European Journal Of Public Health[JOURNAL]
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200 papers
Retention of nurses in the Portuguese NHS: organizational, career, and work-life balance factors shaping intention to stay.
Morgado M, Beja A, Morais R … +1 more , Correia T
Eur J Public Health · 2026 Feb · PMID 41335460 · Publisher ↗
Nurse retention is a critical challenge across Europe, directly affecting workforce sustainability, quality of care, and health systems resilience. Despite persistent shortages and increasing emigration, evidence on nurs...
Nurse retention is a critical challenge across Europe, directly affecting workforce sustainability, quality of care, and health systems resilience. Despite persistent shortages and increasing emigration, evidence on nurse retention determinants within the Portuguese National Health Service (NHS) remains limited. This study aims to identify factors influencing nurses' intention to stay in the NHS, contributing to national and European debates on sustainable workforce strategies. A quantitative, observational, cross-sectional survey was conducted among a representative sample of 1494 nurses working in NHS. A validated questionnaire was developed using a Nominal Group Technique and Delphi Panel with stakeholders, to measure job satisfaction with Likert scales. Inferential statistical analyses, including t-tests and multiple linear regression, examined associations between intention to stay and factors such as job satisfaction, work-life balance, career development opportunities, remuneration, and sociodemographic characteristics. Fixed work schedules, overall job satisfaction, age, satisfaction with work-life balance, and career development emerged as significant predictors of intention to stay. Satisfaction with salary and financial incentives, while low, was not statistically significant. Findings highlight the importance of integrated workforce retention strategies combining organizational improvements, career progression pathways, and work-life balance policies. These findings differ from those observed among physicians in parallel research, confirming the need for profession-specific retention approaches. This study provides new evidence on nurse retention in Portugal, reinforcing the need for human resources policies aligned with European Union priorities on workforce sustainability. Cross-country policy learning and evidence-informed, context-sensitive strategies are crucial for supporting nurse retention and health system resilience.
Exploring moral injury among physicians in the Republic of Moldova and Romania: a qualitative study.
Papuc I, Ungureanu MI
Eur J Public Health · 2026 Feb · PMID 41335418 · Publisher ↗
Moral Injury is an emerging concept initially studied in the military context, capturing the profound psychological, emotional, and spiritual suffering experienced by individuals who perceive that they have transgressed...
Moral Injury is an emerging concept initially studied in the military context, capturing the profound psychological, emotional, and spiritual suffering experienced by individuals who perceive that they have transgressed their deeply held moral or ethical beliefs. In healthcare, Moral Injury occurs when systemic constraints, organizational policies, or professional commitments force healthcare workers (HCWs) to act in ways that dissent from their values. Our study aimed to explore qualitatively the phenomenon of Moral Injury among physicians in healthcare settings in Romania and the Republic of Moldova, focusing on how systemic and organizational factors contribute to their experiences. The study employed a qualitative research design. We collected and analysed 17 interviews with doctors from Romania and Republic of Moldova. We identified four central themes and subsequent sub-themes: Perception and Understanding of Moral Injury; Factors contributing to Moral Injury; Impact on Patient Safety and Quality of Care; Coping Strategies and Emotional Survival Mechanisms. Our findings suggest that Moral Injury is not the result of isolated events but rather the outcome of persistent exposure to systemic dysfunctions, including coercive hierarchies, politicized leadership, inadequate resources, and the prioritization of economic performance over patient welfare. Physicians described feelings of shame and betrayal when compelled to comply with orders that contradicted their professional ethics.
Policy responses to doctor and nurse migration in the European Region: insights from nine country case-studies.
Dussault G, Zapata T, Buchan J … +21 more , Andersen Y, Salomudin Y, Montebello V, Tuseth Aasheim E, Blidaru TC, Garofil ND, Humphries N, Gabrani J, Nadareishvili I, Ghazaryan E, Comsa R, Qurbonova R, Otgon S, Bejtja G, Makhmudova P, Dastan I, Dias C, Roubal T, Nandi S, Llop-Girones A, Azzopardi-Muscat N
Eur J Public Health · 2026 Feb · PMID 41335409 · Publisher ↗
The WHO Regional Office for Europe conducted 9 country studies of migration of doctors and nurses. This paper identifies similarities and variations in migratory flows, factors that influence them, and related policy res...
The WHO Regional Office for Europe conducted 9 country studies of migration of doctors and nurses. This paper identifies similarities and variations in migratory flows, factors that influence them, and related policy responses. The 9 countries include 4 that integrate the European Economic Area (EEA), Ireland, Malta, Norway, and Romania, and 5 non-EEA, Albania, Armenia, Georgia, Moldova, Tajikistan. Case writers used a common study template that covered international outflows and inflows, mobility push, and pull factors, and related policy interventions. Data sources include the WHO/Europe-OECD-Eurostat joint questionnaire and country databases. Emigration is motivated by low wages, dissatisfaction with working conditions, inadequate practice environment, excessive workloads and lack of opportunities for professional development. Flows for doctors and nurses vary in volume over time, and in countries of origin and destination. Pull factors include the free circulation of persons within the EEA for citizens of member states, easy access to work permits, common or easily learned language, and the presence of a diaspora in a destination country. Policies to improve retention include increasing the number of training places, making remuneration and working conditions more attractive and compulsory service. All countries have some health workforce development plan, but implementation is a challenge everywhere. Policies should be tailored to country labour market conditions, migration trends, and institutional capacity. Better understanding of migration flows will improve the effectiveness of policy responses.
'Why wouldn't I want to go?': doctor migration, retention, return, and Ireland's future medical workforce.
Humphries N, Byrne JP
Eur J Public Health · 2026 Feb · PMID 41335405 · Publisher ↗
Health workforce shortages pose a challenge to European health systems. Challenging working conditions in healthcare were intensified by the global financial crisis and the coronavirus disease of 2019 (COVID-19) pandemic...
Health workforce shortages pose a challenge to European health systems. Challenging working conditions in healthcare were intensified by the global financial crisis and the coronavirus disease of 2019 (COVID-19) pandemic. In Ireland deteriorating working conditions for hospital doctors triggered a pattern of emigration and an increased dependence on international medical graduates. This article seeks to better understand doctor emigration and its implications for Ireland's future workforce, drawing on the case of Irish doctors who emigrated to Australia. The paper draws on three forms of data: (i) secondary data from the Australian Department of Home Affairs on visas issued to Irish citizen doctors; (ii) open-ended survey responses from hospital doctors working in Ireland (2019, N = 469) and, (iii) qualitative interview data from Irish doctors (2018, N = 51) in Australia. Research ethics permission was granted by the host institution. Significantly more Irish doctors were issued with Australian work visas in 2024 (624) than in 2005 (72). Hospital doctor survey respondents described how emigration decision-making was informed by poor working conditions, inadequate staffing levels, poor wellbeing, and dissatisfaction with the quality of care delivered. Emigrant Irish doctors in Australia indicated that similar issues deterred their return. This article shows that Ireland has high rates of outward and inward doctor migration a limited policy focus on retention or return. Our findings indicate that challenging working conditions are a driver of emigration and a deterrent to return. We call for a more person-centred approach to the medical workforce which would improve doctor working conditions, prioritize their wellbeing and promote retention/return.
A decade of change in age, sex distribution, and comorbidities of obstructive sleep apnoea in Finland.
Palomäki M, Linna M, Anttalainen U … +4 more , Kolari T, Partinen M, Saaresranta T, Keto J
Eur J Public Health · 2026 Mar · PMID 41330356 · Full text
There is limited information on changes over time in the incidence, age, sex, and comorbidities of obstructive sleep apnoea. We extracted data from the Finnish Secondary Care Register to assess the incidence of obstructi...
There is limited information on changes over time in the incidence, age, sex, and comorbidities of obstructive sleep apnoea. We extracted data from the Finnish Secondary Care Register to assess the incidence of obstructive sleep apnoea, the age and sex distribution, and the prevalence of 26 comorbidities of incident obstructive sleep apnoea patients in Finnish specialized care in 2010 and 2020. Analyses were conducted for three age groups (18 - 39, 40 - 64, and ≥65 years), stratified by sex, and for the total population. From 2010 to 2020, the incidence of clinically diagnosed obstructive sleep apnoea increased from 1.7 to 6.1 per 1000 (from 2.4 to 7.6 per 1000 for men and from 1.0 to 4.6 per 1000 for women). The proportion of the youngest group increased from 11.0% to 12.7% and the oldest group from 20.2% to 27.2%. The largest increase in incidence was observed in the youngest group for both sexes. Among men, the prevalence of six comorbidities decreased, and of eight increased. Among women, the prevalence of seven comorbidities decreased, and of four increased. Obstructive sleep apnoea is being diagnosed increasingly in young adults and those aged 65 years and older. Changes in comorbidities suggest increased recognition and treatment of cardiovascular risk factors and, on the other hand, the ageing of the population. A decrease in some comorbidities suggests that incident obstructive sleep apnoea patients are less morbid despite their increased age.
Waiting times for health services, health, and labour market outcomes.
Siciliani L
Eur J Public Health · 2026 Mar · PMID 41329126 · Full text
Waiting times for health care is a significant health policy concern across many health systems, which has been exacerbated by the COVID-19 pandemic. Long waiting times for non-emergency care generate health losses to pa...
Waiting times for health care is a significant health policy concern across many health systems, which has been exacerbated by the COVID-19 pandemic. Long waiting times for non-emergency care generate health losses to patients because health benefits are postponed. They can increase the risk of mortality or morbidity and reduce patient ability to benefit from health care. Waiting times can also generate negative spill-over effects on labour market outcomes. For individuals in the working age, employed individuals might end up on sick leave and claim sickness benefits, or experience reduced productivity if they continue to work. Individuals looking for a job may find it harder to find employment or become economically inactive. We conduct a narrative review of the literature on the effect of waiting times on health losses and labour market outcomes. There is growing literature documenting the effect of longer waiting times on labour market outcomes. Although limited, the literature identifies potentially harmful effects in particular when patients are waiting for mental health services and orthopaedic treatment. The findings have implications for prioritization of patients on the list and for allocation of resources within the health sector and across sectors.
The evolving landscape of scientific publishing practices and implications for public health research.
Boccia S, Pezzullo AM, Valz Gris A … +1 more , Abalkina A
Eur J Public Health · 2026 Feb · PMID 41328002 · Publisher ↗
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Europe must react against a manmade public health catastrophe at its borders.
Albreht T, Marchandise C, Allebeck P
Eur J Public Health · 2025 Dec · PMID 41290007 · Full text
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Tobacco smoking by disability status before and after COVID-19 onset: a repeated cross-sectional analysis of 1 087 678 adults.
Adebisi YA, Alshahrani NZ, Daberechi OJ … +2 more , Ogunkola IO, Lucero-Prisno DE
Eur J Public Health · 2026 Mar · PMID 41283822 · Full text
Smoking remains a leading cause of preventable illness and death in the United Kingdom, but little is known about recent trends in smoking disparities between disabled and non-disabled adults, particularly in the context...
Smoking remains a leading cause of preventable illness and death in the United Kingdom, but little is known about recent trends in smoking disparities between disabled and non-disabled adults, particularly in the context of the coronavirus disease 2019 (COVID-19) pandemic. We analysed UK Annual Population Survey data from 2017 to 2023 for adults aged ≥18 years. Smoking status was classified as current, ex-, or never smoker, and disability status was defined according to the Equality Act. Multinomial logistic regression was used to estimate pooled adjusted relative risk ratios (RRRs) for smoking outcomes by disability status, and then separately for periods before (2017-19) and after (2020-23) the pandemic onset. To test whether the pandemic had an effect beyond underlying trends, we fitted a joint model including survey year and a post-2020 indicator. Adjusted average marginal effects quantified absolute percentage point (pp) differences in predicted probabilities between disabled and non-disabled adults. The analytic sample comprised 1 087 678 adults, of whom 26.7% (n = 290 536) reported a disability. In pooled adjusted analyses covering all survey years, and controlling for age, sex, education, ethnicity, marital status, and region of residence, disabled adults had higher relative risk ratios of being current smokers (RRR = 1.78; 95% CI: 1.75-1.80; P < .001) and ex-smokers (RRR = 1.44; 95% CI: 1.42-1.45; P < .001) compared with never smokers. Period-stratified analyses (not adjusted for temporal trends) showed adjusted RRRs for current smoking of 1.65 (95% CI: 1.62-1.68; P < .001) before and 1.95 (95% CI: 1.91-1.99; P < .001) after the pandemic onset. In the fully adjusted joint model accounting for temporal trends (survey year) and pandemic period, the disability × pandemic period interaction was not statistically significant (χ2 = 3.11; P = .21). Adjusted average marginal effects from the trend-adjusted model showed that disabled adults had a higher predicted probability of current smoking both before (+5.63 percentage points; 95% CI: 5.30-5.96; P < .001) and after (+4.60 pp; 95% CI: 4.25-4.96; P < .001) the pandemic onset, representing a modest narrowing of the absolute gap (difference = -1.03 pp; P = .001). Disabled adults remained substantially more likely to smoke than their non-disabled counterparts. After accounting for underlying temporal trends, the onset of the COVID-19 pandemic did not independently change this association, highlighting the continued need for disability-inclusive cessation strategies.
Differential effects of adolescent health behaviours on adult cardiometabolic health by parental and neighbourhood socioeconomic background.
Jackisch J, Noor N, Raitakari OT … +6 more , Lehtimäki T, Kähönen M, Cullati S, Delpierre C, Kivimäki M, Carmeli C
Eur J Public Health · 2026 Feb · PMID 41283821 · Publisher ↗
Adolescent healthy behaviours may improve cardiometabolic health in adulthood differently across socioeconomic groups. We aimed to quantify the effects of adolescent healthy behaviours on multiple biomarkers of adult car...
Adolescent healthy behaviours may improve cardiometabolic health in adulthood differently across socioeconomic groups. We aimed to quantify the effects of adolescent healthy behaviours on multiple biomarkers of adult cardiometabolic health by socioeconomic backgrounds. We used a population-based cohort of Finnish adolescents from the Young Finns Study (1980-89, n = 2984) followed into adulthood (2001-11). Healthy behaviours (no smoking, no alcohol consumption, sufficient physical activity, daily fruit and vegetable consumption) and socioeconomic backgrounds (parental- and neighbourhood-related) were measured in adolescence (12-18 years). Biomarkers of adiposity [waist circumference, body mass index (BMI)], cardiovascular [blood pressure (BP), cholesterol, apolipoprotein B], and metabolic [plasma glucose, insulin resistance] outcomes were measured in adulthood (33-40 years). We estimated conditional average effects of healthy behaviours via inverse-probability-weighted marginal structural models. Sufficient physical activity lowered adiposity biomarkers to a greater extent among adolescents from disadvantaged neighbourhood, with additional decreases of 2.2 cm [95% confidence interval (CI): -0.1 to 4.7] in waist circumference and 1 kg/m2 (95% CI: 0.2 to 1.9) in BMI. In contrast, daily fruit and vegetable consumption lowered BP with additional 2.0-3.6 mmHg (95% CI: 0.3 to 6.1) among adolescents with advantaged either parental or neighbourhood socioeconomic backgrounds. There was little evidence for differential effects on other outcomes and for no smoking and alcohol. Socioeconomic backgrounds modified the effects of adolescent physical activity and fruit and vegetable consumption on adult cardiometabolic health. These findings indicate that population-wide interventions promoting healthy behaviours during adolescence have the potential to either mitigate or exacerbate long-term socioeconomic inequalities in cardiometabolic health.
Measuring patient experience of integrated care in multiple sclerosis: development and validation of the Integrated Care Experience Scale (ICES-MS).
Manacorda T, Bandiera P, Lamendola P … +4 more , Salivetto M, Terzuoli F, Battaglia MA, Ponzio M
Eur J Public Health · 2026 Mar · PMID 41275360 · Full text
People with multiple sclerosis (MS) need to receive health and social care services from a diverse range of provider organizations, which carries risks such as disjointed care, discontinuities, and duplication. Many inno...
People with multiple sclerosis (MS) need to receive health and social care services from a diverse range of provider organizations, which carries risks such as disjointed care, discontinuities, and duplication. Many innovation programmes aim to provide better integrated and person-centred care (IPCC) for people with chronic conditions, including MS. Measuring patient experience is essential to evaluate interventions meant to shift the service model towards coordinated and personalized care. These transformations are central to global strategies for addressing the needs of ageing populations. AISM-Italian MS Association adapted an 8-item questionnaire, ICES-MS, from a set of questions originally designed for chronic patients in general. A total of 1602 persons with MS living in Italy completed the ICES-MS as a part of a broader survey that included other validated questionnaires on disability (Self-EDSS) and quality of life (EQ-5D-3L and EQ-VAS). Participants' responses were also linked with data from a previous AISM survey on 169 Italian Clinical Centres. Structural, construct, criterion, and known-groups validity of ICES-MS were evaluated. The ICES-MS scale is a robust unidimensional measure of patient experience of IPCC in MS, with strong internal consistency and appropriate convergent validity with EQ-5D-3L and EQ-VAS. ICES-MS scores varied as expected by participants' age and disability level. ICES-MS is a valid, succinct scale to measure patient experience of IPCC care in MS in Italy, and its original design suggests value in exploring its use in other chronic conditions and different countries.
Distinct substance use patterns and risk of unintentional injury, violence, and mortality in adolescence: a latent class analysis and 8-year prospective cohort study of 68 301 students aged 15-19 years.
Kruckow S, Hansen ER, Feldstein Ewing SW … +5 more , Rømer K, Peden AE, Bramming M, Kjeld SG, Tolstrup JS
Eur J Public Health · 2026 Feb · PMID 41275359 · Publisher ↗
Adolescence is a life stage characterized by physical, social, and emotional changes including a shift towards peer orientation and an explorative approach to substance use. Previously, we identified distinct adolescent...
Adolescence is a life stage characterized by physical, social, and emotional changes including a shift towards peer orientation and an explorative approach to substance use. Previously, we identified distinct adolescent substance use patterns. Here we characterized adolescents with distinct patterns of substance use and tested whether patterns were associated with acute outcomes. Data from the Danish National Youth Cohort 2014, comprising 68 301 participants aged 15-19 years attending upper secondary education, were used. Previously identified substance use patterns were Alcohol Only (48.8%), Frequent Binge Drinking (23.3%), Experimental Use (16.3%), and Early Multiple Use (11.6%). Adolescents with distinct substance use patterns were characterized by adverse childhood experiences, social networks, parental support, and mental health. Associations between patterns and the risk of unintentional injury, violence, and mortality were assessed over an 8.2-year follow-up period. An accumulation of adverse childhood experiences, lack of parental support and poor mental health were observed in adolescents with most substance use. Substance use patterns were associated with the risk of unintentional injury, violence, and mortality in a dose-dependent manner. For instance, compared to Alcohol Only, hazard ratios (95% CI) for severe unintentional injury were 1.25 (1.08-1.44), 1.40 (1.17-1.66), 1.50 (1.25-1.79) for adolescents with Frequent Binge Drinking, Experimental Use, and Early Multiple Use. Adolescent substance use patterns were associated with short- and long-term risks of acute health outcomes. Additionally, disadvantages cluster in adolescents with more substance use, highlighting the aggregation and potential interaction of challenges faced by vulnerable subgroups that extend into adulthood.
Navigating new healthcare systems: a qualitative exploration of barriers, facilitators, and service utilization among Ukrainian refugees in five host countries.
Scherzer M, Mazhnaia A, Alpatova P … +5 more , Zub T, Maddah D, Tahirukaj A, Papowitz H, Habersaat KB
Eur J Public Health · 2026 Feb · PMID 41258910 · Publisher ↗
The invasion of Ukraine by the Russian Federation on 24 February 2022 displaced millions. While the European Union's Temporary Protection Directive aims to facilitate the right to healthcare for Ukrainian citizens stayin...
The invasion of Ukraine by the Russian Federation on 24 February 2022 displaced millions. While the European Union's Temporary Protection Directive aims to facilitate the right to healthcare for Ukrainian citizens staying in European Union Member States, health systems were already heavily burdened. Ensuring efficient and accessible care for refugees requires insights into individual and context-specific barriers to and facilitators of uptake of health services. In depth interviews were conducted between May 2022 and September 2023 in five countries receiving refugees from Ukraine. Interview guides and rapid analysis procedures followed a modified capability, opportunity, motivation-behaviour (COM-B) framework. Language was a cross-cutting issue touching all COM-B factors. Mental health services use was characterized by specific barriers and drivers across COM-B factors. Additional barriers include health literacy, long wait times for appointments, and lack of sufficient focus on the most vulnerable groups. Drivers include peer and community support, perceived high quality of care and trust in health workers. Successful navigation of new health systems depends on strong health literacy, availability of actionable information, additional support for the most vulnerable and support for health workers. Study insights can inform revisions to health services being offered to refugees from Ukraine and provide considerations for future refugee health crises in any location.
Age-specific changes in obesity and associated cardiometabolic risk factors: a two-decade study of the Finnish adults.
Lundqvist A, Jääskeläinen T, Lehtoranta L … +6 more , Aspholm S, Vessari H, Ojanen A, Palosaari T, Cederberg-Tamminen H, Saukkonen T
Eur J Public Health · 2026 Feb · PMID 41254954 · Publisher ↗
We analyzed age-specific changes in obesity and associated cardiometabolic risk factors from 2000 to 2023 in Finland. The study is based on two cross-sectional health examination surveys in years 2000 and 2023, represent...
We analyzed age-specific changes in obesity and associated cardiometabolic risk factors from 2000 to 2023 in Finland. The study is based on two cross-sectional health examination surveys in years 2000 and 2023, representing the Finnish adults (aged 30-64 years). Associations between obesity and cardiometabolic risk factors were assessed using age-adjusted logistic regression. From 2000 to 2023, the overall prevalence of obesity (BMI ≥30 kg/m2) increased from 21% to 30% in men, and from 22% to 30% in women. Class II-III obesity (BMI ≥35 kg/m2) doubled reaching 9.9% and 12.6% in men and women, respectively, in 2023. Most marked changes were observed in younger adults, among whom the obesity rates doubled, and class II-III obesity tripled. Obesity was strongly associated with other cardiometabolic risk factors in both 2000 and 2023. Over 90% of individuals with obesity had at least one associated cardiometabolic risk factor. In 2023, the age-adjusted odds of glucose metabolism abnormalities, hypertension, and dyslipidemia in individuals with obesity, compared to normal-weight individuals, were 5.67 (95% CI 3.24-9.94), and 6.52 (4.49-9.46), and 3.91 (2.52-6.06) in men, and 7.49 (3.09-18.13), and 4.79 (3.64-6.29) and 3.22 (2.23-4.64), in women, respectively. Obesity rates in Finland have increased significantly over the past two decades, especially in young adults. Given the persistent risk of cardiometabolic complications in individuals with obesity, the increasing obesity rates are projected to place a substantial public health burden. These findings underscore the urgent need for effective strategies to address the obesity epidemic and mitigate its health impacts.
Italian survey on maternal acceptance and views on RSV vaccination during pregnancy.
Lubrano C, Locati F, Casaccia F … +5 more , Trespidi L, Cucchi R, Parisi F, Ossola MW, Cetin I
Eur J Public Health · 2026 Feb · PMID 41254949 · Publisher ↗
Passive immunization plays a pivotal role in prenatal care. This study aimed to assess maternal awareness, knowledge, and adherence to vaccinations during pregnancy, specifically for pertussis, influenza, and respiratory...
Passive immunization plays a pivotal role in prenatal care. This study aimed to assess maternal awareness, knowledge, and adherence to vaccinations during pregnancy, specifically for pertussis, influenza, and respiratory syncytial virus (RSV), while also evaluating how the approval of the RSV vaccine during pregnancy has been received by women and healthcare professionals. A cross-sectional survey was conducted at Mangiagalli Hospital in Milan between August and November 2024. Pregnant women were asked to complete a self-administered questionnaire regarding socioeconomic characteristics, knowledge of vaccine-preventable diseases, and vaccination acceptance. Multivariate logistic regression examined associations between socioeconomic factors and vaccination behavior. A total of 390 participants were considered for final analysis. 89.7% of women had received or would receive the pertussis vaccine, 72.3% the influenza vaccine (P < .001), and 74.9% the RSV vaccine (P < .001). Education, employment status, and number of children were significantly associated with higher vaccination rates. The gynecologist was the primary source of information for most women (60.5%). Barriers to vaccination included a lack of prior discussion with healthcare providers and concerns about vaccine safety. Nevertheless, 83.8% of women would be favorable to receiving all vaccines together and 86.4% would prefer receiving the vaccine themselves rather than having monoclonal antibodies administered to their neonates. Maternal education and effective communication with healthcare providers are crucial in improving vaccination acceptance during pregnancy. Personalizing vaccination counseling for women with lower educational levels and those expecting their first child is essential.
Injuries and well-being among adolescents in Finland from 2013 to 2021.
Korpilahti U, Koivisto M, Partonen T … +5 more , Haikonen K, Hakulinen T, Lillsunde P, Rautava P, Koivusilta L
Eur J Public Health · 2026 Feb · PMID 41241817 · Publisher ↗
Injuries lead to heath loss, disability, and significant costs. The aim of this study was to evaluate self-reported home and leisure injuries outside school by the 8th and 9th graders in Finnish secondary schools, and po...
Injuries lead to heath loss, disability, and significant costs. The aim of this study was to evaluate self-reported home and leisure injuries outside school by the 8th and 9th graders in Finnish secondary schools, and potential explanatory factors associated with their injuries. Data were gathered on 383 550 pupils in cross-sectional surveys (every second school year) done between years 2013 and 2021. Associations between injuries and the explanatory variables were assessed using logistic regression analysis. Bronfenbrenner's bioecological model and the KINDL-R health-related quality of life measurement were used as the framework for this study. Nearly a third of the respondents (n = 120 494, 31.4%) had been injured one or more times during leisure time or at home. The most common injuries among all respondents were sport-related injuries (19.8%), other injuries sustained during leisure time (13.8%) and at home or nearby (9.4%). The use of safety equipment was quite low. The potential risk for injuries was highest among those who were severely anxious, those who often consumed enough alcohol to become heavily drunk, those who had tried or used drugs before, and adolescents of foreign background who had been born abroad. Adolescents with no close friends had a lower association with injury. Boys were more likely to sustain injuries than girls. Injuries suffered in leisure time and at home were linked to risky behaviour, emotional well-being, social and family relationships, and housing. Professionals in preventive work need to take the complex factors behind injuries into account.
Europe in a hybrid war: health security as strategic defence.
Marchandise C, McKee M
Eur J Public Health · 2025 Dec · PMID 41240376 · Full text
Abstract loading — click title to view on PubMed.
Trends in initiation of regular cigarette smoking in 28 European countries, 1940-2019: retrospective reconstruction from repeated cross-sectional surveys.
Teshima A, Bannon O, Filippidis FT … +5 more , Feliu A, Gallus S, Peruga A, Martínez C, Fernández E
Eur J Public Health · 2025 Dec · PMID 41236782 · Full text
In the European Union (EU), one in five youth currently smoke, with over half establishing regular smoking by age 18. Yet, evidence on the historical trends of smoking initiation remains scarce despite its importance for...
In the European Union (EU), one in five youth currently smoke, with over half establishing regular smoking by age 18. Yet, evidence on the historical trends of smoking initiation remains scarce despite its importance for tobacco control. Using four waves of the Special Eurobarometer survey (2012-20; n = 110 753, aged ≥15), we retrospectively estimated trends in initiation rates (IRs) of regular cigarette smoking in the EU from 1940 to 2019 among individuals aged 10-24 by sex, region, and country for each calendar decade. EU-wide smoking IRs have decreased compared to the peak period, with narrowing disparities by sex and region. For males, the IRs have declined from 5.7% (95% CI = 5.6-5.9) in the 1970s to 3.2% (95% CI = 3.0-3.3) in the 2010s, and for females from 3.9% (95% CI = 3.7-4.0) in the 1990s to 2.4% (95% CI = 2.3-2.5) in the 2010s. The decline was more pronounced among young adults aged 18-24 than minors aged 10-17, with minors' IRs surpassing those of young adults during the 2010s. Marked declines occurred among young adults in all regions, while among minors, a clear decrease was observed only for males in Northern Europe. Concerningly, the IRs among minors have trended upward in Eastern Europe for both sexes. Despite declining youth smoking initiation, an unacceptably high number of European youth still begin smoking regularly before the legal age of 18. Stricter and comprehensive tobacco control policies targeting youth, along with smoke-free generation initiatives, could substantially reduce future tobacco use and smoking-related mortality.
Tattoos in the general Swedish population: prevalence, determinants, and exposure characteristics.
Nielsen C, Jöud AS
Eur J Public Health · 2026 Apr · PMID 41236770 · Full text
Tattoo ink on the European market has been reported to contain many human toxicants, which has raised concerns about health effects. Clarifying the exposure distribution in the population is key to understanding potentia...
Tattoo ink on the European market has been reported to contain many human toxicants, which has raised concerns about health effects. Clarifying the exposure distribution in the population is key to understanding potential public health implications. We investigated the prevalence of tattoos in a population-based Swedish cohort of 13 046 individuals aged 20-68 years with exposure data collected through a questionnaire in 2021. In addition, we characterized the tattooed population in terms of sociodemographic and socioeconomic determinants and exposure characteristics using multivariable logistic regression, regressing tattoo status on sex, age, educational attainment, marital status, smoking, snuff use, and alcohol consumption. The age-standardized tattoo prevalence was estimated at 29% (95% confidence interval [CI] 27%-30%). Tattoos were more common in the younger age groups, particularly among females. Males were younger when they received their first tattoo and tended to have a larger tattooed body surface. Tattoo exposure was associated with unfavourable socioeconomic characteristics, with the highest odds ratio observed for current smokers compared with never-smokers (2.86; 95% CI 2.42-3.38). Our results suggest that any tattoo-related adverse effects may exacerbate existing inequalities in health. Additionally, the high prevalence in younger age groups indicates a likely shift in the characteristics of the tattooed population over time, which may have further implications for public health.
The use of artificial intelligence in healthcare as perceived by the citizens and patients: a narrative review of the literature.
Nuccetelli F, Gabellone V, Marsano F … +4 more , Giovanetti F, Dri P, Valetto MR, Prato R
Eur J Public Health · 2025 Dec · PMID 41235511 · Full text
The growth of scientific literature on large language models (LLMs), such as ChatGPT, anticipates their central role for accessing health information but poses potential risks, including the false belief that artificial...
The growth of scientific literature on large language models (LLMs), such as ChatGPT, anticipates their central role for accessing health information but poses potential risks, including the false belief that artificial intelligence (AI) could replace doctors in providing reliable information. Our study, part of the Slow AI project launched in partnership with the Slow Medicine ETS Association, reviewed the literature on ChatGPT use by the public, analyzing citizens' and patients' perceptions of using AI for health-related questions, identifying key benefits and concerns, and providing recommendations for the safe and effective use of LLMs. We conducted a narrative review following PRISMA guidelines, including qualitative, quantitative, and mixed-methods studies, selected through a search of the PubMed database. Data were extracted and analyzed using a predefined form. Out of 388 records, 120 studies were included, primarily from the USA (65), Europe (19), and Asia (15). Most studies focused on general medicine (37), with patients (57) being the main participants. Key findings include that LLMs improve access to health information, aiding diagnostic accuracy and patient understanding. However, risks exist, such as inaccurate or outdated information, lack of empathy, and privacy concerns. These challenges highlight the need for reliable AI training with real-world data and clinician oversight to mitigate risks. Lastly, while LLMs can improve communication, they should complement, not replace human interaction. LLMs in healthcare offer great potential but also present risks. Safeguards and clinician oversight are crucial to preserve patient safety and doctor-patient relationship.
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