Search Results (63)

Background: Non-communicable diseases (NCDs) are a leading cause of mortality globally, contributing significantly to the burden on healthcare systems. Understanding the spatiotemporal patterns of NCD mortality is crucial for identifying vulnerable populations and regions at high risk. Objectives: Here, we evaluated the spatiotemporal patterns of NCD mortality in the Metropolitan Area of the Valley of Mexico (MAVM) from 2000 to 2019 for five International Classification of Diseases chapters (4, 5, 6, 9, and 10) at two spatial scales: the municipal level and metropolitan region. Methods: Mortality rates were calculated for the total population and stratified by sex and age groups at both spatial scales. In addition, the relative risk (RR) of mortality was estimated to identify vulnerable population groups and regions with a high risk of mortality, using women and the 25–34 age group as reference categories for population-level analysis, and the overall MAVM mortality rate as the reference for municipal-level analysis. Results: Mortality trends showed that circulatory-system diseases (Chapter 9) are emerging as a concerning health issue, with 45 municipalities showing increasing mortality trends, especially among older adults. Respiratory-system diseases (Chapter 10), mental and behavioral disorders (Chapter 5) and nervous-system diseases (Chapter 6) predominantly did not exhibit a consistent general mortality trend. However, upon disaggregating by sex and age groups, specific negative or positive trends emerged at the municipal level for some of these chapters or subgroups. Endocrine, nutritional, and metabolic diseases (Chapter 4) showed a complex pattern, with some age groups presenting increasing mortality trends, and 52 municipalities showing increasing trends overall. The RR showed men and older age groups (≥35 years) exhibiting higher mortality risks. The temporal trend of RR allowed us to identify spatial mortality hotspots mainly in chapters related to circulatory, endocrine, and respiratory diseases, forming four geographical clusters in Mexico City that show persistent high risk of mortality. Conclusions: The spatiotemporal analysis highlights municipalities and vulnerable populations with a consistently elevated mortality risk. These findings emphasize the need for monitoring NCD mortality patterns at both the municipal and metropolitan levels to address disparities and guide the implementation of health policies aimed at reducing mortality risk in vulnerable populations. Full article

Background/Objectives: Climate change is a major factor exacerbating non-communicable diseases (NCDs) such as cardiovascular diseases, neoplasms, respiratory diseases, and diabetes, especially in vulnerable Latin American regions. This study analyzes the impact of environmental exposures related to climate change on the NCD burden in eight Latin American countries by quantifying the disability-adjusted life years (DALYs) attributable to these factors. Using Global Burden of Disease (GBD) data (1990–2021), we performed multiple linear regression to assess associations between DALYs and environmental risk factors—air pollution (particulate matter, nitrogen dioxide), radon, lead, and extreme temperatures—in Argentina, Brazil, Chile, Colombia, Costa Rica, Mexico, Peru, and Uruguay. The study included major NCDs, and the population was stratified by age and sex. Results: Ischemic heart disease was the leading cause of DALYs in most countries. Particulate matter pollution was the main environmental risk factor contributing to the NCD burden, mainly affecting cardiovascular and respiratory diseases. Mexico showed the highest DALYs from particulate and ozone pollution; temperature and lead exposure also contributed in some countries. Nitrogen dioxide was the primary risk factor for asthma. Statistically significant relationships between environmental factors and DALYs were confirmed. Conclusions: Climate change-related exposures significantly increase the burden of NCDs in Latin America. Targeted interventions in industry, transportation, and energy, along with sustainable urban policies, are essential to mitigate health impacts and reduce disparities. Integrating environmental health into public policies can improve health outcomes amid ongoing climate challenges. Full article

Background: Tobacco use is responsible for eight million preventable deaths annually, making it a major modifiable risk factor for chronic conditions such as cardiovascular diseases, respiratory illnesses, and over 20 types of cancers. Objective: This study aimed to systematically review the barriers and facilitators of tobacco cessation interventions at both the population and healthcare system levels in the U.S. Understanding these determinants is critical for narrowing health disparities, optimizing resource allocation, and ultimately, enhancing tobacco cessation success rates across all demographic groups. Methods: A comprehensive literature search was conducted across the PubMed, Embase, and Web of Science databases, guided by the population, intervention, comparison, and outcome framework and quality assessment guided by PRISMA guidelines. Data extraction focused on study characteristics, intervention types, barriers, facilitators, and cessation outcomes at both the population and health system levels. The random effects forest plots were graphed to estimate pooled effect sizes for both medical and non-medical interventions. Results: A total of 35 studies met the inclusion criteria from an initial pool of 1555 identified records. Socioeconomic disadvantages, digital inequities, and low motivation constitute primary barriers at the individual level, while systemic factors such as healthcare access limitations, inadequate provider engagement, and lack of financial support further hinder cessation efforts. Financial incentives, culturally tailored interventions, and digital engagement strategies significantly improve tobacco cessation outcomes. Public health implications: as identified by the study, tailored interventions, the expansion of health coverage policies to include intervention, digital solutions, and healthcare resource workforce training will help improve tobacco cessation intervention outcomes. Full article

Objective: Our population-based cohort study aims to compute the uptake of the influenza vaccine and the associated risk of hospitalization for respiratory diseases of infectious origin based on the residency setting and dementia status of people aged 65 or over. Methods: We conducted a retrospective cohort study on the whole population of residents aged ≥65 in Lombardy, the most populated Italian region. Using region-wide administrative data, we computed the seasonal prevalence of vaccination for influenza from 1 October 2022 to 30 April 2023. To estimate the risk of hospitalization, we applied Fine-Gray sub-distribution hazard models, accounting for the competing risk of death and adjusting for confounders. Results: Our study analyzed 2,420,279 individuals aged 65+ in Lombardy. Overall, 51.4% received an influenza vaccination in 2022–2023. Among residents living at home, 50.8% were vaccinated, while nursing home residents had an uptake of 74.0%. People living with dementia reported a vaccination coverage of 62.6%, and vaccination rates were higher among those residing in nursing homes than those who lived at home. The adjusted sub-hazard ratios (SHRs) showed higher hospitalization risks of 1.88 for unvaccinated individuals with dementia and 1.74 for unvaccinated individuals without dementia living at home. In nursing homes, the SHR for respiratory hospitalization was 2.20 for individuals without dementia and 2.40 for dementia patients. Vaccination reduced risks across all groups, but disparities persisted. Conclusions: People living with dementia were more likely to be hospitalized for respiratory diseases. However, they reported an influenza vaccination coverage that was below expectations and similar to the general population, both in nursing homes and home-living settings. Public health institutions should extend and mention dementia as a higher-risk condition. Full article

Maternal immunization is a key strategy for protecting pregnant individuals and newborns from infectious diseases. This review examines the mechanisms and benefits of maternal immunization, with a focus on transplacental IgG transfer and immune system interactions. We provide an overview of current recommendations and the safety and efficacy profiles of maternal vaccines, including influenza, tetanus–diphtheria–acellular pertussis (Tdap), respiratory syncytial virus (RSV), COVID-19, and hepatitis B. Additionally, we analyze the barriers to maternal immunization, such as misinformation, vaccine hesitancy, and disparities in healthcare access, while exploring potential strategies to overcome these challenges through targeted educational initiatives, improved provider communication, and policy-driven interventions aimed at increasing vaccine confidence and accessibility. Finally, this review highlights recent innovations and future directions in maternal immunization, including emerging vaccines for Group B Streptococcus and cytomegalovirus. Expanding immunization programs and advancing research on maternal–fetal immunity are essential to optimizing vaccination strategies, improving public health outcomes, and reducing the global burden of infectious diseases. Full article

Syndromic surveillance has evolved into a vital public health tool, providing near real-time data to detect and respond to health threats. While states administer syndromic surveillance systems, Tribal Epidemiology Centers (TECs) serve American Indian and Alaska Native (AIAN) communities across multistate regions, often encountering significant barriers to data access and utilization. This manuscript explores how TECs access and use syndromic surveillance data to address health disparities in AIAN populations, highlighting successes, innovations, and ongoing challenges. The Alaska Native Epidemiology Center (ANEC), Great Plains Tribal Epidemiology Center (GPTEC), and Northwest Tribal Epidemiology Center (NWTEC) provide insights into their syndromic surveillance practices. This includes data access methods, the creation of dashboards and reports, technical assistance for Tribal Health Organizations (THOs), and strategies for overcoming jurisdictional and data-sharing barriers. TECs have successfully leveraged syndromic surveillance to monitor critical health issues, including respiratory illnesses, substance misuse, behavioral health, and maternal care. Collaborative efforts have addressed race misclassification and data gaps, enabling targeted interventions such as air purifier distribution and improving health care delivery for tribal veterans. However, TECs can face restrictive data use agreements, jurisdictional misalignments, and limited access to granular data, hindering their ability to serve AIAN communities comprehensively. Syndromic surveillance offers transformative potential for improving public health in AIAN communities. To fully realize this potential, systemic changes are needed to streamline data-sharing agreements and improve data accuracy. These efforts, along with strong collaborations between TECs and state health departments, are critical to advancing health equity, respecting tribal sovereignty, and ensuring timely, actionable insights for AIAN populations. Full article

Periodontal disease is a prevalent chronic inflammatory condition that impacts over a billion people worldwide, leading to substantial tooth loss, reduced quality of life, and heightened systemic health risks. This narrative review synthesizes current evidence regarding the global burden of periodontal disease, its established associations with systemic conditions including cardiovascular disease, diabetes, adverse pregnancy outcomes, respiratory infections, and neurodegenerative disorders, and its significant socioeconomic implications. The review focused on the following research question: What is the global burden of periodontal disease, and how do its systemic and socioeconomic implications necessitate integrated public health strategies? A structured search of the PubMed, Scopus, and WHO databases from 2000 to 2024 was conducted to identify relevant literature using key terms, including “periodontal disease”, “global burden”, “systemic inflammation”, and “public health strategies”. Out of 312 initially identified articles, 175 satisfied the inclusion criteria for the final synthesis. The findings underscore the significance of periodontal disease as a modifiable risk factor for various noncommunicable diseases, the influence of healthcare disparities on disease progression, and the critical necessity for integrated public health strategies to mitigate the global burden of periodontal disease and its consequences. The review concludes that coordinated policy reform, health system integration, and enhanced research efforts are crucial for mitigating the global burden of periodontal disease and advancing health equity. Full article

Background: Managing multimorbidity is a major challenge for healthcare systems. Cardiometabolic multimorbidity (CMM) is highly prevalent and linked to increased disease burden, functional decline, and mortality. While most studies focus on cross-sectional analyses, longitudinal approaches are essential for understanding disease progression and identifying patient groups who may benefit from targeted interventions. Objectives: This systematic review synthesises evidence from longitudinal studies on the incidence and progression of CMM, exploring transitions between multimorbidity clusters and their clinical implications. Methods: A systematic search was conducted in MEDLINE and EMBASE following PRISMA guidelines. Studies were included if they employed longitudinal designs and clustering techniques to assess multimorbidity evolution. The quality of evidence was evaluated using the GRADE system. Results: Ten studies met the inclusion criteria. CMM occurs across all age groups and both sexes, showing the highest mortality and functional decline rates. Patients with CMM frequently develop additional cardiometabolic conditions or transition to related clusters. Many also experience neurodegenerative and mental health disorders. Individuals from respiratory multimorbidity clusters often transition to CMM. Moreover, CMM is more prevalent in lower socioeconomic populations. Conclusions: Understanding multimorbidity trajectories enables targeted preventive strategies. Identifying patients with predictable progression can help design adequate and effective interventions, reduce health disparities, and improve healthcare outcomes. Full article

Objectives: We aimed to analyze the landscape of viral respiratory illnesses (VRIs) in a large metropolitan area in Southern California with a focus on the COVID-19 pandemic. Methods: We conducted a retrospective cohort study within the UCLA Health System, which evaluated children aged 0–5 years who received comprehensive respiratory viral panel (cRVP) testing during August–February of 2018–2023. The patient demographics, disease severity, and clinical course were specifically compared during the pandemic. Predictors of significant VRI were determined by multivariate logistic regression. Results: A total of 1321 children underwent cRVP testing, and 753 positive subjects were identified during the study period. Rhinovirus (RV) was by far the most frequent virus detected across 5 years, even during the COVID-19 pandemic, followed by respiratory syncytial virus (RSV). Along with RSV and human metapneumovirus, RV was identified as an independent risk for significant disease and occurred irrespective of co-infection with other viruses. Conclusions: RV was the most common viral pathogen in young children, even during the height of the COVID-19 pandemic, and was an independent driver of moderate-to-severe disease, particularly in children with comorbidities. Ethnic disparities were also observed as a risk for significant disease, underscoring the need for targeted interventions and heightened clinical vigilance in pediatric populations. Full article

Even though in mid-2023 the World Health Organization declared the end of the public health emergency of international concern status for COVID-19, many areas of uncertainty about SARS-CoV-2 infection pathophysiology remain. Although in the last 4 years pharmaceutical industries widely invested in the development of effective antiviral treatments and vaccines, large disparities in their availability worldwide still exist, thus fostering the investigation of nutritional supplements as adjuvant therapeutic approaches for disease management, especially in resource-limited settings. During the COVID-19 pandemic, vitamin D has been widely used as an over-the-counter solution to improve disease evolution, thanks to its known immunomodulatory and anti-inflammatory actions. Ecological and observational studies support a relationship between hypovitaminosis D and COVID-19 negative outcomes and, according to this evidence, several research groups investigated the role of vitamin D supplementation in protecting from SARS-CoV-2 infection and/or improving disease evolution. This narrative review is intended to offer insights into the existing data on vitamin D’s biological effects in respiratory infections, especially in COVID-19. Furthermore, it will also offer a brief overview of the complex interplay between vitamin D and vaccine-elicited immune response, with special attention to anti-COVID-19 vaccines. Full article

Background: Influenza is a highly contagious respiratory disease that poses significant health and economic burdens. Mice are commonly used as animal models for studying influenza virus pathogenesis and the development of vaccines and drugs. However, the viral volume used for nasal inoculation varies substantially in reported mouse influenza infection models, and the appropriate viral dose is crucial for reproducing experimental results. Methods: Mice were inoculated with mouse lung-adapted strains of influenza virus A/Puerto Rico/8/34 (H1N1) via intranasal administration of 10 μL, 20 μL, and 40 μL at doses of 200 plaque-forming units (PFU) and 2000 PFU. This study investigated the impact of varying viral inoculum volumes on murine outcomes at identical doses and assessed the disparities across diverse dosage levels. Results: Regarding weight change trajectories, mortalities, lung tissue viral titers, and pathological manifestations, the group that received the 40 μL inoculation volume within the low-dose infection mice (200 PFU) manifested a statistically significant divergence from those inoculated with both the 10 μL and 20 μL volumes. Within the context of high-dose infections (2000 PFU), groups that received inoculation volumes of 20 μL and 40 μL exhibited marked disparities when compared to those receiving the 10 μL volume. Conclusions: Disparities in inoculation volume, even under uniform infection dosages, engender differential outcomes in pathogenicity. Of particular note, the viral replication efficacy at a 20 μL inoculation volume demonstrates conspicuous fluctuations across diverse infection dose regimens. Full article

Canada, as one of the largest oil and gas producer in the world, is responsible for large emissions of methane, a powerful greenhouse gas. At low levels, methane is not a direct threat to human health; however, human health is affected by exposure to pollutants co-emitted with methane. The objectives of this research were to estimate and map pollutants emitted by the oil and gas industry, to assess the demographic of the population exposed to oil and gas activities, and to characterize the impact of well density on cardiovascular- and respiratory-related outcomes with a focus on Alberta. We estimated that ~13% and 3% people in Alberta reside, respectively, within 1.5 km of an active well and 1.5 km of a flare. Our analysis suggests that racial and socioeconomic disparities exist in residential proximity to active wells, with people of Aboriginal identity and people with less education being more exposed to active wells than the general population. We found increased odds of cardiovascular-related (1.13–1.29 for low active well density) and respiratory-related (1.07–1.19 for low active well density) outcomes with exposure to wells. Close to 100 countries produce oil and gas, making this a global issue. There is an important need for additional studies from other producing jurisdictions outside the United States. Full article

This comprehensive review synthesizes the current knowledge regarding the characteristics of particulate matter (PM) at locations directly impacted by industrial emissions. A particular emphasis was given to the morphology and size of these particles and their chemical characteristics per type of industrial activity. The relationship between the exposure to PM from industrial activities and health issues such as cancer, cardiovascular, and respiratory diseases was also discussed, highlighting significant epidemiological findings. Furthermore, this work highlights the source apportionment of PM in these areas as well as available databases for source profiles. The majority of the studies accentuate the ambiguity found in the identification of industrial sources mainly due to the lack of specific tracers and the overlapping between these sources and other natural and anthropogenic ones. The contribution of industrial sources to PM concentrations is generally less than 10%. Moreover, this review gathers studies conducted in the 18 countries of the East Mediterranean-Middle East (EMME) region, focusing on sites under industrial influence. In these studies, PM₁₀ concentrations range from 22 to 423 μg/m³ while PM_2.5 levels vary between 12 and 250 μg/m³. While extensive studies have been conducted in Egypt, Iran, and Lebanon, a lack of research in the UAE, Bahrain, Greece, Israel, Palestine, and Yemen highlights regional disparities in environmental health research. The major industrial sources found in the region were oil and gas industries, metallurgical industries, cement plants, petrochemical complexes, and power plants running on gas or heavy fuel oil. Future research in the region should focus on longitudinal studies and a more detailed chemical analysis of PM in the vicinity of industrial areas to enhance the accuracy of current findings and support effective policy making for air pollution control. Full article

American Indian/Alaska Native (AI/AN) persons in the US experience a disparity in chronic respiratory diseases compared to white persons. Using Behavioral Risk Factor Surveillance System (BRFSS) data, we previously showed that the AI/AN race/ethnicity variable was not associated with asthma and/or chronic obstructive pulmonary disease (COPD) in a BRFSS-defined subset of 11 states historically recognized as having a relatively high proportion of AI/AN residents. Here, we investigate the contributions of the AI/AN variable and other sociodemographic determinants to disease disparity in the remaining 39 US states and territories. Using BRFSS surveys from 2011 to 2019, we demonstrate that irrespective of race, the yearly adjusted prevalence for asthma and/or COPD was higher in the 39-state region than in the 11-state region. Logistic regression analysis revealed that the AI/AN race/ethnicity variable was positively associated with disease in the 39-state region after adjusting for sociodemographic covariates, unlike in the 11-state region. This shows that the distribution of disease prevalence and disparity for asthma and/or COPD is non-uniform in the US. Although AI/AN populations experience this disease disparity throughout the US, the AI/AN variable was only observed to contribute to this disparity in the 39-state region. It may be important to consider the geographical distribution of respiratory health determinants and factors uniquely impactful for AI/AN disease disparity when formulating disparity elimination policies. Full article

The global adoption of face masks as a preventive measure against the spread of the SARS-CoV-2 virus (COVID-19) has spurred extensive research into their filtration efficacy. This study begins by elucidating various mechanisms of particle penetration and comparing filtration efficiency formulas with experimental data from prior studies. This is compared to the filtration efficiency experimental measurement developed in our previous study. Moreover, it delves into fluid dynamics simulations to examine different turbulent airflow models. Specifically, it contrasts the airflow velocity distribution of the k-ω and k-ε turbulent flow models with that of a quadrant-based average velocity model developed within this research. Furthermore, the study conducts fluid dynamic simulations to assess airflow profiles for six distinct medical and non-medical face masks. The results underscore substantial disparities among the simulations, emphasising the criticality of employing accurate fluid dynamics models for evaluating airflow patterns during diverse respiratory activities such as breathing, coughing, or sneezing, thereby enhancing environmental health in the realm of infectious disease prevention. Full article