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.

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.

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.

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.

Prospective data on the natural history of alcohol-use disorders (AUD) from adolescence into middle adulthood are scarce. This study aims to describe the prevalence, incidence, and remission of Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 AUD from adolescence into middle adulthood and thereafter characterise those who do and do not develop AUD symptoms or experience remission.

Exposure to digital alcohol marketing content might be associated with pro-alcohol-related attitudes and behaviours, including the likelihood of initiating or sustaining the use of alcohol, especially among adolescents (aged <18 years) and young adults (aged 18-25 years). This study aimed to examine the relationship between exposure to digital alcohol marketing content and alcohol use outcomes.

Liver cirrhosis is a leading global cause of morbidity and mortality, with rising incidence driven by alcohol-related liver disease (ALD) and metabolic dysfunction-associated steatotic liver disease (MASLD). Pronounced socioeconomic disparities in ALD-related and MASLD-related cirrhosis highlight the need for targeted prevention strategies in disadvantaged groups. We aimed to investigate socioeconomic and demographic differences in cirrhosis incidence, clinical presentation, and aetiology over time in Sweden.

The COVID-19 pandemic led to substantial health services disruption in England. Health-care policy makers need reliable national-level information on disease burden to plan services. Whole-population individual-level data, which are routinely collected and linked across multiple sources, provide comprehensive estimates that can be regularly updated at low cost. We aimed to measure the burden of cardiovascular diseases in the whole population of England from 2020 to 2024.

Living in poverty increases the risk for mortality. Existing research that examines life course poverty typically relies on measures separated by decades of time. Here, we aimed to estimate the association of 20-year cumulative poverty exposure from emerging adulthood through to established adulthood with premature mortality assessed over the following 15 years.

Premature mortality rates are higher in the USA than other peer nations. Few studies have assessed the association between cumulative unsecured debt and subsequent premature mortality. The aim of this study was to investigate the association between cumulatively accrued unsecured debt over 20 years of early adulthood and subsequent premature mortality in midlife (age 41-62 years).

Life expectancy in the USA is considerably lower than in most high-income countries, with many deaths considered preventable. The extent by which poor performance on prevention measures and public health policies in the USA could be contributing to this issue is not well understood. To address this issue, we compared publicly available population-based indicators of health care across different levels of prevention in the USA and six high-income countries (ie, Australia, Canada, Germany, France, Sweden, and the UK) and Organisation for Economic Co-operation and Development countries between 2010 and 2023. Relative to comparator countries, the USA had a younger population and lower smoking rates, but it had higher obesity prevalence, calorie intake, illicit drug use, and gun and vehicle ownership. Regarding public health policies that lie largely outside the health-care system, the USA compared unfavourably to comparator countries. For measures dependent on the health-care system, the USA performed well across several measures of clinical prevention, including screening rates and diagnosis and control of chronic conditions. However, the USA was worse on measures of access to health care and coverage. While the USA performs well in prevention efforts within the health-care system compared with other countries for people with access to the system, it faces greater risk from external factors, generally worse dietary intake, and implements weaker public health prevention and regulation against harmful products that might exacerbate these issues. To improve population health, policy makers should prioritise multi-sectoral investments in prevention policies and improve access to health care.