Journal of Preventive Medicine and Public Health

Original Articles

Association of Sedentary Lifestyle With Skeletal Muscle Strength and Mass in US Adolescents: Results From the National Health and Nutrition Examination Survey (2011-2014): Kun-Hee Oh, Jin-Young Min, Kang Seo, Kyoung-Bok Min; J Prev Med Public Health. 2025;58(3):278-288. Published online January 30, 2025; DOI: https://doi.org/10.3961/jpmph.24.614; Funded: National Research Foundation of Korea, Ministry of Education, Science and Technology, Seoul National University Hospital

1,473 View
185 Download
1 Web of Science
1 Crossref

Abstract Summary PDF Supplementary Material

Objectives
Excessive sedentary behavior in youth is a major global issue, contributing to the rise in childhood obesity and metabolic diseases. International public health authorities have issued guidelines recommending that children and adolescents limit their daily sedentary time, including screen time. However, to date, no studies have explored the relationship between sedentary behavior as an exposure factor and skeletal muscle strength and mass as outcomes in this population. The present study investigated the association of sedentary behavior with handgrip strength (HGS) and appendicular lean mass (ALM) among United States adolescents.
Methods
A total of 1449 adolescent participants from the National Health and Nutrition Examination Survey (2011-2014) were included. Information on sedentary behavior, specifically daily sedentary time, was obtained through a self-reported questionnaire. Muscular parameters, including HGS and ALM, were measured. To adjust for differences in body size, these parameters were divided by body mass index (BMI) and weight. Linear regression analyses were performed to evaluate the associations between daily sedentary time and each muscular parameter, adjusting for age, sex, ethnicity, annual family income, and moderate-to-vigorous physical activity (MVPA).
Results
The linear regression analyses revealed negative associations between daily sedentary time and all muscular parameters, apart from absolute ALM. These included HGS (β, -0.265; standard error [SE], 0.074; p=0.001), HGS/BMI (β, -0.021; SE, 0.004; p<0.001), HGS/weight (β, -0.008; SE, 0.002; p<0.001), ALM/BMI (β, -0.008; SE, 0.003; p=0.010), and ALM/weight (β, -0.003; SE, 0.001; p=0.005).
Conclusions
After adjusting for MVPA, daily sedentary time was inversely associated with HGS, HGS/BMI, HGS/weight, ALM/BMI, and ALM/weight in United States adolescents.

Summary

Korean summary
소아청소년기의 과도한 좌식 습관은 소아 비만 등의 건강문제를 초래하여 전세계적인 공중보건학적 이슈가 되었고, 이에 따라 다수의 공중보건 관련 가이드라인에서 소아청소년의 일일 좌식 시간을 제한할 것을 권고하고 있다. 미국 국민건강영양조사(NHANES) 자료를 이용하여 15-19세 청소년을 대상으로 일일 좌식 시간과 각 근육 관련 변수(악력, 상대적 악력, 사지골격근량, 상대적 사지골격근량)의 상관관계를 선형 회귀분석을 통해 분석하였으며, 나이, 성별, 인종, 연간 가구 소득, 중-고강도 신체활동을 공변량으로 보정하였다. 미국 청소년에서 중-고강도 신체활동을 보정한 뒤에도, 일일 좌식 시간과 악력, 악력/BMI, 악력/체중, 사지골격근량/BMI, 사지골격근량/체중은 각각 음의 상관관계를 나타내었다.

Key Message
Since excessive sedentary behavior in youth is a global issue, contributing to the childhood obesity, international public health authorities issued guidelines recommending that adolescents limit their daily sedentary time. For eligible study population of U.S. adolescents aged 15-19 year-old of NHANES, linear regression analyses were performed to evaluate the associations between daily sedentary time and each muscular parameter (HGS, relative HGS, ALM, and relative ALM), adjusting for age, sex, ethnicity, annual family income, and moderate-to-vigorous physical activity (MVPA). After adjusting for MVPA, daily sedentary time was inversely associated with HGS, HGS/BMI, HGS/weight, ALM/BMI, and ALM/weight in U.S. adolescents.

Citations

Citations to this article as recorded by

Teenagers with Obesity at the Gym: Recommendations for Physical Activity, Diet, and Supplementation—A Narrative Review
Agnieszka Kozioł-Kozakowska, Małgorzata Wójcik, Paulina Mazur-Kurach, Dorota Drożdż, Anna Brzęk
Nutrients.2025; 17(11): 1798. CrossRef

Multi-group Causal Model of Mental Health Literacy and Helping Behavior Toward People at Risk of Depression Among Thai and Vietnamese Health Science Students: Anchalee Jansem, Ungsinun Intarakamhang, Charin Suwanwong, Krittipat Chuenphitthayavut, Sudarat Tuntivivat, Khuong Le, Le Thi Mai Lien, Pitchada Prasittichok; J Prev Med Public Health. 2025;58(3):241-249. Published online January 13, 2025; DOI: https://doi.org/10.3961/jpmph.24.449; Funded: Faculty of Humanities, SWU Thailand, Sciences and Humanities, Vietnam National University

1,618 View
237 Download

Abstract Summary PDF: Objectives
Depression affects 23.3% of Thai and 15.2% of Vietnamese health science students, rates that exceed the global average of 4.4%. This study compared the causal models of mental health literacy and helping behavior toward individuals at risk of depression between these 2 groups.
Methods
This cross-sectional study was conducted from April 2023 to October 2023 and included 422 students from Thailand and Vietnam, who were studying medicine, nursing, psychology, and physical therapy. Stratified random sampling was used to select 211 students from each country. Data collection was performed using a Likert scale, which showed total-item correlations ranging from 0.24 to 0.83 and Cronbach’s alpha values between 0.74 and 0.86. The data were analyzed using a structural equation model.
Results
The causal models were consistent with the empirical data. The helping behavior of students toward peers at risk of depression was significantly influenced by their mental health literacy (effect size [ES], 0.91). This influence was also mediated indirectly by self-efficacy (ES, 0.18), positive attitudes (ES, 0.29), and social support (ES, 0.77). Collectively, these factors accounted for 83% of the variance in helping behavior. Social support had a more pronounced effect on mental health literacy among Vietnamese students than among their Thai counterparts (ES, 0.46 vs. 0.27, p<0.05). Conversely, positive attitudes had a stronger influence among Thai students than among Vietnamese students (ES, 0.17 vs. 0.01, p<0.05).
Conclusions
The causal models of helping behavior among Thai and Vietnamese health science students exhibited no significant differences. However, improving mental health literacy is crucial, as it significantly impacts helping behavior.; Summary

Key Message
This study compared causal models of mental health literacy (MHL) and helping behavior toward people at risk of depression between Thai and Vietnamese health science students. Findings indicated that MHL significantly impacted helping behavior (effect size [ES], 0.91), mediated indirectly by self-efficacy (ES, 0.18), positive attitudes (ES, 0.29), and social support (ES, 0.77), with no significant differences in the overall causal models between groups. However, variations in effects were noted, such as social support having a more pronounced effect on MHL among Vietnamese students than their Thai counterparts (ES, 0.46 vs. 0.27), while positive attitudes had a stronger influence among Thai students (ES, 0.17) than Vietnamese (ES, 0.01).

Vulnerability Assessment and Enhanced Community-based Care and Management of Patients With Tuberculosis in Korea: A Crossover Design: Jeongmi Seo, Dawoon Jeong, In-Hyuk Lee, Jiyeon Han, Yunhyung Kwon, Eunhye Shim, Hongjo Choi; J Prev Med Public Health. 2025;58(3):317-325. Published online February 25, 2025; DOI: https://doi.org/10.3961/jpmph.24.597; Funded: Korea Disease Control and Prevention Agency, National Research Foundation of Korea, Ministry of Science and ICT, Korea University

854 View
106 Download

Abstract Summary PDF Supplementary Material: Objectives
People-centered care and social protection are critical for improving tuberculosis (TB) treatment outcomes. This study aimed to evaluate whether a vulnerability assessment tool, developed for an enhanced community-based care and management (ECCM) program in 2 Korean cities, could predict and improve final TB treatment outcomes based on patients’ vulnerability levels.
Methods
Treatment outcomes in the ECCM group were compared with those in a control group, stratified by vulnerability level. During stage 1, one city served as the intervention region and the other as the control, with a crossover in stage 2. The vulnerability assessment included all notified patients with TB, and those identified as highly vulnerable in the intervention group received social support following a consultation with a case manager.
Results
The vulnerability assessment tool demonstrated moderate predictive ability for unfavorable outcomes, with an area under the curve of 0.70 (95% confidence interval, 0.63 to 0.77). The patients with high vulnerability who received ECCM treatment demonstrated a 19.8-percentage point (%p) higher treatment success rate than the high vulnerability subcategory of the control group. ECCM also appeared to reduce loss to follow-up and TB-related mortality by 8.4%p and 7.3%p, respectively, although these findings should be interpreted with caution.
Conclusions
The results suggest that providing social support tailored to patient vulnerability at the time of diagnosis could improve TB treatment outcomes.; Summary

Korean summary
결핵 진단 시점의 임상적, 사회적, 그리고 결핵 관련 취약성 평가는 부정적인 치료 결과를 예측하는 데 유의미한 지표가 될 수 있다. 높은 취약성을 지닌 집단에 대해 지역사회 기반의 맞춤형 사례관리를 시행한 결과, 부정적 치료 결과를 일정 수준 감소시킬 수 있었다. 결핵의 사회적 결정요인과 노년 결핵환자 증가라는 역학적 상황은 지역사회 기반의 사회적 지원을 통해 개선 가능할 것이다.

Key Message
Clinical, social, and tuberculosis-related vulnerabilities assessed at the time of TB diagnosis can serve as meaningful predictors of unfavorable treatment outcomes. Community-based, ehnahced case management for highly vulnerable groups has been shown to reduce such negative outcomes to some extent. The social determinants of tuberculosis and the increasing prevalence of TB among the elderly may be addressed through community-based social support.

Cohort Profile

Etiome Study Using Molecular Epigenetic Markers and Lung Organoid in Korean School Meal Service Workers (Etiome Study in S-meal Workers): Study Protocol: Sungji Moon, Soseul Sung, Sue K. Park; J Prev Med Public Health. 2025;58(3):231-240. Published online April 10, 2025; DOI: https://doi.org/10.3961/jpmph.25.020; Funded: National Cancer Center, Ministry of Health and Welfare, Korea Health Industry Development Institute

1,009 View
160 Download

Abstract Summary PDF Supplementary Material: School meal service workers may face an increased risk of lung cancer due to the nature of their work. This study aims to assess environmental exposure levels during occupational cooking among these workers in Seoul, Korea, and to examine the associations with carcinogen-associated biomarkers. Additionally, the study seeks to verify lung carcinogenesis through experiments using lung organoids treated with carcinogens, such as polycyclic aromatic hydrocarbons (PAHs) and particulate matter. Here, we introduce the study protocol and outline our research strategies. This etiome study employs molecular epidemiological approaches involving at least 200 school meal service workers from 25-30 school cafeterias in Seoul, as well as in vitro lung organoid experiments. The study includes a questionnaire survey to analyze workers’ occupational environments, focusing on exposure to hazardous substances such as cooking oil fumes and assessing the use of personal protective equipment (e.g., masks) and the presence of ventilation systems. We measure molecular epigenomic biomarkers, including PAH adducts and metabolites along with methylation markers, in the exposure and control groups. Additionally, lung organoid experiments are performed to investigate the potential for lung cancer development due to respiratory carcinogen exposure in cooks. This study is expected to contribute to health risk assessments and the establishment of preventive strategies for meal service workers.; Summary

Korean summary
조리업 종사자의 폐암 발생 위험도가 높다고 보고되지만 실제 발암 물질에 어느정도 노출되어 있는지 전 세계적으로 아직까지 밝혀진 바 없습니다. 본 연구는 서울시내 학교 조리업 종사자 모집과 발암물질 노출 마커 측정 대한 방법론적인 논문이며 향후 추적 관찰할 수 있는 코호트 연구에 대한 초석 역할을 합니다.

Key Message
Although previous studies have reported an increased risk of lung cancer among cooking workers, the extent of their exposure to carcinogens has not yet been well characterized globally. This study presents the methodology for recruiting school cooking workers in Seoul and measuring biomarkers of carcinogen exposure. It serves as a foundational step toward establishing a prospective cohort for long-term follow-up.

Original Articles

Development of Machine Learning Models to Categorize Life Satisfaction in Older Adults in Korea: Suyeong Bae, Mi Jung Lee, Ickpyo Hong; J Prev Med Public Health. 2025;58(2):127-135. Published online October 23, 2024; DOI: https://doi.org/10.3961/jpmph.24.324; Funded: Fostering Outstanding Universities for Research, Ministry of Education, National Research Foundation of Korea

12,415 View
274 Download
1 Web of Science
1 Crossref

Abstract Summary PDF

Objectives
This study aimed to identify factors associated with life satisfaction by developing machine learning (ML) models to predict life satisfaction in older adults living alone.
Methods
Data were extracted from 3112 older adults participating in the 2020 Korea Senior Survey. We employed 5 ML models to classify the life satisfaction of older adults living alone: logistic Lasso regression, decision tree-based classification and regression tree (CART), C5.0, random forest, and extreme gradient boost (XGBoost). The variables used as predictors included demographics, health status, functional abilities, environmental factors, and activity participation. The performance of these ML models was evaluated based on accuracy, precision, recall, F1-score, and area under the curve (AUC). Additionally, we assessed the significance of variable importance as indicated by the final classification models.
Results
Out of the 1411 older adults living alone, 45.3% expressed satisfaction with their lives. The XGBoost model surpassed the performance of other models, achieving an F1-score of 0.72 and an AUC of 0.75. According to the XGBoost model, the five most important variables influencing life satisfaction were overall community satisfaction, self-rated health, opportunities to interact with neighbors, proximity to a child, and satisfaction with residence.
Conclusions
Overall satisfaction with the community environment emerged as the most significant predictor of life satisfaction among older adults living alone. These findings indicate that enhancing the supportiveness of the community environment could improve life satisfaction for this demographic.

Summary

Korean summary
본 연구는 2020년 노인실태조사에 참여한 3,112명의 독거노인 데이터를 활용하여 이들의 삶의 만족도를 분류하는 머신러닝 모델을 개발하였다. 아울러, 해당 모델을 통해 독거노인의 삶의 만족도 분류에 영향을 미치는 주요 변수를 도출하였다. 본 연구는 독거노인의 삶의 만족도 향상을 위해 고려해야 할 핵심 요인들을 제시한다는 점에서 의의가 있다.

Key Message
This study developed a machine learning model to classify life satisfaction among 3,112 older adults living alone, based on data from the 2020 Korea Senior Survey. Furthermore, the study identified key variables that contribute to the classification of life satisfaction in this population. These findings provide insights into important factors that should be considered to enhance the life satisfaction of older adults living alone.

Citations

Citations to this article as recorded by

Prevalence of depression and its associated factors among Korean women: A cross-sectional study in Seoul
Thi Thanh Lan Nguyen, Van Cuong Nguyen
Archives of Psychiatric Nursing.2025; 57: 151928. CrossRef

The Impact of Student-led Community Health Screenings on Clients’ Health Knowledge and Outcomes: A Qualitative Study in New Zealand: JiaRong Yap, Wendy Wenming Zhai, Cindy Seunghee Pak, Sharon Brownie; J Prev Med Public Health. 2025;58(2):167-176. Published online November 28, 2024; DOI: https://doi.org/10.3961/jpmph.24.366; Funded: Trust Waikato Community Impact Grant, Wintec – Te Pūkenga, Braemar Charitable Trust

1,075 View
199 Download

Abstract Summary PDF: Objectives
This study investigated the impact of community health screenings (CHS) on the Asian community, focussing on the role of a student-led health and wellness centre in promoting and improving health outcomes. The CHS is a collaboration between Te Kotahi Oranga | Health and Wellness Centre and The Asian Network Incorporated, offering free health screenings to Asian migrants in the Waikato region, New Zealand.
Methods
Employing a qualitative approach, we interviewed clients who participated in the CHS to determine their perceptions regarding the effectiveness of the programme, its influence on their health knowledge and actions, and their overall satisfaction with the service. The Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist was used to report the study.
Results
Data analysis utilising reflexive thematic analysis yielded 5 themes: satisfaction and appreciation for the free health screening; strengthened commitment to better personal health; barriers and challenges in accessing public healthcare services; improved knowledge and awareness of health risks; and provision of more health screening tests and health seminars. The findings highlight the significance of culturally tailored health initiatives in addressing healthcare disparities, emphasising the need for innovative strategies to ensure continuity of care and support for underserved populations.
Conclusions
This research contributes to the understanding of how student-led health interventions can enhance public health efforts and improve health outcomes in Asian and migrant communities.; Summary

Key Message
This study explores the impact of a student-led community health screening (CHS) programme on Asian migrants in New Zealand, focusing on its effects on health knowledge and outcomes. Through qualitative interviews, five key themes emerged: participant satisfaction, commitment to personal health, barriers to healthcare access, increased awareness of health risks, and the need for expanded screening services. The findings underscore the value of culturally tailored health initiatives in reducing healthcare disparities and highlight the role of student-led interventions in enhancing preventative care and promoting health equity in underserved populations.

Medication-related Burden and Experience With Medications in Indonesian Older Adults With Chronic Diseases: A Mixed-method Study: Yeni Farida, Anna Wahyuni Widayanti, Tri Murti Andayani, Probosuseno Probosuseno; J Prev Med Public Health. 2025;58(2):188-198. Published online November 20, 2024; DOI: https://doi.org/10.3961/jpmph.24.374; Funded: Scholarship of Education Fund Management Institute, Lembaga Pengelola Dana Pendidikan

1,226 View
213 Download

Abstract Summary PDF: Objectives
This study explored the specific medication-related burdens experienced by older adults with chronic disease and the contributing factors.
Methods
An exploratory mixed-method study was conducted at a teaching hospital in Surakarta City, Central Java, Indonesia. Combining the Indonesian version of the Living with Medicine Questionnaire (LMQ) and semi-structured interviews allowed for a comprehensive understanding of the medication-related burden. Differences in LMQ scores related to patient characteristics were analyzed using the t-test, F-test, or other alternatives. Quantitative and qualitative data triangulation was used to derive trustworthy and dependable results.
Results
The overall LMQ mean score was 90.4 (n=129), indicating a moderate burden. The average LMQ scores varied significantly based on the number of medications, treatment duration, and the presence of cardiovascular disease (CVD), diabetes mellitus (DM) and stroke. The qualitative study found 3 themes in the chronic medication use of older adults: experiences, challenges, and motivation. Despite their limited understanding of a medication’s name and indication, some patients managed their medications based on the physical look and packaging of the medication. The study also found that patient motivation and familial support could effectively counteract the fatigue and dissatisfaction associated with taking medication.
Conclusions
Older adults with chronic diseases faced medication-related burdens associated with the presence of CVD, DM, stroke, a treatment duration >5 years, and the use of >10 medications. Effective communication with healthcare professionals is required to understand patients’ needs and concerns, thereby helping manage the challenges of medication-related burdens.; Summary

Key Message
Older adults with chronic diseases experienced an increasing burden in taking medication with multimorbidity, number of medicines and duration of illness. Motivation and familial support is crucial to minimize these burdens.

Church Leaders’ Health Behaviors and Program Implementation in the Faith, Activity, and Nutrition Program in the United States: Kelsey R. Day, Sara Wilcox, Lindsay Decker, John Bernhart, Meghan Baruth, Andrew T. Kaczynski, Christine A. Pellegrini; J Prev Med Public Health. 2025;58(2):146-155. Published online November 13, 2024; DOI: https://doi.org/10.3961/jpmph.24.384; Funded: Centers for Disease Control and Prevention

1,126 View
172 Download

Abstract Summary PDF: Objectives
Church leaders are important to the success of faith-based health promotion interventions through the role modeling of health behaviors. However, clergy may be at a higher risk of chronic disease than their congregants and their health is understudied. This study examined church leaders’ health-related behaviors, differences in health behaviors by socio-demographic characteristics, and associations between health behaviors and church-level implementation of an ecological intervention.
Methods
Pastors (n=93) and church coordinators (n=92) reported body mass index (BMI), self-rated health, fruit and vegetable consumption (F&V), and physical activity (PA) at baseline and 12 months post-training in the intervention. Church coordinators reported program implementation for their church. Socio-demographic differences and associations between changes in health behaviors and program implementation were tested with regression models. Changes in health-related variables were examined using paired t-tests and McNemar’s test.
Results
Pastors (40.9% women, 41.9% Black/African American) had a mean BMI of 30.0 kg/m²; 23.7% met F&V guidelines and 45.2% met PA guidelines. Black/African American pastors were less likely to meet F&V guidelines and had lower self-rated health than their counterparts. Pastor PA improved over time, but pastor health behaviors were not associated with program implementation. Church coordinators’ (94.6% women, 39.1% Black/African American) mean BMI was 27.8 kg/m²; 27.2% met F&V guidelines and 62.0% met PA guidelines. Black/African American church coordinators had higher BMIs and lower self-rated health than their counterparts. Church coordinator F&V intake improved over time; self-rated health was positively associated with PA program implementation.
Conclusions
This study underscores the need for preventive interventions for church leaders.; Summary

Key Message
This study explored the health behaviors of church leaders, including differences by socio-demographics and changes in church leader health behaviors during the 12-month implementation of a faith-based physical activity and dietary intervention. Most Pastors did not meet fruit and vegetable (F&V) or physical activity (PA) guidelines. Pastor PA improved over time but was unrelated to program implementation. Most church coordinators did not meet F&V guidelines while over half met PA guidelines. Coordinators’ F&V intake improved, over time, and their self-rated health correlated with program implementation. This study underscores the need for preventive interventions for church leaders.

Predictors of Quality of Life Among Older Residents in Rural and Urban Areas in Indonesia: An Approach Using the International Classification of Functioning, Disability, and Health: Dwi Rosella Komalasari, Chutima Jalayondeja, Wattana Jalayondeja, Yusuf Alam Romadon; J Prev Med Public Health. 2025;58(2):199-207. Published online November 29, 2024; DOI: https://doi.org/10.3961/jpmph.24.423; Funded: Hibah Integrasi Tridharma, Universitas Muhammadiyah Surakarta

1,451 View
222 Download

Abstract Summary PDF: Objectives
The International Classification of Functioning, Disability, and Health (ICF) model provides a comprehensive framework for understanding health and quality of life (QoL) in older adults in both rural and urban settings, each presenting unique advantages and challenges. This study aimed to explore the relationship between factors based on the ICF model and QoL among older residents of these areas.
Methods
A cross-sectional study was conducted, involving 286 older adults aged 60 years or older from rural and urban areas of Surakarta, Central Java, Indonesia. The WHOQoL-BREF was utilized to assess QoL. The co-factors included personal factors, impairments, and activity limitations.
Results
Multiple linear regression analysis indicated that cardiovascular endurance was the strongest significant factor associated with QoL in rural areas (B=0.027, standard error [SE]=0.013, p=0.050). In urban areas, gender emerged as the most significant factor influencing QoL (B=-13.447, SE=2.360, p<0.001), followed by hemoglobin level (B=-1.842, SE=0.744, p=0.015), age (B=-0.822, SE=0.217, p<0.001), and cognitive function (B=0.396, SE=0.162, p=0.016).
Conclusions
Efforts to improve QoL for older adults in rural areas should focus on enhance physical performance through exercise. In urban areas, the maintenance of QoL is influenced by personal factors. It is crucial to address physical performance through exercise to enhance QoL in rural settings. Meanwhile, focusing on mental health, financial security, and social connections is recommended to improve QoL for older adults in urban areas.; Summary

Key Message
The ICF model offers a comprehensive framework to assess health and QoL in older adults living in rural and urban areas. Both areas highlight the distinct advantages and challenges unique. Cardiovascular endurance is a vital factor in determining the QoL for older adults in rural areas, while hemoglobin levels, age, and cognition shape the well-being of those in urban environments.

Perspective

Almost 80 Years After Hiroshima and Nagasaki: Are World Governments and Healthcare Systems Ready for a Nuclear War?: Céleo Ramírez, Reyna M. Durón; J Prev Med Public Health. 2025;58(2):227-229. Published online December 17, 2024; DOI: https://doi.org/10.3961/jpmph.24.577; Funded: Universidad Tecnológica Centroamericana

1,593 View
219 Download

Abstract Summary PDF: Since the detonation of the first atomic bomb during World War II, geopolitical issues and armed conflicts have reminded us of the threat posed by nuclear weapons in the short, medium, and long term. The potential consequences include millions of deaths and severe injuries from blast, heat, and acute ionizing radiation. Whatever the country, in the post-acute stage of a nuclear attack, the first challenge for health and rescue personnel will be gaining access to affected populations amidst destroyed infrastructure, hazardous radioactivity, and limited health facilities and medical supplies. Subsequently, the focus will shift to providing timely and appropriate treatment for survivors, addressing environmental damage, and combating malnutrition. Beyond the immediate human toll, the destruction of city infrastructure and the loss of centuries of cultural heritage are also at stake. Governments and health systems must prepare for these scenarios, although any medical or mitigation response may prove inadequate to halt the devastating impact of a failed disarmament or nuclear non-proliferation treaty. Scientists should raise awareness about the dire consequences of nuclear warfare and the realities of a post-nuclear era.; Summary

Key Message
A nuclear war would pose severe immediate and long-term consequences, including mass casualties, radiation exposure, and the collapse of infrastructure. In the aftermath, health systems will face immense challenges in providing care and addressing environmental damage. Governments and scientists must raise awareness about the catastrophic impact of nuclear warfare and the urgent need for effective disarmament, non-proliferation treaties, and peace efforts.

Original Articles

Associations of Sex and Household Area With Physical Activity and Sedentary Behavior During Total and Partial COVID-19 Lockdowns in Chile: A Study in Adults Aged 18-44 Years: Jairo Vanegas-López, Rodrigo Guzmán-Venegas, Gabriel Marzuca-Nassr, Claudio Muñoz-Poblete, Gonzalo Quiroz-Sandoval, Juan Silva-Urra, Andres Orellana-Uribe, Sebastián Dubó, Ignacio Sepúlveda, José Luis Márquez; J Prev Med Public Health. 2025;58(2):177-187. Published online December 5, 2024; DOI: https://doi.org/10.3961/jpmph.24.461; Funded: Dicyt Project, Vicerrectoría de Investigación, Innovación y Creación, Universidad de Santiago de Chile

1,176 View
206 Download

Abstract Summary PDF: Objectives
The coronavirus disease 2019 pandemic led to various intensities of lockdowns, affecting lifestyles globally. This study investigates the impact of partial lockdown versus total lockdown on adult physical activity (PA) and sedentary behavior.
Methods
A cross-sectional online survey was conducted from April 2020 to October 2020, with 493 participants included in the analysis.
Results
The analysis revealed no significant differences in total PA or total sitting time between partial lockdown and total lockdown scenarios. However, moderate physical activity (MPA) significantly decreased during total lockdowns, with more pronounced reductions among females than males. Notably, a positive correlation was found between household area and MPA, suggesting that larger living spaces may encourage more PA. A negative correlation was observed between sitting time and MPA during both types of lockdown.
Conclusions
Total lockdown conditions were associated with a significant decrease in MPA, highlighting sex disparities in PA responses. Living space size emerged as a crucial factor in maintaining PA levels during restricted conditions. This study emphasizes the need to consider environmental and demographic factors in public health strategies during prolonged periods of restricted movement.; Summary

Key Message
This study assessed the impact of partial and total COVID-19 lockdowns on physical activity and sedentary behavior in Chilean adults aged 18–44 years. Although total physical activity and sitting time did not significantly differ between lockdown types, moderate physical activity was significantly lower during total lockdowns, particularly among females. A positive association between household area and moderate activity suggests that public health strategies should consider gender and living conditions to mitigate the negative effects of prolonged restricted movement.

The Relationship Between Park Access and Quality and Various Health Metrics in a Metropolitan Area in South Carolina Using the CDC PLACES Dataset: Jenna Pellizzari, Farnaz Hesam Shariati, Andrew T. Kaczynski; J Prev Med Public Health. 2025;58(2):208-217. Published online December 13, 2024; DOI: https://doi.org/10.3961/jpmph.24.325; Funded: University of South Carolina

1,098 View
196 Download

Abstract Summary PDF: Objectives
Limited access to high-quality green spaces could contribute to growing rates of chronic diseases and unhealthy behaviors. Public parks provide numerous benefits for population well-being. However, past research has shown mixed results regarding the association between proximal parks and residents’ physical and mental health. This study examined the relationship between diverse elements of park access and quality and multiple health outcomes.
Methods
Seventy-three unique parks within 70 census tracts in 4 cities in South Carolina were analyzed. Data about 7 aspects of park quality (transportation access, facility availability, facility quality, amenity availability, park aesthetics, park quality concerns, neighborhood quality concerns) were collected via on-site observations using the Community Park Audit Tool. Health data for each tract (obesity, no leisure time physical activity, high blood pressure, coronary heart disease, high cholesterol, diabetes, depression, poor mental health) were collected from the CDC PLACES dataset. Linear regression analyses examined the association between 10 park access and quality metrics and 8 health metrics, controlling for socio-demographic characteristics.
Results
All associations were in the unexpected direction except 1 relationship involving mental health. Specifically, positive associations were found between the number of parks and obesity, the number of parks and no leisure time physical activity, transportation access and obesity, and transportation access and high blood pressure. As concerns about neighborhood quality increased, poor mental health status worsened.
Conclusions
This study provides valuable information for public health professionals and researchers. Further research is needed to expand on and elucidate these findings.; Summary

Key Message
Parks can be key components of healthy communities, but more research is needed about how park availability and characteristics affect health. This study examined the relationship between diverse elements of park access and quality and multiple physical and mental health outcomes. The results were largely mixed, with some positive and some negative relationships; these findings can be expanded upon with further study.

Who Dies Alone? Demographics, Underlying Diseases, and Healthcare Utilization Patterns of Lonely Death Individuals in Korea: Haibin Bai, Jae-ryun Lee, Min Jung Kang, Young-Ho Jun, Hye Yeon Koo, Jieun Yun, Jee Hoon Sohn, Jin Yong Lee, Hyejin Lee; J Prev Med Public Health. 2025;58(2):218-226. Published online March 4, 2025; DOI: https://doi.org/10.3961/jpmph.24.704; Funded: Ministry of Health and Welfare

2,515 View
172 Download

Abstract Summary PDF Supplementary Material: Objectives
Lonely death is defined as “a person living in a state of social isolation, disconnected from family, relatives, and others, who dies from suicide, illness, or other causes”. This study investigated the characteristics of individuals who die alone in Korea.
Methods
We constructed a database of lonely death cases by linking data from the Korea Crime Scene Investigation Unit of the Korea National Police Agency with National Health Insurance Service (NHIS) records. A descriptive analysis was performed to evaluate the demographics, underlying diseases, and healthcare utilization patterns among lonely death cases.
Results
Among the 3122 individuals identified as lonely death cases, 2621 (84.0%) were male and 501 (16.0%) were female. The most common age group was 50-59 years (n=930, 29.8%). The NHIS covered 2161 individuals (69.2%), whereas 961 individuals (30.8%) were enrolled in Medical Aid (MA). The highest number of lonely deaths occurred in Seoul areas, with 1468 cases (47.0%). Mood disorders were diagnosed in 1020 individuals (32.7%), and various alcohol-related diseases, including alcoholic liver disease, were also observed. Outpatient visits increased leading up to death but declined in the final 3 months, while hospitalizations decreased and emergency room visits slightly increased.
Conclusions
Most lonely death cases involved male in their 50s, with a disproportionately high number of MA beneficiaries compared to the general population. Many of these individuals also experienced mental health issues or alcohol-related disorders. Preventing social isolation and strengthening social safety nets are critical to reducing the occurrence of lonely deaths.; Summary

Korean summary
한국에서 고독사란 법적으로 “가족, 친척 등 주변 사람들과 단절된 채 사회적 고립상태로 생활하던 사람이 자살ㆍ병사 등으로 임종”하는 것으로 정의하고 있다. 고독사 사망자는 대체적으로 50대 남성이었고, 의료급여 수급권자의 비율이 일반 인구보다 월등히 높았으며, 사망자 대다수는 정신건강 문제 또는 알코올성 질환을 앓고 있었다. 사회적 고립의 예방 및 사회안전망 구축은 고독사 예방에 있어 매우 중요한 역할을 할 것으로 보인다.

Key Message
Lonely death is defined as “a person living in a state of social isolation, disconnected from family, relatives, and others, who dies from suicide, illness, or other causes”. This study investigated the characteristics of individuals who die alone in Korea. Most lonely death cases involved male in their 50s, with a disproportionately high number of MA beneficiaries compared to the general population. Many of these individuals also experienced mental health issues or alcohol-related disorders. Preventing social isolation and strengthening social safety nets are critical to reducing the occurrence of lonely deaths.

The Effects of Subjective Socioeconomic Status and Social Capital on Self-rated Health and Perceived Quality of Life: A Cross-sectional Survey-based Study in a Minority Group in Iran: Rashid Ahmadifar, Nader Rajabi-Gilan, Shirzad Rostamizadeh, Nsrolah Nadimi, Parviz Sobhani, Adel Irankhah; J Prev Med Public Health. 2025;58(1):11-20. Published online October 5, 2024; DOI: https://doi.org/10.3961/jpmph.24.210; Funded: Kermanshah University of Medical Sciences

17,177 View
508 Download

Abstract Summary PDF: Objectives
The purpose of this study is to examine the impact of subjective socioeconomic status and social capital on self-rated health and quality of life among a minority group in Iran.
Methods
This cross-sectional study involved 800 individuals from a minority group in Iran. The sampling method was clustering, and data collection was conducted using a questionnaire. Data analysis was performed using SPSS version 18 and Stata version 8.
Results
The results of logistic regression analysis revealed that subjective socioeconomic status (odds ratio [OR], 1.47; 95% confidence interval [CI], 1.34 to 1.61), belonging and empathy (OR, 1.09; 95% CI, 1.03 to 1.15), and trust (OR, 1.06; 95% CI, 1.00 to 1.13) significantly impacted the quality of life. Additionally, the logistic regression analysis for factors influencing self–rated health demonstrated significant effects for the age group of 31-50 years (OR, 0.59; 95% CI, 0.38 to 0.91), gender (OR, 0.65; 95% CI, 0.46 to 0.92), academic education (OR, 2.00; 95% CI, 1.22 to 3.26), subjective socioeconomic status (OR, 1.27; 95% CI, 1.16 to 1.38), chronic disease (OR, 4.52; 95% CI, 2.49 to 8.19), belonging and empathy (OR, 1.06; 95% CI, 1.01 to 1.11), and participation (OR, 1.12; 95% CI, 1.00 to 1.24).
Conclusions
The findings indicate that bonding social capital significantly influences health levels and quality of life. Focusing on delegating local responsibilities to community members and striving to promote participation in health programs, along with increasing the socioeconomic status of minority groups, can effectively improve their health and quality of life.; Summary

Key Message
The overall findings suggest that the dimensions of bonding social capital were more effective in predicting respondents' self-rated health (SRH) and perceived quality of life (QOL). Specifically, the variables of belonging/empathy and trust, were found to increase the likelihood of a positive QOL by 9% and 6%, respectively. The findings also showed that belonging/empathy and participation increase the likelihood of a positive SRH by 6% and 12%, respectively. Additionally, a 1-unit increase in Subjective Socioeconomic Status was associated with a 27% and 47% increase in the likelihood of having a positive SRH and QOL respectively.

Development and Validation of an Instrument to Assess the Safe Use of Antidiabetic Medication to Prevent Hypoglycemia Requiring Hospitalization Among Ambulatory Patients With Type 2 Diabetes Mellitus in Bali, Indonesia: Made Krisna Adi Jaya, Fita Rahmawati, Nanang Munif Yasin, Zullies Ikawati; J Prev Med Public Health. 2025;58(1):52-59. Published online October 24, 2024; DOI: https://doi.org/10.3961/jpmph.24.424; Funded: Indonesia Center for Education Financial Services, Center for Higher Education Funding, Endowment Funds for Education

1,430 View
323 Download

Abstract Summary PDF: Objectives
Ambulatory patients with type 2 diabetes mellitus (T2DM) require special attention when being discharged from the hospital with anti-diabetes medication. This necessity stems primarily from the risk of adverse drug reactions, particularly hypoglycemia. However, this risk is significantly influenced by the patients’ knowledge and behavior regarding their medication use. This study aimed to develop instrument to assess the risk of medication-related hypoglycemia in ambulatory T2DM patients by clinical pharmacists.
Methods
The study was conducted using an observational design that included multiple stages. These stages involved item development through focus group discussions (FGDs), content validation by clinical pharmacists, and criterion and construct validation by ambulatory T2DM patients using a cross-sectional approach.
Results
A total of 10 question items were developed for assessment by clinical pharmacists following FGDs and content validation. Criterion and construct validation identified 8 valid question items through multivariate analysis (p<0.05). The scoring system developed demonstrated a linear relationship between the score and the number of items at risk in the instrument (p<0.05, R²=0.988). Additionally, the instrument was named “Medication-related Hypoglycemia Risk Score Assessment Tools (HYPOGLYRISK).”
Conclusions
The findings of this study suggest that HYPOGLYRISK may serve as a useful tool for clinical pharmacists to evaluate the risk of medication-related hypoglycemia in ambulatory T2DM patients. Additionally, this instrument could assist clinical pharmacists in identifying priority patients and tailoring educational services to meet their specific goals and needs.; Summary

Key Message
- HYPOGLYRISK is an instrument that can be used to assess the risk of hypoglycemia requiring hospitalization in T2DM patients. This instrument met all the requirements for psychometric properties testing in this study. - Patients discharged on antidiabetic medications can be screened for risk of severe hypoglycemia using HYPOGLYRISK, specifically by pharmacists, during drug dispensing. - Patients with T2DM must be ensured to have knowledge related to the five dimensions of medication safety to avoid the risk of hypoglycemia requiring hospitalization.

First
Prev
Page of 16
Next
Last

Funded articles