The epidemiology of smoking and e-cigarette use in the Hungarian adult population in 2018 / A dohányzás és az e-cigaretta-használat epidemiológiája a felnott magyar népesség körében 2018-ban.

Összefoglaló. Bevezetés: Nagyszámú kutatás igazolta, hogy a dohányzás növeli a legjelentosebb krónikus betegségek kockázatát. Habár 2009 óta csökkeno tendenciát mutat Magyarországon a hagyományos dohányzók aránya, az e-cigarettát kipróbálóké az utóbbi években folyamatosan növekszik. Célkituzés: A 2018-ban a felnott lakosság körében végzett Népegészségügyi Felmérés dohányzásra és e-cigaretta-használatra vonatkozó eredményeinek bemutatása az elozo vizsgálatok tükrében. Módszer: A kérdoíves felmérésben 1586 fo került személyesen lekérdezésre. Az iteratív súlyozás a többlépcsos mintavételi designhatást és a 2016-os mikrocenzus adatait vette figyelembe. Eredmények: 2018-ban a dohányzók aránya a magyar felnott lakosság körében 28,7% (95% MT: 26,3-31,1%), az e-cigarettát használók aránya pedig 1,7% (95% MT: 1,1-2,5%) volt. Az iskolai végzettség a 65 év alattiak esetében a dohányzást befolyásoló tényezo volt (EH: 3,32; 95% MT: 2,53-4,34), de a 65 éves és annál idosebb korcsoportban már nem (EH: 1,11; 95% MT: 0,59-2,09). Az e-cigarettát kipróbálók és használók között a leginkább említett (54,3% 95% MT: 44,0-64,5%) motivációs tényezocsoport a dohányzásról való leszokással, az ártalomcsökkentéssel és a visszaesés megelozésével volt kapcsolatos. A 65 éves és idosebb korcsoportban a dohányzók aránya 2015-höz képest emelkedett. 2018-ban az alapfokú iskolai végzettséguek körében volt a legmagasabb a dohányzók aránya, míg 2014-ben az érettségivel nem rendelkezo középfokú végzettséguek körében. Következtetés: Bár összességében csökkent, az alacsony iskolai végzettséguek és az idosek körében emelkedett a dohányzók aránya Magyarországon. Az e-cigarettát kipróbálók és használók száma növekvo tendenciát mutat hazánkban. Eredményeink az alacsony iskolai végzettséguekre kiemelten fókuszáló, megelozo és leszokást támogató népegészségügyi alprogramokat is tartalmazó komplex beavatkozást sürgetnek. Orv Hetil. 2022; 163(1): 31-38. INTRODUCTION: The body of evidence suggests that smoking increases the risk of the most prevalent chronic diseases. Although the proportion of traditional smokers in Hungary has been on a declining trend since 2009, the proportion of those who tried e-cigarette has been steadily increasing in recent years. OBJECTIVE: To present - in the light of previous studies - the results of the Public Health Survey among adults in 2018 on smoking and e-cigarette use. METHOD: 1586 persons were personally interviewed in a survey. The iterative weighting algorithm considered both the design effect of multistaged sampling and the 2016 Hungarian microcensus. RESULTS: In 2018, the proportion of smokers in the Hungarian adult population was 28.7% (95% CI 26.3-31.1%), and the proportion of e-cigarette users was 1.7% (95% CI 1.1-2.5%). Educational level was a predictor of smoking among respondents younger than 65 years old (OR 3.32; 95% CI 2.53-4.34), but not for those aged 65 years or older (OR 1.11; 95% CI 0.59-2.09). Among e-cigarette ever or current users, the most commonly mentioned (54.3% 95% CI 44.0-64.5%) motivational factor-group to try or use e-cigarettes included motivations to quit smoking, to reduce harm, and to avoid relapsing. In the population aged 65 years old or older, the proportion of smokers increased compared to 2015. The proportion of smokers was the highest among those with primary education in 2018, while in 2014, it was the highest among those with secondary education without a graduation certificate. CONCLUSION: In Hungary, although overall smoking rates are declining, the smoking rate in the low educational group and among the elderly increased. The number of people trying or using e-cigarettes is showing an increasing trend in our country. Our results call for a complex public health intervention program including prevention and smoking cessation supporting subprograms with high focus on those with primary education. Orv Hetil. 2022; 163(1): 31-38.

Methodology and implementation of the WHO European Childhood Obesity Surveillance Initiative (COSI).

Establishment of the WHO European Childhood Obesity Surveillance Initiative (COSI) has resulted in a surveillance system which provides regular, reliable, timely, and accurate data on children's weight status-through standardized measurement of bodyweight and height-in the WHO European Region. Additional data on dietary intake, physical activity, sedentary behavior, family background, and school environments are collected in several countries. In total, 45 countries in the European Region have participated in COSI. The first five data collection rounds, between 2007 and 2021, yielded measured anthropometric data on over 1.3 million children. In COSI, data are collected according to a common protocol, using standardized instruments and procedures. The systematic collection and analysis of these data enables intercountry comparisons and reveals differences in the prevalence of childhood thinness, overweight, normal weight, and obesity between and within populations. Furthermore, it facilitates investigation of the relationship between overweight, obesity, and potential risk or protective factors and improves the understanding of the development of overweight and obesity in European primary-school children in order to support appropriate and effective policy responses.

Vaping-Related Adverse Events and Perceived Health Improvements: A Cross-Sectional Survey among Daily E-Cigarette Users.

Web-based samples of e-cigarette users commonly report significant vaping-related health improvements (HIs) and mild adverse events (AEs). This cross-sectional study with in-person interviewing data collection examined self-reported AEs and perceived HIs among Hungarian adult current daily exclusive e-cigarette (n = 65) and dual users (n = 127), and former daily e-cigarette users (n = 91) in 2018. Logistic regression was used to evaluate associations between reporting any AEs/HIs, vaping status, and covariates. More former users (52.7%) reported AEs than current users (39.6%; p = 0.038). Exclusive and dual daily users reported similar rates of AEs (44.6% and 37.0%, respectively; p = 0.308). More current users (46.9%) experienced HIs than former users (35.2%; p = 0.064). Exclusive daily users were more likely to report HIs than dual users (63.1% versus 38.6%; p = 0.001). Former user status and smoking cessation/reduction reasons increased the odds of reporting AEs, whereas nicotine-containing e-liquid use and older age decreased the odds of reporting AEs. Exclusive vaper status, using advanced generation devices, and smoking cessation/reduction reasons increased the odds of experiencing HIs. This study, which used a traditional data collection methodology, found a higher rate of AEs and a lower rate of HIs compared to web-based surveys. Our results highlight that experiencing AEs and HIs is affected by users' characteristics, in addition to the device and e-liquid type.

Dietary Sodium and Potassium Intake in Hungarian Elderly: Results from the Cross-Sectional Biomarker2019 Survey.

High sodium intake and inadequate potassium intake are associated with high blood pressure. The elderly are more salt sensitive than other age groups, yet a reliable estimate of the dietary sodium and potassium intake of this age group in Hungary is unavailable. The study aimed to estimate the sodium and potassium intakes in the Hungarian elderly from 24 h urine sodium and potassium excretion. In this cross-sectional study, participants were selected from patients of general practitioners practicing in western Hungary. The participants comprised 99 men and 90 women (mean age 67.1 (SD 5.4] years) who participated in the Biomarker2019 survey and returned a complete 24 h urine collection. We assessed dietary sodium and potassium by determining 24 h urinary sodium and potassium excretions and 3-day dietary records. The mean urinary sodium was 188.8 (73.5) mmoL/day, which is equivalent to 11.0 g of salt/day; and the mean urinary potassium was 65.8 (24.3) mmoL/day, which is equivalent to 3.03 g of potassium/day, after adjusting for non-urinary potassium losses. Only 7% of the subjects met the World Health Organization's recommended target of less than 5 g of salt/day, and 33% consumed at least the recommended potassium amount of 3.5 g/day, based on the estimates from 24 h urine excretion. For most elderly, sodium intake exceeds, and potassium does not reach, dietary recommendations. The results underline the need to intensify salt reduction efforts in Hungary.

Socioeconomic differences in food habits among 6- to 9-year-old children from 23 countries-WHO European Childhood Obesity Surveillance Initiative (COSI 2015/2017).

BACKGROUND: Socioeconomic differences in children's food habits are a key public health concern. In order to inform policy makers, cross-country surveillance studies of dietary patterns across socioeconomic groups are required. The purpose of this study was to examine associations between socioeconomic status (SES) and children's food habits. METHODS: The study was based on nationally representative data from children aged 6-9 years (n = 129,164) in 23 countries in the World Health Organization (WHO) European Region. Multivariate multilevel analyses were used to explore associations between children's food habits (consumption of fruit, vegetables, and sugar-containing soft drinks) and parental education, perceived family wealth and parental employment status. RESULTS: Overall, the present study suggests that unhealthy food habits are associated with lower SES, particularly as assessed by parental education and family perceived wealth, but not parental employment status. We found cross-national and regional variation in associations between SES and food habits and differences in the extent to which the respective indicators of SES were related to children's diet. CONCLUSION: Socioeconomic differences in children's food habits exist in the majority of European and Asian countries examined in this study. The results are of relevance when addressing strategies, policy actions, and interventions targeting social inequalities in children's diets.

Substantial variation across geographic regions in the obesity prevalence among 6-8 years old Hungarian children (COSI Hungary 2016).

BACKGROUND: There have been previous representative nutritional status surveys conducted in Hungary, but this is the first one that examines overweight and obesity prevalence according to the level of urbanization and in different geographic regions among 6-8-year-old children. We also assessed whether these variations were different by sex. METHODS: This survey was part of the fourth data collection round of World Health Organization (WHO) Childhood Obesity Surveillance Initiative which took place during the academic year 2016/2017. The representative sample was determined by two-stage cluster sampling. A total of 5332 children (48.4% boys; age 7.54 ± 0.64 years) were measured from all seven geographic regions including urban (at least 500 inhabitants per square kilometer; n = 1598), semi-urban (100 to 500 inhabitants per square kilometer; n = 1932) and rural (less than 100 inhabitants per square kilometer; n = 1802) areas. RESULTS: Using the WHO reference, prevalence of overweight and obesity within the whole sample were 14.2, and 12.7%, respectively. According to the International Obesity Task Force (IOTF) reference, rates were 12.6 and 8.6%. Northern Hungary and Southern Transdanubia were the regions with the highest obesity prevalence of 11.0 and 12.0%, while Central Hungary was the one with the lowest obesity rate (6.1%). The prevalence of overweight and obesity tended to be higher in rural areas (13.0 and 9.8%) than in urban areas (11.9 and 7.0%). Concerning differences in sex, girls had higher obesity risk in rural areas (OR = 2.0) but boys did not. Odds ratios were 2.0-3.4 in different regions for obesity compared to Central Hungary, but only among boys. CONCLUSIONS: Overweight and obesity are emerging problems in Hungary. Remarkable differences were observed in the prevalence of obesity by geographic regions. These variations can only be partly explained by geographic characteristics. TRIAL REGISTRATION: Study protocol was approved by the Scientific and Research Ethics Committee of the Medical Research Council ( 61158-2/2016/EKU ).

Weight Status of 7-Year-Old Hungarian Children between 2010 and 2016 Using Different Classifications (COSI Hungary).

AIMS: To describe the prevalence of thinness, overweight, and obesity in Hungarian children (age 7.0-7.9 years) according to different classifications, to assess the progress between 2010 and 2016, and to investigate whether tendencies differ according to gender. METHODS: A national representative sample was generated by two-stage cluster sampling, and a total of 2,651 children (50.9% boys; age 7.49 ± 0.3 years) were measured (weight and height) in October 2016. Population estimates were calculated using the WHO, IOTF, and national cut-offs. RESULTS: Prevalence of thinness (including grade 1 and 2) was 12.6% based on the IOTF criteria and 15.6% based on the WHO definition. 22.5% of children were identified as overweight or obese according to the IOTF classification, compared with 28.4% according to the WHO definition. Between 2010 and 2016, each classification indicated possible stability in overweight and obesity prevalence. In contrast, the prevalence of thinness grade 2 almost doubled in 6 years according to all definitions (p < 0.05). No significant gender difference was observed in the progress. CONCLUSION: Overweight and obesity appeared to be stable over 6 years, but we detected growing thinness rates. Routine collection of high-quality data that are based on standardized and comparable methods is essential to monitor the childhood obesity problem.

[Hungarian Diet and Nutritional Status Survey - The OTAP2014 study. V. Vitamin intake of the Hungarian population]. / Országos Táplálkozás- és Tápláltsági Állapot Vizsgálat ­ OTÁP2014. V. A magyar lakosság vitaminbevitele.

INTRODUCTION AND AIM: The Hungarian Diet and Nutritional Status Survey was implemented on a sub-sample of the European Health Interview Survey. In this paper, the authors present the data on the vitamin intake of the Hungarian population. METHOD: The survey represents the vitamin intake of the Hungarian non-institutionalised adult population of 18 years and older. There are significant differences between men's and women's vitamin intake. RESULTS: The intake of all water-soluble vitamins except for vitamin C is higher in men than in women, and the difference between the genders regarding the intake of vitamin E and D is significant. The intake of vitamin B1, B2, B6, B12, niacin and vitamin C is in line with the recommendations, however, there is an unfavourable decrease in the intake of vitamin A and ß-carotene in the case of men compared to the previous survey. Vitamin D and folic acid intakes are critically low, particularly in the elderly, and mainly in case of vitamin D. The population's intake of panthotenic acid and biotin did not reach the recommendations. CONCLUSION: In order to reach the dietary reference intakes and to prevent deficiencies, it is necessary to inform the population and to make healthy food choices available. Orv Hetil. 2017; 158(33): 1302-1313.

[Hungarian Diet and Nutritional Status Survey - The OTAP2014 study. IV. Microelement intake of the Hungarian population]. / Országos Táplálkozás és Tápláltsági Állapot Vizsgálat ­ OTÁP2014. IV. A magyar lakosság mikroelem-bevitele.

INTRODUCTION AND AIM: The Hungarian Diet and Nutritional Status Survey examined the dietary habits of the Hungarian population. This publication presents the microelement intake. METHOD: The survey represents the microelement intake of the Hungarian non-institutionalised adult population of 18 years and older. RESULTS: While the intake of iron, copper and manganese corresponded with the recommendations in males, in females it was insufficient. The iron intake of women in their reproductive age (9.8 mg/d) stayed well below the recommendation, thus representing a high health risk. In comparison to earlier Hungarian data chromium intake decreased significantly in both sexes (men p = 0.000, women p = 0.008) and the zinc intake of men (9.6 mg/d) decreased below recommended. CONCLUSION: Since the consumption of whole grain products with high microelement content in Hungary is very low, it would be favourable to increase the proportion of these foods in the diet. In case of women it is also necessary to increase the consumption of food groups (e.g. meat, fruits) contributing to the iron intake. Furthermore, communication of adequate nutrition, and the availability of healthy foods is essential for the entire population. Orv Hetil. 2017; 158(21): 803-810.

[Hungarian Diet and Nutritional Status Survey - OTÁP2014. II. Energy and macronutrient intake of the Hungarian population]. / Országos Táplálkozás és Tápláltsági Állapot Vizsgálat ­ OTÁP2014. II. A magyar lakosság energia- és makrotápanyag-bevitele.

INTRODUCTION AND AIM: The aim of the study was to assess and monitor the dietary habits and nutrient intake of Hungarian adults. METHOD: Three-day dietary records were used for dietary assessment, the sample was representative for the Hungarian population aged ≥18ys by gender and age. RESULTS: The mean proportion of energy from fat was higher (men: 38 energy%, women: 37 energy%), that from carbohydrates was lower (men: 45 energy%, women: 47 energy%) than recommended, the protein intake is adequate. CONCLUSION: Unfavorable change compared to the previous survey in 2009 was the increase of fat and saturated fatty acid energy percent in women, the decrease in fruit and vegetable consumption, which explains the decreased fiber intake. An increasing trend in added sugar energy percent in each age groups of both genders was observed compared to 2009. Interventions focusing on the promotion of fruit and vegetable consumption and decreasing of saturated fat and added sugar intake are needed. Orv. Hetil., 2017, 158(15), 587-597.

[Hungarian Diet and Nutritional Status Survey - OTÁP2014. III. Macroelement intake of the Hungarian population]. / Országos Táplálkozás és Tápláltsági Állapot Vizsgálat ­ OTÁP2014. III. A magyar lakosság makroelem-bevitele.

INTRODUCTION AND AIM: The Hungarian Diet and Nutritional Status Survey examined the dietary habits of the Hungarian adult population. The aim of the study is to present the macroelement intake of the population. METHOD: The study represents the macrolement intake of the population with age 18 or over on the day of 31 December 2013, of those who are non-institutionalised. RESULTS: Salt intake decreased compared to the findings of the previous study in 2009 but it is still extremely high (15.9 g in men and 11.2 g in women). The potassium intake is below the recommendation, which together with a high sodium intake increases the risk of high blood pressure. Calcium intake in the youngest age group reached the recommendations, whereas the intake in the oldest age group was well below the references. Magnesium intake complied with the recommendation, the intake of phosphorus however exceeded it. High sodium intake still represents substantial public health risk. CONCLUSION: The reduction that occured in the population's salt intake since 2009 demonstrates the effectiveness of implemented prevention programs, cooperation with the industry and public awareness campaigns. Orv Hetil. 2017; 158(17): 653-661.

[Hungarian Diet and Nutritional Status Survey 2014. I. Nutritional status of the Hungarian adult population]. / Országos Táplálkozás és Tápláltsági Állapot Vizsgálat 2014. I. A magyar felnott lakosság tápláltsági állapota.

INTRODUCTION AND AIM: The Hungarian Diet and Nutritional Status Survey examines the obesity prevalence, dietary habits and, since 2014, physical activity in Hungarian adults in every 5 years. METHOD: The survey provides national data representative by age and gender, based on anthropometric measurements and international standards. RESULTS: In 2014, nearly two-thirds of adults were overweight or obese. 28.2% of men and 31.5% of women were obese. Prevalence of morbid obesity were 2.6% and 3.3% in men and women, respectively. Abdominal obesity was more prevalent among women than men (55% vs. 38%), and the rate was increasing with age in both genders. In elderly, 55% of men and almost 80% of women were abdominally obese. CONCLUSION: In conclusion, the prevalence of overweight, obesity, and abdominal obesity is high in Hungarian adults. In order to tackle obesity, we need to obtain representative and measured data, which form the basis of targeted interventions and the assessment of their impact. Orv. Hetil., 2017, 158(14), 533-540.

[Hungarian Diet and Nutritional Status Survey -- the OTAP2009 study. III. Vitamin intake of the Hungarian population]. / Országos Táplálkozás és Tápláltsági Állapot Vizsgálat - OTÁP2009. III. A magyar lakosság vitaminbevitele.

UNLABELLED: For the healthy status the adequate intake of vitamins is essential. AIM AND METHOD: The Hungarian Diet and Nutritional Status Survey - joining to the European Health Interview Survey - studied the dietary habits of the Hungarian population. This work presents the vitamins intake. RESULTS: The intake of all water soluble vitamins, vitamin E and D were significantly higher in men than in women. Favourable phenomena were the increased ß-carotene and vitamin C intakes in men and women compared to the earlier data. Intakes of vitamin C, B1-, B2-, B6- and B12, and niacin meet the recommendations. Crucially low intakes of vitamin D and folate were calculated in both genders, particularly in the elders, mainly in case of vitamin D. Imperfect intakes of panthotenic acid and biotin were also observed. CONCLUSIONS: For maintaining the adequate vitamin supply and for prevention of vitamin deficiency, diversified nutrition, information of the population on the basic principles of healthy nutrition and availability of healthy food are essential.

[Hungarian Diet and Nutritional Status Survey -- the OTAP2009 study. II. Energy and macronutrient intake of the Hungarian population]. / Országos Táplálkozás és Tápláltsági Állapot Vizsgálat - OTÁP2009. II. A magyar lakosság energia- és makrotápanyag-bevitele.

UNLABELLED: The Hungarian Diet and Nutritional Status Survey is the fourth in the row of the Hungarian national dietary surveys conducted by the Institute for Food and Nutrition Science. AIMS: The present study was performed to provide valid, up-to-date data on energy and nutrient intakes and dietary habits of the Hungarian adult population. METHODS: The energy and nutrient intakes were calculated on validated three-day dietary records of a representative sample by age and gender of the Hungarian population aged ≥ 18 ys. RESULTS: The energy percentage of fat was too high (39 E% for men and 36 E% for women), that of carbohydrate was too low (45 E% for men and 48 E% for women), whereas that of protein met the recommendation (15 E% for men and 15 E% for women). CONCLUSIONS: Reduction of the nutritional risk factors would greatly reduce the mortality and morbidity rates of nutrition-related diseases.

[Hungarian Diet and Nutritional Status Survey - the OTAP2009 study. IV. Macroelement intake of the Hungarian population]. / Országos Táplálkozás és Tápláltsági Állapot Vizsgálat - OTÁP2009. IV. A magyar lakosság makroelem-bevitele.

UNLABELLED: The adequate intake of minerals is basically important for healthy nutrition. AIM AND METHOD: The Hungarian Diet and Nutritional Status Survey - joining to the European Health Interview Survey - studied the dietary habits of the Hungarian population. The present publication describes the macroelement intake. RESULTS: The salt intake is unusually high (17.2 g in men and 12.0 g in women), the potassium intake remains well below the recommendation. These factors substantially increase the risk of cardiovascular diseases including high blood-pressure. The calcium intake stays below the recommendation except in the youngest males, the oldest men and women are at risk from this point of view. While magnesium intake suited the recommendation, the intake of phosphorus exceeded it twice. CONCLUSIONS: Focusing on marcroelements, high sodium/salt intake represents the highest public health risk. The implementation of STOP SALT! National Salt Reducing Programme, i.e. decrease the salt content of processed food and provide proper information to the population about excessive salt consumption, should result in a beneficial change of salt intake and ameliorate the public health conditions.

[Hungarian Diet and Nutritional Status Survey -- the OTAP2009 study. V. Intake of microelements in the Hungarian population]. / Országos Táplálkozás és Tápláltsági Állapot Vizsgálat - OTÁP2009. V. A magyar lakosság mikroelem-bevitele.

UNLABELLED: For a healthy status the adequate intake of microelements is vital. AIM AND METHOD: The Hungarian Diet and Nutritional Status Survey - joining to the European Health Interview Survey - studied the dietary habits of the Hungarian population. The present paper demonstrates the microelement intake. RESULTS: While the intake of iron, copper and zinc was sufficient in males, it was deficient in females according to the Hungarian recommendations. Especially women in their reproductive age ingested iron below the recommendation, thus representing a health risk. In comparison to earlier Hungarian data, zinc and chromium intake decreased unfavorable. CONCLUSIONS: Since in Hungary the consumption of the whole grain products with high trace element content is traditionally low, as also reflected in the present study, it would be desirable to increase the contribution of these foods in the diet in order to enhance the intake of microelements.

[Hungarian diet and nutritional status survey -- the OTAP2009 study. I. Nutritional status of the Hungarian population]. / Országos Táplálkozás- és Tápláltsági Állapot Vizsgálat - OTÁP2009. I. A magyar lakosság tápláltsági állapota.

UNLABELLED: Obesity is a leading public health problem, but representative data on measured prevalence among Hungarian adults has been missing since the late eighties. AIM AND METHOD: Joining in European Health Interview Survey the aim of the OTAP2009 study was to provide data representative by age and gender on the prevalence of obesity and abdominal obesity among Hungarian adults based on their measured anthropometric data. RESULTS: Participation rate was 35% (n = 1165). Data shows that nearly two-thirds of adults are overweight or obese. 26.2% of men and 30.4% of women are obese. Prevalence of morbid obesity is 3.1% and 2.6% in men and women, respectively. Abdominal obesity is more prevalent among women than men (51.0% vs. 33.2%), and rate is increasing parallel with age in both gender. In elderly, 55% of men and almost 80% of women are abdominally obese. CONCLUSIONS: Besides interventions of population level for tackling obesity, individual preventive measures are indispensable.

[Analysis of associations between mortality and biological and social-economic individual determinants]. / A halandóságot befolyásoló egyéni biológiai és társadalmi-gazdasági tényezok hatásrendszerének vizsgálata.

Health impact assessment is an internationally recognized tool for informed decision-making. The authors participated in building statistical models for assessing the health effects of decisions made inside and outside the health sector. They used logistic regression to investigate the role of individual factors like gender, age, education and economic activity determining the all-cause mortality and diseases of circulatory system and neoplasm as well. The results of statistical modelling proved that gender, education and economic activity modify the effect of age on mortality in multiple interactions. Since several factors have impact simultaneously on mortality, modifying the others' effects, analyzing these associations only by use of multivariate statistical methods is an adequate approach. Models presented in this article can be starting points for investigations exploring the effects of multiple health-determinants and researches in which also social-economic determinants are included in health impact assessment.

[How do social-economic differences in residential characteristics affect mortality? A literature review]. / Hogyan befolyásolják a térségi társadalmi-gazdasági különbségek a halandóságot? Irodalmi áttekintés.

Authors review studies on associations between mortality and geographic distribution of social-economic health determinants published in the last 15 years. Hungarian publications after the 1990ies identified several indicators with effect on mortality related to the place of residence such as size of the settlement, population density, joblessness, average income, education, and racial or ethnic mixture. As a rule, these papers analyzed time and geographically aggregated data with simple descriptive statistical approach. Major international studies, however, aside the area indicators commonly included individual data and applied multilevel statistical analysis. Earlier, the incoherent results of some complex statistical analyses were explained by lack of overall health concept, which could utilize effects both at individual and population levels. The most recent multilevel statistical methodology, using information related to spatial correlation and fitted to health models, can help researchers to better understand the causes and effects of health inequities.

Assessment of the health information system in Hungary / by Marta Bakacs, Csilla Kaposvari, Benigna Kiss, Jozsef Vitrai and Janos Vizi

This assessment of the National Health Information System (NHIS) in Hungary was conducted as part of a project of the WHO Regional Office for Europe. Its goal is to enable a better use of information in decision-making, while taking into account the other factors influencing decisions. The methodology was developed in Romania in June 2003, and then tested in the Czech Republic, Denmark, Hungary and Poland in 2004. This report is the result of the Hungarian experience. Semi-structured interviews of high-level key-informants, both decision-makers and professionals working in the field of health information, were performed by a Hungarian team, with the support of WHO. The project methodology is based on building capacities in the country. It aims at identifying gaps and unmet needs in all components of the Health Information System (HIS), both at national and district levels. It will serve as a basis for reviewing and strengthening the HIS; as a result, the HIS could be a better instrument for good governance, responsive to the needs of modern Public Health as expressed by different target audiences and users