Pub Date : 2025-09-22DOI: 10.1016/s2468-2667(25)00229-4
Housing is a fundamental human right. Yet, UN Habitat estimates that 2·8 billion people around the world face some form of housing inadequacy, 1 billion people live in informal settlements and slums, and 300 million people are homeless. Adequate, safe, and affordable housing is not a luxury. The Sustainable Development Goal target 11.1—ensure access for all to adequate, safe and affordable housing and basic services and upgrade slums by 2030—is clear, and the next 5 years will be crucial for countries to meet their targets. Housing is increasingly recognised as a determinant of health and wellbeing, yet governments are slow to act and poor housing remains a substantial challenge and a threat to public health in many countries.
{"title":"Housing: a determinant of health and equity","authors":"","doi":"10.1016/s2468-2667(25)00229-4","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00229-4","url":null,"abstract":"Housing is a fundamental human right. Yet, <span><span>UN Habitat</span><svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"><path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"></path></svg></span> estimates that 2·8 billion people around the world face some form of housing inadequacy, 1 billion people live in informal settlements and slums, and 300 million people are homeless. Adequate, safe, and affordable housing is not a luxury. The Sustainable Development Goal target 11.1—ensure access for all to adequate, safe and affordable housing and basic services and upgrade slums by 2030—is clear, and the next 5 years will be crucial for countries to meet their targets. Housing is increasingly recognised as a determinant of health and wellbeing, yet governments are slow to act and poor housing remains a substantial challenge and a threat to public health in many countries.","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"27 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145116393","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 : 2025-09-12DOI: 10.1016/s2468-2667(25)00142-2
Rebecca Bentley, Kate Mason, David Jacobs, Tony Blakely, Philippa Howden-Chapman, Ang Li, Gary Adamkiewicz, Aaron Reeves
Housing is a key social determinant of health. Healthy housing is affordable, suitable, and secure. It is characterised by warmth, dryness, and proper ventilation; free from hazards such as mould and toxins; accessible to occupants with functional limitations; and provides foundational security. Conversely, exposure to unhealthy home environments can negatively affect respiratory and cardiovascular health, mental wellbeing, infectious disease transmission, and injury risk. Housing-focused health interventions and programmes offer a unique opportunity to bridge the gap between housing and health, potentially leading to improved population health outcomes across various domains. This Series paper integrates contemporary understanding of housing and housing systems into a social and economic determinants framework. We illustrate how housing systems contribute to poor health outcomes and health inequalities, providing a foundation for exploring housing's potential to support health across jurisdictions globally. Although our framework can be used to examine the relationship between specific housing hazards (eg, mould, cold, or heat) and health, its primary focus is on understanding how these hazards are generated and distributed through characteristics of the housing system (eg, building codes or housing finance). By addressing these housing system determinants, we propose an alternative approach to achieving healthier housing. This framework aims to support the strategic use of housing to promote good health for all populations.
{"title":"Housing as a social determinant of health: a contemporary framework","authors":"Rebecca Bentley, Kate Mason, David Jacobs, Tony Blakely, Philippa Howden-Chapman, Ang Li, Gary Adamkiewicz, Aaron Reeves","doi":"10.1016/s2468-2667(25)00142-2","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00142-2","url":null,"abstract":"Housing is a key social determinant of health. Healthy housing is affordable, suitable, and secure. It is characterised by warmth, dryness, and proper ventilation; free from hazards such as mould and toxins; accessible to occupants with functional limitations; and provides foundational security. Conversely, exposure to unhealthy home environments can negatively affect respiratory and cardiovascular health, mental wellbeing, infectious disease transmission, and injury risk. Housing-focused health interventions and programmes offer a unique opportunity to bridge the gap between housing and health, potentially leading to improved population health outcomes across various domains. This Series paper integrates contemporary understanding of housing and housing systems into a social and economic determinants framework. We illustrate how housing systems contribute to poor health outcomes and health inequalities, providing a foundation for exploring housing's potential to support health across jurisdictions globally. Although our framework can be used to examine the relationship between specific housing hazards (eg, mould, cold, or heat) and health, its primary focus is on understanding how these hazards are generated and distributed through characteristics of the housing system (eg, building codes or housing finance). By addressing these housing system determinants, we propose an alternative approach to achieving healthier housing. This framework aims to support the strategic use of housing to promote good health for all populations.","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"38 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145043095","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 : 2025-09-12DOI: 10.1016/s2468-2667(25)00141-0
Ang Li, Mathew Toll, Ralph Chapman, Philippa Howden-Chapman, Diana Hernández, Holly Samuelson, Alistair Woodward, Rebecca Bentley
Anthropogenic climate change is causing rapid shifts in temperature and weather patterns, both in location and intensity, making living conditions increasingly hazardous. This complicates housing's frontline role in protecting human health. When housing systems fail to provide universal access to secure, affordable, and suitable housing, social and health inequalities related to climate change are amplified. The location, construction, and operation of homes influence greenhouse gas emissions and must be improved to reduce their environmental impacts. This paper, the second in a Series on housing as a social determinant of health, builds a framework for conceptualising the interactions between housing, climate, and health. It identifies the pathways through which climate change affects housing and exacerbates health risks, and reflects on policy responses for climate resilience in housing and health.
{"title":"Housing at the intersection of health and climate change","authors":"Ang Li, Mathew Toll, Ralph Chapman, Philippa Howden-Chapman, Diana Hernández, Holly Samuelson, Alistair Woodward, Rebecca Bentley","doi":"10.1016/s2468-2667(25)00141-0","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00141-0","url":null,"abstract":"Anthropogenic climate change is causing rapid shifts in temperature and weather patterns, both in location and intensity, making living conditions increasingly hazardous. This complicates housing's frontline role in protecting human health. When housing systems fail to provide universal access to secure, affordable, and suitable housing, social and health inequalities related to climate change are amplified. The location, construction, and operation of homes influence greenhouse gas emissions and must be improved to reduce their environmental impacts. This paper, the second in a Series on housing as a social determinant of health, builds a framework for conceptualising the interactions between housing, climate, and health. It identifies the pathways through which climate change affects housing and exacerbates health risks, and reflects on policy responses for climate resilience in housing and health.","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"26 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145043093","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 : 2025-09-12DOI: 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。
{"title":"Displacement, health outcomes, and the human rights of people experiencing homelessness in the USA","authors":"Jesse Lloyd Goldshear, Tina Kempin Reuter, Ricky N Bluthenthal, Annick Borquez","doi":"10.1016/s2468-2667(25)00197-5","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00197-5","url":null,"abstract":"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 (<em>City of Grants Pass v Johnson</em>)—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.","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"77 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145043728","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 : 2025-09-11DOI: 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.
{"title":"Designing men's health policy: the 5R Framework","authors":"Paul M Galdas, Zac E Seidler, John L Oliffe","doi":"10.1016/s2468-2667(25)00202-6","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00202-6","url":null,"abstract":"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.","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"26 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145043235","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 : 2025-09-09DOI: 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
{"title":"Men's mental health: we need systems, not symbols","authors":"David Francis Hunt, Hazel Banks, Daniel K Y Kan, Phil Ruthen, Felicity Thomas, Geoff Wong","doi":"10.1016/s2468-2667(25)00196-3","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00196-3","url":null,"abstract":"The UK Government is currently developing the country's first national strategy on men's mental health.<span><span><sup>1</sup></span></span> Male suicide is a priority—rightly so, given men account for approximately 75% of suicide deaths globally.<span><span><sup>2</sup></span></span> WHO has identified male suicide as a crucial but under-addressed public health issue.<span><span><sup>2</sup></span></span>","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"33 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145043128","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 : 2025-09-09DOI: 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
{"title":"Confronting Spain's failure in the prevention of suicidal behaviour","authors":"Manuel Canal-Rivero, Miguel Ruiz-Veguilla","doi":"10.1016/s2468-2667(25)00195-1","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00195-1","url":null,"abstract":"Spain did not meet WHO's goal of reducing suicide rates by 10% by 2020;<span><span><sup>1</sup></span></span> 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.<span><span><sup>2</sup></span></span> 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.<span><span><sup>2</sup></span></span>","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"24 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145043126","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 : 2025-09-05DOI: 10.1016/s2468-2667(25)00224-5
No Abstract
没有抽象的
{"title":"Correction to Lancet Public Health 2025; 10: e160–64","authors":"","doi":"10.1016/s2468-2667(25)00224-5","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00224-5","url":null,"abstract":"No Abstract","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"30 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145003334","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 : 2025-09-04DOI: 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.
{"title":"Correction to Lancet Public Health 2025; 10: e774–83","authors":"","doi":"10.1016/s2468-2667(25)00223-3","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00223-3","url":null,"abstract":"<em>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.</em> Lancet Public Health <em>2025;</em> 10: <em>774–83</em>—In this Article, the y-axis values in figure 1 have been corrected. These corrections have been made as of Sept 4, 2025.","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"104 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144987549","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 : 2025-08-27DOI: 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
{"title":"Targeting alcohol use in high-risk population groups: a US microsimulation study of beverage-specific pricing policies","authors":"Carolin Kilian, Charlotte Buckley, Julia M Lemp, Xinyi Kou, William C Kerr, Nina Mulia, Robin C Purshouse, Jürgen Rehm, Charlotte Probst","doi":"10.1016/s2468-2667(25)00165-3","DOIUrl":"https://doi.org/10.1016/s2468-2667(25)00165-3","url":null,"abstract":"<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","PeriodicalId":56027,"journal":{"name":"Lancet Public Health","volume":"36 1","pages":""},"PeriodicalIF":50.0,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144910990","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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