Journal of Preventive Medicine and Public Health

Original Articles

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

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

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

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

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

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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.

Association Between Non-adherence to Diabetes Management and Poor Sleep Quality Based on the Korean Community Health Survey: Horim A. Hwang, Hyunsuk Jeong, Hyeon Woo Yim; J Prev Med Public Health. 2025;58(3):260-268. Published online January 14, 2025; DOI: https://doi.org/10.3961/jpmph.24.486

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Abstract Summary PDF Supplementary Material

Objectives
Adhering to management guidelines, including routine follow-up and education, is crucial for the effective management of chronic diseases such as diabetes. Uncontrolled diabetes is linked to poor sleep quality. We used nationally representative data from community-dwelling Koreans to investigate potential associations between non-adherence to diabetes management and poor sleep quality.
Methods
Of the 228 340 participants in the 2018 Korea Community Health Survey, we analyzed data from 68 246 participants aged 65 years and older. Based on their diabetes status and adherence to diabetes-related tests (glycated hemoglobin, fundus examination, and urine microalbuminuria) and management education, study participants were divided into 3 groups: no diabetes, adherence, and non-adherence. Outcome variables included poor overall sleep quality and sleep disturbances, as measured by the Pittsburgh Sleep Quality Index.
Results
The study included 934 participants in the adherence group (2.0%) and 13 420 in the non-adherence group (20.2%). Participants displaying non-adherence were significantly more likely to report poor overall sleep quality (adjusted odds ratio [aOR], 1.09; 95% confidence interval [CI], 1.04 to 1.13) and to experience sleep fragmentation, nocturia, pain during sleep, and difficulty falling asleep compared to participants without diabetes. Even in the earlier stage of diabetes, non-adherent participants were more likely to report poor sleep quality (aOR, 1.06; 95% CI, 1.00 to 1.18).
Conclusions
Patients with diabetes who do not follow management guidelines are more likely to experience poor sleep quality than those without diabetes. Emphasizing diabetes management and increasing awareness of management strategies may improve sleep quality among patients with this disease.

Summary

Korean summary
혈당조절이 되지 않는 당뇨병이 수면 관련 문제의 발생 위험을 높이는 것은 기존 연구에서 알려져 있었으나, 당뇨관리 여부가 지역사회에 거주하는 당뇨환자들의 수면의 질에 미치는 영향은 충분히 탐구 되지 않았었다. 당뇨 관리 (연 2회 이상 당화혈색소 검사, 매년 당뇨합병증 검사, 당뇨관리교육 이수)에 순응하지 않는 당뇨환자들은 당뇨가 없는 일반인들에 비해 수면 문제를 호소할 가능성이 유의하게 높은 것이 확인되었다. 이는 당뇨 유병기간으로 층화분석하였을때도 일관되게 확인되었다.

Key Message
Uncontrolled diabetes is associated with increased risk of sleep-related problems, but the knowledge on the impact of poor diabetes management on the sleep quality of community dwelling patients with diabetes is limited. Diabetes patients who did not adhere to diabetes management (<2 hemoglobin A1c tests, did not take diabetes complication test, or received diabetes management education) were more significantly more likely to report overall poor sleep quality than those without diabetes. The above association remained significant when the patients were stratified by diabetes duration.

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Assessment of Sleep Quality and Its Determinants Among Patients with Type 2 Diabetes Mellitus in Mogadishu, Somalia: A Cross-Sectional Study
Nur Mohamed, Rahma Haji Mohamud, Fadumo Hilowle, Tigad Ali, Yusuf Abdirisak Mohamed, Adan Gabow, Hawa Mohamed, Nor Sidow, Mohamed Sheikh Hassan, Mohamud Waberi
Diabetes, Metabolic Syndrome and Obesity.2025; Volume 18: 1949. 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

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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.

Scoping Review

Use of Data Linkage Methods to Investigate Healthcare Interactions in Individuals Who Self-harm and Die by Suicide: A Scoping Review: Ferdi W. Djajadisastra; J Prev Med Public Health. 2025;58(2):114-126. Published online November 20, 2024; DOI: https://doi.org/10.3961/jpmph.24.448

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Abstract Summary PDF Supplementary Material: Objectives
In this review, the primary objective was to comprehensively summarize and evaluate the themes and analytical strategies of studies that used data linkage methods to examine the healthcare engagement of individuals with self-harming and suicidal tendencies. Additionally, the review sought to identify gaps in the existing literature and suggest directions for future research in this area.
Methods
This review utilized the PubMed, PsycINFO, and Scopus databases. Employing a scoping review methodology, 27 papers were analyzed.
Results
One particularly common data source is the routine information collected by government agencies. However, some studies supplement this data with newly collected information. Compared to other research methods, data linkage offers the advantage of incorporating participants from diverse backgrounds into the analysis. Most relevant studies using data linkage methods have primarily focused on identifying socio-demographic correlates of self-harm, suicide deaths, and healthcare interactions. Additionally, some studies have used cluster analysis to identify patterns of healthcare utilization within affected populations. Certain papers have employed unique methods to measure self-harm and healthcare interactions, while one study utilized a moderator analytical approach.
Conclusions
Data linkage offers a promising approach for researching the dynamics between self-harm, suicide, and healthcare contact. A notable challenge, however, is the focus of most studies on the associations between socio-demographic factors and the risks of self-harm and suicide.; Summary

Key Message
The scoping review aims to summarize and evaluate the themes and analytical strategies of studies that have used data linkage methods to examine the healthcare engagement of individuals with self-harming and suicidal tendencies. Data linkage offers a promising approach for researching the dynamics between self-harm, suicide, and healthcare contact. However, most studies primarily focus on the associations between socio-demographic factors and the risks of self-harm and suicide. Future research should emphasize the inclusion of additional variables through new data collection, integrating them with existing datasets, or adopting more innovative approaches to analyzing available data.

Original Articles

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

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

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

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

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Abstract Summary PDF

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

Summary

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

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

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

Perspective

Polypharmacy and Therapeutic Inertia in Extreme Longevity: A Potential Clinical Ageism Scenario Secondary to Important Gaps in Clinical Evidence: María Viviana Pantoja, Ivan David Lozada-Martinez; J Prev Med Public Health. 2024;57(5):508-510. Published online September 27, 2024; DOI: https://doi.org/10.3961/jpmph.24.364

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Abstract Summary PDF

Population aging is a global health priority due to the dramatic increase in the proportion of older persons worldwide. It is also expected that both global life expectancy and disability-free life expectancy will increase, leading to a significant rise in the proportion of individuals with extreme longevity, such as non-agenarians and centenarians. The inaccuracy of clinical evidence on therapeutic interventions for this demographic could lead to biased decision-making, influenced by age-related beliefs or misperceptions about their therapeutic needs. This represents a potential clinical ageism scenario stemming from gaps in clinical evidence. Such biases can result in 2 significant issues that adversely affect the health status and prognosis of older persons: polypharmacy and therapeutic inertia. To date, documents on polypharmacy in non-agenarians and centenarians account for less than 0.35% of the overall available evidence on polypharmacy. Furthermore, evidence regarding therapeutic inertia is non-existent. The purpose of this letter is to discuss polypharmacy and therapeutic inertia as potential clinical ageism scenarios resulting from the clinical evidence gaps in extreme longevity.

Summary

Key Message
The inaccuracy of clinical evidence on therapeutic interventions for extreme longevity (nonagenarians and centenarians) could lead to biased decision-making, influenced by age-related beliefs or misperceptions about their therapeutic needs: polypharmacy and therapeutic inertia. To date, documents on polypharmacy in nonagenarians and centenarians account for less than 0.35% of the overall available evidence on polypharmacy. Furthermore, evidence regarding therapeutic inertia is non-existent. This letter discusses polypharmacy and therapeutic inertia as potential clinical ageism scenarios resulting from the clinical evidence gaps in extreme longevity.

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Association between home care and health phenotype of centenarians: Is it a necessary new criterion in home health care?
Ivan David Lozada‐Martinez, Paula Andrea Correa‐Diaz, Jorge Luis Correa‐Rosales, Juan‐Manuel Anaya
Australasian Journal on Ageing.2025;[Epub] CrossRef

Original Articles

Factors Associated With Post-term Birth and Its Relationship to Neonatal Mortality in Japan: An Analysis of National Data From 2017 to 2022: Tasuku Okui, Naoki Nakashima; J Prev Med Public Health. 2024;57(6):564-571. Published online September 24, 2024; DOI: https://doi.org/10.3961/jpmph.24.355

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Abstract Summary PDF Supplementary Material: Objectives
Prior research has not yet examined the relationship between post-term birth and neonatal mortality in Japan, along with factors associated with post-term birth. We investigated these associations utilizing nationwide birth data from Japan.
Methods
Birth and mortality data were obtained from the Vital Statistics of Japan for the years 2017 to 2022. The post-term birth rate was calculated by birth characteristics, and the neonatal mortality rates for post-term and term births were computed. Additionally, log-binomial regression analysis was employed to explore the associations between post-term birth and neonatal mortality, as well as between various characteristics and post-term birth. The characteristics considered included infant sex, maternal age group, parity, maternal nationality, maternal marital status, and household occupation.
Results
This study analyzed data from 4 698 905 singleton infants born at 37 weeks of gestational age or later. Regression analysis revealed that post-term birth was positively associated with neonatal mortality. The adjusted risk ratio for neonatal mortality in post-term compared to term births was 8.07 (95% confidence interval, 5.06 to 12.86). Factors positively associated with post-term birth included female infant sex, older maternal age, primiparity, non-Japanese maternal nationality, unmarried status, and various household occupations, including farmer, full-time worker at a smaller company, other type of worker, and unemployed. Younger maternal age was inversely associated with post-term birth.
Conclusions
In Japan, post-term birth represents a risk factor for neonatal mortality. Additionally, socio-demographic characteristics, such as maternal marital status, nationality, and parity were found to be predictors of post-term birth.; Summary

Key Message
This study investigated the relationship between post-term birth and neonatal mortality in Japan, along with factors associated with post-term birth. Regression analysis revealed that post-term birth was significantly and positively associated with neonatal mortality. Additionally, socio-demographic characteristics, such as older maternal age, primiparity, non-Japanese maternal nationality, and unmarried status were found to be predictors of post-term birth.

The Influence of Family Adversities on Longitudinal Changes in Physical Inactivity Among Korean Adolescents During the COVID-19 Pandemic: Tae Kyoung Lee, Jing Zhu, Young Mi Kim, Ze-Kai Jiang, Meilin Zhang, Won Ha Choi, Tae-Young Pak, Hana Song; J Prev Med Public Health. 2024;57(5):443-450. Published online August 4, 2024; DOI: https://doi.org/10.3961/jpmph.24.236

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Abstract Summary PDF Supplementary Material: Objectives
Lack of physical activity has a critical effect on the physical and mental health of adolescents. This study examined the influence of family adversities on the longitudinal changes in physical inactivity among adolescents during the coronavirus disease 2019 (COVID-19) pandemic.
Methods
The study used multi-wave data from the Korean Children and Youth Panel Survey, including 2590 Korean adolescents aged 12-14 years. The longitudinal trajectory of physical inactivity among adolescents and the effects of related factors were estimated using a latent growth modeling method.
Results
Our results revealed a significant increase in physical inactivity among adolescents over time. At the onset of the pandemic, approximately one-seventh of Korean middle schoolers reported a lack of physical activity. However, 3 years later, during the quarantine, nearly one-fifth of these adolescents reported a significant increase in their physical inactivity. Initially, low level parental education was predictive of adolescents’ physical inactivity, but this effect diminished over time, becoming statistically insignificant by the end of the 3-year period. Moreover, the increase in physical inactivity over the 3 years was significantly influenced by parental rejection.
Conclusions
These findings suggest that adolescents who experience parental rejection are more likely to report an increase in sedentary behaviors in contexts such as the COVID-19 pandemic.; Summary

Korean summary
본 연구는 팬데믹 기간 동안 청소년의 신체 활동 변화와 신체 활동 부족에 대한 부정적 가정 환경의 영향을 조사했다. 한국 청소년 2,590명을 대상으로 한 3년간의 종단 패널 데이터를 잠재 성장 모형으로 분석하여 신체 활동 부족의 변화를 추적하였다. 그 결과, 팬데믹 기간 동안 청소년들의 신체 활동 부족이 현저히 증가했으며, 부모의 거부가 이러한 증가에 유의한 영향을 미친 것으로 나타났다.

Key Message
This study examined the impact of family adversities on the longitudinal changes in physical inactivity among 2,590 Korean adolescents during the COVID-19 pandemic. Over the 3-year period, physical inactivity increased significantly, with parental rejection playing a key role in this rise. While low parental education initially predicted higher levels of inactivity, its influence diminished over time.

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

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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.

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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
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

Association Between Objective Social Isolation and Unmet Medical Needs: A Nationwide Cross-sectional Study in Korea: Jeong Min Yang, Seul Ki Lee, Jae Hyun Kim; J Prev Med Public Health. 2024;57(3):242-251. Published online April 27, 2024; DOI: https://doi.org/10.3961/jpmph.23.516

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Abstract Summary PDF Supplementary Material: Objectives
The aim of this study was to analyze the relationship between objective social isolation (SI) and unmet medical needs (UMN) in adults aged 19 and older.
Methods
A cross-sectional analysis was conducted of 208 619 adults aged 19 and older, excluding missing data, using the 2019 Korea Community Health Survey. To analyze the association between objective SI and UMN, the chi-square test and logistic regression analysis were performed.
Results
The prevalence of UMN was 1.14 times higher (odds ratio [OR], 1.14; 95% confidence interval [CI], 1.06 to 1.23) among those with SI than among those without SI, and the OR for groups with 5 SI types was 2.77 (95% CI, 1.86 to 4.12) compared to those with no SI types. In addition, a stratified analysis by age group showed that the association between SI and UMN existed even in groups under 64 years old. However, among those aged 65 and older, SI was associated with an OR of 1.53 (95% CI, 1.37 to 1.71) for UMN compared to non-SI. As the number of SI types increased, the prevalence of UMN also increased, indicating a strong association between SI and UMN in older adults.
Conclusions
This study found that individuals with SI experienced UMN due to fear and anxiety about interpersonal relationships. Therefore, based on the results of this cross-sectional study, it is necessary to investigate the causal relationship between SI and UMN through future longitudinal data.; Summary

Korean summary
본 연구는 2019년 지역사회건강조사를 활용하여 사회적 고립과 미충족의료 간의 연관성을 분석한 연구이다. 분석 결과 사회적 고립이 있을 경우 비사회적고립 집단에 비하여 미충족의료 경험률이 높았고, 사회적 고립의 강도가 높아질수록 강한 연관성을 발견할 수 있었다. 본 연구 결과를 바탕으로 미충족의료 취약 집단에 대한 정책적, 제도적 기반 마련이 요구된다.

Key Message
This study analyzed the association between social isolation and unmet medical needs using the 2019 Korea Community Health Survey. The analysis revealed that individuals experiencing social isolation had a higher rate of unmet medical needs compared to the non-social isolation group. Furthermore, a stronger association was observed as the intensity of social isolation increased. Based on the results of this study, there is a need to establish policy and institutional foundations to support vulnerable groups with unmet medical needs.

Perspective

The Paradox of the Ugandan Health Insurance System: Challenges and Opportunities for Health Reform: Emmanuel Otieno, Josephine Namyalo; J Prev Med Public Health. 2024;57(1):91-94. Published online December 30, 2023; DOI: https://doi.org/10.3961/jpmph.23.110

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Abstract Summary PDF

For nearly four decades, Ugandans have experienced a period marked by hope, conflict, and resilience across various aspects of healthcare reform. The health insurance system in Uganda lacks a legal framework and does not extend benefits to the entire population. In Uganda, community-based health insurance is common among those in the informal sector, while private medical insurance is typically provided to employees by their workplaces and agencies. The National Health Insurance Scheme Bill, introduced in 2019, was passed in 2021. If the President of Uganda gives his assent to the National Health Insurance Bill, it will become a significant policy driving health and universal health coverage. However, this bill is not without its shortcomings. In this perspective, we aim to explore the complex interplay of challenges and opportunities facing Uganda’s health sector.

Summary

Key Message
For the Ugandans, nearly the last four decades have been years of hope, conflict, and resilience in a myriad of contexts for healthcare reform. Health insurance system has no legal framework and provides benefits not to the entire national population. The 2019 National Health Insurance scheme Bill was passed in 2021. If the President of Uganda assents to the National Health Insurance Bill, it will be a compelling policy in health and health for all policies. But this Bill has several drawbacks. In this perspective, we aimed to provide intricacies and mix of challenges and opportunities for the health sector.

Citations

Citations to this article as recorded by

Regulation of artificial intelligence in Uganda’s healthcare: exploring an appropriate regulatory approach and framework to deliver universal health coverage
Kalule Grancia Mugalula
International Journal for Equity in Health.2025;[Epub] CrossRef
Desafíos éticos en los modelos de seguro de salud de Uganda: abordando dilemas para mejorar la equidad, el acceso y la sostenibilidad
Bernard Rabwoni
Medicina y Ética.2025; 36(3): 858. CrossRef
Economic assessment of potential changes to essential medicines for diabetes in Uganda
Atousa Bonyani, Tracy K. Lin, Ambrose Jakira, Isaac D. Kimera, Martin Muddu, Jeremy I. Schwartz, James G. Kahn, Sonak D. Pastakia
PLOS One.2025; 20(6): e0326806. CrossRef
Emergency Obstetric Care Access Dynamics in Kampala City, Uganda: Analysis of Women’s Self-Reported Care-Seeking Pathways
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Global Health: Science and Practice.2024; 12(6): e2400242. CrossRef

Original Article

Impact of Physical Activity on the Association Between Unhealthy Adolescent Behaviors and Anxiety Among Korean Adolescents: A Cross-sectional Study: Hyo-jung Lee, Jeong Pil Choi, Kunhee Oh, Jin-Young Min, Kyoung-Bok Min; J Prev Med Public Health. 2023;56(6):552-562. Published online November 15, 2023; DOI: https://doi.org/10.3961/jpmph.23.313

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Abstract Summary PDF: Objectives
Adolescents who engage in unhealthy behaviors are particularly vulnerable to anxiety. We hypothesized that participation in physical activity could influence the relationship between anxiety and unhealthy behaviors in adolescents. These behaviors include smoking, alcohol consumption, and unsafe sexual activity.
Methods
This study included 50 301 students from the first year of middle school to the third year of high school, all from Korea. The unhealthy adolescent behaviors examined included current alcohol consumption, current smoking, and unsafe sexual behavior. Anxiety levels were assessed using the Generalized Anxiety Disorder-7 questionnaire (GAD-7).
Results
The participants had a mean age of 15.19 years and an average GAD-7 score of 4.23. No significant differences were observed in GAD-7 score among exercising participants when categorized by smoking status (p=0.835) or unsafe sexual behavior (p=0.489). In contrast, participants in the non-exercise group who engaged in these behaviors demonstrated significantly higher GAD-7 scores (p<0.001 and 0.016, respectively). The only significant interaction was found between unsafe sexual behavior and exercise (p=0.009). Based on logistic regression analysis, within the non-exercise group, significant positive associations were observed between current smoking and anxiety (odds ratio [OR], 1.36; 95% confidence interval [CI], 1.18 to 1.57), as well as between unsafe sexual behavior and anxiety (OR, 1.33; 95% CI, 1.02 to 1.73). However, within the exercise group, no significant association was found between anxiety and either smoking or unsafe sexual behavior. Furthermore, no significant interaction was observed between unhealthy behaviors and exercise.
Conclusions
These findings are insufficient to conclude that physical activity influences the relationship between unhealthy behaviors and anxiety.; Summary

Korean summary
이 연구는 신체활동이 한국 청소년들사이에서 불안과 불건강행태간의 관계에 어떠한 영향을 미치는지 조사하였다. 이 연구에서 신체활동을 하지 않는 청소년에서만 흡연 및 불안전한 성행위와 같은 불건강행태와 불안 간의 유의미한 연관성을 보였음에도 불구하고, 이러한 불건강행태와 운동 간에는 같은 방향의 유의미한 상호작용이 관찰되지 않았다. 따라서 이 연구는 신체 활동이 청소년들의 불건강행태와 불안간의 관계에 직접 미치는 영향에 대해 명확하게 결론을 내릴 수 없었다.

Key Message
Among Korean adolescents, this study found that significant associations between unhealthy behaviors such as smoking and unsafe sex, and anxiety were only observed in adolescents who did not engage in physical activity. Despite this, no significant interaction was observed between these unhealthy behaviors and exercise. Contrary to popular belief, this study concludes that the evidence is insufficient to definitively say that physical activity influences the relationship between adolescent unhealthy behaviors and anxiety.

Perspective

Epidemiological Model for Conventional Tobacco Control Measures and Tobacco Endgame Policies: Heewon Kang, Sung-il Cho; J Prev Med Public Health. 2023;56(5):481-484. Published online September 26, 2023; DOI: https://doi.org/10.3961/jpmph.23.239

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Abstract Summary PDF Supplementary Material

Epidemiological models, also known as host-agent-vector-environment models, are utilized in public health to gain insights into disease occurrence and to formulate intervention strategies. In this paper, we propose an epidemiological model that incorporates both conventional measures and tobacco endgame policies. Our model suggests that conventional measures focus on relationships among agent-vector-host-environment components, whereas endgame policies inherently aim to change or eliminate those components at a fundamental level. We also found that the vector (tobacco industry) and environment (physical and social surroundings) components were insufficiently researched or controlled by both conventional measures and tobacco endgame policies. The use of an epidemiological model for tobacco control and the tobacco endgame is recommended to identify areas that require greater effort and to develop effective intervention measures.

Summary

Korean summary
이 연구는 기존의 담배규제와 관련된 역학 모형을 확장하여 담배 수요를 줄이기 위한 조치인 MPOWER 정책과 담배 종결전의 주요 정책을 아우르는 개념적 모형을 제시하였다. 각 정책을 개념적 모형 내 배치한 결과, MPOWER 정책은 모형 내 구성요소 간의 연결을 끊는 것을 목표로 하는 반면, 종결전 정책은 모형 내 요소들을 영구적으로 변화시키거나 제거하려는 특성을 가지고 있는 것으로 나타났다. 담배규제정책이 개체, 병원체, 벡터 및 환경 요소에 대한 균형 잡힌 포트폴리오를 갖추고 있는지 평가하기 위해 이 개념적 모형을 활용할 수 있다.

Key Message
We extended the conceptual epidemiological model for tobacco control by incorporating measures to reduce the demand for tobacco (MPOWER measures) and key endgame policies. The model suggests that MPOWER measures focus on disconnecting the relationships between model components, while endgame policies aim to permanently change or eliminate the components themselves. This model can be used to examine whether a country or jurisdiction's tobacco control policy maintains a balanced portfolio across agent, host, vector, and environmental factors.

Citations

Citations to this article as recorded by

Extent and Characteristics of Illegal Tobacco Sales on Social Media X
Heewon Kang, Naeun Kang, Gil-yong Kim, Hun Min Jang, Woojin Jeong, Susan Park
Journal of the Korean Society for Research on Nicotine and Tobacco.2025; 16(1): 17. CrossRef
Prosociality and public support for tobacco control policies among South Korean adults: A cross-sectional study
Jaeyoung Ha, Heewon Kang, Ichiro Kawachi, Jieun Hwang, Sung-il Cho
SSM - Population Health.2025; 30: 101809. CrossRef
Public support for tobacco endgame policies in South Korea: Findings from the 2020 International Tobacco Control Korea Survey
Heewon Kang, Wonjeong Yoon, Hong Gwan Seo, Sungkyu Lee, Sujin Lim, Gil-yong Kim, Su Young Kim, Steve S Xu, Mi Yan, Anne C K Quah, Janet Chung-Hall, Lorraine V Craig, Coral E Gartner, Geoffrey T Fong, Sung-il Cho
Tobacco Control.2024; : tc-2023-058454. CrossRef
Decrease in household secondhand smoking among Korean adolescents associated with smoke-free policies: grade-period-cohort and interrupted time series analyses
Hana Kim, Heewon Kang, Sung-il Cho
Epidemiology and Health.2023; 46: e2024009. CrossRef

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