Lancet Public Health最新文献

{"title":"Control of childhood obesity and implications for policy in China","authors":"Yanhui Dong, Changzheng Yuan, Jiajia Dang, Xinli Song, Guo Cheng, Yajun Chen, Haijun Wang, Jie Mi, Bo Xi, Yi Song","doi":"10.1016/s2468-2667(24)00263-9","DOIUrl":"https://doi.org/10.1016/s2468-2667(24)00263-9","url":null,"abstract":"Prevention and control of childhood obesity in China is complex. Despite numerous existing policy endeavours, particularly Healthy China 2030, accompanied by multiministerial initiatives, childhood obesity persists and even exacerbates. In this paper, we review current national policies, assess progress of the existing system managing childhood weight, and identify implementation challenges. Leveraging insights from existing literature and guided by a PEDALS (ie, problem, evidence-based practice, determinants, actions, long term, and scalability) framework, we propose a strategy to refine and integrate current policies, interventions, and research into a policy framework, embedding evidence-based practices into practical solutions for childhood obesity prevention and control in China.","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"65 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142678611","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":"Public health interventions against childhood obesity in China","authors":"Changzheng Yuan, Yanhui Dong, Hui Chen, Le Ma, Lihong Jia, Jiayou Luo, Qin Liu, Yifei Hu, Jun Ma, Yi Song","doi":"10.1016/s2468-2667(24)00245-7","DOIUrl":"https://doi.org/10.1016/s2468-2667(24)00245-7","url":null,"abstract":"China is confronted with the challenge of increasing childhood obesity. Although interventions for childhood obesity have been developed, their effectiveness and implementation can vary considerably across nations. In this paper, we review and consolidate the evidence on childhood obesity intervention strategies aimed at multiple levels and components across life, in China. School-based interventions, primarily delivered with group-based dietary and physical education, have shown potential efficacy and can be enhanced by integrating food environment reform and family support. However, most interventional studies were done in eastern and urban areas of China, which highlights the need for attention in regions with insufficient health resources where policies and initiatives are less accessible. In addition, the sparse reporting on implementation design and delivery might hinder the scalability of potentially effective strategies. Amid rapid social and economic development over the past few decades, China faces unique challenges on urbanisation, physical inactivity, and nutritional transitions, necessitating an updated policy agenda for primary prevention of childhood obesity. Structural longitudinal evaluations of public initiatives led by the government and organisations along with inclusive and equitable interventions targeting children of different ages, urban–rural regions, and different ethnic and socioeconomic groups are warranted. Tackling childhood obesity in China needs a cohesive approach that integrates social, economic, cultural, and environmental strategies, combining school-based, family-based, and individual-based approaches, and concerted efforts from multiple sectors and entities within China.","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"14 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142678612","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":"Diabetes in China part 1: epidemiology and risk factors","authors":"Yu Xu, Jieli Lu, Mian Li, Tiange Wang, Kan Wang, Qiuyu Cao, Yi Ding, Yu Xiang, Siyu Wang, Qianqian Yang, Xuan Zhao, Xiaoyun Zhang, Min Xu, Weiqing Wang, Yufang Bi, Guang Ning","doi":"10.1016/s2468-2667(24)00250-0","DOIUrl":"https://doi.org/10.1016/s2468-2667(24)00250-0","url":null,"abstract":"The prevalence of diabetes in China is rapidly increasing. China now has the largest number of people living with diabetes worldwide, accounting for approximately one-quarter of the global diabetes population. Since the late 1970s, China has experienced profound changes and rapid economic growth, leading to shifts in lifestyle. Changing dietary patterns, reduced physical activity, and stress have contributed to the growing prevalence of overweight and obesity, which are important determinants potentiating the link between insulin resistance and diabetes. Social and environmental factors, such as education, air pollution, and exposure to endocrine-disrupting chemicals, have also contributed to the growing diabetes epidemic in China. The country has one of the fastest ageing populations in the world, which forecasts continued increases in the prevalence of diabetes and its complications. This Review provides an overview of the ongoing diabetes epidemic and risk factors, providing evidence to support effective implementation of public health interventions to slow and prevent the diabetes epidemic in China.","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"23 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142678616","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 comprehensive nationwide smoke-free legislation in China","authors":"Shiwei Liu, Zhuo Chen","doi":"10.1016/s2468-2667(24)00272-x","DOIUrl":"https://doi.org/10.1016/s2468-2667(24)00272-x","url":null,"abstract":"Tobacco use is the leading cause of preventable death globally, accounting for more than 7 million deaths worldwide, including nearly 1·3 million deaths due to second-hand smoke.<span><span>¹</span></span> There is no safe threshold of exposure to second-hand smoke, and smoke-free environments are a proven way to adequately protect people from the harmful effects of second-hand smoke without harming businesses.<span><span>²</span></span> Legislation is required to effectively implement smoke-free environments.<span><span>²</span></span> Systematic reviews have shown that smoke-free legislation is associated with substantial reductions in morbidity and mortality from cardiovascular disease, respiratory system disease, and perinatal outcomes.<span><span>³</span></span>","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"22 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142672954","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 comprehensive smoke-free legislation on smoking behaviours and macroeconomic outcomes in Shanghai, China: a difference-in-differences analysis and modelling study","authors":"Hongqiao Fu, Sian Tsuei, Yunting Zheng, Simiao Chen, Shirui Zhu, Duo Xu, Winnie Yip","doi":"10.1016/s2468-2667(24)00262-7","DOIUrl":"https://doi.org/10.1016/s2468-2667(24)00262-7","url":null,"abstract":"<h3>Background</h3>China has one of the highest levels of tobacco consumption globally, and there is no national smoke-free legislation. Although more than 20 Chinese cities have passed local smoke-free laws since 2008, evidence on their effectiveness in reducing smoking behaviours and their economic benefits is scarce. By exploiting a natural quasi-experiment, whereby a comprehensive public smoking ban was implemented in Shanghai in March, 2017, this study aims to assess the impact of the policy on individual smoking behaviours and quantify its effect on macroeconomic outcomes.<h3>Methods</h3>In this difference-in-differences analysis and modelling study, we used data on smoking behaviours from the 2012, 2014, 2016, and 2018 waves of the China Family Panel Studies. We used a difference-in-differences approach to investigate trends in smoking prevalence in respondents in Shanghai, relative to respondents from other direct-administered municipalities, provincial capital cities, and subprovincial municipalities (control group), after the implementation of a smoking ban in 2017. All respondents aged 18 years or older were included, with the exception of people who lived in Beijing and rural areas. The primary variable of interest in the difference-in-differences analysis was self-reported smoking status. Based on the difference-in-differences estimation of reduction in smoking prevalence, we then used a health-augmented macroeconomic model to estimate the potential macroeconomic gains if such a ban was implemented across China for the period 2017–35.<h3>Findings</h3>14 688 respondents were included in the analysis: 5766 from Shanghai and 8922 from the control group. After the implementation of the smoking ban in Shanghai in 2017, smoking prevalence decreased by 2·2 percentage points (95% CI 2·1–2·3), equivalent to an 8·4% reduction in the number of current smokers. The smoking ban had a larger effect on men, people with a higher level of education, unmarried people, and younger people when compared with their respective counterparts. The modelling analysis showed that implementing a nationwide comprehensive public smoking ban similar to that in Shanghai would result in a 0·04–0·07% increase in the national gross domestic product in China between 2017 and 2035, outweighing the economic costs of smoking ban enforcement.<h3>Interpretation</h3>The smoking ban in Shanghai shows that a comprehensive public smoking ban with strict enforcement is effective in curbing smoking behaviours. Moreover, the implementation of a comprehensive public smoking ban across China would be cost-effective.<h3>Funding</h3>National Social Science Fund of China.","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"69 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142672956","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: e834–35","authors":"","doi":"10.1016/s2468-2667(24)00265-2","DOIUrl":"https://doi.org/10.1016/s2468-2667(24)00265-2","url":null,"abstract":"<em>Tan M. Mandatory salt targets: a key policy tool for global salt reduction efforts.</em> Lancet Public Health <em>2024;</em> 9: <em>e834–35—</em>In this Linked Comment, the fifth sentence of the third paragraph should have said US$8·0 billion. This correction has been made as of Nov 4, 2024.","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"45 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142579855","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 2024 China report of the Lancet Countdown on health and climate change: launching a new low-carbon, healthy journey","authors":"Wenjia Cai, Chi Zhang, Shihui Zhang, Yuqi Bai, Max Callaghan, Nan Chang, Bin Chen, Huiqi Chen, Liangliang Cheng, Hancheng Dai, Weicheng Fan, Dabo Guan, Yixin Hu, Yifan Hu, Junyi Hua, Cunrui Huang, Hong Huang, Jianbin Huang, Xiaomeng Huang, John S Ji, Peng Gong","doi":"10.1016/s2468-2667(24)00241-x","DOIUrl":"https://doi.org/10.1016/s2468-2667(24)00241-x","url":null,"abstract":"2023 was a landmark year for climate change globally, across Asia, and within China. Global average temperatures were 1·45°C higher than the pre-industrial average, making it the warmest year on record since 1850. In Asia, 2023 was the second-hottest year documented. China recorded its highest-ever average temperature at 10·71°C (0·82°C above the 1981–2010 average), had its second-lowest rainfall since 2012, and endured notable flood and drought events.","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"195 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142579856","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":"Mandatory salt targets: a key policy tool for global salt reduction efforts","authors":"Monique Tan","doi":"10.1016/s2468-2667(24)00227-5","DOIUrl":"https://doi.org/10.1016/s2468-2667(24)00227-5","url":null,"abstract":"Salt is consumed in excess in most countries, with global salt intake averaging at more than double the recommended maximum limit of 5 g per day. By raising blood pressure, excess salt intake is a major risk factor for cardiovascular disease, the leading cause of premature death and ill health worldwide. In 2013, all WHO Member States committed to a 30% reduction in average salt intake by 2025. However, as of 2023, none were on track to achieve it.<span><span>¹</span></span>","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"15 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142556011","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":"Workplace mortality risk and social determinants among migrant workers: a systematic review and meta-analysis","authors":"Karen Lau, Robert Aldridge, Marie Norredam, George Frederick Mkoma, Mathura Kugan, Rosita Chia-Yin Lin, Ligia Kiss, Cathy Zimmerman, Sally Hargreaves","doi":"10.1016/s2468-2667(24)00226-3","DOIUrl":"https://doi.org/10.1016/s2468-2667(24)00226-3","url":null,"abstract":"&lt;h3&gt;Background&lt;/h3&gt;Migrant workers, a population of 170 million, often work in dangerous or unhealthy working environments and are likely to suffer workplace injuries and labour abuses. However, the risk of mortality in migrant workers compared with local workers is unknown. We aim to synthesise global evidence on migrant worker mortality risk and identify social determinants to inform health and safety protections for migrant workers.&lt;h3&gt;Methods&lt;/h3&gt;We conducted a systematic review and meta-analysis of peer-reviewed literature to examine mortality outcomes among migrant workers and associated risk factors. We searched MEDLINE, Embase, PsycINFO, and Ovid Global Health for studies published between Jan 1, 2000, and Jan 17, 2023, reporting quantitative primary research in English. A broad definition of migrant worker was used, including any worker who is foreign-born (ie, international first-generation migrant workers), either in paid employment or self-employment. Internal migrants, second-generation migrants, and foreign health-care workers were excluded. The primary outcome was any reported mortality, including all-cause mortality, cause-specific mortality, suicide, homicide, and fatal occupational injury. We used meta-analysis to compare outcomes between migrant worker and local worker populations, and a random-effects model to calculate pooled estimates. We used narrative synthesis to develop a data-driven conceptual framework capturing the intersectional social determinants of mortality in migrant workers. The study protocol is registered on PROSPERO, CRD42023372893.&lt;h3&gt;Findings&lt;/h3&gt;Of 11 495 identified records, 44 were included in the systematic review, of which 11 studies were pooled in meta-analyses. Data were from 16 countries, most of which were high-income countries, and included 44 338 migrant worker deaths, including migrants from the agriculture, construction, mining, and service industries. Compared with local workers, migrant workers had a higher risk of fatal occupational injury (pooled relative risk 1·71, 95% CI 1·22–2·38; eight studies; &lt;em&gt;I&lt;/em&gt;&lt;sup&gt;2&lt;/sup&gt;=99·4%), and a lower risk of all-cause mortality (0·94, 0·88–0·99; three studies, &lt;em&gt;I&lt;/em&gt;&lt;sup&gt;2&lt;/sup&gt;=90·7%). Migrant workers were more likely to die from external causes of death (such as falls or assaults) than internal causes of death (such as respiratory or digestive diseases) compared with local workers, with migrant workers also more likely to die from work-related homicides, especially in the retail and sex industries, with some evidence of higher suicide rates among female migrant workers compared with female local workers. Influential social determinants for poor fatality outcomes include migration-related factors (such as lower language proficiency, undocumented status, and long duration of stay) and labour-related factors (such as precarious employment, labour migration policies, and economic deregulation policies).&lt;h3&gt;Interpretation&lt;/h3&gt;Migrant workers have a ","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"213 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142555722","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":"Estimated health benefits, costs, and cost-effectiveness of implementing WHO's sodium benchmarks for packaged foods in India: a modelling study","authors":"Kathy Trieu, Liping Huang, Leopold N Aminde, Linda Cobiac, Daisy H Coyle, Mary Njeri Wanjau, Sudhir Raj Thout, Bruce Neal, Jason H Y Wu, Lennert Veerman, Matti Marklund, Rachita Gupta","doi":"10.1016/s2468-2667(24)00221-4","DOIUrl":"https://doi.org/10.1016/s2468-2667(24)00221-4","url":null,"abstract":"<h3>Background</h3>Excess dietary sodium intake has been associated with death and disability. WHO has released global sodium benchmarks for packaged foods to support countries to reduce population sodium intake. This study aimed to assess the potential health effect, costs, and cost effectiveness of implementing these WHO sodium benchmarks in India.<h3>Methods</h3>We used a multiple cohort, proportional multistate, life table (Markov) model to estimate the health gains and cost effectiveness for adults if sodium content in packaged foods complied with the WHO benchmarks compared to the status quo. We used India-specific dietary surveys, food composition tables, foods sales data, and sodium content data from packaged food labels to estimate sodium intake before and after the intervention. Data on blood pressure, cardiovascular disease, and chronic kidney disease burden were obtained from the Global Burden of Diseases, Injuries, and Risk Factors study, and the effect of sodium reduction on blood pressure and disease risk was modelled on the basis of meta-analyses of randomised trials and cohort studies. Intervention and health-care costs were used to estimate net costs, and calculate the incremental cost per health-adjusted life-year (HALY) gained. Costs and HALYs were discounted at 3%.<h3>Findings</h3>In the first 10 years, compliance with the WHO sodium benchmarks was estimated to avert a mean of 0·3 (95% uncertainty interval [UI] 0·2–0·5) million deaths from cardiovascular diseases and chronic kidney disease, a mean of 1·7 (95% UI 1·0–2·4) million incident cardiovascular disease events, and 0·7 (0·4–1·0) million new chronic kidney disease cases, compared with current practice. Over 10 years, the intervention was projected to be cost saving (100·0% probability), generating 1·0 (0·6 to 1·4) billion HALYs and US$0·8 (95% UI 0·3 to 1·4) million in cost savings. Over the population lifetime, the intervention could prevent 4·2 (2·4–6·0) million deaths from cardiovascular diseases and chronic kidney disease, 14·0 (8·2–20·1) million incident cardiovascular disease events, and 4·8 (2·8–6·8) new chronic kidney disease cases, with an 84·2% probability of being cost-saving and 100·0% probability of being cost-effective.<h3>Interpretation</h3>Our modelling data suggest a high potential for compliance with WHO sodium benchmarks for packaged food being associated with substantial health gains and cost savings, making a strong case for India to mandate the implementation of the WHO sodium benchmarks, particularly as packaged food consumption continues to rise.<h3>Funding</h3>WHO Country Office India.","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"3 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142556460","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}