Annual Review of Public Health最新文献

Global progress toward universal health coverage (UHC) has varied widely across low- and middle-income countries (LMICs) in recent years. To better understand these differences, we used an analytical framework to compare individual health system components, or substructures, across selected LMICs, identifying institutional and policy mechanisms that shape UHC performance. Our case study comparison includes 12 countries spanning high and low UHC performance, as indicated by World Bank and World Health Organization (WHO) indicators for service coverage and financial risk protection as well as considerations of equity concerns not captured by these metrics. We highlight that stronger performance is associated with unified risk pooling, strategic purchasing, robust primary care-based integrated delivery, a systemic approach toward public/private service delivery, strategic investments in health infrastructure and workforce, and accountable governance. Future analyses and reviews using this comparative case study method with a structured analytical framework would be helpful in further advancing our understanding of the drivers of UHC progress and guiding policy reform.

Rapid decarbonization and climate adaptation are urgent to avoid the worst impacts of climate change, but past efforts at large-scale societal change and infrastructure investments have often exacerbated racialized and socioeconomic inequalities and further entrenched the structural drivers and root causes of climate change. We review dimensions of climate justice in the literature and define just climate solutions as those that (a) address root causes and dismantle structural drivers of social inequality and injustice; (b) are community centered and ground-truthed; (c) are reparative and maximally beneficial for historically marginalized populations; and (d) disrupt existing power relations to transform who controls framing, design, implementation, and accountability. We offer a set of guiding questions to help researchers, practitioners, community advocates, and policymakers operationalize this definition to evaluate climate actions in the context of mitigation, adaptation, and disaster response and recovery efforts.

Racism is an underlying cause of health inequities and is entrenched in health systems, disproportionately affecting marginalized groups. Advancing health equity requires reimagining health systems to uproot racism from health-related policymaking. Racism, in its systemic, cultural, and interpersonal forms, remains a significant threat to health equity, a barrier to reform, and a public health crisis. This review draws lessons from US social movements-including tobacco control, sexual and gender minority rights, criminal justice reform, civil rights, and reproductive justice-to identify effective strategies for change. Drawing on key theories, typologies, and insights from the literature, we examine how organizing, messaging, and mobilization have shaped narratives, have fostered public will, and have driven policy reform. Prior movements can serve as a guide for the development and implementation of a social change movement aimed at addressing racism in public health.

Scientists are facing increasing challenges concerned with improving the health of the public. Declining trust in expertise, new diseases, widening disparities in access to care, and environmental changes all challenge population health science to lean into work that can help move societies closer to solutions. To do this work effectively, we need to nudge population health science toward research that engages with consequential health challenges, which will require a reprioritization of how we generate, measure, and articulate health impact. In this review, we provide a history of evaluating impact, along with a comprehensive framework for conceptualizing future public health research impacts. In addition, we review evaluation models and highlight best practices for measuring impact. We introduce a new framework that builds on realist evaluation principles for assessing the impact of public health research and addresses the need to communicate these impacts to diverse audiences. To achieve this reprioritization, we recognize the need for organizational and systemic changes that can incentivize, prioritize, and reward impact-driven engagement.

Policing in the United States functions as a structural determinant of health, with direct and collateral impacts that extend well beyond maintaining order and public safety. This review synthesizes recent evidence (from 2015 to 2025) on the relationship between policing and health. Using a rapid evidence assessment, we examine peer-reviewed and gray literature to capture physical, mental, and community-level outcomes, as well as pathways and mechanisms that link policing to health. Findings indicate that police use of force results in significant injury and deaths annually, disproportionately affecting communities of color. Beyond direct effects, policing contributes to chronic stress, trauma, and economic strain across community and occupational ecosystems. These collateral impacts compound existing structural inequities. Despite promising alternatives to police responses, evidence gaps and reliance on cross-sectional studies limit causal inference. Future research should strengthen data systems, focus on causal research, and integrate public health priorities into public safety strategies.

Early-onset cancers (EOCs), typically defined as cancers diagnosed before age 50, are rising across multiple organ sites and populations globally. EOCs often exhibit more aggressive biology than later-onset cancers and contribute disproportionately to premature mortality and morbidity. A large sex disparity exists, with two-thirds of EOCs diagnosed in women. While EOC incidence is increasing broadly, patterns vary by geography, income, and race/ethnicity, offering clues about the role of health behaviors, environmental exposures, preventive care, and broader social and economic contexts. Gaps remain in our etiologic understanding of EOCs, including the contribution of modifiable environmental factors. Addressing this burden will require coordinated research using novel epidemiologic, intervention, and implementation science approaches, alongside policy action. We provide an overview of EOC trends, examine key methodological considerations, review established and suspected risk factors, and highlight opportunities to strengthen prevention and early detection, with a focus on US and relevant global considerations.

Childhood trauma research and practice have multidisciplinary origins and seek to identify, prevent, and mitigate maltreatment sources in childhood. Since the seminal 1998 Centers for Disease Control and Prevention-Kaiser Permanente Adverse Childhood Experiences Study, the concepts of adverse and positive childhood experiences (ACEs and PCEs, respectively) have gained traction and interest. ACEs research has recently expanded to evaluate family and community sources of adversity. A lack of consensus on the operationalization and measurement of these constructs limits our understanding of their role (whether protective or risk factors) and utility for research or interventions. We review research on ACEs/PCEs and child development, adult health, and intergenerational outcomes, discuss their measurement, and provide an advanced conceptualization of ACEs/PCEs for public health. Use of the proposed expanded framework can aid researchers in elucidating the role of ACEs and PCEs across the life course in a contextually relevant manner. Researchers should consider contextual and sociocultural factors when developing and adapting instruments to measure ACEs/PCEs.

Disinformation is a coordinated or deliberate effort to knowingly circulate misinformation (i.e., false information) to gain money, power, or reputation. While most public health research has focused on misinformation, disinformation can have particularly pernicious direct and indirect public health effects, including a growing impact on public health policy and the reputation of public health evidence and institutions. This review focuses on the role of disinformation for profit among multinational corporations, antiscience policy, and how and why disinformation is increasing. It also examines approaches to address disinformation in public health and social policy, such as a greater focus on the nature and power of framing, strategies for "prebunking" of predictable narratives, and denormalization and countermarketing.

This critical review explores the current state of health economic evaluations of community-based public health interventions. Referencing 79 systematic reviews, it highlights the diversity of interventions, target populations, and evaluation methods while identifying promising cost-effectiveness evidence and significant methodological challenges. Key issues include inconsistent terminology, limited data from low- and middle-income countries, and variability in assessment approaches, which hinder comparability and policy application. The article emphasizes the need for standardized frameworks, tailored guidelines to inform evidence generation and decision-making, and stronger research capacity for conducting high-quality economic evaluations, particularly in resource-constrained settings. We highlight the importance of incorporating broader perspectives, such as spillover effects, and developing innovative modeling techniques to better capture community dynamics. Addressing these gaps will enhance the quality, rigor, and relevance of evaluations, supporting more sustainable investments in community health initiatives worldwide. Strengthening evaluation practices will ultimately improve resource allocation and health outcomes across populations and settings globally.

The number of older adults with hearing loss increases dramatically with age, as does hearing loss severity, yet hearing aid use lags substantially behind prevalence, due, in part, to affordability and accessibility barriers for hearing care. Recent studies have demonstrated that hearing loss is closely linked to the onset of dementia; declines in cognitive, physical, and social function; and poorer health care utilization. Recent gold-standard randomized controlled trials suggest that hearing care modifies poor health outcomes in some older adults. Concurrent with research, policy efforts have attempted to narrow the gap in hearing aid ownership among older adults with hearing loss. This article reviews the evidence and gaps in research on an issue of critical health and economic importance.