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Wang J, Wu H, Liu Y, Wang W. Health welfare in the digital era: Exploring the impact of digital trade on residents' health. ECONOMICS AND HUMAN BIOLOGY 2024; 54:101414. [PMID: 39089003 DOI: 10.1016/j.ehb.2024.101414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 07/03/2024] [Accepted: 07/25/2024] [Indexed: 08/03/2024]
Abstract
As a product combining information and communication technology, digital technology, and traditional trade, digital trade represents a new form of international trade development in the context of economic globalization. As its scale continues to expand, digital trade not only profoundly impacts consumer health behaviors and environmental pollution control but also enhances opportunities for residents to access healthcare products and services. This could potentially have a significant promoting effect on residents' health levels. However, the extent and mechanisms through which digital trade affects residents' health remain unclear. Accordingly, this study fills in a gap in the research by calculating the provincial-level digital trade index for China from 2012-2020 and matching it with data from the China Family Panel Studies. The goal is to find the micro-causal mechanisms of digital trade on residents' health from green consumption and environmental improvement perspectives. The results show that digital trade reduces residents' medical expenses and improves their health. We use a quasi-natural experiment by treating the cross-border e-commerce comprehensive pilot zone as a digital trade treatment group and conducting a difference-in-differences estimation, finding that the health effects of digital trade remain significant. Heterogeneity indicates that the health effects of digital trade are powerful for middle- and high-income households and rural residents. In the east and center, in regions with well-developed transportation infrastructure and digital financial inclusion, the development of digital trade is more conducive to residents' health. Additionally, we demonstrate that digital trade can affect residents' health by promoting green consumption, eliminating energy poverty (i.e., improving indoor air pollution), and enhancing environmental quality (i.e., improving outdoor environmental pollution). This study provides solid scientific empirical evidence for enhancing human sustainable development through global digital trade.
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Affiliation(s)
- Jianlong Wang
- School of Economics, Sichuan University, Chengdu 610064, China.
| | - Haitao Wu
- International Business School, Hainan University, Haikou 570228, China.
| | - Yong Liu
- School of Economics, Sichuan University, Chengdu 610064, China.
| | - Weilong Wang
- School of Economics, Sichuan University, Chengdu 610064, China.
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Santa-Ramírez HA, Otálvaro-Castro GJ, Joost S, Melgar-Quiñonez H, Bilal U, Stringhini S. Small area vulnerability, household food insecurity and child malnutrition in Medellin, Colombia: results from a repeated cross-sectional study. LANCET REGIONAL HEALTH. AMERICAS 2023; 23:100521. [PMID: 37275622 PMCID: PMC10238747 DOI: 10.1016/j.lana.2023.100521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 04/27/2023] [Accepted: 05/11/2023] [Indexed: 06/07/2023]
Abstract
Background Malnutrition and food insecurity might be driven not only by individual factors but also by contextual conditions, such as area-level deprivation or vulnerability. This study aimed to analyze the association between area-level vulnerability and i) household food insecurity and ii) malnutrition in children in Medellin, Colombia, during the years 2017 and 2018. Methods We obtained data from two different sources: the Living Standards Measurement Survey (LSMS) and the nutrition surveillance system of Medellin. The main outcomes were food insecurity in households with children and anthropometric indicators for children under five. The main predictor was area-level vulnerability. Mixed effects Poisson regression with robust standard errors models were conducted to test the association of quintiles of deprivation with each outcome. Findings Households with children living in areas with the highest deprivation had 1.9 times the prevalence of food insecurity as compared to those living in areas with the lowest deprivation (PR 1.91, 95% CI 1.42-2.57). Similar results were observed for underweight/risk of underweight (PR 1.26, 95% CI 1.11-1.42), stunting/risk of stunting (PR 1.36, 95% CI 1.22-1.53) and stunting (PR 1.93 95% CI 1.55-2.39) among children under five. We found no consistent associations with wasting/risk of wasting or excess weight/risk of overweight across quintiles of deprivation. Interpretation This study sheds light on the role of area-level vulnerability on malnutrition in children in Medellin, Colombia, showing a pattern of increasing prevalence of food insecurity, underweight and stunting by quintile of deprivation. Funding Swiss School of Public Health (SSPH+) and Centre for Global Health Inequalities Research (CHAIN).
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Affiliation(s)
- Hugo-Alejandro Santa-Ramírez
- Unit of Population Epidemiology, Division of Primary Care, Geneva University Hospitals, Geneva, Switzerland
- Health Policy and Management Research Group, National Faculty of Public Health, University of Antioquia, Medellin, Colombia
| | - Gabriel-Jaime Otálvaro-Castro
- Health Policy and Management Research Group, National Faculty of Public Health, University of Antioquia, Medellin, Colombia
| | - Stéphane Joost
- Unit of Population Epidemiology, Division of Primary Care, Geneva University Hospitals, Geneva, Switzerland
- Group of Geographic Information Research and Analysis in Population Health (GIRAPH), Geneva, Switzerland
- Laboratory of Geographic Information Systems (LASIG), School of Architecture, Civil and Environmental Engineering (ENAC), École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Hugo Melgar-Quiñonez
- McGill Institute for Global Food Security, School of Human Nutrition, McGill University, Montreal, Canada
| | - Usama Bilal
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, USA
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, USA
| | - Silvia Stringhini
- Unit of Population Epidemiology, Division of Primary Care, Geneva University Hospitals, Geneva, Switzerland
- Department of Health and Community Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- University Centre for General Medicine and Public Health (UNISANTE), University of Lausanne, Lausanne, Switzerland
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Food trade among Pacific Island countries and territories: implications for food security and nutrition. Global Health 2022; 18:104. [PMID: 36517886 PMCID: PMC9750728 DOI: 10.1186/s12992-022-00891-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 11/07/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND There is growing attention to intra-regional trade in food. However, the relationship between such trade and food and nutrition is understudied. In this paper, we present an analysis of intra-regional food trade in the Pacific region, where there are major concerns regarding the nutritional implications of international food trade. Using a new regional database, we examine trends in food trade among Pacific Island Counties and Territories (PICTs) relative to extra-regional trade. RESULTS Intra-regional trade represents a small, but increasing proportion of total imports. The major food group traded within the Pacific is cereal grains and flour, which represented 51% of total intra-regional food trade in 2018. Processed and prepared foods, sweetened or flavoured beverages, processed fish, and sugar and confectionary are also traded in large quantities among PICTs. Trade in root crops is negligible, and overall intra-regional trade of healthy foods is limited, both in terms of tonnage and relative to imports from outside the region. Fiji remains the main source of intra-regional imports into PICTs, particularly for non-traditional staple foods. CONCLUSIONS This study highlights the growth in trade of staple foods intra-regionally, indicating a role for Fiji (in particular) in regional food security. Within this overall pattern, there is considerable opportunity to enhance intra-regional trade in traditional staple foods, namely root crops. Looking forward, the current food system disruption arising from the COVID-19 pandemic and associated policy measures has highlighted the long-term lack of investment in agriculture, and suggests an increased role for regional approaches in fostering trade in healthy foods.
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Barlow P, Sanap R, Garde A, Winters LA, Mabhala MA, Thow AM. Reassessing the health impacts of trade and investment agreements: a systematic review of quantitative studies, 2016-20. Lancet Planet Health 2022; 6:e431-e438. [PMID: 35550082 DOI: 10.1016/s2542-5196(22)00047-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 02/17/2022] [Accepted: 02/18/2022] [Indexed: 06/15/2023]
Abstract
To ensure a high level of health protection, governments must ensure that health and trade policy objectives are aligned. We conducted a systematic review of the health impacts of trade policies, including trade and investment agreements (TIAs), to provide a timely overview of this field. We systematically reviewed studies evaluating the health impacts of trade policies published between Jan 19, 2016, and July 10, 2020. Included studies were quantitative studies evaluating the impact of TIAs and trade policies on health determinants or outcomes. We evaluated methodological quality and performed a narrative synthesis. 21 of 28 067 articles identified via searches met our criteria. Methodologically strong studies found reduced child mortality, deteriorating worker health, rising supplies of sugar, ultra-processed food, tobacco, and alcohol supplies, and increased drug overdoses following trade reforms, compared with the time periods before trade reform. However, associations varied substantially across contexts and socioeconomic characteristics. Our findings show that trade policies, including TIAs, have diverse effects on health and health determinants. These effects vary substantially across contexts and socioeconomic groups. Governments seeking to adopt healthy trade policies should consider these updated findings to ensure that opportunities for health improvement are leveraged and widely shared, while harms are avoided, especially among vulnerable groups.
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Affiliation(s)
- Pepita Barlow
- Department of Health Policy, London School of Economics and Political Science, London, UK.
| | - Rujuta Sanap
- Department of Health Policy, London School of Economics and Political Science, London, UK
| | - Amandine Garde
- School of Law and Social Justice, University of Liverpool, Liverpool, UK
| | - L Alan Winters
- Department of Economics, University of Sussex Business School, Brighton, UK
| | - Mzwandile A Mabhala
- Department of Public Health and Wellbeing, University of Chester, Chester, UK
| | - Anne-Marie Thow
- Menzies Centre for Health Policy and Economics, School of Public Health, Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia
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Abstract
AbstractGlobal trade has shaped food systems over centuries, but modern trade agreements are hastening these changes and making them more complex, with implications for public health and nutrition transition. This study aimed to understand the impact of the 2018 Comprehensive and Progressive Agreement for Trans-Pacific Partnership (CPTPP) on the policy space for public health nutrition in Vietnam. We conducted comparative document review and key informant interviews, and our analysis drew on a framework of policy space and the theory of advocacy coalitions. We identified 10 CPTPP sections with potential public health nutrition implications; and 50 Vietnamese policies relevant to nutrition having one or more tensions with one or more CPTPP sections. A majority of policy tensions were in sections of the CPTPP relating to technical barriers to trade and government procurement; most tensions related to protecting policy-making from vested interests. Different groups of policy actors hold different beliefs and interests on these issues, and therefore promote different framings and policy approaches. We identified two advocacy coalitions working very separately on issues affecting nutrition policy space: a trade coalition holding the policy position that free trade improves nutrition by default; and a nutrition coalition holding the policy position that nutrition should be explicitly considered in trade policy. The policy space for nutrition in Vietnam has important potential constraints through written policy, and the trade and nutrition coalitions will need to interact more regularly and constructively in order to foresee where these tensions will arise in practice, and create plans for their mitigation. This study adds to global evidence of free trade agreement impacts on nutrition policy space, and we extend previous work by explaining these actor groupings in the policy space through the theory of advocacy coalitions.
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Chaves LF, Friberg MD, Hurtado LA, Marín Rodríguez R, O'Sullivan D, Bergmann LR. Trade, uneven development and people in motion: Used territories and the initial spread of COVID-19 in Mesoamerica and the Caribbean. SOCIO-ECONOMIC PLANNING SCIENCES 2022; 80:101161. [PMID: 34629563 PMCID: PMC8488209 DOI: 10.1016/j.seps.2021.101161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 09/02/2021] [Accepted: 09/22/2021] [Indexed: 06/13/2023]
Abstract
Mesoamerica and the Caribbean form a region comprised by middle- and low-income countries affected by the COVID-19 pandemic differently. Here, we ask whether the spread of COVID-19, measured using early epidemic growth rates (r), reproduction numbers (R t ), accumulated cases, and deaths, is influenced by how the 'used territories' across the regions have been differently shaped by uneven development, human movement and trade differences. Using an econometric approach, we found that trade openness increased cases and deaths, while the number of international cities connected at main airports increased r, cases and deaths. Similarly, increases in concentration of imports, a sign of uneven development, coincided with increases in early epidemic growth and deaths. These results suggest that countries whose used territory was defined by a less uneven development were less likely to show exacerbated COVID-19 patterns of transmission. Health outcomes were worst in more trade-dependent countries, even after controlling for the impact of transmission prevention and mitigation policies, highlighting how structural effects of economic integration in used territories were associated with the initial COVID-19 spread in Mesoamerica and the Caribbean.
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Affiliation(s)
- Luis Fernando Chaves
- Vigilancia de la Salud, Ministerio de Salud, San José, San José, Costa Rica
- Unidad de Análisis Epidemiolόgico y Bioestadística, Instituto Conmemorativo Gorgas de Estudios de la Salud, Ciudad de Panamá, Panama
| | - Mariel D Friberg
- Earth System Science Interdisciplinary Center (ESSIC), University of Maryland, College Park, MD, 20740-3823, USA
| | - Lisbeth A Hurtado
- Unidad de Análisis Epidemiolόgico y Bioestadística, Instituto Conmemorativo Gorgas de Estudios de la Salud, Ciudad de Panamá, Panama
| | | | - David O'Sullivan
- School of Geography, Environment and Earth Science, Victoria University of Wellington, Wellington, New Zealand
| | - Luke R Bergmann
- Department of Geography, University of British Columbia, Vancouver, British Columbia, Canada
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Sánchez-Ortiz NA, Unar-Munguía M, Bautista-Arredondo S, Shamah-Levy T, Colchero MA. Changes in apparent consumption of staple food in Mexico associated with the gradual implementation of the NAFTA. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0001144. [PMID: 36962675 PMCID: PMC10021749 DOI: 10.1371/journal.pgph.0001144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 11/03/2022] [Indexed: 11/24/2022]
Abstract
In 1994, the United States, Canada, and Mexico signed the North American Free Trade Agreement (NAFTA) to remove trade barriers and facilitate cross-border trade in goods and services. Worldwide, trade agreements, urbanization and economic development have shaped significant changes in dietary habits. This study aims to evaluate the association between the gradual implementation of NAFTA and changes in apparent consumption of staple foods in Mexico. We analyzed national apparent consumption of animal- and vegetable-source foods, using data from the Food and Agriculture Organization of the United Nations (FAO) from 1970 to 2018. Association between NAFTA and apparent consumption was estimated using interrupted time series analysis (ITSA) with synthetic controls and included two inflection points based on the implementation of NAFTA: 1994, when the agreement began, and 2008 when it was fully implemented. As a result, comparing Mexico with the synthetic control, we found a significant decrease in apparent consumption of pulses, -3.22 and -1.92 kcal/capita/day in the post-1994 and post-2008 periods, respectively. The vegetable-source foods showed an increase of 5.79 kcal/capita/day after 2008. The trends of apparent consumption of animal-source foods, eggs, and milk had significant increases after 1994 and 2008. The apparent consumption of meat increased only after 2008. The implementation of NAFTA was associated with an increase in apparent consumption of food from animal-source and a decrease in consumption of pulses. After 2008, an increase in apparent consumption of vegetable-source foods was observed.
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Affiliation(s)
- Néstor A Sánchez-Ortiz
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
- Center for Health Systems Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Mishel Unar-Munguía
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Sergio Bautista-Arredondo
- Center for Health Systems Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Teresa Shamah-Levy
- Center for Evaluation and Surveys Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - M Arantxa Colchero
- Center for Health Systems Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
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Howard PH, Ajena F, Yamaoka M, Clarke A. “Protein” Industry Convergence and Its Implications for Resilient and Equitable Food Systems. FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2021. [DOI: 10.3389/fsufs.2021.684181] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Recent years have seen the convergence of industries that focus on higher protein foods, such as meat processing firms expanding into plant-based substitutes and/or cellular meat production, and fisheries firms expanding into aquaculture. A driving force behind these changes is dominant firms seeking to increase their power relative to close competitors, including by extending beyond boundaries that pose constraints to growth. The broad banner of “protein” offers a promising space to achieve this goal, despite its nutritionally reductionist focus on a single macronutrient. Protein firm strategies to increase their dominance are likely to further diminish equity in food systems by exacerbating power asymmetries. In addition, the resilience of food systems has the potential to be weakened as these strategies tend to reduce organizational diversity, as well as the genetic diversity of livestock and crops. To better understand these changes, we visually characterize firms that are most dominant in higher protein food industries globally and their recent strategic moves. We discuss the likelihood for these trends to further jeopardize food system resilience and equity, and we make recommendations for avoiding these impacts.
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