Journal of Preventive Medicine and Public Health

Editorial

Our Valuable Contributors: Reviewers of 2024: Sue K. Park; J Prev Med Public Health. 2025;58(2):113-113. Published online March 28, 2025; DOI: https://doi.org/10.3961/jpmph.25.241

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Original Articles

Who Dies Alone? Demographics, Underlying Diseases, and Healthcare Utilization Patterns of Lonely Death Individuals in Korea: Haibin Bai, Jae-ryun Lee, Min Jung Kang, Young-Ho Jun, Hye Yeon Koo, Jieun Yun, Jee Hoon Sohn, Jin Yong Lee, Hyejin Lee; J Prev Med Public Health. 2025;58(2):218-226. Published online March 4, 2025; DOI: https://doi.org/10.3961/jpmph.24.704

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Abstract Summary PDF Supplementary Material: Objectives
Lonely death is defined as “a person living in a state of social isolation, disconnected from family, relatives, and others, who dies from suicide, illness, or other causes”. This study investigated the characteristics of individuals who die alone in Korea.
Methods
We constructed a database of lonely death cases by linking data from the Korea Crime Scene Investigation Unit of the Korea National Police Agency with National Health Insurance Service (NHIS) records. A descriptive analysis was performed to evaluate the demographics, underlying diseases, and healthcare utilization patterns among lonely death cases.
Results
Among the 3122 individuals identified as lonely death cases, 2621 (84.0%) were male and 501 (16.0%) were female. The most common age group was 50-59 years (n=930, 29.8%). The NHIS covered 2161 individuals (69.2%), whereas 961 individuals (30.8%) were enrolled in Medical Aid (MA). The highest number of lonely deaths occurred in Seoul areas, with 1468 cases (47.0%). Mood disorders were diagnosed in 1020 individuals (32.7%), and various alcohol-related diseases, including alcoholic liver disease, were also observed. Outpatient visits increased leading up to death but declined in the final 3 months, while hospitalizations decreased and emergency room visits slightly increased.
Conclusions
Most lonely death cases involved male in their 50s, with a disproportionately high number of MA beneficiaries compared to the general population. Many of these individuals also experienced mental health issues or alcohol-related disorders. Preventing social isolation and strengthening social safety nets are critical to reducing the occurrence of lonely deaths.; Summary

Korean summary
한국에서 고독사란 법적으로 “가족, 친척 등 주변 사람들과 단절된 채 사회적 고립상태로 생활하던 사람이 자살ㆍ병사 등으로 임종”하는 것으로 정의하고 있다. 고독사 사망자는 대체적으로 50대 남성이었고, 의료급여 수급권자의 비율이 일반 인구보다 월등히 높았으며, 사망자 대다수는 정신건강 문제 또는 알코올성 질환을 앓고 있었다. 사회적 고립의 예방 및 사회안전망 구축은 고독사 예방에 있어 매우 중요한 역할을 할 것으로 보인다.

Key Message
Lonely death is defined as “a person living in a state of social isolation, disconnected from family, relatives, and others, who dies from suicide, illness, or other causes”. This study investigated the characteristics of individuals who die alone in Korea. Most lonely death cases involved male in their 50s, with a disproportionately high number of MA beneficiaries compared to the general population. Many of these individuals also experienced mental health issues or alcohol-related disorders. Preventing social isolation and strengthening social safety nets are critical to reducing the occurrence of lonely deaths.

Vulnerability Assessment and Enhanced Community-based Care and Management of Patients With Tuberculosis in South Korea: A Crossover Design: Jeongmi Seo, Dawoon Jeong, In-Hyuk Lee, Jiyeon Han, Yunhyung Kwon, Eunhye Shim, Hongjo Choi; Received October 10, 2024 Accepted January 14, 2025 Published online February 25, 2025; DOI: https://doi.org/10.3961/jpmph.24.597 [Accepted]

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Abstract PDF: Objectives
People-centered care and social protection are critical for improving tuberculosis (TB) treatment outcomes. This study aimed to evaluate whether a vulnerability assessment tool, developed for an enhanced community-based care and management (ECCM) program in 2 South Korean cities, could predict and improve final TB treatment outcomes based on patients’ vulnerability levels.
Methods
Treatment outcomes in the ECCM group were compared with those in a control group, stratified by vulnerability level. During stage 1, one city served as the intervention region and the other as the control, with a crossover in stage 2. The vulnerability assessment included all notified patients with TB, and those identified as highly vulnerable in the intervention group received social support following a consultation with a case manager. Results: The vulnerability assessment tool demonstrated moderate predictive ability for unfavorable outcomes, with an area under the curve of 0.70 (95% CI, 0.63 to 0.77). The patients with high vulnerability who received ECCM treatment demonstrated a 19.8-percentage point (%p) higher treatment success rate than the high-vulnerability subcategory of the control group. ECCM also appeared to reduce LTFU and TB-related mortality by 8.4%p and 7.3%p, respectively, although these findings should be interpreted with caution. Conclusions: The results suggest that providing social support tailored to patient vulnerability at the time of diagnosis could improve TB treatment outcomes.; Summary

The Role of Time Preferences in Compliance With COVID-19 Preventive Behaviors: A Quasi-hyperbolic Discounting Approach: Moslem Soofi, Ali Kazemi Karyan, Shahin Soltani, Zahra Alipoor, Behzad Karamimatin; Received August 17, 2024 Accepted February 3, 2025 Published online February 13, 2025; DOI: https://doi.org/10.3961/jpmph.24.453 [Accepted]

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Abstract PDF: Objectives: This study aimed to investigate the role of time preferences in compliance with COVID-19 preventive behaviors in an adult population of Iran.
Methods
A web-based questionnaire was utilized to conduct a cross-sectional survey of 672 Iranian adults. The parameters of time preferences were estimated using a quasi-hyperbolic discounting model, and the relationship between COVID-19 preventive behaviors and time preferences was examined using a Probit regression model.
Results
A significant association was observed between the preventive behaviors of COVID-19 and the levels of patience and present-biased preferences among the study participants. Individuals who exhibited low levels of patience were found to be 12.8 percentage points less inclined to follow preventive behaviors compared to those with high levels of patience. The likelihood of having good preventive behaviors of COVID-19 was found to decrease by 14.3 percentage points among individuals with a present bias as opposed to those with a bias toward future.
Conclusions
patience and present-biased preferences are important determinants of adopting preventive behaviors against COVID-19. These behavioral characteristics should be considered in the design of control and prevention programs. Considering people's discounting behavior and time (in)consistency in their preferences in the design of COVID-19 policy interventions can provide valuable insights for developing tailored public health policy interventions.; Summary

Association of Sedentary Lifestyle with Skeletal Muscle Strength and Mass in US Adolescents: Results from the National Health and Nutrition Examination Survey (2011-2014): Kun-Hee Oh, Jin-Young Min, Kang Seo, Kyoung-Bok Min; Received October 17, 2024 Accepted December 31, 2024 Published online January 30, 2025; DOI: https://doi.org/10.3961/jpmph.24.614 [Accepted]

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Abstract PDF: Objectives
Excessive sedentary behavior in youth is a major global issue, contributing to the rise in childhood obesity and metabolic diseases. International public health authorities have issued guidelines recommending that children and adolescents limit their daily sedentary time, including screen time. However, to date, no studies have explored the relationship between sedentary behavior as an exposure factor and skeletal muscle strength and mass as outcomes in this population. The present study investigated the association of sedentary behavior with handgrip strength (HGS) and appendicular lean mass (ALM) among US adolescents.
Methods
A total of 1,449 adolescent participants from the National Health and Nutrition Examination Survey (2011-2014) were included. Information on sedentary behavior, specifically daily sedentary time, was obtained through a self-reported questionnaire. Muscular parameters, including HGS and ALM, were measured. To adjust for differences in body size, these parameters were divided by body mass index (BMI) and weight. Linear regression analyses were performed to evaluate the associations between daily sedentary time and each muscular parameter, adjusting for age, sex, ethnicity, annual family income, and moderate-to-vigorous physical activity (MVPA).
Results
The linear regression analyses revealed negative associations between daily sedentary time and all muscular parameters, apart from absolute ALM. These included HGS (β=−0.2652, standard error [SE]=0.0740; p=0.0011), HGS/BMI (β=−0.0215, SE=0.0044; p<0.0001), HGS/weight (β=−0.0079, SE=0.0016; p<0.0001), ALM/BMI (β=−0.0083, SE=0.0030; p=0.01), and ALM/weight (β=−0.0030, SE=0.0010; p=0.0047).
Conclusions
After adjusting for MVPA, daily sedentary time was inversely associated with HGS, HGS/BMI, HGS/weight, ALM/BMI, and ALM/weight in US adolescents.; Summary

Association Between Basic Immunization Status and Stunting in Toddlers Aged 12 to 59 Months in Indonesia: Ekadesi Purwanti, Siti Masitoh, Sudarto Ronoatmodjo; Received May 6, 2024 Accepted January 13, 2025 Published online January 30, 2025; DOI: https://doi.org/10.3961/jpmph.24.230 [Accepted]

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Abstract PDF: Objectives
Immunization has been identified as a specific nutrition-related intervention to address the direct causes of stunting. This study examines the association between basic immunization status and stunting among toddlers in Indonesia.
Methods
We conducted a cross-sectional analysis using data from the 2021 Study of Indonesia’s Nutritional Status. A total of 70,267 toddlers, aged 12 to 59 months, were examined. Cox regression was employed to calculate prevalence ratios (PRs) with their 95% confidence intervals (CIs).
Results
The prevalence of stunting among children aged 12 to 59 months in Indonesia was 23.1%, while 74.92% of children under 5 years old had complete basic immunization status. Multivariable analysis revealed a statistically significant association between basic immunization status and the incidence of stunting. Relative to toddlers with complete basic immunization, those with incomplete (partial) immunization were at a 1.18 times higher risk of stunting (adjusted PR, 1.18; 95% CI, 1.15 to 1.22). Furthermore, toddlers who had not been immunized at all faced an even greater stunting risk (adjusted PR, 1.27; 95% CI, 1.17 to 1.37). This association persisted after adjusting for variables such as maternal education, economic status, and the child’s birth weight.
Conclusions
Basic immunization status influences the incidence of stunting in toddlers aged 12 to 59 months. Thus, parents must ensure that their children’s immunizations are completed according to the recommended schedule. Additionally, it is crucial to increase parental awareness regarding health service utilization, disease prevention, and the nutritional needs of toddlers.; Summary

Association Between Digital Addiction and Physical Activity in Korean Adults Across Age Groups: An Analysis of Community Health Survey Data: Kyungsin Lee, Inmyung Song; Received November 11, 2024 Accepted January 7, 2025 Published online January 24, 2025; DOI: https://doi.org/10.3961/jpmph.24.683 [Accepted]

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Abstract PDF: Objectives
Extensive research has been conducted on digital addiction, particularly concerning internet, gaming, and smartphone use among adolescents and young adults. However, there is limited information about digital addiction in adults, especially in relation to physical activity. This study investigated the prevalence of digital addiction among Korean adults and explored its association with physical activity across various age groups.
Methods
Using data from the 2023 Community Health Survey (n=231,752), this study estimated the prevalence of digital addiction, defined as experiencing impaired daily functioning due to excessive internet, gaming, or smartphone use. Physical activity was defined as exercise and regular walking. Multiple logistic regression was conducted to examine the association between physical activity and digital addiction in the full sample and by age group (under 40, 40–59, and 60+ years).
Results
In 2023, the prevalence of digital addiction among adults was estimated to be 12.0%. Significantly higher odds of digital addiction were observed in younger age groups. Individuals who reported perceived stress or depression were at an increased risk for digital addiction. Conversely, physical activity was linked to a reduced risk of digital addiction, with odds ratios of 0.96 (p<0.05) for exercise and 0.93 (p<0.001) for regular walking. Notably, regular walking was associated with a reduced risk of digital addiction only in the 40–59 age group.
Conclusions
Physical activity, particularly regular walking, is linked to a lower risk of digital addiction in Korean adults. Encouraging regular walking may help reduce digital addiction among middle-aged adults.; Summary

Association Between Geriatric Oral Health Assessment Index and Cardiovascular Disease in Korean Older Adults: Kyu-Taek Lim, Ji-won Choe, Seung-sik Hwang; J Prev Med Public Health. 2025;58(1):103-112. Published online January 14, 2025; DOI: https://doi.org/10.3961/jpmph.24.569

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Abstract Summary PDF: Objectives
This study examined the association between oral health-related quality of life (OHRQoL), as assessed by the Geriatric Oral Health Assessment Index (GOHAI), and cardiovascular disease (CVD) outcomes among Korean older adults.
Methods
Data from 5413 participants in the Korean Longitudinal Study of Aging were analyzed. GOHAI scores were categorized as either “poor” (<40) or “not poor” (≥40). Generalized estimating equation models were used to assess the relationship between GOHAI scores and CVD prevalence, with analyses stratified by sex.
Results
Poor GOHAI score was significantly associated with elevated odds of CVD (odds ratio [OR], 1.13; 95% confidence interval [CI], 1.07 to 1.19; p<0.001). This association was stronger in female (OR, 1.36) compared to male (OR, 1.12). Poor oral health is indicative of systemic inflammation and age-related vulnerabilities, underscoring the utility of the GOHAI as an instrument for early identification of CVD risk.
Conclusions
Poor oral health, as measured by the GOHAI, is associated with an increased risk of CVD among older adults, especially female. These findings support the use of the GOHAI as a cost-effective screening tool for the early assessment of CVD risk. Further research is warranted to explore inflammatory biomarkers and sex-specific mechanisms that could inform targeted interventions.; Summary

Korean summary
노년층에서 구강건강 관련 삶의 질(OHRQoL)이 낮을수록 심혈관계 질환(CVD) 위험이 높아지며, 특히 여성에서 더 두드러졌습니다. 본 연구는 노년 구강 건강 평가 지수(GOHAI)를 사용했습니다.

Key Message
Poor GOHAI scores are associated with higher CVD risk, with stronger effects in females. This highlights the potential of GOHAI as an effective tool for early detection and prevention of CVD.

Association Between Non-adherence to Diabetes Management and Poor Sleep Quality Based on the Korean Community Health Survey: Horim Hwang, Hyunsuk Jeong, Hyeon Woo Yim; Received August 29, 2024 Accepted December 26, 2024 Published online January 14, 2025; DOI: https://doi.org/10.3961/jpmph.24.486 [Accepted]

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Abstract PDF: Objectives
Adhering to management guidelines, including routine follow-up and education, is crucial for the effective management of chronic diseases such as diabetes. Uncontrolled diabetes is linked to poor sleep quality. We used nationally representative data from community-dwelling Koreans to investigate potential associations between non-adherence to diabetes management and poor sleep quality.
Methods
Of the 228,340 participants in the 2018 Korea Community Health Survey, we analyzed data from 68,246 participants aged 65 years and older. Based on their diabetes status and adherence to diabetes-related tests (glycated hemoglobin, fundus examination, and urine microalbuminuria) and management education, study participants were divided into 3 groups: no diabetes, adherence, and non-adherence. Outcome variables included poor overall sleep quality and sleep disturbances, as measured by the Pittsburgh Sleep Quality Index. Results: The study included 934 participants in the adherence group (2.0%) and 13,420 in the non-adherence group (20.2%). Participants displaying non-adherence were significantly more likely to report poor overall sleep quality (adjusted odds ratio [aOR], 1.09; 95% confidence interval [CI], 1.04 to 1.13) and to experience sleep fragmentation, nocturia, pain during sleep, and difficulty falling asleep compared to participants without diabetes. Even in the earlier stage of diabetes, non-adherent participants were more likely to report poor sleep quality (aOR, 1.06; 95% CI, 1.001 to 1.18).
Conclusions
Patients with diabetes who do not follow management guidelines are more likely to experience poor sleep quality than those without diabetes. Emphasizing diabetes management and increasing awareness of management strategies may improve sleep quality among patients with this disease.; Summary

Associations Between Multiple Falls and Mental Health Indices in Korean Older Adults: A Cross-sectional Study: Chaelyn Lim, Hyunjin Son, Byoung-Gwon Kim, Byengchul Yu, Jiwon Kim, Young-Seoub Hong; Received August 28, 2024 Accepted December 30, 2024 Published online January 14, 2025; DOI: https://doi.org/10.3961/jpmph.24.482 [Accepted]

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Abstract PDF: Objectives
This study was performed to investigate the prevalence of falls, mental health issues, and health behaviors among older adults, as well as to analyze the association between multiple falls and mental health status in this population.
Methods
We utilized data from the 2017, 2019, and 2021 Korean Community Health Survey, a nationwide survey organized by region and conducted by the Korea Disease Control and Prevention Agency. Participants were categorized into no-fall, single-fall, and multiple-fall groups based on responses to an index question regarding fall experiences and the number of such incidents reported in the survey. The chi-square test was applied to understand the characteristics of the elderly population in the community. Subsequently, multinomial logistic regression analysis was conducted to clarify the association between falls and mental health.
Results
Integrated data analysis revealed that 11.3% of participants experienced a single fall, while 5.7% reported multiple falls. Participants from low-education and low-income backgrounds exhibited relatively high rates of falls. Additionally, non-drinkers and non-smokers reported falls more frequently than their counterparts who consumed alcohol and smoked. Multinomial logistic regression revealed significant associations between multiple falls and mental health factors. In particular, the severity of depression was directly proportional to the likelihood of experiencing multiple falls, with an odds ratio of 2.953 (95% confidence interval, 2.493 to 3.497).
Conclusions
We identified associations between various mental health-related factors—including sleep duration, subjective stress, the presence of depression, and Patient Health Questionnaire-9 score—and the occurrence of multiple falls.; Summary

Multi-group Causal Model of Mental Health Literacy and Helping Behavior Toward People at Risk of Depression Among Thai and Vietnamese Health Science Students: Anchalee Jansem, Ungsinun Intarakamhang, Charin Suwanwong, Krittipat Chuenphitthayavut, Sudarat Tuntivivat, Khuong Le, Le Thi Mai Lien, Pitchada Prasittichok; Received August 15, 2024 Accepted December 13, 2024 Published online January 13, 2025; DOI: https://doi.org/10.3961/jpmph.24.449 [Accepted]

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Abstract PDF: Objectives
Depression affects 23.3% of Thai and 15.2% of Vietnamese health science students, rates that exceed the global average of 4.4%. This study compared the causal models of mental health literacy and helping behavior toward individuals at risk of depression between these 2 groups.
Methods
This cross-sectional study was conducted from April to October 2023 and included 422 students from Thailand and Vietnam, who were studying medicine, nursing, psychology, and physical therapy. Stratified random sampling was used to select 211 students from each country. Data collection was performed using a Likert scale, which showed total-item correlations ranging from 0.24 to 0.83 and Cronbach’s alpha values between 0.74 and 0.86. The data were analyzed using a structural equation model.
Results
The causal models were consistent with the empirical data. The helping behavior of students toward peers at risk of depression was significantly influenced by their mental health literacy (effect size [ES]=0.91). This influence was also mediated indirectly by self-efficacy (ES=0.18), positive attitudes (ES=0.29), and social support (ES=0.77). Collectively, these factors accounted for 83% of the variance in helping behavior. Social support had a more pronounced effect on mental health literacy among Vietnamese students than among their Thai counterparts (ES=0.46 vs. 0.27, p<0.05). Conversely, positive attitudes had a stronger influence among Thai students than among Vietnamese students (ES=0.17 vs. 0.01, p<0.05).
Conclusions
The causal models of helping behavior among Thai and Vietnamese health science students exhibited no significant differences. However, improving mental health literacy is crucial, as it significantly impacts helping behavior.; Summary

Utilization of Acid Suppressants After Withdrawal of Ranitidine in Korea: An Interrupted Time Series Analysis: Jeong Pil Choi, Sangwan Kim, Jung Su Park, Mi-Sook Kim, Nam-Kyong Choi, Cheol Min Shin, Joongyub Lee; J Prev Med Public Health. 2025;58(1):21-30. Published online December 30, 2024; DOI: https://doi.org/10.3961/jpmph.24.357

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Abstract Summary PDF Supplementary Material: Objectives
This study was performed to evaluate the utilization patterns of acid suppressants following the withdrawal of ranitidine in Korea.
Methods
Health Insurance Review & Assessment Service (HIRA) data from January 2016 to May 2023 were utilized to assess the usage of histamine H2 receptor antagonists (H2RAs) and proton pump inhibitors (PPIs) for acid-related diseases. Drug utilization was calculated for each agent based on the defined daily dose (DDD). To evaluate changes in utilization following the ranitidine recall, an interrupted time series analysis was conducted using segmented linear regression and an autoregressive integrated moving average model.
Results
Before the withdrawal of ranitidine, the DDD per 100 000 inhabitants per day was increasing by 6.9 (95% confidence interval [CI], 4.7 to 9.0) for H2RAs and by 19.3 (95% CI, 16.9 to 21.8) for PPIs each month. After the recall, H2RA utilization immediately declined by -1041.7 (95% CI, -1115.8 to -967.7), followed by a monthly increase of 6.6 (95% CI, 3.7 to 9.6) above the previous trend. PPI utilization temporarily surged by 235.2 (95% CI, 149.1 to 321.3), then displayed a monthly increase of 4.1 (95% CI, 0.7 to 7.6) on top of the pre-recall trend. Among PPIs, esomeprazole and rabeprazole demonstrated notable increases, representing the most commonly used acid suppressants in 2023.
Conclusions
PPI usage rose prominently following the withdrawal of ranitidine from the market. Considering the potential adverse effects of PPIs, further research is necessary to evaluate the public health implications of shifts in the utilization of acid suppressants.; Summary

Korean summary
- 위산분비억제제의 국내 사용량은 양성자 펌프 억제제를 중심으로 지속적으로 증가하고 있으며, 라니티딘이 시장에서 퇴출된 이후 더욱 급격히 증가하는 양상이 관찰되었다. - 양성자 펌프 억제제 사용 증가와 관련해 장기 복용의 안전성, 처방의 적절성, 잠재적 오남용의 가능성, 비용효과성의 측면에서의 보건학적 의의에 대한 평가가 필요하다.

Key Message
- The use of gastric acid suppressive drugs in Korea has demonstrated a consistent upward trend, with proton pump inhibitors (PPIs) predominating, especially following the withdrawal of ranitidine from the market. - The escalating utilization of PPIs necessitates a comprehensive evaluation of their public health implications, encompassing the long-term safety, appropriateness of prescribing, potential overuse, and cost-effectiveness.

Perspective

Almost 80 Years After Hiroshima and Nagasaki: Are World Governments and Healthcare Systems Ready for a Nuclear War?: Céleo Ramírez, Reyna M. Durón; J Prev Med Public Health. 2025;58(2):227-229. Published online December 17, 2024; DOI: https://doi.org/10.3961/jpmph.24.577

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Abstract Summary PDF: Since the detonation of the first atomic bomb during World War II, geopolitical issues and armed conflicts have reminded us of the threat posed by nuclear weapons in the short, medium, and long term. The potential consequences include millions of deaths and severe injuries from blast, heat, and acute ionizing radiation. Whatever the country, in the post-acute stage of a nuclear attack, the first challenge for health and rescue personnel will be gaining access to affected populations amidst destroyed infrastructure, hazardous radioactivity, and limited health facilities and medical supplies. Subsequently, the focus will shift to providing timely and appropriate treatment for survivors, addressing environmental damage, and combating malnutrition. Beyond the immediate human toll, the destruction of city infrastructure and the loss of centuries of cultural heritage are also at stake. Governments and health systems must prepare for these scenarios, although any medical or mitigation response may prove inadequate to halt the devastating impact of a failed disarmament or nuclear non-proliferation treaty. Scientists should raise awareness about the dire consequences of nuclear warfare and the realities of a post-nuclear era.; Summary

Key Message
A nuclear war would pose severe immediate and long-term consequences, including mass casualties, radiation exposure, and the collapse of infrastructure. In the aftermath, health systems will face immense challenges in providing care and addressing environmental damage. Governments and scientists must raise awareness about the catastrophic impact of nuclear warfare and the urgent need for effective disarmament, non-proliferation treaties, and peace efforts.

Original Articles

The Relationship Between Park Access and Quality and Various Health Metrics in a Metropolitan Area in South Carolina Using the CDC PLACES Dataset: Jenna Pellizzari, Farnaz Hesam Shariati, Andrew T. Kaczynski; J Prev Med Public Health. 2025;58(2):208-217. Published online December 13, 2024; DOI: https://doi.org/10.3961/jpmph.24.325

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Abstract Summary PDF: Objectives
Limited access to high-quality green spaces could contribute to growing rates of chronic diseases and unhealthy behaviors. Public parks provide numerous benefits for population well-being. However, past research has shown mixed results regarding the association between proximal parks and residents’ physical and mental health. This study examined the relationship between diverse elements of park access and quality and multiple health outcomes.
Methods
Seventy-three unique parks within 70 census tracts in 4 cities in South Carolina were analyzed. Data about 7 aspects of park quality (transportation access, facility availability, facility quality, amenity availability, park aesthetics, park quality concerns, neighborhood quality concerns) were collected via on-site observations using the Community Park Audit Tool. Health data for each tract (obesity, no leisure time physical activity, high blood pressure, coronary heart disease, high cholesterol, diabetes, depression, poor mental health) were collected from the CDC PLACES dataset. Linear regression analyses examined the association between 10 park access and quality metrics and 8 health metrics, controlling for socio-demographic characteristics.
Results
All associations were in the unexpected direction except 1 relationship involving mental health. Specifically, positive associations were found between the number of parks and obesity, the number of parks and no leisure time physical activity, transportation access and obesity, and transportation access and high blood pressure. As concerns about neighborhood quality increased, poor mental health status worsened.
Conclusions
This study provides valuable information for public health professionals and researchers. Further research is needed to expand on and elucidate these findings.; Summary

Key Message
Parks can be key components of healthy communities, but more research is needed about how park availability and characteristics affect health. This study examined the relationship between diverse elements of park access and quality and multiple physical and mental health outcomes. The results were largely mixed, with some positive and some negative relationships; these findings can be expanded upon with further study.

The Diabetogenic Effect of Statin Use May Interact With Polygenic Risk Scores for Type 2 Diabetes: Evidence From the UK Biobank: Jong Hyun Park, Kyu-Taek Lim, Jooyeon Lee, Yongjin Gil, Joohon Sung; J Prev Med Public Health. 2025;58(1):92-102. Published online December 11, 2024; DOI: https://doi.org/10.3961/jpmph.24.671

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Abstract Summary PDF Supplementary Material: Objectives
Statins are essential in the prevention of cardiovascular disease; however, their association with type 2 diabetes mellitus (T2DM) risk is concerning. We examined whether genetic susceptibility to T2DM modifies the association between regular statin use and T2DM risk.
Methods
This study included 447 176 individuals from the UK Biobank without baseline diabetes or major cardiovascular disease. Statin use was recorded at baseline, and T2DM incidence was determined using clinical records. Polygenic risk scores (PRS) for T2DM risk were provided by the UK Biobank. Using propensity scores adjusted for age, sex, body mass index, and comorbidities, 14 831 statin users were matched with 37 060 non-users. Cox proportional hazards models were used to estimate the interaction effect of statin use and PRS on T2DM incidence, adjusting for key confounders.
Results
In the propensity-matched cohort, 3675 of 51 891 participants developed T2DM over a mean follow-up period of 13.7 years. Within the top 5% of the PRS distribution, per 1000 person-years, the incidence of T2DM was 15.42 for statin users versus 12.18 for non-users. Among the lowest 5%, the incidence was 1.90 for statin users and 1.65 for non-users. Based on the Cox proportional hazards model, regular statin use was associated with a 1.24-fold increased T2DM risk (95% confidence interval [CI], 1.15 to 1.33). Furthermore, PRS exhibited a significant multiplicative interaction with regular statin use (odds ratio, 1.10; 95% CI, 1.02 to 1.19).
Conclusions
PRS may help identify individuals particularly susceptible to the diabetogenic effects of statins, providing a potential path for personalized cardiovascular disease management.; Summary

Korean summary
스타틴은 심혈관 질환 예방에 필수적이지만, 제2형 당뇨병 발생 위험을 높인다고 알려져 있습니다. 본 연구는 영국 바이오뱅크 데이터를 활용하여, 스타틴 사용과 제2형 당뇨병 다유전자 위험 점수(Polygenic Risk Score, PRS)의 상호작용이 당뇨병 발생 위험에 미치는 영향을 분석했습니다. 연구 결과, PRS가 높은 집단에서는 스타틴 사용이 제2형 당뇨병 발생 위험을 유의하게 증가시켰으나, PRS가 낮은 집단에서는 스타틴 사용이 오히려 당뇨병 위험을 낮추는 경향을 보였습니다. 이러한 결과는 유전적 요인을 고려한 맞춤형 심혈관 질환 예방 전략의 중요성을 시사합니다.

Key Message
This study highlights that the diabetogenic effect of statins interacts significantly with genetic predisposition, as quantified by polygenic risk scores (PRS) for type 2 diabetes mellitus (T2DM). Individuals with high PRS are at a significantly increased risk of developing T2DM with statin use, while those with low PRS may experience a reduced risk. These findings underscore the potential of integrating genetic risk stratification into clinical decision-making to optimize the balance between cardiovascular benefits and T2DM risk in statin therapy.

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