BACKGROUND
The study addresses the need to identify population subgroups with co-occurring behavioral risk factors (BRF) in Poland to inform effective public health interventions. It notes that local authorities are responsible for health programmes but their alignment with population needs is unclear. Methods: A cross-sectional survey was conducted in 2018 on a random representative sample of 3000 Polish adults (aged ≥20). Data on socio-demographics and BRF (smoking, alcohol problems, unhealthy diet, physical inactivity, overweight) were collected via computer-assisted personal interviewing. TwoStep cluster analysis was used to identify population subgroups. Additionally, all 228 health programmes submitted for assessment in 2018 were reviewed to evaluate their focus on BRF. Key Results: Four clusters were identified: 'The youngest' (29%), 'Multi-risks' (26%), 'The oldest' (27%), and 'Healthy lifestyle' (18%). The 'Multi-risk' cluster was characterized by high prevalence of multiple BRF: 59% smoked, 35% had alcohol problems, 79% had unhealthy diets, 64% were physically inactive, and 73% were overweight. This group had an average age of 50, was predominantly male (81%), and had basic vocational education (53%). In contrast, only 40 of 228 health programmes addressed BRF in adults, and just 20 addressed more than one habit. Programmes focused on access to care (e.g., vaccination, rehabilitation) rather than BRF reduction, with formal age-based eligibility criteria. Limitations: The study is cross-sectional and based on self-reported data. It focuses on adults (≥20 years), excluding younger populations where risk behaviors may originate. The survey pre-dates the COVID-19 pandemic, though the authors note subsequent trends may have exacerbated risk factors. Implications: The findings highlight a significant mismatch between the identified high-risk population and the scope of local health programmes. There is a need for tailored, multi-risk interventions targeting the 'Multi-risk' cluster, particularly men with lower education, to address health inequalities and reduce excess mortality.
