Global Asthma Disparities: Deciphering the Multifaceted Environmental Exposome Between Eastern and Western Populations

Bio-medical anthropological perspective on urban-rural and socioeconomic disparities in Eastern Croatia

Background: Cardiovascular diseases (CVDs) remain the leading cause of death in Croatia, accounting for 37% of all deaths, with a standardized mortality rate of 572.8/100,000, substantially exceeding the EU average of 367.6/100,000. The Osijek-Baranja region in eastern Croatia, characterized by both continental climate and significant urban-rural gradients, presents a particularly high burden of modifiable CVD risk factors. Bio-medical anthropological approaches offer a critical lens for examining how biological vulnerability intersects with socioeconomic, environmental, and lifestyle determinants of cardiovascular health at the population level. Objective: To analyse the prevalence and distribution of cardiovascular risk factors, including hypertension, dyslipidaemia, obesity, and physical inactivity, across urban and rural populations in eastern Croatia, and to assess associations with socioeconomic deprivation indicators and anthropometric measurements. Subjects and methods: A cross-sectional study was conducted in the Osijek-Baranja County, encompassing adult participants registered with general practice offices in both urban and rural settings. Anthropometric assessments (body mass index, waist circumference, waist-hip ratio) were performed alongside clinical measurements (blood pressure, fasting lipid profiles). Socioeconomic data were collected through structured questionnaires. Data were analysed using multivariate logistic regression to identify independent predictors of elevated cardiovascular risk. Results: Rural participants demonstrated a significantly higher prevalence of arterial hypertension, increased BMI, elevated waist circumference and waist-hip ratio, and elevated LDL cholesterol compared to urban counterparts. Urban participants showed significantly greater rates of insufficient physical activity. Overall, more than 75% of participants exhibited at least two major modifiable cardiovascular risk factors, consistent with regional epidemiological patterns documented across continental Croatia. Conclusions: The findings highlight the persistence of high cardiovascular risk factor burden in eastern Croatia, with pronounced urban-rural disparities mediated by both biological and socioeconomic factors. A targeted, community-based public health strategy, integrating bio-medical anthropological profiling into cardiovascular prevention programmes, is urgently needed for this high-risk region. These results underscore the value of integrating anthropometric and population-level biological data into cardiovascular health interventions.

Social Inequalities and Gestational Risk in Rural and Urban Women: A Systematic Review of Literature

Maternal health reflects social equity and remains strongly influenced by the Social Determinants of Health (SDH), particularly in rural and low-resource settings. The objective was to describe social inequalities and their effect on pregnancy risk. This systematic review, conducted under PRISMA 2020 guidelines. The databases were PubMed, Scopus, and ScienceDirect. The synthesis of evidence reveals a direct correlation between the poverty index and the severity of complications. In various Latin American and middle-income country contexts, the maternal mortality ratio reached 75.19 per 1,000 live births, exceeding the national average, with critical vulnerability among women over 40 years of age (Ratio: 165.75). Although urban areas report a higher number of cases (251 vs. 165), rural areas face greater barriers related to the "third delay" (transportation and referral). The cost of care for severe preeclampsia (USD 827) acts as an impoverishment factor for low-income families, exacerbating the cycle of inequality. Social inequalities are not only geographical, but also structural and economic. A differentiated public policy is needed to mitigate the access gap in sparsely populated rural areas in order to effectively reduce maternal morbidity and mortality in the department.

Does Multilingualism Shape Aging Equally Across Populations?

Environmental pollutants and the rising burden of inflammatory bowel disease in East Asia: a narrative review.

Inflammatory bowel disease (IBD) is rising at an alarming rate in parallel with rapid urbanization in newly industrialized parts of the world, including East Asia. Simultaneously, environmental pollutants are also an escalating problem in these regions. Recent studies have reported on associations between environmental pollutants and IBD, however, data on this topic specific to East Asia are limited. In this review, we summarize available data on environmental pollutants and related exposures in East Asia and their relationship with IBD. Motor vehicle emissions and industrial wastes are key sources of air pollution, while drinking water, seafood and vegetable produce constitute main sources of heavy metal and pesticide exposure. Microplastics are even more ubiquitous and pervasive toxicants. Mechanistic data suggest that environmental pollutants may influence IBD risk and outcomes through microbial dysbiosis and intestinal barrier disruption, ultimately leading to intestinal inflammation. Understanding the impact of environmental exposures and outcomes is key to potentially identify modifiable factors and inform strategies to predict, prevent and mitigate the rising burden of IBD in East Asia.

Urban environment, health, and equity

Background: Urban residents are exposed to multiple environmental stressors, but robust evidence on inequities in environmental exposure and associated health and well-being outcomes remains limited. Aim: To assess inequities in residential exposure to air pollution (PM2.5, PM10, and NO2), traffic noise (road, railway, and aircraft) and greenness (NDVI within 300 m), and to characterize associations with self-reported symptoms and annoyances. Methods: The study population comprised 46,282 adults (18–84 years) residing in Stockholm County, Sweden, who responded to the Swedish National Environmental Health Survey 2023. Residential exposure (dichotomized) was based on geocoded address coordinates and stratified by socioeconomic status (SES) and building type. Logistic regression estimated adjusted odds ratios (OR) with 95% confidence intervals (95% CI) and tested effect modification via interaction terms. Results: Apartment residents were more often exposed to air pollution and noise and had less surrounding greenness than house residents. SES-stratified analyses revealed exposure-specific patterns, but no consistent overall trends. Air pollution exposure was associated with perceived poor outdoor air quality (NO2: OR = 3.22; 95% CI = 2.75–3.79), traffic noise with, for example, high noise annoyance (road traffic: OR = 4.59; 95% CI = 4.02–5.26), and greenness, for example, with lower perceived indoor heat stress during summer (OR = 0.83; 95% CI = 0.79–0.88). Self-reported health and well-being varied by SES and building type. Conclusions: Our study reveals concentrated environmental stressors in dense residential areas and highlights multidimensional environmental inequities. Environmental exposure was associated with self-perceived health and well-being, underscoring the need for integrated, system-based policies, such as One Health, to promote sustainable urban well-being.

Beyond aging: Local sensitivity of hearing health disparities to socioeconomic and environmental factors across the United States

Aging is the primary determinant of human hearing loss; however, the roles of socioeconomic and environmental factors on hearing health outcomes remain insufficiently understood. This study integrates explainable machine learning and geospatial analysis by employing a Geographical Random Forest model coupled with SHapley Additive exPlanations (GRF-SHAP) to investigate contributors to hearing health outcomes across the contiguous United States. Results indicate spatial heterogeneity in dominant predictors across countries. Globally, racial minority social vulnerability, the percentage of veterans, and point-of-interest density are the three most influential non-aging predictors. Higher racial minority vulnerability and higher point-of-interest density are generally associated with better hearing health outcomes, whereas higher veteran concentration tends to be associated with worse hearing health outcomes. Locally, the influence of these variables varies across counties. For example, point-of-interest density emerges as the predominant predictor across counties in New York State, whereas racial minority social vulnerability dominates in counties across Florida. The proposed GRF-SHAP framework offers a scalable and interpretable approach for identifying globally and locally dominant determinants of hearing health. By moving beyond aging-centric explanations, this study demonstrates that hearing health is shaped by a complex interplay of social vulnerability, infrastructure conditions, and community characteristics that vary geographically.