The Developmental Origins of Health and Disease (DOHaD) framework has transformed understanding of how early-life exposures shape health across the life course, yet populations from Oceania remain underrepresented in this research. The Raine Study is a globally unique, multigenerational longitudinal pregnancy cohort established in Western Australia, one of the world’s most geographically isolated regions. The study recruited 2900 pregnant women (Generation1) in 1989, which resulted in 2868 live births forming Generation 2, and is now currently recruiting Generation 3 (the children of Generation 2). This paper describes the evolution of the Raine Study from its origins as a pregnancy cohort grounded in DOHaD to a comprehensive life-course and multigenerational research resource. This resource has led to key research findings that have informed international clinical guidelines and national and state health policies across areas including prenatal development and care safety, neurodevelopment, cardiometabolic health, obesity, liver disease, physical activity, mental health, sedentary behaviour, sleep, and assisted reproductive technologies. Central to the Raine Study’s success is a longstanding commitment to participant partnership and engagement, resulting in exceptional retention and strong consumer involvement in governance and research prioritisation. The Raine Study demonstrates the critical value of well-characterised, place-based cohorts for advancing DOHaD and life-course science and provides a globally significant resource to inform prevention strategies, precision medicine, and public health policy across generations.

Antibiotic resistance is a critical global health threat, with over a million deaths linked to resistant infections every year. Inappropriate antibiotic use for childhood diarrhoeal illness is a significant contributor to antimicrobial resistance. This is particularly important in low-resource settings where antibiotics are often used without clear clinical indication. This study explored the knowledge and perspectives of antibiotic stewardship among clinicians and caregivers of paediatric patients in Bangladesh. In-depth interviews were conducted with 18 clinicians and 36 patient caregivers across three government hospitals. While few clinicians were familiar with the term ‘antibiotic stewardship’, most understood its core principles and supported judicious prescribing. Caregivers were generally unfamiliar with the concept of antimicrobial stewardship, though a few acknowledged the risks of antibiotic overuse. Clinicians described informal stewardship efforts but highlighted the absence of structured programmes. Key challenges to stewardship included community-level antibiotic dispensing by informal providers, staffing shortages, caregiver expectations for antibiotics, and pressure to satisfy families’ perceived expectations. Despite barriers, clinicians expressed support for educational initiatives and system-level efforts to promote antibiotic stewardship. These findings underscore the need for integrated, facility- and community-based approaches like decision-making support tools for providers, institutional reviews of antibiotic use, and community education on the dangers of inappropriate antibiotic use. Strengthening antibiotic stewardship in low-resource settings like Bangladesh is essential to curb misuse and combat the growing threat of antibiotic resistance.

The COVID-19 pandemic unfolded alongside an unprecedented ‘infodemic’ that reshaped public engagement with science, health, and authority. This study examines how online infodemics translated into collective resistance and influenced population health through political mobilisation. Using structural equation models across six European countries, I conceptualise resistance as a latent construct – captured by residential mobility and protests opposing vaccines, lockdowns, and public health measures linked to populist radical right (PRR) movements – acting as a behavioural bridge between digital information environments and epidemic outcomes. The findings reveal a robust infodemic–resistance–epidemic pathway: greater exposure to infodemic content consistently predicts stronger opposition to non-pharmaceutical interventions (NPIs) and vaccination. This effect is strongest in Germany and Italy, where PRR networks amplified narratives of ‘elite overreach’ and ‘freedom under threat’, transforming online discontent into organised mobilisation. In other countries, resistance appears weaker and more pandemic-specific. By integrating informational, political, and epidemiological processes, the analysis shows how epidemics can evolve into politicised collective behaviour that undermines compliance and sustains transmission. The results highlight populist mobilisation as a key amplifier of epidemic risk and suggest that effective responses must rebuild trust, depoliticise health communication, and address structural sources of grievance.

Medicaid work requirements were found in 2018 to be contrary to the Medicaid statute because, according to the D.C. Circuit, “the objective of Medicaid was to furnish medical assistance.” Even though the Secretary of Health and Human Services determined that the work requirements were “likely to assist in improving health outcomes,” the court concluded that “better health outcomes as [an] objective of Medicaid … lacks textual support. Indeed, the statute makes no mention of that objective.”

With the second Trump administration making Medicaid work requirements a centerpiece of its budget, the “objectives of Medicaid” reemerge as both an important statutory constraint on the program and a foundational question for health policy. Though the upcoming debate will likely ride on the efficacy of work requirements, the broad implications of the litigation will inevitably shape broad implications for future Medicaid policy.

This article delves into the Medicaid statute to reveal its core objectives, and it makes one legal and one policy claim. First, Medicaid’s statutory language does support the promotion of better health outcomes as one of the program’s objectives, and second, providing services that fall outside “medical assistance” is critical in improving health outcomes to beneficiaries. As an empirical matter, nonmedical services have become a staple of health care delivery in recent decades, including in some of Medicaid’s signature initiatives, and a careless revisitation of the legality of work requirements undermine some of the program’s most important advances.

To address the legality of work requirements, courts should embrace Medicaid’s broader objectives and instead apply one of the statute’s mostly ignored requirements: states must evaluate the efficacy of their innovations. The Medicaid statute encourages states to experiment with new health care delivery strategies to find more affordable and cost-effective strategies to promote population health, including those that rely on nonmedical interventions, but the constraint is not whether those innovations are consistent with Medicaid’s legal objectives but rather whether they are empirically shown to improve population health. And precisely because public health research has identified a wealth of social, behavioral, and nonmedical interventions that have proven to be effective in promoting population health, a proper understanding of the Medicaid statute and the program’s objectives are critical in implementing effective health policy, in the second Trump administration and beyond.

Cervicovaginal fluid (CVF) represents a promising biospecimen for ovarian cancer biomarker discovery, but metabolomics typically requires specialized collection methods. We assessed the feasibility of applying untargeted metabolomics to self-collected CVF from 10 ovarian cancer patients in the ORCHiD (Ovarian Cancer Epidemiology, Healthcare Access and Disparities) study using ultrahigh performance liquid chromatography-tandem mass spectroscopy. We detected 1107 compounds mapping to 1002 unique metabolite identifiers across 9 super chemical classes, with detection rates of 62–99%. One-third of detected metabolites overlapped with published studies, while two-thirds were novel. Sample-level detection profiles were broadly consistent. Untargeted metabolomics on self-collected CVF is technically feasible and enables metabolite discovery for population-based cancer research.

Mortality trends among Indigenous peoples in Brazil remain poorly characterised. An ecological time-series study (2010–2022) was conducted, comparing Indigenous and non-Indigenous populations using nationwide open-access demographic and mortality data. Mortality was stratified by sex, age, and ICD-10 groups, populations were compared using Pearson’s chi-square test (p < 0.05), and trends were evaluated with joinpoint regression (JR) to estimate Average Annual Percentage Changes (AAPCs). Between 2010 and 2022, mortality among Indigenous peoples increased by 82.5% (from 2,927 to 5,343), compared with a 42.3% increase in the non-Indigenous population. Over 40% of deaths among Indigenous peoples occurred outside health facilities in both years, versus fewer than 30% among non-Indigenous populations. Crude mortality rates remained lower in Indigenous peoples (2010: 35.8 versus 55.9; 2022: 43.5 versus 74.8 per 10,000 population). However, age-specific differences were marked: mortality among Indigenous children and adolescents (0–19 years) was 3.3 times higher in 2010 and 3.8 times higher in 2022, while mortality among adults aged ≥40 years was approximately 2.5 times lower in both years compared with non-Indigenous populations (all p < 0.05). Mortality rates among Indigenous peoples were consistently higher for maternal, perinatal, and congenital conditions in both 2010 and 2022. JR revealed heterogeneous proportional mortality trends: significant increases in perinatal, congenital, and external causes (AAPC approximately 5.0–6.4%), as well as neoplasms, circulatory, haematological, digestive, respiratory, and endocrine/metabolic diseases (AAPC approximately 1.6–4.4%); a significant decline in infectious and parasitic diseases (AAPC −6.6%); and stability in other groups. Indigenous peoples in Brazil continued to face unfavourable mortality, particularly among children, adolescents, and maternal conditions. Many leading causes of death are preventable. Strengthening primary healthcare, expanding prenatal and perinatal services, improving vaccination and mental-health support, and adopting culturally safe, community-driven strategies to address chronic diseases are critical to reducing inequities and preventable deaths.

Hypertension (HTN) is the primary cause of preventable cardiovascular-related deaths globally, representing the most important modifiable risk factor for preventing such deaths. Nearly 700 million of the 1.3 billion adults with HTN worldwide remain untreated, most of whom live in low-and middle-income countries, including East Africa. Barriers to the diagnosis of HTN also impact treatment adherence after diagnosis and the initiation of treatment. This scoping review used a qualitative synthesis method to describe studies examining the cultural and contextual factors influencing HTN treatment adherence in East Africa and the lived experiences of patients with HTN to gain a better understanding of these factors in the region. A total of 34 studies, 25 qualitative and 9 mixed-methods designs from five East African nations were included in the final review. Reported influencing factors are classified into individual, structural, and social factors. Lack of HTN literacy and limited risk perception were often cited as individual barriers to adherence, along with mental health challenges, including fear of stigma, while trust and HTN literacy enhanced adherence. Inconsistent healthcare delivery, lack of access, and financial constraints were the most reported structural factors. Social norms surrounding health behaviours and attitudes towards HTN treatment were identified as key determinants of adherence at the social level. The findings underscore the complex interplay of individual, structural, and social factors associated with HTN treatment adherence in East Africa, offering practical ways to enhance adherence in the region at all three levels.

Biosocial birth cohort studies are uniquely positioned to be novel sites of interdisciplinary research. Their enduring commitment to specific field sites and populations, recurring grant renewal cycles, ability to ask prospective questions while drawing on long-standing data repositories, and more ensure ongoing collaboration and allow research to remain responsive to the evolving needs and timelines of multiple disciplines. However, it is widely recognised that interdisciplinary work is often easier imagined than achieved, and additional conditions are required to facilitate it beyond assembling teams of varied experts. This piece offers mediating practices as a concept that refers to the practical, multi-directional, and relational processes that attempt to resolve tensions that interdisciplinary teams often confront. Mediating practices bridge gaps among different disciplines’ data and methods, often relying on pragmatic strategies, like re-designing data infrastructures or planning action items after a meeting, to do so. As such, mediating practices are crucial to conducting successful interdisciplinary research. Further, the concept of mediating practices foregrounds the actions of junior team members who often perform these practices, highlighting the need to foster epistemic humility and models of horizontal knowledge production in interdisciplinary teams. Here, the authors discuss their experiences and insights as members of interdisciplinary projects and outline how mediating practices emerged in these projects and enabled interdisciplinary success.

This study aimed to investigate the influence of socio-demographic and epidemiological factors on the secular changes in body size indicators (height, weight, and BMI) among young adults aged 17–22 years in Moscow from the early 20th century to the present. Published average anthropometric data from screening surveys conducted from 1880/1925–26 to 2020–21 were analysed (4,823 males and 5,952 females), along with demographic data from the Federal State Statistics Service of the Russian Federation. Findings revealed consistent anthropometric trends and strong associations between secular changes in body size of Moscow youth and socio-demographic indicators such as population size, life expectancy, and infant mortality rates. An increase in height and weight was noted against the backdrop of urbanisation, increased life expectancy, and reduced infant mortality. These results indicate that the urbanisation process and the transformation of the epidemiological landscape in 20th-century Russia – marked by enhancements in public health, modernisation of the healthcare system, and medical advancements – have had a significant impact on changes in body size across generations. Notably, from the mid-20th century onwards, with the exception of the final decade, conditions favourable to growth and development were established, culminating in a significant increase in definitive anthropometric parameters across successive generations. The findings underscore the imperative for policymakers to bolster investments in urban development, healthcare, and education. Such strategic investments are essential for sustaining and amplifying the positive physical development trends witnessed.

The normative principle that every individual is equally entitled to continued life is a subject of debate in ethics, health economics and policy. We reconsider this principle in the context of setting priorities for healthcare interventions. When applied without restriction, the principle overlooks quality of life concerns entirely. However, we contend that it remains ethically relevant in certain situations, particularly when patients suffer from conditions unrelated to the therapeutic areas and treatments under consideration. Thus, we defend the principle while also emphasizing the need for its application within tight limits.

Diet indices are quantitative assessments of the quality of population intake. Understanding diet quality is crucial to support health and well-being; however, knowledge of diet quality across racial groups is limited. To examine diet quality of acial groups ‘White’, ‘Black’, ‘Asian’, and ‘Other’ in the United Kingdom (U.K.) and United States (U.S.), U.K. and U.S. national survey data were used to calculate Alternative Healthy Eating Index (AHEI-2010), Diet Quality Index-International (DQI-I), and EAT-Lancet scores. ANCOVA tests compared median total quality scores across racial groups adjusting for covariates. Kruskal–Wallis tests examined differences in individual component scores. Spearman correlations identified association of diet quality scores across indices. Highest diet quality scores were reported for U.K. and U.S. Asian groups. Most noticeable differences were apparent between U.S. Asian and White/Black groups (62% Asians within highest tertile of AHEI-2010 score vs. 29% Whites; P < 0.001). All racial groups demonstrated poor diet quality in terms of sustainability; EAT-Lancet scores were <40% of maximum total score for U.S. White, Black, and Other groups. AHEI-2010 diet quality scores were moderately associated with EAT-Lancet scores, evident across all groups (r = 0.53–0.65; P < 0.001). There is a need for all groups to increase intake of wholegrains, especially Black groups (mean Wholegrain score for U.S. Black group within DQI-I was 0.60 (maximum score of 5)) as demonstrated within AHEI-2010, DQI-I, and EAT-Lancet component scores. Additionally, increased intake of vegetables and legumes and decreased intake of processed and red meat would improve the adequacy, healthiness, and sustainability of U.K. and U.S. racial diets.

In the field of American state politics, the tension between majoritarian institutions and equality has largely been ignored. Do state institutions that empower majority preferences exacerbate disparities in social outcomes? Under what conditions do majoritarian institutions exacerbate inequalities in the American states? Our argument is that equality is most likely to be threatened under majoritarian institutions when (1) there are systemic participatory biases and/or (2) there are widespread prejudices about particular groups in society. We find that more majoritarian institutions are associated with larger disparities between White and Black life expectancy and poverty rates across the American states, but not differences in educational attainment. We also find that this effect is moderated by racial context, with majoritarian institutions being associated with greater disparities for states with diverse racial contexts and smaller disparities in more homogenous states. These findings suggest that majoritarian institutions operate to the benefit of the White majority, while coming at the cost of minority population outcomes when a racial threat is perceived, and presumably, public opinion is biased.