Journal Description
International Journal of Environmental Research and Public Health
International Journal of Environmental Research and Public Health
is a transdisciplinary, peer-reviewed, open access journal published monthly online by MDPI. It covers Global Health, Healthcare Sciences, Behavioral and Mental Health, Infectious Diseases, Chronic Diseases and Disease Prevention, Exercise and Health Related Quality of Life, Environmental Health and Environmental Sciences. The International Society Doctors for the Environment (ISDE) and Italian Society of Environmental Medicine (SIMA) are affiliated with IJERPH and their members receive a discount on the article processing charges.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within Scopus, PubMed, MEDLINE, PMC, Embase, GEOBASE, CAPlus / SciFinder, and other databases.
- Journal Rank: CiteScore - Q1 (Public Health, Environmental and Occupational Health)
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 25.8 days after submission; acceptance to publication is undertaken in 3.3 days (median values for papers published in this journal in the second half of 2024).
- Recognition of Reviewers: reviewers who provide timely, thorough peer-review reports receive vouchers entitling them to a discount on the APC of their next publication in any MDPI journal, in appreciation of the work done.
- Testimonials: See what our editors and authors say about IJERPH.
- Sections: published in 7 topical sections.
- Companion journal: Air.
Latest Articles
Perspectives of Primary Healthcare Workers on HIV Injectable Pre-Exposure Prophylaxis (PrEP): A Scoping Review Protocol
Int. J. Environ. Res. Public Health 2025, 22(6), 830; https://doi.org/10.3390/ijerph22060830 (registering DOI) - 24 May 2025
Abstract
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South Africa continues to experience a high HIV prevalence, necessitating innovative prevention strategies aligned with the UNAIDS 95-95-95 targets. Long-acting injectable pre-exposure prophylaxis (PrEP), such as cabotegravir (CAB-LA), offers a promising alternative to daily oral regimens. However, the perspectives of primary healthcare workers
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South Africa continues to experience a high HIV prevalence, necessitating innovative prevention strategies aligned with the UNAIDS 95-95-95 targets. Long-acting injectable pre-exposure prophylaxis (PrEP), such as cabotegravir (CAB-LA), offers a promising alternative to daily oral regimens. However, the perspectives of primary healthcare workers (PHCWs)—key implementers of this intervention—remain underexplored. This scoping review aims to systematically map existing literature on PHCWs’ knowledge, awareness, perceptions, barriers, facilitators, and implementation experiences related to injectable PrEP within the South African healthcare context. The review will follow the Arksey and O’Malley framework, enhanced by Levac et al., and will be reported following PRISMA-ScR guidelines. A comprehensive search will be conducted across PubMed, Scopus, CINAHL (EBSCOhost), Web of Science, and Google Scholar, without language or date restrictions. The search strategy will employ both controlled vocabulary (e.g., MeSH and CINAHL Subject Headings) and free-text terms. Studies meeting the inclusion criteria will be managed using EndNote X20 and appraised using the Mixed Methods Appraisal Tool (MMAT) 2018 version. Data will be synthesized thematically and presented narratively and in tabular form. By consolidating PHCWs’ perspectives, this review will identify implementation challenges, training needs, and systemic barriers, informing the development of context-specific strategies for PrEP rollout. The findings are expected to support the design of effective, culturally relevant educational interventions and guide policymakers in strengthening HIV prevention efforts in high-burden settings.
Full article
Open AccessArticle
Māori Health, Wellbeing, and Disability in Aotearoa New Zealand: A National Survey
by
Tristram R. Ingham, Bernadette Huatau Jones, Meredith A. Perry, Andrew Sporle, Tom Elliott, Paula Toko King, Gabrielle Baker, Barry Milne, Tori Diamond and Linda Waimarie Nikora
Int. J. Environ. Res. Public Health 2025, 22(6), 829; https://doi.org/10.3390/ijerph22060829 - 23 May 2025
Abstract
Māori, the Indigenous people of Aotearoa New Zealand, experience wide-ranging inequities compared with non-Māori. This survey aimed to explore the holistic health, wellbeing, and disability experiences of New Zealand’s Indigenous Māori population from a Māori worldview, addressing gaps in culturally relevant data often
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Māori, the Indigenous people of Aotearoa New Zealand, experience wide-ranging inequities compared with non-Māori. This survey aimed to explore the holistic health, wellbeing, and disability experiences of New Zealand’s Indigenous Māori population from a Māori worldview, addressing gaps in culturally relevant data often overlooked by standard health surveys. A robust cross-sectional survey was conducted with 7359 participants of Māori descent using Kaupapa Māori Research principles. Data were analysed using the Te Pae Māhutonga framework, a Māori health promotion model. Participants demonstrated strong cultural identity, with 32.3% understanding spoken Māori fairly well and 97.3% defining a broad non-nuclear concept of whānau (family). While over half reported high life satisfaction, 58.4% experienced discrimination, mainly based on ethnicity and appearance. Access to healthcare revealed that 32.6% were unable to contact a general practitioner due to cost. Socioeconomic challenges were prevalent; nearly a quarter borrowed from family or friends to meet daily living costs, and over a third economized on fresh produce to save money. This study reveals significant gaps in mainstream health data and demonstrates that a culturally aligned, methodological approach is feasible and crucial for informing policies that address the needs and rights of Māori, as guaranteed under Te Tiriti o Waitangi. These results could inform global, indigenous research addressing culturally relevant health, wellbeing and disability inequities.
Full article
(This article belongs to the Special Issue Socio-Economic and Environmental Determinants of Health Disparities and Population Health)
Open AccessArticle
Frequent Users in Psychiatric Consultations: A 6-Year Retrospective Study in the Emergency Department
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Carla Maria Gramaglia, Eleonora Gambaro, Alessandro Feggi, Amalia Jona, Valentina Zanoli, Francesco Gavelli, Gian Carlo Avanzi, Daniela Ferrante, Silviana Maria Patratanu, Erica Valerio and Patrizia Zeppegno
Int. J. Environ. Res. Public Health 2025, 22(6), 828; https://doi.org/10.3390/ijerph22060828 - 23 May 2025
Abstract
The increasing prevalence of emergency room (ER) visits for mental health concerns presents a significant challenge for healthcare systems. This study aimed to analyze the socio-demographic and clinical characteristics associated with frequent users of psychiatric consultations in the ER of Maggiore della Carità
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The increasing prevalence of emergency room (ER) visits for mental health concerns presents a significant challenge for healthcare systems. This study aimed to analyze the socio-demographic and clinical characteristics associated with frequent users of psychiatric consultations in the ER of Maggiore della Carità University Hospital in Novara, Italy. A retrospective observational study was conducted over a six-year period (2017–2022), including all psychiatric consultations recorded in a hospital database. Frequent users were defined as individuals undergoing at least three psychiatric consultations in the ER within a year. Univariable and multivariable logistic models were employed to identify significant socio-demographic and clinical predictors of frequent use. Of the 1565 individuals who received psychiatric consultations in the ER, 92 (5.88%) were identified as frequent users. Factors associated with higher ER utilization included being unmarried (aOR 1.35, 95% CI 1.02–1.79), younger age (aOR 1.32, 95% CI 1.02–1.72), homelessness, diagnosis of schizophrenia, substance use disorder (aOR 1.49, 95% CI 1.06–2.09), and ongoing psychopharmacological treatment (aOR 1.56, 95% CI 1.12–2.18). These findings highlight the need for targeted interventions to improve care continuity and community-based support for individuals at risk of frequent ER visits for psychiatric reasons.
Full article
Open AccessArticle
State Preemption and Local Tobacco Control: Constraints and Opportunities for Innovation in the US
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Rishika Chakraborty, Micah L. Berman, Y. Tony Yang, Yan Li, Yan Wang, Debra Bernat, Sabrina Zhang and Carla J. Berg
Int. J. Environ. Res. Public Health 2025, 22(6), 827; https://doi.org/10.3390/ijerph22060827 - 23 May 2025
Abstract
State preemption of local laws may impede tobacco control, yet little research has examined local policy activity before, during, and after preemption. This study addresses this gap. We summarized state laws preempting local smoke-free workplace, youth access, and licensure laws (CDC’s STATE) and
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State preemption of local laws may impede tobacco control, yet little research has examined local policy activity before, during, and after preemption. This study addresses this gap. We summarized state laws preempting local smoke-free workplace, youth access, and licensure laws (CDC’s STATE) and local legislative activity before, during, and after preemption (Americans for Nonsmokers’ Rights Foundation) across 1999–2021. Preemption existed for smoke-free workplaces in 18 states, youth access in 21, and licensure in 13. Regarding smoke-free workplace laws, local laws were passed in 5 of 11 states with preemption throughout; among seven states with partial-period preemption, local laws were enacted before preemption or after repeal in three states but during preemption in two. Regarding youth access, localities adopted laws (e.g., addressing purchase/use/possession or e-cigarettes) in 11 of 18 states with preemption throughout; among the three states with partial-period preemption, localities passed laws before preemption in one state and during preemption in two. For licensure, localities passed laws (e.g., licensing requirements/penalties) in eight of nine states with preemption throughout and three of four states with partial-period preemption. Although state preemption reduced local activity, some localities advanced tobacco control during preemption, underscoring the need for localities to exercise autonomy permitted under preemption.
Full article
(This article belongs to the Section Infectious Diseases, Chronic Diseases, and Disease Prevention)
Open AccessArticle
The Influence of Maternal Information Sources on Infant Oral Hygiene Practices for Six-Month-Olds in South Australia: A Cross-Sectional Study
by
Meng-Wong Taing, Wanrong Li, Loc G. Do and Diep H. Ha
Int. J. Environ. Res. Public Health 2025, 22(6), 826; https://doi.org/10.3390/ijerph22060826 - 23 May 2025
Abstract
This study aimed to investigate the association between the different information sources on infant oral hygiene accessed by mothers and infant oral hygiene practices in South Australia. Information on the oral hygiene practices used in 6-month-old infants—gum/tooth cleaning in the past 3 months,
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This study aimed to investigate the association between the different information sources on infant oral hygiene accessed by mothers and infant oral hygiene practices in South Australia. Information on the oral hygiene practices used in 6-month-old infants—gum/tooth cleaning in the past 3 months, frequency of brushing, and the usage of fluoridated toothpaste—were acquired from the Study of Mothers’ and Infants’ Life Events Affecting Oral Health (SMILE) cohort survey. Descriptive statistics and multivariable logistic regression modelling were used to analyse the relationship between the information sources and infant oral hygiene practices. The majority of mothers (60.4%) reported not having cleaned their 6-month-old’s gums/teeth in the past 3 months. One-third of mothers with 6-month-olds did not seek information on infant oral hygiene. Mothers who sought advice from dentists were more likely to have cleaned their infant’s gums/teeth in the past 3 months, and those with infants whose teeth had erupted were also more likely to clean their infants’ teeth twice or more daily. We can conclude that mothers who sought information on infant oral hygiene from more than one source adopted generally better oral hygiene practices for their infants, with a dentist’s advice notably increasing the likelihood of mothers following the guidelines for cleaning their infants’ teeth.
Full article
(This article belongs to the Special Issue Perceptions of Women, Child and Adolescents' Oral Health)
Open AccessSystematic Review
Barriers and Facilitators of Tobacco Cessation Interventions at the Population and Healthcare System Levels: A Systematic Literature Review
by
Sanchita Sultana, Joseph Inungu and Shayesteh Jahanfar
Int. J. Environ. Res. Public Health 2025, 22(6), 825; https://doi.org/10.3390/ijerph22060825 - 23 May 2025
Abstract
Background: Tobacco use is responsible for eight million preventable deaths annually, making it a major modifiable risk factor for chronic conditions such as cardiovascular diseases, respiratory illnesses, and over 20 types of cancers. Objective: This study aimed to systematically review the barriers and
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Background: Tobacco use is responsible for eight million preventable deaths annually, making it a major modifiable risk factor for chronic conditions such as cardiovascular diseases, respiratory illnesses, and over 20 types of cancers. Objective: This study aimed to systematically review the barriers and facilitators of tobacco cessation interventions at both the population and healthcare system levels in the U.S. Understanding these determinants is critical for narrowing health disparities, optimizing resource allocation, and ultimately, enhancing tobacco cessation success rates across all demographic groups. Methods: A comprehensive literature search was conducted across the PubMed, Embase, and Web of Science databases, guided by the population, intervention, comparison, and outcome framework and quality assessment guided by PRISMA guidelines. Data extraction focused on study characteristics, intervention types, barriers, facilitators, and cessation outcomes at both the population and health system levels. The random effects forest plots were graphed to estimate pooled effect sizes for both medical and non-medical interventions. Results: A total of 35 studies met the inclusion criteria from an initial pool of 1555 identified records. Socioeconomic disadvantages, digital inequities, and low motivation constitute primary barriers at the individual level, while systemic factors such as healthcare access limitations, inadequate provider engagement, and lack of financial support further hinder cessation efforts. Financial incentives, culturally tailored interventions, and digital engagement strategies significantly improve tobacco cessation outcomes. Public health implications: as identified by the study, tailored interventions, the expansion of health coverage policies to include intervention, digital solutions, and healthcare resource workforce training will help improve tobacco cessation intervention outcomes.
Full article
(This article belongs to the Special Issue Advancing One Health Approaches for Health Promotion and Disease Prevention: Transdisciplinary Perspectives)
Open AccessSystematic Review
Neuroscientific Insights into the Built Environment: A Systematic Review of Empirical Research on Indoor Environmental Quality, Physiological Dynamics, and Psychological Well-Being in Real-Life Contexts
by
Aitana Grasso-Cladera, Maritza Arenas-Perez, Paulina Wegertseder-Martinez, Erich Vilina, Josefina Mattoli-Sanchez and Francisco J. Parada
Int. J. Environ. Res. Public Health 2025, 22(6), 824; https://doi.org/10.3390/ijerph22060824 - 23 May 2025
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The research aims to systematize the current scientific evidence on methodologies used to investigate the impact of the indoor built environment on well-being, focusing on indoor environmental quality (IEQ) variables such as thermal comfort, air quality, noise, and lighting. This systematic review adheres
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The research aims to systematize the current scientific evidence on methodologies used to investigate the impact of the indoor built environment on well-being, focusing on indoor environmental quality (IEQ) variables such as thermal comfort, air quality, noise, and lighting. This systematic review adheres to the Joanna Briggs Institute framework and PRISMA guidelines to assess empirical studies that incorporate physiological measurements like heart rate, skin temperature, and brain activity, which are captured through various techniques in real-life contexts. The principal results reveal a significant interest in the relationship between the built environment and physiological as well as psychological states. For instance, thermal comfort was found to be the most commonly studied IEQ variable, affecting heart activity and skin temperature. The research also identifies the need for a shift towards using advanced technologies like Mobile Brain/Body Imaging (MoBI) for capturing real-time physiological data in natural settings. Major conclusions include the need for a multi-level, evidence-based approach that considers the dynamic interaction between the brain, body, and environment. This study advocates for the incorporation of multiple physiological signals to gain a comprehensive understanding of well-being in relation to the built environment. It also highlights gaps in current research, such as the absence of noise as a studied variable of IEQ and the need for standardized well-being assessment tools. By synthesizing these insights, the research aims to pave the way for future studies that can inform better design and policy decisions for indoor environments.
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Open AccessArticle
Influence of Socio-Ecological and Economic Correlates on Marijuana Legalization Policy Across the States of America
by
Mashooq Salehin and Vijayan K. Pillai
Int. J. Environ. Res. Public Health 2025, 22(6), 823; https://doi.org/10.3390/ijerph22060823 - 23 May 2025
Abstract
Marijuana legalization has been at the center of debate in the social and political realm of the United States. So far, thirty nine states and the District of Columbia have legalized marijuana either for recreational or medical purposes. States are taking a cautious
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Marijuana legalization has been at the center of debate in the social and political realm of the United States. So far, thirty nine states and the District of Columbia have legalized marijuana either for recreational or medical purposes. States are taking a cautious approach to legalization in a policy context consisting of multi-layered sociopolitical systems. Strong arguments from advocacy groups supporting and opposing legalization highlight the significance of assessing the impact of marijuana use and its legalization on the well-being of the community and its members. Utilizing the social determinants of health and system perspectives, this study measures the cumulative effect of six socio-ecological and economic predictors, such as the state’s marijuana use prevalence and median household income, on the dependent variable of marijuana legality scores using discriminant analysis and One-way ANOVA. As hypothesized, the result shows a significant influence of the predictors on the state policy score of marijuana legality. Predicted associations between independent and dependent variables were also found. Findings suggest that without a supportive policy context comprising social, economic, and political factors, marijuana legalization might not have the desired impact on the community. Implications and recommendations for future research are provided.
Full article
Open AccessProtocol
The Effectiveness of Indoor Residual Spraying for Malaria Control in Sub-Saharan Africa: A Systematic Protocol Review and Meta-Analysis
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Moses Ocan, Kevin Ouma Ojiambo, Loyce Nakalembe, Geofrey Kinalwa, Alison A. Kinengyere, Sam Nsobya, Emmanuel Arinaitwe and Henry Mawejje
Int. J. Environ. Res. Public Health 2025, 22(6), 822; https://doi.org/10.3390/ijerph22060822 - 23 May 2025
Abstract
Background: Indoor residual spraying (IRS) is a core insecticide-based vector control tool employed in most malaria-affected settings globally. However, mosquito vectors have developed resistance to nearly all of the insecticides currently used in IRS. This has necessitated a transition to new classes of
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Background: Indoor residual spraying (IRS) is a core insecticide-based vector control tool employed in most malaria-affected settings globally. However, mosquito vectors have developed resistance to nearly all of the insecticides currently used in IRS. This has necessitated a transition to new classes of insecticides, from mostly using dichlorodiphenyltrichloroethane (DDT) and pyrethroids from 1997 to 2010 to carbamates in 2011 and organophosphates in 2013. In addition, other vector control measures, like the use of long-lasting insecticide-treated bed nets (LLINs), have also been employed for malaria control. Despite the implementation of these mosquito vector control interventions, malaria remains a disease of public health concern, especially in sub-Saharan Africa, which bears over 90% of the disease burden. This review will thus collate evidence on the effectiveness of IRS for malaria control in sub-Saharan Africa. Methods and analysis: The systematic review will be conducted following a priori criteria developed using the PRISMA guidelines. Articles will be obtained through a search of the Web of Science, Google Scholar, Medline via PubMed, Scopus and Embase databases. Mesh terms and Boolean operators (“AND”, “OR”) will be used in the article search. Additionally, websites of malaria research institutions will be searched. The article search will be conducted by two independent librarians (AAK and RS). All identified articles will be transferred to EPPI-reviewer v6.15.1.0 software. Article screening and data abstraction will be performed in duplicate by four reviewers (KOO, LN, GK and MO), and any further disagreements will be resolved through discussion and consensus. We shall extract data on the country, region, study design, insecticide combination, season, susceptibility procedure used, vector control interventions, population, mosquito species, malaria incidence or prevalence, insecticide efficacy, susceptibility, genotypic resistance, vector mortality and knockdown effect. Data analysis will be performed using STATA v17.0. Effect sizes will be statistically pooled using inverse-variance-weighted random-effects meta-analysis. Heterogeneity and publication bias in the articles will be assessed using the I2 statistic and a funnel plot, respectively. For the studies that will not be included in the meta-analysis, a narrative synthesis will be written following the Cochrane Consumer and Communication Review Group format. Results: The findings of this review will help generate evidence on the effectiveness of indoor residual spraying using WHO pre-qualified insecticides in malaria control in sub-Saharan Africa. This protocol was registered in PROSPERO, registration number CRD42024517119.
Full article
(This article belongs to the Section Infectious Diseases, Chronic Diseases, and Disease Prevention)
Open AccessArticle
Medically Attended Outpatient Parainfluenza Virus Infections in Young Children from a Single Site in Machala, Ecuador
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Manika Suryadevara, Dongliang Wang, Freddy Pizarro Fajardo, Jorge Luis Carrillo Aponte, Froilan Heras, Cinthya Cueva Aponte, Irene Torres and Joseph Domachowske
Int. J. Environ. Res. Public Health 2025, 22(6), 821; https://doi.org/10.3390/ijerph22060821 - 23 May 2025
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Parainfluenza virus (PIV) infections contribute to the overall childhood morbidity from acute respiratory illness, yet virus-specific epidemiologic data are lacking across many regions globally. Here, we describe the clinical manifestations, seasonality, and meteorologic associations with PIV infections in Ecuadorian children. Between July 2018
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Parainfluenza virus (PIV) infections contribute to the overall childhood morbidity from acute respiratory illness, yet virus-specific epidemiologic data are lacking across many regions globally. Here, we describe the clinical manifestations, seasonality, and meteorologic associations with PIV infections in Ecuadorian children. Between July 2018 and July 2023, we documented demographic and clinical information from children younger than 5 years seen in a single public health clinic with signs and symptoms consistent with an acute respiratory infection. Nasopharyngeal swabs collected at study enrollment underwent multiplex polymerase chain reaction-based diagnostic testing (Biofire FilmArray v. 1.7™). Regional meteorological data from the same period were provided by Ecuador’s Instituto Nacional de Meteorologia e Hidrologia. Parainfluenza viruses were detected in 9% of the 1251 enrolled subjects. PIVs were most frequently detected between March and July, with no change in seasonality following SARS-CoV-2 pandemic onset. Clinical manifestations of PIV infections included non-specific upper respiratory illness (82%), laryngotracheitis (3%), and bronchiolitis (11%). Events of PIV detection were negatively associated with ambient temperature and rainfall. Our findings highlight the contribution that PIVs play in the morbidity associated with pediatric medically attended outpatient respiratory tract infection and provide new insights into the seasonal epidemiology of PIV infections in coastal Ecuador.
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Open AccessReview
Antecedents of Workplace Psychological Safety in Public Safety and Frontline Healthcare: A Scoping Review
by
Emily Ip, Rani Srivastava, Liana Lentz, Sandra Jasinoski and Gregory S. Anderson
Int. J. Environ. Res. Public Health 2025, 22(6), 820; https://doi.org/10.3390/ijerph22060820 - 23 May 2025
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Workplace psychological safety (PS) has been recognized as crucial in mitigating organizational stressors and enhancing positive workplace outcomes, particularly in high-risk occupations such as healthcare and public safety. This scoping review aims to synthesize the existing literature on psychological safety in high-risk workplaces
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Workplace psychological safety (PS) has been recognized as crucial in mitigating organizational stressors and enhancing positive workplace outcomes, particularly in high-risk occupations such as healthcare and public safety. This scoping review aims to synthesize the existing literature on psychological safety in high-risk workplaces to identify key antecedents, workplace enhancements, and research gaps. A systematic search of studies published between 2010 and January 2025 was conducted across multiple databases, including CINAHL, Medline, ERIC, JSTOR, PsycInfo, Business Source Ultimate, and Sociological Abstract. Inclusion criteria focused on adult workers in high-risk workplace environments. Following screening and eligibility assessments, 16 studies from six countries were selected for analysis. Data were extracted and thematically analyzed based on leadership styles, organizational structures, and workplace culture related to psychological safety. The review identified three primary antecedents of psychological safety in high-risk workplaces: (1) inclusive and transformational leadership styles, (2) hierarchical structures and power dynamics, and (3) workplace climate and communication culture. Studies consistently found that inclusive leadership, ethical integrity, and transformational leadership were strongly associated with higher psychological safety levels. While hierarchical structures provided the necessary organization, overly rigid hierarchies often suppressed employee voice and innovation. A workplace culture characterized by trust, transparency, and open communication fosters greater psychological safety and improved teamwork and well-being.
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Open AccessArticle
Exploring Vaccine Hesitancy in the Philippines: A Content Analysis of Comments on National TV Channel YouTube Videos
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Daniel Fritz Silvallana, Carlos Elias and Daniel Catalan-Matamoros
Int. J. Environ. Res. Public Health 2025, 22(6), 819; https://doi.org/10.3390/ijerph22060819 - 22 May 2025
Abstract
Examining public attitudes towards COVID-19 vaccination is crucial for understanding the global effort to combat the ongoing pandemic. Social media platforms such as YouTube play a significant role in the dissemination of information and misinformation about the vaccine, making it imperative to analyze
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Examining public attitudes towards COVID-19 vaccination is crucial for understanding the global effort to combat the ongoing pandemic. Social media platforms such as YouTube play a significant role in the dissemination of information and misinformation about the vaccine, making it imperative to analyze user comments to gain insights into vaccine perceptions. Analyzing the Philippines case is particularly significant as it provides insights into the attitudes towards COVID-19 vaccination in a country that has been heavily impacted by the pandemic. The current study investigates the discourse surrounding vaccine hesitancy in comments on YouTube videos announcing the COVID-19 vaccination campaign by the Philippines national TV channels and its impact on engagement levels. A total of 741 YouTube comments were analyzed, with 80% exhibiting vaccine-hesitant related discourse. The results indicate that those with negative attitudes towards COVID-19 vaccination exhibit higher engagement levels than those supporting vaccination (p < 0.05). Additionally, the most commonly used themes in vaccine-hesitant posts were “ingredients”, “health department control”, “pharmaceutical interest”, and “adverse effects”. Moreover, 134 sources were identified among the posts, with vaccine-hesitant posts utilizing more sources than supportive vaccine posts (p < 0.001). The most significant information sources utilized in the posts were related to other YouTube users, politicians, clinicians, and scientific papers. Finally, a total of 890 discourses were coded, with the most frequently used discourse types among vaccine-hesitant posts being negationist, institutional, preventive, political, and pharmaceutical. These findings offer valuable insights into the nature and prevalence of vaccine hesitancy discourse on social media platforms and its impact on public engagement. This study highlights the importance of targeted communication strategies and the provision of accurate information from reliable sources in addressing vaccine hesitancy.
Full article
(This article belongs to the Special Issue Evolving Role of Social Media in Health Communication)
Open AccessReview
A Call to Integrate Measures of Environmental Context into Research on Maternal Brain Health
by
Sofia I. Cárdenas and Bridget L. Callaghan
Int. J. Environ. Res. Public Health 2025, 22(6), 818; https://doi.org/10.3390/ijerph22060818 - 22 May 2025
Abstract
Environmental factors—especially those related to interpersonal relationships and physical resources—profoundly impact women’s neurobiology and mental health. Despite this, environmental factors, including socioeconomic status, early life adversity, and neighborhood resources, are less explored within the maternal brain literature. This literature highlights pregnancy as a
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Environmental factors—especially those related to interpersonal relationships and physical resources—profoundly impact women’s neurobiology and mental health. Despite this, environmental factors, including socioeconomic status, early life adversity, and neighborhood resources, are less explored within the maternal brain literature. This literature highlights pregnancy as a developmental phase in adult women’s lifespans marked by neurobiological shifts supporting fetal development and optimizing caregiving behaviors. While neurobiological shifts during this period are well-documented, pregnancy is also associated with a heightened risk for mental health challenges. This narrative review, focusing on the last 10 years, examines the research that underscores the importance of integrating environmental factors into research frameworks to comprehensively understand their effects on maternal neurobiology and mental health throughout pregnancy. Building on this research, authors discuss future research methodologies that will support a more comprehensive understanding of the intersection between environmental contexts, maternal neurobiology, and mental health.
Full article
(This article belongs to the Special Issue How Reproductive Life Events Influence Women's Mental Health)
Open AccessArticle
Equitable Healthcare Access for Type 2 Diabetes Patients Under a Low-Income Group Health Care Scheme: A Sustainable Development Goal Perspective
by
Sin Wei Tey, Kingston Rajiah, Mari Kannan Maharajan, Norasila Binti Zakaria and Nor Haslinda Binti Ishak
Int. J. Environ. Res. Public Health 2025, 22(6), 817; https://doi.org/10.3390/ijerph22060817 - 22 May 2025
Abstract
Objective: The purpose of this study is to explore the factors influencing access to healthcare services among Type 2 Diabetes Mellitus (T2DM) patients enrolled in the PEKA B40 programme at a public health clinic in Melaka, Malaysia. It aims to examine how key
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Objective: The purpose of this study is to explore the factors influencing access to healthcare services among Type 2 Diabetes Mellitus (T2DM) patients enrolled in the PEKA B40 programme at a public health clinic in Melaka, Malaysia. It aims to examine how key dimensions—availability, accessibility, accommodation, and acceptance—affect patients’ experiences and the utilisation of diabetes-related healthcare services. This study also seeks to identify gaps and challenges within the current healthcare delivery system, particularly for low-income populations, to inform strategies for improving equitable and sustainable access to care. Methods: This study was conducted in a public health clinic in Melaka, Malaysia. Purposive sampling was used among T2DM patients under the “Health Care Scheme for Group B40” programme in a public health clinic in Melaka, Malaysia. The study included participants with at least a 6-month history of T2DM to ensure substantial experience in accessing healthcare services. Results: Fifteen patients participated in this study. Elderly individuals, retirees, and those with average incomes demonstrated higher healthcare service utilisation. Ethnic diversity was crucial, revealing its impact on health behaviours and healthcare-seeking patterns. Primary or secondary education levels among participants highlighted the necessity for targeted health literacy efforts. Conclusions: This study highlighted notable awareness and satisfaction among patients concerning the availability, accessibility, and accommodation of services, particularly emphasising the importance of geographical proximity in healthcare services. However, challenges faced by elderly individuals in accessing social support are also highlighted. The potential of enhancing the amenities of healthcare facilities to improve patient experiences is also reflected in our results. These insights provide evidence for the effectiveness of the Malaysian healthcare system in catering to a diverse demographic and can also be helpful in refining healthcare strategies and further optimising patient-centred care in Malaysia.
Full article
(This article belongs to the Special Issue Access to Public Health Services and Challenges to Healthcare Management)
Open AccessReview
Health Knowledge About Early Diagnosis of Autism Spectrum Disorders: A Case for Soft Transdiagnostic Approaches to Better Represent the Clinical and Scientific Reality of ASD
by
Mirah Dow and Ting Wang
Int. J. Environ. Res. Public Health 2025, 22(6), 816; https://doi.org/10.3390/ijerph22060816 - 22 May 2025
Abstract
Objective: This study explores the current state of science regarding DSM-5 diagnostic criteria for Autism Spectrum Disorder (ASD) in young children. It examines the effectiveness of existing diagnostic methods and evaluates the potential of transdiagnostic approaches for early intervention. Method: A systematic literature
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Objective: This study explores the current state of science regarding DSM-5 diagnostic criteria for Autism Spectrum Disorder (ASD) in young children. It examines the effectiveness of existing diagnostic methods and evaluates the potential of transdiagnostic approaches for early intervention. Method: A systematic literature review was conducted using MEDLINE, PsycINFO, and the Psychology and Behavioral Sciences Collection, focusing on peer-reviewed studies published between 2020 and 2023. The search followed PRISMA guidelines, selecting articles investigating ASD diagnosis in toddlers and preschoolers using DSM-5 criteria, behavioral assessments, and emerging diagnostic tools. Results: Findings indicate that DSM-5 provides a structured framework for ASD diagnosis, but it has limitations in early identification. It is necessary to integrate multiple assessment tools. Recent research highlights transdiagnostic models, which move beyond rigid diagnostic categories to capture the complexities of ASD presentation in young children. Conclusion: The literature supports a shift towards a transdiagnostic approach that combines behavioral, biological, and environmental assessments. This study underscores the need for interdisciplinary collaboration to refine ASD diagnostic frameworks to ensure more accurate and timely diagnoses that better serve affected children and their families.
Full article
(This article belongs to the Section Behavioral and Mental Health)
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Open AccessEditorial
Integrating Exposome into Lifecourse Understanding of Cognitive Ageing and Dementia: Current Evidence, Methodological Challenges, and Future Directions
by
Jessica Gong and Paola Zaninotto
Int. J. Environ. Res. Public Health 2025, 22(6), 815; https://doi.org/10.3390/ijerph22060815 - 22 May 2025
Abstract
Cognitive decline and dementia represent some of the most pressing challenges to global public health, especially amid rapidly ageing populations worldwide [...]
Full article
(This article belongs to the Special Issue Exposomic Approach to Dementia and Cognitive Ageing)
Open AccessArticle
The Roles of Dissociation and Depression in PTSD Among Soldiers Exposed to Combat
by
Leah Shelef, Nir Spira, Uzi Bechor, Jacob Rotschield and Eran Shadach
Int. J. Environ. Res. Public Health 2025, 22(6), 814; https://doi.org/10.3390/ijerph22060814 - 22 May 2025
Abstract
Exposure to severe combat situations significantly raises the risk of depression and post-traumatic stress disorder (PTSD). Trauma survivors may use dissociation as a defense mechanism, increasing the likelihood of PTSD. This study aims to explore the roles of dissociation and depression in PTSD
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Exposure to severe combat situations significantly raises the risk of depression and post-traumatic stress disorder (PTSD). Trauma survivors may use dissociation as a defense mechanism, increasing the likelihood of PTSD. This study aims to explore the roles of dissociation and depression in PTSD among soldiers exposed to combat who sought help from the Israel Combat Stress Reaction Unit. Method: This cross-sectional study involved 927 individuals who participated in a particular military operation in 2014 [98.5% male (n = 906); mean age = 27.08 (SD = 5.93)]. Participants completed three questionnaires: the Dissociative Experiences Scale (DES), the Beck Depression Inventory (BDI), and the Post-Traumatic Stress Symptom Checklist (PCL-5) for PTSD. Results: Our results showed that severe PTSD (PCL score ≥ 33) was found in 30.4% of participants, and 76.6% showed dissociative symptoms (DES score ≥ 30). Additionally, 23.5% experienced moderate depression, while 19.1% reported severe depressive symptoms. A Generalized Linear Model revealed that both depression and dissociation significantly contribute to PTSD. Individuals with depression were three times more likely to experience post-traumatic symptoms compared to 1.23 times for those with dissociative symptoms. Conclusions: Life-threatening situations significantly predicted higher PTSD symptoms, serving as a risk factor for depression and dissociation, which play important roles in PTSD, with depression having notably greater impact.
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(This article belongs to the Special Issue Mental Health and Psychological Resilience: The Mental Health Burden of Terrorism, Epidemiology, Risk Factors and Global Disparities)
Open AccessArticle
Exploring Sedentary and Nutritional Behaviour Patterns in Relation to Overweight and Obesity Among Youth from Different Demographic Backgrounds in Saudi Arabia
by
Anwar Al-Nuaim and Ayazullah Safi
Int. J. Environ. Res. Public Health 2025, 22(5), 813; https://doi.org/10.3390/ijerph22050813 - 21 May 2025
Abstract
Background: The prevalence of overweight and obesity has increased over the last three decades, becoming a major public health concern. This issue is particularly pressing in terms of the impact it has on the population of the Kingdom of Saudi Arabia (KSA). Thus,
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Background: The prevalence of overweight and obesity has increased over the last three decades, becoming a major public health concern. This issue is particularly pressing in terms of the impact it has on the population of the Kingdom of Saudi Arabia (KSA). Thus, the aim of this research was to explore the nutritional and lifestyle habits of youth in the Al-Ahsa region of the KSA. Methods: This cross-sectional study included a total of 1270 secondary-school boys and girls (15–19 years) from all five of the Al-Ahsa Governorate districts. BMI and waist circumference measurements were recorded using anthropometric measurements, and the lifestyle–Arab Teens Lifestyle Survey (ATLS) was used to measure sedentary and eating habits. Results: Chi-square analysis revealed that a higher proportion of females (90.68%) than males (79.18%) exceeded two hours of daily sedentary time. Frequent sugary drink consumption (>3 times per week) was similar in males (67.40%) and females (66.11%). Students from different geographical locations showed significant differences in exceeding cut-off scores for fast food (χ2 = 24.503, p < 0.001), cakes/doughnuts (χ2 = 8.414, p = 0.015), sweets/candy (χ2 = 19.613, p < 0.001), and energy drinks (χ2 = 21.650, p < 0.001). Conclusions: Al-Ahsa is the largest governorate in the KSA. It has some of the largest health risks regarding obesity and poor lifestyle habits. This study highlights the major need for future research and policy interventions.
Full article
Open AccessReview
Impact of Climate Change on Schistosomiasis Transmission and Distribution—Scoping Review
by
Kwame Kumi Asare, Muhi-Deen Wonwana Mohammed, Yussif Owusu Aboagye, Kathrin Arndts and Manuel Ritter
Int. J. Environ. Res. Public Health 2025, 22(5), 812; https://doi.org/10.3390/ijerph22050812 - 21 May 2025
Abstract
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Schistosomiasis, a neglected tropical disease caused by parasitic worms of the genus Schistosoma and transmitted through freshwater snails, affects over 200 million people worldwide. Climate change, through rising temperatures, altered rainfall patterns, and extreme weather events, is influencing the distribution and transmission dynamics
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Schistosomiasis, a neglected tropical disease caused by parasitic worms of the genus Schistosoma and transmitted through freshwater snails, affects over 200 million people worldwide. Climate change, through rising temperatures, altered rainfall patterns, and extreme weather events, is influencing the distribution and transmission dynamics of schistosomiasis. This scoping review examines the impact of climate change on schistosomiasis transmission and its implications for disease control. This review aims to synthesize current knowledge on the influence of climate variables (temperature, rainfall, water bodies) on snail populations, transmission dynamics, and the shifting geographic range of schistosomiasis. It also explores the potential effects of climate adaptation policies on disease control. The review follows the Arksey and O’Malley framework and PRISMA-ScR guidelines, including studies published from 2000 to 2024. Eligible studies were selected based on empirical data on climate change, schistosomiasis transmission, and snail dynamics. A two-stage study selection process was followed: title/abstract screening and full-text review. Data were extracted on environmental factors, snail population dynamics, transmission patterns, and climate adaptation strategies. Climate change is expected to increase schistosomiasis transmission in endemic regions like Sub-Saharan Africa, Southeast Asia, and South America, while some areas, such as parts of West Africa, may see reduced risk. Emerging hotspots were identified in regions not currently endemic. Climate adaptation policies, such as improved water management and early warning systems, were found effective in reducing transmission. Integrating climate adaptation strategies into schistosomiasis control programs is critical to mitigating the disease’s spread, particularly in emerging hotspots and shifting endemic areas.
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Open AccessReview
A Horizon Scan of Neurotechnology Innovations
by
Shona Haston, Sean Gill, Katie Twentyman, Elizabeth Green, Opeyemi Agbeleye, Claire Eastaugh, Dawn Craig, Sonia Garcia Gonzalez-Moral and Andrew Mkwashi
Int. J. Environ. Res. Public Health 2025, 22(5), 811; https://doi.org/10.3390/ijerph22050811 - 21 May 2025
Abstract
Neurotechnology is a rapidly emerging field with vast potential within healthcare, but also has inherent concerns. There is, therefore, a need to ensure the responsible and ethical development and regulation of these technologies. This horizon scan aimed to provide an overview of neurotechnologies
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Neurotechnology is a rapidly emerging field with vast potential within healthcare, but also has inherent concerns. There is, therefore, a need to ensure the responsible and ethical development and regulation of these technologies. This horizon scan aimed to provide an overview of neurotechnologies in development and those approved by the FDA as of June 2024 for a range of conditions relating to mental health, healthy ageing, and physical disability. Searches of clinical trials, conferences, journals, and news were performed in March 2024. Relevant technologies were identified through a process of screening, data extraction and synthesis. A total of 81 unique neurotechnologies were identified, with 23 relating to mental health, 31 to healthy ageing, and 42 to physical disability. A total of 79% percent did not yet have FDA approval and 77.4% were at earlier stages of development (pilot/feasibility studies), with 22.6% at pivotal or post-market stages. Digital elements were common features of the technologies, including software, apps, and connectivity to other devices; however, there were only three technologies with an identifiable AI component. A complex regulatory landscape and unique ethical and safety concerns associated with neurotechnology could pose challenges to innovators, though the emerging nature of the field also provides an opportunity to pre-emptively address potential issues.
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(This article belongs to the Special Issue Digital Innovations for Health Promotion)
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