European Journal Of Public Health[JOURNAL]
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200 papers
Allergy prevention-a new public health perspective.
Haahtela T, Puska P
Eur J Public Health · 2026 Mar · PMID 41481371 · Full text
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Declining 28-day population myocardial infarction case-fatality trends in Catalonia, Spain: an analysis of the possible contribution of emergency management network.
Tizón-Marcos H, Camps-Vilaró A, Roman-Dégano I … +7 more , Subirana I, Cainzos-Achirica M, Puig T, Mauri J, Lidon RM, Arbelo E, Marrugat J
Eur J Public Health · 2026 Mar · PMID 41477688 · Full text
The implementation of emergency care networks for ST-elevation myocardial infarction (STEMI), like Codi IAM in Catalonia, has reduced time to reperfusion. We hypothesized that Codi IAM would decrease the 28-day case-fata...
The implementation of emergency care networks for ST-elevation myocardial infarction (STEMI), like Codi IAM in Catalonia, has reduced time to reperfusion. We hypothesized that Codi IAM would decrease the 28-day case-fatality rate for acute myocardial infarction (AMI) by enabling more patients with sudden cardiac death (SCD) to receive timely treatment. We linked the Codi IAM registry, Catalan hospital discharge records, and mortality registry. The study included 97 325 AMI patients aged 35-84 years hospitalized or deceased between 2008 and 2019. We compared trends in prehospital, in-hospital, and overall 28-day standardized case-fatality rates between the preimplementation (2008-10) and implementation periods (2011-19). Annual Percentage Change (APC) and spline trends were analyzed. During the study period, the mean age of AMI patients decreased from 70 to 67 years (P < .001), and the percentage of women declined from 29.2% to 25.7% (P < .001). Comorbidities increased, with higher rates of hypertension (38.8%-49.9%, P < .001), diabetes (23.9%-31.9%, P < .001), and cardiovascular disease history (26.5%-28.5%, P < .001). The overall 28-day AMI case-fatality significantly declined post-2010 (P < .001), mainly due to a decline in prehospital case-fatality (SCD) after 2010 (P < .001). In-hospital case-fatality declined until 2011 (P < .001) and stabilized afterward (P = .12). The decrease in prehospital 28-day AMI case-fatality paralleled the Codi IAM implementation, suggesting a possible transfer of recovered out-of-hospital SCD patients to hospitals, with limited changes in in-hospital mortality rates.
IT solutions for health workforce shortages: improving administrative processes and care access-a comparative study of five European countries.
Michalska K, Gonzalez Gonzalez AI, Likic R … +3 more , Flinterman L, Dan S, Domagała A
Eur J Public Health · 2026 Feb · PMID 41477686 · Publisher ↗
The healthcare sector faces a critical shortage of healthcare workers, creating significant challenges in healthcare delivery. The use of Information Technology (IT) solutions in healthcare presents potential remedies to...
The healthcare sector faces a critical shortage of healthcare workers, creating significant challenges in healthcare delivery. The use of Information Technology (IT) solutions in healthcare presents potential remedies to reduce the negative consequences of this problem. The purpose of this study was to identify IT solutions implemented to mitigate the effects of medical shortages and improve administrative processes and care access. The study used a systematic approach integrating desk research, national expert consultations and comparative analysis to examine IT solutions in healthcare systems. Five European countries were selected for the in-depth analysis: Poland, the Netherlands, Spain, Finland, and Croatia. The impact on administrative processes, care access, and the functioning of healthcare systems was assessed. The study identified a variety of regulatory frameworks, common implementation strategies and the institutions responsible for these activities. All compared countries used telemedicine, e-prescriptions and various types of health applications. It was found that the most frequently used IT solutions were electronic health record (EHR) and e-prescription systems. However, IT training, its organization, financing and mandatory nature differed in individual countries. In addition, common barriers were identified across all countries, such as financial constraints and interoperability issues. Integrating IT solutions offers opportunities to address health workforce shortages and enhance healthcare efficiency. Tailored strategies and collaborative efforts are essential to address financial constraints and interoperability issues. Implementing best practices identified in this study can improve administrative processes and care access. Future research should prioritize longitudinal impact assessments and explore new technologies to optimize healthcare IT solutions.
Using lifespan variation to better understand long-term trends in health inequalities in Scotland and Europe.
Walsh D, Hoehn A, Dundas R … +2 more , McCartney G, Whyte B
Eur J Public Health · 2026 Feb · PMID 41429155 · Publisher ↗
Cross-country comparisons of socioeconomic inequalities in mortality/life expectancy (LE) face limitations regarding the comparability of population subgroup data. One potential alternative which can overcome this limita...
Cross-country comparisons of socioeconomic inequalities in mortality/life expectancy (LE) face limitations regarding the comparability of population subgroup data. One potential alternative which can overcome this limitation is lifespan variation (LV). Our aims were to: (i) compare long-term trends in LV across Western European countries, focussing on Scotland as a country with known wide LE inequalities; and (ii) explore the validity of LV through comparisons with ranked measures of socioeconomic inequalities in mortality/LE within Scotland. We calculated e† (one measure of LV) using Human Mortality Database data from 1855 to 2021 for European nations, by sex. We then compared e† with absolute inequalities in mortality and LE by ranked area-level socioeconomic deprivation for all 32 local government areas in Scotland. Male and female LV in Scotland is the highest in Western Europe. For males especially, this resulted from increases in the 1980s-1990s, and was made worse by further increases in the early 2010s. All UK nations have relatively high LV, especially among females. Comparisons of sub-national, area-based, data show a moderate level of correlation between ranked LV and absolute socioeconomic inequalities in mortality (0.57), and male (0.48) and female (0.51) LE. For cross-country comparisons, LV may be a useful proxy for absolute socioeconomic inequalities in mortality/LE where comparable socioeconomic measures are not available; however, it requires cautious interpretation. Given the high level of, and recent increases in, LV in Scotland and the UK, the need for socioeconomic policies to narrow health inequalities has never been more urgent.
A method of estimating cervical cancers prevented by the introduction of national screening in Ireland.
Grimes DR, Brennan A, Walsh C
Eur J Public Health · 2026 Mar · PMID 41416470 · Full text
Cervical cancer screening is a life-saving endeavour. The introduction of an organized population-based national screening programmes has potential to both reduce incidence of cervical cancer in an asymptomatic populatio...
Cervical cancer screening is a life-saving endeavour. The introduction of an organized population-based national screening programmes has potential to both reduce incidence of cervical cancer in an asymptomatic population and detect early-stage cancers for accelerated treatment. A methodology for estimating cancers prevented by such programmes has immediate utility. This work derives a model for estimating cancer prevented by screening, applied to data from Ireland's organized national cervical screening programme since its introduction in August 2008 to August 2022. A novel Markov-chain model for human papilloma virus (HPV) induced cervical cancer was derived with realistic transition probabilities validated against literature estimates. Data from the Irish National Screening Programme (CervicalCheck) and from the National Cancer Registry of Ireland (NCRI) was applied to estimate the number of cancers prevented by screening, changes in Irish cancer detection since the implementation of screening, and treatment costs saved by screening. Since its inception in 2008, the modelling in this work suggests that CervicalCheck has prevented an estimated 5557 cancers (95% confidence interval: 5114-6000 cancers) and saved €102 million in future treatment costs (95% confidence interval: €94-110 million) not including inflation costs. Additionally, 48.8% (95% confidence interval: 41.4%-56.2%) of all cervical cancers in Ireland have been detected through screening between 2008 and 2022. National screening in Ireland has been highly effective at reducing future cervical cancers, and detecting asymptomatic cancers. The model outlined here has direct future applicability for the assessment of national and regional cervical cancer screening programmes.
Regulations for international non-proprietary name prescribing and substitution, relevant for cross-border ePrescribing and eDispensation services in the European Union.
Vander Stichele R, Roumier J, Van Nimwegen D … +5 more , Kalra D, Gkogkidis A, Vegiotti N, Quintana Y, Wilson P
Eur J Public Health · 2026 Mar · PMID 41410792 · Full text
Prescribing by international non-proprietary name (INN) and substitution rules are advocated in the education and practice of rational prescribing, and for cost containment policy. Regulations that restrict or foster INN...
Prescribing by international non-proprietary name (INN) and substitution rules are advocated in the education and practice of rational prescribing, and for cost containment policy. Regulations that restrict or foster INN prescribing and substitution exist in all member states. The aim of this study is to describe the national regulations in European Union (EU) countries, to nation-specific tools for ePrescribing and eDispensation systems based on the standards for Identification of Medicinal Products (IDMP) in the European Health Data Space. A survey was sent to the policy makers from national competent authorities, active in UNICOM, and responsible for writing and monitoring national regulations. Data were collected from 14 EU countries. INN prescribing is mandatory in Greece, Portugal, and Estonia. It is allowed in Germany, Belgium, Norway, Spain, the Netherlands, and Italy (seldom used). Substitution based on precise substance and dose form is mandatory in Finland and Sweden, and allowed in Ireland (with a positive list). In Austria and Croatia, only brand substitution is possible. Rules for a substitution module in the cross-border ePrescribing and eDispensing services can be set up, with three possible levels of equivalent lists: brand substitution, PhPID substitution, and INN substitution. Harmonization of national rules is needed, also for exemptions and the possibility of physician's veto. This may be facilitated by the implementation of IDMP. The European Commission has the legal basis to foster this harmonization. It will have major implications for research, handling of drug shortages, and clinical care.
Association between alcohol consumption and musculoskeletal pain among employed and retired British civil servants: a multiple group latent class analysis.
Zhao Z, Lallukka T, Chandola T … +1 more , Britton A
Eur J Public Health · 2026 Feb · PMID 41406953 · Publisher ↗
Problematic alcohol use has been suggested to be associated with higher prevalence of musculoskeletal pain (MSP) among manual workers; however, such relationship remains understudied among non-manual workers. This cross-...
Problematic alcohol use has been suggested to be associated with higher prevalence of musculoskeletal pain (MSP) among manual workers; however, such relationship remains understudied among non-manual workers. This cross-sectional study investigated the association between alcohol consumption and MSP patterns among non-manual workers. We analysed 6847 non-manual civil servants and retirees aged 50-75 years from the phase 7 of the British Whitehall II Cohort study. Self-reported alcohol consumption was measured as average weekly intake and an alcohol dependency score. MSP was assessed through self-reported anatomical pain sites in the upper body and their frequency. We used multiple-group latent class analysis to identify MSP patterns by age, sex, and employment status. Multinomial logistic regression was used to assess the association between alcohol and pain patterns, adjusting for covariates. There were 3651 (53.3%) reported MSP, with four patterns identified: all upper-body pain sites (6.9%), low back pain (LBP) alone (10.3%), combined LBP and cervical pain (24.8%), and upper-extremity pain (11.3%). We did not observe any significant association between alcohol consumption/dependency and any pain patterns (Ps > .05). Above-moderate alcohol consumption was associated with combined LBP/cervical pain (OR: 1.31, 95% CI: 1.05-1.31) among retirees. Potential alcohol dependency was associated with upper-extremity pain among women (OR: 2.04, 95% CI: 1.15-3.60) and early retirees (OR: 1.81, 95% CI: 1.15-2.84). No overall association between alcohol consumption and MSP was found. Increased spinal pain was found in retirees who exceeded recommended limits, and increased extremity pain was found in women and early retirees with potential alcohol dependency.
Responding to current and future challenges in the health and care workforce: linking innovative research, policies, and practices.
Ungureanu MI, Falkenbach M, Kuhlmann E … +1 more , Correia T
Eur J Public Health · 2026 Feb · PMID 41405437 · Publisher ↗
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Mortality disparity by socioeconomic position in people with and without diabetes: open cohort studies in four high-income countries.
Ter Braake JG, Vos RC, Røssell EL … +8 more , Magliano DJ, Wild SH, Scottish Diabetes Research Network Epidemiology Group , Walsh D, Morton JI, Boel Graversen S, Støvring H, Laurberg T
Eur J Public Health · 2026 Feb · PMID 41401381 · Publisher ↗
There have been mixed findings on whether mortality is socially patterned among people with diabetes. We compared all-cause mortality trends by socioeconomic position (SEP) among people with and without diabetes for 2004...
There have been mixed findings on whether mortality is socially patterned among people with diabetes. We compared all-cause mortality trends by socioeconomic position (SEP) among people with and without diabetes for 2004-21 in four high-income countries. We conducted open cohort studies in Australia, Denmark, the Netherlands, and Scotland and included national or regional populations aged 35-69 years. We used the European standard population in 2013 to calculate age-standardized mortality rates (ASMRs) by calendar year, SEP quintile, diabetes status, and sex. SEP quintiles were defined using standardized disposable household income in Denmark and the Netherlands, and area-based indices in Australia and Scotland. We calculated the age-standardized slope index of inequality and age-adjusted relative index of inequality using Poisson regression as absolute and relative measures of socioeconomic inequality, respectively across the study populations stratified by calendar year, diabetes status, and sex. About 208 011 deaths occurred during 17 million person years (py) of follow-up among 35- to 69-year olds with diabetes, and 1.1 million deaths during 298 million py of follow-up among people without diabetes. ASMRs generally increased with increasing deprivation and varied between 1.3 (95% CI: 1.2-1.4) deaths per 1000 py to 29.4 (95% CI: 26.0-32.8) deaths per 1000 py. We found absolute and relative mortality inequality that increased during the follow-up period among adults without diabetes. Measures of absolute and relative inequality among adults with diabetes widened in some populations by country and sex. To conclude, disparities in mortality by SEP increased during follow-up in most countries. Strategies are needed to reduce excess mortality associated with low SEP and diabetes and related socioeconomic inequality.
Representation matters-for a stronger public health workforce.
Albreht T, Marchandise C, Kluge HHP … +5 more , Muscat NA, Yon Y, Ilinca S, Franco M, Barnhoorn F
Eur J Public Health · 2025 Dec · PMID 41401367 · Full text
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Is home always the best place to live? Preferences for place of residence and long-term care among the community-dwelling oldest old in Finland.
Pulkki JM, Aaltonen MS, Jylhä MK … +1 more , Enroth LM
Eur J Public Health · 2025 Dec · PMID 41401366 · Full text
The aging in place policy emphasizes the older people's own desire to live at home. However, there is limited evidence on preferences for place of residence and long-term care, especially regarding the oldest old people....
The aging in place policy emphasizes the older people's own desire to live at home. However, there is limited evidence on preferences for place of residence and long-term care, especially regarding the oldest old people. This study aims to fill this knowledge gap by identifying the preferences and associated factors of community-dwelling people aged 90+. Survey data, including a total age cohort of 90 years and older in one geographic area in Finland was analyzed descriptively and with multinomial logistic regression. The total study population was 1834 of which two-thirds were community-dwellers. Of the community-dwellers 71% preferred to live at their current homes, 18% preferred to live at their current homes if they received more help, and 11% would prefer to live in a residential care facility. Those who preferred to live at home had better functioning, rarely experienced dizziness, tiredness, loneliness, and pain, were more often satisfied with their life, and had better self-rated health compared to other preference groups. Preferences shifted gradually: the poorer the respondents' health, functional capacity, and well-being, the more likely they preferred to get more help at home or live in residential care. One-third of the respondents either preferred to have more help in their current home or to move to residential care, indicating that home was not the best place for them to live at that time. Findings suggest that the preferences for living at home are not stable but a dynamic process among the oldest old people.
Associations between leisure-time physical activity and sleep problems among 11 346 Danish adults: the moderating role of stress.
Bjerkén APB, Ahrensberg H, Andersen S … +3 more , Aadahl M, Christensen AI, Petersen CB
Eur J Public Health · 2026 Mar · PMID 41401098 · Full text
Sleep problems constitute a significant public health issue. Previous studies have found that regular leisure-time physical activity has the potential to improve sleep quality. However, stress may influence both physical...
Sleep problems constitute a significant public health issue. Previous studies have found that regular leisure-time physical activity has the potential to improve sleep quality. However, stress may influence both physical activity and sleep, acting as a potential moderator in this association. The aim was to examine cross-sectional associations between self-reported leisure-time physical activity and sleep problems, as well as the potential moderating role of stress. The study population consists of 11 346 Danish adults (age ≥16 years) from the national representative Danish Health and Morbidity Survey conducted in 2021. Associations between leisure-time physical activity and sleep problems were analysed using multiple adjusted logistic regression, which included an investigation of effect modification by level of self-perceived stress. Adjusted odds ratios (ORs) for experiencing sleep problems were 1.37 [95% confidence interval (CI): 1.20-1.56] among participants who were mainly sedentary during leisure time, and 0.81 (95% CI: 0.72-0.91) among those with moderate to vigorous physical activity level compared to those with light physical activity level. Within all strata of stress levels, higher physical activity was positively associated with lower odds of sleep problems. For example, in the high stress level stratum, ORs were 0.80 (95% CI: 0.63-1.03) and 1.64 (95% CI: 1.28-2.11) in participants who were moderately to vigorously physically active and sedentary, respectively, compared to those who were lightly physically active. Higher levels of leisure-time physical activity appear to be associated with a lower prevalence of sleep problems, even among individuals who experience high levels of stress.
Research methodologies for creating competency frameworks for the public health workforce: a scoping review.
Kilani MA, Rodriguez-Feria P, Pavlova M … +5 more , Krasna H, Aljohar BA, Aragon de Leon E, Giraldo-Noack N, Czabanowska K
Eur J Public Health · 2026 Feb · PMID 41400839 · Publisher ↗
Competency frameworks are vital for the Public Health Workforce (PHW) capabilities, education, and standards. In the past years, several competency frameworks have been published for the PHW. However, methodologies to de...
Competency frameworks are vital for the Public Health Workforce (PHW) capabilities, education, and standards. In the past years, several competency frameworks have been published for the PHW. However, methodologies to define the competencies and domains vary significantly. This scoping review maps methodologies for multi-professional PHW frameworks (2018-24), identifying practices, patterns, and reporting gaps. Following the Joanna Briggs Institute guidance and PRISMA-ScR checklist, Medline, Embase, Global Health, and WorldCat were searched (2018-24) for multi-professional PHW frameworks. Dual screening and extraction captured characteristics and sequential methods. Methods were categorized and analyzed descriptively for frequency, sequence, and reporting completeness. Fifty-eight frameworks met inclusion (from 813 records), mostly North America/Europe. Methods reported for 44 (75.9%) frameworks. Most frequent: literature/document reviews (45.4%), survey/questionnaire (29.5%), expert consultation/panels (22.7%), interviews (22.7%), Delphi (20.4%). Literature/document reviews was the most common first step (34.1%). Frameworks used 1-9 steps (avg 2.96); 82.6% multi-step (evidence synthesis + stakeholder engagement ± validation). Significant reporting gaps: 14 (24.1%) lacked details; quality varied. PHW framework development shows diversity and multi-step processes but suffers from reporting gaps and inconsistencies. Standardization and transparency (e.g. following the CONFERD-HP) are crucial. Multi-method approaches integrating evidence synthesis, stakeholder engagement, and validation are recommended to enhance rigor, comparability, and utility for strengthening the global PHW.
Political context and COVID-19 vaccine hesitancy in the European Union: populism, government trustworthiness, and policy.
Bowler S, Carpiano RM
Eur J Public Health · 2026 Feb · PMID 41397688 · Publisher ↗
Vaccine hesitancy is a significant 21st Century public health challenge, with vaccines being increasingly politicized in public and government discourse and policymaking, particularly since the introduction of COVID-19 v...
Vaccine hesitancy is a significant 21st Century public health challenge, with vaccines being increasingly politicized in public and government discourse and policymaking, particularly since the introduction of COVID-19 vaccines. We evaluate the potential roles of national political and policy context for individuals' COVID-19 vaccine hesitancy across 27 European Union countries at two timepoints of the pandemic-assessing the extent to which national-level populism and government trustworthiness are associated with individuals' COVID-19 vaccination attitudes and receipt (actual or intended)-directly and indirectly via COVID-19-related policies. We analyzed May 2021 and February 2022 Eurobarometer survey data merged with nation-level populist parties' vote share, Transparency International's Corruption Index, the COVID-19 Policy Stringency Index, plus nation- and respondent-level controls. Increased levels of government trustworthiness and COVID-19 policies, but not populism, were each associated with more positive COVID-19 vaccine attitudes (though not substantively) and, respectively, lower odds of anti-vaccine and uncertain (vs. pro-vaccine) COVID-19 vaccination receipt/intentions. These associations were limited to only the May 2021 period that followed government and scientific scrutiny of vaccine safety signals. No evidence indicated that attitudes and receipt/intention were indirectly associated with populism and trustworthiness via COVID-19 policies. Our findings indicate that governments viewed as more trustworthy have citizens more accepting of government-run vaccination programs. These pandemic era analyses corroborate prior pre-COVID-19 research on nation-level evaluations of populism and vaccine acceptance. Our study highlights the value of multilevel approaches and multiple time periods and measures for advancing understanding of how political context may contribute to vaccination decision-making.
Physician retention in a context of workforce shortages: evidence from Portugal's National Health Service with European policy implications.
Osório R, Morais R, Correia T
Eur J Public Health · 2026 Feb · PMID 41396586 · Publisher ↗
Physician shortages threaten healthcare system sustainability across Europe. Retaining physicians is critical to maintaining service capacity and quality. Despite its importance, physician retention remains a pressing is...
Physician shortages threaten healthcare system sustainability across Europe. Retaining physicians is critical to maintaining service capacity and quality. Despite its importance, physician retention remains a pressing issue in Europe, including in Portugal, where the Portuguese National Health Service (NHS) continues to face significant retention challenges. We conducted a quantitative, observational, cross-sectional study to identify determinants of physician retention in Portugal. A validated survey was developed using a Nominal Group Technique and Delphi Panel with stakeholders. The questionnaire measured job satisfaction with Likert scales. A stratified sampling strategy ensured representation across Portugal's five mainland health regions, yielding 1398 physicians. Data were collected via self-administered electronic questionnaires. Analyses included descriptive statistics, ANOVA, t-tests, and linear regression to assess predictors of retention. Physicians with longer seniority reported higher intention to remain, with those over 10 years showing the strongest intention (mean = 3.72; SD = 1.05; P < .001). Fixed schedules were linked to higher intended retention than shift work (mean = 3.42 vs. 3.18; P = .015). Job satisfaction was the strongest predictor (β = 0.267; P < .001), followed by age (β = 0.222; P < .001), satisfaction with work characteristics (β = 0.125; P = .002), and career development (β = 0.097; P = .011). Satisfaction with human resources and work-life balance was not significant. Physician retention is shaped by seniority, schedule stability, work environment, and career development. Policies fostering supportive environments, predictable schedules, and professional growth are needed to sustain the workforce, to European systems.
Strengthening interprofessional collaboration by working with cross-sectoral boundaries: introducing mental health teams in Denmark.
Mejsner SB, Burau V, Fehsenfeld M
Eur J Public Health · 2026 Feb · PMID 41396584 · Publisher ↗
Interprofessional collaboration across sectors is a major challenge for the health and care workforce. Collaboration often remains weak, as fragmented services cannot match complex needs. Working with the underlying prof...
Interprofessional collaboration across sectors is a major challenge for the health and care workforce. Collaboration often remains weak, as fragmented services cannot match complex needs. Working with the underlying professional, organizational, and administrative boundaries may help to address the challenge, but we know little about how managers and professionals do this. This study examines how boundary work can strengthen interprofessional collaboration, based on the introduction of mental health teams in three Danish municipalities. A qualitative case study was conducted involving three intersectoral teams consisting of health and social care professionals in Central Denmark Region. Data collection included observations of interactions, 27 semi-structured interviews with users, professionals, and middle managers, and three focus group interviews. Key themes and dynamics in boundary work were identified using thematic network analysis. Findings indicate that boundary work by management established shared frameworks for interprofessional collaboration, such as weekly board meetings and risk categorization systems. In two municipalities, these frameworks fostered collaborative boundary work among professionals, agreeing on how to share information and adjust care plans collectively. However, in the third municipality, professionals competed to defend existing boundaries, hindering the introduction of new collaborative practices. Working with boundaries can help to address the challenge of interprofessional collaboration across sectors by combining top-down and bottom-up strategies by managers and professionals. However, implementation needs fine-tuning to existing professional hierarchies and local organizational contexts. Managers also need to acknowledge the limits of steering boundary work, which thrives on autonomy in daily interactions among professionals.
Associations between adverse childhood experiences and oral health in Norwegian adults, and the impact of social support and adulthood revictimization. The HUNT4 Survey.
Sørbø MF, Sun YQ, Kvist T … +7 more , Rønneberg A, Myran L, Havnen A, Willumsen T, Dahllöf G, Feuerherm AJ, Høvik H
Eur J Public Health · 2026 Feb · PMID 41391007 · Publisher ↗
Adverse childhood experiences (ACEs) increase the risk of various health issues, including oral problems. ACEs also heighten the risk of revictimization, though the impact of adulthood revictimization on oral health is l...
Adverse childhood experiences (ACEs) increase the risk of various health issues, including oral problems. ACEs also heighten the risk of revictimization, though the impact of adulthood revictimization on oral health is less understood. Conversely, positive influences, such as a trusted adult in childhood, may buffer these effects. This study examines how different dimensions of adversity relate to oral health. This cross-sectional study included 37 559 adults from the HUNT4 Survey, a general population study in Norway. We examined distinct ACE exposures: (i) specific ACEs (i.e. sexual, physical and psychological abuse, bully victimization, parental divorce, and death of a parent), (ii) cumulative ACE, (iii) combined exposure of ACE and adult support, and (iv) adversity trajectories identified by group-based trajectory modelling of ACE and adulthood sexual, physical and psychological abuse. Associations with oral health were assessed by logistic regression, estimating odds ratios with 95% confidence intervals. Most ACE types were associated with poorer adult oral health outcomes, exhibiting a dose-response gradient, where one-unit ACE increase indicated a higher likelihood of self-reported poor dental health (28%), dental fear (31%), and no dental visit in the last 2 years (10%). Combined exposure of ACE and adult support showed that those with high support had lower odds of reporting poor oral health. The revictimized trajectory exhibited the strongest association with impaired oral health outcomes. Our findings support that ACEs are linked to poor oral health later in life, especially among those revictimized as adults, whilst supportive childhood relations may buffer this effect.
Risk factors for unmet health care need: evidence from the large population-based Healthy Finland 2022-cohort.
Elovainio M, Jääskeläinen T, Koskinen S … +1 more , Aalto AM
Eur J Public Health · 2026 Feb · PMID 41351301 · Publisher ↗
There is a need to efficiently identify groups at risk of unmet health service needs. In response, we developed and evaluated the performance of a regression model to assess unmet health service needs in the Finnish popu...
There is a need to efficiently identify groups at risk of unmet health service needs. In response, we developed and evaluated the performance of a regression model to assess unmet health service needs in the Finnish population. The study population consisted of population-based Healthy Finland 2022-cohort participants (N = 18 442), aged 20-104. The primary outcome was self-reported unmet need for physician's or nurse's services. A total of 38 potential risk factors were evaluated. Statistical models were developed using bootstrap-enhanced LASSO regression (bolasso). Of the participants, 5875 (32%) were classified as experiencing unmet health care need. The C-index from the final model including 15 predictors from the best bolasso models varied between 0.73 and 0.76 and pooled C-index over the imputed data sets was 0.75 (95% CI 0.70-0.79). Fifteen factors-including health-related, socioeconomic variables, heavy alcohol use, experiences with health services, caregiving for others, and language group-were found to be strongly associated with an increased risk of unmet health care needs and may be a useful targets for preventing unmet health care need.
Health risk behaviours, obesity, and gambling severity: findings from a nationwide population study.
Grönroos T, Salonen AH, Latvala TA … +3 more , Kouvonen A, Lundqvist A, Kontto JP
Eur J Public Health · 2026 Feb · PMID 41346033 · Publisher ↗
Prior research on the relationship between health risk behaviours (HRBs), obesity, and gambling has primarily focused on problem gambling, while studies focusing on lower severity levels are scarce. Moreover, this relati...
Prior research on the relationship between health risk behaviours (HRBs), obesity, and gambling has primarily focused on problem gambling, while studies focusing on lower severity levels are scarce. Moreover, this relationship has rarely been analysed separately for women and men. This study aimed to investigate the association between HRBs, obesity, and the full spectrum of gambling severity in women and men. Cross-sectional population-based data from Healthy Finland Survey 2022-23 was exploited, including adults aged 20+ years (n = 28 154, response rate 46%, mean age 52 years). The Problem Gambling Severity Index (PGSI) was used as the dependent variable, both in continuous (score 0-27) and categorical (non-problem, low-risk, moderate-risk, and problem gambling) form. Independent variables included HRBs (daily smoking, excessive drinking, low fruit and vegetable (F & V) consumption, low physical activity, and insufficient sleep) and obesity. Sociodemographic factors, suboptimal self-rated health, and psychological distress were adjusted for. Daily smoking, excessive drinking, low F & V consumption, and insufficient sleep were less prevalent in the non-problem gambling category (PGSI score = 0) compared to the low-risk (score 1-2), moderate-risk (score 3-7), and problem gambling (score ≥8) categories. After adjusting for potential confounding variables, all HRBs and obesity, except for physical inactivity, were significantly associated with higher PGSI scores. These findings highlight the need for public health strategies that address gambling across the entire risk spectrum. Moreover, a holistic approach that considers the individual's broader life context could strengthen both research and prevention efforts.
The novel use of endemic corridors for addictive behavior surveillance in Spain.
Guerra-Tort C, Teijeiro A, Santiago-Pérez MI … +5 more , García G, Martín-Gisbert L, Candal-Pedreira C, Rey-Brandariz J, Pérez-Ríos M
Eur J Public Health · 2026 Feb · PMID 41338234 · Publisher ↗
To describe the pattern of contacts with the healthcare system associated with drug use in Spain in the years 2022 and 2023. For the period 2016-23, data derived from a registry of activity in specialized care, included...
To describe the pattern of contacts with the healthcare system associated with drug use in Spain in the years 2022 and 2023. For the period 2016-23, data derived from a registry of activity in specialized care, included in the clinical-administrative database of Spanish hospitals (Registro de Atención Especializada-Conjunto Mínimo Básico de Datos), were extracted. Contacts with the healthcare system associated with alcohol, cannabis, cocaine, morphine derivatives, and sedative-hypnotics use were analyzed. The methodology of endemic corridors was applied for each drug category based on data from 2016-21. The series of contacts in 2022 and 2023 were then represented in the corridors to compare their expected and observed pattern. A total of 193 433 contacts associated with the use of alcohol (90 735), cannabis (39 730), cocaine (23 485), morphine derivatives (4888), and sedative-hypnotics (34 595) were analyzed for the period 2016-23. Of the contacts, 70.3% corresponded to men and 23.4% corresponded to people aged 45-54. The number of contacts increased for all categories of drugs in 2022 and 2023. This increase was reflected in the corridors, where contacts were mainly located in alert zones, and sometimes in epidemic zones. The results of this study show that endemic corridors allow the surveillance of the pattern of contacts with the healthcare system associated with drug use and, indirectly, of drug use itself. This methodology should be further studied as a complement in epidemiological surveillance of addictive behaviors at a population level.
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