Socio-environmental Determinants Research Articles

Inequalities in preterm birth by deprivation and ethnicity: A national cohort study in England

Abstract Background Preterm birth has decreased in the UK; however, the extent of inequalities remains unclear. This study aimed to quantify socioeconomic and ethnic inequalities in preterm birth rates using routinely collected maternity data in England. Methods Retrospective analysis of cohort data from the NHS England Hospital Episode Statistics (HES). All women aged 13-55 with a singleton livebirth (April 2018 to March 2021) at 24-42 weeks were included. Multivariate Poisson regression was used to estimate the rate of preterm birth (livebirth between 24 + 0 and 36 + 6 weeks’) for each ethnic and deprivation postcode group, these were compared to white women from the least deprived 20% of areas. We iteratively developed the model, adjusting for covariates associated with preterm birth. A post-hoc calculation identified the rate of preterm birth for each ethnic group at each level of deprivation. Results We identified 1,111,045 livebirths between April 2018 and March 2021. The rate of preterm birth increased with socioeconomic deprivation and was highest at 7.1% per 100 livebirths (95%CI:7.00-7.20) in women living in the 20% most deprived areas, compared to 5.6% (95%CI:5.50-5.74) in women in the 20% least deprived areas. White women had the lowest preterm birth rate at 6.5% (95%CI:6.47-6.58) and South Asian women had the highest rate at 6.9% (95%CI:6.76-7.04) (Table 2). The rate of preterm birth increased according to increased area-level deprivation across all ethnic groups. In areas of high deprivation, the preterm birth rate was similar across ethnic groups. Whereas in less deprived areas, there were marked inequalities between ethnic groups. Conclusions Inequalities in preterm birth remain, despite overall decreases in preterm birth. We found area deprivation and individual ethnicity interact to increase the risk of preterm birth in marginalized communities. Interventions need to holistically consider the structural and socioenvironmental determinants of preterm birth. Key messages • Area deprivation and ethnicity remain key drivers of inequalities in preterm birth, despite overall decreases in preterm birth. • To reduce inequalities tailored prevention strategies are needed to address socioenvironmental and structural determinants of preterm birth in high deprivation areas and minoritized ethnicity groups.

The socio-environmental determinants of diabetes and their consequences.

The intricate connections between health and the environment are often overlooked globally, yet they play a pivotal role in shaping our well-being. Astonishingly, environmental risk factors contribute to nearly 24% of the global disease burden, underscoring the critical impact of our surroundings on health. At the crossroads of this issue lies Diabetes, a rapidly growing non-communicable disease that highlights the delicate balance between human health and environmental sustainability. This epidemic offers a unique lens through which to explore how environmental factors contribute to the prevalence of Diabetes, revealing the complex interplay at work. Despite growing awareness, healthcare systems worldwide face challenges integrating environmental threats into more effective diabetes care strategies CONCLUSIONS: This perspective highlights the urgent need for collaborative efforts and innovative solutions that address the environmental dimensions of diabetes management. Doing so can build healthier communities and pave the way for a more sustainable future.

Exploring the role of proximal and distal socioenvironmental determinants on the practice of mammography among Argentine women

Exploring the role of proximal and distal socioenvironmental determinants on the practice of mammography among Argentine women

Implications for Socio-environmental Determinants of Health-Informed Health Worker Wellness Programs: Findings from a Cross-Sectional Study.

To explore how socio-environmental factors may potentially impact health outcomes across different groups of health workers (HW). Data from the California Healthy Places Index (HPI) and administrative dataset including 12,715 HWs were analyzed using analysis of variance and two-step cluster analysis to evaluate variations in socio-environmental factors across 11 HW job categories. While physicians had the highest average HPI percentiles (69th percentile) across almost all HPI components, the lower-wage HWs consistently ranked below the state average (50th percentile). Overall, the HPI percentile was lowest for environmental living conditions and pollution for all HCWs (30th percentile). The education (52nd percentile) and economic components (59th percentile) were higher than the state average. The findings from this highlight the importance of socio-environmental determinants of health-informed employee wellness programs and research studies.

Paving the complex path to building climate resilient cities through disaster health diplomacy and international public health policy

Disaster resilience defines society’s capabilities to resist/adapt/recover from hazardous events. Priorities for action were outlined at the Sendai Framework for Disaster Risk Reduction to reduce disaster risks by understanding the process, strengthening governance, investing in resilience, improving preparedness/effective response capacities/rehabilitation processes/reconstruction procedures. Disaster diplomacy is a fast growing interdisciplinary field. Natural disasters potentially generate opportunities for diplomatic interaction between rival parties/conflicting states. Climate crisis is growing. By large, Summer 2023 was globally the warmest on record. The 2015 Paris Agreement was a landmark; UNOHCHR proposes a universal decleration of disaster rights. Climate change has widespread impacts on human health. “The greatest health threat of the 21stcentury” affects socio environmental determinants of health, clean air/water/food/shelter. Ninety percent of all disasters are climate/weather related, resulting in >410,000deaths in the last decade, expected to cause 250,000 additional deaths/year from malnutrition/malaria,/diarrhoea/heat stress in 2030 2050. IFRC focuses on strengthening ownership/community leadership/outreach/funding/forecasting/anticipatory action. Climate related flashpoints are the early warnings of impending crises. Turkey Greece have a lot in common from a climate change/disaster resilience viewpoint. Successive earthquakes generated rescue responses/mutual aid/outpouring of sympathy between the two countries within the last decade. Extreme weather events, high temperatures, severe rainfalls continue to batter both countries. Global warming brought intense flooding/wildfires to Southeast Europe/Southwest Asia. Climate change is expected to become the strongest driver of human migration through complex mechanisms in the Mediterranean Basin. The sustainability of Greece’s migration policies may be challenged against the global climate crisis. Environmental change has potential impacts on human health. Health diplomacy in international relations focuses on protecting health/well being. In the past, health interventions as foreign policy were regarded not to be associated with diplomatic disaster efforts. This oral presentation challenges earlier opinions and proposes a “climate change health diplomacy model” for improving capacities in disaster resilience. Around the world, health care professionals speak a unique/universal language of their own. Countries with “otherwise conflicting interests,” stand in solidarity during natural disasters. Through further elaborating on the principles of sustainable collaboration on disaster risks/health diplomacy/climate change, a “first time disaster health diplomacy model” may be developed to serve the world. An outline is hereby presented, 1 to define paths of communication versus the current ad hoc disaster diplomacy efforts, 2 to incorporate risks into the disaster diplomacy plan, 3 to incorporate a well planned disaster health diplomacy agreement. As the Turkish saying goes, “HEALTH COMES FIRST”.

The Socio-Environmental Determinants of Childhood Malnutrition: A Spatial and Hierarchical Analysis.

Despite a remarkable reduction in global poverty and famines, substantial childhood malnutrition continues to persist. In 2017, over 50 million and 150 million young children suffered from acute malnutrition (wasting) and chronic malnutrition (stunting), respectively. Yet, the measurable impact of determinants is obscure. We evaluate proposed socio-environmental related determinants of stunting and wasting across Kenya and Nigeria and quantify their effectiveness. We combine health and demographic data from Kenya and Nigeria Demographic Health Surveys (2003, 2008-2009, 2013, 2014) with spatially explicit precipitation, temperature, and vegetation data. Geospatial and disaggregated data help to understand better who is at risk and where to target mitigation efforts. We evaluate the responsiveness of malnutrition indicators using a four-level random intercept hierarchical generalized logit model. We find that spatial and hierarchical relationships explain 28% to 36% of malnutrition outcome variation. Temporal variation in precipitation, temperature, and vegetation corresponds with more than a 50% change in malnutrition rates. Wasting is most impacted by mother's education, family wealth, clinical delivery, and vaccinations. Stunting is most impacted by family wealth, mother's education, clinical delivery, vaccinations, and children asymptomatic of fever, cough, or diarrhea. Remotely monitored climatic variables are powerful determinants, however, their effects are inconsistent across different indicators and locations.

Life narratives of individuals with psychosis in ethnic minority and migrant communities in Canada and the Netherlands

AbstractBackground Increased psychosis risk has long been reported for some migrant and ethnic minority populations, a finding has been replicated in different parts of the world, with risk seeming to persist for further generations. Several explanations such as genetic liability or selective migration, higher cannabis-use or higher exposure to neurodevelopmental risk factors were considered unlikely explanations. Rather, exposure to adversity experiences found to be a determinant of psychotic disorders, such as parental separation, social and economic disadvantage, discrimination, social exclusion and marginalization. Additionally, migrants often live in cities, where high population density, low social cohesion and social fragmentation and deprivation, combined with lack of green space and urban stress increase the psychosis risk. Although previous research work has emphasized the quantitative exploration of social-environmental determinants of psychosis, qualitative studies allow for the generation of innovative, rich and nuanced understandings about a given phenomenon, being an ideal approach in face of complex social dynamics and contexts. Concretely, the associations are established, however, the underlying mechanisms and experiences remain largely unknown. This study aims to address several research gaps identified in research on the issues of psychosis, socio-environmental determinants of mental health, migration and ethnicity, and inequalities by exploring the life narratives and experiences of service-users with first psychosis with distinct ethnic, racial and migrant backgrounds.Methods Participants aged between 18 and 35 years old, who have been diagnosed with a first psychosis are recruited in Montreal, Canada, and in the Netherlands. The aim is to recruit at least 20-25 individuals from each site, but recruitment is still ongoing. Qualitative interviews of about an hour are being held, and transcripts will be analyzed with Nvivo, software for qualitative data. Categories and clusters will be formed from the narratives, resulting in common themes that are important to the patients, in their understanding of the development of their psychosis, and the help they have received.ResultsPreliminary data show that the patients have predominantly African or (Eastern)European background, moved around a lot, and experiences inequities. Help and care were not always available for them, not always beneficial. Participants experiences a lot of isolation and deplacement, together with socio-economic disadvantages. Common themes as to by which mechanisms these aspects play a role will further be explored.DiscussionThese findings will be discussed in light of the quantitative data already existing. Implications for prevention and interventions will be discussed.Disclosure of InterestNone Declared

Vulnerability factors and care specific to women and addictions

Like behavioral addictions, substance misuse is a complex disorder, influenced by psychological, clinical and socio-environmental determinants. The processes that lead to addiction are common to both men and women, but patterns of use, risk behaviors and their repercussions differ. Women's access to care is often delayed because they are regularly subjected to stigmatization, violence, and economic or family constraints. Caremust be better adapted to their specific needs.

Analyzing socio-environmental determinants of bone and soft tissue cancer in Indonesia

BackgroundThis study is designed to explore the potential impact of individual and environmental residential factors as risk determinants for bone and soft tissue cancers, with a particular focus on the Indonesian context. While it is widely recognized that our living environment can significantly influence cancer development, there has been a notable scarcity of research into how specific living environment characteristics relate to the risk of bone and soft tissue cancers.MethodsIn a cross-sectional study, we analyzed the medical records of oncology patients treated at Prof. Suharso National Referral Orthopedic Hospital. The study aimed to assess tumor malignancy levels and explore the relationships with socio-environmental variables, including gender, distance from the sea, sunrise time, altitude, and population density. Data were gathered in 2020 from diverse sources, including medical records, Google Earth, and local statistical centers. The statistical analyses employed Chi-square and logistic regression techniques with the support of Predictive Analytics SoftWare (PASW) Statistics 18.ResultsBoth bivariate and multivariate analyses revealed two significant factors associated with the occurrence of bone and soft tissue cancer. Age exhibited a statistically significant influence (OR of 5.345 and a p-value of 0.000 < 0.05), indicating a robust connection between cancer development and age. Additionally, residing within a distance of less than 14 km from the sea significantly affected the likelihood of bone and soft tissue cancers OR 5.604 and p-value (0.001 < 0.05).ConclusionsThe study underscores the strong association between age and the development of these cancers, emphasizing the need for heightened vigilance and screening measures in older populations. Moreover, proximity to the sea emerges as another noteworthy factor influencing cancer risk, suggesting potential environmental factors at play. These results highlight the multifaceted nature of cancer causation and underscore the importance of considering socio-environmental variables when assessing cancer risk factors. Such insights can inform more targeted prevention and early detection strategies, ultimately contributing to improved cancer management and patient outcomes.

Социально-психологические детерминанты отношения различных социальных групп к беспилотному автомобилю как технологии будущего

Background. Despite the active development of self-driving transport technology conducted by leading companies around the world, people's attitude to such technology remains ambiguous. The problem of the attitudes of individuals and various social groups to this type of transport, as well as the specifics of the socio-psychological determinants of such attitudes, remain insufficiently studied. Objective. To study the socio-psychological determinants of attitudes toward unmanned vehicles depending on professional background, specifics of the residence place, and age group. Study Participants. The study involved 967 people aged 16 to 72 years (Mage = 25.95; SD = 11.83), including 260 men (27%) and 707 women (73%). Methods. Portrait Value Questionnaire, scale “Inclusion” of the Fundamental Interpersonal Relations Orientation questionnaire, Ten-Item Personality Inventory, the methodology of “Trust/distrust of a person to the world, himself and other people”, a questionnaire of attitudes towards technology, the author's methodology for assessing attitudes towards autonomous vehicles. Results. It is shown that attitudes towards unmanned transport differ among people of different professional backgrounds, living in the cities with different population density, and belonging to different age groups. Multiple regression analysis revealed the intrapersonal predictors of such an attitude: an individual value profile, personality traits, basic trust, the need for inclusion in interpersonal communication, and a technical worldview. At the same time, the set of identified predictors depends on the socio-environmental and socio-demographic determinants. The data analysis allowed to develop an empirical model of socio-psychological determinants of a person's attitude towards an unmanned vehicle. Conclusions. The attitude towards an unmanned vehicle is determined by a number of socio-psychological determinants, which include intrapersonal (individual value profile, personality traits, basic trust, the need for inclusion in interpersonal communication and technical worldview), as well as external socio-environmental and socio-demographic determinants (professional background, place of residence and age specifics).

HIV Prevention and Care Among Black Cisgender Sexual Minority Men and Transgender Women: Protocol for an HIV Status-Neutral Cohort Study Using an Observational-Implementation Hybrid Approach.

Black cisgender gay, bisexual, and other sexual minority men (SMM) and transgender women (TW) continue to be heavily affected by HIV. Further research is needed to better understand HIV prevention and care outcomes in this population. In particular, there is a need for research examining the impact of substance use and sleep health on HIV prevention and treatment outcomes among Black SMM and TW. This paper outlines the study methods being used in the recently launched follow-up study to the Neighborhoods and Networks (N2) study, which we refer to as N2 Part 2 (N2P2). N2P2 aims to address this gap in the literature, build off the findings of the original N2 study, and identify socioenvironmental determinants of health, including whether neighborhood and network factors mediate and moderate these relationships. Building on the N2 cohort study in Chicago from 2018 to 2022, N2P2 used a prospective longitudinal cohort design and an observational-implementation hybrid approach. With sustained high levels of community engagement, we aim to recruit a new sample of 600 Black SMM and TW participants residing in the Chicago metropolitan statistical area. Participants are asked to participate in 3 study visits across an 18-month study period (1 visit every 9 months). Four different forms of data are collected per wave: (1) an in-person survey, (2) biological specimen collection, (3) a daily remote ecological momentary assessment for 14 days after each study visit, and (4) data from electronic health records. These forms of data collection continue to assess neighborhood and network factors and specifically explore substance use, sleep, immune function, obesity, and the implementation of potential interventions that address relevant constructs (eg, alcohol use and pre-exposure prophylaxis adherence). The N2P2 study was funded in August 2021 by the National Institute of Drug Abuse (R01DA054553 and R21DA053156) and National Heart, Lung, and Blood Institute (R01HL160325). This study was launched in November 2022. Recruitment and enrollment for the first wave of data collection are currently ongoing. The N2P2 study is applying innovative methods to comprehensively explore the impacts of substance use and sleep health on HIV-related outcomes among an HIV status-neutral cohort of Black SMM and TW in Chicago. This study is applying an observational-implementation hybrid design to help us achieve findings that support rapid translation, a critical priority among populations such as Black SMM and TW that experience long-standing inequities with regard to HIV and other health-related outcomes. N2P2 will directly build off the findings that have resulted from the original N2 study among Black SMM and TW in Chicago. These findings provide a better understanding of multilevel (eg, individual, network, and neighborhood) factors that contribute to HIV-related outcomes and viral suppression among Black SMM and TW. DERR1-10.2196/48548.

Socioenvironmental determinants as indicators of plague risk in the central highlands of Madagascar: Experience of Ambositra and Tsiroanomandidy districts.

Human plague cases are reported annually in the central highland regions of Madagascar, where the disease is endemic. The socioenvironmental characteristics and lifestyles of the populations of the central highland localities could be linked to this endemicity. The aim of this study was to determine socioenvironmental determinants that may be associated with plague risk and explain this variation in epidemiological contexts. The current study was based on the distribution of plague cases between 2006 and 2015 that occurred in localities of districts positioned in the central highlands. Household surveys were performed from June to August 2017 using a questionnaire and direct observations on the socioenvironmental aspects of households in selected localities. Bivariate and multivariate analyses were performed to highlight the socioenvironmental parameters associated with plague risk in both districts. A total of 503 households were surveyed, of which 54.9% (276/503) were in Ambositra and 45.1% (227/503) were in Tsiroanomandidy. Multivariate analyses showed that thatched roofs [adjusted odds ratio (AOR): 2.63; 95% confidence interval (95% CI): 1.78-3.88] and ground floor houses [AOR: 2.11; 95% CI: 1.3-3.45-] were significantly associated with the vulnerability of a household to plague risk (p value<0.05). Plague risk in two districts of the Malagasy central highlands is associated with human socioenvironmental characteristics. Socioenvironmental characteristics are parameters expressing spatial heterogeneity through the difference in epidemiological expression of the plague in Ambositra and Tsiroanomandidy. These characteristics could be used as indicators of vulnerability to plague risk in plague-endemic areas.

Socio-Environmental Determinants of Mental and Behavioral Disorders in Youth: A Machine Learning Approach.

Growing evidence indicates that extreme environmental conditions in summer months have an adverse impact on mental and behavioral disorders (MBD), but there is limited research looking at youth populations. The objective of this study was to apply machine learning approaches to identify key variables that predict MBD-related emergency room (ER) visits in youths in select North Carolina cities among adolescent populations. Daily MBD-related ER visits, which totaled over 42,000 records, were paired with daily environmental conditions, as well as sociodemographic variables to determine if certain conditions lead to higher vulnerability to exacerbated mental health disorders. Four machine learning models (i.e., generalized linear model, generalized additive model, extreme gradient boosting, random forest) were used to assess the predictive performance of multiple environmental and sociodemographic variables on MBD-related ER visits for all cities. The best-performing machine learning model was then applied to each of the six individual cities. As a subanalysis, a distributed lag nonlinear model was used to confirm results. In the all cities scenario, sociodemographic variables contributed the greatest to the overall MBD prediction. In the individual cities scenario, four cities had a 24-hr difference in the maximum temperature, and two of the cities had a 24-hr difference in the minimum temperature, maximum temperature, or Normalized Difference Vegetation Index as a leading predictor of MBD ER visits. Results can inform the use of machine learning models for predicting MBD during high-temperature events and identify variables that affect youth MBD responses during these events.

Socioeconomic and environmental determinants of foot and mouth disease incidence: an ecological, cross-sectional study across Iran using spatial modeling

Foot-and-mouth disease (FMD) is a highly contagious animal disease caused by a ribonucleic acid (RNA) virus, with significant economic costs and uneven distribution across Asia, Africa, and South America. While spatial analysis and modeling of FMD are still in their early stages, this research aimed to identify socio-environmental determinants of FMD incidence in Iran at the provincial level by studying 135 outbreaks reported between March 21, 2017, and March 21, 2018. We obtained 46 potential socio-environmental determinants and selected four variables, including percentage of population, precipitation in January, percentage of sheep, and percentage of goats, to be used in spatial regression models to estimate variation in spatial heterogeneity. In our analysis, we employed global models, namely ordinary least squares (OLS), spatial error model (SEM), and spatial lag model (SLM), as well as local models, including geographically weighted regression (GWR) and multiscale geographically weighted regression (MGWR). The MGWR model yielded the highest adjusted {R}^{2} of 90%, outperforming the other local and global models. Using local models to map the effects of environmental determinants (such as the percentage of sheep and precipitation) on the spatial variability of FMD incidence provides decision-makers with helpful information for targeted interventions. Our findings advocate for multiscale and multidisciplinary policies to reduce FMD incidence.

How much bilateral and multilateral climate adaptation finance is targeting the health sector? A scoping review of official development assistance data between 2009-2019.

Climate change is adversely affecting human health. Rapid and wide-scale adaptation is urgently needed given the negative impact climate change has across the socio-environmental determinants of health. The mobilisation of climate finance is critical to accelerate adaptation towards a climate resilient health sector. However, a comprehensive understanding of how much bilateral and multilateral climate adaptation financing has been channelled to the health sector is currently missing. Here, we provide a baseline estimate of a decade's worth of international climate adaptation finance for the health sector. We systematically searched international financial reporting databases to analyse 1) the volumes, and geographic targeting, of adaptation finance for the health sector globally between 2009-2019 and 2) the focus of health adaptation projects based on a content analysis of publicly available project documentation. We found that health was largely a co-benefit, not the principal objective, within the projects. We estimate that USD 1,431 million (4.9%) of total multilateral and bilateral adaptation has been committed to health activities across the decade. However, this is likely an overestimate of the true figure. Most health adaptation projects were in Sub-Saharan Africa, with average project funding comparable to East Asia and the Pacific and the MENA region. Fragile and conflict affected countries received 25.7% of total health adaptation financing. The paucity of health indicators as part of project monitoring and evaluation criteria and the lack of emphasis on local adaptation were particularly significant. This study contributes to the wider evidence base on global health adaptation and climate financing by quantifying adaptation funds directed towards the health sector and revealing specific gaps in financing health adaptation. We anticipate these results will support researchers in developing actionable research on health and climate finance and decision-makers in mobilizing funds to low-resource settings with high health sector adaptation needs.

Biopsychosocial Model of Traumatic Stress Symptoms in Women Experiencing Homelessness: A Qualitative Descriptive Study

Trauma is nearly ubiquitous among women experiencing homelessness (WEH). WEH develop post-traumatic stress disorder (PTSD) at rates far exceeding the general population. The consequences of untreated PTSD can cascade, exacerbating existing physical, mental, and social health inequities, placing this population at risk for disproportionate biopsychosocial health adversity. Despite the outsized impact of PTSD, WEH are less likely to access or receive appropriate trauma-focused services. Understanding the unique and intersecting factors that contribute to the disproportionate PTSD toll on WEH may elucidate risk and protective factors, as well as possible intervention pathways to address the disparate trauma burden. This study employed a qualitative descriptive approach to develop understanding of the determinants of trauma risk, exposure, and outcomes among WEH. Semi-structured interviews were completed with 10 WEH, six shelter staff, four mental health professionals. Six deductively biopsychosocial model-derived themes were identified, alongside supporting categories. Themes/categories highlighted the role of biological, psychological, and socio-environmental determinants in shaping risk for and actualization of traumatic events and adverse outcomes. Trauma played an outsized role in shaping the health of WEH participants in this study, and the need for and interest in tailored trauma screening, treatment, psychoeducation options was highlighted. Recursive relationships between biopsychosocial determinants and trauma impact were identified. Participants emphasized population tailored trauma-focused interventions, specifically brief co-designed and community partner implemented interventions that address substance use behaviors, while leveraging the strengths of WEH. Addressing the marked trauma burden in WEH shows promise in promoting measurable biopsychosocial health improvements in this resilient yet overlooked population.

Mapping public health training in Latin America: perspectives for training institutionsMapeamento da formação em saúde pública na América Latina: perspectivas para as instituições formadoras

Map the public health training courses and programs offered in Latin America, and identify regional training strategies and competencies developed in health workers. An internet search was conducted to identify public health training courses and programs offered by Latin American institutions. The following data were collected: name, country, and province/state of the training institution; course name; type of institution; educational level; modality; accreditation; year first offered; periodicity; and contact information. The programs and curricula on offer were analyzed by training level using descriptive content analysis, and the main competencies developed were identified. The mapping identified 2 296 public health training opportunities in all Latin American subregions, distributed across 29 of the Region's 33 countries; these were fairly heterogeneous, both conceptually and programmatically, with uneven geographical distribution within and between countries. In the analysis of curricula and programmatic contents, a need for greater linkage with essential public health functions was detected. It is necessary to adapt the competencies and skills developed by the courses and programs to the demands of users of the regional health services, programs, and systems in order to achieve programs aimed at tackling the socio-environmental determinants of health and the production and reproduction of inequalities.

Susceptibility to smoking and determinants among never-smoking high school students in Thailand.

To prevent youth from becoming smokers, it is essential to understand factors contributing to them becoming susceptible to smoking. The aim of this study was thus to estimate the prevalence of smoking susceptibility among neversmoking youth in Thailand and to identify determinants associated with such behavior. Cross-sectional data for 4572 eighth-grade students (aged 13-15 years) from 120 secondary schools were obtained from a classroom-based survey using a self-administered questionnaire. Using data from never-smoking students (n=3180), simple and multiple logistic regression analyses were performed to identify factors associated with smoking susceptibility. Frequencies and proportions for descriptive statistics are reported along with adjusted odds ratios and 95% confidence intervals for logistic regression models. A total of 16.4% of Thai never-smoking youth were susceptible to smoking. Several variables of interest were identified in multivariable analysis as significantly associated with increased susceptibility to smoking: being male (AOR=3.16; 95% CI: 25.4-3.92), having a positive attitude toward smoking - agreeing that smoking displays maturity (AOR=1.49; 95% CI: 1.07-2.09), the perception that smoking helps relieve stress (AOR=1.57; 95% CI: 1.14-2.15), the presence of current smoking peers (AOR=2.04; 95% CI: 1.57-2.66), exposure to secondhand smoking in public (AOR=1.51; 95% CI: 1.17-1.94), exposure to online cigarette and smoking-related advertising occasionally (AOR=1.98; 95% CI: 1.49-2.65), attendance at schools where there are sometimes anti-smoking education activities (AOR=1.57; 95% CI: 1.18-2.07); as well as exposure to anti-tobacco messages rarely (AOR=1.40; 95% CI: 1.05-1.87), occasionally (AOR=1.48; 95% CI: 1.12-1.96) and infrequently (AOR=1.41; 95% CI : 1.07-1.87). Approximately one in six Thai never-smoking youth was found to be susceptible to smoking. Findings suggest it should be useful to supplement relevant tobacco prevention and control efforts by considering such interpersonal and socio-environmental determinants, among vulnerable people to smoke.

Socio-environmental determinants of parasitic intestinal infections among children: a cross-sectional study in Nigeria

Socio-environmental determinants of parasitic intestinal infections among children: a cross-sectional study in Nigeria

Environmental and social determinants of thyroid cancer: A spatial analysis based on the Geographical Detector.

Thyroid cancer has increased sharply in China in recent years. This change may be attributable to multiple factors. The current study aimed to explore the environmental and social determinants of thyroid cancer. Incidence data from 487 cancer registries in 2016 were collected. Eight factors were considered, namely, air pollution, green space, ambient temperature, ultraviolet radiation, altitude, economic status, healthcare, and education level. A geographical detector (measured by q statistic) was used to evaluate the independent and interactive impact of the eight factors on thyroid cancer. Social factors, especially economic status and healthcare level (q>0.2), were most influential on thyroid cancer.Ultraviolet radiation, air pollution, and temperature had more impact on women, while green space and altitude had more influence on men. Enhanced effects were observed when two factors interacted. Spatially, economic status, healthcare, and air pollution were positively associated with thyroid cancer, while education level, green space, and altitude were negatively related to thyroid cancer. The socio-environmental determinants and spatial heterogeneity of thyroid cancer were observed in this study. These findings may improve our understanding of thyroid cancer epidemiology and help guide public health interventions.