Monthly Archives: August 2026

Extreme Heat Connected to 33 Health Problems, Not Just Heat Stroke and Dehydration

When temperatures soar, emergency physicians typically expect more cases of dehydration and heat stroke. But a new Northwestern University study suggests extreme heat is connected to a much broader range of health problems treated in emergency departments and urgent care clinics, including skin conditions, kidney problems, multiple sclerosis and injuries from traffic accidents.

The findings, published Aug. 26 in Science Advances, could help emergency departments and health care systems better prepare for heat waves, which are becoming more frequent with climate change. Heat-related illness can be difficult to track because medical records often document the condition being treated without indicating whether extreme temperatures may have contributed.

Researchers used an innovative approach inspired by methods from genomics research to examine 1,803 diagnoses across nearly 1 million emergency department and urgent care visits in Chicago between May and September from 2011 to 2023. They identified 33 diagnoses associated with extreme heat exposure, including several conditions that have received relatively little attention in previous heat-related health research.

“If we’re only tracking the more commonly known heat-related illnesses, we’ll underestimate the true heat-related health burden, which could result in vulnerable people and communities being overlooked,” said corresponding author Hyojung Jang, a Ph.D. candidate in biostatistics at Northwestern University Feinberg School of Medicine. She said protecting people and communities most vulnerable to the effects of climate change is an important public health responsibility.

Among the diagnoses associated with extreme heat were skin rashes and swelling, acute kidney failure, multiple sclerosis, mental and behavioural disorders, insect bites and stings, traffic accidents, assault and firearm-related injuries. Co-author Daniel Horton said previous research has found that extreme heat can increase stress and aggressive behaviour, potentially contributing to accidents and other injuries.

Unlike earlier studies that typically began with predetermined conditions such as heat exhaustion, heat stroke or heart disease, the researchers used a data-driven approach adapted from genome-wide association studies. By linking clinical information from Chicago’s CAPriCORN data network with climate data according to location and time, the researchers were able to explore a much wider range of potential health effects.

Although the study focused only on Chicago, the researchers said the framework could be applied to other cities, states and countries. It could also be used with different types of health information, including death records and ambulance calls, potentially giving public health officials a more complete picture of how extreme temperatures affect communities.

The findings could also influence how cities prepare for increasingly severe heat. Chicago already uses a Heat Vulnerability Index to help identify neighbourhoods at greater risk and prioritize measures such as air-conditioning upgrades at park fieldhouses. Other proposed strategies include planting more trees, adding shade at bus stops, strengthening heat protections for outdoor workers and ensuring adequate cooling in apartments. Horton said that because extreme heat is associated with numerous health outcomes, reducing people’s exposure to dangerously high temperatures is critical.

More information: Hyojung Jang et al, Identifying heat-related diagnoses in emergency department visits among adults in Chicago: A heat-wide association study, Science Advances. DOI: 10.1126/sciadv.aed3977

Journal information: Science Advances Provided by Northwestern University

Not Just About Hunger: Food Insecurity May Affect Brain Health in Later Life

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Older adults who experienced food insecurity in both midlife and later life had nearly four times the probability of probable dementia compared with those who remained food secure, according to new research from the University of Michigan. The findings suggest that food insecurity later in life may be particularly important to cognitive health.

The study, published in The American Journal of Clinical Nutrition, found the strongest association among adults who experienced food insecurity in later life. In contrast, researchers found no significant association between food insecurity experienced only during midlife and probable dementia. While food insecurity is often viewed mainly as a problem of hunger and inadequate nutrition, researchers are increasingly examining its broader effects on health across the life course.

Researchers used longitudinal data from the University of Michigan’s Institute for Social Research Panel Study of Income Dynamics, the longest-running nationally representative household panel survey in the United States. Because the survey has followed families for decades, researchers were able to examine whether the timing of food insecurity was associated with cognitive health later in life.

“Not only can we now track the changes one family experiences, but by collecting this information for decades, we can also examine different parts of the life course,” said Noura Insolera, assistant research scientist at the Institute for Social Research. She noted that long-term data make it possible to investigate connections between experiences such as food insecurity and dementia risk many years later.

The study followed 2,051 adults and examined food insecurity during two periods: midlife, from 1999 to 2003, and later life, from 2015 to 2019. About 3% of participants experienced food insecurity only in midlife, 5.2% only in later life and 5% during both periods. The association with probable dementia was concentrated among those experiencing food insecurity in later adulthood.

Adults who experienced food insecurity during both periods had an estimated 40% probability of probable dementia, compared with 11% among those who remained food secure. Participants who experienced food insecurity only in later life also had a significantly higher estimated probability, at 34%. However, the researchers cautioned that the study cannot establish whether food insecurity directly contributes to dementia or whether other related factors help explain the association.

Food insecurity may affect health through several pathways. In addition to the physical consequences of inadequate nutrition, uncertainty about obtaining enough food can create significant psychological stress. Insolera said older adults facing financial pressures may sometimes choose to spend less on food in order to cover bills and other essential expenses. The combination of nutritional challenges and the stress associated with food insecurity could have broader consequences for health.

The findings highlight the importance of identifying and addressing food insecurity among older adults. Although health care providers increasingly screen patients for food insecurity, connecting people with effective assistance can be challenging. Insolera pointed to expanded Supplemental Nutrition Assistance Program (SNAP) benefits provided during the COVID-19 pandemic as an example of how government intervention can support families, suggesting that stronger food assistance programs could help address food insecurity and its potential long-term health consequences.

More information: Cindy W Leung et al, Associations between mid-life and later-life food insecurity on probable dementia in a national sample of United States adults, American Journal of Clinical Nutrition. DOI: 10.1016/j.ajcnut.2026.101386

Journal information: American Journal of Clinical Nutrition Provided by University of Michigan

Connecting People with Nature and Community May Reduce Loneliness

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Nature-based social prescribing may help reduce loneliness among adults living in socioeconomically vulnerable urban areas, according to a trial conducted in Barcelona by the European RECETAS consortium. The study found that loneliness declined among participants who received nature-based social prescribing, with those experiencing greater loneliness and poorer emotional wellbeing at the outset gaining more from a facilitated group programme. The findings suggest that support may be more effective when tailored to individual needs.

Loneliness is increasingly recognised as a significant public health concern because of its effects on physical and mental wellbeing. In Spain, about 20% of the population reports experiencing loneliness, while an estimated 100,000 people in Barcelona are affected. Social prescribing aims to address social and emotional needs by connecting people with activities and resources in their communities. Nature-based social prescribing extends this approach by encouraging participation in activities in parks, gardens and other natural spaces.

The EU-funded RECETAS project tested an intervention called Friends in Nature (FiN), which combines nature experiences with peer support and facilitated group activities. The programme aims to create opportunities for social connection while helping participants engage with their local natural environment and community.

Researchers recruited 320 adults experiencing loneliness from 12 socioeconomically vulnerable neighbourhoods in the Barcelona metropolitan area. Participants had a median age of about 63 years, and 80% were women. Half participated in FiN, attending two-hour weekly small-group sessions for nine weeks with trained facilitators. Activities included visits to parks, gardens, riverways, coastal areas and cultural heritage sites, alongside group discussions and peer support.

The other half received a 30-minute motivational interview and information about nature-based activities available in their neighbourhoods, which they could pursue independently. Across all participants, loneliness decreased by an average of 10.5% after three months and by 16.8% after one year. However, researchers found no significant difference in loneliness between the two groups after three months and no significant changes in health-related quality of life.

Further analysis showed that participants’ circumstances at the beginning of the study influenced how much they benefited from the different approaches. Those experiencing greater loneliness and poorer emotional wellbeing gained more from the facilitated FiN groups. Participants with lower levels of loneliness and better emotional wellbeing experienced comparable improvements from the lighter approach involving an interview and information about local activities.

The findings suggest that a single approach may not work equally well for everyone. People facing greater social and emotional difficulties may benefit from structured peer support, group activities and trained facilitators. In contrast, others may need only assistance identifying opportunities to connect with nature and their communities. The Barcelona findings also differed from a RECETAS trial in Helsinki involving frail older adults in assisted-living facilities, where FiN produced greater reductions in loneliness and improvements in several aspects of health-related quality of life.

Researchers noted that the Barcelona study included mostly women and had a median participant age of around 63, which may limit how broadly the results apply to younger adults and men. Nevertheless, the findings highlight the potential of nature-based social prescribing to strengthen social health in urban communities. By bringing people together through shared experiences in natural spaces, these programmes may help people develop relationships, participate more actively in their communities and strengthen feelings of belonging, purpose and connection.

More information: Laura Coll-Planas et al, Effectiveness of a nature-based social prescribing intervention on loneliness and health-related quality of life among vulnerable urban adults (RECETAS-BCN): an observer-blinded randomised controlled trial, The Lancet Regional Health – Europe. DOI: 10.1016/j.lanepe.2026.101821

Journal information: The Lancet Regional Health – Europe Provided by Barcelona Institute for Global Health (ISGlobal)

New Mothers May Need Time Before Feeling Ready to Care for Their Baby

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The first days after childbirth bring major physical and emotional changes. Although rooming-in, where mothers and newborns remain together around the clock, is standard practice in many maternity wards, not every new mother feels ready to care for her baby independently immediately after delivery. A new study suggests that this sense of readiness depends less on physical recovery than on a mother’s emotional well-being.

Researchers from Wroclaw Medical University investigated the factors that influence how prepared women feel to care for their newborns. Published in the Journal of Clinical Medicine, the study found that psychological factors, particularly anxiety and the ability to cope with difficult emotions, were more strongly associated with maternal readiness than postpartum pain or normal physiological changes following childbirth.

The study included 200 women in a maternity ward 48 to 72 hours after giving birth. Participants rated how ready they felt to care for their newborn independently during the day and at night, as well as their readiness to breastfeed. Researchers also examined pain, anxiety, mood, social support, psychological flexibility and postpartum changes in blood parameters to determine which factors were most closely linked to perceived readiness.

The findings suggest that readiness for newborn care involves much more than practical skills, physical health or previous parenting experience. Instead, it reflects whether a woman feels that she has sufficient physical and emotional resources to care for her baby independently at that particular moment. The researchers emphasised that feeling unready should not be interpreted as a measure of a mother’s competence or parenting ability.

Anxiety emerged as one of the strongest factors. Women with higher anxiety levels on the second day after childbirth reported feeling significantly less ready to care for their newborn independently and to breastfeed. Psychological flexibility, or the ability to function effectively despite uncomfortable thoughts, emotions or physical sensations, was also important. By comparison, postpartum pain and the normal decline in haemoglobin levels appeared to have much less influence on perceived readiness.

The researchers also found that readiness to breastfeed and readiness for independent newborn care were related but distinct. Women who felt prepared to breastfeed generally reported greater readiness for newborn care, but being motivated or prepared to breastfeed did not necessarily mean feeling capable of providing around-the-clock care. Some mothers may therefore feel confident about feeding their baby while still needing additional assistance with other aspects of newborn care.

The findings could have practical implications for maternity care. Rather than assuming that childbirth automatically means a woman is ready for 24-hour newborn care, healthcare professionals could briefly assess anxiety levels and ask mothers how prepared they feel. The study also found that women were more likely to report high readiness during the daytime than at night, suggesting that nighttime care may be particularly demanding and that some mothers could benefit from additional support during these hours.

The researchers argue that postpartum care should be more individualised and responsive to mothers’ changing needs. Simple conversations about emotional well-being and perceived readiness could help identify women who need extra assistance, while practical guidance from midwives and lactation consultants may help build confidence. Because readiness can differ considerably between women and may change from day to day, rooming-in and other postpartum practices should take both physical recovery and emotional well-being into account.

More information: Anna Prokopowicz et al, Maternal Readiness for Newborn Self-Care in the Early Postpartum Period: Associations with Maternal Psychophysical State and Declared Breastfeeding Readiness, Journal of Clinical Medicine. DOI: 10.3390/jcm15124522

Journal information: Journal of Clinical Medicine Provided by Wroclaw Medical University

Longer Gaps Between Meals Linked to Faster Disease Accumulation in Older Adults

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Older adults who typically went longer between meals accumulated chronic diseases more rapidly over time than those who had shorter meal intervals, according to a study from Karolinska Institutet published in the Journal of Internal Medicine. The association was particularly strong among adults aged 78 years and older.

Interest in fasting and meal timing has grown considerably in recent years, with some research exploring their potential effects on metabolism and health. However, much of this research has focused on younger and middle-aged adults, leaving uncertainty about whether longer periods without food have similar associations with health in later life.

To investigate, researchers examined whether the longest interval between meals during a typical day was associated with the rate at which older adults accumulated chronic diseases. The study focused on multimorbidity, or the presence of multiple chronic health conditions, which becomes increasingly common as people age.

The researchers analysed data from the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K). The study included 2,981 people living in Stockholm who were aged 60 years or older when the research began. Participants were followed for up to 15 years, allowing researchers to track changes in their health and the development of chronic conditions over an extended period.

Participants provided information about the times they typically ate during a 24-hour period, which researchers used to estimate the duration of their longest daily interval between meals. The analysis found that longer gaps were associated with a faster accumulation of chronic diseases over time. Those whose longest daily interval between meals ranged from 14 to 24 hours accumulated diseases more rapidly than participants whose longest interval was between six and 11.5 hours.

The association was not limited to overall disease burden. Longer meal intervals were also linked to a faster accumulation of cardiovascular and neuropsychiatric diseases. However, researchers did not find the same association for musculoskeletal diseases, suggesting that the relationship between meal timing and health may vary depending on the type of chronic condition.

“Much of the research on fasting has been conducted in younger or middle-aged populations. Our findings suggest that the associations may be different in older adults, particularly among the oldest age groups,” said Adrián Carballo Casla, the study’s last author and a postdoctoral researcher at the Aging Research Center, Department of Neurobiology, Care Sciences and Society at Karolinska Institutet. The findings were especially pronounced among participants aged 78 and older, highlighting the importance of studying meal patterns specifically in older populations.

The researchers cautioned that the findings show an association rather than a cause-and-effect relationship. The study cannot establish that longer periods between meals directly caused participants to accumulate chronic diseases more quickly, or whether other health, lifestyle or behavioural factors contributed to the observed pattern. Nevertheless, the results suggest that findings about fasting in younger populations may not necessarily apply to older adults and that age should be carefully considered when examining the potential health effects of meal timing.

More information: Luis Kalmbach et al, Habitual fasting duration and accelerated multimorbidity in older adults, Journal of Internal Medicine. DOI: 10.1111/joim.70150

Journal information: Journal of Internal Medicine Provided by Karolinska Institutet

Digital Wellness Program Supports Better Mental Health for Adults with Chronic Conditions

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A digital wellness program combining guided movement, breathing and meditation exercises, coping-skills training and health education can reduce symptoms of anxiety and depression in adults living with chronic medical conditions, according to a new study published in PLOS Medicine. The research was led by Dr. Puneeta Tandon of the University of Alberta and colleagues.

More than half of adults with chronic physical conditions experience anxiety, depression or fatigue, which can significantly affect their quality of life. Yet access to effective support can be limited by mobility challenges, geography, cost and shortages of trained clinicians. Researchers say digital programs could provide a more accessible way to help people manage these common symptoms from home.

The researchers conducted a fully remote randomized controlled trial involving 825 adults across 13 countries. Participants had chronic medical conditions including primary biliary cholangitis (PBC), chronic digestive diseases, cirrhosis and heart failure. They were assigned to a waitlist control group, a self-directed digital program called eMPower, or the same program supplemented by weekly telephone check-ins from trained non-clinicians.

Over 12 weeks, eMPower provided participants with guided movement, breathing and meditation exercises, coping strategies and disease education. Participants who received the program with telephone support showed significantly greater improvements in anxiety and depression than those in the control group. They also reported better quality of life and reduced fatigue.

Exploratory analyses found that participants using the self-directed program also experienced significant improvements compared with the control group. Researchers found no significant difference between the self-directed and telephone-supported versions, although the study was not designed to determine whether the two approaches were equally effective. The finding suggests that digital programs may potentially reach more people without requiring individual support for every participant.

“Rather than developing separate digital programs for each condition, a single cross-condition approach with tailoring for disease-specific education is effective in addressing shared symptoms,” the researchers said. Tandon noted that while these strategies do not replace medication or professional mental health care when needed, they can provide people living with chronic illness with practical tools they can use at home.

The fully online design also helped researchers include people who might otherwise face difficulties participating in clinical research. The average participant was 56 years old, nearly one-quarter were over 65, and 84 per cent completed the 12-week follow-up. First author Emily Johnson said the online approach helped reach people experiencing severe fatigue or mobility limitations, those living far from specialist centres and those unable to accommodate additional appointments.

The researchers noted that the study primarily involved women with higher levels of education and followed participants for only 12 weeks, meaning its longer-term effects and applicability to broader populations remain uncertain. However, patient representatives welcomed the results. Gail Wright, President of the Canadian PBC Society, said the program produced meaningful improvements in fatigue and quality of life among people with PBC, highlighting the potential for evidence-based self-management programs to complement medical treatment for chronic conditions.

More information: Emily Johnson et al, Effect of a digital intervention on mental health symptoms in adults with chronic conditions: A three-arm randomized controlled trial, PLOS Medicine. DOI: 10.1371/journal.pmed.1005198

Journal information: PLOS Medicine Provided by PLOS

Why We Remember Differently as We Get Older

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Research from the University of East Anglia (UEA) is shedding new light on how memory changes as we age, revealing that older adults tend to recall fewer specific details and may find it more difficult to switch between different types of memories. Rather than showing memory ageing as a simple process of decline, the findings suggest that vivid, moment-specific recollections may gradually give way to broader, more generalised knowledge.

Lead researcher Prof Louis Renoult, from UEA’s School of Psychology, said memories tend to become less detailed and more focused on the overall story as people get older. Older adults may therefore retain the “big picture” of an experience while recalling fewer of the sights, sounds, emotions and other details associated with a particular moment.

The researchers investigated autobiographical memory – the personal experiences that make up the stories of our lives. These can include specific, one-time events, such as a birthday party, as well as categoric memories involving repeated or general experiences, such as commuting to work. The team was particularly interested in how easily younger and older adults could move between these different forms of memory.

The study involved 37 students and 37 older adults from the community. Participants were given cue words, such as “market”, and asked to recall both specific and categoric memories. They first recalled each type separately before being asked to switch back and forth between them, increasing the demands on cognitive control. Researchers assessed how accurately participants followed the instructions and the amount of detail contained in their responses.

Across both age groups, memory performance declined when participants had to switch between memory types. However, older adults had particular difficulty recalling categoric memories, such as routine experiences like commuting, under switching conditions. Their ability to retrieve specific memories, such as a particular birthday celebration, was less affected, suggesting that some forms of memory retrieval may be more vulnerable to ageing when people must adapt quickly between different mental tasks.

Important differences also emerged in the content of the memories. When older adults recalled specific events, their accounts contained fewer details tied directly to the experience, including sights, sounds and emotions. At the same time, they included more semantic information – general knowledge, interpretations and broader understanding related to the event. A similar pattern appeared when participants recalled categoric memories.

The findings suggest that age-related memory changes are not simply about forgetting information. Instead, ageing may change how memories are accessed, organised and expressed. According to Prof Renoult, the reduced richness of older adults’ recollections may reflect changes in brain systems involved in retrieving detailed contextual information and managing more demanding cognitive tasks, particularly when people need to switch rapidly between different forms of recall.

These changes could have implications for everyday activities that require flexible thinking and memory, including storytelling, decision-making and problem-solving. But the shift towards generalised knowledge may also bring advantages. Drawing on broader semantic knowledge can support pattern recognition, efficient communication and wisdom accumulated through experience. The researchers hope that a better understanding of how memory evolves throughout life could ultimately help inform approaches designed to support healthy cognitive ageing.

More information: Melega, Greta et al, Age-related differences in autobiographical memory recall: impact of retrieval mode switching, Psychology and Aging. DOI: 10.1037/pag0001009

Journal information: Psychology and Aging Provided by University of East Anglia

Brexit Changed the UK Health Care Workforce but Did Little to Ease Doctor Shortages

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The United Kingdom’s vote to leave the European Union (EU) was associated with major shifts in health care worker migration and worsening physician shortages in England, according to a new study published in JAMA Health Forum. The findings suggest Brexit changed where the UK recruited doctors and nurses without resolving persistent workforce shortages.

Researchers found that an immediate decline followed the 2016 Brexit referendum in doctors and nurses arriving from EU countries. Although recruitment from non-EU countries increased in subsequent years, physician vacancies in England’s National Health Service (NHS) continued to rise, while overall nurse immigration declined.

Like many high-income countries, the UK relies heavily on internationally trained health professionals to meet workforce needs. Before Brexit, health care workers from EU countries could move relatively freely to the UK. Researchers examined how the referendum affected these migration patterns and whether changes in international recruitment contributed to workforce shortages.

Researchers from the Harvard Pilgrim Health Care Institute, Massachusetts General Hospital, London South Bank University, and the WHO Europe Human Resources for Health Group analysed health workforce data from 2008 to 2019. The study included more than 418,000 physicians and 358,000 nurses who migrated to Organisation for Economic Co-operation and Development (OECD) countries. Researchers compared trends in the UK with those in 32 other high-income OECD countries before and after the referendum.

The Brexit referendum was associated with an immediate decline of about 825 physicians and 2,771 nurses arriving from EU countries in 2016. In the years that followed, immigration from non-EU countries increased by an estimated 3,110 physicians and 1,437 nurses annually. Despite this increase, NHS physician vacancies in England grew by an estimated 383 positions, indicating that increased recruitment from elsewhere did not fully offset workforce pressures.

“The Brexit referendum changed where the United Kingdom recruited its health care workforce, with fewer clinicians arriving from Europe and more from countries in Africa and Asia. Our findings show that these shifts were not enough to prevent growing physician shortages within the National Health Service,” said lead author Tarun Ramesh, a research fellow at the Harvard Pilgrim Health Care Institute.

The researchers also found that migration from EU countries began declining well before the UK formally left the EU in 2020. Senior author Hao Yu, an associate professor of population medicine at Harvard Medical School and the Harvard Pilgrim Health Care Institute, said the findings demonstrate that health care workforce migration can be highly sensitive to policy signals. Uncertainty surrounding future immigration rules was associated with changes in the flow of doctors and nurses even before the formal withdrawal.

The researchers said the findings have broader implications for countries considering immigration restrictions. Policymakers should consider how such policies could affect health care staffing and access to care, particularly in health systems that depend heavily on internationally trained professionals. They should also consider the consequences of increasing recruitment from countries in Africa and Asia that may already face shortages within their own health care workforces.

More information: Tarun Ramesh et al, Health Care Workforce Immigration to the UK After Its European Union Membership Referendum, JAMA Health Forum. DOI: 10.1001/jamahealthforum.2026.2868

Journal information: JAMA Health Forum Provided by Harvard Pilgrim Health Care Institute

Study Reveals Persistent Food Insecurity in Formerly Redlined Areas

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Poor housing, high crime and underperforming schools may have a greater influence on access to healthy food than transportation or income in neighbourhoods historically affected by redlining, according to a new study. Redlining was a discriminatory practice that denied loans, insurance and mortgages to residents of certain neighbourhoods, disproportionately affecting racial and ethnic minority communities.

The study, led by Sebastian Linde, a health policy researcher at the Texas A&M University School of Public Health, examined why some neighbourhoods have better access to healthy food than others. The findings suggest that simply opening more grocery stores may not be enough to address food insecurity. Instead, researchers say improving the broader neighbourhood environment could be key to creating lasting change.

“This suggests that simply adding grocery stores is not the answer — solutions should be found for the entire neighborhood environment,” Linde said. He noted that understanding the underlying causes of limited food access could help city planners and policymakers develop more effective strategies rather than focusing solely on increasing the number of food retailers.

The issue is particularly important because poor diets are closely associated with obesity and other health problems. Adult obesity in the United States has risen substantially over the past two decades, while severe obesity has also increased. Financial hardship can further compound the problem, as households with limited resources may rely on cheaper, less nutritious foods. Food shortages can also contribute to stress and unhealthy eating patterns when food becomes available.

Although redlining was outlawed in 1968, researchers say its effects continue to shape many communities. Historically redlined neighbourhoods often experience persistent poverty and segregation, along with other social and economic disadvantages. Many of these communities also have numerous fast-food restaurants but few grocery stores offering healthier food choices, potentially contributing to long-term differences in health outcomes.

The researchers analysed data from nearly 9,600 neighbourhoods across 38 states, combining U.S. Census information with historical redlining maps and data comparing the availability of grocery stores and fast-food restaurants. They also used a specialised dataset designed to examine connections between historical differences in access to credit and present-day health disparities. The analysis considered factors including housing, education, crime and safety, transportation, social cohesion, the built environment, and community wealth and income.

The results showed that historically redlined areas generally experienced greater neighbourhood hardship, although access to healthy food varied considerably. Some communities had few or no healthy food options, while others had relatively good access. Among the factors examined, high crime rates, substandard housing and poorer educational environments emerged as the strongest drivers associated with differences in food access.

Linde said improving food security will likely require collaboration among housing, city planning, public health agencies and community organisations. Strategies such as community gardens could also strengthen social connections while supporting healthier neighbourhoods. Although the study cannot establish cause and effect and did not examine factors such as food affordability or quality, the researchers say neighbourhood-level approaches could help communities address the long-term consequences of redlining and develop locally appropriate solutions to improve food security.

More information: Rebekah J. Walker et al, Structural Drivers of Neighborhood Food Access: Implications for Policy Change, Obesity. DOI: 10.1002/oby.70205

Journal information: Obesity Provided by Texas A&M University

Smokers Left Behind by Health Systems in the World’s Poorest Countries

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Only 13 low- and middle-income countries provide smokers with the full range of support needed to quit, leaving around 1.3 billion people without access to effective care, according to a new study. Researchers warn that major gaps in tobacco treatment remain, particularly in countries carrying the greatest burden of tobacco-related disease.

Researchers from the University of York, New York University and Harvard University found that most smokers worldwide have limited access to effective quitting services. Tobacco remains the world’s leading cause of preventable death, killing more than seven million people each year, yet treatment for tobacco addiction is still unavailable or inadequate for much of the global population.

More than 80% of tobacco users live in low- and middle-income countries, where healthcare systems often face substantial disease burdens while having fewer resources to help people stop smoking. Although many governments report that cessation support is available, the researchers found that only 13 lower-income countries provide the standard of care recommended by the World Health Organization (WHO), combining behavioural counselling with free or subsidised medication.

By examining healthcare delivery in countries including India and Vietnam, the researchers found that a complex mix of local factors influences access to smoking-cessation services. These include cultural attitudes towards smoking, government policies, healthcare financing, available resources and political interference from the tobacco industry. Such differences can significantly affect whether smokers are able to obtain appropriate treatment.

Because these barriers vary considerably between countries and communities, the researchers argue that smoking-cessation programmes need to be adapted to local circumstances rather than following a single global model. Professor Kamran Siddiqi, from Hull York Medical School, said healthcare systems have a fundamental responsibility to treat tobacco addiction, noting that effective interventions can be inexpensive to implement while producing substantial health and economic benefits.

The review, published in the New England Journal of Medicine, highlights several low-cost strategies that could expand access to cessation services even in countries with limited healthcare resources. These include national quitlines and mobile health services that provide advice remotely, as well as community health workers who can reach smokers living in rural and underserved areas.

The researchers also recommend making tobacco screening and treatment a routine part of healthcare. Approaches such as “Ask-Advise-Connect” allow healthcare professionals to identify tobacco users during regular appointments, advise them to quit and connect them directly with treatment. Proven smoking-cessation medications, including nicotine patches, cytisine and varenicline, are also considered cost-effective and should be more widely licensed and accessible. The researchers argue that governments or insurers should cover full courses of treatment so that cost does not prevent people from receiving help.

Professor Donna Shelly of New York University said ensuring equitable access to comprehensive tobacco-cessation support as part of standard healthcare is essential to preventing millions of tobacco-related deaths worldwide. The researchers conclude that expanding affordable, locally appropriate treatment could substantially reduce the global health and economic burden of tobacco, particularly in lower-income countries where most tobacco users live.

More information: Donna Shelley et al, Evidence-Based Tobacco-Cessation Strategies for Low- and Middle-Income Countries, New England Journal of Medicine. DOI: 10.1056/NEJMra2507061

Journal information: New England Journal of Medicine Provided by University of York

Good Friends, Better Health: Global Study Highlights the Power of Friendship

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A major global study has found that fulfilling friendships and close social relationships are strongly associated with better physical and mental health. Published in the peer-reviewed Journal of Mental Health, the research analysed data from more than 200,000 adults and found that people who were more satisfied with their friendships and relationships tended to report better overall health and well-being.

The study, led by Dr Veli Durmuş of Kütahya Health Sciences University in Türkiye, included 204,907 adults aged 18 and older across 22 countries. Participants came from culturally and geographically diverse countries, including the UK, US, Australia, Argentina, Brazil, Germany, Spain, India, Japan, Egypt, Nigeria, South Africa and Mexico, making it one of the most comprehensive studies of its kind.

Using data from the Global Flourishing Study, researchers examined participants’ satisfaction with their friendships and close relationships, as well as the quality of their childhood relationships with their mothers and fathers. Participants also rated their current mental and physical health, while researchers considered other factors including income and education.

The results showed a clear pattern: people who reported greater satisfaction with their friendships and close relationships were also more likely to report better mental and physical health. Positive childhood relationships with parents were similarly associated with better health and well-being in adulthood, although this association was weaker than that observed for current friendships and relationships.

Dr Durmuş says the findings highlight the importance of social connections throughout life. While early family relationships may contribute to later well-being, people’s social environments continue to evolve. Friendships, partnerships and other meaningful relationships developed in adulthood may strengthen or modify the influence of childhood experiences and provide important sources of emotional and social support.

Previous research suggests that strong relationships can help protect people against stress, support self-esteem and help individuals manage their emotions positively. The new findings provide broader international evidence that the quality of social relationships is closely connected with health across different cultures. However, some differences were observed by age and country. Mental health scores were lower among people in their mid-thirties to late forties than among those aged 18 to 34, while scores were higher among adults aged 65 and older. Friendship and relationship satisfaction were highest in Indonesia and lowest in Japan.

Other social and demographic factors were also associated with health. Being married, having sufficient financial resources and identifying with a religion were linked with better mental and physical health scores. Overall, the findings suggest that strong social relationships may represent a “universal pillar” of well-being across diverse cultural and national settings.

Dr Durmuş argues that policymakers should recognise social relationships as an important component of public health and incorporate social connection into health promotion and prevention strategies. However, the study cannot establish cause and effect. Because the findings are based on self-reported information collected at one point in time, they reflect participants’ subjective perceptions of their relationships and health rather than proving that stronger friendships directly cause better health.

More information: Veli Durmuş, Do social and family relationships affect self-rated mental and physical health? Evidence from nationally representative samples across 22 countries, Journal of Mental Health. DOI: 10.1080/09638237.2026.2695973

Journal information: Journal of Mental Health Provided by Taylor & Francis Group

Endometriosis Takes a Financial Toll: Women May Lose a Month’s Pay Annually

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Menstrual leave and flexible work arrangements are the forms of workplace support women with endometriosis say would help them most, according to a new study by researchers at Semmelweis University published in Preventive Medicine Reports. Pain and fatigue can contribute to work absences and reduced job performance, creating significant financial consequences for women with the condition.

The first large-scale study of its kind in Central and Eastern Europe found that women with endometriosis lose an average of €1,757 in income each year—roughly equivalent to one month’s average salary in Hungary. The estimate reflects income lost because of work absences and does not include reduced productivity while at work or health care expenses.

Researchers analysed data from 566 women with endometriosis and 447 women without the condition, using internationally validated questionnaires to assess work productivity, absenteeism, and work ability. Over four weeks, women with endometriosis lost an average of 12.7 work hours because of health-related problems, compared with 5.7 hours among women in the control group.

“The impact of endometriosis is not only a health issue but also a major social and economic one,” said Dr. Dóra Balogh, Assistant Professor in the Department of Obstetrics and Gynecology at Semmelweis University and senior author of the study. She noted that because the condition affects women during highly active stages of their lives, it can have consequences for employment, career development, and long-term financial security.

Endometriosis affects about 10% of women of reproductive age worldwide. It is a chronic gynecological condition in which tissue similar to the lining of the uterus grows outside the uterus. The condition can cause chronic pelvic pain, painful periods, fatigue, and, in some cases, infertility, while diagnosis may take years after symptoms first appear.

The study also found substantial differences in work ability. Among women with endometriosis, 42% had poor work ability, compared with 17.9% of women without the condition. Poor work ability indicates that health problems make it more difficult for a person to perform their job and may increase the risk of prolonged work disability or eventually leaving the workforce.

“The most surprising finding was that nearly half of the women with endometriosis fell into this category,” said Dr. Dominika Miklós, a resident physician at Semmelweis University and first author of the study. She said that without appropriate support, endometriosis may make everyday work more difficult and threaten women’s ability to remain in the workforce over the long term.

Workplace awareness remains another challenge. Fifty-four percent of respondents said their employer had little or no knowledge of endometriosis, while only 17% believed their workplace was sufficiently informed. Women identified menstrual leave, flexible hours, remote or hybrid work, and greater employer understanding as the support they would value most. Conducted as part of the international FEMaLe (Finding Endometriosis with Machine Learning) research programme, the study concludes that flexible workplace policies and better-informed employers could help women with endometriosis maintain employment and reduce the condition’s broader social and economic impact.

More information: Dominika Miklos et al, Endometriosis as a determinant of work disability in the Hungarian population: quantifying productivity loss and the need for workplace prevention strategies, Preventive Medicine Reports. DOI: 10.1016/j.pmedr.2026.103501

Journal information: Preventive Medicine Reports Provided by Semmelweis University