Lancet Public Health最新文献

{"title":"Social health—the neglected third pillar","authors":"","doi":"10.1016/s2468-2667(25)00175-6","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00175-6","url":null,"abstract":"On June 30, 2025, the WHO Commission on Social Connection published its flagship <span><span>report</span><svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"><path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"></path></svg></span> <em>From loneliness to social connection—charting a path to healthier societies</em>, bringing attention to a timely and critical, but under-recognised public health issue. The report follows the 2023 <span><span>call from the US Surgeon General</span><svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"><path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"></path></svg></span> Vivek Murthy (co-chair of the WHO Commission report) who declared loneliness and social isolation an epidemic in the USA, and the adoption by <span><span>the World Health Assembly</span><svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"><path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"></path></svg></span> in May 2025, of the first resolution on social connection. The Commission on Social Connection report is unambiguous: social disconnection—social isolation or loneliness—is widespread, with severe effects on health, wellbeing, and society, and must be recognised and addressed accordingly. Yet, social isolation and loneliness have remained largely overlooked in public health agendas.","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"8 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144664643","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":"Outreach health-care services for people experiencing exclusion in high-income countries","authors":"Luke Johnson, Sophie Nadia Gaber, Rebecca Langella, Eleanor Turner-Moss, Jeremy Weleff, Thomas Brothers, Aaron Koay, Andrew C Hayward, Serena Luchenski, Patrick Perri, Al Story, Binta Sultan, Rikke Siersbaek","doi":"10.1016/s2468-2667(25)00144-6","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00144-6","url":null,"abstract":"Inclusion health aims to prevent and address health and social inequalities for people experiencing exclusion, such as people experiencing homelessness, people who have a history of contact with the criminal justice system, people who use drugs, sex workers, vulnerable migrants, victims of modern slavery and human trafficking, and Romany Gypsy, Roma, and Travellers communities. These populations have poor health outcomes and disproportionate health inequities, partly resulting from inadequate health-care access. Outreach services can improve health-care access, but there is little evidence of how outreach operates successfully. We conducted a realist review of multicomponent outreach health-care services to understand the circumstances under which outreach works for people experiencing exclusion and why. Key components of effective outreach include person-centred services and appointments, staff expertise, high-quality communication, and close partnership with people experiencing exclusion and relevant organisations. Service users are likely to develop trust and further engage through positive experiences and regular interaction with the same staff.","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"676 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144645544","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":"Vaccinations and regional inequalities in Italy","authors":"Carlo Signorelli, Flavia Pennisi, Giovanni Rezza","doi":"10.1016/s2468-2667(25)00140-9","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00140-9","url":null,"abstract":"No Abstract","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"9 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144520812","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":"Correction to Lancet Public Health 2024; 9: e684–99","authors":"","doi":"10.1016/s2468-2667(25)00122-7","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00122-7","url":null,"abstract":"No Abstract","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"27 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144520945","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":"E-cigarettes in people with substance use disorder","authors":"Joanna M Streck, Nancy A Rigotti","doi":"10.1016/s2468-2667(25)00147-1","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00147-1","url":null,"abstract":"People with substance use disorder (SUD) have a high prevalence of cigarette smoking.<span><span>¹</span></span> Clinical trials of smoking cessation interventions with efficacy in the overall population of people who smoke have had little success in people with SUD, in part due to methodological limitations.<span><span>²</span></span> Innovative and effective tobacco cessation treatments are urgently needed for this group. Nicotine-containing electronic cigarettes (e-cigarettes) are non-combustible nicotine products with substantial evidence of smoking cessation efficacy among people who smoke cigarettes,<span><span>³</span></span> but few randomised trials have tested e-cigarettes for people with SUD.<span><span>⁴</span></span>","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"10 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144520734","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":"Homeless shelter contacts and suicide risk: a critical window for intervention","authors":"Erik Christiansen, Mette Reilev","doi":"10.1016/s2468-2667(25)00121-5","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00121-5","url":null,"abstract":"Homelessness has long been associated with an elevated risk of suicide and self-harm, but previous studies have largely been restricted to selected patient groups, such as those presenting to hospital following self-harm. A new nationwide, population-based study by Sandra F Nilsson and colleagues<span><span>¹</span></span> contributes substantially to the existing body of knowledge on the association between homelessness and suicidal behaviour. Applying a strong registry-based, cohort study design, the authors show markedly elevated risks of both suicide and self-harm among people experiencing homelessness in Denmark compared with the general population. The authors find that 1·3% of male individuals experiencing homelessness and 0·9% of female individuals experiencing homelessness died by suicide within 10 years, with suicide mortality rates 8 times higher for males and 15 times higher for females than in the general population. Nearly 10% of people experiencing homelessness had self-harmed, reflecting a 6-fold increased risk over the same period compared with the general population. In addition, the study shows that the risk of suicide and self-harm was especially high shortly after shelter contact and among individuals with frequent shelter use.","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"195 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144520803","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":"Nicotine e-cigarettes for smoking cessation following discharge from smoke-free inpatient alcohol and other drug withdrawal services: a pragmatic two-arm, single-blinded, parallel-group, randomised controlled trial","authors":"Billie Bonevski, Jane Rich, Dan I Lubman, Catherine Segan, Amanda Baker, Ron Borland, Chris Oldmeadow, Coral Gartner, Natalie Walker, Adrian Dunlop, Mark Daglish, Christopher Bullen, Linda Bauld, David Jacka, Joshua B B Garfield, Rose McCrohan, Ashleigh Guillaumier, Victoria Manning","doi":"10.1016/s2468-2667(25)00101-x","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00101-x","url":null,"abstract":"&lt;h3&gt;Background&lt;/h3&gt;Nicotine-containing electronic cigarettes (e-cigarettes) have been shown to be effective for smoking cessation among general populations, but there is little evidence in people with substance use disorders (SUDs). We aimed to assess the effectiveness of e-cigarettes for smoking abstinence in people with SUD following discharge from smoke-free inpatient withdrawal services.&lt;h3&gt;Methods&lt;/h3&gt;We conducted a pragmatic, two-arm, single-blinded, parallel-group randomised controlled trial. The majority of this study took place in the community after the participants were discharged from inpatient stay. Adults who were tobacco smokers (motivated to quit; not using e-cigarettes) from five smoke-free inpatient withdrawal services in Australia were recruited and randomly assigned by computer using stratified block (1:1) to receive a 12-week supply of either e-cigarettes or combination nicotine replacement therapy (cNRT) with Quitline behavioural counselling on discharge. Participants were advised to use e-cigarettes as much or as often as necessary or desired and cNRT according to instructions. Researchers collecting outcome data were masked to treatment group. The primary outcome was 7 months continuous tobacco smoking abstinence as measured at 9 months after randomisation. The primary analysis was performed using an intention-to-treat approach, with sensitivity analyses following per-protocol, treatment adherence, and complete case analysis approaches. Serious adverse events were classified by a physician as non-serious or serious and causality assessed. We analysed serious adverse events by treatment group and calculated an incident rate ratio for each comparison. This trial is completed and is registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12619001787178).&lt;h3&gt;Findings&lt;/h3&gt;Between Sept 29, 2020, and June 3, 2022, 363 participants were enrolled. Of 363 participants, 207 (57%) were men and 151 (42%) were women; 179 (49%) were randomly assigned to e-cigarettes and 184 (51%) to cNRT. At follow-up, 19 (11%) of 179 participants in the e-cigarette group reported 7 months’ continuous abstinence, compared with 18 (10%) of 184 participants in the cNRT group, with no significant differences between groups (risk ratio 1·09; 95% credible interval [CrI] 0·52–1·89). The probability of a positive risk difference was 60% and Bayes factor was 0·04, indicating little evidence of a treatment effect. 15 serious adverse events occurred in the e-cigarette group and 13 occurred in the cNRT group (incident rate ratio 1·18; 95% CrI 0·56–2·54, p=0·65). None were treatment-related.&lt;h3&gt;Interpretation&lt;/h3&gt;There was no evidence of a difference in cessation rates or adverse effects after 9 months of follow-up between participants given e-cigarettes or cNRT following discharge from inpatient SUD withdrawal services. Both treatments had approximately 10% smoking continuous abstinence rates among a population that is hard to treat and who ha","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"47 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144520811","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":"Adolescent substance use patterns and subsequent risk of mental and behavioural disorders, substance use, and suicidal behaviour: a cohort study","authors":"Elisabeth R Hansen, Sofie Kruckow, Sarah W Feldstein Ewing, Merete Nordentoft, Kristine Rømer Thomsen, Janne S Tolstrup","doi":"10.1016/s2468-2667(25)00115-x","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00115-x","url":null,"abstract":"<h3>Background</h3>Despite growing knowledge of distinct patterns of substance use in adolescents, their associations with later adverse mental health and substance use outcomes remain poorly understood. We aimed to identify adolescent substance use patterns, describe adolescents with distinct patterns, and test the hypothesis that substance use patterns predict mental disorders, hospital contacts due to alcohol or drug use, and suicidal behaviour.<h3>Methods</h3>We used a school-based survey of 68 301 adolescents (mean age 17·8 [SD 0·99]) in upper-secondary education, to identify substance use patterns using latent class analysis. Adolescents with distinct patterns were characterised by individual, social, and environmental health-related factors using logistic regression. First-time hospital contacts attributable to alcohol use, drug use, any mental or behavioural disorder, suicidal behaviour, eating disorder, anxiety or obsessive-compulsive disorder, and depression were assessed using hospital and prescription register data, with follow-up occurring from 2014 to 2022. Associations between substance use patterns and outcomes were examined using Cox regression.<h3>Findings</h3>We identified the substance use patterns alcohol only (48·8%), frequent binge drinking (23·3%), experimental substance use (16·3%), and early-onset multiple substance use (11·6%). Adverse childhood experiences, economic disadvantages, and poor physical and mental health were accumulated in the experimental substance use and the early-onset multiple substance use groups. Notably, the risks of most studied outcomes were consistently higher in the experimental substance use and early-onset multiple substance use groups. Compared with the alcohol only group, the early-onset multiple substance use group had the highest risks, including alcohol-attributable hospital contacts (hazard ratio 2·25 [95% CI 1·89–2·68]), drug-attributable hospital contacts (10·7 [8·78–13·1]), any mental or behavioural disorder or use of psychotropic medication (1·58 [1·48–1·69]), and suicidal behaviour (3·20 [2·55–4·03]). Surprisingly, the frequent binge drinking group had a lower risk of any mental or behavioural disorder (0·83 [0·77–0·89) than the alcohol only group. The higher risk of all outcomes in the experimental and early-onset multiple substance use groups remained across the 8 years of follow-up.<h3>Interpretation</h3>Adolescents with high-risk substance use face an increased risk of adverse mental and substance use outcomes in young adulthood, and health and social disadvantages tend to cluster within this group. Targeted preventive efforts should prioritise these vulnerable young people.<h3>Funding</h3>Tryg Foundation.","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"64 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144520816","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":"Conditional cash transfers: an investment in health","authors":"","doi":"10.1016/s2468-2667(25)00150-1","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00150-1","url":null,"abstract":"Government-led cash transfer programmes providing money to individuals or households are a cornerstone of poverty reduction strategies in many countries. Over the past three decades, more than 100 countries have introduced cash transfer programmes (unconditional or conditional) as part of their poverty reduction and social protection strategies. Conditional cash transfer (CCT) programmes, which provide payments to the poorest households conditional on certain requirements, primarily conditionalities on education and health, are crucial for achieving Sustainable Development Goal (SDG) 1 (no poverty), SDG3 (health), and SDG4 (education). With global economic growth now projected to weaken further to 2·3%, according to the <span><span>Global Economic Prospects report</span><svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"><path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"></path></svg></span>, published by the World Bank on June 10, will governments be tempted to deprioritise such programmes due to financial constraints?","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"13 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144520732","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":"Socioeconomic inequalities in life expectancy in Australia, 2013–22: an ecological study of trends and contributions of causes of death","authors":"Sergey Timonin, Tim Adair, Jennifer Welsh, Vladimir Canudas-Romo","doi":"10.1016/s2468-2667(25)00138-0","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00138-0","url":null,"abstract":"<h3>Background</h3>Despite having one of the highest life expectancies in the world, Australia has considerable subnational variation in health. Our aim was to examine contemporary trends in area-based socioeconomic inequalities in life expectancy, including age-specific and cause-specific components.<h3>Methods</h3>In this ecological study, we used individual death records and estimated resident population (ERP) to calculate life expectancy and cause-specific life-years lost for each decile of the Australian Bureau of Statistics (ABS) Index of Relative Socio-Economic Advantage and Disadvantage (IRSAD) for the whole population in Australia for 2013–22. We used the ABS Death Registrations data in the Person Linked Integrated Data Asset for individual-level records on all deaths that occurred and were registered in Australia, including year of death, age, sex, underlying cause of death, and Statistical Area Level 2 (SA2). We excluded death records in which SA2 was unknown and deaths and ERPs for people living in SA2 where IRSAD could not be defined due to small population counts. We measured inequality by the Slope Index of Inequality (SII) and the absolute gap between the most advantaged (D10) and most disadvantaged (D1) deciles.<h3>Findings</h3>Socioeconomic inequalities in life expectancy widened before reaching a maximum in 2016–18 at SII 4·7 years (95% CI 4·4–5·0) for females and in 2017–19 for males (6·8 years [6·4–7·1]), reflecting little improvement or even deterioration in life expectancy in the more disadvantaged areas. During the COVID-19 pandemic (from 2020) inequalities continued to narrow for males (they had begun to narrow just before the pandemic) but widened for females, largely due to COVID-19 mortality. The effect of other causes of death varied over time and differed by sex, with ischaemic heart disease, lung cancer, and chronic obstructive pulmonary disease consistently being the largest contributors to life expectancy inequalities.<h3>Interpretation</h3>Socioeconomic inequalities in life expectancy in Australia were larger in 2020–22 than in 2013–15, despite some reductions just before and during (for males only) the COVID-19 pandemic. Sustained public health efforts to prevent and manage specific chronic conditions, as well as to reduce premature mortality from injuries (particularly suicide and traffic accidents) and substance misuse among populations in the most disadvantaged areas are needed to reduce socioeconomic inequalities in life expectancy and further increase longevity in Australia<h3>Funding</h3>Australian Research Council.","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"19 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144520813","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}