The COVID-19 pandemic had an adverse impact on the mental health of frontline workers including firefighters. To better understand this occurrence, this cross-sectional study evaluated the prevalence of depression, anxiety, and stress among 105 operational team and elite team firefighters in Kota Bharu, Kelantan State, Malaysia before and after the pandemic. The Depression, Anxiety and Stress Scale-21 (DASS-21), a validated self-reporting survey tool, was used to assess symptoms of depression, anxiety, and stress among the survey respondents. Findings revealed that firefighters had an increased level of anxiety and depression during the post-pandemic period compared to the pre-pandemic period. However, there was a decrease in the stress levels (20%) reported by study participants. Respondents belonging to the operational team had a higher reported level of depression, anxiety, and stress than those from the elite team. This may be attributed the operational team being more exposed to the risk of COVID-19 infection on account of their routine and more voluminous workload. The findings of this study suggest that firefighters, in general, are at an increased risk of mental health problems as a result of the COVID-19 pandemic. Knowing this, it is important to consider these findings when addressing the prevention and management of mental health among firefighters. This includes providing additional support and devoting more resources to those who are most at risk for experiencing symptoms of mental health such as firefighters performing functions aligned with that of an operational team.

Financial shocks have an incredible socioeconomic effect on both developed and developing countries. Various recent studies demonstrated that bad public governance impacted public health across all nations. In fact, this study aims to use panel data for 21 countries from the Middle East and North Africa (MENA) region over the period 2000–2020 to scrutinize the effect of both governance and financial crises on public health. We use the generalized method of moments (GMM) approach to carry out the empirical analysis. The objective of using this method is to deal with the issue of endogeneity between exogen variables. Results outline that there is a significant positive association between public governance indicators and public health. Moreover, we found a strong negative association between financial shocks and public health. Thus, the direct negative impact of financial crisis on public health could be mitigated by the indirect positive impacts via institutions and good public governance. This study gives insights to policymakers to take appropriate measures to decrease the severity of the financial shocks and improve healthcare services.

The effectiveness of frailty intervention programs for older adults in Korean communities has been inconsistent, posing challenges for public health nurses (PHNs). This study aims to develop an evidence-based intervention using the Intervention Mapping (IM) Protocol. The program followed the IM Protocol’s six steps, which provide a systematic method for developing and implementing theory-based health promotion programs. In Step 1, the needs of the subjects were identified through systematic review and interviews. In Step 3, the theme of the program was established as ‘health promotion for frail older adults’, and the components and scope were confirmed. The contents of the program included concepts of social support and social networks. In Step 4, after conducting a pilot test, the results were reflected and modifications were made. In Step 6, the evaluation tool was revised, and an effective evaluation plan was established. The final program was designed based on the program and interview results. The pilot test in Step 4 involved a one-group pretest-posttest and focus group interview with 15 pre-frail older adults. The IM Protocol-based health promotion program effectively addressed the needs of the subjects and improved frailty issues.

Previous studies support the direct relationship between outdoor physical activity and natural spaces in cities. The Active City and Nature concept explores the relationship between urban, green and active environments; it aims to demonstrate the scientific evidence for the need for action to be taken to increase participation in active living and sport, leading to healthier cities and communities. Our research seeks to analyse the city’s natural spaces as scenarios to encourage physical activity and sport, through a combined study of qualitative research techniques: the use of a digital webGIS platform, collaborative maps made by citizens, and surveys conducted with citizens and the local government. This methodology has been tested in the city of Malaga, the European City of Sport 2020. The study of the city’s main sport areas, the waterfront and natural green spaces provided data on the types of physical activity taking place in each of these areas and the physical activity needs of citizens. This research argues that it is important to know the criteria of local communities for physical activity and/or sport in natural environments, as well as the main demands expressed. This will provide valuable information to design and manage natural public spaces as a means of promoting physical activity and healthy habits.

This article analyses the complex factors contributing to rising medical expenses, focusing on the senior citizen demographic in Malaysia. With the global aging population, notably in lower and middle-income countries, the study highlights the escalating medical and health insurance costs, driven by age, income source, modern healthcare, and geographical residence. The research draws on an extensive literature review, demographic analysis, and quantitative methods to examine these determinants. It critically analyzes Malaysia’s healthcare system, which operates on a dual-tier model, and the financial burden placed on senior citizens. The findings indicate that age, source of income, and geographical residence significantly influence medical expenses, whereas modern healthcare’s impact is not statistically significant. The study calls for government intervention, insurance industry adjustments, and private sector support to mitigate the financial strain on senior citizens. Recommendations include tax relief adjustments, National Health Insurance Scheme implementation, and employment sustainability for seniors. This research provides some recommendations to policymaking, the insurance industry, and academia by providing insights into managing the healthcare needs of an aging population sustainably.