International Journal of Environmental Research and Public Health

17 pages, 1334 KiB

Open AccessArticle

Well-Being of Family Caregivers of Individuals with Spinal Cord Injury: The Moderating Effects of Online Versus In-Person Social Support

by Victoria Bogle, William C. Miller, Heather Cathcart and Somayyeh Mohammadi

Int. J. Environ. Res. Public Health 2025, 22(7), 1075; https://doi.org/10.3390/ijerph22071075 (registering DOI) - 5 Jul 2025

Abstract

Objective: Family members of individuals with spinal cord injury often take on caregiving responsibilities, which can lead to caregiver burden. One factor that can mitigate the adverse effects of caregiving, such as caregiver burden, is receiving social support. Caregivers can obtain support from [...] Read more.

Objective: Family members of individuals with spinal cord injury often take on caregiving responsibilities, which can lead to caregiver burden. One factor that can mitigate the adverse effects of caregiving, such as caregiver burden, is receiving social support. Caregivers can obtain support from people they meet in person (in-person support) and on social media platforms (online support). The current cross-sectional correlational design study investigated the moderating effect of in-person and online support on the association between relationship quality, caregiver competence, caregiver distress, and caregiver burden (dependent variables). Methods: Family caregivers of an individual with spinal cord injury (n = 115) completed an online survey assessing relationship quality, competence, distress, burden, and in-person and online supports. Results: Moderation analyses showed that the negative associations between relationship quality and physical burden (B = −0.58; p = 0.019) and caregiver competence and physical burden (B = −0.73; p = 0.013) were more pronounced at higher levels of online social support. Furthermore, the magnitude of the negative associations between relationship quality and emotional burden (B = −0.52; p < 0.001) and caregiver competence and emotional burden (B = −0.34, p = 0.012) were more pronounced at higher levels of in-person social support. Moderation analyses also revealed that the positive association between distress and social burden (B = 0.47; p = 0.029) and emotional burden (B = 0.26; p = 0.045) were stronger when caregivers reported higher levels of online support. Conclusions: In-person and online support can buffer some aspects of caregiver burden on caregiver well-being. While online support is usually considered beneficial, greater online engagement may contribute to higher levels of burden when the distress is high. It is possible, however, that caregivers who are more distressed engage more with online media to receive support. Full article

(This article belongs to the Special Issue Family Caregiving, Nursing and Health Promotion)

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10 pages, 1006 KiB

Open AccessArticle

U.S. Federal and State Medicaid Spending: Health Policy Patterns by Political Party Leadership and Census Demographics

by Jamaji C. Nwanaji-Enwerem and Pamaji Nwanaji-Enwerem

Int. J. Environ. Res. Public Health 2025, 22(7), 1074; https://doi.org/10.3390/ijerph22071074 - 4 Jul 2025

Abstract

Medicaid is a vital public health program, serving over 70 million Americans from many backgrounds. Understanding how Medicaid spending varies by political leadership and demographic factors can inform policy discussions and advocacy efforts. We conducted a cross-sectional descriptive analysis of state Medicaid spending [...] Read more.

Medicaid is a vital public health program, serving over 70 million Americans from many backgrounds. Understanding how Medicaid spending varies by political leadership and demographic factors can inform policy discussions and advocacy efforts. We conducted a cross-sectional descriptive analysis of state Medicaid spending using publicly available data. Our findings show that individuals identifying as White comprise the largest single racial group of Medicaid beneficiaries both nationally and in most states. While the 2020 Census Diversity Index correlated strongly with total Medicaid spending, no significant association was found with per enrollee spending or the federal share of Medicaid funding. States led by Democrats had higher total Medicaid spending when compared to Republican-led states. However, Republican-led states received a larger proportion of federal Medicaid funding. Among political leadership levels, Senate representation showed the strongest relationship with Medicaid spending trends compared to gubernatorial leadership and presidential voting history. In conclusion, we demonstrate that Medicaid spending impacts all racial groups and both major political parties. However, funding structures and political representation reflect distinct spending patterns. Given the evolving demographic and political landscape, ongoing policy discussions should ensure that Medicaid remains a public health program that remains effective at safeguarding human health. Full article

(This article belongs to the Special Issue Health Economics Perspectives on Health Promotion and Health Equity)

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13 pages, 761 KiB

Open AccessArticle

Ex-Vapers’ Perspectives on Helpful and Unhelpful Influences During Their Quit Journeys

by Mohammed Al-Hamdani, Courtney McKay, Katelynn Carter-Rogers and Steven Smith

Int. J. Environ. Res. Public Health 2025, 22(7), 1073; https://doi.org/10.3390/ijerph22071073 - 4 Jul 2025

Abstract

There is limited understanding of what influences vaping cessation, especially as vaping regulations change, and different jurisdictions have different regulations. This study involves 281 ex-vapers (16–24 years) from Nova Scotia, Canada. A content analysis was used to understand and compare youth and young [...] Read more.

There is limited understanding of what influences vaping cessation, especially as vaping regulations change, and different jurisdictions have different regulations. This study involves 281 ex-vapers (16–24 years) from Nova Scotia, Canada. A content analysis was used to understand and compare youth and young adults’ (YA) experiences of quitting vaping. Both helpful and unhelpful factors for quitting vaping were identified; each category had five themes and twenty-one sub-themes. Helpful factors were consistent across both age categories and included planned and unplanned vaping control interventions, health concerns, social support, evidence-based support, and unassisted quitting methods. Similarly, the five themes identified as unhelpful factors were consistent for both age groups: negative personal implications, negative social influences, planned and unplanned vaping control interventions, the side effects of previous use, and simultaneous and alternative substance use. Policies that limit access and raise awareness about lung health and well-being can help youth quit vaping. For YAs, increasing awareness about social support and health concerns is crucial. Raising e-cigarette costs and reducing vaping normalization supports quitting for YAs. Stress reduction and training to handle social pressure could aid youth, while YAs might benefit from treatment for other substance use to help with nicotine quitting. Full article

(This article belongs to the Special Issue Regulating the Use of Electronic Devices for Vaping and Vaping to Promote Youth and Young Adult Health)

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16 pages, 284 KiB

Open AccessArticle

Examining the Impact of the COVID-19 Pandemic on Suicide-Attempt Survivors

by Martina Fruhbauerova, Julie Cerel, Athena Kheibari, Alice Edwards, Jessica Stohlmann-Rainey and Dese’Rae Stage

Int. J. Environ. Res. Public Health 2025, 22(7), 1072; https://doi.org/10.3390/ijerph22071072 - 4 Jul 2025

Abstract

Despite initial concerns about the severe negative impact of COVID-19 on individuals with a history of mental health problems and suicide attempts, its effects remain unclear. This study examined the pandemic’s impact on individuals with and without lived experience of suicide attempts. An [...] Read more.

Despite initial concerns about the severe negative impact of COVID-19 on individuals with a history of mental health problems and suicide attempts, its effects remain unclear. This study examined the pandemic’s impact on individuals with and without lived experience of suicide attempts. An online nationwide sample of 1351 adults from the United States completed questionnaires from 26 May to 25 June 2021. A history of suicide attempt(s) (n = 159; 12%) was associated with significantly higher odds of utilizing mental health services, hospitalization for psychiatric reasons, and contacting hotlines. This history predicted worse outcomes in functioning, optimism, despair, and impairment. Notably, 57.6% of these individuals believed surviving a suicide attempt made them more resilient, while 21.9% expressed uncertainty about its impact on their resilience. In sum, participants with a history of suicide attempt(s) reported more depressive symptoms, worse daily functioning, more despair, less optimism, and greater service utilization during the pandemic, yet many also cited increased resilience due to their suicide history. Full article

(This article belongs to the Section Behavioral and Mental Health)

20 pages, 665 KiB

Open AccessArticle

Improving Access to Radiotherapy in Gauteng: A Framework for Equitable Cancer Care

by Portia N. Ramashia, Pauline B. Nkosi and Thokozani P. Mbonane

Int. J. Environ. Res. Public Health 2025, 22(7), 1071; https://doi.org/10.3390/ijerph22071071 - 3 Jul 2025

Abstract

Radiotherapy, a critical component of cancer treatment, faces significant challenges in Gauteng, South Africa. These disparities hinder the achievement of Sustainable Development Goal 3, primarily due to systemic issues, socioeconomic barriers, and limitations within the health system. This article presents the House framework, [...] Read more.

Radiotherapy, a critical component of cancer treatment, faces significant challenges in Gauteng, South Africa. These disparities hinder the achievement of Sustainable Development Goal 3, primarily due to systemic issues, socioeconomic barriers, and limitations within the health system. This article presents the House framework, designed to enhance access to radiotherapy services by integrating the WHO Health Systems framework with the dimensions of access proposed by Penchansky and Thomas. The framework is visually represented as a house, with Policy & Governance as the foundation, WHO building blocks as pillars, and Equitable Cancer Care and Improved Outcomes as the roof. A mixed-methods approach was utilized, combining quantitative data from radiotherapy facilities and qualitative insights from healthcare professionals to identify barriers and potential solutions. Findings indicate significant disparities in resource distribution and accessibility between public and private institutions, compounded by socioeconomic factors like transport costs and lack of awareness. The article discusses innovative proposed framework using the 5As of access as potential solutions. The House framework serves as a valuable tool for policymakers and healthcare providers aiming to improve radiotherapy access and promote equitable cancer care in Gauteng, ultimately working towards reducing disparities in cancer outcomes. Full article

(This article belongs to the Special Issue Advancing Health Equity—Addressing Cancer Disparities)

25 pages, 647 KiB

Open AccessArticle

Self-Management at Work’s Moderating Effect on the Relations Between Psychosocial Work Factors and Well-Being

by Carol-Anne Gauthier, Tyler Pacheco, Élisabeth Proteau, Émilie Auger and Simon Coulombe

Int. J. Environ. Res. Public Health 2025, 22(7), 1070; https://doi.org/10.3390/ijerph22071070 - 3 Jul 2025

Abstract

Mental health self-management (MHS) strategies may help workers with mental health concerns preserve and enhance their well-being. However, little research has explored how these strategies may help mitigate the effects of negative psychosocial work factors (PWFs) on well-being outcomes. This cross-sectional study investigated [...] Read more.

Mental health self-management (MHS) strategies may help workers with mental health concerns preserve and enhance their well-being. However, little research has explored how these strategies may help mitigate the effects of negative psychosocial work factors (PWFs) on well-being outcomes. This cross-sectional study investigated (1) the relationship between PWFs and well-being, (2) the association between MHS at work and well-being, and (3) the moderating role of self-management in preventing negative PWFs’ deleterious effects. A sample of 896 Francophone workers in Canada completed a questionnaire that included self-reported measures related to workplace, self-management, and well-being. Structural equation modeling (conducted via the MPlus software, version 8.6) revealed that psychological demands were negatively related to positive well-being outcomes and positively associated with adverse well-being outcomes. Competency-related autonomy was positively associated with flourishing, and recognition was positively associated with flourishing and positive well-being at work, as well as being negatively associated with burnout and depression. Surprisingly, supervisor support was negatively related to positive well-being and positively related to burnout and depression. MHS was positively associated with positive well-being at work, flourishing, and work performance, but had no relationship with negative mental health. MHS significantly moderated the relationship between each PWF and well-being at work in both beneficial and adverse ways, depending on the specific well-being indicator being considered. From a workplace well-being perspective, this suggests that although self-management may help workers preserve and enhance their positive well-being, organizations must also directly target PWFs to prevent negative well-being outcomes. Full article

(This article belongs to the Special Issue Health Literacy, Promotion and Prevention Improve Workers’ Health)

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12 pages, 468 KiB

Open AccessReview

Hot Weather and Violence Against Women: A Global Scoping Review

by Chiratidzo Hope Mulambo, Rishu Thakur and Supriya Mathew

Int. J. Environ. Res. Public Health 2025, 22(7), 1069; https://doi.org/10.3390/ijerph22071069 - 3 Jul 2025

Abstract

Temperature increases due to climatic changes have been increasingly recognized as posing significant public health challenges, with wide-ranging socio-economic implications. This scoping review examines the relationship between high temperatures and violence against women (VAW) globally. Nine studies from both high-income and low- and [...] Read more.

Temperature increases due to climatic changes have been increasingly recognized as posing significant public health challenges, with wide-ranging socio-economic implications. This scoping review examines the relationship between high temperatures and violence against women (VAW) globally. Nine studies from both high-income and low- and middle-income countries were included in this review. The findings suggest an overall positive association between high temperatures and rates of VAW. Theoretical frameworks, including the temperature–aggression hypothesis and routine activity theory, offer insights into the mechanisms driving this relationship. Key risk factors such as socioeconomic status, urban heat island effects, rurality, patriarchal norms, and alcohol consumption were considered to be risk factors affecting rates of VAW. Despite growing evidence, research gaps persist, particularly in regions with high rates of VAW and in the form of qualitative studies that capture women’s lived experiences. The positive associations between temperature and VAW underscore the urgency of integrating gender-sensitive strategies into climate adaptation policies to mitigate the compounding risks of climate change and gender-based violence. Full article

(This article belongs to the Collection 2nd Edition of Achieving Environmental Health Equity: Great Expectations)

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13 pages, 280 KiB

Open AccessArticle

The Hidden Danger of Unintentional Child Injuries in an Urban Domestic Environment: Considering Unintentional Injuries from Another Angle

by Ping Tang, Qin Fan, Jingmin Sun, Jianlin Ji, Liling Yang, Wenjuan Tang and Qunfeng Lu

Int. J. Environ. Res. Public Health 2025, 22(7), 1068; https://doi.org/10.3390/ijerph22071068 - 3 Jul 2025

Abstract

Background: Unintentional injuries are the primary cause of death and disability among children. This study aimed to examine the current status of home environments for children aged 0–6 years in the Shanghai area of China and assess the factors that pose safety hazards [...] Read more.

Background: Unintentional injuries are the primary cause of death and disability among children. This study aimed to examine the current status of home environments for children aged 0–6 years in the Shanghai area of China and assess the factors that pose safety hazards for unintentional injuries within households. Methods: A cross-sectional survey was carried out in Shanghai between November 2021 and October 2023. Results: Parents from 1825 families, with 929 (50.90%) boys and 896 (49.10%) girls, participated in this research. In all, 752 children (41.21%) experienced unintentional injuries. The home environment posed a high risk of unintentional injuries in 1008 families (55.23%), medium risk in 381 families (20.88%), and low risk in 436 families (23.89%). The results showed a negative correlation between the occurrence of unintentional injuries and the status of the family environment; children in families with high-risk home environments were more likely to experience unintentional injuries (odds ratio [OR] = 1.490, confidence interval [CI] = 1.216–1.826), fall injuries (OR = 1.605, CI = 1.268–2.031), and external injuries (OR = 1.578, CI = 1.159–2.148). Conclusions: Parents should enhance their safety awareness by focusing on potential hazards at home and taking appropriate measures to improve the home environment, thereby creating a safe and comfortable setting for the healthy growth of their children. Full article

(This article belongs to the Section Environmental Health)

18 pages, 673 KiB

Open AccessArticle

Children’s Nature Use and Related Constraints: Nationwide Parental Surveys from Norway in 2013 and 2023

by Vegard Gundersen, Zander Venter, Odd Inge Vistad, Berit Junker-Köhler and Line Camilla Wold

Int. J. Environ. Res. Public Health 2025, 22(7), 1067; https://doi.org/10.3390/ijerph22071067 - 3 Jul 2025

Abstract

A growing number of research studies show that children spend less time in natural environments, which may have detrimental effects on children’s mental and physical health. This study explores changes in children’s (6–12 years) use of nearby nature and constraints on playing in [...] Read more.

A growing number of research studies show that children spend less time in natural environments, which may have detrimental effects on children’s mental and physical health. This study explores changes in children’s (6–12 years) use of nearby nature and constraints on playing in nature between 2013 and 2023. We apply an ecological approach, including individual, social, and structural constraints on outdoor play. The study is based on national surveys of parents reporting child play behavior for eight activity categories and nineteen categories of constraints/motivation. Findings reveal a decreasing tendency for time spent on all activity categories and increasing constraints for 17 of 19 categories during the study period. Our ecological approach reveals that there is less time for children’s nature use in contemporary society, and activities are more common in built areas than in nature. The survey identifies some important socio-cultural differences regarding gender, age, and residential setting. In future research, the focus should be on how reduced connection to nature affects children’s mental and physical health, and beyond this, how it affects the understanding of and care for nature among future generations. Full article

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31 pages, 587 KiB

Open AccessReview

Transition of Mental Health Services from Institutional to Community-Based Care Abroad and Its Context for Slovenia—Advantages and Risks

by Katja Horvat Golob, Alenka Temeljotov Salaj and Brigita Novak Šarotar

Int. J. Environ. Res. Public Health 2025, 22(7), 1066; https://doi.org/10.3390/ijerph22071066 - 3 Jul 2025

Abstract

Deinstitutionalization is a transition from psychiatric hospitals and other mental health institutions as the primary setting for treatment of individuals with chronic mental health disorders to a range of services, including psychiatric care, that support independent functioning of an individual within the community. [...] Read more.

Deinstitutionalization is a transition from psychiatric hospitals and other mental health institutions as the primary setting for treatment of individuals with chronic mental health disorders to a range of services, including psychiatric care, that support independent functioning of an individual within the community. The transition has been encouraged by guidelines from the European Expert Group and further specified in the Slovenian Resolution on the National Programme of Mental Health 2018–2028. This integrated systematic and narrative literature review includes 47 international articles from PubMed, along with information on Slovenian mental health legislation and its implementation, to provide insights into deinstitutionalization abroad and its relevance for Slovenia. Although the transition to community-based care is welcomed for promoting independence and respecting individuals’ wants, there are cases where institutional care remains necessary to ensure safety and treatment during the exacerbation of chronic mental health disorders. The quality of care and outcomes generally improve with community-based care. However, the closure of institutions can lead to many unintended consequences, such as the revolving door phenomenon and transinstitutionalization. Both the advantages of community-based care and the important roles of mental health hospitals and other institutions are emphasized. Full article

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13 pages, 259 KiB

Open AccessArticle

COVID-19 and the Syndemic of Intimate Partner Violence, Mental Health, Substance Use, and HIV Care Engagement Among Black Sexual Minority Men Living with HIV in the US South

by Carrie L. Nacht, Hannah E. Reynolds, Chadwick K. Campbell, Kirstin Kielhold, Wilson Vincent, Daniel E. Siconolfi, Susan M. Kegeles and Erik D. Storholm

Int. J. Environ. Res. Public Health 2025, 22(7), 1065; https://doi.org/10.3390/ijerph22071065 - 3 Jul 2025

Abstract

Background: Black sexual minority men (BSMM) are disproportionately affected by HIV incidence and have lower rates of HIV care engagement (e.g., retention in care, viral suppression), particularly in the US South. The COVID-19 pandemic exacerbated co-occurring psychosocial syndemic factors (e.g., depression, violence, substance [...] Read more.

Background: Black sexual minority men (BSMM) are disproportionately affected by HIV incidence and have lower rates of HIV care engagement (e.g., retention in care, viral suppression), particularly in the US South. The COVID-19 pandemic exacerbated co-occurring psychosocial syndemic factors (e.g., depression, violence, substance use) that disproportionately impact BSMM living with HIV (BSMM+), but the impact of the pandemic on HIV care engagement among BSMM+ in the US South has not been explored in depth. Methods: BSMM+ (n = 27) were recruited from a longitudinal cohort in Dallas and Houston, Texas. Participants with less-than-optimal HIV care engagement, previous experiences of intimate partner violence (IPV), and prevalence of self-reported substance use were purposively selected for in-depth interviews from June 2022 to August 2023. Interviews lasted 54 min on average and were audio-recorded, transcribed, and de-identified before applying a thematic analysis approach. Results: Over half of participants experienced a relationship with IPV, used illicit substances in the past 60 days, and were depressed. Interviews highlighted that, during the COVID-19 pandemic, heightened levels of depression, substance use, and IPV individually and synergistically inhibited ART adherence and HIV care engagement. Participants described how IPV served to worsen their mental health and substance use, which, in turn, were the core drivers of poor HIV care engagement. Conclusions: The findings suggest that the COVID-19 pandemic exacerbated the syndemics of IPV, mental health, and substance use, and these acted as barriers to HIV care engagement. Future adherence interventions should synergistically address syndemic factors to maximize effectiveness. Full article

(This article belongs to the Special Issue HIV Care Engagement and Quality of Life Among People Living with HIV)

17 pages, 1269 KiB

Open AccessArticle

Reconstructing Cross-Cultural Meanings of Addiction Among Women from Three Countries

by Caitlyn D. Placek, Lora Adair, Ishita Jain, Sugandh Gupta, Vandana Phadke and Maninder Singh

Int. J. Environ. Res. Public Health 2025, 22(7), 1064; https://doi.org/10.3390/ijerph22071064 - 3 Jul 2025

Abstract

The gender gap in drug use is narrowing in regions where access to criminalized substances, such as opioids, is increasing. While research shows that substance use is gendered, less is known about the cultural norms and values shaping women’s drug use, as most [...] Read more.

The gender gap in drug use is narrowing in regions where access to criminalized substances, such as opioids, is increasing. While research shows that substance use is gendered, less is known about the cultural norms and values shaping women’s drug use, as most studies focus on men. Cross-national comparisons of cultural models of addiction are needed to better understand how addiction is perceived and to inform culturally responsive treatment approaches for women. This study examined cultural models of addiction among reproductive-aged women receiving treatment for substance misuse in London, Toronto, and Delhi. Participants completed a semi-structured questionnaire with open-ended and free-list prompts. Findings revealed shared cultural models attributing drug use to psychological factors, such as self-medicating to manage negative emotions or enhance positive ones, as well as relational, developmental, and biological influences. In conclusion, the study highlights the importance of incorporating cultural models into research and treatment. By using an inductive approach to explore meanings surrounding drug use among people in recovery, researchers can better understand how interventions are received and interpreted through existing internal frameworks. Full article

(This article belongs to the Section Behavioral and Mental Health)

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15 pages, 785 KiB

Open AccessReview

Health Care and Access to Quality Social-Health Services of the Roma and Sinti: A Scoping Review

by Danilo Buonsenso, Davide Pata, Francesca Raffaelli, Giorgio Malorni, Francesca Colaiaco and Walter Malorni

Int. J. Environ. Res. Public Health 2025, 22(7), 1063; https://doi.org/10.3390/ijerph22071063 - 2 Jul 2025

Abstract

Background: The aim of this scoping review is to analyze the health status of Roma and Sinti in Europe, highlighting the issues faced by children and women. In addition, we want to examine the access of these groups to health care services and [...] Read more.

Background: The aim of this scoping review is to analyze the health status of Roma and Sinti in Europe, highlighting the issues faced by children and women. In addition, we want to examine the access of these groups to health care services and to identify possible interventions to increase their use. Methods: Our research was conducted on Pubmed, Google Scholar, and the Trip Database. We selected articles written in English, Spanish, and Italian published since 2015. Results: Studies have shown that the health status of Roma and Sinti populations is generally worse than that of the rest of the population. Limited access to care is due to several specific factors, such as beliefs, traditions, and the lack of awareness of widespread direct and indirect discrimination against these groups by healthcare professionals. The studies reviewed have shown how mistrust can be broken down through multi-centered interventions linked to information, education, and communication through mediators able to interact with these populations, as well as through appropriate training of the health workers in charge. Conclusions: The health of the Roma and Sinti populations is commonly worse than that of the rest of the population. This is particularly true for the large proportion of people confined to suburban camps. However, the available evidence signals the low quality of life they experience and the need for interventions involving the communities and the establishment of ad hoc orientation or initial care contact points in the segregated areas. This could lead to an improvement in the integration of this population into the National Health Systems’ activities. Full article

(This article belongs to the Special Issue Advances in Primary Health Care and Community Health)

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24 pages, 360 KiB

Open AccessArticle

Depression and Anxiety Outcomes Among Young Adults Who Self-Reported Experiencing Commercial Sexual Exploitation in Adolescence

by Sarah M. Godoy, Adam R. Englert, Nofar Mazursky, Luisa Prout and William J. Hall

Int. J. Environ. Res. Public Health 2025, 22(7), 1062; https://doi.org/10.3390/ijerph22071062 - 2 Jul 2025

Abstract

The commercial sexual exploitation (CSE) of children is a distinct form of sexual trauma, resulting in immediate mental health issues. Few studies explore associations between family-level factors in adolescence and health outcomes in adulthood among this population. Utilizing a nationally representative dataset, we [...] Read more.

The commercial sexual exploitation (CSE) of children is a distinct form of sexual trauma, resulting in immediate mental health issues. Few studies explore associations between family-level factors in adolescence and health outcomes in adulthood among this population. Utilizing a nationally representative dataset, we explored differences and associations between mental health outcomes and domains of the Family Health Development framework among respondents who self-reported CSE (N = 502; mean age = 15.03, SD = 1.34; 67% male; 50% white). We conducted ordinary least squares and binary logistic regressions using a hierarchical approach to analyze the CES-D depression scale, anxious personality scale, and self-reported diagnoses of depression and anxiety/panic disorder. At Wave IV, when participants were aged 24–32, 20% of participants reported ever having a diagnosis of depression, and 12% reported ever having an anxiety/panic disorder diagnosis. Family receipt of public assistance during adolescence significantly predicted depression and anxiety symptoms in adulthood, highlighting associations between family structure and mental health. Gender and race significantly predicted anxiety symptoms and having a diagnosis of depression and anxiety/panic disorder. Findings underscore the need for targeted training and comprehensive health screenings for providers to better understand and address the long-term mental health needs of CSE-impacted groups. Full article

(This article belongs to the Special Issue Biopsychosocial Predictors of Vulnerability, Resilience, and Intervention Responsiveness Among Trauma-Exposed Populations)

35 pages, 498 KiB

Open AccessReview

A Scoping Review on the Coping Strategies Used by Intimate Partner Violence Survivors

by Xiu Hui Ong, Poh Chua Siah, Qiu Ting Chie and Wan Ying Lee

Int. J. Environ. Res. Public Health 2025, 22(7), 1061; https://doi.org/10.3390/ijerph22071061 - 2 Jul 2025

Abstract

Intimate partner violence (IPV) is a widespread issue with severe consequences for women’s well-being. This scoping review synthesizes research on coping strategies among female IPV survivors, evaluates measurement approaches, and assesses the applicability of the 11 families of coping framework. Analyzing 27 studies [...] Read more.

Intimate partner violence (IPV) is a widespread issue with severe consequences for women’s well-being. This scoping review synthesizes research on coping strategies among female IPV survivors, evaluates measurement approaches, and assesses the applicability of the 11 families of coping framework. Analyzing 27 studies (2017–2022) from the Scopus database, we identified key coping patterns. In response to the first research question, the review revealed methodological diversity, with qualitative interviews predominating (55.56% of studies) alongside quantitative measures such as the Brief-COPE and IPV Strategies Index. All documented coping strategies were successfully categorized using Skinner’s framework, demonstrating its comprehensive utility for IPV research. This complete categorization directly answers our second research question, confirming the framework’s effectiveness for classifying IPV coping strategies. By using this framework, we identified key coping patterns, with seeking social support emerging as the most prevalent strategy (88.89% of studies), followed by escape–avoidance (55.56%) and problem-solving (44.44%). The findings underscore the value of adopting a standardized classification system to enhance consistency across studies and improve comparative analyses. The study contributes to theoretical development by validating Skinner’s model in IPV contexts and offers practical guidance for future research design. By demonstrating the universal applicability of the 11 families of coping, this scoping review provides a foundation for systematic investigations of coping mechanisms and informs targeted support interventions for survivors. Full article

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10 pages, 260 KiB

Open AccessArticle

Impact of Social Support on the Functioning of Patients Receiving Home Nursing Care

by Bożena Ewa Kopcych, Paweł Falkowski and Daniela Patricia Santos Costa

Int. J. Environ. Res. Public Health 2025, 22(7), 1060; https://doi.org/10.3390/ijerph22071060 - 2 Jul 2025

Abstract

The type of non-professional or professional support received affects the quality of life of the patient and their caregivers. Social support is the type of interaction that is taken by the patient and his caregivers in a problematic, difficult, stressful, or critical situation. [...] Read more.

The type of non-professional or professional support received affects the quality of life of the patient and their caregivers. Social support is the type of interaction that is taken by the patient and his caregivers in a problematic, difficult, stressful, or critical situation. Aim: The aim of the study was to assess the impact of social support on the functioning of patients under nursing home care. Material and methods: The study included 148 chronically ill patients under home nursing care. The study used the diagnostic survey method; the research technique was a questionnaire containing basic data about the respondent and the Social Support Scale (SWS) by Krystyna Kmiecik-Baran. Results: The need to continue the causal treatment at home means that the main source of support for care beneficiaries are nurses who provide medical services at the patient’s home, supported by doctors and family members of the patient. According to patients’ subjective assessment of the support they received from nurses, patients rated the informational support provided by nurses highest at 14.3 points and emotional support at 13.3 points (SD 1.776). on a scale where the maximum score was 16 points. In the opinion of the surveyed patients, the value-added support provided was the lowest-rated category by patients, 9.74 points (SD 2.505). Instrumental support was also rated very poorly by the respondents (10.17 points (SD 2.069). In each category, there was no statistically significant difference at the p < 0.05 level in the respondents’ evaluation, which means that the expressed opinion on each type of support from the highest to the lowest evaluation: informational, emotional, instrumental, and evaluative—overlapped in the patient group and the family group. Conclusions: Patients under home care highly appreciated the support provided to them by the nursing staff. Social support for a chronically ill person who requires constant care and care by the nursing staff is a form of direct impact that relieves stress and tension, minimizes the effects of the disease, directly affects the course of treatment and care, and prevents stigmatization. Full article

18 pages, 1420 KiB

Open AccessReview

Unequal Gains? A Literature Review on the Affordable Care Act’s Effects on Healthcare Utilization Across Racial and Ethnic Groups

by Ahmad Reshad Osmani

Int. J. Environ. Res. Public Health 2025, 22(7), 1059; https://doi.org/10.3390/ijerph22071059 - 2 Jul 2025

Abstract

The Affordable Care Act (ACA), implemented in 2010, aimed to expand healthcare access, reduce costs, and address long-standing disparities in the U.S. healthcare system, particularly among racial and ethnic minorities. This paper reviews the ACA’s impact on healthcare utilization for these populations, with [...] Read more.

The Affordable Care Act (ACA), implemented in 2010, aimed to expand healthcare access, reduce costs, and address long-standing disparities in the U.S. healthcare system, particularly among racial and ethnic minorities. This paper reviews the ACA’s impact on healthcare utilization for these populations, with a focus on insurance coverage, preventive services, and health outcomes. While Medicaid expansion significantly reduced uninsured rates and increased access to care in states that adopted the expansion, millions of low-income individuals, many of whom are racial and ethnic minorities, remain uninsured in non-expansion states. The elimination of cost-sharing for preventive services under the ACA contributed to increased utilization of cancer screenings, vaccinations, and other preventive measures among minority groups. However, challenges persist, including affordability barriers, geographic disparities, and cultural and linguistic obstacles. This review also highlights the ongoing need for policy interventions, such as nationwide Medicaid expansion, and future research on the long-term effects of the ACA on health outcomes for minority populations. Full article

(This article belongs to the Section Global Health)

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29 pages, 832 KiB

Open AccessArticle

Cultivating Well-Being: An Exploratory Analysis of the Integral Benefits of Urban Gardens in the Promotion of Active Ageing

by Noelia Fernández-Salido, Alfonso Gallego-Valadés, Carlos Serra-Castells and Jorge Garcés-Ferrer

Int. J. Environ. Res. Public Health 2025, 22(7), 1058; https://doi.org/10.3390/ijerph22071058 - 1 Jul 2025

Abstract

Ageing is a global demographic trend that has increased the total prevalence of multimorbidity, disability and frailty, posing ever greater challenges for public health systems. For older people, ageing is often associated with a loss of quality of life, independence and well-being. This [...] Read more.

Ageing is a global demographic trend that has increased the total prevalence of multimorbidity, disability and frailty, posing ever greater challenges for public health systems. For older people, ageing is often associated with a loss of quality of life, independence and well-being. This study analyses the role of urban gardens as spaces that promote active ageing and contribute to the physical, psychological and social well-being of older adults. Focusing on the urban areaof Valencia, this research adopts a qualitative approach based on in-depth semi-structured interviews with 15 older adults who regularly participate in urban gardens. The findings indicate that urban gardens contribute significantly to active ageing by providing opportunities for regular physical activity, emotional well-being, social engagement, and improved nutrition through the cultivation of food by the participants themselves. These spaces also enhance autonomy, stimulate cognitive functions, elevate mood, and offer a renewed sense of purpose following retirement. Moreover, urban gardens serve as inclusive environments that promote intergenerational interaction and reinforce community bonds. As multifunctional spaces, they hold considerable potential for enhancing the quality of life among older adults and addressing key public health challenges associated with population ageing. Consequently, their integration into urban planning frameworks should be prioritised. Full article

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18 pages, 857 KiB

Open AccessArticle

Assessment of SDG 3 Research Priorities and COVID-19 Recovery Pathways: A Case Study from University of the Western Cape, South Africa

by Josè M. Frantz, Pearl Erasmus and Lumka Magidigidi-Mathiso

Int. J. Environ. Res. Public Health 2025, 22(7), 1057; https://doi.org/10.3390/ijerph22071057 - 1 Jul 2025

Abstract

The COVID-19 pandemic has disrupted the progress toward Sustainable Development Goal 3, particularly in developing countries, exacerbating existing health disparities and creating new challenges for health systems worldwide. This study explores the role of university research in advancing SDG 3 targets in a [...] Read more.

The COVID-19 pandemic has disrupted the progress toward Sustainable Development Goal 3, particularly in developing countries, exacerbating existing health disparities and creating new challenges for health systems worldwide. This study explores the role of university research in advancing SDG 3 targets in a post-pandemic context using the University of the Western Cape as a case study. Through qualitative data analysis of research titles and abstracts registered between 2020 and 2022, we applied the WHERETO model of McTighe and Bloom’s Taxonomy to categorize research according to the SDG 3 targets and indicators. This approach provides insight into which health priorities were addressed through scholarly research at UWC in alignment with the UN 2030 Agenda, particularly during pandemic recovery. Our findings indicate that research priorities largely corresponded with South Africa’s health challenges, with the highest concentration of studies addressing non-communicable diseases and mental health (Target 3.4), infectious diseases (Target 3.3), and medicine development (Target 3.b). These priorities align with the National Health Research Committee’s identified health priorities for disadvantaged communities in the Western Cape. Notably, research on mental health and emergency preparedness (Target 3.d) increased significantly during the pandemic period, reflecting shifting priorities in response to COVID-19. This study offers critical insights into how university research shifted priorities adapted during the pandemic and identifies areas requiring focused attention to support post-pandemic recovery. By highlighting research gaps and opportunities, our findings provide a foundation for developing more comprehensive approaches to health research that address the disparities exacerbated by COVID-19 while advancing the 2030 agenda. This model could inform research prioritization at other institutions facing similar challenges in both local and global contexts. Full article

(This article belongs to the Special Issue Despair and Desires for Health Promotion After the COVID-19 Pandemic: Achieving Sustainable Development Goal 3)

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International Journal of Environmental Research and Public Health

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