The Lancet Public Health

BackgroundDuring the early phase of the Covid-19 pandemic in England, people with pre-existing conditions that put them at severe clinical risk if infected were advised to drastically reduce face-to-face contacts in a policy known as "shielding". The impact of this policy in preventing COVID-19 hospitalisations and deaths has not been evaluated at the national level using transmission-dynamic modelling. MethodsWith the approval of NHS England, we present a retrospective cohort evaluation of the...

ObjectivesTo quantify patterns of preventable death in Australian coronial findings, measure government compliance with coroner recommendations across jurisdictions, and identify case characteristics associated with recommendation issuance and acceptance. DesignCross-sectional computational text analysis of publicly available coronial findings using unsupervised topic modelling and rule-based classification. SettingAustralian coronial system, all eight state and territory jurisdictions, findin...

BackgroundLong-acting injectable buprenorphine (LAI-BUP) is safe and effective, however is dramatically underutilized in comparison to oral formulations. Little is known regarding how buprenorphine prescribers view LAI-BUP, and which medication attributes they prioritize when selecting treatment for opioid use disorder (OUD). MethodsA secondary analysis of a national, cross-sectional online survey of U.S. physicians who prescribe buprenorphine for OUD was conducted. Respondents reported OUD cas...

BackgroundThe introduction of mandatory calorie labelling among large food businesses (chains) in England in 2022 has been found to have little impact on consumer behaviour, but overall calories on restaurant menus have decreased slightly. This study examined menu changes post policy implementation, and the population groups likely to have been affected most. MethodsMenu data from 169 chains in Great Britain were extracted from two online food delivery platforms in June 2022 and June 2023. We s...

Introduction Heat waves are increasingly frequent and linked to higher mortality risks in Hong Kong. However, estimates of total excess mortality associated with heat waves remain unavailable. This study quantifies excess deaths associated with heat waves in Hong Kong from 2014 to 2023. Methods Daily age- and sex-specific mortality rates and population data were obtained from the Hong Kong Life Tables and Census and Statistics Department. Temperature data came from the Hong Kong Observatory, and...

FluSurvey is a participatory surveillance system used to monitor trends in influenza and other respiratory viruses through weekly symptom surveys among the UK population. We aimed to characterise the wider impact of "influenza-like illnesses" (ILI) among FluSurvey participants and assess correlations of ILI with other established influenza surveillance systems. We included data reported by FluSurvey participants over the 2023-24 and 2024-25 winter seasons. Using weekly symptoms surveys, we deri...

ObjectivesTo characterize emergency department (ED) clinician engagement with electronic health record (EHR)-based social drivers of health (SDOH) data; test whether engagement differs in encounters with opioid use disorder (OUD); and, among OUD encounters, assess whether engagement is associated with medications for OUD (MOUD) treatment. Materials and MethodsWe conducted a cross-sectional study of adult ED encounters (January 2023-October 2024). OUD encounters, identified with a structured phe...

BackgroundIn 2016, Chile mandated that products high in sugar carry warning labels. Following this policy, use and consumption of non-nutritive sweeteners (NNS) increased, raising concerns about intake among children. Chile is now considering adding a new warning to its labeling system stating: "CONTAINS NON-NUTRITIVE SWEETENERS, AVOID CONSUMPTION AMONG CHILDREN." However, this and other NNS labeling approaches - e.g., Colombias "CONTAINS NON-NUTRITIVE SWEETENERS" stop signs - have never been em...

Health metrics and modelling capacity have expanded to address present burden and burden attributable to risk factors in the past. There remains a gap in accessible tools that estimate avoidable burden; --that is, the future health and economic impacts of preventive and treatment interventions. This paper describes and demonstrates the Health Interventions Impact Calculator (HIIC), a free web-based analysis and visualisation tool that allows for rapid estimation of the future health and economi...

ObjectiveIn England, since 2022, large businesses providing food in the out-of-home sector are required to display calorie information for non-prepacked food and non-alcoholic drink items. This study estimates long-term cost-effectiveness of the policy by extrapolating real-world evidence on short-term policy effects in England. DesignThe lifetime health economic impacts of calorie labelling were simulated using a microsimulation model. The analysis adopted a health systems perspective to compa...

BACKGROUNDThis study evaluates the reach, scalability, and implementation of a large-scale, multi-site tele-buprenorphine program designed to treat opioid use disorder (OUD) within rural carceral settings. Given that individuals transition frequently between jails and the community, these facilities represent a critical window for OUD intervention, yet they often face significant provider shortages and logistical barriers. We conducted a retrospective chart review of 842 unique patients (1,321 t...

PurposeAdequate hydration is vital for health, yet many people do not meet fluid recommendations. This study aimed to characterise the role of water and sugar-sweetened beverages in hydration across different levels of socioeconomic status (SES) in the UK. MethodsIn a pre-registered cross-sectional study, participants (N = 1,112) recalled beverages consumed on the previous day and reported urine colour as an indicator of their hydration status. We analysed water intake (H1), sugar-sweetened bev...

BackgroundClimate change is increasingly recognised as a threat to population health and healthcare systems, yet the effects of environmental variability on pharmaceutical prescribing remain poorly characterised in the UK. Using a wide array of open-source datasets, we examine the effect of environmental, geographic and socioeconomic factors on prescribing habits in England. MethodsWe linked monthly, practice-level prescribing data for England (2010-2025) to meteorological, air-quality, floodin...

BackgroundThe COVID-19 pandemic was strongly shaped by the interaction between population behaviour and transmission dynamics. Standard mathematical models do not account for this interaction, however. Objectivewe tested whether adding a mechanistic representation of population behavioural dynamics improves the ability of a mathematical model to explain and predict COVID-19 pandemic waves. MethodsWe compared a standard Susceptible-Infected-Recovered (SIR) model to a variant (SIRx) with a mecha...

Modernizing dietary surveillance is essential for addressing diet-related chronic disease, yet traditional self-report tools remain burdensome and error-prone. Edna, a mobile ecological momentary diet assessment (mEMDA) platform, was developed through a multidisciplinary, user-centered process to enable real-time, low-burden dietary reporting with image-assisted portion estimation and automated nutrient coding. In three iterative rounds of national remote testing (N = 146 U.S. adults, 19-65 year...

BackgroundLong-acting injectable buprenorphine (LAIB) has been positioned as a potentially transformative option for opioid use disorder (OUD), in part because patient experiences reported in qualitative studies emphasize reduced daily burden, increased "freedom," reduced stigma, and fewer pressures related to diversion--while also noting barriers such as insufficient information, early adverse experiences, and concerns about coercion. MethodsWe conducted a cross-sectional online survey of adul...

Embedding equity into vaccine eligibility is essential for reducing health inequalities. Yet, adult vaccine eligibility in most European countries is primarily based on fixed age thresholds, prioritising cost-effectiveness. This approach risks excluding the most vulnerable populations living in deprived communities with poorer health and shorter survival into older age. Extending eligibility based on clinical risk partially addresses this gap. Higher rates of underdiagnosis and delayed diagnosis...

BackgroundUnderstanding the drivers of protective behavior during infectious disease outbreaks is critical for public health policy. App-based experimental epidemic games (epigames) offer a novel method to study these behaviors empirically, but their external validity--how well in-game choices reflect real-life beliefs--still needs to be rigorously tested. MethodsWe conducted a two-week randomized controlled trial (N=567) using the Epigames smartphone app at the American University of Iraq - Ba...

BackgroundEpidemic forecasting research often assesses ensembles and their component models using probabilistic scoring rules. Quantifying how individual models affect ensemble performance is challenging, particularly across multiple targets and spatial scales. MethodsWe present Winter 2024-25 forecasts of Influenza and COVID-19 hospital admissions in England and conduct a retrospective simulation using the operational component models. Forecasts were scored using the per capita weighted interv...

BackgroundAdults with intellectual disabilities who display behaviours that challenge (BtC) are more prone to poor health. This study seeks to evidence the long-term health outcomes for this population. MethodsWe conducted a longitudinal cohort study of adults with intellectual disabilities aged 18+ years in England using data from Clinical Practice Research Datalink Aurum (01/2003-12/2023) linked to Hospital Episode Statistics and Office for National Statistics. Main outcome measures were Annu...