Background: Cardiovascular disease (CVD) has remained the leading cause of death in the United States (US) for over a century. Despite progress in identifying risk factors and treatments, health disparities driven by social determinants of health (SDOH) remain underexplored. One key SDOH is the neighborhood and built environment, which influences cardiovascular (CV) health through behaviors and access to healthy food. This study examines how housing cost burden (HCB), a component of neighborhood and built environment, influences CV risk behaviors and outcomes in urban US zip codes. Methods: Health data for urban zip codes of the US was extracted from the CDC PLACES database, which utilizes data from the Behavioral Risk Factor Surveillance System (BRFSS). HCB prevalence for each zip code was obtained from the American Community Survey (ACS) and divided into the following quartile ranges to ensure even distribution: low (0–19.5%), moderate (19.6–25.2%), high (25.3–32.6%), and severe (>32.6%). Descriptive statistics in R summarized the prevalence of health risk behaviors (binge drinking, smoking, short sleep duration, no leisure physical activity [PA]) and outcomes (diabetes [DM], hypertension [HTN], obesity, coronary heart disease [CHD], and stroke [CVA]) within each group. Kruskal-Wallis tests with Dunn’s post-hoc and univariate analysis assessed associations between HCB and CV outcomes. Results: Increased HCB was associated with higher rates cigarette smoking, shorter sleep duration, and lack of PA in urban zip codes of the US, shown in Figure 1 (p < 0.001, Kruskal-Wallis test). Higher HCB was also linked to increased prevalence of DM, HTN, obesity, CHD, and CVA, and lower rates of binge drinking (p < 0.001, Kruskal-Wallis test). A univariate regression analysis showed a similar positive association between HCB and cigarette smoking, physical inactivity, short sleep duration, DM, HTN, obesity, and CVA (p<0.001). However, no significant association was found between HCB and CHD (p = 0.213, univariate analysis). Interestingly, limiting the analysis to zip codes with populations over 5,000 resulted in a significant positive association between HCB and CHD (p = 0.041, univariate analysis). Conclusion: HCB strongly correlates with CV risk behaviors and outcomes in urban US zip codes. These findings highlight the necessity of coupling social and medical care through approaches such as SDOH screening and public health interventions to advance equitable CV care.

Illicit drug use and associated health risk behaviors among sexual minority youth.

Background: Adolescents are vulnerable to certain morbidities and even mortalities due to risk-taking behaviors. Such kind of behavior renders adolescents unable to grow and develop to their full potential, leading to a loss for a country in both economic and demographic terms. Aims and Objectives: This study aims to estimate the prevalence of health risk behaviors and its association with various sociodemographic parameters among adolescents, and also compare the risk taking behavior and its perception among adolescents residing in rural and urban field practice areas. Materials and Methods: It is a cross-sectional study among adolescents residing in the field practice areas of SGRRIM and HS. Data were collected, coded, and entered, and the statistical evaluation was done using appropriate mathematical tools (Microsoft Excel, Statistical Package for the Social Sciences version 24.0). Risk-taking behavior was assessed in terms of human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) awareness, substance use, unintentional injuries, and risk-taking perceptions. Results: This study reveals significant differences in health awareness and risk behaviors among adolescents based on their place of residence. Although just over half (51.2%) of the participants were knowledgeable about HIV/AIDS, urban adolescents were notably more informed than those in rural areas. The prevalence of substance abuse, while relatively low overall (3.3%), was higher in urban adolescents, as were injury rates over the past year. Encouragingly, a majority of adolescents supported road safety measures, such as the compulsory use of helmets (67%) and seatbelts (66.8%). These findings emphasize the need for focused health education, particularly in rural areas, and for reinforcing safety behaviors among all adolescents. Conclusion: Adolescent health education must be strengthened, especially in rural areas, to address knowledge gaps and reduce risky behaviors. At the same time, the positive attitude toward road safety among youth should be leveraged to promote safer practices and prevent injuries.

Nature contact and health risk Behaviours: Results from an 18 country study.

People with severe mental illness (SMI) are at greater risk of obesity, cardiovascular disease and diabetes than the general population, due to a higher prevalence of health risk behaviours. Research is needed to inform tailored interventions to improve the health behaviours (diet, physical activity and sleep) of people with SMI in South Asia as these behaviours are closely linked to obesity. The study aimed to explore the barriers and facilitators to healthy diet, physical activity and good sleep among individuals with SMI. A qualitative design was employed using photovoice, semi-structured interviews and focus group discussions. Participants included 16 people with SMI, 16 caregivers and 17 health professionals in Bangladesh and Pakistan. Data were analysed thematically, informed by the socio-ecological framework. A complex interplay of individual, familial and societal factors influenced these health behaviours. Individual factors include knowledge, beliefs and mental health limitations. Caregivers play a crucial role in influencing behaviour. At the societal level, gender expectations, financial constraints and religious influences significantly impact these behaviours. The insights from this research can inform tailored interventions for this vulnerable group and highlight the need for integrated services, financial support and improved urban planning.

People with severe mental illness (SMI) are at greater risk of obesity, cardiovascular disease and diabetes than the general population, due to a higher prevalence of health risk behaviours. Research is needed to inform tailored interventions to improve the health behaviours (diet, physical activity and sleep) of people with SMI in South Asia as these behaviours are closely linked to obesity. The study aimed to explore the barriers and facilitators to healthy diet, physical activity and good sleep among individuals with SMI. A qualitative design was employed using photovoice, semi-structured interviews and focus group discussions. Participants included 16 people with SMI, 16 caregivers and 17 health professionals in Bangladesh and Pakistan. Data were analysed thematically, informed by the socio-ecological framework. A complex interplay of individual, familial and societal factors influenced these health behaviours. Individual factors include knowledge, beliefs and mental health limitations. Caregivers play a crucial role in influencing behaviour. At the societal level, gender expectations, financial constraints and religious influences significantly impact these behaviours. The insights from this research can inform tailored interventions for this vulnerable group and highlight the need for integrated services, financial support and improved urban planning.

Health Risk Behaviors of Adolescents in Europe: A Latent Profile Analysis of Health Behavior in School-Aged Children Survey Data From 43 Countries

Traditionally, the prevalence of health-risk behaviours is high among university students. Although these behaviours are often analysed in isolation, there is likely evidence for the co-occurrence of multiple risk behaviours. In this study, a latent class analysis (LCA) was conducted with cross-sectional data from 840 Portuguese students (55.4% female) to explore patterns of multiple risk behaviours across seven behavioural dimensions (alcohol consumption, smoking, unhealthy eating, sedentary behaviour, risky sexual practices, illicit drug use, and self-medication). Additionally, a latent class regression was performed to explore predictors (perceived well-being and sociodemographic and academic characteristics) for each behavioural pattern. A three-class model emerged with different probabilities of risk: Low-risk behaviours (51.4%), Moderate-risk behaviors (14.9%), and High-risk behaviours (33.7%). Students with better perceptions of well-being and health were likelier to be in the healthier class. Students in the low- and moderate-risk classes were more likely to be in their first year of study, not in a romantic relationship and to be full-time students. Students who had not changed residence at the beginning of their studies and were female were more likely to be in the healthiest class. This study provides essential strategies for health promotion among university students, offering crucial insights for the design of effective health promotion interventions, especially targeted at specific groups of students with similar patterns of multiple risk behaviours.

The effects of health risk behaviors to excess mortality in the population with depression: A cohort study based on NHANES data

Chronic musculoskeletal pain and anxiety/depression are significant public health problems. We hypothesised that adults with both conditions constitute a group at especially high risk of future cardiovascular health outcomes. To determine whether having comorbid chronic musculoskeletal pain and anxiety/depression is associated with the excess prevalence of selected known cardiovascular health risk behaviours. A cross-sectional survey of adults aged 35+ years randomly sampled from 26 GP practice registers in West Midlands, England. Respondents were classified into four groups based on self-reported presence/absence of chronic musculoskeletal pain (pain present on most days for six months) and anxiety or depression (Hospital Anxiety and Depression Score 11+). Standardised binomial models were used to estimate standardised prevalence ratios and prevalence differences between the four groups in self-reported obesity, tobacco smoking, physical inactivity, and unhealthy alcohol consumption after controlling for age, sex, ethnicity, deprivation, employment status and educational attainment. The excess prevalence of each risk factor in the group with chronic musculoskeletal pain-anxiety/depression comorbidity was estimated. Totally, 14519 respondents were included, of whom 1329 (9%) reported comorbid chronic musculoskeletal pain-anxiety/depression, 3612 (25%) chronic musculoskeletal pain only, 964 (7%) anxiety or depression only, and 8614 (59%) neither. Those with comorbid chronic musculoskeletal pain-anxiety/depression had the highest crude prevalence of obesity (41%), smoking (16%) and physical inactivity (83%) but the lowest for unhealthy alcohol consumption (18%). After controlling for covariates, the standardised prevalence ratios and differences for the comorbid group compared with those with neither chronic musculoskeletal pain nor anxiety/depression were as follows: current smoking [1.86 (95% CI 1.58, 2.18); 6.8%], obesity [1.93 (1.76, 2.10); 18.9%], physical inactivity [1.21 (1.17, 1.24); 14.3%] and unhealthy alcohol consumption [0.81 (0.71, 0.92); -5.0%]. The standardised prevalences of smoking and obesity in the comorbid group exceeded those expected from simple additive interaction.

Objective: Risky health behaviors have an impact on physical and mental health. Data on health risk behaviors among students in Vietnam are limited. This study aims to describe and identify associated factors of health risk behaviors among Vietnamese students aged 13-18 in two districts in Ha Nam province. Methods: We conducted a cross-sectional study among 600 students aged 13-18 in two districts in Ha Nam in July - 2022. Results: There was 25.5% of participants had at least 1 health risk behavior. History of alcohol consumption was the most frequent of health risk behavior. There were 9 students had sexual intercourse. The final multi-variable logistics regression showed that students aged 14 years (aOR: 2.29, 95%CI: 1.28 – 4.20) or 16 years (aOR 7.02, 95%CI: 2.57 – 20.41) or 18 years (aOR5.58, 95%CI: 1.48 – 21.63) had a higher chance to have health risk behaviors than 13-years-old students. Female students (aOR: 0.51; 95%CI: 0.34 – 0.75) had lower rate of health risk behaviors than male students. We also found history of using tobacco (aOR: 15.7, 95%CI: 3.07 – 103.89) was associated with the history of having sex in participants. Conclusions: The prevalence of health risk behaviors among Vietnamese students aged 13-18 in Ha Nam was quite high. There should be more prevention, activities and consultation for students aged 13-18 in Viet Nam.

Ayurveda is not simply a medical science but a life science, which has majorly described various fundamental principles that help Ayurveda education and research in India that can be further reinforced with innovative and creative motivations. Strategies and futuristic plans are considered essential to be implemented with active initiation by concerned Government bodies for creating awareness among the faculties, students and upcoming scholars of Ayurveda. Children are more susceptible to many diseases due to their transitional immune system. Good health is associated with reduced dropout and massive education performance and productivity. Children are sensitive to the diseases like malnutrition, infectious diseases, intestinal parasites, skin diseases, eye and ear, and dental caries. Ayurveda describes Dinacharya, Rutucharya, Matravat Ahara, Kala Bhojana, Sadvritta etc. and a copious number of the preparation for the prevention and management of these diseases, which helps in better development of children for tomorrow. Incorporating the principles of Ayurveda in school health, one can reduce the prevalence of health risk behaviours and promote healthy behaviours among children, ultimately leading to a positive effect on health and helping build a vibrant future for the nation with healthy and skilled citizens.

The prevalence of epidemiological health-risk behaviors and mental well-being in the COVID-19 pandemic, stratified by sociodemographic factors in Association of South East Asian Nations (ASEAN) university students, were examined in the research. Data were collected in March–June 2021 via an online survey from 15,366 university students from 17 universities in seven ASEAN countries. Analyzed data comprised results on physical activity, health-related behaviors, mental well-being, and sociodemographic information. A large proportion of university students consumed sugar-sweetened beverages (82.0%; 95%CI: 81.4, 82.6) and snacks/fast food daily (65.2%; 95%CI: 64.4, 66.0). About half (52.2%; 95%CI: 51.4, 53.0) consumed less than the recommended daily amounts of fruit/vegetable and had high salt intake (54%; 95%CI: 53.3, 54.8). Physical inactivity was estimated at 39.7% (95%CI: 38.9, 40.5). A minority (16.7%; 95%CI: 16.1, 17.3) had low mental well-being, smoked (8.9%; 95%CI: 8.4, 9.3), and drank alcohol (13.4%; 95%CI: 12.8, 13.9). Country and body mass index had a significant correlation with many health-risk behaviors and mental well-being. The research provided important baseline data for guidance and for the monitoring of health outcomes among ASEAN university students and concludes that healthy diet, physical activity, and mental well-being should be key priority health areas for promotion among university students.

Background: The aim of this study was to evaluate the trends of prevalence of health risk behaviors (HRBs) and health conditions over a 10 year period (2008–2018) in a representative sample of adolescents of Tuscany Region, Italy. Methods: This was a repeated cross-sectional (four survey waves) study. The prevalence of 17 HRBs and health conditions were analyzed by age, sex, and socioeconomic status (SES). Results: A total of 21,943 students were surveyed. During the study period, decreases in smoking participation, cocaine use, driving under the influence of alcohol and drugs, and problem gambling were observed, while alcohol abuse and at-risk sexual behaviors remained unchanged or increased. Males resulted more frequently involved in most of the HRBs, while females more frequently reported physical inactivity, regular smoking, and not using a condom. Female participation in smoking and alcohol abuse behaviors, fruit and vegetable consumption, and bullying worsened over the study period. Smoking, poor dietary habits, physical inactivity, high distress level, and obesity were more frequently observed in low-SES students than in high-SES students. Conclusions: The findings showed different tendencies in adolescent participation in HRBs over the last decade; concerning trends in at-risk sexual behaviors and alcohol consumption and females’ risk-taking behavior on the rise require careful monitoring.

Background:There is no official and representative information on certain health-risk behaviors in Iran. This national survey was performed to determine the prevalence of five high-risk behaviors among the adult population and underlying factors.Methods:This cross-sectional study was performed in 23 provinces of Iran in 2019 involving 10,957 participants. The following five risky behaviors were evaluated: (a) using illicit drugs in the past month, (b) drinking alcohol in the past month, (c) having extramarital sex in the past year, (d) having suicidal thoughts in the past month, (e) and attempting suicide in the past year. The logistic regression model was used for analyses and associations were reported using odds ratio (OR) with its 95% confidence interval (CI).Results:The prevalence of health-risk behaviors was as follows: illicit drug use 10.4%, drinking alcohol 16.8%, extramarital sex 9.9%, suicidal thoughts 8.8%, and suicide attempt 5.4%. Almost 27.6% of the participants were involved in at least one risky behavior. There was a strong association between illicit drugs use and male gender 2.51 (2.11–2.98) and using psychiatric medications 2.96 (2.46–3.55); between drinking alcohol and male gender 2.23 (1.93–2.58); between extramarital sex and divorced/widowed status 2.43 (1.72–3.44) and having an intimate friend of the opposite sex 3.75 (3.13–4.51); between suicidal thoughts and using psychiatric medications 2.23 (1.83–2.72); between suicide attempt and a history of running away from home 2.10 (1.64–2.68).Conclusion:More than one-fourth Iranian adult population is involved in at least one risky behavior. Engaging in any risky behavior may increase the possibility of engaging in other high-risk behaviors.

Aboriginal and Torres Strait Islander Australians are at high risk of Type 2 diabetes and its complications. Optimal lifestyle choices can improve health outcomes. A thematic review of original research publications related to smoking, nutrition, alcohol intake, physical activity and emotional wellness in Aboriginal and Torres Strait Islander Australians with diabetes was performed. Overall, 7118 English-language publications were identified by search engines (PubMed, CINAHL, Scopus, Medline-Web of Science, and Google Scholar) with search terms Indigenous Australians OR Aboriginal and Torres Strait Islanders AND diabetes AND lifestyle OR smoking OR nutrition OR alcohol OR physical activity OR emotional wellbeing and their common synonyms. After review of abstracts and publication reference lists, 36 articles met inclusion criteria and were reviewed. In general, the self-reported health-related behaviours of Aboriginal and Torres Strait Islander Australian adults with diabetes, which is predominantly Type 2 diabetes, was suboptimal. An important clinical challenge in diabetes care is to sustainably reduce smoking, improve nutrition (including alcohol use), increase physical activity, reduce sedentary time, and improve emotional wellbeing, which should lead to reduced rates of diabetes complications. Regular assessments and multi-stakeholder input, including individuals, communities, clinical, health policy, societal and government inputs and partnerships, are desirable to facilitate closing the gap in health between Aboriginal and Torres Strait Islander and non-Indigenous Australians.

Risk behaviors and signs of burnout are associated with substantial health losses and university dropouts. Physical activity can be an effective approach to reduce these factors. The objective of this study was to analyze aspects related to health behaviors, physical activity, and signs of burnout in university students and their association with physical activity. The probabilistic cluster sample consisted of 3,578 regularly enrolled undergraduate students from UFPR in Curitiba, based on a population sample of 24,032 university students. The students completed the MBI-SS and NCHA II instruments. Descriptive statistics were used to identify demographic indicators and characteristics of the university environment. For the proportion of subjects with respective confidence intervals (CI = 95%), contingency tables involving the chi-square test (χ2) were used. The prevalence of signs of burnout was estimated in punctual proportions accompanied by the respective confidence intervals (CI = 95%). To analyze the associations between the independent variables and signs of burnout, the Hierarchical Logistic Regression was used through an analysis adjusted by the other independent variables involved in the models (CI = 95%). Results showed that the prevalence of individuals who showed signs of burnout was 40.4%. The hierarchical multiple regression model pointed to: female sex (OR = 1.30; 1.11–1.51); age between 20–24 years (OR = 1.51; 1.25–1.83); and 25–29 years (OR = 1.69; 1.27–2.24); being single (OR = 2.67; 1.01–7.10); presenting regular/poor health perception (OR = 1.59; 1.13–2.22), belonging to Human Sciences courses (OR = 1.37; 1.14–1.64); attending 2nd or 3rd year (OR = 1.34; 1.12–1.61); poor academic performance (OR = 5.35; 4.11–6.96); mean (OR = 2.08; 1.78–2.43). We conclude that academics showed a high prevalence of health risk behaviors and correlate and diagnose emotional problems and signs of burnout. Signs of burnout were significantly associated with the practice of physical activity in its three dimensions; however, in the adjusted analysis for demographic indicators, the characteristics of the university environment, and health behaviors, physical activity was not significant for the model.

Adolescents are considered vulnerable due to their ability to venture into Health Risk Behaviours (HRBs) that may have a long-term detrimental effect on their total wellbeing. The major focus of previous adolescents' studies in Nigeria has been on parent-adolescent communication and the relationship it has with their academic performance and sexual behaviour; none has explored the association of social connectedness and HRBs among in-school adolescents. Thus, the aim of this study is to assess and compare social connectedness and HRBs among in-school adolescents in urban and rural areas of Oyo State. A school-based comparative cross-sectional design was employed wherein 2071 in-school adolescents were selected via a multistage cluster sampling in Ibarapa Central and Ibadan North Local Government Areas (LGAs) of Oyo State. The independent variables were socio-demographic characteristics, family characteristics and social connectedness while the dependent variable was HRBs. The data was analysed using descriptive statistics, chi square, t-test, ANOVA and logistic regression with level of statistical significance set at 5%. Overall, slightly over one-half of the respondents (51.9%) were from the urban LGA and 54.2% were females. The mean age of respondents was 13.7 ± 2.1 years and 46.7% were early adolescents aged 10-13 years. The prevalence of HRBs among in-school adolescents was high (91.8%) and the mean score of social connectedness among in-school adolescents was high, with a slightly higher mean in rural area (131.71 ± 16.43) compared to (131.04 ± 14.47) in urban area. However, this was not statistically significant (p = 0.322). The mean scores of the domains of religious connectedness (p = 0.176), school connectedness (p < 0.001), peer connectedness (p < 0.001) and social-media connectedness (p = 0.003) were higher in the rural areas. However, the mean score of family connectedness among respondents was higher in the urban area (p < 0.001). The odds of having engaged in HRBs were significantly 1.57 times more likely among respondents who were males than those who were females {AOR = 1.57, 95% CI: 1.12-2.19}. The odds of having engaged in HRBs was significantly 1.44 times more likely among respondents who live in an urban area than among those who live in a rural area {AOR = 1.44, 95% CI: 1.03-2.01}. For a unit increase in the total score of social-media connectedness of the students, the odds of having engaged in HRBs was reduced by 0.95 {AOR = 0.95, 95% CI: 0.92-0.99}. There were significantly lower mean scores for social connectedness among respondents who had engaged in HRBs compared to their counterpart who had not engaged in HRBs. Therefore, various efforts targeted at improving social connectedness with its domains could be recommended to prevent in-school adolescents from engaging in HRBs.

There is growing evidence that people who are transgender and gender diverse (TGD) are impacted by disparities across a variety of cardiovascular risk factors compared with their peers who are cisgender. Prior literature has characterized disparities in cardiovascular morbidity and mortality as a result of a higher prevalence of health risk behaviors. Mounting research has revealed that cardiovascular risk factors at the individual level likely do not fully account for increased risk in cardiovascular health disparities among people who are TGD. Excess cardiovascular morbidity and mortality is hypothesized to be driven in part by psychosocial stressors across the lifespan at multiple levels, including structural violence (eg, discrimination, affordable housing, access to health care). This American Heart Association scientific statement reviews the existing literature on the cardiovascular health of people who are TGD. When applicable, the effects of gender-affirming hormone use on individual cardiovascular risk factors are also reviewed. Informed by a conceptual model building on minority stress theory, this statement identifies research gaps and provides suggestions for improving cardiovascular research and clinical care for people who are TGD, including the role of resilience-promoting factors. Advancing the cardiovascular health of people who are TGD requires a multifaceted approach that integrates best practices into research, health promotion, and cardiovascular care for this understudied population.

People with a mental illness experience a disproportionate burden of chronic disease morbidity and mortality; contributed to by a higher prevalence of health risk behaviours that increase the risk of chronic disease development. Amongst this population there is little understanding of multiple risk behaviour co-occurrence and client interest in improving multiple such risks. A cross-sectional survey was undertaken with a random selection of 557 clients of 12 community mental health services in Australia. Participants reported their engagement in health risk behaviours (tobacco smoking, harmful alcohol consumption, inadequate fruit and/or vegetable consumption, and inadequate physical activity), and those deemed 'at risk' reported whether they were seriously considering improving their risk behaviours. Almost all participants engaged in at least one risk behaviour (96.1%), with 78.4% of participants engaging in two or more risk behaviours. Of those with two risks, the most frequently paired behaviours were inadequate fruit and vegetable consumption and inadequate physical activity (39.7%); of those with three risks the most common combination was inadequate fruit and vegetable consumption, tobacco smoking and harmful alcohol consumption (42.5%). Of those at risk for all behaviours, 68.4% were interested in improving multiple behaviours, and 14% were interested in improving all; with these participants being most frequently interested in changing smoking, nutrition, and physical activity (19.3%), followed by all risk behaviours (14.0%). The findings strengthen the evidence that people with a mental illness are interested in improving their health risk behaviours and indicate a need to address the multiple health risks in this population group.