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Displacement, health outcomes, and the human rights of people experiencing homelessness in the USA 美国无家可归者的流离失所、健康结果和人权
IF 5 1区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-09-12 DOI: 10.1016/s2468-2667(25)00197-5
Jesse Lloyd Goldshear, Tina Kempin Reuter, Ricky N Bluthenthal, Annick Borquez
The USA is currently experiencing multiple overlapping economic and public health crises: rising costs of housing, increased homelessness, and record drug overdose mortality. In many urban areas, people who are homeless have become increasingly visible, often congregating in so-called encampments. The public reaction and policy response to this increased visibility has been largely punitive and carceral. Jurisdictions across the USA have adopted policies of forced displacement, often carried out by law enforcement officers and sanitation workers, and enforced via threat of fines, arrest, or both. The widespread adoption of these policies—especially given the 2024 US Supreme Court decision (City of Grants Pass v Johnson)—represents a violation of international human rights law. Public health professionals should use the framework of international human rights to fight against these harmful policies.
美国目前正经历多重重叠的经济和公共卫生危机:住房成本上升,无家可归者增加,以及创纪录的药物过量死亡率。在许多城市地区,无家可归的人越来越多,他们经常聚集在所谓的营地。公众的反应和政策对这种日益增加的能见度的反应在很大程度上是惩罚性的和冷漠的。美国各地的司法管辖区都采取了强迫流离失所的政策,通常由执法人员和环卫工人执行,并通过罚款、逮捕或两者兼而有之的威胁来执行。这些政策的广泛采用——尤其是考虑到2024年美国最高法院的判决(City of Grants Pass v Johnson)——违反了国际人权法。公共卫生专业人员应利用国际人权框架来反对这些有害的政策。
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引用次数: 0
Designing men's health policy: the 5R Framework 设计男性健康政策:5R框架
IF 5 1区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-09-11 DOI: 10.1016/s2468-2667(25)00202-6
Paul M Galdas, Zac E Seidler, John L Oliffe
Despite growing awareness of gendered health inequalities, men remain under-represented in public health policy and practice. They have shorter life expectancy, higher preventable mortality, and lower engagement with health services compared with women, especially among groups living in marginalising conditions. To support system-level responses, we propose the 5R Framework (Research, Reach, Respond, Retain, and Relational) to guide the development of gender-responsive health systems. Each component offers direction for addressing men's needs through inclusive data, targeted engagement, tailored care, sustained participation, and equity-driven policy. The 5R Framework builds on earlier work for programme design by applying gender-transformative principles at a system level. The 5R Framework offers a strategic model for translating evidence into scalable, equitable policy and service reform.
尽管人们日益认识到两性保健不平等,但男子在公共保健政策和做法中的代表性仍然不足。与妇女相比,他们的预期寿命较短,可预防的死亡率较高,对保健服务的参与程度较低,特别是在生活在边缘化条件下的群体中。为了支持系统级反应,我们提出了5R框架(研究、覆盖、反应、保留和关系),以指导促进性别平等的卫生系统的发展。每个组成部分都为通过包容性数据、有针对性的参与、量身定制的护理、持续参与和公平驱动的政策来满足男性需求提供了方向。5R框架建立在早期方案设计工作的基础上,在系统一级应用性别变革原则。5R框架为将证据转化为可扩展、公平的政策和服务改革提供了一个战略模式。
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引用次数: 0
Men's mental health: we need systems, not symbols 男性心理健康:我们需要系统,而不是符号
IF 5 1区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-09-09 DOI: 10.1016/s2468-2667(25)00196-3
David Francis Hunt, Hazel Banks, Daniel K Y Kan, Phil Ruthen, Felicity Thomas, Geoff Wong
The UK Government is currently developing the country's first national strategy on men's mental health.1 Male suicide is a priority—rightly so, given men account for approximately 75% of suicide deaths globally.2 WHO has identified male suicide as a crucial but under-addressed public health issue.2
联合王国政府目前正在制定该国第一个关于男子心理健康的国家战略考虑到男性占全球自杀死亡人数的75%,男性自杀是当务之急世卫组织已将男性自杀确定为一个至关重要但未得到充分处理的公共卫生问题
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引用次数: 0
Confronting Spain's failure in the prevention of suicidal behaviour 直面西班牙在预防自杀行为方面的失败
IF 5 1区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-09-09 DOI: 10.1016/s2468-2667(25)00195-1
Manuel Canal-Rivero, Miguel Ruiz-Veguilla
Spain did not meet WHO's goal of reducing suicide rates by 10% by 2020;1 instead, the country has experienced a decade marked by a consistent rise in suicide mortality. National statistics indicate a concerning upward trend, with a cumulative increase of 17·42% (95% CI 12·29–22·78) in suicide rates over 2012–22.2 This statistic points to a substantial societal challenge and reveals a clear gender disparity: the increase has been a notable 32·08% (20·64–44·60) among women compared with 13·45% (7·77–19·43) among men, signalling a pressing need for more effective suicide prevention strategies.2
西班牙没有达到世卫组织到2020年将自杀率降低10%的目标;相反,这个国家经历了自杀死亡率持续上升的十年。国家统计数据显示了一个令人担忧的上升趋势,2012年至22.2年间,自杀率累计增长了17.42% (95% CI 12.29 - 22.78)。这一统计数据表明了一个重大的社会挑战,并揭示了明显的性别差异:女性的增幅为32.08%(20.64 - 44.60),而男性的增幅为13.45%(7.77 - 19.43),这表明迫切需要更有效的自杀预防策略
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引用次数: 0
Correction to Lancet Public Health 2025; 10: e160–64 《柳叶刀公共卫生2025》更正;10: e160 - 64
IF 5 1区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-09-05 DOI: 10.1016/s2468-2667(25)00224-5
No Abstract
没有抽象的
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引用次数: 0
Correction to Lancet Public Health 2025; 10: e774–83 《柳叶刀公共卫生2025》更正;10: e774 - 83
IF 5 1区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-09-04 DOI: 10.1016/s2468-2667(25)00223-3
Ward IL, Barrett SL, Razieh C, et al. Maternal ethnic group, socioeconomic status, and neonatal and child mortality: a nationwide cohort study in England and Wales. Lancet Public Health 2025; 10: 774–83—In this Article, the y-axis values in figure 1 have been corrected. These corrections have been made as of Sept 4, 2025.
张建军,张建军,张建军,等。母亲族群、社会经济地位、新生儿和儿童死亡率:英格兰和威尔士的一项全国性队列研究。《柳叶刀公共卫生2025》;[10:774 - 83]在本文中,图1中的y轴值已被更正。这些更正已于2025年9月4日作出。
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引用次数: 0
Targeting alcohol use in high-risk population groups: a US microsimulation study of beverage-specific pricing policies 针对高危人群的酒精使用:美国饮料特定定价政策的微观模拟研究
IF 5 1区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-08-27 DOI: 10.1016/s2468-2667(25)00165-3
Carolin Kilian, Charlotte Buckley, Julia M Lemp, Xinyi Kou, William C Kerr, Nina Mulia, Robin C Purshouse, Jürgen Rehm, Charlotte Probst
<h3>Background</h3>Raising retail prices on alcoholic beverages preferred by high-risk groups (males, those of low socioeconomic status, and those with heavy alcohol use) might selectively reduce their alcohol consumption. However, the differential impact of beverage-specific price increases on US population groups has yet to be studied. This study aimed to simulate the effect of beverage-specific price increases on alcohol use within subgroups of the adult US population defined by sex, educational attainment, and alcohol use category.<h3>Methods</h3>An individual-level microsimulation of the US population (aged 18–79 years) was used to simulate alcohol consumption from 2000 to 2019 based on individual characteristics (ie, sex, age, race, ethnicity, and educational attainment as a proxy for socioeconomic status categorised as high school degree or less, some college, and college degree or more) and previous alcohol use. The microsimulation model was generated via integration of diverse data sources including decennial US Census data, annual data from the American Community Survey, annual data from the National Vital Statistics System, annual data from the Behavioral Risk Factor Surveillance System, and biennial, longitudinal data from the Panel Study of Income Dynamics. Policy parameters were informed by the existing literature. Four national policy scenarios were compared with a reference scenario without price change in 2019: a uniform price increase of 10% (scenario 1), a uniform price increase of 30% (scenario 2), a beverage-specific price increase of 30% for beer and spirits and 10% for wine (scenario 3), and a beverage-specific price increase of 50% for beer and spirits and 10% for wine (scenario 4). Individual-level effects on alcohol consumption were simulated using beverage-specific own-price elasticities. Sensitivity analysis assessed assumption-based correlation coefficient between alcohol consumption and the individual-level percent reduction in alcohol consumed; and the application of the beverage-non-specific own-price participation elasticity.<h3>Findings</h3>Scenario 4 had the strongest effect on alcohol use overall and most effectively reduced consumption in high-risk groups: males and females with high alcohol use (more than 60 g of pure alcohol per day for males and 40 g of pure alcohol per day for females) and low educational attainment (high school degree or less) reduced their alcohol use by –17·30% (–17·62 g per day, credible interval [CI] –21·77 to –13·20) and –17·49% (–12·25 g per day, CI –14·72 to –9·58), respectively. In comparison, smaller relative changes were observed among groups at less risk of harm.<h3>Interpretation</h3>Disproportionate increases in retail prices for the cheapest beverages, beer and spirits, might lead to a greater decline in consumption among high-risk groups. Pricing policies could thus be used as a powerful public health tool to mitigate the unequal alcohol-attributable burden of disease.<h3>F
背景:提高高风险人群(男性、社会经济地位低的人群和大量饮酒的人群)喜欢的酒精饮料的零售价格,可能会选择性地减少他们的酒精消费。然而,饮料特定价格上涨对美国人群的不同影响还有待研究。本研究旨在模拟按性别、受教育程度和酒精使用类别划分的美国成年人口亚组中特定饮料价格上涨对酒精使用的影响。方法对美国人口(18-79岁)进行个人层面的微观模拟,根据个人特征(即性别、年龄、种族、民族和教育程度,作为社会经济地位(高中或以下学历,部分大学学历,大学学历或以上)和以前的酒精使用情况,模拟2000年至2019年的酒精消费情况。微观模拟模型是通过整合各种数据源生成的,这些数据源包括十年一次的美国人口普查数据、美国社区调查的年度数据、国家生命统计系统的年度数据、行为风险因素监测系统的年度数据以及两年一次的收入动态小组研究的纵向数据。政策参数由现有文献提供。将四种国家政策情景与2019年没有价格变化的参考情景进行比较:价格统一上涨10%(情景1),价格统一上涨30%(情景2),啤酒和烈酒特定饮料价格上涨30%,葡萄酒特定饮料价格上涨10%(情景3),啤酒和烈酒特定饮料价格上涨50%,葡萄酒特定饮料价格上涨10%(情景4)。个体水平对酒精消费的影响是用饮料特有的自身价格弹性来模拟的。敏感性分析评估了酒精消费量与个人水平酒精消费量减少百分比之间基于假设的相关系数;以及饮料非特异性自价参与弹性的应用。FindingsScenario 4对饮酒的影响最强的整体和最有效地减少消耗在高危人群:男性和女性高饮酒(每天超过60克的纯酒精对男性和女性每天40 g的纯酒精)和低教育程度(高中学历或更少)减少了酒精使用-17·30%(-17·62克/天,可信区间[CI] -21·77 - -13·20)和-17·49%(-12·每天25克,CI -14·72年9·58),分别。相比之下,在危害风险较低的组中观察到的相对变化较小。最便宜的饮料,啤酒和烈酒的零售价格不成比例地上涨,可能导致高风险群体的消费大幅下降。因此,价格政策可以作为一种强有力的公共卫生工具,减轻由酒精引起的不平等疾病负担。资助国家酒精滥用和酒精中毒研究所,国家卫生研究院
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引用次数: 0
National, regional, and global statistics on alcohol consumption and associated burden of disease 2000–20: a modelling study and comparative risk assessment 2000 - 2020年国家、区域和全球酒精消费和相关疾病负担统计数据:模型研究和比较风险评估
IF 5 1区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-08-27 DOI: 10.1016/s2468-2667(25)00174-4
Kevin Shield, Ari Franklin, Ashley Wettlaufer, Ivneet Sohi, Meera Bhulabhai, Elizabeth K Farkouh, Ilinca-Gabriela Radu, Iman Kassam, Mikayla Munnery, Ronaz Remtulla, Sarah Richter, Farhana Safa, Sara Tasnim, Abhinav Thakral, Mavra Qamar, Jürgen Rehm

Background

Data on alcohol consumption and associated health harms are essential to evaluate progress in achieving global health goals. This study aims to estimate global alcohol consumption from 2000 to 2020, and the global burden of alcohol-attributable harms from 2000 to 2019.

Methods

In this global analysis, adult per capita consumption data estimates were modelled on the basis of sales, survey, and traveller data. Drinking status and past 30-day heavy episodic drinking were estimated through regression analyses of 540 surveys from 174 countries. Alcohol-attributable harms were estimated using a comparative risk assessment methodology by combining alcohol consumption data with corresponding relative risks obtained from meta-analyses and cohort studies. Mortality and morbidity data were obtained from WHO Global Health Estimates.

Findings

Globally, average alcohol consumption in 2019 among adults was 5·5 L (95% uncertainty interval 4·9–6·2), which increased from 5·1 L (4·6–5·7) in 2000. From 2019 to 2020 alcohol consumption decreased to 4·9 L (4·3–5·6). In 2019, alcohol consumption was associated with 2·6 (2·3–3·1) million deaths (4·7% of all deaths) and 116·0 million disability-adjusted life-years (DALYs) lost (4·6% of all DALYs lost). In contrast to alcohol consumption, the number of alcohol-attributable deaths decreased by 31·0% and DALYs lost per 100 000 people decreased by 27·4% from 2000 to 2019.

Interpretation

Alcohol is attributed to a large burden of disease, which disproportionately affects people in Eastern Europe and in Central and Southern Sub-Saharan Africa, and young people. Accordingly, these regions should implement policies such as alcohol taxation increases, availability reductions, and marketing restrictions to reduce alcohol-related harms.

Funding

WHO.
关于酒精消费和相关健康危害的数据对于评估实现全球卫生目标的进展至关重要。本研究旨在估计2000年至2020年的全球酒精消费量,以及2000年至2019年的全球酒精相关危害负担。方法在这项全球分析中,成人人均消费数据估算是基于销售、调查和旅行者数据建模的。通过对174个国家540项调查的回归分析,估计了饮酒状况和过去30天的重度间歇性饮酒。使用比较风险评估方法,通过将酒精消费数据与从荟萃分析和队列研究中获得的相应相对风险相结合,估计酒精归因危害。死亡率和发病率数据来自世卫组织《全球卫生估计》。在全球范围内,2019年成年人的平均饮酒量为5.5升(95%不确定区间为4.9 - 6.2),比2000年的5.1升(4.6 - 5.7)有所增加。从2019年到2020年,酒精消费量下降到4.9 L(4.3 - 5·6)。2019年,酒精消费与260万(230万至110万)例死亡(占所有死亡人数的4.7%)和1.16亿残疾调整生命年(DALYs)损失(占所有DALYs损失的4.6%)相关。与酒精消费相比,2000年至2019年,酒精导致的死亡人数下降了31.0%,每10万人损失的伤残调整生命年下降了27.4%。酒精造成了很大的疾病负担,这对东欧、撒哈拉以南非洲中部和南部的人们以及年轻人造成了不成比例的影响。因此,这些区域应实施诸如增加酒精税、减少可获得性和限制营销等政策,以减少与酒精有关的危害。
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引用次数: 0
Salt substitutes and misrepresentation of WHO recommendations 盐替代品和误传世卫组织建议
IF 5 1区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-08-27 DOI: 10.1016/s2468-2667(25)00169-0
Francesco P Cappuccio
No Abstract
没有抽象的
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引用次数: 0
Alcohol's health burden: secondhand harms matter 酒精的健康负担:二手危害问题
IF 5 1区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-08-27 DOI: 10.1016/s2468-2667(25)00198-7
Max G Griswold, Katherine J Karriker-Jaffe
Estimating the global health burden of alcohol remains a priority for researchers and policymakers, providing necessary context for tracking policy progress and framing public discussion on the harmful effects of alcohol. In The Lancet Public Health, Kevin Shield and colleagues1 provide an updated assessment measuring the global health burden of alcohol. The evidence from their study suggests that global consumption rose 17·4% between 2000 and 2019, accounting for 2·6 million deaths and 4·6% of total disability-adjusted life years—a grim reminder of alcohol's societal toll and the slow progress towards the UN Sustainable Development Goals and WHO Noncommunicable Disease Global Monitoring Framework targets.
估计酒精造成的全球健康负担仍然是研究人员和政策制定者的一个优先事项,为跟踪政策进展和组织公众讨论酒精的有害影响提供必要的背景。在《柳叶刀公共卫生》杂志上,Kevin Shield及其同事提供了一份最新的评估报告,衡量了酒精对全球健康造成的负担。他们的研究证据表明,2000年至2019年期间,全球酒精消费量增长了17.4%,导致260万人死亡,占残疾调整生命年总数的4.6%——这严峻地提醒人们,酒精的社会代价以及实现联合国可持续发展目标和世卫组织非传染性疾病全球监测框架目标的进展缓慢。
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引用次数: 0
期刊
Lancet Public Health
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