This continues amidst rising population-level depression and suicide rates, especially among students in higher education. This work aims to understand changes in SGM student mental health over time. Participants: N = 483,574 responses to the Healthy Minds Study (2007C2022) were examined from 18 to 35-year-old U.S. college and university students. Methods: Linear and logistic regressions were used to examine associations between SGM identity and mental health. Mediation and structural equation modeling were used to examine potential links among risk factors. Results: On average, ∼18% of students identified as SGM, which included a 6-fold increase in SGM self-identification across this 15-year period. Depression rates increased over time; ∼12% of students reported major depression. SGM students were 3.18 times (z = 111.16, p < .001) more likely to report depression than non-SGM students (26.85% vs. 8.53%). Disproportionate discrimination and lack of school belonging partially explained SGM disparities in depression. SGM students were twice as likely to utilize therapy (z = 115.42, p < .001) but half as likely seek help from family (z = 55.48, p ≤ .001). Conclusions: Academic institutions must take concrete steps to reduce barriers mental health care, combat discrimination, and bolster community belonging and interpersonal support for SGM students.

Bringing Trust Building to Life Within Health Policy-Making Comment on "Placing Trust at the Heart of Health Policy and Systems"

Public trust is crucial for health policy-making as it is closely linked to public participation and policy-makers’ legitimacy. While we have witnessed increasing interest in issues of public trust, especially since COVID-19, we argue that efforts should be made to deeply integrate the concept of public trust into health policy-making from the design to the implementation, assessment, and evaluation processes across the public health and medical domains. We propose four key aspects to consider for building public trust in the healthcare system, which have emerged from our past and ongoing health policy research on public trust: to understand trust before aiming to build trust; to provide tailored guidance on trust building in health policy; to develop trust performance indicators to assess trust interventions; and to implement targeted communication strategies.

A stress-coping analysis of ‘stranded’ Australians seeking repatriation during the COVID-19 pandemic

ABSTRACT Objective The COVID-19 pandemic declared in early 2020 led to the closure of Australia’s international borders and the stranding of thousands of Australians overseas. We surveyed “stranded” Australians pre- and post-repatriation to evaluate their stress-coping responses at the time and the longer-term impacts of their experience. Method Stranded Australians (n = 587; 18–70 years of age; M = 40.15, SD = 11.90) completed a survey measuring COVID-19 impact, stressor appraisal and coping strategy, and psychological adjustment, and 203 of them completed a follow-up survey of psychological adjustment and posttraumatic stress disorder (PTSD) symptoms post-repatriation. Results Path analysis showed that “primary” appraisals of the repatriation situation (i.e. as a threat or challenge) were positively associated with negative affect, use of avoidant coping, and poorer psychological adjustment. Although the follow-up survey revealed improvements in psychological adjustment, initial use of avoidant coping was associated with higher levels of PTSD post-repatriation. Conclusion Primary appraisals and avoidant coping were associated with poorer psychological adjustment and longer-term PTSD symptomatology. The results highlight the need for ongoing mental health support for repatriated Australians and call for higher prioritisation of practical and mental health support in the event of future border closures.

A longitudinal health promotion program for autistic children and their caregivers: Impact of an urban community-based program.

Autistic children, as well as their primary caregivers (e.g., parents), experience greater health disparities when compared with the general population. Despite this reality, there has been relatively little priority placed on promoting positive trajectories of health in either of these underserved populations. The primary purpose of this study was to examine the impact of participation in a 12-month, longitudinal health promotion program designed for both autistic children and their parent. A total of 27 families participated in the intervention, including 29 autistic children (83% male, M = 8.28 ± 3.60 years) and 27 parents (93% female, M = 40.04 ± 7.95). Families attended in-person health promotion programming for 90 min per week. Children and parents were evaluated at four time points across the program, including baseline (0-months), 4-months, 8-months, and 12-months. Children were measured on fundamental motor competence, physical fitness, body composition, and proxy-reported physical activity. Parents were measured on body composition, physical fitness, and self-reported physical activity. Significant improvements were observed for autistic children in motor competence (p < 0.001) and grip strength (p = 0.006), and for parents in body mass index (p = 0.004) and aerobic capacity (p = 0.003) across the 12-month intervention. Differing trajectories of improvement were noted between urban- and suburban-dwelling families on multiple outcomes. The knowledge acquired from this research may offer initial support for the need to bolster opportunities for accessible and ongoing health promotion programs for both autistic children and their parents.

Assessing the Utility of Prediction Scores PAINT, ISARIC4C, CHIS, and COVID-GRAM at Admission and Seven Days after Symptom Onset for COVID-19 Mortality.

The COVID-19 pandemic underscores the need for accurate prognostic tools to predict patient outcomes. This study evaluates the effectiveness of four prominent COVID-19 prediction scores-PAINT, ISARIC4C, CHIS, and COVID-GRAM-at two critical time points: at admission and seven days post-symptom onset, to assess their utility in predicting mortality among hospitalized patients. Conducted at the Clinical Emergency Hospital Pius Brînzeu in Timișoara, this retrospective analysis included adult patients hospitalized with confirmed SARS-CoV-2 infection. Eligible patients had complete data for the scores at both time points. Statistical analysis involved ROC curves and logistic regression to assess the scores' predictive accuracy for mortality. The study included 215 patients, split into 139 survivors and 76 non-survivors. At admission, the PAINT, ISARIC4C, CHIS, and COVID-GRAM scores significantly differentiated between the survival outcomes (p < 0.0001). The best cutoff values at admission were 6.26 for PAINT, 7.95 for ISARIC4C, 5.58 for CHIS, and 0.63 for COVID-GRAM, corresponding to sensitivities of 85.47%, 80.56%, 88.89%, and 83.33% and specificities of 77.34%, 82.12%, 75.01%, and 78.45%, respectively. By day seven, the cutoff values increased, indicating deteriorating conditions in patients who eventually succumbed to the virus. The hazard ratios at admission for exceeding these cutoffs were significant: PAINT (HR = 3.45), ISARIC4C (HR = 2.89), CHIS (HR = 4.02), and COVID-GRAM (HR = 3.15), highlighting the scores' abilities to predict severe outcomes. One week post symptom onset, these scores' predictive values and corresponding hazard ratios increased, further validating their prognostic significance over time. The evaluated COVID-19 prediction scores robustly predict mortality at admission and become more predictive by the seventh day of symptom onset. These findings support the use of these scores in clinical settings to facilitate early identification and intervention for high-risk patients, potentially improving patient outcomes during the ongoing global health crisis.

Functioning School Leadership During COVID-19

The current global pandemic has created an extraordinary and unprecedented opportunity for educational authorities to initiate significant reforms in the operating protocols of schools as a necessary response to the challenges posed by the COVID-19 crisis. The abrupt shift from traditional, in-person classroom instruction to remote and online learning environments has highlighted the need for swift action and thorough preparedness, requiring educational systems to adapt rapidly to new teaching methods and technologies. The long-lasting impact of the COVID-19 pandemic has introduced additional challenges for school leadership, emphasizing the urgent need for change and adaptation during this ongoing global health emergency. The critical role of academic leadership has become increasingly important, as leaders are now tasked with addressing complex issues and ensuring that education continues to be delivered effectively despite the disruptions caused by the pandemic. This study conducts a comprehensive analysis of the current literature on the effects of school leadership during the COVID-19 pandemic. It aims to identify significant trends, advancements, and insights regarding academic leadership practices and their impact on school communities during the pandemic. Practical guidelines and views are offered for immediate use and future research areas.

Establishing Australia’s national linked COVID Register

Objective and ApproachThe Australian Institute of Health and Welfare (AIHW) is an independent statutory Australian Government agency tasked with collating health data across federal and state/territory governments, and is accredited to provide complex integration, de-identification and secure access to linked data. To support research into the COVID pandemic, the AIHW has created a national-level COVID Register, which integrates COVID case data from infectious disease registers, and data from hospitals and intensive care, immunisation, deaths, health system usage data, aged care and disability support. ResultsData were probabilistically linked using the AIHW’s linkage spine, matching names, addresses, date of birth and sex. The AIHW data linkage protocols are based on the Five Safes framework which reinforce management of the privacy and confidentiality of data. Linkage rates for COVID cases across participating jurisdictions generally exceeded 95%. Ongoing work aims to increase the coverage of COVID cases, both in time and to include case data from one remaining jurisdiction. ConclusionsLinking disparate datasets from multiple sources has created a critical resource for exploring COVID and patient journeys in Australia. Currently, the Register supports projects to estimate expenditure associated with COVID, describe the impact of COVID for subgroups such as people living rural and remote areas, or those with dementia. ImplicationsUltimately, the Register will be integrated into the National Health Data Hub to enable ongoing health research and analysis through enduring national linked health data. The value of the Register extends beyond COVID and into other infectious diseases and chronic conditions.

Persisting social disadvantage and intercensal social mobility in Northern Ireland: an examination of morbidity and all-cause mortality using three waves of the Northern Ireland Longitudinal Study (NILS).

Objective and ApproachUsing census returns from three waves of NILS (1991, 2001, 2011) linked with mortality data, we examined morbidity/mortality outcomes by socio-economic disadvantage over time (using an individual-level deprivation index derived from educational attainment, social class, housing tenure and household car availability at each census). These were combined to generate two indicators of Intercensal social mobility: measuring no change, and upward/downward mobility between censuses. The relationship between mobility (2001-2011) and (separately) self-reported mental ill-health (MIH) at the 2011 Census and all-cause mortality (2011-2015) were examined using logistic regression and Cox PH modelling respectively. Results Population comprised 288,262 individuals aged 25-74 in 2011, recording 19,318 deaths (2011-2015) and 23,959 (8.3%) reporting MIH. MIH: those with no intercensal mobility followed the standard pathway associated with persisting disadvantage (comparing with the most advantaged the least advantaged recorded OR=16.13:95%CI=13.50,19.28); and while both the upwardly and downwardly mobile generally recorded higher ORs than those consistently most advantaged, the magnitude of ORs increased with social distance traversed; and ORs for downward mobility were consistently higher than with upward mobility. Patterns associated with all-cause mortality were similar. ConclusionsThis suggests: upward mobility retains something of the social patterning pertaining in social disadvantage levels left behind; downward mobility may be connected to ongoing health issues. Poor health outcomes remain strongly associated with socio-economic circumstance. Implications Research focusing on relationship between social mobility, disadvantage and health outcomes in NI is limited: access to more precise administrative data will enhance possibilities associated with evidence-based policy formation.

Staff Perceptions of Mental Health Relapse Prevention Support in a Specialist Mental Health Service in an Intellectual Disability Setting

ABSTRACTBackgroundThe present study investigated staff perspectives on supporting individuals with intellectual disabilities with mental health relapse prevention.MethodsEight staff with experience working with or supporting individuals engaged with a specialist mental health in intellectual disability (MHID) service (team member = 2, management roles = 2, nursing/social care = 4; average years' experience = 16 years, SD = 13.7) completed semi‐structured interviews and thematic analysis was conducted on the resulting data.FindingsParticipants held mostly positive views of MHID supports and described being actively involved in individualised and person‐centred mental health supports. There was variation in awareness and recognition of relapse prevention between MHID and other (frontline) staff. Although frontline staff generally did not express explicit knowledge of relapse prevention, there was implicit staff awareness surrounding ongoing mental health supports, managing risk and coping strategies. Frontline staff also reported a lack of knowledge of the discharge process from the MHID service. Staff questioned the nature of discharge in mental health intellectual disability supports.ConclusionThis study identifies a gap in frontline staff's explicit knowledge of mental health relapse prevention, while also highlighting the importance of ongoing mental health support for individuals with intellectual disabilities.

Rational selection of TbpB variants elucidates a bivalent vaccine formulation with broad spectrum coverage against Neisseria gonorrhoeae.

Neisseria gonorrhoeae is the causative agent of gonorrhea, an on-going public health problem due in part to the lack of success with efforts to develop an efficacious vaccine to prevent this sexually transmitted infection. An attractive candidate vaccine antigen because of its essential function and surface exposure, the gonococcal transferrin binding protein B (TbpB) exhibits high levels of antigenic variability which poses a significant obstacle in evoking a broadly protective vaccine composition. Here, we utilize phylogenetic information to rationally select TbpB variants for inclusion into a potential gonococcal vaccine and identify two TbpB variants that when formulated together elicit a highly cross-reactive antibody response in both rabbits and mice against a diverse panel of TbpB variants and clinically relevant gonococcal strains. Further, this formulation performed well in experimental proxies of real-world usage, including eliciting bactericidal activity against 8 diverse gonococcal strains and decreasing the median duration of colonization after vaginal infection in female mice by two heterologous strains of N. gonorrhoeae . Together, these data support the use of a combination of TbpB variants for a broadly protective gonococcal vaccine.

Ethnic Identification and Stress: Examining HPA Axis Reactivity in Response to a Discrimination Related Laboratory Stressor

Through processes of colonization, American Indians and Alaskan Natives (AI/AN) have faced continuous, ongoing efforts to diminish their unique ethnic identities. Maintaining a robust ethnic identity may shield against harms related to colonization, such as ethnic discrimination. Ethnic discrimination is a psychosocial stressor with implications for the reactivity of our main stress axis, the hypothalamic-pituitary-adrenal (HPA) axis. However, whether ethnic identification buffers against ethnic discrimination remains unclear. The current study examined the stress-buffering effects of two facets of ethnic identification – exploration and commitment – on HPA reactivity in 303 urban-dwelling AI/AN using samples of salivary cortisol collected throughout a discrimination-based stressor task. Building on the rejection-identification hypothesis and other related theories, we hypothesized that ethnic identity exploration will predict greater HPA axis reactivity and commitment will predict lesser HPA axis reactivity. Findings revealed that exploration and commitment were both positively related to stress levels, contrary to expectations that commitment would weaken the relationship between discrimination and stress. Results align with broader findings suggesting ethnic identity can intensify stress responses to discrimination. These findings contribute to a deeper understanding of discrimination-related stress and ethnic identification as they relate to ongoing health disparities and challenges experienced by AI/AN communities.

A Patient-Centered Conceptual Model of AYA Cancer Survivorship Care Informed by a Qualitative Interview Study.

Purpose: Conceptual models provide frameworks to illustrate relationships among patient-, provider-, system-, and community-level factors that inform care delivery and research. Existing models of cancer survivorship care focus largely on pediatric or adult populations whose needs differ from adolescents and young adults (AYAs). We developed a patient-centered conceptual model of AYA survivorship care. Methods: We conducted a narrative literature review of current conceptual and theoretical models of care. We engaged AYA cancer survivors (n = 25) in semi-structured one-hour telephone interviews. Most participants were in their 20s and 30s, and the majority (84%) were women. Recruitment was stratified by age and time since cancer diagnosis. We conducted a thematic analysis of interview transcripts to identify themes that exemplified patient-centered care. Results: Most participants identified as white and female. Leukemia and breast cancer were the most common cancer types. Main themes included the need for (1) care coordination, (2) ongoing mental health support, (3) connection to AYA peer support, (4) support during fertility preservation efforts, (5) support with financial burden, (6) support for quality of life, (7) information about and support with side effects and late effects, and (8) attention to the unique needs of young adults. Conclusions: We present a patient-centered conceptual model of AYA survivorship care needs that can inform future cancer care delivery and research.

In vitro antifungal activity of eucalyptol and its interaction with antifungal drugs against clinical dermatophyte isolates including Trichophyton indotineae

BackgroundDermatophytosis, a prevalent fungal infection, often exhibits treatment failure. It poses ongoing public health concerns, urging exploration of alternative treatment strategies. This study examines eucalyptol’s in vitro activity and its interaction with antifungal agents against dermatophyte isolates.MethodsOverall, 489 patients clinically suspected of dermatophytosis were investigated, and the causative agents were molecularly identified. The antifungal activity of eucalyptol, itraconazole, terbinafine, and griseofulvin was assessed according to the guideline of the Clinical and Laboratory Standards Institute (CLSI M38 ed3). The interaction between eucalyptol and the aforementioned antifungals was determined using a checkerboard method.ResultsDermatophytosis was confirmed in 30 out of 489 (6.13%) patients, with a female-to-male ratio of 3:2 and an age range of 8–67 years. The most commonly observed clinical manifestation was tinea corporis (34.21%), and Trichophyton indotineae (n = 14, 46%) was the most common causative agent. Antifungal susceptibility testing revealed that eucalyptol exhibited antidermatophyte properties with minimum inhibitory concentrations (MIC) ranging from 0.78 to 25 mg/mL. Itraconazole demonstrated the lowest geometric mean (GM) value (MIC range: 0.0019–0.25 µg/mL, GM: 0.015 µg/mL), while griseofulvin exhibited the highest GM value (MIC range: 0.125–8 µg/mL, GM: 2.37 µg/mL). The in vitro interaction of eucalyptol with antifungal drugs, except for its combination with terbinafine against two Trichophyton tonsurans isolates resulting in synergistic effects, showed indifference (n = 70, 77.77%) and antagonistic types (n = 18, 20%).ConclusionAmong the evaluated antifungals, itraconazole demonstrated the highest effectiveness against clinical isolates, while eucalyptol alone exhibited a more pronounced effect than when combined with antifungal agents.

Child protection and developmental trajectories of children who entered care as infants

AbstractInfants have the highest rate of admission into out‐of‐home care in Australia, with rising rates of entry to care occurring around the world. Our previous research identified children who entered care as infants as having high levels of developmental vulnerability. The objective of this study was to determine the child protection and developmental trajectories of children who entered care as infants and whether meeting developmental needs through service provision improves trajectories and outcomes for these children. This is a prospective cohort study using three waves (2011–2016) of survey data from the New South Wales Pathways of Care Longitudinal Study which includes standardised assessments (Age and Stages Questionnaire, Brief Infant Toddler Social Emotional Assessment and the Child Behaviour Checklist), as well as linked administrative child protection and health data. Our findings suggest that children who entered care as infants predominantly remained in the care system and had a high level of developmental vulnerability as infants. A large group had positive physical and cognitive developmental trajectories with service provision increasing over time; however, early service provision is needed. Another group was identified as having early social–emotional concerns and displaying worsening social–emotional trajectories. Intervention for this group is an important priority to reduce risk of ongoing poor mental health outcomes.

Health worker protests and the COVID-19 pandemic: an interrupted time-series analysis.

To assess the impact of the coronavirus disease 2019 (COVID-19) pandemic on protests by health workers. We conducted an interrupted time series analysis of data from 159 countries for 2years before and after the World Health Organization classified COVID-19 as a pandemic in March 2020, thus between 2018 and 2022. We produced models examining two main outcomes: (i)the total weekly number of health worker protests globally; and (ii)the number of countries with one or more health worker protests in a given week. In total, there were 18 322 health worker protests in 133 countries between 2018 and 2022. The number of weekly health worker protests globally increased by 47% (30.1/63.5), an increase of 30.1 protests per week (95% confidence interval, CI: 11.7-48.6) at the onset of the COVID-19 pandemic. Furthermore, the number of countries experiencing such protests in a given week increased by 24% (5.7/24.1) following the declaration of the pandemic (an increase of 5.7 countries; 95% CI: 3.5-7.8). The pandemic increased the overall level of health worker protests globally as well as the number of countries experiencing such protests. These protests highlight discontent in the health workforce. Given the ongoing global health workforce crisis, understanding and addressing the drivers of health worker discontent is important for global health policy and security.

School refusal: Considerations for the primary care NP.

School refusal refers to child- or adolescent-motivated refusal to attend school or remain in school for the duration of the school day. Importantly, the child or adolescent does not conceal their absence from school from their caregivers. Root causes for school refusal include anxiety, mood disorders, untreated learning disorders, and social difficulties. Long-term outcomes of school refusal include further social withdrawal, ongoing mental health issues, and unemployment. This article reviews the differences between school refusal and other types of chronic absenteeism, and it describes behaviors that may manifest in a child or adolescent who avoids attending school. The primary care provider's role in evaluation and treatment of this population is discussed.

Support Needs, Barriers, and Facilitators for Fathers With Fear of Childbirth in Sweden: A Mixed-Method Study.

The aim of this mixed-method study was to identify support needs, as well as barriers and facilitators to seeking support in a sample of Swedish fathers with a fear of childbirth (FOC). Participants completed an anonymous quantitative online survey (N = 131), with three free-text items for those self-identifying as having an FOC (N = 71) and five individual in-depth interviews. Data analysis included descriptive and chi-square analyses for quantitative data, and manifest content analysis for qualitative data. Those with a severe FOC were more likely to report having on-going mental health difficulties (p = .039) and one fifth (21%) of the participants with severe FOC wanted to receive professional treatment, but only 8.1% received treatment. Most participants either preferred individual support or to receive support together with their partner. Fathers with severe FOC were more likely to report one or more barriers than those without FOC (p = .005), where unwanted social stigma was the single largest barrier. Qualitative findings identified one main category: Expectant fathers missing and wishing for support for FOC composed four generic categories: (1) support in developing an understanding of their fear, (2) coping by being aware of feelings, (3) professional support through trust and respect, and (4) needing individualized support. To encourage healthy fathers, clinical professionals should find ways to support fathers, such as by providing them with their own perinatal appointments, asking them about their feelings, as well as screening, diagnosing, and treating fathers with severe FOC.

Assessment of health impacts in retired antisera-producing horses: Blood biochemistry and serum amyloid A analysis.

Horses used for antisera production are repeatedly hyperimmunized to produce high levels of specific antibodies. This prolonged process can lead to various health issues, including amyloidosis, which involves the accumulation of amyloid proteins in organs and tissues, potentially causing organ dysfunction and failure. These horses are often retired when they no longer produce adequate antibody levels. This study aimed to evaluate the impact of prolonged antisera production on the health of retired horses by examining their blood biochemistry and serum amyloid A (SAA) levels, which are indicators of systemic inflammation and organ damage. Blood samples were collected from 12 horses for this study. Nine horses were retired antisera-producing horses that had been discontinued for 2 years, while three healthy non-antisera-producing horses were used as controls. These twelve horses were divided into four groups based on the duration of their active period as antisera producers (never been used, 2-3 years, 4-5 years, and 6-7 years). We measured key blood biochemistry parameters and SAA levels to evaluate the health status of the horses. Total protein, fibrinogen, and globulin levels were elevated, whereas other parameters remained normal. The findings indicate that despite normal SAA levels, the horses exhibited signs of ongoing health issues related to their previous use in antisera production, such as increased total plasma protein, fibrinogen, and globulin levels, as well as the presence of amyloid deposits in vital organs such as the liver and kidneys, as observed in post-mortem examinations. Despite normal SAA levels, retired antisera-producing horses showed elevated total protein, fibrinogen, and globulin levels, indicating ongoing health issues.

Design and Implementation of an Employee Health Management Information System

This study developed an information system for employee health management aimed at enhancing workplace health and increasing corporate competitiveness. The employee health management information system (EHMIS) integrates health data analytics, risk assessments, and personalized health intervention measures to promote a healthier workforce. The platform emphasizes data privacy, seamless integration with existing human resources systems, and provides tools for monitoring health trends, reducing absenteeism, and improving overall productivity. The building process includes needs assessment, system architecture design, information security, functionality integration, and evaluation. The implementation strategy prioritizes employee engagement and continuous improvement, effectively assisting companies in human resource management and ongoing health promotion for employees.

The Impact of Solid Waste Management Practices on Vector-Borne Disease Risk in Thiruvanathapuram

Vector-borne diseases (VBDs), including dengue, chikungunya, and malaria, present ongoing public health challenges, particularly in urban areas of tropical regions. Thiruvananthapuram, the capital city of Kerala, has seen a concerning rise in VBD cases, correlating with the city's rapid urbanization and inadequate solid waste management (SWM) practices. Poorly managed waste contributes to the proliferation of disease vectors, such as mosquitoes, by providing ideal breeding grounds, thereby exacerbating the risk of disease transmission. Despite the known association between inadequate SWM and VBDs, there is a paucity of localized studies that quantitatively examine this relationship in Thiruvananthapuram. This study seeks to bridge this gap by investigating the impact of existing SWM practices on the incidence of VBDs in the city. The findings aim to inform public health strategies and policy interventions that can mitigate the risk of VBDs through improved waste management. This cross-sectional study was conducted across 20 wards in Thiruvananthapuram, selected based on their varying levels of SWM effectiveness and reported VBD cases. Data collection involved field surveys to assess SWM practices, structured interviews with residents, and observational studies to identify potential breeding sites for vectors. Health records were analyzed to map the distribution of VBD cases in these wards. Statistical analyses, including correlation and regression, were employed to explore the relationship between SWM practices and VBD incidence. The study revealed a significant correlation between poor SWM practices and elevated VBD risk. Wards with inadequate waste management infrastructure exhibited a 40% higher incidence of dengue and chikungunya cases compared to areas with better-managed waste disposal systems (p &lt; 0.01). Notably, 65% of households in the high-risk wards were found to dispose of waste improperly, contributing to the creation of vector breeding sites. Additionally, only 42% of residents were aware of the link between improper waste disposal and increased VBD risk, highlighting a critical gap in public awareness. This study concludes that inadequate SWM practices are a major contributor to the elevated risk of VBDs in Thiruvananthapuram. Addressing these challenges through improved waste management infrastructure and increased public awareness is crucial for reducing disease incidence. The outcomes of this research provide essential insights for local authorities and policymakers, emphasizing the urgent need for effective interventions to combat VBDs in urban areas.