Journal of Preventive Medicine and Public Health

Special Article

The Humidifier Disinfectant Disaster in Korea: Implications for Preventive Medicine and Public Health: Sue K. Park, Woojin Lim, Dong-Wook Lee, Mina Ha, Chang Hyun Lee, Hae-Kwan Cheong; J Prev Med Public Health. 2026;59(4):337-342. Published online July 21, 2026; DOI: https://doi.org/10.3961/jpmph.26.248

373 View
53 Download

Abstract Summary PDF: The humidifier disinfectant disaster in Korea was one of the most severe environmental health disasters of recent decades. It showed that indoor household chemical products used in daily life can cause fatal health effects at the population level when inhalation risks are not adequately assessed before marketing. The disaster also reaffirmed the central role of epidemiology in detecting emerging environmental health threats and guiding public health responses. Fifteen years after the disaster was recognized, major challenges remain, including defining the full spectrum of health damage, providing compensation, and ensuring long-term support. The Special Act on Remedy for Damage Caused by Humidifier Disinfectants, fully amended in 2026, represents an important institutional advance. By explicitly defining the joint liability of the state and relevant companies, the amended Act reflects a shift toward a more public, state-administered system of compensation and health support. This disaster also highlights the roles of public health professionals in generating epidemiological evidence on delayed or newly recognized diseases and sequelae, applying that evidence in clinical and policy contexts, and establishing life-course–based lifelong health management programs. For the 2026 comprehensive amendment to produce meaningful progress, continued efforts are needed to clarify long-term health effects and refine health data–based surveillance systems so that scientific evidence can be translated effectively into policy.; Summary

Korean summary
가습기살균제 참사로 인한 지연성 및 다계통 건강영향을 규명하고, 역학적 근거를 배상과 장기 지원으로 연결하는 데에는 여전히 해결해야 할 과제가 남아 있다. 본 논문은 국가와 기업의 책임, 포용적 배상, 건강데이터 기반 감시체계, 생애주기별 건강관리를 강조하면서, 참사의 정책적 교훈과 2026년 「가습기살균제 피해구제를 위한 특별법」 전부개정의 함의를 검토한다. 이러한 체계의 강화는 예방의학과 공중보건이 사후적 재난 대응을 넘어 향후 환경보건 위기의 사전 예방으로 나아가는 데 기여할 수 있다.

Key Message
Unmet needs remain in identifying delayed and multisystem health effects from the humidifier disinfectant disaster and translating epidemiological evidence into compensation and long-term support. This article reviews the disaster’s policy lessons and the implications of the 2026 full amendment of the Special Act, emphasizing state–corporate responsibility, inclusive compensation, health-data–based surveillance, and life-course health management. Strengthening these systems can help preventive medicine and public health move from post-disaster response toward proactive prevention of future environmental health crises.

Original Article

Association Between Prolonged Sedentary Time and Elevated High-sensitivity C-reactive Protein Among Korean Adults Aged 65 Years or Older: KNHANES 2022: Roma Seol, Chaemin Chun, Sang Ok Cho; J Prev Med Public Health. 2026;59(4):373-380. Published online July 13, 2026; DOI: https://doi.org/10.3961/jpmph.26.091

415 View
34 Download

Abstract Summary PDF: Objectives
Sedentary behavior has emerged as a health risk factor distinct from insufficient physical activity. This study examined the association between sedentary time and high-sensitivity C-reactive protein (hs-CRP), a marker of systemic inflammation, among Korean older adults.
Methods
Data were obtained from the 2022 Korea National Health and Nutrition Examination Survey. Among 1667 participants aged 65 years or older with available hs-CRP measurements, 496 with leukocyte counts ≥10 000 cells/mm3 or hs-CRP levels ≥10.0 mg/L were excluded, yielding a final sample of 1171 participants. hs-CRP levels ≥1.0 mg/L were classified as abnormal. Differences in the prevalence of abnormal hs-CRP were assessed using the chi-square test, and multivariable logistic regression analysis was performed to evaluate the association between sedentary time and abnormal hs-CRP after adjustment for covariates.
Results
The prevalence of abnormal hs-CRP was higher among participants who did not engage in regular walking (prevalence ratio [PR], 1.24; 95% confidence interval [CI], 1.05 to 1.46) and those with adverse cardiometabolic profiles, including elevated blood pressure, dyslipidemia, and abdominal obesity. It was also higher among participants with sedentary time ≥10 hr/day (PR, 1.20; 95% CI, 1.02 to 1.41). In multivariable logistic regression analysis, prolonged sedentary time remained associated with abnormal hs-CRP levels after adjustment for covariates (odds ratio, 1.31; 95% CI, 1.01 to 1.71).
Conclusions
Prolonged sedentary time was independently associated with elevated hs-CRP levels among Korean adults aged 65 years or older. Accordingly, sedentary behavior reduction may be a useful target for chronic disease prevention strategies in older populations.; Summary

Korean summary
2022년 국민건강영양조사 자료를 분석한 결과, 65세 이상 한국 노인에서 하루 10시간 이상의 장시간 좌식행동은 높은 hs-CRP 수준과 독립적으로 관련되었다. 본 연구는 노인의 만성질환 예방과 건강한 노화를 위해 신체활동 증진뿐만 아니라 장시간 좌식행동을 줄이는 전략도 중요할 수 있음을 시사한다.

Key Message
Among Korean adults aged 65 years or older, sedentary time of ≥10 hr/day was independently associated with elevated high-sensitivity C-reactive protein (hs-CRP) levels. These findings suggest that reducing prolonged sedentary time, alongside promoting physical activity, may be an important behavioral target for chronic disease prevention and healthy aging.

Brief Report

Primary Healthcare Utilization of Undocumented Migrants in Busan, South Korea: A Retrospective Chart Review of a Free Clinic From 2020 to 2024: Yujin Lee, Hyunjin Moon, Saerom Kim; J Prev Med Public Health. 2026;59(4):421-427. Published online July 9, 2026; DOI: https://doi.org/10.3961/jpmph.26.037

516 View
40 Download

Abstract Summary PDF Supplementary Material: Objectives
This study examined healthcare utilization patterns and health needs among undocumented migrants attending a free clinic in Busan, South Korea.
Methods
We retrospectively analyzed clinical records from 750 undocumented migrants who made 2111 clinic visits between 2020 and 2024. The primary outcome was the number of clinic visits. Diagnoses were classified using the International Classification of Primary Care, Second Edition. Mixed-effects negative binomial regression, with nationality specified as a random intercept, was used to model visit counts and to assess interaction effects between gender and other variables.
Results
Cardiovascular and endocrine diseases were the most prevalent conditions, with chronic diseases accounting for a substantial proportion of clinic visits. In multivariable analysis accounting for gender-based effect modification (model 2), older age was significantly associated with increased visit frequency (β=0.030; 95% confidence interval [CI], 0.014 to 0.045, p<0.001). The association between chronic disease and visit frequency differed significantly by gender (gender×chronic disease interaction, β=0.488; 95% CI, 0.053 to 0.924, p=0.028). Linear combination testing indicated that men with chronic diseases visited the clinic 1.9 times as frequently as men without chronic disease, whereas chronic disease status showed little association with visit frequency among women.
Conclusions
Undocumented migrants attending the free clinic experienced a substantial burden of chronic disease, and healthcare utilization patterns differed by gender. These findings highlight the need for inclusive healthcare policies and targeted interventions for this population.; Summary

Korean summary
본 연구는 2020?2024년 부산 소재 무료진료소를 방문한 미등록 이주민 750명의 진료기록 2111건을 후향적으로 분석하여 일차의료 이용 양상을 파악했다. 고혈압·당뇨병·이상지질혈증 등 만성질환이 전체 방문 사유의 45.5%를 차지했으며, 혼합효과 음이항 회귀분석 결과 연령이 높을수록 방문 빈도가 증가했고 성별과 만성질환 간 상호작용이 유의했다. 공적 의료보장에서 배제된 미등록 이주민의 의료필요를 파악하는 데에 단일 진료소의 의료이용 분석은 제한적인 정보를 제공할 뿐이며, 한국에서 함께 살아가는 이주민들의 건강과 의료접근성 개선을 위한 학술적 노력이 지속되어야 할 것으로 보인다.

Key Message
This retrospective study analyzed 2111 visits by 750 undocumented migrants attending a free clinic in Busan, South Korea (2020–2024). Chronic diseases—hypertension, diabetes, and lipid disorder—accounted for 45.5% of visit reasons, and mixed-effects negative binomial regression showed that visit frequency increased with age, with a significant interaction between gender and chronic disease. Although analysis of healthcare utilization at a single clinic provides only limited information on the healthcare needs of undocumented migrants excluded from public healthcare coverage, continued scholarly efforts appear warranted to improve the health and healthcare access of migrants living as part of Korean society.

Perspective

Fine Particulate Matter (PM_2.5), the Exposome, and Cumulative Health Risk: A Life-course Perspective: Sarawut Sangkham, Piyanuch Lonan, Narongsuk Munkong, Arthid Thim-Uam, Worradorn Phairuang; J Prev Med Public Health. 2026;59(4):432-436. Published online July 1, 2026; DOI: https://doi.org/10.3961/jpmph.26.219

784 View
58 Download

Abstract Summary PDF: Fine particulate matter (PM_2.5; aerodynamic diameter ≤2.5 μm) is a leading contributor to the global burden of disease and is associated with substantial morbidity and mortality. However, its health effects are often evaluated within single-exposure frameworks, limiting causal inference and reducing the translational relevance of evidence for policy development. In this study, we reconceptualise PM_2.5 within the exposome framework by integrating external exposures, internal biological responses, and structural determinants of health across the life course. PM_2.5 comprises a complex and dynamic mixture of pollutants from ambient and household sources, including biomass combustion, traffic emissions, and industrial activities. After inhalation, PM_2.5 particles can penetrate the respiratory tract, and finer fractions may enter the systemic circulation, where they induce oxidative stress, inflammation, epigenetic dysregulation, and endocrine disruption. These mechanisms contribute to a broad spectrum of adverse health outcomes, including cardiovascular, respiratory, metabolic, and neurodegenerative diseases as well as cancers. The multi-level and temporally accumulated nature of these effects highlights the limitations of reductionist exposure assessment and underscores the need for integrative, systems-based approaches. Integrating cumulative impact assessment with exposome-wide approaches that leverage satellite, clinical, land-use, urban planning, and socioeconomic data can improve the characterization of context-specific cumulative health effects. Positioning PM_2.5 as a sentinel indicator of cumulative environmental risk provides a unifying framework for exposome-informed science and supports the development of more precise, equitable, and policy-relevant interventions.; Summary

Key Message
This perspective considers PM 2.5 as a sentinel marker of cumulative environmental risk within the context of the exposome. The integration of external exposures, biological responses, and social determinants across the life course can help us understand chronic disease development. Moreover, this approach may facilitate more comprehensive, equitable, and policy-relevant environmental health strategies.

Original Articles

Behavioral Segmentation of Integrative Care Use Among Older Adults With Knee Osteoarthritis in a Rural District in Northern Thailand: Kitrawee Jiraratsatit, Wijittra Ubolkam, Kaysorn Sumpowthong; J Prev Med Public Health. 2026;59(4):411-420. Published online June 23, 2026; DOI: https://doi.org/10.3961/jpmph.26.263

383 View
41 Download

Abstract Summary PDF: Objectives
To identify behavioral segments of integrative care use among older adults with knee osteoarthritis in a rural district in Northern Thailand and to compare these segments according to PRECEDE-related factors and baseline characteristics.
Methods
This analytical cross-sectional study included 302 community-dwelling older adults with primary knee osteoarthritis in Thoen District, Lampang Province, Northern Thailand. Data were collected through face-to-face interviews using a structured questionnaire that assessed demographic and health characteristics, PRECEDE-related factors, and behaviors across 3 care domains: professional medical care, traditional medicine, and community-based medicine. Standardized behavioral domain scores were analyzed using hierarchical cluster analysis, followed by k-means clustering. Differences among segments were examined using chi-square tests, one-way analysis of variance, or Kruskal-Wallis tests, as appropriate.
Results
Three behavioral segments were identified: high engagement (20.9%), intermediate engagement (48.0%), and low engagement (31.1%). The 3 behavioral domains differed significantly across segments (all p<0.001; η²=0.400–0.535). Baseline demographic and health characteristics did not differ significantly among segments. In contrast, significant differences among segments were observed for the total enabling score, access, decision-making, total reinforcing score, social support, and attitude, whereas perceived information showed no significant difference.
Conclusions
Older adults with knee osteoarthritis were not behaviorally homogeneous in their use of professional, traditional, and community-based care. Segment differences were more pronounced for enabling and reinforcing conditions than for perceived information alone. These findings support segment-informed health promotion strategies in primary care and community settings.; Summary

Key Message
This study found three distinct patterns of care use among older adults with knee osteoarthritis in rural Northern Thailand: high, intermediate, and low engagement in professional, traditional, and community-based care. Differences between the groups were more apparent in access, decision-making, and social support than in perceived information. These findings highlight the potential value of tailoring primary care and community-based support to the needs of each group.

Social Networking Service Usage Behaviors and Loneliness Among Adults in Seoul, Korea: A Population-based Cross-sectional Study: Kang Seo, Kun-Hee Oh, Baek-Yong Choi, Jin-Young Min, Kyoung-Bok Min, Seung-Woo Ryoo, Seok-Yoon Son, Ji-Hyeon Lee, Taehoon Kim; J Prev Med Public Health. 2026;59(4):381-391. Published online June 23, 2026; DOI: https://doi.org/10.3961/jpmph.26.024

9,909 View
56 Download

Abstract Summary PDF: Objectives
Although social network services (SNS) are prevalent globally, the relationship between SNS use and loneliness remains complex, particularly regarding qualitative behavioral patterns. This study examined associations between specific SNS behaviors and loneliness among Seoul adults and explored differences by age and digital literacy.
Methods
Data from the 2024 Seoul Survey were analyzed (n=34 142; mean age, 52.3 years). Loneliness was assessed with 2 items measuring isolation in family and non-family relationships. Five SNS behavioral domains were examined: active use, information-seeking use, communication priority, social comparison, and exclusionary feeling. Digital literacy was dichotomized using an 8-item scale, with scores ≥6 considered high. Multivariable logistic regression estimated adjusted associations.
Results
Overall SNS use was associated with lower odds of loneliness than non-use (adjusted odds ratio [aOR], 0.90; 95% confidence interval [CI], 0.83 to 0.98). However, higher odds were observed for specific SNS behaviors compared with non-use: active use (aOR, 1.24), communication priority (aOR, 1.26), social comparison (aOR, 1.50), and exclusionary feeling (aOR, 1.66); information-seeking use was not significant (aOR, 1.11). A dose–response pattern peaked at 3 problematic behaviors (aOR, 3.21; 95% CI, 2.82 to 3.65). Associations between SNS behaviors and loneliness were stronger among adults aged ≥60 years and participants with high digital literacy.
Conclusions
Although overall SNS use was associated with modestly lower odds of loneliness, qualitative SNS engagement—particularly problematic behaviors—was strongly associated with higher odds. Older adults and participants with high digital literacy appeared particularly vulnerable when performing problematic SNS behaviors, underscoring the need for behavior-focused, population-tailored education and interventions.; Summary

Korean summary
기존 연구는 SNS 이용량에 주로 주목해, 어떤 이용 방식이 외로움과 관련되는지는 분명하지 않았다. 서울 성인 34,142명에서 SNS 이용자는 비이용자보다 외로움 오즈가 다소 낮았으나, 일상 공유·온라인 소통 우선·사회적 비교·소외감을 보이는 이용자는 오히려 높았고 세 가지가 겹칠 때 가장 높았다. 이 경향은 60세 이상과 기능적 디지털 문해력이 높은 집단에서 더 뚜렷했으므로, 외로움 예방은 SNS 이용 여부가 아니라 이용 방식과 자기조절 역량을 다루어야 한다.

Key Message
Most population evidence treats social network service (SNS) use as a matter of quantity, leaving unclear which qualitative patterns of engagement matter for loneliness. In 34 142 Seoul adults, any SNS use was associated with slightly lower odds of loneliness, whereas self-presentation, prioritizing online contact, social comparison, and feeling excluded were each associated with higher odds - peaking when three such behaviors co-occurred, and strongest in adults aged 60 years or older and in those with high functional digital literacy. Loneliness prevention should therefore address how people use SNS, and digital education should cultivate self-regulation rather than technical skill alone.

National Trends in Healthcare Quality in Korea: A Multidimensional Assessment Using OECD Health Care Quality Indicators (2008–2023): Hyejin Lee, Soo-Hee Hwang, Sang-A Cho, Hyemin Jung, Youngs Chang, Jieun Yun, Sanghyun Cho, Un-Na Kim, Hye Yeon Koo, Eun Byul Cho, Do Hee Kim, Jin Yong Lee; J Prev Med Public Health. 2026;59(3):225-238. Published online May 20, 2026; DOI: https://doi.org/10.3961/jpmph.26.233

5,684 View
127 Download

Abstract Summary PDF Supplementary Material: Objectives
Assessing healthcare quality at the national level is essential for evaluating health system performance and identifying areas requiring improvement. This study examined long-term trends in healthcare quality in Korea from 2008 to 2023 using internationally comparable indicators.
Methods
We conducted a trend analysis of healthcare quality in Korea using the Organization for Economic Cooperation and Development (OECD) Health Care Quality and Outcomes framework and quality indicators. Indicators across multiple domains, including acute care, primary care, prescribing in primary care, mental healthcare, and patient experiences, were analyzed and compared with OECD averages.
Results
Healthcare quality in Korea improved across several domains. Thirty-day mortality for acute myocardial infarction decreased from 14.2% in 2008 to 10.2% in 2023, while mortality for ischemic stroke declined from 8.7% to 5.5%. Avoidable hospitalizations decreased substantially, with hospitalizations for chronic obstructive pulmonary disease declining by 59.7%. The proportion of patients with diabetes receiving cholesterol-lowering treatment increased from 44.1% to 82.5%. However, the proportion of broad-spectrum antibiotic prescriptions remained substantially higher than the OECD average (40.3 vs. 15.5%). In mental healthcare, excess mortality ratios increased from 4.3 in 2010 to 4.9 in 2023 for schizophrenia and from 3.5 to 4.3 for bipolar disorder, while post-discharge suicide rates showed little improvement. Patient experience indicators related to patient-physician communication improved and approached OECD averages.
Conclusions
Healthcare quality in Korea improved substantially between 2008 and 2023, particularly in acute care outcomes and chronic disease management. However, persistent challenges remain in areas such as antibiotic use, polypharmacy, and mental healthcare. These findings provide internationally comparable evidence to inform future health policy and healthcare quality improvement efforts.; Summary

Korean summary
이 연구는 OECD Health Care Quality Indicators(HCQI)를 활용하여 2008년부터 2023년까지 한국 의료의 질 변화를 주요 OECD 국가와 비교·분석하였다. 분석 결과, 한국의 급성기 치료 성과(급성심근경색과 허혈성·출혈성 뇌졸중의 30일 사망률)와 만성질환 관리 수준(천식·만성폐쇄성폐질환·심부전·당뇨병의 입원율 감소와 당뇨병 환자의 적절한 약물치료 증가)은 전반적으로 향상된 것으로 나타났다. 그러나 광범위 항생제 사용, 고령층 다약제 처방, 중증 정신질환자의 초과사망 및 퇴원 후 자살률 등은 여전히 OECD 평균 대비 취약한 영역으로 나타나, 지속적인 질 관리와 정책 개선이 필요하다.

Key Message
This study analyzed changes in healthcare quality in Korea from 2008 to 2023 compared with major OECD countries using the OECD Health Care Quality Indicators (HCQI). Acute care outcomes and chronic disease management improved overall, including reduced 30-day mortality for acute myocardial infarction and stroke and lower hospitalization rates for major chronic diseases. However, broad-spectrum antibiotic use, polypharmacy among older adults, excess mortality among patients with severe mental illness, and post-discharge suicide rates remained worse than the OECD average, highlighting the need for continuous quality improvement and policy reform.

Contribution of Medication Expenditures to Catastrophic Health Expenditures in Iran: An Inequality Analysis: Abdoreza Mousav, Rajabali Daroudi, Ali Akbari Sari, Masoomeh Gholami, Saeed Mohammadpour, Ali Akbar Fazaeli; J Prev Med Public Health. 2026;59(3):298-307. Published online May 14, 2026; DOI: https://doi.org/10.3961/jpmph.26.025

1,337 View
52 Download

Abstract Summary PDF Supplementary Material: Objectives
Catastrophic health expenditures (CHE) is a well-established indicator of financial risk protection. This study aimed to examine the contribution of medication expenditure to CHE and the associated socioeconomic inequalities.
Methods
Data were drawn from 6 nationally representative income and expenditure surveys covering the period 2019–2024. Using the budget share method, CHE was defined as out-of-pocket (OOP) health payments exceeding 25% of a household’s total consumption expenditure. The contribution of medication expenditures to CHE was then calculated as the difference in the proportion of households experiencing CHE with and without medication payments. Socioeconomic inequalities were quantified using the Concentration Index (CI), and decomposition analysis was conducted to identify the primary drivers of overall socioeconomic inequality in the contribution of medication expenditures to CHE.
Results
During the study period, medications represented a substantial share of household health expenditures and contributed to CHE. In 2024, OOP spending on medications accounted for 31.2% of total health expenditures, while the contribution of medication expenditures to CHE was 1.28%. The CI indicated that the contribution of medication expenditures to CHE was concentrated among poorer households. Decomposition analysis further identified medium-sized households, male-headed households, households with employed heads, insured households, and urban households as the main contributors to this socioeconomic inequality.
Conclusions
In Iran, OOP payments for medications constitute a substantial share of household healthcare expenditures and contribute to CHE. Because the roots of inequality extend beyond the healthcare system, addressing this issue requires a comprehensive, cross-sectoral strategy that integrates broader social and economic policies.; Summary

Key Message
• Medications are a major component of out-of-pocket health expenditures in Iran. In 2024, they accounted for 31.2% of total health spending and contributed 1.28% to catastrophic health expenditures. • This burden is disproportionately concentrated among poorer households. • Addressing this issue requires policy actions beyond the health sector and stronger cross-sectoral strategies to improve financial risk protection.

Cross-cultural Adaptation and Psychometric Validation of 3 Health Literacy Instruments (SAHL-E, AAHLS, and HLS-EU-Q47) in Hindi Among Rural Adults in North India: Dheeraj Sharma; J Prev Med Public Health. 2026;59(2):194-203. Published online March 30, 2026; DOI: https://doi.org/10.3961/jpmph.25.893

1,800 View
114 Download

Abstract Summary PDF Supplementary Material: Objectives
Health literacy (HL) is a key determinant of health behaviors and health outcomes. However, the lack of validated Hindi-language instruments limits its assessment in India. This study aimed to translate, culturally adapt, and psychometrically validate 3 internationally recognized tools—the Short Assessment of Health Literacy in English (SAHL-E), the All Aspects of Health Literacy Scale (AAHLS), and the European Health Literacy Survey Questionnaire (HLS-EU-Q47)—for Hindi-speaking adults in rural North India.
Methods
A community-based cross-sectional study enrolled 250 adults from 5 villages in Uttar Pradesh. Translation followed forward–backward procedures with expert review and pretesting. Psychometric evaluation included internal consistency (Cronbach α), test–retest reliability (intraclass correlation coefficients, ICC), construct validity (exploratory factor analysis), convergent and known-groups validity, and feasibility indicators (completion rates and interview duration).
Results
All instruments demonstrated strong psychometric performance. Cronbach α values were 0.84 (SAHL-E), 0.87 (AAHLS), and 0.93 (HLS-EU-Q47), and ICCs ranged from 0.86 to 0.94. Factor structures aligned with theoretical expectations. Convergent correlations ranged from 0.42 to 0.61 (p<0.001), and known-groups validity analyses showed significant differences according to education and occupation. Completion rates exceeded 98%, and the mean interview duration was approximately 32 minutes.
Conclusions
The Hindi-adapted SAHL-E, AAHLS, and HLS-EU-Q47 demonstrated strong reliability, validity, and feasibility for assessing HL among rural adults in India.; Summary

Key Message
The Hindi versions of SAHL-E, AAHLS, and HLS-EU-Q47 showed acceptable reliability and construct validity among rural adults in North India. The instruments retained their expected factor structures and demonstrated moderate correlations with each other, indicating related but distinct dimensions of health literacy. These findings support their use for assessing health literacy in Hindi-speaking rural populations.

Socioeconomic and Regional Disparities in Under-five Mortality in Indonesia: Insights From Indonesia’s 2020 Census: Asep Hermawan; J Prev Med Public Health. 2026;59(3):258-266. Published online March 20, 2026; DOI: https://doi.org/10.3961/jpmph.25.763

1,428 View
105 Download

Abstract Summary PDF Supplementary Material: Objectives
This study examined district-level and municipality-level socioeconomic determinants of the under-five mortality rate (U5MR) to inform equitable policies aimed at achieving Sustainable Development Goal (SDG) 3.2.
Methods
An ecological cross-sectional study was conducted using data from 514 districts and municipalities in Indonesia. U5MR estimates were obtained from Statistics Indonesia and calculated using the indirect Trussell method based on the 2020 Population Census Long Form. Poverty rate, mean years of schooling, gross regional domestic product per capita, and total fertility rate (TFR) were analyzed using bivariate and multivariable ordinary least squares regression with robust standard errors. To account for spatial dependence, a spatial autoregressive (SAR) model was additionally applied. Spatial mapping was used to illustrate geographic variation.
Results
U5MR ranged from 10.7 to 75.8 deaths per 1000 live births across districts and municipalities. Higher TFR (β=13.21, p<0.001) and higher poverty rates (β=0.61, p<0.001) were associated with higher U5MR, whereas higher educational attainment was associated with lower U5MR (β=−0.79, p=0.001). The association between poverty and mortality was stronger in rural districts than in municipalities (interaction β=−0.30, p=0.06). The SAR model identified significant spatial dependence and demonstrated improved model fit. Spatial clustering revealed an east-west divide, with the highest mortality observed in Papua and East Nusa Tenggara.
Conclusions
Fertility, poverty, and educational attainment are key predictors of child survival in Indonesia, with districts in eastern regions bearing disproportionate burdens. Policy efforts should prioritize family planning, maternal education, and targeted support for socioeconomically disadvantaged districts to accelerate progress toward achieving SDG 3.2 by 2030.; Summary

Key Message
Socioeconomic inequalities remain important determinants of under-five mortality in Indonesia at the district and municipality levels. Higher poverty and fertility rates were associated with increased mortality, whereas higher educational attainment was associated with lower mortality. Equity-oriented and geographically targeted interventions, particularly in disadvantaged eastern districts, are essential to accelerate progress toward Sustainable Development Goal 3.2.

Modeling the Impact of Behavior Changes on Mortality Attributable to Non-communicable Diseases in Canada: Laurence Tanguay, Pierre Faivre, Saïd Mekari, Pierre Philippe Wilson Registe, Emily Richard, Jennifer Russell, Mathieu Belanger; J Prev Med Public Health. 2026;59(2):152-161. Published online March 17, 2026; DOI: https://doi.org/10.3961/jpmph.25.663

1,842 View
135 Download

Abstract Summary PDF Supplementary Material: Objectives
In Canada, non-communicable diseases account for 88% of all deaths, most of which could be prevented through a healthier diet, regular physical activity (PA), smoking cessation, and reduced alcohol consumption. This study aims to estimate the number of deaths that could be prevented or delayed if (1) the average behaviors of Canadians aligned with recommendations for healthy behaviors, or if (2) the average behaviors of Canadians equaled those of residents in the provinces with the healthiest behaviors.
Methods
We used the Preventable Risk Integrated Model macrosimulation model to estimate the number of deaths that could be prevented through population-level behavioral changes. Information on Canadians’ health behaviors was obtained from the most recent edition of the Canadian Community Health Survey (2015), which reported diet (from 20 487 participants) as well as PA, alcohol consumption, smoking, and sedentary time (from 110 095 participants). Age-specific and gender-specific mortality data for 2015 were obtained from Canadian Vital Statistics, and 95% uncertainty intervals (UI) were calculated through Monte Carlo analyses.
Results
Following behavioral recommendations could have prevented 30 756 deaths (95% UI, 25 867 to 34 965) in 2015. Improving Canadians’ lifestyles to match the behaviors of the healthiest provinces could have prevented 6758 deaths (95% UI, 5062 to 8382). Improvements in fruit and vegetable intake alone could have prevented most of these deaths. Most preventable deaths were attributed to cardiovascular diseases.
Conclusions
These findings show that even modest, realistic lifestyle improvements at the population level could substantially reduce the burden of chronic disease in Canada.; Summary

Key Message
Small and realistic improvements in population-level fruits and vegetable consumption, physical activity level, avoidance of tobacco use, and reduction in salt ingestion could amount to nearly 7,000 lives saved per year in Canada. Given most of these lives saved could result from only a few behavioral improvements, the findings suggest that public health should prioritize interventions focused on increasing fruit and vegetable intake as well as promoting physical activity and smoking cessation.

Income-related Inequalities in Cancer Screening Among Korean Adults Aged 40 and Above: A Cross-sectional Analysis of the Age-varying Mediation of Health Literacy: Hyejin Hong, Hyun-Jin Goo, Hyebin Choi, Sin Kam, Jong-Yeon Kim; J Prev Med Public Health. 2026;59(2):184-193. Published online March 12, 2026; DOI: https://doi.org/10.3961/jpmph.25.866

1,829 View
91 Download

Abstract Summary PDF Supplementary Material: Objectives
This study investigated how the mediating effect of health literacy (HL) on the association between income and cancer screening participation varies by age among Korean adults aged 40 years and older, with the aim of identifying the optimal timing for HL interventions.
Methods
Data from 4171 adults aged ≥40 years in the 2023 Korea National Health and Nutrition Examination Survey were analyzed using moderated mediation analysis implemented with the lavaan.survey package, accounting for the complex sampling design. The Johnson–Neyman technique was used to identify age thresholds at which the mediation effect became statistically significant, and the number needed to benefit (NNB) was calculated to estimate the potential efficiency of interventions targeting this pathway.
Results
Each 1-quintile increase in income was associated with a 16.0% higher likelihood of undergoing cancer screening (odds ratio=1.16, p<0.001). The mediating effect of HL increased significantly with age (index of moderated mediation=0.000438, p=0.048). Mediation became statistically significant from age 54.2 years (Johnson–Neyman threshold), with the proportion of the total effect mediated rising from 0.1% among adults aged 40–49 years to 8.1% among those aged ≥70 years. The NNB for this pathway indicated substantial intervention efficiency in older adults (NNB=372 for ages ≥70), whereas the mediation effect was not statistically significant in the 50–59 age group.
Conclusions
HL significantly mediated the relationship between income and cancer screening participation from the mid-50s onward, with progressively greater contributions at older ages. These findings support age-differentiated strategies, including structural accessibility improvements for adults in their 40s and early 50s and integrated income–HL interventions for individuals aged ≥55 years. Experimental studies are warranted to confirm these associations.; Summary

Korean summary
40세 이상 한국 성인에서 소득과 암검진 참여 간 건강문해력의 매개효과는 54.2세부터 유의해지기 시작하여 연령 증가에 따라 점진적으로 강화되었다. 70세 이상에서 매개 비율은 8.1%, 중재효율(NNB=372)이 가장 높았다. 이는 55세 이상에서 소득 지원과 건강문해력 향상을 결합한 연령별 맞춤형 중재가 필요함을 시사한다.

Key Message
Health literacy mediation of the income–cancer screening relationship became statistically significant from age 54.2 years and strengthened progressively with age among Korean adults aged ≥40 years. Among adults aged ≥70 years, health literacy accounted for 8.1% of the total income effect, with the highest intervention efficiency (NNB=372). These findings suggest that integrated income support and health literacy interventions are warranted for adults aged ≥55 years.

Associations Between Tobacco Use Behaviors and Metabolic Syndrome in Korean Adults: Analysis of the 2020–2022 KNHANES: Jinsun Kim, Seungju Kim; J Prev Med Public Health. 2026;59(2):174-183. Published online March 5, 2026; DOI: https://doi.org/10.3961/jpmph.25.684

1,732 View
116 Download

Abstract Summary PDF: Objectives
This study examined the association between various tobacco product use behaviors and metabolic syndrome (MetS) among Korean adults.
Methods
Data from 15 359 adults aged ≥19 years who participated in the 2020–2022 Korea National Health and Nutrition Examination Survey were analyzed. Participants were classified as dual users, e-cigarettes (EC; nicotine-containing liquid-type)/ heated tobacco products (HTP) users, cigarette-only users, ex-smokers, or non-smokers. MetS was defined according to the NCEP ATP III criteria. Subgroup analyses were conducted by survey year and age group. Complex-sample cross-tabulation and logistic regression analyses were performed.
Results
All types of tobacco product use were associated with an increased likelihood of MetS compared with non-smokers. This association was particularly evident among dual users (odds ratio [OR], 1.48; 95% confidence interval [CI], 1.12 to 1.94) and cigarette-only users (OR, 1.19; 95% CI, 1.01 to 1.41). The highest risk was observed among adults aged 19–39 years and among dual users in 2020.
Conclusions
Dual use and cigarette smoking were associated with a higher likelihood of MetS, particularly among younger adults. Efforts are needed to reduce the misconception that EC/HTP products are less harmful alternatives and to strengthen education and prevention in order to prevent changes in tobacco use behavior from leading to new health risks.; Summary

Korean summary
이 연구는 2020–2022년 국민건강영양조사 자료를 이용하여 국내 성인의 담배 사용 형태와 대사증후군 간의 연관성을 분석하였다. 총 15,359명을 대상으로 분석한 결과, 모든 담배 사용 형태는 비흡연자에 비해 대사증후군 위험 증가와 관련되었으며, 특히 이중사용자와 궐련 단독 사용자에서 유의한 연관성이 나타났다. 이러한 연관성은 19–39세 젊은 성인에서 더욱 두드러졌다. 본 연구는 전자담배 및 가열담배의 안전성에 대한 인식을 재고하고, 변화하는 담배 사용 행태에 대응한 예방 전략의 필요성을 시사한다.

Key Message
Using data from 15,359 Korean adults in the 2020–2022 KNHANES, this study analyzed associations between tobacco use behaviors and metabolic syndrome (MetS). All tobacco use types increased MetS risk, with significant associations observed among dual users (OR 1.48) and cigarette-only users (OR 1.19). This risk was most pronounced in young adults aged 19–39. These findings suggest a need to address misconceptions about EC/HTP products and to improve education and prevention strategies in the context of evolving tobacco use patterns.

Scoping Review

Reporting Quality for Comorbidity Adjustment in Studies Using Korean Health Insurance Claim Data: A Scoping Review: Kyoung-Hoon Kim; J Prev Med Public Health. 2026;59(2):123-131. Published online January 6, 2026; DOI: https://doi.org/10.3961/jpmph.25.839

1,845 View
162 Download
1 Web of Science
1 Crossref

Abstract Summary PDF

Objectives
Adjustment for comorbidity is essential in observational studies using administrative data to ensure the reproducibility and transparency of research findings. However, the reporting quality of comorbidity adjustment in studies using the National Health Insurance Claim Data (NHICD) has not yet been evaluated. This study aimed to assess the reporting quality of comorbidity adjustment in health outcome studies that used the NHICD.
Methods
We conducted a PubMed search in April 2025 using the terms “(Korea OR Korean) AND (‘health insurance claim*’ OR claims data OR NHIS OR HIRA) AND (2024).” Of the 239 retrieved studies, 82 outcome studies that exclusively used the NHICD and adjusted for comorbidities as confounding variables were included. Reporting quality was evaluated across 3 domains: (1) scope of data, (2) range of diagnostic codes, and (3) length of the look-back period.
Results
Among the 82 studies, 33 (40.2%) used ad hoc selection, 33 (40.2%) used the Charlson comorbidity index, and 13 (15.9%) applied both methods. The Elixhauser comorbidity measure was rarely used, appearing in only 3 studies. Only 3 studies explicitly described the scope of data used, and 6 reported the diagnostic code range. The look-back period was specified in 26 studies (31.7%), with 1 year being the most commonly reported duration.
Conclusions
The reporting quality of comorbidity adjustment in studies using the NHICD remains suboptimal. Transparent and standardized reporting of data scope, diagnostic code range, and look-back period is essential to improve the reproducibility and comparability of research findings.

Summary

Korean summary
건강보험 청구자료를 활용한 관찰연구에서 동반질환 보정은 연구 결과의 타당성을 확보하는 데 중요한 요소이나, 그 보고 수준은 충분히 평가되지 않았다. 본 연구는 2024년에 발표된 건강보험 청구자료 기반 연구를 대상으로 문헌검색을 수행하고, 데이터 범위, 진단코드 범위, 관찰기간 측면에서 동반질환 보정의 보고 수준을 평가하였다. 그 결과, 대부분의 연구에서 이러한 핵심 방법론적 정보가 충분히 보고되지 않았으며, 보고 방식에도 상당한 변이가 존재하였다. 이러한 결과는 연구의 재현성과 비교 가능성을 제한할 수 있음을 의미하며, 향후 행정자료 기반 연구의 신뢰성과 방법론적 정확성을 높이기 위해 표준화되고 투명한 보고가 필요함을 시사한다.

Key Message
The reporting quality of comorbidity adjustment in studies using Korean health insurance claims data remains suboptimal. Key methodological elements, including the scope of data, diagnostic code range, and look-back period, are frequently omitted or insufficiently described, limiting the reproducibility and comparability of findings. Transparent and standardized reporting of these components is essential to improve methodological rigor and support more reliable evidence generation in administrative data research.

Citations

Citations to this article as recorded by

Psoriasis and Risk of Colorectal Cancer: A Nationwide Population-Based Cohort Study in Korea
Kyeong Min Han, Dae Myoung Yoo, Ho Suk Kang, Hyo Geun Choi, Joo-Hee Kim, Nan Young Kim, Kyueng-Whan Min, Mi Jung Kwon
Diseases.2026; 14(6): 200. CrossRef

Original Articles

Development of Machine Learning Models to Predict Health Insurance Claim Costs Among Older Indonesians: A Retrospective Predictive Modeling Study: Yeni Mahwati, Dhihram Tenrisau, Syarif Rahman Hasibuan, Bhirau Wilaksono, Yeni Indriyani, Andi Afdal Abdullah, Halik Malik, Andi Alfian Zainuddin; J Prev Med Public Health. 2026;59(2):132-142. Published online January 6, 2026; DOI: https://doi.org/10.3961/jpmph.25.350

2,781 View
314 Download

Abstract Summary PDF Supplementary Material: Objectives
The objective of this study was to develop machine learning models to predict health insurance claim costs among older adults in Indonesia.
Methods
This study utilized secondary data from the Indonesian National Health Insurance program (Jaminan Kesehatan Nasional [JKN]) spanning 2017 to 2023. Three modeling techniques—linear regression, random forest, and XGBoost—were employed to predict individual claim costs. Model performance was assessed using the root mean square error (RMSE), coefficient of determination (R²), and mean absolute error (MAE). Additionally, variable importance analysis was conducted to identify key predictors.
Results
XGBoost with 500 boosting rounds yielded the best performance, with an RMSE of 11 360 283, an R² of 0.81, and an MAE of 4 485 917, outperforming both linear regression (RMSE, 13 710 035; R²=0.72) and random forest (RMSE, 12 434 238; R²=0.78). Notably, outpatient care was identified as the most consistent predictor across all models. Other significant predictors included length of stay (LOS), diagnosis type (International Classification of Diseases, 10th revision chapter), facility type, facility classification, and severity of illness, particularly for moderate cases. Although LOS and diagnosis type were important predictors, these findings should be interpreted in the context of Indonesia’s fixed Indonesian Case-Based Groups payment system.
Conclusions
XGBoost provides reliable predictions of claim costs among older adults, capturing clinical, utilization, and structural drivers. These findings can inform targeted interventions, improve chronic disease management, optimize the referral system, and support integration of predictive tools into JKN to enhance responsiveness and promote sustainable, equitable financing.; Summary

Key Message
Machine learning models, particularly XGBoost, demonstrated superior performance in predicting healthcare costs among older adults in Indonesia. Nonlinear relationships between outpatient visits, severity, and diagnoses highlight the limitations of conventional linear approaches. These findings support the integration of advanced predictive models into national health insurance systems to improve cost management and resource allocation.

Determinants of Smoking Relapse Among Indonesian Children: A National Cross-sectional Analysis Using Global Youth Tobacco Surveillance Data: Risky Kusuma Hartono, Muhammad Abdul Rohman, Renny Nurhasana, Aryana Satrya, Salsabila Nadya, Ni Made Shellasih, Fadhilah Rizky Ningtyas, Astri Hanna Waruwu; J Prev Med Public Health. 2026;59(2):162-173. Published online December 12, 2025; DOI: https://doi.org/10.3961/jpmph.25.703

2,258 View
220 Download

Abstract Summary PDF: Objectives
This study aimed to identify the determinants associated with 4 smoking trajectories (never smoking, current smoking, consistently quitting smoking, and smoking relapse) among Indonesian children using pooled national data.
Methods
This study analyzed children’s smoking trajectories using pooled data from the Indonesian Global Youth Tobacco Survey (2006, 2009, 2014, and 2019). Multinomial logistic regression was applied to examine 4 categories of smoking behavior, and propensity score matching (PSM) was used to address potential selection bias related to advertising exposure.
Results
Higher prices (>IDR31 000/USD1.87) (relative risk ratio [RRR], 0.527) were protective against relapse. This policy effect was systematically undermined by single-stick purchasing, which increased relapse risk by 57.41 times (p<0.01). Peer smoking (RRR, 3.696) and exposure to advertisements in sports events (RRR, 1.477) were also significant risk factors for relapse. Free cigarette distribution demonstrated the strongest association, corresponding to a 23.1 percentage-point increase in relapse probability.
Conclusions
The findings indicate that children’s smoking relapse in Indonesia is shaped by distinct behavioral trajectories. Relapse was influenced by the widespread availability of single-stick cigarettes, pervasive marketing, peer dynamics, and relatively affordable prices. These results underscore the urgent need for a comprehensive strategy that includes substantially increasing excise taxes, eliminating single-stick sales, and fully banning tobacco advertising. Simultaneous implementation of these measures is crucial to prevent relapse and interrupt the progression toward lifelong nicotine addiction.; Summary

Key Message
- To examine factors associated with smoking relapse among Indonesian children, including price, affordability, and advertising exposure. - Pooled Global Youth Tobacco Survey data (2006–2019) were analyzed using multinomial logistic regression and propensity score matching. - Higher cigarette prices (>IDR31,000) reduced relapse risk (RRR 0.527), while single-stick purchases (>57-fold), peer smoking (RRR 3.696), sports advertising exposure (RRR 1.477), and receiving free cigarettes (+23.1 percentage points) significantly increased relapse. - Relapse is driven by accessibility, social influence, and marketing, requiring comprehensive tobacco control policies.

Feasibility and Preliminary Impacts of a Diabetes Education Chatbot Simulation on Glycemic Targets, Loneliness, and Health Beliefs in Indonesia: An Explanatory Mixed-methods Study: Yohanes Andy Rias, Wildan Akasyah, Tri Ana Mulyati, Harwina Widya Astuti, Herminio Noronha, Fakhrudin Nasrul Sani, Hsiu-Ting Tsai; J Prev Med Public Health. 2026;59(1):56-65. Published online December 3, 2025; DOI: https://doi.org/10.3961/jpmph.25.334

2,909 View
266 Download
1 Crossref

Abstract Summary PDF Supplementary Material

Objectives
Chatbot technology improves access to and engagement with diabetes education. However, few studies have evaluated the feasibility and rigorously assessed the impact of chatbots among individuals with type 2 diabetes (T2DM) using theory-based approaches. This pilot study assessed the feasibility and preliminary impact of a chatbot on glycemic targets, loneliness, and perceived health beliefs among adults with T2DM.
Methods
An explanatory mixed-methods approach, comprising a one-group experimental design and qualitative interviews, was used. The chatbot simulation, named “TakonGendhis,” was developed based on conceptual models derived from the technology acceptance model and the health belief model. Feasibility included usefulness, ease of use, and intention to use. Preliminary impact was evaluated based on changes in glycemic targets, loneliness, and health beliefs from baseline to 12 weeks post-intervention. Qualitative data were gathered through individual interviews and focus group discussions and were analyzed thematically. Narrative synthesis was employed to integrate findings from the quantitative and qualitative phases of the study.
Results
The scores for usefulness, ease of use, and intention to use were 26.55, 27.32, and 34.03, respectively. Quantitative analysis revealed reduced loneliness, improved health beliefs, and lower glycemic scores after the 12-week intervention. The qualitative study identified 4 themes: feasibility, beliefs, emotional support, and areas for improvement.
Conclusions
The intervention was feasible and had beneficial preliminary impacts on glycemic targets, loneliness, and health beliefs. Addressing feasibility, beliefs, emotional support, and identified areas for improvement may increase patients’ willingness to use the chatbot.

Summary

Key Message
This mixed-methods study highlights that a diabetes education chatbot simulation is both feasible and beneficial in its preliminary impact for individuals with diabetes in Indonesia. The preliminary results indicate possible enhancements in glycemic targets, reduced feelings of loneliness, and more encouraging health beliefs, confirmed by qualitative insights about user feasibility, beliefs, emotional support, and areas for improvement.

Citations

Citations to this article as recorded by

Peningkatan Keterampilan Wawancara Kontekstual Melalui Interaksi Siswa Dan Google Gemini Di SMP Negeri 1 Tlanakan
Habiburrahman Habiburrahman, Rofi’ati Nur Diana Islam, Nadia Fitri, Halilatur Rohemah
Indonesian Journal of Innovation Multidisipliner Research.2026; 4(2): 3651. CrossRef

The Relationship Between Social Support and Health-promoting Behaviors Among Older Adults in Fasa, Iran: A Cross-sectional Study: Afsaneh Ghasemi, Zhale Zandieh, Zahra Khiyali, Navid Alinejad, Ramin Hayati, Azizallah Dehghan, Zahra Hosseini Nejad, Mohammadreza Keshtkar; J Prev Med Public Health. 2026;59(3):239-248. Published online December 1, 2025; DOI: https://doi.org/10.3961/jpmph.25.502

65,535 View
304 Download

Abstract Summary PDF: Objectives
Health-promoting behaviors are essential for maintaining independence and enhancing quality of life in aging populations. This study aimed to investigate the relationship between social support and health-promoting behaviors among older adults in Fasa, Iran in 2020.
Methods
A cross-sectional study was conducted involving 300 older adults attending a specialized outpatient clinic in Fasa, Iran. Data were collected using a demographic questionnaire, the Walker Health-Promoting Lifestyle Profile, and the Canty Perceived Social Support Scale, administered either through self-report or structured interviews. Statistical analyses were performed using SPSS version 25 and included descriptive statistics, analysis of variance, the chi-square test, and multiple linear regression analyses.
Results
The mean age of participants was 68.9±7.8 years. Most participants were women (56.6%), married (81.7%), and had less than a high school education (41.3%). The mean scores for health-promoting behaviors and perceived social support were 124.2±31.3 and 24.4±9.4, respectively. A statistically significant positive association was observed between perceived social support and health-promoting behaviors (r=0.10, p=0.04). Social support, gender, and education level were identified as significant predictors of health-promoting behaviors, collectively explaining 34% of the variance.
Conclusions
These findings emphasize the pivotal role of social support in promoting health-related behaviors among older adults. Interventions that strengthen social support networks, foster enabling environments, and address gender and educational disparities are recommended to improve health outcomes and quality of life in aging populations. Policymakers and healthcare planners should incorporate these determinants into the design of targeted, evidence-based interventions for older adults.; Summary

Key Message
This study highlights that perceived social support is significantly associated with health-promoting behaviors among older adults in Fasa, Iran. Higher levels of social support, along with demographic factors such as gender and education, significantly predict engagement in healthier lifestyle behaviors. These findings underscore the importance of strengthening social support networks and developing targeted interventions to improve health behaviors and enhance quality of life in aging populations

Assessing Hospital Surgical Functions in Korea: A Functional Analysis Using the Disease Control Priorities, 3rd Edition Essential Surgery List (2013-2022): Haibin Bai, Jin-Hwan Kim, Yukyung Park; J Prev Med Public Health. 2025;58(6):635-646. Published online September 23, 2025; DOI: https://doi.org/10.3961/jpmph.25.407

2,505 View
236 Download

Abstract Summary PDF Supplementary Material: Objectives
Korea has achieved near-universal health coverage through a predominantly privatized healthcare system. However, this structural fragmentation has created significant ambiguity regarding the roles of different healthcare organizations, particularly in ensuring equitable provision of essential surgical services across geographic and institutional boundaries.
Methods
We conducted a retrospective study using the full national health insurance claims database provided by the Health Insurance Review & Assessment Service (2013-2022). Essential surgical procedures from the Disease Control Priorities, 3rd edition Essential Surgery List were mapped to insurance claims codes, and their provision was analyzed across healthcare facilities and regions. Functional capacity was defined using minimum annual volume thresholds of 12, 24, 60, and 120 procedures.
Results
Essential surgery more than doubled between 2013 and 2022, increasing from 2.79 million to nearly 6 million cases. Superior general hospitals and general hospitals consistently delivered high volumes of essential surgeries, while hospital-level facilities experienced marked functional decline, particularly in obstetric services. We observed increasing centralization of surgical services in higher-tier and metropolitan facilities, alongside selective decentralization for lower-risk procedures such as cataract surgery. Regional disparities were especially pronounced for obstetric care.
Conclusions
Functional capacity for essential surgery remains highly uneven across hospitals and regions, undermining equitable access. Policy efforts should focus on strengthening lower-tier hospitals in underserved areas and implementing minimum functionality standards tailored to local needs. Clarifying institutional roles within Korea’s mixed healthcare system is essential to improving accountability and ensuring equitable distribution of essential surgical services.; Summary

Korean summary
본 연구는 DCP3 Essential Surgery List를 한국의 건강보험 청구자료(2013–2022)에 적용하여 필수수술 제공기관의 기능적 변화를 평가하였다. 전체 필수수술 건수는 크게 증가했음에도 불구하고 이를 제공하는 의료기관 수는 지속적으로 감소하며 지역 간 격차도 확대되고 있었다. 필수수술 접근성을 강화하기 위해서는 우선 의료기관 수준별로 제공해야 할 필수 기능을 명확히 규정하는 정책적 가이드가 필요하며, 이를 기반으로 지역 단위의 종합병원·병원급 기능을 지속적으로 모니터링하고 관리하는 체계를 마련해야 한다.

Key Message
This study applies the DCP3 Essential Surgery List to South Korea’s national health insurance claims data (2013–2022) and shows that, despite a substantial rise in essential surgery volumes, the number of institutions providing these procedures has declined, widening regional disparities. Strengthening access to essential surgery requires first establishing clear guidance on the functions expected at each level of care, followed by systematic monitoring to ensure that general and hospital-level facilities maintain the capacity to deliver these core services. Such a combined approach is critical for securing equitable and regionally sustained surgical access.

Changes in Adolescents’ Compliance Rate in Response to Policy Changes: COVID-19 Toothbrushing Restrictions in Schools for Korea: Suhyun Choi, Yubeen Kim, Joo Mi Kim, Joohyeon Kim, Jaewon Jeon, Jae-Seok Song, Yeunhee Kwak, Se-Hwan Jung, Nam-jun Kim; J Prev Med Public Health. 2026;59(1):35-45. Published online September 8, 2025; DOI: https://doi.org/10.3961/jpmph.25.448

1,722 View
195 Download

Abstract Summary PDF: Objectives
This study investigated changes in toothbrushing in adolescents in response to public health policy changes during coronavirus disease 2019 (COVID-19) focusing on behavioral trends before, during, and after policy enforcement according to socio-demographic subgroups.
Methods
Data from the Korean Youth Risk Behavior Survey (2018–2024) were divided into 3 periods: before (2018–2019), during (2020–2022), and after (2023–2024) the implementation of COVID-19 school restrictions. A total of 354 943 middle and high school students were included. The primary outcome variable was self-reported toothbrushing after lunch at school. Multivariable logistic regression was conducted, adjusting for confounders such as sex, academic performance, school level, school type, handwashing, and oral health status (toothache and gum bleeding).
Results
The compliance rate for toothbrushing declined significantly during the restriction period across all groups. It varied by sex, school type, school level, health-related behaviors (drinking, smoking, handwashing), and oral health status. Female students, middle schoolers, students in single-sex schools, non-smokers, and those practicing hand hygiene showed higher compliance. After restrictions were lifted, toothbrushing rates improved but remained lower than pre-pandemic levels. Recovery of the toothbrushing rate was observed in most groups, particularly among female students, high schoolers, and those with positive health-related behaviors. However, academic performance and oral health status were not significantly associated with recovery rate in adjusted analyses.
Conclusions
This study highlights that adolescents’ health behaviors are highly sensitive to environmental and policy changes. Variations in compliance and recovery rates underscore the need for adolescent-centered policies that account for both compliance and recovery, especially during crises such as pandemics.; Summary

Korean summary
청소년의 점심식사 후 칫솔질 행동은 COVID-19 학교 방역 제한 기간 동안 감소하였으며, 제한 해제 이후에도 부분적인 회복에 그쳤다. 순응도와 회복 양상은 집단별 특성에 따라 다르게 나타났다. 따라서 공중보건 정책은 행동의 순응뿐 아니라 회복까지 고려하여, 집단별 특성에 맞게 설계할 필요가 있다.

Key Message
Adolescents’ toothbrushing after lunch declined during COVID-19 school restrictions and showed only partial recovery after restrictions were lifted. Patterns of compliance rate and recovery rate varied according to subgroup characteristics. Therefore, public health policies should be designed to consider both compliance and recovery rates, tailored to subgroup-specific characteristics.

From Rich to Poor: A Decomposition Analysis of Socioeconomic Inequality in Health-related Quality of Life in Iran: Satar Rezaei; J Prev Med Public Health. 2025;58(5):538-547. Published online August 20, 2025; DOI: https://doi.org/10.3961/jpmph.25.383

5,641 View
238 Download
1 Web of Science
1 Crossref

Abstract Summary PDF Supplementary Material

Objectives
Socioeconomic status (SES) is a well-established predictor of health outcomes across an individual’s lifespan. People from lower socioeconomic backgrounds generally have shorter life expectancies and lower levels of health-related quality of life (HRQoL) compared with those from higher-income groups. This study aimed to quantify income-related inequalities in HRQoL among adults in Iran.
Methods
A total of 3518 adults aged 18 years and older were selected using a convenience sampling method across 9 provinces in Iran. HRQoL was assessed with the EuroQoL 5-Dimension 5-Level (EQ-5D-5L) instrument, which evaluates 5 dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. The concentration index (CI) approach was used to measure income-related inequality in worse HRQoL (disutility=1–utility value) and to identify the socioeconomic factors contributing to the observed inequality.
Results
The CI for worse HRQoL was -0.116, while the CI for the EuroQol visual analogue scale (EQ-VAS) score was 0.027. The CIs for reporting any problems in the EQ-5D-5L dimensions were: mobility (-0.122), self-care (-0.070), usual activities (-0.074), pain/discomfort (-0.139), and anxiety/depression (-0.139). Decomposition analysis showed that income (38.00%), educational level (31.53%), age (8.05%), and physical activity (7.30%) were the main factors contributing to socioeconomic inequality in poorer HRQoL in Iran.
Conclusions
This study identified a pro-poor distribution of poorer HRQoL and reported problems across all dimensions of the EQ-5D-5L in Iran. Targeted interventions should focus on reducing disparities in income, education, and physical activity levels.

Summary

Key Message
The study of 3518 adults across 9 Iranian provinces revealed significant pro-poor socioeconomic inequality in health-related quality of life (HRQoL), with worse HRQoL concentrated among lower-income groups (concentration index: -0.116). Income (38%) and education level (31.53%) were the largest contributors to this inequality, followed by age (8.05%) and physical activity (7.30%) based on decomposition analysis. All five EQ-5D-5L health dimensions showed more reported problems in lower socioeconomic groups, emphasizing the need for targeted interventions addressing income, education, and lifestyle factors to reduce HRQoL disparities in Iran.

Citations

Citations to this article as recorded by

Environmental injustice, marginalization and resistance: an intersectional analysis from Iran
Elham Hoominfar
Local Environment.2026; : 1. CrossRef

Prevalence and Severity of Depression Among Patients With Anemia Attending a Rural Outpatient Clinic in Faridabad, India: A Cross-sectional Study: Prince , Urvashi , Rajat Sharma, Jubair Shamsi, Satya Vir Singh; J Prev Med Public Health. 2025;58(6):629-634. Published online August 9, 2025; DOI: https://doi.org/10.3961/jpmph.25.363

2,236 View
246 Download

Abstract Summary PDF: Objectives
This study was performed to determine the prevalence and severity of depression among patients previously diagnosed with anemia and to explore associated clinical and socio-demographic factors.
Methods
This cross-sectional study was conducted from October 2024 to February 2025, among 300 patients with anemia attending the outpatient clinic at the Rural Health Training Centre, Amrita School of Medicine, Faridabad, Haryana. Data on socio-demographic and clinical variables were collected using a structured questionnaire. Depression was evaluated using the Patient Health Questionnaire-9 (PHQ-9). Associations of anemia severity with depression presence and severity were analyzed using the chi-square test, logistic regression, and ordinal logistic regression, with adjustment for potential confounders.
Results
The prevalence of depression (PHQ-9 score>9) among patients with anemia was 31.3%. Severe anemia was significantly associated with higher odds of depression (adjusted odds ratio [aOR], 3.02; 95% confidence interval [CI], 1.13 to 8.07; p=0.027) and more severe depression (aOR, 2.87; 95% CI, 1.14 to 7.27; p=0.026). Symptoms such as weakness (aOR, 3.57) and shortness of breath (aOR, 2.71) were also significantly associated with depression. Moderate anemia displayed a non-significant trend.
Conclusions
Severe anemia is independently associated with both the presence and severity of depression. Routine mental health screening should be integrated into anemia management protocols, especially in rural healthcare settings.; Summary

Key Message
Anemia is a common problem in India, whereas there is a growing awareness about mental health issues like depression. This study was conducted at a Rural Health Training Centre in India, to estimate the prevalence and severity of depression among patients with anemia. The prevalence of anemia was found to be 31.3% (PHQ-9 score > 9), and severe anemia was associated with higher odds of depression and more severe depression. Our study indicated a need of routine mental health screening in patients with anemia.

Lifestyle and Psychological Factors Associated With Depression in College Students in Hokkaido, Japan During the COVID-19 Pandemic: A Cross-sectional Study: Atsushi Mizumoto, Reiya Tsuji, Kotomi Echizen, Yuichi Takata; J Prev Med Public Health. 2025;58(6):581-588. Published online July 22, 2025; DOI: https://doi.org/10.3961/jpmph.25.186

3,237 View
211 Download

Abstract Summary PDF: Objectives
Although studies have demonstrated a decline in mental health during the early stages of the coronavirus disease 2019 (COVID-19) pandemic, the long-term psychological effects remain insufficiently understood. This study conducted a web-based questionnaire survey to identify factors associated with depression among college students in Hokkaido, Japan, during the COVID-19 pandemic.
Methods
A total of 187 participants who responded to a questionnaire administered in April 2022 were included in this study. The survey evaluated depressive symptoms using the Center for Epidemiologic Studies Depression Scale (CES-D) and included items on exercise habits, sleep duration, food frequency score (FFS), World Health Organization-Five Well-Being Index (WHO-5), Fear of COVID-19 Scale (FCV-19S), daily step count, part-time job participation, and involvement in club activities.
Results
The mean CES-D score was 18.2±9.9, with 95 participants (50.8%) exhibiting symptoms of depression. Compared to those in the depression group, participants in the non-depression group were significantly more likely to engage in regular exercise and part-time jobs, as well as higher FFS, WHO-5, and FCV-19S scores. Logistic regression analysis showed that, even after adjusting for confounding variables, the WHO-5 score, FCV-19S score, and participation in part-time jobs remained significantly associated with depression scores.
Conclusions
Almost half of the participants showed symptoms of depression. These symptoms were associated with poor exercise habits and lack of part-time employment, among other factors. Among college students who had experienced more than 2 years of the pandemic, engaging in part-time work may have reduced social isolation and helped lower the risk of depression.; Summary

Key Message
This study conducted a web-based survey to identify factors associated with depression among college students in Hokkaido during the COVID-19 pandemic. Compared with students in the depression group, those without depression were more likely to engage in regular exercise and part-time jobs and had higher FFS, WHO-5, and FCV-19S scores. Logistic regression showed that WHO-5, FCV-19S, and participation in part-time jobs remained significantly associated with depression after adjustment. Among students who had experienced more than two years of the pandemic, part-time employment may have reduced social isolation and lowered the risk of depression.

Association Between Disability and Participation in Sports or Physical Activities: Evidence From a Chilean Population-based Survey: Renzo Gianmarco Avila-Terrones, Leslie Paulina Quiroga-Morales, J. Jhonnel Alarco; J Prev Med Public Health. 2025;58(6):599-608. Published online July 12, 2025; DOI: https://doi.org/10.3961/jpmph.25.249

2,886 View
178 Download
1 Web of Science
1 Crossref

Abstract Summary PDF Supplementary Material

Objectives
This study aimed to estimate the association between disability and participation in sports or physical activity during the past month among individuals in Chile.
Methods
A cross-sectional analysis was conducted using data from the Second National Disability Study (ENDISC II) of Chile. The dependent variable was defined as participation in sports or physical activity in the last month, while the independent variable was disability status, as determined by the ENDISC II methodology. Crude and adjusted ordinal logistic regression models were employed to calculate odds ratios (ORs) with 95% confidence intervals (95% CIs).
Results
The analysis included data from 12 236 Chilean participants. Individuals with mild or moderate disability were 54% more likely to participate in lower levels of sports or physical activity (OR, 1.54; 95% CI, 1.27 to 1.87). Those with severe disability exhibited a 73% increased likelihood (OR, 1.73; 95% CI, 1.19 to 2.52) compared to individuals without disabilities, after adjusting for multiple confounding factors.
Conclusions
In Chile, individuals with disabilities participated less frequently in sports or physical activity during the past month than those without disabilities.

Summary

Key Message
This study analyzed national data from Chile to examine the relationship between disability and participation in sports or physical activity. Individuals with disabilities, particularly those with severe limitations, were significantly less likely to engage in physical activity than those without disabilities, even after adjusting for multiple confounders. These findings highlight a critical public health gap and underscore the need for inclusive and accessible physical activity strategies to reduce inequalities.

Citations

Citations to this article as recorded by

Riding toward inclusion: the journey of adapted cycling
Stephanie Sorraghan, Sally Logan, Valerie Watchorn, Dion Williams, Danielle Hitch, Joanne M. Watson, Kathryn Aedy, Therese Dogra, Pearse Fay, Matthew Haanappel, Aarti Shukla, Glen Lebeau, James Little, John McKenna, Kerry Townsend, Kate L. M. Anderson
Frontiers in Sports and Active Living.2026;[Epub] CrossRef

Perspective

Towards Mental Health Equity: Task Shifting Strategy to Overcome Barriers in Primary Healthcare Services in India: Suganya Panneerselvam, Senthilkumar Ramasamy, Sanjana Agrawal; J Prev Med Public Health. 2025;58(5):548-551. Published online June 13, 2025; DOI: https://doi.org/10.3961/jpmph.25.144

2,950 View
326 Download

Abstract Summary PDF: Mental illness remains among the top 10 causes of the global burden of disease. According to the National Mental Health Survey of India, 10.6% of adults exhibit mental disorders. India ideally requires 3 psychiatrists per 100 000 population, yet the current ratio is only 0.7 per 100 000. The country thus faces an urgent need to strengthen mental health infrastructure and expand training programs. Vulnerable groups—particularly residents of rural and remote areas, women, and older adults—are disproportionately affected by this situation. Individuals with mental illness often suffer in silence, enduring human rights violations, stigma, and discrimination. India’s National Mental Health Programme seeks to ensure the availability and accessibility of minimum mental health care for all, with a focus on the most vulnerable and underserved populations. The World Health Organization recommends task shifting or task sharing to improve access and deliver healthcare services in remote areas. Community Health Officers (CHOs) and Accredited Social Health Activists use community-based assessment checklists to identify individuals at risk of communicable, non-communicable, and mental health disorders. CHOs then ensure continuity of care through regular follow-up, bridging the gap between diagnosis and ongoing treatment. This practice significantly augments the effectiveness of community-level mental health interventions. Integrating mental health into primary health care should facilitate earlier detection and treatment of mental health disorders.; Summary

Key Message
Mental illness remains among the top 10 causes of the global burden of disease. Stigma associated with these disorders exacerbates the problem, leading to social discrimination. The Ayushman Bharat initiative is a transformative step towards strengthening India’s healthcare system. CHOs and ASHAs use community-based assessment checklists to identify individuals at risk of communicable, non-communicable, and mental health disorders within their communities. This task-shifting approach empowers local communities and fosters participation, reducing disease burden and offering a sustainable, effective model.

Original Articles

Asthma Exacerbation in Indonesia: Analysis of Mental, Socio-demographic, Behavioral, and Biological Risk Factors Using the 2018 Indonesian Basic Health Research: Siti Isfandari, Sulistyowati Tuminah, Laurentia Konadi Miharja; J Prev Med Public Health. 2025;58(3):250-259. Published online May 16, 2025; DOI: https://doi.org/10.3961/jpmph.24.719

7,126 View
538 Download

Abstract Summary PDF: Objectives
Asthma represents a significant global health burden, with exacerbations impacting quality of life. Although risk factors for asthma exacerbation (AE) have been identified, data specific to Indonesia remain scarce. We investigated risk factors for AE among Indonesian adolescents and adults.
Methods
A cross-sectional analysis of the 2018 National Health Survey was conducted, including Indonesian participants aged 15 and older with diagnosed asthma. Logistic regression was employed to identify risk factors for AE.
Results
A total respondents aged 15 years or older were 706 689 participants. The prevalence of asthma was 2.6% (18 574 participants). Among individuals with asthma, 59.7% experienced exacerbation, and 21.4% reported symptoms indicating emotional distress (ED). Both ED and diagnosed heart disease (DHD) were linked to increased odds of AE, with adjusted odds ratios (aORs) of 1.27 (95% confidence interval [CI], 1.18 to 1.37) and 1.21 (95% CI, 1.06 to 1.38), respectively. Being diagnosed with asthma at age 15 or older was associated with an aOR of 1.56 (95% CI, 1.45 to 1.66). Those with lower socioeconomic status (SES) also faced comparatively high risk (aOR, 1.37; 95% CI, 1.23 to 1.52). In contrast, physical activity was inversely related to AE (aOR, 0.72; 95% CI, 0.64 to 0.81).
Conclusions
ED, DHD, lower SES, and later-onset asthma were identified as significant risk factors for AE. This underscores the need for comprehensive asthma management strategies that prioritize mental health, cardiovascular health, and early intervention. Addressing these factors could substantially reduce the burden of AE in Indonesia. Further longitudinal studies are necessary to elucidate the causal relationships involved and evaluate the effectiveness of targeted interventions.; Summary

Key Message
Asthma represents a significant global health burden, with exacerbation impacting individual quality of life. Emotional distress, diagnosed heart disease, asthma diagnosis after the age of 15 years, and lower socioeconomic status were associated with an increased risk of asthma exacerbation, while physical activity was not. Our findings underscore the importance of addressing mental health comorbidities, encouraging physical activity, and considering socioeconomic disparities when developing asthma management strategies. Educating patients about asthma and its triggers can reduce exacerbations and improve disease control. Since asthma severity differs across individuals and age groups, clinicians must regularly monitor patients and adjust treatment as needed.

Are Non-standard Work Schedules Related to Sleep Difficulty and Health-related Quality of Life in Korea? An Examination of Gender Differences: Seowoo Park, Ji Sun Park, Moo Hyuk Lee, Young Kyung Do; J Prev Med Public Health. 2025;58(4):396-405. Published online April 15, 2025; DOI: https://doi.org/10.3961/jpmph.24.378

46,420 View
301 Download
1 Crossref

Abstract Summary PDF Supplementary Material

Objectives
The rise of flexible and diverse work schedules has become increasingly common in modern society. This study aims to investigate whether non-standard work schedules are related to sleep difficulty and other aspects of health-related quality of life (HRQoL) in Korea, with special attention to gender differences.
Methods
Data from the 2019 and 2021 National Health and Nutrition Examination Survey (Phase 8) were used, with a final sample consisting of 6735 participants. Ordinal logistic regression analysis was performed on sleep difficulty and the other seven items of the Health-related Quality of Life Instrument with 8 items (HINT-8) to examine associations with work schedules. Linear regression analysis was also conducted using the HINT-8 index as a composite measure.
Results
Non-standard work schedules were associated with a higher likelihood of sleep disturbances compared to the standard daytime work schedule. In particular, the negative impact of the night work schedule on sleep was greater for women than for men. Women working under the night work schedule were 12.2 percentage points more likely to report severe sleep difficulty than women under the day work schedule (9.6%). Additionally, the working, happiness, and vitality items of the HINT-8 were negatively associated with the night work schedule, whereas the other HINT-8 items and the HINT-8 index did not exhibit similar results.
Conclusions
Non-standard work schedules are associated with increased sleep difficulty, particularly among women, and negatively affect several aspects of HRQoL, including vitality, happiness, and work performance. Given their rising prevalence and adverse impact on workers’ sleep, health, well-being, as well as workplace safety and performance, non-standard work schedules should be recognized as a significant public health concern.

Summary

Korean summary
저녁 및 밤 시간대 근무는 수면을 포함한 건강 관련 삶의 질에 부정적 영향을 끼치며, 그 영향은 여성에서 더 크게 나타난다. 비표준시간대 근무는 중요한 공중보건학적 문제이다.

Key Message
Non-standard work schedules are associated with increased sleep difficulty, particularly among women, and negatively affect several aspects of health-related quality of life, including vitality, happiness, and work performance. Given their rising prevalence and adverse impact on workers’ sleep, health, well-being, as well as workplace safety and performance, non-standard work schedules should be recognized as a significant public health concern.

Citations

Citations to this article as recorded by

Health-Related Quality of Life and Its Influencing Factors Among Patients With Coronary Heart Disease and Type 2 Diabetes Mellitus: A Cross-Sectional Study
Xin Yang Liu, Lele Bi, Qiaoyun Jin, Haixia Hu, Wenjing Liu, Li Cheng
Journal of Cardiovascular Nursing.2026;[Epub] CrossRef

Prognostic Scoring Model for the Transition From Acute to Chronic Non-specific Low Back Pain in Primary Health Care Units in Indonesia: Djoko Kuswanto, Riva Satya Radiansyah, Dwinka Syafira Eljatin, Muhammad Nazhif Haykal, Rumman Karimah, Ratri Dwi Indriani, Zain Budi Syulthoni, Erna Furaidah, Andiva Satrio Rinaldi, Hafira Nushifa Putri, Jessica Felina Adi, Anak Agung Bagus Wirayuda; J Prev Med Public Health. 2025;58(4):422-430. Published online April 12, 2025; DOI: https://doi.org/10.3961/jpmph.24.581

6,459 View
339 Download
1 Crossref

Abstract Summary PDF Supplementary Material

Objectives
Non-specific low back pain (NSLBP) is a prevalent health issue that can progress from acute to chronic, resulting in prolonged disability and diminished quality of life. This study aimed to develop a prognostic scoring model to predict the transition from acute to chronic NSLBP in primary care settings.
Methods
This prospective cohort study enrolled 112 adults with acute NSLBP from primary health care units in Indonesia. Participants were assessed at baseline and at a 3-month follow-up visit. Bivariate and multivariable analyses were conducted to identify significant predictors of chronicity. A scoring system was then developed based on the final logistic regression model.
Results
Three factors were found to be significant predictors of the transition to chronic NSLBP: age above 30 years, low education level, and moderate to severe pain intensity. The prognostic scoring model demonstrated good discrimination, with an area under the receiver operating characteristic curve of 0.705, 70.8% sensitivity, and 62.5% specificity at the optimal cut-off score of 2.5.
Conclusions
This simple prognostic scoring model can help clinicians identify patients at high-risk of developing chronic NSLBP. Early identification of at-risk patients could guide targeted interventions to prevent chronicity. Further validation in diverse populations is necessary to confirm the broader applicability of this model.

Summary

Key Message
This prospective cohort study developed a prognostic scoring model to predict the transition from acute to chronic non-specific low back pain (NSLBP) in primary care settings in Indonesia. The study identified three significant predictors: age above 30 years, low education level, and moderate to severe pain intensity, which formed a simple scoring system with good discrimination ability (AUC = 0.705, sensitivity 70.8%, specificity 62.5%). This practical tool enables clinicians to identify high-risk patients early and implement targeted interventions to prevent chronicity in primary healthcare settings.

Citations

Citations to this article as recorded by

The Role of Dexketoprofen/Tramadol in Multimodal Therapy to Prevent Acute Postsurgical and Acute Low Back Pain from Developing into Chronic Pain: A Delphi Consensus Study
Giustino Varrassi, Maria Dolma Gudez-Santos, Magdi Hanna, Magdalena Kocot-Kępska, Antonio Montero Matamala, Marco Antonio Narvaez Tamayo, Serge Perrot, Jose Luis Aguilar, Omar Al Hamad, Lu’i Al-Husinat, Raad Al-Khafaji, Abdallah Allam, Ezio Amorizzo, Nadi
Pain and Therapy.2026; 15(1): 175. CrossRef

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

17,654 View
449 Download
2 Web of Science
2 Crossref

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.

Citations

Citations to this article as recorded by

Comparison of health care utilisation and spending among National Health Insurance and Medical Aid beneficiaries in Korea
Agnus M. Kim, Doojin Ryu, Jin Yong Lee
BMC Health Services Research.2026;[Epub] CrossRef
Understanding of solitary death in people living in the community: A scoping review
Chung Min Cho, Hyeun Jun Moon, Jee-Hye Yoo
Global Public Health.2025;[Epub] CrossRef

The Role of Time Preferences in Compliance With COVID-19 Preventive Behaviors in Iran: A Quasi-hyperbolic Discounting Approach: Moslem Soofi, Ali Kazemi Karyani, Shahin Soltani, Zahra Alipoor, Behzad Karamimatin; J Prev Med Public Health. 2025;58(3):326-335. Published online February 13, 2025; DOI: https://doi.org/10.3961/jpmph.24.453

4,201 View
303 Download

Abstract Summary PDF: Objectives
This study aimed to investigate the role of time preferences in compliance with coronavirus disease 2019 (COVID-19) preventive behaviors in an adult population of Iran.
Methods
A web-based questionnaire was utilized to conduct a cross-sectional survey of 672 Iranian adults. The parameters of time preferences were estimated using a quasi-hyperbolic discounting model, and the relationship between COVID-19 preventive behaviors and time preferences was examined using a probit regression model.
Results
A significant association was observed between the preventive behaviors of COVID-19 and the levels of patience and present-biased preferences among the study participants. Individuals who exhibited low levels of patience were found to be 12.8 percentage points less inclined to follow preventive behaviors compared to those with high levels of patience. The likelihood of having good preventive behaviors of COVID-19 was found to decrease by 14.3 percentage points among individuals with a present bias as opposed to those with a bias toward future.
Conclusions
Patience and present-biased preferences are important determinants of adopting preventive behaviors against COVID-19. These behavioral characteristics should be considered in the design of control and prevention programs. Considering people’s discounting behavior and time (in)consistency in their preferences in the design of COVID-19 policy interventions can provide valuable insights for developing tailored public health policy interventions.; Summary

Key Message
This study explored how time preferences—patience and present bias—affect compliance with COVID-19 preventive behaviors among Iranian adults. Using a web-based survey and quasi-hyperbolic discounting model, it found that those with low patience or present-biased preferences were less likely to follow preventive measures than those with high patience or future-oriented preferences. The findings highlight the need to consider time preferences in designing effective public health interventions to improve adherence to preventive measures.

Association Between Geriatric Oral Health Assessment Index and Cardiovascular Disease in Korean Older Adults: Kyu-Taek Lim, Ji-won Choe, Seung-sik Hwang; J Prev Med Public Health. 2025;58(1):103-112. Published online January 14, 2025; DOI: https://doi.org/10.3961/jpmph.24.569

6,799 View
594 Download
5 Web of Science
5 Crossref

Abstract Summary PDF

Objectives
This study examined the association between oral health-related quality of life (OHRQoL), as assessed by the Geriatric Oral Health Assessment Index (GOHAI), and cardiovascular disease (CVD) outcomes among Korean older adults.
Methods
Data from 5413 participants in the Korean Longitudinal Study of Aging were analyzed. GOHAI scores were categorized as either “poor” (<40) or “not poor” (≥40). Generalized estimating equation models were used to assess the relationship between GOHAI scores and CVD prevalence, with analyses stratified by sex.
Results
Poor GOHAI score was significantly associated with elevated odds of CVD (odds ratio [OR], 1.13; 95% confidence interval [CI], 1.07 to 1.19; p<0.001). This association was stronger in female (OR, 1.36) compared to male (OR, 1.12). Poor oral health is indicative of systemic inflammation and age-related vulnerabilities, underscoring the utility of the GOHAI as an instrument for early identification of CVD risk.
Conclusions
Poor oral health, as measured by the GOHAI, is associated with an increased risk of CVD among older adults, especially female. These findings support the use of the GOHAI as a cost-effective screening tool for the early assessment of CVD risk. Further research is warranted to explore inflammatory biomarkers and sex-specific mechanisms that could inform targeted interventions.

Summary

Korean summary
노년층에서 구강건강 관련 삶의 질(OHRQoL)이 낮을수록 심혈관계 질환(CVD) 위험이 높아지며, 특히 여성에서 더 두드러졌습니다. 본 연구는 노년 구강 건강 평가 지수(GOHAI)를 사용했습니다.

Key Message
Poor GOHAI scores are associated with higher CVD risk, with stronger effects in females. This highlights the potential of GOHAI as an effective tool for early detection and prevention of CVD.

Citations

Citations to this article as recorded by

Oral health-related quality of life in cardiovascular patients- a systematic review
Kamyar Nasiri, Farzaneh Nikfarjam, Ali keshavarzian, Naghmeh shenasa, Wissam Hamid Al-janabi, Radhwan Abdul Kareem, Hayder Naji Sameer, Fateme Moradi
BMC Cardiovascular Disorders.2026;[Epub] CrossRef
Breaking the silos: a systematic review of oral health integration strategies for improved oral health and cardiovascular outcomes
Wania Usmani, Charlotte Park, Sharta Ogato, Millicent Raymond, Maximilian Pangratius de Courten, Peter W. Lange, Fahad Hanna
Frontiers in Public Health.2026;[Epub] CrossRef
Association between longitudinal trajectories of cognitive functioning and all-cause mortality among middle-aged and older adults in South Korea: Exploring the mediating role of oral health-related quality of life
Seong-Uk Baek, Jin-Ha Yoon
GeroScience.2026;[Epub] CrossRef
Assessment of oral health-related quality of life and its association with periodontal status in geriatric patients
Seval Ceylan Şen, Özlem Saraç Atagün, Gülbahar Ustaoğlu, Zeynep Hazan Yildiz
BMC Oral Health.2025;[Epub] CrossRef
Evaluation of the Geriatric Oral Health Assessment Index Based on Oral Health-Related Behaviors and Status of Older Adults in Gangneung-si
Jin-Sun Choi, Hye-Rim Jeon, Soo-Myoung Bae, Sun-Jung Shin, Bo-Mi Shin, Hye-Young Yoon, Hyo-Jin Lee
Journal of Dental Hygiene Science.2025; 25(4): 360. CrossRef

Associations Between Multiple Falls and Mental Health Indices in Korean Older Adults: A Cross-sectional Study: Chaelyn Lim, Hyun-Jin Son, Byung-Gwon Kim, Byeng-Chul Yu, Jiwon Kim, Young-Seoub Hong; J Prev Med Public Health. 2025;58(3):269-277. Published online January 14, 2025; DOI: https://doi.org/10.3961/jpmph.24.482

7,540 View
453 Download

Abstract Summary PDF Supplementary Material: Objectives
This study was performed to investigate the prevalence of falls, mental health issues, and health behaviors among older adults, as well as to analyze the association between multiple falls and mental health status in this population.
Methods
We utilized data from the 2017, 2019, and 2021 Korean Community Health Survey, a nationwide survey organized by region and conducted by the Korea Disease Control and Prevention Agency. Participants were categorized into no-fall, single-fall, and multiple fall groups based on responses to an index question regarding fall experiences and the number of such incidents reported in the survey. The chi-square test was applied to understand the characteristics of the elderly population in the community. Subsequently, multinomial logistic regression analysis was conducted to clarify the association between falls and mental health.
Results
Integrated data analysis revealed that 11.3% of participants experienced a single fall, while 5.7% reported multiple falls. Participants from low-education and low-income backgrounds exhibited relatively high rates of falls. Additionally, non-drinkers and non-smokers reported falls more frequently than their counterparts who consumed alcohol and smoked. Multinomial logistic regression revealed significant associations between multiple falls and mental health factors. In particular, the severity of depression was directly proportional to the likelihood of experiencing multiple falls, with an odds ratio of 2.95 (95% confidence interval, 2.49 to 3.50).
Conclusions
We identified associations between various mental health-related factors—including sleep duration, subjective stress, the presence of depression, and Patient Health Questionnaire-9 score—and the occurrence of multiple falls.; Summary

Korean summary
본 연구는 한국의 65세 이상 노인을 대상으로 낙상 경험과 정신건강 지표 간의 연관성을 분석한 단면 연구이다. 다회 낙상은 수면 시간, 주관적 스트레스, 우울감, PHQ-9 점수 등 다양한 정신건강 요인과 유의한 관련이 있었으며, 특히 우울증이 심할수록 낙상 발생 위험이 높아지는 경향을 보였다.

Key Message
Multiple falls among Korean older adults were significantly associated with mental health-related factors, including sleep duration, subjective stress, and Patient Health Questionnaire-9 (PHQ-9) scores. These results emphasize the need for comprehensive interventions targeting both physical and mental health to prevent recurrent falls in the elderly.

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

7,219 View
546 Download
2 Web of Science
3 Crossref

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).

Citations

Citations to this article as recorded by

Relationship between extraversion and mental health literacy in Chinese adolescents: a chain mediation model
Zhanfang Liu, Fangru Yuan, Jianzheng Du
Frontiers in Psychology.2026;[Epub] CrossRef
Mental Health Literacy, Related Knowledge, and Depression Risk Among Thai Undergraduate Health Science Students: A Cross-sectional Study
Tipvarin Benjanirat, Jatuporn Ounprasertsuk, Jutatip Sillabutra, Khwanruedi Phoowadkean
Middle East Journal of Rehabilitation and Health Studies.2026;[Epub] CrossRef
Health and Mental Well-Being of Academic Staff and Students in Thailand: Validation and Model Development
Ungsinun Intarakamhang, Cholvit Jearajit, Hanvedes Daovisan, Phoobade Wanitchanon, Saichol Panyachit, Kanchana Pattrawiwat
Education Sciences.2025; 15(10): 1310. CrossRef

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

4,756 View
432 Download
4 Web of Science
3 Crossref

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.

Citations

Citations to this article as recorded by

More Parks Are Linked to Lower Tract-Level Mental Distress in Less-Walkable Neighborhoods: A South Carolina Analysis
Farnaz Hesam Shariati, Jennifer Fillo, Mohammad Javad Koohsari, Andrew T. Kaczynski
Ecopsychology.2026;[Epub] CrossRef
Urban green space dimensions, visit behavior, and mental well-being: A comparative study of Singapore and Hong Kong
Kwan Ok Lee, Alex Hey Yeung
Cities.2026; 171: 106734. CrossRef
Spatially varying associations between a small-area index of livability and mental health outcomes in New York City: A geographically weighted Poisson regression approach
Khushboo Agarwal, Rachel L. Thompson, Glen D. Johnson
Spatial and Spatio-temporal Epidemiology.2026; 57: 100806. CrossRef

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

6,863 View
537 Download
2 Crossref

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.

Citations

Citations to this article as recorded by

Determinants of Quality of Life among Older Adults Living in Agricultural Communities in Nakhon Si Thammarat, Thailand
Yodfah Ratmanee
Community and Social Development Journal.2026; 27(1): 142. CrossRef
Community-Based SENORITA Gymnastics for Improving Menopausal Symptoms and Quality of Life Among Postmenopausal Women: A Quasi-Experimental Study
Ni Putu Karunia Ekayani, Linda Meliati, Sukaisi Sukaisi
Journal of Applied Nursing and Health.2026; 8(2): 1414. 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

4,393 View
453 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.

Health Effects of Heavy Metal Exposure Among E-waste Workers and Community-dwelling Adults in Thailand: A Cross-sectional Study: Chonyitree Sangwijit, Parichat Ong-artborirak, Warangkana Naksen, Kraiwuth Kallawicha, Pallop Siewchaisakul; J Prev Med Public Health. 2025;58(2):156-166. Published online November 21, 2024; DOI: https://doi.org/10.3961/jpmph.24.415

8,139 View
600 Download
1 Crossref

Abstract Summary PDF Supplementary Material

Objectives
Global concern is increasing about the health effects of electronic waste (e-waste). This study examines the health impacts of heavy metal (HM) exposure among e-waste workers (EWWs) and community-dwelling adults (CDAs) in Northeastern Thailand and identifies factors associated with adverse health outcomes.
Methods
A cross-sectional study was conducted of 164 EWWs and 164 CDAs. A survey was employed to collect data on participant characteristics, symptoms, anxiety, depression, and sleep quality. Urine samples were analyzed for lead (Pb) and cadmium (Cd) levels using atomic absorption spectrometry. Multiple logistic regression analysis was used to identify factors impacting health.
Results
Across all participants, urinary Pb and Cd levels ranged from 5.30 µg/g to 29.50 µg/g creatinine and from 0.60 µg/g to 4.00 µg/g creatinine, respectively. The most frequently reported health issues pertained to musculoskeletal disorders (MSDs) at 38.70%, central nervous system (CNS) issues at 36.60%, and skin disorders at 31.10%. Multivariable analysis indicated that the presence of MSDs was significantly associated with exposure to Pb and Cd. Poor sleep quality (PSQ) was significantly linked to CNS problems, while body mass index was significantly related to skin disorders. Factors including primary education level or below, smoking, cleaning the house more than 3 times weekly, and PSQ were significantly linked to depression. Anxiety was significantly associated with PSQ.
Conclusions
Environmental exposure to Pb and Cd can have adverse health impacts in the form of MSDs. Depression and anxiety are common conditions among CDAs. Public health officials should monitor HM exposure and mental health within the community.

Summary

Key Message
- Pb and Cd level was not significant difference between e-waste workers and community-dwelling adults. - Pb and Cd can adversely affect symptoms in the MSD and PSQ affects the CNS in e-waste workers. - E-waste workers had a higher chance of having musculoskeletal disorder, central nervous system disorder, and skin disorder problems than community-dwelling adults but a lower chance of having depression and anxiety than community-dwelling adults.

Citations

Citations to this article as recorded by

Estimated Dietary Lead Exposure Through Aquatic Animal Consumption and Health Symptoms in a Lake-Dependent Community: Evidence from Nong Han Lake, Northeast Thailand
Birabongse Hardthakwong, Kulthida Y. Kopolrat, Panchamapohn Rattanahon, Sribud Srichaijaroonpong, Piyapong Chaiyasarn, Narita Fakkaew, Nutta Taneepanichskul, Ratanee Kammoolkon
International Journal of Environmental Research and Public Health.2026; 23(7): 899. CrossRef

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

5,258 View
416 Download
1 Crossref

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.

Citations

Citations to this article as recorded by

Faith-Integrated Education and Rabies Prevention Behaviors among Dog-Owning Households: A Qualitative Phenomenological Study in Indonesia
Maria Kornelia Ringgi Kuwa, Marianus Oktavianus Wega, Maria Sofia Anita Aga
International Journal of Health Concord.2025; 1(2): 99. CrossRef

Knowledge, Attitudes, and Practices Regarding Influenza Vaccination Among Healthcare Workers in Saudi Arabia: A Cross-sectional Study: Laila M. Almutairi, Mona A. Almusawi, Abeer M. Albalawi, Musallam Y. Abu Hassan, Adel F. Alotaibi, Tariq M. Almutairi, Randah M. Alalweet, Abdullah M. Asiri; J Prev Med Public Health. 2024;57(6):586-594. Published online November 8, 2024; DOI: https://doi.org/10.3961/jpmph.24.283

10,953 View
323 Download
4 Web of Science
6 Crossref

Abstract Summary PDF Supplementary Material

Objectives
Influenza vaccination is important for healthcare workers in order to prevent both the illness itself and transmission to patients. Previous studies in Saudi Arabia have revealed low influenza vaccine coverage among healthcare workers due to misconceptions. This study aimed to assess knowledge, attitudes, and practices regarding influenza vaccination among healthcare workers during 2021, addressing the current data gap.
Methods
A cross-sectional study was conducted, including 1273 healthcare workers from the Ministry of Health in Saudi Arabia. A self-administered questionnaire was distributed to participants via email.
Results
Most participants had an appropriate extent of knowledge, with 37.1% having a high level and 26.6% having a moderate level. Positive attitudes toward the influenza vaccine were observed in 41.2% of participants, and 80.2% demonstrated good vaccine practices. However, the vaccine coverage was 50.8% in the past 12 months. Factors associated with vaccine uptake included previous vaccination, workplace availability, awareness of guidelines, engagement in training programs, type of workplace settings, and having positive attitudes toward the vaccine. The most common reason for not getting vaccinated was the perception of being at low risk, making vaccination unnecessary.
Conclusions
Participants exhibited positive knowledge, attitudes, and practices regarding influenza vaccination. However, the observed vaccine uptake rate fell below the recommended coverage rate, indicating the presence of a knowledge-behavior gap. Targeted interventions are recommended to improve vaccination uptake among healthcare workers in Saudi Arabia.

Summary

Key Message
This study assesses knowledge, attitudes, and practices regarding influenza vaccination among healthcare workers in Saudi Arabia, and reveals that most participants had an appropriate extent of knowledge, positive attitudes toward the influenza vaccine, and good vaccine practices. However, the vaccine uptake rate was below the desired coverage target, indicating a knowledge-behavior gap. Our findings suggest implementing interventions that enhance accessibility, provide workplace support, conduct awareness campaigns, and tackle barriers impeding vaccination, to improve uptake rates among healthcare workers in Saudi Arabia.

Citations

Citations to this article as recorded by

Nationwide Patterns and Predictors of Sick Leave Among Healthcare Workers in Kuwait, 2022
Saleh Alsarhan, Lolwah Alzafiri, Eiman Alawadhi
Healthcare.2026; 14(6): 758. CrossRef
Seasonal Influenza Vaccine Uptake, Acceptance and Willingness to Vaccinate in Post-COVID-19 Vaccine Era Among Adult High-Risk Groups in Gulf Cooperation Council Countries (GCC): A Narrative Review of the Literature
Moath Aljohani
Vaccines.2026; 14(4): 351. CrossRef
Vaccination Practices Regarding Seasonal Influenza Vaccine Among Healthcare Workers of a Tertiary Care Hospital in Kashmir: A Cross-Sectional Study
Basina Gulzar, Syed Najmul Ain
International Journal of Health Sciences and Research.2026; : 9. CrossRef
Vaccination Adherence and Barriers Among Non-healthcare Workers and Volunteers During the Hajj
Mohammed E Shaybah, Osama Alsehli, Ali Al Harthi, Rami M Babukur, Baher Alwaraky, Mohammed Bafaqih, Muhab Masoud, Mohammed Alzhrani, Abdulghafur Kashgari, Abdualrahman Al-Asmari , Mokhtar M Shatla, Majed Obaid
Cureus.2026;[Epub] CrossRef
National expert consensus recommendations on influenza vaccination in Saudi Arabia (2025)
Ashraf Al Amir, Abdullah Alshehri, Ali Al Barrak, Fayssal Farahat, Hala Joharjy, Hassan Omran, Khalid Elawad, Mahdi Alnamnakani, Majed Alshamrani, Majid S. Al-Thaqafy, Nisreen AlSherbeeni, Omar Alzomor, Reem Alameer, Najim Z. Alshahrani
Journal of Family and Community Medicine.2026; 33(3): 167. CrossRef
Assessing the Determinants of Influenza Vaccine Uptake in Malaysia: Strategies to Improve Public Health and Service Delivery
Prebha Manickam, Tina Varghese, Suwarna Senthilvasan, Rubithra Ramesh, Suveitra Balanei Balasubramaniam
Cureus.2025;[Epub] CrossRef

Necessity of Analyzing the Korea Community Health Survey Using 7 Local Government Types: Seowoo Park, Haibin Bai, Jae-ryun Lee, Soomin Kim, Hyemin Jung, Jin Yong Lee; J Prev Med Public Health. 2025;58(1):83-91. Published online November 5, 2024; DOI: https://doi.org/10.3961/jpmph.24.388

9,235 View
504 Download
1 Web of Science

Abstract Summary PDF Supplementary Material: Objectives
This study examined the potential of a new analytical framework for the Korea Community Health Survey (KCHS) with classification criteria for the sub-national governmental level, the degree of urbanization including an urban-rural multimodal category, and population size as a more effective tool to address local health problems and deduce practical implications.
Methods
Retrospective survey data from 2023 KCHS were obtained. Frequency analyses were performed for self-rated good health status, current smoking status, and unmet medical needs as proxies for health status, as well as health behavior and healthcare utilization, utilizing individual weights to represent national community residents.
Results
We established a new classification of local governments into 7 types to facilitate regional comparisons. These local government types are presumably composed of populations showing statistically significant differences in demographic characteristics. There were evident differences in health status, health behavior, and healthcare utilization in comparisons of groups categorized by local government types.
Conclusions
This study suggests that regional disparities can be analyzed using a new typology of local governments. This practically effective approach could be used in decision-making for community-centered health projects in terms of community health planning. Future research should conduct analyses of KCHS data that use these 7 local government types to comprehensively reflect regional characteristics.; Summary

Korean summary
이 연구는 지방자치단체 층위와 도·농복합시를 포함한 도시화 정도, 인구 규모를 고려한 분류 기준을 사용하여 지역사회건강조사(KCHS)에 대한 새로운 분석틀의 가능성을 검토한다. 기초 지방자치단체 7가지 유형으로 분류했을 때, 연구 대상자 집단은 인구 통계학적 특성에 대해 유의미하게 달랐으며 건강 상태, 건강 행태 및 의료 이용에 뚜렷한 차이를 보였다. 이 연구는 지역보건의료계획 측면에서 지역사회 중심 건강증진사업에 대한 의사 결정에 실질적으로 효과적인 접근 방법이 될 수 있는 기초 지방자치단체의 새로운 유형을 제안한다.

Key Message
This study examines the potential of a new analytical framework for the Korea Community Health Survey (KCHS) with classification criteria for the sub-national governmental level, the degree of urbanization including an urban-rural multimodal category, and population size. In comparisons of groups categorized by 7 local government types, populations were significantly different considering demographic characteristics and there were evident differences in health status, health behavior, and healthcare utilization. This study suggests a new typology of local governments which could be a practically effective approach in decision-making for community-centered health projects in terms of community health planning.

Institutional Delivery in the Philippines: Does a Minimum of 8 Antenatal Care Visits Matter?: Felly Philipus Senewe, Agung Dwi Laksono, Roy Glenn Albert Massie, Leny Latifah, Syarifah Nuraini, Rozana Ika Agustiya, Jane Kartika Propiana, Wahyu Pudji Nugraheni; J Prev Med Public Health. 2025;58(1):44-51. Published online October 22, 2024; DOI: https://doi.org/10.3961/jpmph.24.245

23,834 View
770 Download
3 Web of Science
2 Crossref

Abstract Summary PDF

Objectives
This cross-sectional study investigated the association between the utilization of 8 antenatal care (ANC) visits and delivery in a healthcare institution in the Philippines, using data from the 2022 National Demographic and Health Survey.
Methods
A sample of women who had given birth within the past 3 years was selected for analysis (n=4452). The association between ANC utilization and institutional delivery was assessed using logistic regression models, covariates by relevant socio-demographic factors, and childbirth history.
Results
We found that 97.2% of respondents who completed ANC opted for institutional delivery. A higher proportion of rural residents did not undergo institutional delivery than urban residents (12.9 vs. 6.9%). The group aged 20-24 years had the highest coverage (92.8%), and the group aged 40-44 years had the lowest. Higher education levels, employment, and greater wealth were associated with higher institutional delivery rates. Divorced or widowed mothers (85.1%) and grand multiparous mothers had lower rates than other groups. Multivariable logistic regression analysis showed a significant positive association between ANC utilization and institutional deliveries after adjusting for covariates (adjusted odds ratio, 2.486; 95% confidence interval, 2.485 to 2.487; p<0.001).
Conclusions
ANC visits were associated with deliveries in institutions in the Philippines. Policymakers should promote ANC by ensuring 8 World Health Organization-recommended visits, strengthening programs, conducting community outreach, addressing access barriers, and integrating maternal health services to increase institutional births and improve maternal and infant health.

Summary

Key Message
This study examines the determinants of institutional delivery in the Philippines, with a focus on compliance with the WHO-recommended eight antenatal care (ANC) visits. Analysis of data from the 2022 National Demographic and Health Survey reveals a strong positive correlation between completing the recommended ANC visits and choosing institutional delivery, alongside significant influences from maternal age, education, marital status, employment, socioeconomic status, and parity. Findings underscore the importance of expanding ANC access and targeted interventions, particularly in underserved areas, to increase institutional delivery rates and improve maternal and neonatal health outcomes.

Citations

Citations to this article as recorded by

Correlates of facility-based childbirth: A health belief model approach using the National Demographic and Health Survey - Philippines
Denise B. Musni, Maria Paz N. Marquez
Philippine Journal of Health Research and Development.2025; 29(4): 34. CrossRef
Prevalence and risk factors of stillbirths among pregnant women from twelve high-volume birthing facilities of Karachi, Pakistan: a longitudinal cohort study
Danya Arif Siddiqi, Muhammad Zia Muneer, Sundus Iftikhar, Mubarak Taighoon Shah, Vijay Kumar Dharma, Fatima Miraj, Mariam Mehmood, Irshad Ali Sodhar, Farrukh Raza Malik, Subhash Chandir
BMC Pregnancy and Childbirth.2025;[Epub] CrossRef

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

27,860 View
836 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.

Incidence and Influencing Factors of Avoidable Mortality in Korea From 2013-2022: Analysis of Cause-of-death Statistics: Jeong Min Yang, Jieun Hwang; J Prev Med Public Health. 2024;57(6):540-551. Published online September 23, 2024; DOI: https://doi.org/10.3961/jpmph.24.232

7,680 View
277 Download
1 Web of Science
1 Crossref

Abstract Summary PDF Supplementary Material

Objectives
This study aimed to identify trends in avoidable mortality (AVM) in 16 provincial and metropolitan regions of Korea and determine the factors influencing AVM.
Methods
First, the avoidable mortality rate (AVMR) was calculated using the Statistics Korea cause-of-death and population data by age and region from 2013 to 2022. Second, a health determinants model was built, and we identified the factors influencing AVM using generalized estimating equations analysis.
Results
Although the AVMR per 100 000 people displayed a steadily decreasing trend from 2013 to 2020, it began to increase in 2021. Meanwhile, Jeonnam, Jeonbuk, Gyeongnam, Gyeongbuk, Chungnam, Chungbuk, and Gangwon Provinces showed a higher AVMR than the national average. The analysis revealed that each 1-unit increase in the older adult population, smoking, perceived stress, or non-local medical utilization was associated with an increase in the AVMR. Conversely, 1-unit increases in the male-to-female ratio, marriage rate, positive self-rated health, local medical utilization, doctor population, influenza vaccination rate, cancer screening rate, or financial independence were associated with decrease in the AVMR.
Conclusions
This study established that the AVMR, which had been continuously decreasing across the 16 regions, shifted to an increasing trend in 2021. We also identified several factors influencing AVM. Further studies are needed to confirm the reasons for this shift in the AVMR and explore the factors that influence AVM across Korea’s 16 provincial and metropolitan regions.

Summary

Korean summary
본 연구는 전국 및 16개 시도의 회피가능사망률 추이를 파악하고 건강결정요인 모형을 통해 영향요인을 파악하기 위함이다. 분석 결과, 전반적으로 2013년부터 2020년까지 회피가능사망률은 감소 추세를 보였으나, 2021년을 기점으로 회피가능사망률이 증가하였으며, 지역별 회피가능사망률의 편차가 존재하였다. 본 연구를 통해 우리나라의 회피가능사망 현황을 파악할 수 있으며, 향후 조기사망 감소를 위한 기초 근거로 활용될 수 있을 것으로 판단한다.

Key Message
This study examines trends in avoidable mortality (AVM) rates across Korea and its 16 provinces, identifying factors using a health determinant model. From 2013 to 2020, AVM rates declined, but an increase was observed from 2021. These findings highlight the current state of AVM in Korea and offer key insights for strategies to reduce premature deaths.

Citations

Citations to this article as recorded by

Exploring the association between community-level factors and health literacy using multilevel analysis
Inhyung Cho, Sung-il Cho
BMC Public Health.2025;[Epub] CrossRef

Healthcare Utilization and Discrepancies by Income Level Among Patients With Newly Diagnosed Type 2 Diabetes in Korea: An Analysis of National Health Insurance Sample Cohort Data: Eun Jee Park, Nam Ju Ji, Chang Hoon You, Weon Young Lee; J Prev Med Public Health. 2024;57(5):471-479. Published online August 20, 2024; DOI: https://doi.org/10.3961/jpmph.24.165

8,027 View
259 Download
5 Web of Science
5 Crossref

Abstract Summary PDF

Objectives
The use of qualitative healthcare services or its discrepancy between different income levels of the type 2 diabetes (T2D) patients has seldom been studied concurrently. The present study is unique that regarding T2D patients of early stages of diagnosis. Aimed to assess the utilization of qualitative healthcare services and influence of income levels on the inequality of care among newly diagnosed patients with T2D.
Methods
A retrospective cohort study of 7590 patients was conducted by the National Health Insurance Service National Sample Cohort 2.0 from 2002 to 2015. Insured employee in 2013 with no history of T2D between 2002 and 2012 were included. The standard of diabetes care includes hemoglobin A1c (HbAlc; 4 times/y), eyes (once/y) and lipid abnormalities (once/y). Multivariate logistic regression analysis was performed to examine the difference between income levels and inequality of care.
Results
From years 1 to 3, rates of appropriate screening fell from 16.9% to 14.1% (HbA1c), 15.8% to 14.5% (eye), and 59.2% to 33.2% (lipid abnormalities). Relative to income class 5 (the highest-income group), HbA1 screening was significantly less common in class 2 (year 2: odds ratio [OR], 0.78; 95% confidence interval [CI], 0.61 to 0.99; year 3: OR, 0.79; 95% CI, 0.69 to 0.91). In year 1, lipid screening was less common in class 1 (OR, 0.84; 95% CI, 0.73 to 0.98) than in class 5, a trend that continued in year 2. Eye screening rates were consistently lower in class 1 than in class 5 (year 1: OR, 0.73; 95% CI, 0.60 to 0.89; year 2: OR, 0.63; 95% CI, 0.50 to 0.78; year 3: OR, 0.81; 95% CI, 0.67 to 0.99).
Conclusions
Newly diagnosed T2D patients have shown low rate of HbA1c and screening for diabetic-related complications and experienced inequality in relation to receiving qualitative diabetes care by income levels.

Summary

Korean summary
의료서비스 이용의 강도와 질을 측정하는 당뇨 관련 합병증 검진율은 저소득층에서 특히 낮았습니다. 보편적 건강 보장이 있는 국가에서도 신환환자 특히 낮은 경제적 계층의 치료 불균형을 해소 하기 위해서는 재정적 부담은 절감하고, 건강 문해력 증진시키고, 일차의료 기관의 기능을 최적화 하여 책임을 강화하는 것이 필요합니다.

Key Message
Diabetic-related complications screening rates that measure the intensity and quality of medical care service usage were statistically lower in low-income groups. Reducing financial burden, promoting health literacy and optimizing the function of primary care physician and reinforcing the health care provider’s accountability are necessary to address the discrepancy of care for those with low socioeconomic status people in early stage of disease, even in nations with universal health coverage.

Citations

Citations to this article as recorded by

Smoking Cessation and Relapse Transitions Before and After Cigarette Price Increases among Korean Adults
Hana Kim, Heewon Kang, Jieun Hwang, Sung-il Cho
Journal of the Korean Society for Research on Nicotine and Tobacco.2026; 17(2): 54. CrossRef
Income level and the risk of incident dementia among adults aged ≥50 with newly diagnosed type 2 diabetes: a population-based cohort study using the NHIS-Senior database in South Korea
Su-Min Park, Ah Jung Ko, Jae Hyeok Lim, Eun-Cheol Park
BMJ Open.2026; 16(7): e112641. CrossRef
Utilization of glycated hemoglobin testing in the Korean health check-up population from local clinics and hospitals and its impact on diabetes and prediabetes classification
Rihwa Choi, Mi-Jung Park, Sang Gon Lee
BMC Endocrine Disorders.2026;[Epub] CrossRef
Older Adults with Diabetes in Korea: Latest Clinical and Epidemiologic Trends
Kyuho Kim, Bongseong Kim, Kyuna Lee, Yu-Bae Ahn, Seung-Hyun Ko, Sung Hee Choi, Kyungdo Han, Jae-Seung Yun
Diabetes & Metabolism Journal.2025; 49(2): 183. CrossRef
Long-term clinical outcome and risk stratification across stages of cardiovascular-kidney-metabolic syndrome in a nationwide cohort
Hyun-Jin Kim, Byung Sik Kim, Hasung Kim, Jungkuk Lee, Ha Hye Jo, Dong Wook Kim, Jeong-Hun Shin, Ki-Chul Sung
The Korean Journal of Internal Medicine.2025; 40(6): 975. CrossRef

Effects of the Local Environment and Nutritional Status on the Incidence of Acute Respiratory Infections Among Children Under 5 Years Old in Indonesia: Tri Bayu Purnama, Keita Wagatsuma, Masdalina Pane, Reiko Saito; J Prev Med Public Health. 2024;57(5):461-470. Published online August 2, 2024; DOI: https://doi.org/10.3961/jpmph.24.246

12,358 View
543 Download
5 Web of Science
6 Crossref

Abstract Summary PDF Supplementary Material

Objectives
This study aimed to map the incidence of acute respiratory infections (ARIs) among under-5 children in Indonesia, address the triple burden of malnutrition, and analyze the impact of malnutrition on ARIs, taking into account the environmental and wealth disparities in Indonesia.
Methods
This study utilized an ecological design, analyzing aggregate data from the Indonesia Nutrition Survey, 2022. It encompassed 33 provinces and 486 districts/cities, involving a total of 334 878 children under 5 years of age. Partial least squares structural equation modeling was employed to investigate the relationships among wealth, environment, malnutrition (stunting, wasting, and underweight), and ARIs.
Results
The proportion of ARI cases in Indonesia was generally concentrated in central Sumatra, the western and eastern parts of Java, and eastern Papua. In contrast, the northern part of Sumatra, central Kalimantan, central Sulawesi, and central Papua had a higher proportion of malnutrition cases compared to other regions. Negative associations were found between malnutrition and ARIs (path coefficient =-0.072; p<0.01) and between wealth and environment (path coefficient =-0.633; p<0.001), malnutrition (path coefficient=-0.399; p<0.001), and ARIs (path coefficient=-0.918; p<0.001).
Conclusions
An increasing wealth index is expected to contribute to reducing ARIs, malnutrition and environmental burdens in the future. This study emphasizes the necessity for focused strategies that address both immediate health challenges and the underlying socioeconomic determinants to improve child health outcomes in the Indonesian context.

Summary

Key Message
In Indonesia, Acute Respiratory Infections (ARI) cases were predominantly concentrated in central Sumatra, western and eastern Java, and eastern Papua, while malnutrition cases were more prevalent in northern Sumatra, central Kalimantan, central Sulawesi, and central Papua. A negative association was observed between malnutrition and ARIs. Additionally, wealth had significant negative associations with the environment, malnutrition, and ARIs, suggesting socio-environmental disparities contribute to health outcomes in these regions.

Citations

Citations to this article as recorded by

Multidimensional energy poverty and childhood respiratory health across 26 low and lower middle income countries
Cailiang Xia, Maryam Sadiq, Sidra Younas
Scientific Reports.2026;[Epub] CrossRef
Exploration of the Temporal Trends, Prevalence, and Factors of Acute Respiratory Infection or Diarrhoea: A Cross‐Sectional Analysis of Three National Surveys
Mahdia Ahmed, Md Fuad Al Fidah, Mahabub Uz Zaman, Md Ridwan Islam, Tahmeed Ahmed, Mustafa Mahfuz
Health Science Reports.2026;[Epub] CrossRef
Household Water and Sanitation Practices and Their Association With Diarrheal and Acute Respiratory Infections Among Children Under Five in Ghana: A Cross‐Sectional Predictive Model and Spatial Analysis
Yula Salifu, Paul Gyan, Joseph Lasong, Williams Walana
Health Science Reports.2026;[Epub] CrossRef
Demographic and infectious profiles of stunted children under five in Central Java: Evidence from the 2023 Indonesian Health Survey
Siti Maisyaroh Bakti Pertiwi, Muhammad Fahri Firdaus, Naela Fadhila, Bela Prasasti, Petro Mathias Ongoma
BIO Web of Conferences.2026; 247: 02013. CrossRef
Prevalence and risk factors of acute respiratory infection and diarrhea among children under 5 years old in low-middle wealth household, Indonesia
Tri Bayu Purnama, Keita Wagatsuma, Reiko Saito
Infectious Diseases of Poverty.2025;[Epub] CrossRef
Geographical variation in community-acquired pneumonia prevalence during the COVID-19 pandemic in northern Sumatra, Indonesia
Tri Bayu Purnama, Keita Wagatsuma, Masdalina Pane, Reiko Saito
Discover Public Health.2025;[Epub] CrossRef

Workstation Risk Factors for Work-related Musculoskeletal Disorders Among IT Professionals in Indonesia: Tofan Agung Eka Prasetya, Nurul Izzah Abdul Samad, Aisy Rahmania, Dian Afif Arifah, Ratih Andhika Akbar Rahma, Abdullah Al Mamun; J Prev Med Public Health. 2024;57(5):451-460. Published online July 25, 2024; DOI: https://doi.org/10.3961/jpmph.24.214

19,308 View
677 Download
4 Web of Science
5 Crossref

Abstract Summary PDF

Objectives
This study aimed to identify workstation factors influencing work-related musculoskeletal disorders (WMSDs) among information technology (IT) professionals in Indonesia.
Methods
A cross-sectional study was conducted among 150 IT workers at small-enterprise companies who were randomly selected across East Java, Indonesia. The data were modeled using multiple linear regression, with a 95% level of confidence for determining statistical significance.
Results
The respondents reported that the neck had the highest level of discomfort and was the most at risk of WMSDs, followed by the lower back, right shoulder, and upper back. Screen use duration (p=0.040) was associated with whole-body WMSDs, along with seat width (p=0.059), armrest (p=0.027), monitor (p=0.046), and a combined telephone and monitor score (p=0.028). Meanwhile, the factors significantly related to the risk of WMSDs in the hands and wrist were working period (p=0.039), night shift (p=0.024), backrest (p=0.008), and mouse score (p=0.032).
Conclusions
Occupational safety authorities, standards-setting departments, and policymakers should prioritize addressing the risk factors for WMSDs among IT professionals.

Summary

Key Message
This study investigates workstation risk factors contributing to work-related musculoskeletal disorders (WMSDs) among IT professionals in Indonesia. Findings indicate that neck discomfort is the most prevalent, with significant associations identified between WMSDs and factors such as screen use duration, seating arrangements, and work conditions. The results underscore the need for ergonomic improvements and targeted preventive measures to enhance occupational health and safety for IT workers.

Citations

Citations to this article as recorded by

Evaluation of working posture and neck pain among IT professionals – an observational study
Amita Aggarwal, Tushar J. Palekar
International Journal of Occupational Safety and Ergonomics.2026; : 1. CrossRef
The correlation between workplace ergonomics and musculoskeletal complains in Iranian technical and vocational training organization; a semi-quantitative study to provide preventive educational strategies
Maryam Ebrahimi, Fereshteh Kordestani, Mohammad Ghasemi
Journal of Education and Health Promotion.2026;[Epub] CrossRef
Workplace Risks for IT Professionals Associated with Barriers to Healthy Behavior: A Review of International Research in the Context of the Healthy Workplace Model
Olga O. Gofman, Elena Shumeiko, German S. Nikiforov
RUDN Journal of Psychology and Pedagogics.2026; 22(4): 671. CrossRef
Integrative risk mapping of musculoskeletal disorders among office workers: a hybrid Delphi–Fuzzy AHP approach
Marzieh Abbasinia, Elham Entezarizarch
BMC Musculoskeletal Disorders.2026;[Epub] CrossRef
Work-related musculoskeletal disorders and digitalization: past adoption, current utilization, and future concerns
Young-Mee Kim, Sung-il Cho
BMC Public Health.2025;[Epub] CrossRef

HIV-related Perceptions, Knowledge, Professional Ethics, Institutional Support, and HIV/AIDS-related Stigma in Health Services in West Sumatra, Indonesia: An Empirical Evaluation Using PLS-SEM: Vivi Triana, Nursyirwan Effendi, Brian Sri Pra Hastuti, Cimi Ilmiawati, Dodi Devianto, Afrizal Afrizal, Adang Bachtiar, Rima Semiarty, Raveinal Raveinal; J Prev Med Public Health. 2024;57(5):435-442. Published online July 15, 2024; DOI: https://doi.org/10.3961/jpmph.23.503

5,905 View
386 Download
1 Web of Science

Abstract Summary PDF: Objectives
The aim of this study was to investigate the significance of associations between knowledge, professional ethics, institutional support, perceptions regarding HIV/AIDS, and HIV/AIDS-related stigma among health workers in West Sumatra, Indonesia.
Methods
We conducted a cross-sectional study involving health workers at public hospitals and health centers in West Sumatra in June 2022. The Health Care Provider HIV/AIDS Stigma Scale was employed to assess the stigma associated with HIV/AIDS. To estimate and evaluate the model’s ability to explain the proposed constructs, we utilized the standardized partial least squares structural equation model (PLS-SEM).
Results
In total, 283 individuals participated in this study (average age, 39 years). The majority were female (91.2%), nearly half were nurses (49.5%), and 59.4% had been working for more than 10 years. The study revealed that HIV/AIDS-related stigma persisted among health workers. The PLS-SEM results indicated that all latent variables had variance inflation factors below 5, confirming that they could be retained in the model. Knowledge and professional ethics significantly contributed to human immunodeficiency virus (HIV)-related stigma, with an effect size (f²) of 0.15 or greater. In contrast, perceived and institutional support had a smaller impact on HIV-related stigma, with an effect size (f²) of at least 0.02. The R 2 value for health worker stigma was 0.408, suggesting that knowledge, professional ethics, institutional support, and perceived support collectively explain 40.8% of the variance in stigma.
Conclusions
Improving health workers’ understanding of HIV, fostering professional ethics, and strengthening institutional support are essential for reducing HIV-related stigma in this population.; Summary

Key Message
This study explores the relationships between HIV knowledge, professional ethics, institutional support, perceptions of HIV/AIDS, and HIV/AIDS-related stigma among healthcare workers in West Sumatra, Indonesia. Using a PLS-SEM model, the analysis reveals that HIV knowledge and professional ethics significantly reduce HIV-related stigma, while the effects of perceptions and institutional support are less pronounced. The model explains 40.8% of the variance in stigma, highlighting the critical role of improving HIV knowledge, fostering ethical conduct, and strengthening institutional support. These findings suggest that comprehensive strategies addressing these factors are essential to reducing HIV/AIDS stigma in healthcare settings.

The Associations Between Physical Activity and Mental Health Problems in Middle-aged Indonesians: Sri Handayani, Siti Isfandari, Diyan Ermawan Effendi, Rozana Ika Agustiya, Irfan Ardani, Arief Priyo Nugroho, Yunita Fitrianti; J Prev Med Public Health. 2024;57(4):379-387. Published online July 12, 2024; DOI: https://doi.org/10.3961/jpmph.24.003

9,073 View
385 Download
1 Web of Science
3 Crossref

Abstract Summary PDF

Objectives
Mental health issues have become a growing concern worldwide. Research has shown that regular physical activity (PA) can positively affect mental health. This study investigated the associations between PA and mental health problems (MHPs) in middle-aged Indonesians.
Methods
The study utilized data from the 2018 Indonesian Basic Health Research Survey and used a cross-sectional approach. The participants included individuals aged 40-60 years who completed the 20-question Self-Reporting Questionnaire. A logistic regression was performed to analyze a sample of 263 930 data points.
Results
Nearly 10.4% of the participants suffered from mental health issues. Notably, among those who did not engage in moderate and vigorous PA, a sign of MHPs was found in 12.5% of participants. Those who met World Health Organization standards for PA were less likely to experience MHPs (10.1%). This study found a significant association between PA and mental health. After adjusting for smoking, alcohol consumption, non-communicable diseases, and socio-demographic variables like age, sex, education, occupation, marital status, and residence, the connection between PA and mental health became even stronger (adjusted odds ratio, 0.81; 95% confidence interval, 0.78 to 0.85; p<0.001).
Conclusions
Regular PA has been shown to affect mental health positively. Therefore, it is important to improve health education and efforts to raise awareness among middle-aged Indonesians about the importance of PA in maintaining good mental health.

Summary

Key Message
This study revealed a significant association between physical activity (PA) and mental problems (MHPs) among middle-aged Indonesians. Individuals who engaged in moderate to vigorous PA were less likely to experience MHPs compared to those who did not meet recommended PA levels. This association remained strong after adjusting confounding variables such as smoking, alcohol consumption, non-communicable diseases, and socio- demographic factors. Therefore, promoting regular physical activity could be a beneficial strategy for improving mental health status in this population.

Citations

Citations to this article as recorded by

USO DE ANTIDEPRESSIVOS E ANSIOLÍTICOS PÓS PANDEMIA E SEUS IMPACTOS: REVISÃO DE LITERATURA
Francivania Silva de Oliveira, Francisca Sabrina Vieira Lins, José Guilherme Ferreira Marques Galvão, Diego Igor Alves Fernandes de Araújo, Rafaela de Oliveira Nóbrega
Revista Multidisciplinar do Nordeste Mineiro.2025; 10(1): 1. CrossRef
Domain-specific physical activity and depressive symptoms in Korean adults: An isotemporal substitution study using KNHANES data
Jungmi Park, Hee-Kyoung Nam, Sung-Il Cho, Henri Tilga
PLOS One.2025; 20(12): e0338722. CrossRef
PREVALÊNCIA DO USO DE ANTIDEPRESSIVOS E/OU ANSIOLÍTICOS EM PRATICANTES DE ATIVIDADE FÍSICA DE UMA ACADEMIA DE TERESINA
Mariana Lima Teixeira, Ivair de Sousa Lima, Luís Felipe Araújo Pereira Lustosa, Paula Lins Gonçalves, Aureliano Machado de Oliveira
Revista Contemporânea.2024; 4(12): e7097. CrossRef

Causal Model of Herb Use Behavior Among Working-age Adults in Thailand: Pitchada Prasittichok, Patcharee Duangchan, Sattawat Prapasiri, Ungsinun Intarakamhang; J Prev Med Public Health. 2024;57(4):399-406. Published online June 21, 2024; DOI: https://doi.org/10.3961/jpmph.23.554

8,341 View
356 Download

Abstract Summary PDF: Objectives
This study developed a causal relationship model of herb use from observational data and analyzed the direct and indirect effects of herb use on health according to the model.
Methods
A cross-sectional study was conducted with 400 participants aged 26-59 years, selected through multistage random sampling. The instruments used for data collection included demographic information, herb use, health literacy (HL), perceived social support, societal values, and attitudes toward herb use. The conceptual model, hypothesized based on prior evidence, was tested using confirmatory factor analysis through structural equation modeling. Path coefficients were estimated using the maximum likelihood method.
Results
The final model utilized empirical data, which showed that perceived social support had the most significant impact on herb use. This was followed by HL, positive attitudes toward herbal remedies, and societal values, with coefficients of 0.31, 0.18, and 0.16, respectively. When analyzing variables that indirectly affected herb use, it was clear that positive attitudes, perceived social support, and societal values significantly influenced herb use through HL, with influence coefficients of 0.08, 0.16, and 0.04, respectively. Together, these variables accounted for 68% of the variance in herb use.
Conclusions
The findings from this study can be utilized to develop and implement strategies that guide the use of herbal products, ultimately aiming to improve human health.; Summary

Key Message
A causal relationship model of herb use was created from observational data in this research, and the direct and indirect impacts of herb use on health were examined based on the model. The most vital factor influencing the use of herbal remedies is the level of social support perceived by an individual. Significant roles are also played by health literacy, positive attitudes toward herbal remedies, and societal values. Positive outlooks, community backing, and cultural principles indirectly influence the utilization of herbal remedies through health literacy. The research results can help develop approaches to encourage the correct usage of herbal items, ultimately improving public health.

The Impact of COVID-19 on Healthcare Services in Bangladesh: A Qualitative Study on Healthcare Providers’ Perspectives: Sharmin Parveen, Md. Shahriar Mahbub, Nasreen Nahar, K. A. M. Morshed, Nourin Rahman, Ezzat Tanzila Evana, Nazia Islam, Abu Said Md. Juel Miah; J Prev Med Public Health. 2024;57(4):356-369. Published online June 9, 2024; DOI: https://doi.org/10.3961/jpmph.24.081

12,261 View
372 Download
2 Web of Science
4 Crossref

Abstract Summary PDF

Objectives
The objective of this study was to explore healthcare providers’ experiences in managing the coronavirus disease 2019 (COVID-19) pandemic and its impact on healthcare services.
Methods
A qualitative study was conducted with 34 healthcare professionals across 15 districts in Bangladesh. Among the participants, 24 were health managers or administrators stationed at the district or upazila (sub-district) level, and 10 were clinicians providing care to patients with COVID-19. The telephone interviews were conducted in Bangla, audio-recorded, transcribed, and then translated into English. Data were analyzed thematically.
Results
Most interviewees identified a range of issues within the health system. These included unpreparedness, challenges in segregating COVID-19 patients, maintaining isolation and home quarantine, a scarcity of intensive care unit beds, and ensuring continuity of service for non-COVID-19 patients. The limited availability of personal protective equipment, a shortage of human resources, and logistical challenges, such as obtaining COVID-19 tests, were frequently cited as barriers to managing the pandemic. Additionally, changes in the behavior of health service seekers, particularly increased aggression, were reported. The primary motivating factor for healthcare providers was the willingness to continue providing health services, rather than financial incentives.
Conclusions
The COVID-19 pandemic presented a unique set of challenges for health systems, while also providing valuable lessons in managing a public health crisis. To effectively address future health crises, it is crucial to resolve a myriad of issues within the health system, including the inequitable distribution of human resources and logistical challenges.

Summary

Key Message
This qualitative study explored healthcare providers' perspectives on the impact of the COVID-19 pandemic on healthcare services. Issues within the health system, such as a lack of skilled human resources, insufficient critical care facilities, low coverage of COVID-19 tests, inadequate logistical support, poor health behaviors and practices among health service seekers posed barriers to managing the pandemic at different healthcare levels. Ensuring personal protection for health professionals in the face of a novel disease presented a significant challenge. Increasing resource allocation and developing the capacity of healthcare providers were identified as potential solutions.

Citations

Citations to this article as recorded by

Patterns of COVID-19 mortality during the second and third waves in Sri Lanka: a cross-sectional study from a tertiary care center
Shamila De Silva, Dileepa Ediriweera, Nimasha Ekanayake, Tharini Solangaarachchi, Kavinda Perera, Asanga Wickremasinghe, Rasika Liyanage
BMC Infectious Diseases.2026;[Epub] CrossRef
The Female Sex Workers' Experiences of Accessing Healthcare Services in Bangladesh: A Qualitative Investigation
Shaharior Rahman Razu, Kim Usher, Rikki Jones, Md. Shahidul Islam
Diversity & Inclusion Research.2025;[Epub] CrossRef
Impacts of Covid-19 on the Treatment of Kidney Dialysis Patients in Bangladesh: Lessons Learned and Future Directions

European Journal of Medical and Health Sciences.2025; : 533. CrossRef
Specific Trends in Blood Utilization During the COVID-19 Pandemic: A Retrospective Analysis of a Hungarian Clinical Centre
Sándor Pál, Margit Solymár, Barbara Réger, Hussain Alizadeh, András Vereczkei, Tamás Kiss, Zsuzsanna Faust
Journal of Clinical Medicine.2025; 14(22): 7943. CrossRef

First
Prev
Page of 10
Next
Last

Search