Personal Health Status Research Articles

Health status of persons with dementia and caregivers' burden during the second wave of COVID-19 pandemic: an Indian study.

The article aims to find out the health status of PwD and caregivers' burden during the peak of second wave of COVID-19 and make a comparison with the preceding trough phase. The study was conducted with 53 PwD and their caregivers in two phases. On their visit to the hospital during the unlock phase (phase 1), data were collected for CDR from PwD, and NPI-Q and ZBI from their caregivers. During the peak of second wave (phase 2), data were collected for NPI-Q, ZBI, and DASS-21 through telephonic communication, and statistical analyses were performed on the collected data. Significantly higher caregiver burden (p=0.001) and neuropsychiatric symptoms (NPSs) [both in severity (p=0.019) and distress (p=0.013)] were observed among the respondents during the peak of second wave of the pandemic as compared to the preceding trough phase. Positive correlations were observed between the caregiver burden and depression, anxiety, and stress of the caregivers (p<0.001) and between the severity of dementia in PwD and caregiver burden (p<0.001) for both the first and second phases. Positive correlation was also observed between the severity of dementia in PwD and depression (p=0.042) and stress (p=0.023) of caregivers. Significant increase in the burden and distress was observed among caregivers due to increased NPSs of PwD during the second wave of COVID-19 pandemic.

Race, Gender, Sexual Orientation, and Willingness to Vaccinate for COVID-19

Around the world, and particularly in the United States, where COVID-19 vaccinations are widely available, questions about vaccine acceptance have become very important. Working with an online sample of 788 cisgender adults living in Southeastern United States, we studied predictors of variation in the willingness to vaccinate. Guided by the Health Belief Model, we assessed perceived threat, motivations for vaccination, hesitations about vaccination, personal health conditions, and demographic variables among participants who varied in race (“White” and “Black”), gender (cisgender men, women), and sexual identity (heterosexual, sexual minority). Consistent with the Health Belief Model, results showed that demographics (e.g., race, sex, political affiliation, etc.), perceived threat of COVID-19, motivations for vaccination, and hesitations about vaccination significantly predicted willingness to vaccinate. Over and above the predictions based on all of these variables, sexual identity was also a significant predictor; members of sexual minorities were more likely than their heterosexual peers to be willing to vaccinate. Overall, we found that taking sexual orientation into account can lead to improved prediction of the willingness to vaccinate. For this reason, public health officials should account for sexual identity in their models of vaccination uptake.

Communications Through Contemporary Tools of Information and Communication Technology: Cross-sectional Study Evaluating Health Among Separated Family Members.

BackgroundThe number of single-living workers separated from their spouses and families has been increasing due to the need to create a balance between life and work. Workers are assigned everywhere in globalized workplaces while also caring for their family members in the context of Japan’s aging society. At the same time, the mental and health status of persons living separately from their families is a matter of concern. The development of interpersonal communication means using information and communications technology (ICT) tools and the internet is remarkable, enabling simultaneous 2-way communication across distances and national borders. The easy accessibility to simultaneous communication is expected to improve the psychosocial status of isolated family members.ObjectiveThis study aims to clarify the health benefits of ICT by using a psychosocial health assessment, the characteristics of ICT tools, and the frequency of communication among the workers and their families who live separately.MethodsThis was a cross-sectional study planned and conducted in Japan. Study participants, including adults who live separately from other family members or have separately living family members due to work, were recruited to answer a web response survey about ICT usage status, health status, and life and society evaluation. This study recruited 73 participants divided into 2 groups by their communication tools and frequencies, and their separated life, health, and psychosocial status were statistically compared.ResultsAmong the 73 study participants, 15 were categorized in the high communication–skilled (HCS) group that used both types of ICT tools to communicate frequently: “live,” such as video chat and voice call, and “nonlive,” such as SMS text message service and email. A simple comparison between the HCS and reference groups showed significant differences in the cohesion with the neighborhood (P=.03), perceived social position (P=.01), and happiness (P<.001); however, there were no significant differences in the health (psychological distress, P=.08; self-rated health, P=.07), lifestyle (drinking, P>.99; current smoking, P=.37), and dyadic trust in family members living separately (P=.80). Further, in a multivariate regression analysis adjusted for confounding factors, such as educational history, age, gender, and job status, poor subjective health showed a prevalence odds ratio of less than 1 (OR 0.17, 95% CI 0.03-1.02). The HCS group showed significant positive relationships in the cohesion score with the neighborhood (P=.01; β=2.40, 95% CI 0.56-4.24), perceived social position (P=.03; β=1.17, 95% CI 0.11-2.23), and happiness score (P=.002; β=1.46, 95% CI 0.58-2.34) in the same multivariate regression models.ConclusionsThis study suggested that people who frequently communicate with separated family members by taking advantage of various ICT tools can maintain a better mental state and better social relations among those who live alone and are separated from their families.

A COMPARATIVE ANALYSIS OF DEPRESSIVE DISORDERS IN CHILDREN AND ADULTS: META-ANALYSIS OF ETIOLOGY, ASSESSMENT TOOLS AND INTERVENTIONS

Depressive disorder is one of the most commonly found non-communicable types of clinical disorder having serious impact, not only on the mental health status; but also on the health and socio-economic status of the concerned person. Though reason for depressive disorder is not conned to a particular reason, a wide range of chronic health issues, socio-demographic conditions, and even the family background have major impact on its occurrence. Patterns of intervention management in both adults and children involve psychotherapy with some specically designed self-help tools. In peculiar cases, depending upon the severity of depression, antidepressants can be used in pharmacotherapy. The current study meta- analysis is a systematic review analysis of depressive disorder causes in both adults and children through the validation of the assessment tools involved in measuring the severity and the types of interventions used by expert clinicians, to provide better cure of diseases.

Influence of college education on happiness: A quasi-experimental study based on higher education expansion in China.

Previous studies have documented a positive association between college education and happiness. However, the endogeneity of college education attainment is rarely examined, and a more robust link between college education and happiness needs to be built. Based on the Chinese General Social Survey data of 2017, the present study used the quasi-experiment of China’s higher education expansion started in 1999 to construct a fuzzy regression discontinuity design to examine the causal association between college education and happiness. It is observed that college education indeed improved Chinese happiness, but this positive association was stronger in males than in females. Further, college education was observed to improve happiness by improving individual political status, perceived personal status, health and family social status, but not by increasing personal income. Accordingly, the government should continue to promote the development of higher education, and the fairness of higher education development deserves more attention to reduce population disparities in happiness.

Characteristics Associated with Good Self-Perceived Mental Health among United States Adults with Arthritis.

Mental health disorders are prevalent among United States (US) adults with arthritis. Yet, little is known about characteristics associated with mental health among US adults with arthritis. This retrospective cross-sectional study used 2019 Medical Expenditures Panel Survey data to assess the association between multiple personal characteristics and mental health status among US adults with arthritis. Hierarchical logistic regression models modeled associations between personal characteristics and mental health status. Model 1 included predisposing factors, model 2 included predisposing and enabling factors, while model 3 included predisposing, enabling, and need factors. The a priori alpha level was 0.05. Analyses accounted for the complex survey design and were weighted to produce national estimates. Among 28,512 individuals, 4984 met the inclusion criteria. Of these, 4181 had good mental health (85.5%, 95% confidence interval (CI) = 84.3%, 86.7%). The following characteristics were associated with good mental health status in the final adjusted model: age 18–64 vs. ≥65 (adjusted odds ratio (AOR) = 0.29, 95% CI = 0.12, 0.71), Midwest vs. West census region (AOR = 5.17, 95% CI = 1.63, 16.46), no degree vs. higher than high school education (AOR = 0.34, 95% CI = 0.12, 0.92), and high school diploma vs. higher than high school education (AOR = 0.40, 95% CI = 0.18, 0.86). In conclusion, this study suggests such characteristics may be targeted to help improve mental health among this population. Additional efforts are needed to help satisfy the unmet need for mental healthcare among this population.

Evaluation of General Health Status of Persons Living in Socio-Economically Disadvantaged Neighborhoods in a Large European Metropolitan City

Background: Living in socio-economically disadvantaged neighborhoods can predispose persons to numerous health conditions. The purpose of this study was to report the general health conditions of persons living in disadvantaged neighborhoods in Rome, Italy, a large European metropolitan city. Participants were reached through the mobile facilities of the primary care services of the Dicastery for the Charity Services, Vatican City. Methods: People living in disadvantaged neighborhoods were reached with mobile medical units by doctors, nurses, and paramedics. Demographic characteristics, degree of social integration, housing conditions, and history of smoking and/or alcohol use were investigated. Unstructured interviews and general health assessments were performed to investigate common acute and/or chronic diseases, and history of positivity to COVID-19. Basic health parameters were measured; data were collected and analyzed. Results: Over a 10-month period, 436 individuals aged 18–95 years were enrolled in the study. Most lived in dormitories, whereas a few lived in unsheltered settings. Most participants (76%) were unemployed. Smoking and drinking habits were comparable to the general population. The most common pathological conditions were cardiovascular diseases in 103 subjects (23.39%), diabetes in 65 (14.9%), followed by musculoskeletal system disorders (11.7%), eye diseases (10.5%), psychiatric conditions such as anxiety and depression (9.2%), and chronic respiratory conditions (8.7%). Conclusions: Subjects in our sample showed several pathologic conditions that may be related to their living conditions, thus encouraging the development of more efficient and effective strategies for a population-tailored diagnosis and treatment.

Physical Health Conditions in Persons with Spinal Cord Injury Across 21 Countries Worldwide.

ObjectivesTo describe the 3-month prevalence and correlates of self-reported physical health conditions in persons with spinal cord injury (SCI) worldwide.Study designMultinational cross-sectional survey.SubjectsCommunity-living persons with traumatic or non-traumatic SCI aged >18 years from 21 countries representing all the 6 World Health Organization regions.MethodsThe study used data from 11,058 participants in the International SCI Community Survey (InSCI). The survey, based on the International Classification of Functioning, Disability and Health (ICF) Core Sets for SCI, was conducted in 2017–19 simultaneously in the participating countries. The health conditions were reported on a modified version of the SCI Secondary Conditions Scale.ResultsOverall, 95.8% of the participants reported having experienced 1 or more health problems secondary to SCI. Having pain was the most prevalent problem (77.3%), followed by spasticity/muscle spasms (73.5%) and sexual dysfunction (71.3%), and the least prevlent was respiratory problems (28.8%). The participants reported a mean of 7.4 concurrent health conditions. Unmet healthcare needs, being a smoker, being a female, having a complete lesion, and a traumatic injury exhibited significant associations with comorbidity.ConclusionPhysical health problems secondary to SCI are extremely common worldwide and demand investment in appropriate management, medical care and preventative measures.LAY ABSTRACTMore than 500,000 people experience a spinal cord injury (SCI) every year. Because of the impairments of having SCI, many experience co-occurrence of additional health conditions, called comorbidity. This study describes the 3-month prevalence, and associated factors of self-reported physical health conditions secondary to SCI across 21 countries worldwide. The study uses data from 11,058 adults with SCI participating in the International SCI Community Survey in 2017–19. The results showed that physical health problems secondary to SCI are extremely common worldwide. Having pain, muscle spasms/spasticity, sexual dysfunction and bowel dysfunction were the most common, all with rates above 70%. The participants experienced a mean of 7 concurrent health conditions in addition to their SCI. Those reporting unmet healthcare needs, being a smoker, female, and having a complete lesion were most at risk for having comorbidity. These findings demand investment in appropriate management, medical care and preventative measures.

RWD49 Comorbidities and Perceived Health Status in Persons with Cancer: A Retrospective Analysis of the Medical Expenditure Panel Survey (MEPS)

Comorbidities can further challenge prognosis and general wellbeing of cancer patients. This study aimed to assess the association between comorbidities and perceived health status (PHS) of United States(US) persons with cancer.

Does high-speed rail relieve income-related health inequalities? A quasi-natural experiment from China

IntroductionThe rapid increases in income and high-speed rail (HSR) construction in China raise the prospect of reshaping the space economy, the exploration of which, from the perspective of optimised transportation networks, can provide insights into alleviating the increasing health inequalities. MethodsBased on matched data of prefecture-level cities and Chinese Labor Dynamic Survey packages from 2014 to 2018, we used the ordered probit model and ordinary least squares (OLS) with time- and city-fixed effects to estimate the effects of HSR on personal health status. We calculated the degree of income-related health inequalities and decomposed the contributive degree of HSR to health inequalities by decomposing the concentration index (CI) and Blinder-Oaxaca, respectively. ResultsPersonal health status showed significant differences under different income levels and in areas with and without HSR. The estimated coefficients regarding HSR on personal health status were 0.112 in the ordered probit model and 0.167 in the OLS model. The CI of health inequalities showed a positive coefficient of 0.059, with a pro-rich phenomenon. Contribution decomposition of CI showed that HSR accounted for an important contribution of 1.919% to health inequalities. Blinder-Oaxaca decomposition revealed that the contribution of HSR to overall CI was 0.075% from 2014 to 2018. CI decomposition also demonstrated a decreasing trend over time in the HSR's contribution to increasing health inequalities. Further, mechanism analysis showed that HSR improved health more significantly among high-income groups in ways that included improved high quality of healthcare services, socioeconomic status, and social capital. ConclusionsThere is a pro-rich distribution of health in China, and HSR exacerbates health inequalities more significantly among high-income groups in several ways, including high-quality healthcare services, socioeconomic status, and social capital. Furthermore, HSR has the potential to decrease health inequalities in the future.

Oral Cancer

Oral cancer or mouth cancer is a type of cancer that forms in the oral cavity, resulting in the uncontrolled growth of abnormal cells that damage the surrounding tissue. There are several factors that accelerate oral cancer, including human papillomavirus (HPV) infections, genetic influences, UV light and substance use. Abnormalities, namely white or reddish patches, lumps and chronic sores in the oral cavity, may be noticed by the patient. Nowadays, many means of treatment are available, including surgery, radiation, chemotherapy, and targeted drugs. However, the risk factors can affect people at different levels. The treatment will be applied individually depending on personal physical and mental health conditions. Furthermore, most of the treatments rely on modern technology, they are progressively developing to maximize their efficiency. This article aims to provide an overview of cancer, oral cavity, diagnosis, complications, medical treatments and self-prevention to avoid risk factors. Overall, the authors have analysed and reorganised so that the audience has a broader understanding of this disease.

Commencement of flash glucose monitoring is associated with a decreased rate of depressive disorders among persons with diabetes (FLARE-NL7)

IntroductionDepressive disorders are more common among persons with diabetes, as compared with persons without diabetes. The burden of glucose management is known to associate with depressive symptoms. This study aims...

Managing Fatigue in Patients with Paroxysmal Nocturnal Hemoglobinuria: A Patient-Focused Perspective.

The most frequently reported symptom in patients with paroxysmal nocturnal hemoglobinuria (PNH), a disease characterized by complement mediated hemolysis and chronic anemia, is “fatigue”. The latter seems the best word to communicate patient’ perception of personal health status and disease impact on daily living, namely quality of life (QoL). Objectivating QoL and grading patient’s fatigue is one of the most difficult medical tasks given the highly heterogeneous communication skills of patients and caregivers and the multitude of meanings that might be attributed to this term. Along with anemia, QoL in PNH is also affected by the emotional burden of a chronic life-long disease with heterogeneous treatment requirement, risk of hemolytic exacerbations (breakthrough hemolysis) and of thrombosis. In the last decade, structured surveys and scores have been adapted from cancer settings to evaluate fatigue and QoL in patients with PNH, and to assess the benefit of complement inhibitors in this setting. Eculizumab was the first drug utilized and was shown to improve QoL scores in the registrative trials. However, the intravenous fortnightly administration, the presence of residual anemia, and the risk of extravascular hemolysis are some of the unmet needs impacting QoL under eculizumab. Several novel drugs have been designed to improve patients’ convenience and alleviate anemia and fatigue. In this review, we focus on available studies that evaluated fatigue and QoL in PNH patients, and the effect of old and new therapeutic strategies.

Designing intelligent self-checkup based technologies for everyday healthy living

Recent years have seen increasing interest in health promotion or disease prevention, rather than disease treatment/management, as a more cost-effective approach towards healthcare. Technologies designed to help build healthy habits, or lifestyle technologies, have important roles to play in that respect. However, so far, they are mainly explored without considering individual health statuses, which may lead to people’s excessive pursuit of quantified goals and cause negative health outcomes. In addition, while AI-powered health checkup technologies have become available for consumers to assess health on their own, they are mainly disease-oriented, and their potential for preventive health – everyday health assessment and early interventions through lifestyle changes – has been largely under-explored. This paper attempts to combine intelligent self-checkup and personalized lifestyle technologies so as to provide suggestions based on personal health status, as a potentially more effective approach to support preventive health in everyday life, or everyday healthy living as we call it in this paper. In particular, we present the iterative design process of a mobile application which supports AI-powered everyday health assessment based on face examination and adaptive inquiry, and provides personalized and adaptive lifestyle advice. Design improvements were made based on the first pilot study, and a 4-week field trial of the final design prototype reveals a number of design implications for intelligent health technologies to better support everyday healthy living.

Strengthening a Model of Community Food Security in Central Java During the Pandemic

Achieving food and nutrition security for all people remains one of the defining challenges for humanity in the 21st century. The crisis related to strengthening food security during the Covid-19 pandemic has become a global concern. The World Food Program states that despite developments in agricultural technology, micronutrient deficiencies and stunting remain problems. The purpose of this study was to determine the pattern of food and non-food consumption of the community in Temanggung Regency, as well as the efforts in dealing with community food security. A qualitative approach was used in analyzing a model to formulate policies for strengthening community food security during the COVID-19 pandemic. The results showed that the Temanggung Regency Government has designed an intervention by preparing a strategic plan and implementing a cross-sectoral approach. The policy programs and activities relate to food safety, quality of food intake and nutrition. However, according to the results, promoting food security in villages does not guarantee a decrease in malnutrition, and in some villages such as Kalimangis, the health status of children has actually deteriorated. The relationship between food security and family nutritional conditions is not linear due to factors related to environmental health, cleanliness and healthy lifestyle behaviors. Therefore, interventions in the field of food security have to be followed by interventions related to personal health status and environmental conditions.&#x0D; Keywords: food security, program intervention model, environmental health

Общая заболеваемость жителей Алтайского края, подвергнувшихся радиационному воздействию в результате испытаний на Семипалатинском полигоне, в 2020-2021 годах

During the years of operation of the Semipalatinsk test site, a significant part of the residents of the Altai Region were exposed to radiation to varying degrees. The Altai Medical Dosimetric Register (AMDR), which contains information about the health status of persons in this category, operates in the region. The purpose of the work is to obtain up-to-date data on the health status of the AMDR contingents. The article presents an analysis of the indicators of the general morbidity of the inhabitants of the region exposed to radiation as a result of tests at the Semipalatinsk test site for 2020-2021. The most common diseases and features of the dynamics of the overall morbidity in these contingents of the register were identified.

Gearing Up for a Vaccine Requirement: A Mixed Methods Study of COVID-19 Vaccine Confidence Among Workers at an Academic Medical Center.

Assessing barriers to vaccination among healthcare workers may be particularly important given their roles in their respective communities. We conducted a mixed methods study to explore healthcare worker perspectives on receiving COVID-19 vaccines at a large multisite academic medical center. A total of 5,917 employees completed the COVID-19 vaccine confidence survey (20% response rate). Most participants were vaccinated (93%). Compared to vaccinated participants, unvaccinated participants were younger (60% < 44 years), more likely to be from a non-Asian minority group (48%), and more likely to be nonclinical employees (57% vs. 46%). Among the unvaccinated respondents, 53% indicated they would be influenced by their healthcare provider, while 19% reported that nothing would influence them to get vaccinated. Key perceived barriers to vaccination from the qualitative analysis included the need for more long-term safety and efficacy data, a belief in the right to make an individual choice, mistrust, a desire for greater public health information, personal health concerns, circumstances such as prior COVID-19 infection, and access issues. Strategies endorsed by some participants to address their concerns about safety and access included a communication campaign, personalized medicine approaches (e.g., individual appointments to discuss how the vaccine might interact with personal health conditions), and days off to recover. Mistrust and a belief in the right to make an individual choice may be harder barriers to overcome; further dialogue is needed. These findings reflect potential strategies for vaccine requirements that healthcare organizations can implement to enhance vaccine confidence. In addition, organizations can ask respected health professionals to serve as spokespeople, which may help shift the perspectives of unvaccinated healthcare workers.

Prevalence of children witnessed violence in a pediatric emergency department.

Witnessed violence is a form of child abuse with detrimental effects on child wellbeing and development, whose recognition relies on the assessment of their mother exposure to intimate partner violence (IPV). The aim of this study was to assess the frequency of witnessed violence in a population of children attending a pediatric emergency department (ED) in Italy, by searching for IPV in their mother, and to define the characteristics of the mother–child dyads. An observational cross-sectional study was conducted from February 2020 to January 2021. Participating mothers were provided a questionnaire, which included the Woman Abuse Screening Tool (WAST) and additional questions about their baseline data and health. Descriptive analysis was reported as frequency and percentage for the categorical variables and median and interquartile range (IQR) for quantitative variables. Mothers and children screened positive and negative for IPV and witnessed violence, respectively, were compared by the chi-square test or the exact Fisher test for categorical variables, and by the Wilcoxon-Mann–Whitney test for continuous variables. Out of 212 participating mothers, ninety-three (43.9%) displayed a positive WAST. Mothers tested positive were mainly Italian (71%, p 0.003), had a lower level of education (median age at school dropout 19, p 0.0002), and a higher frequency of unemployment (p 0.001) and poor personal health status (8.6%, p 0.001). The children of mothers tested positive showed a higher occurrence of abnormal psychological-emotional state (38.7%, p 0.002) and sleep disturbances (26.9%, p 0.04).Conclusion: IPV was common in a population of mothers seeking care for their children in a pediatric ED. What is Known:• Witnessed violence is a form of child abuse, usually inferred by their mothers’ exposure to IPV. The latter is suffered by one in three women worldwide.What is New:• This study shows a 43.9% prevalence of IPV among mothers attending an Italian pediatric ED.• Positive mother-child dyads displayed a higher frequency of poor mothers’ health status and children’s abnormal emotional state and sleep disturbances.

Exploring the Workplace Bullying of Indonesian Caregivers and Its Influencing Factors in Taiwan.

Background: Bullying can pose a risk to the health and safety of humans, including the risk of damage to the emotional, psychosocial, mental, or physical health of employees in the workplace. In this study, we aimed to understand the personal characteristics, mental health, sleep quality, and workplace bullying status of Indonesian caregivers and explore the influencing factors of workplace bullying among them. Methods: This cross-sectional study was based on a structured questionnaire in Indonesian, which was designed to collect the data of essential personal characteristics, workplace bullying, sleep quality, and mental health using the Indonesian versions of the Negative Acts Questionnaire–Revised (NAQ-R), Pittsburgh Sleep Quality Index (PSQI), and the Brief Symptoms Rating Scale (BSRS-5). Results: A total of 60.9% of Indonesian caregivers never experienced workplace bullying in Taiwan. A multiple regression analysis revealed that being a household caregiver (β = 0.14, p = 0.021), sleep quality (β = 0.18, p = 0.031), and mental health (β = 0.44, p < 0.001) were significantly correlated with the overall workplace bullying scores of the respondents and revealed that these three variables explained 45% of the variance. Conclusions: Taiwan Indonesian caregivers have a similar workplace bullying rate to Indonesian employees in the workplace. This study indicated the relationships among the workplace bullying of foreign caregivers and demonstrated that being a household caregiver, sleep quality, and mental health were closely related.

Health risks and perceptions of residents exposed to multiple sources of air pollutions: A cross-sectional study on landfill and stone mining in Danang city, Vietnam

Health risks and perceptions of residents living nearby landfills or stone mines/quarries have been well documented; however, the multiple impacts of these two pollution sources have yet to be investigated. This study aims at giving insights into the impacts of residents exposed to two pollution sources in Danang city, Vietnam: Khanh Son landfill and Phuoc Tuong quarry. In this cross-sectional study, 7-point-Likert scale questionnaires were used to collect information from 314 respondents which were divided into three groups: i) Landfill-Stone mine (LS) exposed group within 1 km from both sources, ii) Stone mine (ST) exposed group within 1 km from the stone mine, and iii) the far-exposed group about 2–3 km from the two emission sites. Air pollutants (including H2S, CH4, and total suspended particles (TSP)) and noise levels were also sampled. In addition, we estimated the potential health risk assessment due to the exposure to hydrogen sulphide in the study areas.The findings have shown that 1) There is a statistical difference (p-value < 0.001) between the two exposed groups and far-exposed group regarding health risks and residents’ perceptions; 2) Compared to the ST exposed group, the LS exposed group statistically showed a higher perception to bad odours and skin diseases; lower satisfaction with regards to the personal health condition and the operation of the landfill; and higher willingness to change current living locations; and 3) There is evidence to indicate that elevated concentrations of air pollutants are associated with the high self-reported health risks and residents' perceptions. Urgent actions should be focused on the LS exposed group, landfill and quarry operations to prevent further adverse health effects.