Objectives With rising rates of reported mental ill health being reflected in trends in benefit receipt, a policy narrative has taken hold that mental health problems are driving the UK's recent increase in economic inactivity. However, while these quantitative trends reflect real experiences of distress, the dominance of mental health as a statistical and administrative explanation for economic inactivity masks significant complexity in the reasons why people are unable to seek, find or sustain employment. Taking a holistic lifecourse perspective on mental health and employment, this study aimed to illuminate the ways in which biography, mental health and social structures are interwoven in ways which challenge deterministic, medicalised and individualised explanations of economic inactivity. Study design Qualitative longitudinal and biographical narrative methods. Methods Biographical interviews with 23 individuals who had experience of both paid employment and the UK benefits system, and who self-identified as having experience of mental health problems. Two longitudinal follow-up interviews over 12-18 months to capture continuity and change in the contemporary policy context. Results Participants represented a diverse range of educational, employment and wider biographical circumstances. However, recurring themes included adverse childhood experiences, derailed education, caring responsibilities, violence and abuse. All of these directly shaped and constrained people's employment prospects and pathways, as well as impacting their mental health. Difficulties securing a stable foothold in the world of work, due to these accumulated disadvantages, left many participants vulnerable to precarious and insecure work. Conclusions Whilst direct support for mental health remains vital, policies aimed at reducing economic inactivity need to take a much wider view, addressing the multitude of intersecting obstacles faced by people with mental health problems. For public health specialists, there is a vested interest in systems-based and cross-sector collaboration across the spectrum of public services, given the associations between good quality work and positive health outcomes.
Objectives Healthcare systems face growing challenges due to ageing populations and lifestyle-related diseases. Psychological disconnection from the future self often leads people to prioritise short-term rewards over long-term health. We examined whether connecting people with their future self improves health beliefs, intentions, and observed behaviour. Study design Pragmatic, unblinded, sequentially allocated proof-of-principle experiment. Methods At a Dutch music festival (Biddinghuizen, August 2023), adult visitors were connected to their future self through an educational, visual, or physical intervention. Self-reported health beliefs and behavioural intentions were assessed before and after using a 12-item Theory of Planned Behaviour questionnaire (7-point Likert scale). Observed health behaviour was measured once through participants’ snack choice immediately afterwards (healthy or unhealthy). Results Of 659 participants, mean scores for all health beliefs and behavioural intentions significantly increased in the total sample: behavioural beliefs by 0.22 (95% CI 0.18–0.27), normative beliefs by 0.15 (95% CI 0.10–0.20), control beliefs by 0.11 (95% CI 0.06–0.16), and behavioural intentions by 0.06 (95% CI 0.01–0.10). When stratified by intervention format, all twelve estimates (four constructs in each of the three formats) were positive, nine of them significant at p < .05. No statistically significant differences between formats were found for any construct (all p > .05). Beliefs explained 49% of variance in behavioural intention (R2 = 0.49, p < .001). Stronger intention was associated with observed healthy snack choices (OR = 1.49, 95% CI 1.24–1.79, p < .001). Conclusions All three interventions were associated with improved health beliefs or behavioural intentions, which were linked to healthier observed snack choice immediately after the intervention. Connecting people with their future self may offer a scalable and low-cost strategy to promote healthier lifestyles. Future research is needed to establish causal effects and durability.
Objectives: To synthesize the available evidence concerning Aedes mosquito ecology and potential establishment, climatic and environmental suitability, epidemiological and urban determinants, and public health surveillance and preparedness relevant to dengue emergence in Tehran, Iran. The review also aimed to distinguish environmental receptivity and potential vector establishment from documented autochthonous dengue transmission and to identify key evidence gaps and surveillance priorities. Study design: Structured narrative/integrative review. Methods: A structured literature search was conducted covering publications and relevant publicly available information from January 2000 to March 2025. PubMed, Scopus, Web of Science, ScienceDirect, Google Scholar, and selected Iranian institutional sources were searched. Evidence was synthesized across four predefined domains: Aedes vector ecology and potential establishment; climatic and environmental suitability; epidemiological, population-level, urban, and infrastructural determinants; and vector surveillance, control, and public health preparedness. Twelve core studies were selected for focused qualitative and integrative analytical synthesis. Evidence was interpreted according to its geographical relevance and methodological basis, distinguishing direct Tehran-specific findings from Iranian, regional, international, and model-based evidence. Results: Available evidence did not demonstrate sustained establishment of Aedes aegypti or Aedes albopictus populations or sustained autochthonous dengue transmission in Tehran. However, climatic variability, warming trends, urban environmental conditions, potential breeding habitats, population mobility, and regional entomological evidence indicate potentially relevant conditions for future environmental receptivity. Climate and spatial models suggest possible expansion of environmental suitability for Aedes vectors and dengue-related transmission under warming scenarios, although these projections do not establish local vector populations or demonstrate dengue transmission in Tehran. Important limitations in standardized longitudinal entomological surveillance and integrated epidemiological and laboratory monitoring remain. Conclusions: Tehran is best characterized as a setting of potential and evolving dengue receptivity rather than established dengue transmission. The available evidence does not justify concluding that persistent Aedes populations or sustained local dengue transmission are established in the city. Standardized longitudinal entomological surveillance, integrated epidemiological and laboratory monitoring, environmental assessment, and coordinated public health preparedness are warranted to reduce uncertainty and facilitate early detection of potential dengue emergence.
Objectives To synthesize the available evidence concerning Aedes mosquito ecology and potential establishment, climatic and environmental suitability, epidemiological and urban determinants, and public health surveillance and preparedness relevant to dengue emergence in Tehran, Iran. The review also aimed to distinguish environmental receptivity and potential vector establishment from documented autochthonous dengue transmission and to identify key evidence gaps and surveillance priorities. Study design Structured narrative/integrative review. Methods A structured literature search was conducted covering publications and relevant publicly available information from January 2000 to March 2025. PubMed, Scopus, Web of Science, ScienceDirect, Google Scholar, and selected Iranian institutional sources were searched. Evidence was synthesized across four predefined domains Aedes vector ecology and potential establishment; climatic and environmental suitability; epidemiological, population-level, urban, and infrastructural determinants; and vector surveillance, control, and public health preparedness. Twelve core studies were selected for focused qualitative and integrative analytical synthesis. Evidence was interpreted according to its geographical relevance and methodological basis, distinguishing direct Tehran-specific findings from Iranian, regional, international, and model-based evidence. Results Available evidence did not demonstrate sustained establishment of Aedes aegypti or Aedes albopictus populations or sustained autochthonous dengue transmission in Tehran. However, climatic variability, warming trends, urban environmental conditions, potential breeding habitats, population mobility, and regional entomological evidence indicate potentially relevant conditions for future environmental receptivity. Climate and spatial models suggest possible expansion of environmental suitability for Aedes vectors and dengue-related transmission under warming scenarios, although these projections do not establish local vector populations or demonstrate dengue transmission in Tehran. Important limitations in standardized longitudinal entomological surveillance and integrated epidemiological and laboratory monitoring remain. Conclusions Tehran is best characterized as a setting of potential and evolving dengue receptivity rather than established dengue transmission. The available evidence does not justify concluding that persistent Aedes populations or sustained local dengue transmission are established in the city. Standardized longitudinal entomological surveillance, integrated epidemiological and laboratory monitoring, environmental assessment, and coordinated public health preparedness are warranted to reduce uncertainty and facilitate early detection of potential dengue emergence.
Objectives To introduce the PoCID-H Model, a multilevel framework conceptualizing political participation as a fundamental determinant of health and a potential lever for reducing health inequalities in the European Union and beyond. Study design The short communication presents a conceptual framework that integrates psychosocial mechanisms, political participation, and health outcomes within the broader context of social inequality. Methods The short communication develops a theoretical perspective linking psychosocial mechanisms, including stress, self-efficacy, and cognition, with political participation and health outcomes. It examines the interactions between individual behaviors, policy contexts, and health systems, emphasizing cyclical feedback loops that may reinforce or mitigate social and health inequalities. Results The PoCID-H Model highlights the interconnected relationships between psychosocial processes, political participation, and health outcomes. It underscores how social inequality may contribute to political disengagement and polarization, particularly among socioeconomically vulnerable populations, and identifies the potential role of political participation in shaping health-related policies and outcomes. Conclusions An activist public health approach is needed to address the structural and psychosocial dimensions of health inequalities. Integrating psychosocial indicators into preventive public health practices and recognizing political participation as a fundamental determinant of health may help strengthen health equity across the European Union and beyond.
