International Journal of Environmental Research and Public Health

Second language acquisition (SLA) is critical for refugee integration and a determinant of health and health care access. Although numerous studies have examined language barriers and health communication, the reciprocal relationship between health and second language acquisition remains underexplored in public health research. This qualitative study draws on interviews with twenty Syrian refugees (nine men and eleven women, aged 22-65) resettled in Norway. Data were collected through semi-structured interviews and analysed using reflexive thematic analysis. Two overarching themes were identified: (1) Learning under strain: health problems and post-migratory stressors constrained SLA; and (2) Relational support: reciprocal interactions with neighbours, colleagues, and volunteers enabled both language learning and functional health. These social arenas acted as low-threshold, health-promoting settings that mitigated isolation and strengthened belonging. The study highlights that language operates as a social determinant of health: inclusive, relational spaces facilitate both SLA and health by enhancing communicative participation and access to care. Refugee integration policy should therefore support accessible community spaces outside formal education to strengthen social inclusion, health literacy and refugees’ ability to navigate health and welfare services.

Type 2 diabetes mellitus (T2DM) is a growing public health challenge worldwide, disproportionately affecting populations in low- and middle-income countries (LMICs). Poor glycemic control contributes significantly to the global burden of non-communicable diseases (NCDs), increasing morbidity, mortality, and healthcare costs. Understanding behavioral and lifestyle determinants is critical for designing effective public health strategies, particularly in resource-limited settings such as Lesotho. A cross-sectional population-based study was conducted among 184 adults with T2DM attending the out-patient department of Maluti Adventist Hospital, Lesotho. Data was collected using a structured questionnaire and analyzed descriptively with SPSS 26 Variables assessed included sociodemographic, dietary practices, physical activity, behavioral risk factors and self-care knowledge. Participants were predominantly aged 45–69 years (65.2%), with an equal sex distribution. Hypertension was the most prevalent comorbidity (65.2%). Risk factor exposure was widespread, 100% consumed fewer than five daily servings of fruits/vegetables, 95.1% reported insufficient physical activity, and 88.0% had elevated blood pressure. Overall, 86.4% had three or more NCD risk factors. Knowledge levels were intermediate, with 33.2% scoring poor, 52.7% moderate, and only 14.1% good. Glycemic control was suboptimal, with 40.8% uncontrolled. This study highlights the urgent public health need to address lifestyle and behavioral determinants of poor glycemic control in Lesotho. Tailored interventions focusing on dietary education, physical activity promotion, and routine monitoring are essential to reduce NCD risks and improve outcomes. The findings have broader implications for achieving Sustainable Development Goal 3.4 on reducing premature NCD mortality in LMICs. Strengthening culturally sensitive health promotion, community-based interventions, and integrated chronic disease care models could significantly advance diabetes prevention and control in low-resource settings.

Dental caries is a prevalent childhood disease with a multifactorial etiology. The aim of the study is to evaluate the prevalence of extensive dental caries and its association with socioeconomic factors, dietary and daily toothbrushing frequency, and sleep disorders (SDs) in children aged 6 to 10 years. A cross-sectional study with 516 children and their caregivers was carried out. Socioeconomic information and data on dietary habits and oral health behaviors were obtained through a questionnaire administered to parents/caregivers. SDs were assessed using the Sleep Disturbance Scale for Children. Extensive dental caries was assessed using the ICDAS II (codes 5–6). Descriptive analyses and multivariate Poisson regression were performed. The prevalence of extensive dental caries was 20.7%. Extensive caries was associated with lower parental education (PR = 1.68; 95% CI: 1.16–2.44; p = 0.006), household income (PR = 5.64; 95% CI: 1.67–18.99; p = 0.005), frequent consumption of sugary snacks/drinks (PR = 2.74; 95% CI: 1.97–3.83; p < 0.001), and greater severity of SD (PR = 1.02; 95% CI: 1.00–1.03; p = 0.007). Extensive dental caries lesions are more common in children whose parents/caregivers have lower levels of education and income, consume more sugary foods/drinks, and have SDs.