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Epidemic exposure : the rich flee and the poor take the bus
\"This work provides a look at health and economic inequality in pandemics\"-- Provided by publisher.
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Identifying a gap in drowning prevention: high-risk populations
IntroductionSome populations have been less susceptible to reductions in drowning than others. It has been hypothesised that this is due to prevention strategies failing to account for the influence of social determinants (such as ethnicity, socioeconomic status). Populations such as ethnic minorities have been over-represented in injury statistics, however this is not well explored in drowning. This study aims to identify high-risk populations for drowning, risk factors and prevention strategies.MethodsA literature review undertaken systematically using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses approach was conducted of peer-reviewed literature in English, published between 1990 and 2018 from high-income countries. Search terms included drowning, water safety, ethnic minority, migrant, and culturally diverse.ResultsIn total, 35 articles were included. High-risk populations identified were: ethnic minorities, First Nations/Aboriginal people, migrants and rural residents. Over half (51%) focused on children (0–18 years). Risk factors included social determinants, swimming ability and knowledge, attitudes and behaviour. Four intervention studies were found; two focused on upskilling adults from high-risk populations to increase employment opportunities within the aquatic industry; an evaluation of a 10-year rock fishing safety education project and a learn-to-swim programme for minority children. Proposed prevention strategies included education, practical skills, research, policy and engagement.DiscussionLimited literature exists pertaining to drowning among adults from high-risk populations. There is a need to increase the sophistication of drowning prevention strategies addressing the disparities in drowning from a culturally appropriate perspective. Acknowledging the role of the social determinants of health in drowning prevention is essential in order to improve drowning outcomes for high-risk populations globally.
Journal Article
Risky business: a 15-year analysis of fatal coastal drowning of young male adults in Australia
IntroductionDrowning is a leading cause of unintentional death, especially for males. In Australian coastal waters, young male adults account for 25% of the burden of male drowning. This study aims to describe young male coastal drowning deaths and to examine the prevalence of risk factors, especially alcohol and drugs.MethodsCharacteristics of unintentional fatal drowning involving males (15–34 years) were compared with other adults (15 years and older). Data were sourced from the National Coronial Information System (Australia) and Surf Life Saving incident reports (2004/2005–2018/2019). Relative risk was calculated and χ2 tests of independence were performed (p<0.05). Blood alcohol and drug concentrations were analysed with permutational analyses of variance.ResultsYoung males drowned more while jumping (9.85 times), swimming/wading (1.41 times), at rock/cliff locations (1.42 times) and on public holidays (1.8 times). Young males drowned less while boating (0.81 times), scuba diving (2.08 times), offshore (1.56 times) or due to medical factors (3.7 times). Young males drowned more (1.68 times) after consuming illicit drugs (amphetamines 2.26 times; cannabis 2.25 times) and less with prescription drugs (benzodiazepines 2.6 times; opiates 4.1 times; antidepressants 7.7 times). Blood serum concentrations of cannabis were higher in young males, while amphetamine and alcohol were lower.DiscussionUnsafe behaviours alongside certain activities or locations create deadly combinations of risk factors. A relationship between age, activity, attitude and affluence is proposed, where young males drown more in affordable activities with fewer regulations. Our results support multilevel strategies (spanning life stages) to reduce young male coastal drowning.
Journal Article
Quantifying rip current-related drowning deaths and exposure on Australian beaches
BackgroundRip currents are the leading coastal hazard on Australian beaches and a significant contributor to coastal drowning. This comprehensive study explored the long-term epidemiology and exposure-based mortality rates of Australian rip current drowning deaths, with the purpose of informing rip-related education efforts to reduce coastal drowning risk.MethodsA retrospective descriptive analysis of rip current drowning deaths between 1 July 2004 and 30 June 2023 was conducted, and rip current involvement was determined using data triangulation methods (incident narrative, beach imagery and expert opinion). Temporal trends were examined using Joinpoint regression, while Australian population and coastal participation data were used to calculate mortality rates.Results407 rip current drowning deaths were identified (21 deaths/year); an exposure-based mortality rate of 0.11/1 million coastal visits. Incidents predominantly involved males (85%), 20–34 years (38%), occurred in regional/remote areas (59%) and in the presence of others (80%). For every rip current drowning death, an estimated 2449 people were rescued by someone else and 8171 individuals self-rescued.DiscussionDespite small reductions in the rate of rip current drowning among males, little overall progress has been seen in attempts to decrease the mortality burden. Future efforts will require an expanded approach, beyond traditional means.ConclusionsRip currents remain a significant public health threat and the number one coastal hazard contributing to preventable mortality along Australia’s coastline.Implications for public health: Improved rip current education approaches, development and evaluation are needed to direct effective messaging to at-risk groups.
Journal Article
Mapping the Distributions of Mosquitoes and Mosquito-Borne Arboviruses in China
The geographic expansion of mosquitos is associated with a rising frequency of outbreaks of mosquito-borne diseases (MBD) worldwide. We collected occurrence locations and times of mosquito species, mosquito-borne arboviruses, and MBDs in the mainland of China in 1954−2020. We mapped the spatial distributions of mosquitoes and arboviruses at the county level, and we used machine learning algorithms to assess contributions of ecoclimatic, socioenvironmental, and biological factors to the spatial distributions of 26 predominant mosquito species and two MBDs associated with high disease burden. Altogether, 339 mosquito species and 35 arboviruses were mapped at the county level. Culex tritaeniorhynchus is found to harbor the highest variety of arboviruses (19 species), followed by Anopheles sinensis (11) and Culex pipiens quinquefasciatus (9). Temperature seasonality, annual precipitation, and mammalian richness were the three most important contributors to the spatial distributions of most of the 26 predominant mosquito species. The model-predicted suitable habitats are 60–664% larger in size than what have been observed, indicating the possibility of severe under-detection. The spatial distribution of major mosquito species in China is likely to be under-estimated by current field observations. More active surveillance is needed to investigate the mosquito species in specific areas where investigation is missing but model-predicted probability is high.
Journal Article
Burden of unintentional drowning in China from 1990 to 2019 and exposure to water: findings from the Global Burden of Disease 2019 study
BackgroundDrowning is an important contributor to the burden of deaths in China. Exposure to open water is a risk factor for drowning, but few studies quantify its impact on drowning. The purpose of this study was to provide an up-to-date analysis of unintentional drowning in China, including impact of exposure to open water.MethodsChinese provincial data from the Global Burden of Disease Study 2019 were used to describe the burden of unintentional drowning in 33 provinces and changes from 1990 to 2019. Provincial outdoor open water resource data were used to explore the relationship between outdoor open water resources and drowning burden using K-median clustering analysis.ResultsBetween 1990 and 2019, the unintentional drowning incidence, mortality and disability adjusted life years (DALY) rates declined by 31.2%, 68.6% and 74.9%, respectively, with differences by age, sex and province. In 2019, the DALY rate for drowning was relatively higher in children under 20 year, the elderly over 80 years than other age groups and was relatively higher in men. There was no statistical difference in overall incidence rate by sex. Provincial differences in unintentional drowning burden show a positive relationship with the availability and size of outdoor open water.ConclusionsAs expected availability of water increases drowning risk. There is a need to address drowning environmental risk especially among children and the elderly. Localised water safety plans which consider drowning burden and environmental risk factors are needed in China to ensure a sustained decline of unintentional drowning.
Journal Article
Correlates of suicidal ideation and non-suicidal self-injury in a large community sample of children
ObjectiveRelatively little research has examined the correlates of suicidal ideation (SI) and non-suicidal self-injury (NSSI) in children. To address this gap, we sought to identify demographic, psychological and parent-related factors associated with increased SI and NSSI in this population.MethodParticipants were 697 children (ages 7–11; 62.6% Non-Hispanic White; 51.9% boys) and their mothers recruited from the community. Information was collected regarding children’s histories of SI and NSSI, demographics, children’s and mothers’ psychopathology, mothers’ prior suicide attempt and parenting styles.ResultsSI and NSSI were relatively common in this age range, with lifetime rates of 12.6% and 6.3%, respectively. Rates of both outcomes were higher in boys, Hispanic youth, children with histories of major depression or post-traumatic stress disorder, children with higher levels of internalising and externalising symptoms and children of mothers with histories of agoraphobia. Additional relations were specific to SI (child history of generalised anxiety disorder, mother’s prior suicide attempt and maternal warmth) or NSSI (minority race, mother history of panic disorder and maternal authoritarianism).ConclusionsResults provide evidence for correlates of SI and NSSI in children spanning demographic, psychopathology-related and parenting variables, which may further our understanding of which children are at greatest risk for self-injurious thoughts and behaviours.
Journal Article
The time is now: advancing shared risk and protective factor approaches to injury and violence prevention
Using a shared risk and protective factor (SRPF) approach to prevention acknowledges a shift in the ways we work. The fundamental question at the root of our efforts should no longer be how we address a single, specific public health issue. Instead, we should be asking how we can develop a system that supports well-being holistically. We should be striving to increase the resources to which people have access in a way that proactively prevents multiple public health issues, improves the context in which people live out their lives, and develops a broad spectrum of resilience.The fields of injury and violence prevention (IVP) and public health are at a critical juncture to address the true causes of injuries and violence. It is imminently vital for all stakeholders across IVP to work upstream and align funding, interventions, and evaluations in ways that embrace SRPF approaches. The value of this approach is multifold: it tackles multiple population health outcomes through multisector interventions, it positively impacts social determinants of health; it is sustainable and it maximises financial resources. While theoretical buy-in for the SRPF approach is high, there remain challenges in the field to operationalise such an approach. The time is now for the field to collectively embrace an SRPF approach and rally together to strengthen the evidence base. Researchers, practitioners, funders and national organisations must align their goals in prioritising upstream, primary prevention through addressing SRPF to enhance public health infrastructure and reduce societal inequities.
Journal Article
Out of the silos: embedding injury prevention into the Sustainable Development Goals
Globally, unintentional injuries contribute significantly to disability and death. Prevention efforts have traditionally focused on individual injury mechanisms and their specific risk factors, which has resulted in slow progress in reducing the burden. The Sustainable Development Goals (SDGs) represent a global agenda for promoting human prosperity while respecting planetary boundaries. While injury prevention is currently only recognised in the SDG agenda via two road safety targets, the relevance of the SDGs for injury prevention is much broader. In this State of the Art Review, we illustrate how unintentional injury prevention efforts can be advanced substantially within a broad range of SDG goals and advocate for the integration of safety considerations across all sectors and stakeholders. This review uncovers injury prevention opportunities within broader global priorities such as urbanisation, population shifts, water safeguarding and corporate social responsibility. We demonstrate the relevance of injury prevention efforts to the SDG agenda beyond the health goal (SDG 3) and the two specific road safety targets (SDG 3.6 and SDG 11.2), highlighting 13 additional SDGs of relevance. We argue that all involved in injury prevention are at a critical juncture where we can continue with the status quo and expect to see more of the same, or mobilise the global community in an ‘Injury Prevention in All Policies’ approach.
Journal Article
Food security and related health risk among adults in the Limpopo Province of South Africa
Food insecurity, obesity and hyper tension remain major public health issues related to nutrition in South Africa. The purpose of this study was to determine household food security and the health risk of the adult population in the Limpopo Province using cross-sectional designs. A stratified random sampling method was used to recruit adults aged 18 to 65 years in the Limpopo Province of South Africa. Data were collected using a validated, structured questionnaire. All data were analysed using SPSS version 25.0. The study included 640 par ticipants with an average age of 36.2±17.6 years and a household size of five persons; 74.5% of par ticipants fell in the low monthly income bracket (≤ZAR3000). The mean dietary diversity score was 3.99 (CI: 2.79-5.19). The prevalence of food insecurity was 31.3%, obesity 35.2% and hyper tension 32.3%. Being a woman, older and married significantly positively influenced obesity and hyper tension. Also, a healthy eating lifestyle such as high dietary diversity was found to positively influence obesity status, while daily eating of fruit and vegetables positively significantly influenced the hyper tension status of par ticipants (p<0.05). Food insecurity, obesity and hyper tension rates remain high among adults in the Limpopo Province of South Africa with consumption of a diet low in dietary variety. Aged and married women were more likely to be obese and hyper tensive, while daily fruit and vegetable intake were found to be a protective factor. Educational and nutritional intervention should be designed and geared towards promoting fruit and vegetable intake in the community.Significance: • Households had a diet low in dietary variety, with dietary diversity revealed as a determinant of health risk. • Dietary diversity is inversely correlated with household food security. • The findings also identified household determinants of obesity and hypertension, which are major public health issues in South Africa.
Journal Article