Lancet Public Health最新文献

{"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}

{"title":"Potassium-enriched salt: a new era for UK salt reduction?","authors":"Elisa Pineda, Thomas E Beaney","doi":"10.1016/s2468-2667(25)00074-x","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00074-x","url":null,"abstract":"WHO's new guideline advocating for the switch from regular salt (sodium chloride) to potassium-enriched salt substitutes marks a transformative step in global efforts to reduce hypertension, stroke, and cardiovascular disease.<span><span>¹</span></span> Despite pioneering salt reduction strategies since the early 2000s, the UK faces a stagnation in progress.<span><span>2</span></span>, <span><span>3</span></span> The new guideline should provide a renewed impetus for a stronger public health approach.","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"9 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143933267","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":"Medical conditions and the risk of subsequent major depressive disorder: a nationwide, register-based, retrospective cohort study","authors":"Per E Sigvardsen, Emil Fosbøl, Anders Jørgensen, Christian Torp-Pedersen, Lars Køber, Klaus F Kofoed","doi":"10.1016/s2468-2667(25)00073-8","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00073-8","url":null,"abstract":"<h3>Background</h3>Major depressive disorder can develop subsequent to medical conditions; however, it is unknown if some individuals are at higher risk than others. We aimed to provide comprehensive estimates for the risk of major depressive disorder subsequent to the onset of various medical conditions.<h3>Methods</h3>In this nationwide, population-based, retrospective cohort study, individuals living in Denmark between Jan 1, 1995, and Dec 31, 2022, were included. Individuals who already had a medical condition or major depressive disorder within a 5-year washout period were excluded. Information on medical conditions and major depressive disorder was obtained from the National Danish Registries. The exposure was onset of medical conditions, defined as any of nine categories: circulatory, endocrine, pulmonary, gastrointestinal, urogenital, musculoskeletal, haematological, cancers, and neurological. The endpoint was major depressive disorder. Hazard ratios (HRs) were estimated with adjusted Cox regression models. Absolute risks were estimated with competing-risk survival analysis.<h3>Findings</h3>6 528 353 individuals were followed up for a total of 100 770 621 person-years. 2 114 575 (32·4%) individuals were diagnosed with a medical condition and 1 112 043 (17·0%) individuals were diagnosed with major depressive disorder. Individuals with medical conditions had a higher rate of major depressive disorder than those without (HR 2·26, 95% CI 2·25–2·28). In the first month after onset of a medical condition, the HR for major depressive disorder was 4·62 (95% CI 4·50–4·74). The HR in the first months after onset of a medical condition was further elevated in individuals aged 60 years or older (HR 9·04, 95% CI 8·63–9·47), in patients hospitalised for a medical condition (11·83, 11·25–12·45), and in those with at least two medical conditions (8·92, 8·74–9·11). Musculoskeletal conditions had the highest HR for major depressive disorder (2·50, 2·49–2·51), whereas endocrine conditions had the lowest (1·35, 1·34–1·36). More than 10 years after onset of a medical condition the HR for major depressive disorder was 1·84 (95% CI 1·82–1·86). The absolute risk for major depressive disorder 20 years after onset of a medical condition was 18·9% (18·8–19·0) in men and 24·4% (24·3–24·5) in women compared with 6·9% (6·8–7·0%) in matched men without a medical condition and 10·7% (10·6–10·8%) in matched women without a medical condition.<h3>Interpretation</h3>Onset of medical conditions is associated with an elevated risk of major depressive disorder and is further elevated immediately after diagnosis and in specific subgroups. These findings can be used for early detection and to give attention to specific groups in the period after onset of medical conditions.<h3>Funding</h3>The Research Council of Rigshospitalet.","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"39 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143931073","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":"Risk of depressive disorder after a range of medical conditions: the importance of registers","authors":"Oleguer Plana-Ripoll, Natalie C Momen","doi":"10.1016/s2468-2667(25)00113-6","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00113-6","url":null,"abstract":"The interplay between major depressive disorder and other medical conditions is complex and likely bidirectional.<span><span>¹</span></span> With the use of electronic administrative registers, it is possible to comprehensively investigate associations between different comorbid conditions. This type of data often includes routinely collected information on an entire population, allowing researchers to consider such associations in detail without the risk of recall bias.","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"142 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143931076","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 2025; 10: e391–400","authors":"","doi":"10.1016/s2468-2667(25)00114-8","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00114-8","url":null,"abstract":"<em>Li A, Leppold C. Long-term mental health trajectories across multiple exposures to climate disasters in Australia: a population-based cohort study.</em> Lancet Public Health <em>2025;</em> 10: <em>e391–400</em>—In table 2 of this Article, the text in the far left column for the subcategories below Second disaster and Third disaster should have read “<em>vs</em> before disaster one”. This correction has been made as of April 30, 2025.","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"13 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143893914","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":"Estimating global direct health-care spending on neurological and mental health between 2000 and 2019: a modelling study","authors":"A J Mitchell, Ian E Cogswell, Jeremy Dalos, Golsum Tsakalos, Jiali Lei, Andrei Oros, Quinn Rafferty, Serena Santoni, Xaviera Steele, Joseph L Dieleman, Angela E Apeagyei","doi":"10.1016/s2468-2667(25)00089-1","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00089-1","url":null,"abstract":"<h3>Background</h3>The burden of brain disorders, including neurological and mental health conditions, is rising globally. Despite the increasing burden, literature quantifying global spending patterns on care services for brain disorders is sparse. Our aim was to quantify the direct spending on health care associated with brain disorders between 2000 and 2019.<h3>Methods</h3>In this modelling study, we estimated direct spending for 24 brain disorders across 204 countries in males and females across 18 age groups between 2000 and 2019. We used disease prevalence and incidence from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023, relative price of care estimates from the Institute for Health Metrics and Evaluation Disease Expenditure Project, and type of care-specific and country-specific adjustment factors from the National Health Accounts, to develop estimates of direct health spending on brain disorders. We adjusted our estimates using a hierarchical linear mixed-effects model regression.<h3>Findings</h3>We estimated US$1·7 trillion (95% uncertainty interval 1·6–1·9) in direct health-care spending on brain disorders in 2019, in which spending grew annually at 3·5% (3·2–3·7) since 2000. Direct spending on services for neurological disorders accounted for 51·8% (48·4–55·6) of total spending in 2019, in which inpatient care services represented the largest fraction of overall spending on brain health globally. Older adults aged 50–74 years had the highest spending on care services and the steepest growth. There were minimal sex differences overall.<h3>Interpretation</h3>Direct spending on brain health contributes to a substantial economic burden for societies. In light of an increasingly ageing global population, it is crucial that policy makers prioritise interventions that support households affected by brain disorders.<h3>Funding</h3>Roche Holdings and Genentech.","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"30 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143889444","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 mental health trajectories across multiple exposures to climate disasters in Australia: a population-based cohort study","authors":"Ang Li, Claire Leppold","doi":"10.1016/s2468-2667(25)00068-4","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00068-4","url":null,"abstract":"<h3>Background</h3>Tracking populations through increasingly frequent climate disasters and understanding what contributes to mental health risks is crucial for adaption and planning for a climate changed world. We aimed to examine mental health trajectories after consecutive climate-related disasters and assess differences in mental health outcomes by temporal proximity to previous disasters and risk profiles.<h3>Methods</h3>Using longitudinal population-based Australian data from 2009 to 2019, people who experienced home damage from at least one disaster (flood, bushfire, or cyclone) were included in the exposure population and tracked from pre-disaster to post-disaster years after each exposure. Cumulative mental health effects of each sequential exposure were estimated through various mental health measures using a panel event study design with linear models in comparison to unexposed matched controls, pre-disaster baselines, and across stratified risk groups. The main mental health outcome was measured with the 5-item mental health inventory (MHI-5).<h3>Findings</h3>Mental health effects became more severe with successive disasters. MHI-5 scores declined by 1·61 (95% CI –2·69 to –0·52) and 3·37 (–6·45 to –0·29) during the first and repeat disaster exposures, respectively, compared with the year preceding the first disaster. Recovery to a pre-disaster baseline was more delayed with repeat disaster exposures. There were greater declines in mental health when disasters were closer to the previous exposure (1–2 years apart) than further away (3 or more years). Risk factors that shape mental health trajectories either remained consistent across multiple exposures (social support as protective and long-term health conditions as risks) or became more salient during subsequent exposures (lower household income and rural areas more vulnerable to the mental health effects of repeat disasters).<h3>Interpretation</h3>Additional disaster exposures were associated with greater declines in mental health and shifts in some risk factors. Multiple disaster exposures must be urgently considered in public health, welfare, and disaster services.<h3>Funding</h3>Australian Research Council.","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"67 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143889443","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":"Screen no matter the risk?","authors":"Frerik Smit, Axelle Braggion, Arnaud Chiolero","doi":"10.1016/s2468-2667(25)00093-3","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00093-3","url":null,"abstract":"The systematic review by Naomi Tan and colleagues published in <em>The Lancet Public Health</em> (February issue) on the perceptions of personalised risk-based cancer screening reflects a growing trend in the field, with a risk-based approach seemingly being the future of cancer screening.<span><span>¹</span></span> In an era of personalised medicine and precision public health, there is considerable appeal in tailoring cancer screening according to individual risk. By identifying and screening people at high risk of cancer who are likely to benefit the most from screening, the hope is to maximise cancer-specific mortality reductions without exposing people who are at low risk—and unlikely to benefit from screening—to potential harms.<span><span>1</span></span>, <span><span>2</span></span> This approach represents one strategy for preventing low-value, population-based screening.<span><span>³</span></span>","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"34 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143889441","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":"Climate disasters and mental health: directions for research, practice, and policy","authors":"Sarah R Lowe, Dana Rose Garfin","doi":"10.1016/s2468-2667(25)00097-0","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00097-0","url":null,"abstract":"Climate change has increased the frequency, severity, and lethality of climate disasters, including hurricanes, wildfires, and floods, with these trends expected to escalate.<span><span>¹</span></span> Resultingly, individuals and communities will be at increased risk of exposure to multiple disasters over time. Since robust research has correlated disaster exposure with mental ill health,<span><span>2</span></span>, <span><span>3</span></span> understanding how successive disasters affect population mental health is crucial.","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"42 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143889439","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}