SEARCHCROSS-SECTIONALpublic_health, epidemiology

cross-sectional·public_health, epidemiology, preventive_medicine, cardiology, addiction_medicine, nutrition·PMC10002111

Clustering of the Adult Population According to Behavioural Health Risk Factors as the Focus of Community-Based Public Health Interventions in Poland

International Journal of Environmental Research and Public Health · 5 authors, 3 centres

AI SUMMARY

FIDELITY 100%

POPULATIONAdult inhabitants of Poland aged 20+ (random representative sample of 3000)

INTERVENTIONCluster analysis to identify subgroups sharing behavioral risk factors; review of local health programmes

COMPARISONBetween identified clusters and general population; between health programme offerings and population needs

This summary was generated by AI from a single paper. It has not been reviewed by a clinician and is not clinical advice. Verify against the source before acting on it.

AGENT 01 · STRUCTURED SUMMARY

TRACE TO SOURCE

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TL;DR

This study identified four distinct clusters of behavioral risk factors in the Polish adult population using a 2018 national survey of 3000 respondents. One cluster, termed "Multi-risks" (26% of adults), was predominantly male (81%), aged ~50, with basic vocational education, and had alarmingly high rates of smoking (59%), alcohol problems (35%), unhealthy diet (79%), physical inactivity (64%), and overweight (73%). The clinical significance is that local health programmes in Poland rarely target multiple behavioral risk factors simultaneously and largely fail to reach this high-risk group, highlighting a critical gap in public health intervention design.

Full summary

3,229 CHARS

**Background:** Poland has a higher percentage of deaths due to cardiovascular diseases (43% vs. 37% EU average in 2017) and a higher proportion of deaths attributable to behavioral risk factors (44% vs. 37% in EU). The difference in life expectancy between men and women is 8 years, one of the highest in the EU. Despite this, studies on the co-occurrence of behavioral risk factors in the Polish population are rare. This study aimed to identify population subgroups sharing similar behavioral risk factors and socio-demographic characteristics, and to assess whether local health programmes address their needs.

**Methods:** A questionnaire survey was conducted in Autumn 2018 on a random representative sample of 3000 Polish inhabitants aged 20+. The sample was drawn from the PESEL registry using stratification by province and residence location class, with two-stage sampling (communes then individuals). Experienced interviewers used CAPI methodology. TwoStep cluster analysis was applied using binary variables (sex, marital status, rural/urban residence, smoking, alcohol problems, overweight, lack of recreational physical activity, unhealthy diet, low fruit/vegetable intake, infrequent fish consumption, lack of preventive examinations/vaccination), categorical variable (education), and quantitative variable (age). All 228 health programmes submitted to AOTMiT for 2018 were reviewed.

**Key Results:** Four clusters were identified: (1) "The youngest" (29% of adults) — high unhealthy food intake, low preventive care; (2) "Multi-risks" (26%) — all risk factors much more frequent than general population; (3) "The oldest" (27%) — low physical activity, high overweight/obesity; (4) "Healthy lifestyle" (18%) — all risk factors significantly less common. The "Multi-risks" cluster had: 59% [95% CI: 56–63%] smoking, 35% [32–38%] alcohol problems, 79% [76–82%] unhealthy food, 83% too few vegetables/fruit, 64% [60–67%] physically inactive, 73% [70–76%] overweight. This group was 81% [79–84%] male, average age 50, 53% [50–57%] with basic vocational education. In 2018, only 40 of 228 health programmes addressed behavioral risk factors in adults; only 20 referred to more than one habit. No programmes were dedicated exclusively to reducing behavioral risk factors. 34% of adult programmes targeted people over 60/65, and 40% of all programmes were for children/adolescents only.

**Clinical Implications:** The "Multi-risks" cluster, constituting ~25% of Polish adults, represents a critical target for public health intervention. These individuals have multiple modifiable risk factors but are largely unreached by current health programmes, which focus on vaccination, screening, and rehabilitation rather than comprehensive lifestyle modification. Over one-third of this cluster did not seek medical help in the past year, and nearly three-quarters undertook no preventive measures. The authors recommend tailored, culture-sensitive interventions, potentially delivered through primary care or occupational medicine settings, and emphasize that local health programmes need to move beyond formal age/disease criteria to address the clustering of behavioral risk factors in specific socio-demographic groups.

PICO

PPOPULATION

Adult inhabitants of Poland aged 20+ (random representative sample of 3000)

IINTERVENTION

Cluster analysis to identify subgroups sharing behavioral risk factors; review of local health programmes

OOUTCOME

Prevalence of behavioral risk factors (smoking, alcohol problems, unhealthy diet, physical inactivity, overweight); proportion of health programmes addressing multiple risk factors

STUDY TYPE

cross-sectional

SPECIALTY

public_health

SUMMARISED BY

AI pipeline

FIDELITY CHECK

100% · A

ORIGINAL PAPER

PMC10002111

Clustering of the Adult Population According to Behavioural Health Risk Factors as the Focus of Community-Based Public Health Interventions in Poland

International Journal of Environmental Research and Public Health

READ THE FULL PAPER

ABSTRACT

Effective lifestyle health promotion interventions require the identification of groups sharing similar behavioural risk factors (BRF) and socio-demographic characteristics. This study aimed to identify these subgroups in the Polish population and check whether local authorities’ health programmes meet their needs. Population data came from a 2018 question survey on a random representative sample of 3000 inhabitants. Four groups were identified with the TwoStep cluster analysis method. One of them (“Multi-risk”) differed from the others and the general population by a high prevalence of numerous BRF: 59% [95% confidence interval: 56–63%] of its members smoke, 35% [32–38%] have alcohol problems, 79% [76–82%] indulge in unhealthy food, 64% [60–67%] do not practice recreational physical activity, and 73% [70–76%] are overweight. This group, with an average age of 50, was characterised by an excess of males (81% [79–84%]) and people with basic vocational education (53% [50–57%]). In 2018, only 40 out of all 228 health programmes in Poland addressed BRF in adults; only 20 referred to more than one habit. Moreover, access to these programmes was limited by formal criteria. There were no programmes dedicated to the reduction of BRF exclusively. The local governments focused on improving access to health services rather than on a pro-health change in individual behaviours.

CITATION EXPORT

Anna Poznańska, Katarzyna Lewtak, Bogdan Wojtyniak et al.. Clustering of the Adult Population According to Behavioural Health Risk Factors as the Focus of Community-Based Public Health Interventions in Poland. International Journal of Environmental Research and Public Health. (2023). https://doi.org/10.3390/ijerph20054402

AUTHORS

5 · 3 CENTRES

Anna Poznańska, Katarzyna Lewtak, Bogdan Wojtyniak, Jakub Stokwiszewski, Bożena Moskalewicz

1Department of Population Health Monitoring and Analysis, National Institute of Public Health NIH—National Research Institute, 24 Chocimska Street, 00-791 Warsaw, Poland
2Department of Social Medicine and Public Health, Medical University of Warsaw, 3 Oczki Street, 02-007 Warsaw, Poland
3Department of Health Promotion and Chronic Diseases Prevention, National Institute of Public Health NIH—National Research Institute, 00-791 Warsaw, Poland

EDITOR / REVIEWER

Anna Dzielska, Agnieszka Malkowska-Szkutnik