SummaryBackgroundAs Indonesia moves to provide health coverage for all citizens, understanding patterns of morbidity and mortality is important to allocate resources and address inequality. The Global Burden of Disease 2016 study (GBD 2016) estimates sources of early death and disability, which can inform policies to improve health care.MethodsWe used GBD 2016 results for cause-specific deaths, years of life lost, years lived with disability, disability-adjusted life-years (DALYs), life expectancy at birth, healthy life expectancy, and risk factors for 333 causes in Indonesia and in seven comparator countries. Estimates were produced by location, year, age, and sex using methods outlined in GBD 2016. Using the Socio-demographic Index, we generated expected values for each metric and compared these against observed results.FindingsIn Indonesia between 1990 and 2016, life expectancy increased by 8·0 years (95% uncertainty interval [UI] 7·3–8·8) to 71·7 years (71·0–72·3): the increase was 7·4 years (6·4–8·6) for males and 8·7 years (7·8–9·5) for females. Total DALYs due to communicable, maternal, neonatal, and nutritional causes decreased by 58·6% (95% UI 55·6–61·6), from 43·8 million (95% UI 41·4–46·5) to 18·1 million (16·8–19·6), whereas total DALYs from non-communicable diseases rose. DALYs due to injuries decreased, both in crude rates and in age-standardised rates. The three leading causes of DALYs in 2016 were ischaemic heart disease, cerebrovascular disease, and diabetes. Dietary risks were a leading contributor to the DALY burden, accounting for 13·6% (11·8–15·4) of DALYs in 2016.InterpretationOver the past 27 years, health across many indicators has improved in Indonesia. Improvements are partly offset by rising deaths and a growing burden of non-communicable diseases. To maintain and increase health gains, further work is needed to identify successful interventions and improve health equity.FundingThe Bill & Melinda Gates Foundation.

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Predictor variables previously examined in separate studies (prior beliefs, peer pressure, family smoking, advertising, and antismoking information) were combined in a single study, surveying 246 adolescents. The variables were found to be significant predictors of smoking level, but the importance of each predictor varied by grade level, gender, and ethnicity. Overall, family smoking behavior, peer pressure, and prior beliefs were more important in predicting smoking level than were advertising and antismoking information. Public policy implications are discussed. U.S. tobacco companies, especially R. J. Reynolds Tobacco (RJR), have faced and are currently under charges that they intentionally target adolescents as young as fourteen in their advertising campaigns. From 1973 to 1990 R. J. Reynolds produced internal corporate communications and marketing actions that focused on persuading young people to smoke RJR brands, including Camel and Winston, according to a government probe (Mintz and Tony 1998). This finding, among other charges, led the U.S. Government to pursue and settle a lawsuit against tobacco companies. In addition, lawsuits by individual states have been filed to recoup billions of dollars in medical costs to treat tobacco-related diseases. The states of Texas, Florida, Minnesota, and Mississippi settled lawsuits totalling $40 billion to be paid over twenty-five years (Meier 1998).One result of the recent (1998) settlement of the Government's case against tobacco companies is that the industry must pay $206 billion to forty-six states over twenty-five years to settle lawsuits, including $250 million over ten years to study ways to reduce teen smoking and to meet strict goals for reducing smoking in the U.S. The settlement eliminates billboard ads and brand names in sports stadiums. The tobacco industry is also prohibited from using cartoon characters in tobacco ads, from selling apparel and merchandise with brand name logos, and from placing

An experiment with 236 children, ages 6 to 11, tested whether providing nutrition information (calories and fat grams) or healthy heart symbol on fast food menus influenced the calories and fat content of the items they chose to order. There was evidence that children exposed to menus with heart symbols chose healthier meals than children exposed to menus with calories and fat content or menus with no nutrition information. Children of parents with inaccurate perceptions of their child's weight tended to make poorer food choices, as did children who visited fast food restaurants more frequently.

Approximately five million children under the age of 18 will eventually die from smoking‐related disease. However, antismoking advertisements directed to adolescents appear to be reducing the prevalence of smoking among youth. The reported study extends prior research using an experiment over time (N= 565) to test the influence of individual factors (grade level, gender, and ethnicity) on the effectiveness of two types of message content in antismoking advertisements. Predictor variables from prior research, such as beliefs about smoking and family and peer smoking, were included as covariates in the analysis. As expected, effectiveness was influenced by individual factors. Long‐term health content was more effective among nonwhites, males, and high school students, while short‐term content appeared to work better among junior high males.