European Journal Of Public Health[JOURNAL]
Sun
200 papers
COVID-19 outcomes by immigrant generation in Sweden: a national cohort population-based study.
Cederström A, Rostila M, Juárez SP
Eur J Public Health · 2025 Dec · PMID 41222480 · Full text
There is a scarcity of studies examining the impact of the COVID-19 pandemic on the descendants of immigrants, a group representing a growing segment of the population in many countries. This study utilized a national co...
There is a scarcity of studies examining the impact of the COVID-19 pandemic on the descendants of immigrants, a group representing a growing segment of the population in many countries. This study utilized a national cohort event history analysis in Sweden, consisting of all residents aged over 20 years at the end of 2019 (n = 7 871 444), with a follow-up period from 31 December 2019 to 1 June 2021. Poisson regression was used to estimate incidence rate ratios for severe COVID-19 morbidity [hospitalization, intensive care unit (ICU) admission] and COVID-19-related mortality based on generation status [first generation (G): foreign-born, arrived as adults; the 1.5 generation: foreign-born, arrived as a child; second generation: native-born to two foreign-born parent; and 2.5 generation: native-born to one foreign-born parents] stratified by their region of origin (Nordics, Global South, and Global North) using the majority population (two native-born parents) as reference. All immigrant generations experienced higher rates for severe COVID-19 morbidity compared to the majority population. While this pattern is observed across all regions of origin, the largest differences appear among individuals with a Global South background. Adjusting for social and health factors moderately attenuates the estimates for the descendants of immigrants. Mixed results are found regarding COVID-19 mortality by region of origin and generational status. All immigrant generations experience a COVID-19 morbidity burden comparable to first-generation immigrants and should thus be considered when planning preventive measures to prepare for future pandemics and health crises.
Trends in incidence, prevalence, and survival of primary liver cancer in the United Kingdom (2000-2021).
Cuyàs B, Alvarado-Tapias E, Tan EH … +9 more , Golozar A, Duarte-Salles T, Delmestri A, Argemi J, Man WY, Burn E, Guarner-Argente C, Prieto Alhambra D, Newby D
Eur J Public Health · 2026 Mar · PMID 41212072 · Full text
Primary liver cancer (PLC) remains a global health challenge. Understanding trends in the disease burden and survival is crucial to inform decisions regarding screening, prevention, and treatment. Population-based cohort...
Primary liver cancer (PLC) remains a global health challenge. Understanding trends in the disease burden and survival is crucial to inform decisions regarding screening, prevention, and treatment. Population-based cohort study using UK primary care data from the Clinical Practice Research Datalink (CPRD) GOLD (2000-2021), replicated in CPRD Aurum. Crude and age-standardized incidence rates (IRs), crude period prevalence (PP), and survival at 1, 5, and 10 years were calculated, and stratified by age, sex, and diagnosis year. The crude IR of PLC was 4.56 (95% CI 4.42-4.70) per 100 000 person-years between 2000 and 2021, with an increase over time across age and sex strata. Sex-specific IR for males was higher than females, 6.60 (95% CI 6.36-6.85) vs. 2.58 (95% CI 2.44-2.74) per 100 000 person-years. Age-standardized IR showed identical trends. Crude PP showed a seven-fold increase over the study period, with PP 0.02% (95% CI 0.019%-0.022%) in 2021, and a 2.8-fold higher PP in males. Survival at 1, 5, and 10 years after diagnosis was 41.7%, 13.2%, and 7.1%, respectively, for both sexes. One-year survival increased only in men, from 33.2% in 2005-2009 to 49.3% in 2015-2019. Over the past two decades, there has been a substantial increase in the number of patients diagnosed with PLC. Despite a slight improvement in median and one-year survival in men, prognosis remains poor. To improve the survival of PLC patients, it is necessary to understand the epidemiological changes and address preventable risk factors associated with liver disease and promote early detection and access to care.
National identification and trust in institutions: understanding lower COVID-19 vaccination uptake among ethnic minorities in Europe.
Foran AM, Jetten J, Muldoon OT
Eur J Public Health · 2025 Dec · PMID 41211740 · Full text
COVID-19 vaccine hesitancy among ethnic minority groups presents a public health challenge. However, there is limited understanding as to why ethnic minorities often exhibit lower levels of vaccine uptake. This study inv...
COVID-19 vaccine hesitancy among ethnic minority groups presents a public health challenge. However, there is limited understanding as to why ethnic minorities often exhibit lower levels of vaccine uptake. This study investigates the role of national identification and institutional trust in explaining differences in COVID-19 vaccine uptake between majority and minority ethnic groups. Using a large, cross-national dataset of 20 European countries (N = 31 240), we conducted multilevel structural equation modelling to assess the impact of ethnic identification on COVID-19 vaccine uptake, mediated by national identification and trust in institutions. Our findings revealed significant group differences, with minority group members reporting lower levels of national identification, trust in institutions and COVID-19 vaccine uptake compared to majority group members. We also found that ethnic identification indirectly influences COVID-19 vaccine uptake through national identification and trust in institutions. Specifically, people from minority ethnic groups tend to report lower levels of national identification, which makes them less likely to trust institutions. This lower level of trust, in turn, reduces their likelihood of COVID-19 vaccine uptake. Our findings underscore the importance of fostering inclusive national identities and building institutional trust to reduce COVID-19 vaccine hesitancy among ethnic minorities. Public health strategies that address these social dynamics are essential for increasing vaccination rates and ensuring equitable health outcomes across diverse populations.
Trends in central nervous system cancers mortality in the United States and the underlying sociodemographic determinants, 1999-2020.
Zhong C, Wang Y, Deng X … +12 more , Qu Y, Lin Z, Sun Y, Zhang M, Zhu K, Hu P, Li S, Sun J, Du Z, Hao Y, Zhang W, Zhao N
Eur J Public Health · 2025 Dec · PMID 41206962 · Full text
Though central nervous system (CNS) cancers have become a critical health concern in the United States, a comprehensive understanding of the nationwide and group-specific trends over time is still limited. This surveilla...
Though central nervous system (CNS) cancers have become a critical health concern in the United States, a comprehensive understanding of the nationwide and group-specific trends over time is still limited. This surveillance-based study used data obtained from the National Center for Health Statistics. Age-standardised mortality trends and the Average Annual Percent Change (AAPC) trends were estimated by demographic. We calculated the relative risks between various county-level socioeconomic factors and mortality for CNS cancers. CNS cancers death rates have decreased from 1999 to 2020 in the U.S., while they increased by 2% annually (AAPC, 0.2%, 95% CI [0.0% to 0.4%]) among people aged ≥65 years. The highest increase in CNS cancer was observed among Asian or Pacific Islanders (AAPC, 1.3%, 95% CI [0.8% to 2.3%]), followed by American Indian/Alaska Native individuals (AAPC, 1.2%, 95% CI [-0.3% to 3.0%]). Additionally, individuals residing in counties with greater poverty, more rural area, and lower education levels tended to have higher age-standardised mortality. There were varying degrees of increased mortality rates from CNS cancers by demographic. The strong association of CNS cancers mortality with county SES and rurality suggests that county-based public health strategies are needed to reduce this disparity in mortality.
Global index of lifestyle quality and non-suicidal self-injury in the SESSAMO project: a Spanish adolescents cohort.
Goñi-Sarriés A, Morata-Sampaio L, Díez-Suárez A … +3 more , Pírez G, Zorrilla I, Sánchez-Villegas A
Eur J Public Health · 2026 Feb · PMID 41206960 · Publisher ↗
Adolescents' failure to embrace healthy lifestyles constitutes a serious public health issue, such that its relationship to non-suicidal self-injury (NSSI) merits further research. The aim of the study was to ascertain t...
Adolescents' failure to embrace healthy lifestyles constitutes a serious public health issue, such that its relationship to non-suicidal self-injury (NSSI) merits further research. The aim of the study was to ascertain the association between a Global Index of Lifestyle Quality (GILQ) and the presence of NSSI. Cross-sectional analysis of a sample of 2nd- to 4th-year ESO students (Obligatory Secondary Education, from ages 14 to 16) recruited for the SESSAMO project, a multicenter prospective cohort study. Exposure variables were collected, including eating patterns, physical activity, screen use, the consumption of cannabis, alcohol and tobacco, risky sexual behavior, gambling, spend time with friends, and sleep quality. To determine the presence of NSSI, a validated questionnaire was administered. The association between different lifestyles and the presence of NSSI was analyzed through multivariate logistic regression models. 2042 adolescents were included. Physical activity, screen use, risky sexual behavior, sleep quality, and daytime sleepiness showed inverse and statistically significant associations with the presence of NSSI in multivariate models. A higher lifestyle score was associated with a 71% reduction in the likelihood of engaging in NSSI (OR for extreme quartiles of GILQ adherence =0.29; 95% CI = 0.15-0.57). The result was similar when boys and girls were analyzed separately. A healthy lifestyle was inversely associated with the presence of NSSI in this sample of Spanish adolescents. Lifestyles could function as potential predictors of NSSI.
The use of alcohol-free and low-alcohol drinks in pregnancy in the UK.
Maslin K, Hopper H, Shawe J
Eur J Public Health · 2025 Dec · PMID 41206711 · Full text
Alcohol-free drinks [beers, ciders, wines, and spirits containing <0.05% alcohol by volume (ABV)], and low-alcohol drinks (between 0.05% and 1.2% ABV) are increasingly available and may be used as a harm reduction measur...
Alcohol-free drinks [beers, ciders, wines, and spirits containing <0.05% alcohol by volume (ABV)], and low-alcohol drinks (between 0.05% and 1.2% ABV) are increasingly available and may be used as a harm reduction measure. However, it is not known what pregnant women think and feel about these drinks and how regularly they are consumed before and during pregnancy. A cross-sectional online survey was developed and piloted. Women ≥18 years in the UK who were pregnant, or recently pregnant, were recruited via targeted social media advertising. Of the 2092 respondents, 47.8% (n = 1001) were currently pregnant; 55.7% (n = 1167) were between 25 and 34 years, 90.0% were White (n = 1881); 6.1% (n = 128) were drinking alcohol at "increasing risk" levels (>14 units/week) before pregnancy. During pregnancy, 13.5% (n = 282) consumed alcohol, which was more common in the increasing risk category (P < .01). Alcohol-free or low-alcohol drinks were consumed by 71.3% (n = 1491) of respondents during pregnancy; 91.4% of the increasing risk category versus 69.9% of the lower risk category (P < .01). The most common reasons for consuming alcohol-free or low-alcohol drinks were "to choose a safer alternative" (71.9%, n = 1073) and "to feel included in social events involving alcohol" (68.8%, n = 1026). More than half of respondents (56.7%) thought there was insufficient information available about consuming alcohol-free and low-alcohol drinks during pregnancy, with internet searching the primary source of information. Although alcohol-free and low-alcohol drinks are commonly consumed during pregnancy, there are some safety concerns. Their role as a harm reduction measure in those who are drinking alcohol at increasing risk levels prepregnancy needs further investigation.
Associations between diagnoses linked with adverse COVID-19-related outcomes and sickness absence due to COVID-19 or COVID-19 like diagnoses: a prospective Swedish cohort study of 292 274 blue-collar workers in the retail and wholesale industry.
Cybulski L, Pettersson E, Alexanderson K … +1 more , Farrants K
Eur J Public Health · 2025 Dec · PMID 41206672 · Full text
Several diagnoses have been associated with increased risk for adverse health outcomes following COVID-19 infection. Whether these diagnoses also predispose individuals to long-term sickness absence (SA) due to COVID-19...
Several diagnoses have been associated with increased risk for adverse health outcomes following COVID-19 infection. Whether these diagnoses also predispose individuals to long-term sickness absence (SA) due to COVID-19 is unclear. The aim was to examine associations between risk diagnoses and long-term SA due to COVID-19/COVID-19-like diagnoses among blue-collar workers in the retail and wholesale industry. We conducted a two-year prospective cohort study of all blue-collar workers aged 18-67 in 2019, employed in retail and wholesale industry in Sweden (N = 292 274), using linked microdata from several nationwide registers. We estimated odds ratios (OR) through logistic regression models to determine the association between diagnoses linked with adverse health outcomes following COVID-19 infection and SA spells due to COVID-19/COVID-19-like diagnoses in 2020-2021. We included COVID-19-like diagnoses because of diagnostic uncertainty early in the pandemic. Of all the workers, 34 594 (11.8%) had least one COVID-19 risk diagnosis. Only 7812 (2.7%) workers had SA due to COVID-19/COVID-19-like diagnoses in the two-year follow-up (2020-2021). Most risk diagnoses were associated with elevated likelihoods of SA due to COVID-19, particularly immunodeficiency (OR 2.58; 95% CI 1.68-3.27) and respiratory disease (2.00; 1.89-2.12). The associations for these diagnoses and diabetes and hypertension persisted after we stratified by prior SA, but no other risk diagnosis was significantly associated with SA due to COVID-19/COVID-19-like diagnoses among those with prior SA in 2019. Stratifying on all-cause SA thus removed the association between most COVID-19 risk diagnoses and SA due to COVID-19/COVID-19-like diagnoses.
Human papillomavirus vaccinations' impact on preterm birth rates.
Koivisto T, Kalliala I, Eriksson T … +3 more , Nieminen P, Lehtinen M, Louvanto K
Eur J Public Health · 2026 Feb · PMID 41206665 · Publisher ↗
Removal of human papillomavirus (HPV) infection associated precancerous cervical lesions by conization is one of the most important causes of preterm birth. Prophylactic HPV-vaccinations can prevent these lesions and red...
Removal of human papillomavirus (HPV) infection associated precancerous cervical lesions by conization is one of the most important causes of preterm birth. Prophylactic HPV-vaccinations can prevent these lesions and reduce the need of their ablative treatment, thereby preventing preterm births. We evaluated whether preterm birth rates vary between HPV-vaccinated and unvaccinated women. Study subjects comprised 6200 cluster-randomized cohorts of HPV-vaccinated and 1667 hepatitis B-virus vaccinated women born in 1992-1993, and age- and community-aligned reference cohort of 19 473 unvaccinated women born in 1990-1991. Age-aligned registry linkage data from the nationwide Finnish Medical Birth Registry were retrieved up to 2018 (older age cohorts) and 2020 (younger age cohorts). Preterm births were categorized as early (gestational age of 22 + 0-33 + 6 weeks) and late preterm births (gestational age 34 + 0-36 + 6 weeks). Logistic regression was used to evaluate the association of HPV-vaccination and preterm births. By the age 28, 23.9% (n = 1484) of HPV-vaccinees and 28.4% (n = 6006) of the unvaccinated women had at least one childbirth recorded. Precisely, 4.1% (n = 61) of HPV-vaccinated and 5.2% (n = 310) of unvaccinated primiparas had a preterm birth. The association of preterm birth with HPV-vaccination was protective with a borderline significant odds ratio of 0.79 (95% CI 0.59-1.04). Most preterm births were at late preterm among both HPV-vaccinees (3.1%) and unvaccinated women (3.4%). Prophylactic HPV-vaccination is likely to reduce the incidence of preterm births. The decrease of preterm births is crucial to reduce the need for extensive and costly postnatal care and life-long morbidity.
The combined impact of smoking, alcohol, and obesity on past trends in educational inequalities in life expectancy in England and Wales, Finland, and Italy, 1990-2017.
Janssen F, Martikainen P, Zengarini N … +2 more , Sizer A, Kunst AE
Eur J Public Health · 2026 Feb · PMID 41206660 · Publisher ↗
Socioeconomic inequalities in mortality are large and persistent. While the differential timing and impact of the smoking, alcohol, and obesity epidemics among socioeconomic groups likely influenced past trends in socioe...
Socioeconomic inequalities in mortality are large and persistent. While the differential timing and impact of the smoking, alcohol, and obesity epidemics among socioeconomic groups likely influenced past trends in socioeconomic mortality inequalities, the evidence is scarce. We estimated the combined impact of smoking, alcohol, and obesity on past trends in educational inequalities in remaining life expectancy at age 30 (e30) in England and Wales, Finland, and Italy (Turin). To do so, we used long-term timeseries of annual individually-linked mortality data by educational level (low, middle, high), sex, and age (30+). We multiplicatively aggregated estimates of smoking-, alcohol-, and obesity-attributable mortality by educational level to obtain "lifestyle-attributable mortality" (LAM) by educational level. We compared trends in educational inequalities in e30 with and without LAM using segmented regression. We found that smoking-, alcohol-, and obesity-attributable mortality individually contributed 23%, 14%, and 10%, respectively, to the average educational inequality in e30 of 4.4 years in 1992-2017, and 44% combined (males: 51%; females: 34%). LAM contributed 57%, 63%, and 43%, respectively, to the increase in educational inequalities in e30 among Finnish males (1987-2008), Finnish females (1987-2017), and Italian males (1990-2018); tempered the decline in inequalities among British females (1992-2017); and was responsible for the reversal in 2008 from increasing to declining inequalities among Finnish males. Targeting socioeconomic inequalities in smoking, alcohol, and obesity could, thus, substantially reduce socioeconomic inequalities in e30, and the increasing time trends in these inequalities. The observed country differences in the importance of these lifestyle factors demonstrate the need for context-specific strategies.
Mortality risk associated with heatwave exposure based on daily maximum, minimum, and combined temperature thresholds.
Yin Z, Xiao L, Tang C … +6 more , Zhen S, Li Q, Dou Y, Xiao Z, Liang F, Liang X
Eur J Public Health · 2026 Mar · PMID 41206566 · Full text
Most prior studies assessed heatwave-related mortality using daily mean temperature as an indicator, limiting the ability to differentiate between daytime and nighttime heat effects. We collected individual mortality rec...
Most prior studies assessed heatwave-related mortality using daily mean temperature as an indicator, limiting the ability to differentiate between daytime and nighttime heat effects. We collected individual mortality records with corresponding residential exposure data on daily temperature, relative humidity and ozone during warm seasons from 2016 to 2022 in Jiulongpo district, Chongqing, China. Heatwaves were categorized into three types: those defined by daily maximum temperature, daily minimum temperature, and a combination of both. A time-stratified case-crossover design was applied to assess the associations between heatwaves and mortality. During the study period, 17 552 deaths were recorded. We observed that heatwaves defined by combined temperature thresholds were associated with the highest mortality risks, with odds ratios (ORs) ranging from 1.08 (95% CI: 1.01-1.15) to 1.32 (95% CI: 1.17-1.48) under different heatwave definitions. For heatwaves defined by daily maximum temperature, ORs ranged from 1.06 (95% CI: 0.98-1.14) to 1.13 (95% CI: 1.03-1.24), while heatwaves defined by daily minimum temperature showed ORs ranging from 1.04 (95% CI: 0.99-1.10) to 1.27 (95% CI: 1.13-1.43). Exposure to heatwaves was consistently associated with increased risks of all-cause and cardiovascular mortality, but not respiratory mortality. The associations were stronger among men and under higher ozone conditions compared to their counterparts. Exposure to heatwaves significantly increased mortality risks, with the highest risks observed for compound heatwaves involving both daytime and nighttime heat. These findings underscore that the health risks associated with nighttime heat exposure should not be overlooked.
Quality of care in an era of global challenges: a transformational vision for WHO European Region and beyond.
Fonseca VR, Ivanković D, Maliqi B … +9 more , Klazinga N, Larsson S, Kuipers EJ, Triantafyllou C, Hall J, Vildiridi L, Permanand G, Azzopardi Muscat N, Breda J
Eur J Public Health · 2026 Apr · PMID 41206124 · Full text
Health systems today face overlapping pressures-from demographic shifts, workforce shortages, climate change, and geopolitical and economic instability. This strains their ability to deliver effective and equitable care...
Health systems today face overlapping pressures-from demographic shifts, workforce shortages, climate change, and geopolitical and economic instability. This strains their ability to deliver effective and equitable care and erodes public trust. Traditional approaches to quality of care, often focused on service volumes or process compliance, are proving insufficient to address these system-wide challenges. In response, this paper proposes a transformational vision for quality of care that moves beyond traditional models. This vision is rooted in two interconnected pillars. First, a focus on outcomes that truly matter to people and populations, prioritizing health and well-being over service volume. The second pillar is a whole-systems perspective that embeds quality across all levels of governance, policy, and financing. This transformation is made possible through three key enablers. First, an empowered workforce and accountable leadership are needed to drive change. Second, data must be used transparently to build trust and guide results-focused work. Finally, innovative solutions and tools must enhance quality and be aligned with equity. Drawing on practical implementation examples, this paper outlines a roadmap for system-wide alignment of health systems-to rebuild trust, improve resource use, and advance health equity. This makes quality a lasting foundation for resilient, sustainable, and equitable healthcare.
Opportunities and challenges of a population health management approach for improving young people's mental health.
Wills J, Oha JT, Bridge G … +5 more , Callaghan P, Flood C, Jenkins C, Reavey P, Sykes S
Eur J Public Health · 2025 Dec · PMID 41190674 · Full text
Population Health Management uses available data to tailor services to identified and latent needs. It is advocated by the integrated care system in England, yet challenges remain regarding data availability, linkage, an...
Population Health Management uses available data to tailor services to identified and latent needs. It is advocated by the integrated care system in England, yet challenges remain regarding data availability, linkage, and application. This paper reports on the adoption of a population health management approach to design a complex programme aimed at improving young people's mental health. In-depth qualitative interviews were conducted with local government public health professionals (PH) (n = 5), intervention leads (n = 3), and one focus group of young contributors to intervention design (n = 5) to explore how population health management informed programme design and was perceived by stakeholders. Data were analysed using Delve.io. Key learning for public health included: (i) Data analysis for the PHM approach was strengthened by a dedicated data scientist, though some regarded the PHM approach as not new; (ii) Routine data had limited capacity to fully identify need, and linking datasets across health, social care, and education remained difficult; (iii) Local insights and co-production with young people were critical in identifying target groups not visible in routine datasets. Routine health data capture only part of the picture, often reflecting those already in contact with services. PHM approaches in public health need to integrate qualitative insights and local intelligence alongside quantitative analysis to address inequalities effectively.
Confidence in knowledge, childbirth fear, and preference for cesarean birth among Polish women: a cross-sectional study.
Surma P, Micek A, Bednarek-Chałuda M … +2 more , Stoll K, Nenko I
Eur J Public Health · 2026 Feb · PMID 41190673 · Publisher ↗
In Poland, 48 in 100 babies are born by cesarean section, which is among the highest rate of cesarean birth (CB) in the Organization for Economic Cooperation and Development (OECD) countries. Several factors are linked t...
In Poland, 48 in 100 babies are born by cesarean section, which is among the highest rate of cesarean birth (CB) in the Organization for Economic Cooperation and Development (OECD) countries. Several factors are linked to higher CB rates, including childbirth fear prior to pregnancy (CFPP), and physician versus midwifery led models of care. In order to decrease CB rates, it is crucial to understand modifiable factors that are associated with childbirth preferences. In this study, we tested how confidence in knowledge of pregnancy and birth was related to: (i) fear of childbirth, preference for: (ii) mode of birth and (iii) prenatal care provider type. We recruited 782 women aged 18-35 (mean 24.7, SD 3.19) who had never been pregnant but desired to have at least one child in the future. Women with moderate and high levels of confidence in knowledge had lower odds of high fear of childbirth compared to women with low levels of confidence (aOR = 0.57, 95% CI: 0.39-0.83 and aOR = 0.54, 95% CI: 0.33-0.88, respectively). Neither moderate nor high levels of confidence in knowledge were associated with a preference for CB (aOR = 1.10, 95% CI: 0.73-1.67 and aOR = 0.92, 95% CI: 0.55-1.55, respectively) compared to low levels. In addition, women with high levels of confidence in knowledge had significantly lower odds of preferring obstetricians (aOR = 0.49, 95% CI: 0.26-0.89), compared to midwives. Our study provides evidence that confidence in knowledge is related to fear of childbirth and prenatal care provider preferences.
Rates and determinants of alcohol-drinking categories in France: a general population survey.
Rolland B, de Ternay J, Haesebaert J … +6 more , Delile JM, Savy M, Tubiana-Rey B, Naassila M, Lespine LF, JANOVER Study Group
Eur J Public Health · 2025 Dec · PMID 41183568 · Full text
In an online-based survey conducted among a representative sample (n = 5000) of the French general population, the category of alcohol use, i.e. no-alcohol use (NAU: 18.5%), low-risk drinking (LRD: 59.4%), hazardous drin...
In an online-based survey conducted among a representative sample (n = 5000) of the French general population, the category of alcohol use, i.e. no-alcohol use (NAU: 18.5%), low-risk drinking (LRD: 59.4%), hazardous drinking (HD: 14.9%), and alcohol use disorder (AUD: 7.2%) was determined, using the AUDIT questionnaire. Multinomial logistic regression models, using LRD as the reference, showed that younger adults were more likely to report NAU, but also HD, and AUD; women were less likely to report HD and AUD, while high occupational status was associated with reduced NAU and increased HD.
The impact of risk prioritization in COVID-19 vaccination in Belgium on hospital and intensive care unit admissions.
Vermeiren E, Braeye T, Stouten V … +4 more , De Maeseneer J, Scheerens C, Crombez J, van Loenhout JAF
Eur J Public Health · 2026 Apr · PMID 41175106 · Full text
Belgium prioritized primary COVID-19 vaccination of persons aged 18-64 years with underlying health conditions over their same-aged peers, leading to an accelerated administration of a first dose of 35 days. We assessed...
Belgium prioritized primary COVID-19 vaccination of persons aged 18-64 years with underlying health conditions over their same-aged peers, leading to an accelerated administration of a first dose of 35 days. We assessed this strategy's impact on hospital admissions, in comparison to alternative scenarios, using generalized causal inference techniques with a hierarchical Bayesian model. A solely age-based scenario showed a significant increase in hospital admissions of 254, while random-allocation and no-vaccination scenarios showed even higher increases (604 and 1998, respectively). These results emphasize the importance of prioritization strategies in a pandemic context and the benefits of COVID-19 vaccines in general.
Maternal employment and childhood overweight in Turkey: a cross-sectional study from 22 provinces.
Küçükerdönmez Ö, Akder RN, Meseri R
Eur J Public Health · 2026 Feb · PMID 41175104 · Publisher ↗
This cross-sectional study aimed to examine the association between maternal employment and childhood overweight status, providing insights into potential preventive strategies. Overweight was defined as a body mass inde...
This cross-sectional study aimed to examine the association between maternal employment and childhood overweight status, providing insights into potential preventive strategies. Overweight was defined as a body mass index ≥85th percentile. Data were collected through face-to-face interviews and anthropometric measurements. Univariate and logistic regression analyses were performed using SPSS 25.0. Based on an estimated 20% prevalence of childhood overweight, a sample size of 683 was calculated with a 95% CI and 3% margin of error. To ensure heterogeneity, 1400 mother-child dyads were included. Among the 1459 children studied, 29.4% were overweight, while 54.5% of mothers were overweight. After adjusting for confounders, children of full-time employed mothers had a 1.4 times higher risk of being overweight (95% CI: 1.060-1.936). Additional risk factors included maternal smoking, maternal overweight status, and increasing maternal age. These findings emphasize the need for structured support for working mothers, including workplace policies for work-life balance, affordable childcare meal programs, and school initiatives for healthy eating and activity. Policymakers should address the unintended health impacts of maternal employment.
A scoping review of multiple deprivation indices in Europe.
Mogin G, Gorasso V, Idavain J … +7 more , Lepnurm M, Delaunay-Havard S, Kocbach Bølling A, Buekers J, Luyten A, Devleesschauwer B, Baravelli CM
Eur J Public Health · 2025 Dec · PMID 41166234 · Full text
Multiple deprivation indices (MDIs) measure community-level deprivation using various socio-economic indicators such as education level, unemployment rate, or family structure. With their growing use across Europe and th...
Multiple deprivation indices (MDIs) measure community-level deprivation using various socio-economic indicators such as education level, unemployment rate, or family structure. With their growing use across Europe and the need to evaluate health impacts on vulnerable populations, this scoping review provides an overview of MDIs in the region. Insights into their construction methods will help provide guidance to researchers in developing future indices. This scoping review was conducted as part of the four-year research project funded through EU Horizon Europe-Burden of disease-based methods for estimating the socio-economic cost of environmental stressors (BEST-COST). We searched Medline, Embase, and Web of Science using terms covering deprivation in Europe. Articles meeting the inclusion criteria were reviewed to identify MDIs and their methodologies. Those including a health indicator were excluded from the study. From 163 articles meeting our inclusion criteria, 18 MDIs were identified. The number of underlying indicators ranged from 4 to 22 across MDIs. Most indices were built for small geographical areas, such as municipalities, districts, or census tracts. Ten indices applied weights derived from statistical methods such as principal components analysis, while the other eight applied equal weights and calculated the index as a simple arithmetic sum or mean composite score. The review highlights high variability in MDI methodologies and emphasizes that aligning MDI selection with the context and objectives of a study. Furthermore, due to the vast cultural and geographical diversity across European countries, developing a Europe-wide index requires careful consideration of the methodologies to be employed.
The surge in infectious complications of dental and periodontal infections in the Czech Republic between 2010 and 2022.
Mihalčin M, Chrdle A, Fašaneková L … +3 more , Peřina V, Májek T, Macková B
Eur J Public Health · 2026 Feb · PMID 41159935 · Publisher ↗
Dental and periodontal infections can lead to serious systemic complications through bacterial dissemination. While global awareness of these risks is increasing, data on the incidence and outcomes of such complications...
Dental and periodontal infections can lead to serious systemic complications through bacterial dissemination. While global awareness of these risks is increasing, data on the incidence and outcomes of such complications remain limited. This study aims to quantify the incidence of serious extraoral infectious complications associated with dental infectious foci, using dental procedures as markers of active oral infection, in the Czech Republic between 2010 and 2022. A retrospective analysis was conducted using data from the National Register of Reimbursed Health Services. Patients who underwent invasive dental procedures indicating active dental/periodontal infection and were hospitalized for severe infectious conditions within 7 days were identified. This temporal criterion captured both cases where dental procedures preceded systemic spread and cases where dental foci were identified during workup for serious infections. Descriptive statistics and linear regression analysed incidence rates and temporal trends. Among 15 098 093 dental procedures over 13 years, annual hospitalizations for associated infectious complications ranged from 855 to 1252 cases. Overall incidence was 12.82 per 100 000 population annually. Oral region complications (cellulitis, abscesses, osteomyelitis) were most common (9.48 per 100 000), followed by systemic complications (sepsis and endocarditis) (2.89 per 100 000). Significant increasing trends were observed for jaw periostitis (P = .006), endocarditis (P < .001), and central nervous system abscesses (P = .027), while acute sinusitis declined (P < .001). This population-based analysis reveals a substantial incidence of serious infectious complications associated with dental infectious foci, with concerning increasing trends in potentially life-threatening conditions. These findings emphasize the importance of preventive dental care and early intervention strategies.
Associations between tobacco smoking and mortality: a sex-stratified cohort analysis.
Vallée A
Eur J Public Health · 2025 Dec · PMID 41134686 · Full text
To investigate the associations between tobacco smoking and mortality, focusing on all-cause, cardiovascular, and cancer mortality, with analyses stratified by sex. A total of 333 559 participants were included. Smoking...
To investigate the associations between tobacco smoking and mortality, focusing on all-cause, cardiovascular, and cancer mortality, with analyses stratified by sex. A total of 333 559 participants were included. Smoking status was categorized as current, past, or never. Cox proportional hazards regression models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality outcomes, adjusted for potential confounders. During a median follow-up of 11.8 years, 20 381 deaths occurred, including 4024 cardiovascular deaths. Current smokers had substantially increased risks of all-cause mortality (HR 2.37 [2.25-2.50] in males; HR 2.65 [2.47-2.84] in females), cardiovascular mortality (HR 2.58 [2.31-2.87] in males; HR 3.79 [3.17-4.54] in females), and cancer mortality (HR 2.47 [2.30-2.66] in males; HR 2.46 [2.25-2.69] in females) compared with never-smokers. Past smokers also exhibited elevated risks, and a clear dose-response relationship was observed with increasing smoking intensity and pack-years. Overall survival was higher in females, but the relative risks associated with smoking were largely comparable across sexes. Tobacco smoking is strongly associated with increased mortality risk, showing a clear dose-response relationship and long-term adverse effects even after cessation. The detrimental impact of smoking was broadly similar in males and females, with only minor differences. These findings reinforce the urgent need for universal prevention and cessation strategies to reduce the burden of smoking-related disease.
Did migrants experience a COVID-19 mortality disadvantage in the Swedish care setting? An observational cohort study on type of care and mortality among older migrants in Sweden.
Mussino E, Juárez SP, Modig K … +2 more , Andersson G, Drefahl S
Eur J Public Health · 2025 Dec · PMID 41133898 · Full text
This study examines COVID-19 mortality across long-term care settings comparing migrants and Swedish-born during the first 2 years of the pandemic. Previous research shows that migrants faced higher risks of severe COVID...
This study examines COVID-19 mortality across long-term care settings comparing migrants and Swedish-born during the first 2 years of the pandemic. Previous research shows that migrants faced higher risks of severe COVID-19 outcomes, contrasting with the observed Migrant Mortality Advantage. Using Swedish total population data (2019-22), we stratified participants aged 70+ by care setting and migration status. We analysed the first pandemic year (March 2020-February 2021) and the second year (March 2021-February 2022), alongside pre-pandemic mortality data for context. Outcome measures included all deaths from COVID-19 and other causes. Cox proportional hazards models were employed adjusting for sociodemographic and health variables. Our findings highlight the significant impact of care settings on COVID-19 mortality in the first pandemic year, exceeding that for other causes of death. Migrants born in low- or middle-income countries in institutional care had higher mortality rates (HR = 42.88, 95% CI = 36.69-50.13) than Swedish-born individuals in institutional care (HR = 25.83, 95% CI = 24.12-27.65) relative to Swedish-born with no care. This contrasts with mortality patterns for non-COVID causes before and during the pandemic, indicating a specific migrant disadvantage during the first year. In the second year, the excess COVID-19 mortality in care settings decreased yet continued to be higher for migrants than for Swedish-born, likely influenced by the equalizing effect of vaccinations. Despite mitigation efforts, a clear migrant mortality disadvantage persisted among those receiving home care or living in care homes.
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