Preventive Medicine

Pay-it-forward subsidies substantially boost pneumococcal and influenza vaccination at lower cost in older adults

Among 221 Chinese adults aged 60 years or older, a pay-it-forward model markedly increased PPSV23 vaccination versus standard self-pay. Pneumococcal uptake was 70.9% with pay-it-forward versus 13.5% with standard care (adjusted OR 17.20, 95% CI 8.39-37.60). Influenza vaccination also increased (30.0% vs 17.1%; adjusted OR 2.29, 95% CI 1.17-4.65), alongside higher confidence in vaccine safety, importance, and effectiveness. Per-person economic cost per vaccinated patient was lower with pay-it-forward (US $95.67 vs $278.56), despite higher referral success. 1

Meeting more 24-hour movement guidelines is linked to lower all-cause and CVD mortality in US adults

In 41,930 US adults, adherence to integrated 24-hour movement guidelines was associated with substantially lower mortality over 9.9 years. Compared with meeting no guideline, hazard ratios for all-cause mortality were 0.81, 0.75, and 0.63 for meeting 1, 2, or 3 guidelines, respectively. For cardiovascular mortality, only meeting all three guidelines—activity, limited sitting, and 7–9 hours sleep—showed a clear reduction (HR 0.53, 95% CI 0.37-0.76). A significant dose-response pattern supports promoting a healthy full-day movement profile rather than focusing on physical activity alone. 2

Structured physical activity counseling halves long-term mortality in sedentary adults with type 2 diabetes

In 300 sedentary adults with type 2 diabetes, annual one-month counseling on physical activity and sedentary behavior for three years lowered 10-year mortality. Over 10.3 years, deaths were 18 in the intervention group versus 35 in controls (p = 0.010). The fully adjusted hazard ratio for mortality was 0.414 (95% CI 0.229-0.750), indicating a robust survival benefit. Reduced mortality was mainly from fewer cancer deaths, suggesting broad benefits beyond cardiometabolic control. 3

E-cigarette taxes modestly reduce use and show heterogeneous pass-through and demand elasticity

This systematic review of 27 studies found that e-cigarette taxation generally increased prices and modestly reduced use. Meta-analysis of three US studies showed lower odds of e-cigarette use among adults in taxed settings (OR 0.89, 95% CI 0.84-0.94). Young adults aged 18–24 also had reduced use (OR 0.87, 95% CI 0.78-0.98), indicating some preventive value for emerging users. Price elasticity ranged from -0.62 to -0.02, and pass-through from 0.07 in China to 1.67 in the USA, highlighting market variability. 4