Journal of Preventive Medicine and Public Health

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; Funded: Fostering Outstanding Universities for Research, Ministry of Education, National Research Foundation of Korea

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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.

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; Funded: Trust Waikato Community Impact Grant, Wintec – Te Pūkenga, Braemar Charitable Trust

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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.

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; Funded: Scholarship of Education Fund Management Institute, Lembaga Pengelola Dana Pendidikan

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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.

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; Funded: Centers for Disease Control and Prevention

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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.

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; Funded: Hibah Integrasi Tridharma, Universitas Muhammadiyah Surakarta

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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.

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; Funded: Universidad Tecnológica Centroamericana

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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

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; Funded: Dicyt Project, Vicerrectoría de Investigación, Innovación y Creación, Universidad de Santiago de Chile

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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.

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; Funded: University of South Carolina

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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; Funded: Ministry of Health and Welfare

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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.

The Effects of Subjective Socioeconomic Status and Social Capital on Self-rated Health and Perceived Quality of Life: A Cross-sectional Survey-based Study in a Minority Group in Iran: Rashid Ahmadifar, Nader Rajabi-Gilan, Shirzad Rostamizadeh, Nsrolah Nadimi, Parviz Sobhani, Adel Irankhah; J Prev Med Public Health. 2025;58(1):11-20. Published online October 5, 2024; DOI: https://doi.org/10.3961/jpmph.24.210; Funded: Kermanshah University of Medical Sciences

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Abstract Summary PDF: Objectives
The purpose of this study is to examine the impact of subjective socioeconomic status and social capital on self-rated health and quality of life among a minority group in Iran.
Methods
This cross-sectional study involved 800 individuals from a minority group in Iran. The sampling method was clustering, and data collection was conducted using a questionnaire. Data analysis was performed using SPSS version 18 and Stata version 8.
Results
The results of logistic regression analysis revealed that subjective socioeconomic status (odds ratio [OR], 1.47; 95% confidence interval [CI], 1.34 to 1.61), belonging and empathy (OR, 1.09; 95% CI, 1.03 to 1.15), and trust (OR, 1.06; 95% CI, 1.00 to 1.13) significantly impacted the quality of life. Additionally, the logistic regression analysis for factors influencing self–rated health demonstrated significant effects for the age group of 31-50 years (OR, 0.59; 95% CI, 0.38 to 0.91), gender (OR, 0.65; 95% CI, 0.46 to 0.92), academic education (OR, 2.00; 95% CI, 1.22 to 3.26), subjective socioeconomic status (OR, 1.27; 95% CI, 1.16 to 1.38), chronic disease (OR, 4.52; 95% CI, 2.49 to 8.19), belonging and empathy (OR, 1.06; 95% CI, 1.01 to 1.11), and participation (OR, 1.12; 95% CI, 1.00 to 1.24).
Conclusions
The findings indicate that bonding social capital significantly influences health levels and quality of life. Focusing on delegating local responsibilities to community members and striving to promote participation in health programs, along with increasing the socioeconomic status of minority groups, can effectively improve their health and quality of life.; Summary

Key Message
The overall findings suggest that the dimensions of bonding social capital were more effective in predicting respondents' self-rated health (SRH) and perceived quality of life (QOL). Specifically, the variables of belonging/empathy and trust, were found to increase the likelihood of a positive QOL by 9% and 6%, respectively. The findings also showed that belonging/empathy and participation increase the likelihood of a positive SRH by 6% and 12%, respectively. Additionally, a 1-unit increase in Subjective Socioeconomic Status was associated with a 27% and 47% increase in the likelihood of having a positive SRH and QOL respectively.

Development and Validation of an Instrument to Assess the Safe Use of Antidiabetic Medication to Prevent Hypoglycemia Requiring Hospitalization Among Ambulatory Patients With Type 2 Diabetes Mellitus in Bali, Indonesia: Made Krisna Adi Jaya, Fita Rahmawati, Nanang Munif Yasin, Zullies Ikawati; J Prev Med Public Health. 2025;58(1):52-59. Published online October 24, 2024; DOI: https://doi.org/10.3961/jpmph.24.424; Funded: Indonesia Center for Education Financial Services, Center for Higher Education Funding, Endowment Funds for Education

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Abstract Summary PDF: Objectives
Ambulatory patients with type 2 diabetes mellitus (T2DM) require special attention when being discharged from the hospital with anti-diabetes medication. This necessity stems primarily from the risk of adverse drug reactions, particularly hypoglycemia. However, this risk is significantly influenced by the patients’ knowledge and behavior regarding their medication use. This study aimed to develop instrument to assess the risk of medication-related hypoglycemia in ambulatory T2DM patients by clinical pharmacists.
Methods
The study was conducted using an observational design that included multiple stages. These stages involved item development through focus group discussions (FGDs), content validation by clinical pharmacists, and criterion and construct validation by ambulatory T2DM patients using a cross-sectional approach.
Results
A total of 10 question items were developed for assessment by clinical pharmacists following FGDs and content validation. Criterion and construct validation identified 8 valid question items through multivariate analysis (p<0.05). The scoring system developed demonstrated a linear relationship between the score and the number of items at risk in the instrument (p<0.05, R²=0.988). Additionally, the instrument was named “Medication-related Hypoglycemia Risk Score Assessment Tools (HYPOGLYRISK).”
Conclusions
The findings of this study suggest that HYPOGLYRISK may serve as a useful tool for clinical pharmacists to evaluate the risk of medication-related hypoglycemia in ambulatory T2DM patients. Additionally, this instrument could assist clinical pharmacists in identifying priority patients and tailoring educational services to meet their specific goals and needs.; Summary

Key Message
- HYPOGLYRISK is an instrument that can be used to assess the risk of hypoglycemia requiring hospitalization in T2DM patients. This instrument met all the requirements for psychometric properties testing in this study. - Patients discharged on antidiabetic medications can be screened for risk of severe hypoglycemia using HYPOGLYRISK, specifically by pharmacists, during drug dispensing. - Patients with T2DM must be ensured to have knowledge related to the five dimensions of medication safety to avoid the risk of hypoglycemia requiring hospitalization.

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; Funded: National Research Foundation of Korea, Ministry of Science and ICT

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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.

Factors Associated With Post-term Birth and Its Relationship to Neonatal Mortality in Japan: An Analysis of National Data From 2017 to 2022: Tasuku Okui, Naoki Nakashima; J Prev Med Public Health. 2024;57(6):564-571. Published online September 24, 2024; DOI: https://doi.org/10.3961/jpmph.24.355; Funded: JSPS KAKENHI

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Abstract Summary PDF Supplementary Material: Objectives
Prior research has not yet examined the relationship between post-term birth and neonatal mortality in Japan, along with factors associated with post-term birth. We investigated these associations utilizing nationwide birth data from Japan.
Methods
Birth and mortality data were obtained from the Vital Statistics of Japan for the years 2017 to 2022. The post-term birth rate was calculated by birth characteristics, and the neonatal mortality rates for post-term and term births were computed. Additionally, log-binomial regression analysis was employed to explore the associations between post-term birth and neonatal mortality, as well as between various characteristics and post-term birth. The characteristics considered included infant sex, maternal age group, parity, maternal nationality, maternal marital status, and household occupation.
Results
This study analyzed data from 4 698 905 singleton infants born at 37 weeks of gestational age or later. Regression analysis revealed that post-term birth was positively associated with neonatal mortality. The adjusted risk ratio for neonatal mortality in post-term compared to term births was 8.07 (95% confidence interval, 5.06 to 12.86). Factors positively associated with post-term birth included female infant sex, older maternal age, primiparity, non-Japanese maternal nationality, unmarried status, and various household occupations, including farmer, full-time worker at a smaller company, other type of worker, and unemployed. Younger maternal age was inversely associated with post-term birth.
Conclusions
In Japan, post-term birth represents a risk factor for neonatal mortality. Additionally, socio-demographic characteristics, such as maternal marital status, nationality, and parity were found to be predictors of post-term birth.; Summary

Key Message
This study investigated the relationship between post-term birth and neonatal mortality in Japan, along with factors associated with post-term birth. Regression analysis revealed that post-term birth was significantly and positively associated with neonatal mortality. Additionally, socio-demographic characteristics, such as older maternal age, primiparity, non-Japanese maternal nationality, and unmarried status were found to be predictors of post-term birth.

Scoping Review

Is Farming a Risk Occupation for Cardio-cerebrovascular Diseases? A Scoping Review on Cardio-cerebrovascular Disease Risk in Farmers: Hyeonjun Kim, Wongeon Jung, Sunjin Jung, Seunghyeon Cho, Inho Jung, Hansoo Song, Ki-Soo Park, Seong-Yong Yoon, Joo Hyun Sung, Seok-Ju Yoo, Won-Ju Park; J Prev Med Public Health. 2024;57(6):521-529. Published online August 23, 2024; DOI: https://doi.org/10.3961/jpmph.24.302; Funded: National Institute of Agricultural Sciences, Rural Development Administration

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Abstract Summary PDF Supplementary Material

Objectives
In Korea, cardio-cerebrovascular disease (CCVD) is recognized as an occupational disease when sufficient evidence of a work-related burden exists. In 2021, approximately 26.8% of the payments from occupational disease insurance under the Industrial Accident Compensation Insurance Act were allocated to CCVDs. However, due to the specific nature of insurance policies for farmers, CCVD is not acknowledged as an occupational disease in their case.
Methods
We reviewed studies on the differences in the incidence, prevalence, and mortality rates of CCVDs between farmers and the general population or other occupations and described the exposure of farmers to risk factors for CCVDs.
Results
Several studies showed that farming is a high-risk occupation for CCVDs, with the following risk factors: long working hours, night work, lack of holidays, and strenuous physical labor; physical factors (noise, cold, heat, humidity, and vibration); exposure to hazardous gases (diesel exhaust, carbon monoxide, hydrogen sulfide, carbon disulfide, nitrogen oxides, and polycyclic aromatic hydrocarbons), pesticides, and dust (particulate matter, silica, and organic dust); exposure to a hypoxic environment; and job-related stress. Social isolation and lack of accessible medical facilities also function as additional risk factors by preventing farmers from receiving early interventions.
Conclusions
Farmers are exposed to various risk factors for CCVDs and are an occupation at risk for CCVDs. More studies are needed in the future to elucidate this relationship. This study lays the groundwork for future research to develop guidelines for approving CCVDs as occupational diseases among farmers.

Summary

Korean summary
이 연구는 농업이 뇌심혈관질환과 연관된 고위험 직업임을 입증하는 근거를 검토하였습니다. 농업인은 긴 근무 시간, 격렬한 신체 노동, 유해 가스 및 살충제 노출 등 다양한 위험 요인과 더불어 의료 접근성 부족과 같은 문제에 직면해 있습니다. 이는 뇌심혈관질환을 농업인의 업무 관련 질병으로 인정하기 위한 가이드라인 개발에 중요한 기초를 제공합니다.

Key Message
This study reviewed evidence supporting that farming is a high-risk occupation associated with cardio-cerebrovascular diseases. Farmers face various risk factors, including long working hours, strenuous physical labor, exposure to hazardous gases and pesticides, and challenges such as limited access to medical care. This provides an essential foundation for developing guidelines to recognize cardio-cerebrovascular diseases as work-related illnesses among farmers.

Citations

Citations to this article as recorded by

Leveraging Administrative Health Databases to Address Health Challenges in Farming Populations: Scoping Review and Bibliometric Analysis (1975-2024)
Pascal Petit, Nicolas Vuillerme
JMIR Public Health and Surveillance.2025; 11: e62939. CrossRef

Original Article

Workstation Risk Factors for Work-related Musculoskeletal Disorders Among IT Professionals in Indonesia: Tofan Agung Eka Prasetya, Nurul Izzah Abdul Samad, Aisy Rahmania, Dian Afif Arifah, Ratih Andhika Akbar Rahma, Abdullah Al Mamun; J Prev Med Public Health. 2024;57(5):451-460. Published online July 25, 2024; DOI: https://doi.org/10.3961/jpmph.24.214; Funded: Universitas Airlangga

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Abstract Summary PDF: Objectives
This study aimed to identify workstation factors influencing work-related musculoskeletal disorders (WMSDs) among information technology (IT) professionals in Indonesia.
Methods
A cross-sectional study was conducted among 150 IT workers at small-enterprise companies who were randomly selected across East Java, Indonesia. The data were modeled using multiple linear regression, with a 95% level of confidence for determining statistical significance.
Results
The respondents reported that the neck had the highest level of discomfort and was the most at risk of WMSDs, followed by the lower back, right shoulder, and upper back. Screen use duration (p=0.040) was associated with whole-body WMSDs, along with seat width (p=0.059), armrest (p=0.027), monitor (p=0.046), and a combined telephone and monitor score (p=0.028). Meanwhile, the factors significantly related to the risk of WMSDs in the hands and wrist were working period (p=0.039), night shift (p=0.024), backrest (p=0.008), and mouse score (p=0.032).
Conclusions
Occupational safety authorities, standards-setting departments, and policymakers should prioritize addressing the risk factors for WMSDs among IT professionals.; Summary

Key Message
This study investigates workstation risk factors contributing to work-related musculoskeletal disorders (WMSDs) among IT professionals in Indonesia. Findings indicate that neck discomfort is the most prevalent, with significant associations identified between WMSDs and factors such as screen use duration, seating arrangements, and work conditions. The results underscore the need for ergonomic improvements and targeted preventive measures to enhance occupational health and safety for IT workers.

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