Population growth, poverty and health

Unveiling the health consequences of air pollution in the world's most polluted nations

Air pollution poses a persuasive threat to global health, demonstrating widespread detrimental effects on populations worldwide. Exposure to pollutants, notably particulate matter with a diameter of 2.5 µm (PM2.5), has been unequivocally linked to a spectrum of adverse health outcomes. A nuanced understanding of the relationship between them is crucial for implementing effective policies. This study employs a comprehensive investigation, utilizing the extended health production function framework alongside the system generalized method of moments (SGMM) technique, to scrutinize the interplay between air pollution and health outcomes. Focusing on a panel of the top twenty polluted nations from 2000 to 2021, the findings yield substantial insights. Notably, PM2.5 concentration emerges as a significant factor, correlating with a reduction in life expectancy by 3.69 years and an increase in infant mortality rates by 0.294%. Urbanization is found to increase life expectancy by 0.083 years while concurrently decreasing infant mortality rates by 0.00022%. An increase in real per capita gross domestic product corresponds with an improvement in life expectancy by 0.21 years and a decrease in infant mortality rates by 0.00065%. Similarly, an elevated school enrollment rate is associated with a rise in life expectancy by 0.17 years and a decline in infant mortality rates by 0.00032%. However, a higher population growth rate is found to modestly decrease life expectancy by 0.019 years and slightly elevate infant mortality rates by 0.000016%. The analysis reveals that per capita greenhouse gas emissions exert a negative impact, diminishing life expectancy by 0.486 years and elevating infant mortality rates by 0.00061%, while per capita energy consumption marginally reduces life expectancy by 0.026 years and increases infant mortality rates by 0.00004%. Additionally, economic volatility shock presents a notable decrement in life expectancy by 0.041 years and an increase in infant mortality rates by 0.000045%, with inflationary shock further exacerbating adverse health outcomes by lowering life expectancy by 0.70 years and elevating infant mortality rates by 0.00025%. Moreover, the study scrutinizes the role of institutional quality, revealing a constructive impact on health outcomes. Specifically, the institutional quality index is associated with an increase in life expectancy by 0.66% and a decrease in infant mortality rates by 0.0006%. Extending the analysis to examine the nuanced dimensions of institutional quality, the findings discern that economic institutions wield a notably stronger positive influence on health outcomes compared to political and institutional governance indices. Finally, the results underscore the pivotal moderating role of institutional quality in mitigating the deleterious impact of PM2.5 concentration on health outcomes, counterbalancing the influence of external shocks, and improving the relationships between explanatory variables and health outcome indicators. These findings offer critical insights for guiding evidence-based policy implications, with a focus on fostering resilient, sustainable, and health-conscious societies.

Prevalence of neck pain and its associated factors in Africa: a systematic review and meta-analysis protocol

INTRODUCTION

Neck pain is one of the most prevalent musculoskeletal pain conditions with multifactorial impact including pain, disability and reduced quality of life. To the best of our knowledge, no systematic review and meta-analysis is available to provide reliable data on the pooled prevalence of neck pain and its associated factors in Africa. Thus, the objective of this study is to describe a protocol for a systematic review and meta-analysis on the prevalence of neck pain and its associated factors in Africa.

METHODS

This systematic review protocol has been designed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P). A systematic search will be conducted among six key electronic databases including PubMed/MEDLINE, Scopus, African Journals Online, EMBASE, CINAHL and Web of Science, from inception onwards. Population-based cross-sectional studies reporting prevalence of neck pain in the African continent will be included. The primary outcome will be the prevalence of neck pain, whereas the secondary outcomes will be the factors associated with neck pain prevalence. Two independent reviewers will screen the titles/abstracts and relevant full-text articles of potentially relevant studies. Data from eligible studies will be extracted using a customised data extraction form. The risk of bias and methodological quality of the included studies will be assessed using the Newcastle-Ottawa Scale and critical appraisal tool, respectively. A narrative synthesis will be used to summarise the prevalence estimates of neck pain and associated factors. However, if feasible, random-effects meta-analysis will be conducted with Revman V.5.4 software. Additionally, subgroup, sensitivity and publication bias analyses will be conducted.

DISCUSSION

This will be the first systematic review and meta-analysis to systematically identify and synthesise available literature on the prevalence of neck pain and its associated factors in Africa. The results of this review may assist health professionals and policymakers to plan and implement evidence-based strategies that will lessen the burden of neck pain.

ETHICS AND DISSEMINATION

Data from previously published studies will be collected and analysed and hence ethical approval will not be sought for this study. The results of this review will be disseminated through publication in a peer-reviewed academic journal and presentation at relevant academic conferences.

PROSPERO REGISTRATION NUMBER

CRD42021273585.

Geo-environmental and socioeconomic determinants of poverty in China: an empirical analysis based on stratified poverty theory

According to the stratified poverty theory, poverty includes individual (people) and regional (place) poverty. Understanding the interaction mechanism between individual poverty and regional poverty is crucial to achieving the UN goal of poverty eradication by 2030. However, at present, the relevant empirical research is still limited by the availability of data. To fill this important gap, based on the multi-source data of poverty census, geo-environmental and socio-economic data of China's 1587 counties in 2013, we used exploratory spatial data analysis (ESDA) and spatial econometric models (spatial-lag and spatial-error model) to identify determinants of individual poverty and regional poverty in this county. Results show that the spatial distribution of the rural poor in China had strong spatial dependence (Global Moran's I = 0.574). There was a high degree of spatial overlap between individual poverty and regional poverty. The poverty-causing factors were complex and varied across regions and individuals. Disease of family members was the leading factor driving rural areas in Northeast, Central, and Southwest China. Northeast China was mainly affected by the illness and lack of labor skills of family members. The complex terrain conditions were the determinants driving rural poverty in most areas of China. Improved transportation can greatly reduce rural poverty. Geographical isolation or lack of geographical capital caused by complex terrain conditions, backward transportation, and regional closure promoted regional poverty. In turn, regional poverty-causing factors further restricted the improvement of rural residents' self-development ability and aggravated individual poverty. Our findings indicate that individual poverty and regional poverty have different poverty-causing mechanisms and poverty reduction priorities. Effective poverty reduction strategies require the coordinated promotion of individual and regional poverty reduction. The reduction of individual poverty should focus on enhancing the livelihood capital of the poor through differentiated policy intervention, while regional poverty alleviation should focus on creating a favorable development environment by increasing infrastructure investment and public service supply.

Subsidy as An Economic Instrument for Environmental Protection: A Case of Global Fertilizer Use

Fertilizer subsidies may constitute a key economic tool with which to provide food for the growing population. Therefore, this work aimed to (i) assess the effectiveness of subsidized chemical (NPK) fertilizer use in food production by comparing the crop output between developed and developing regions and (ii) examine the benefits of organic fertilizer and the need for its use in developing regions such as Africa. Secondary data from 2000 to 2019 on global subsidized fertilizer use, crop production, income, and other agro-environmental parameters, such as climate and soil, were collected from the international databases of the World Bank, Food and Agriculture Organization (FAO), Forest Resources Assessment (FRA), National Aeronautics and Space Administration (NASA), and World Income Inequalities Database (WID), as well as countries’ national statistics. Data were analyzed using qualitative, quantitative, and geospatial software and techniques, such as SPSS, averages, multivariate analysis, and spatial analytical Geographic Information System (GIS) tools. The results reveal that the total global fertilizer use continuously increased from 79 million tonnes in 2000 to 125 million tonnes in 2019. Subsidized fertilizer use and crop production increased with countries’ economic status. For example, countries or regions with more economic resources tended to have higher fertilizer subsidies. More than 95% of North American and European countries recorded the highest total chemical fertilizer use, ranging from 855,160 to 18,224,035 kg ha−1. In terms of organic fertilizer production, the percentage contribution in Africa relative to global production was only 2%, which was about 932,538 million tonnes below the production yield in North America. More organic fertilizer and less inorganic fertilizer should be encouraged instead of the total eradication of chemical fertilizers. This is especially applicable to developing countries, where food production is low due to poor soil and high food demand owing to a harsh environment and rapid population growth.

How Is Mortality Affected by Fossil Fuel Consumption, CO2 Emissions and Economic Factors in CIS Region?

It is widely discussed that GDP growth has a vague impact on environmental pollution due to carbon dioxide emissions from fossil fuels consumed in production, transportation, and power generation. The main purpose of this study is to investigate the relationships between economic growth, fossil fuel consumption, mortality (from cardiovascular disease (CVD), diabetes mellitus (DM), cancer, and chronic respiratory disease (CRD), and environmental pollution since environmental pollution can be a reason for societal mortality rate increases. This study uses the generalized method of moments (GMM) estimation technique for the Commonwealth of Independent States (CIS) members for the period from 1993–2018. The major results revealed that the highest variability of mortality could be explained by CO2 variability. Regarding fossil fuel consumption, the estimation proved that this variable positively affects mortality from CVD, DM, cancer, and CRD. Additionally, any improvements in the human development index (HDI) have a negative effect on mortality increases from CVD, DM, cancer, and CRD in the CIS region. It is recommended that the CIS members implement different policies to improve energy transitions, indicating movement from fossil fuel energy sources to renewable sources. Moreover, we recommend the CIS members enhance various policies for easy access to electricity from green sources and increase the renewable supply through improved technologies, sustainable economic growth, and increase the use of green sources in daily social life.

Health shocks in sub-Saharan Africa: are the poor and uninsured households more vulnerable?

BACKGROUND

In developing countries, health shock is one of the most common idiosyncratic income shock and the main reason why households fall into poverty. Empirical research has shown that in these countries, households are unable to access formal insurance markets in order to insure their consumption against health shocks. Thus, in this study, are the poor and uninsured households more vulnerable from health shocks? We investigate the factors that lead to welfare loss from health shocks, and how to break the vulnerability from health shocks in three Sub-Saharan Africa (SSA) countries, namely, Burkina Faso, Niger and Togo.

METHODS

This study focusses on 1597 households in Burkina Faso, 1342 households in Niger and 930 households in Togo. A three-step Feasible Generalized Least Squares (FGLS) method was used to estimate vulnerability to poverty and to model the effects of health shocks on vulnerability to poverty.

RESULTS

The estimates of vulnerability show that about 39.04%, 33.69%, and 69.03% of households are vulnerable to poverty, in Burkina Faso, Niger, and Togo respectively. Both interaction variables, 'health shocks and wealth' and 'health shocks and access to health insurance' had a significant negative effect on reducing household's vulnerability to poverty. Poverty is the leading cause of economic loss from health shocks as the poorer cannot afford the purchase of sufficient quantities of quality food, preventive and curative health care, and education. We found that lack of health insurance coverage had a significant effect by increasing the incidence of welfare loss from health shocks. Moreover, household size, type of health care used, gender, education and age of the head of the household as well as the characteristics of housing affect vulnerability to poverty.

CONCLUSION

Our findings suggest that for the poor households, reduction of user fees of health care at the point of service or expansion of health insurance could mitigate vulnerability to poverty. Other challenges-birth control policy, adequate sanitation facilities and a universal basic education program-need to be addressed in order to reduce significantly the effects of health shocks on vulnerability to poverty in SSA.

Does Size Matter? A Study of Risk Perceptions of Global Population Growth

The global human population now exceeds 7 billion and is projected to reach 10 billion around 2060. While population growth has been associated with certain benefits (e.g., economies of scale, technological advancements), theoretical models, probabilistic projections, and empirical evidence also indicate that this growth could increase the likelihood of many adverse events (e.g., climate change, resource shortages) and the impact of these events, as more people are exposed to the outcomes. While concerns about these issues are well-documented in the academic literature, there is little evidence concerning the public's perceptions of the risks associated with global population growth (GPG) and how these perceptions are likely to influence related decisions. To address these issues, we conducted a U.K.-based study that examined respondents' risk perceptions of GPG, their willingness to embrace mitigation/precautionary behaviors, and reasons for variations in these two factors. We found that GPG is perceived as a moderate-to-high risk, with concerns about the increased likelihood of resource shortages, ecological damage, and violent conflict being foremost. Respondents believed that the worst effects of GPG would arrive around 2050 and would be experienced by the world's poorest people. Respondents who perceived greater levels of risk from GPG were generally those who indicated a greater willingness to embrace mitigation behaviors (e.g., reduce resource consumption) and preventative actions (e.g., support political action to limit growth). We discuss how our findings might be utilized to better manage the potential challenges associated with GPG and we suggest several directions for further research.

Syphilis as a social disease: experience from the post-communist transition period in Estonia

Increased incidence of sexually transmitted diseases (STD) and radical social changes have taken place at the same time in Estonia. Our aim was to study the trends in syphilis incidence, selected sociodemographic factors and health status indicators during the economic transition. Associations were estimated by the ordinary least square regression method for change in and actual values of syphilis and tuberculosis incidence rate (IR), percentage of non-ethnic Estonians and urban population, homicides rate, unemployment rate and, birth rate. The analysis was performed by counties at three different time periods. Syphilis IR significantly correlated with the proportion of non-ethnic Estonians, urban population, tuberculosis IR and birth rate. Change of syphilis IR correlated significantly with concurrent changes in unemployment rate and tuberculosis IR. Our findings support the theory that syphilis is a social disease, thus emphasizing the importance of social factors in the occurrence of STDs.

Terrorism in Japan

Although the 1995 Tokyo subway sarin attack probably was the most widely reported terrorist event in Japan to date (5,500 injured, 12 dead), the country has suffered numerous other large terrorism-related events in recent decades, including bombings of the headquarters of Mitsubishi Heavy Industries in Tokyo in 1974 (207 injured, 8 dead), the Hokkaido Prefectural Government office building in Sapporo in 1976 (80 injured, 2 dead), and the Yosakoi-Soran Festival in Sapporo in 2000 (10 injured, none dead). Japan also has experienced two other mass-casualty terrorist events involving chemical releases, including the 1994 Matsumoto sarin attack (600 injured, 7 dead) and the 1998 Wakayama arsenic incident (67 injured, 4 dead). Until 1995, emergency management in Japan focused on planning and preparedness at the local level for the frequent disasters caused by natural events. Since that time, substantial progress has been made in advancing emergency planning and preparedness for terrorism-related events, including the designation of disaster centers in each prefecture, the implementation of several education and training programs for nuclear, biological, and chemical terrorism, and the establishment of a national Anti terrorism Office within the Ministry of Health, Labor, and Welfare.

HIV risk environment for Ghanaian women: challenges to prevention

Ghana is experiencing high rates of HIV transmission and women have been identified as a group with increased vulnerability to infection. Women's vulnerability may be influenced by factors such as gender, unequal power relationships and poverty. Research was undertaken in Ghana from January to May 1999 to examine the experiences of HIV sero-positive women. Thirty-one women were interviewed to explore the broad context of disease transmission and to identify factors that mediated women's ability to protect themselves from infection. The poverty experienced by many of the women during their childhood years, coupled with a societal belief that favored the education of males, restricted the participants' educational and vocational opportunities. With limited education and few vocational skills, many of the women took boyfriends to assist them with the purchase of food, clothing and shelter, as a strategy for survival. For most women, the use of condoms with sexual partners was restricted by the high value placed on fertility, the negative association of condoms with prostitution, and the women's limited ability to influence decision-making in this area. The women's narratives provide a compelling description of the context of HIV transmission in Ghana. Strategies to expand and intensify the response to HIV prevention are presented and critiqued.

Disaster medicine in the 21st century: future hazards, vulnerabilities, and risk

The prediction of future disasters drives the priorities, urgencies, and perceived adequacies of disaster management, public policy, and government funding. Disasters always arise from some fundamental dysequilibrium between hazards in the environment and the vulnerabilities of human communities. Understanding the major factors that will tend to produce hazards and vulnerabilities in the future plays a key role in disaster risk assessment. The factors tending to produce hazards in the 21st Century include population growth, environmental degradation, infectious agents (including biological warfare agents), hazardous materials (industrial chemicals, chemical warfare agents, nuclear materials, and hazardous waste), economic imbalance (usually within countries), and cultural tribalism. The factors tending to generate vulnerabilities to hazardous events include population growth, aging populations, poverty, maldistribution of populations to disaster-prone areas, urbanization, marginalization of populations to informal settlements within urban areas, and structural vulnerability. An increasing global interconnectedness also will bring hazards and vulnerabilities together in unique ways to produce familiar disasters in unfamiliar forms and unfamiliar disasters in forms not yet imagined. Despite concerns about novel disasters, many of the disasters common today also will be common tomorrow. The risk of any given disaster is modifiable through its manageability. Effective disaster management has the potential to counter many of the factors tending to produce future hazards and vulnerabilities. Hazard mitigation and vulnerability reduction based on a clear understanding of the complex causal chains that comprise disasters will be critical in the complex world of the 21st Century.