Lancet Public Health最新文献

{"title":"Health impact and economic evaluation of the Expanded Program on Immunization in China from 1974 to 2024: a modelling study","authors":"Chaofan Wang, Xiaozhen Lai, Kaja Abbas, Koen B Pouwels, Haijun Zhang, Mark Jit, Hai Fang","doi":"10.1016/s2468-2667(25)00039-8","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00039-8","url":null,"abstract":"<h3>Background</h3>The Expanded Program on Immunization (EPI), initiated by WHO in 1974, is a cornerstone of public health. China's EPI covers more than a sixth of the world's population and includes eight routine vaccines with high coverage rates. This study aimed to estimate health and economic impacts of China's EPI over the past 50 years (1974–2024).<h3>Methods</h3>This study mathematically modelled the impact of all eight routine vaccines in China's EPI against eight pathogens (measles, pertussis, hepatitis B, tuberculosis, hepatitis A, Japanese encephalitis, meningitis A, and poliomyelitis) based on data availability and their substantial disease burden, particularly accounting for non-linearities in vaccine impact. Health and economic outcomes were determined using mathematical models between a counterfactual scenario without vaccination (vaccine coverage set to zero) and the current vaccination scenario (routine vaccination scheduled at age 0–6 years), based on calendar year and birth cohort approaches. The health impact of China's EPI from 1974 to 2024 was measured in the number of cases, deaths, and disability-adjusted life-years (DALYs) averted.<h3>Findings</h3>We estimated that China's EPI averted 703·02 million cases (95% credible interval 699·51–722·80) and 2·48 million deaths (2·14–2·97) in 1974–2024 based on the calendar year approach, equivalent to averting an estimated 160·22 million DALYs (145·05–196·99). Using the birth cohort approach, we predicted 707·41 million cases (703·93–727·03) and 7·01 million deaths (6·95–7·87) averted over the lifetime, corresponding to 279·02 million DALYs (265·78–316·12). From a societal perspective, the aggregated cost of vaccination was estimated to be US$124·06 billion (120·49–127·49), although the benefits amounted to $2417·85 billion (2359·38–2710·35). China's EPI yielded an aggregate benefit–cost ratio of 19·48 (18·82–22·08) from the societal perspective and 8·02 (7·64–8·80) from the provider's perspective.<h3>Interpretation</h3>China's EPI has shown remarkable health and economic achievements, contributing to worldwide EPI success in the past 50 years. Further investment in EPI is warranted to sustain coverage and expand vaccine inclusion in China and globally.<h3>Funding</h3>Beijing Natural Science Foundation.<h3>Translation</h3>For the Chinese translation of the abstract see Supplementary Materials section.","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"261 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143866434","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":"Comparing the effects of prescribed safer opioid supply and methadone in Ontario, Canada: a population-based matched cohort study","authors":"Tara Gomes, Daniel McCormack, Gillian Kolla, Samantha Young, Ahmed M Bayoumi, Ashley Smoke, Ping Li, Tony Antoniou","doi":"10.1016/s2468-2667(25)00070-2","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00070-2","url":null,"abstract":"&lt;h3&gt;Background&lt;/h3&gt;Prescribed safer opioid supply (SOS) programmes are novel harm reduction interventions. We examined health outcomes among people receiving SOS over time and relative to a similar group of people receiving methadone.&lt;h3&gt;Methods&lt;/h3&gt;We conducted a population-based cohort study among new SOS and methadone recipients in Ontario, Canada, who commenced treatment between Jan 1, 2016 and Dec 31, 2021. People receiving SOS were matched (1:1) to new methadone recipients based on age (within 3 years), sex, location of residence (public health unit), and propensity score (within 0·2 SDs). Primary outcomes were hospital-treated opioid-related toxicities, emergency department visits and inpatient hospitalisations, incident infections, and health-care costs (in CA$, excluding costs related to primary care services and medications) over 1 year of follow-up. Outcome rates were calculated over the follow-up period, with censoring on death, discontinuation of SOS or methadone, or end of follow-up (360 days). Within-group changes in outcomes were assessed using interrupted time-series analysis, and Prentice–Williams–Peterson regression was used to assess between-group differences in recurrent events.&lt;h3&gt;Findings&lt;/h3&gt;Of the 991 new recipients prescribed SOS and 25 116 new methadone recipients who met the eligibility criteria, 856 (86·4%) people receiving SOS were matched to 856 people receiving methadone. In the within-group analysis, matched SOS recipients had significant improvements in the monthly rate of opioid toxicities (step change –1·09 events per 100 individuals [95% CI –2·12 to –0·07]; p=0·037), all-cause emergency department visits (–8·85 per person-year [–13·5 to –4·20]; p=0·0002), all-cause inpatient hospitalisations (–2·08 per person-year [–3·41 to –0·75]; p=0·0022), incident infections (–0·68 per person-year [–1·22 to –0·14]; p=0·013), and non-primary-care-related health-care costs (–$91 699 per person-year [–112 749 to –70 650]; p&lt;0·0001). Results were consistent for methadone recipients. In the between-group analysis, individuals commencing SOS had significantly higher hazards of opioid toxicity (hazard ratio 2·83 [95% CI 1·97 to 4·06]), emergency department visits (1·16 [1·05 to 1·29]), and inpatient admissions (1·50 [1·13 to 1·99]), no significant difference in the rate of incident infection (1·51 [0·87 to 2·61]), and were less likely to discontinue treatment than those commencing methadone (0·62 [0·55 to 0·70]). When treatment discontinuation was removed as a censoring criterion, we found no difference between groups in the hazard of any of the primary outcomes except opioid toxicity (1·65 [1·38 to 1·97]).&lt;h3&gt;Interpretation&lt;/h3&gt;SOS and methadone were associated with improvements in health outcomes, including reduced opioid toxicities and health-care use, in the year after treatment initiation. The findings suggest SOS programmes play an important, complementary role to traditional opioid agonist treatment in expanding the opt","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"45 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143862268","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":"Trends in alcohol-specific deaths in England, 2001–22: an observational study","authors":"Melissa Oldham, Sarah Jackson, Jamie Brown, Vera Buss, Gautam Mehta, Jennifer Beam Dowd, John Holmes, Colin Angus","doi":"10.1016/s2468-2667(25)00047-7","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00047-7","url":null,"abstract":"<h3>Background</h3>Following the COVID-19 pandemic, many countries saw large increases in rates of alcohol-specific deaths, including England. This study aimed to examine whether there have been changes in the characteristics of those dying by specific cause of death, age, sex, and area-level deprivation.<h3>Methods</h3>Using annual mortality data in England published by the Office for National Statistics, we describe the prevalence and 95% CI of age-standardised rates of alcohol-specific deaths overall and by age, sex, area-level deprivation measured by quintiles of the Index of Multiple Deprivation (IMD), and cause of death between 2001 and 2022. We also compared demographic profiles of those dying before the COVID-19 pandemic (2017–19) and after (2020–22); calculated crude absolute differences in rates and relative rate ratios across age, sex, and IMD; and used a multivariable Poisson regression model to calculate the rate ratio and adjusted absolute differences for deaths by IMD quintile for each period, adjusting for age and sex.<h3>Findings</h3>Age-standardised rates of alcohol-specific deaths in England remained largely unchanged until 2019, before rising sharply by 19·4% in 2020 and continuing to rise by a further 13·5% to the highest level on record in 2022: 14·7 (95% CI 14·4–15·0) per 100 000 people. There were few relative demographic changes in alcohol-specific mortality between 2017–19 (pre-pandemic) and 2020–22 (after the start of the COVID-19 pandemic) because the largest absolute increases in alcohol-specific mortality were seen among groups that had the highest pre-pandemic rates, including men (absolute rate increase, 3·87; relative increase, 25·9%) and those from areas of higher deprivation (absolute rate increase, 4·72; relative increase, 22·5%). When examining causes of deaths, the largest absolute increase was in alcohol-related liver disease (2·37; relative increase, 27·2%), with the largest relative increase in acute causes (absolute rate increase, 0·49; relative increase, 35·4%), although these accounted for a smaller proportion of deaths compared to alcohol-related liver disease. There was little to no change in deaths from alcohol dependence syndrome (absolute rate increase, 0·02; relative increase, 5·8%).<h3>Interpretation</h3>Alcohol-specific deaths in England remain high and increased after the COVID-19 pandemic. Policies should aim to reduce rates of alcohol consumption at the population level. Substantial investment is also required to facilitate early detection of liver disease and effective treatment.<h3>Funding</h3>Cancer Research UK","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"26 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143820033","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":"Implementing public health policy to tackle alcohol-related harms","authors":"Pojsakorn Danpanichkul, Karn Wijarnpreecha","doi":"10.1016/s2468-2667(25)00048-9","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00048-9","url":null,"abstract":"The Global Burden of Disease Study 2021 identifies alcohol consumption as one of the top ten leading risk factors for disability.<span><span>¹</span></span> The COVID-19 pandemic has substantially affected public health, including shifts in alcohol-related mortality trends. Melissa Oldham and colleagues<span><span>²</span></span> critically examine alcohol-specific deaths in England over the past two decades, revealing a sharp increase since 2020. The most pronounced absolute rises were seen among men (absolute rate increase, 3·87; relative increase, 25·9%) and those from socioeconomically disadvantaged areas (absolute rate increase, 4·72; relative increase, 22·5%), exacerbating existing health inequalities and underscoring the need for targeted policy responses.","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"4 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143820032","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":"Effect of extending PrEP initiation to primary care settings: a nationwide cohort study in France","authors":"Sophie Bamouni, Sophie Billioti de Gage, David Desplas, Julie Valbousquet, Julie Lamant, Jean-Philippe Joseph, François Dabis, Agnès Viot, Mojgan Hessamfar, Salim Fakir, Rosemary Dray-Spira, Michel Carles","doi":"10.1016/s2468-2667(25)00062-3","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00062-3","url":null,"abstract":"<h3>Background</h3>Pre-exposure prophylaxis (PrEP) medicines are key to reducing HIV infection. Improving access, increasing initiation, and expanding the populations covered is therefore important. In June, 2021, in France, PrEP initiation was extended to primary care. The aim of this study was to describe the deployment and characteristics of PrEP initiation in primary care.<h3>Methods</h3>We did a nationwide cohort study using data obtained from the French National Health Data System (Système National des Données de Santé). We included all people aged 15 years or older, who initiated PrEP in primary care between June 1, 2021, and Dec 31, 2022. We estimated the number of PrEP initiations per month over the period, and the characteristics of people initiating PrEP and prescribers, and PrEP use.<h3>Findings</h3>13 500 individuals initiated PrEP in primary care during the study period. The mean number of PrEP initiations increased from 654 (SD 64) per month between July and December, 2021, to 783 (SD 86) per month between July and December, 2022. Individuals initiating PrEP were predominantly male (12 996 [96·3%] of 13 500 individuals) with a mean age of 36 years (SD 11·8), who lived in large urban areas (9581 [71·0%]). 1012 (7·5%) of 13 500 individuals were socioeconomically disadvantaged. Of the 5125 PrEP initiation prescribers, 4542 (88·6%) were general practitioners (GPs), and 4713 (44·7%) of 10 525 were the patient's family practitioner. In the 6 months after PrEP initiation, 6216 (70·8%) of 8783 PrEP initiators had at least one monthly renewal (mean 3·3 renewals [SD 1·7]). 11 961 (82·4%) of 14 507 renewals were made by the same practitioner who had initiated PrEP, and this proportion was higher when the prescriber who had initiated PrEP was the family practitioner (6225 [92·5%] of 7135 renewals).<h3>Interpretation</h3>Although the number of PrEP initiations in primary care steadily increased over the study period, the profile of users was unchanged when compared with before extension. The high proportion of PrEP initiations not prescribed by family practitioners highlights potential barriers to sharing sexual health concerns with the family practitioner. Extending PrEP to women, individuals who are socioeconomically disadvantaged, and all those who might benefit from it will require increased awareness among target audiences and practitioners.<h3>Funding</h3>French National Agency for Medicines and Health Products Safety.","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"183 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143806184","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":"Extending PrEP access and coverage in France","authors":"Leslie Grammatico-Guillon, Yazdan Yazdanpanah","doi":"10.1016/s2468-2667(25)00067-2","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00067-2","url":null,"abstract":"Pre-exposure prophylaxis (PrEP) has become a key strategy for HIV prevention worldwide.<span><span>1</span></span>, <span><span>2</span></span> Since 2016 in France, PrEP—in particular a fixed-dose combination of oral tenofovir disoproxil fumarate and emtricitabine—has been available and fully covered by the French Health Insurance for people considered at high-risk of HIV acquisition. Since its introduction, the number of PrEP initiations has steadily increased, with an estimated 103 407 individuals initiating PrEP up to June, 2024.<span><span>3</span></span>, <span><span>4</span></span> Nevertheless, barriers to uptake and adherence remain, and disparities in PrEP initiation are a concern. In 2023, fewer than 20% of eligible men who have sex with men (MSM) and 2–4% of women at high risk of HIV acquisition were estimated to have initiated PrEP.<span><span>5</span></span>, <span><span>6</span></span>","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"18 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143806242","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":"Could people live longer and healthier?","authors":"Qiushi Feng, Daisheng Tang","doi":"10.1016/s2468-2667(25)00072-6","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00072-6","url":null,"abstract":"Japan is an important case in ageing research, showing how the epidemiological transition progresses in a society with almost 30% of its population older than 65 years. The latest Global Burden of Disease (GBD) Study 2021, published in <em>The Lancet Public Health</em>, traced a 30-year transformation of morbidity and mortality in Japan.<span><span>¹</span></span> The study suggests that Japan has seen a slowed or plateaued trend in the continuously extended life expectancy for the past three decades, and an even slower pace of healthy life expectancy. Additionally, and importantly, regional disparity continues to widen across prefectures.<span><span>¹</span></span>","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"15 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143766631","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":"Changes in incarceration and tuberculosis notifications from prisons during the COVID-19 pandemic in Europe and the Americas: a time-series analysis of national surveillance data","authors":"Amy Zheng, Lena Faust, Anthony D Harries, Pedro Avedillo, Michael Akodu, Miranda Galvan, Beatriz Barreto-Duarte, Bruno B Andrade, César Ugarte-Gil, Alberto L Garcia-Basteiro, Marcos Espinal, Joshua L Warren, Leonardo Martinez","doi":"10.1016/s2468-2667(24)00325-6","DOIUrl":"https://doi.org/10.1016/s2468-2667(24)00325-6","url":null,"abstract":"<h3>Background</h3>The COVID-19 pandemic disrupted tuberculosis control programmes globally; whether or not this disproportionately affected people who were incarcerated is unknown. We aimed to evaluate changes in incarceration and tuberculosis notifications in prisons in Europe and the Americas during the COVID-19 pandemic.<h3>Methods</h3>Data from WHO Pan American Health Organization (PAHO) and WHO Europe were used to conduct a joint hierarchical Bayesian negative binomial time-series. This approach accounted for world region, country-specific temporal trends, and country-specific autocorrelated random effects to simultaneously model and predict both annual prison population (ie, the offset) and prison tuberculosis cases (ie, the primary outcome). Results were used to calculate percentage differences between predicted and observed annual tuberculosis notifications and prison populations during the COVID-19 pandemic years (2020–22).<h3>Findings</h3>In total, 22 of 39 countries from PAHO and 25 of 53 countries from WHO Europe were included (representing 4·9 million people incarcerated annually), contributing 520 country-years of follow-up. Observed tuberculosis notifications in prisons were lower than predicted in 2020 (–26·2% [95% credible interval –66·3 to 7·8), 2021 (–46·4% [–108·8 to 3·9]), and 2022 (–48·9 [–124·4 to 10·3]). These decreasing trends were consistent across Europe and the Americas, but larger decreases were seen in low-burden settings in 2020 (–54·8% [–112·4 to –4·8]) and 2021 (–68·4% [–156·6 to –2·9]), high-burden settings in 2021 (–89·4% [–190·3 to –10·4]), and Central and North America in 2021 (–100·3% [–239·0 to –6·3]). Observed incarceration levels were similar to predicted levels (&lt;10% difference overall) during all COVID-19 pandemic years.<h3>Interpretation</h3>Tuberculosis notifications in prisons from 47 countries in Europe and the Americas were lower than expected (at times &gt;50% lower) during COVID-19 pandemic years, despite consistent incarceration levels. Reasons for this change in tuberculosis notifications might be multifactorial and include missed diagnoses and implementation of COVID-19 pandemic measures, reducing transmission. Greater prioritisation of people who are incarcerated is needed to ensure appropriate access to care in the face of future pandemics.<h3>Funding</h3>Canadian Institutes of Health Research, National Institutes of Health, and Oswaldo Cruz Foundation, Brazil.","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"183 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143745274","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":"Rates, causes, and risk factors for death among justice-involved young people in Australia: a retrospective, population-based data linkage study","authors":"Stuart A Kinner, Lucas Calais-Ferreira, Jesse T Young, Rohan Borschmann, Alan Clough, Ed Heffernan, Scott Harden, Matthew J Spittal, Susan M Sawyer","doi":"10.1016/s2468-2667(25)00042-8","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00042-8","url":null,"abstract":"<h3>Background</h3>Children and adolescents exposed to the youth justice system have poor health profiles, but little is known about their subsequent mortality. We aimed to examine mortality outcomes in a large, state-wide cohort of young people in Australia who had contact with the youth justice system.<h3>Methods</h3>We linked youth justice records in the state of Queensland, Australia from July 1, 1993, to June 30, 2014, with adult correctional records and the National Death Index, for records up to Jan 31, 2017. We calculated all-cause and cause-specific crude mortality rates per 100 000 person-years, and age-standardised and sex-standardised mortality ratios with 95% CIs. Calculations were performed for the whole cohort and in subgroups defined by sex, Indigenous status, and youth justice history. We used survival analysis to identify demographic and criminal justice factors associated with all-cause mortality.<h3>Findings</h3>Of 49 011 individuals in the study sample, 321 were excluded due to data linkage or data quality issues and 20 were excluded as they did not have an age or date of birth recorded, which resulted in 48 670 (99·3%) participants. 11 897 (24·4%) participants were female, 36 773 (75·6%) were male, and 13 250 (27·2%) were Indigenous. During a median of 13·5 years (IQR 8·4–18·4) of follow-up, we observed 1431 (2·9%) deaths among the 48 670 participants. Median age at end of follow-up was 28·6 years (IQR 23·6–33·6). The most common causes of death were suicide (495 [34·6%]), transport accidents (244 [17·1%]), and accidental drug poisoning (209 [14·6%]). The all-cause crude mortality rate was 218·9 deaths (95% CI 207·9–230·6) and the all-cause standard mortality ratio was 4·2 (3·9–4·4). In multivariable analyses, mortality rates were higher for males (adjusted hazard ratio [aHR] 1·5 [95% CI 1·3–1·7]); those who had been subject to community supervision (aHR 1·3 [1·1–1·5]), or detention (aHR 2·1 [1·8–2·4]) versus charge only; and those under adult correctional supervision in the community (aHR 1·9 [1·5–2·4]) versus unsupervised. More than half of the observed deaths occurred before 25 years of age, and very few (1·6%) occurred in custody.<h3>Interpretation</h3>Justice-involved young people are at markedly increased risk of premature death from largely preventable causes. Reducing the burden of preventable death among these young people will require coordinated, multi-sectoral responses that extend beyond the criminal justice system.<h3>Funding</h3>National Health and Medical Research Council, Australia.","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"53 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143745178","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":"Health care universalism in Italy: a debunked myth","authors":"Anna Odone, Riccardo Vecchio","doi":"10.1016/s2468-2667(25)00064-7","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00064-7","url":null,"abstract":"Almost 50 years ago the Italian National Health Service (NHS) was established under the principles of health care universalism, equity, and solidarity. Where do we stand today? In an ageing society, where there is a struggle to balance increasing health needs with available resources to sustain health care, answering this question is imperative. In <em>The Lancet Public Health</em>, The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) Italian Collaborators have taken up the challenge again,<span><span>¹</span></span> after a previous attempt in 2019.<span><span>²</span></span>","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"42 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143745154","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}