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doi: 10.1093/pubmed/fdag003pmid: 41620956
BackgroundOverweight and obesity rates have skyrocketed over the last three decades, particularly in developing countries. This study examines the prevalent trends, and spatial and temporal patterns of overweight/obesity among India’s adult women.MethodsUsing unit-level data from the National Family Health Surveys (NFHSs), this study examines the extent of overweight/obesity among adult women. Majority of the extant studies in the Indian context focus on a single metric, i.e. headcount ratio. This approach only considers a single cut-off point and ignores the differences beyond this threshold. However, the obesity burden is unlikely to be evenly distributed. To address this, I incorporate measures that explicitly take this into consideration and resort to a distribution-sensitive metric, i.e. the Foster-Greer-Thorbecke index (FGT), to identify the underlying changes in the body mass index (BMI) distribution.ResultsThe analysis reveals a consistent increase in most FGT index measures, particularly among urban women. The results suggest that interventions should preferably be group-specific and targeted in nature.ConclusionsThe findings highlight that a distribution-sensitive metric provides a more nuanced understanding of the prevalent inequalities in the BMI distribution. It helps to capture the non-linear health and economic dimensions of the growing overweight or obesity burden in India.
Woo, Misong; Park, Hyewon; Lee, Wanhyung
doi: 10.1093/pubmed/fdag033pmid: 42114020
BackgroundThe relationship between body image distortion (BID) and suicidal behaviors remains understudied regarding gender differences. This study examined associations between BID and suicidal behaviors among South Korean adolescents.MethodsWe used the Korea Youth Risk Behavior Survey (2019–24), which included 317 798 adolescents. BID was defined as a discrepancy between the body mass index and perceived body image. Gender-stratified logistic regressions were conducted to examine the associations between BID and suicidal ideation, planning, and attempts. The regression models were adjusted for sociodemographic characteristics.ResultsBID was associated with overall suicidal behaviors [adjusted odds ratio (aOR) = 1.36, 95% CI: 1.32–1.40]. Among adolescent girls, BID increased the odds of overall suicidal behaviors (aOR = 1.28, 95% CI: 1.24–1.32), suicidal ideation (aOR = 1.27, 95% CI: 1.22–1.31), suicide planning (aOR = 1.31, 95% CI: 1.24–1.39), and suicide attempts (aOR = 1.35, 95% CI: 1.26–1.44). Among boys, BID increased the odds of overall suicidal behaviors (aOR = 1.16, 95% CI: 1.10–1.22), suicidal ideation (aOR = 1.16, 95% CI: 1.10–1.22), suicide planning (aOR = 1.21, 95% CI: 1.11–1.31), and suicide attempts (aOR = 1.26, 95% CI: 1.13–1.40).ConclusionBID is associated with suicidal behaviors, particularly among girls. Targeted interventions addressing BID may mitigate suicide risk. Adolescent health programs should prioritize gender-sensitive policies and body image education.
doi: 10.1093/pubmed/fdag012pmid: 41691478
BackgroundPublic health has long relied on quantitative indicators to document suffering and guide action. In contexts of mass violence, however, statistical approaches alone may be insufficient to capture the full scope of population-level harm.MethodsThis reflective essay engages Zahir Raihan’s 1971 short documentary film ‘Stop Genocide’, produced during the Bangladesh Liberation War, as a case study in visual testimony. The film is examined as a form of public health witnessing that documents harm through proximity, narrative, and moral insistence rather than epidemiologic measurement.Results‘Stop Genocide’ depicts civilian targeting, forced displacement, and collective trauma in ways that anticipate contemporary public health concepts, including structural violence and health system collapse. The film foregrounds patterns of harm that are recognizable at the population level, even in the absence of formal surveillance data.DiscussionRevisiting ‘Stop Genocide’ raises critical questions about what forms of evidence public health recognizes as legitimate, particularly when data systems are disrupted or politically constrained. Situating epidemiologic data within a broader epistemic framework that includes art, testimony, and witnessing may strengthen ethical public health practice in times of mass violence.
Hrzic, Rok; Wyper, Grant M A; Mechili, Enkeleint A; Unim, Brigid; Freitas, Alberto; Santric Milicevic, Milena; Caballero, Ismael; Santos, João Vasco
doi: 10.1093/pubmed/fdag014pmid: 41744208
BackgroundHealth data are essential to guide effective public policies, especially in contexts of increasing complexity and the need for rapid responses. The Global Burden of Disease (GBD) study is central to burden of disease estimates, including in the European Union (EU). This study identified gaps in the data underlying morbidity estimates in the 2023 GBD study for 27 EU countries.MethodsThe GBD2023 Sources Tool was used to identify morbidity data sources, which were analysed by country, year, age, and disease. Data coverage was defined as the inclusion of at least one source for all combinations of age, country, year, and disease.ResultsHighest data coverage was observed in Sweden, Austria, and Germany, and lowest in Hungary, Romania, and Bulgaria. There was high coverage for infectious diseases, but considerable gaps for leading morbidity causes, including musculoskeletal (15.9%) and mental disorders (32.9%) and unintentional injuries (28.1%). Data coverage was highest for the 2000s.ConclusionThe study highlighted variations in EU morbidity data coverage in the GBD2023, suggesting potential differences in estimate reliability. Differences may stem from national health information systems and data-sharing barriers. To enhance estimate accuracy and benchmarking among European health systems, improving data collection and utilization is crucial.
Gatti, Alessandro; Giuriato, Matteo; Vandoni, Matteo; Messina, Giovanni; Malavolta, Rita; Cavallo, Caterina; Pirazzi, Agnese; Pellino, Vittoria Carnevale; Lovecchio, Nicola; Lazzer, Stefano
doi: 10.1093/pubmed/fdag020pmid: 41785039
ABSTRACTBackgroundPhysical fitness (PF) is a crucial indicator of long-term health in children, influencing risks for cardiovascular disease, obesity, and overall mortality. Despite its significance, Italy lacks a national surveillance system able to track PF trends in children, hindering efforts to combat rising obesity rates. This study aims to evaluate temporal trends in PF through a possible surveillance system in elementary school children.MethodsA repeated cross-sectional study was performed and consisted of assessing five PF domains: balance, upper and lower limb strength, cardiorespiratory fitness (CRF), and, speed-agility, along with BMI z-scores. PF trends were analyzed by age and sex, with logistic regression assessing the link between PF and obesity risk. Effects sizes (ES, Cohen’s d) were computed to describe the trend’s magnitude.ResultsCRF improved across all ages, especially in 10–11-year-olds (ES > 1.00). Younger children (6–9 years) showed gains in speed-agility, upper and lower limb strength, but these plateaued in older groups. We observed a decline in balance in 10-year-old boys.ConclusionsOverall, PF levels increased over time, with the most notable improvements observed in CRF. Implementing a nationwide PF surveillance system would facilitate continuous tracking of fitness trends, enabling policymakers to identify declines and develop targeted interventions.
Joe, William; Prakash, Atma; Ahluwalia, Komal; Kim, Rockli; Subramanian, S V
doi: 10.1093/pubmed/fdag030pmid: 42127412
BackgroundTwinning rates are increasing globally and in India, yet a comprehensive analysis of nutritional outcomes and growth patterns among twins in low-and middle income countries remains limited.MethodsThis was a cross-sectional study utilizing data from India's National Family Health Survey, 2019–2021. The final analytic sample comprised 224 177 children (0–59 months). We employed logistic regression models and Coarsened Exact Matching. The primary outcomes included anthropometric failure (stunting, wasting, underweight), anemia, diarrhea, and acute respiratory infection (ARI).ResultsTwins had a consistently higher prevalence for most adverse health outcomes. For instance, severe anemia prevalence was 4.29% (95% CI: 3.42, 5.16) in twins versus 2.09% (95% CI: 2.03, 2.15) in singletons, with 70% higher adjusted odds (aOR: 1.70; 95% CI: 1.28, 2.25). Nutritional disadvantages were most pronounced in the 0–5 months age group and attenuated with age. Disparities were greatest among the poorest groups, though the increased risk of severe anemia persisted across all wealth quintiles. Twins had lower prevalence and adjusted odds for ARI and diarrhea than singletons.ConclusionSignificant health disparities persist between twins and singletons in India, particularly in early childhood and among disadvantaged groups. These findings underscore the need for targeted, equity-focused public health interventions to improve nutritional and health outcomes for twins across India.
Seema, Minnat; Afoakwah, Clifford; Byrnes, Joshua
doi: 10.1093/pubmed/fdag032pmid: 42033247
BackgroundMaternal mental health is an important determinant of child development, yet most evidence relies on short exposure windows or single-wave measures. Less is known about how long-run maternal mental health relates to child outcomes when child development data are observed intermittently.MethodsUsing nationally representative longitudinal household panel data, we examined associations between maternal mental health and child behavioural outcomes, academic performance, and expectations of future university participation. Child outcomes were observed in three survey waves, while maternal mental health was measured repeatedly over a longer period. Maternal mental health was operationalized as long-run averages of general mental health and psychological distress. Ordinary least squares models were estimated with adjustment for child, maternal, and household characteristics, and standard errors were clustered at the mother level.ResultsHigher maternal psychological distress was associated with poorer academic performance and less favourable behavioural and educational outcomes. Associations involving general maternal mental health were attenuated after full adjustment.ConclusionsPersistent maternal psychological distress is associated with poorer child academic outcomes. Although causal inference is not possible, the findings highlight maternal mental wellbeing as an important correlate of child development.
Yalew, Melaku; Lumsden, Amanda L; Mulugeta, Anwar; Madakkatel, Iqbal; Lee, Sang Hong; Oehler, Martin K; Mäenpää, Johanna; Hyppönen, Elina
doi: 10.1093/pubmed/fdag034pmid: 42127414
BackgroundOvarian cancer (OC) remains a major global health issue, often diagnosed late and lacking effective screening.MethodsMR studies until 11 September 2023 were identified by a systematic search across nine databases. We complied with PRISMA guidelines and included different OC subtypes and all exposures studied, conducting meta-analyses where feasible to combine estimates from non-overlapping samples.ResultsWe identified 120 articles examining genetic evidence for an association between 230 exposures and OC risk. Endometriosis, late age at menopause, and several adiposity measures were robustly associated with greater OC risk. In contrast, late age at menarche, higher adiponectin, and body fat without adverse metabolic profile were associated with lower risk (favourable adiposity: meta-analysis OR per SD 0.35, 95% CI 0.20–0.61). Meta-analyses on lipid-lowering drug target HMG-CoA reductase inhibitor (OR 0.66, 95% CI 0.53–0.82), serum vitamin D (OR 0.88, 95% CI 0.82–0.95), and dried fruit intake (HR 0.61, 95% CI 0.41–0.91) were supportive of protective associations.ConclusionsGenetic evidence confirms OC risks associated with endometriosis, and age at menarche and menopause. While greater overall adiposity increases the risk, fat without an adverse metabolic profile appears protective. Associations between vitamin D and HMG-CoA reductase inhibition with OC risk warrant further study.
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