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Background and Objectives: Diabetes is one of the most common chronic non-communicable diseases and represents a major public health problem. At the global level, the epidemic character of diabetes mellitus can be attributed to an extended life expectancy but also to lifestyle. The aim of this study was to examine the sociodemographic, health, and lifestyle characteristics of adults with type 2 diabetes mellitus in Serbia. Materials and Methods: The research is part of the Serbian Population Health Survey conducted in the period from October to December 2019 by the Republic Statistical Office, in cooperation with the Institute of Public Health of Serbia “Dr Milan Jovanović Batut” and the Ministry of Health of the Republic of Serbia. The research instrument was standardized questionnaires constructed in accordance with the European Health Interview Survey (EHIS—European Health Interview Survey, wave 3) questionnaire, which were adapted to the specifics of our area. The research was conducted as a cross-sectional study on a representative sample of the adult population of Serbia. Results: Among 1138 adults with type 2 diabetes in Serbia (52.8% female; mean age 66.0 ± 11.9 years), overweight and obesity were highly prevalent (40.1% and 34.4%, respectively), with Obesity I predominating. Significant gender differences were observed: female more often reported obesity, multimorbidity, and depressive symptoms, whereas men were more physically active and more frequently overweight. Most participants were physically inactive, consumed breakfast and bread daily, and had low engagement in cycling and sports. Alcohol consumption was significantly higher in men, while dietary habits differed by gender for bread intake. These findings highlight substantial gender- and lifestyle-related disparities among adults with type 2 diabetes in Serbia. Conclusions: Targeted interventions promoting healthy lifestyle, physical activity, psychosocial support, and chronic disease management are urgently needed to address gender- and lifestyle-related disparities in adults with type 2 diabetes in Serbia.

Background/Objectives: Health literacy represents the ability to access, understand, appraise, and apply health information for making appropriate health decisions. It is closely linked to education, income, employment, and overall health outcomes. Limited health literacy is associated with poor self-care, inadequate treatment adherence, and increased healthcare utilization. This study aimed to assess the level of health and medication adherence behaviors among primary health care users in Montenegro and examine its association with key demographic and socioeconomic factors. Methods: A cross-sectional, multicenter study was conducted among 202 primary health care users at the Primary Healthcare Center Danilovgrad, Plav and Ulcinj, Montenegro. Data were collected using a demographic questionnaire, the standardized European Health Literacy Questionnaire (HLS-EU-Q-47), and the Attitudes towards Medication Adherence Self-Reported Questionnaire (ADHERE-7). Statistical analyses included descriptive statistics, χ2 tests, and univariate and multivariate regression. Results: The mean HLS-EU-Q Index was 33.55 ± 8.05. Significant differences in literacy levels were observed by age (p = 0.022), material status (p = 0.043), and self-rated health (p = 0.020). In multivariate ordinal regression analysis, lower income (<400 €) was associated with lower odds of belonging to a higher health literacy category (OR = 0.22, 95% CI: 0.02–0.92, p = 0.039), while no statistically significant associations were observed for gender, education level, or employment status after adjustment. The mean ADHERE-7 score of the study population was 21.78 ± 5.19. When analyzed in relation to the level of health literacy, the highest mean ADHERE-7 score was observed among participants with excellent health literacy (24.28 ± 4.90). Lower levels of health literacy were associated with lower odds of belonging to higher health literacy categories among participants reporting selected non-adherence behaviors, including missing therapy 3–4 times per week (OR = 0.30), frequently skipping prescribed medication when feeling well (OR = 0.03), and reducing or omitting therapy due to perceived lack of benefit or high costs (OR range: 0.10–0.31). Conclusions: Health literacy among primary care users in Montenegro is moderate, with a substantial proportion exhibiting limited literacy. Low income is a key determinant of limited literacy, and limited health literacy was associated with poorer medication adherence. Targeted educational and policy interventions are needed to improve health literacy and reduce health inequalities.

Pancreatic cancer is a significant public health problem worldwide. It is currently ranked as the 12th most common malignancy and the 6th leading cause of cancer mortality. This study aimed to investigate sex-specific and age-specific pancreatic cancer mortality trends and disparities in the Serbia from 2000 to 2021. A descriptive epidemiological population-based study analyzing pancreatic cancer mortality was conducted. Age-standardized mortality rates (ASMRs) were calculated using the Segi's world standard population. Temporal trends for pancreatic cancer mortality were assessed using the joinpoint regression analysis. Age-standardized rate of pancreatic cancer in Serbia was 6.4/100,000 (7.9/100,000 in men, 5.1/100,000 in women). The rates were found to be 1.6 times higher in men than women. Pancreatic cancer mortality trend significantly increased from 2000 to 2010 in men (APC=+2.4%, 95%CI: 0.3 – 1.4), after 2010 rates nonsignificantly decline (APC=−0.4%; (95%CI: −2.5 – 0.5). In women, mortality trend significantly increased by +1.8% at an annual level (95%CI: 0.7–2.7). The mortality of pancreatic cancer increased by age. The joinpoint analysis showed a significant rising trend of mortality rates in all age groups 60+, with the highest average annual percent change being reported in the age groups 85+ (AAPC=+3.1 (95%CI: 1.6–4.5)). The provision of updated statistics on the occurrence and outcomes of pancreatic cancer, time trends among various population groups, along with a better understanding of its etiology and identification of causal changeable risk factors – are essential when it comes to the primary prevention of this particular disease.

Population aging is defined as one of the most current phenomena and challenges facing world. The WHO defines population aging as one of greatest successes of human society, resulting from reduction of mortality among elderly and their longer life expectancy in the protection of population, pharmacology, public health and promotion of healthy lifestyles. The certainty of the continuity of population aging in future continues to capture attention of the general public and initiates a whole series of open questions that will require very specific and concrete answers from each country. The aim of this paper is to review available literature to indicate the specific determinants of the elderly population, identify the challenges faced by the elderly population and indicate implications of the phenomenon of population aging. The unstoppable process of population ageing has profound consequences for health, social and economic spheres of society due to specific and very different needs of elderly population. The role of demographics, social factors, health needs and barriers as economic resources and differences in use of health services among elderly need to be systematically addressed and monitored. A well-organized health and social care system is important for improving the health of older people. Public health policy should address the diversity of health and functional conditions experienced by older people and maximize number of people who promote a positive journey of ageing. The creation and implementation of innovative strategies to improve health and quality of life of older people would enable well-being in old age.

Background and Objectives: Prehypertension and hypertension are the most common cardiovascular disorders worldwide and are increasingly considered one of the most serious public health problems, particularly in developing countries. The objective of this study was to determine the frequency and demographic and socioeconomic predictors of prehypertension and hypertension in the adults in Serbia, and to examine the relationship between prehypertension and hypertension and health behavior determinants (smoking, alcohol use, physical activity) and individual aspects of health (a health self-assessment, multimorbidity, BMI, depressive symptoms). Materials and Methods: The research is part of the fourth National Population Health Survey conducted in 2019, which was conducted by the Republic Institute of Statistics, in cooperation with the Institute of Public Health of Serbia and the Ministry of Health of the Republic of Serbia. As a research instrument, questionnaires were used in accordance with the methodology of the European Health Survey. For the purposes of this research, data on the adult population aged 20 and over were used. Results: Women are at a reduced risk for both prehypertension (OR  =  0.328) and hypertension (OR = 0.349) by nearly 70%. Similarly, those aged below 60 years have a lower risk for prehypertension and those younger than 40 years have a lower risk for hypertension (OR = 0.995), whereas people with a lower education have a 4.3 times higher risk of prehypertension (OR = 4.323) and a 1.6 times higher risk of hypertension (OR =  1.614). The poor have a 1.4 times higher risk of prehypertension (OR = 1.413) and a 1 times higher risk of hypertension (OR = 1.035). People with multimorbidity have a 1.2 times higher risk of both prehypertension (OR = 1.218) and a 4.8 times higher risk of hypertension (OR = 4.867). Conclusions: Male gender, lower education, poverty, age and the presence of multimorbidity are significant predictors of prehypertension and hypertension in the Serbian adult population, so preventive strategies should be aimed at these sensitive population groups.

Background and Objectives: Urban–rural health disparities reflect differences in health outcomes, healthcare access, and socio-economic conditions between populations. In Serbia, limited research has quantified how socio-demographic and socio-economic characteristics influence settlement type and healthcare utilization. The aim of this study was to examine the relationship between settlement type and socio-demographic/socio-economic factors, and to assess whether these differences are reflected in patterns of healthcare utilization. Materials and Methods: Data were drawn from the 2019 Serbian National Health Survey, a nationally representative, stratified, two-stage random sample including 12,439 adults aged ≥20 years. Settlement type (urban vs. rural) was the primary dependent variable. Descriptive statistics, Chi-square and t-tests, and bivariate and multivariate logistic regression models were used to assess associations. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated, with significance set at p < 0.05. Results: Urban residence was more likely among unmarried individuals, those living in Šumadija/Central Serbia, and those with higher education. Primary or lower education reduced the odds of urban residence, and middle-income groups were less likely to live in urban areas compared to the richest. Settlement type was not significantly associated with hospital or day hospital use. However, rural residents had lower use of prescribed medicines, higher use of non-prescribed medicines, and more frequent physiotherapy visits. Private practice use was over twice as likely in urban settlements. Conclusions: To address urban–rural healthcare disparities in Serbia, targeted strategies could include enhancing health literacy in rural areas, incentivizing physicians to work in underserved regions, expanding telemedicine and mobile health services, improving access to prescribed medications, and strengthening public–private healthcare integration to ensure equitable access across all settlement types.

Background/Objectives: One of the raising public health problems in the adolescent population is obesity, which has reached epidemic proportions worldwide. The aim of this work is to determine the prevalence of obesity in the population of children of secondary school, age 15 to 19 years in Serbia and the determinate connection with demographic and socio-economic characteristics of the respondents and their eating habits and physical activity. Methods: The research is part of the fourth National Population Health Survey conducted in 2019, which was conducted by the Republic Institute of Statistics, in cooperation with the Institute of Public Health of Serbia and the Ministry of Health of the Republic of Serbia. As a research instrument, questionnaires were used in accordance with the methodology of the European Health Survey. For the purposes of this research, data on the adult population aged 15–19 and over were used. Results: The association of overweight with demographic and socioeconomic characteristics was examined using binary regression. In the univariate model, male gender (OR = 1.95), younger age (OR = 1.57) and Region of Vojvodina (OR = 2.47) stood out as significant predictors of overweight, which was confirmed by the multivariate model. Conclusions: The results of our study emphasize that the prevalence of obesity in the population of high school youth is at a significant level and that a lot more needs to be done to promote healthy lifestyles and raise awareness of their benefits on health status.

Background: According to World Health Organisation data, on the top ten causes of death in the world in 2019, ischemic heart diseases ranked first, followed by stroke and chronic respiratory diseases. This study aimed to make cross-section of the current mortality rates of indicators of circulatory diseases, ischemic heart diseases and cerebrovascular diseases, access the trends of indicators in Serbia more than two decades and to find the correlation of these observed indicators between males and females. Methods: Medical indicators were taken from the publicly available Health for all databases that deals with long-term evaluation and monitoring of indicators obtained from national authorities. In this epidemiological study, following indicators were analysed: indicator of standardized circulatory diseases, ischemic heart disease, and cerebrovascular diseases. SPSS was used for statistical analysis. Results: Between 1998 and 2021 all of the mortality indicators were decreasing in Serbia. Between 2002 and 2005 observed indicators had almost constant decreasing trend. The standardized mortality for circulatory disease along with indicators for mortality from ischemic diseases and cerebrovascular disease was more prevalent among males than females, Conclusion: Continuing the follow of indicators is of the great importance for public health and macroeconomic of countries. This decreasing trend in Serbia must remain constant and that can be effectively done through continuous improvement of health systems, focusing on the primary health care and conducting pharmacoeconomic studies and epidemiological studies.

Background: Lower socioeconomic groups were more affected by depressive symptoms among adults of Serbia. In this study, we tested a model that examines association between sociodemographic factors and depressive symptoms among adult population in Serbia. Methods: The study was conducted within the National Health Survey of the Serbian population in 2019. The questionnaires used as instruments in this study were created in accordance with the questionnaires of the European Health Interview Survey –Third Wave. The Patient Health Questionnaire - 8 was used to evaluate the presence of depressive symptoms to the adult population aged 20 years and over. The relations between depression symptoms and a set of independent variables were examined with univariate and multivariate logistic regression analyses. Results: The prevalence of mild depressive symptoms was 6.6%, %, the prevalence of depressive episodes was 2.2%, while 91.2% of respondents had no depressive symptoms. In the univariate regression model, depressive episodes is 1.9 times more frequent in women (OR=1.909), 6.6 times more frequent in persons over 80 years of age (OR=6.610 ), 3.1 times more frequent in divorced or without a partner (OR=3.143 ), 6.6 times more frequent in persons with low education (OR=6.609), 3.3 times more frequent in persons with a poor well-being index (OR=3.373), 3.6 times more frequent in persons inactive (OR=3.649) and 1.9 times more frequent in persons from Vojvodina (OR=1.902). Conclusion: Sociodemographic factors should be considered for policymaking and for the development of new interventions to lower prevalence of depressive symptoms in adults.

Background: Students making the transition from high school to university find it difficult to maintain good eating routines/lifestyles and mental health, due to time constraints and stress. The goal of the study was to analyse the correlation between previously mentioned topics. Methods: We included 948 students, aged 18-27, at the Faculty of Medical Sciences in Serbia and the research was conducted in 2020. Chi-square was used for statistical analysis. Modified WHO questionnaire for lifestyle and eating habits was used, as well as standardized questionnaires for anxiety and depression. Results: Respondents who had more prominent symptoms of depression (moderate or severe) and anxiety had a significantly higher percentage of eating less than three meals a day (47.7%, 35.7%), skipped breakfast (38.6%, 33.5%), consumed alcohol (11.4%, 3.8%), used energy drinks (38.6%, 31.7%), were on some type of diet (36.6%, 30.2%), were not satisfied with their appearance (66.7%, 53%) and not engaging in physical activity (43.2%, 33.1%). Significant predictors for severe depressive and anxiety symptoms were the consumption of alcoholic beverages, energy drinks, satisfaction with personal appearance and physical activity during a day. Conclusion: The results suggest that some of the eating and lifestyle habits were linked to higher risks of developing depressive or anxiety symptoms.