Search Results (184)

Certain environmental exposures are associated with COVID-19 incidence and mortality. To determine whether environmental context is associated with other COVID-19 experiences, we used data from the nationally representative Tufts Equity in Health, Wealth, and Civic Engagement Study data (n = 1785; three survey waves 2020–2022 for adults in the United States). Environmental context was assessed using self-reported climate stress and county-level air pollution, greenness, toxic release inventory site, and heatwave data. Self-reported COVID-19 experiences included willingness to vaccinate, health impacts, receiving assistance for COVID-19, and provisioning assistance for COVID-19. Self-reported climate stress in 2020 or 2021 was associated with increased COVID-19 vaccination willingness by 2022 (odds ratio [OR] = 2.35; 95% confidence interval [CI] = 1.47, 3.76), even after adjusting for political affiliation (OR = 1.79; 95% CI = 1.09, 2.93). Self-reported climate stress in 2020 was also associated with increased likelihood of receiving COVID-19 assistance by 2021 (OR = 1.89; 95% CI = 1.29, 2.78). County-level exposures (i.e., less greenness, more toxic release inventory sites, and more heatwaves) were associated with increased vaccination willingness. Air pollution exposure in 2020 was positively associated with the likelihood of provisioning COVID-19 assistance in 2020 (OR = 1.16 per µg/m³; 95% CI = 1.02, 1.32). Associations between certain environmental exposures and certain COVID-19 outcomes were stronger among those who identify as a race/ethnicity other than non-Hispanic White and among those who reported experiencing discrimination; however, these trends were not consistent. A latent variable representing a summary construct for environmental context was associated with COVID-19 vaccination willingness. Our results suggest that intersectional equity issues affecting the likelihood of exposure to adverse environmental conditions are also associated with health-related outcomes. Full article

In response to contemporary challenges such as the COVID-19 pandemic, climate change, armed conflicts, and economic instability, healthcare systems worldwide are increasingly confronted with multifaceted and overlapping crises—collectively referred to as polycrisis. These interconnected threats amplify one another, placing unprecedented strain on healthcare infrastructure, governance, and equity. The COVID-19 pandemic alone led to an estimated 16.3 million missed hospitalizations in 2020 and 14.7 million in 2021, revealing systemic vulnerabilities and deepening social inequalities. Armed conflicts, such as in Syria and Gaza, have devastated healthcare access. In Gaza, by mid-2024, 85% of the population had been forcibly displaced, with only 17 of 36 hospitals partially functioning and over 885 healthcare workers killed. Climate change further exacerbates health burdens, with over 86% of urban residents globally exposed to harmful air pollution, contributing to 1.8 million deaths annually. This study introduces a novel perspective by applying social epidemiology to the analysis of polycrisis. While the existing literature often emphasizes political or economic dimensions, our approach highlights how overlapping crises affect population health, social vulnerability, and systemic resilience. By integrating sociodemographic and environmental data, social epidemiology supports crisis-resilient care models, targeted interventions, and equitable health policies. We argue for a stronger mandate to invest in data infrastructure, enhance surveillance, and embed social determinants into health system responses. Full article

COVID-19 vaccine hesitancy (VH), like attitudes towards other vaccines, is a critical global public health concern. Despite numerous studies covering psychological, sociodemographic, and other determinants of vaccine acceptance, resistance, and hesitance, few studies have reported these factors among students, particularly in politically unstable settings like Ukraine. This cross-sectional, descriptive, and quantitative study assesses hesitancy towards COVID-19 vaccines, utilizing the 5Cs Model. Among 936 respondents surveyed in 2023, 64% received at least one shot of the COVID-19 vaccine (acceptant), 11% were still considering getting vaccinated (hesitant), and 25% refused vaccination (resistant). Vaccination behavior is significantly associated with the 5Cs. Higher collective responsibility significantly increased acceptance and reduced resistance, while higher constraints lowered the chances of being either acceptant or resistant. Confidence protected against resistance. Complacency, counterintuitively, reduced odds of resistance, pointing to differences between passive hesitancy and active refusal. Male gender and sources of information and misinformation influenced confidence. Collective responsibility was positively associated with official sources and negatively with conspiracy beliefs. Complacency increased with official sources, while constraints and calculation were least explained by predictors. Practical barriers should be tackled through improved accessibility and fostering collective responsibility via targeted communication strategies. These findings provide actionable insights for policymakers, healthcare providers, and academic institutions to enhance vaccine uptake among university students, particularly in crisis settings. Full article

Air pollution monitoring in ungauged zones presents unique challenges yet remains critical for understanding environmental health impacts and socioeconomic dynamics in the Eastern Mediterranean region. This study investigates air pollution patterns in northwestern Syria during 2019–2024, analyzing NO₂ and CO concentrations using Sentinel-5P TROPOMI satellite data processed through Google Earth Engine. Monthly concentration averages were examined across eight key locations using linear regression analysis to determine temporal trends, with Spearman’s rank correlation coefficients calculated between pollutant levels and five meteorological parameters (temperature, humidity, wind speed, atmospheric pressure, and precipitation) to determine the influence of political governance, economic conditions, and environmental sustainability factors on pollution dynamics. Quality assurance filtering retained only measurements with values ≥ 0.75, and statistical significance was assessed at a p < 0.05 level. The findings reveal distinctive spatiotemporal patterns that reflect the region’s complex political-economic landscape. NO₂ concentrations exhibited clear political signatures, with opposition-controlled territories showing upward trends (Al-Rai: 6.18 × 10⁻⁸ mol/m²) and weak correlations with climatic variables (<0.20), indicating consistent industrial operations. In contrast, government-controlled areas demonstrated significant downward trends (Hessia: −2.6 × 10⁻⁷ mol/m²) with stronger climate–pollutant correlations (0.30–0.45), reflecting the impact of economic sanctions on industrial activities. CO concentrations showed uniform downward trends across all locations regardless of political control. This study contributes significantly to multiple Sustainable Development Goals (SDGs), providing critical baseline data for SDG 3 (Health and Well-being), mapping urban pollution hotspots for SDG 11 (Sustainable Cities), demonstrating climate–pollution correlations for SDG 13 (Climate Action), revealing governance impacts on environmental patterns for SDG 16 (Peace and Justice), and developing transferable methodologies for SDG 17 (Partnerships). These findings underscore the importance of incorporating environmental safeguards into post-conflict reconstruction planning to ensure sustainable development. Full article

Travestis and transgender women in Brazil face a disproportionate burden of mental health conditions, exacerbated by structural discrimination, violence, and social exclusion. This narrative review synthesizes evidence on the prevalence of depression, anxiety, suicidality, and substance use among travestis and transgender women in Brazil, and examines intersecting social and health disparities. We searched PubMed, Embase, and PsycINFO in April 2025, identifying peer-reviewed studies in English or Portuguese reporting mental health outcomes or associated social determinants of health in this population. Thirty-one studies across twelve different cities (n = 7683) were included and grouped into two thematic domains. Reported prevalence ranged from 16–70.1% for depression, 24.8–26.5% for anxiety, and 25–47.3% for suicidality. Substance use was also highly prevalent, with studies reporting high rates of alcohol (21.5–72.7%), tobacco (56.6–61.6%), cannabis (19–68.9%), and cocaine/crack (6–59.8%) use. Discrimination, violence, economic hardship, and HIV were consistently associated with psychological distress and barriers to care. These findings underscore the urgent need to integrate mental health, gender-affirming care, and HIV services into Brazil’s Unified Health System (Sistema Único de Saúde–SUS), strengthen anti-discrimination and violence-prevention policies, and adopt inclusive public health strategies that prioritize the leadership and lived experiences of transgender, nonbinary, and gender diverse people, particularly amid rising political threats to gender-affirming care. Full article

Municipal solid waste (MSW) is rising globally, and improper management harms the environment and public health. As a result, there is heightened interest in finding effective solutions, and identifying research trends helps determine the best management and valorization pathways. However, the existing reviews often focus narrowly on specific technologies or regional case studies, lacking a comprehensive analysis of global research trends. This study addresses this significant gap by conducting a large-scale trend analysis based on 15,646 relevant articles screened from 25,068 Scopus-indexed publications from 1904 to 2023 using title, abstract, and keyword analysis. Literature-based comparative assessments were conducted to critically evaluate the pathways through TEE (techno-economic and environmental), SWOT (strengths, weaknesses, opportunities, and threats), and PESTEL (political, economic, social, technological, environmental, and legal) frameworks. Since 1990, article publication has increased by about 10% annually, consistently concentrating on thermochemical conversion and, more recently, on sustainability and circular economy perspectives. Seven distinct pathways for MSW management were identified, with recycling and material recovery, followed by thermochemical conversion for high-calorific waste and biochemical conversion for high-organic waste, showing the most promise. The findings aim to help researchers understand MSW research trends and assist planners in identifying effective management and valorization strategies. Full article

Introduction: This study examined how social, economic, and political factors influenced psychological and physical health disparity in Japan during the COVID-19 pandemic. Method: Using survey data from three surveys from 2020 to 2021, we identified significant associations between well-being and biological, economic, social, and ethico-political dimensions. Results: Key findings suggest that not only biological factors, but also social, economic, and political factors are essential for the psychosomatic health disparities in static and dynamic analysis. Discussion: This paper proposes the term psychosomatic health by proving the correlation between physical and psychological health disparities. Conclusion: Accordingly, communitarian intervention, the multi-dimensional and integrated policy that addresses not only economic needs but also social and political equity/fairness, is required. Full article

In Portugal, public policies promoting a healthy diet have gained prominence in recent years, reflecting a growing concern with the population’s health status and its individual, social, economic, and political impact. These policies aim to mitigate the impact of inadequate eating habits as a determinant of health and the population’s disease burden. Based on a document analysis, the main objective of this article is to explore public healthy diet policies in Portugal following the 2017 implementation of the Estratégia Integrada para a Promoção da Alimentação Saudável (Integrated Strategy for the Promotion of a Healthy Diet), which is the primary guiding instrument for these policies. Among the most impactful legislative measures found in this sector, we highlight the reformulation of food products, food taxation, food marketing regulation, food incentives, and food labeling. Despite significant progress in promoting healthy diets, some challenges still remain, particularly the growing prevalence of behavior-related chronic non-communicable diseases, like obesity, such as the maintenance of a set of health determinants related to inadequate nutrition. Thus, the continuity and deepening of such policies, combined with continuous impact assessments, are crucial to ensuring a healthier future. Full article

Background: Vaccine hesitancy (VH) is a significant public health challenge, especially during the COVID-19 pandemic. Despite extensive research on the psychological and socio-political determinants of VH, its psychophysiological mechanisms remain unexplored. Grounded in the Somatic Marker Hypothesis, this study aims to investigate the neurophysiological and affective processes underlying VH. Methods: Two experiments will assess sensorimotor resonance and affective processes in VH. In the first experiment, motor-evoked potentials (MEPs) will be recorded from the deltoid and extensor carpi radialis muscles while participants view images of people receiving COVID-19 and influenza vaccines, as well as blood injections (Block 1), and images of vial containing the same substances (Block 2). Facial electromyographic (EMG) activity will measure disgust and fear responses. In the second experiment, skin conductance response (SCR) will be recorded during a virtual reality-based fear conditioning and extinction paradigm. Expected Outcomes: We hypothesize that vaccine-hesitant individuals will exhibit altered sensorimotor resonance, higher affective responses to vaccination stimuli, and impaired fear extinction learning. Psychological traits such as disgust sensitivity, paranoia, anxiety, and dogmatism are expected to be associated with VH. Conclusions: By identifying the psychophysiological mechanisms of VH, this study will contribute to developing effective vaccine promotion strategies to address future public health emergencies. Full article

Marijuana legalization has been at the center of debate in the social and political realm of the United States. So far, thirty nine states and the District of Columbia have legalized marijuana either for recreational or medical purposes. States are taking a cautious approach to legalization in a policy context consisting of multi-layered sociopolitical systems. Strong arguments from advocacy groups supporting and opposing legalization highlight the significance of assessing the impact of marijuana use and its legalization on the well-being of the community and its members. Utilizing the social determinants of health and system perspectives, this study measures the cumulative effect of six socio-ecological and economic predictors, such as the state’s marijuana use prevalence and median household income, on the dependent variable of marijuana legality scores using discriminant analysis and One-way ANOVA. As hypothesized, the result shows a significant influence of the predictors on the state policy score of marijuana legality. Predicted associations between independent and dependent variables were also found. Findings suggest that without a supportive policy context comprising social, economic, and political factors, marijuana legalization might not have the desired impact on the community. Implications and recommendations for future research are provided. Full article

One of the main reasons for migration is the search for a better quality of life. The concept of quality of life is very broad, encompassing economic, social, political, and cultural factors. According to the World Migration Report 2022, 3.6 percent of the world’s population are migrants. This number is growing due to geopolitical reasons. Increasing migration flows affect the growth of the part of the population living in urban areas, that is, urbanisation. The scale of migration is growing along with the search for a better life. In Lithuania, according to the Department of Statistics, as well as throughout the world, the number of people living in cities is constantly growing; for comparison, a 3% growth has been observed over 4 years, in the European Union, according to the World Bank, 1%, and in the world—1%. The term urbanisation also describes social changes that are determined by the concentration of the population. To ensure quality of life, cities face challenges such as ensuring security, integration of migrants into society and the labour market, the functioning of the health and education system, and sustainable development of cities. Despite growing interest, the impact of migrant flows on the quality of life in cities has not been sufficiently studied in the world scientific literature. Most research is focused on the causes of migration, migrant integration, demographic changes, or labour market interactions. However, less attention is paid to how the dynamics of migrant flows affect the quality of life in cities. Comprehensive assessment is lacking. The goal is to assess the link between quality of life and the dynamics of migration flows in urbanised areas. The article, which conducted a systematic and comparative analysis of concepts published in the scientific literature, formed the concept of quality of life in urban areas, identified the factors that determine quality of life, and studied the link between the quality of life in the city and the dynamics of migration flows. This assessment will allow us to combine the factors that determine quality of life in terms of changes in migrant flows into a common system. To achieve this goal, statistical processing, correlation analysis, and CRITIC methods will be applied. Full article

This article showcases Syrian refugees’ narratives of trauma and survival, through a phenomenological approach to in-depth research, with refugees who have resettled in Australia. It explores their journey towards resettlement, highlighting the nexus between displacement in the home–transit–host countries and the biopsychosocial determinants of mental health. Since the 2011 uprising, over 12 million Syrians have been displaced, both internally and worldwide. A refugee’s journey to safety often involves multiple displacements and exposure to dangerous, life-threatening, and dehumanising experiences. We have therefore adopted a qualitative approach that counters this dehumanisation by honouring the unique humanity in the voice of each of our research participants. This article aims to portray the nuanced interdependence between the individual, social, and political contexts of seven Syrian refugees’ lived experiences through an in-depth consideration of what they have told us, how they narrate their stories, and the meanings they ascribe to what they have experienced. The findings of this small yet eloquent study reinforce the insight that the journey to resettlement is far from linear and that resettlement itself is a process marked by recurrent and persistent complexities. The article suggests that the resilience of these refugees is best understood as an ethical and altruistic commitment to collective well-being, transcending notions of individual fortitude. Full article

This innovative study focuses on identifying the primary trends in citizens’ decision-making regarding sustainable and healthy water use and the promotion of tap water options. The primary objective of this study was to investigate whether there was a connection between citizen-consumer choices of tap water versus bottled water and their socio-demographic attributes or environmental awareness and consciousness, which both influence the access to and quality of drinking water. The availability, safety and quality of drinking water is a basic human right and an important public health issue. Water plays a crucial role in terms of increasing geo-political and socio-economic importance. Several researchers have examined the multiple elements influencing customers’ opinions about the quality of water and services, finding that a variety of internal and external factors play a role. To accomplish the study goals, a variety of research methodologies were applied to the use case of Kilkis city, Region of Central Macedonia, Greece. Gaining insight was first facilitated via communication with a focus group of local professionals and policy-makers. Then, a social survey of 407 randomly chosen citizens was conducted to collect the data. The key determinants influencing citizens’ drinking water choices were investigated using multivariate data analysis. Specifically, cluster analysis was employed to group customers exhibiting similar water usage patterns, resulting in the identification of two groups: (a) individuals who favored bottled water and (b) individuals who favored tap water with no filtration. The comparison of the distribution of water consumers between these two clusters, via a Chi-Square test with cross tabulation analysis, showed that customers’ drinking water buying habits were not influenced by their socio-demographic traits. On the other hand, the choice of tap water was found to be positively connected to citizens’ increased level of environmental consciousness. The outcomes of this study can help the stakeholders involved to assist in making improvements to customer service programs for encouraging tap water use, as a more sustainable and healthy water option. Moreover, the population could potentially be motivated to adopt updated technologies for recycling water down the line, moving towards sustainable water resource management. Full article

In parallel with the global landscape, the architecture profession is losing its appeal in Turkey, as evidenced by a decline in school occupancy rates to 79%. Accordingly, the Higher Education System (YÖK) has decreased architecture program quotas by an average of 20%. This study establishes a comprehensive model outlining the key factors influencing these orientations to better understand architecture students’ career paths. This paper investigates how architecture students’ perceptions of the construction industry influence their career choices, particularly their likelihood of staying in the sector. The devised model is empirically validated via data collected from 419 online survey questionnaires. Utilizing SPSS 23 and LISREL 8.8 software, a range of analyses, including frequency, validity, reliability, exploratory and confirmatory factor analysis, and structural equation modeling, are conducted. The model posits “intention to stay in the sector (IS)” as a dependent latent variable, affected by independent latent variables like “nature of the profession (NP)”, “prestige (PR)”, “working conditions (WCs)”, “health and stress (HS)”, “salary and benefits (SB)”, “ethical and political processes (EPs)”, “authorities and responsibilities (AR)”, and “conformity to expectations (CE)”. The findings demonstrate that NP, PR, WCs, SB, HS, EPs, AR, and CE significantly influence IS. Particularly, NP and PR substantially impact the preference for the architectural profession and the determination to remain in the sector. In contrast, WCs, HS, SB, and EPs affect IS negatively. This research contributes significantly to the literature on the career intentions of architecture students by presenting a model that captures the factors influencing their career choices. The model is supported by substantial empirical evidence and is based on a comprehensive literature review. Full article

This study applies a systems analysis to further our understanding of the many pathways linking climate stress to human (im)mobility and interpersonal violence via natural resource stress within eight countries (Burkina Faso, Chad, Mali, Mauritania, Niger, Nigeria, Senegal, and Sudan) across the Sahel region. To illustrate the multiple pathways within the climate–(im)mobility–violence–health nexus, contextual and conceptual systems maps were drawn out based on secondary qualitative data from 24 peer-reviewed journal articles selected from a search result of 394 publications. Even though the geography, environment, socio-political context, traditions, and cultural history were highly diverse, the overarching factors that determined people’s (im)mobility and health outcomes, in association with natural resource stress and violence, were very similar. These vulnerability pathways included gendered immobility, interpersonal conflict, and lack of social protection, which provide important lessons and offer tangible opportunities for policy interventions. The vulnerability pathways often eroded access to natural resources and positive (im)mobility and (mental) health outcomes, which ended up entrapping people in extended cycles of violence and exploitation—especially certain intersectional positions and disadvantaged groups (whether within a household, society, or country). Full article