European Journal of Public Health 

About: European Journal of Public Health is an academic journal published by Oxford University Press. The journal publishes majorly in the area(s): Medicine & Population. It has an ISSN identifier of 1101-1262. Over the lifetime, 8495 publications have been published receiving 133327 citations.

Health literacy in Europe: comparative results of the European health literacy survey (HLS-EU)

Abstract: Background : Health literacy concerns the capacities of people to meet the complex demands of health in modern society. In spite of the growing attention for the concept among European health policymakers, researchers and practitioners, information about the status of health literacy in Europe remains scarce. This article presents selected findings from the first European comparative survey on health literacy in populations. M ethods : The European health literacy survey (HLS-EU) was conducted in eight countries: Austria, Bulgaria, Germany, Greece, Ireland, the Netherlands, Poland and Spain ( n = 1000 per country, n = 8000 total sample). Data collection was based on Eurobarometer standards and the implementation of the HLS-EU-Q (questionnaire) in computer-assisted or paper-assisted personal interviews. R esults : The HLS-EU-Q constructed four levels of health literacy: insufficient, problematic, sufficient and excellent. At least 1 in 10 (12%) respondents showed insufficient health literacy and almost 1 in 2 (47%) had limited (insufficient or problematic) health literacy. However, the distribution of levels differed substantially across countries (29–62%). Subgroups within the population, defined by financial deprivation, low social status, low education or old age, had higher proportions of people with limited health literacy, suggesting the presence of a social gradient which was also confirmed by raw bivariate correlations and a multivariate linear regression model. Discussion : Limited health literacy represents an important challenge for health policies and practices across Europe, but to a different degree for different countries. The social gradient in health literacy must be taken into account when developing public health strategies to improve health equity in Europe.

Bullying and symptoms among school-aged children: international comparative cross sectional study in 28 countries

Abstract: Background: There have been no large-scale international comparisons on bullying and health among adolescents. This study examined the association between bullying and physical and psychological symptoms among adolescents in 28 countries. Methods: This international cross-sectional survey included 123,227 students 11, 13 and 15 years of age from a nationally representative sample of schools in 28 countries in Europe and North America in 1997–98.The main outcome measures were physical and psychological symptoms. Results: The proportion of students being bullied varied enormously across countries. The lowest prevalence was observed among girls in Sweden (6.3%, 95% CI: 5.2–7.4), the highest among boys in Lithuania (41.4%, 95% CI 39.4–43.5). The risk of high symptom load increased with increasing exposure to bullying in all countries. In pooled analyses, with sex stratified multilevel logistic models adjusted for age, family affluence and country the odds ratios for symptoms among students who were bullied weekly ranged from 1.83 (95% CI 1.70–1.97) to 2.11 (95% CI 1.95–2.29) for physical symptoms (headache, stomach ache, backache, dizziness) and from 1.67 (95% CI 1.55–1.78) to 7.47 (95% CI 6.87–8.13) for psychological symptoms (bad temper, feeling nervous, feeling low, difficulties in getting to sleep, morning tiredness, feeling left out, loneliness, helplessness). Conclusion: There was a consistent, strong and graded association between bullying and each of 12 physical and psychological symptoms among adolescents in all 28 countries.

Ensuring rigour in qualitative research

Abstract: The issues of reliability and validity in qualitative research are not as readily codified as has been the case for quantitative research. However, a variety of methods do exist and are reviewed here. This general review is followed by a detailed illustration of selected techniques, including the use of counting in qualitative research, the development of systematic coding schemes with the aid of computer programmes, searching for deviant cases and the use of the transcription techniques of conversation analysis. The examples given are drawn from a variety of studies conducted by the authors.

Global and regional hearing impairment prevalence: an analysis of 42 studies in 29 countries

Abstract: Background: Hearing impairment is a leading cause of disease burden, yet population-based studies that measure hearing impairment are rare. We estimate regional and global hearing impairment prevalence from sparse data and calculate corresponding uncertainty intervals. Methods: We accessed papers from a published literature review and obtained additional detailed data tabulations from investigators. We estimated the prevalence of hearing impairment by region, sex, age and hearing level using a Bayesian hierarchical model, a method that is effective for sparse data. As the primary objective of modelling was to produce regional and global prevalence estimates, including for those regions with scarce to no data, models were evaluated using cross-validation. Results: We used data from 42 studies, carried out between 1973 and 2010 in 29 countries. Hearing impairment was positively related to age, male sex and middle- and low-income regions. We estimated that the global prevalence of hearing impairment (defined as an average hearing level of 35 decibels or more in the better ear) in 2008 was 1.4% (95% uncertainty interval 1.0–2.2%) for children aged 5–14 years, 9.8% (7.7–13.2%) for females >15 years of age and 12.2% (9.7–16.2%) for males >15 years of age. The model exhibited good external validity in the cross-validation analysis, with 87% of survey estimates falling within our final model's 95% uncertainty intervals. Conclusion: Our results suggest that the prevalence of child and adult hearing impairment is substantially higher in middle- and low-income countries than in high-income countries, demonstrating the global need for attention to hearing impairment.

August 2003 Heat Wave in France: Risk Factors for Death of Elderly People Living at Home

Abstract: The August 2003 heat wave in France resulted in many thousands of excess deaths particularly of elderly people. Individual and environmental risk factors for death among the community-dwelling elderly were identified. We conducted a case-control survey and defined cases as people aged 65 years and older who lived at home and died from August 8 through August 13 from causes other than accident, suicide, or surgical complications. Controls were matched with cases for age, sex, and residential area. Interviewers used questionnaires to collect data. Satellite pictures provided profiles of the heat island characteristics around the homes. Lack of mobility was a major risk factor along with some pre-existing medical conditions. Housing characteristics associated with death were lack of thermal insulation and sleeping on the top floor, right under the roof. The temperature around the building was a major risk factor. Behaviour such as dressing lightly and use of cooling techniques and devices were protective factors. These findings suggest people with pre-existing medical conditions were likely to be vulnerable during heat waves and need information on how to adjust daily routines to heat waves. In the long term, building insulation and urban planning must be adapted to provide protection from possible heat waves.