BMJ Public Health

BackgroundMedical students represent a critical population for photoprotection education, as future physicians responsible for skin cancer prevention counseling. However, no previous studies have characterized knowledge, attitudes, and practices (KAP) regarding photoprotection among medical students in Central America or the Caribbean. ObjectiveTo assess KAP related to photoprotection and identify associated factors among medical students at a Nicaraguan university. MethodsA cross-sectional st...

Suicide is one of the worlds leading public health problems, with more than 720,000 deaths annually. Suicide has traditionally been studied from an individual perspective. However, research has increasingly highlighted the influence of community-level factors on suicide risk. This study aimed to (1) analyse the spatial distribution of suicide mortality at the provincial level in Spain (2018-2022); (2) perform stratified analyses by sex and age group; and (3) compare suicide risk across differen...

BackgroundHelmet use is a proven safety measure that reduces the risk of head injury among cyclists and e-scooter riders. Despite legal requirements for pedal bikes and e-bikes in Australia, compliance varies, particularly among users of electric vehicles. The growing popularity of e-bikes and e-scooters in urban areas presents new public health challenges, yet observational data on helmet use, behavioural determinants, and the effectiveness of safety interventions remain limited. AimPhase 4 of...

BackgroundHome disciplinary practices shape childrens health and development. Yet, comprehensive, up-to-date global evidence on their levels, trends, and socioeconomic and regional inequalities remains limited. This study provides the first global prevalence estimates of both violent and non-violent forms of discipline, examining regional disparities, variations by child and family characteristics, and changes over time. MethodsWe drew from 176 nationally-representative Multiple Indicator Clust...

Young people are increasingly remaining in the parental home for longer - a trend associated with poorer mental health. There is little evidence on this transition for young people with disability. We used three waves of the Australian Census Longitudinal Dataset, a 5% sample of linked Census records. Two analyses compared transitions between 2011-2016 and 2016-2021 among people 15-34y living with parents at baseline with complete data on disability and housing. The proportion of people no longe...

BackgroundAdolescent girls and young women (AGYW) are disproportionately vulnerable to HIV. Despite expanded HIV testing services (HTS), the majority of AGYW remain unaware of their HIV status. This study aimed to assess determinants of HIV testing uptake among AGYW in mainland Tanzania before and after stratifying by age group (15-19 and 20-24 years) using data from three national surveys conducted over time. MethodologyA cross-sectional secondary data analysis was conducted using data from th...

BackgroundArticle 5.3 of the WHO Framework Convention on Tobacco Control requires Parties to protect policies from tobacco industry interference, yet implementation remains weak internationally. Aotearoa New Zealands (Aotearoa NZ) is seen as a leader in tobacco control, yet little is known about its implementation of Article 5.3 protections. This study examines these protections as well as existing transparency measures in light of the 2024 repeal of world-leading tobacco control policies. Meth...

Because of its recent regulatory approval in southern and eastern Africa, CAB PrEP represents a scientific advancement with unknown implementation costs in most African countries. To our knowledge, this paper is the first study comparing PrEP costs in health facilities where clients had a choice between three PrEP methods. We collected and analyzed the direct service delivery costs for each method using the same costing approach and assumptions at three facilities in Lesotho and six facilities i...

BackgroundHelmet use is a proven safety measure that reduces the risk of head injury among cyclists and e-scooter riders. Despite legal requirements for pedal bikes and e-bikes in Australia, compliance varies, particularly among users of electric vehicles. The growing popularity of e-bikes and e-scooters in urban areas presents new public health challenges, yet observational data on helmet use, behavioural determinants, and the effectiveness of safety interventions remain limited. AimPhase 3 of...

IntroductionNational trends in youth suicide risk may mask significant regional variations within a country. This article attempts to account for spatio-temporal trends through a comparative analysis across South America and Europe. This paper analyzes the spatiotemporal patterns in suicide mortality among young people (10-29 years) in Argentina, Chile, Spain, and Uruguay during the period 1997-2021. MethodsOfficial data from vital statistics and population censuses of the four countries were a...

BackgroundCOVID-19 non-pharmaceutical interventions (NPIs) disrupted transmission of many infectious diseases worldwide. While disruption patterns are well-documented, systematic analysis of post-pandemic recovery trajectories across diverse pathogens remains limited. We examined disruption and recovery of 47 nationally notifiable diseases in Australia from 2015 to 2025. MethodsWe analysed NNDSS surveillance data for 47 diseases across six transmission modes, quantifying disruption using observ...

BackgroundThe growing interest in applying artificial intelligence in personalized nutrition is challenged by the complex nature of dietary advice that must balance health, economic, and personal factors. Though automated solutions using either Linear Programming (LP) or Large Language Models (LLMs) already exist, they have significant drawbacks. LP often lacks personalization, whereas LLMs can be unreliable for precise calculations. ObjectivesTo develop and assess a model that integrates a Mix...

ObjectivesPeople impacted by the criminal-legal system face significant challenges to securing and sustaining permanent housing. This study was designed to assess housing outcomes of an integrated intervention that offered housing, medical, and behavioral health services to individuals with criminal-legal system involvement. MethodsAfter a baseline needs assessment, participants were linked to services and completed quarterly study visits for up to 12 months. We used descriptive statistics to a...

Many Asian American (AA) subgroups experience disproportionate rates of cardiometabolic (CMB) conditions, yet the contextual drivers of these disparities remain unclear. Little is known about the role of Asian residential segregation, often conceptualized as Asian enclaves, with limited prior work largely ignoring region of origin and nativity. Using six years of population-based survey data from New York City (N>6,000 AAs) linked with multiple sources of community data, we examine how residence...

BackgroundFemale sex workers (FSW) are a key population for HIV prevention and care. Increasing evidence suggests that social and structural barriers are key drivers of HIV transmission. This global systematic review assesses whether experiencing violence is associated with worse HIV outcomes among FSW. Methods and FindingsWe searched MEDLINE, Embase, and PsycINFO databases for studies published from January 1st, 2010 to February 10th, 2025 assessing the impact of violence on HIV outcomes among...

BackgroundSexual minority (SM) individuals have worse mental health than heterosexual peers. However, there is no total population-based and national-level evidence on differences in risk of self-harm and suicide by sexual orientation. This study provides the first national population-based estimates in England and Wales. MethodsUsing 2021 Census data linked with hospital records and death registrations, we analysed sexual orientation (SO) differences in: (i) at least one hospital inpatient adm...

BackgroundHealth behaviors established during young adulthood significantly shape the long-term risk of non-communicable diseases and mental health disorders. Although behaviors such as diet, physical activity, sleep, and substance use are often targeted individually, growing evidence suggests these behaviors function as an interconnected system. However, the organization of lifestyle behaviors at the system level, and which behaviors exert the greatest structural influence, remains poorly under...

BackgroundEvidence from high-income countries suggests that COVID-19 may adversely affect cognitive functioning, yet population-based data from African countries remain scarce. Understanding how COVID-19 symptom burden, chronic disease, and mental health intersect to shape cognitive outcomes is critical in low-resource settings disproportionately affected by structural and health system constraints. MethodsCross-sectional data were collected from 3,058 adults (M_age = 27.2 years) in Botswana, G...

Alcohol Use Disorder (AUD) is a multifactorial condition with severe individual and societal impacts. Extending our 2024 study, this work examines lifestyle, background, and family history determinants of AUD using an expanded dataset from the All of Us Research Program. The updated analysis includes approximately 2.5 times more participants than the prior study, enabling improved statistical power and evaluation of result stability over time. Using interpretable machine learning models and stat...

Sleep architecture is essential for metabolic and cardiovascular health, yet the impact of day-to-day dietary variation on objective sleep physiology remains unclear. Using 4.8 thousand person-nights with real-time dietary logs and multi-stage wearable sleep recordings, we examined how prior-day nutrition relates to next-night sleep under free-living conditions. Higher fiber density was associated with increased restorative sleep, including +0.59 pp deep sleep, +0.76 pp REM sleep, -1.35 pp light...