Lancet Regional Health-Americas最新文献

{"title":"Reducing intersectional cancer disparities through education","authors":"Davidi Tawfiles , Brent R. Weil , Terry L. Buchmiller , Isaac G. Alty , Puneeth Iyengar , Nancy Y. Lee , Craig W. Lillehei , Edward Christopher Dee","doi":"10.1016/j.lana.2025.101086","DOIUrl":"10.1016/j.lana.2025.101086","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"46 ","pages":"Article 101086"},"PeriodicalIF":7.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143747010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inequity of NIH cancer funding in the United States: an ecological study predicting funding based on disease burden from 2008 through 2023","authors":"Eli Berglas ,&nbsp;David Musheyev ,&nbsp;Aaron B. Lavi ,&nbsp;Rachel S. Berglas ,&nbsp;Rachel Berglas ,&nbsp;Abdo E. Kabarriti","doi":"10.1016/j.lana.2025.101081","DOIUrl":"10.1016/j.lana.2025.101081","url":null,"abstract":"<div><h3>Background</h3><div>Disease burden has been used to predict National Institutes of Health (NIH) funding but included diseases with little underlying relationship. Here we focus on cancers to create a more appropriate model to allow for more targeted scrutinization of funding allocation.</div></div><div><h3>Methods</h3><div>An ecological study using NIH funding data (2008–2023) was performed. Inclusion of cancers was based on their presence in the NIH Research Portfolio Online Reporting Tool and the 2021 Global Burden of Disease (GBD) study. Disability-adjusted life years (DALY) were collected and to evaluate the impact of public interest, Google Trends data was used. Multivariable linear regression determined appropriate funding based on disease burden and public interest. To quantify how each cancer’s funding differed from model predictions residual values were used to calculate the percent over/under funding.</div></div><div><h3>Findings</h3><div>Fifteen cancers met inclusion criteria. Neuroblastoma had the greatest ratio of funding to DALYs per 100,000 people (US$14,000,000) while lung cancer had the lowest (US$300,000). Stomach cancer was the most underfunded (197.9% [95% CI: 136.0%, 276.2%]) while brain cancer was the most overfunded (64.1% [95% CI: 53.8%, 72.1%]). Even at their lowest funding values in the study period brain, breast, and colorectal cancer all had greater than 40% overfunding. Contrarily, the lowest annual funding for leukemia, uterine, and stomach cancer received less than 150% of expected funding. Despite its overfunding brain cancer had an increase in DALYs in the study period.</div></div><div><h3>Interpretation</h3><div>Modeling by disease category demonstrated disparities in funding indicating the need for reevaluation for possible funding inequities. The year-by-year approach taken in this study will drive the ability for future research to better understand NIH funding decisions. Additionally, the role of public interest in research funding needs to be further evaluated to ensure that popularity does not override disease burden, in funding decisions.</div></div><div><h3>Funding</h3><div>No Funding.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"45 ","pages":"Article 101081"},"PeriodicalIF":7.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143747109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Call to build health equity","authors":"Rocío Sáenz ,&nbsp;Ximena Avellaneda ,&nbsp;Carlos F. Cáceres ,&nbsp;Arachu Castro ,&nbsp;Leonela Castro ,&nbsp;Luiz Augusto Galvão ,&nbsp;Ingrid Gómez ,&nbsp;Wendy López ,&nbsp;Pedro Mas ,&nbsp;Jossel Quesada ,&nbsp;Amy Ritterbusch ,&nbsp;Wilmer Sancho ,&nbsp;Luis Fernando Solís ,&nbsp;Manuel Urbina ,&nbsp;Board of Directors and Technical Secretariat of the Health Equity Network of the Americas (HENA)","doi":"10.1016/j.lana.2025.101071","DOIUrl":"10.1016/j.lana.2025.101071","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"45 ","pages":"Article 101071"},"PeriodicalIF":7.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143746588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of demographic and epidemiologic transitions on growing health expenditures in Latin America and the Caribbean: a descriptive study","authors":"Yvonne N. Flores ,&nbsp;Timothy Roberton ,&nbsp;Marisol Torres Toledano ,&nbsp;Carla Jorge Machado ,&nbsp;Angélica López Hernández ,&nbsp;Claudio A. García Mora ,&nbsp;Daniel Maceira ,&nbsp;Caitlin M. Noonan ,&nbsp;Andrea M. Prado ,&nbsp;T. Alafia Samuels ,&nbsp;Andrés I. Vecino Ortiz ,&nbsp;Angela Vega Landaeta ,&nbsp;Krishna D. Rao","doi":"10.1016/j.lana.2025.101070","DOIUrl":"10.1016/j.lana.2025.101070","url":null,"abstract":"<div><h3>Background</h3><div>Many countries in Latin America and the Caribbean (LAC) have undergone significant economic, demographic, and epidemiological changes. We examined the role of these factors on the growth of health expenditures in several LAC countries.</div></div><div><h3>Methods</h3><div>Demographic data, disease prevalence, and proportion of current health expenditure (CHE) per capita, by expenditure type, were obtained for several LAC countries. Health expenditure matrices were created for the years 2018 or 2019, disaggregated by age group and ICD-10 Chapter, for seven index countries (Argentina, Brazil, Colombia, Costa Rica, Mexico, Peru, and Trinidad and Tobago).</div></div><div><h3>Findings</h3><div>Uruguay has largest population over 70 years (11%, n = 378,501), while Honduras has lowest (2.3%, n = 236,783). Barbados and Chile have the greatest proportion of total DALYs due to chronic diseases (&gt;80%), while Bolivia and Guatemala have the lowest (60%). Per capita CHE is lowest in Honduras (&lt;$500) and highest in Panama ($2500). CHE is highest among the 85+ age group, and for circulatory, respiratory, and digestive diseases.</div></div><div><h3>Interpretation</h3><div>Important differences were observed in health care spending by disease category and age group. Given the ongoing demographic and epidemiological transitions in LAC, health care spending in the area is expected to increase.</div></div><div><h3>Funding</h3><div>This study was funded by the <span>Inter-American Development Bank</span>.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"44 ","pages":"Article 101070"},"PeriodicalIF":7.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143777435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why disaggregated data on health expenditures has been elusive, but will not remain so","authors":"Ramiro Guerrero ,&nbsp;Krishna D. Rao","doi":"10.1016/j.lana.2025.101073","DOIUrl":"10.1016/j.lana.2025.101073","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"44 ","pages":"Article 101073"},"PeriodicalIF":7.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143748469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The termination of Seguro Popular: impacts on the care of high-cost diseases in the uninsured population in Mexico","authors":"Luis Javier Cortés-Adame ,&nbsp;Octavio Gómez-Dantés","doi":"10.1016/j.lana.2025.101078","DOIUrl":"10.1016/j.lana.2025.101078","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"46 ","pages":"Article 101078"},"PeriodicalIF":7.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143747838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Child abuse prevalence estimates in Canada; comparisons of nationally representative data from 2012 to 2022: a population-based study","authors":"Tracie O. Afifi ,&nbsp;Julie-Anne McCarthy ,&nbsp;Ana Osorio ,&nbsp;Lauren MacGowan ,&nbsp;Tamara L. Taillieu ,&nbsp;Ashley Stewart-Tufescu ,&nbsp;Jitender Sareen ,&nbsp;Harriet L. MacMillan ,&nbsp;Lil Tonmyr ,&nbsp;Ian Colman ,&nbsp;Mark A. Ferro ,&nbsp;Kelly K. Anderson ,&nbsp;Jordan Edwards","doi":"10.1016/j.lana.2025.101072","DOIUrl":"10.1016/j.lana.2025.101072","url":null,"abstract":"<div><h3>Background</h3><div>Up-to-date nationally representative Canadian statistics on child abuse with a focus on sex, sexual identity, and age cohorts are overdue. The objective of the current study was to examine child abuse prevalence estimates (physical abuse, sexual abuse, exposure to intimate partner violence (EIPV), and any child abuse) among adult Canadians, associations with sex (male or female), sexual identity (heterosexual, lesbian or gay, bisexual, or other), and age cohort, and to compare data from 2022 with 2012.</div></div><div><h3>Methods</h3><div>Data were obtained from two Statistics Canada cross-sectional surveys: 1) the 2012 Canadian Community Health Survey-Mental Health (2012 CCHS-MH; n = 23,395; 18+ years) and 2) the 2022 Mental Health and Access to Care (2022 MHACS; n = 9409; 18+ years).</div></div><div><h3>Findings</h3><div>The prevalence of any child abuse in Canada in 2022 was 34.4%, which was significantly higher compared to 2012 (32.1%; p = 0.006). Among the youngest respondents (18–27 years), the prevalence of any child abuse had also increased from 21.7% in 2012 to 26.8% in 2022 (p = 0.002). Sex and age cohort differences were noted. In addition, those identifying as other than heterosexual generally had increased odds of child abuse experiences (Adjusted Odds Ratios ranging from 1.48 to 3.12).</div></div><div><h3>Interpretation</h3><div>The retrospective self-reported prevalence in 2022 was 2.3 percentage points higher compared to 2012. There continues to be a widespread need to develop approaches focusing on child abuse prevention and response, and to ensure that providers receive training in how to recognize and respond safely to family violence, including child abuse.</div></div><div><h3>Funding</h3><div><span>Canadian Institutes of Health Research</span> and <span>Canada Research Chair</span>.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"45 ","pages":"Article 101072"},"PeriodicalIF":7.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143725965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes and heterogeneity in quality-amenable excess mortality in Mexico: a systematic analysis for the years 2012, 2018, and 2021","authors":"Sofia Castro Vargas ,&nbsp;Diego Rios-Zertuche ,&nbsp;Sebastian Bauhoff","doi":"10.1016/j.lana.2025.101061","DOIUrl":"10.1016/j.lana.2025.101061","url":null,"abstract":"<div><h3>Background</h3><div>Low quality of care has emerged as key policy concern in low and middle-income countries. This study explores the changes and heterogeneity in preventable and healthcare-amenable excess mortality across regions and demographic groups in Mexico for 2012, 2018, and 2021.</div></div><div><h3>Methods</h3><div>We estimate excess mortality for the top ten healthcare amenable causes of death in Mexico. Excess mortality is categorized into preventable mortality, which could be avoided by preventing disease onset, and amenable mortality, which could be avoided through timely and effective healthcare. In broad terms, amenable mortality is derived by comparing case fatality rates in Mexico from those in a group of benchmark countries. This amenable mortality is further split into low quality and non-utilization amenable. The analysis used data from the Global Burden of Disease (GBD) study and the Encuesta Nacional de Salud y Nutrición (ENSANUT) surveys.</div></div><div><h3>Findings</h3><div>The findings indicate that healthcare-amenable mortality attributed to low quality was 52·5% in 2012 and 57·2% in 2021. Diabetes mellitus and chronic kidney disease were the predominant causes of amenable deaths, with an estimated 28,953 and 23,772 deaths in 2021, respectively. In 2021, an estimated 25·41 per 100,000 males died due to poor quality compared to 17·31 per 100,000 females. The of share of quality-amenable mortality for some conditions was also different between males and females in 2021. For diabetes mellitus, 38·7% of amenable mortality in males was due to poor quality, compared to 52·4% for females and for chronic kidney disease the percentage for males was 35·1% as opposed to 49·4% for females.</div></div><div><h3>Interpretation</h3><div>The large share of healthcare-amenable deaths attributable to poor quality underscores the persistent deficiencies in healthcare delivery processes. Despite efforts to improve healthcare quality, substantive disparities remain, particularly across factors such as sex and age. The findings highlight the need for targeted healthcare policies aimed at improving quality for all groups. Future policies should prioritize addressing the specific needs of high-risk groups to improve the overall performance of the healthcare system.</div></div><div><h3>Funding</h3><div>This study received no external funding.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"45 ","pages":"Article 101061"},"PeriodicalIF":7.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143725964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does use of domestic insecticides undermine public health control strategies?","authors":"Walter Fabricio Silva Martins ,&nbsp;Lee Rafuse Haines ,&nbsp;Martin James Donnelly ,&nbsp;David Weetman","doi":"10.1016/j.lana.2025.101076","DOIUrl":"10.1016/j.lana.2025.101076","url":null,"abstract":"<div><div>Vector-borne diseases (VBD), particularly dengue and malaria, pose a growing threat to human health worldwide. While insecticides remain the cornerstone of vector control programmes, their efficacy is being compromised by increasing insecticide resistance in mosquito populations, leading to control failures that have significant epidemiological and socioeconomic implications. Current research has predominantly examined resistance development in the context of public health interventions and agricultural applications. However, the contribution of domestic insecticide use to resistance evolution in VBD-endemic regions remains inadequately characterised. Evidence indicates that household insecticide utilisation is extensive, with approximately 60% of residents in endemic areas regularly employing domestic insecticidal products for personal protection. This viewpoint highlights how the poorly regulated household insecticide market may significantly contribute to resistance development. Therefore, understanding the impact of domestic insecticide products and usage patterns is urgently needed to preserve the efficacy of vector control campaigns and protect public health outcomes.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"45 ","pages":"Article 101076"},"PeriodicalIF":7.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143725966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence, distribution and future projections of Parkinson disease in Brazil: insights from the ELSI-Brazil cohort study","authors":"Thomas Hugentobler Schlickmann ,&nbsp;Marcelo Somma Tessari ,&nbsp;Wyllians Vendramini Borelli ,&nbsp;Gabriel Alves Marconi ,&nbsp;Gabriela Magalhães Pereira ,&nbsp;Eduardo Zimmer ,&nbsp;Alastair Noyce ,&nbsp;Ignacio Fernandez Mata ,&nbsp;Carlos Roberto de Mello Rieder ,&nbsp;Daniel Teixeira-dos-Santos ,&nbsp;Artur Francisco Schumacher Schuh","doi":"10.1016/j.lana.2025.101046","DOIUrl":"10.1016/j.lana.2025.101046","url":null,"abstract":"<div><h3>Background</h3><div>There is limited epidemiological data regarding Parkinson's disease (PD) prevalence in Brazil, which hinders adequate public health policies planning and patient care. This study aimed to investigate the distribution, prevalence, and clinical characteristics of PD among older adults in Brazil.</div></div><div><h3>Methods</h3><div>This cross-sectional study used data from the ELSI-Brazil cohort, a Brazilian nationally representative study of individuals aged 50 and older. Data were collected through door-to-door surveys with standardized questionnaires. PD diagnosis was based on self-reported data. We calculated PD prevalence in the general population and specific age groups, studied its association with clinical variables, and projected PD prevalence in Brazil from 2024 to 2060.</div></div><div><h3>Findings</h3><div>A total of 9881 respondents were included in this study, and 93 reported a medical diagnosis of PD. The crude prevalence of PD among Brazilians aged 50 or more was 0.84% (95% CI: 0.64%–1.09%), with an age- and sex-standardized prevalence of 0.86% (95% CI: 0.62%–1.10%). Men were more affected than women (OR: 2.35, 95% CI: 1.35–4.08; p &lt; 0.01), and the prevalence was higher in older age groups, from 0.39% in those aged 50–59 years to 2.75% in those 80 years and older. PD individuals had higher rates of stroke, depression, functional dependency, and were more likely to need walking support or be bedridden. Projections indicated that PD cases in Brazil will rise from 535,999 (95% CI: 309,963–922,948) in 2024 to 1,250,638 (95% CI: 734,660–2,117,585) by 2060.</div></div><div><h3>Interpretation</h3><div>This study reveals the prevalence and distribution of PD in Brazil, showing many patients with advanced disease and suggesting underdiagnosis in early stages. There is a need for better diagnostic accuracy, improved access to neurologists, and comprehensive public health strategies to manage the rising prevalence and healthcare demands of PD in Brazil.</div></div><div><h3>Funding</h3><div>This study did not receive any funding. The ELSI-Brazil cohort was funded by the <span>Ministry of Health of Brazil</span>.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"44 ","pages":"Article 101046"},"PeriodicalIF":7.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143714444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}