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Fu J, Fu S, Wang X, Wang X. The association between Internet use and intrinsic capacity among older adults in China: The mediating role of social participation. Public Health Nurs 2024. [PMID: 39221697 DOI: 10.1111/phn.13405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Accepted: 08/15/2024] [Indexed: 09/04/2024]
Abstract
OBJECTIVE This study aims to explore the relationship between Internet use and intrinsic capability among Chinese older adults, and the potential mediating role of social participation. METHODS We verified the correlation between Internet use and intrinsic capacity using multiple linear regression and verified the mediating role of social participation using the Sobel and Bootstrap tests. RESULTS The results of multiple linear regression show that there is a significant positive association between Internet use and intrinsic capacity (B = 0.717, p < .001); and social participation plays a mediating role, explaining a total of 20.5% of the association (indirect effect = 0.147, 95% CI: 0.067-0.227). CONCLUSION Our findings suggest that Internet use significantly improves intrinsic capacity among Chinese older adults, with social participation playing a mediating role. Increasing Internet adoption rates and promoting social participation may help improve intrinsic capacity among older adults.
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Affiliation(s)
- Jianying Fu
- School of Nursing, Guizhou Medical University, Guiyang, Guizhou, China
| | - Shuxia Fu
- Guiyang Maternal and Child Health Hospital, Guiyang, Guizhou, China
| | - Xiao Wang
- School of Nursing, Guizhou Medical University, Guiyang, Guizhou, China
| | - Xiuhong Wang
- School of Nursing, Guizhou Medical University, Guiyang, Guizhou, China
- The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
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Immurana M, Azuug M, Abdullahi I, Kisseih KG, Mohammed A, Boachie MK, Kizhakkekara TJM. Road injuries, labor productivity, and economic growth in Africa: A panel study. Health Sci Rep 2024; 7:e2316. [PMID: 39291263 PMCID: PMC11405458 DOI: 10.1002/hsr2.2316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 06/28/2024] [Accepted: 07/29/2024] [Indexed: 09/19/2024] Open
Abstract
Background and Aims Globally, millions of people suffer from road injuries, with Africa having the highest burden of road injury deaths. This public health problem has the potential to reduce labor productivity and hence hamper economic growth, especially on the African continent. This study, to the best of the authors' knowledge, therefore seeks to provide the first empirical evidence of the interaction or combined effect of road injuries and labor productivity on economic growth in African countries. Methods The study uses annual data on 45 African countries over the period, 2002 to 2019. The dynamic panel system generalized method of moments regression is used as the estimation technique. Results The findings show that the interaction of road injuries with labor productivity has a negative significant effect on economic growth in both the short-run (coefficient: -1.96, p < 0.01) and long-run (coefficient: -1.93, p < 0.01) periods. Conclusion There is a need to increase investment in road safety to reduce the prevalence of road injuries on the African continent.
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Affiliation(s)
- Mustapha Immurana
- Institute of Health Research University of Health and Allied Sciences Ho Ghana
| | - Muniru Azuug
- Department of Economics Education University of Education Winneba Ghana
| | - Ibrahim Abdullahi
- Safe Haven Insurance Brokers Ltd Accra Ghana
- Department of Economics Memorial University of Newfoundland St. John's Newfoundland Canada
| | - Kwame Godsway Kisseih
- Christian Health Association of Ghana Secretariat Accra Ghana
- Vignan's Foundation for Science, Technology & Research Vadlamudi Andhra Pradesh India
| | - Ayisha Mohammed
- Akenten Appiah-Menka University of Skills Training and Entrepreneurial Development Kumasi Ghana
| | - Micheal Kofi Boachie
- School of Nursing and Public Health, College of Health Sciences University of KwaZulu Natal Glenwood Durban South Africa
- Faculty of Health Sciences, School of Public Health, SAMRC/Wits Centre for Health Economics and Decision Science -PRICELESS SA University of the Witwatersrand Braamfontein Johannesburg South Africa
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Jung D, Kim B. The effect of health facility births on newborn mortality in Malawi. INTERNATIONAL JOURNAL OF HEALTH ECONOMICS AND MANAGEMENT 2024; 24:393-406. [PMID: 37010654 DOI: 10.1007/s10754-023-09348-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 03/09/2023] [Indexed: 06/19/2023]
Abstract
We examine the effect of health facility delivery on newborn mortality in Malawi using data from a survey of mothers in the Chimutu district, Malawi. The study exploits labour contraction time as an instrumental variable to overcome endogeneity of health facility delivery. The results show that health facility delivery does not reduce 7-day and 28-day mortality rates. In a low-income country like Malawi where the healthcare quality is severely compromised, we conclude that encouraging health facility delivery may not guarantee positive health outcomes for newborn births.
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Affiliation(s)
- Dawoon Jung
- Korea Institute of Public Finance, Sejong, Republic of Korea
| | - Booyuel Kim
- Department of Environmental Planning, Graduate School of Environmental Studies, Seoul National University, Gwanak-ro 1, Gwanak-gu, Seoul, 08826, Republic of Korea.
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Cheah YK, Suleiman A, Ramly M. HIV Knowledge and Its Associated Sociodemographic Factors among Female Sex Workers in Malaysia. Malays J Med Sci 2024; 31:160-172. [PMID: 38984243 PMCID: PMC11229571 DOI: 10.21315/mjms2024.31.3.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 11/16/2023] [Indexed: 07/11/2024] Open
Abstract
Background Female sex workers (FSWs) have a high risk of human immunodeficiency virus (HIV) infection. In spite of the alarming fact that a large proportion of FSWs does not have adequate HIV knowledge, the association between sociodemographic factors and HIV knowledge among FSWs have yet to be thoroughly explored in the context of Malaysia. The aims of this study are the following: i) to determine HIV knowledge and ii) to examine the associated factors of HIV knowledge. Methods An observational cross-sectional study was conducted. Data from the Integrated Biological and Behavioral Surveillance Survey (IBBS) 2017 (n = 630) were used. The survey was carried out in all states in Malaysia and its duration was 4 months (from March 2017 to June 2017). Ordered probit regressions were utilised to shed light on the association between sociodemographic variables and levels of HIV knowledge. Results A large proportion of FSWs had middle-level HIV knowledge (44.1%). FSWs with tertiary-level education were 19.5% more likely to have high-level HIV knowledge compared to those without formal education. The probability of having low-level HIV knowledge was 6.8% lower among FSWs with monthly incomes of RM1,500-RM1,999 than those having incomes of ≤ RM499. Being single instead of married was associated with 7.6%-8% lower probabilities of having low- and middle-level HIV knowledge. Conclusion Public health interventions to improve FSWs' HIV knowledge need to take into consideration the role of sociodemographic factors.
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Affiliation(s)
- Yong Kang Cheah
- School of Economics, Finance and Banking, College of Business, Universiti Utara Malaysia, Kedah, Malaysia
| | - Anita Suleiman
- HIV/STI/Hepatitis C Sector, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Mazliza Ramly
- HIV/STI/Hepatitis C Sector, Ministry of Health Malaysia, Putrajaya, Malaysia
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Hansen KS, Moreno-Ternero JD, Østerdal LP. Quality- and productivity-adjusted life years: From QALYs to PALYs and beyond. JOURNAL OF HEALTH ECONOMICS 2024; 95:102885. [PMID: 38705048 DOI: 10.1016/j.jhealeco.2024.102885] [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: 01/08/2024] [Revised: 04/16/2024] [Accepted: 04/22/2024] [Indexed: 05/07/2024]
Abstract
We develop a unified framework for the measurement and valuation of health and productivity. Within this framework, we characterize evaluation functions allowing for compromises between the classical quality-adjusted life years (QALYs) and its polar productivity-adjusted life years (PALYs). Our framework and characterization results provide a new normative basis for the economic evaluation of health care interventions, as well as occupational health and safety policies, aimed to impact both health and productivity of individuals.
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Affiliation(s)
- Kristian S Hansen
- National Research Centre for the Working Environment (NFA), Copenhagen, Denmark.
| | | | - Lars P Østerdal
- Department of Economics, Copenhagen Business School, Denmark.
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Choi Y, Park EJ, Lee SY, Kim HY, Lee WY. Mental health effects associated with COVID-19 financial assistance in South Korea: a comparison of employment status. BMC Public Health 2024; 24:805. [PMID: 38486196 PMCID: PMC10938843 DOI: 10.1186/s12889-024-18283-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 03/05/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND COVID-19 has created tensions across different sectors of the society, but the impact has been unequal. Vulnerable people have been most affected, especially those with insecure employment and who have experienced economic hardships due to unemployment and lost wages. The combination of social change and economic hardships due to the pandemic increases the risk of poor mental health. Some countries have utilized financial assistance to alleviate economic hardships caused by COVID-19, and in South Korea, the central and local governments have implemented COVID-19 financial assistance. This study analysed the impact of financial assistance on mental health associated with working status during the COVID-19 pandemic in South Korea. METHODS The participants of this study were randomly selected from residents of Gyeonggi-do after being proportionally allocated by resident registration population status. A total of 1,000 adult males and females aged 19 years or older in Gyeonggi-do who received financial assistance from the central and local governments were selected. A retrospective pre-post-study design was applied, and mental health surveys including the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder 7-item scale (GAD-7) were applied. RESULTS The results show that depression scores averaged 5.5 and anxiety scores averaged 4.4 before COVID-19 Financial Assistance. It is similar to the national average of 5.1 and 4.5 respectively at that time. After the assistance, depression scores dropped to 4.5, and anxiety scores dropped to 3.2. Before the assistance, depression and anxiety were higher among temporary day labourers with less job security, and they showed the most significant improvement in mental health. For full-time workers, there was no significant change in anxiety or depression after receiving the assistance. CONCLUSIONS Financial assistance can provide material resources and also positively affect mental health. In particular, it had a greater impact on the relatively vulnerable groups, such as those in unstable employment.
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Affiliation(s)
- Yoonjoo Choi
- Division of Cancer Prevention, National Cancer Control Institute, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang, Republic of Korea
| | - Eun-Joo Park
- Department of Preventive Medicine, College of Medicine, Chung-Ang University, 84, Heuk-seok dong, Dong-jak gu, Seoul, Republic of Korea
| | - Soon-Young Lee
- Department of Preventive Medicine, College of Medicine, A-Jou University, 206, Worldcup-Ro, Young-tong gu, Suwon, Republic of Korea
| | - Hee-Yeon Kim
- Department of Policy Research, Gyeonggi Welfare Foundation, Gyeong-su daero, Jang-an gu, 1150, Suwon, Republic of Korea
| | - Weon-Young Lee
- Department of Preventive Medicine, College of Medicine, Chung-Ang University, 84, Heuk-seok dong, Dong-jak gu, Seoul, Republic of Korea.
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Rahman T, Gasbarro D, Alam K, Alam K. Rural‒urban disparities in household catastrophic health expenditure in Bangladesh: a multivariate decomposition analysis. Int J Equity Health 2024; 23:43. [PMID: 38413959 PMCID: PMC10898052 DOI: 10.1186/s12939-024-02125-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 02/08/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND Rural‒urban disparity in catastrophic healthcare expenditure (CHE) is a well-documented challenge in low- and middle-income countries, including Bangladesh, limiting financial protection and hindering the achievement of the Universal Health Coverage target of the United Nations Sustainable Development Goals. However, the factors driving this divide remain poorly understood. Therefore, this study aims to identify the key determinants of the rural‒urban disparity in CHE incidence in Bangladesh and their changes over time. METHODS We used nationally representative data from the latest three rounds of the Bangladesh Household Income and Expenditure Survey (2005, 2010, and 2016). CHE incidence among households seeking healthcare was measured using the normative food, housing, and utilities method. To quantify covariate contributions to the rural‒urban CHE gap, we employed the Oaxaca-Blinder multivariate decomposition approach, adapted by Powers et al. for nonlinear response models. RESULTS CHE incidence among rural households increased persistently during the study period (2005: 24.85%, 2010: 25.74%, 2016: 27.91%) along with a significant (p-value ≤ 0.01) rural‒urban gap (2005: 9.74%-points, 2010: 13.94%-points, 2016: 12.90%-points). Despite declining over time, substantial proportions of CHE disparities (2005: 87.93%, 2010: 60.44%, 2016: 61.33%) are significantly (p-value ≤ 0.01) attributable to endowment differences between rural and urban households. The leading (three) covariate categories consistently contributing significantly (p-value ≤ 0.01) to the CHE gaps were composition disparities in the lowest consumption quintile (2005: 49.82%, 2010: 36.16%, 2016: 33.61%), highest consumption quintile (2005: 32.35%, 2010: 15.32%, 2016: 18.39%), and exclusive reliance on informal healthcare sources (2005: -36.46%, 2010: -10.17%, 2016: -12.58%). Distinctively, the presence of chronic illnesses in households emerged as a significant factor in 2016 (9.14%, p-value ≤ 0.01), superseding the contributions of composition differences in household heads with no education (4.40%, p-value ≤ 0.01) and secondary or higher education (7.44%, p-value ≤ 0.01), which were the fourth and fifth significant contributors in 2005 and 2010. CONCLUSIONS Rural‒urban differences in household economic status, educational attainment of household heads, and healthcare sources were the key contributors to the rural‒urban CHE disparity between 2005 and 2016 in Bangladesh, with chronic illness emerging as a significant factor in the latest period. Closing the rural‒urban CHE gap necessitates strategies that carefully address rural‒urban variations in the characteristics identified above.
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Affiliation(s)
- Taslima Rahman
- Murdoch Business School, Murdoch University, Perth, WA, 6150, Australia.
- Institute of Health Economics, University of Dhaka, Dhaka, 1000, Bangladesh.
| | - Dominic Gasbarro
- Murdoch Business School, Murdoch University, Perth, WA, 6150, Australia
| | - Khorshed Alam
- School of Business, University of Southern Queensland, Toowoomba, QLD, 4350, Australia
| | - Khurshid Alam
- Murdoch Business School, Murdoch University, Perth, WA, 6150, Australia
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Okamoto S, Sata M, Rosenberg M, Nakagoshi N, Kamimura K, Komamura K, Kobayashi E, Sano J, Hirazawa Y, Okamura T, Iso H. Universal health coverage in the context of population ageing: catastrophic health expenditure and unmet need for healthcare. HEALTH ECONOMICS REVIEW 2024; 14:8. [PMID: 38289516 PMCID: PMC10826197 DOI: 10.1186/s13561-023-00475-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 12/18/2023] [Indexed: 02/02/2024]
Abstract
BACKGROUND Universal health coverage means that all people can access essential health services without incurring financial hardship. Even in countries with good service coverage and financial protection, the progress towards universal health coverage may decelerate or be limited with respect to the growing older population. This study investigates the incidence/prevalence, determinants, and consequences of catastrophic health expenditure (CHE) and unmet need for healthcare and assesses the potential heterogeneity between younger (≤ 64 years) and older people (65 years≤). METHODS Utilising an annual nationally representative survey of Japanese aged 20 years and over, we estimated the incidence of CHE and unmet need for healthcare using disaggregated estimates by household members' age (i.e. ≤64 years vs. 65 years≤) between 2004 and 2020. Using a fixed-effects model, we assessed the determinants of CHE and unmet need along with the consequences of CHE. We also assessed the heterogeneity by age. RESULTS Households with older members were more likely to have their healthcare needs met but experienced CHE more so than households without older members. The financial consequences of CHE were heterogeneous by age, suggesting that households with older members responded to CHE by reducing food and social expenditures more so than households without older members reducing expenditure on education. Households without older members experienced an income decline in the year following the occurrence of CHE, while this was not found among households with older members. A U-shaped relationship was observed between age and the probability of experiencing unmet healthcare need. CONCLUSIONS Households with older members are more likely to experience CHE with different financial consequences compared to those with younger members. Unmet need for healthcare is more common among younger and older members than among their middle-aged counterparts. Different types and levels of health and financial support need to be incorporated into national health systems and social protection policies to meet the unique needs of individuals and households.
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Affiliation(s)
- Shohei Okamoto
- Research Team for Social Participation and Healthy Aging, Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi City, Tokyo, 1730015, Japan.
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku City, Tokyo, Japan.
- Research Center for Financial Gerontology, Keio University, 2-15-45 Mita, Minato City, Tokyo, Japan.
| | - Mizuki Sata
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku City, Tokyo, Japan
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, 35 Shinanomachi, Shinjuku City, Tokyo, Japan
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Campus USÖ, Örebro, SE-701 82, Sweden
| | - Megumi Rosenberg
- World Health Organization Centre for Health Development, I.H.D. Centre Building, 9th Floor 7. 1-5-1 Wakinohama-Kaigandori, Chuo-ku, Kobe City, Hyogo, Japan
| | - Natsuko Nakagoshi
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, 35 Shinanomachi, Shinjuku City, Tokyo, Japan
| | - Kazuki Kamimura
- Research Center for Financial Gerontology, Keio University, 2-15-45 Mita, Minato City, Tokyo, Japan
- Hirao School of Management, Konan University, 8-33 Takamatsucho, Nishinomiya City, Hyogo, Japan
| | - Kohei Komamura
- Research Center for Financial Gerontology, Keio University, 2-15-45 Mita, Minato City, Tokyo, Japan
- Faculty of Economics, Keio University, 2-15-45 Mita, Minato City, Tokyo, Japan
| | - Erika Kobayashi
- Research Team for Social Participation and Healthy Aging, Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi City, Tokyo, 1730015, Japan
| | - Junko Sano
- Research Center for Financial Gerontology, Keio University, 2-15-45 Mita, Minato City, Tokyo, Japan
- Tokyo Kasei Gakuin University, 22 Sanbancho, Chiyoda City, Tokyo, Japan
| | - Yuzuki Hirazawa
- Faculty of Economics, Keio University, 2-15-45 Mita, Minato City, Tokyo, Japan
| | - Tomonori Okamura
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, 35 Shinanomachi, Shinjuku City, Tokyo, Japan
| | - Hiroyasu Iso
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku City, Tokyo, Japan
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Brammli-Greenberg S, Hovav B. Unmet needs and the effect of healthcare system generosity on prevention activity - A multilevel analysis. Soc Sci Med 2024; 340:116473. [PMID: 38064824 DOI: 10.1016/j.socscimed.2023.116473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 11/23/2023] [Accepted: 11/25/2023] [Indexed: 01/23/2024]
Abstract
INTRODUCTION Maintaining a healthy lifestyle and obtaining preventive care (hereafter, prevention-activity) usually have an inverse association with poverty status and unmet needs. We seek to estimate the extent to which the effect of individual unmet needs status on prevention-activity is moderated by the generosity of the healthcare system. MATERIALS AND METHODS Two datasets were combined: Pre-Covid Wave-8 (2019-2020) of the Survey of Health, Ageing and Retirement in Europe (SHARE, Release 8.0.0), with 46,500 individuals aged 50+ from 27 countries (26 European countries and Israel) and 12 healthcare generosity variables obtained from the OECD Health Statistics Library. An econometric two-level model was used in three sequentially models. Outcome variables included five prevention-activities align over a continuum (sports, smoking, flu vaccinations, mammography, and colon cancer screening) and unmet needs status, defined as the lack of resources necessary to meet basic human and medical needs. RESULTS We found that unmet needs at the individual level had a significant negative fixed effect in all of the prevention-activity models including a healthy lifestyle, primary prevention and secondary prevention. Sources of intra-country variation were social/public insurance, health expenditure and number of nurses, which have had a significant and positive effect on an individual's prevention-activities (except years of smoking). Nonetheless, the gaps in generous countries between people reporting on unmet need and others were larger or similar to those in less generous countries, suggesting that disparities increase with the generosity of the health system. CONCLUSIONS The study provides insight into the effect of health system generosity on socioeconomic inequalities in healthy lifestyle and prevention care. Our findings suggest that the state has an important and decisive role to play in ensuring that prevention services are accessible to the entire population, particularly those reporting unmet needs.
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Affiliation(s)
- Shuli Brammli-Greenberg
- The Hebrew University-Hadassah Braun School of Public Health and Community Medicine, Israel.
| | - Boaz Hovav
- The Max Stern Yezreel Valley College Health Systems Management Department, Israel; University of Haifa School of Public Health, Israel
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Chen W, Ding M, Wang X. The Contribution of the Internet to Promoting Mental Health for Older Adults: Cross-Sectional Survey in China. J Med Internet Res 2023; 25:e40172. [PMID: 38113096 PMCID: PMC10762612 DOI: 10.2196/40172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 05/19/2023] [Accepted: 08/20/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Health is an important topic for everyone and essential to high-quality economic and social development. Recently, some researchers have suggested that older adults' internet use may have a health effect. OBJECTIVE This study specifically aims to clarify the relationship between internet use and the mental health of older adults, for which other surveys present contradictory results. METHODS Data were obtained from the China Longitudinal Aging Social Survey conducted in 2018. A total of 6648 participants were included. Mental health was assessed by the 12-item Center for Epidemiological Studies Depression Scale. Ordinary least squares regression was adopted to explore the relationship between internet use (independent variable) and the mental health of older adults. Robustness analysis, sensitivity analysis, and heterogeneity analysis were conducted in detail to verify the empirical result. A mediating effect analysis was further conducted to discover the effect mechanism between the dependent and independent variables. RESULTS It was found that internet use and smartphone use can significantly improve the mental health of older adults (ordinary least squares, β=.075; P<.001). After endogenous and robustness tests were conducted, the aforementioned conclusion remained robust. In particular, participation in voluntary activities played a mediating role in the relationship between internet use and the mental health of older adults. In addition, younger subjective age enhanced the positive effect of internet use on the mental health of older adults. CONCLUSIONS Internet users showed higher levels of mental health among Chinese older adults. To improve the mental health of older adults, the government should not only cultivate the ability to use the internet but also encourage greater participation in voluntary activities among older adults.
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Affiliation(s)
- Weichao Chen
- Department of Editing and Publishing, Hunan Normal University, Changsha, China
| | - Mengjun Ding
- Department of Editing and Publishing, Hunan Normal University, Changsha, China
| | - Xiaoyan Wang
- Department of Statistics, Hunan University, Changsha, China
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Binyaruka P, Foss A, Alibrahim A, Mziray N, Cassidy R, Borghi J. Supply-side factors influencing demand for facility-based delivery in Tanzania: a multilevel analysis. HEALTH ECONOMICS REVIEW 2023; 13:52. [PMID: 37930445 PMCID: PMC10629065 DOI: 10.1186/s13561-023-00468-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 10/20/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND Improving access to facility-based delivery care has the potential to reduce maternal and newborn deaths across settings. Yet, the access to a health facility for childbirth remains low especially in low-income settings. To inform evidence-based interventions, more evidence is needed especially accounting for demand- and supply-side factors influencing access to facility-based delivery care. We aimed to fill this knowledge gap using data from Tanzania. METHODS We used data from a cross-sectional survey (conducted in January 2012) of 150 health facilities, 1494 patients and 2846 households with women who had given births in the last 12 months before the survey across 11 districts in three regions in Tanzania. The main outcome was the place of delivery (giving birth in a health facility or otherwise), while explanatory variables were measured at the individual woman and facility level. Given the hierarchical structure of the data and variance in demand across facilities, we used a multilevel mixed-effect logistic regression to explore the determinants of facility-based delivery care. RESULTS Eighty-six percent of 2846 women gave birth in a health facility. Demand for facility-based delivery care was influenced more by demand-side factors (76%) than supply-side factors (24%). On demand-side factors, facility births were more common among women who were educated, Muslim, wealthier, with their first childbirth, and those who had at least four antenatal care visits. On supply-side factors, facility births were more common in facilities offering outreach services, longer consultation times and higher interpersonal quality. In contrast, facilities with longer average waiting times, longer travel times and higher chances of charging delivery fees had few facility births. CONCLUSIONS Policy responses should aim for strategies to improve demand like health education to raise awareness towards care seeking among less educated groups and those with higher parity, reduce financial barriers to access (including time costs to reach and access care), and policy interventions to enhance interpersonal quality in service provision.
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Affiliation(s)
- Peter Binyaruka
- Department of Health System, Impact Evaluation and Policy, Ifakara Health Institute, PO Box 78373, Dar es Salaam, Tanzania.
| | - Anna Foss
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Abdullah Alibrahim
- College of Engineering and Petroleum, Kuwait University, Kuwait City, Kuwait
| | - Nicholaus Mziray
- Department of Health System, Impact Evaluation and Policy, Ifakara Health Institute, PO Box 78373, Dar es Salaam, Tanzania
| | - Rachel Cassidy
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
- KPM Center for Public Management, University of Bern, Schanzeneckstrasse 1, Bern, 3012, Switzerland
| | - Josephine Borghi
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
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Nguyen HT, Christian H, Le HT, Connelly L, Zubrick SR, Mitrou F. The impact of weather on time allocation to physical activity and sleep of child-parent dyads. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 880:163249. [PMID: 37023819 DOI: 10.1016/j.scitotenv.2023.163249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 03/19/2023] [Accepted: 03/30/2023] [Indexed: 05/27/2023]
Abstract
PURPOSE Previous studies showed that unfavourable weather conditions discourage physical activity. However, it remains unclear whether unfavourable weather conditions have a differential impact on physical activity in children compared with adults. We aim to explore the differential impact of weather on time allocation to physical activity and sleep by children and their parents. METHOD We use nationally representative data with time use indicators objectively measured on multiple occasions for >1100 Australian pairs of 12-13-year-old children and their middle-aged parents, coupled with daily meteorological data. We employ an individual fixed effects regression model to estimate the causal impact of weather. RESULTS We find that unfavourable weather conditions, as measured by cold or hot temperatures or rain, cause children to reduce moderate- and vigorous-intensity physical activity time and increase sedentary time. However, such weather conditions have little impact on children's sleep time or the time allocation of their parents. We also find substantial differential weather impact, especially on children's time allocation, by weekdays/weekends and parental employment status, suggesting that these factors may contribute to explaining the differential weather impact that we observed. Our results additionally provide evidence of adaptation, as temperature appears to have a more pronounced impact on time allocation in colder months and colder regions. CONCLUSION Our finding of a negative impact of unfavourable weather conditions on the time allocated to physical activity by children indicates a need to design policies to encourage them to be more physically active on days with unfavourable weather conditions and hence improve child health and wellbeing. Evidence of a more pronounced and negative impact on the time allocated to physical activity by children than their parents suggests that extreme weather conditions, including those associated with climate change, could make children vulnerable to reduced physical activity.
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Affiliation(s)
- Ha Trong Nguyen
- Telethon Kids Institute & The University of Western Australia, Australia.
| | - Hayley Christian
- Telethon Kids Institute & The University of Western Australia, Australia
| | - Huong Thu Le
- Telethon Kids Institute & The University of Western Australia, Australia
| | - Luke Connelly
- The University of Queensland, Australia & The University of Bologna, Italy
| | - Stephen R Zubrick
- Telethon Kids Institute & The University of Western Australia, Australia
| | - Francis Mitrou
- Telethon Kids Institute & The University of Western Australia, Australia
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The effect of increasing health disaster risk and public spending on economy conditions: a DSGE perspective. INTERNATIONAL JOURNAL OF HEALTH GOVERNANCE 2023. [DOI: 10.1108/ijhg-04-2022-0042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
PurposeThe main motivation of the present study is to understand the severity of the effect of health shock on Iran's oil economy and analyze the role of government under these conditions.Design/methodology/approachDynamic stochastic general equilibrium (DSGE) models can show the precise interactions between market decision-makers in the context of general equilibrium. Since the duration of the virus outbreak and its effect on the economy is not known, it is more appropriate to use these models.FindingsThe results of the survey of hands-on policies scenarios compared to the state of hands-off policy indicate that the effect of government expending shocks on the economy under pandemic disease conditions has much less feedback on macroeconomic variables.Originality/valueAs a proposed policy, it is recommended that the government play a stabilizing role under pandemic disease conditions.Key messages There is no study regarding health shock and its economic effects in Iran using DSGE models. Also, in foreign studies, the health shock in an oil economy has not been modeled.The general idea in the present study is how the prevalence of a pandemic infectious disease affects the dynamics of macroeconomic variables.In three different scenarios, according to the persistence of health disaster risk and the deterioration rate of health capital due to this shock, the model is simulated.In modeling pandemic diseases, quarantine hours are considered as part of the total time of individuals.According to the research findings, it is recommended that the government, as a policy-maker, play a stabilizing role under pandemic crises conditions.
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Lin Z, Fu M, Chen X. Self-perceived memory is negatively associated with chronic disease awareness: Evidence from blood biomarker data. SSM Popul Health 2023; 22:101361. [PMID: 36852376 PMCID: PMC9958050 DOI: 10.1016/j.ssmph.2023.101361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 02/02/2023] [Accepted: 02/07/2023] [Indexed: 02/11/2023] Open
Abstract
Background and objectives Cognitive misperception contributed to poor decision-making; yet their impact on health-related decisions is less known. We examined how self-perceived memory was associated with chronic disease awareness among older Chinese adults. Research design and methods Data were obtained from the China Health and Retirement Longitudinal Study. Nationally representative blood biomarkers were collected in 2015 to identify participants' dyslipidemia and diabetes status. Among participants with biomarker identified dyslipidemia or diabetes, disease awareness was defined as self-reported diagnosis of the conditions as of 2018. The association of self-perceived memory with chronic disease awareness was determined by weighted multivariate logistic regressions adjusting for cognitive ability and covariates. Results Among 4578 adults aged 60 and over, 1442 and 759 individuals were identified having dyslipidemia and diabetes, with proportions of disease awareness being 38.0% and 58.1%, respectively. The proportions were lower for individuals with better self-perceived memory and those with more impaired cognitive ability, showing opposite patterns. Adjusting for cognitive ability and covariates, self-perceived memory was negatively associated with the dyslipidemia (OR = 0.80, 95%CI: 0.63-1.02) and diabetes (OR = 0.71, 95%CI: 0.55-0.92) awareness. In particular, older adults with the highest level of self-perceived memory had significantly lower disease awareness as compared to those with the lowest level of self-perceived memory (OR = 0.51, 95%CI: 0.28-0.94 for dyslipidemia; and OR = 0.42, 95%CI: 0.21-0.84 for diabetes). The negative association was robust to adjusting for alternative cognitive measures, and was stronger for individuals with rural status, lower education, or living without children. Discussion and implications Cognitive misperception poses great challenges to chronic disease awareness. Targeted interventions and supports are needed, particularly for those more disadvantaged.
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Affiliation(s)
- Zhuoer Lin
- Department of Health Policy and Management, Yale School of Public Health, USA
| | - Mingqi Fu
- Center for Social Security Studies, Wuhan University, China
| | - Xi Chen
- Department of Health Policy and Management, Yale School of Public Health, USA,Department of Economics, Yale University, USA,Yale Alzheimer's Disease Research Center, USA,Corresponding author. Department of Health Policy and Management, Yale School of Public Health, 60 College St, New Haven, CT, 06520, USA.
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Romero G, Cardenas E, Osorio AM. Decomposing the Intraurban Malnutrition Gap Between Poor and Non-poor Children in Colombia : Decomposing the Intraurban Malnutrition Gap Between Poor and Non-poor Children in Colombia. J Urban Health 2023; 100:63-75. [PMID: 36534227 PMCID: PMC9762643 DOI: 10.1007/s11524-022-00683-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/11/2022] [Indexed: 12/23/2022]
Abstract
In Colombia, although it can be said that, on average children living in urban areas have better quality of life than their rural peers, it is also true that within cities, there are high levels of socioeconomic inequality. Our objective is to identify the contribution of the factors that explain the gap in stunting and excess weight between poor and non-poor children under 5 years of age in urban areas of Colombia. We use data from the 2015 National Nutritional Status Survey, and two nonlinear decomposition techniques based on the classical decomposition method developed by Blinder-Oaxaca. With a sample of 6877 observations, the results show that the intraurban gap of stunting between poor and non-poor children in urban areas is 4.8 percentage points. Its main determinants are the mother's educational level (46.5%), affiliation to the health system by the mother (19.4%), and assisted delivery in a medical institution (16.6%). For excess weight, the gap is - 2.1 percentage points, and its main determinants are the mother's educational level (39.2%) and birth attended by a physician (21.8%). This study suggests the coexistence of a double burden of malnutrition (DBM) in children under 5 years of age living in urban areas of Colombia. Stunting is associated with low-income levels while excess weight is associated with higher income levels. The identification of the main determinants of DBM and its relative importance, constitutes a contribution for public policy makers aimed at reducing socioeconomic gaps.
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Affiliation(s)
- Gustavo Romero
- International Doctorate School of the University of Murcia (EIDUM), PhD Program in Economics (DEcIDE), Murcia, Spain
| | - Ernesto Cardenas
- School of Economics, Sergio Arboleda University, Bogotá, Colombia.
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Yu Z, Qin W, Li J. Intergenerational transmission of parental risky health behaviors in Chinese children: Are there socioeconomic status differences? Front Med (Lausanne) 2023; 9:842817. [PMID: 36698800 PMCID: PMC9870313 DOI: 10.3389/fmed.2022.842817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 12/05/2022] [Indexed: 01/11/2023] Open
Abstract
Background Risky health behaviors in childhood, including smoking, alcohol consumption, and having a poor diet, are the major sources of non-communicable diseases in adulthood. This study aimed to examine how parents affect children's risky health behaviors and whether intergenerational transmission differs based on socioeconomic status (SES). Methods Data were extracted from the 1991-2015 China Health and Nutrition Survey (CHNS). Smoking (n = 5,946), alcohol consumption (n = 7,821), and sugar-sweetened beverages (SSBs) consumption (n = 3,537) were used as proxies for risky health behaviors in children. A binary choice model for panel data with a random-effect specification was employed to examine whether risky health behaviors can be transmitted from parents to their children. Subsequently, we conducted a seemingly unrelated estimation test (SUEST) to explore the differences in parental transmission between the different SES groups. Results We found strong intergenerational persistence of smoking, alcohol drinking, and SSBs drinking behaviors, except for the mothers' smoking behavior. Mothers had a greater influence on children's alcohol drinking and SSBs drinking behaviors than fathers both in urban and rural areas and in different SES groups. The intergenerational transmission of SSBs drinking behavior exhibited a decreasing trend with increasing SES for both urban and rural families. In urban areas, mothers' alcohol drinking behavior has a decreasing trend with increasing education level, occupation, and income; however, in rural areas, the influence of mothers' alcohol drinking behavior occurred in the same direction with increasing education level and occupation type. In rural areas, the influence of fathers' drinking and smoking behaviors on children appears to mostly increase with increasing SES. Meanwhile, the influence of such behaviors among urban fathers would decrease with increasing SES. Conclusion Parents' behaviors and SES can influence the initiation of risky health behaviors in their offspring. Thus, to promote healthy behaviors, policymakers can introduce health education programs for parents, particularly for those living in rural areas and with a low SES.
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Affiliation(s)
- Zexuan Yu
- Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Biostatistics, Brown University School of Public Health, Providence, RI, United States
| | - Wen Qin
- Infirmary of Shandong University, Jinan, China
| | - Jiajia Li
- Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
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Wu G, Cheng J, Yang F, Riaz N. Intermittent water supply and self-rated health in rural China's karst region. Front Public Health 2023; 11:1054730. [PMID: 36935699 PMCID: PMC10017750 DOI: 10.3389/fpubh.2023.1054730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 01/31/2023] [Indexed: 03/06/2023] Open
Abstract
Introduction With rapid economic and social development, surging demand for domestic water, and the increasing shortage of water resources, the applications of intermittent water supply systems have become more common in rural China and other developing countries. The accompanying hygiene risks require our more attention. Methods Based on the Grossman model, this paper conducted an IV-Oprobit model to investigate whether and how intermittent water supply affect rural residents' self-rated health status. Our data came from "China Karst Rural Economic Survey (CKRS)", which covers 8 provinces and 641 villages in rural China's karst region. Results and discussion We found that: (1) Intermittent water supply has adverse effects on the self-rated health status of rural residents. Compared with the rural residents under continuous water supply, the probability of "fair" health status under intermittent water supply significantly increases by 18.2%, while the probability of "excellent" significantly reduces by 58.8%. (2) Residents' water storage behavior and sanitary water habit are important mechanisms for intermittent water supply to affect residents' self-rated health status; (3) Intermittent water supply has a greater impact on the self-rated health of females and the groups with lower education levels. The results of our study have the following policy implications: relevant departments should make a rational plan about water supply methods and improve related supporting measures; we should strengthen health education for rural residents on water behavior to standardize their water storage and sanitary water behavior; government should enhance the pertinence of policy implementation and favor specific measures to specific populations.
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Affiliation(s)
- Guoyong Wu
- China Center of Western Capacity Development Research, School of Economics, Guizhou University, Guiyang, Guizhou, China
- Guizhou Grassroots Social Governance Innovation High-End Think Tank, Ecological Civilization (Guizhou) Research Institute, Guiyang, Guizhou, China
- Rural Revitalization Institute in Karst Region of China, Guizhou University, Guiyang, Guizhou, China
| | - Jianwei Cheng
- China Center of Western Capacity Development Research, School of Economics, Guizhou University, Guiyang, Guizhou, China
- *Correspondence: Jianwei Cheng
| | - Fan Yang
- China Center of Western Capacity Development Research, School of Economics, Guizhou University, Guiyang, Guizhou, China
| | - Noman Riaz
- China Center of Western Capacity Development Research, School of Economics, Guizhou University, Guiyang, Guizhou, China
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Jiang N, Grytten J, Kinge JM. Inequality in access to dental services in a market-based dental care system: A population study from Norway 1975-2018. Community Dent Oral Epidemiol 2022; 50:548-558. [PMID: 34806803 DOI: 10.1111/cdoe.12709] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 11/10/2021] [Accepted: 11/12/2021] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To examine income-related inequalities in access to dental services from 1975 to 2018. In Norway, dental care services for adults are privately financed. This may lead to income-related inequalities in access. In the early 1970s, that is, at the beginning of the study period, there were marked inequalities in access to dental services according to personal income. However, from the beginning of the 1970s, there has been a large increase in gross national income per capita in Norway as a result of the growth of the oil and gas industry. This increase in income also meant that people with a low income in 1975 had a rise in their level of income. According to the law of diminishing utility, an increase in income leads to higher consumption of dental services for people with a low level of income compared to people with a high level of income. The study hypothesis is that the inequalities in access to dental services that existed in 1975 became less over time. METHODS Statistics Norway collected samples of cross-sectional health survey data for the following years: 1975, 1985, 1995, 2002, 2008, 2012 and 2018. For each sample, individuals 21 years and older were drawn randomly from the non-institutionalized adult population using a two-stage stratified cluster sample technique. Inequalities were measured using the concentration index. The dependent variable was the use of dental services during the last year, and the key independent variable was equivalized household income. RESULTS The concentration index for inequalities in use of dental services according to income decreased from 0.10 (95% CI = 0.09, 0.11) in 1975 to 0.04 (95% CI = 0.03, 0.05) in 2018. The decrease was particularly large from 2002 to 2012. This was a period with a large growth in gross national income. CONCLUSION People with a low income had a marked increase in their purchasing power from 1975 to 2018. This coincided with an increase in demand for dental care for this low-income group.
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Affiliation(s)
- Nan Jiang
- Department of Community Dentistry, University of Oslo, Oslo, Norway
| | - Jostein Grytten
- Department of Community Dentistry, University of Oslo, Oslo, Norway.,Department of Obstetrics and Gynecology, Institute of Clinical Medicine, Akershus University Hospital, Lørenskog, Norway
| | - Jonas Minet Kinge
- Department of Community Dentistry, University of Oslo, Oslo, Norway.,Norwegian Institute of Public Health, Oslo, Norway
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Abstract
The year 2022 is the 50th anniversary of the publication of my demand for health model in "On the Concept of Health Capital and the Demand for Health," Journal of Political Economy 80(2): 223-255, and in The Demands for Health: A Theoretical and Empirical Investigation, NBER Occasional Paper 119 New York: Columbia University Press for the NBER. To mark that occasion, this editorial focuses on the history of the model and its impacts on the field of health economics.
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Affiliation(s)
- Michael Grossman
- City University of New York Graduate Center, National Bureau of Economic Research, and Institute of Labor Economics, New York, New York, USA
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20
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Aregbeshola BS, Khan SM. Barriers to enrollment in National Health Insurance Scheme among informal sector workers in Nigeria. WORLD MEDICAL & HEALTH POLICY 2022. [DOI: 10.1002/wmh3.542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Bolaji S. Aregbeshola
- Priority Research Centre for Health Behaviour, School of Medicine and Public Health, College of Health, Medicine and Wellbeing The University of Newcastle Callaghan New South Wales Australia
| | - Samina M. Khan
- Department of Public Health, Pakistan Institute of Medical Sciences (PIMS) Shaheed Zulfiqar Ali Bhutto Medical University Islamabad Pakistan
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Association between Social Integration, Social Exclusion, and Vaccination Behavior among Internal Migrants in China: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137915. [PMID: 35805576 PMCID: PMC9265632 DOI: 10.3390/ijerph19137915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/25/2022] [Accepted: 06/27/2022] [Indexed: 11/17/2022]
Abstract
Cross-sectional studies about the association between social integration, social exclusion, and vaccination behavior among internal migrants in China are lacking. In this study, we aimed to explore the association between the influenza vaccination behavior and social integration as well as social exclusion in China based on a cross-sectional study. We included 12,467 participants aged 15 years old or above from the 2017 Migrant Population Dynamic Monitoring Survey (MDMS). We used univariate analysis and logistic regression models to access the association between social integration, exclusion status, and influenza vaccination rates. Results suggested that the association between social integration and the vaccination rate was significantly positive. Moving between different districts impact on people’s mental health and their health performance. Significant association between influenza vaccination behavior and education attainment, income status, health record, and awareness of basic public health services program was reported. Therefore, in order to reduce the incidence of influenza disease and increase the vaccination rate, policymakers and the public should promote social integration for internal migrants. Meanwhile, our finding also implies possible strategies to promote COVID-19 vaccination.
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22
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Kambourova Z, Kalwij A. Are there employment and income gains of a national breast cancer screening program? HEALTH ECONOMICS REVIEW 2022; 12:33. [PMID: 35727354 PMCID: PMC9210695 DOI: 10.1186/s13561-022-00380-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 05/31/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The Dutch national breast cancer screening program invites women aged 50-75 for screening. By detecting the disease in an early phase, the program aims to achieve lower breast cancer mortality and improve breast cancer survivors' health. Arguably, the latter also improves the employability of diagnosed women. OBJECTIVE This study investigates the effects of the Dutch national breast cancer screening program on diagnosed women's employment and income. METHODS The empirical analysis uses data of 229,357 women aged 40-59, of whom 10,515 were diagnosed with breast cancer at an age in the range 47-53. A regression-based difference-in-differences estimator is used to identify program effects by comparing outcomes for women diagnosed at ages 47-49 with the outcomes for those diagnosed at ages 50-53. The empirical models account for individual fixed effects, and for age and year fixed effects by using a control group of women who were not diagnosed with breast cancer. RESULTS Women's employment rates declined in the six-year period after a breast cancer diagnosis with, on average, about 3 percentage points and their incomes declined with, on average, about 5% over this period. The empirical evidence, based on a comparison of outcomes for women diagnosed at ages 47-49 with the outcomes for those diagnosed at ages 50-53 when covered by the breast cancer screening program, does not support that these declines in employment and income were affected by the program. The evidence also does not support short or medium-term survival gains of the program. CONCLUSIONS The findings of this study suggest that the Dutch national breast cancer screening program yields no discernible short or medium-term employment and income gains for women diagnosed with breast cancer.
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Affiliation(s)
- Zornitza Kambourova
- Utrecht University School of Economics, P.O. Box 80125, 3508, TC Utrecht, The Netherlands
| | - Adriaan Kalwij
- Utrecht University School of Economics, P.O. Box 80125, 3508, TC Utrecht, The Netherlands
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Immurana M, Kisseih KG, Yakubu MZ, Yusif HM. Financial inclusion and households’ choice of solid waste disposal in Ghana. BMC Public Health 2022; 22:1117. [PMID: 35659211 PMCID: PMC9166503 DOI: 10.1186/s12889-022-13512-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 05/23/2022] [Indexed: 12/02/2022] Open
Abstract
Background As the amount of solid waste generated by households in Ghana continues to grow, policy makers are preoccupied with finding better means of managing these solid wastes. To this end, a number of studies have been conducted on the factors that determine the choice of solid waste disposal method among households in Ghana. Notwithstanding, while financial inclusion is deemed as an effective tool for improved solid waste management, none of these studies paid attention to it. This study therefore, investigates the effect of financial inclusion on the choice of solid waste disposal method among households in Ghana. Methods The study uses data from the Ghana Living Standards Survey round 7 (GLSS7). The multinomial probit regression is used as the empirical estimation technique. Results Our results show that financial inclusion increases the likelihood of households opting for the collection method of solid waste disposal relative to burning, public dumping and indiscriminate disposal of solid waste. Conclusion Financial inclusion enables households to opt for a healthy solid waste disposal method (collection method), hence, in policy makers’ attempts to improve solid waste disposal, paying attention to financial inclusion can be a very useful strategy.
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Peracchi F, Rossetti C. A nonlinear dynamic factor model of health and medical treatment. HEALTH ECONOMICS 2022; 31:1046-1066. [PMID: 35306705 DOI: 10.1002/hec.4495] [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: 04/07/2021] [Revised: 01/27/2022] [Accepted: 02/23/2022] [Indexed: 06/14/2023]
Abstract
Quantitative assessments of the relationship between health and medical treatment are of great importance to policy makers. To overcome endogeneity problems we formulate and estimate a tractable dynamic factor model where observed health outcomes are driven by the individual's latent health. The dynamics of latent health reflects both exogenous health deterioration and endogenous health investments. Our model allows us to investigate the effect of medical treatment on current health, as well as on future medical treatment and health outcomes. We estimate the model by maximum simulated likelihood and minimum distance methods using a rich longitudinal data set from Italy obtained by merging a number of administrative archives. These data contain detailed information on medical drug purchase, hospitalization, and mortality for a representative sample of elderly hypertensive patients. Our findings show that the observed autocorrelation in medical treatment reflects both permanent and time-varying observed and unobserved heterogeneity. They also show that medical drug purchase significantly maintains future health levels and prevents transitions to worse health. This suggests that policies aimed at increasing the awareness and the compliance of hypertensive patients help reduce cardiovascular risks and consequent hospitalization and mortality.
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Affiliation(s)
- Franco Peracchi
- University of Rome Tor Vergata, Roma, Lazio, Italy
- EIEF, Roma, Lazio, Italy
| | - Claudio Rossetti
- LUISS Guido Carli, Roma, Italy
- Deloitte Financial Advisory, Roma, Italy
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Bala MM, Singh S, Kumar N, Janor H. Predicting key drivers for health care expenditure growth in the Middle East region: a Grossman-PLS modeling approach. Expert Rev Pharmacoecon Outcomes Res 2022; 22:1021-1031. [PMID: 35491846 DOI: 10.1080/14737167.2022.2073222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Numerous studies have provided evidence to the literature on the demand side of the determinants of health-care expenditure by employing the Grossman model. However, understanding the supply side of the determinants of health-care expenditure will be of crucial importance for improving health outcomes. METHODS This study has used panel data for 15 Middle-East region countries for the time period of 2000-2016 Initially, Grossman's model of the demand for care is estimated. Furthermore, a Parallel model of the supply of care is estimated for contradistinction analysis. Finally, an integrated partial least square structural equation model is being developed. RESULTS Results show that the relative wage rate and aging variables are the only indicators that are statistically significant with theoretically consistent signs as postulated by Grossman's theoretical model. The opposite is true with schooling and the proxy of the medical care relative prices. However, in the parallel model, all the four drivers of the demand for care are statistically significant determinants of health-care spending. CONCLUSIONS Therefore, expansion of health insurance coverage particularly for the elderly cohort of the population could be a promising mechanism to boost the demand for care and eventually improve health outcomes.
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Affiliation(s)
- Muhammad Muazu Bala
- School of Liberal Arts and Basic Sciences, Department of Economics, SRM University-AP, Amaravati, India
| | - Shailender Singh
- Department of Commerce, School of Entrepreneurship and Management Studies, SRM University-AP, Amaravati, India
| | - Nishant Kumar
- Amity School of Business, Amity University, Noida, India
| | - Hawati Janor
- Faculty of Economics and Management, Universiti Kebangsaan Malaysia, Malaysia
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Heckley G, Nordin M, Gerdtham U. The health returns of attending university for the marginally eligible student. HEALTH ECONOMICS 2022; 31:877-903. [PMID: 35212069 PMCID: PMC9306799 DOI: 10.1002/hec.4484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 11/25/2021] [Accepted: 01/20/2022] [Indexed: 06/14/2023]
Abstract
A key policy question is whether continued expansion of university education is beneficial for the marginally eligible student. In this paper we exploit an arbitrary university eligibility rule combined with regression discontinuity design to estimate the causal effect of university attendance on healthcare utilization amongst young adults in Sweden. We find that the eligibility rule leads to a clear jump in university attendance of between 10% and 14% points for both males and females. 2SLS estimates find that a 10% point increase in university attendance causes a roughly one percentage point increase in hospital admissions due to mental ill health for males, almost exclusively related to alcohol and narcotics. Our findings for females, however, imply the opposite, suggesting that university attendance decreases hospital admissions related to mental health. The results for males sit in contrast to results from previous studies, and suggest that the effect of university education on health for the male student at the margin of eligibility is different to that of the average student.
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Affiliation(s)
- Gawain Heckley
- Health Economics UnitDepartment of Clinical SciencesLund UniversityLundSweden
| | | | - Ulf‐G. Gerdtham
- Health Economics UnitDepartment of Clinical SciencesLund UniversityLundSweden
- Department of EconomicsLund UniversityLundSweden
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Immurana M, Kisseih KG, Yusif HM, Yakubu ZM. The effect of financial inclusion on open defecation and sharing of toilet facilities among households in Ghana. PLoS One 2022; 17:e0264187. [PMID: 35245300 PMCID: PMC8896660 DOI: 10.1371/journal.pone.0264187] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 02/04/2022] [Indexed: 11/18/2022] Open
Abstract
Globally, and in Ghana, a lot of people do practice open defecation as well as share toilet facilities with other households. Meanwhile, open defecation in particular, is associated with numerous negative health and economic effects. To this end, a number of empirical studies have been conducted on the determinants of access to sanitation facilities among households in Ghana. Nonetheless, while financial inclusion (sustainable ways of ensuring easier accessibility to cheap and useful financial products and services among individuals/firms) can enhance the ability of households or individuals to afford toilet facilities, hence, could help in curbing open defecation and sharing of toilet facilities among households, the previous studies on Ghana did not pay attention to it. This study therefore uses data from the 7th round of the Ghana Living Standards Survey (GLSS7) to examine the association of financial inclusion with open defecation and sharing of toilet facilities among households in Ghana. The binary logit regression is used as the empirical estimation technique. The results show that, financial inclusion in general is associated with lesser likelihood of open defecation and sharing of toilet facilities among households in Ghana after controlling for welfare quintile, urban or rural residence and other covariates. Moreover, while informal financial inclusion is statistically insignificant, formal financial inclusion is found to be associated with reduced open defecation and sharing of toilet facilities among households. Thus, in the attempt to eliminate open defecation as well as reduce the sharing of toilet facilities among households in Ghana, conscious efforts should be devoted towards enhancing formal financial inclusion.
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Affiliation(s)
- Mustapha Immurana
- Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana
- * E-mail: ,
| | | | - Hadrat Mohammed Yusif
- Department of Economics, Kwame Nkrumah University of Science and Technology, PMB, Kumasi, Ghana
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Nguyen TXT, Lal S, Abdul-Salam S, Khan MSR, Kadoya Y. Financial Literacy, Financial Education, and Cancer Screening Behavior: Evidence from Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084457. [PMID: 35457329 PMCID: PMC9030491 DOI: 10.3390/ijerph19084457] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 04/05/2022] [Accepted: 04/06/2022] [Indexed: 12/31/2022]
Abstract
Although Japan has a well-established cancer screening program and has implemented several initiatives to increase screening rates, levels of cancer screening can be further improved. Based on a rational decision-making framework, this study examines the role of financial literacy and financial education, which measure peoples' knowledge about investment and savings, respectively, in improving cancer screening rates in Japan. The main data were extracted from Osaka University's Preference Parameters Study for 2011. The dependent variable was the number of cancer screenings while the two main independent variables were financial literacy and financial education. Ordered probit regression models were run to test the association between financial literacy, financial education, and the number of cancer screenings. The results showed a positive relationship between financial education and cancer screening behavior in Japan, while no significant association was observed between financial literacy and screening behavior. Furthermore, according to findings stratified by three age groups, the positive association between financial education and cancer screening behavior was particularly evident in 50- to 59-year-olds, while the effects of other demographic, socioeconomic, and risky health behavior variables were not consistent. It is imperative that implementation of more financial education programs is an effective intervention to encourage cancer screening behavior in Japanese populations.
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Wang TH, Lu J. Does Advanced Human Capital Structure Provide Positive Feedback on Public Health? Evidence From China. Front Public Health 2022; 10:829716. [PMID: 35356015 PMCID: PMC8959410 DOI: 10.3389/fpubh.2022.829716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 02/09/2022] [Indexed: 11/13/2022] Open
Abstract
This paper explores the relationship of advanced human capital structure with public health applying the panel threshold regression model in China. The empirical results highlight that the advanced human capital structure has a non-linear single threshold effect on population health indicators. The health-promoting effect of advanced human capital structure is significantly weaker when exceeding the threshold. These asymmetric effects are strongly related to the response of China's health policies. The promotion effect of the advanced human capital structure on public health has significant heterogeneity in different regions. There is a single threshold value in the eastern and central regions, but the threshold value and facilitation effect are different. However, the western region has no threshold. The heterogeneity effects are caused by the different levels of advanced human capital structure. Governments should adopt appropriate public health policies according to the development characteristics of different regions.
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Broughel J, Chambers D. Federal Regulation and Mortality in the 50 States. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2022; 42:592-613. [PMID: 34164842 DOI: 10.1111/risa.13774] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 06/03/2021] [Accepted: 06/07/2021] [Indexed: 05/21/2023]
Abstract
Previous research speculates that some regulations are counterproductive in the sense that they increase (rather than decrease) mortality risk. However, few empirical studies have measured the extent to which this phenomenon holds across the regulatory system as a whole. Using a novel U.S. state panel data set spanning the period 2000-2014, we estimate the effect of U.S. federal regulation on state-level mortality. We find that a 1% increase in federal regulation of state economies is associated with an increase in an index of state mortality of between 0.53% and 1.35%. These findings are robust to the form of mortality measure, choice of covariates, and the inclusion/exclusion of various regions, states, and industries. We also provide an update of the "cost-per-life saved cutoff," which is the counterproductive risk threshold for expenditures. We find that expenditures in excess of $38.6 million (2019 dollars) per life saved can be expected to increase mortality risk. This article fills an important gap in the empirical literature and boosts the credibility of mortality risk analysis, whereby public policymakers weigh both the expected lives saved and lost due to a proposed regulation or other policy.
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Affiliation(s)
- James Broughel
- Mercatus Center at George Mason University, Arlington, VA, USA
| | - Dustin Chambers
- Mercatus Center at George Mason University, Arlington, VA, USA
- Perdue School of Business, Salisbury University, Salisbury, MD, USA
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31
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Kyan A, Takakura M. Socioeconomic inequalities in physical activity among Japanese adults during the COVID-19 pandemic. Public Health 2022; 207:7-13. [DOI: 10.1016/j.puhe.2022.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 02/25/2022] [Accepted: 03/10/2022] [Indexed: 11/27/2022]
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Ying YH, Lee WL, Chi YC, Chen MJ, Chang K. Demographics, Socioeconomic Context, and the Spread of Infectious Disease: The Case of COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042206. [PMID: 35206390 PMCID: PMC8872250 DOI: 10.3390/ijerph19042206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/19/2022] [Accepted: 02/10/2022] [Indexed: 02/01/2023]
Abstract
Importance: Due to the evolving variants of coronavirus disease 2019 (COVID-19), it is important to understand the relationship between the disease condition and socioeconomic, demographic, and health indicators across regions. Background: Studies examining the relationships between infectious disease and socioeconomic variables are not yet well established. Design: A total of 3042 counties in the United States are included as the observation unit in the study. Two outcome variables employed in the study are the control of disease spread and infection prevalence rates in each county. Method: Data are submitted to quantile regression, hierarchical regression, and random forest analyses to understand the extent to which health outcomes are affected by demographics, socioeconomics, and health indicators. Results: Counties with better control of the disease spread tend to have lower infection rates, and vice versa. When measuring different outcome variables, the common risk factors for COVID-19 with a 5% level of statistical significance include employment ratio, female labor ratio, young population ratio, and residents’ average health risk factors, while protective factors include land size, housing value, travel time to work, female population ratio, and ratio of residents who identify themselves as mixed race. Conclusions: The implications of the findings are that the ability to maintain social distancing and personal hygiene habits are crucial in deterring disease transmission and lowering incidence rates, especially in the early stage of disease formation. Relevant authorities should identify preventive factors and take early actions to fight infectious diseases in the future.
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Affiliation(s)
- Yung-Hsiang Ying
- Department of Business Administration, National Taiwan Normal University, Taipei 106, Taiwan;
| | - Wen-Li Lee
- Department of Healthcare Information and Management, Ming Chuan University, Taoyuan 333, Taiwan; (W.-L.L.); (Y.-C.C.)
| | - Ying-Chen Chi
- Department of Healthcare Information and Management, Ming Chuan University, Taoyuan 333, Taiwan; (W.-L.L.); (Y.-C.C.)
| | - Mei-Jung Chen
- Department of Biomedical Engineering, Ming Chuan University, Taoyuan 333, Taiwan;
| | - Koyin Chang
- Department of Healthcare Information and Management, Ming Chuan University, Taoyuan 333, Taiwan; (W.-L.L.); (Y.-C.C.)
- Harris School of Public Policy, University of Chicago, Chicago, IL 60611, USA
- Correspondence:
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Savelyev PA, Ward BC, Krueger RF, McGue M. Health endowments, schooling allocation in the family, and longevity: Evidence from US twins. JOURNAL OF HEALTH ECONOMICS 2022; 81:102554. [PMID: 34847444 DOI: 10.1016/j.jhealeco.2021.102554] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 10/19/2021] [Accepted: 11/08/2021] [Indexed: 06/13/2023]
Abstract
We analyze data from the Minnesota Twin Registry (MTR), combined with the Socioeconomic Survey of Twins (SST), and new mortality data, and contribute to two bodies of literature. First, we demonstrate a beneficial causal effect of education on health and longevity in contrast to other twin-based studies of the US population, which show little or no effect of education on health. Second, we present evidence that is consistent with parental compensation through education for differences in their children's endowments that predict health, but find no evidence that parents reinforce differences in endowments that predict earnings. We argue that there is a bias towards detecting reinforcement both in this paper and in the literature. Despite this bias, we still find statistical evidence of compensating behavior. We account for observed and unobserved confounding factors, sample selection bias, and measurement error in education.
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Affiliation(s)
- Peter A Savelyev
- The College of William & Mary, 300 James Blair Dr., Chancellor's Hall, Room 317, Williamsburg VA 23185, USA.
| | | | - Robert F Krueger
- Department of Psychology, The University of Minnesota, Twin Cities, USA
| | - Matt McGue
- Department of Psychology, The University of Minnesota, Twin Cities, USA
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Eibich P, Goldzahl L. Does retirement affect secondary preventive care use? Evidence from breast cancer screening. ECONOMICS AND HUMAN BIOLOGY 2021; 43:101061. [PMID: 34555616 PMCID: PMC8683749 DOI: 10.1016/j.ehb.2021.101061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 08/31/2021] [Accepted: 08/31/2021] [Indexed: 06/13/2023]
Abstract
This paper examines the causal impact of retirement on preventive care use by focusing on breast cancer screening. It contributes to a better understanding of the puzzling results in the literature reporting mixed effects on health care consumption at retirement. We use five waves of data from the Eurobarometer surveys conducted between 1996 and 2006, covering 25 different European countries. We address the endogeneity of retirement by using age thresholds for pension eligibility as instrumental variables in a bivariate probit model. We find that retirement reduces mammography use and other secondary preventive care use. Our results suggest that health status, income, and knowledge on cancer prevention and treatment contribute little to our understanding of the effects of retirement. Instead, our evidence suggests important effect heterogeneity based on the generosity of the social health insurance system and organized screening programs.
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Affiliation(s)
- Peter Eibich
- Max Planck Institute for Demographic Research, Konrad-Zuse-Str. 1, 18057 Rostock, Germany; Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, UK.
| | - Léontine Goldzahl
- EDHEC Business School, 24 Avenue Gustave Delory, CS 50411, 59057 Roubaix Cedex 1, France.
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35
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Atella V, Goldman D, McFadden D. Disparate ageing: The role of education and socioeconomic gradients in future health and disability in an international context. HEALTH ECONOMICS 2021; 30 Suppl 1:3-10. [PMID: 34128290 DOI: 10.1002/hec.4374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 06/03/2021] [Indexed: 06/12/2023]
Affiliation(s)
- Vincenzo Atella
- Department of Economics and Finance, University of Rome Tor vergata and CEIS Tor Vergata, Roma, Italy
| | - Dana Goldman
- Leonard D. Schaeffer Center for Health Policy & Economics, University of Southern California, Los Angeles, California, USA
| | - Daniel McFadden
- Leonard D. Schaeffer Center for Health Policy & Economics, University of Southern California, Los Angeles, California, USA
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Hyun MK, Kan MY. The Association Between Work Status and the Use of Healthcare Services Among Women in the Republic of Korea. Saf Health Work 2021; 13:51-58. [PMID: 35936212 PMCID: PMC9346942 DOI: 10.1016/j.shaw.2021.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 08/30/2021] [Accepted: 10/12/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction Previous studies on occupational health focussed predominately on the occurrence of occupational diseases. Relatively few studies have measured how employment is associated with the use of healthcare services. This study investigates the association between employment and the extent and range of healthcare use, such as medical expenditures, of women in South Korea. Methods We analyze data of the Korean Health Panel, an ongoing longitudinal national representative survey, from 2008 to 2017, to identify the status of economic activity of women by year and age group. We estimate the association between female employment status and medical expenditures by using random effect panel Tobit models. Furthermore, we investigate the association between employment status and the range of healthcare services in biomedicine and traditional Korean medicine (KM) by conducting conditional fixed-effects logistic regression analyses. Results For women aged between 25 and 65 in 2017, the majority of them were employed or self-employed. (The proportion of employment of self-employment equals 64.80%). In addition, working women spent 11.6% less on healthcare than nonworking women, and self-employment lowered the healthcare expenditure by 13.1%. Neither work nor the type of work is related to the types and range of healthcare service use. Being employed or self-employed is negatively associated with women’s expenditure on healthcare. Conclusions The findings show that employment is associated with less spending on healthcare. They imply that employment has a positive impact on women’s health.
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Affiliation(s)
- Min Kyung Hyun
- Department of Preventive Medicine, College of Korean Medicine, Dongguk University, Republic of Korea
| | - Man-Yee Kan
- Department of Sociology, University of Oxford, United Kingdom
- Corresponding author. Department of Sociology, University of Oxford, 42-43 Park End Street, Oxford OX1 1JD, United Kingdom.
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37
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Government Health Expenditure and Public Health Outcomes: A Comparative Study among EU Developing Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010725. [PMID: 34682472 PMCID: PMC8535729 DOI: 10.3390/ijerph182010725] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 10/09/2021] [Accepted: 10/10/2021] [Indexed: 12/18/2022]
Abstract
The aim of this paper was to empirically analyze the relationship between public health expenditure and health outcomes among EU developing countries. Using regression analysis and factor analysis, we documented that public health expenditure and health outcomes are in a long-run equilibrium relationship and the status of health expenditure can improve life expectancy and reduce infant mortality. Secondarily, we studied how the status of good governance, health care system performance, and socioeconomic vulnerabilities affect the public health’s outcomes in the selected countries. We found that the effectiveness of health and the way to reduce infant mortality or to improve life quality is directed conditioned by good governance status. Moreover, the consolidation of health care system performance directly improves the quality of life among EU developing countries, which indicates that public policymakers should intervene and provide political and financial support through policy mixes.
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38
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Gunadi C, Ryu H. Does the rise of robotic technology make people healthier? HEALTH ECONOMICS 2021; 30:2047-2062. [PMID: 34046963 DOI: 10.1002/hec.4361] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 03/10/2021] [Accepted: 05/10/2021] [Indexed: 06/12/2023]
Abstract
Technological advancements bring changes to our life, altering our behaviors as well as our role in the economy. In this paper, we examine the potential effect of the rise of robotic technology on health. Using the variation in the initial distribution of industrial employment in US cities and the difference in robot adoption across industries over time to predict robot exposure at the local labor market, we find evidence that higher penetration of industrial robots in the local economy is positively related to the health of the low-skilled population. A 10% increase in robots per 1000 workers is associated with an approximately 10% reduction in the share of low-skilled individuals reporting poor health. Further analysis suggests that the reallocation of tasks partly explains this finding. A 10% increase in robots per 1000 workers is associated with an approximately 1.5% reduction in physical tasks supplied by low-skilled workers.
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Affiliation(s)
- Christian Gunadi
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, San Diego, California, USA
| | - Hanbyul Ryu
- Hanyang University (ERICA Campus), College of Business and Economics, Ansan-si, South Korea
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39
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Heer B, Rohrbacher S. Endogenous longevity and optimal tax progressivity. JOURNAL OF HEALTH ECONOMICS 2021; 79:102515. [PMID: 34399312 DOI: 10.1016/j.jhealeco.2021.102515] [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: 11/09/2020] [Revised: 07/16/2021] [Accepted: 07/31/2021] [Indexed: 06/13/2023]
Abstract
We study the impact of endogenous longevity on optimal tax progressivity and inequality in an overlapping generations model with skill heterogeneity. Higher tax progressivity decreases both the longevity gap and net income inequality, but at the expense of lower average lifetime and income. We find that the welfare-maximizing income tax is less progressive in our model with endogenous longevity than in our model with exogenous longevity. In a highly stylized calibration of the US economy, we show that optimal tax progressivity is less than what prevails under the current US tax system. Our results are robust to the range of empirical labor supply elasticity and the assumptions of missing annuity markets and stochastic health. Our conclusion for the optimal progressivity of the US tax system can be altered by the adoption of a more egalitarian welfare function or by increases in prevailing levels of wage inequality.
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Affiliation(s)
- Burkhard Heer
- University of Augsburg, Department of Economics, Universitatsstrasse 16, 86159 Augsburg, Germany; CESifo, Munich, Germany.
| | - Stefan Rohrbacher
- University of Augsburg, Department of Economics, Universitatsstrasse 16, 86159 Augsburg, Germany.
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40
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Adu P, Jurcik T, Dmitry G. Mental health literacy in Ghana: Implications for religiosity, education and stigmatization. Transcult Psychiatry 2021; 58:516-531. [PMID: 34165347 DOI: 10.1177/13634615211022177] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Research on Mental Health Literacy (MHL) has been growing internationally. However, the beliefs and knowledge of Ghanaians about specific mental disorders have yet to be explored. This vignette study was conducted to explore the relationships between religiosity, education, stigmatization and MHL among Ghanaians using a sample of laypeople (N = 409). The adapted questionnaire presented two vignettes (depression and schizophrenia) about a hypothetical person. The results revealed that more participants were able to recognize depression (47.4%) than schizophrenia (15.9%). Religiosity was not significantly associated with recognition of mental disorders but was positively associated with both social and personal stigma for depression, and negatively associated with personal and perceived stigma for schizophrenia. Moreover, education was found to be positively associated with disorder recognition, and negatively with perceived stigma. Finally, perceived stigma was positively associated with disorder recognition, whereas personal stigma for schizophrenia related negatively to recognition of mental disorders. In conclusion, education but not religiosity predicted identification accuracy, but both predictors were associated with various forms of stigma. Findings from this study have implications for MHL and anti-stigma campaigns in Ghana and other developing countries in the region.
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Affiliation(s)
- Peter Adu
- 68192National Research University Higher School of Economics, Moscow, Russia
| | - Tomas Jurcik
- 68192National Research University Higher School of Economics, Moscow, Russia
| | - Grigoryev Dmitry
- 68192National Research University Higher School of Economics, Moscow, Russia
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41
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Xu Y, Yilmazer T. Childhood socioeconomic status, adulthood obesity and health: The role of parental permanent and transitory income. Soc Sci Med 2021; 283:114178. [PMID: 34225035 DOI: 10.1016/j.socscimed.2021.114178] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 06/14/2021] [Accepted: 06/23/2021] [Indexed: 12/16/2022]
Abstract
Children from low SES backgrounds experience long-term economic deprivation in addition to excessive income volatility during childhood. Little is known about whether parental income influences adulthood weight and health through either prolonged or transitory hardship. Using the intergenerational feature of the Panel Study of Income Dynamics (PSID), we link parents' income records from a 47-year panel (1968-2015 waves) to health outcomes of 3976 adult children (1999-2015 waves) in the United States. We calculate parental permanent income to measure prolonged disadvantages, as well as transitory income peaks and valleys at various early-life stages to measure transitory advantages and disadvantages, respectively. Our findings show that parental permanent income is negatively associated with obesity and adverse health outcomes in multiple adulthood stages. We also detect negative associations between transitory income peaks in adolescence and adverse weight and health outcomes. Our findings provide strong empirical support for the influence of prolonged material hardship on adverse weight and health outcomes and no support for the influence of transitory material hardship. Our findings also show that policies that improve parental permanent income and provide higher transitory income are essential to generate healthier adults.
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Affiliation(s)
- Yilan Xu
- Department of Agricultural and Consumer Economics, University of Illinois at Urbana-Champaign, 309 Mumford Hall, 1301 W. Gregory Drive, Urbana, IL, 61801, USA.
| | - Tansel Yilmazer
- Department of Human Sciences, Ohio State University, 1787 Neil Avenue, 115C Campbell Hall, Columbus, OH, 43210, USA.
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Abstract
Lack of exercise, which increases the risk of many serious physical and mental illness, has been a common health issue in Japan. Recent studies confirm that financial literacy discourages irrational behavior like gambling and smoking. We therefore investigate how financial literacy, as a rational decision-making instrument, relates to peoples’ exercise behavior in Japan. We hypothesize that financial literacy encourages people to exercise regularly. Using Osaka University’s Preference Parameters Study (PPS) for 2010, we categorized respondents into two groups: those who exercise regularly or at least once a week and those who do not. Our probit estimation results show that financial literacy is positively related with exercise behavior, meaning that financially literate people are more likely to exercise regularly. As the COVID-19 health pandemic seems to exacerbate peoples’ physical inactivity, the results of our study show an alternative approach to encourage exercise. We therefore recommend that governments implement a financial literacy improvement policy to alleviate the lack of exercise.
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Khan MSR, Putthinun P, Watanapongvanich S, Yuktadatta P, Uddin MA, Kadoya Y. Do Financial Literacy and Financial Education Influence Smoking Behavior in the United States? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2579. [PMID: 33806645 PMCID: PMC7967511 DOI: 10.3390/ijerph18052579] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 02/27/2021] [Accepted: 03/01/2021] [Indexed: 12/29/2022]
Abstract
Smoking is still a serious economic, health, and social problem despite various efforts to curb its prevalence. We examined the influence of financial literacy and financial education on the smoking behavior in the United States in terms of the use of rational decision-making abilities to reduce irrational behavior. We hypothesized that financial literacy and financial education, as proxies for rational decision making, would reduce the likelihood of smoking. We used data from the Preference Parameters Study (PPS) of Osaka University conducted in the United States in 2010 and applied probit regression models to test our hypothesis on a sample of 3831 individuals. We found that financially literate people are less likely to be smokers, though we found no clear role of financial education in reducing the likelihood of smoking. Further, respondents' gender, age, unemployment status, and risky health behaviors such as drinking and gambling, have a significantly positive association with smoking, while marital status, university degree, family size, household income, household assets, physical exercise, and level of happiness have a significantly negative association. Our findings suggest that financial literacy, as an instrument encouraging rational decision making, could be a tool to help reduce smoking in the United States.
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Affiliation(s)
- Mostafa Saidur Rahim Khan
- School of Economics, Hiroshima University, 1-2-1 Kagamiyama, Higashihiroshima, Hiroshima 739-8525, Japan; (P.P.); (S.W.); (P.Y.); (Y.K.)
| | - Pongpat Putthinun
- School of Economics, Hiroshima University, 1-2-1 Kagamiyama, Higashihiroshima, Hiroshima 739-8525, Japan; (P.P.); (S.W.); (P.Y.); (Y.K.)
| | - Somtip Watanapongvanich
- School of Economics, Hiroshima University, 1-2-1 Kagamiyama, Higashihiroshima, Hiroshima 739-8525, Japan; (P.P.); (S.W.); (P.Y.); (Y.K.)
| | - Pattaphol Yuktadatta
- School of Economics, Hiroshima University, 1-2-1 Kagamiyama, Higashihiroshima, Hiroshima 739-8525, Japan; (P.P.); (S.W.); (P.Y.); (Y.K.)
| | - Md. Azad Uddin
- Graduate School for International Development and Cooperation, Hiroshima University, 1-5-1 Kagamiyama, Higashihiroshima, Hiroshima 739-8529, Japan;
| | - Yoshihiko Kadoya
- School of Economics, Hiroshima University, 1-2-1 Kagamiyama, Higashihiroshima, Hiroshima 739-8525, Japan; (P.P.); (S.W.); (P.Y.); (Y.K.)
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Pedron S, Schmaderer K, Murawski M, Schwettmann L. The association between childhood socioeconomic status and adult health behavior: The role of locus of control. SOCIAL SCIENCE RESEARCH 2021; 95:102521. [PMID: 33653585 DOI: 10.1016/j.ssresearch.2020.102521] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 11/20/2020] [Accepted: 12/20/2020] [Indexed: 06/12/2023]
Abstract
The socioeconomic environment in childhood is a powerful determinant for health behavior in adulthood, subsequently influencing health outcomes. However, the underlying mechanisms are insufficiently understood. This study assesses locus of control (LOC) as a mediator linking childhood socioeconomic status (SES) with health behavior (smoking, regular alcohol consumption, unhealthy diet and low physical activity). Drawing on a representative sample from Germany (SOEP), we investigated these relations using structural equations modelling. Results show that externally oriented LOC explains up to 6% of the relationship between childhood SES and health behavior in adulthood, independently from adult SES. Stratification indicates that these results hold in women but not in men, in younger and middle-aged individuals but not in older ones. Hence, control beliefs play a modest yet significant role in shaping the socioeconomic gradient in health behavior and might have far-reaching consequences on how morbidity and mortality arise and persist across generations.
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Affiliation(s)
- Sara Pedron
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstr. 1, 85764, Neuherberg, Germany; German Center for Diabetes Research, Ingolstädter Landstr. 1, 85764, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Ludwig-Maximilians-University Munich, Marchioninistr. 15, 81377, Munich, Germany; Pettenkofer School of Public Health, Munich, Germany.
| | - Katharina Schmaderer
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstr. 1, 85764, Neuherberg, Germany
| | - Monika Murawski
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstr. 1, 85764, Neuherberg, Germany; IFT Institut für Therapieforschung, Leopoldstr. 175, 80804, Munich, Germany
| | - Lars Schwettmann
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstr. 1, 85764, Neuherberg, Germany; Department of Economics, Martin Luther University Halle-Wittenberg, Große Steinstraße 73, 06108, Halle (Saale), Germany
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Manian S. Conflict and Risky Health Behavior: Evidence from Mexico's Drug War. JOURNAL OF DEVELOPMENT ECONOMICS 2021; 148:102562. [PMID: 33071432 PMCID: PMC7566850 DOI: 10.1016/j.jdeveco.2020.102562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Risky health behaviors contribute to a large share of disease in developing countries, yet few papers have studied the effect of conflict on these behaviors. The canonical health capital model predicts that conflict should increase risky health behaviors: as the likelihood of survival falls, incentives to invest in preventive measures also fall, increasing risk-taking. However, recent findings from various violent contexts, including the drug war in Mexico, suggest the behavioral response to conflict may reduce risk-taking. In this paper, I identify the effect of insecurity on sexual risk-taking using unique panel data on female sex workers in Ciudad Juarez, Mexico. I show that more intense conflict generates a large reduction in risky sex transactions. I rule out several alternate explanations, including compositional changes in sex markets and changes in drug use. The results suggest that the behavioral response to insecurity can mitigate the negative effects of conflict on health.
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Affiliation(s)
- Shanthi Manian
- P.O. Box 646210, Washington State University, Pullman, WA 99164-6210
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Impact of Credit Constraints from Formal Financial Institutions on Rural Residents' Health in China. Healthcare (Basel) 2020; 9:healthcare9010006. [PMID: 33374650 PMCID: PMC7822418 DOI: 10.3390/healthcare9010006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 12/14/2020] [Accepted: 12/19/2020] [Indexed: 11/17/2022] Open
Abstract
This is the first study in China that looks at the impact of credit constraints from formal financial institutions on Chinese rural residents’ health. We use the Chinese Household Income Project (CHIP) data collected by the Annual Household Survey Office of Integration of Urban and Rural in the National Bureau of Statistics in 2014. We measure rural residents’ health status with self-rated health assessment and the number of sick days in 2013. The results obtained from using the ordered probit model show that, in general, credit constraints from formal financial institutions significantly and negatively affect the self-rated health of Chinese rural residents. When an endogeneity issue is addressed using the instrumental variable (IV) approach, this paper’s results are still robust. The results also show that the impact of credit constraints from formal financial institutions on rural residents’ self-rated health is significant in male, female, married, and unmarried sub-groups. Further, we find that credit constraints from formal financial institutions impact rural residents’ health through income and economic vulnerability. The findings have implications for preventing rural residents from falling into a health trap due to credit constraints from formal financial institutions.
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Lagomarsino E, Spiganti A. No gain in pain: psychological well-being, participation, and wages in the BHPS. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2020; 21:1375-1389. [PMID: 32960389 PMCID: PMC7581575 DOI: 10.1007/s10198-020-01234-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 08/27/2020] [Indexed: 06/11/2023]
Abstract
Accounting for endogeneity, unobserved heterogeneity, and sample selection in an unified framework, we investigate the effect of psychological well-being on wages and labour market participation using a panel from the British Household Panel Survey. We find the effect of psychological well-being on labour market outcomes to differ across gender. In particular, psychological distress significantly reduces participation across genders, but, conditional on participation, has a significant negative effect on hourly wages only in the female sample.
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Affiliation(s)
| | - Alessandro Spiganti
- Department of Economics, European University Institute, Fiesole, Italy
- Department of Economics, Ca’ Foscari University of Venice, Venice, Italy
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Ko H. Moral hazard effects of supplemental private health insurance in Korea. Soc Sci Med 2020; 265:113325. [PMID: 32905966 DOI: 10.1016/j.socscimed.2020.113325] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 07/19/2020] [Accepted: 08/22/2020] [Indexed: 11/29/2022]
Abstract
Supplemental private health insurance has gained popularity despite having a mandatory social health insurance program in Korea. Private insurance supplements the social insurance program by covering co-pays and services not covered by social insurance. Using longitudinal microdata from the 2008-2014 Korea Health Panel, this study finds evidence of favorable selection into supplemental private insurance. Results show that supplemental private insurance increases outpatient and hospitalization utilization. Private health insurance generates welfare benefits especially among the elderly and low-income individuals, though the coverage rate for these groups is low.
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Affiliation(s)
- Hansoo Ko
- New York University Wagner Graduate School of Public Service, 295 Lafayette street room3034, New York, NY, 10012, USA; University of Illinois at Chicago School of Public Health, USA.
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Atake EH. Socio-economic inequality in maternal health care utilization in Sub-Saharan Africa: Evidence from Togo. Int J Health Plann Manage 2020; 36:288-301. [PMID: 33000498 DOI: 10.1002/hpm.3083] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 09/02/2020] [Accepted: 09/18/2020] [Indexed: 11/07/2022] Open
Abstract
INTRODUCTION Despite improvements in health care in Togo, the maternal mortality rate remains high, and regional antenatal care and facility-based deliveries are limited. The aim of this study is to measure socioe-conomic inequality in maternal health care (MHC) utilization during pregnancy and delivery. METHOD The data were obtained from the last two rounds of the 1998 and 2013 Togo Demographic and Health Survey. Concentration index, concentration curve and logistic regression were used to measure and examine socio-economic inequality in antenatal care and facility-based deliveries. RESULTS The concentration indices for antenatal visits and facility-based deliveries were 0.142 and 0.246 in 1998 and 0.129 and 0.159 in 2013, indicating inequality bias towards the rich in both. Household wealth status and women's education were the most significant contributors to inequality in antenatal visits and facility-based deliveries. In 2013, household economic status contributed approximately 75.66% of the inequality in facility-based deliveries, while mothers' education significantly contributed approximately 18.22% to the inequality in antennal visits. Additionally, universal health coverage should be considered as one of the main vehicles for reducing inequalities in the use of MHCs. CONCLUSION The results suggest that inequality in MHC utilization during pregnancy and delivery may be effectively reduced by improving the relevant strategies, in particular, those targeted at reducing poverty and illiteracy. School curricula need to be comprehensively addressed for ensuring essential sexual and reproductive education. Our results suggest that the use of MHC can be increased by broadening health insurance to include exemptions for poor and rural households.
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Immurana M. How does FDI influence health outcomes in Africa? AFRICAN JOURNAL OF SCIENCE, TECHNOLOGY, INNOVATION AND DEVELOPMENT 2020. [DOI: 10.1080/20421338.2020.1772952] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Mustapha Immurana
- Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana
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