Long-term conditions (LTC) such as diabetes, cardiovascular disease (CVD), overweight and obesity have a significant impact in Aotearoa (New Zealand). Māori communities are disproportionately affected, making LTCs a critical equity issue for the country(1). These inequities are not incidental but reflect the direct legacy of colonisation. An intervention shown to have a positive impact across a range of LTCs is a plant-based diet(2), yet nutrition trials in Aotearoa are limited. No published controlled nutrition trials consider a Māori worldview of kai (food) or acknowledge that for Māori, weight may not be the best anthropometric measure. Nutrition is a key determinant of improving health outcomes. To enable equitable health outcomes, research must value Western science alongside mātauranga Māori (Māori knowledge) and incorporate traditional food sources. The purpose of this project is therefore to determine the impact of an Aotearoa-specific nutrition approach with a Māori worldview of kai and prioritising plants. The study is a non-randomised, mixed-methods, single-arm pilot in Gisborne with 11 participants (82% were Māori), guided by Kaupapa Māori methodology (a Māori methodology). The research upholds tino rangatiratanga (Māori sovereignty), ensures Māori governance and oversight, and honours Te Tiriti o Waitangi (the Treaty of Waitangi) principles. Outcome measures will be performed at baseline and 12 weeks, including quality of life using a Kaupapa Māori questionnaire and semi-structured interviews, and metabolic health markers (HbA1c, lipids, blood pressure, weight, waist-to-hip ratio). Adherence is not assessed by monitoring energy intake, but rather supported with recipes, meal plans, weekly check-ins, and a Facebook group to encourage kōrero, pātai, and whanaungatanga. The programme focuses on sustainable lifestyle changes responsive to whānau needs. Kai ā Nuku is a nutrition programme, integrating mātauranga Māori and nutrition science. Approximately 90% of food is sourced from seasonal plants. Core principles include daily beans or lentils, fermented foods (sauerkraut, kimchi, apple cider vinegar), sourdough bread, and unprocessed grains (quinoa, buckwheat, black rice). Limitations include red meat for special occasions, eggs fewer than three per week, no dairy except goat products, no added sugar, and limited processed foods, alcohol, and caffeine. Māori kai practices are integrated: fish and kaimoana three times per week, rewena bread as sourdough, karengo (seaweed), and kaanga pirau and toroi (traditional fermented foods). The themes constructed from this research suggest that Kaupapa Māori health interventions, grounded in whānau-centred (family-centred) approachesand te ao Māori (Maori worldview) understandings of health, remain fundamental for Māori whānau. Participants’ experiences also indicate that hinengaro (mental and emotional well-being) and quality of life are critical markers of health. The quantitative findings demonstrated improvements in hinengaro scores (16.2 ± 4 v 18.4 ± 3.6; p < 0.05), total Kaupapa Māori quality of life scores (20.8 ± 5.7 v 22.25 ± 5.1; p < 0.05), total cholesterol (4.7 ± 1 v 3.9 ± 0.7; p < 0.05), low-density lipoprotein cholesterol (2.7 ± 0.7 v 2.1 ± 0.2; p < 0.05), body weight (99.9 ± 17.1 v 93.8 ± 13.5; p < 0.05), and waist circumference (109 ± 9.4 v 101.2 ± 9; p < 0.01). The Kai ā Nuku study demonstrates that dietary and lifestyle interventions grounded in both evidence-based science and mātauranga can enhance the health and well-being of whānau. The findings from this study support the need for continued investigation, including well-designed randomised controlled trials.

This commentary examines the imperative of including people with lived and living experience (PWLE) in the development of digital innovations for substance use disorders (SUD). Centering PWLE in design processes improves usability, equity, and effectiveness, particularly for individuals with multimorbidity and those facing socioeconomic marginalization. Participatory approaches – such as co-design workshops and community-led monitoring – alongside ethical and regulatory considerations, are critical to both the prevention and treatment of SUD. However, meaningful involvement is often hindered by limited funding, disparities in digital access and literacy, and complex data privacy laws. The commentary underscores the need for supportive policy frameworks and sustained investment that prioritize culturally sensitive, person-centered design. Ensuring digital health tools for SUD are informed by the insights and needs of PWLE is essential for creating inclusive, effective, and ethically grounded responses to the ongoing challenges of substance use and recovery.

Public policies contribute to structural racism and health inequities. To dismantle structural racism and advance health equity, methods aligning scientific evidence, community priorities, and political will are needed to implement equity-focused interventions. This study combined community-based participatory research and legal epidemiology methods to inform local policy in East Point, Georgia. The community informed a comprehensive policy approach to address social determinants of health (SDOH) and advance health equity and identified East Point’s Comprehensive Plan Update as an opportunity to advance health equity through policy. Key findings informed a legal epidemiology study to assess variation in including equity and health equity in comprehensive plans across 32 jurisdictions. Limited adoption of equity and health equity provisions were found, revealing opportunities to inform the East Point policymaking process. Research findings were summarized and disseminated to the community and policymakers. In 2023, East Point adopted equity, health, and health equity into its comprehensive plan for the first time. This case study demonstrates that collaborative, multi-sector, community-centered approaches can support policy interventions that address historical race-based, health-harming policies, and thereby dismantle structural racism. Inclusion of health equity in East Point’s comprehensive plan provides a foundation for future implementation of policies that address SDOH and health inequities.

Dr. C. Norman Coleman’s impact is difficult to measure overall, even if one focuses only on his work as NCI’s Radiation Research Program (RRP) leader. His laboratory work spanned immune-oncology and radiation therapy, RNA biology, normal tissue and tumor tissue radiobiology, and the development of tissue chips for use in radiation biology research. His programmatic leadership helped the RRP develop health equity programs addressing Native American access to optimal cancer care, evaluation of hadron therapy biology, radiation biology, reproducibility and rigor, foundational molecular biology of the tumor and normal tissue caused by radiation therapy dynamically, and global health and security issues. While doing all these things, he found time to mentor countless people in the field, many now leaders, and to read and discuss science across disciplines. He was a dedicated, caring, kind scientist who truly wanted to help and improve the world for others.

Amid growing interest in the integration of health and social care to improve outcomes, communities across the United States have explored development of Community Information Exchanges (CIEs). A CIE is a community governed infrastructure that enables critical health and social information to be responsibly shared among partner organizations in support of holistic coordination of care. The development and use of a CIE give rise to a host of legal and policy challenges. Use and disclosure of data through a CIE are governed by a patchwork of different legal requirements, at times distinct and at times overlapping. Development of a legal framework for a CIE requires attention to clearly articulated data flows, detailed use cases, strong legal agreements and policy considerations. CIEs typically rely on an individual’s express consent to share their information, requiring careful evaluation of applicable laws and regulations and promotion of community trust and equity. And because many participants in a CIE are HIPAA covered entities, functions of the CIE must fit within HIPAA’s regulatory framework. This article examines in depth two components of a sound legal framework—consent models and HIPAA compliance—identifying considerations and lessons learned to support lawful and ethical information sharing through a CIE.

The high cost of medication is a common challenge for many Americans. This is particularly true for patients served by Federally Qualified Health Centers (FQHCs) that often have low income and are medically vulnerable. In this article I discuss the history and purpose behind the creation of the 340B drug pricing program, legislation enacted to limit the cost of drugs used by patients covered by Medicaid that requires drug manufacturers to enter into discount agreements with the Health Resources and Services Administration (HRSA), and how for years this program has been used to finance health care provision for communities that use FQHCs as their source of primary care. Additionally, I will discuss the history behind the creation of FQHCs and how that mission is affected by litigation and proposed reforms that would limit the ability of FQHCs to leverage savings and revenue from the program to fund health services for their patient populations. I argue that reinforcement of existing discounting practices, along with limited reforms of the 340B program are necessary to avoid disruption of health care provision for patients of FQHCs and to ensure that the 340B program continues to perform as intended.

For more than a century, US courts generally deferred to public health authorities, recognizing their expertise and the necessity of swift, science-based action to protect population health. This deference supported legal interventions that substantially increased life expectancy, reduced morbidity, and advanced health equity. In recent years, however, courts — particularly the Supreme Court — have retreated from this approach. Specifically, Supreme Court–driven doctrinal shifts favoring free exercise challenges, limiting deference to administrative agencies, and undermining equal protection have eroded public health authority and constrained governments’ capacity to protect health and improve equity. Drawing on an empirical review of 30 lawsuits filed between January 2024 and May 2025 challenging governmental and institutional health equity initiatives, the paper demonstrates that the majority of these cases resulted in the invalidation or abandonment of equity-focused policies. These findings illustrate how contemporary judicial rulings are limiting governments’ and institutions’ authority and ability to safeguard health, particularly the health of our most vulnerable and marginalized populations. The paper concludes with a call to action: a coordinated public health strategy to build and sustain a jurisprudence that supports the fair, effective, and evidence-based exercise of public health authority.

Despite increasing efforts to promote and support breastfeeding, the United States continues to have some of the lowest exclusive and sustained breastfeeding rates globally. Foreign-born immigrants and refugees specifically have been reported to have high initiation but low exclusive breastfeeding (EBF) rates. This scoping review aims to explore what is known about strategies to support breastfeeding among foreign-born mothers in the United States using the Arksey & O’Malley framework for scoping reviews and PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews). Six databases were searched using a comprehensive search strategy and 2103 articles were identified, of which 31 met eligibility criteria and discussed 33 specific breastfeeding interventions. The articles describe a range of interventions, including breastfeeding promotion and education (n = 30), hands-on breastfeeding support (n = 9), material support like giving breastfeeding supplies and food (n = 16), social support (n = 18) and social marketing campaigns (n = 1) to promote community support for breastfeeding. Common strategies for implementing these interventions include individual counselling (n = 21), group breastfeeding education (n = 17), informational materials (n = 12) and family support promotion (n = 11). In total, 87·3% of the immigrant mothers targeted by these breastfeeding support interventions were Hispanic, and 4·5% and 7·0% were mothers of African and Asian descent, respectively. This study reveals limited data and key gaps in efforts to preserve the culture of breastfeeding and promote EBF among multicultural immigrant and refugee families, particularly non-Hispanic groups. Addressing these gaps will improve optimal infant feeding practices among foreign-born mothers in the United States and, consequently, maternal and infant health outcomes.