Asia Pacific Journal of Public Health

Southeast Asia plays a vital role in the global alcohol trade, with rapid economic growth and increasing intra-regional travel contributing to shifts in alcohol consumption. This descriptive review of publicly available data sources aims to assess the extent to which alcohol control policies in Southeast Asia align with the World Health Organization (WHO)’s SAFER framework. Data on alcohol consumption, gross domestic product (GDP) per capita, religious demographics, and life expectancy were obtained from recent publicly available sources, including the World Bank Group and the WHO. Policy data were collected from official legal documents in each country’s official language(s). Measures targeting drink-driving, alcohol availability, and alcohol advertising were most frequently implemented. All countries had some form of alcohol taxation, although levels and structures varied. Treatment services for alcohol use disorders were seldom available. The findings highlight key policy gaps and regional disparities in alcohol regulation. These insights may guide policymakers and stakeholders in developing more effective and harmonized alcohol control strategies. Limitations of the review include the lack of detailed data on policy enforcement and the exclusion of alcohol-related policies not covered by the SAFER framework.

Frailty and cognitive impairment are two major geriatric syndromes occurring at a rapid rate in low- and middle-income countries (LMIC) in Asia. This study aimed to provide a detailed overview of the Transforming Cognitive Frailty into Later-life Self-Sufficiency (AGELESS) cohort and to perform a bibliometric analysis. Participants were recruited from eight of the 14 states in Malaysia. Basic demographics, cognitive function, medical history, psychological well-being, health care utilization, physical performance and laboratory, including blood and stool, samples were collected. A Google Scholar search and bibliometric analysis was conducted to identify publications, journals, keywords and main findings. The AGELESS dataset contains data from 6064 individuals aged ≥55 years at recruitment from 2012. One hundred and eighty-seven papers have been published to date on healthy ageing, dementia and health care. Key published findings were in the areas of cognitive health and ageing, blood-based biomarkers, frailty, chronic disease, social support, quality of life, technology, as well as nutrition and lifestyle. In conclusion, the AGELESS study contributed to data addressing the imbalance in published research from LMIC. While the continuity of the cohort had been challenged by resource and infrastructure constraints, findings from the longitudinal cohort had been invaluable for informing local practices and policies.

Measles remains endemic in Pakistan despite global vaccine efforts to prevent its transmission. This study sought to identify the patterns of measles cases in Pakistan, understand the reasons for its recurrence, and determine the optimal timing for measles vaccine campaigns in Pakistan to be most effective. As such, a time series analysis of the monthly measles incidence in Pakistan from 2014 to 2024, obtained from World Health Organization’s international measles database, was performed to identify temporal patterns in infections. An increasing trend was identified in the monthly measles cases overtime, along with seasonal swings of low occurrences during the summer, with average lows reaching 304 cases, and a rise during the winter months, with average highs reaching 1038 cases. An automated Seasonal Auto-Regressive Integrated Moving Average (SARIMA) model was further applied to forecast the future incidence of measles, which revealed a three-fold increase in measles cases in the next two years, compared with 2023-2024. Low routine vaccine coverage, topped with climate change related migration and subsequent crowding in urban spaces were found to be major contributors to measles transmission in the country. Findings suggest that supplementary vaccination campaigns are essential and if held in August–September, can mitigate the anticipated rise in measles transmission beginning October every year.

Mother-to-child transmission (MTCT) is a primary source of hepatitis B virus (HBV) infection in endemic regions. The World Health Organization (WHO) aims to reduce HBV seroprevalence among children under five to less than 0.1% by 2030. In Malaysia, the seroprevalence of hepatitis B surface antigen (HBsAg) in children has declined to 0.4%, but additional measures are needed. A pilot study in Sarawak, Malaysia, screened 474 pregnant women for HBsAg. Those with high MTCT risk received tenofovir disoproxil fumarate from 28 weeks of gestation to 12 weeks postpartum. Infants received timely birth-dose HBV vaccine and hepatitis B immunoglobulin (HBIG) where indicated. Among screened women, 1.9% were HBsAg positive, with 55.6% newly diagnosed. No MTCT cases were observed. Risk factors included maternal age over 35 years old household exposure, and sexual transmission risk. These findings demonstrate the feasibility of WHO’s PMTCT strategies in low-resource settings, supporting nationwide expansion in Malaysia.

Measles remains a global health threat, and rising vaccine hesitancy in Malaysia underscores the need for locally tailored communication strategies to strengthen public trust and vaccination. This current research developed and validated the Parental Health Education (PaHE)-Measles toolkit, grounded in the Health Belief Model, to support parental confidence and the uptake of measles, mumps, and rubella (MMR) vaccination in Malaysia through a four-stage process: information gathering, preliminary adaptation design, preliminary adaptation testing, and adaptation refinement. Five multidisciplinary experts validated its content both in Malay and English, and 10 health care providers confirmed overall quality. The acceptability was assessed among 30 end-users. The PaHE-Measles achieved a Content Validity Index (CVI) score of 1.0 from expert reviewers, whereas health care providers rated its understandability and actionability more than 80%. End-users reported an average score of over 9.0. In conclusion, PaHE-Measles is a valid and ready toolkit for educating parents, countering misinformation, and strengthening vaccine confidence.

While COVID-19-related stigma perception is recognized as a mental health risk, its effects on the general population are understudied. This study examined the link between stigma perception and symptoms of anxiety disorder among the general population in South Korea. This study used data from a nationwide survey, the Korean National Mental Health Survey related to COVID-19. Anxiety symptoms were measured using the Generalized Anxiety Disorder 7-item scale (GAD-7). Stigma perception was assessed with a single question and categorized as “No,” “Yes,” or “Strongly Yes.” Logistic regression was used, adjusting for demographic, socioeconomic, COVID-19-related, and health-related factors. Results showed that 12.7% of respondents met the criteria for anxiety disorder. Compared with those who perceived no stigma, individuals who answered “Yes” had 2.12 (95% CI [1.31, 3.46]) times higher odds of anxiety, and those who answered “Strongly Yes” had 6.61 (95% CI [3.75, 11.62]) times higher odds. Other significant factors included marital status, lower income, worsened economic conditions during the pandemic, subjective stress, poor sleep quality, and underlying health conditions. These findings suggest that stigma perception related to COVID-19 is a strong and independent risk factor for anxiety. Public health interventions should incorporate anti-stigma strategies to support mental health during and beyond pandemic.

This study investigated the association of COVID-19 booster vaccine hesitancy with health literacy (HL) and the number of information sources used in Japan. Using data from a longitudinal survey of 6601 vaccinated participants, multivariable logistic regression was used to estimate adjusted odds ratios (AORs). Of the participants, 6.6% were hesitant toward the booster. Higher HL was associated with lower odds of hesitancy (AOR = 0.85, 95% CI = 0.77-0.94). Of its subscales, communicative (AOR = 0.86, 95% CI = 0.79-0.95) and critical (AOR = 0.90, 95% CI = 0.83-0.99) literacy were significantly associated with lower hesitancy, but functional literacy was not. Using more diverse information sources (>3 vs. ≤3) was also associated with lower hesitancy (AOR = 0.70, 95% CI = 0.57-0.87). Higher communicative and critical HL and the use of diverse information sources were associated with lower booster hesitancy. Enhancing these capabilities may be a key strategy for increasing vaccination rates.

The present study examined how perceived barriers to leisure-time physical activity (LTPA) differed by socioeconomic status (SES) (household income, years of education, and occupation), considering the relationships among barriers and distinguishing between barriers to initiation and maintenance. In this study, 2024 nationwide survey data from 27 197 (13 634 women and 13 563 men) Japanese adults aged 18 to 64 years were analyzed. The key findings are as follows. The types of perceived barriers were classified into “health issues,” “lack of time,” “dislike/hassle,” and so on. “Health issues” was negatively associated with household income and years of education. With respect to the barriers to initiating LTPA, years of education was negatively associated with “dislike/hassle,” whereas higher education increased the likelihood of “lack of time” as a barrier to adhering to LTPA. In addition, lower economic status was associated with maintenance-stage barriers among women, underscoring the need for promotion strategies tailored to both SES and LTPA stages.

Micronutrient sufficiency is essential for health, yet many Chinese adults fall short of recommended intake levels. Using data from 12 382 adults in the China Health and Nutrition Survey, this study examined the prevalence of micronutrient sufficiency—defined by 2023 Dietary Reference Intakes for six vitamins and seven minerals—and its associations with subjective well-being (SWB), health care costs, and mortality. Only 10% of adults met sufficiency criteria. Sufficient intake was associated with higher odds of life satisfaction (OR = 1.12, 95% CI [1.02, 1.24], P < .05), with stronger effects in women (OR = 1.16, 95% CI [1.02, 1.32]) and those aged 40 to 49 (OR = 1.44, 95% CI [1.15, 1.79]). No significant association was found with mortality (HR = 1.02, 95% CI [0.75, 1.38]). However, sufficiency was linked to a 7% annual reduction in health care costs (−140.4 Yuan), largely mediated by improved SWB. These results highlight the low prevalence of adequate micronutrient intake and suggest potential benefits for mental well-being and health care savings, supporting the need for targeted nutrition policies in China.

Child health and well-being remain a challenge in Indonesia, partly due to low health insurance coverage among children younger than five, especially in informal sector households. Many informal workers are not classified as poor, making insurance unaffordable for their families. Using data from the 2022 National Socio-economic Survey (SUSENAS), this study examined the social determinants of health insurance ownership among children younger than five years old, focusing on household head employment, child health, and family well-being. Results show that children from households of informal workers are less likely to be insured than those from formal sector households (adjusted odds ratio [AOR] = 0.80, 95% CI [0.76, 0.84]). Low education (AOR = 1.30, 95% CI [1.23, 1.37]) and poverty further reduce access, while having a national identity number (AOR = 4.10, 95% CI [3.78, 4.45]) increase the likelihood of coverage.

This cross-sectional study examined sociodemographic factors influencing diet quality among 691 Cambodian schoolchildren aged 6 to 11 years. The average Global Dietary Recommendation (GDR) score was 9.47, with 49% achieving a GDR-healthy diet. Only 15.63% consumed All-5 recommended food groups, whereas 63.53% met the minimum dietary diversity (MDD). After adjusting for confounding factors, children aged 9 to 11 years were significantly more likely to consume all five food groups than those aged 6 to 8 years (adjusted odds ratio [AOR] = 1.55, 95% confidence interval, CI [1.02, 2.37], P = .04). Schoolchildren with caregivers having only primary education were significantly less likely to meet the MDD (AOR = 0.49, 95% CI [0.27, 0.90], P = .02). Interventions should prioritize improving diet quality among school-aged children by fostering multisectoral collaboration to create healthier school food environments and ensure access to diverse, nutritious foods.

Workplace bullying (WPB) remains a persistent occupational hazard in Malaysian health care, particularly affecting house officers who face heavy workloads and rigid hierarchies. This study examined the prevalence of WPB among house officers in Malaysian public hospitals and explored its association with Psychosocial Safety Climate (PSC) and conflict management styles (CMS). A multicentre cross-sectional study was conducted across thirteen hospitals using validated instruments. Multivariable regression analyses identified key factors while adjusting for sociodemographic and institutional factors. WPB affected 23.4% of respondents. Higher PSC (β = −0.70; P ≤ .001), problem-solving CMS (β = −1.08; P ≤ .001), longer employment duration (β = −0.21; P = .032), and female gender (β = −4.32; P ≤ .001) were associated with lower WPB. Increasing age (β = 0.77; P = .033), ethnic minority (β = 5.79; P ≤ .001), and avoidance (β = 0.47; P = .049) and forcing (β = 0.99; P ≤ .001) CMS were associated with higher WPB. The findings highlight the importance of strengthening PSC and enhancing conflict management skills to promote safer and healthier working environments.

Undergraduate public health programs have expanded in Asia, yet little is known about how national contexts shape curriculum design and workforce preparation. This study compared the undergraduate public health curricula of Taiwan and Vietnam to examine how governance structures, health system priorities, and workforce needs influence educational models. A comparative curriculum analysis was conducted using official program documents, supported by interviews with senior faculty to contextualize policy and institutional factors. Courses were categorized into major domains to assess required and elective distributions, thematic emphases, specialization pathways, and internship structures. Taiwan’s curriculum emphasizes flexibility and specialization, with extensive electives and strong representation in environmental and occupational health, epidemiology, and quantitative analysis, alongside pathways linked to professional certification. Vietnam’s curriculum is standardized and community-oriented, emphasizing foundational medical sciences, communicable disease control, health promotion, and sequenced community-based internships that reflect its vertically organized preventive health system. Differences in experiential learning and credentialing opportunities further distinguish workforce preparation in the two countries. The findings show that curriculum architecture mirrors broader national development priorities and system capacities. The study underscores the importance of competency-based and context-responsive curriculum reform and provides insights for strengthening public health workforce readiness across the Asia-Pacific region.