Sexual minority adolescents consistently exhibit a higher prevalence of suicidality compared with their heterosexual peers. This study aims to decompose the disparity in suicidal ideation by quantifying the extent to which it is attributable to differences in exposure to risk and protective factors between heterosexual and sexual minority adolescents, as opposed to differences in their responses to these factors. In addition, this study addresses the limited evidence from Chinese contexts by examining these mechanisms among adolescents in Hong Kong.

Data were extracted from a population-based survey conducted among local secondary school students in Hong Kong in 2021, encompassing 6883 adolescents. Logistic regression examined the factors associated with suicidal ideation. Decomposition analysis assessed the contribution of these factors to disparities in suicidal ideation between heterosexual and sexual minority adolescents, as well as disparities between sexual minority boys and girls.

Body dissatisfaction, cyberbullying, sexual harassment, perceptions of family life and academic performance were associated with suicidal ideation among adolescents, irrespective of their sex or sexual orientation. Approximately 31%–45% of the disparities in suicidal ideation were driven by differences in their exposure to risk and protective factors, and 55%–69% were driven by differences in how these factors relate to suicidal ideation and potentially unobserved characteristics. Among these factors, perceptions of family life played the most substantial role. Sex-specific patterns were also observed.

The higher prevalence of suicidal ideation among Chinese sexual minority adolescents appears to reflect both their greater exposure to stress and lower levels of support, as well as their distinct responses to these factors. Family-related factors are crucial for understanding this disparity. The observed sex differences emphasize the necessity for more nuanced approaches to addressing the varied experiences of sexual minority adolescents in Chinese societies.

To examine the association between long-term poverty exposure and census tract-level food insecurity rates across the USA.

Cross-sectional study using nationwide census data. Spatial error models were used to estimate differences in food insecurity rates by long-term poverty exposure, adjusting for rurality–urbanicity.

All census tracts in the USA.

US census tracts with complete data on food insecurity, long-term poverty status and rural–urban classification. Due to historical differences in data availability, sample sizes varied across models.

In the inclusive framework, tracts classified as Persistent Poverty Since 1990 had food insecurity rates 7·2 percentage points higher than other tracts (P < 0·001); tracts classified as Enduring Poverty Since 1980 had rates 7·1 points higher (P < 0·001); and those classified as Enduring Poverty Since 1970 had rates 6·3 points higher (P < 0·001). In the mutually exclusive framework, where each tract was assigned to only one poverty category based on the earliest qualifying decade, food insecurity was 6·3 points higher in tracts with Persistent Poverty only, 4·7 points higher in tracts with Enduring Poverty Since 1980 only, and 6·3 points higher in tracts with Enduring Poverty Since 1970 only (all P < 0·001). All models adjusted for Rural-Urban Commuting Area (RUCA) codes and accounted for residual spatial autocorrelation.

Long-term poverty exposure is strongly associated with elevated food insecurity at the census tract level. These findings underscore the importance of integrating historical measures of disadvantage and the value of tract-level analysis for identifying communities at risk of food insecurity.

Food insecurity is prevalent among underserved communities and contributes to maternal–child health disparities. The perinatal period – from pregnancy through 1 year postpartum – provides a critical window of opportunity to identify and address food insecurity. However, perinatal providers face barriers that prevent them from providing screening, referrals and follow-up services. The study aimed to understand barriers perceived by perinatal providers to implement strategies to screen, refer and follow up for food-insecure pregnant people and children living in underserved areas.

This qualitative phenomenological study explored multi-level barriers perceived by perinatal providers when implementing strategies for screening, referral and follow-up for food insecurity guided by the socio-ecological model.

This study was conducted within five zip codes of Southern Nevada (89101, 89106, 89030, 89031 and 89032) selected for their prevalence of food insecurity and health disparities.

Semi-structured interviews were conducted with fifteen perinatal providers.

Barriers at the individual provider level included lack of knowledge and education on food insecurity; at the interpersonal level included patient hesitancy to reveal sensitive information to providers; at the institutional level included lack of standard procedures to conduct screening, referrals and follow-up services; and at the community and policy levels identified organisational capacity and historical distrust of healthcare systems as obstacles to offering equitable care for food insecurity in perinatal settings.

Addressing these multi-level barriers is essential to implementing effective food insecurity mitigation strategies within perinatal care settings. Utilising the created recommendations may promote equitable care for food insecurity within clinical and community perinatal settings.

To examine parents’ lived experiences of implementing cot-only advice in a contemporary Australian cohort, assess alignment with the international literature on infant sleep and shared sleep practices, and determine whether explicit risk minimization guidelines address information needs identified by parents.

The risk elimination approach to shared sleeping has dominated public health messaging for decades but has been unsuccessful in reducing Sudden Unexpected Deaths in Infancy (SUDI) rates, while bedsharing rates have remained stable. The risk minimization approach offers an alternative, pragmatic framework for reducing controllable risks.

A retrospective, secondary, qualitative directed content analysis of free-text responses related to bed-sharing drawn from the 2017 Infant Care Awareness and Routines Evaluation among Queenslanders (I-CARE Qld Study) cross-sectional survey dataset. 3,341 primary caregivers (97% mothers) of infants aged approximately three months, born in Queensland between April and May 2017. For this secondary analysis, free-text responses related to co-sleeping/bedsharing were extracted and analysed qualitatively in line with study objectives.

Queensland parents expressed a desire for more information and non-judgemental education on improving safety while sharing sleep with their baby. Nearly a third of this cohort reported difficulty following advice to sleep their baby separately citing infant temperament/ needs, breastfeeding and caregiver fatigue or exhaustion as top rationales for this difficulty, aligning with earlier international findings. Some awareness by parents of risk minimization strategies to improve shared sleep safety was evident and in alignment with current Queensland Clinical Guidelines. There is an urgent need for public health messaging on safer infant sleep to better align with the lived experiences of parents and families through the adoption of a universal, proactive risk minimization approach to shared sleep. Co-designing guidance with parents may serve to bridge the gap between idealized and real-world implementation of safer infant sleep strategies.

Previous studies indicate that African immigrant women in the United States have lower rates of cervical cancer screening and prevention than other racial and immigrant groups, with additional heterogeneity by country of origin, language proficiency, and length of U.S. residence.

This review aimed to (a) summarize barriers and facilitators to screening, (b) examine how existing studies conceptualize African immigrant identity and employ disaggregated analyses, and (c) apply intersectionality and stress process frameworks to highlight structural determinants shaping screening behaviors.

This systematic review, registered with PROSPERO (CRD420251151600), synthesizes evidence on cervical cancer screening and HPV vaccination among African immigrant women in the United States. PubMed, ProQuest, EBSCO, PsycINFO, MEDLINE, Scopus, and Google Scholar were searched for peer-reviewed studies published between January 2010 and December 2024. Seventeen studies met inclusion criteria, including cross-sectional surveys (n = 7), qualitative studies (n = 5), mixed-methods studies (n = 3), retrospective cohort analyses (n = 1), and one randomized controlled trial.

Only 11 of the 17 studies disaggregated African immigrant women by country of origin or related subgroup characteristics. Risk of bias was assessed using the Newcastle–Ottawa Scale for observational studies and the Critical Appraisal Skills Programme checklist for qualitative studies. Across studies, African immigrant women consistently faced barriers to screening, including language discordance, lack of insurance, limited HPV awareness, cultural stigma, and unfamiliarity with the U.S. healthcare system. Interventions such as HPV self-sampling and culturally tailored education showed promise in improving screening uptake.

The findings point to the need for standardized disaggregated data collection, culturally responsive interventions, and theory-driven research to reduce cervical cancer prevention disparities among African immigrant women in the United States.

Adults with intellectual disability (ID) experience marked mental health inequities, yet population-wide estimates that capture both primary- and specialist-care diagnoses remain scarce.

Using nationwide Swedish registries, including primary care, specialist, inpatient, prescription drug, criminal, and suspicion registers, we included all individuals born in Sweden between 1958 and 1997 (N = 3,970,600), including 38,818 individuals with ID diagnoses (0.98%; 49.1% mild, 13.3% moderate, and 9.6% severe/profound). Hazard ratios (HR) were calculated using Cox proportional hazards regression to estimate the relative risk of lifetime diagnoses of major depression, anxiety disorders (ANX), obsessive-compulsive disorder (OCD), bipolar disorder (BD), attention-deficit/hyperactivity disorder (ADHD), drug use disorder, alcohol use disorder, schizophrenia, and other nonaffective psychosis. Additionally, cohort effects on psychiatric diagnosis risks in adults with intellectual disabilities versus the general population were evaluated.

People with ID were at higher risk for all psychiatric and substance use disorders, with HRs ranging from 1.7–2.0 for major depression and anxiety, drug and alcohol use disorders, 3.5–5.8 for BD, OCD and ADHD, and 10.9–12.7 for schizophrenia and other nonaffective psychosis. Higher prevalence was consistently seen among those with mild versus moderate or severe/profound intellectual disability. Relative risks narrowed modestly in successive birth cohorts, although absolute differences remained substantial.

Across six decades of follow-up, adults with ID faced markedly higher psychiatric and substance-use morbidity – most pronounced for psychotic disorders – than the general population. Whole-system mental-health screening and tailored interventions are required to address this persistent disparity.

To enhance representation in LCS research, we examined associations between participant characteristics and their preferred mode of survey completion among individuals eligible for LCS.

Between February 2023 and April 2024, prospective participants were identified using electronic healthcare records from Mass General Brigham and the University of Oklahoma Health Sciences (OUHSC). We offered three modes of survey completion: online, by mail, or by phone. Eligible participants were 50–80 years old, had smoked within the past 15 years, and spoke English or Spanish. We used multinomial logistic regression to estimate relative risk ratios (RRR).

Outreach to 2,822 individuals resulted in a sample of 315 participants. The mean age was 61.7 years (SD = 10.9). Most respondents were women (63.0%) and identified as White (63.3%), 29.8 % were Hispanic. The most common survey completion mode was mail (37.1%), followed by online (35.9%) and phone (27.0%). Characteristics associated with completion by mail were study site (RRR = 6.86, 95%CI:3.10–15.14), and race (RRR = 3.63, 95%CI:1.53–8.61); with respondents at OUHSC or who did not identify as White being more likely to choose mail over online modality. Characteristics associated with phone completion, included older age (RRR = 1.11, 95% CI: 1.03–1.20), Spanish language preference (RRR = 9.28, 95%CI:2.38–36.09), and with local government or community insurance (RRR = 9.91, 95% CI:1.92–51.3).

The current trend toward online surveys may not fully account for individual preferences for LCS research engagement, and could limit the representativeness in LCS studies if offline alternatives are not offered.

To tailor an existing Person-Centred Integrated Care (PC-IC) approach to the needs of patients with low socioeconomic status (LSES) and chronic conditions in primary care.

While Disease Management Programs (DMPs) have been introduced to reduce the burden of chronic diseases, their effectiveness for patients with LSES remains uncertain due to insufficient attention to the individual context. A PC-IC approach may enhance patient outcomes by addressing patients’ cultural backgrounds, values, and health literacy needs, because these factors are particularly relevant for patients with LSES.

A qualitative study was conducted using three co-creation sessions with patients with LSES and chronic conditions, along with general practitioners and practice nurses, to adapt, develop, and test specific elements of the PC-IC approach. Participatory learning and action (PLA) techniques incorporating visual materials were employed to ensure meaningful engagement and input by all participants, including those with limited reading and language skills. Following these sessions, we conducted a validation check by patients on the draft materials.

In the co-creation sessions, an existing PC-IC approach was tailored to the needs of LSES patients with chronic conditions in primary care. The adapted PC-IC approach emphasized key elements as trust, being seen as a person in the social context, shared decision-making, and access to clear and easily understandable information. Existing materials needed to be adapted, resulting in a visual conversation tool. This tool covers the physical, social, and mental health domains as well as daily life, each domain with six to eight topics. It helps to get better insight into the patient’s daily life, wishes, and possibilities. It maps medical and psychosocial issues and supports the patient in gaining a better understanding. The adapted PC-IC approach with the conversation tool is being presented in a training for primary care professionals.

Multimorbidity is increasingly common among older adults in Sub-Saharan Africa (SSA), yet the role of social determinants in shaping its prevalence and outcomes remains underexplored.

This review aimed to (a) identify the prevalence, types, and patterns of multimorbidity among older adults in SSA; (b) examine the influence of social determinants such as income, education, healthcare access, and geographic location; (c) evaluate current approaches for prevention and management; and (d) propose directions for future research.

A systematic search of six databases (PubMed, EMBASE, PsycINFO, Google Scholar, CINAHL, and Global Index Medicus) was conducted to identify quantitative studies published between 2000 and 2024 on adults aged 50 and above. Of 841 records screened, 16 studies met inclusion criteria and passed quality appraisal. The review protocol was registered in PROSPERO (CRD42024607875).

Multimorbidity ranged from 5.4% in Botswana to 71% in Nigeria. Cardiometabolic conditions often co-occurred with infectious and mental disorders. Poverty and low education significantly increased risk (OR: 1.44–7.44). Rural residents faced limited healthcare access, while urban dwellers had higher risks from lifestyle factors. Obesity and food insecurity further heightened vulnerability, especially among women and older adults.

Findings indicate that social determinants critically shape multimorbidity risk and outcomes in SSA. Integrated care models, targeted interventions, and policies addressing structural inequalities are urgently needed. Future research should apply longitudinal and qualitative approaches to clarify causal pathways and inform context-sensitive strategies.

Social determinants of health (SDHs) exert a significant influence on various health outcomes and disparities. This study aimed to explore the associations between combined SDHs and mortality, as well as adverse health outcomes among adults with depression.

The research included 48,897 participants with depression from the UK Biobank and 7,771 from the US National Health and Nutrition Examination Survey (NHANES). By calculating combined SDH scores based on 14 SDHs in the UK Biobank and 9 in the US NHANES, participants were categorized into favourable, medium and unfavourable SDH groups through tertiles. Cox regression models were used to evaluate the impact of combined SDHs on mortality (all-cause, cardiovascular disease [CVD] and cancer) in both cohorts, as well as incidences of CVD, cancer and dementia in the UK Biobank.

In the fully adjusted models, compared to the favourable SDH group, the hazard ratios for all-cause mortality were 1.81 (95% CI: 1.60–2.04) in the unfavourable SDH group in the UK Biobank cohort; 1.61 (95% CI: 1.31–1.98) in the medium SDH group and 2.19 (95% CI: 1.78–2.68) in the unfavourable SDH group in the US NHANES cohort. Moreover, higher levels of unfavourable SDHs were associated with increased mortality risk from CVD and cancer. Regarding disease incidence, they were significantly linked to higher incidences of CVD and dementia but not cancer in the UK Biobank.

Combined unfavourable SDHs were associated with elevated risks of mortality and adverse health outcomes among adults with depression, which suggested that assessing the combined impact of SDHs could serve as a key strategy in preventing and managing depression, ultimately helping to reduce the burden of disease.