Lancet Public Health最新文献

{"title":"The epidemiology and burden of injury in countries of the Association of Southeast Asian Nations (ASEAN), 1990–2021: findings from the Global Burden of Disease Study 2021","authors":"","doi":"10.1016/s2468-2667(25)00069-6","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00069-6","url":null,"abstract":"<h3>Background</h3>Injuries are among the top causes of mortality and disability in southeast Asia. Although injury prevention is a key health priority in the Post-2015 Health Development Agenda of the Association of Southeast Asian Nations (ASEAN), the focus was placed solely on road injuries. The absence of a broader recognition of injury burden and trends hinders future intervention efforts. This study aims to provide a comprehensive analysis of the burden and epidemiological trends of all injuries across ASEAN countries.<h3>Methods</h3>In this analysis of the Global Burden of Disease, Injuries, and Risk Factors Study (GBD) 2021, we estimated incidence, cause-specific mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) by age, sex, location, and year for ten ASEAN member states (Brunei, Cambodia, Indonesia, Myanmar, Laos, Malaysia, the Philippines, Singapore, Thailand, and Viet Nam) from 1990 to 2021. Incidence and non-fatal disease burden were estimated using disease model Bayesian meta-regression (DisMod-MR) 2.1. Mortality was derived from the GBD Cause of Death Ensemble model. Estimates include 95% uncertainty intervals where appropriate.<h3>Findings</h3>In 2021, an estimated 35·5 million (95% UI 33·5–37·7) injury incident cases were reported in ASEAN, resulting in approximately 317 000 deaths (286 000–350 000). Substantial variation was observed across the region, with the age-standardised mortality ranging from 13·4 per 100 000 people (12·7–14·1) in Singapore to 68·5 per 100 000 (54·4–81·9) in Viet Nam. Road injury was the leading cause of mortality and morbidity in most ASEAN countries, with the highest age-standardised DALY rates in Thailand and Malaysia. Self-harm was the leading cause of mortality in Singapore, whereas interpersonal violence was the leading cause of injury deaths in the Philippines. From 1990 to 2021, the region's age-standardised injury incidence rate declined by 23·0% (21·8–24·1). Age-standardised DALY rates decreased substantially for drowning (60·6% [53·2–66·7]) and road injuries (39·6% [32·1–46·4]), whereas falls saw a smaller and more heterogeneous decline of 12·3% (2·6–21·0) over the past 31 years.<h3>Interpretation</h3>The injury epidemiological landscape in ASEAN is complex, with substantial geographical variations and emerging challenges triggered by the rapid sociodemographic transition in the region. Progress has been uneven. Effective burden reduction across different causes of injury requires strategies addressing the wide range of socioenvironmental determinants and system shortfalls. Prevention programmes need to be customised to each country's unique context and development.<h3>Funding</h3>Bill &amp; Melinda Gates Foundation.","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"43 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144153368","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 epidemiology and burden of cardiovascular diseases in countries of the Association of Southeast Asian Nations (ASEAN), 1990–2021: findings from the Global Burden of Disease Study 2021","authors":"","doi":"10.1016/s2468-2667(25)00087-8","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00087-8","url":null,"abstract":"<h3>Background</h3>The Association of Southeast Asian Nations (ASEAN) has undergone substantial epidemiological changes over the past three decades, characterised by a growing burden of cardiovascular disease. This study provides an epidemiological overview of cardiovascular diseases across ASEAN.<h3>Methods</h3>As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2021, we assessed the prevalence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years (DALYs) of 12 cardiovascular diseases, stratified by age, sex, and location, for ten ASEAN member states (Brunei, Cambodia, Indonesia, Laos, Malaysia, Myanmar, the Philippines, Singapore, Thailand, and Viet Nam) from 1990 to 2021. We examined the contribution of major risk factors associated with cardiovascular disease. Diverse data sources and meta-analytical modelling techniques were used to synthesise data and generate consistent estimates for each metric.<h3>Findings</h3>In 2021, there were 36·8 million (95% uncertainty interval 34·4–38·8) prevalent cases of cardiovascular disease and 1·66 million (1·51–1·80) cardiovascular disease deaths across ASEAN. The total number of DALYs was 42·4 million (38·4–46·2), making cardiovascular disease the leading cause of disease burden in the region. Compared with 1990, the number of individuals with cardiovascular disease has increased by 148·1% (144·0–152·5), whereas the age-standardised prevalence rate rose by 2·5% (1·4–3·6). The highest age-standardised prevalence rate was in Malaysia, followed by Indonesia. The top three leading cardiovascular diseases with the highest age-standardised prevalence rates were ischaemic heart disease (2070·6 [1831·3–2358·2] per 100 000 people), lower extremity peripheral arterial disease (1380·8 [1189·8–1598·7] per 100 000 people), and stroke (1300·6 [1230·5–1375·4] per 100 000 people). The age-standardised mortality rate was highest in Laos (410·9 deaths [337·2–485·9] per 100 000 people). Most cardiovascular disease burden was attributed to high systolic blood pressure, dietary risks, air pollution, high low-density lipoprotein cholesterol, and tobacco use, with high BMI and high fasting plasma glucose rapidly rising as attributive factors.<h3>Interpretation</h3>Cardiovascular disease remained the leading cause of mortality and morbidity in ASEAN in 2021. The number of individuals with cardiovascular disease is expected to rise with an ageing population and socioeconomic advancement. Given the disparities across ASEAN, interventions must be tailored at all levels to address the needs in prevention, treatment, and management.<h3>Funding</h3>The Gates Foundation.","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"49 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144153402","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":"Safer opioid supply and health outcomes – Authors' reply","authors":"Tara Gomes, Gillian Kolla, Samantha Young, Ahmed Bayoumi, Tony Antoniou","doi":"10.1016/s2468-2667(25)00119-7","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00119-7","url":null,"abstract":"We thank Robert Tanguay and Nickie Mathew for their comments and welcome the opportunity to clarify key aspects of our study.<span><span>¹</span></span> The authors raise concerns about higher opioid toxicity rates among safer opioid supply (SOS) recipients compared with those initiating methadone. We believe it is important to emphasise our finding that opioid toxicity events declined markedly following both SOS and methadone initiation.<span><span>¹</span></span> The smaller decline among SOS recipients might reflect higher baseline risk and greater ongoing exposure to the unregulated drug supply early in treatment. Importantly, opioid-related and all-cause mortality was exceedingly low in both groups throughout follow-up, highlighting the protective effect of treatment engagement. The authors contrast our findings with those of Hai Nguyen and colleagues, who evaluated population-level trends following policy changes. However, these studies did not examine outcomes among SOS recipients, did not compare SOS with methadone, and were prone to ecological fallacy due to design.<span><span>2</span></span>, <span><span>3</span></span> Thus, these studies are more likely to be biased than our individual-level, matched cohort analysis.","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"10 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144153366","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":"Effectiveness of workplace interventions for health promotion","authors":"Marianna Virtanen, Tea Lallukka, Marko Elovainio, Andrew Steptoe, Mika Kivimäki","doi":"10.1016/s2468-2667(25)00095-7","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00095-7","url":null,"abstract":"Workplaces are an important setting for health promotion, offering established infrastructure, daily access to large populations, and opportunities to engage groups that are often under-represented in such initiatives. Although the effectiveness of workplace health promotion has been evaluated in reviews focusing on specific interventions, a comprehensive overview is needed. To address this gap, we present a quality-informed horizontal analysis encompassing 88 reviews and 339 meta-analysed effect estimates published between 2011 and 2024, covering a broad range of workplace health interventions. Mental health and stress reduction were the most frequently studied targets (36%), followed by weight management and cardiometabolic health (25%), health-related behaviours (22%), and musculoskeletal disorders and pain (17%). According to the GRADE assessment, 71 (21%) of the 339 meta-analysed effect estimates provided evidence of moderate quality, and the remainder were categorised as low or very low quality, with none classified as high quality. Mindfulness showed effectiveness across multiple stress and mental health outcomes, and cognitive behavioural techniques, stress management, physically oriented methods, and e-health interventions also showed some effectiveness. Multicomponent interventions had small but measurable effects on weight loss, glucose levels, fruit intake, and seasonal influenza vaccination uptake. A variety of behavioural, physical activity, environmental, multicomponent, and e-health interventions influenced physical activity and sedentary time at work. Consistent with findings found in non-occupational settings, effects at the individual level were generally modest but could be meaningful at both the workplace and population levels. In this Review we also discuss the broader public health implications of workplace health promotion, and highlight the strengths and limitations of the existing evidence and propose directions for future research.","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"58 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144153372","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":"Effects of hearing intervention on falls in older adults: findings from a secondary analysis of the ACHIEVE randomised controlled trial","authors":"Adele M Goman, Nasya Tan, James Russell Pike, Sarah Y Bessen, Ziheng (Sally) Chen, Alison R Huang, Michelle L Arnold, Sheila Burgard, Theresa H Chisolm, David Couper, Jennifer A Deal, Nancy W Glynn, Theresa Gmelin, Lisa Gravens-Mueller, Kathleen M Hayden, Pablo Martinez-Amezcua, Christine M Mitchell, James S Pankow, Nicholas S Reed, Victoria A Sanchez, Frank R Lin","doi":"10.1016/s2468-2667(25)00088-x","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00088-x","url":null,"abstract":"<h3>Background</h3>Hearing loss is highly prevalent among older adults and has been associated with an increased likelihood of falling. We aimed to examine the effect of a hearing intervention on falls over 3 years among older adults in a secondary analysis of the ACHIEVE study.<h3>Methods</h3>The Aging and Cognitive Health Evaluation in Elders (ACHIEVE) study was a 3-year, unmasked, randomised controlled trial of adults aged 70–84 years at enrolment with untreated hearing loss and without substantial cognitive impairment. Participants were recruited at four US community-based field sites from two study populations: (1) an ongoing observational study of cardiovascular health (Atherosclerosis Risk in Communities [ARIC] study), and (2) de novo from the community. Participants were randomly assigned (1:1) to a hearing intervention (audiological counselling and provision of hearing aids) or a health education control (didactic education and enrichment activities covering chronic disease prevention topics). A prespecified exploratory outcome was falls. Self-reported falls in the past 12 months were assessed at baseline and annually for 3 years, and analysed by intention to treat with covariate adjustment. The study was registered with ClinicalTrials.gov, NCT03243422, and is completed.<h3>Findings</h3>Between Nov 9, 2017, and Oct 25, 2019, 3004 individuals were screened for eligibility and 977 (238 [24%] from the ARIC study and 739 [76%] de novo) were randomly assigned, with 490 (50%) in the hearing intervention group and 487 (50%) in the health education control group. Overall mean age was 76·8 years (SD 4·0), 523 (54%) participants were female and 454 (46%) were male, and 112 (11%) were Black, 858 (88%) were White, and seven (1%) were other race. In adjusted analyses, the intervention group had a 27% reduction in the mean number of falls over 3 years compared with the control group (intervention group: 1·45 [95% CI 1·28 to 1·61]; control group: 1·98 [1·82 to 2·15]; mean difference: –0·54 [95% CI –0·77 to –0·31]). This 3-year effect of hearing intervention was consistent across both the ARIC and de novo study populations.<h3>Interpretation</h3>Hearing intervention versus a health education control was associated with a reduction in the mean number of falls over 3 years in older adults. Ongoing follow-up of ACHIEVE participants in a separate follow-up study (NCT05532657) will enable examination of the longer term effects of hearing intervention on falls.<h3>Funding</h3>US National Institutes of Health.","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"83 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144153370","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":"Safer opioid supply and health outcomes","authors":"Robert Tanguay, Nickie Mathew","doi":"10.1016/s2468-2667(25)00118-5","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00118-5","url":null,"abstract":"In the Article by Tara Gomes and colleagues,<span><span>¹</span></span> it was concluded that initiation of safer opioid supply (SOS) programmes was associated with improvements in the rate of opioid toxicities, all-cause emergency department visits, all-cause inpatient hospitalisations, incident infections, and non-primary care-related health-care costs. The benefits in these factors were attributed to the initiation of SOS, similar to what was seen in the matched methadone initiation cohort, with the exception that the SOS group had significantly higher rates of opioid toxicity. There are several concerns that were not discussed by the authors, including methadone initiation literature, clarity of how much methadone or other opioid agonist treatments (OATs) were received, the frequency and extent of social services provided, and health-care use, which might affect the conclusions suggested.","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"58 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144153365","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 epidemiology and burden of ten mental disorders in countries of the Association of Southeast Asian Nations (ASEAN), 1990–2021: findings from the Global Burden of Disease Study 2021","authors":"","doi":"10.1016/s2468-2667(25)00098-2","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00098-2","url":null,"abstract":"<h3>Background</h3>The Association of Southeast Asian Nations (ASEAN), a geopolitical and economic network of ten member states, recognises mental disorders as a health priority; however, sparse epidemiological data hinder the development of effective strategies to reduce their prevalence and burden. We aimed to examine the prevalence, morbidity, and disease burden associated with ten mental disorders from 1990 to 2021 in the ASEAN.<h3>Methods</h3>As part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD 2021), we analysed estimates for depressive disorders, anxiety disorders, bipolar disorders, schizophrenia, autism spectrum disorders, conduct disorder, attention-deficit hyperactivity disorder (ADHD), eating disorders, idiopathic developmental intellectual disability, and other mental disorders in ten ASEAN member states (Brunei, Cambodia, Indonesia, Laos, Malaysia, Myanmar, the Philippines, Singapore, Thailand, and Viet Nam). Case definitions were based on Diagnostic and Statistical Manual of Mental Disorders or ICD criteria. Prevalence estimates by age, sex, year, and location were derived using DisMod-MR 2.1, a Bayesian meta-regression modelling tool. Disease burden was quantified by estimating years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs). Estimates are presented with 95% uncertainty intervals (UIs).<h3>Findings</h3>In 2021, 80·4 million (95% UI 73·8–87·2) cases of mental disorders were reported across ASEAN countries, representing a 70·0% (63·5–77·2) increase since 1990. The age-standardised prevalence of mental disorders was 11·9% (10·9–12·9) in 2021, ranging from 10·1% (9·1–11·3) in Viet Nam to 13·2% (11·6–15·3) in Malaysia, with anxiety and depressive disorders being the most common. The age-standardised prevalence of mental disorders increased by 6·5% (3·7–9·8) between 1990 and 2021. Mental disorders accounted for 11·2 million (8·5–14·3) DALYs in 2021, representing an 87·4% (81·1–94·0) increase since 1990. The 10–14 years age group had the highest disease burden attributable to mental disorders, which accounted for 16·3% (12·7–20·5) of total DALYs in this age group. The largest relative increases in the number of cases of mental disorders between 1990 and 2021 were seen in older adults (182·8% [174·9–192·1] among those aged ≥70 years), despite small relative changes in prevalence in these age groups.<h3>Interpretation</h3>The increase in mental disorder prevalence and burden found in this study might partly reflect recent improvements in detection. However, mental disorders now rank among the top ten causes of disease burden in all ASEAN countries except Myanmar, underscoring the urgent need for a comprehensive intersectoral approach to address prevention and treatment gaps across entire populations.<h3>Funding</h3>Gates Foundation.","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"58 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144153369","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 epidemiology and burden of smoking in countries of the Association of Southeast Asian Nations (ASEAN), 1990–2021: findings from the Global Burden of Disease Study 2021","authors":"","doi":"10.1016/s2468-2667(24)00326-8","DOIUrl":"https://doi.org/10.1016/s2468-2667(24)00326-8","url":null,"abstract":"<h3>Background</h3>Tobacco smoking has long been a regional health priority for the Association of Southeast Asian Nations (ASEAN). Despite decades of commitment to implementing tobacco control measures, the ASEAN region continues to face substantial challenges in reversing the epidemic. We aimed to analyse longitudinal data on smoking prevalence and attributable disease burden to understand the trajectory of the smoking epidemic, inform priority setting, and enable effective policy planning.<h3>Methods</h3>We used data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 to evaluate the prevalence of tobacco smoking and its attributable disease burden in the ten ASEAN member states by age and sex, from 1990 to 2021. Current smoking prevalence was estimated using spatiotemporal Gaussian process regression models, which synthesised data from 159 distinctive data sources specific to the ASEAN region in addition to 2646 data sources from other GBD countries. Dose–response risks for 36 health outcomes were derived using the latest burden of proof approach. Population attributable fractions were subsequently calculated and applied to determine the burden in terms of mortality, years of life lost, years lived with disability, and disability-adjusted life-years (DALYs) attributable to tobacco smoking in these countries.<h3>Findings</h3>In 2021, there were approximately 137 million (95% uncertainty interval 134–139) current smokers aged 15 years and older in the ASEAN region, with an estimated age-standardised prevalence of 48·4% (47·5–49·2) among males and 4·47% (4·09–4·92) among females. Tobacco smoking accounted for 10·8% (8·86–12·9) of all-cause mortality across the region. The total number of deaths and DALYs attributed to smoking were 526 000 deaths (433 000–622 000) and 15·7 million (12·9–18·5) DALYs. Death rates varied considerably across the region, especially among males, ranging from 68·9 (55·8–84·2) per 100 000 males in Singapore to 364 (279–463) per 100 000 males in Cambodia. Although smoking prevalence declined substantially in most ASEAN countries between 1990 and 2021, the absolute number of smokers increased by 63·3% (59·0–67·8), and the number of smokers aged 10 years and older increased by 53·0 million (50·2–56·2).<h3>Interpretation</h3>Tobacco smoking remains a persistent public health threat in the ASEAN region. Considerable disparities exist across the region: while some countries have made remarkable progress in tobacco control, others lag behind. As a modifiable risk factor heavily influenced by commercial determinants, smoking can be controlled through effective policy changes. As a geopolitical and economic collaboration network, ASEAN countries must work together to overcome barriers hindering anti-tobacco efforts and collectively devise strategies to strengthen tobacco control across the region.<h3>Funding</h3>Bloomberg Philanthropies and the Bill &amp; Melinda Gates Foundation.","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"54 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144153367","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":"Improving public health in the ASEAN","authors":"","doi":"10.1016/s2468-2667(25)00123-9","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00123-9","url":null,"abstract":"The Association of Southeast Asian Nations (ASEAN) is a regional organisation comprised of ten member states: Brunei, Cambodia, Indonesia, Laos, Malaysia, Myanmar, the Philippines, Singapore, Thailand, and Viet Nam. Home to more than 676 million people, the ASEAN is a geopolitical and economic collaboration network, with stark economic, political, ethnic, and cultural diversities among countries. As the <span><span>ASEAN post-2015 health development agenda</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> is ending and post-2025 planning is underway: robust data on population health are crucial to assess progress and to guide future plans. In this issue of <em>The Lancet Public Health</em>, we publish a series of four Articles led by Marie Ng (National University of Singapore, Singapore), the Institute for Health Metrics and Evaluation, and the ASEAN collaborators. Leveraging data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, they document the epidemiology and burden of major diseases in the region to inform public health priorities setting and policy planning.","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"43 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144153364","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":"De-siloing substance misuse and self-harm research through integrated public health and emergency medicine","authors":"Lisa Schölin, Chris Humphries, Michael Eddleston, Gearóid Brennan, Adam Lloyd, Matthew J Reed, Michael E Bryan, Linda J Smith, Jonathan Brett","doi":"10.1016/s2468-2667(25)00096-9","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00096-9","url":null,"abstract":"Acute and chronic problems related to alcohol, drugs, and self-harm are important public health challenges and are compounded by socioeconomic inequalities. People with substance use disorders or mental ill health, or both, are attended to by ambulance and emergency departments at higher rates than the general population and their outcomes are often poor, with mortality ranging from 5% to 15% within 1 year of receiving emergency care. There is a need to better understand presentations to emergency departments and opportunities for intervention. In this Viewpoint, we discuss the need for a holistic understanding of emergency care interactions linked to alcohol, drugs, and self-harm, and the urgent need for integrated research. We propose an integrated public health and emergency care approach to tackle this issue. Importantly, future research should address the underlying social and environmental determinants of substance misuse and self-harm. When developed in collaboration with people with lived or living experience, such an integrated approach to care and research has the potential to reduce harm, improve quality of life, prevent premature mortality, and inform policy and practice.","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"57 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144066251","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}