Pub Date : 2025-11-25DOI: 10.1016/s2468-2667(25)00259-2
Rui Huang, Chao Wu
{"title":"Hepatitis C: a continuing public health challenge in China","authors":"Rui Huang, Chao Wu","doi":"10.1016/s2468-2667(25)00259-2","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00259-2","url":null,"abstract":"","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"30 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145592853","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}
Pub Date : 2025-11-25DOI: 10.1016/s2468-2667(25)00257-9
Yonghua Yu, Jieli Lu
{"title":"How lifestyle, social determinants of health, and sex shape life expectancy in China","authors":"Yonghua Yu, Jieli Lu","doi":"10.1016/s2468-2667(25)00257-9","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00257-9","url":null,"abstract":"","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"182 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145592857","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}
Pub Date : 2025-11-25DOI: 10.1016/s2468-2667(25)00275-0
Siyan Zhan
{"title":"China's strategy for AI in public health","authors":"Siyan Zhan","doi":"10.1016/s2468-2667(25)00275-0","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00275-0","url":null,"abstract":"","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"20 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145592854","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}
Pub Date : 2025-11-25DOI: 10.1016/s2468-2667(25)00276-2
Shiwei Liu, Jing Wu
{"title":"Leveraging health taxation for public health gains in China","authors":"Shiwei Liu, Jing Wu","doi":"10.1016/s2468-2667(25)00276-2","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00276-2","url":null,"abstract":"","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"29 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145592855","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}
Pub Date : 2025-11-24DOI: 10.1016/s2468-2667(25)00280-4
On Oct 23, 2025, at the Central Committee of the Communist Party of China, the country's 15th 5-year plan, 2026–30, was announced. The final plan is to be unveiled in March 2026, but the recommendations clearly outline key goals for public health, including increasing life expectancy to 80 years, supporting reproductive health and health promotion, and ensuring equitable access to quality health care. Achieving these goals will require sustained effort, innovative strategies, and a strong commitment to addressing both existing and emerging public health challenges. This issue of The Lancet Public Health, our annual issue dedicated to health in China, highlights the progress made, the challenges ahead, and the opportunities to improve public health in the country.
{"title":"Opportunities to improve public health in China","authors":"","doi":"10.1016/s2468-2667(25)00280-4","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00280-4","url":null,"abstract":"On Oct 23, 2025, at the Central Committee of the Communist Party of China, the country's 15th 5-year plan, 2026–30, was announced. The final plan is to be unveiled in March 2026, but the recommendations clearly outline key goals for public health, including increasing life expectancy to 80 years, supporting reproductive health and health promotion, and ensuring equitable access to quality health care. Achieving these goals will require sustained effort, innovative strategies, and a strong commitment to addressing both existing and emerging public health challenges. This issue of <em>The Lancet Public Health</em>, our annual issue dedicated to health in China, highlights the progress made, the challenges ahead, and the opportunities to improve public health in the country.","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"14 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145594057","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}
Pub Date : 2025-11-09DOI: 10.1016/s2468-2667(25)00250-6
Xiao-Xing Liu, Zhe Wang, Si-Jing Chen, Michael V Vitiello, Yun Kwok Wing, Charles M Morin, Jie Shi, Lin Lu
This Review synthesises the epidemiological patterns of sleep and sleep disturbance in China, discusses national strategies and challenges, and proposes future directions. To promote sleep health, the Chinese Government has implemented multifaceted strategies structured across three domains: national policies, health-care systems, and research systems. Despite these efforts, challenges persist in two areas: deep-seated factors that influence sleep disturbance, and systemic limitations in health care and surveillance that constrain an effective response. Progress will depend on a concerted strategy to transform socioeconomic and cultural norms, enhance public awareness, strengthen health-care systems, and build national research and technological infrastructure.
{"title":"Sleep health in China: status, challenges, and promotion strategies","authors":"Xiao-Xing Liu, Zhe Wang, Si-Jing Chen, Michael V Vitiello, Yun Kwok Wing, Charles M Morin, Jie Shi, Lin Lu","doi":"10.1016/s2468-2667(25)00250-6","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00250-6","url":null,"abstract":"This Review synthesises the epidemiological patterns of sleep and sleep disturbance in China, discusses national strategies and challenges, and proposes future directions. To promote sleep health, the Chinese Government has implemented multifaceted strategies structured across three domains: national policies, health-care systems, and research systems. Despite these efforts, challenges persist in two areas: deep-seated factors that influence sleep disturbance, and systemic limitations in health care and surveillance that constrain an effective response. Progress will depend on a concerted strategy to transform socioeconomic and cultural norms, enhance public awareness, strengthen health-care systems, and build national research and technological infrastructure.","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"19 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145477920","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}
Pub Date : 2025-11-09DOI: 10.1016/s2468-2667(25)00253-1
Longbing Ren, Ying Zhou, Keyang Liu, Hao Zhang, Shaojie Li, Yang Hu, Kokoro Shirai, Yuling Jiang, Yifei Wu, Mingzhi Yu, Jiakang Huo, Jie Li, Yan Zhang, Jing Sun, Bo Hu, Tai Hing Lam, David Bishai, Yi Zeng, Erdan Dong, Yao Yao
<h3>Background</h3>Functional independence is the basis for healthy ageing and quality of late life. However, evidence on how healthy lifestyle factors and social determinants of health affect longevity in independence remains limited, particularly regarding sex differences. We aimed to examine the associations of these factors with life expectancy with and without dependency, and to assess whether such effects differ by sex.<h3>Methods</h3>This cohort study used data from the nationally representative Chinese Longitudinal Healthy Longevity Study (CLHLS), which collected data from 2008 to 2021. Participants aged 65–100 years were included if they had at least one follow-up or death record. Healthy lifestyle factors (ie, diet, physical activity, smoking, and alcohol use) and social determinants of health (ie, financial status, education, health-care access, built environment, and social context) were assessed at baseline. Functional independence was determined by self-reported need for assistance with activities of daily living and instrumental activities of daily living at each survey wave. A continuous-time three-state Markov model was applied to estimate hazard ratios and 95% CIs between independence, dependence, and death, yielding total and independent life expectancy by sex, adjusted for covariates.<h3>Findings</h3>11 804 participants were included in the study. At age 65 years, females had longer total life expectancy than males (18·18 years [95% CI 17·74–18·49] <em>vs</em> 15·50 years [15·10–15·89]) but shorter independent life expectancy (10·35 years [10·13–10·55] <em>vs</em> 11·29 years [11·05–11·54]). The gain in independent life expectancy was greater for males with 3–4 healthy lifestyle factors versus males with 0–1 healthy lifestyle factors (2·45 years [2·24–2·67]) compared with females with 3–4 healthy lifestyle factors versus females with 0–1 healthy lifestyle factors (2·09 years [1·90–2·29], p=0·015). However, females had greater gains in independent life expectancy from favourable social determinants of health. Those with 4–5 positive social determinants of health indicators lived 1·95 (1·74–2·16) more years independently compared with those with 0–1, surpassing the 1·67 year (1·49–1·85) gain observed in males (p=0·047). The combination of both favourable lifestyle behaviours and supportive social conditions produced the largest improvement in independent life expectancy, with gains of 3·94 (3·73–4·15) years for males and 3·89 (3·68–4·11) years for females.<h3>Interpretation</h3>Pathways to healthy ageing differ between sexes in China: males benefit more from lifestyle modifications whereas females gain more from improved social conditions. These results underscore the importance of sex-specific public health strategies that focus on reducing unhealthy behaviours among males and improving social support for females.<h3>Funding</h3>National Natural Science Foundation of China and Chinese Academy of Medical Sciences Innovation Fund
{"title":"The effect of healthy lifestyles and social determinants on independent life expectancy and sex differences in China: evidence from a 13-year cohort study","authors":"Longbing Ren, Ying Zhou, Keyang Liu, Hao Zhang, Shaojie Li, Yang Hu, Kokoro Shirai, Yuling Jiang, Yifei Wu, Mingzhi Yu, Jiakang Huo, Jie Li, Yan Zhang, Jing Sun, Bo Hu, Tai Hing Lam, David Bishai, Yi Zeng, Erdan Dong, Yao Yao","doi":"10.1016/s2468-2667(25)00253-1","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00253-1","url":null,"abstract":"<h3>Background</h3>Functional independence is the basis for healthy ageing and quality of late life. However, evidence on how healthy lifestyle factors and social determinants of health affect longevity in independence remains limited, particularly regarding sex differences. We aimed to examine the associations of these factors with life expectancy with and without dependency, and to assess whether such effects differ by sex.<h3>Methods</h3>This cohort study used data from the nationally representative Chinese Longitudinal Healthy Longevity Study (CLHLS), which collected data from 2008 to 2021. Participants aged 65–100 years were included if they had at least one follow-up or death record. Healthy lifestyle factors (ie, diet, physical activity, smoking, and alcohol use) and social determinants of health (ie, financial status, education, health-care access, built environment, and social context) were assessed at baseline. Functional independence was determined by self-reported need for assistance with activities of daily living and instrumental activities of daily living at each survey wave. A continuous-time three-state Markov model was applied to estimate hazard ratios and 95% CIs between independence, dependence, and death, yielding total and independent life expectancy by sex, adjusted for covariates.<h3>Findings</h3>11 804 participants were included in the study. At age 65 years, females had longer total life expectancy than males (18·18 years [95% CI 17·74–18·49] <em>vs</em> 15·50 years [15·10–15·89]) but shorter independent life expectancy (10·35 years [10·13–10·55] <em>vs</em> 11·29 years [11·05–11·54]). The gain in independent life expectancy was greater for males with 3–4 healthy lifestyle factors versus males with 0–1 healthy lifestyle factors (2·45 years [2·24–2·67]) compared with females with 3–4 healthy lifestyle factors versus females with 0–1 healthy lifestyle factors (2·09 years [1·90–2·29], p=0·015). However, females had greater gains in independent life expectancy from favourable social determinants of health. Those with 4–5 positive social determinants of health indicators lived 1·95 (1·74–2·16) more years independently compared with those with 0–1, surpassing the 1·67 year (1·49–1·85) gain observed in males (p=0·047). The combination of both favourable lifestyle behaviours and supportive social conditions produced the largest improvement in independent life expectancy, with gains of 3·94 (3·73–4·15) years for males and 3·89 (3·68–4·11) years for females.<h3>Interpretation</h3>Pathways to healthy ageing differ between sexes in China: males benefit more from lifestyle modifications whereas females gain more from improved social conditions. These results underscore the importance of sex-specific public health strategies that focus on reducing unhealthy behaviours among males and improving social support for females.<h3>Funding</h3>National Natural Science Foundation of China and Chinese Academy of Medical Sciences Innovation Fund","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"79 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145477921","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}
Pub Date : 2025-11-09DOI: 10.1016/s2468-2667(25)00254-3
Jian Li, Lin Pang, Guowei Ding, Wenge Xing, Jiejun Yu, Hui Zheng, Yu Wang, Fuzhen Wang, Liping Shen, Jianhua Liu, Shaodong Ye, Lijian Pei, Feng Wang, Guomin Zhang, Ning Miao, Tongtong Meng, Zundong Yin, Jidong Jia, Jun Yan, Yu Wang, Zhongfu Liu
Background
China has a substantial disease burden of hepatitis C virus (HCV) infection. We aimed to analyse the findings from a national seroepidemiology survey of viral hepatitis in 2020, providing insights into the current state of hepatitis C in China.
Methods
A national, cross-sectional survey was conducted in China using a stratified, three-stage cluster random sampling method to select individuals aged 1–69 years from 160 national disease surveillance points. Venous blood samples that tested positive for anti-HCV antibodies were further tested for HCV RNA. Point estimates and 95% CIs of anti-HCV antibody and HCV RNA prevalence were calculated using Taylor series linearisation for variance estimations. The prevalence estimates were adjusted using weighted calculations. National HCV burden was estimated by the workbook method.
Findings
From Aug 1, 2020, to June 1, 2021, 91 971 individuals were surveyed in 120 counties, with 91 896 (99·9%) blood samples tested and included in the final analysis. The median age of participants was 33 years (IQR 15–52), 39 627 (43·1%) participants were male, 52 269 (56·9%) were female, 75 170 (81·8%) were of Han ethnicity, and 16 726 (18·2%) were in non-Han ethnic groups. 223 (0·24%) individuals tested positive for anti-HCV antibodies, with weighted prevalence of 0·28% (95% CI 0·24–0·34). Among these, 111 (49·8%) tested positive for HCV RNA, resulting in an HCV RNA positive proportion of 0·12% and weighted prevalence of 0·15% (95% CI 0·11–0·20). We estimated 5·54 million individuals who were anti-HCV antibody-positive and 3·22 million with viraemic infections.
Interpretation
The survey findings confirm that China has made important progress in controlling the hepatitis C epidemic. However, the absolute number of individuals infected with HCV remains substantial due to the large population denominator. Concerted efforts are essential to promote a comprehensive strategy to further curb the hepatitis C epidemic.
Funding
Major Science and Technology Special Project of China's 13th 5-Year Plan.
Translation
For the Chinese translation of the abstract see Supplementary Materials section.
{"title":"Seroepidemiology of hepatitis C virus infection in people aged 1–69 years in China: a national, cross-sectional study","authors":"Jian Li, Lin Pang, Guowei Ding, Wenge Xing, Jiejun Yu, Hui Zheng, Yu Wang, Fuzhen Wang, Liping Shen, Jianhua Liu, Shaodong Ye, Lijian Pei, Feng Wang, Guomin Zhang, Ning Miao, Tongtong Meng, Zundong Yin, Jidong Jia, Jun Yan, Yu Wang, Zhongfu Liu","doi":"10.1016/s2468-2667(25)00254-3","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00254-3","url":null,"abstract":"<h3>Background</h3>China has a substantial disease burden of hepatitis C virus (HCV) infection. We aimed to analyse the findings from a national seroepidemiology survey of viral hepatitis in 2020, providing insights into the current state of hepatitis C in China.<h3>Methods</h3>A national, cross-sectional survey was conducted in China using a stratified, three-stage cluster random sampling method to select individuals aged 1–69 years from 160 national disease surveillance points. Venous blood samples that tested positive for anti-HCV antibodies were further tested for HCV RNA. Point estimates and 95% CIs of anti-HCV antibody and HCV RNA prevalence were calculated using Taylor series linearisation for variance estimations. The prevalence estimates were adjusted using weighted calculations. National HCV burden was estimated by the workbook method.<h3>Findings</h3>From Aug 1, 2020, to June 1, 2021, 91 971 individuals were surveyed in 120 counties, with 91 896 (99·9%) blood samples tested and included in the final analysis. The median age of participants was 33 years (IQR 15–52), 39 627 (43·1%) participants were male, 52 269 (56·9%) were female, 75 170 (81·8%) were of Han ethnicity, and 16 726 (18·2%) were in non-Han ethnic groups. 223 (0·24%) individuals tested positive for anti-HCV antibodies, with weighted prevalence of 0·28% (95% CI 0·24–0·34). Among these, 111 (49·8%) tested positive for HCV RNA, resulting in an HCV RNA positive proportion of 0·12% and weighted prevalence of 0·15% (95% CI 0·11–0·20). We estimated 5·54 million individuals who were anti-HCV antibody-positive and 3·22 million with viraemic infections.<h3>Interpretation</h3>The survey findings confirm that China has made important progress in controlling the hepatitis C epidemic. However, the absolute number of individuals infected with HCV remains substantial due to the large population denominator. Concerted efforts are essential to promote a comprehensive strategy to further curb the hepatitis C epidemic.<h3>Funding</h3>Major Science and Technology Special Project of China's 13th 5-Year Plan.<h3>Translation</h3>For the Chinese translation of the abstract see Supplementary Materials section.","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"114 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145477863","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}
Pub Date : 2025-11-09DOI: 10.1016/s2468-2667(25)00256-7
Tiange Chen, Jinyi Zhu, Sian Tsuei, Yunyun Jiang, Yunting Zheng, Duo Xu, Hongqiao Fu
Background
China faces substantial burdens from tobacco, alcohol, and sugar-sweetened beverage (SSB) consumption, yet tax increases on these products have been stagnant. Existing evidence on the health, economic, and fiscal effects of such taxes in China is limited, which hinders tax reforms on tobacco and alcohol and implementation of SSB excise taxes. We aim to quantify the potential effects of increasing these taxes in China.
Methods
We modelled the health, macroeconomic, and fiscal consequences under different tax increase scenarios in China between 2026 and 2050. Years of life gained (YLGs), deaths averted, and additional fiscal revenue were estimated using a cohort state-transition model incorporating age-specific, sex-specific, and income-specific demographic projections, consumption patterns, price elasticities, and relative risk estimates. Macroeconomic benefits were calculated through enhanced labour supply and reduced health-care expenditures using a health-augmented macroeconomic model. Sensitivity analyses were conducted to account for parameter and structural uncertainties.
Findings
From 2026 to 2050, under 20% price increases through tax hikes, taxation of tobacco, alcohol, and SSBs would generate 20·58 million (95% uncertainty interval 12·53–29·19), 9·02 million (5·61–12·92), and 3·67 million (2·40–5·05) YLGs, respectively, and avert 0·86 million (0·53–1·23), 0·36 million (0·22–0·51), and 0·13 million (0·09–0·19) deaths, respectively. Health benefits were concentrated among lower-income groups and males. These health improvements would translate into macroeconomic gains equivalent to 0·043% (0·031–0·060), 0·034% (0·024–0·047), and 0·0016% (0·0013–0·0019) of total gross domestic product, respectively. Additional fiscal revenues would total ¥4·53 trillion (3·70–5·50) for tobacco, ¥2·00 trillion (1·75–2·29) for alcohol, and ¥295·5 billion (227·9–377·1) for SSBs. Higher taxes would yield greater health, economic, and equity gains, but fiscal revenues would decline beyond certain tax share levels (72% for tobacco, 59% for alcohol, and 40% for SSBs).
Interpretation
Increasing excise taxes on tobacco, alcohol, and SSBs in China can simultaneously generate health benefits, macroeconomic gains, and additional fiscal revenues, as well as improve equity.
Funding
National Social Science Fund of China, the Taikang Yicai Public Health and Epidemic Control Fund, and Bill & Melinda Gates Foundation.
Translation
For the Chinese translation of the abstract see Supplementary Materials section.
{"title":"Health and economic effects of increased taxation on tobacco, alcohol, and sugar-sweetened beverages in China: a modelling study","authors":"Tiange Chen, Jinyi Zhu, Sian Tsuei, Yunyun Jiang, Yunting Zheng, Duo Xu, Hongqiao Fu","doi":"10.1016/s2468-2667(25)00256-7","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00256-7","url":null,"abstract":"<h3>Background</h3>China faces substantial burdens from tobacco, alcohol, and sugar-sweetened beverage (SSB) consumption, yet tax increases on these products have been stagnant. Existing evidence on the health, economic, and fiscal effects of such taxes in China is limited, which hinders tax reforms on tobacco and alcohol and implementation of SSB excise taxes. We aim to quantify the potential effects of increasing these taxes in China.<h3>Methods</h3>We modelled the health, macroeconomic, and fiscal consequences under different tax increase scenarios in China between 2026 and 2050. Years of life gained (YLGs), deaths averted, and additional fiscal revenue were estimated using a cohort state-transition model incorporating age-specific, sex-specific, and income-specific demographic projections, consumption patterns, price elasticities, and relative risk estimates. Macroeconomic benefits were calculated through enhanced labour supply and reduced health-care expenditures using a health-augmented macroeconomic model. Sensitivity analyses were conducted to account for parameter and structural uncertainties.<h3>Findings</h3>From 2026 to 2050, under 20% price increases through tax hikes, taxation of tobacco, alcohol, and SSBs would generate 20·58 million (95% uncertainty interval 12·53–29·19), 9·02 million (5·61–12·92), and 3·67 million (2·40–5·05) YLGs, respectively, and avert 0·86 million (0·53–1·23), 0·36 million (0·22–0·51), and 0·13 million (0·09–0·19) deaths, respectively. Health benefits were concentrated among lower-income groups and males. These health improvements would translate into macroeconomic gains equivalent to 0·043% (0·031–0·060), 0·034% (0·024–0·047), and 0·0016% (0·0013–0·0019) of total gross domestic product, respectively. Additional fiscal revenues would total ¥4·53 trillion (3·70–5·50) for tobacco, ¥2·00 trillion (1·75–2·29) for alcohol, and ¥295·5 billion (227·9–377·1) for SSBs. Higher taxes would yield greater health, economic, and equity gains, but fiscal revenues would decline beyond certain tax share levels (72% for tobacco, 59% for alcohol, and 40% for SSBs).<h3>Interpretation</h3>Increasing excise taxes on tobacco, alcohol, and SSBs in China can simultaneously generate health benefits, macroeconomic gains, and additional fiscal revenues, as well as improve equity.<h3>Funding</h3>National Social Science Fund of China, the Taikang Yicai Public Health and Epidemic Control Fund, and Bill & Melinda Gates Foundation.<h3>Translation</h3>For the Chinese translation of the abstract see Supplementary Materials section.","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"22 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145477919","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}
Pub Date : 2025-10-30DOI: 10.1016/s2468-2667(25)00230-0
Wenjia Cai, Chi Zhang, Shihui Zhang, Yuqi Bai, Bin Chen, Jifei Chen, Liangliang Cheng, Weicheng Fan, Lianfang Feng, Dabo Guan, Congkai Hong, Yixin Hu, Junyi Hua, Cunrui Huang, Hong Huang, Jianbin Huang, Xiaomeng Huang, John S Ji, Qiaolei Jiang, Xiaopeng Jiang, Haidong Kan, Jun Kang, Gregor Kiesewetter, Bo Li, Guoao Li, Tiantian Li, Weiyi Liao, Borong Lin, Hualiang Lin, Huan Liu, Qiyong Liu, Xinghan Liu, Yanxiang Liu, Zehua Liu, Zhao Liu, Zhu Liu, Shuhan Lou, Bo Lu, Chenxi Lu, Wei Ma, Zhifu Mi, Yanqing Miao, Guangju Mo, Tim Repke, Chao Ren, Marina Romanello, Jianxiang Shen, Jing Su, Rui Su, Yuze Sun, Xu Tang, Maria Walawender, Can Wang, Hui Wang, Qing Wang, Qiong Wang, Yongyue Wang, Wangyu Wei, Sanmei Wen, Hui Xiong, Bing Xu, Xiu Yang, Yuren Yang, Fanghong Yao, Mingjun Yin, Le Yu, Zhaowu Yu, Jing Zhang, Rui Zhang, Shangchen Zhang, Shaohui Zhang, Zhenyu Zhang, Mengzhen Zhao, Qiang Zhao, Dashan Zheng, Hao Zhou, Jingbo Zhou, Yuye Zhou, Yong Luo, Peng Gong
According to the World Meteorological Organization (WMO), 2024 was the hottest year on record. China had unprecedented heat and heavy precipitation, with a national average temperature of 10·9°C, 1·01°C higher than the historical average (1991–2020), and annual precipitation of 697·7 mm, which is 9·0% higher than the average. As 2025 marks the 10th anniversary of the Paris Agreement and a key juncture for submitting new contributions, accelerating global climate action is imperative, especially in cities, which account for 58% of the world's population and 70% of total carbon emissions.
{"title":"The 2025 China report of the Lancet Countdown on health and climate change: empowering cities for synergistic action","authors":"Wenjia Cai, Chi Zhang, Shihui Zhang, Yuqi Bai, Bin Chen, Jifei Chen, Liangliang Cheng, Weicheng Fan, Lianfang Feng, Dabo Guan, Congkai Hong, Yixin Hu, Junyi Hua, Cunrui Huang, Hong Huang, Jianbin Huang, Xiaomeng Huang, John S Ji, Qiaolei Jiang, Xiaopeng Jiang, Haidong Kan, Jun Kang, Gregor Kiesewetter, Bo Li, Guoao Li, Tiantian Li, Weiyi Liao, Borong Lin, Hualiang Lin, Huan Liu, Qiyong Liu, Xinghan Liu, Yanxiang Liu, Zehua Liu, Zhao Liu, Zhu Liu, Shuhan Lou, Bo Lu, Chenxi Lu, Wei Ma, Zhifu Mi, Yanqing Miao, Guangju Mo, Tim Repke, Chao Ren, Marina Romanello, Jianxiang Shen, Jing Su, Rui Su, Yuze Sun, Xu Tang, Maria Walawender, Can Wang, Hui Wang, Qing Wang, Qiong Wang, Yongyue Wang, Wangyu Wei, Sanmei Wen, Hui Xiong, Bing Xu, Xiu Yang, Yuren Yang, Fanghong Yao, Mingjun Yin, Le Yu, Zhaowu Yu, Jing Zhang, Rui Zhang, Shangchen Zhang, Shaohui Zhang, Zhenyu Zhang, Mengzhen Zhao, Qiang Zhao, Dashan Zheng, Hao Zhou, Jingbo Zhou, Yuye Zhou, Yong Luo, Peng Gong","doi":"10.1016/s2468-2667(25)00230-0","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00230-0","url":null,"abstract":"According to the World Meteorological Organization (WMO), 2024 was the hottest year on record. China had unprecedented heat and heavy precipitation, with a national average temperature of 10·9°C, 1·01°C higher than the historical average (1991–2020), and annual precipitation of 697·7 mm, which is 9·0% higher than the average. As 2025 marks the 10th anniversary of the Paris Agreement and a key juncture for submitting new contributions, accelerating global climate action is imperative, especially in cities, which account for 58% of the world's population and 70% of total carbon emissions.","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"113 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145404814","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}
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