Austerity and health in Europe: disentangling the causal links
The global financial crisis of 2007/08 put increased financial strain on health systems across Europe, and many countries enacted fiscal consolidation measures,1 commonly referred to as ‘austerity.’ A large body of evidence has documented the consequences of these reforms on population health, and the role of health systems as key mediating institutions.1 –4 Nonetheless, these studies insufficiently disentangle how different levels of policymaking influence health outcomes, and often focus on the short-term effects of austerity. (Source: The European Journal of Public Health)
Source: The European Journal of Public Health - September 26, 2019 Category: General Medicine Source Type: research

Ebola: global commitment for local engagement needed
Five years ago, Ebola had the media in its grip. The outbreak in West Africa captured the headlines for years. The fact that the virus managed to reach the USA and Europe, ensured non-stop coverage of the outbreak. In the span of almost 2 years, Ebola infected more than 28 000 people, killing over 11 000 of them. There was a collective sigh of relief when the outbreak was finally declared over in March 2016. (Source: The European Journal of Public Health)
Source: The European Journal of Public Health - September 26, 2019 Category: General Medicine Source Type: research

European Public Health News
In this European Public Health News, all authors address the need for and benefits of European collaboration. Both Azzopardi Muscat and Zeegers Paget reflect on the need for health policy leaders in Europe to step up and speak out for stronger collaboration at European level. Jakab addresses leaving no one behind, one of the main objectives of the UN sustainable development goals (SDG), by emphasizing the need for regional networking. Andriukaitis uses the example of falsified medicines to stress the need for European regulation and collaboration. (Source: The European Journal of Public Health)
Source: The European Journal of Public Health - September 26, 2019 Category: General Medicine Source Type: research

Erratum
11th European Public Health Conference Winds of change: towards new ways of improving public health in Europe Ljubljana, Slovenia 28 November –1 December 2018: DL Migrant, LGBTI and minorities health (Source: The European Journal of Public Health)
Source: The European Journal of Public Health - July 26, 2019 Category: General Medicine Source Type: research

The tobacco industry is dying; disinvestment can speed its demise
(Source: The European Journal of Public Health)
Source: The European Journal of Public Health - July 26, 2019 Category: General Medicine Source Type: research

European Public Health News
In this European Public Health News, both Azzopardi-Muscat and Charpak highlight the issue of migration and public health. Azzopardi-Muscat concludes her column looking forward to the discussions at the upcoming European Public Health conference (20 –23 November 2019 in Marseille, France) and hopes that these discussions will lead to a clear call for policy action in the area of migration and health. Charpak addresses the record number of abstracts that were submitted for this year’s European Public Health conference. More than 2000 abstrac ts were submitted and 150 scientific workshops were proposed. In the EU...
Source: The European Journal of Public Health - July 26, 2019 Category: General Medicine Source Type: research

A practical composite risk score for the development of Haemolytic Uraemic Syndrome from Shiga toxin-producing Escherichia coli
ConclusionWe have developed a composite risk score which may be of practical value, once externally validated, in prompt estimation of risk of HUS from STEC infection. (Source: The European Journal of Public Health)
Source: The European Journal of Public Health - July 21, 2019 Category: General Medicine Source Type: research

Women ’s excess unhealthy life years: disentangling the unhealthy life years gap
ConclusionLower mortality and higher disability prevalence contributed to women ’s longer life expectancy with disability. Women’s higher disability prevalence due to non-fatal disabling conditions was partly offset by lower disability from heart disease and accidents. Conditions differentially impact gender differences in ULY, depending on whether they are mainly life-thre atening or disabling. The conclusions confirm the health-survival paradox. (Source: The European Journal of Public Health)
Source: The European Journal of Public Health - July 5, 2019 Category: General Medicine Source Type: research

Health inequalities: a Research Positioning Exercise at the National Institute of Health, Italy
ConclusionFindings of this Exercise show that ISS researchers identified relevant areas, addressing inequalities in addressing the health. Because of ISS structural peculiarity that includes multidisciplinary expertise, the ISS could provide a significant contribution to HI research challenges and knowledge gaps. (Source: The European Journal of Public Health)
Source: The European Journal of Public Health - June 20, 2019 Category: General Medicine Source Type: research

Association between physical, psychological and social frailty and health-related quality of life among older people
This study aimed to evaluate the association between physical, psychological and social frailty and HRQoL among community-dwelling older people.MethodsA cross-sectional study was performed with baseline data collected in 2015 from the Urban Health Centers Europe (UHCE) project in five European countries, the United Kingdom, Greece, Croatia, The Netherlands and Spain. A total of 2325 participants were included in the baseline measurements of the Urban Health Centers Europe project; 2167 participants (mean age = 79.7; SD=5.6) were included in the analyses after excluding participants with missing data. The Tilburg Frailty In...
Source: The European Journal of Public Health - June 5, 2019 Category: General Medicine Source Type: research

Cumulative childhood adversity, adolescent psychiatric disorder and violent offending in young adulthood
ConclusionCA is associated with elevated risk for violent offending in early adulthood, and the association is partly mediated by adolescent psychiatric disorder. Individuals exposed to cumulative CA who also develop adolescent psychopathology should be regarded as a high-risk group for violent offending, by professionals in social and health services that come into contact with this group. (Source: The European Journal of Public Health)
Source: The European Journal of Public Health - June 5, 2019 Category: General Medicine Source Type: research

Smoking and school absenteeism among 15- to 16-year-old adolescents: a cross-section analysis on 36 European countries
ConclusionWe observed an association between smoking intensity and absenteeism among youth in Europe. This implies that, to the extent that this association is causal, school tobacco control policies may reduce the short-term consequences of smoking on adolescents ’ education and health. (Source: The European Journal of Public Health)
Source: The European Journal of Public Health - June 5, 2019 Category: General Medicine Source Type: research

Changes in socioeconomic mortality inequalities at adult and old ages in Lithuania, 2001 –05 to 2011–15
This article provides evidence about changes in mortality inequalities by education and economic activity status among adults aged 30 –64 and older adults aged 65 and over in Lithuania between 2001–05 and 2011–15. The study shows that the overall mortality decline in Lithuania was not homogeneous across socio-economic groups. The inequitable progress resulted in a widening in absolute and relative mortality inequalities amon g older adults and notable increases in relative mortality inequalities among adults aged 30–64. The total public health burden of mortality inequalities remained very pronounce...
Source: The European Journal of Public Health - June 3, 2019 Category: General Medicine Source Type: research

Satisfaction with mental health treatment among patients with a non-Western migrant background: a survey in a Danish specialized outpatient mental health clinic
ConclusionsImplications for practice based on our findings are to enhance person-centred care and shared decision-making with all patients regardless of cultural background and to prioritize pre- and postgraduate training in cultural competences and cultural humility for healthcare providers. (Source: The European Journal of Public Health)
Source: The European Journal of Public Health - June 1, 2019 Category: General Medicine Source Type: research

Maternal and perinatal outcomes of asylum seekers and undocumented migrants in Europe: a systematic review
ConclusionLimited evidence is available on pregnancy outcomes in AS and UM in Europe. The adverse outcomes reported imply that removing barriers to high-quality maternal care should be a priority. More research focussing on migrant subpopulations, considering potential risk factors such as ethnicity and legal status, is needed to guide policy and optimize care. (Source: The European Journal of Public Health)
Source: The European Journal of Public Health - May 16, 2019 Category: General Medicine Source Type: research

Associations between healthcare consumption in country of origin and in country of residence by people with Turkish and Moroccan backgrounds living in the Netherlands: the HELIUS study
ConclusionPeople with Turkish or Moroccan backgrounds living in the Netherlands who use healthcare in their countries of origin are more likely than non-users to be higher users of healthcare in the Netherlands. We thus found no indications for avoidance of healthcare in the country of residence. (Source: The European Journal of Public Health)
Source: The European Journal of Public Health - May 5, 2019 Category: General Medicine Source Type: research

Gender and socioeconomic inequalities in the implementation of the Basque programme for multimorbid patients
ConclusionThe patient-centred, integrated-care intervention launched by the Department of Health of the Basque Country might have reduced some gender and socioeconomic inequalities in health outcomes, as it avoided more hospitalizations in subgroups that presented with more episodes of decompensation in the reference year. (Source: The European Journal of Public Health)
Source: The European Journal of Public Health - May 5, 2019 Category: General Medicine Source Type: research

Inequity in postpartum healthcare provision at home and its association with subsequent healthcare expenditure
ConclusionAlthough uptake was generally high, low SES women less often received postpartum care, this being associated with higher subsequent healthcare expenses. Strategies to effectively reduce these substantial inequities in early life are urgently needed. (Source: The European Journal of Public Health)
Source: The European Journal of Public Health - April 23, 2019 Category: General Medicine Source Type: research

Trajectories of mobility limitations over 24 years and their characterization by shift work and leisure-time physical activity in midlife
ConclusionNearly two-thirds of the people retired due to disability belonged to high MLs trajectory. High persistent MLs trajectory was associated with physical inactivity in midlife among those retired on SP and on DP. Shift work with night shift predicted high persistent MLs in SP strata. Active involvement in LTPA during midlife could be beneficial to spend MLs free later life. (Source: The European Journal of Public Health)
Source: The European Journal of Public Health - April 22, 2019 Category: General Medicine Source Type: research

Sociodemographic factors associated with secondhand smoke exposure and smoking rules in homes with children
ConclusionThe parent ’s origin and the family structure were associated with SHS exposure and the adoption of smoking bans at home. Moreover, the number of smokers living at home was relevant for the adoption of smoking bans, and the educational attainment for SHS exposure. These factors should be taken into considera tion when designing or implementing smoke-free home programmes. (Source: The European Journal of Public Health)
Source: The European Journal of Public Health - April 22, 2019 Category: General Medicine Source Type: research

Trends in substance use and in the attributable burden of disease and mortality in the WHO European Region, 2010 –16
ConclusionsSubstance use and its attributable mortality and burden of disease have decreased in the WHO European Region since 2010. However, overall levels of substance use and the resulting burden of disease in the Region remain high compared with other regions of the world. (Source: The European Journal of Public Health)
Source: The European Journal of Public Health - April 22, 2019 Category: General Medicine Source Type: research

Moderate emotional reactions to stressful life events are associated with lowest risk of increased alcohol consumption: evidence from the Whitehall II study
ConclusionsIncreases in alcohol consumption following stressful events are least likely if people experience moderate levels of NER to events. Negative emotions in moderate doses should not be regarded as a risk factor for unhealthy behaviours, but rather a potentially protective factor. (Source: The European Journal of Public Health)
Source: The European Journal of Public Health - April 22, 2019 Category: General Medicine Source Type: research

Impact of the 2017 measles outbreak on the emergency care system of a large tertiary-care teaching hospital in Italy: a retrospective analysis
ConclusionA preventable high-infective disease outbreak can lead to a misapply of ED facilities in terms of unjustified admissions, time spent in TIRs, antibiotic prescription and in hospitalization rate. (Source: The European Journal of Public Health)
Source: The European Journal of Public Health - April 16, 2019 Category: General Medicine Source Type: research

Addressing alcohol in routine healthcare in Sweden —population-based surveys in 2010 and 2017
AbstractBackgroundThe aim of the study was to compare how alcohol was addressed in routine healthcare practice in Sweden in 2010 and 2017, following the 2011 implementation of national drinking guidelines.MethodsPopulation-based cross-sectional surveys were conducted in 2010 and in 2017. Subjects were 3200 respondents in 2010 (response rate 54%) and 3000 respondents in 2017 (response rate 51%) in Sweden. Both the 2010 and 2017 surveys collected data on: socio-demographics; alcohol consumption; healthcare visits in the past 12 months and characteristics of alcohol conversations in healthcare (duration, contents, experience ...
Source: The European Journal of Public Health - April 16, 2019 Category: General Medicine Source Type: research

Physical workload and bodily fatigue after work: cross-sectional study among 5000 workers
This study aimed to investigate associations between physical exposures at work and bodily fatigue after work.MethodsDanish workers with physical work (N=5377) answered questions about various physical exposures during work and bodily fatigue after work in the 2010 round of the Danish Work Environment Cohort Study. Associations were modeled using binary logistic regression controlled for various confounders.ResultsMean age among the younger (
Source: The European Journal of Public Health - April 14, 2019 Category: General Medicine Source Type: research

Transnational exchange of surveillance data reveals previously unrecognized TBEV microfocus
We present data from a collaborative effort between Denmark and Sweden on the surveillance of TBEV that resulted in the uncovering of a previously unrecognized possible TBEV microfocus in central Sweden. (Source: The European Journal of Public Health)
Source: The European Journal of Public Health - April 10, 2019 Category: General Medicine Source Type: research

The prevalence of metabolic syndrome among Ghanaian migrants and their homeland counterparts: the Research on Obesity and type 2 Diabetes among African Migrants (RODAM) study
ConclusionMetSyn is highly prevalent in Ghana as well as in Ghanaian migrants in Europe. To assist prevention efforts, further research is needed to understand the mechanisms driving the geographical differences in MetSyn prevalence between migrant and non-migrant Ghanaians. (Source: The European Journal of Public Health)
Source: The European Journal of Public Health - April 9, 2019 Category: General Medicine Source Type: research

Adjuvanted influenza vaccine for the Italian elderly in the 2018/19 season: an updated health technology assessment
ConclusionsAccording to this HTA, aTIV appeared the vaccine of choice in the elderly. HTA should be reapplied whenever new relevant data become available. (Source: The European Journal of Public Health)
Source: The European Journal of Public Health - March 30, 2019 Category: General Medicine Source Type: research

Trajectories of students ’ well-being in secondary education in Germany and differences by social background
ConclusionThis study provides a comprehensive picture of subjective well-being throughout secondary education. Adolescents ’ subjective well-being is linked to social factors regarding family and living conditions as well as school features. Overall, disadvantaged adolescents experience longer periods of lower subjective well-being, thus accumulating the effects of worse psychosocial health opportunities over time. (Source: The European Journal of Public Health)
Source: The European Journal of Public Health - March 29, 2019 Category: General Medicine Source Type: research

Disparities in treatment of diabetes and hypertension among groups of foreign origin and the general Finnish population
ConclusionsThis study indicates disparities in prevalence and management of diabetes and hypertension and their associated risk factors among ethnic groups. Diabetes, CVD risks and treatment outcomes in patients were sub-optimal, especially among foreign origin groups. Comprehensive health promotion strategies are needed to improve cardiometabolic health in vulnerable populations. (Source: The European Journal of Public Health)
Source: The European Journal of Public Health - March 28, 2019 Category: General Medicine Source Type: research

Household dietary salt consumption and mortality from cardiovascular diseases: an ecological panel analysis in Japan
ConclusionsThese findings may suggest that the reduction of salt in processed foods, in addition to individual behavioural change, could be useful for decreasing mortality from ischaemic heart diseases in the Japanese population. Ecological factors related to decreasing cerebrovascular disease mortality in the context of the ageing Japanese population require further investigation. (Source: The European Journal of Public Health)
Source: The European Journal of Public Health - March 20, 2019 Category: General Medicine Source Type: research

Adverse childhood experiences, childhood relationships and associated substance use and mental health in young Europeans
ConclusionsACEs are strongly associated with substance use and mental illness. Harmful relationships are moderated by resilience factors such as supportive childhood relationships. Whilst ACEs continue to affect many children, better prevention measures and interventions that enhance resilience to the life-long impacts of toxic childhood stress are required. (Source: The European Journal of Public Health)
Source: The European Journal of Public Health - March 20, 2019 Category: General Medicine Source Type: research

Associations between adolescent social phobia, sickness absence and unemployment: a prospective study of twins in Sweden
Conclusions: Results suggest that social phobia experienced in adolescence contribute to early adulthood unemployment and SA. Familial factors seemed to explain the association between social phobia and unemployment. (Source: The European Journal of Public Health)
Source: The European Journal of Public Health - March 16, 2019 Category: General Medicine Source Type: research

Increase of internalized mental health symptoms among adolescents during the last three decades
This study was cross-sectional and compared two separate but geographically identical groups of adolescents in a middle-sized industrial municipality in Northern Sweden at two time-points [(i) 1981,n = 1083, (505 girls, 577 boys), response rate 99.7%; (ii) 2014,n = 682, (338 girls, 344 boys), response rate 98.3%]. All students in their last year of compulsory school were included. The same self-report questionnaire, consisting of four sub-scales (functional somatic-, anxiety-, depressive symptoms and conduct problems), was used at both occasions. Data were analyzed with descriptive statistics, two-way ANOVA and general lin...
Source: The European Journal of Public Health - March 11, 2019 Category: General Medicine Source Type: research

Towards explaining time trends in adolescents ’ alcohol use: a multilevel analysis of Swedish data from 1988 to 2011
ConclusionsThe findings of the current study provide an indication that the decreased trend in alcohol use that has been observed in Swedish adolescents over the past few decades may be related to changes in adolescents ’ social interactions with peers. (Source: The European Journal of Public Health)
Source: The European Journal of Public Health - March 11, 2019 Category: General Medicine Source Type: research

Trends in disease mortality before and during the Great Recession in individuals employed in Spain in 2001
ConclusionsIn the group of individuals with a job in 2001 the Great Recession reversed or stabilized the upward trend in all-disease mortality. (Source: The European Journal of Public Health)
Source: The European Journal of Public Health - March 8, 2019 Category: General Medicine Source Type: research

The association between self-harm and area-level characteristics in Northern Ireland: an ecological study
ConclusionThese findings indicate that self-harm rates are highest for those residing in highly deprived areas, where unemployment, crime and low level of education are challenges. Community interventions tailored to meet the needs of specific areas may be effective in reducing suicidal behaviour. (Source: The European Journal of Public Health)
Source: The European Journal of Public Health - March 8, 2019 Category: General Medicine Source Type: research

The role of consumer age and financial profit in vendor compliance for underage alcohol sales
AbstractAge limit restriction for risky products is widely implemented as an instrument to improve public health. To study reasons for vendor (non-)compliance this 2 (underage vs. adult consumer) × 2 (low vs. high profit) field experimental research was conducted. Trained mystery shoppers conducted 218 alcohol purchase attempts. ID checks and compliance were significantly higher when financial profit was low (74% ID checks; 67% compliance) compared with the high-profit conditions (26%; 18%) . There were no significant differences between the adult and underage consumer conditions. The motivation to comply appears to ...
Source: The European Journal of Public Health - March 8, 2019 Category: General Medicine Source Type: research

Do sociodemographic characteristics associated with the use of CAM differ by chronic disease?
ConclusionsSociodemographic characteristics associated with CAM use differ by diseases. The role of CAM in disease management cannot be ignored. Making physicians aware for which disease CAM is used and by whom, may facilitate disease management. (Source: The European Journal of Public Health)
Source: The European Journal of Public Health - March 8, 2019 Category: General Medicine Source Type: research

Parent hazardous drinking and their children ’s alcohol use in early and mid-adolescence: prospective cohort study
ConclusionsThe associations between parents ’ and their adolescent children’s hazardous drinking are unlikely to be due to confounding by socio-demographic and family factors. Parents should be encouraged, and supported by public policy, to reduce their own alcohol consumption in order to reduce their children’s risk of becoming hazardo us drinkers. (Source: The European Journal of Public Health)
Source: The European Journal of Public Health - March 8, 2019 Category: General Medicine Source Type: research

Exposure to second-hand smoke in the context of tobacco policy changes in Estonia, 1996 –2016
ConclusionsThe consistently declining prevalence of SHS exposure among non-smoking population can be at least partially attributed to implementation of tobacco legislations in 2000s. However, the existing sociodemographic and socio-economic differences in SHS exposure require further attention as those in more vulnerable positions are also more exposed to SHS-related health harms. (Source: The European Journal of Public Health)
Source: The European Journal of Public Health - March 8, 2019 Category: General Medicine Source Type: research

Evaluation of new approaches to the access of official monitoring results for live bivalves molluscs
ConclusionHigh accuracy of the developed label-reading algorithm shows potential for providing instant automatic access to the date and production area, but is affected by the variability on the label structure. Although not required by food laws, the majority of the sampled labels included complementary information (classified production area) that will allow access to more precise information about the existing biotoxin tests and analysis results. (Source: The European Journal of Public Health)
Source: The European Journal of Public Health - February 27, 2019 Category: General Medicine Source Type: research

Effects of a randomized, culturally adapted, lifestyle intervention on mental health among Middle-Eastern immigrants
ConclusionA culturally adapted lifestyle intervention addressing T2D prevention in Middle-Eastern immigrants has favorable effects on mental health. The effect was more pronounced at the 4 months than at 2 months follow-up, indicating beneficial effect of longer study duration.Trial registrationwww.clinicaltrials.gov NCT01420198. (Source: The European Journal of Public Health)
Source: The European Journal of Public Health - February 26, 2019 Category: General Medicine Source Type: research

Status quo bias and health behavior: findings from a cross-sectional study
ConclusionA high SQB was associated with unfavorable health behavior and higher BMI. Targeting SQB might be a promising strategy for promoting healthy behavior. (Source: The European Journal of Public Health)
Source: The European Journal of Public Health - February 18, 2019 Category: General Medicine Source Type: research

Gender differences in incidence and in-hospital outcomes of surgical aortic valve replacement in Spain, 2001 –15
AbstractBackgroundwe aim to examine trends in the incidence of surgical aortic valve replacement (SAVR) among women and men in Spain from 2001 to 2015; compare in-hospital outcomes for mechanical and bioprosthetic SAVR by gender and; to identify factors associated with in-hospital mortality (IHM) after SAVR.MethodsWe performed a retrospective study using the Spanish National Hospital Discharge Database, 2001 –15. We included patients that had SAVR as procedure in their discharge report. Propensity score matching (PSM) was performed to assess the impact of gender on the outcomes of mechanical and bioprosthetic SAVR.Re...
Source: The European Journal of Public Health - February 18, 2019 Category: General Medicine Source Type: research

Do ethnic inequalities in multimorbidity reflect ethnic differences in socioeconomic status? The HELIUS study
ConclusionsWe found a significantly higher prevalence of multimorbidity in ethnic minority men and women compared to Dutch, and results pointed to an earlier onset of multimorbidity in ethnic minority groups. These inequalities in multimorbidity were not fully accounted for by differences in SES. (Source: The European Journal of Public Health)
Source: The European Journal of Public Health - February 14, 2019 Category: General Medicine Source Type: research

Framingham score and work-related variables for predicting cardiovascular disease in the working population
ConclusionWork-related variables did not improve predictions of CVD sickness absence by the FPS. The non-laboratory Framingham score can be used to identify health survey participants at risk of CVD sickness absence. (Source: The European Journal of Public Health)
Source: The European Journal of Public Health - February 13, 2019 Category: General Medicine Source Type: research

All-cause and cause-specific mortality in Scotland 1981 –2011 by age, sex and deprivation: a population-based study
ConclusionsDespite reductions in mortality, relative (but not absolute) inequalities widened between 1981 and 2011 for all-cause mortality and for several causes of death. Reducing relative inequalities in Scotland requires faster mortality declines in deprived areas while countering increases in mortality from causes such as drug- and alcohol-related harm and male suicide. (Source: The European Journal of Public Health)
Source: The European Journal of Public Health - February 13, 2019 Category: General Medicine Source Type: research

Socioeconomic inequalities in disability in Europe: contribution of behavioral, work-related and living conditions
ConclusionsInequalities in disability are a major challenge for public health in most European countries. Our findings suggest that these inequalities can be reduced by diminishing inequalities in exposure to well-known health determinants. (Source: The European Journal of Public Health)
Source: The European Journal of Public Health - February 11, 2019 Category: General Medicine Source Type: research

Asbestosis and silicosis hospitalizations in Italy (2001 –2015): results from the National Hospital Discharge Registry
ConclusionHospitalizations data regarding asbestosis and silicosis are consistent. Silicosis had a higher impact than asbestosis on the Italian health system. Although data show decreasing incidence of both fibroses, multiple correspondence analysis highlights that levels of illness severity were higher in silicosis and increased over time in both diseases. Further studies investigating the effectiveness of the current health surveillance programs concerning these diseases are suggested. (Source: The European Journal of Public Health)
Source: The European Journal of Public Health - February 7, 2019 Category: General Medicine Source Type: research