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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: closed (30 June 2020) | Viewed by 54369

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Prof. Dr. Ruoling Chen

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Department of Public Health, Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton WV1 1LY, UK
Interests: epidemiology; global health; big health data
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Dear Colleagues,

IJERPH invites submissions to Special Issue devoted to addressing important research topics in public health and epidemiology globally.

This Special Issue of IJERPH follows the international conference of Global Health and Epidemiology, which was successfully held at the University of Wolverhampton, UK, on 20-23 August 2018 (www.wlv.ac.uk/globalhealth), with which IJERPH was involved and sponsored two best conference presentations awards.

Global health is "the application of the principles of public health to health problems and challenges that transcend national boundaries and to the complex array of global and local forces that affect them”. It implies a global perspective on public health problems, using epidemiological methods.

To improve population health globally and its impact on health care and economics, in this Special Issue we highlight health inequalities locally, nationally and internationally and their solutions, including health systems and policy making.

This Special Issue welcomes original studies, review papers and commentary papers that address global health and epidemiology. Of particular interest are the following themes:

Cardiovascular Diseases
Dementia and Mental Health
Environmental and Occupational Health
Maternal and Child Health
Social Epidemiology and Public Health in Developing Countries
Epidemiological Methods and Health Data Analysis

Prof. Dr. Ruoling Chen
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Related Special Issue

Second Edition of the Global Public Health and Epidemiology in International Journal of Environmental Research and Public Health (1 article)

Published Papers (12 papers)

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Research

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16 pages, 385 KiB

Open AccessArticle

Children with Developmental Disabilities in Low- and Middle-Income Countries: More Neglected and Physically Punished

by Andrea Bizzego, Mengyu Lim, Greta Schiavon and Gianluca Esposito

Int. J. Environ. Res. Public Health 2020, 17(19), 7009; https://doi.org/10.3390/ijerph17197009 - 25 Sep 2020

Cited by 13 | Viewed by 2983

Abstract

Little is known about parenting in the context of developmental disabilities in low- and middle-income countries (LMIC), penalized by both lack of data and a research bias toward western societies. In this study, we apply data mining methods on a large (N = 25,048) dataset from UNICEF to highlight patterns of association between developmental disabilities of children and parental involvement. We focus on the co-presence of multiple disabilities and the quality of childcare in three parenting domains: discipline, caregiving, and education. Our results show that, in LMIC, children with more severe developmental conditions are also more likely to receive low-quality parental care. Specific policies of parental training are needed to improve parental practices in LMIC. Full article

(This article belongs to the Special Issue Global Public Health and Epidemiology)

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14 pages, 333 KiB

Open AccessArticle

Physical Frailty among Urban-Living Community-Dwelling Older Adults in Malaysia

by Camilla Wahida Norazman, Siti Nur’Asyura Adznam and Rosita Jamaluddin

Int. J. Environ. Res. Public Health 2020, 17(18), 6549; https://doi.org/10.3390/ijerph17186549 - 9 Sep 2020

Cited by 17 | Viewed by 2862

Abstract

Frailty is a multidimensional syndrome, which is a worldwide concern within the field of geriatrics due to the aggravating effect on the physical and mental functions of the elderly. This study aimed to determine the prevalence and risk factors of the frailty syndrome among urban-living community-dwelling elderly in Malaysia. A cross-sectional study was conducted among 301 community-dwelling elders. Frailty status was assessed using the Fried phenotype criteria. Depressive symptoms were assessed using the Geriatric Depression Scale (M-GDS-14), whereas the functional abilities and cognitive status were measured using the Lawton Instrumental Activities of Daily Living (Lawton IADL) scale and the Mini-Mental State Examination (MMSE-M), respectively. Malnutrition risk was observed through the abridged version (Short Form) of the Mini Nutritional Assessment (MNA-SF). Multinomial logistic regression analysis was employed to determine the significant predictors of the frailty syndrome. Three hundred and one elderly persons engaged in this study, with a mean age of 67.08 ± 5.536 ranging between 60 to 84 years old. The prevalence values of frailty and pre-frail were 15.9% and 72.8%, respectively, in which women appeared to be at a higher risk of frailty. The multivariate model revealed that frailty could be predicted from an increase in age, lower household income, being at risk of malnutrition, wasting (low skeletal muscle mass), and high serum C-reactive protein (CRP) level. A holistic approach is suggested for managing the frailty syndrome as it involves a decline in the multiple components of the geriatric syndrome. Full article

(This article belongs to the Special Issue Global Public Health and Epidemiology)

13 pages, 2704 KiB

Open AccessArticle

Cancer Mortality Trends in Spain (2000–2016): Differences between Immigrant and Native Populations

by Adriana Oliva-Arocas, Pamela Pereyra-Zamora, José M. Copete and Andreu Nolasco

Int. J. Environ. Res. Public Health 2020, 17(14), 5127; https://doi.org/10.3390/ijerph17145127 - 16 Jul 2020

Cited by 1 | Viewed by 1800

Abstract

Spain’s population has changed thanks to recent immigration. Therefore, a new epidemiological and demographic profile has been generated in the country. This study aims to analyze immigrant and native cancer mortality trends in Spain for the period 2000 to 2016. An ecological study of trends was carried out. Age-standardized rates of cancer mortality (ASR) and annual percentage change (APC) between groups and study sub-periods were calculated. Significant decreases in ASR were observed for cancer in both the native and the immigrant populations, in both men and women. However, in 2014–2016, there was an increase in ASR in the immigrant population compared to 2011–2013, due to the increase in ASR among immigrants from European regions. Differences in ASR by cancer between immigrant and native populations residing in Spain have been identified, both in the rate of decline and magnitude as well as by the birth region of the immigrant population. The increase observed in the cancer mortality trend at the end of the period in some immigrant groups indicates the need to monitor these indicators given the demographic, social, and economic changes. Full article

(This article belongs to the Special Issue Global Public Health and Epidemiology)

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21 pages, 429 KiB

Open AccessArticle

The Emulation and Adaptation of a Global Model of Clinical Practice Guidelines on Chronic Heart Failure in BRICS Countries: A Comparative Study

by Tao Liu, Benjamin Quasinowski and André Soares

Int. J. Environ. Res. Public Health 2020, 17(5), 1735; https://doi.org/10.3390/ijerph17051735 - 6 Mar 2020

Cited by 5 | Viewed by 3135

Abstract

Whilst knowledge about diseases is universal, access to health care is not equally distributed. During the last decade, the countries of BRICS (Brazil, Russia, India, China, South Africa) have become important actors on the global health scene, pushing for universal, affordable, and more equal access to health care. Although non-communicable diseases place a significant burden on all populations and health systems, low- and middle-income countries (LMIC), such as BRICS, have been affected particularly hard. Approximately 80 percent of worldwide deaths from non-communicable diseases occur in LMIC. We examined if guidelines concerning chronic heart failure from BRICS countries are influenced by global scripts and if these guidelines have converged or diverged in an inter-state context. Our analysis shows that guidelines on heart failure published in BRICS predominantly rely on models initially formulated by European or American cardiological organisations. Guidelines from BRICS deviate from these models to some extent, in particular with regard to specific epidemiological conditions. Except for the Indian guideline, they do not, however, extensively engage with BRICS-specific aspects of costs, access to and affordability of health care services. We interpret these results through the lens of sociological theories on globalisation. Consistent with neoinstitutionalism, recommendations for clinical practice guidelines have spread in BRICS countries in a rather isomorphic fashion. Notwithstanding, some local medical traditions have also been included into these guidelines through localised adaptation and variation. Full article

(This article belongs to the Special Issue Global Public Health and Epidemiology)

11 pages, 407 KiB

Open AccessArticle

Passive Smoking Exposure in Living Environments Reduces Cognitive Function: A Prospective Cohort Study in Older Adults

by Fan He, Tian Li, Junfen Lin, Fudong Li, Yujia Zhai, Tao Zhang, Xue Gu and Genming Zhao

Int. J. Environ. Res. Public Health 2020, 17(4), 1402; https://doi.org/10.3390/ijerph17041402 - 21 Feb 2020

Cited by 15 | Viewed by 3008

Abstract

There is currently no consensus regarding the effects of passive smoking exposure on cognitive function in older adults. We evaluated 7000 permanent residents from six regions within Zhejiang Province, China, aged ≥60 years, without cognitive impairment at baseline and during follow-up examinations for two years. The Chinese version of the Mini-Mental State Examination was used to assess the participants’ cognitive function. Multivariate regression analyses were carried out to calculate the adjusted relative risks (RRs) as measures of the association between passive smoking exposure and cognitive impairment after adjusting for potential confounders. The results showed an association between passive smoking exposure in the living environment and increased risk of cognitive impairment (RR: 1.16; 95% confidence interval (CI): 1.01–1.35). No dose–response relationship between the cumulative dose of passive smoking exposure (days) and cognitive impairment was observed. The results of stratified analyses suggested a harmful effect of passive smoking exposure on cognitive function in non-smokers (RR: 1.24; 95% CI: 1.06–1.46), but not in smokers (RR: 1.11; 95% CI: 0.71–1.92). Therefore, passive smoking exposure increased the risk of cognitive impairment in older adults, especially non-smokers. More effective measures to restrict smoking in the living environment should be developed and implemented. Full article

(This article belongs to the Special Issue Global Public Health and Epidemiology)

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10 pages, 1128 KiB

Open AccessArticle

Levels and Determinants of Fine Particulate Matter and Carbon Monoxide in Kitchens Using Biomass and Non-Biomass Fuel for Cooking

by Zafar Fatmi, Georgia Ntani and David Coggon

Int. J. Environ. Res. Public Health 2020, 17(4), 1287; https://doi.org/10.3390/ijerph17041287 - 17 Feb 2020

Cited by 11 | Viewed by 2515

Abstract

To assist interpretation of a study in rural Pakistan on the use of biomass for cooking and the risk of coronary heart disease, we continuously monitored airborne concentrations of fine particulate matter (PM_2.5) and carbon monoxide (CO) for up to 48 h in the kitchens of households randomly selected from the parent study. Satisfactory data on PM_2.5 and CO respectively were obtained for 16 and 17 households using biomass, and 19 and 17 using natural gas. Linear regression analysis indicated that in comparison with kitchens using natural gas, daily average PM_2.5 concentrations were substantially higher in kitchens that used biomass in either a chimney stove (mean difference 611, 95% CI: 359, 863 µg/m³) or traditional three-stone stove (mean difference 389, 95% CI: 231, 548 µg/m³). Daily average concentrations of CO were significantly increased when biomass was used in a traditional stove (mean difference from natural gas 3.7, 95% CI: 0.8, 6.7 ppm), but not when it was used in a chimney stove (mean difference −0.8, 95% CI: −4.8, 3.2 ppm). Any impact of smoking by household members was smaller than that of using biomass, and not clearly discernible. In the population studied, cooking with biomass as compared with natural gas should serve as a good proxy for higher personal exposure to PM_2.5. Full article

(This article belongs to the Special Issue Global Public Health and Epidemiology)

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15 pages, 921 KiB

Open AccessArticle

Explaining Income-Related Inequalities in Dietary Knowledge: Evidence from the China Health and Nutrition Survey

by Yongjian Xu, Siyu Zhu, Tao Zhang, Duolao Wang, Junteng Hu, Jianmin Gao and Zhongliang Zhou

Int. J. Environ. Res. Public Health 2020, 17(2), 532; https://doi.org/10.3390/ijerph17020532 - 15 Jan 2020

Cited by 25 | Viewed by 3804

Abstract

Lack of adequate dietary knowledge may result in poor health conditions. This study aims to measure income-related inequality in dietary knowledge, and to explain the sources of the inequality. Data were from the China Health and Nutrition Survey (CHNS) conducted in 2015. A summary of the dietary knowledge score and dietary guideline awareness was used to measure the dietary knowledge of respondents. The concentration index was employed as a measure of socioeconomic inequality and was decomposed into its determining factors. The study found that the proportion of respondents who correctly answered questions on dietary knowledge was significantly low for some questions. Compared to rural residents, urban residents had a higher proportion of correctly answered dietary knowledge questions. In addition, there are pro-rich inequalities in dietary knowledge. This observed inequality is determined not only by individual factors but also high-level area factors. Our study recommends that future dietary education programs could take different strategies for individuals with different educational levels and focus more on disadvantaged people. It would be beneficial to consider local dietary habits in developing education materials. Full article

(This article belongs to the Special Issue Global Public Health and Epidemiology)

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15 pages, 335 KiB

Open AccessArticle

Factors Associated with Practice-Level Performance Indicators in Primary Health Care in Hungary: A Nationwide Cross-Sectional Study

by Nóra Kovács, Anita Pálinkás, Valéria Sipos, Attila Nagy, Nouh Harsha, László Kőrösi, Magor Papp, Róza Ádány, Orsolya Varga and János Sándor

Int. J. Environ. Res. Public Health 2019, 16(17), 3153; https://doi.org/10.3390/ijerph16173153 - 29 Aug 2019

Cited by 10 | Viewed by 2580

Abstract

The performance of general practitioners (GPs) is frequently assessed without considering the factors causing variability among general medical practices (GMPs). Our cross-sectional national-based study was performed in Hungary to evaluate the influence of GMP characteristics on performance indicators. The relationship between patient’s characteristics (age, gender, education) and GMP-specific parameters (practice size, vacancy of GP’s position, settlement type, and county of GMP) and the quality of care was assessed by multilevel logistic regression models. The variations attributable to physicians were small (from 0.77% to 17.95%). The education of patients was associated with 10 performance indicators. Practicing in an urban settlement mostly increased the quality of care for hypertension and diabetes care related performance indicators, while the county was identified as one of the major determinants of variability among GPs’ performance. Only a few indicators were affected by the vacancy and practice size. Thus, the observed variability in performance between GPs partially arose from demographic characteristics and education of patients, settlement type, and regional location of GMPs. Considering the real effect of these factors in evaluation would reflect better the personal performance of GPs. Full article

(This article belongs to the Special Issue Global Public Health and Epidemiology)

13 pages, 491 KiB

Open AccessArticle

New Health Care Reform and Impoverishment among Chronic Households in China: A Random-Intercept Approach

by Yongjian Xu, Anupam Garrib, Zhongliang Zhou, Duolao Wang, Jianmin Gao, Xiaowei Yang, Xiaojing Fan and Gang Chen

Int. J. Environ. Res. Public Health 2019, 16(6), 1074; https://doi.org/10.3390/ijerph16061074 - 26 Mar 2019

Cited by 4 | Viewed by 3978

Abstract

High out-of-pocket (OOP) payments for chronic disease care often contribute directly to household poverty. Although previous studies have explored the determinants of impoverishment in China, few published studies have compared levels of impoverishment before and after the New Health Care Reform (NHCR) in households with members with chronic diseases (hereafter referred to as chronic households). Our study explored this using data from the fourth and fifth National Health Service Surveys conducted in Shaanxi Province. In total, 1938 households in 2008 and 7700 households in 2013 were included in the analysis. Rates of impoverishment were measured using a method proposed by the World Health Organization. Multilevel logistic modeling was used to explore the influence of the NHCR on household impoverishment. Our study found that the influence of NHCR on impoverishment varied by residential location. After the reform, in rural areas, there was a significant decline in impoverishment, although the impoverishment rate remained high. There was little change in urban areas. In addition, impoverishment in the poorest households did not decline after the NHCR. Our findings are important for policy makers in particular for evaluating reform effectiveness, informing directions for health policy improvement, and highlighting achievements in the efforts to alleviate the economic burden of households that have members with chronic diseases. Full article

(This article belongs to the Special Issue Global Public Health and Epidemiology)

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14 pages, 312 KiB

Open AccessArticle

Associations between Knowledge of the Causes and Perceived Impacts of Climate Change: A Cross-Sectional Survey of Medical, Public Health and Nursing Students in Universities in China

by Lianping Yang, Wenmin Liao, Chaojie Liu, Na Zhang, Shuang Zhong and Cunrui Huang

Int. J. Environ. Res. Public Health 2018, 15(12), 2650; https://doi.org/10.3390/ijerph15122650 - 26 Nov 2018

Cited by 40 | Viewed by 6575

Abstract

This study aimed to measure the knowledge and perceptions of medical, public health, and nursing students about climate change and its impacts, and to identify associations between the knowledge and perceptions. Data were from a nationwide cross-sectional survey of 1387 students sampled in five different regional universities in China (April–May 2017). The knowledge and perceptions of the participants were collected by self-administered questionnaires. We found that most respondents believed that climate change is generally “bad” (83%) and bad for human health (88%), while 67% believed that climate change is controllable. The vast majority of respondents acknowledged illness conditions resulting from poor air quality (95%), heat stress (93%), and extreme weather events (91%) as potential impacts of climate change. Nevertheless, only 39% recognized malnutrition as a consequence of food deprivation resulting from climate change. Around 58% of respondents could correctly identify the causes of climate change. The knowledge of the causes of climate change was not associated with the ability to recognize the health consequences of climate change. However, the knowledge of causes of climate change was a significant predictor of increased awareness of the negative impacts of climate change between the medical and nursing students, although this was not the case among their public health counterparts. Poor knowledge about the causes of climate change is evident among students in China. They are able to recognize the direct links between weather events and health, but less likely to understand the consequences involving complicated pathways. Research and training into the underlying mechanisms of health impacts of climate change needs to be strengthened. Full article

(This article belongs to the Special Issue Global Public Health and Epidemiology)

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13 pages, 1806 KiB

Open AccessReview

Cardiovascular Disease and the Female Disadvantage

by Mark Woodward

Int. J. Environ. Res. Public Health 2019, 16(7), 1165; https://doi.org/10.3390/ijerph16071165 - 1 Apr 2019

Cited by 166 | Viewed by 17178

Abstract

Age-standardised rates of cardiovascular disease (CVD) are substantially higher in men than women. This explains why CVD has traditionally been seen as a “man’s problem”. However, CVD is the leading cause of death in women, worldwide, and is one of the most common causes of disability-adjusted life-years lost. In general, this is under-recognised and, in several ways, women are disadvantaged in terms of CVD. Both in primary and secondary prevention, there is evidence that women are undertreated, compared to men. Women often experience heart disease in a different way compared to men, and lack of recognition of this has been shown to have adverse consequences. Female patients of male cardiac physicians have been found to have worse outcomes than their male counterparts, with no such gender differential for female cardiologists. Clinical trials in CVD primarily recruit male patients, yet, it is well recognised that some drugs act differently in women and men. Diabetes and smoking, and perhaps other risk factors, confer a greater proportional excess cardiovascular risk to women than to men, whilst adverse pregnancies and factors concerned with the female reproductive cycle give women added vulnerability to CVD. However, women’s health research is skewed towards mother and child health, an area where, arguably, the greatest public health gains have already been made, and breast cancer. Hence there is a need to redefine what is meant by “women’s health” to encompass the whole lifecycle, with a stronger emphasis on CVD and other non-communicable diseases. Sex-specific analyses of research data should be the norm, whenever feasible. Full article

(This article belongs to the Special Issue Global Public Health and Epidemiology)

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6 pages, 285 KiB

Open AccessHypothesis

Pollution, Particles, and Dementia: A Hypothetical Causative Pathway

by Anthony Seaton, Lang Tran, Ruoling Chen, Robert L. Maynard and Lawrence J. Whalley

Int. J. Environ. Res. Public Health 2020, 17(3), 862; https://doi.org/10.3390/ijerph17030862 - 30 Jan 2020

Cited by 19 | Viewed by 2778

Abstract

Epidemiological studies of air pollution have shown associations between exposure to particles and dementia. The mechanism of this is unclear. As these seem unlikely in terms of the very small dose likely to reach the brain in usual Western urban circumstances, we extend our 1995 hypothetical explanation of the association of air pollution with cardiac deaths as a plausible alternative explanation of its associations with dementia. Since our original proposal, it has become apparent that inflammation may be carried by blood from organ to organ by biologic microparticles derived from cell membranes. These transmit inflammatory messages to endothelial cells throughout the body as part of a general defensive response to assumed bacterial infection; particulate air pollution has recently been shown to be associated with their release into the blood. We propose that episodic release of biologic microparticles from pollution-induced lung inflammation causes secondary inflammation in the blood-brain barrier and cerebral microbleeds, culminating over time in cognitive impairment. Ultimately, by incomplete repair and accumulation of amyloid, this increases the risk of Alzheimer’s disease. Importantly, this mechanism may also explain the relationships of other inflammatory conditions and environmental factors with cognitive decline, and point to new opportunities to understand and prevent dementia. Full article

(This article belongs to the Special Issue Global Public Health and Epidemiology)

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