National Representative Survey Research Articles

Prevalence and acceptability of psychological and/or economic intimate partner violence, and utilization of mental health services by its survivors in Lithuania.

Lithuania has one of the highest averages in the European Union when it comes to psychological and/or economic intimate partner violence (PE-IPV). IPV survivors are several times more likely to have mental health conditions than those without IPV experiences. The aim of this article is to study the prevalence, characteristics and attitudes of PE-IPV survivors in Lithuania, and the predictors of them accessing mental health services. A cross-sectional study based on a national survey representative of the adult population. The survey was implemented by a third-party independent market research company employing an online survey panel. Logistic regression models were used in the analysis. Almost 50% of women in Lithuania experience PE-IPV. Females are significantly more likely to experience it than males. The vast majority of women find PE-IPV unacceptable; however, only one-third of survivors seek any type of help. Only one-tenth approach mental health services, with divorcees being at higher odds of doing so. Further research is needed to explore predictors and contextual factors of why IPV survivors seek mental healthcare, or not. Policy implications include the need to eliminate IPV and mental health stigma; develop accessible mental health services and effective treatment approaches.

Prevalence of suicidal thoughts and behaviors among young adults between 2000 and 2021: Results from six national representative surveys in France

The study examines the prevalence of 12-month suicidal thoughts and lifetime suicide behaviors among young adults between 2000 and 2021. Data were drawn from the Health Barometer survey, a cross-sectional survey on a French national representative sample. The 2000, 2005, 2010, 2014, 2017, and 2021 survey waves were pooled to examine time trends in 12-month suicidal thoughts and lifetime suicidal behaviors among respondents aged 18 to 25 (n = 13,326), categorized based on sex and on their occupational status: students, those employed, and those who are neither in employment, education or training (NEETs). The 12-month prevalence of suicidal ideation among young adults in 2021 (6.8 %) is no different from that of 2000 (7.0 %), despite a U-shape curve in between. In contrast, the overall prevalence of lifetime suicide attempts was significantly higher in 2021 as compared to what was observed on average in the previous 21 years. In multivariate models, females and NEETs were overall at greatest risk for suicidal ideation and suicidal behaviors. Additional attention and prevention efforts are needed to reach young adults who are neither in employment, education or training.

Metabolically healthy obesity, transition from metabolic healthy to unhealthy status, and carotid atherosclerosis.

Evidence of the effects of metabolically healthy obesity (MHO) on atherosclerosis is limited; the transition effects of metabolic health and obesity phenotypes have been ignored. We examined the association between metabolic health and the transition to atherosclerosis risk across body mass index (BMI) categories in a community population. This cross-sectional study was based on a national representative survey that included 50,885 community participants aged ≥40years. It was conducted from 01 December 2017 to 31 December 2020, in 13 urban and 13 rural regions across Hunan China. Metabolic health was defined as meeting less than three abnormalities in blood pressure, glucose, high-density lipoprotein cholesterol, triglycerides, or waist circumference. The participants were cross-classified at baseline based on their metabolic health and obesity. In addition, the relationship between atherosclerosis and transitions in metabolic health status based on 4733 participants from baseline to the second survey after 2years was considered. The relationship between metabolic health status and the risk of transition to Carotid atherosclerosis (CA) was assessed using logistic regression and Cox proportional hazards regression analyses. In this study, the mean age of the participants was 60.7 years (standard deviation [SD], 10.91), 53.0% were female, and 51.2% had CA. As compared with metabolically healthy normal weight (MHN), those with MHO phenotype (odd ratio [OR] 1.10, 95% confidence interval [CI] 1.02-1.21), metabolically unhealthy normal weight (OR 1.27, 95% CI 1.19-1.35), metabolically unhealthy overweight (OR 1.41, 95% CI 1.33-1.48), and metabolically unhealthy obese (OR 1.54, 95% CI 1.44-1.64) had higher risk for CA. However, during the follow-up of 2years, almost 33% of the participants transitioned to a metabolically unhealthy status. As compared with stable healthy normal weight, transition from metabolically healthy to unhealthy status (hazard ratios [HR] 1.21, 95% [CI] 1.02-1.43) and stable metabolically unhealthy overweight or obesity (MUOO) (HR 1.32, 95% CI 1.17-1.48) were associated with higher risk of CA. In the community population, obesity remains a risk factor for CA despite metabolic health. However, the risks were highest for metabolically unhealthy status across all BMI categories. A large proportion of metabolically healthy overweight or participants with obesity converts to an unhealthy phenotype over time, which is associated with an increased risk of CA.

Spatial analysis of public attitudes towards domestic leisure tourism in Bulgaria

Tourism is a very important sector for the Bulgarian economy with its GDP share varying between 10 and 13% before the COVID-19 health crisis. In 2021 domestic tourism accounted for 89% of the personal travel expenditures of Bulgarians. The purpose of the present paper is to analyse public attitudes towards the domestic leisure tourism in Bulgaria and its spatial distribution at the NUTS-2 regions and the residence place type level. The data used in the research are from a national representative survey based on a two-staged random sample stratified by the Bulgarian districts and the residence place type (capital, district administrative centre, town and village). The methodology includes: literature review, descriptive analysis, spatial analysis, average values, building one- and two- dimensional frequency distributions, statistical hypothesis testing, etc. The indicators used in the paper are: practices for domestic leisure tourism, stay duration in domestic resorts, frequency of domestic leisure tourism, people not practicing domestic leisure tourism, domestic leisure tourism average satisfaction level. The obtained results show the differences between those indicators in NUTS-2 and residence place type level, as well as between summer and winter leisure tourism. The presented results are of particular importance, since some of these differences are significantly large.

Public awareness and perceptions of ocean plastic pollution and support for solutions in the United States

We conducted a nationally-representative survey of United States (U.S.) adults (n=1,960) in 2021 to gather insights on the knowledge, perceptions, and concerns about threats to the ocean, with a specific focus on plastics and microplastic pollution. Responses from the U.S. adult survey group were compared to a group of highly-engaged, Ocean Conservancy members who are very attuned to ocean issues (n=882). Ocean Conservancy is a U.S.-based nonprofit environmental advocacy group working to protect the ocean from today’s greatest challenges. Plastic pollution was the primary ocean concern identified by both U.S. adults and Ocean Conservancy members, surpassing eight other threat categories including oil spills, chemical and nutrient pollution, and climate change. Broad concern was reported for both study groups about the impacts of ocean plastics on marine wildlife, with human health and coastal community impact concerns being less prominent. About half of U.S. adults and 90% of Ocean Conservancy members had heard of microplastics. Both study groups indicated widespread support for microplastic pollution prevention measures in the U.S. and believed industry to be most responsible for taking action to address it. Ocean Conservancy members were generally better informed and more concerned about plastic pollution impacts and microplastics than U.S. adults and reported significantly greater levels of personal action to reduce their plastic footprint when compared to U.S. adults. In general, U.S. adults reported a willingness to refuse single-use plastics, but less frequently brought personal food containers to restaurants for takeout, or contacted local representatives or businesses about reducing plastic waste and pollution. Overall, our survey results provide new insights about public understanding of ocean threats and plastic pollution, willingness to participate in individual plastic-reduction actions, and support for needed solutions.

Association of social isolation and loneliness with the risk of hypertension in middle aged and older adults: Findings from a national representative longitudinal survey

BackgroundSocial isolation and loneliness have been proved to be associated with many adverse health outcomes, but their influence on hypertension remains unclear. This study aimed to assess the relationship of social isolation and loneliness with hypertension risk among middle-aged and older adults in China. MethodsWe used data from the 2011 and 2015 waves of the China Health and Retirement Longitudinal Study. Participants were assessed for social isolation and loneliness at baseline, and hypertension was identified by self-report and blood pressure measurement at follow-up in 2015. Binary logistic regression analyses were conducted to assess the association of social isolation and loneliness with the risk of hypertension. ResultsA total of 3711 residents were included. 13.7 % of the participants had high level of social isolation and 18.1 % felt lonely. During the four-year follow up period, 651 participants developed hypertension. People with high level of social isolation had an increased risk of hypertension (odds ratio [OR]: 1.40, 95 % confidence interval [CI]: 1.09–1.79). Similar results were found between social isolation score and hypertension risk (OR: 1.14, 95 % CI: 1.04–1.26). No significant association between loneliness and hypertension or any interaction effect of social isolation and loneliness on hypertension were observed. LimitationsLimited by the structure of questionnaire, some of the information was derived by self-report, which may lead to recalling bias. ConclusionSocial isolation, rather than loneliness was associated with hypertension for middle aged and older adults. Social support needs to be strengthened for hypertension prevention in community.

Oral health in emerging countries and suggestions for adjusted care strategies

Objective: Investigation into the oral health status of selected emerging countries from different regions of the world, so as to capture a broad spectrum of oral health reality prevailing in fast-growing middle-income countries, the aim being to present helpful steps towards adjusted strategies that improve the dental health of the entire population. Method: Using a composite indicator, the Dental Health Index, the oral health of entire populations is measured and compared with the aid of these quantifiable results. The study relies on existing data, where possible, from national representative surveys. Results: The best performer is the upper middle-income country of China. It is followed by India and Vietnam, two lower middle-income states, which placed second and third, although the two latter populations are largely untouched by professional dental activities. This finding is scientifically challenging to explain and needs further investigation. The relative wealthiest country, Malaysia, ranks in the sixth place while Brazil, with one of the highest dentist per capita ratios in the world, places only eighth, just ahead of the Philippines which ranks last in the study. Conclusion: Over the last decade, the awareness and the willingness shown by all countries to improve their precarious oral care situations resulted in the successful implementation of dental care strategies. However, the main obstacles - the widespread shortage of dentists and the poor oral health awareness among the population, particularly those living in poor and/or rural areas - can only be overcome by development-stage adjusted strategies. The broad use of teledentistry (TD) and priority education and training of mid-level dental professionals could be promising instruments for solving these shortcomings in a manageable period of time and under limited financial resources. To attract additional financial and technical resources and expertise, public/private partnerships should also be encouraged.

Domestic leisure tourism destination choice and who do we trust-the case of Bulgaria

Destination marketing and branding are key factors that considerably influence the destination choices for both domestic and international visitors. Understanding the dynamics of how tourists select which destination to visit is crucial for destination planners, tourism organizations, and businesses. This is particularly so in the context of domestic tourism, in which it is imperative to study the factors that influence consumer choices and more specifically, the factors that influence domestic destination choices. This paper explores the influence of different information sources when choosing a destination in the context of the domestic tourism market in Bulgaria. The study is based on the data collected from a national representative survey (N = 1,003) which utilizes a two-staged random sample stratified by districts and the residence place type. The findings suggest that the most influential information source for destination choice for domestic visitors is the opinions/suggestions of friends and relatives. This is the case for all age groups, regardless of their gender, marital status, number of children, education levels, income, or place of residence. The findings of the study provide valuable insights into the existent literature on domestic tourism and destination marketing. Although particularly focused on the unique dynamics of domestic tourism in Bulgaria, the findings of the study can be useful to tourism stakeholders at destinations with a developed domestic market, particularly in Central and Eastern Europe.

Overview of Patients with Hemophilia in China: Demographics, Diseases, Treatment, and Health Status.

In China, there were over 65,000 hemophilia patients according to estimations requiring overall description. However, former Chinese studies related to hemophilia were based on data of relatively small sample size from single-center or selected multi-centers in specific areas. This study is aimed to provide an overview of patients with hemophilia in China and basic information for optimized hemophilia care and policy decisions in the future. We cooperated with the biggest patient organization of hemophilia in China, Hemophilia Home, got access to over ten thousand registered patients with hemophilia and conducted a national representative online survey in 2021. Descriptive statistics were conducted to describe the mean and standard deviation for continuous variables and numbers and proportions for categorical variables. Nine hundred and fifty patients with hemophilia aged 0-71 years were included in our analysis and divided into 538 children and 412 adults. Compared to international research, consistent results were found regarding the proportions of hemophilia types and hemophilia severity, while Chinese patients had less opportunity to receive the formal education and the lower rate to be employed or married. Although children with hemophilia had higher household income, timely treatment, and more prophylaxis treatment leading to better clinical outcomes and higher HRQoL than adults, there were still more annual bleeds, chronic pains, and lower EQ-VAS scores especially in adults than in other countries. Our findings suggest the urgency for promoting hemophilia care and improving the social adaptation of hemophilia patients in China.

Hand and Oral Hygiene Practices of South Korean Adolescents Before and During the COVID-19 Pandemic

Only a few studies have examined the long-term trends of hand and oral hygiene, especially among adolescents. To investigate the 15-year trends in frequency of handwashing and toothbrushing and examine the factors associated with hand and oral hygiene, particularly during the COVID-19 pandemic. This cross-sectional study, performed from January 1, 2008, to December 31, 2022, used general population-based data from 963 644 individuals in a national representative survey (Korea Youth Risk Behavior Web-based Survey [KYRBS]). COVID-19 pandemic. Trends in hand and oral hygiene practices were measured by how frequently adolescents washed their hands and whether they fulfilled the recommended guidelines for toothbrushing. An interrupted time series analysis using linear and logistic regression models was performed to assess any associations with the COVID-19 pandemic. Hand and oral hygiene behaviors before and during the pandemic in each sociodemographic subgroup were also compared. In the 963 644 adolescents (495 697 [51.4%] male; mean [range] age, 15.01 [12-18] years) who participated in the KYRBS from 2008 to 2022, a 73.3% (95% CI, 59.4%-97.4%; P < .001) immediate increase was seen in overall hand hygiene behavior at the onset of the COVID-19 pandemic compared with the prepandemic period, with a sustained decrease thereafter (β = -0.018; 95% CI, -0.022 to -0.015; P < .001). Meanwhile, no immediate increase was observed in terms of overall oral hygiene behavior (0.1%; 95% CI, -0.9% to 1.1%; P = .82); however, there was a sustained decrease during the pandemic (β = -0.018; 95% CI, -0.020 to -0.016; P < .001). Older age, female sex, nonsmoking status, alcohol use, low household economic level, and poor school performance were significantly associated with poor hand hygiene during the pandemic. In this cross-sectional study of South Korean adolescents, an increase in the prevalence of hand hygiene was observed during the early pandemic; however, this prevalence decreased over time. Meanwhile, the decrease in the prevalence of oral hygiene was more pronounced during the pandemic. This study recommends stronger guidelines for adolescent health coaches, such as teachers or public health advisers, regarding hygiene behaviors, even after the COVID-19 pandemic ends.

Financial Hardship on Food Security in Ageing Populations.

Objective: This study investigated the prevalence of food security, and the association of food security with financial hardship and socio-demographic characteristics among the ageing population in Thailand. Methods: The study extracted data on 1,197 persons age 60years or older from a nationally-representative sample survey of Thai households. The food security data were collected using the Food Insecurity Experience Scale (FIES), developed by the Food and Agriculture Organization. Multiple regression analysis was used to investigate the association between financial hardship, socio-demographic characteristics, and food security. Results: Of the total sample, 71% had food security. The least probability of having food security was observed in the respondents who sometimes and often had income problems (p < 0.001), and felt dissatisfied with their financial situation (p < 0.001). The respondents who were female, at oldest-old age, with lower than primary school education and in the Northeast were less likely to have food security. Conclusion: These findings suggest the need for government assistance for those who are experiencing financial hardship to help them manage their finances and food security more effectively, taking into account different socio-demographic characteristics.

Contraceptive use by number of living children in Ghana: Evidence from the 2017 maternal health survey

Background There is a significant literature describing the link between parity and contraceptive use. However, there is limited knowledge about the disaggregation by parity of the type of contraceptives. In this study, we describe the use of contraceptives by parity among women of reproductive age in Ghana, focusing on use of highly effective methods (injection, pill, intrauterine device, implant, and sterilization). Methods Using the 2017 Ghana Maternal Health Survey, a nationally-representative cross-sectional household survey, we describe contraceptive method use by number of living children among sexually active women of reproductive age. We then estimated predictors of use of highly effective contraception in a multilevel logistic regression model. Results Most women in this survey are not using any method of contraception, although this varies by whether or not they have begun childbearing. Contraceptive method use varies by number of living children. Before having children, natural (periodic abstinence and withdrawal) and episodic (condoms) methods dominate. Once a woman has one living child, method preference changes to injectables and implants. Factors associated with using a highly effective method of contraception are: having &gt;3 children, being in a relationship, having had an abortion, being younger than age 30, and having had sexual intercourse within days of answering the survey (p &lt; .001 for all). Conclusion In this analysis, the number of living children a woman has, her age, and timing of last intercourse are the most significant predictors of using a highly effective method of contraception. However, the majority of participants in this study report not using any method of contraception to avoid unwanted pregnancies. Future research that attempts to unpack the disconnect between not wanting to become pregnant and not using contraception is warranted.

Associations of Healthy Eating Behavior with Mental Health and Health-Related Quality of Life: Results from the Korean National Representative Survey.

Healthy eating behaviors may be related to mental health and health-related quality of life. This study investigates the associations between diet quality, mental health, and health-related quality of life among men and women in Korea. A total of 6823 participants, aged 19, from the 7th Korea National Health and Nutrition Examination Survey from 2016 to 2018 were included. Their overall diet quality was estimated using the Korean Healthy Eating Index (KHEI). Multivariate logistic regression was used to identify the associations between diet quality, mental health, and quality of life. The prevalence of stress perception and depression was highest in the lowest tertile of the KHEI score and higher for women than men. Among men, a significant association was observed only for stress perception and depressive symptoms in the second tertile, with odds ratios of 0.745 (95% CI, 0.585-0.949) and 0.519 (95% CI, 0.275-0.980). In contrast, the multivariate-adjusted odds ratios for stress perception, depressive symptoms, and low EQ-5D index among women in the highest tertile were 0.668 (95% CI, 0.541-0.823), 0.464 (95% CI, 0.288-0.746), and 0.722 (95% CI, 0.566-0.920), and significant dose-response associations were observed. A higher-quality diet was associated with a lower risk of stress and depression and a better quality of life. Thus, healthy eating behaviors may improve mental health and quality of life.

Examining the rural–urban differentials in yoga and mindfulness practices among middle-aged and older adults in India: secondary analysis of a national representative survey

Physical activity and mental well-being play an important role in reducing the risk of various diseases and in promoting independence among older adults. Appropriate physical activity, including yoga and mindfulness practices, can help rectify the loss of independence due to aging and have a positive influence on physical health and functional activities. This study assessed rural–urban differences in yoga and mindfulness practices and their associated factors among middle-aged and older Indian adults. The total sample size considered for the current analysis was 72,250 middle-aged and older adults (aged ≥ 45 years). Bivariate and multivariable logistic regression analyses were used to estimate the prevalence of yoga and mindfulness practices and examine the associations of selected variables with yoga and mindfulness practices among the participants. Further, we used the Fairley decomposition technique to determine the factors contributing to rural–urban differences in the prevalence of yoga and mindfulness practices among middle-aged and older adults. More than 9% of middle-aged and older adults in rural areas and 14% in urban areas reported practicing yoga and mindfulness activities more than once per week. Adults aged ≥ 65 years were more likely to practice yoga and mindfulness activities than those who age 45–54 years were. Those with an education of ten years and above were 2.3 and 2.1 times higher likely to practice yoga in rural (AOR: 2.28; CI: 2.07–2.52) and urban (AOR: 2.13; CI: 1.91–2.37) areas compared to their uneducated peers, respectively. The largest contributors in diminishing the gap in yoga practice among participants were education (44.2%), caste (2.5%), chronic diseases such as hypertension (4.53%), diabetes (1.71%), high cholesterol (3.08%), self-reported pain (5.76%), and difficulties in instrumental activities of daily living (1.22%). The findings suggest that middle-aged and older adults in urban areas practice yoga and mindfulness activities more than their peers in rural areas do. Education level, household characteristics, and health outcomes such as chronic conditions, pain, and functional difficulties explain the observed differences in yoga and mindfulness practices across rural and urban areas. Age-appropriate healthy practices such as yoga and mindfulness should be encouraged to enhance the physical and mental well-being of middle-aged and older adults, especially in rural areas.

The association between electronic health information usage and patient-centered communication: a cross sectional analysis from the Health Information National Trends Survey (HINTS)

BackgroundPatient-provider communication can be assessed by the patient-centered communication (PCC) score. With rapid development of electronic health (eHealth) information usage, we are uncertain of their role in PCC. Our study aims to determine the association between PCC and eHealth usage with the analysis of national representative survey data.MethodsThis is a cross sectional analysis using the Health Information National Trends Survey 5 (HINTS 5) cycle 1 to cycle 4 data (2017–2020). Seven specific questions were used for PCC assessment, and eHealth usage was divided into two types (private-eHealth and public-eHealth usage). A multivariate logistic regression was performed to determine the association between PCC and eHealth usage after the adjustment of other social, demographic, and clinical variables.ResultsOur study analyzed a total of 13,055 unweighted participants representing a weighted population of 791,877,728. Approximately 43% of individuals used private eHealth and 19% used public eHealth. The adjusted odds ratio (AOR) of private-eHealth usage associated with positive PCC was 1.17 (95% CI 1.02–1.35, p = 0.027). The AOR of public-eHealth usage associated with positive PCC was 0.84 (95% CI 0.71–0.99, p = 0.043).ConclusionOur study found that eHealth usage association with PCC varies. Private-eHealth usage was positively associated with PCC, whereas public-eHealth usage was negatively associated with PCC.

A Bottom-Up Analysis of Societal Belief in Judicial Independence in Russia

The study represents a first effort to explore societal sources of support for judicial independence under authoritarianism. Contemporary Russia, which is characterized by legal dualism, under which judges pay close attention to the governing law when resolving mundane cases but routinely twist this law beyond recognition in politicized cases, presents an ideal case study. Drawing primarily on two national representative surveys, fielded in 2008 and 2018, the author finds that a majority of Russians believe their judges to be under the control of political officials. Higher education and prior court experience are key predictors of skepticism. The study complicates the relationship among these factors by singling out Russians with legal education. Despite their high levels of knowledge and experience, law graduates are more likely to believe in judicial independence than other university graduates. This suggests the importance of drawing a contrast between those with profound knowledge, such as lawyers, and those with superficial knowledge. Thanks to their educational socialization and deeper understanding of the messy reality of courts, Russian lawyers are more forgiving of the courts’ shortcomings.

Using Pornography, Paying for Sex, and Violence: A Danish National Survey Study

ABSTRACTOnly a few national cohort studies on using online pornography and buying sex have been published. The overall aim of this study, which analyzed data from a representative Danish national survey, was to provide an overview of incidence and associated population characteristics. The key aims were: first, to analyze frequencies of using online pornography and buying sex stratified by gender and other background characteristics; and, second, to investigate if and how using online pornography and buying sex were associated with sexual satisfaction, sexual activity, and violence. The findings revealed that having ever paid for sex and higher use of pornography were each associated with being male, younger, and not being in a relationship. Further, among men, having ever paid for sex and higher use of pornography were associated with not being sexually satisfied and, in part of the analysis, having committed violence to another person in the last year; however, these particular relationships were not statistically significant in the appropriately controlled regression analysis. We discuss gender, age, sexual aggression, and sexual satisfaction as factors associated with higher pornography use and buying sex.

Involvement in the “Shadow Economy”: Imaginary Psychological Readiness and Real Participation

The article presents unpublished, new empirical data on the psychological readiness of Bulgarians to become part of shadowy economic practices, as well as estimates of actual participation in such practices. The data are derived from a national representative survey of the population conducted in 2021, but have not lost their relevance, since the economic behavior of individuals is characterized by a high degree of constancy. The research shows a relatively high psychological readiness for inclusion in the “shadow economy”, and two violations of the labor and insurance legislation are most often encountered in the Bulgarian economy – work without a contract and work with a fictitious contract, in which the person is insured for a smaller amount, but he is paid additional tax-free cash – “money in a bag”. About one-third of Bulgarians are defined as economic deviants (violating laws and regulations), while the other two-thirds adhere to economic conformism (follow laws and regulations) in their behavior. In this context, the question of mastering the “shadow economy” remains open, and its relevance not only does not diminish, it also necessitates the activation of the efforts of the entire society.

Racial and Ethnic Disparities for Unmet Needs by Mental Health Condition: 2016 to 2021.

Racial and ethnic minority children receive less care and inferior care in the United States, but less is known about how these disparities vary by mental health conditions. We examined unmet mental health needs by condition types to identify potentially hidden racial and ethnic inequities. We used data from the nationally representative National Survey of Children's Health, from 2016 to 2021 (n = 172 107). Logistic regression analyses were applied to mental health conditions in aggregate and individually and adjusted for individual and household characteristics. Relative to non-Hispanic white children with any mental health condition, non-Hispanic Black children had greater odds of unmet needs (adjusted odds ratio [aOR] = 1.56, 95% confidence interval [CI]: 1.18-2.05). Models disaggregated by specific mental health conditions revealed heterogeneous patterns. Specifically, relative to non-Hispanic white children, non-Hispanic Black children displayed elevated odds of unmet needs for behavioral problems (aOR = 1.41, 95% CI: 1.00-2.02), whereas Asian and Hispanic children displayed elevated odds for anxiety (aOR = 2.60, 95% CI: 1.20-4.29 and aOR = 1.41, 95% CI: 1.05-1.90, respectively). Racial and ethnic minority children are disproportionately affected by unmet treatment needs. These disparities vary by individual mental health conditions and persist after controlling for socioeconomic characteristics. Results reveal clinically underserved racial and ethnic groups across different mental health conditions.

Cancer cases attributable to modifiable lifestyle risk factors in Switzerland between 2015 and 2019.

Several modifiable lifestyle risk factors have been linked to higher cancer risk in the literature. Determining the proportion and number of cancer cases attributable to these risk factors is pivotal in informing effective cancer prevention and control plans that have the greatest effect on reducing cancer incidence. We aimed to estimate the proportion and number of incident cancer cases that were attributable to modifiable lifestyle risk factors (ie, tobacco smoking, high alcohol consumption, excess body weight, physical inactivity and unhealthy diet) in Switzerland between 2015 and 2019. The exposure prevalence of selected risk factors was estimated based on the representative national nutrition survey menuCH, the associated relative risks were obtained from systematic literature reviews and the numbers of incident cancer cases were provided by the National Institute for Cancer Epidemiology and Registration. The fractions and numbers of attributable cases were calculated overall, by sex and by the three major language regions of Switzerland. The investigated modifiable risk factors combined were linked to 25.2% of potentially preventable incident cancer cases in Switzerland between 2015 and 2019. The proportion and numbers were slightly larger in males (28.4%, 6945 cases per year) than in females (21.9%, 4493 cases per year), and variations were observed between language regions. Tobacco smoking, excess body weight and high alcohol consumption were the leading contributors to lifestyle-attributable cancer cases. The observed differences in the leading risk factors both within Switzerland and compared to other countries underline the need for regionally and nationally tailored cancer prevention and education strategies.