Search Results (529)

Background: Cognitive decline is a growing public health concern in Latin America, driven by rapid aging, widespread micronutrient inadequacies, and socioeconomic disparities. Despite the recognized importance of nutrition, many older adults struggle to meet daily dietary micronutrients requirements, increasing the risk of mild cognitive impairment (MCI). This study aimed to establish expert consensus on the role of Multivitamin and Mineral supplements (MVMs) in promoting cognitive healthy aging among older adults in Latin America. Methods: A panel of nine experts in geriatrics, neurology, and nutrition applied a modified Delphi methodology to generate consensus statements. The panel reviewed the literature, engaged in expert discussions, and used structured voting to develop consensus statements. Results: Consensus was reached on 14 statements. Experts agreed that cognitive aging in Latin America is influenced by neurobiological, lifestyle, and socioeconomic factors, including widespread micronutrient inadequacies (vitamins B-complex, C, D, E, and minerals such as zinc, magnesium, chromium, copper, iron and selenium), which were identified as critical for global cognitive function and brain structures, yet commonly inadequate in the elderly. While a balanced diet remains essential, MVMs can be recommended as a complementary strategy to bridge nutritional gaps. Supporting evidence, including the COSMOS-Mind trials, demonstrate that MVM use improves memory and global cognition, and reduces cognitive aging by up to 2 years in older adults. Conclusions: MVMs offer a promising, accessible adjunct for cognitive healthy aging in Latin America’s elderly population, particularly where dietary challenges persist. Region-specific guidelines, public health initiatives, and targeted research are warranted to optimize outcomes and reduce health inequities. Full article

The COVID-19 pandemic catalyzed the rapid adoption of remote patient monitoring (RPM) technologies such as telemedicine and wearable devices (WDs), significantly transforming healthcare delivery. Telemedicine made virtual consultations possible, reducing in-person visits and infection risks, particularly for the management of chronic diseases. Wearable devices enabled the real-time continuous monitoring of health that assisted in condition prediction and management, such as for COVID-19. This narrative review addresses these transformations by uniquely synthesizing findings from 13 diverse studies (sourced from PubMed and Google Scholar, 2020–2024) to analyze the parallel evolution of telemedicine and WDs as interconnected RPM components. It highlights the pandemic’s dual impact, as follows: accelerating RPM innovation and adoption while simultaneously unmasking systemic challenges such as inequities in access and a need for robust integration approaches; while telemedicine usage soared during the pandemic, consumption post-pandemic, as indicated by the reviewed studies, suggests continued barriers to adoption among older adults. Likewise, wearable devices demonstrated significant potential in early disease detection and long-term health management, with promising applications extending beyond COVID-19, including long COVID conditions. Addressing the identified challenges is crucial for healthcare providers and systems to fully embrace these technologies and this would improve efficiency and patient outcomes. Full article

Cancer disparities in low- and middle-income countries (LMICs) arise from multifaceted interactions between environmental exposures, infectious agents, and systemic inequities, such as limited access to care. The exposome, a framework encompassing the totality of non-genetic exposures throughout life, offers a powerful lens for understanding these disparities. In LMICs, populations are disproportionately affected by air and water pollution, occupational hazards, and oncogenic infections, including human papillomavirus (HPV), hepatitis B virus (HBV), Helicobacter pylori (H. pylori), human immunodeficiency virus (HIV), and neglected tropical diseases, such as schistosomiasis. These infectious agents contribute to increased cancer susceptibility and poor outcomes, particularly in immunocompromised individuals. Moreover, climate change, food insecurity, and barriers to healthcare access exacerbate these risks. This review adopts a population-level exposome approach to explore how environmental and infectious exposures intersect with genetic, epigenetic, and immune mechanisms to influence cancer incidence and progression in LMICs. We highlight the critical pathways linking chronic exposure and inflammation to tumor development and evaluate strategies such as HPV and HBV vaccination, antiretroviral therapy, and environmental regulation. Special attention is given to tools such as exposome-wide association studies (ExWASs), which offer promise for exposure surveillance, early detection, and public health policy. By integrating exposomic insights into national health systems, especially in regions such as sub-Saharan Africa (SSA) and South Asia, LMICs can advance equitable cancer prevention and control strategies. A holistic, exposome-informed strategy is essential for reducing global cancer disparities and improving outcomes in vulnerable populations. Full article

Introduction: Dental caries and molar–incisor hypomineralisation (MIH) are prevalent conditions affecting children’s oral health, with functional, aesthetic, and psychosocial implications. In Spain, previous studies have highlighted geographic and sociodemographic disparities in their distribution, particularly among rural and migrant populations. Objective: To characterise oral health status, in terms of caries and MIH, among 6–7-year-old children from the towns of Palos de la Frontera, Mazagón, and San Bartolomé. Methods: A cross-sectional study was conducted involving 229 children recruited from public primary schools. Sociodemographic, anthropometric, and behavioural data were collected through clinical examination and interview. Statistical analysis included univariate and multivariate logistic regression. The study protocol was approved by the Ethics Committee of Huelva. Results: The prevalence of caries (DMFT ≥ 1) was 53.3%, with mean DMFT and dft indices of 1.78 and 0.31, respectively. MIH affected 32.8% of the cohort, with a predominance in the first permanent molars (teeth 36 and 26). Multivariate analysis identified independent predictors of caries: African (OR = 7.47; 95% CI: 2.84–23.8) and European (OR = 4.56; 95% CI: 1.26–22.3) parental origin, poor oral hygiene (OR = 3.07; 95% CI: 1.60–6.03), and the presence of MIH (OR = 3.20; 95% CI: 1.64–6.42). The municipality of San Bartolomé was associated with a higher risk of MIH (OR = 2.90; 95% CI: 1.21–7.45). Conclusions: The high prevalence of caries and MIH in the Condado-Campiña district, exceeding national averages, reflects oral health inequities linked to social determinants (migrant origin, locality) and clinical factors (MIH, oral hygiene). Targeted preventive interventions are urgently needed in high-risk populations, including culturally tailored education and policies ensuring equitable access to dental care services. Full article

Africa’s rapid urbanization often exceeds the capacity of governments to provide essential services and infrastructure, exacerbating structural inequalities and exposing vulnerable populations to serious health risks. This paper examines the case of Douala, Cameroon, to demonstrate that health inequities in African cities are not simply the result of urban growth but are shaped by spatial inequities, historical legacies, and systemic exclusion. Disadvantaged neighborhoods are particularly impacted, becoming epicenters of health crises. Using a mixed-methods approach combining spatial analysis, household surveys and interviews, the study identifies three key findings: (1) Healthcare services in Douala are unevenly distributed and dominated by private providers, which limits access for low-income residents. (2) Inadequate infrastructure and environmental risks in informal settlements lead to a higher disease burden and an overflow of demand into better-equipped districts, which overwhelms public health centers across the city. (3) This structural mismatch fuels widespread reliance on informal and unregulated care practices. This study positions Douala as a microcosm of broader public health challenges in rapidly urbanizing African cities. It highlights the need for integrated urban planning and health system reforms that address spatial inequalities, strengthen public health infrastructure, and prioritize equity—key principles for achieving the third Sustainable Development Goal (ensuring good health and well-being for all residents) in sub-Saharan Africa. Full article

Famed lawyer Clarence Darrow (1857–1938) argued strongly for an early-life public health approach to crime prevention, one that focused on education, poverty reduction, and equity of resources. Due to his defense of marginalized persons and his positions that were often at odds with his legal colleagues and public opinion, he was known as the Big Minority Man. He argued that the assumption of free will—humans as free moral agents—justifies systems of inequity, retributive punishment, and “unadulterated brutality.” Here, the authors revisit Darrow’s views and expand upon them via contemporary research. We examine increasingly louder argumentation—from scholars across multiple disciplines—contending that prescientific notions of willpower, free will, blameworthiness, and moral responsibility, are contributing to social harms. We draw from biopsychosocial perspectives and recent scientific consensus papers calling for the dismantling of folk psychology ideas of willpower and blameworthiness in obesity. We scrutinize how the status quo of the legal system is justified and argue that outdated notions of ‘moral fiber’ need to be addressed at the root. The authors examine recent arguments for one of Darrow’s ideas—a public health quarantine model of public safety and carceral care that considers the ‘causes of the causes’ and risk assessments through a public health lens. In our view, public health needs to vigorously scrutinize the prescientific “normative” underpinnings of the criminal justice system. Full article

Women’s decision-making autonomy is widely recognized as a critical determinant of maternal, newborn, and child health (MNCH). However, prevailing measures often conflate genuine autonomy with decisions made within traditional gender roles, risking an overstatement of women’s empowerment. This study examines the extent to which reported female decision-making autonomy reflects authentic agency versus role-based compliance in a patriarchal context. A cross-sectional study was conducted among 280 male household heads in Kakamega County, Kenya, whose partners were pregnant or recently postpartum. Using multi-stage cluster sampling and structured interviews, men reported on household and MNCH decision-making and their rationales, categorized as gender-role conformity, belief in gender equality, or other reasons. Although 40.4% reported that their partners made decisions independently, only 11.4% attributed it to a belief in women’s equality; 28% framed it within traditional gender roles. Men were over four times more likely to perceive women’s decisions as role-based than autonomous (AOR = 4.40; 95% CI: 2.48–5.78). Younger men (18–34) were more likely to report female decision-making (AOR = 5.54; 95% CI: 5.08–7.27), without necessarily endorsing egalitarian norms. Findings highlight the urgent need for gender-transformative MNCH interventions that move beyond surface-level autonomy to address deeper structural inequities. Full article

Background: Teen dating violence (TDV) is a serious public health concern, with sexual and gender minority youth (SGMY) at elevated risk due to minority stress and systemic inequalities. This systematic review examines individual, relational, and contextual risk factors for TDV among SGMY. Methods: A systematic search was conducted in Scopus, Web of Science, and APA PsycInfo on 10 December 2024. Studies published between 2014 and 2024 focusing on teen dating violence (TDV) as an outcome among sexual and gender minority youth (SGMY) aged 13–19 were included. Study selection was independently performed by multiple reviewers using Rayyan. Risk of bias was assessed using the JBI Critical Appraisal Tools. Due to heterogeneity in the study design and measurement tools, a narrative synthesis was conducted. Results: Six risk domains emerged: (1) Demographic/Identity (e.g., gender, orientation, or race); (2) Psychological/Behavioral (e.g., distress or substance use); (3) Violence/Bullying (e.g., cyberbullying or exclusion); (4) Family/Sexual Abuse (e.g., family rejection); (5) Relational/Social (e.g., partner outing); and (6) School/Community (e.g., non-inclusive environments). Bisexual, pansexual, transgender, and racialized youth showed heightened vulnerability. Most studies were conducted in the USA and relied on non-validated TDV measures and cross-sectional designs, limiting comparability and causal inference. Conclusions: SGMY face unique, often overlooked TDV risks. There is a need for intersectional, longitudinal research and inclusive, developmentally appropriate prevention efforts that address both relational and structural factors. This review received no external funding and was not registered. Full article

Background/Objectives: Although the Robin Hood Index (RHI) is increasingly used to quantify geographic health inequality and guide resource redistribution, empirical evidence on whether higher physician density reduces RHI-measured inequality remains limited. This study systematically reviews and meta-analyzes RHI-based research to assess the association between physician distribution and health inequalities. Methods: We conducted a systematic review and meta-analysis of studies using the RHI to evaluate health inequalities, without restrictions on country or publication date. Following PRISMA 2020 guidelines and registered in PROSPERO (CRD42024496486), we searched PubMed, Scopus, and OpenGrey literature, extracted data on physician density and RHI outcomes, and conducted a meta-analysis. Odds ratios (ORs), ln(OR), and 95% confidence intervals (CIs) were calculated, and risk of bias was assessed using the Robvis tool. Results: Seventeen studies covering 720 regions and 1.07 billion individuals were included. Three clusters emerged: physician redistribution (10 studies), poverty–mortality associations (six studies), and systematic reviews (one study). Physician redistribution was strongly associated with increased inequality and policy attention (r = 0.73; p = 0.0038). Meta-analysis of eight redistribution studies yielded a pooled OR of 1.24 (95% CI: 0.54–2.86), consistent in sensitivity analysis (OR = 1.26; 95% CI: 0.56–2.89). Poverty–mortality studies also showed a correlation with the number of variables considered (r = 0.59; p = 0.022). Conclusions: A greater physician supply is associated with increased health inequalities, with statistical support but limited certainty. Methodological heterogeneity in RHI-based studies constrains comparability. Standardized methodologies and broader analytic models are needed to inform research and guide health policy. Full article

The consumption of insects as food is an ancient practice that remains widespread in many regions of Asia, Africa, Latin America, and Oceania. However, this tradition has largely disappeared in Western countries, where it is often met with aversion. Nutritionally, insects can contain up to 60–70% protein (dry weight), along with beneficial fats, minerals, and vitamins, making them comparable to commonly consumed protein sources. Additionally, they contain bioactive compounds that offer health benefits and can contribute to reducing social inequalities in food access. As a sustainable protein source, insects have the potential to meet the demands of a projected global population of 9.7 billion by 2050. From a regulatory perspective, legislation on edible insects is still emerging in many parts of the world, with significant regional differences in the approval process, safety requirements, and permitted species. However, ensuring their safety—particularly in terms of production, preservation, storage, and potential health risks—is crucial. By addressing these concerns, it may be possible to shift the prevailing negative perception in Western societies and enhance consumer acceptance. Thus, we performed a literature review encompassing several issues regarding entomophagy, like insects’ nutritional composition, legislation, benefits, and food safety, and also addressing future perspectives. Full article

This paper reports findings on the social patterning of dog bite injuries in Scotland and discusses their implications for prevention policies. Previous studies have shown evidence of social inequalities in dog bites in other countries, but this analysis provides new evidence about Scotland. Three sources of health record data are used (NHS 24 (telephone) records, accident and emergency department records, and hospital admissions records). The records span the period of 2007–2019 and combine information on 59,111 health records involving injuries caused by dogs (from 48,599 different individuals). The results are presented, summarising the volume of dog bite injuries across time periods by the age of respondents, the location of the incident, and the Scottish Index of Multiple Deprivation categorisation for their locality. The results suggest consistent patterns of social inequality in injuries caused by dogs. We argue that the most important finding concerns the higher risk for people from more deprived areas, and we discuss mechanisms that might lie behind the patterns and how policies might respond to them. Existing policies focus on the breed of dog and punitive strategies, but we argue that different approaches are more likely to be effective in addressing a socially stratified public health issue. Full article

The COVID-19 pandemic significantly disrupted higher education worldwide, imposing strict isolation measures, transitioning learning online, and exacerbating existing social and economic inequalities. This literature review examines the pandemic’s impact on the mental health of college students, with a focus on those belonging to minority groups, including racial, ethnic, migrant, gender, sexuality-based, and low-income populations. While elevated levels of anxiety, depression, and loneliness were observed across all students, findings indicate that LGBTQ+ and low-income students faced the highest levels of psychological distress, due to compounded stressors such as family rejection, unsafe home environments, and financial insecurity. Racial and ethnic minority students reported increased experiences of discrimination and reduced access to culturally competent mental healthcare. International and migrant students were disproportionately affected by travel restrictions, legal uncertainties, and social disconnection. These disparities underscore the need for higher education institutions to implement targeted, inclusive mental health policies that account for the unique needs of at-risk student populations during health crises. Full article

Background/Objectives: Access to nutritious and well-balanced food is essential for well-being. We investigated the relationship between food insecurity (FI) and cardiovascular health (CVH). Methods: This cross-sectional analysis included a nationwide sample consisting of 12,369 Korean adults. The 18-item Household Food Security Survey Module was employed to evaluate FI, with categories ranging from none, to mild, to moderate-to-severe. CVH was assessed through the “Life’s Essential 8” (LE8) framework established by the American Heart Association. This framework includes four health behaviors (diet quality, exercise, tobacco use, and sleep) and four biometric factors (body mass index, blood lipids, blood glucose, and blood pressure). Overall, CVH was scored on a scale from 0 to 100 and categorized into ideal (LE8 score: 80–100), intermediate (LE8 score: 50–79), and poor CVH (LE8 score: 0–49). Multivariate linear and logistic regression models were used to determine the association of FI with CVH status. Results: Within the sample, 3.7% and 0.8% experienced mild and moderate-to-severe FI, respectively. Compared with those without FI, individuals with mild (β: −2.92; 95% CI [confidence interval]: −4.37, −1.48) or moderate-to-severe (β: −7.71; 95% CI: −11.22, −4.20) FI had lower LE8 scores. Additionally, those with mild or moderate-to-severe FI were more likely to have poor CVH status (OR [odds ratio]: 2.14; 95% CI: 1.33, 3.66 for mild FI and OR: 4.83; 95% CI: 1.64, 14.17 for moderate-to-severe FI). Conclusions: FI is negatively associated with CVH in Korean adults. These findings underscore the need for comprehensive policy interventions to enhance food access and promote CVH in this at-risk population. Full article

The Roma population is one of Europe’s largest ethnic minorities, often living in inadequate living conditions, worse than those of the majority population. They frequently lack access to essential services, even in high-income countries. This lack of basic services—particularly in combination with proximity to (stray) animals and human and solid waste—significantly increases environmental health risks, and leads to a higher rate of endoparasitic infections. Our study sheds light on the living conditions and health situation in Roma communities in Slovakia, focusing on the prevalence of intestinal endoparasitic infections across various settlement localisations. It highlights disparities and challenges in access to safe drinking water, sanitation, and hygiene (WASH) and other potentially disease-exposing factors among these marginalised populations. This study combines a comprehensive review of living conditions as per national data provided through the Atlas of Roma communities with an analysis of empirical data on parasitological infection rates in humans, animals, and the environment in settlements, applying descriptive statistical methods. It is the first study in Europe to provide detailed insights into how living conditions vary and cause health risks across Roma settlements, ranging from those integrated within villages (inside, urban), to those isolated on the outskirts (edge, sub-urban) or outside villages (natural/rural). Our study shows clear disparities in access to services, and in health outcomes, based on where people live. Our findings underscore the fact that (i) place—geographical centrality in particular—in an already challenged population group plays a major role in health inequalities and disease exposure, as well as (ii) the urgent need for more current and comprehensive data. Our study highlights persistent disparities in living conditions within high-income countries and stresses the need for greater attention and more sensitive targeted health-promoting approaches with marginalised communities in Europe that take into consideration any and all of the humans, ecology, and animals affected (=One Health). Full article

Air pollution is a growing environmental and public health concern, particularly in urban areas where vehicular emissions, industrial activities, and public events contribute to deteriorating air quality. This study examines air pollution concentrations in two districts of Cusco, Peru, using an interdisciplinary approach that integrates environmental monitoring and social risk perception analysis. Air quality measurements revealed elevated levels of PM2.5 and NO₂, with 40–60% of data falling within “Moderate” or “Unhealthy for sensitive groups” categories according to international standards. Notably, major cultural events such as Inti Raymi were associated with a threefold increase in pollutant concentrations, highlighting their impact on urban air quality. Simultaneously, surveys and interviews assessed public perception, revealing a varied understanding of pollution risks and a general concern for health impacts, especially in more polluted and densely populated areas. However, trust in scientists remains limited, which poses challenges for the implementation of evidence-based environmental strategies. This study highlights significant environmental inequality within the city, with central districts facing greater pollution burdens than peripheral zones. These findings underscore the need for holistic air quality management strategies that combine scientific assessments with community engagement. Strengthening trust between scientists and local populations is essential to develop inclusive and effective interventions that align with both technical and social priorities, particularly in rapidly urbanizing contexts such as Cusco. Full article