The Lancet Regional Health: Western Pacific最新文献

{"title":"Critical care access and outcomes in residents of inpatient-care catchment areas with and without ICUs: a nationwide cohort study in Japan","authors":"Hiroyuki Ohbe ,&nbsp;Nobuaki Shime ,&nbsp;Kei Nishiyama ,&nbsp;Takuya Sato ,&nbsp;Kent Doi ,&nbsp;Kiyohide Fushimi ,&nbsp;Hiroki Matsui ,&nbsp;Hideo Yasunaga ,&nbsp;Daisuke Kudo","doi":"10.1016/j.lanwpc.2026.101868","DOIUrl":"10.1016/j.lanwpc.2026.101868","url":null,"abstract":"<div><h3>Background</h3><div>In Japan, many secondary medical areas (SMAs), defined as regional self-sufficient inpatient-care planning units, are not equipped with intensive care unit (ICU) beds. We aimed to describe the national distribution of SMAs without ICUs, compared post-arrival outcomes among ICU-admitted patients, and evaluated ICU access and mortality among critically ill patients.</div></div><div><h3>Methods</h3><div>This retrospective cohort study linked data from the Diagnosis Procedure Combination database with the Hospital Bed Function Report of 2022. The primary exposure was residence in an SMA without ICU beds. Outcomes were assessed using multivariate generalized linear models.</div></div><div><h3>Findings</h3><div>Among 335 SMAs, 140 (41.8%) lacked ICU beds, encompassing 11.6% of the national population and 46.0% of the land area. Among the 282,894 ICU-admitted patients, residents of SMAs without ICUs travelled substantially farther to reach an ICU (median 32.4 vs. 5.7 km), but had no statistically significant difference in adjusted in-hospital mortality (adjusted risk difference, −0.38 percentage points; 95% confidence interval [CI], −0.81 to 0.05). In a separate analysis of 467,200 critically ill patients, those living in SMAs without ICUs had lower ICU admission rates (24.9% vs. 35.6%) and statistically significant but small increase in adjusted in-hospital mortality (adjusted risk difference +0.96 percentage points; 95% CI: 0.17–1.75).</div></div><div><h3>Interpretation</h3><div>Nearly half of SMAs lack ICU beds. While post-arrival ICU outcomes were similar, residence in an SMA without ICUs was associated with reduced ICU access and higher mortality among critically ill patients.</div></div><div><h3>Funding</h3><div>Ministry of Health, Labor and Welfare, Japan; and Japan Agency for Medical Research and Development.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"70 ","pages":"Article 101868"},"PeriodicalIF":8.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147799789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adaptive functioning in school-aged children with spinal muscular atrophy in the treatment era: a non-randomised cohort study","authors":"Emily E. Farah ,&nbsp;Sarah-Grace Paguinto ,&nbsp;Melissa R. Mandarakas ,&nbsp;Karen Herbert ,&nbsp;Smriti Krishan ,&nbsp;Hugo Sampaio ,&nbsp;Didu S. Kariyawasam ,&nbsp;Michelle A. Farrar","doi":"10.1016/j.lanwpc.2026.101866","DOIUrl":"10.1016/j.lanwpc.2026.101866","url":null,"abstract":"<div><h3>Background</h3><div>Despite diagnostic and therapeutic advances for spinal muscular atrophy (SMA), long-term outcomes focused on functional independence for children have not been explored. This study aimed to characterise adaptive functioning for affected children within the contemporary SMA treatment paradigm.</div></div><div><h3>Methods</h3><div>This prospective, non-randomised Australian cohort study was conducted from January 1 to November 14 2025 and included children with SMA aged 4–12 years, diagnosed and treated through newborn screening (NBS) or clinical referral (CR). Adaptive functioning was primarily assessed using the Pediatric Evaluation of Disability Inventory Computer Adaptive Test.</div></div><div><h3>Findings</h3><div>Thirty-nine children participated (NBS n = 18, CR n = 21) with median treatment duration of 67.3 months (IQR 54.0–85.0). Children had high levels of participation with scores within expected range for age-matched peers for social/cognitive (38/39, 97%), responsibility (35/39, 90%), daily activities (29/39, 74%) and mobility (16/39, 41%) domains. A greater proportion of children identified through NBS achieved expected scores for all domains compared to children diagnosed through CR (NBS 14/18 (78%), CR 2/21 (10%), p &lt; 0.001). All children diagnosed through NBS with 3 survival motor neuron 2 gene (<em>SMN2</em>) copies achieved expected scores for all domains (3 <em>SMN2</em> 7/7 (100%), 2 <em>SMN2</em> 7/11 (64%)). Children diagnosed through CR with higher functional status at diagnosis reported greater frequency of daily activities scores within expected range (walkers 7/7 (100%), sitters 2/5 (40%), non-sitters 3/9 (33%), p = 0.02).</div></div><div><h3>Interpretation</h3><div>Whilst heterogenous in terms of performance-based measures, children with SMA have collective strengths in social-cognitive and responsibility aspects of adaptive functioning. Early diagnosis and treatment through NBS and <em>SMN2</em> copy number are important modifiers of long-term adaptive functioning, providing evidence for individualized goal-setting, monitoring and multidisciplinary care.</div></div><div><h3>Funding</h3><div>National Health and Medical Research Council Investigator Grant (1194940, 2026317), University of New South Wales (UGCA1064).</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"70 ","pages":"Article 101866"},"PeriodicalIF":8.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147799788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and associated factors of non-suicidal self-injury among Chinese adults: a national, population-based cross-sectional study","authors":"Yi Guo ,&nbsp;Qinghua Fan ,&nbsp;Zhongjian Liu ,&nbsp;Xiaolin Xu ,&nbsp;Gang Wang ,&nbsp;Haibo Wang","doi":"10.1016/j.lanwpc.2026.101871","DOIUrl":"10.1016/j.lanwpc.2026.101871","url":null,"abstract":"<div><h3>Background</h3><div>Non-suicidal self-injury (NSSI) is a major global public health issue, however, its prevalence and characteristics among Chinese adults remain poorly understood due to the absence of nationwide epidemiological data. This study aimed to assess the prevalence, frequency, requirement for treatment, and associated factors of NSSI in a nationally sample of community-dwelling Chinese adults.</div></div><div><h3>Methods</h3><div>A population-based, cross-sectional survey was conducted in China from June to August 2024. Using a multistage, stratified, cluster-sampling method, a total of 25,047 Chinese Nationals aged 18 or older were included. Data on NSSI (including lifetime prevalence, past-year frequency, and requirement for treatment) and its sociodemographic and psychosocial correlates, were collected through structured questionnaires.</div></div><div><h3>Findings</h3><div>After logical checks and quota sampling based on national population statistics, 25,047 participants were included in the final analysis. The estimated lifetime prevalence of NSSI was 4.1% (95% CI: 3.8%–4.3%). Past-year prevalence was 2.0% (95% CI: 1.8%–2.2%), while 1.4% (95% CI: 1.3%–1.6%) of participants reported NSSI episodes requiring medical treatment. Multivariate logistic regression analysis revealed a strong graded association between NSSI risk and both the severity of depressive symptoms (OR up to 7.02, 95% CI 5.75–8.57 for severe symptoms; P &lt; 0.001) and the number of chronic physical conditions (OR up to 1.83, 95% CI 1.43–2.35 for ≥2 conditions; P &lt; 0.001). Additional significant risk factors included younger age, female sex (OR = 1.38, 95% CI 1.19–1.60; P = 0.006), only-child status (OR = 1.23, 95% CI 1.06–1.43; P &lt; 0.001), recent trauma (OR = 1.80, 95% CI 1.56–2.07; P &lt; 0.001), smoking (OR = 1.97, 95% CI 1.66–2.35; P &lt; 0.001), and obesity (OR = 1.42, 95% CI 1.02–1.99; P = 0.040).</div></div><div><h3>Interpretation</h3><div>The substantial prevalence of NSSI among Chinese adults represents a serious public health challenge. These findings suggest that NSSI in the adult population deserves greater clinical attention and that future research should assess the value of incorporating self-harm screening into routine health assessments. Globally, these findings support the case for increased attention and research funding for understanding NSSI in LMICs.</div></div><div><h3>Funding</h3><div>This study was supported by the <span>Brain Science and Brain-like Intelligence Technology-National Science and Technology</span> Major Project (<span><span>2021ZD0200600</span></span>).</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"70 ","pages":"Article 101871"},"PeriodicalIF":8.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147851804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term outcomes in the pre-moyamoya stage of RNF213-related vasculopathy presenting with ischaemic stroke or transient ischaemic attack: insights from the NCVC Genome Registry","authors":"Takeshi Yoshimoto ,&nbsp;Yorito Hattori ,&nbsp;Hiroyuki Ishiyama ,&nbsp;Eri Kiyoshige ,&nbsp;Soshiro Ogata ,&nbsp;Kunihiro Nishimura ,&nbsp;Yoko Okada ,&nbsp;Yasuhisa Akaiwa ,&nbsp;Michi Kawamoto ,&nbsp;Masahiko Ichijo ,&nbsp;Hiroyasu Inoue ,&nbsp;Toshiki Mizuno ,&nbsp;Hidekazu Tomimoto ,&nbsp;Daisuke Kawakami ,&nbsp;Masafumi Ihara","doi":"10.1016/j.lanwpc.2026.101863","DOIUrl":"10.1016/j.lanwpc.2026.101863","url":null,"abstract":"<div><h3>Background</h3><div><em>RNF213</em> is a susceptibility gene for moyamoya disease, with the p.R4810K variant being the founder mutation. However, long-term outcomes in non-moyamoya stage of <em>RNF213</em>-related vasculopathy remain poorly characterised in longitudinal studies.</div></div><div><h3>Methods</h3><div>This multicentre, prospective, longitudinal study was conducted from March 2017 to March 2022. It included patients with ischaemic stroke (IS) or transient ischaemic attack (TIA) within one week of onset. Patients with moyamoya disease were excluded. The primary outcome was recurrent symptomatic IS or TIA. Subgroup analyses with Essen Stroke Risk Score (ESRS) assessed whether the variant improved risk stratification beyond traditional factors. A retrospective validation cohort was used for sensitivity analysis.</div></div><div><h3>Findings</h3><div>A total of 1267 patients were prospectively enrolled from eight comprehensive stroke centres across Japan. Among these patients (469 [37.0%] women; median age 75 years), 36 (2.8%) carried the variant. The median follow-up period was 3.61 years. The variant was an independent predictor of the primary outcome (adjusted hazard ratio [aHR] 5.58, 95% confidence interval [CI] 2.15–14.54). Even variant carriers with low ESRS had a higher risk of the primary outcome (aHR 4.26, 95% CI 1.32–13.71) than non-carriers with high ESRS. Among patients with largr-artery atherosclerosis, the variant remained significantly associated with the primary outcome (aHR 4.90, 95% CI 1.32–18.25). Among the variant carriers, 2.8% were newly diagnosed with moyamoya disease. In the validation cohort of the National Cerebral and Cardiovascular Center (n = 716), the variant remained an independent predictor of the primary outcome (aHR 4.47, 95% CI 2.33–8.58).</div></div><div><h3>Interpretation</h3><div>The <em>RNF213</em> p.R4810K variant increases the risk of recurrent ischaemic events and identifies a distinct patient group with IS or TIA at “pre-moyamoya” stage.</div></div><div><h3>Funding</h3><div>The Japan Agency for Medical Research and Development (JP21ek0210120 and JP21ek0210126).</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"70 ","pages":"Article 101863"},"PeriodicalIF":8.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147799787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Temporal trends in sepsis hospitalisations and mortality in Aotearoa New Zealand, 2000-2019: a population-based study” [The Lancet Regional Health – Western Pacific, Volume 65, December 2025, 101767]","authors":"Sharla McTavish ,&nbsp;Jane Zhang ,&nbsp;June Atkinson ,&nbsp;Amanda Kvalsvig ,&nbsp;Alice Hyun Min Kim ,&nbsp;Colin McArthur ,&nbsp;Paul Huggan ,&nbsp;Michael G. Baker","doi":"10.1016/j.lanwpc.2026.101865","DOIUrl":"10.1016/j.lanwpc.2026.101865","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"70 ","pages":"Article 101865"},"PeriodicalIF":8.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147797923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reorienting health promotion in remote Pacific Island communities: building family and child-centered agent-of-change models for sustainable behavior change","authors":"Shahmir H. Ali ,&nbsp;Derry Fahrizal Ulum ,&nbsp;Yoshida Aussiana Samosir ,&nbsp;Kelesi Whippy","doi":"10.1016/j.lanwpc.2026.101869","DOIUrl":"10.1016/j.lanwpc.2026.101869","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"70 ","pages":"Article 101869"},"PeriodicalIF":8.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147799990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expanding mountain-type zoonotic visceral leishmaniasis in China: a multi-source data-driven investigation","authors":"Zhengbin Zhou ,&nbsp;Yanfeng Gong ,&nbsp;Lulu Huang ,&nbsp;Zhongqiu Li ,&nbsp;Yuwan Hao ,&nbsp;Yuanyuan Li ,&nbsp;Haobo Ni ,&nbsp;Limin Yang ,&nbsp;Xinyi Wang ,&nbsp;Canjun Zheng ,&nbsp;Ying Liu ,&nbsp;Xiaodong Tian ,&nbsp;Wenting Wu ,&nbsp;Qin Liu ,&nbsp;Yi Zhang ,&nbsp;Shang Xia ,&nbsp;Junhu Chen ,&nbsp;Yibiao Zhou ,&nbsp;Robert Berquist ,&nbsp;Xiaonong Zhou ,&nbsp;Qun Li","doi":"10.1016/j.lanwpc.2026.101858","DOIUrl":"10.1016/j.lanwpc.2026.101858","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Mountain-type zoonotic visceral leishmaniasis (MT-ZVL) is undergoing rapid re-emergence in central China and demonstrates significant potential for further dissemination. The aim of this study was to provide information on optimal control strategies by estimating the disease’s current distribution and potential for spread into new areas.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We used a three-pronged approach: (1) active field surveillance in 57 potential-risk counties in 2022 to investigate the distribution of the &lt;em&gt;Phlebotomus chinensis&lt;/em&gt; (&lt;em&gt;P. chinensis&lt;/em&gt;) vector and canine infections based on serological positivity; (2) study of annual surveillance reports of &lt;em&gt;P. chinensis&lt;/em&gt; distribution and canine infection in 42 counties in Henan, Shanxi and Beijing (2023–2024); and (3) passive surveillance via China’s National Notifiable Disease Surveillance System (NNDSS) revealing 1137 human MT-ZVL cases for the 2019–2024 period. We constructed a database based on an innovative active/passive surveillance approach and applied the optimized ecological niche model based on incorporating environmental, biological (the &lt;em&gt;P. chinensis&lt;/em&gt; vector and infectious canines) and socioeconomic covariates to predict the relative risk of transmission at the 1 × 1 km resolution across central China. Model performance was validated using 239 unique, geolocated human case occurrences (2022–2024). This allowed us to map the MT-ZVL risk and quantify the populations at-risk within stratified risk tiers.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;The field surveillance across 20 of 57 potential MT-ZVL risk counties captured 7552 &lt;em&gt;P. chinensis&lt;/em&gt; specimens (mean density: 13.7 sandflies/trap/night), with a high peak in Jiexiu County, Shanxi Province (499.8). In 14 counties with confirmed &lt;em&gt;P. chinensis&lt;/em&gt; presence, canine infections were recorded in 9 counties giving a mean seroprevalence of 2.7% (44/1648), with the highest proportion at 16.2% (21/130) seen in Yuzhou County, Henan Province. Annual surveillance reports confirmed &lt;em&gt;P. chinensis&lt;/em&gt; presence in 24 of 42 monitored counties, with seropositive canines in two counties. The final training dataset included the recorded findings of 270 &lt;em&gt;P. chinensis&lt;/em&gt; sandflies, 224 infected canines and 213 human case records. Extreme gradient boosting demonstrated superior predictive performance for human MT-ZVL infection risk, significantly outperforming benchmark models, with the area under the curve (AUC) of 0.950 (95% CI: 0.921–0.979) in internal validation and 0.913 (95% CI: 0.886–0.940) in external validation. Model performance was further validated by 88.3% of indigenous cases occurring within predicted high-risk zones. These high-risk zones were concentrated in hilly terrain along the Taihang, Lvliang and Qinling Mountains—primarily in central-southern Shanxi, Hebei-Shanxi border regions, eastern Shaanxi and north-western Henan. This study identified 117 high-risk or ver","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"70 ","pages":"Article 101858"},"PeriodicalIF":8.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147799790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chikungunya and severe fever with thrombocytopenia syndrome added to Class B notifiable infectious diseases in China","authors":"Jue Liu","doi":"10.1016/j.lanwpc.2026.101870","DOIUrl":"10.1016/j.lanwpc.2026.101870","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"70 ","pages":"Article 101870"},"PeriodicalIF":8.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147799989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The toll of tobacco: smoking-attributable health spending in South Korea, 2014–2024. National claims evidence for cost recovery","authors":"Katelyn J. Yoo ,&nbsp;Sooyeol Park ,&nbsp;Haryeom Ghang ,&nbsp;Neil W. Schluger ,&nbsp;Chao Quan ,&nbsp;Sung-In Jang ,&nbsp;Ki-Suck Jung ,&nbsp;David Bishai","doi":"10.1016/j.lanwpc.2026.101843","DOIUrl":"10.1016/j.lanwpc.2026.101843","url":null,"abstract":"<div><h3>Background</h3><div>South Korean policymakers are weighing tobacco control and financing options amid rising health-care costs. This study estimates the direct medical expenditure attributable to active and second-hand smoking (SHS) using Korea's National Health Insurance Service (NHIS) claims data (2014–2024) and quantifies the fiscal burden borne by the public insurer vs. households.</div></div><div><h3>Methods</h3><div>Annual NHIS claims data for all beneficiaries for the period 2014–2024 were linked with disease-specific Population Attributable Fractions (PAFs) derived from the Global Burden of Disease (GBD) study. Costs were stratified by sex, age, income group, and payer (NHIS vs. out-of-pocket) and expressed in 2024 US dollars.</div></div><div><h3>Findings</h3><div>Smoking-attributable medical spending totaled USD 29.86 billion over the period from 2014 to 2024. In 2024 alone, costs reached USD 3.38 billion, representing 19.7% of expenditure for the analyzed conditions and approximately 4.0% of national health expenditure. The fiscal burden was shared between the public insurers (82.5%) and households (17.5% out-of-pocket). Costs were highest among men (80.1%) and adults aged 50–79 (80.7%), reflecting a “lagged epidemic” driven by historical exposure. The top 10 conditions accounted for 88.2% of total smoking-attributable spending, with cancers absorbing 35.2% and cardiometabolic diseases absorbing 53.1%. Costs for men were driven by active smoking (∼90%), while costs for women were largely attributable to SHS, which accounted for 48% of their total costs compared to 9% for men.</div></div><div><h3>Interpretation</h3><div>Past smoking choices of South Koreans have left a legacy of current medical costs that many non-smokers are now facing. Women and men who never chose to smoke are succumbing to illness due to SHS which accounts for 16.5% of overall costs. New generations of workers must bear these costs through taxation and premiums to finance South Korea's health care system. The current decline in smoking prevalence is insufficient to arrest the rising financial momentum of historical exposure. These findings provide evidence for a way out of the cycle by correcting prices of tobacco to include the social costs. A polluter-pays framework would recover public health expenditures and deter new generations from imposing consequences of their personal choices on others.</div></div><div><h3>Funding</h3><div>None.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"70 ","pages":"Article 101843"},"PeriodicalIF":8.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147799776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Impact of the national steps challenge physical activity programme on obesity and type 2 diabetes prevalence in Singapore to 2050: simulation-based forecasting analysis” [The Lancet Regional Health – Western Pacific, Volume 68, March 2026, 101831]","authors":"Bekzod Normatov ,&nbsp;Haolong Song ,&nbsp;Shihui Jin ,&nbsp;Xinyu Zhang ,&nbsp;Yichen He ,&nbsp;Nigel W.H. Lim ,&nbsp;Vong Fee Zen ,&nbsp;Muhammad Hafiz Bin Mohd Aziz ,&nbsp;Falk Müller-Riemenschneider ,&nbsp;Charmaine Pei Ling Lee ,&nbsp;Borame L. Dickens","doi":"10.1016/j.lanwpc.2026.101876","DOIUrl":"10.1016/j.lanwpc.2026.101876","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"70 ","pages":"Article 101876"},"PeriodicalIF":8.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147851803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}