JMIR Public Health and Surveillance

Increasing human mobility and population connectivity have intensified the risks of global pathogen spread, while concurrent shifts in human demographic patterns, ecological factors, and climatic conditions have altered the global landscape of this risk. Genomic surveillance can serve as a critical tool for early detection of emerging pathogen threats; however, challenges remain in deciding where to monitor, in understanding trade-offs among surveillance modalities, and in translating detections...

BackgroundRecreational cannabis legalization has expanded rapidly across US states. The regulatory approaches states adopt vary widely, with varying implications for public health. This study aimed to characterize heterogeneity in recreational cannabis laws (RCLs) across US states and to identify state-level characteristics associated with these regulatory models. MethodsWe conducted Latent Class Analysis (LCA) of state-year RCL provisions from 2013 to 2024 (n=612) to identify distinct RCL appr...

BackgroundTuberculosis (TB) remains a major public health challenge in Nepal, with incidence rates substantially higher than global estimates. Accurate forecasting of TB incidence is essential for early warning systems, resource allocation, and targeted interventions. This study aimed to develop and validate a hybrid Seasonal Autoregressive Integrated Moving Average (SARIMA) and Convolutional Neural Network Auto-Regressive (CNNAR) model for TB incidence forecasting in Nepal. MethodsMonthly TB i...

ObjectiveExplore self-reported racial discrimination in healthcare. MethodsRepresentative population sample, Switzerland, repeated cross-sectional data 2016 to 2024 (N=15,525). ResultsContrary to expectation, respondents from the migration-related population (foreign citizens, foreign born, migration background, first/second generation) report less racial discrimination than members of the majority population. Over time, we see an increase in the non migration-related population reporting (rac...

Large-scale epidemics are consistently associated with increased psychological distress and substantial changes in human mobility, yet the relationship between mental health responses and effective population mobility remains overlooked. During the COVID-19 pandemic, non-pharmaceutical interventions (NPIs) such as lockdowns and travel restrictions altered daily movement patterns while simultaneously affecting psychological well-being. Importantly, formal policy stringency alone does not fully ca...

Emergency department (ED) triage decisions critically impact patient care and are standardized, yet ethnoracial disparities in triage assignment are well documented. We analyzed ethnoracial differences in triage assignments across four U.S. EDs (two adult, two pediatric), comprising 1.4 million encounters from 2011-2025. To better characterize these disparities, we developed an automated triage algorithm that replicates the Emergency Severity Index (ESI) criteria, the standard triage protocol us...

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...

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...

ObjectivesTo quantify patterns of preventable death in Australian coronial findings, measure government compliance with coroner recommendations across jurisdictions, and identify case characteristics associated with recommendation issuance and acceptance. DesignCross-sectional computational text analysis of publicly available coronial findings using unsupervised topic modelling and rule-based classification. SettingAustralian coronial system, all eight state and territory jurisdictions, findin...

BackgroundLong COVID affects millions worldwide, yet the long-term trajectory of healthcare costs remains poorly characterized. Prior studies with limited follow-up have documented elevated but stable excess costs, leaving uncertainty about whether the economic burden attenuates or persists over time. MethodsWe conducted a retrospective cohort study using electronic health record data from 12 hospitals and 20 community health centers (January 2018 through December 2024). Adults with documented ...

ObjectiveTo re-estimate and re-validate the Area Deprivation Index to address recent criticism of the existing index, which is calculated and distributed by Neighborhood Atlas. Data SourcesTo calculate the updated Area Deprivation Index (ADI), we obtained 17 census measures from the 2018-2022 American Community Survey (ACS) 5-year data that reflected poverty, housing, employment, and education within census block groups, census tracts, and counties. To validate the association of the updated in...

BackgroundSouth Koreas healthcare system, while technologically advanced, faces persistent inefficiencies in health information exchange (HIE) across its fragmented hospital network. Blockchain technology has been proposed as a decentralised infrastructure for secure, interoperable health data sharing, yet empirical evidence quantifying the efficiency gains attributable to blockchain-based HIE systems at the hospital network level remains absent. Traditional performance metrics fail to distingui...

ImportanceRecent reports have highlighted an intense influenza activity related to the circulation of the influenza A(H3N2) subclade k variant. There is no data available on the impact of the emergence of H3N2 subclade k on the severity of the 2025-2026 epidemic or on the clinical phenotype of patients requiring admission to the intensive care unit (ICU). ObjectiveTo compare the clinical presentation, hospital mortality and virological characteristics of patients with laboratory-confirmed influ...

1.AI is already finding its way into the diagnostic radiology realm of various regions around the world, but there is still a lack of evidence on the situation in LMICs. This qualitative study examined the research problem through the perspectives of clinicians regarding the adoption of AI-Radiology in Karachi, Pakistan, using the Technology Acceptance Model and interpreting the results into practice and policy using the Problem Driven Iteration Adaptation lens. 13 clinicians (radiologists, tert...

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...

BackgroundRisk communication is critical in shaping public response during infectious disease outbreaks. This study quantitatively examined whether Nigerian media coverage during the 2024 cholera outbreak reflected a proactive or reactive risk communication pattern. MethodsA Python-based systematic content analysis was conducted on 352 unique news articles published by major Nigerian media sources in 2024. K-Means was used to cluster and quantify thematic patterns, TextBlob for sentiment polari...

BackgroundEmerging in January 2020, the SARS-CoV-2 pandemic quickly exposed the limitations of traditional contact tracing and overwhelmed the contact tracing efforts of US health departments. In response, Kaiser Permanente partnered with the Public Health Institute to launch the California Contact Tracing Support Initiative. This innovative, clinically integrated program aimed to link Kaiser Permanente members diagnosed at their facilities directly with contact tracing and supportive clinical c...

BackgroundArtificial intelligence is increasingly embedded in healthcare delivery. Its legitimacy depends on institutional governance, not technical performance alone. Prior research has centered on clinicians and patients. Less attention has been given to cybersecurity professionals who sustain the digital infrastructures that support health AI. This study examines how cybersecurity professionals conceptualize AI as clinical infrastructure and how these interpretations shape understandings of t...

BackgroundPhysical activity is a key modifiable determinant of health, yet current guidelines primarily emphasize moderate-to-vigorous physical activity and provide limited guidance on other actionable dimensions such as daily step count and sedentary time. The growing availability of wearables enables high-resolution measurement of these metrics and assessment of their associations with clinical outcomes. MethodsMinute-level wearable data from adult participants of All of Us between 2015-2023 ...

Accurate quantification of individual exposure to air pollutants remains a major challenge in environmental health, as fixed-site monitoring fails to account for mobility, indoor environments, and physiological variability. We deployed TracMyAir, a smartphone-based digital health platform designed to generate time-resolved, personalized exposure and inhaled dose estimates for PM2.5 and ozone under real-world conditions. In an exploratory study of 18 adults contributing more than 1,500 participan...