Journal of Preventive Medicine and Public Health

Volume 58(2); March 2025

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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Scoping Review

Use of Data Linkage Methods to Investigate Healthcare Interactions in Individuals Who Self-harm and Die by Suicide: A Scoping Review: Ferdi W. Djajadisastra; J Prev Med Public Health. 2025;58(2):114-126. Published online November 20, 2024; DOI: https://doi.org/10.3961/jpmph.24.448

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Abstract Summary PDF Supplementary Material: Objectives
In this review, the primary objective was to comprehensively summarize and evaluate the themes and analytical strategies of studies that used data linkage methods to examine the healthcare engagement of individuals with self-harming and suicidal tendencies. Additionally, the review sought to identify gaps in the existing literature and suggest directions for future research in this area.
Methods
This review utilized the PubMed, PsycINFO, and Scopus databases. Employing a scoping review methodology, 27 papers were analyzed.
Results
One particularly common data source is the routine information collected by government agencies. However, some studies supplement this data with newly collected information. Compared to other research methods, data linkage offers the advantage of incorporating participants from diverse backgrounds into the analysis. Most relevant studies using data linkage methods have primarily focused on identifying socio-demographic correlates of self-harm, suicide deaths, and healthcare interactions. Additionally, some studies have used cluster analysis to identify patterns of healthcare utilization within affected populations. Certain papers have employed unique methods to measure self-harm and healthcare interactions, while one study utilized a moderator analytical approach.
Conclusions
Data linkage offers a promising approach for researching the dynamics between self-harm, suicide, and healthcare contact. A notable challenge, however, is the focus of most studies on the associations between socio-demographic factors and the risks of self-harm and suicide.; Summary

Key Message
The scoping review aims to summarize and evaluate the themes and analytical strategies of studies that have used data linkage methods to examine the healthcare engagement of individuals with self-harming and suicidal tendencies. Data linkage offers a promising approach for researching the dynamics between self-harm, suicide, and healthcare contact. However, most studies primarily focus on the associations between socio-demographic factors and the risks of self-harm and suicide. Future research should emphasize the inclusion of additional variables through new data collection, integrating them with existing datasets, or adopting more innovative approaches to analyzing available data.

Original Articles

Development of Machine Learning Models to Categorize Life Satisfaction in Older Adults in Korea: Suyeong Bae, Mi Jung Lee, Ickpyo Hong; J Prev Med Public Health. 2025;58(2):127-135. Published online October 23, 2024; DOI: https://doi.org/10.3961/jpmph.24.324

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Abstract Summary PDF: Objectives
This study aimed to identify factors associated with life satisfaction by developing machine learning (ML) models to predict life satisfaction in older adults living alone.
Methods
Data were extracted from 3112 older adults participating in the 2020 Korea Senior Survey. We employed 5 ML models to classify the life satisfaction of older adults living alone: logistic Lasso regression, decision tree-based classification and regression tree (CART), C5.0, random forest, and extreme gradient boost (XGBoost). The variables used as predictors included demographics, health status, functional abilities, environmental factors, and activity participation. The performance of these ML models was evaluated based on accuracy, precision, recall, F1-score, and area under the curve (AUC). Additionally, we assessed the significance of variable importance as indicated by the final classification models.
Results
Out of the 1411 older adults living alone, 45.3% expressed satisfaction with their lives. The XGBoost model surpassed the performance of other models, achieving an F1-score of 0.72 and an AUC of 0.75. According to the XGBoost model, the five most important variables influencing life satisfaction were overall community satisfaction, self-rated health, opportunities to interact with neighbors, proximity to a child, and satisfaction with residence.
Conclusions
Overall satisfaction with the community environment emerged as the most significant predictor of life satisfaction among older adults living alone. These findings indicate that enhancing the supportiveness of the community environment could improve life satisfaction for this demographic.; Summary

Korean summary
본 연구는 2020년 노인실태조사에 참여한 3,112명의 독거노인 데이터를 활용하여 이들의 삶의 만족도를 분류하는 머신러닝 모델을 개발하였다. 아울러, 해당 모델을 통해 독거노인의 삶의 만족도 분류에 영향을 미치는 주요 변수를 도출하였다. 본 연구는 독거노인의 삶의 만족도 향상을 위해 고려해야 할 핵심 요인들을 제시한다는 점에서 의의가 있다.

Key Message
This study developed a machine learning model to classify life satisfaction among 3,112 older adults living alone, based on data from the 2020 Korea Senior Survey. Furthermore, the study identified key variables that contribute to the classification of life satisfaction in this population. These findings provide insights into important factors that should be considered to enhance the life satisfaction of older adults living alone.

Prevalence, Sources, and Correlates of Second-hand Smoke Exposure Among Non-smoking Pregnant Women in India: Farheen Ahmed, Nilesh Gawde, Sulabha Parasuraman; J Prev Med Public Health. 2025;58(2):136-145. Published online December 4, 2024; DOI: https://doi.org/10.3961/jpmph.24.278

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Abstract Summary PDF: Objectives
Second-hand tobacco smoke (SHS) is a risk factor for adverse health outcomes, particularly among pregnant women. This study aimed to address the research gap concerning the prevalence and correlates of SHS exposure at home and in public settings among non-smoking pregnant women in India.
Methods
The dataset from the Global Adult Tobacco Survey (2016-17), India, was utilised to evaluate the prevalence of SHS exposure in pregnant women both at home and in public spaces. Multivariable logistic regression analysis was employed to identify the determinants of SHS exposure among this population.
Results
The prevalence of SHS exposure at home was 36.9%, while exposure outside the home was 26.5%. Among non-smoking pregnant women, 10.0% were exposed to SHS on public transport. The risk of SHS exposure at home was significantly higher in the North (adjusted odds ratio [aOR], 5.33; 95% confidence interval [CI], 2.45 to 11.60), Central (aOR, 4.46; 95% CI, 1.98 to 10.02), and Northeast (aOR, 4.18; 95% CI, 1.78 to 9.81) regions compared to the South. Pregnant women aged 25-34 (aOR, 0.61; 95% CI, 0.39 to 0.93) and those aged 35 and above (aOR, 0.48; 95% CI, 0.27 to 0.86), as well as those with secondary (aOR, 0.50; 95% CI, 0.30 to 0.85) or higher education (aOR, 0.30; 95% CI, 0.15 to 0.58), had lower odds of SHS exposure at home. For SHS exposure outside the home, the North region (aOR, 2.53; 95% CI, 1.19 to 5.36), employment status (aOR, 1.99; 95% CI, 1.13 to 3.47), and belonging to scheduled tribes (aOR, 3.20; 95% CI, 1.25 to 8.21) were associated with higher odds.
Conclusions
The prevalence of SHS exposure among pregnant non-smoking women was notably high both at home and in external environments.; Summary

Key Message
Our secondary analysis of GATS-2 India data (2016-17) showed that the prevalence of Second-hand Tobacco smoke (SHS) exposure at home was high (36.9%) among non-smoking pregnant women in India. Among pregnant women, younger age, lower education levels, and residing in the country's North, Central, and Northeast regions were significantly associated with higher odds of SHS exposure at home. Overall, about a quarter (26.5%) of pregnant women reported SHS exposure outside their home. Tribal women, employed ones, and those residing in the North region were at higher risk of SHS exposure outside their homes during their pregnancies.

Church Leaders’ Health Behaviors and Program Implementation in the Faith, Activity, and Nutrition Program in the United States: Kelsey R. Day, Sara Wilcox, Lindsay Decker, John Bernhart, Meghan Baruth, Andrew T. Kaczynski, Christine A. Pellegrini; J Prev Med Public Health. 2025;58(2):146-155. Published online November 13, 2024; DOI: https://doi.org/10.3961/jpmph.24.384

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Abstract Summary PDF: Objectives
Church leaders are important to the success of faith-based health promotion interventions through the role modeling of health behaviors. However, clergy may be at a higher risk of chronic disease than their congregants and their health is understudied. This study examined church leaders’ health-related behaviors, differences in health behaviors by socio-demographic characteristics, and associations between health behaviors and church-level implementation of an ecological intervention.
Methods
Pastors (n=93) and church coordinators (n=92) reported body mass index (BMI), self-rated health, fruit and vegetable consumption (F&V), and physical activity (PA) at baseline and 12 months post-training in the intervention. Church coordinators reported program implementation for their church. Socio-demographic differences and associations between changes in health behaviors and program implementation were tested with regression models. Changes in health-related variables were examined using paired t-tests and McNemar’s test.
Results
Pastors (40.9% women, 41.9% Black/African American) had a mean BMI of 30.0 kg/m²; 23.7% met F&V guidelines and 45.2% met PA guidelines. Black/African American pastors were less likely to meet F&V guidelines and had lower self-rated health than their counterparts. Pastor PA improved over time, but pastor health behaviors were not associated with program implementation. Church coordinators’ (94.6% women, 39.1% Black/African American) mean BMI was 27.8 kg/m²; 27.2% met F&V guidelines and 62.0% met PA guidelines. Black/African American church coordinators had higher BMIs and lower self-rated health than their counterparts. Church coordinator F&V intake improved over time; self-rated health was positively associated with PA program implementation.
Conclusions
This study underscores the need for preventive interventions for church leaders.; Summary

Key Message
This study explored the health behaviors of church leaders, including differences by socio-demographics and changes in church leader health behaviors during the 12-month implementation of a faith-based physical activity and dietary intervention. Most Pastors did not meet fruit and vegetable (F&V) or physical activity (PA) guidelines. Pastor PA improved over time but was unrelated to program implementation. Most church coordinators did not meet F&V guidelines while over half met PA guidelines. Coordinators’ F&V intake improved, over time, and their self-rated health correlated with program implementation. This study underscores the need for preventive interventions for church leaders.

Health Effects of Heavy Metal Exposure Among E-waste Workers and Community-dwelling Adults in Thailand: A Cross-sectional Study: Chonyitree Sangwijit, Parichat Ong-artborirak, Warangkana Naksen, Kraiwuth Kallawicha, Pallop Siewchaisakul; J Prev Med Public Health. 2025;58(2):156-166. Published online November 21, 2024; DOI: https://doi.org/10.3961/jpmph.24.415

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Abstract Summary PDF Supplementary Material: Objectives
Global concern is increasing about the health effects of electronic waste (e-waste). This study examines the health impacts of heavy metal (HM) exposure among e-waste workers (EWWs) and community-dwelling adults (CDAs) in Northeastern Thailand and identifies factors associated with adverse health outcomes.
Methods
A cross-sectional study was conducted of 164 EWWs and 164 CDAs. A survey was employed to collect data on participant characteristics, symptoms, anxiety, depression, and sleep quality. Urine samples were analyzed for lead (Pb) and cadmium (Cd) levels using atomic absorption spectrometry. Multiple logistic regression analysis was used to identify factors impacting health.
Results
Across all participants, urinary Pb and Cd levels ranged from 5.30 µg/g to 29.50 µg/g creatinine and from 0.60 µg/g to 4.00 µg/g creatinine, respectively. The most frequently reported health issues pertained to musculoskeletal disorders (MSDs) at 38.70%, central nervous system (CNS) issues at 36.60%, and skin disorders at 31.10%. Multivariable analysis indicated that the presence of MSDs was significantly associated with exposure to Pb and Cd. Poor sleep quality (PSQ) was significantly linked to CNS problems, while body mass index was significantly related to skin disorders. Factors including primary education level or below, smoking, cleaning the house more than 3 times weekly, and PSQ were significantly linked to depression. Anxiety was significantly associated with PSQ.
Conclusions
Environmental exposure to Pb and Cd can have adverse health impacts in the form of MSDs. Depression and anxiety are common conditions among CDAs. Public health officials should monitor HM exposure and mental health within the community.; Summary

Key Message
- Pb and Cd level was not significant difference between e-waste workers and community-dwelling adults. - Pb and Cd can adversely affect symptoms in the MSD and PSQ affects the CNS in e-waste workers. - E-waste workers had a higher chance of having musculoskeletal disorder, central nervous system disorder, and skin disorder problems than community-dwelling adults but a lower chance of having depression and anxiety than community-dwelling adults.

The Impact of Student-led Community Health Screenings on Clients’ Health Knowledge and Outcomes: A Qualitative Study in New Zealand: JiaRong Yap, Wendy Wenming Zhai, Cindy Seunghee Pak, Sharon Brownie; J Prev Med Public Health. 2025;58(2):167-176. Published online November 28, 2024; DOI: https://doi.org/10.3961/jpmph.24.366

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Abstract Summary PDF: Objectives
This study investigated the impact of community health screenings (CHS) on the Asian community, focussing on the role of a student-led health and wellness centre in promoting and improving health outcomes. The CHS is a collaboration between Te Kotahi Oranga | Health and Wellness Centre and The Asian Network Incorporated, offering free health screenings to Asian migrants in the Waikato region, New Zealand.
Methods
Employing a qualitative approach, we interviewed clients who participated in the CHS to determine their perceptions regarding the effectiveness of the programme, its influence on their health knowledge and actions, and their overall satisfaction with the service. The Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist was used to report the study.
Results
Data analysis utilising reflexive thematic analysis yielded 5 themes: satisfaction and appreciation for the free health screening; strengthened commitment to better personal health; barriers and challenges in accessing public healthcare services; improved knowledge and awareness of health risks; and provision of more health screening tests and health seminars. The findings highlight the significance of culturally tailored health initiatives in addressing healthcare disparities, emphasising the need for innovative strategies to ensure continuity of care and support for underserved populations.
Conclusions
This research contributes to the understanding of how student-led health interventions can enhance public health efforts and improve health outcomes in Asian and migrant communities.; Summary

Key Message
This study explores the impact of a student-led community health screening (CHS) programme on Asian migrants in New Zealand, focusing on its effects on health knowledge and outcomes. Through qualitative interviews, five key themes emerged: participant satisfaction, commitment to personal health, barriers to healthcare access, increased awareness of health risks, and the need for expanded screening services. The findings underscore the value of culturally tailored health initiatives in reducing healthcare disparities and highlight the role of student-led interventions in enhancing preventative care and promoting health equity in underserved populations.

Associations of Sex and Household Area With Physical Activity and Sedentary Behavior During Total and Partial COVID-19 Lockdowns in Chile: A Study in Adults Aged 18-44 Years: Jairo Vanegas-López, Rodrigo Guzmán-Venegas, Gabriel Marzuca-Nassr, Claudio Muñoz-Poblete, Gonzalo Quiroz-Sandoval, Juan Silva-Urra, Andres Orellana-Uribe, Sebastián Dubó, Ignacio Sepúlveda, José Luis Márquez; J Prev Med Public Health. 2025;58(2):177-187. Published online December 5, 2024; DOI: https://doi.org/10.3961/jpmph.24.461

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Abstract Summary PDF: Objectives
The coronavirus disease 2019 pandemic led to various intensities of lockdowns, affecting lifestyles globally. This study investigates the impact of partial lockdown versus total lockdown on adult physical activity (PA) and sedentary behavior.
Methods
A cross-sectional online survey was conducted from April 2020 to October 2020, with 493 participants included in the analysis.
Results
The analysis revealed no significant differences in total PA or total sitting time between partial lockdown and total lockdown scenarios. However, moderate physical activity (MPA) significantly decreased during total lockdowns, with more pronounced reductions among females than males. Notably, a positive correlation was found between household area and MPA, suggesting that larger living spaces may encourage more PA. A negative correlation was observed between sitting time and MPA during both types of lockdown.
Conclusions
Total lockdown conditions were associated with a significant decrease in MPA, highlighting sex disparities in PA responses. Living space size emerged as a crucial factor in maintaining PA levels during restricted conditions. This study emphasizes the need to consider environmental and demographic factors in public health strategies during prolonged periods of restricted movement.; Summary

Key Message
This study assessed the impact of partial and total COVID-19 lockdowns on physical activity and sedentary behavior in Chilean adults aged 18–44 years. Although total physical activity and sitting time did not significantly differ between lockdown types, moderate physical activity was significantly lower during total lockdowns, particularly among females. A positive association between household area and moderate activity suggests that public health strategies should consider gender and living conditions to mitigate the negative effects of prolonged restricted movement.

Medication-related Burden and Experience With Medications in Indonesian Older Adults With Chronic Diseases: A Mixed-method Study: Yeni Farida, Anna Wahyuni Widayanti, Tri Murti Andayani, Probosuseno Probosuseno; J Prev Med Public Health. 2025;58(2):188-198. Published online November 20, 2024; DOI: https://doi.org/10.3961/jpmph.24.374

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Abstract Summary PDF: Objectives
This study explored the specific medication-related burdens experienced by older adults with chronic disease and the contributing factors.
Methods
An exploratory mixed-method study was conducted at a teaching hospital in Surakarta City, Central Java, Indonesia. Combining the Indonesian version of the Living with Medicine Questionnaire (LMQ) and semi-structured interviews allowed for a comprehensive understanding of the medication-related burden. Differences in LMQ scores related to patient characteristics were analyzed using the t-test, F-test, or other alternatives. Quantitative and qualitative data triangulation was used to derive trustworthy and dependable results.
Results
The overall LMQ mean score was 90.4 (n=129), indicating a moderate burden. The average LMQ scores varied significantly based on the number of medications, treatment duration, and the presence of cardiovascular disease (CVD), diabetes mellitus (DM) and stroke. The qualitative study found 3 themes in the chronic medication use of older adults: experiences, challenges, and motivation. Despite their limited understanding of a medication’s name and indication, some patients managed their medications based on the physical look and packaging of the medication. The study also found that patient motivation and familial support could effectively counteract the fatigue and dissatisfaction associated with taking medication.
Conclusions
Older adults with chronic diseases faced medication-related burdens associated with the presence of CVD, DM, stroke, a treatment duration >5 years, and the use of >10 medications. Effective communication with healthcare professionals is required to understand patients’ needs and concerns, thereby helping manage the challenges of medication-related burdens.; Summary

Key Message
Older adults with chronic diseases experienced an increasing burden in taking medication with multimorbidity, number of medicines and duration of illness. Motivation and familial support is crucial to minimize these burdens.

Predictors of Quality of Life Among Older Residents in Rural and Urban Areas in Indonesia: An Approach Using the International Classification of Functioning, Disability, and Health: Dwi Rosella Komalasari, Chutima Jalayondeja, Wattana Jalayondeja, Yusuf Alam Romadon; J Prev Med Public Health. 2025;58(2):199-207. Published online November 29, 2024; DOI: https://doi.org/10.3961/jpmph.24.423

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Abstract Summary PDF: Objectives
The International Classification of Functioning, Disability, and Health (ICF) model provides a comprehensive framework for understanding health and quality of life (QoL) in older adults in both rural and urban settings, each presenting unique advantages and challenges. This study aimed to explore the relationship between factors based on the ICF model and QoL among older residents of these areas.
Methods
A cross-sectional study was conducted, involving 286 older adults aged 60 years or older from rural and urban areas of Surakarta, Central Java, Indonesia. The WHOQoL-BREF was utilized to assess QoL. The co-factors included personal factors, impairments, and activity limitations.
Results
Multiple linear regression analysis indicated that cardiovascular endurance was the strongest significant factor associated with QoL in rural areas (B=0.027, standard error [SE]=0.013, p=0.050). In urban areas, gender emerged as the most significant factor influencing QoL (B=-13.447, SE=2.360, p<0.001), followed by hemoglobin level (B=-1.842, SE=0.744, p=0.015), age (B=-0.822, SE=0.217, p<0.001), and cognitive function (B=0.396, SE=0.162, p=0.016).
Conclusions
Efforts to improve QoL for older adults in rural areas should focus on enhance physical performance through exercise. In urban areas, the maintenance of QoL is influenced by personal factors. It is crucial to address physical performance through exercise to enhance QoL in rural settings. Meanwhile, focusing on mental health, financial security, and social connections is recommended to improve QoL for older adults in urban areas.; Summary

Key Message
The ICF model offers a comprehensive framework to assess health and QoL in older adults living in rural and urban areas. Both areas highlight the distinct advantages and challenges unique. Cardiovascular endurance is a vital factor in determining the QoL for older adults in rural areas, while hemoglobin levels, age, and cognition shape the well-being of those in urban environments.

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.

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.

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.

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