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

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.1 Despite pioneering salt reduction strategies since the early 2000s, the UK faces a stagnation in progress.2, 3 The new guideline should provide a renewed impetus for a stronger

BackgroundMajor 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. MethodsIn this nationwide, population-based, retrospective cohort study, individuals living in Denmark

The interplay between major depressive disorder and other medical conditions is complex and likely bidirectional.1 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

Li A, Leppold C. Long-term mental health trajectories across multiple exposures to climate disasters in Australia: a population-based cohort study. Lancet Public Health 2025; 10: e391–400—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 “vs before disaster one”. This correction has been made as of April 30, 2025

Halving under-5 mortality within a generation has been the most spectacular success in health during modern times. The child survival movement of the Millennium Development Goal era (2000–15) unlocked levels of political commitment and new investment never before seen in women's and children's health. Why? Because a remarkable coalition was built between civil society, scientists, policy makers, and

In The Lancet Public Health, Olivia Bannon and colleagues1 provide empirical data to show the distinctive advantage of tobacco taxes in saving children's lives and reducing health inequalities. The authors found that substantial tax increases on cigarettes reduce mortality in children younger than 5 years (hereafter referred to as under-5 mortality), with the poorest quintile benefiting the most. However

Climate change has increased the frequency, severity, and lethality of climate disasters, including hurricanes, wildfires, and floods, with these trends expected to escalate.1 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,2, 3 understanding how successive disasters

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The systematic review by Naomi Tan and colleagues published in The Lancet Public Health (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.1 In an era of personalised medicine and precision public health, there is considerable appeal in tailoring cancer screening

Although increasing cigarette taxes is known to improve child survival, there are few data on their effect on socioeconomic inequalities in child mortality. We investigated the association between cigarette taxation and socioeconomic inequalities in mortality in children younger than 5 years (hereafter referred to as under-5 mortality) in low-income and middle-income countries (LMICs).

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.

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.

The global prevalence of chronic diseases and high costs of health care are complex challenges that are driving countries to focus on addressing the social determinants of health and downstream social needs. These challenges require innovative health-care practices that integrate disease prevention, treatment, and management with salutogenic initiatives to promote population health. Many countries

BackgroundThe 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). MethodsThis study mathematically modelled the impact

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.

The Global Burden of Disease Study 2021 identifies alcohol consumption as one of the top ten leading risk factors for disability.1 The COVID-19 pandemic has substantially affected public health, including shifts in alcohol-related mortality trends. Melissa Oldham and colleagues2 critically examine alcohol-specific deaths in England over the past two decades, revealing a sharp increase since 2020. The

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.

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.

Pre-exposure prophylaxis (PrEP) has become a key strategy for HIV prevention worldwide.1, 2 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

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 The Lancet Public Health, traced a 30-year transformation of morbidity and mortality in Japan.1 The study suggests that Japan has seen a slowed or plateaued trend in

Although preventable and curable, 10·8 million people were diagnosed with tuberculosis and 1·25 million people died from tuberculosis in 2023.1 It is a disease that disproportionately affects marginalised groups—for instance, it has been clearly shown that there is a high tuberculosis incidence and low case detection rate in prison populations globally.2 Indeed, WHO has identified incarcerated people

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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 The Lancet Public Health, The Global Burden of Diseases

As noted by Di Simone and colleagues in their Correspondence,1 the change in Italian law introducing the right to public primary health care for people experiencing homelessness through registration with a general practitioner (GP) represents an important first step against inequities in health care.

BackgroundChildren 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. MethodsWe linked youth justice records in the state of Queensland, Australia from July 1, 1993, to June

BackgroundThe 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. MethodsData from WHO Pan American Health Organization (PAHO) and WHO Europe were used

BackgroundPhysical inactivity is rising globally, exacerbating the burden of preventable deaths and diseases. Despite extensive research on promoting physical activity in the workplace, synthesising the existing literature is challenging due to the wide variety of interventions and outcomes. This study aims to provide a comprehensive synthesis of intervention effects to inform health promotion initiatives

BackgroundOver the past two decades, the Italian National Health Service has been gradually decentralised, with Italy's 21 regional governments now responsible for managing their health services. This change, coupled with austerity measures and a steadily ageing population, has adversely affected universal health coverage and equity, exacerbating inequalities and regional disparities. This study aimed

Given Japan's rapidly ageing demographic structure, comprehensive and long-term evaluations of its national and subnational health progress are important to inform public health policy. This study aims to assess Japan's population health, using the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 to analyse the country's evolving disease patterns.

Jan 20, 2025, US President Donald Trump took charge of the Oval Office and began by signing an array of executive orders spanning from withdrawal from WHO and the Paris Climate Agreement to freezing trillions of US$ worth of federal funding and a ban on diversity, equity, and inclusion programmes. The new US Administration's onslaught on some of the world's most respected scientific public health institutions

March 4th is World Obesity Day, a unified day of action calling for a response to the obesity crisis. Obesity is one of the most concerning public health crises globally. According to WHO, since 1990, obesity has more than doubled in adults and quadrupled in adolescents. In 2022, 2·5 billion adults had overweight, including 890 million with obesity, and 390 million children and adolescents aged 5–19

Evidence from electronic health records is transforming what we know about the health inequalities experienced by people with disabilities. In The Lancet Public Health, Amina Banda and colleagues produced another excellent example of this approach, using large-scale data from the Netherlands to demonstrate that participation in cancer screening programmes is around 20% lower for people with intellectual

The study in The Lancet Public Health by Erin Brennand and colleagues1 looking at abortion care in Alberta, Canada, tests an optimistic hypothesis held by many, that the 2017 implementation and deregulation of mifepristone for medication abortion would substantially improve access to care. Until 2017, abortion in Canada was almost exclusively available through procedures carried out by physicians in

Social determinants of health, although widely acknowledged, tend to be poorly translated into policy. Health programme initiatives too often underline individual accountability, which reinforces a flawed narrative that overlooks structural barriers—poverty, inequitable access to resources, unsafe environments, and harmful commercial practices—which shape health behaviours.1

BackgroundPeople with an intellectual disability face diverse health disparities, including challenges accessing cancer care. In the Netherlands, as in many other countries, there are national screening programmes for early detection of breast, cervical, and colon cancer. These programmes were, however, initially introduced for the general population, and they often fail to meet the needs of the population

BackgroundEquitable access to abortion care remains a challenge in public health. Current Canadian abortion reporting overlooks modern practices such as mifepristone medication abortion and has no access and equity metrics. We aimed to comprehensively analyse abortion care provision in Alberta (the fourth largest province in Canada, home to more than 4 million people) focusing on temporal trends in

Despite Germany's robust economy, comprehensive social welfare system, and the country ranking third among Organisation for Economic Co-operation and Development countries in terms of per-capita health spending, its health indicators still lag behind those of other European nations. Germany also has one of the highest prevalences of major modifiable risk factors for non-communicable diseases within

Artificial intelligence (AI) can rapidly analyse large and complex datasets, extract tailored recommendations, support decision making, and improve the efficiency of many tasks that involve the processing of data, text, or images. As such, AI has the potential to revolutionise public health practice and research, but accompanying challenges need to be addressed. AI can be used to support public health

A decade after World Health Assembly Resolution 67.19 recognised palliative care as a component of comprehensive care and universal health coverage throughout the life course, a balanced approach to opioid access remains elusive. Disparities in the alleviation of serious health-related suffering persist, characterised by two parallel opioid-related public health crises: a pandemic of unrelieved pain

An estimated 49·5 million small-scale miners worldwide are exposed to high concentrations of silica during their work. The substantial morbidity and mortality of silicosis and tuberculosis among workers exposed to such intensities have been documented. This Viewpoint raises concern at the failure to respond to a growing epidemic of lung disease (predominantly silicosis and tuberculosis) among small-scale

Epilepsy is one of the most common serious neurological disorders and affects individuals of all ages across the globe. The aim of this study is to provide estimates of the epilepsy burden on the global, regional, and national levels for 1990–2021.

Deaths from suicide are a tragic yet preventable cause of mortality. Quantifying the burden of suicide to understand its geographical distribution, temporal trends, and variation by age and sex is an essential step in suicide prevention. We aimed to present a comprehensive set of global, regional, and national estimates of suicide burden.

Decades of steady improvements in life expectancy in Europe slowed down from around 2011, well before the COVID-19 pandemic, for reasons which remain disputed. We aimed to assess how changes in risk factors and cause-specific death rates in different European countries related to changes in life expectancy in those countries before and during the COVID-19 pandemic.

In January, 2025, the US Surgeon General released an Advisory on alcohol consumption and cancer risk.1 He briefly summarised the evidence on alcohol and cancer, including underlying biological mechanisms, and concluded that alcohol use is a leading preventable cause of cancer in the USA and globally, causing around 100 000 and 750 000 cancer cases annually, respectively.2 The carcinogenicity of alcohol

Friedman J, Ciccarone D. The public health risks of counterfeit pills. Lancet Public Health 2025; 10: e58–62—In this Viewpoint, the final sentence of the first paragraph of The possibility of a global synthetic drug crisis section should have read “to synthetic products such as methamphetamine and fentanyl”. This correction has been made as of Feb 10, 2025.

Nitrous oxide has been increasing in popularity as a recreational drug in the past decade, and with this an increase in health harms related to nitrous oxide use, particularly nitrous oxide-induced myeloneuropathy. In response, governments in many countries have adopted new laws that either target the end user, by criminalising possession, or target suppliers. The effect of these measures remains to

Life expectancy of people with HIV has increased considerably. We used data from the Comparative Outcomes And Service Utilization Trends (COAST) study to examine sex differences in life expectancy and mortality between 1996 and 2020 among people with HIV in British Columbia (BC), Canada.

People who are homeless or face uncertain housing and economic situations encounter substantial challenges in managing acute and chronic diseases, as poor living conditions can worsen health outcomes. Health status depends on the conditions in which people are born, live, and age, and monitoring social determinants of health is essential in addressing health inequities, especially in supporting socially

We read with interest the article by Yiran Liu and colleagues assessing the contribution of mass incarceration to tuberculosis incidence in six Latin American countries.1 We welcome the attention that the authors bring to this important determinant of tuberculosis, yet we note that the authors do not mention the gendered dimension of this issue.

Global Burden of Disease US Health Disparities Collaborators. Life expectancy by county and educational attainment in the USA, 2000–19: an observational analysis. Lancet Public Health 2025; 10: e136–47—In this Article, the last sentence of the Summary, Findings should read “Over the study period, the gap in life expectancy between the college graduate population and those with less than a high-school

Feb 4 marks World Cancer Day—an opportunity to raise awareness about cancer and to reflect on the latest trends, challenges, and hopes. Acknowledging that cancer is not simply a medical diagnosis, but rather a unique personal story, the World Cancer Day campaign places people at the centre and calls for a people-centred approach to cancer.

Exposure to adverse childhood experiences (ACEs), including abuse, neglect, and household challenges, have harmful implications for long-term health and mental health outcomes.1 Indeed, ACEs are one of the leading determinants of mental health disorders and are associated with increased health-care use into adulthood.1, 2 ACEs have the potential to infiltrate the family context, having implications

Regular physical activity is associated with a lower risk of cardiovascular disease and cancer, and with longevity.1 Studies on physical activity and health have initially been based on observational studies with small sample sizes.2 Nowadays, the study quality has improved and includes laboratory-based studies with controlled interventions, albeit with limited external validity, as well as longitudinal

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The study by Julia Rey Brandariz and colleagues1 provides a novel approach to estimating the effect of a tobacco-elimination strategy on lung-cancer mortality by projecting outcomes for a cohort born between 2006 and 2010 across 185 countries. Although this simulation study offers promising results, with the potential to prevent more than 40% of deaths from lung cancer in the cohort, several issues

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Macdonald C, Macpherson G, Leppan O, et al. Interventions to reduce harms related to drug use among people who experience incarceration: systematic review and meta-analysis. Lancet Public Health 2024; 9: e684–99—In the Findings section of the Summary of this Article, the 95% CI in the second sentence should read “Therapeutic community interventions reduced re-arrest at 6–12 months (six studies; odds

Personalised risk-based screening (PRBS) can enhance the efficiency of cancer screening programnes, but little is known about support for its implementation among the general public and health-care professionals. We aimed to summarise the acceptability and perceptions of PRBS for breast, cervical, colorectal, lung, and prostate cancer screening among these groups.