Search Results (1,595)

Background/Objectives: The two major subtypes of inflammatory bowel disease (IBD)—Crohn’s disease (CD) and ulcerative colitis (UC)—are known to increase the likelihood of developing colorectal cancer (CRC). While this relationship has been well studied in Western populations, evidence from East Asia remains limited and inconsistent. Using nationwide cohort data, this study explored the potential connection between IBD and CRC in a large Korean population. Methods: We conducted a retrospective cohort study using data from the Korean National Health Insurance Service–National Sample Cohort from 2005 to 2019. A total of 9920 CRC patients were matched 1:4 with 39,680 controls using propensity scores based on age, sex, income, and region. Overlap weighting and multivariable logistic regression were used to evaluate the association between IBD and CRC. Subgroup analyses were conducted to assess effect modification by demographic and clinical factors. Results: IBD markedly increased the likelihood of developing CRC (adjusted odds ratio (aOR) = 1.38; 95% confidence interval (CI): 1.20–1.58; p < 0.001), with the association primarily driven by UC (aOR = 1.52; 95% CI: 1.27–1.83). CD appeared unrelated to heightened CRC risk overall, though a significant association was observed among low-income CD patients (aOR = 1.58; 95% CI: 1.15–2.16). The UC–CRC association persisted across all subgroups, including patients without comorbidities. Conclusions: Our findings support an independent association between IBD—particularly UC—and increased CRC risk in Korea. These results underscore the need for personalized CRC surveillance strategies that account for disease subtype, comorbidity burden, and socioeconomic status, especially in vulnerable subpopulations. Full article

Achieving food security for a growing population under a changing climate is a key concern in Senegal, where agriculture employs 77% of the workforce with a majority of small farmers who rely on the production of crops for their subsistence and for income generation. Moreover, due to the underproductive soils and variable rainfall, Senegal depends on imports to fulfil 70% of its food requirements. In this research, we considered four crops that are crucial for Senegalese agriculture: millet, sorghum, peanuts and rice. We used crop simulation models to explore existing yield gaps and optimal agronomic practices. Improving the N fertilizer management in sorghum and millet resulted in 40–100% increases in grain yields. Improved N symbiotic fixation in peanuts resulted in yield increases of 20–100% with highest impact in wetter locations. Optimizing irrigation management and N fertilizer use resulted in 20–40% gains. The best N fertilizer strategy for sorghum and millet included applying low rates at sowing and in early development stages and adjusting a third application, considering the expected rainfall. Peanut yields of the variety 73-33 were higher than Fleur-11 in all locations, and irrigation showed no clear economic advantage. The best N fertilizer management for rainfed rice included applying 30 kg N/ha at sowing, 25 days after sowing (DAS) and 45 DAS. The best combination of sowing dates for a possible double rice crop depended on irrigation costs, with a first crop planted in January or March and a second crop planted in July. Our work confirmed results obtained in field research experiments and identified management practices for increasing productivity and reducing yield variability. Those crop management practices can be implemented in pilot experiments to further validate the results and to disseminate best management practices for farmers in Senegal. 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

This study assesses the effects of the COVID-19 pandemic on catastrophic health expenditures and income inequality in Benin. A microsimulation was calibrated to estimate the impact of the pandemic under three different shock scenarios: low, moderate, and severe. The analysis relies on secondary data from household living condition surveys. The results indicate that the COVID-19 crisis would lead to a significant average income loss of up to 20% and income inequality, while the number of households with catastrophic health expenditures would increase by 4%. More importantly, the findings reveal heterogeneous impacts across households, with urban residents, younger individuals, more educated households, and male-headed households experiencing the greatest income decline. These findings underscore the need for targeted health coverage and employment policies to better protect vulnerable populations in Benin in the face of future shocks. Full article

Housing affordability is a major determinant of quality of life. Despite the relatively high GDP per capita in Hong Kong (HK) (USD 460,000), about one-third of the population lives in public rental housing (PRH) because they cannot afford private housing. Existing research estimating the benefits of PRH or direct housing supports faces methodological limitations. Addressing this research gap, our study adopts an “in-kind subsidy” approach to estimate the monetary value of PRH, quantifying how much less PRH households might save monthly if they resided in private rental units, after controlling for confounding factors. This paper examines the association of housing types and household savings by applying ordinary least squares (OLS) regression to compare savings among PRH tenants, non-PRH tenants, and mortgage-free homeowners, based on seven rounds of the Household Expenditure Survey data (1989/1990 to 2019/2020). PRH tenants saved significantly more than private housing tenants. In terms of household savings, the value of HK PRH has steadily increased from HKD 4483 in 1999/2000, to HKD 9187 in 2019/2020. For every dollar increase in income, a household would have the propensity to save 0.7 dollars in 2019/2020. Given limited public resources, our findings offer robust evidence regarding the value of public housing. The results underscore the importance of the equitable allocation and effective management of current PRH stock to enhance the upward mobility of low- to middle-income households amid limited housing resources in HK. Full article

Background/Objectives: Syphilis, a re-emerging global public health issue, has shown increasing incidence over the past decade, particularly among key populations such as men who have sex with men (MSM), people living with HIV, and pregnant women. This narrative review aimed to synthesize global epidemiological trends of syphilis from 2015 to 2025, with a focus on surveillance gaps, regional disparities, and structural determinants. Methods: A broad narrative approach was used to collect and analyze epidemiological data from 2015 to 2025. The literature was retrieved from databases (PubMed, Scopus) and official reports from the WHO, CDC, and ECDC. Included materials span observational studies, surveillance reports, and modeling data relevant to global trends and public health responses. Results: Globally, syphilis incidence has increased, with notable surges in North America, Europe, and Asia. MSM remain disproportionately affected, while congenital syphilis is resurging even in high-income countries. Low- and middle-income countries report persistent burdens, especially among women of reproductive age, often exacerbated by limited screening and surveillance infrastructure. The COVID-19 pandemic disrupted syphilis-related services and further exacerbated underreporting, hindering timely detection and response efforts. Surveillance systems vary widely in their completeness and quality, which significantly hinders global data comparability and coordinated public health responses. Conclusions: Despite its curability, syphilis continues to spread due to fragmented prevention strategies, inequities in access to care, and insufficient surveillance. Strengthening diagnostic access, integrating prevention efforts into broader health systems, and addressing social determinants are essential. Improved surveillance, equitable access, and innovation—including diagnostics and potential vaccine research—are critical to controlling the global syphilis epidemic. Full article

Cadmium is widely recognized as an important environmental toxicant that may give rise to kidney dysfunction, bone disease, and cancer in humans and animals. Kidney dysfunction occurs at very low exposures and is often considered as the most sensitive or critical effect. Cadmium exposures of concern occur in many countries. In low- and middle-income countries with small-scale mining, excessive exposure to cadmium and other metals occurs in occupational and environmental settings. This is of particular importance in view of the growing demand for metals in global climate change mitigation. Since the 1970s, the present authors have contributed evidence concerning the role of metallothionein and other factors in influencing the toxicokinetics and toxicity of cadmium, particularly as it relates to the development of adverse effects on kidneys in humans and animals. The findings gave a background to the development of biomarkers employed in epidemiological studies, demonstrating the important role of metallothionein in protection against cadmium-induced kidney dysfunction in humans. Studies in cadmium-exposed population groups demonstrated how biomarkers of kidney dysfunction changed during 8 years after drastic lowering of environmental cadmium exposure. Other epidemiological studies showed the impact of a good zinc status in lowering the prevalence of cadmium-related kidney dysfunction. Increased susceptibility to Cd-induced kidney dysfunction was shown in a population with high exposure to inorganic arsenic when compared with a group with low such exposure. Several national and international organizations have used part of the reviewed information, but the metallothionein-related biomarkers and the interaction effects have not been fully considered. We hope that these data sets will also be included and improve risk assessments and preventive measures. Full article

Iron deficiency (ID) is the most prevalent micronutrient deficiency globally, affecting approximately one in four individuals, with a particularly high burden among children, women of reproductive age, and populations in low- and middle-income countries. It contributes significantly to the global burden of disease, with consequences ranging from impaired cognitive and motor development in children to increased risks during pregnancy, including low birth weight, preterm delivery, and maternal mortality, as well as reduced physical performance and quality of life in adults. ID often precedes iron deficiency anemia (IDA), though clinical and functional impairments—such as cognitive deficits, immune dysfunction, and fatigue—can occur even in the absence of anemia. Despite its widespread nature, challenges remain in precisely defining, diagnosing, and treating ID effectively. Advances in diagnostic tools allow for earlier detection, while novel therapeutic strategies, including updated oral dosing regimens and modern intravenous iron formulations, offer improved efficacy and tolerability. These approaches are particularly valuable in minimizing gastrointestinal side effects and enhancing patient adherence. This review is based on a comprehensive literature search conducted primarily through PubMed and Scopus, emphasizing studies published within the past 10–15 years. It is thematically structured to explore the epidemiology, health consequences, diagnostic complexities, and therapeutic developments related to ID. It highlights the multifactorial nature of ID and underscores the urgent need for early identification, targeted interventions, and updated clinical guidelines to reduce the long-term health and societal impacts of this preventable and treatable condition. Full article

This study investigates the critical link between child care accessibility and local labor force participation, addressing a gap in current research that often lacks local spatial granularity. While over half of the U.S. population resides in child care deserts, disproportionately affecting rural, low-income, and minority communities, the economic implications for local labor markets remain underexplored. Leveraging Michigan child care license data and Census tract-level demographic and employment characteristics, this research employs a spatial econometric approach to estimate the impact of geographic distance to child care facilities on labor supply using descriptive data. Our findings consistently demonstrate that increased distance to child care is significantly associated with reduced labor force participation. While female labor force participation is lower in areas with constrained access to child care, we also found that households with two parents are also less likely to have full labor force participation when access to child care is constrained. The cost-effective framework used here can be replicated to identify specific communities most impacted by child care-related employment disruptions. The analytical findings can be instrumental in targeting and prioritizing child care policy interventions. 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

In low- and middle-income countries, notably in rural agricultural populations exposed to environmental and occupational dangers, respiratory impairment and noncommunicable diseases (NCDs) are major public health issues. This cross-sectional study examined the associations between lung function, functional capacity, and cardiovascular responses to the Six-Minute Walk Test (6MWT) in 137 adults from San Pa Tong District, Northern Thailand. Lung function was assessed using spirometry, and participants were classified accordingly. Hemodynamic parameters, including blood pressure, heart rate, rate-pressure product, and oxygen saturation, were measured before and after the 6MWT. Participants with impaired lung function walked significantly shorter distances (p = 0.004), and walking distance was positively correlated with forced vital capacity (FVC) and forced expiratory volume in one second (FEV₁). Logistic regression confirmed that walking distance independently predicted lung function impairment after adjusting for age and sex. Cardiovascular responses to exercise also varied significantly across demographic subgroups. These findings support the use of the 6MWT as a practical, cost-effective, and scalable method for detecting lung function impairments in resource-limited rural settings. To our knowledge, this is among the first studies to demonstrate the predictive value of the 6MWT for lung function impairment in a Southeast Asian agricultural population. Full article

This study developed an Energy Quadrilemma Index (EQI) for Latin American countries, analyzing data from six countries from 2014 to 2020. Using the Principal Component Analysis method, this work reduced the dimensionality of 20 indicators grouped into four dimensions: energy security, energy equity, sustainable development, and a new social context axis. The results reveal significant disparities among the countries in the study. For example, Uruguay shows robust indicators, Paraguay exhibits low utilization of the energy it produces, and Chile displays the poorest results in the sustainable development axis. Many countries’ widespread dependence on hydroelectricity makes them vulnerable to water crises. The results show that social, economic, and structural inequalities represent the main barriers to the energy transition, often marginalizing low-income populations. Ensuring a fair and inclusive transition requires implementing targeted policies and solutions adapted to each country’s specific context. Although Costa Rica leads in performance, it faces significant challenges in the field of sustainability. In contrast, Honduras has made some progress with sustainable development but still demonstrates weaknesses in other areas. These results highlight that standardized solutions can exacerbate regional inequalities, demanding approaches more tailored to local needs. This work’s novelty lies in the use of the social context dimension as a feature to assess energy poverty in selected countries. Full article

Health literacy is a critical determinant of health outcomes, yet it is often overlooked, particularly among marginalized groups. This paper explores the significance of health literacy, with a particular focus on low-income African American and Black (AA/B) men, a population that faces unique challenges due to intersecting factors such as race, gender, socioeconomic status, and educational disparities. We examine how these factors contribute to health literacy gaps, highlighting adverse effects on health outcomes for AA/B men compared to the general population. Additionally, we stress the growing importance of digital literacy in an increasingly technology-driven world. Not actively addressing digital health literacy, especially within chronic disease self-management programs (CDSMPs), further exacerbates health disparities within this group. Recommendations are provided for improving health literacy, with specific strategies to also enhance general literacy and digital literacy, among low-income AA/B men. The paper also advocates for a systematic review of the existing literature on health literacy among this group, emphasizing the need for tailored interventions that account for the unique challenges faced by low-income AA/B men. In conclusion, the paper underscores the critical need for targeted research and practical approaches to improve health literacy and ultimately health outcomes for AA/B men in the digital age, particularly through CDSMPs. Full article

Background/Objectives: Breast milk donation is increasingly recognized as a vital public health resource, providing optimal nutrition for infants who cannot be breastfed by their biological mothers. Human milk banks play a crucial role in supporting infant health, particularly for preterm and medically vulnerable infants. Despite its recognized benefits, the practice of breast milk donation and utilization remains influenced by a complex interplay of individual, social, and cultural factors. Methods: This study systematically examines how demographic and sociocultural variables are associated with attitudes and behaviors related to breast milk donation. Data were collected from 1223 Israeli mothers via questionnaires distributed through WhatsApp groups between April and May 2025. By analyzing the questionnaire results, the research identified key predictors of willingness to donate and use donated milk, as well as patterns of awareness and perceived support within different population groups. Results: Higher education (χ² = 12.87, p = 0.0016) and settlement type (χ² = 83.096, p = 0.000) were significantly associated with greater willingness to donate breast milk. Income level had no effect on donation behavior, though higher-income participants were more open to its use (χ² = 86.838, p = 0.000). Lifestyle also influenced perceptions of social support (F(2, 1220) = 259.4036, p < 0.001) and cultural support (F(2, 1220) = 601.2383, p < 0.001) of milk donation and use. Significant correlation was found between perceived cultural and social support (t = 5.140, p = 0.000), emphasizing their interrelated influence on milk donation attitudes. Conclusions: The findings assist in guiding the development of public health policies, as well as targeted awareness campaigns, to promote equitable access to donor milk services across varied communities. From the public health perspective, the findings of this study can orientate campaigns that encourage both donation and use of breast milk focusing on segments of the population in which the level of awareness is relatively low. Full article

Property crime is a pressing issue in maintaining social order and urban sustainability, particularly in regions marked by pronounced socioeconomic disparity. While the link between socioeconomic stress and crime is well established, regional variations in Thailand have not been fully examined. Therefore, the purpose of this research was to examine spatial patterns of property crime and identify the potential associations between property crime and socioeconomic environment across Thailand. Using nationally compiled property-crime data from official sources across all provinces of Thailand, we employed geographic information system (GIS) tools to conduct a spatial cluster analysis at the sub-national level across 76 provinces. Both global and local statistical techniques were applied to identify spatial associations between property-crime rates and neighborhood-level socioeconomic conditions. The results revealed that property-crime clusters are primarily concentrated in the south, while low-crime areas dominate parts of the north and northeast regions. To analyze the spatial dynamics of property crime, we used geospatial statistical models to investigate the influence of socioeconomic variables across provinces. We found that property-crime rates were significantly associated with monthly income, areas experiencing high levels of household debt, migrant populations, working-age populations, an uneducated labor force, and population density. Identifying associated factors and mapping geographic regions with significant spatial clusters is an effective approach for determining where issues concentrate and for deepening understanding of the underlying patterns and drivers of property crime. This study offers actionable insights for enhancing safety, resilience, and urban sustainability in Thailand’s diverse regional contexts by highlighting geographies of vulnerability. Full article