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Sample records for behavioral health economics

  1. Applying Behavioral Economics to Public Health Policy

    PubMed Central

    Matjasko, Jennifer L.; Cawley, John H.; Baker-Goering, Madeleine M.; Yokum, David V.

    2016-01-01

    Behavioral economics provides an empirically informed perspective on how individuals make decisions, including the important realization that even subtle features of the environment can have meaningful impacts on behavior. This commentary provides examples from the literature and recent government initiatives that incorporate concepts from behavioral economics in order to improve health, decision making, and government efficiency. The examples highlight the potential for behavioral economics to improve the effectiveness of public health policy at low cost. Although incorporating insights from behavioral economics into public health policy has the potential to improve population health, its integration into government public health programs and policies requires careful design and continual evaluation of such interventions. Limitations and drawbacks of the approach are discussed. PMID:27102853

  2. The behavioral economics of health and health care.

    PubMed

    Rice, Thomas

    2013-01-01

    People often make decisions in health care that are not in their best interest, ranging from failing to enroll in health insurance to which they are entitled, to engaging in extremely harmful behaviors. Traditional economic theory provides a limited tool kit for improving behavior because it assumes that people make decisions in a rational way, have the mental capacity to deal with huge amounts of information and choice, and have tastes endemic to them and not open to manipulation. Melding economics with psychology, behavioral economics acknowledges that people often do not act rationally in the economic sense. It therefore offers a potentially richer set of tools than provided by traditional economic theory to understand and influence behaviors. Only recently, however, has it been applied to health care. This article provides an overview of behavioral economics, reviews some of its contributions, and shows how it can be used in health care to improve people's decisions and health.

  3. Special issue: Behavioral Economics and Health Annual Symposium.

    PubMed

    2011-09-01

    The application of behavioral economics to health and health care has captured the imagination of policymakers across the political spectrum. The idea is that many people are irrational in predictable ways, and that this both contributes to unhealthy behaviors like smoking and holds one of the keys to changing those behaviors. Because health care costs continue to increase, and a substantial portion of costs are incurred because of unhealthy behaviors, employers and insurers have great interest in using financial incentives to change behaviors. However, it is in the details that complexity and controversies emerge. Who should the targets be, and what outcomes should be rewarded? How should incentives be structured, to maximize their effectiveness and minimize unintended consequences? In what situations should we be intervening to affect decisions by people who may prefer to be obese or to smoke, and in what situations should we accept their preferences? To begin to answer these questions, the Penn-CMU Roybal P30 Center on Behavioral Economics and Health held its first annual Behavioral Economics and Health Symposium on March 24-25, 2011 with support from the Robert Wood Johnson Foundation. The symposium drew more than 50 researchers, scholars, and health professionals from a variety of disciplines, including medicine, public health, economics, law, management, marketing, and psychology. They heard perspectives on behavioral economics from public and private funders, the CEO of the University of Pennsylvania Health System, and the CEO of stickK.com, a start-up company that uses online, voluntary commitment contracts to help people achieve their goals. Participants formed eight working groups to review the current state-of-the-art in a variety of clinical contexts and to consider how behavioral economics could inform a research agenda to improve health. This Issue Brief summarizes the findings of these working groups and the symposium.

  4. Economic Opportunity, Health Behaviors, and Mortality in the United States

    PubMed Central

    Venkataramani, Atheendar S.; Chatterjee, Paula; Kawachi, Ichiro; Tsai, Alexander C.

    2016-01-01

    Objectives We assessed whether economic opportunity was independently associated with health behaviors and outcomes in the United States. Methods Using newly available, cross-sectional, county-level data from the Equality of Opportunity Project Database and vital statistics, we estimated associations between all-cause mortality rates (averaged over 2000–2012) and economic opportunity, adjusting for socioeconomic, demographic, and health system covariates. Our measure of economic opportunity was the county-average rank in the national income distribution attained by individuals born to families in the bottom income quartile. Secondary outcomes included rates of age- and race-specific mortality, smoking, obesity, hypertension, and diabetes. Results An increase in economic opportunity from the lowest to the highest quintile was associated with a 16.7% decrease in mortality. The magnitudes of association were largest for working-age adults and African Americans. Greater economic opportunity was also associated with health behaviors and risk factors. Conclusions Economic opportunity is a robust, independent predictor of health. Future work should investigate underlying causal links and mechanisms. PMID:26691108

  5. Health psychology meets behavioral economics: introduction to special issue.

    PubMed

    Hanoch, Yaniv; Finkelstein, Eric Andrew

    2013-09-01

    Introduces the special issue of Health Psychology, entitled Health Psychology Meets Behavioral Economics. Psychologists have long been interested in understanding the processes that underlie health behaviors and, based on health behavior models that they have developed, have devised a spectrum of effective prevention and treatment programs. More recently, behavioral economists have also provided evidence of effective behavior change strategies through nonprice mechanisms in a variety of contexts, including smoking cessation, weight loss, and illicit drug use. Yet, although all are addressing similar issues, surprisingly little cross-fertilization has taken place between traditional economists, behavioral economists, and psychologists. This special issue is rooted in the assumption that collaboration between economists and psychologists can promote the development of new methodologies and encourage exploration of novel solutions to enduring health problems. The hope is that readers will be intrigued and inspired by the methodologies used in the different articles and will explore whether they might be applicable to the problems they are addressing. Collaborative efforts, although challenging and at times risky, are a promising way to produce more innovative studies, results, and interventions.

  6. Some current dimensions of the behavioral economics of health-related behavior change.

    PubMed

    Bickel, Warren K; Moody, Lara; Higgins, Stephen T

    2016-11-01

    Health-related behaviors such as tobacco, alcohol and other substance use, poor diet and physical inactivity, and risky sexual practices are important targets for research and intervention. Health-related behaviors are especially pertinent targets in the United States, which lags behind most other developed nations on common markers of population health. In this essay we examine the application of behavioral economics, a scientific discipline that represents the intersection of economics and psychology, to the study and promotion of health-related behavior change. More specifically, we review what we consider to be some core dimensions of this discipline when applied to the study health-related behavior change. Behavioral economics (1) provides novel conceptual systems to inform scientific understanding of health behaviors, (2) translates scientific understanding into practical and effective behavior-change interventions, (3) leverages varied aspects of behavior change beyond increases or decreases in frequency, (4) recognizes and exploits trans-disease processes and interventions, and (5) leverages technology in efforts to maximize efficacy, cost effectiveness, and reach. These dimensions are overviewed and their implications for the future of the field discussed.

  7. Behavioral economics.

    PubMed

    Camerer, Colin F

    2014-09-22

    Behavioral economics uses evidence from psychology and other social sciences to create a precise and fruitful alternative to traditional economic theories, which are based on optimization. Behavioral economics may interest some biologists, as it shifts the basis for theories of economic choice away from logical calculation and maximization and toward biologically plausible mechanisms.

  8. Behavioral Economics

    PubMed Central

    Reed, Derek D.; Niileksela, Christopher R.; Kaplan, Brent A.

    2013-01-01

    In recent years, behavioral economics has gained much attention in psychology and public policy. Despite increased interest and continued basic experimental studies, the application of behavioral economics to therapeutic settings remains relatively sparse. Using examples from both basic and applied studies, we provide an overview of the principles comprising behavioral economic perspectives and discuss implications for behavior analysts in practice. A call for further translational research is provided. PMID:25729506

  9. Approaches based on behavioral economics could help nudge patients and providers toward lower health spending growth.

    PubMed

    King, Dominic; Greaves, Felix; Vlaev, Ivo; Darzi, Ara

    2013-04-01

    Policies that change the environment or context in which decisions are made and "nudge" people toward particular choices have been relatively ignored in health care. This article examines the role that approaches based on behavioral economics could play in "nudging" providers and patients in ways that could slow health care spending growth. The basic insight of behavioral economics is that behavior is guided by the very fallible human brain and greatly influenced by the environment or context in which choices are made. In policy arenas such as pensions and personal savings, approaches based on behavioral economics have provided notable results. In health care, such approaches have been used successfully but in limited ways, as in the use of surgical checklists that have increased patient safety and reduced costs. With health care spending climbing at unsustainable rates, we review the role that approaches based on behavioral economics could play in offering policy makers a potential set of new tools to slow spending growth.

  10. Make the Healthy Choice the Easy Choice: Using Behavioral Economics to Advance a Culture of Health.

    PubMed

    Volpp, Kevin G; Asch, David A

    2016-11-01

    Despite great advances in the science and technology of health care, a large gap separates theoretically achievable advances in health from what individuals and populations actually achieve. Human behavior sits on the final common pathway to so many of our health and health care goals, including the prevention and management of illness and the fostering of wellness. Behavioral economics is a relatively new field offering approaches to supplement many of the conventional approaches to improving health behaviors that rely on education or standard economic theory. While those conventional approaches presume that an educated public will naturally make decisions that optimize personal welfare, approaches derived from behavioral economics harness existing and predictable patterns of behavior that often lead people to make choices against their best interests. By keeping these predictable patterns of behavior in mind when designing health insurance, health care programs, or the health-related aspects of everyday life, behavioral economists aim to meet people half-way: no longer asking them to reshape their behavior to something more health promoting, but helping the behavioral patterns they already follow lead them to better health.

  11. Economic pressure and health and weight management behaviors in African American couples: A family stress perspective.

    PubMed

    O'Neal, Catherine W; Arnold, Amy Laura; Lucier-Greer, Mallory; Wickrama, K A S; Bryant, Chalandra M

    2015-05-01

    This study extends the family stress model by examining the influence of economic pressure on health and weight management behaviors mediated by depressive symptoms and spousal support among 506 African American married couples. The actor-partner interdependence model accounted for the interdependent nature of relationships. Findings support the family stress model; yet pathways differed slightly for husbands and wives. Economic pressure directly influenced depressive symptoms and spousal support. Spousal support was a buffer against poor health and weight management behaviors for husbands, while depressive symptoms exacerbated poor health and weight management behaviors for wives. These mechanisms have implications for practitioners who promote African American couples' well-being.

  12. Health Insurance Coverage and Take-Up: Lessons from Behavioral Economics

    PubMed Central

    Baicker, Katherine; Congdon, William J; Mullainathan, Sendhil

    2012-01-01

    Context Millions of uninsured Americans ostensibly have insurance available to them—many at very low cost—but do not take it up. Traditional economic analysis is based on the premise that these are rational decisions, but it is hard to reconcile observed enrollment patterns with this view. The policy prescriptions that the traditional model generates may thus fail to achieve their goals. Behavioral economics, which integrates insights from psychology into economic analysis, identifies important deviations from the traditional assumptions of rationality and can thus improve our understanding of what drives health insurance take-up and improved policy design. Methods Rather than a systematic review of the coverage literature, this article is a primer for considering issues in health insurance coverage from a behavioral economics perspective, supplementing the standard model. We present relevant evidence on decision making and insurance take-up and use it to develop a behavioral approach to both the policy problem posed by the lack of health insurance coverage and possible policy solutions to that problem. Findings We found that evidence from behavioral economics can shed light on both the sources of low take-up and the efficacy of different policy levers intended to expand coverage. We then applied these insights to policy design questions for public and private insurance coverage and to the implementation of the recently enacted health reform, focusing on the use of behavioral insights to maximize the value of spending on coverage. Conclusions We concluded that the success of health insurance coverage reform depends crucially on understanding the behavioral barriers to take-up. The take-up process is likely governed by psychology as much as economics, and public resources can likely be used much more effectively with behaviorally informed policy design. PMID:22428694

  13. Was the economic crisis of 2008 good for Icelanders? Impact on health behaviors.

    PubMed

    Ásgeirsdóttir, Tinna Laufey; Corman, Hope; Noonan, Kelly; Ólafsdóttir, Þórhildur; Reichman, Nancy E

    2014-03-01

    This study uses the 2008 economic crisis in Iceland to identify the effects of a macroeconomic downturn on a range of health behaviors. We use longitudinal survey data that include pre- and post-reports from the same individuals on a range of health-compromising and health-promoting behaviors. We find that the crisis led to large and significant reductions in health-compromising behaviors (such as smoking, drinking alcohol or soft drinks, and eating sweets) and certain health-promoting behaviors (consumption of fruits and vegetables), but to increases in other health-promoting behaviors (consumption of fish oil and recommended sleep). The magnitudes of effects for smoking are somewhat larger than what has been found in past research in other contexts, while those for alcohol, fruits, and vegetables are in line with estimates from other studies. Changes in work hours, real income, financial assets, mortgage debt, and mental health, together, explain the effects of the crisis on some behaviors (such as consumption of sweets and fast food), while the effects of the crisis on most other behaviors appear to have operated largely through price increases.

  14. Physical activity counseling in primary care: Insights from public health and behavioral economics.

    PubMed

    Shuval, Kerem; Leonard, Tammy; Drope, Jeffrey; Katz, David L; Patel, Alpa V; Maitin-Shepard, Melissa; Amir, On; Grinstein, Amir

    2017-02-15

    Physical inactivity has reached epidemic proportions in modern society. Abundant evidence points to a causal link between physical inactivity and increased risk for numerous noncommunicable diseases, such as some types of cancer and heart disease, as well as premature mortality. Yet, despite this overwhelming evidence, many individuals do not meet the recommended amount of physical activity required to achieve maximum health benefits. Because primary care physicians' advice is highly regarded, clinicians have the unique opportunity to play an important role in enabling patients to modify their behavior at the point of care with the goal of guiding patients to adopt and maintain an active lifestyle. In the current study, the authors evaluate pertinent literature from the fields of medicine/public health and economics/psychology to suggest a comprehensive approach to physical activity counseling at the primary care level. They first examine the public health approach to physical activity counseling, and then proceed to offer insights from behavioral economics, an emerging field that combines principles from psychology and economics. The application of key behavioral economics tools (eg, precommitment contracts, framing) to physical activity counseling in primary care is elaborated. CA Cancer J Clin 2017. © 2017 American Cancer Society.

  15. Transplantation at the nexus of behavioral economics and health care delivery.

    PubMed

    Schnier, K E; Cox, J C; McIntyre, C; Ruhil, R; Sadiraj, V; Turgeon, N

    2013-01-01

    The transplant surgeon's decision to accept and utilize an organ typically is made within a constrained time window, explicitly cognizant of numerous health-related risks and under the potential influence of considerable regulatory and institutional pressures. This decision affects the health of two distinct populations, those patients receiving organ transplants and those waiting to receive a transplant; it also influences the physician's life and their institute's productivity. The numerous, at times nonaligned, incentives established by the complex clinical and regulatory environment, have been derived specifically to influence physicians' behaviors, and though well intended, may lead to responses that are nonoptimal when considering the myriad stakeholders being influenced. This may compromise the quality of care provided to the population at risk, and has potential to influence the physician-patient relationship. A synergistic collaboration between transplant physicians and economists that is focused on this decision environment may help to alleviate these strains. This viewpoint discusses behavioral economic principles and how they might be applied to transplantation. Specifically, the previous medical decision-making literature on transplantation will be reviewed and a discussion on how a behavioral model of physician decision making can be utilized will be explored. To date this approach has not been integrated into transplantation decision making.

  16. Behavioral economics: reunifying psychology and economics.

    PubMed

    Camerer, C

    1999-09-14

    "Behavioral economics" improves the realism of the psychological assumptions underlying economic theory, promising to reunify psychology and economics in the process. Reunification should lead to better predictions about economic behavior and better policy prescriptions.

  17. Complexity and behavioral economics.

    PubMed

    Rosser, J Barkley; Rosser, Marina V

    2015-04-01

    This paper will consider the relationship between complexity economics and behavioral economics. A crucial key to this is to understand that Herbert Simon was both the founder of explicitly modern behavioral economics as well as one of the early developers of complexity theory. Bounded rationality was essentially derived from Simon's view of the impossibility of full rationality on the part of economic agents. Modern complexity theory through such approaches as agent-based modeling offers an approach to understanding behavioral economics by allowing for specific behavioral responses to be assigned to agents who interact within this context, even without full rationality. Other parts of modern complexity theory are considered in terms of their relationships with behavioral economics. Fundamentally, complexity provides an ultimate foundation for bounded rationality and hence the need to use behavioral economics in a broader array of contexts than most economists have thought appropriate.

  18. Low Self-Esteem during Adolescence Predicts Poor Health, Criminal Behavior, and Limited Economic Prospects during Adulthood

    ERIC Educational Resources Information Center

    Trzesniewski, Kali H.; Donnellan, M. Brent; Moffitt, Terrie E.; Robins, Richard W.; Poulton, Richie; Caspi, Avshalom

    2006-01-01

    Using prospective data from the Dunedin Multidisciplinary Health and Development Study birth cohort, the authors found that adolescents with low self-esteem had poorer mental and physical health, worse economic prospects, and higher levels of criminal behavior during adulthood, compared with adolescents with high self-esteem. The long-term…

  19. Leveraging insights from behavioral economics to increase the value of health-care service provision.

    PubMed

    Patel, Mitesh S; Volpp, Kevin G

    2012-11-01

    United States health expenditures continue to escalate at unsustainable rates. A recent movement around increasing price transparency has been suggested as a way of reducing the rate of increase in expenditures, with legislative efforts taking place at both the state and federal level. While this seems on the surface like a good idea, simply providing information on prices to physicians, particularly trainees, may not achieve the type of large changes in practice patterns that proponents expect. The manner in which price transparency is implemented will likely play a significant role in its effectiveness as an intervention. In this article, the authors review efforts of transparency and default options from other contexts and leverage insights from behavioral economics to provide recommendations for increasing the likelihood that price transparency will lead to physicians weighing the relative value of interventions.

  20. Internet-Based Cognitive Behavioral Therapy for Insomnia: A Health Economic Evaluation

    PubMed Central

    Thiart, Hanne; Ebert, David Daniel; Lehr, Dirk; Nobis, Stephanie; Buntrock, Claudia; Berking, Matthias; Smit, Filip; Riper, Heleen

    2016-01-01

    Study Objectives: Lost productivity caused by insomnia is a common and costly problem for employers. Although evidence for the efficacy of Internet-based cognitive behavioral therapy for insomnia (iCBT-I) already exists, little is known about its economic effects. This study aims to evaluate the cost-effectiveness and cost-benefit of providing iCBT-I to symptomatic employees from the employer's perspective. Methods: School teachers (N = 128) with clinically significant insomnia symptoms and work-related rumination were randomized to guided iCBT-I or a waitlist-control-group, both with access to treatment as usual. Economic data were collected at baseline and 6-mo follow-up. We conducted (1) a cost-effectiveness analysis with treatment response (Reliable Change [decline of 5.01 points] and Insomnia Severity Index < 8 at 6-month follow-up) as the outcome and (2) a cost-benefit analysis. Because both analyses were performed from the employer's perspective, we focused specifically on absenteeism and presenteeism costs. Statistical uncertainty was estimated using bootstrapping. Results: Assuming intervention costs of €200 ($245), cost-effectiveness analyses showed that at a willingness-to-pay of €0 for each positive treatment response, there is an 87% probability that the intervention is more cost effective than treatment as usual alone. Cost-benefit analyses led to a net benefit of €418 (95% confidence interval: −593.03 to 1,488.70) ($512) per participant and a return on investment of 208% (95% confidence interval: −296.52 to 744.35). The reduction in costs was mainly driven by the effects of the intervention on presenteeism and to a lesser degree by reduced absenteeism. Conclusions: Focusing on sleep improvement using iCBT-I may be a cost-effective strategy in occupational health care. Clinical Trials Registration: Title: Online Recovery Training for Better Sleep in Teachers with High Psychological Strain. German Clinical Trial Register (DRKS), URL: https

  1. Behavioral economics: Reunifying psychology and economics

    PubMed Central

    Camerer, Colin

    1999-01-01

    Behavioral economics” improves the realism of the psychological assumptions underlying economic theory, promising to reunify psychology and economics in the process. Reunification should lead to better predictions about economic behavior and better policy prescriptions. PMID:10485865

  2. The Economics of Health.

    ERIC Educational Resources Information Center

    Cairns, John

    1978-01-01

    Discusses the relationship of economics to health, health services, and supply and demand of health care. Examines alternative mechanisms by which health resources can be allocated and considers who should make decisions about rationing medical care. (DB)

  3. Behavioral economics: merging psychology and economics for lifestyle interventions.

    PubMed

    Thorgeirsson, Tryggvi; Kawachi, Ichiro

    2013-02-01

    The field of behavioral economics combines psychology and economics to investigate how individuals actually behave as opposed to how they would behave if they were being perfectly rational (as in the sense of maximizing their utility). Although initial applications focused on consumer behavior, such as explaining why people failed to save adequately for retirement, the field has moved increasingly into the area of explaining health behaviors as well as the design of lifestyle interventions, such as weight loss and smoking-cessation programs. This article provides an overview of several important behavioral economics concepts of relevance to public health and health behavior change.

  4. Locating Economic Risks for Adolescent Mental and Behavioral Health: Poverty and Affluence in Families, Neighborhoods, and Schools.

    PubMed

    Coley, Rebekah Levine; Sims, Jacqueline; Dearing, Eric; Spielvogel, Bryn

    2017-02-28

    Research has identified risks of both poverty and affluence for adolescents. This study sought to clarify associations between income and youth mental and behavioral health by delineating economic risks derived from family, neighborhood, and school contexts within a nationally representative sample of high school students (N = 13,179, average age 16). Attending schools with more affluent schoolmates was associated with heightened likelihoods of intoxication, drug use, and property crime, but youth at poorer schools reported greater depressive and anxiety symptoms, engagement in violence, and for male adolescents, more frequent violence and intoxication. Neighborhood and family income were far less predictive. Results suggest that adolescent health risks derive from both ends of the economic spectrum, and may be largely driven by school contexts.

  5. Behavioral economics and regulatory analysis.

    PubMed

    Robinson, Lisa A; Hammitt, James K

    2011-09-01

    Behavioral economics has captured the interest of scholars and the general public by demonstrating ways in which individuals make decisions that appear irrational. While increasing attention is being focused on the implications of this research for the design of risk-reducing policies, less attention has been paid to how it affects the economic valuation of policy consequences. This article considers the latter issue, reviewing the behavioral economics literature and discussing its implications for the conduct of benefit-cost analysis, particularly in the context of environmental, health, and safety regulations. We explore three concerns: using estimates of willingness to pay or willingness to accept compensation for valuation, considering the psychological aspects of risk when valuing mortality-risk reductions, and discounting future consequences. In each case, we take the perspective that analysts should avoid making judgments about whether values are "rational" or "irrational." Instead, they should make every effort to rely on well-designed studies, using ranges, sensitivity analysis, or probabilistic modeling to reflect uncertainty. More generally, behavioral research has led some to argue for a more paternalistic approach to policy analysis. We argue instead for continued focus on describing the preferences of those affected, while working to ensure that these preferences are based on knowledge and careful reflection.

  6. Financial incentives for healthy behavior: ethical safeguards for behavioral economics.

    PubMed

    Lunze, Karsten; Paasche-Orlow, Michael K

    2013-06-01

    Economic incentives to promote healthy behavior are becoming increasingly common and have been suggested as an approach to decreasing healthcare costs. Ethical concerns about programs with such incentives are that they may contribute to inequities, be coercive, interfere with therapeutic relationships, undermine personal responsibility for health, and decrease social solidarity. Additionally, they may be a source of stigma or discrimination, promote dependence, and be unfair for those already engaged in targeted health behaviors or those who cannot fulfill the incentivized behaviors. Incentive programs need to incorporate appropriate safeguards to monitor these risks and support fairness in offering economic incentives to promote healthy behavior.

  7. The behavioral economics of violence.

    PubMed

    Rachlin, Howard

    2004-12-01

    From the viewpoint of teleological behaviorism the first question to ask in attempting to understand any behavior, including violent behavior, is: What are its contingencies of reward and punishment? Or, to put the question in economic terms: What are the short-term and long-term costs and benefits that such behavior entails? Let us therefore consider the costs and benefits of youth violence. Among the short-term costs of violent behavior are the physical effort of the act, the possibility of immediate physical retaliation, immediate social disapproval, and the opportunity cost of other social acts that the violent behavior takes the place of (you can't be affectionate and violent at the same time, for instance). Among the immediate benefits of violent behavior are the intrinsic satisfaction of the violent act itself and any extrinsic benefit; if A violently appropriates B's new sneakers then obtaining the sneakers reinforces A's violence. These immediate benefits may well outweigh the costs in many contexts. Among the long-term costs of violent behavior are delayed retaliation, possible social disapproval and loss of social support, rejection from a social group, job loss, and health risks associated with a violent lifestyle. Among the long-term benefits are long-term intimidation of others (your neighbor is less likely to build a fence on your property if you have a reputation for violence), and a possibly exciting lifestyle. These long-term benefits may well be outweighed by the long-term costs. Opposition of long-term net costs to short-term net benefits, where it exists, creates a personal self-control trap: Overall satisfaction may decrease monotonically with rate of the target behavior but, regardless of its rate, the immediate satisfaction of doing it is always higher than that of not doing it. In the case of violent behavior, this trap is exacerbated by the fact that as a person's violence increases, net immediate reinforcement also increases (due to

  8. Behavioral Health & Performance

    NASA Video Gallery

    Summary of the Behavioral Health and Performance Operations Group’s work including an overview of astronaut selection, behavioral health services provided to astronauts, the psychological aspects o...

  9. [Fostering of health economics in Germany].

    PubMed

    Ulrich, V

    2012-05-01

    Health economics is now well established in Germany with the aim to apply economic tools to answer problems in health and health care. After a short review of the international development of health economics and the development in Germany in particular, the article looks at selected recent topics of health economic analysis in Germany (economic evaluation, industrial economics, health and education).

  10. The Economics of University Behavior.

    ERIC Educational Resources Information Center

    Garvin, David A.

    The behavior of universities is considered from an economic perspective. It is assumed that both the administration and the faculty pursue goals consistent with their own self-interests. In addition to reviewing studies from other disciplines, the market in which institutions compete is described, and a formal model of the university as a…

  11. Maximization, learning, and economic behavior

    PubMed Central

    Erev, Ido; Roth, Alvin E.

    2014-01-01

    The rationality assumption that underlies mainstream economic theory has proved to be a useful approximation, despite the fact that systematic violations to its predictions can be found. That is, the assumption of rational behavior is useful in understanding the ways in which many successful economic institutions function, although it is also true that actual human behavior falls systematically short of perfect rationality. We consider a possible explanation of this apparent inconsistency, suggesting that mechanisms that rest on the rationality assumption are likely to be successful when they create an environment in which the behavior they try to facilitate leads to the best payoff for all agents on average, and most of the time. Review of basic learning research suggests that, under these conditions, people quickly learn to maximize expected return. This review also shows that there are many situations in which experience does not increase maximization. In many cases, experience leads people to underweight rare events. In addition, the current paper suggests that it is convenient to distinguish between two behavioral approaches to improve economic analyses. The first, and more conventional approach among behavioral economists and psychologists interested in judgment and decision making, highlights violations of the rational model and proposes descriptive models that capture these violations. The second approach studies human learning to clarify the conditions under which people quickly learn to maximize expected return. The current review highlights one set of conditions of this type and shows how the understanding of these conditions can facilitate market design. PMID:25024182

  12. Maximization, learning, and economic behavior.

    PubMed

    Erev, Ido; Roth, Alvin E

    2014-07-22

    The rationality assumption that underlies mainstream economic theory has proved to be a useful approximation, despite the fact that systematic violations to its predictions can be found. That is, the assumption of rational behavior is useful in understanding the ways in which many successful economic institutions function, although it is also true that actual human behavior falls systematically short of perfect rationality. We consider a possible explanation of this apparent inconsistency, suggesting that mechanisms that rest on the rationality assumption are likely to be successful when they create an environment in which the behavior they try to facilitate leads to the best payoff for all agents on average, and most of the time. Review of basic learning research suggests that, under these conditions, people quickly learn to maximize expected return. This review also shows that there are many situations in which experience does not increase maximization. In many cases, experience leads people to underweight rare events. In addition, the current paper suggests that it is convenient to distinguish between two behavioral approaches to improve economic analyses. The first, and more conventional approach among behavioral economists and psychologists interested in judgment and decision making, highlights violations of the rational model and proposes descriptive models that capture these violations. The second approach studies human learning to clarify the conditions under which people quickly learn to maximize expected return. The current review highlights one set of conditions of this type and shows how the understanding of these conditions can facilitate market design.

  13. Understanding consumer decisions using behavioral economics.

    PubMed

    Zandstra, Elizabeth H; Miyapuram, Krishna P; Tobler, Philippe N

    2013-01-01

    Consumers make many decisions in everyday life involving finances, food, and health. It is known from behavioral economics research that people are often driven by short-term gratification, that is, people tend to choose the immediate, albeit smaller reward. But choosing the delayed reward, that is, delaying the gratification, can actually be beneficial. How can we motivate consumers to resist the "now" and invest in their future, leading to sustainable or healthy habits? We review recent developments from behavioral and neuroimaging studies that are relevant for understanding consumer decisions. Further, we present results from our field research that examined whether we can increase the perceived value of a (delayed) environmental benefit using tailored communication, that is, change the way it is framed. More specifically, we investigated whether we can boost the value of an abstract, long-term "green" claim of a product by expressing it as a concrete, short-term benefit. This is a new application area for behavioral economics.

  14. Economic Stress and Mental Health

    PubMed Central

    Butts, Hugh F.

    1979-01-01

    This paper correlates economic stress with minority status, resource allocations for mental health programs, and vulnerability to mental disability. Several hypotheses are advanced: 1. A major and recurring psychological pattern of the American national character is prowhite, antiblack paranoia. 2. Mental health fiscal allocations and programmatic determinations in ghetto, lower socioeconomic, minority-populated urban areas are predicated on political and racist considerations, the underlying motivation being to keep minorities at greater risk of mental disability. 3. Economic privation and stress increase vulnerability to mental illness, especially in a minority population for whom health, mental health, educational, and social services are grossly inadequate. 4. Poverty and economic stress combine with health systems that are unresponsive to the needs of blacks and other minorities, resulting in the perpetuation of disabilities and other conditions in blacks that are potentially preventable. 5. Health and mental health resources should be increased rather than diminished during periods of economic stress, especially in the public sector. 6. In order to provide each citizen with access to quality health and mental health care regardless of race and/or economic status, there must be enacted a national health insurance program based on tax-levy monies that will cover all aspects of health and mental health care. 7. Racism and social status will continue to be powerful determinants of the quality of service that white professionals render to black patients and to poor white patients, unless our training institutions mount a massive campaign to train appropriately and to include significant numbers of minority candidates and trainees in the effort. To date this effort is virtually nonexistent. PMID:439171

  15. Dopamine, behavioral economics, and effort.

    PubMed

    Salamone, John D; Correa, Merce; Farrar, Andrew M; Nunes, Eric J; Pardo, Marta

    2009-01-01

    There are numerous problems with the hypothesis that brain dopamine (DA) systems, particularly in the nucleus accumbens, directly mediate the rewarding or primary motivational characteristics of natural stimuli such as food. Research and theory related to the functions of mesolimbic DA are undergoing a substantial conceptual restructuring, with the traditional emphasis on hedonia and primary reward yielding to other concepts and lines of inquiry. The present review is focused upon the involvement of nucleus accumbens DA in behavioral activation and effort-related processes. Viewed from the framework of behavioral economics, the effects of accumbens DA depletions and antagonism on food-reinforced behavior are highly dependent upon the work requirements of the instrumental task, and DA depleted rats are more sensitive to increases in response costs (i.e., ratio requirements). Moreover, interference with accumbens DA transmission exerts a powerful influence over effort-related choice behavior. Rats with accumbens DA depletions or antagonism reallocate their instrumental behavior away from food-reinforced tasks that have high response requirements, and instead these rats select a less-effortful type of food-seeking behavior. Nucleus accumbens DA and adenosine interact in the regulation of effort-related functions, and other brain structures (anterior cingulate cortex, amygdala, ventral pallidum) also are involved. Studies of the brain systems regulating effort-based processes may have implications for understanding drug abuse, as well as energy-related disorders such as psychomotor slowing, fatigue or anergia in depression and other neurological disorders.

  16. Dopamine, Behavioral Economics, and Effort

    PubMed Central

    Salamone, John D.; Correa, Merce; Farrar, Andrew M.; Nunes, Eric J.; Pardo, Marta

    2009-01-01

    There are numerous problems with the hypothesis that brain dopamine (DA) systems, particularly in the nucleus accumbens, directly mediate the rewarding or primary motivational characteristics of natural stimuli such as food. Research and theory related to the functions of mesolimbic DA are undergoing a substantial conceptual restructuring, with the traditional emphasis on hedonia and primary reward yielding to other concepts and lines of inquiry. The present review is focused upon the involvement of nucleus accumbens DA in behavioral activation and effort-related processes. Viewed from the framework of behavioral economics, the effects of accumbens DA depletions and antagonism on food-reinforced behavior are highly dependent upon the work requirements of the instrumental task, and DA depleted rats are more sensitive to increases in response costs (i.e., ratio requirements). Moreover, interference with accumbens DA transmission exerts a powerful influence over effort-related choice behavior. Rats with accumbens DA depletions or antagonism reallocate their instrumental behavior away from food-reinforced tasks that have high response requirements, and instead these rats select a less-effortful type of food-seeking behavior. Nucleus accumbens DA and adenosine interact in the regulation of effort-related functions, and other brain structures (anterior cingulate cortex, amygdala, ventral pallidum) also are involved. Studies of the brain systems regulating effort-based processes may have implications for understanding drug abuse, as well as energy-related disorders such as psychomotor slowing, fatigue or anergia in depression and other neurological disorders. PMID:19826615

  17. THE HEALTH EFFECTS OF ECONOMIC DECLINE

    PubMed Central

    Catalano, Ralph; Goldman-Mellor, Sidra; Saxton, Katherine; Margerison-Zilko, Claire; Subbaraman, Meenakshi; LeWinn, Kaja; Anderson, Elizabeth

    2013-01-01

    The recent recession and lingering high unemployment will likely lead to a burst of research studying the health effects of economic decline. We aim to inform that work by summarizing empirical research concerned with those effects. We separate the studies into groups defined by questions asked, mechanisms invoked, and outcomes studied. We conclude that although much research shows that undesirable job and financial experiences increase the risk of psychological and behavioral disorder, many other suspected associations remain poorly studied or unsupported. The intuition that mortality increases when the economy declines, for example, appears wrong. We note that the research informs public health programming by identifying risk factors, such as job loss, made more frequent by economic decline. The promise that the research would identify health costs and benefits of economic policy choices, however, remains unfulfilled and will likely remain so without stronger theory and greater methodological agreement. PMID:21054175

  18. Health economic evaluation in England.

    PubMed

    Raftery, James

    2014-01-01

    The 2010 National Health Service Constitution for England specified rights and responsibilities, including health economic evaluation for the National Institute for Health and Care Excellence (NICE) and the Joint Committee on Vaccinations and Immunisations. The National Screening Committee and the Health Protection Agency also provide advice to the Government based on health economic evaluation. Each agency largely follows the methods specified by NICE. To distinguish the methods from neoclassical economics they have been termed "extra-welfarist". Key differences include measurement and valuation of both benefits (QALYs) and costs (healthcare related). Policy on discounting has also changed over time and by agency. The debate over having NICE's methods align more closely with neoclassical economics has been prominent in the ongoing development of "value based pricing". The political unacceptability of some decisions has led to special funding for technologies not recommended by NICE. These include the 2002 Multiple Sclerosis Risk Sharing Scheme and the 2010 Cancer Drugs Fund as well as special arrangements for technologies linked to the end of life and for innovation. Since 2009 Patient Access Schemes have made price reductions possible which sometimes enables drugs to meet NICE's cost-effectiveness thresholds. As a result, the National Health Service in England has denied few technologies on grounds of cost-effectiveness.

  19. Human Health, Environmental and Economic Assessments

    EPA Pesticide Factsheets

    Human health and environmental assessments characterize health and environmental risks associated with exposure to pollution. Economic assessments evaluate the cost and economic impact of a policy or regulation & can estimate economic benefits.

  20. Q methodology in health economics.

    PubMed

    Baker, Rachel; Thompson, Carl; Mannion, Russell

    2006-01-01

    The recognition that health economists need to understand the meaning of data if they are to adequately understand research findings which challenge conventional economic theory has led to the growth of qualitative modes of enquiry in health economics. The use of qualitative methods of exploration and description alongside quantitative techniques gives rise to a number of epistemological, ontological and methodological challenges: difficulties in accounting for subjectivity in choices, the need for rigour and transparency in method, and problems of disciplinary acceptability to health economists. Q methodology is introduced as a means of overcoming some of these challenges. We argue that Q offers a means of exploring subjectivity, beliefs and values while retaining the transparency, rigour and mathematical underpinnings of quantitative techniques. The various stages of Q methodological enquiry are outlined alongside potential areas of application in health economics, before discussing the strengths and limitations of the approach. We conclude that Q methodology is a useful addition to economists' methodological armoury and one that merits further consideration and evaluation in the study of health services.

  1. Health economics--concepts and conceptual problems.

    PubMed

    Satpathy, S K; Bansal, R D

    1982-01-01

    Awareness of the economic manifestation of health and diseases and the limited resources allocated to health care services has brought to the focus a new discipline - health economics. Cost accounting, cost benefit, cost effectiveness methods etc. are increasingly becoming an integral part of the health management and evaluation of health programmes. Various concepts and problems relating to health economics are discussed in the present paper. More efforts should be made to conduct health economic studies in hospitals and health centres by which the process of standardisation of the concepts, would be easier. Health economics should also find its due place in the medical curriculum.

  2. Behavioral Health Program Element

    NASA Technical Reports Server (NTRS)

    Leveton, Lauren B.

    2006-01-01

    The project goal is to develop behavioral health prevention and maintenance system for continued crew health, safety, and performance for exploration missions. The basic scope includes a) Operationally-relevant research related to clinical cognitive and behavioral health of crewmembers; b) Ground-based studies using analog environments (Antarctic, NEEMO, simulations, and other testbeds; c) ISS studies (ISSMP) focusing on operational issues related to behavioral health outcomes and standards; d) Technology development activities for monitoring and diagnostic tools; and e) Cross-disciplinary research (e.g., human factors and habitability research, skeletal muscle, radiation).

  3. The economics of health insurance.

    PubMed

    Jha, Saurabh; Baker, Tom

    2012-12-01

    Insurance plays an important role in the United States, most importantly in but not limited to medical care. The authors introduce basic economic concepts that make medical care and health insurance different from other goods and services traded in the market. They emphasize that competitive pricing in the marketplace for insurance leads, quite rationally, to risk classification, market segmentation, and market failure. The article serves as a springboard for understanding the basis of the reforms that regulate the health insurance market in the Patient Protection and Affordable Care Act.

  4. Comparative effectiveness research as choice architecture: the behavioral law and economics solution to the health care cost crisis.

    PubMed

    Korobkin, Russell

    2014-02-01

    With the Patient Protection and Affordable Care Act ("ACA") set to dramatically increase access to medical care, the problem of rising costs will move center stage in health law and policy discussions. "Consumer directed health care" proposals, which provide patients with financial incentives to equate marginal costs and benefits of care at the point of treatment, demand more decisionmaking ability from consumers than is plausible due to bounded rationality. Proposals that seek to change the incentives of health care providers threaten to create conflicts of interest between doctors and patients. New approaches are desperately needed. This Article proposes a government-facilitated but market-based approach to improving efficiency in the private market for medical care that I call "relative value health insurance." This approach focuses on the "choice architecture" necessary to enable even boundedly rational patients to contract for an efficient level of health care services through their health insurance purchase decisions. It uses comparative effectiveness research, which the ACA funds at a significant level for the first time, to rate medical treatments on a scale of one to ten based on their relative value, taking into account expected costs and benefits. These relative value ratings would enable consumers to contract with insurers for different levels of medical care at different prices, reflecting different cost-quality trade-offs. The Article describes both the benefits of relative value health insurance and the impediments to its implementation. It concludes with a brief discussion of how relative value ratings could also help to rationalize expenditures on public health insurance programs.

  5. Health Behaviors of Psychotherapists.

    ERIC Educational Resources Information Center

    Royak-Schaler, Renee; Feldman, Robert H. L.

    1984-01-01

    Examined the health behaviors practiced by psychotherapists (N=86) themselves and the extent to which they focus on these behaviors with their clients. Results indicated that psychotherapists actively evaluate and make recommendations to their clients in the areas of diet, physical exercise, and relaxation practice. (JAC)

  6. Health economics and health policy: experiences from New Zealand.

    PubMed

    Cumming, Jacqueline

    2015-06-01

    Health economics has had a significant impact on the New Zealand health system over the past 30 years. In this paper, I set out a framework for thinking about health economics, give some historical background to New Zealand and the New Zealand health system, and discuss examples of how health economics has influenced thinking about the organisation of the health sector and priority setting. I conclude the paper with overall observations about the role of health economics in health policy in New Zealand, also identifying where health economics has not made the contribution it could and where further influence might be beneficial.

  7. [Advances and challenges in health economics].

    PubMed

    Pena, P H; Arredondo, A; Ortiz, C; Rosenthal, G

    1995-08-01

    Health economics is a specialized field of economic science that applies the economic perspective to the fields of health, the medical-industrial complex and health services. A brief review of the evolution of this speciality by subject, as well as the level achieved assessed in terms of generation, diffusion, reproduction and application of its specialized knowledge, is presented.

  8. The behavioral economics of young adult substance abuse.

    PubMed

    Murphy, James G; Dennhardt, Ashley A

    2016-11-01

    Alcohol and drug use peaks during young adulthood and can interfere with critical developmental tasks and set the stage for chronic substance misuse and associated social, educational, and health-related outcomes. There is a need for novel, theory-based approaches to guide substance abuse prevention efforts during this critical developmental period. This paper discusses the particular relevance of behavioral economic theory to young adult alcohol and drug misuse, and reviews of available literature on prevention and intervention strategies that are consistent with behavioral economic theory. Behavioral economic theory predicts that decisions to use drugs and alcohol are related to the relative availability and price of both alcohol and substance-free alternative activities, and the extent to which reinforcement from delayed substance-free outcomes is devalued relative to the immediate reinforcement associated with drugs. Behavioral economic measures of motivation for substance use are based on relative levels of behavioral and economic resource allocation towards drug versus alternatives, and have been shown to predict change in substance use over time. Policy and individual level prevention approaches that are consistent with behavioral economic theory are discussed, including brief interventions that increase future orientation and engagement in rewarding alternatives to substance use. Prevention approaches that increase engagement in constructive future-oriented activities among young adults (e.g., educational/vocational success) have the potential to reduce future health disparities associated with both substance abuse and poor educational/vocational outcomes.

  9. Nutrition economics - characterising the economic and health impact of nutrition.

    PubMed

    Lenoir-Wijnkoop, I; Dapoigny, M; Dubois, D; van Ganse, E; Gutiérrez-Ibarluzea, I; Hutton, J; Jones, P; Mittendorf, T; Poley, M J; Salminen, S; Nuijten, M J C

    2011-01-01

    There is a new merging of health economics and nutrition disciplines to assess the impact of diet on health and disease prevention and to characterise the health and economic aspects of specific changes in nutritional behaviour and nutrition recommendations. A rationale exists for developing the field of nutrition economics which could offer a better understanding of both nutrition, in the context of having a significant influence on health outcomes, and economics, in order to estimate the absolute and relative monetary impact of health measures. For this purpose, an expert meeting assessed questions aimed at clarifying the scope and identifying the key issues that should be taken into consideration in developing nutrition economics as a discipline that could potentially address important questions. We propose a first multidisciplinary outline for understanding the principles and particular characteristics of this emerging field. We summarise here the concepts and the observations of workshop participants and propose a basic setting for nutrition economics and health outcomes research as a novel discipline to support nutrition, health economics and health policy development in an evidence and health-benefit-based manner.

  10. Empathy promotes altruistic behavior in economic interactions

    PubMed Central

    Klimecki, Olga M.; Mayer, Sarah V.; Jusyte, Aiste; Scheeff , Jonathan; Schönenberg, Michael

    2016-01-01

    What are the determinants of altruism? While economists assume that altruism is mainly driven by fairness norms, social psychologists consider empathy to be a key motivator for altruistic behavior. To unite these two theories, we conducted an experiment in which we compared behavior in a standard economic game that assesses altruism (the so-called Dictator Game) with a Dictator Game in which participants’ behavioral choices were preceded either by an empathy induction or by a control condition without empathy induction. The results of this within-subject manipulation show that the empathy induction substantially increased altruistic behavior. Moreover, the increase in experienced empathy predicted over 40% of the increase in sharing behavior. These data extend standard economic theories that altruism is based on fairness considerations, by showing that empathic feelings can be a key motivator for altruistic behavior in economic interactions. PMID:27578563

  11. Behavioral economics and empirical public policy.

    PubMed

    Hursh, Steven R; Roma, Peter G

    2013-01-01

    The application of economics principles to the analysis of behavior has yielded novel insights on value and choice across contexts ranging from laboratory animal research to clinical populations to national trends of global impact. Recent innovations in demand curve methods provide a credible means of quantitatively comparing qualitatively different reinforcers as well as quantifying the choice relations between concurrently available reinforcers. The potential of the behavioral economic approach to inform public policy is illustrated with examples from basic research, pre-clinical behavioral pharmacology, and clinical drug abuse research as well as emerging applications to public transportation and social behavior. Behavioral Economics can serve as a broadly applicable conceptual, methodological, and analytical framework for the development and evaluation of empirical public policy.

  12. Behavioral economics strategies for promoting adherence to sleep interventions.

    PubMed

    Stevens, Jack

    2015-10-01

    Cognitive-behavioral treatment for insomnia and continuous positive airway pressure therapy for obstructive sleep apnea are among the most efficacious sleep interventions. Unfortunately, adherence levels are disappointingly low for these interventions. Behavioral economics offers a promising framework for promoting adherence, often through relatively brief and straightforward strategies. The assumptions, goals, and key strategies of behavioral economics will be introduced. These strategies include providing social norms information, changing defaults, using the compromise effect, utilizing commitment devices, and establishing lottery-based systems. Then, this review will highlight specific behavioral economic approaches to promote patient adherence for three major sleep interventions: 1) behavioral treatment for pediatric insomnia, 2) cognitive-behavioral treatment for adult insomnia, and 3) continuous positive airway pressure for obstructive sleep apnea. Next, behavioral economic strategies will be discussed as ways to improve health care provider adherence to clinical practice guidelines regarding appropriate prescribing of hypnotics and ordering sleep-promoting practices for hospitalized inpatients. Finally, possible concerns that readers may have about behavioral economics strategies, including their efficacy, feasibility, and sustainability, will be addressed.

  13. Education, cognition, health knowledge, and health behavior.

    PubMed

    Mocan, Naci; Altindag, Duha T

    2014-04-01

    Using data from NLSY97, we analyze the impact of education on health behavior. Controlling for health knowledge does not influence the impact of education on health behavior, supporting the productive efficiency hypothesis. Accounting for cognitive ability does not significantly alter the relationship between education and health behavior. Similarly, the impact of education on health behavior is the same between those with and without a learning disability, suggesting that cognition is not likely to be a significant factor in explaining the impact of education on health behavior.

  14. Behavioral Economic Factors Related to Pediatric Obesity.

    PubMed

    Jacques-Tiura, Angela J; Greenwald, Mark K

    2016-06-01

    Behavioral economics (BE) suggests that food and activity choices are governed by costs, available alternatives, and reinforcement. This article reviews basic, translational, and intervention research using a BE framework with overweight or obese children up to age 18. We address BE concepts and methods, and discuss developmental issues, the continuum of BE intervention approaches, findings of studies focused on increasing the cost of unwanted behaviors (ie, energy-dense food intake and sedentary behavior) and decreasing the cost of desired behaviors (ie, healthy food intake and PA), and our team's recent basic behavioral studies using BE approaches with minority adolescents.

  15. Using behavioral economics to promote healthy behavior toward sun exposure in adolescents and young adults.

    PubMed

    García-Romero, Maria T; Geller, Alan C; Kawachi, Ichiro

    2015-12-01

    Skin cancer represents an important public health problem, and it is associated with ultraviolet radiation exposure, particularly at early ages. Unhealthy sun exposure and intentional tanning continue to be the trend among young people. Multiple interventions to raise awareness of the risks of sun exposure have been implemented, without necessarily translating into decreased unhealthy behaviors or skin cancer incidence rates. Behavioral economics adds a set of concepts and tools to potentially boost the efficacy of existing approaches to decrease unhealthy sun exposure. This paper reviews public health interventions that have been based in behavioral economics concepts and their results, and provides examples of new and creative ways physicians and health professionals can actively apply insights from behavioral economics to counsel teenagers and young adults about skin cancer prevention.

  16. [Health Economics: thirty years of evolution].

    PubMed

    López Casasnovas, Guillem

    2009-01-01

    The purpose is to offer a subjective reflection on the evolution and the new developments of Health Economics as an academic subject, its influence in the health policies and fundamentals for understanding its big crossroads today.

  17. The impact of economic globalisation on health.

    PubMed

    Koivusalo, Meri

    2006-01-01

    The analysis of the impact of economic globalisation on health depends on how it is defined and should consider how it shapes both health and health policies. I first discuss the ways in which economic globalisation can and has been defined and then why it is important to analyse its impact both in terms of health and health policies. I then explore the ways in which economic globalisation influences health and health policies and how this relates to equity, social justice, and the role of values and social rights in societies. Finally, I argue that the process of economic globalisation provides a common challenge for all health systems across the globe and requires a broader debate on values, accountability, and policy approaches.

  18. Health as an economic engine: evidence for the importance of health in economic development.

    PubMed

    Mirvis, David M; Chang, Cyril F; Cosby, Arthur

    2008-01-01

    Most discussions on the relationships between health and economic conditions have focused on the impact of differences in personal finances or national economic conditions on health. Recently, however, the role of health as an 'economic engine' has been promoted. This paradigm proposes that better health leads to economic development. Evidence from historical, national, and transnational studies have shown that improved health increases economic growth through impacts on micro- and macro-economic factors. In this review, we will summarize the evidence supporting these concepts as a basis for discussing their implications for underdeveloped regions within the United States.

  19. HIT: time to end behavioral health discrimination.

    PubMed

    Rosenberg, Linda

    2012-10-01

    While the Health Information Technology for Economic and Clinical Health Act, enacted as part of the American Recovery and Reinvestment Act of 2009, provided $20.6 billion for incentive payments to support the adoption and meaningful use of health information technology (HIT), behavioral health organizations were not eligible to receive facility payments. The consequences of excluding behavioral health from HIT incentive payments are found in the results of the "HIT Adoption and Meaningful Use Readiness in Community Behavioral Health" survey. The survey found that only 2% of community behavioral health organizations are able to meet federal meaningful use (MU) requirements-compare this to the 27% of Federally Qualified Health Centers and 20% of hospitals that already meet some level of MU requirements. Behavioral health organizations, serving more than eight million adults, children, and families with mental illnesses and addiction disorders, are ready and eager to adopt HIT to meet the goals of better healthcare, better health, and lower costs. But reaching these goals may prove impossible unless behavioral health achieves "parity" within healthcare and receives resources for the adoption of HIT.

  20. Contemporary health care economics: an overview.

    PubMed

    McLaughlin, Nancy; Ong, Michael K; Tabbush, Victor; Hagigi, Farhad; Martin, Neil A

    2014-11-01

    Economic evaluations provide a decision-making framework in which outcomes (benefits) and costs are assessed for various alternative options. Although the interest in complete and partial economic evaluations has increased over the past 2 decades, the quality of studies has been marginal due to methodological challenges or incomplete cost determination. This paper provides an overview of the main types of complete and partial economic evaluations, reviews key methodological elements to be considered for any economic evaluation, and reviews concepts of cost determination. The goal is to provide the clinician neurosurgeon with the knowledge and tools needed to appraise published economic evaluations and to direct high-quality health economic evaluations.

  1. Health economics education in undergraduate medical training: introducing the health economics education (HEe) website

    PubMed Central

    2013-01-01

    In the UK, the General Medical Council clearly stipulates that upon completion of training, medical students should be able to discuss the principles underlying the development of health and health service policy, including issues relating to health economics. In response, researchers from the UK and other countries have called for a need to incorporate health economics training into the undergraduate medical curricula. The Health Economics education website was developed to encourage and support teaching and learning in health economics for medical students. It was designed to function both as a forum for teachers of health economics to communicate and to share resources and also to provide instantaneous access to supporting literature and teaching materials on health economics. The website provides a range of free online material that can be used by both health economists and non-health economists to teach the basic principles of the discipline. The Health Economics education website is the only online education resource that exists for teaching health economics to medical undergraduate students and it provides teachers of health economics with a range of comprehensive basic and advanced teaching materials that are freely available. This article presents the website as a tool to encourage the incorporation of health economics training into the undergraduate medical curricula. PMID:24034906

  2. Health economics education in undergraduate medical training: introducing the health economics education (HEe) website.

    PubMed

    Oppong, Raymond; Mistry, Hema; Frew, Emma

    2013-09-13

    In the UK, the General Medical Council clearly stipulates that upon completion of training, medical students should be able to discuss the principles underlying the development of health and health service policy, including issues relating to health economics. In response, researchers from the UK and other countries have called for a need to incorporate health economics training into the undergraduate medical curricula. The Health Economics education website was developed to encourage and support teaching and learning in health economics for medical students. It was designed to function both as a forum for teachers of health economics to communicate and to share resources and also to provide instantaneous access to supporting literature and teaching materials on health economics. The website provides a range of free online material that can be used by both health economists and non-health economists to teach the basic principles of the discipline. The Health Economics education website is the only online education resource that exists for teaching health economics to medical undergraduate students and it provides teachers of health economics with a range of comprehensive basic and advanced teaching materials that are freely available. This article presents the website as a tool to encourage the incorporation of health economics training into the undergraduate medical curricula.

  3. Health Education and Behavioral Analysis.

    ERIC Educational Resources Information Center

    Prue, Donald M.; And Others

    1987-01-01

    A review of theoretical and experimental literature on school health education indicates that most programs have focused on health knowledge despite conflicting information on the impact of knowledge based programs on health behaviors. Needed are interventions that include environmental engineering to support health behaviors and use of…

  4. Behavioral Economics and Empirical Public Policy

    ERIC Educational Resources Information Center

    Hursh, Steven R.; Roma, Peter G.

    2013-01-01

    The application of economics principles to the analysis of behavior has yielded novel insights on value and choice across contexts ranging from laboratory animal research to clinical populations to national trends of global impact. Recent innovations in demand curve methods provide a credible means of quantitatively comparing qualitatively…

  5. Health economics in the genomic age.

    PubMed

    Szucs, Thomas D

    2005-01-01

    Health economics has experienced a substantial rise within the healthcare industry over the past few years. Several disciplines have developed new techniques to evaluate the economic impact of pharmaceuticals in clinical care. Clinicians, pharmacists, economists, epidemiologists, and operations researchers have contributed to this field. Given the economic reality that resources are limited and needs and expectations are not infinite, medical economists try to find solutions on how these resources can be allocated optimally, to maximize the production of health or what society perceives as health. Health economists differentiate allocation efficiency and production efficiency. From the perspective of a health insurance plan allocation efficiency is reached when those drug classes or clinical programs are covered that will produce most health per expenditure. This requires a common monetary metric of health gains across the broad spectrum of diseases, conditions, and health outcomes. Once it is decided to cover a specific treatment or clinical program, economists try to identify the most cost-effective product within a class of comparable choices using cost-effectiveness and cost-utility analyses. Both allocation and production efficiency are two critically important concepts for the economic success of biotech products. This article will provide a rationale why health economics is critically important for the future of healthcare and explains fundamental economic tools for evaluating products and services with special emphasis on gene-derived technologies.

  6. HIV Testing, Subjective Beliefs and Economic Behavior

    PubMed Central

    Thornton, Rebecca L.

    2013-01-01

    This paper examines the effects of learning HIV status on economic behavior among rural Malawians. According to economic life-cycle models, if learning HIV results is informative about additional years of life, being diagnosed HIV-positive or negative should predict changes in consumption, investment and savings behavior with important micro and macro-economic implications. Using an experiment that randomly assigned incentives to learn HIV results, I find that while learning HIV results had short term effects on subjective belief of HIV infection, these differences did not persist after two years. Consistent with this, there were relatively few differences two years later in savings, income, expenditures, and employment between those who learned and did not learn their status. PMID:24369439

  7. Health behavior: issues, contradictions and dilemmas.

    PubMed

    Alonzo, A A

    1993-10-01

    American medicine faces many contradictions and dilemmas. This is especially the case with regard to preventive health behavior. This paper explores the effects of several issues, contradictions and dilemmas on the American experience with primary preventive health behavior. These issues include: individualism, victim blaming, therapeutic nihilism, the over abundance of health information, America as a culture of risk takers, and the dilemma of the jungle vs the zoo. Four types of health behavior are defined. The first type of health behavior is the primary prevention of disease, defect, injury or disability. The second type is detection of asymptomatic disease, injury and defect. Third, is the promotion of enhanced levels of health, wellness and quality of life. And the fourth, at a more societal level, protective behaviors to make environmental transactions safe from disease, injury, defect and disability. These four types of health behavior are each explored in relation to societal values, technology and economics to determine which of these facilitate or impede health behavior at both the individual and societal levels.

  8. Health Economics Research: An Annotated Bibliography.

    ERIC Educational Resources Information Center

    Dillard, Carole D.; And Others

    This annotated bibliography lists books and journal articles published since 1976 which deal with health economics and which are based on health services research supported by the National Center for Health Services Research (NCHSR). Articles prepared by NCHSR staff are listed as intramural. All other articles cite the NCHSR grant or contract…

  9. [Economics of health system transformation].

    PubMed

    González Pier, Eduardo

    2012-01-01

    Health conditions in Mexico have evolved along with socioeconomic conditions. As a result, today's health system faces several problems characterized by four overlapping transitions: demand, expectations, funding and health resources. These transitions engender significant pressures on the system itself. Additionally, fragmentation of the health system creates disparities in access to services and generates problems in terms of efficiency and use of available resources. To address these complications and to improve equity in access and efficiency, thorough analysis is required in how the right to access health care should be established at a constitutional level without differentiating across population groups. This should be followed by careful discussion about what rules of health care financing should exist, which set of interventions ought to be covered and how services must be organized to meet the health needs of the population.

  10. Metro Nature, Environmental Health, and Economic Value

    PubMed Central

    Robbins, Alicia S.T.

    2015-01-01

    Background Nearly 40 years of research provides an extensive body of evidence about human health, well-being, and improved function benefits associated with experiences of nearby nature in cities. Objectives We demonstrate the numerous opportunities for future research efforts that link metro nature, human health and well-being outcomes, and economic values. Methods We reviewed the literature on urban nature-based health and well-being benefits. In this review, we provide a classification schematic and propose potential economic values associated with metro nature services. Discussion Economic valuation of benefits derived from urban green systems has largely been undertaken in the fields of environmental and natural resource economics, but studies have not typically addressed health outcomes. Urban trees, parks, gardens, open spaces, and other nearby nature elements—collectively termed metro nature—generate many positive externalities that have been largely overlooked in urban economics and policy. Here, we present a range of health benefits, including benefit context and beneficiaries. Although the understanding of these benefits is not yet consistently expressed, and although it is likely that attempts to link urban ecosystem services and economic values will not include all expressions of cultural or social value, the development of new interdisciplinary approaches that integrate environmental health and economic disciplines are greatly needed. Conclusions Metro nature provides diverse and substantial benefits to human populations in cities. In this review, we begin to address the need for development of valuation methodologies and new approaches to understanding the potential economic outcomes of these benefits. Citation Wolf KL, Robbins AS. 2015. Metro nature, environmental health, and economic value. Environ Health Perspect 123:390–398; http://dx.doi.org/10.1289/ehp.1408216 PMID:25626137

  11. Global health funding and economic development.

    PubMed

    Martin, Greg; Grant, Alexandra; D'Agostino, Mark

    2012-04-10

    The impact of increased national wealth, as measured by Gross Domestic Product (GDP), on public health is widely understood, however an equally important but less well-acclaimed relationship exists between improvements in health and the growth of an economy. Communicable diseases such as HIV, TB, Malaria and the Neglected Tropical Diseases (NTDs) are impacting many of the world's poorest and most vulnerable populations, and depressing economic development. Sickness and disease has decreased the size and capabilities of the workforce through impeding access to education and suppressing foreign direct investment (FDI). There is clear evidence that by investing in health improvements a significant increase in GDP per capita can be attained in four ways: Firstly, healthier populations are more economically productive; secondly, proactive healthcare leads to decrease in many of the additive healthcare costs associated with lack of care (treating opportunistic infections in the case of HIV for example); thirdly, improved health represents a real economic and developmental outcome in-and-of itself and finally, healthcare spending capitalises on the Keynesian 'economic multiplier' effect. Continued under-investment in health and health systems represent an important threat to our future global prosperity. This editorial calls for a recognition of health as a major engine of economic growth and for commensurate investment in public health, particularly in poor countries.

  12. Global health funding and economic development

    PubMed Central

    2012-01-01

    The impact of increased national wealth, as measured by Gross Domestic Product (GDP), on public health is widely understood, however an equally important but less well-acclaimed relationship exists between improvements in health and the growth of an economy. Communicable diseases such as HIV, TB, Malaria and the Neglected Tropical Diseases (NTDs) are impacting many of the world's poorest and most vulnerable populations, and depressing economic development. Sickness and disease has decreased the size and capabilities of the workforce through impeding access to education and suppressing foreign direct investment (FDI). There is clear evidence that by investing in health improvements a significant increase in GDP per capita can be attained in four ways: Firstly, healthier populations are more economically productive; secondly, proactive healthcare leads to decrease in many of the additive healthcare costs associated with lack of care (treating opportunistic infections in the case of HIV for example); thirdly, improved health represents a real economic and developmental outcome in-and-of itself and finally, healthcare spending capitalises on the Keynesian 'economic multiplier' effect. Continued under-investment in health and health systems represent an important threat to our future global prosperity. This editorial calls for a recognition of health as a major engine of economic growth and for commensurate investment in public health, particularly in poor countries. PMID:22490207

  13. Conditional Economic Incentives for Reducing HIV Risk Behaviors: Integration of Psychology and Behavioral Economics

    PubMed Central

    Operario, Don; Kuo, Caroline C.; Sosa-Rubí, Sandra G.; Gálarraga, Omar

    2014-01-01

    Objective This paper reviews psychology and behavioral economic approaches to HIV prevention, and examines the integration and application of these approaches in conditional economic incentive (CEI) programs for reducing HIV risk behavior. Methods We discuss the history of HIV prevention approaches, highlighting the important insights and limitations of psychological theories. We provide an overview of the theoretical tenets of behavioral economics that are relevant to HIV prevention, and utilize CEIs as an illustrative example of how traditional psychological theories end behavioral economics can be combined into new approaches for HIV prevention. Results Behavioral economic interventions can complement psychological frameworks for reducing HIV risk by introducing unique theoretical understandings about the conditions under which risky decisions are amenable to intervention. Findings from illustrative CEI programs show mixed but generally promising effects of economic interventions on HIV and STI prevalence, HIV testing, HIV medication adherence, and drug use. Conclusion CEI programs can complement psychological interventions for HIV prevention and behavioral risk reduction. To maximize program effectiveness, CEI programs must be designed according to contextual and population-specific factors that may determine intervention applicability and success. PMID:24001243

  14. A behavioral economics perspective on tobacco taxation.

    PubMed

    Cherukupalli, Rajeev

    2010-04-01

    Economic studies of taxation typically estimate external costs of tobacco use to be low and refrain from recommending large tobacco taxes. Behavioral economics suggests that a rational decision-making process by individuals fully aware of tobacco's hazards might still lead to overconsumption through the psychological tendency to favor immediate gratification over future harm. Taxes can serve as a self-control device to help reduce tobacco use and enable successful quit attempts. Whether taxes are appropriately high depends on how excessively people underrate the harm from tobacco use and varies with a country's circumstances. Such taxes are likely to be more equitable for poorer subgroups than traditional economic analysis suggests, which would strengthen the case for increased tobacco taxation globally.

  15. Unpaid work in health economic evaluations.

    PubMed

    Krol, Marieke; Brouwer, Werner

    2015-11-01

    Given its societal importance, unpaid work should be included in economic evaluations of health care technology aiming to take a societal perspective. However, in practice this does not often appear to be the case. This paper provides an overview of the current place of unpaid work in economic evaluations in theory and in practice. It does so first by summarizing recommendations regarding the inclusion of unpaid labor reported in health economic textbooks and national guidelines for economic evaluations. In total, three prominent health economic text-books were studied and 28 national health economic guidelines. The paper, moreover, provides an overview of the instruments available to measure lost unpaid labor and reports on a review of the place of unpaid labor in applied economic evaluations in the area of rheumatoid arthritis. The review was conducted by examining methodology of evaluations published between 1 March 2008 and 1 March 2013. The results of this study show that little guidance is offered regarding the inclusion of unpaid labor in economic evaluations in textbooks and guidelines. The review identified five productivity costs instruments including questions about unpaid work and 33 economic evaluations of treatments for rheumatoid arthritis of which only one included unpaid work. The results indicate that unpaid work is rarely included in applied economic evaluations of treatments for rheumatoid arthritis, despite this disease expecting to be associated with lost unpaid work. Given the strong effects of certain diseases and treatments on the ability to perform unpaid work, unpaid work currently receives less attention in economic evaluations than it deserves.

  16. What is the economic evidence for mHealth? A systematic review of economic evaluations of mHealth solutions

    PubMed Central

    Cato, Kenrick; Falzon, Louise; Stone, Patricia W.

    2017-01-01

    Background Mobile health (mHealth) is often reputed to be cost-effective or cost-saving. Despite optimism, the strength of the evidence supporting this assertion has been limited. In this systematic review the body of evidence related to economic evaluations of mHealth interventions is assessed and summarized. Methods Seven electronic bibliographic databases, grey literature, and relevant references were searched. Eligibility criteria included original articles, comparison of costs and consequences of interventions (one categorized as a primary mHealth intervention or mHealth intervention as a component of other interventions), health and economic outcomes and published in English. Full economic evaluations were appraised using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist and The PRISMA guidelines were followed. Results Searches identified 5902 results, of which 318 were examined at full text, and 39 were included in this review. The 39 studies spanned 19 countries, most of which were conducted in upper and upper-middle income countries (34, 87.2%). Primary mHealth interventions (35, 89.7%), behavior change communication type interventions (e.g., improve attendance rates, medication adherence) (27, 69.2%), and short messaging system (SMS) as the mHealth function (e.g., used to send reminders, information, provide support, conduct surveys or collect data) (22, 56.4%) were most frequent; the most frequent disease or condition focuses were outpatient clinic attendance, cardiovascular disease, and diabetes. The average percent of CHEERS checklist items reported was 79.6% (range 47.62–100, STD 14.18) and the top quartile reported 91.3–100%. In 29 studies (74.3%), researchers reported that the mHealth intervention was cost-effective, economically beneficial, or cost saving at base case. Conclusions Findings highlight a growing body of economic evidence for mHealth interventions. Although all studies included a comparison of

  17. Health Behavior in Ecological Context

    ERIC Educational Resources Information Center

    Simons-Morton, Bruce

    2013-01-01

    Health is best understood within an ecological context. Accordingly, health promotion involves processes that foster supportive environments and healthful behavior. Thus, effective health promotion programs are typically multilevel, focusing not only on the population at risk but also on the environmental conditions that contribute so importantly…

  18. Measurement of costs for health economic evaluation.

    PubMed

    Riewpaiboon, Arthorn

    2014-05-01

    The provision of guidelines on cost measurement for health economic evaluations enable research to be more standardized and hence more comparable, which offers clear benefits for policy formulation and health management. The guidelines herein focus on three aspects-the cost of health intervention/health care programs, the cost of illness/health risks, and use of costs in health economic evaluation. For each aspect, the main concepts and methods are outlined, and recommendations for the Thai context are presented. There is particular focus on how to calculate various costs according to different evaluation methods and perspectives, how to evaluate source of cost data, how to make value adjustments and how to present cost measurement findings.

  19. Using Insights From Behavioral Economics to Strengthen Disaster Preparedness and Response.

    PubMed

    Linnemayr, Sebastian; O'Hanlon, Claire; Uscher-Pines, Lori; Van Abel, Kristin; Nelson, Christopher

    2016-10-01

    Behavioral economics is based on the idea that individuals' decisions are affected by systematic and predictable cognitive biases and that these same biases can be leveraged to change behavior and improve decision-making. Insights from behavioral economics have been used to encourage a range of desired behaviors but have rarely been used in disaster preparedness and response, though traditional efforts by public health practitioners have failed to increase adoption of key preparedness behaviors. In this work, we aim to show how some of the key concepts in the behavioral economics literature are applicable to behaviors related to disaster preparedness and response, and we present ideas for behavioral economics-based interventions that we vetted with public health officials. Two of the best-received interventions were applications of social norms approaches, which leverage social influence bias, and commitment devices, which leverage present bias and loss aversion. Although the current evidence base for the applications of concepts from behavioral economics in disaster preparedness and response is weak, behavioral economics has achieved positive results in similar decision-making contexts. The low cost and potentially high impact of behavioral economics-based interventions warrant further investigation and testing. (Disaster Med Public Health Preparedness. 2016;page 1 of 7).

  20. Economic assessment of animal health performance.

    PubMed

    Galligan, David

    2006-03-01

    This article describes the fundamental principles of economic assessment of animal health performance in the modem animal production environment. Animal production is a complex system of combined inputs (eg, physical inputs, managerial decision choices) into a production process that produces products valued by society. Perturbations to this system include disease processes and management inefficiencies. Economic valuation of these perturbations must account for the marginal changes in revenues and cost, the time dimensions of occurrence, the inherent risk characteristics of biologic systems, and any opportunity value that exists that allows management to intervene within the process and make economically influencing decisions. It has been recognized that improving animal health can play a major role in achieving efficient and economically rewarding production.

  1. Family Economic Security Policies and Child and Family Health.

    PubMed

    Spencer, Rachael A; Komro, Kelli A

    2017-03-01

    In this review, we examine the effects of family economic security policies (i.e., minimum wage, earned income tax credit, unemployment insurance, Temporary Assistance to Needy Families) on child and family health outcomes, summarize policy generosity across states in the USA, and discuss directions and possibilities for future research. This manuscript is an update to a review article that was published in 2014. Millions of Americans are affected by family economic security policies each year, many of whom are the most vulnerable in society. There is increasing evidence that these policies impact health outcomes and behaviors of adults and children. Further, research indicates that, overall, policies which are more restrictive are associated with poorer health behaviors and outcomes; however, the strength of the evidence differs across each of the four policies. There is significant diversity in state-level policies, and it is plausible that these policy variations are contributing to health disparities across and within states. Despite increasing evidence of the relationship between economic policies and health, there continues to be limited attention to this issue. State policy variations offer a valuable opportunity for scientists to conduct natural experiments and contribute to evidence linking social policy effects to family and child well-being. The mounting evidence will help to guide future research and policy making for evolving toward a more nurturing society for family and child health and well-being.

  2. Behavioral economics: "nudging" underserved populations to be screened for cancer.

    PubMed

    Purnell, Jason Q; Thompson, Tess; Kreuter, Matthew W; McBride, Timothy D

    2015-01-15

    Persistent disparities in cancer screening by race/ethnicity and socioeconomic status require innovative prevention tools and techniques. Behavioral economics provides tools to potentially reduce disparities by informing strategies and systems to increase prevention of breast, cervical, and colorectal cancers. With an emphasis on the predictable, but sometimes flawed, mental shortcuts (heuristics) people use to make decisions, behavioral economics offers insights that practitioners can use to enhance evidence-based cancer screening interventions that rely on judgments about the probability of developing and detecting cancer, decisions about competing screening options, and the optimal presentation of complex choices (choice architecture). In the area of judgment, we describe ways practitioners can use the availability and representativeness of heuristics and the tendency toward unrealistic optimism to increase perceptions of risk and highlight benefits of screening. We describe how several behavioral economic principles involved in decision-making can influence screening attitudes, including how framing and context effects can be manipulated to highlight personally salient features of cancer screening tests. Finally, we offer suggestions about ways practitioners can apply principles related to choice architecture to health care systems in which cancer screening takes place. These recommendations include the use of incentives to increase screening, introduction of default options, appropriate feedback throughout the decision-making and behavior completion process, and clear presentation of complex choices, particularly in the context of colorectal cancer screening. We conclude by noting gaps in knowledge and propose future research questions to guide this promising area of research and practice.

  3. Global Health and the Global Economic Crisis

    PubMed Central

    Gill, Stephen; Bakker, Isabella

    2011-01-01

    Although the resources and knowledge for achieving improved global health exist, a new, critical paradigm on health as an aspect of human development, human security, and human rights is needed. Such a shift is required to sufficiently modify and credibly reduce the present dominance of perverse market forces on global health. New scientific discoveries can make wide-ranging contributions to improved health; however, improved global health depends on achieving greater social justice, economic redistribution, and enhanced democratization of production, caring social institutions for essential health care, education, and other public goods. As with the quest for an HIV vaccine, the challenge of improved global health requires an ambitious multidisciplinary research program. PMID:21330597

  4. Use of psychology and behavioral economics to promote healthy eating.

    PubMed

    Roberto, Christina A; Kawachi, Ichiro

    2014-12-01

    Understanding the psychology of how people make decisions can shed light on important factors contributing to the cause and maintenance of public health problems like obesity. This knowledge can and should inform the design of government and private-sector public health interventions. Several insights from psychology and behavioral economics that help explain why people are particularly vulnerable to the current food environment are discussed. These insights fall into the following categories: the influence of starting points (status quo bias and anchoring effects); communicating health information (simplicity and framing); and unintended consequences of policy interventions (compensation, substitution, and the peanuts effect). The paper discusses opportunities for improving the design of food policies and interventions by altering default options, providing the public with simple and meaningful nutrition information, carefully constructing the framing of public health messages, and designing food policies to minimize unintended consequences, such as compensation and substitution.

  5. Organizational economics and health care markets.

    PubMed Central

    Robinson, J C

    2001-01-01

    As health policy emphasizes the use of private sector mechanisms to pursue public sector goals, health services research needs to develop stronger conceptual frameworks for the interpretation of empirical studies of health care markets and organizations. Organizational relationships should not be interpreted exclusively in terms of competition among providers of similar services but also in terms of relationships among providers of substitute and complementary services and in terms of upstream suppliers and downstream distributors. This article illustrates the potential applicability of transactions cost economics, agency theory, and organizational economics more broadly to horizontal and vertical markets in health care. Examples are derived from organizational integration between physicians and hospitals and organizational conversions from nonprofit to for-profit ownership. PMID:11327173

  6. Adolescent Health Problems: Behavioral Perspectives. Advances in Pediatric Psychology.

    ERIC Educational Resources Information Center

    Wallander, Jan L., Ed.; Siegel, Lawrence J., Ed.

    This book examines the relationship between adolescent risk-taking behaviors and health. The health-related problems of adolescents frequently are manifestations of social, economic, or behavioral factors. Following an overview (Siegal), the chapters in the first section of the book explore general and conceptual issues: (1) "Epidemiology of…

  7. Neural basis of economic bubble behavior.

    PubMed

    Ogawa, A; Onozaki, T; Mizuno, T; Asamizuya, T; Ueno, K; Cheng, K; Iriki, A

    2014-04-18

    Throughout human history, economic bubbles have formed and burst. As a bubble grows, microeconomic behavior ceases to be constrained by realistic predictions. This contradicts the basic assumption of economics that agents have rational expectations. To examine the neural basis of behavior during bubbles, we performed functional magnetic resonance imaging while participants traded shares in a virtual stock exchange with two non-bubble stocks and one bubble stock. The price was largely deflected from the fair price in one of the non-bubble stocks, but not in the other. Their fair prices were specified. The price of the bubble stock showed a large increase and battering, as based on a real stock-market bust. The imaging results revealed modulation of the brain circuits that regulate trade behavior under different market conditions. The premotor cortex was activated only under a market condition in which the price was largely deflected from the fair price specified. During the bubble, brain regions associated with the cognitive processing that supports order decisions were identified. The asset preference that might bias the decision was associated with the ventrolateral prefrontal cortex and the dorsolateral prefrontal cortex (DLPFC). The activity of the inferior parietal lobule (IPL) was correlated with the score of future time perspective, which would bias the estimation of future price. These regions were deemed to form a distinctive network during the bubble. A functional connectivity analysis showed that the connectivity between the DLPFC and the IPL was predominant compared with other connectivities only during the bubble. These findings indicate that uncertain and unstable market conditions changed brain modes in traders. These brain mechanisms might lead to a loss of control caused by wishful thinking, and to microeconomic bubbles that expand, on the macroscopic scale, toward bust.

  8. Mycotoxins: significance to global economics and health

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Mycotoxins are fungal metabolites produced my micro-fungi (molds and mildews) that have significant impacts on global economics and health. Some of these metabolites are beneficial, but most are harmful and have been associated with well-known epidemics dating back to medieval times. The terms ‘myco...

  9. Health behaviors of Operating Engineers.

    PubMed

    Duffy, Sonia A; Missel, Amanda L; Waltje, Andrea H; Ronis, David L; Fowler, Karen E; Hong, OiSaeng

    2011-07-01

    Operating Engineers (heavy equipment operators in construction) may be at particular risk for heart disease and cancer related to their exposure to environmental dust and smoking, the sedentary nature of their job, and long hours of exposure to the sun. The aim of this study was to characterize the health behaviors of Operating Engineers. This cross-sectional survey from a convenience sample of Operating Engineers (N = 498) used validated instruments to measure smoking, drinking, diet, exercise, sleep, and sun exposure. Univariate and bivariate analyses to detect differences by age were conducted. The sample scored significantly worse on all five health behaviors compared to population norms. Those who were older were less likely to smoke and chew tobacco and more likely to eat fruits and vegetables. Many were interested in services to improve their health behaviors. Health behavior interventions are needed and wanted by Operating Engineers.

  10. [Health economics: in search of efficiency].

    PubMed

    Schlander, Michael

    2009-01-01

    Economic terms such as efficiency, optimality and social welfare carry strong positive connotations. Sometimes non-economists may overlook the substantive difference between the scientific definition of these terms and their use in common parlance. This difference will be highly relevant if and when economic statements about efficiency are presented or interpreted in a normative way, i.e., implying that efficiency equals social desirability. Any statement about efficiency rests on implicit or explicit assumptions concerning the appropriate effectiveness criterion because efficiency invariably is an instrumental or secondary objective only, subject to clarification of the primary objectives to be pursued. In the absence of an agreement on the primary objectives of a collectively funded health scheme, the pursuit of efficiency may lead to health care allocation decisions that are not in line with prevailing social value judgements. Therefore, exposition and acceptance of the specific value judgements underlying economic evaluations of health care programmes should be a prerequisite to any attempt towards their normative interpretation. As regards the implementation of cost benefit evaluation in health care, the cautious stance taken by the German Institute for Quality and Efficiency in Health Care (IQWiG) appears to be well justified in the absence of such a fundamental consensus, especially when these evaluations are meant to address issues of allocative efficiency.

  11. Behavioral Economics Applied to Energy Demand Analysis: A Foundation

    EIA Publications

    2014-01-01

    Neoclassical economics has shaped our understanding of human behavior for several decades. While still an important starting point for economic studies, neoclassical frameworks have generally imposed strong assumptions, for example regarding utility maximization, information, and foresight, while treating consumer preferences as given or external to the framework. In real life, however, such strong assumptions tend to be less than fully valid. Behavioral economics refers to the study and formalizing of theories regarding deviations from traditionally-modeled economic decision-making in the behavior of individuals. The U.S. Energy Information Administration (EIA) has an interest in behavioral economics as one influence on energy demand.

  12. Economic analysis in health care research.

    PubMed

    Rizk, Diaa E E

    2008-04-01

    There is contemporary widespread acceptance in the medical community of the need to address economic perspective of healthcare, specifically whether the benefits of a proposed or existing medical intervention are sufficient to justify that particular use of scarce health resources. The use of any scarce resources whether manpower, buildings or equipment has an opportunity cost in terms of the benefits foregone by denying those resources to other competing claims. Health economics emphasizes the need to assess formally the implications of choices over the deployment of resources. A number of economic evaluation techniques such as cost-benefit analysis and cost-effectiveness analysis have thus been developed to aid this formal assessment and to help identify the most efficient allocation of resources. The methodological quality and principles of economic analyses studies recently published in the biomedical literature, however, can be further improved. The most common limitations are in the methodology or presentation of cost, incremental analyses, sensitivity analysis and discounting. The ten methodological principles that should be incorporated in studies addressing economic analyses are highlighted. Understanding the methodology of cost-benefit analysis and cost-effectiveness analysis is critical for biomedical researchers, editors, reviewers and readers from developing countries to accurately interpret the results of the growing body of these articles.

  13. Heal Thyself...: Faculty Health Behavior.

    ERIC Educational Resources Information Center

    Grady, Kathleen E.

    1985-01-01

    A study was designed to assess faculty health behaviors at the beginning of each of the three years of a Health Promotion/Disease Prevention grant for comparisons over time. This article reports the results of the first comparison between the two faculties. (CT)

  14. Helping You Choose Quality Behavioral Health Care

    MedlinePlus

    Helping You Choose Quality Behavioral Health Care Selecting quality behavioral health care services for yourself, a relative or friend requires special thought and attention. The Joint Commission on ...

  15. Health and safety economics: limitations of economic appraisal of occupational health services activities in Poland.

    PubMed

    Rydlewska-Liszkowska, Izabela

    2002-01-01

    Methods of economic appraisal developed for evaluating activities in health care system may as well be successfully used for evaluating occupational health service activities. This involves the problem of resources management and cost containment not only at the company level, but also at different managerial and institutional levels. The decision makers have to know what resources are spent on occupational health, what is the effectiveness and efficiency of investing in employees health. The key issue of good understanding of the theory and practice of economic appraisal is a precise definition of costs, effectiveness and benefits. Another important area is the identification of information sources and barriers of economic appraisal. The results of the project carried out by the Nofer Institute of Occupational Medicine have provided evidence that defining costs, effectiveness and benefits of preventive activities need to be developed. It becomes even more clear after an analysis of existing limitations of economic appraisal in Polish enterprises.

  16. Economic recession and mental health: an overview.

    PubMed

    Cooper, Brian

    2011-01-01

    Effects of the current global economic downturn on population mental health will emerge in the years ahead. Judging from earlier experience of financial crises in various parts of the world, stresses associated with rising unemployment, poverty and social insecurity will lead to upward trends in many national suicide rates, as well as to less readily charted increase in the prevalence of psychiatric illness, alcohol-related disorders and illicit drug use. At the same time, mental health services are being cut back as part of government austerity programs. Budget cuts will thus affect psychiatric services adversely just when economic stressors are raising the levels of need and demand in affected populations. Proactive fiscal and social policies could, however, help to mitigate the health consequences of recession. Evidence- based preventive measures include active labor market and family support programs, regulation of alcohol prices and availability, community care for known high-risk groups, and debt relief projects. Economic mental health care could best be achieved, not by decimating services but by planning and deploying these to meet the needs of defined area populations.

  17. The economics of eHealth and mHealth.

    PubMed

    Schweitzer, Julian; Synowiec, Christina

    2012-01-01

    While mHealth has the potential to overcome traditional obstacles to the delivery of health services to the poor in lower and middle-income countries--issues related to access, quality, time, and resources--there is little evidence as to whether the expected benefits and savings can be actualized on a large scale. As a first step to developing the investment case for mHealth, this article outlines some of the key economic and financial questions that need to be answered in developing in-country eHealth investments. The proposed questions focus on the costs of eHealth infrastructure; regulatory structures that provide incentives at different levels of the health delivery system to encourage investment in, and use of, eHealth; and measuring the outcomes of successful eHealth utilization, including anticipated return on investment.

  18. Individualized Behavioral Health Monitoring Tool

    NASA Technical Reports Server (NTRS)

    Mollicone, Daniel

    2015-01-01

    Behavioral health risks during long-duration space exploration missions are among the most difficult to predict, detect, and mitigate. Given the anticipated extended duration of future missions and their isolated, extreme, and confined environments, there is the possibility that behavior conditions and mental disorders will develop among astronaut crew. Pulsar Informatics, Inc., has developed a health monitoring tool that provides a means to detect and address behavioral disorders and mental conditions at an early stage. The tool integrates all available behavioral measures collected during a mission to identify possible health indicator warning signs within the context of quantitatively tracked mission stressors. It is unobtrusive and requires minimal crew time and effort to train and utilize. The monitoring tool can be deployed in space analog environments for validation testing and ultimate deployment in long-duration space exploration missions.

  19. Abnormal economics in the health sector.

    PubMed

    Hsaio, W C

    1995-01-01

    The implosion of centrally-planned economies has led to a widespread and uncritical belief that a free market is the best mechanism for structuring the economic and social sectors. Many international agencies have pushed this belief on the developing nations. This paper offers a critical analysis of the effectiveness of using free market principles to structure the health sector. We try to answer two questions: in what spheres can the market operate freely? In what spheres is government action required? According to economic theory, the market is only appropriate for producing and distributing private goods. This study analyzed health care and subdivides it into three categories (public, merit, and private goods) to clarify where the market has a legitimate role. Next, we analyze two of the five markets in the health sector--financing and delivery--and assess the respective roles of the market and government Competitive markets have certain prerequisites. We identify the major market failures by evaluating where these conditions are not satisfied. Next, we draw on international experience to ascertain the seriousness of those failures and the capacity of government action to correct them. Lessons are drawn for developing nations about the appropriateness of market strategies to finance and deliver health care.

  20. Developing policy solutions for a more active nation: Integrating economic and public health perspectives.

    PubMed

    Bleich, Sara N; Sturm, Roland

    2009-10-01

    Both economic and public health/medical perspectives play an important role in the policy process but often approach policy questions in an incompatible way. Harnessing any synergy requires an understanding of the other perspective. We begin by comparing and contrasting the economic and public health perspectives, including introducing relevant economic concepts. We next identify economic considerations for the development of environmental incentives that promote physical activity. We then assess features of the political environment which could impact the success of policy alternatives aimed at increasing physical activity. We conclude with several policy levers that may promote active living. Throughout the manuscript, we use the term economics to refer to classical economics and utility maximization rather than behavioral economics. In addition, we focus mostly on normative economics (which offers prescriptions for what should be done) rather than positive economics (which offers predictions of economic outcomes conditional on various hypothetical scenarios).

  1. Rewarding Healthy Food Choices in SNAP: Behavioral Economic Applications

    PubMed Central

    Richards, Michael R; Sindelar, Jody L

    2013-01-01

    Context American obesity rates continue to escalate, but an effective policy response remains elusive. Specific changes to the Supplemental Nutrition Assistance Program (SNAP) have been proposed as one way to improve nutrition and combat obesity among lower-income populations. While current SNAP proposals hold promise, some important challenges still remain. Methods We discuss the four most common recommendations for changes to SNAP and their benefits and limitations. We then propose three new delivery options for SNAP that take advantage of behavioral economic insights and encourage the selection of healthy foods. Findings Although the existing proposals could help SNAP recipients, they often do not address some important behavioral impediments to buying healthy foods. We believe that behavioral economics can be used to design alternative policies with several advantages, although we recognize and discuss some of their limitations. The first proposal rewards healthy purchases with more SNAP funds and provides an additional incentive to maintain healthier shopping patterns. The second proposal uses the opportunity to win prizes to reward healthy food choices, and the prizes further support healthier habits. The final proposal simplifies healthy food purchases by allowing individuals to commit their SNAP benefits to more nutritious selections in advance. Conclusions Reforming the delivery structure of SNAP's benefits could help improve nutrition, weight, and overall health of lower-income individuals. We advocate for more and diverse SNAP proposals, which should be tested and, possibly, combined. Their implementation, however, would require political will, administrative capacity, and funding. PMID:23758515

  2. Issues surrounding the health economic evaluation of genomic technologies

    PubMed Central

    Buchanan, James; Wordsworth, Sarah; Schuh, Anna

    2014-01-01

    Aim Genomic interventions could enable improved disease stratification and individually tailored therapies. However, they have had a limited impact on clinical practice to date due to a lack of evidence, particularly economic evidence. This is partly because health economists are yet to reach consensus on whether existing methods are sufficient to evaluate genomic technologies. As different approaches may produce conflicting adoption decisions, clarification is urgently required. This article summarizes the methodological issues associated with conducting economic evaluations of genomic interventions. Materials & methods A structured literature review was conducted to identify references that considered the methodological challenges faced when conducting economic evaluations of genomic interventions. Results Methodological challenges related to the analytical approach included the choice of comparator, perspective and timeframe. Challenges in costing centered around the need to collect a broad range of costs, frequently, in a data-limited environment. Measuring outcomes is problematic as standard measures have limited applicability, however, alternative metrics (e.g., personal utility) are underdeveloped and alternative approaches (e.g., cost–benefit analysis) underused. Effectiveness data quality is weak and challenging to incorporate into standard economic analyses, while little is known about patient and clinician behavior in this context. Comprehensive value of information analyses are likely to be helpful. Conclusion Economic evaluations of genomic technologies present a particular challenge for health economists. New methods may be required to resolve these issues, but the evidence to justify alternative approaches is yet to be produced. This should be the focus of future work in this field. PMID:24236483

  3. Behavioral health: the propaedeutic requirement.

    PubMed

    Brady, Joseph V

    2005-06-01

    Concern about the behavioral effects of spaceflight can be traced back a half century to the earliest preparatory bioastronautics experiments in the mid-1 950s. A central focus of the first primate suborbital flights, as well as the orbital chimpanzee pretest flights of Project Mercury, was the effects of such stressful ventures on the learned performances of these space behavioral health pioneers. The hiatus in spaceflight behavioral health experimental investments that followed these early initiatives began with the advent of the 'human astronaut' era of the mid-1960s, and has dominated the last several decades. Contemporary concerns in this regard have most recently been articulated by a turn-of-the-century Committee of the Institute of Medicine, National Academy of Sciences, providing a visionary view of space medicine during travel beyond Earth orbit. This 2-yr study focused on those most complex behavioral health interactions involving humans in extreme, isolated, and confined microsocieties-areas that have not received the necessary level of attention. The evident behavioral health issues raised by the prospect of long-duration exploratory missions beyond Earth orbit, including performance and general living conditions, recovery and support systems, and the screening, selection, and training of candidate participants are reviewed and discussed.

  4. The economic value of health care data.

    PubMed

    Harper, Ellen M

    2013-01-01

    The amount of health care data in our world has been exploding, and the ability to store, aggregate, and combine data and then use the results to perform deep analyses have become ever more important. "Big data," large pools of data that can be captured, communicated, aggregated, stored, and analyzed, are now part of every sector and function of the global economy. While most research into big data thus far has focused on the question of their volume, there is evidence that the business and economic possibilities of big data and their wider implications are important for consideration. It is even offering the possibility that health care data could become the most valuable asset over the next 5 years as "secondary use" of electronic health record data takes off.

  5. Behavior change, health, and health disparities: An introduction

    PubMed Central

    Higgins, Stephen T.

    2015-01-01

    This Special Issue of Preventive Medicine (PM) focuses on behavior change, health, and health disparities, topics of fundamental importance to improving population health in the U.S. and other industrialized countries. While the U.S. health care system and those of other industrialized countries were developed to manage infectious disease and acute illnesses, it is chronic health conditions that most need to be understood and managed in the 21st century. The evidence is clear that personal behavior patterns like cigarette smoking and physical inactivity/obesity are critically important proximal causes of chronic disease (cardiovascular disease, site-specific cancers, type-2 diabetes) and as such behavior change will need to be a key component of their management. As the outstanding contributions to this Special Issue illustrate, substantial headway is being made in advancing knowledge including developing effective prevention and treatment strategies, with cigarette smoking being an excellent example that change is possible. That said, cigarette smoking continues to be responsible for approximately 480,000 premature deaths annually in the U.S. alone and 5 million globally. So more needs to be done, especially in economically disadvantaged populations. The same certainly applies to the challenges of the obesity epidemic, which of course is a more recent problem and understandably efforts to curtail it are in earlier stages of development. PMID:25456804

  6. Health Instruction Packages: Behavioral Sciences.

    ERIC Educational Resources Information Center

    Mackey, Dianne Dee; And Others

    These four learning modules present text and exercises designed to help allied health students understand various elements of positive interaction with people. The first module, "Maslow's Hierarchy of Needs" by Dianne Mackey, defines human needs, presents Maslow's theories, and helps the learner identify behaviors that reflect the…

  7. Is Economics Coursework, or Majoring in Economics, Associated with Different Civic Behaviors?

    ERIC Educational Resources Information Center

    Allgood, Sam; Bosshardt, William; van der Klaauw, Wilbert; Watts, Michael

    2012-01-01

    Using data collected from graduates who attended four large public universities in 1976, 1986, or 1996, the authors investigate the relationship between studying economics and civic behaviors. They compare students who majored in economics, business, or other majors, and by the number of undergraduate economics courses completed. Coursework is…

  8. HEALTH CARE ECONOMICS IN ROMANIA--DYNAMICS AND EVOLUTION.

    PubMed

    Tamba, B I; Azoicăi, Doina; Druguş, Daniela

    2016-01-01

    Health economics refers to the analysis of medical institutions considering their economic and social efficacy, but also the regularity and the relationships that govern the phenomena and the processes from the field of health with the final purpose of achieving better results with the minimum of resources; it represents the study of health price in its complexity. The economics of the population's health needs and in particular the health needs in case of the poor groups of the population, consider health to be the main component of global human vulnerability. Health economics tries to change the simple interpretation of health price and disease cost into a wider consideration of a system administration similar to educational and social economics and the study of health in the context of the multiple specializations of the macro economy of the national group, as it is an instrument in the country's great economics symphony.

  9. Health Literacy and Women's Health-Related Behaviors in Taiwan

    ERIC Educational Resources Information Center

    Lee, Shoou-Yih D.; Tsai, Tzu-I; Tsai, Yi-Wen; Kuo, Ken N.

    2012-01-01

    Extant health literacy research is unclear about the contribution of health literacy to health behaviors and is limited regarding women's health issues. The primary purpose of this study is to investigate the association between health literacy and five health behaviors (Pap smear screening, annual physical checkup, smoking, checking food…

  10. The health impact of economic sanctions.

    PubMed Central

    Garfield, R.; Devin, J.; Fausey, J.

    1995-01-01

    Embargoes and sanctions are tools of foreign policy. They can induce a decline in economic activity in addition to reducing imports and untoward health effects can supervene, especially among older persons and those with chronic illnesses. Often, violations of the rights of life, health, social services, and protection of human dignity occur among innocent civilians in embargoed nations. This paper examines the effects of embargoes and sanctions against several nations, and calls for studies to determine ways in which economic warfare might be guided by the rule of humanitarian international law, to reduce the effects on civilians. It suggests that the ability to trade in exempted goods and services should be improved, perhaps by establishing uniform criteria and definitions for exemptions, operational criteria under which sanctions committees might function, and methods for monitoring the impact of sanctions on civilian populations in targeted states, particularly with regard to water purity, food availability, and infectious-disease control. Prospective studies are advocated, to generate the data needed to provide better information and monitoring capacity than presently exists. PMID:10101382

  11. Health research systems: promoting health equity or economic competitiveness?

    PubMed Central

    Loff, Bebe

    2012-01-01

    Abstract International collaborative health research is justifiably expected to help reduce global health inequities. Investment in health policy and systems research in developing countries is essential to this process but, currently, funding for international research is mainly channelled towards the development of new medical interventions. This imbalance is largely due to research legislation and policies used in high-income countries. These policies have increasingly led these countries to invest in health research aimed at boosting national economic competitiveness rather than reducing health inequities. In the United States of America and the United Kingdom of Great Britain and Northern Ireland, the regulation of research has encouraged a model that: leads to products that can be commercialized; targets health needs that can be met by profitable, high-technology products; has the licensing of new products as its endpoint; and does not entail significant research capacity strengthening in other countries. Accordingly, investment in international research is directed towards pharmaceutical trials and product development public–private partnerships for neglected diseases. This diverts funding away from research that is needed to implement existing interventions and to strengthen health systems, i.e. health policy and systems research. Governments must restructure their research laws and policies to increase this essential research in developing countries. PMID:22271965

  12. BEHAVIORAL HAZARD IN HEALTH INSURANCE*

    PubMed Central

    Baicker, Katherine; Mullainathan, Sendhil; Schwartzstein, Joshua

    2015-01-01

    A fundamental implication of standard moral hazard models is overuse of low-value medical care because copays are lower than costs. In these models, the demand curve alone can be used to make welfare statements, a fact relied on by much empirical work. There is ample evidence, though, that people misuse care for a different reason: mistakes, or “behavioral hazard.” Much high-value care is underused even when patient costs are low, and some useless care is bought even when patients face the full cost. In the presence of behavioral hazard, welfare calculations using only the demand curve can be off by orders of magnitude or even be the wrong sign. We derive optimal copay formulas that incorporate both moral and behavioral hazard, providing a theoretical foundation for value-based insurance design and a way to interpret behavioral “nudges.” Once behavioral hazard is taken into account, health insurance can do more than just provide financial protection—it can also improve health care efficiency. PMID:23930294

  13. [Economic crisis and mental health. SESPAS report 2014].

    PubMed

    Gili, Margalida; García Campayo, Javier; Roca, Miquel

    2014-06-01

    Studies published before the financial crisis of 2008 suggest that economic difficulties contribute to poorer mental health. The IMPACT study conducted in primary health care centers in Spain found a significant increase in common mental disorders. Between 2006 and 2010, mood disorders increased by 19%, anxiety disorders by 8% and alcohol abuse disorders by 5%. There were also gender differences, with increased alcohol dependence in women during the crisis period. The most important risk factor for this increase was unemployment. In parallel, antidepressant consumption has increased in recent years, although there has not been a significant inrease in the number of suicides. Finally, the study offers some proposals to reduce the impact of the crisis on mental health: increased community services, employment activation measures, and active policies to reduce alcohol consumption and prevent suicidal behavior, particularly among young people.

  14. Social capital, economics, and health: new evidence.

    PubMed

    Scheffler, Richard M; Brown, Timothy T

    2008-10-01

    In introducing this Special Issue on Social Capital and Health, this article tracks the popularization of the term and sheds light on the controversy surrounding the term and its definitions. It sets out four mechanisms that link social capital with health: making information available to community members, impacting social norms, enhancing the health care services and their accessibility in a community, and offering psychosocial support networks. Approaches to the measurement of social capital include the Social Capital Community Benchmark Survey (SCCBS) developed by Robert Putnam, and the Petris Social Capital Index (PSCI), which looks at community voluntary organizations using public data available for the entire United States. The article defines community social capital (CSC) as the extent and density of trust, cooperation, and associational links and activity within a given population. Four articles on CSC are introduced in two categories: those that address behaviors -- particularly utilization of health services and use of tobacco, alcohol, and drugs; and those that look at links between social capital and physical or mental health. Policy implications include: funding and/or tax subsidies that would support the creation of social capital; laws and regulations; and generation of enthusiasm among communities and leaders to develop social capital. The next steps in the research programme are to continue testing the mechanisms; to look for natural experiments; and to find better public policies to foster social capital.

  15. Chronic Disease Disparities by County Economic Status and Metropolitan Classification, Behavioral Risk Factor Surveillance System, 2013

    PubMed Central

    Theis, Kristina A.; Self-Brown, Shannon; Roblin, Douglas W.; Barker, Lawrence

    2016-01-01

    Introduction Racial/ethnic disparities have been studied extensively. However, the combined influence of geographic location and economic status on specific health outcomes is less well studied. This study’s objective was to examine 1) the disparity in chronic disease prevalence in the United States by county economic status and metropolitan classification and 2) the social gradient by economic status. The association of hypertension, arthritis, and poor health with county economic status was also explored. Methods We used 2013 Behavioral Risk Factor Surveillance System data. County economic status was categorized by using data on unemployment, poverty, and per capita market income. While controlling for sociodemographics and other covariates, we used multivariable logistic regression to evaluate the relationship between economic status and hypertension, arthritis, and self-rated health. Results Prevalence of hypertension, arthritis, and poor health in the poorest counties was 9%, 13%, and 15% higher, respectively, than in the most affluent counties. After we controlled for covariates, poor counties still had a higher prevalence of the studied conditions. Conclusion We found that residents of poor counties had a higher prevalence of poor health outcomes than affluent counties, even after we controlled for known risk factors. Further, the prevalence of poor health outcomes decreased as county economics improved. Findings suggest that poor counties would benefit from targeted public health interventions, better access to health care services, and improved food and built environments. PMID:27584875

  16. [Health economic evaluation of disease management programs].

    PubMed

    Greiner, W

    2006-01-01

    Disease management has become an important element in the improvement of care for people with chronic illnesses and has become embedded in the discussion on health policy in recent years. The approach has been introduced very differently to the health systems worldwide. Since 1 January 2003 accredited disease management programs (DMPs) have been a part of the risk structure compensation scheme of the German statutory health insurance. This is seen as the first step to a morbidity orientation of the risk structure compensation. DMPs have to be evaluated according the German Social Law, especially whether the objectives of the programs and the criteria for inclusion of the patients have been met and the quality of care for the patients is insured. The criteria for evaluation are threefold: medical issues, economic issues and subjective quality of life of the patients. Due to the immense amounts of data which can be expected the evaluation of the German DMPs is a huge logistical challenge. Until now not very much is known about the data quality. The evaluation is focused on the perspective of the sickness funds as e.g. information about indirect cost is not collected. In the article the methods for evaluation are described and critically discussed.

  17. Introduction to health economics and decision-making: Is economics relevant for the frontline clinician?

    PubMed

    Goeree, Ron; Diaby, Vakaramoko

    2013-12-01

    In a climate of escalating demands for new health care services and significant constraints on new resources, the disciplines of health economics and health technology assessment (HTA) have increasingly been turned to as explicit evidence-based frameworks to help make tough health care access and reimbursement decisions. Health economics is the discipline of economics concerned with the efficient allocation of health care resources, essentially trying to maximize health benefits to society contingent upon available resources. HTA is a broader field drawing upon several disciplines, but which relies heavily upon the tools of health economics and economic evaluation. Traditionally, health economics and economic evaluation have been widely used at the political (macro) and local (meso) decision-making levels, and have progressively had an important role even at informing individual clinical decisions (micro level). The aim of this paper is to introduce readers to health economics and discuss its relevance to frontline clinicians. Particularly, the content of the paper will facilitate clinicians' understanding of the link between economics and their medical practice, and how clinical decision-making reflects on health care resource allocation.

  18. Health Care Seeking Behavior in Southwest Ethiopia

    PubMed Central

    Begashaw, Bayu; Tessema, Fasil; Gesesew, Hailay Abrha

    2016-01-01

    Background Rural and urban populations have disparate socio-demographic and economic characteristics, which have an influence on equity and their health seeking behavior. We examined and compared the health care seeking behavior for perceived morbidity between urban and rural households in Southwest Ethiopia. Methods Analytic cross-sectional study was conducted among urban and rural households living in Esera district of Southwest Ethiopia. A random sample of 388 head of households (126 urban and 262 rural) were selected. A pretested and structured questionnaire was used for data collection with face-to-face interview. In addition to descriptive methods, binary logistic regression was used to identify factors associated with health seeking behavior at p value of less than 0.05. Results Of the sample household heads, 377 (97.2%) (119 urban and 258 rural) were successfully interviewed. Among these, 58.4% (95% CI, 53.3–63.3%) of the households sought care from modern health care that was lower among rural (48.1%) than urban (80.7%) households. The prevalence of self-treatment was 35.3% in urban and 46.1% in rural households. Among the factors considered for modern health care utilization, higher monthly income (AOR, 5.6; 95% CI, 2.04–15.4), perceived severity of disease (AOR, 2.5; 95% CI, 1.1–5.8), acute duration of disease (AOR, 8.9; 95% CI, 2.4–33.3) and short distance from health facilities (AOR, 3; 95% CI, 1.2–8.4) among rural and being married (AOR, 11.3; 95% CI, 1.2–110.2) and perceived severity of disease (AOR, 6.6; 95% CI, 1.1–10.9) among urban households showed statistically significant association. Conclusions The general health seeking behavior of households on perceived morbidity was satisfactory but lower in rural compared to urban households. Self-medication was also widely practiced in the study area. The findings signal the need to work more on accessibility and promotion of healthcare seeking behavior especially among rural households

  19. A Framework for Including Family Health Spillovers in Economic Evaluation.

    PubMed

    Al-Janabi, Hareth; van Exel, Job; Brouwer, Werner; Coast, Joanna

    2016-02-01

    Health care interventions may affect the health of patients' family networks. It has been suggested that these "health spillovers" should be included in economic evaluation, but there is not a systematic method for doing this. In this article, we develop a framework for including health spillovers in economic evaluation. We focus on extra-welfarist economic evaluations where the objective is to maximize health benefits from a health care budget (the "health care perspective"). Our framework involves adapting the conventional cost-effectiveness decision rule to include 2 multiplier effects to internalize the spillover effects. These multiplier effects express the ratio of total health effects (for patients and their family networks) to patient health effects. One multiplier effect is specified for health benefit generated from providing a new intervention, one for health benefit displaced by funding this intervention. We show that using multiplier effects to internalize health spillovers could change the optimal funding decisions and generate additional health benefits to society.

  20. The role of behavioral economics and behavioral decision making in Americans' retirement savings decisions.

    PubMed

    Knoll, Melissa A Z

    2010-01-01

    Traditional economic theory posits that people make decisions by maximizing a utility function in which all of the relevant constraints and preferences are included and weighed appropriately. Behavioral economists and decision-making researchers, however, are interested in how people make decisions in the face of incomplete information, limited cognitive resources, and decision biases. Empirical findings in the areas of behavioral economics and judgment and decision making (JDM) demonstrate departures from the notion that man is economically rational, illustrating instead that people often act in ways that are economically suboptimal. This article outlines findings from the JDM and behavioral-economics literatures that highlight the many behavioral impediments to saving that individuals may encounter on their way to financial security. I discuss how behavioral and psychological issues, such as self-control, emotions, and choice architecture can help policymakers understand what factors, aside from purely economic ones, may affect individuals' savings behavior.

  1. Using Behavioral Economics to Design Physician Incentives That Deliver High-Value Care.

    PubMed

    Emanuel, Ezekiel J; Ubel, Peter A; Kessler, Judd B; Meyer, Gregg; Muller, Ralph W; Navathe, Amol S; Patel, Pankaj; Pearl, Robert; Rosenthal, Meredith B; Sacks, Lee; Sen, Aditi P; Sherman, Paul; Volpp, Kevin G

    2016-01-19

    Behavioral economics provides insights about the development of effective incentives for physicians to deliver high-value care. It suggests that the structure and delivery of incentives can shape behavior, as can thoughtful design of the decision-making environment. This article discusses several principles of behavioral economics, including inertia, loss aversion, choice overload, and relative social ranking. Whereas these principles have been applied to motivate personal health decisions, retirement planning, and savings behavior, they have been largely ignored in the design of physician incentive programs. Applying these principles to physician incentives can improve their effectiveness through better alignment with performance goals. Anecdotal examples of successful incentive programs that apply behavioral economics principles are provided, even as the authors recognize that its application to the design of physician incentives is largely untested, and many outstanding questions exist. Application and rigorous evaluation of infrastructure changes and incentives are needed to design payment systems that incentivize high-quality, cost-conscious care.

  2. How behavioral science can advance digital health.

    PubMed

    Pagoto, Sherry; Bennett, Gary G

    2013-09-01

    The field of behavioral science has produced myriad data on health behavior change strategies and leveraged such data into effective human-delivered interventions to improve health. Unfortunately, the impact of traditional health behavior change interventions has been heavily constrained by patient and provider burden, limited ability to measure and intervene upon behavior in real time, variable adherence, low rates of implementation, and poor third-party coverage. Digital health technologies, including mobile phones, sensors, and online social networks, by being available in real time, are being explored as tools to increase our understanding of health behavior and to enhance the impact of behavioral interventions. The recent explosion of industry attention to the development of novel health technologies is exciting but has far outpaced research. This Special Section of Translational Behavioral Medicine, Smartphones, Sensors, and Social Networks: A New Age of Health Behavior Change features a collection of studies that leverage health technologies to measure, change, and/or understand health behavior. We propose five key areas in which behavioral science can improve the impact of digital health technologies on public health. First, research is needed to identify which health technologies actually impact behavior and health outcomes. Second, we need to understand how online social networks can be leveraged to impact health behavior on a large scale. Third, a team science approach is needed in the developmental process of health technologies. Fourth, behavioral scientists should identify how a balance can be struck between the fast pace of innovation and the much slower pace of research. Fifth, behavioral scientists have an integral role in informing the development of health technologies and facilitating the movement of health technologies into the healthcare system.

  3. 78 FR 25309 - Advisory Committee for Social, Behavioral and Economic Sciences; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-30

    ... ADVISORY Advisory Committee for Social, Behavioral and Economic Sciences; Notice of Meeting In accordance... announces the following meeting: Name: Advisory Committee for Social, Behavioral and Economic Sciences..., Behavioral and Economic Sciences, National Science Foundation, 4201 Wilson Boulevard, Room 905,...

  4. [Economic expansion and the health crisis in Paraguay].

    PubMed

    Weisskoff, R

    1993-06-01

    In spite of the rapid economic development experienced by Paraguay during recent years, the country's health conditions remain among the poorest in Latin America. This article strives to explain, by presenting a model of Paraguay's economic and health care systems, why health care and economic growth have not advanced at the same rate. By examining various economic and health care indicators, hospital registries, family planning activities, and statistics on drinking-water and health care services distribution among central departments with established populations, as well as recently populated peripheral areas, the conclusion is reached that the country's poor health conditions might be the direct result of accelerated expansion of the agricultural frontier. In closing, recommendations are made for updating health statistics via new health survey, improved training for rural health care personnel, and closer coordination among the four public hospital systems in the cities.

  5. Is income relevant for health expenditure and economic growth nexus?

    PubMed

    Halıcı-Tülüce, Nadide Sevil; Doğan, İbrahim; Dumrul, Cüneyt

    2016-03-01

    This paper examines the relationship between health expenditure and economic growth using panel data consisting low and high-income countries. Using dynamic panel data methodology, we analyze twenty five high-income and nineteen low-income economies for the periods of 1995-2012 and 1997-2009, respectively. We find reciprocal relationship between health expenditure and economic growth in the short run and one-way causality from economic growth to public health expenditure in the long-run. In high-income countries, there is a two-way causality for both private and public health expenditures in the short-run, while in the long-run there is a one-way causality between economic growth and private health expenditures. The crucial finding of this study is that private health expenditures have negative influence on economic growth while public health expenditures have both negative and statistically significant effect.

  6. Parental and child health beliefs and behavior.

    PubMed

    Dielman, T E; Leech, S; Becker, M H; Rosenstock, I M; Horvath, W J; Radius, S M

    1982-01-01

    Personal interviews concerning health beliefs and behaviors were conducted with a parent and child in each of 250 households. Index scores were constructed for parental and child health beliefs, and these scores were entered, along with demographic variables, in a series of multiple regression analyses predicting child health beliefs and behaviors. The age of the child was the variable most highly associated with three of four child health behaviors and four of six child health beliefs. The children's snacking between meals and cigarette smoking were related to several parental behaviors and, to a lesser extent, parental health beliefs. The children's health beliefs were less predictable than were their health behaviors, and the observed significant relationships were with parental health beliefs and demographics. The implications for the design of health education programs are discussed.

  7. [The economic-financial crisis and health in Spain. Evidence and viewpoints. SESPAS report 2014].

    PubMed

    Cortès-Franch, Imma; González López-Valcárcel, Beatriz

    2014-06-01

    The objectives of the SESPAS 2014 Report are as follows: a) to analyze the impact of the economic crisis on health and health-related behaviors, on health inequalities, and on the determinants of health in Spain; b) to describe the changes in the Spanish health system following measures to address the crisis and assess its potential impact on health; c) to review the evidence on the health impact of economic crises in other countries, as well as policy responses; and d) to suggest policy interventions alternative to those carried out to date with a population health perspective and scientific evidence in order to help mitigate the impact of the economic downturn on health and health inequalities. The report is organized in five sections: 1) the economic, financial and health crisis: causes, consequences, and contexts; 2) the impact on structural determinants of health and health inequalities; 3) the impact on health and health-related behaviors, and indicators for monitoring; 4) the impact on health systems; and 5) the impact on specific populations: children, seniors, and immigrants. There is some evidence on the relationship between the crisis and the health of the Spanish population, health inequalities, some changes in lifestyle, and variations in access to health services. The crisis has impacted many structural determinants of health, particularly among the most vulnerable population groups. Generally, policy responses on how to manage the crisis have not taken the evidence into account. The crisis may contribute to making public policy vulnerable to corporate action, thus jeopardizing the implementation of healthy policies.

  8. Early-Childhood Poverty and Adult Attainment, Behavior, and Health

    ERIC Educational Resources Information Center

    Duncan, Greg J.; Ziol-Guest, Kathleen M.; Kalil, Ariel

    2010-01-01

    This article assesses the consequences of poverty between a child's prenatal year and 5th birthday for several adult achievement, health, and behavior outcomes, measured as late as age 37. Using data from the Panel Study of Income Dynamics (1,589) and controlling for economic conditions in middle childhood and adolescence, as well as demographic…

  9. [The impact of health economics: a status report].

    PubMed

    Tunder, R

    2011-12-01

    "Health is not everything, but without health, everything is nothing" (cited from Arthur Schopenhauer, German philosopher, 1788-1860). The relationship between medicine and economics could not have been put more precisely. On the one hand there is the need for a maximum of medical care and on the other hand the necessity to economize with scarce financial resources. The compatibility of these two aspects inevitably leads to strains. How to approach this challenge? From medicine to economics or from economics to medicine? The present article intends to raise awareness to regard the "economization of medicine" not just as a threat, but also as an opportunity. Needs for economic action are pointed out, and insights as well as future perspectives for the explanatory contribution for health economics are given.

  10. Clustering of health-related behaviors, health outcomes and demographics in Dutch adolescents: a cross-sectional study

    PubMed Central

    2013-01-01

    Background Recent studies show several health-related behaviors to cluster in adolescents. This has important implications for public health. Interrelated behaviors have been shown to be most effectively targeted by multimodal interventions addressing wider-ranging improvements in lifestyle instead of via separate interventions targeting individual behaviors. However, few previous studies have taken into account a broad, multi-disciplinary range of health-related behaviors and connected these behavioral patterns to health-related outcomes. This paper presents an analysis of the clustering of a broad range of health-related behaviors with relevant demographic factors and several health-related outcomes in adolescents. Methods Self-report questionnaire data were collected from a sample of 2,690 Dutch high school adolescents. Behavioral patterns were deducted via Principal Components Analysis. Subsequently a Two-Step Cluster Analysis was used to identify groups of adolescents with similar behavioral patterns and health-related outcomes. Results Four distinct behavioral patterns describe the analyzed individual behaviors: 1- risk-prone behavior, 2- bully behavior, 3- problematic screen time use, and 4- sedentary behavior. Subsequent cluster analysis identified four clusters of adolescents. Multi-problem behavior was associated with problematic physical and psychosocial health outcomes, as opposed to those exerting relatively few unhealthy behaviors. These associations were relatively independent of demographics such as ethnicity, gender and socio-economic status. Conclusions The results show that health-related behaviors tend to cluster, indicating that specific behavioral patterns underlie individual health behaviors. In addition, specific patterns of health-related behaviors were associated with specific health outcomes and demographic factors. In general, unhealthy behavior on account of multiple health-related behaviors was associated with both poor psychosocial

  11. Economics and Health Reform: Academic Research and Public Policy.

    PubMed

    Glied, Sherry A; Miller, Erin A

    2015-08-01

    Two prior studies, conducted in 1966 and in 1979, examined the role of economic research in health policy development. Both concluded that health economics had not been an important contributor to policy. Passage of the Affordable Care Act offers an opportunity to reassess this question. We find that the evolution of health economics research has given it an increasingly important role in policy. Research in the field has followed three related paths over the past century-institutionalist research that described problems; theoretical research, which proposed relationships that might extend beyond existing institutions; and empirical assessments of structural parameters identified in the theoretical research. These three strands operating in concert allowed economic research to be used to predict the fiscal and coverage consequences of alternative policy paths. This ability made economic research a powerful policy force. Key conclusions of health economics research are clearly evident in the Affordable Care Act.

  12. Behavioral Economics of Self-Control Failure

    PubMed Central

    Heshmat, Shahram

    2015-01-01

    The main idea in this article is that addiction is a consequence of falling victim to decision failures that lead to preference for the addictive behaviors. Addiction is viewed as valuation disease, where the nervous system overvalues cues associated with drugs or drug-taking. Thus, addiction can be viewed as a diminished capacity to choose. Addicted individuals assign lower values to delayed rewards than to immediate ones. The preference for immediate gratification leads to self-control problems. This article highlights a number of motivational forces that can generate self-control failure. PMID:26339218

  13. Behavioral Economics of Self-Control Failure.

    PubMed

    Heshmat, Shahram

    2015-09-01

    The main idea in this article is that addiction is a consequence of falling victim to decision failures that lead to preference for the addictive behaviors. Addiction is viewed as valuation disease, where the nervous system overvalues cues associated with drugs or drug-taking. Thus, addiction can be viewed as a diminished capacity to choose. Addicted individuals assign lower values to delayed rewards than to immediate ones. The preference for immediate gratification leads to self-control problems. This article highlights a number of motivational forces that can generate self-control failure.

  14. Health Behaviors among Baby Boomer Informal Caregivers

    ERIC Educational Resources Information Center

    Hoffman, Geoffrey J.; Lee, Jihey; Mendez-Luck, Carolyn A.

    2012-01-01

    Purpose of the Study: This study examines health-risk behaviors among "Baby Boomer" caregivers and non-caregivers. Design and Methods: Data from the 2009 California Health Interview Survey of the state's non-institutionalized population provided individual-level, caregiving, and health behavior characteristics for 5,688 informal…

  15. Behavioral Economics Matters for HIV Research: The Impact of Behavioral Biases on Adherence to Antiretrovirals (ARVs)

    PubMed Central

    Stecher, Chad

    2016-01-01

    Behavioral economics (BE) has been used to study a number of health behaviors such as smoking and drug use, but there is little knowledge of how these insights relate to HIV prevention and care. We present novel evidence on the prevalence of the common behavioral decision-making errors of present-bias, overoptimism, and information salience among 155 Ugandan HIV patients, and analyze their association with subsequent medication adherence. 36 % of study participants are classified as present-biased, 21 % as overoptimistic, and 34 % as having salient HIV information. Patients displaying present-bias were 13 % points (p = 0.006) less likely to have adherence rates above 90 %, overoptimistic clients were 9 % points (p = 0.04) less likely, and those not having salient HIV information were 17 % points (p < 0.001) less likely. These findings indicate that BE may be used to screen for future adherence problems and to better design and target interventions addressing these behavioral biases and the associated suboptimal adherence. PMID:25987190

  16. Behavioral Economics Matters for HIV Research: The Impact of Behavioral Biases on Adherence to Antiretrovirals (ARVs).

    PubMed

    Linnemayr, Sebastian; Stecher, Chad

    2015-11-01

    Behavioral economics (BE) has been used to study a number of health behaviors such as smoking and drug use, but there is little knowledge of how these insights relate to HIV prevention and care. We present novel evidence on the prevalence of the common behavioral decision-making errors of present-bias, overoptimism, and information salience among 155 Ugandan HIV patients, and analyze their association with subsequent medication adherence. 36 % of study participants are classified as present-biased, 21 % as overoptimistic, and 34 % as having salient HIV information. Patients displaying present-bias were 13 % points (p = 0.006) less likely to have adherence rates above 90 %, overoptimistic clients were 9 % points (p = 0.04) less likely, and those not having salient HIV information were 17 % points (p < 0.001) less likely. These findings indicate that BE may be used to screen for future adherence problems and to better design and target interventions addressing these behavioral biases and the associated suboptimal adherence.

  17. Crisis as opportunity: international health work during the economic depression.

    PubMed

    Borowy, Iris

    2008-01-01

    The economic depression of the 1930s represented the most important economic and social crisis of its time. Surprisingly, its effect on health did not show in available morbidity and mortality rates. In 1932, the League of Nations Health Organisation embarked on a six-point program addressing statistical methods of measuring the effect and its influence on mental health and nutrition and establishing ways to safeguard public health through more efficient health systems. Some of these studies resulted in considerations of general relevance beyond crisis management. Unexpectedly, the crisis offered an opportunity to reconsider key concepts of individual and public health.

  18. Pay-for-performance: toxic to quality? Insights from behavioral economics.

    PubMed

    Himmelstein, David U; Ariely, Dan; Woolhandler, Steffie

    2014-01-01

    Pay-for-performance programs aim to upgrade health care quality by tailoring financial incentives for desirable behaviors. While Medicare and many private insurers are charging ahead with pay-for-performance, researchers have been unable to show that it benefits patients. Findings from the new field of behavioral economics challenge the traditional economic view that monetary reward either is the only motivator or is simply additive to intrinsic motivators such as purpose or altruism. Studies have shown that monetary rewards can undermine motivation and worsen performance on cognitively complex and intrinsically rewarding work, suggesting that pay-for-performance may backfire.

  19. Do Social and Economic Policies Influence Health? A Review

    PubMed Central

    Joshi, Pamela; Geronimo, Kimberly; Acevedo-Garcia, Dolores

    2014-01-01

    Although social and economic policies are not considered part of health services infrastructure, such policies may influence health and disease by altering social determinants of health (SDH). We review social and economic policies in the US that have measured health outcomes among adults in four domains of SDH including housing and neighborhood, employment, family strengthening/marriage, and income supplementation. The majority of these policies target low-income populations. These social policies rarely consider health as their initial mission or outcomes. When measuring health, the programs document mental health and physical health benefits more than half the time, although some effects fade with time. We also find considerable segregation of program eligibility by gender and family composition. Policy makers should design future social policies to evaluate health outcomes using validated health measures; to target women more broadly across the socioeconomic spectrum; and to consider family caregiving responsibilities as ignoring them can have unintended health effects. PMID:25984439

  20. Do Social and Economic Policies Influence Health? A Review.

    PubMed

    Osypuk, Theresa L; Joshi, Pamela; Geronimo, Kimberly; Acevedo-Garcia, Dolores

    2014-09-01

    Although social and economic policies are not considered part of health services infrastructure, such policies may influence health and disease by altering social determinants of health (SDH). We review social and economic policies in the US that have measured health outcomes among adults in four domains of SDH including housing and neighborhood, employment, family strengthening/marriage, and income supplementation. The majority of these policies target low-income populations. These social policies rarely consider health as their initial mission or outcomes. When measuring health, the programs document mental health and physical health benefits more than half the time, although some effects fade with time. We also find considerable segregation of program eligibility by gender and family composition. Policy makers should design future social policies to evaluate health outcomes using validated health measures; to target women more broadly across the socioeconomic spectrum; and to consider family caregiving responsibilities as ignoring them can have unintended health effects.

  1. Early childhood economic disadvantage and the health of Hispanic children

    PubMed Central

    Schmeer, Kammi K.

    2016-01-01

    This research provides a longitudinal view of early childhood economic deprivation and its associations with health among young Hispanic children born in the United States. Of additional interest is whether economic deprivation is associated with child health similarly across all Hispanic children or whether associations differ by maternal nativity or country of origin. Fragile Families and Child Wellbeing data and multinomial logistic regression are used to estimate the effects of total years in poverty, material hardship, and lack of health insurance on Hispanic children’s health status at age 5 and change in health status between ages 1 and 5. Results show that multiple measures of early childhood economic deprivation have additive negative associations with Hispanic child health, and that living more years in poverty is associated with declining health status among young Hispanic children. Interaction effects indicate that early childhood poverty has stronger associations with lower age 5 health status and declining health between ages 1 and 5 for children with foreign-born Hispanic mothers than for those with native-born Hispanic mothers. No differences were found in the associations between economic deprivation and child health by maternal country of origin. These results suggest an important role of economic resources for protecting Hispanic child health, and that poor Hispanic children with immigrant mothers may be at particularly high risk of developing health problems as they move out of infancy and into early childhood. PMID:22818489

  2. China at the crossroads: the economics of tobacco and health

    PubMed Central

    Hu, T‐W; Mao, Z; Ong, M; Tong, E; Tao, M; Jiang, H; Hammond, K; Smith, K R; de Beyer, J; Yurekli, A

    2006-01-01

    Objective To analyse economic aspects of tobacco control policy issues in China. Methods Published and collected survey data were used to analyse economic consequences of smoking. Economic analysis was used to address the role of tobacco farmers and the cigarette industry in the Chinese economy. Results In the agricultural sector, tobacco has the lowest economic rate of return of all cash crops. At the same time, the tobacco industry's tax contribution to the central government has been declining. Conclusion Economic gains become less important as the negative health impact of smoking on the population garners more awareness. China stands at a crossroads to implement the economic promises of the World Health Organization's Framework Convention on Tobacco Control and promote the health of its population. PMID:16723674

  3. [Ethics versus economics in public health? On the integration of economic rationality in a discourse of public health ethics].

    PubMed

    Rothgang, H; Staber, J

    2009-05-01

    In the course of establishing the discourse of public health ethics in Germany, we discuss whether economic efficiency should be part of public health ethics and, if necessary, how efficiency should be conceptualized. Based on the welfare economics theory, we build a theoretical framework that demands an integration of economic rationality in public health ethics. Furthermore, we consider the possible implementation of welfare efficiency against the background of current practice in an economic evaluation of health care in Germany. The indifference of the welfare efficiency criterion with respect to distribution leads to the conclusion that efficiency must not be the only criteria of public health ethics. Therefore, an ethical approach of principles should be chosen for public health ethics. Possible conflicts between principles of such an approach are outlined.

  4. Big Data and Health Economics: Strengths, Weaknesses, Opportunities and Threats.

    PubMed

    Collins, Brendan

    2016-02-01

    'Big data' is the collective name for the increasing capacity of information systems to collect and store large volumes of data, which are often unstructured and time stamped, and to analyse these data by using regression and other statistical techniques. This is a review of the potential applications of big data and health economics, using a SWOT (strengths, weaknesses, opportunities, threats) approach. In health economics, large pseudonymized databases, such as the planned care.data programme in the UK, have the potential to increase understanding of how drugs work in the real world, taking into account adherence, co-morbidities, interactions and side effects. This 'real-world evidence' has applications in individualized medicine. More routine and larger-scale cost and outcomes data collection will make health economic analyses more disease specific and population specific but may require new skill sets. There is potential for biomonitoring and lifestyle data to inform health economic analyses and public health policy.

  5. [Health economic aspects of physical-mental comorbidity].

    PubMed

    Lehnert, T; Konnopka, A; Riedel-Heller, S; König, H-H

    2011-01-01

    Physical-mental comorbidity is often associated with worse clinical and psychosocial outcomes, reduced health-related quality of life, and increased healthcare utilization. The following article is dedicated to the health economic aspects of physical-mental comorbidity. It presents basic theoretical and methodological aspects of cost-of-illness studies and economic evaluations related to physical-mental comorbidity, which are explained and discussed for the practical example of comorbid depression in diabetes mellitus. The results show that mental comorbidity in diabetes is associated with increased healthcare costs, which can in part be attributed to an increased somatic health service use. Appropriate interventions can lower these excess costs. Economic evaluations assessing the effectiveness of interventions for depressive diabetics have shown that overall health can be improved and costs saved. However, especially in health economics, mental comorbidity in somatic diseases has not been comprehensively investigated and further research is warranted.

  6. Environmental Effects on Public Health: An Economic Perspective

    PubMed Central

    Remoundou, Kyriaki; Koundouri, Phoebe

    2009-01-01

    In this article we critically review the economic literature on the effects of environmental changes on public health, in both the developed and the developing world. We first focus on the economic methodologies that are available for the evaluation of the effects (social costs and benefits) of environmental changes (degradation/preservation) on public health. Then, we explain how the monetary valuations of these effects can feed back in the construction of economic policy for creating agent-specific incentives for more efficient public health management, which is also equitable and environmentally sustainable. Our exposition is accompanied by a synthesis of the available quantitative empirical results. PMID:19742153

  7. Responsible leader behavior in health sectors.

    PubMed

    Longest, Beaufort

    2017-02-06

    Purpose The purpose of this paper is to expand attention to responsible leader behavior in the world's health sectors by explaining how this concept applies to health sectors, considering why health sector leaders should behave responsibly, reviewing how they can do so, and asserting potential impact through an applied example. Design/methodology/approach This paper is a viewpoint, reflecting conceptualizations rooted in leadership literature which are then specifically applied to health sectors. A definition of responsible leader behavior is affirmed and applied specifically in health sectors. Conceptualizations and viewpoints about practice of responsible leader behavior in health sectors and potential consequences are then discussed and asserted. Findings Leadership failures and debacles found in health, but more so in other sectors, have led leadership researchers to offer insights, many of them empirical, into the challenges of leadership especially by more clearly delineating responsible leader behavior. Practical implications Much of what has been learned in the research about responsible leader behavior offers pathways for health sector leaders to more fully practice responsible leadership. Social implications This paper asserts and provides a supporting example that greater levels of responsible leader behavior in health sectors hold potentially important societal benefits. Originality/value This paper is the first to apply emerging conceptualizations and early empirical findings about responsible leader behavior specifically to leaders in health sectors.

  8. Mothers' Economic Hardship and Behavior Problems in Their Early Adolescents

    ERIC Educational Resources Information Center

    Burrell, Ginger Lockhart; Roosa, Mark W.

    2009-01-01

    Concerns about the heightened prevalence of behavior problems among adolescents from low-income families have prompted researchers to understand processes through which economic variables influence functioning within multiple domains. Guided by a stress process framework and social contextual theory, this study examines processes linking perceived…

  9. The Economic Behavior of Academic Research Libraries: Toward a Theory.

    ERIC Educational Resources Information Center

    Liu, Lewis G.

    2003-01-01

    Examines the economic behavior of academic research libraries, arguing that academic research libraries seek to maximize universities' utility by expanding library collections. Findings are consistent with those from a previous study using a different ranking system and sample data and reconfirm that library collections contribute significantly to…

  10. Behavioral Economic Predictors of Overweight Children's Weight Loss

    ERIC Educational Resources Information Center

    Best, John R.; Theim, Kelly R.; Gredysa, Dana M.; Stein, Richard I.; Welch, R. Robinson; Saelens, Brian E.; Perri, Michael G.; Schechtman, Kenneth B.; Epstein, Leonard H.; Wilfley, Denise E.

    2012-01-01

    Objective: Our goal was to determine whether behavioral economic constructs--including impulsivity (i.e., steep discounting of delayed food and monetary rewards), the relative reinforcing value of food (RRV[subscript food]), and environmental enrichment (i.e., the presence of alternatives to unhealthy foods in the home and neighborhood…

  11. Health, "illth," and economic growth: medicine, environment, and economics at the crossroads.

    PubMed

    Egger, Garry

    2009-07-01

    Economic growth has been the single biggest contributor to population health since the Industrial Revolution. The growth paradigm, by definition, is dynamic, implying similar diminishing returns on investment at both the macro- and the micro-economic levels. Changes in patterns of health in developing countries, from predominantly microbial-related infectious diseases to lifestyle-related chronic diseases (e.g., obesity, type 2 diabetes) beyond a point of economic growth described as the epidemiologic transition, suggest the start of certain declining benefits from further investment in the growth model. These changes are reflected in slowing improvements in some health indices (e.g., mortality, infant mortality) and deterioration in others (e.g., disability-associated life years, obesity, chronic diseases). Adverse environmental consequences, such as climate change from economic development, are also related to disease outcomes through the development of inflammatory processes due to an immune reaction to new environmental and lifestyle-related inducers. Both increases in chronic disease and climate change can be seen as growth problems with a similar economic cause and potential economic and public health-rather than personal health-solutions. Some common approaches for dealing with both are discussed, with a plea for greater involvement by health scientists in the economic and environmental debates in order to deal effectively with issues like obesity and chronic disease.

  12. Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement.

    PubMed

    Husereau, Don; Drummond, Michael; Petrou, Stavros; Carswell, Chris; Moher, David; Greenberg, Dan; Augustovski, Federico; Briggs, Andrew H; Mauskopf, Josephine; Loder, Elizabeth

    2013-03-25

    Economic evaluations of health interventions pose a particular challenge for reporting. There is also a need to consolidate and update existing guidelines and promote their use in a user friendly manner. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement is an attempt to consolidate and update previous health economic evaluation guidelines efforts into one current, useful reporting guidance. The primary audiences for the CHEERS statement are researchers reporting economic evaluations and the editors and peer reviewers assessing them for publication. The need for new reporting guidance was identified by a survey of medical editors. A list of possible items based on a systematic review was created. A two round, modified Delphi panel consisting of representatives from academia, clinical practice, industry, government, and the editorial community was conducted. Out of 44 candidate items, 24 items and accompanying recommendations were developed. The recommendations are contained in a user friendly, 24 item checklist. A copy of the statement, accompanying checklist, and this report can be found on the ISPOR Health Economic Evaluations Publication Guidelines Task Force website (www.ispor.org/TaskForces/EconomicPubGuidelines.asp). We hope CHEERS will lead to better reporting, and ultimately, better health decisions. To facilitate dissemination and uptake, the CHEERS statement is being co-published across 10 health economics and medical journals. We encourage other journals and groups, to endorse CHEERS. The author team plans to review the checklist for an update in five years.

  13. Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement.

    PubMed

    Husereau, Don; Drummond, Michael; Petrou, Stavros; Carswell, Chris; Moher, David; Greenberg, Dan; Augustovski, Federico; Briggs, Andrew H; Mauskopf, Josephine; Loder, Elizabeth

    2013-01-01

    Economic evaluations of health interventions pose a particular challenge for reporting. There is also a need to consolidate and update existing guidelines and promote their use in a user friendly manner. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement is an attempt to consolidate and update previous health economic evaluation guidelines efforts into one current, useful reporting guidance. The primary audiences for the CHEERS statement are researchers reporting economic evaluations and the editors and peer reviewers assessing them for publication. The need for new reporting guidance was identified by a survey of medical editors. A list of possible items based on a systematic review was created. A two round, modified Delphi panel consisting of representatives from academia, clinical practice, industry, government, and the editorial community was conducted. Out of 44 candidate items, 24 items and accompanying recommendations were developed. The recommendations are contained in a user friendly, 24 item checklist. A copy of the statement, accompanying checklist, and this report can be found on the ISPOR Health Economic Evaluations Publication Guidelines Task Force website: (www.ispor.org/TaskForces/EconomicPubGuidelines.asp). We hope CHEERS will lead to better reporting, and ultimately, better health decisions. To facilitate dissemination and uptake, the CHEERS statement is being co-published across 10 health economics and medical journals. We encourage other journals and groups, to endorse CHEERS. The author team plans to review the checklist for an update in five years.

  14. Toward quantifying the abuse liability of ultraviolet tanning: A behavioral economic approach to tanning addiction.

    PubMed

    Reed, Derek D; Kaplan, Brent A; Becirevic, Amel; Roma, Peter G; Hursh, Steven R

    2016-07-01

    Many adults engage in ultraviolet indoor tanning despite evidence of its association with skin cancer. The constellation of behaviors associated with ultraviolet indoor tanning is analogous to that in other behavioral addictions. Despite a growing literature on ultraviolet indoor tanning as an addiction, there remains no consensus on how to identify ultraviolet indoor tanning addictive tendencies. The purpose of the present study was to translate a behavioral economic task more commonly used in substance abuse to quantify the "abuse liability" of ultraviolet indoor tanning, establish construct validity, and determine convergent validity with the most commonly used diagnostic tools for ultraviolet indoor tanning addiction (i.e., mCAGE and mDSM-IV-TR). We conducted a between-groups study using a novel hypothetical Tanning Purchase Task to quantify intensity and elasticity of ultraviolet indoor tanning demand and permit statistical comparisons with the mCAGE and mDSM-IV-TR. Results suggest that behavioral economic demand is related to ultraviolet indoor tanning addiction status and adequately discriminates between potential addicted individuals from nonaddicted individuals. Moreover, we provide evidence that the Tanning Purchase Task renders behavioral economic indicators that are relevant to public health research. The present findings are limited to two ultraviolet indoor tanning addiction tools and a relatively small sample of high-risk ultraviolet indoor tanning users; however, these pilot data demonstrate the potential for behavioral economic assessment tools as diagnostic and research aids in ultraviolet indoor tanning addiction studies.

  15. Age Related Changes in Preventive Health Behavior.

    ERIC Educational Resources Information Center

    Leventhal, Elaine A.; And Others

    Health behavior may be influenced by age, beliefs, and symptomatology. To examine age-related health beliefs and behaviors with respect to six diseases (the common cold, colon-rectal cancer, lung cancer, heart attack, high blood pressure, and senility), 396 adults (196 males, 200 females) divided into three age groups completed a questionnaire…

  16. Washington State Survey of Adolescent Health Behaviors.

    ERIC Educational Resources Information Center

    Washington State Dept. of Social and Health Services, Olympia.

    The 1992 Washington State Survey of Adolescent Health Behaviors (WSSAHB) was created to collect information regarding a variety of adolescent health behaviors among students in the state of Washington. It expands on two previous administrations of a student tobacco, alcohol, and other drug survey and includes questions about medical care, safety,…

  17. Building bridges between health economics research and public policy evaluation.

    PubMed

    Debrand, Thierry; Dourgnon, Paul

    2010-12-01

    The Institut de Recherche et Documentation en Economie de la Santé (IRDES) Workshop on Applied Health Economics and Policy Evaluation aims at disseminating health economic research's newest findings and enhancing the community's capacity to address issues that are relevant to public policy. The 2010 program consisted of 16 articles covering a vast range of topics, such as health insurance, social health inequalities and health services research. While most of the articles embedded theoretical material, all had to include empirical material in order to favor more applied and practical discussions and results. The 2010 workshop is to be the first of a series of annual workshops in Paris gathering together researchers on health economics and policy evaluation. The next workshop is to be held at IRDES in June 2011.

  18. Health care economics in Serbia: current problems and changes.

    PubMed

    Stosić, Sanja; Karanović, Nevena

    2014-11-01

    One of the fundamental rights of every human being is to enjoy "the highest attainable standard of health". Achieving better health requires no only adequate medical knowledge and technologies, laws and social measures in the field of health care, but also sufficient funding for fulfilling people's right to health. However, economic crisis has left every community with limited possibility of investing in health care and forced them to use the available resources more efficiently. This is the reason why health financing policy represents an important and integral part of the health system concerned with how financial resources are generated, allocated and used. Development of new drugs and medical technologies, population aging, increased incidence of chronic diseases as well as the peoples' rising demands from health care providers lead to a constant increase of health system costs worldwide. In these circumstances, countries in transition, like Serbia, face difficult challenges in financing their health systems. Current economic crisis and budget constraints do not allow the Government to simply allocate more public revenues for health and solve the people's expectations by increasing the spending. Instead, Serbia is forced to start reforms to provide a more efficient health system. The reform processes are positioned within the wider context of European integration and public administration reforms. This paper provides a short description of the health care system in Serbia focusing on the healthcare economics and reforms and their influence on financial sustainability.

  19. Systematic review of employer-sponsored wellness strategies and their economic and health-related outcomes.

    PubMed

    Kaspin, Lisa C; Gorman, Kathleen M; Miller, Ross M

    2013-02-01

    This review determines the characteristics and health-related and economic outcomes of employer-sponsored wellness programs and identifies possible reasons for their success. PubMed, ABI/Inform, and Business Source Premier databases, and Corporate Wellness Magazine were searched. English-language articles published from 2005 to 2011 that reported characteristics of employer-sponsored wellness programs and their impact on health-related and economic outcomes among US employees were accepted. Data were abstracted, synthesized, and interpreted. Twenty references were accepted. Wellness interventions were classified into health assessments, lifestyle management, and behavioral health. Improved economic outcomes were reported (health care costs, return on investment, absenteeism, productivity, workers' compensation, utilization) as well as decreased health risks. Programs associated with favorable outcomes had several characteristics in common. First, the corporate culture encouraged wellness to improve employees' lives, not only to reduce costs. Second, employees and leadership were strongly motivated to support the wellness programs and to improve their health in general. Third, employees were motivated by a participation-friendly corporate policy and physical environment. Fourth, successful programs adapted to the changing needs of the employees. Fifth, community health organizations provided support, education, and treatment. Sixth, successful wellness programs utilized technology to facilitate health risk assessments and wellness education. Improved health-related and economic outcomes were associated with employer-sponsored wellness programs. Companies with successful programs tended to include wellness as part of their corporate culture and supported employee participation in several key ways.

  20. Health Risk Behaviors and Academic Achievement

    MedlinePlus

    ... 2009 † Health-Risk Behaviors Percentage of U.S. high school students who engaged in each risk behavior, by type of grades mostly earned A’s B’s C’s D’s/F’s Unintentional Injury and Violence-Related Behaviors Rarely or never wore a seat ...

  1. Tests of Behavioral-Economic Assessments of Relative Reinforcer Efficacy: Economic Substitutes

    ERIC Educational Resources Information Center

    Madden, Gregory J.; Smethells, John R.; Ewan, Eric E.; Hursh, Steven R.

    2007-01-01

    This experiment was conducted to test predictions of two behavioral-economic approaches to quantifying relative reinforcer efficacy. According to the first of these approaches, characteristics of averaged normalized demand curves may be used to predict progressive-ratio breakpoints and peak responding. The second approach, the demand analysis,…

  2. Tests of Behavioral-Economic Assessments of Relative Reinforcer Efficacy II: Economic Complements

    ERIC Educational Resources Information Center

    Madden, Gregory J.; Smethells, John R.; Ewan, Eric E.; Hursh, Steven R.

    2007-01-01

    This experiment was conducted to test the predictions of two behavioral-economic approaches to quantifying relative reinforcer efficacy. The normalized demand analysis suggests that characteristics of averaged normalized demand curves may be used to predict progressive-ratio breakpoints and peak responding. By contrast, the demand analysis holds…

  3. Economics of health in South Africa: past, present and future.

    PubMed

    Benatar, S R

    1989-01-01

    Some of the background to the present structure of medicine in South Africa, an outline of some economic aspects of our current (inadequate) health care service and tentative suggestions regarding the directions in which our health services should be moving to facilitate the legitimization (political) and accumulation (economic) processes required to meet the needs and demands of all the people of an internationally recognized, just and free South Africa are presented.

  4. [Efficiency assessment of investment in workers' health--economic issues].

    PubMed

    Rydlewska-Liszkowska, Izabela; Dawydzik, Lech T

    2002-01-01

    The economic analysis of efficiency of investment in health care and health at large by means of cost-benefit or cost-effectiveness techniques is the subject of implementation work in a number of countries. Poland's integration with the countries of the European Union justifies the need to understand and to use economic analyses. Unfortunately, these activities encounter many methodological and executive barriers. The investments in workers' health are not only investments in health care and the improvement of working conditions, but also in compensations, including financial ones, resulting from adverse effects of factors influencing the health of working population. The financial reporting system that exists in Poland does not ensure the possibility of full presentation of the aggregated data on the financing of activities for workers' health and diminishing of the adverse effects of factors present in the work environment. The information on the outcome of the investments in workers' health come from different sources, which means that it applies to different groups subjected to the analysis. The problem lies not only in the assessment of profitability of health investments but also in the social problem of the division of the resultant costs and benefits among various branches of the national economy. Therefore, the analyses involving mutual relations between individual sectors that invest in workers' health and those that bear consequences is essential in the terms of economic analyses. The authors present the determinants of economic evaluation in regard to health of working population in Poland.

  5. Health seeking behaviors of African Americans: implications for health administration.

    PubMed

    Hewins-Maroney, Barbara; Schumaker, Alice; Williams, Ethel

    2005-01-01

    Disparities in health care and good health between African Americans and other populations while established in the literature are traditionally based on socioeconomic measures of race, income, age, and education (Bailey, 2000; Lillie-Blanton, Brodie, Rowland, Altman and McIntosh, 2000; Ren and Amick, 1996; Watson, 2001; Weinick, Zuvekas, and Cohen, 2000). This study broadens the scope by exploring how sociocultural (poverty, racism, prejudice, and discrimination) and psychosocial factors (perceived health status, the lack of personal efficacy in contributing to decisions about health care. feelings of helplessness, and the lack of trust in the health care providers) relate to health-seeking behaviors of African Americans (Bailey, 1991; Ren and Amick, 1996, Watson, 2001). Interviews were conducted with 111 African American adult patients at a community health center, focusing on health-seeking behaviors, and sociocultural and psychosocial factors. Results suggest that when these negative factors are removed, the health seeking behaviors of African Americans closely mirror the behaviors of the majority population. Subjects did not view themselves in poorer health, fail to seek medical attention when needed, or distrust their primary health care providers. In general, fears associated with health care were attributed to illness rather than health care providers, although a weak linkage was found between patient self-esteem and fear or dislike of future treatment by physicians (adj R2= .362, S.E. =15, F=21, sig. <.001). The study highlights the need for further study in two areas: cultural competency of health care providers, especially those from Asia and Africa who are often assigned to community health centers, and the impact of an accessible community health center on the health seeking behaviors and health status of predominately African American communities.

  6. Behavioral economic decision making and alcohol-related sexual risk behavior.

    PubMed

    MacKillop, James; Celio, Mark A; Mastroleo, Nadine R; Kahler, Christopher W; Operario, Don; Colby, Suzanne M; Barnett, Nancy P; Monti, Peter M

    2015-03-01

    The discipline of behavioral economics integrates principles from psychology and economics to systematically characterize decision-making preferences. Two forms of behavioral economic decision making are of relevance to HIV risk behavior: delay discounting, reflecting preferences for immediate small rewards relative to larger delayed rewards (i.e., immediate gratification), and probability discounting, reflecting preferences for larger probabilistic rewards relative to smaller guaranteed rewards (i.e., risk sensitivity). This study examined questionnaire-based indices of both types of discounting in relation to sexual risk taking in an emergency department sample of hazardous drinkers who engage in risky sexual behavior. More impulsive delay discounting was significantly associated with increased sexual risk-taking during a drinking episode, but not general sexual risk-taking. Probability discounting was not associated with either form of sexual risk-taking. These findings implicate impulsive delay discounting with sexual risk taking during alcohol intoxication and provide further support for applying this approach to HIV risk behavior.

  7. The behavioral economics of will in recovery from addiction.

    PubMed

    Monterosso, John; Ainslie, George

    2007-09-01

    Behavioral economic studies demonstrate that rewards are discounted proportionally with their delay (hyperbolic discounting). Hyperbolic discounting implies temporary preference for smaller rewards when they are imminent, and this concept has been widely considered by researchers interested in the causes of addictive behavior. Far less consideration has been given to the fact that systematic preference reversal also predicts various self-control phenomena, which may also be analyzed from a behavioral economic perspective. Here we summarize self-control phenomena predicted by hyperbolic discounting, particularly with application to the field of addiction. Of greatest interest is the phenomenon of choice bundling, an increase in motivation to wait for delayed rewards that can be expected to result from making choices in whole categories. Specifically, when a person's expectations about her own future behavior are conditional upon her current behavior, the value of these expectations is added to the contingencies for the current behavior, resulting in reduced impulsivity. Hyperbolic discounting provides a bottom-up basis for the intuitive learning of choice bundling, the properties of which match common descriptions of willpower. We suggest that the bundling effect can also be discerned in the advice of 12-step programs.

  8. The behavioral economics of will in recovery from addiction

    PubMed Central

    Monterosso, John; Ainslie, George

    2007-01-01

    Behavioral economic studies demonstrate that rewards are discounted proportionally with their delay (hyperbolic discounting). Hyperbolic discounting implies temporary preference for smaller rewards when they are imminent, and this concept has been widely considered by researchers interested in the causes of addictive behavior. Far less consideration has been given to the fact that systematic preference reversal also predicts various self-control phenomena, which may also be analyzed from a behavioral economic perspective. Here we summarize self-control phenomena predicted by hyperbolic discounting, particularly with application to the field of addiction. Of greatest interest is the phenomenon of choice bundling, an increase in motivation to wait for delayed rewards that can be expected to result from making choices in whole categories. Specifically, when a person’s expectations about her own future behavior are conditional upon her current behavior, the value of these expectations is added to the contingencies for the current behavior, resulting in reduced impulsivity. Hyperbolic discounting provides a bottom-up basis for the intuitive learning of choice bundling, the properties of which match common descriptions of willpower. We suggest that the bundling effect can also be discerned in the advice of 12-step programs. PMID:17034958

  9. The Delineation of Economic and Health Service Areas and the Location of Health Manpower Education Programs.

    ERIC Educational Resources Information Center

    Leyes, John M.; And Others

    The research reported pertains to the interrelationships of the economic system, the health-care delivery system, and the health manpower education systems. In this research it was learned that in a part of the intermountain region predominately rural in nature, the economic and the health systems are closely related. Challenge is given to the…

  10. [Valuation of health-related quality of life and utilities in health economics].

    PubMed

    Greiner, Wolfgang; Klose, Kristina

    2014-01-01

    Measuring health-related quality of life is an important aspect in economic evaluation of health programmes. The development of utility-based (preference-based) measures is advanced by the discipline of health economics. Different preference measures are applied for valuing health states to produce a weighted health state index. Those preference weights should be derived from a general population sample in case of resource allocation on a collective level (as in current valuation studies of the EuroQol group).

  11. [The economic-industrial health care complex and the social and economic dimension of development].

    PubMed

    Gadelha, Carlos Augusto Grabois; Costa, Laís Silveira; Maldonado, José

    2012-12-01

    The strategic role of health care in the national development agenda has been increasingly recognized and institutionalized. In addition to its importance as a structuring element of the Social Welfare State, health care plays a leading role in the generation of innovation - an essential element for competitiveness in knowledge society. However, health care's productive basis is still fragile, and this negatively affects both the universal provision of health care services and Brazil's competitive inclusion in the globalized environment. This situation suggests the need of a more systematic analysis of the complex relationships among productive, technological and social interests in the scope of health care. Consequently, it is necessary to produce further knowledge about the Economic-Industrial Health Care Complex due to its potential for contributing to a socially inclusive development model. This means reversing the hierarchy between economic and social interests in the sanitary field, thus minimizing the vulnerability of the Brazilian health care policy.

  12. Public Housing, Health, and Health Behaviors: Is There a Connection?

    ERIC Educational Resources Information Center

    Fertig, Angela R.; Reingold, David A.

    2007-01-01

    This paper explores the relationship between public housing, health outcomes, and health behaviors among low-income housing residents. While public housing can be a dangerous and unhealthy environment in which to live, the subsidized rent may free up resources for nutritious food and health care. In addition, public housing may be of higher…

  13. Integrating Behavioral Economics and Behavioral Genetics: Delayed Reward Discounting as an Endophenotype for Addictive Disorders

    ERIC Educational Resources Information Center

    MacKillop, James

    2013-01-01

    Delayed reward discounting is a behavioral economic index of impulsivity, referring to how much an individual devalues a reward based on its delay in time. As a behavioral process that varies considerably across individuals, delay discounting has been studied extensively as a model for self-control, both in the general population and in clinical…

  14. Behavioral economic analysis of demand for fuel in North America.

    PubMed

    Reed, Derek D; Partington, Scott W; Kaplan, Brent A; Roma, Peter G; Hursh, Steven R

    2013-01-01

    Emerging research clearly indicates that human behavior is contributing to climate change, notably, the use of fossil fuels as a form of energy for everyday behaviors. This dependence on oil in North America has led to assertions that the current level of demand is the social equivalent to an "addiction." The purpose of this study was to apply behavioral economic demand curves-a broadly applicable method of evaluating relative reinforcer efficacy in behavioral models of addiction-to North American oil consumption to examine whether such claims of oil addiction are warranted. Toward this end, we examined government data from the United States and Canada on per capita energy consumption for transportation and oil prices between 1995 and 2008. Our findings indicate that consumption either persisted or simultaneously increased despite sharp increases in oil price per barrel over the past decade.

  15. Structural Factors Affecting Health Examination Behavioral Intention.

    PubMed

    Huang, Hui-Ting; Kuo, Yu-Ming; Wang, Shiang-Ru; Wang, Chia-Fen; Tsai, Chung-Hung

    2016-04-01

    Disease screening instruments used for secondary prevention can facilitate early determination and treatment of pathogenic factors, effectively reducing disease incidence, mortality rates, and health complications. Therefore, people should be encouraged to receive health examinations for discovering potential pathogenic factors before symptoms occur. Here, we used the health belief model as a foundation and integrated social psychological factors and investigated the factors influencing health examination behavioral intention among the public in Taiwan. In total, 388 effective questionnaires were analyzed through structural model analysis. Consequently, this study yielded four crucial findings: (1) The established extended health belief model could effectively predict health examination behavioral intention; (2) Self-efficacy was the factor that most strongly influenced health examination behavioral intention, followed by health knowledge; (3) Self-efficacy substantially influenced perceived benefits and perceived barriers; (4) Health knowledge and social support indirectly influenced health examination behavioral intention. The preceding results can effectively increase the acceptance and use of health examination services among the public, thereby facilitating early diagnosis and treatment and ultimately reducing disease and mortality rates.

  16. Structural Factors Affecting Health Examination Behavioral Intention

    PubMed Central

    Huang, Hui-Ting; Kuo, Yu-Ming; Wang, Shiang-Ru; Wang, Chia-Fen; Tsai, Chung-Hung

    2016-01-01

    Disease screening instruments used for secondary prevention can facilitate early determination and treatment of pathogenic factors, effectively reducing disease incidence, mortality rates, and health complications. Therefore, people should be encouraged to receive health examinations for discovering potential pathogenic factors before symptoms occur. Here, we used the health belief model as a foundation and integrated social psychological factors and investigated the factors influencing health examination behavioral intention among the public in Taiwan. In total, 388 effective questionnaires were analyzed through structural model analysis. Consequently, this study yielded four crucial findings: (1) The established extended health belief model could effectively predict health examination behavioral intention; (2) Self-efficacy was the factor that most strongly influenced health examination behavioral intention, followed by health knowledge; (3) Self-efficacy substantially influenced perceived benefits and perceived barriers; (4) Health knowledge and social support indirectly influenced health examination behavioral intention. The preceding results can effectively increase the acceptance and use of health examination services among the public, thereby facilitating early diagnosis and treatment and ultimately reducing disease and mortality rates. PMID:27043606

  17. International Inequalities: Algebraic Investigations into Health and Economic Development

    ERIC Educational Resources Information Center

    Staats, Susan; Robertson, Douglas

    2009-01-01

    The Millennium Project is an international effort to improve the health, economic status, and environmental resources of the world's most vulnerable people. Using data associated with the Millennium Project, students use algebra to explore international development issues including poverty reduction and the relationship between health and economy.…

  18. Meta-Evaluation of Worksite Health Promotion Economic Return Studies.

    ERIC Educational Resources Information Center

    Chapman, Larry S.

    2003-01-01

    This meta-evaluation provides a standardized look at the quality of the economic evaluation literature for multi-component worksite health promotion programs. Analysis of 42 studies suggests that the evidence is very strong for average reductions in sick leave, health plan costs, and workers' compensation and disability costs of slightly more than…

  19. Applying lessons from behavioral economics to increase flu vaccination rates.

    PubMed

    Chen, Frederick; Stevens, Ryan

    2016-05-06

    Seasonal influenza imposes an enormous burden on society every year, yet many people refuse to obtain flu shots due to misconceptions of the flu vaccine. We argue that recent research in psychology and behavioral economics may provide the answers to why people hold mistaken beliefs about flu shots, how we can correct these misconceptions, and what policy-makers can do to increase flu vaccination rates.

  20. Promoting Health and Behavioral Health Equity in California.

    PubMed

    Mishra, Meenoo; Lupi, Monica Valdes; Miller, Wm Jahmal; Nolfo, Tamu

    2016-01-01

    Behavioral health disparities are not usually considered part of the same system of health disparities. However, the California Department of Public Health focused its health equity strategies on reducing behavioral health disparities through its California Statewide Plan to Promote Health and Mental Health Equity. This statewide plan was developed through a community-wide stakeholder engagement and outreach process. In addition, the California Reducing Disparities Project is a prevention and early intervention effort to reduce mental health disparities in underserved populations. This strategic plan represents the voice of several racial/ethnic communities, such as African American, Asian and Pacific Islander, Latino, Native American, as well as lesbian, gay, bisexual, transgender, and queer and questioning communities in California, through 5 strategic planning workgroups. The workgroups were composed of a broad range of stakeholders, including community leaders, mental health care providers, consumer and family members, individuals with lived experience, and academia. This case example highlights the various efforts of California's Office of Health Equity in eliminating behavioral health disparities and promoting mental health equity, as well as discusses the unique statutory and regulatory role of the Office of Health Equity's deputy director.

  1. Behavioral economic measures of alcohol reward value as problem severity indicators in college students.

    PubMed

    Skidmore, Jessica R; Murphy, James G; Martens, Matthew P

    2014-06-01

    The aims of the current study were to examine the associations among behavioral economic measures of alcohol value derived from 3 distinct measurement approaches, and to evaluate their respective relations with traditional indicators of alcohol problem severity in college drinkers. Five behavioral economic metrics were derived from hypothetical demand curves that quantify reward value by plotting consumption and expenditures as a function of price, another metric measured proportional behavioral allocation and enjoyment related to alcohol versus other activities, and a final metric measured relative discretionary expenditures on alcohol (RDEA). The sample included 207 heavy-drinking college students (53% female) who were recruited through an on-campus health center or university courses. Factor analysis revealed that the alcohol valuation construct comprises 2 factors: 1 factor that reflects participants' levels of alcohol price sensitivity (demand persistence), and a second factor that reflects participants' maximum consumption and monetary and behavioral allocation toward alcohol (amplitude of demand). The demand persistence and behavioral allocation metrics demonstrated the strongest and most consistent multivariate relations with alcohol-related problems, even when controlling for other well-established predictors. The results suggest that behavioral economic indices of reward value show meaningful relations with alcohol problem severity in young adults. Despite the presence of some gender differences, these measures appear to be useful problem indicators for men and women.

  2. Protecting Pakistan's health during the global economic crisis.

    PubMed

    Jooma, R; Khan, A; Khan, A A

    2012-03-01

    The world is facing an unprecedented global economic crisis, with many countries needing to reconsider their level of health care spending. This paper explores the many consequences of the global economic turndown on Pakistan's health, including reduced government and donor spending and increased poverty with the consequent diversion of funds away from health. Nevertheless, these challenges may provide opportunities not only to mitigate the adverse effects of the economic crisis but also to institute some much-needed reforms that may not receive political support during more affluent times. Our suggestions focus on setting priorities based on the national disease burden, prioritizing prevention interventions, demanding results, curbing corruption, experimenting with innovative funding mechanisms, advocating for increased funding by presenting health spending as an investment rather than an expense and by selected recourse to civil society interventions and philanthropy to bridge the gap between available and needed resources.

  3. Cognitive skills affect economic preferences, strategic behavior, and job attachment.

    PubMed

    Burks, Stephen V; Carpenter, Jeffrey P; Goette, Lorenz; Rustichini, Aldo

    2009-05-12

    Economic analysis has so far said little about how an individual's cognitive skills (CS) are related to the individual's economic preferences in different choice domains, such as risk taking or saving, and how preferences in different domains are related to each other. Using a sample of 1,000 trainee truckers we report three findings. First, there is a strong and significant relationship between an individual's CS and preferences. Individuals with better CS are more patient, in both short- and long-run. Better CS are also associated with a greater willingness to take calculated risks. Second, CS predict social awareness and choices in a sequential Prisoner's Dilemma game. Subjects with better CS more accurately forecast others' behavior and differentiate their behavior as a second mover more strongly depending on the first-mover's choice. Third, CS, and in particular, the ability to plan, strongly predict perseverance on the job in a setting with a substantial financial penalty for early exit. Consistent with CS being a common factor in all of these preferences and behaviors, we find a strong pattern of correlation among them. These results, taken together with the theoretical explanation we offer for the relationships we find, suggest that higher CS systematically affect preferences and choices in ways that favor economic success.

  4. Editorial: 2nd Special Issue on behavior change, health, and health disparities

    PubMed Central

    Higgins, Stephen T.

    2016-01-01

    This Special Issue of Preventive Medicine (PM) is the 2nd that we have organized on behavior change, health, and health disparities. This is a topic of fundamental importance to improving population health in the U.S. and other industrialized countries that are trying to more effectively manage chronic health conditions. There is broad scientific consensus that personal behavior patterns such as cigarette smoking, other substance abuse, and physical inactivity/obesity are among the most important modifiable causes of chronic disease and its adverse impacts on population health. As such behavior change needs to be a key component of improving population health. There is also broad agreement that while these problems extend across socioeconomic strata, they are overrepresented among more economically disadvantaged populations and contribute directly to the growing problem of health disparities. Hence, behavior change represents an essential step in curtailing that unsettling problem as well. In this 2nd Special Issue, we devote considerable space to the current U.S. prescription opioid addiction epidemic, a crisis that was not addressed in the prior Special Issue. We also continue to devote attention to the two largest contributors to preventable disease and premature death, cigarette smoking and physical inactivity/obesity as well as risks of co-occurrence of these unhealthy behavior patterns. Across each of these topics we included contributions from highly accomplished policymakers and scientists to acquaint readers with recent accomplishments as well as remaining knowledge gaps and challenges to effectively managing these important chronic health problems. PMID:26257372

  5. EPA guidance on mental health and economic crises in Europe.

    PubMed

    Martin-Carrasco, M; Evans-Lacko, S; Dom, G; Christodoulou, N G; Samochowiec, J; González-Fraile, E; Bienkowski, P; Gómez-Beneyto, M; Dos Santos, M J H; Wasserman, D

    2016-03-01

    This European Psychiatric Association (EPA) guidance paper is a result of the Working Group on Mental Health Consequences of Economic Crises of the EPA Council of National Psychiatric Associations. Its purpose is to identify the impact on mental health in Europe of the economic downturn and the measures that may be taken to respond to it. We performed a review of the existing literature that yields 350 articles on which our conclusions and recommendations are based. Evidence-based tables and recommendations were developed through an expert consensus process. Literature dealing with the consequences of economic turmoil on the health and health behaviours of the population is heterogeneous, and the results are not completely unequivocal. However, there is a broad consensus about the deleterious consequences of economic crises on mental health, particularly on psychological well-being, depression, anxiety disorders, insomnia, alcohol abuse, and suicidal behaviour. Unemployment, indebtedness, precarious working conditions, inequalities, lack of social connectedness, and housing instability emerge as main risk factors. Men at working age could be particularly at risk, together with previous low SES or stigmatized populations. Generalized austerity measures and poor developed welfare systems trend to increase the harmful effects of economic crises on mental health. Although many articles suggest limitations of existing research and provide suggestions for future research, there is relatively little discussion of policy approaches to address the negative impact of economic crises on mental health. The few studies that addressed policy questions suggested that the development of social protection programs such as active labour programs, social support systems, protection for housing instability, and better access to mental health care, particularly at primary care level, is strongly needed.

  6. Health Economics of Nutrition Intervention in Asia: Cost of Malnutrition.

    PubMed

    Mizumoto, Kaori; Murakami, Genki; Oshidari, Kenro; Trisnantoro, Laksono; Yoshiike, Nobuo

    2015-01-01

    Asia has recorded the fastest economic growth in the world. However, some countries are still struggling with economic stagnation and poverty. Even in the emerging countries, there are economic disparities between urban and rural areas within a country. Reflecting the situations, nutritional issues in Asia came to be the antithetical situation of excess and insufficiency. The rate of overweight and obesity keeps increasing, especially in emerging countries. Meanwhile, underweight is still a critical problem in the region. Although the importance of nutrition is well recognized for social and economic development, it is difficult to identify the immediate outcome of nutrition interventions. Evidence-based decision-making is an important element of quality health care and efficiency and effectiveness are always key words. Along with enhanced attention to accountability and transparency of budget use in health services, attention to the economic evaluation of nutrition interventions has increased in recent years. In this symposium, we will review the current situation of nutritional issues and economic evaluation of nutrition interventions in Asia through experience of an international organization, the basis and trends for health care economics, and also efforts have been made in an Asian country. Discussion will be made about efficient and effective ways to evaluate projects/programmes for nutrition improvement.

  7. Social, Economic, and Health Disparities Among LGBT Older Adults

    PubMed Central

    Emlet, Charles A.

    2016-01-01

    LGBT older adults are a heterogeneous population with collective and unique strengths and challenges. Health, personal, and economic disparities exist in this group when compared to the general population of older adults, yet subgroups such as transgender and bisexual older adults and individuals living with HIV are at greater risk for disparities and poorer health outcomes. As this population grows, further research is needed on factors that contribute to promoting health equity, while decreasing discrimination and improving competent service delivery. PMID:28366981

  8. [Family cohesion associated with oral health, socioeconomic factors and health behavior].

    PubMed

    Ferreira, Luale Leão; Brandão, Gustavo Antônio Martins; Garcia, Gustavo; Batista, Marília Jesus; Costa, Ludmila da Silva Tavares; Ambrosano, Gláucia Maria Bovi; Possobon, Rosana de Fátima

    2013-08-01

    Overall health surveys have related family cohesion to socio-economic status and behavioral factors. The scope of this study was to investigate the association between family cohesion and socio-economic, behavioral and oral health factors. This was a, cross-sectional study with two-stage cluster sampling. The random sample consisted of 524 adolescents attending public schools in the city of Piracicaba-SP. Variables were evaluated by self-applied questionnaires and caries and periodontal disease were assessed by DMF-T and CPI indices. The adolescent's perception of family cohesion was assessed using the family adaptability and cohesion scale. Univariate and multinomial logistic regression shows that adolescents with low family cohesion were more likely than those with medium family cohesion to have low income (OR 2,28 95% CI 1,14- 4,55), presence of caries (OR 2,23 95% CI 1,21-4,09), less than two daily brushings (OR 1,91 95% CI 1,03-3,54). Adolescents with high family cohesion were more likely than those with medium family cohesion to have high income and protective behavior against the habit of smoking. Thus, the data shows that adolescent perception of family cohesion was associated with behavioral, socio-economic and oral health variables, indicating the importance of an integral approach to patient health.

  9. Economics of health planning--Costa Rica as an example.

    PubMed

    Neuhauser, D

    1991-01-01

    Costa Rica has been unusually successful in providing high levels of health for its people given its economic resources. It is proposed that there are two reasons for its success. Having no military, Costa Rica has had resources to invest in health care. Having a relatively equal income and education distribution and a democratic government, it has been able to provide health care widely rather than just to the elites. This paper examines production functions for health and possible directions for appropriate management of health as Costa Rica confronts the chronic disease pattern of the developed world.

  10. Economic Shocks and Public Health Protections in US Metropolitan Areas

    PubMed Central

    Hogg, Rachel A.

    2015-01-01

    Objectives. We examined public health system responses to economic shocks using longitudinal observations of public health activities implemented in US metropolitan areas from 1998 to 2012. Methods. The National Longitudinal Survey of Public Health Systems collected data on the implementation of 20 core public health activities in a nationally representative cohort of 280 metropolitan areas in 1998, 2006, and 2012. We used generalized estimating equations to estimate how local economic shocks relate to the scope of activities implemented in communities, the mix of organizations performing them, and perceptions of the effectiveness of activities. Results. Public health activities fell by nearly 5% in the average community between 2006 and 2012, with the bottom quintile of communities losing nearly 25% of their activities. Local public health delivery fell most sharply among communities experiencing the largest increases in unemployment and the largest reductions in governmental public health spending. Conclusions. Federal resources and private sector contributions failed to avert reductions in local public health protections during the recession. New financing mechanisms may be necessary to ensure equitable public health protections during economic downturns. PMID:25689201

  11. The diffusion of health economics knowledge in Europe : The EURONHEED (European Network of Health Economics Evaluation Database) project.

    PubMed

    de Pouvourville, Gérard; Ulmann, Philippe; Nixon, John; Boulenger, Stéphanie; Glanville, Julie; Drummond, Michael

    2005-01-01

    This paper overviews the EURONHEED (EUROpean Network of Health Economics Evaluation Databases) project. Launched in 2003, this project is funded by the EU. Its aim is to create a network of national and international databases dedicated to health economic evaluation of health services and innovations. Seven centres (France, Germany, Italy, The Netherlands, Spain, Sweden and the UK) are involved covering 17 countries. The network is based on two existing databases, the French CODECS (COnnaissance et Decision en EConomie de la Sante) database, created in 2000 by the French Health Economists Association (College des Economistes de la Sante), and the UK NHS-EED (NHS Economic Electronic Database), run by the Centre for Reviews and Dissemination, University of York, York, England. The network will provide bibliographic records of published full health economic evaluation studies (cost-benefit, cost-utility and cost-effectiveness studies) as well as cost studies, methodological articles and review papers. Moreover, a structured abstract of full evaluation studies will be provided to users, allowing them access to a detailed description of each study and to a commentary stressing the implications and limits, for decision making, of the study. Access will be free of charge. The database features and its ease of access (via the internet: http://www.euronheed.org) should facilitate the diffusion of existing economic evidence on health services and the generalisation of common standards in the field at the European level, thereby improving the quality, generalisability and transferability of results across countries.

  12. APPLYING INSIGHTS FROM BEHAVIORAL ECONOMICS TO POLICY DESIGN

    PubMed Central

    Madrian, Brigitte C.

    2014-01-01

    The premise of this article is that an understanding of psychology and other social science disciplines can inform the effectiveness of the economic tools traditionally deployed in carrying out the functions of government, which include remedying market failures, redistributing income, and collecting tax revenue. An understanding of psychology can also lead to the development of different policy tools that better motivate desired behavior change or that are more cost-effective than traditional policy tools. The article outlines a framework for thinking about the psychology of behavior change in the context of market failures. It then describes the research on the effects of a variety of interventions rooted in an understanding of psychology that have policy-relevant applications. The article concludes by discussing how an understanding of psychology can also inform the use and design of traditional policy tools for behavior change, such as financial incentives. PMID:25520759

  13. Health capabilities and diabetes self-management: the impact of economic, social, and cultural resources.

    PubMed

    Weaver, Robert R; Lemonde, Manon; Payman, Naghmeh; Goodman, William M

    2014-02-01

    While the "social determinants of health" view compels us to explore how social structures shape health outcomes, it often ignores the role individual agency plays. In contrast, approaches that focus on individual choice and personal responsibility for health often overlook the influence of social structures. Amartya Sen's "capabilities" framework and its derivative the "health capabilities" (HC) approach attempts to accommodate both points of view, acknowledging that individuals function under social conditions over which they have little control, while also acting as agents in their own health and well-being. This paper explores how economic, social, and cultural resources shape the health capability of people with diabetes, focusing specifically on dietary practices. Health capability and agency are central to dietary practices, while also being shaped by immediate and broader social conditions that can generate habits and a lifestyle that constrain dietary behaviors. From January 2011 to December 2012, we interviewed 45 people with diabetes from a primary care clinic in Ontario (Canada) to examine how their economic, social, and cultural resources combine to influence dietary practices relative to their condition. We classified respondents into low, medium, and high resource groups based on economic circumstances, and compared how economic resources, social relationships, health-related knowledge and values combine to enhance or weaken health capability and dietary management. Economic, social, and cultural resources conspired to undermine dietary management among most in the low resource group, whereas social influences significantly influenced diet among many in the medium group. High resource respondents appeared most motivated to maintain a healthy diet, and also had the social and cultural resources to enable them to do so. Understanding the influence of all three types of resources is critical for constructing ways to enhance health capability, chronic

  14. College Student Adjustment and Health Behaviors

    ERIC Educational Resources Information Center

    Hall, Lisa Anne

    2010-01-01

    This study explored the relationship between student adjustment theory and college student health behaviors. Specifically, this research examined first-year freshmen college student physical activity and nutrition behaviors and impact on adjustment to college (N = 37,564). The design for this study was a non-experimental "ex post facto"…

  15. Relationship between Peer Status and Health Behaviors.

    ERIC Educational Resources Information Center

    Terre, Lisa; And Others

    1992-01-01

    Investigated relative influence of background characteristics (age, gender, race, socioeconomic status, family type) and peer status on health-related behaviors (physical activity, eating habits, smoking, alcohol use, stress-related behaviors) in 589 junior high school students. Peer popularity provided no significant increment in prediction of…

  16. Hypertension Education: Impact on Parent Health Behaviors.

    ERIC Educational Resources Information Center

    Walker, Peter; Portnoy, Barry

    This study sought to determine the effects of a high blood pressure education program for sixth graders on the preventive hypertension health attitudes and behaviors of their parents. Attention was focused on the role of students ("significant others") in affecting parental attitude and behavior changes relating to the three risk factors of…

  17. The impact of economic issues on Nigerian health sciences libraries.

    PubMed Central

    Belleh, G S; Akhigbe, O O

    1991-01-01

    Economic issues are among the most important factors affecting health sciences libraries in Nigeria. These issues are influenced by the political, cultural, geographic, and demographic characteristics of the country. Significant economic issues are the dependence of the national economy on a single commodity, large foreign debt and spiraling inflation, stringent foreign exchange control measures, and inadequate realization by authorities of the role and importance of health sciences libraries. With shrinking budgets, resources, and staff, health sciences libraries can neither grow nor afford library automation. Health sciences librarians must take initiatives for cooperative activities to increase and make the most of resources, pursue nontraditional methods of fund-raising, educate authorities about the role and importance of libraries, and develop and implement a plan for the development and growth of health sciences libraries in the country. PMID:1884083

  18. Engaging Health Professionals in Health Economics: A Human Capital Informed Approach for Adults Learning Online

    ERIC Educational Resources Information Center

    Lieberthal, Robert D.; Leon, Juan

    2015-01-01

    The authors describe a Wikipedia-based project designed for a graduate course introducing health economics to experienced healthcare professionals. The project allows such students to successfully write articles on niche topics in rapidly evolving health economics subspecialties. These students are given the opportunity to publish their completed…

  19. Health Status, Personal Definition of Health, and Health Behavior Choice in the Elderly.

    ERIC Educational Resources Information Center

    Wood, Norma J.

    The purpose of this study was to investigate the relationships among health status, personal definition of health, and health behavior choice in the elderly. Self-assessed health status was measured using a modified Cantril Ladder, personal definition of health was measured using the Laffrey Health Conception Scale (LHCS), and health behavior…

  20. Women's health and behavioral health issues in health care reform.

    PubMed

    Chin, Jean Lau; Yee, Barbara W K; Banks, Martha E

    2014-01-01

    As health care reform promises to change the landscape of health care delivery, its potential impact on women's health looms large. Whereas health and mental health systems have historically been fragmented, the Affordable Care Act (ACA) mandates integrated health care as the strategy for reform. Current systems fragment women's health not only in their primary care, mental health, obstetrical, and gynecological needs, but also in their roles as the primary caregivers for parents, spouses, and children. Changes in reimbursement, and in restructuring financing and care coordination systems through accountable care organizations and medical homes, will potentially improve women's health care.

  1. [Public health in major socio-economic crisis].

    PubMed

    Cosmacini, G

    2014-01-01

    The term "crisis" in different cultures (such as ancient Greece or China) can have a positive meaning, since it indicates a time of growth, change and opportunity. Over the centuries there have been times of severe economic and social crisis that led to the implementation of major reforms and improved population health. Nowadays, despite the new economic crisis which has also affected health care for its rising costs, health economics does not hesitate to affirm the importance of key objectives such as prevention and medical assistance. Prevention is not prediction. Prevention means "going upstream" and fixing a problem at the source; the goal is to reduce diseases' effects, causes and risk factors, thereby reducing the prevalence of costly medical conditions.

  2. Core and comprehensive health care services: 4. Economic issues.

    PubMed Central

    Wyman, M; Feeley, J; Brimacombe, G; Doucette, K

    1995-01-01

    This article reviews the economic dimensions of the CMA's decision-making framework on core and comprehensive services. The framework was developed in a policy context characterized by three government objectives: reduction, reallocation and reassignment of health care resources. One economic-evaluation tool for the determination of core services is cost-effectiveness analysis. Some of the critical demand-side and supply-side considerations include the perceived value of medical services, the availability of private insurance and the supply of health care providers. The article concludes that shifting services to the private sector should not be viewed as a panacea for reducing the costs and improving the economic efficiency of the health care system, or for increasing patient access to, or the cost-effectiveness of high-quality care. PMID:7743446

  3. Economic Techniques of Occupational Health and Safety Management

    NASA Astrophysics Data System (ADS)

    Sidorov, Aleksandr I.; Beregovaya, Irina B.; Khanzhina, Olga A.

    2016-10-01

    The article deals with the issues on economic techniques of occupational health and safety management. Authors’ definition of safety management is given. It is represented as a task-oriented process to identify, establish and maintain such a state of work environment in which there are no possible effects of hazardous and harmful factors, or their influence does not go beyond certain limits. It was noted that management techniques that are the part of the control mechanism, are divided into administrative, organizational and administrative, social and psychological and economic. The economic management techniques are proposed to be classified depending on the management subject, management object, in relation to an enterprise environment, depending on a control action. Technoeconomic study, feasibility study, planning, financial incentives, preferential crediting of enterprises, pricing, profit sharing and equity, preferential tax treatment for enterprises, economic regulations and standards setting have been distinguished as economic techniques.

  4. Exploring Older Adults' Health Information Seeking Behaviors

    ERIC Educational Resources Information Center

    Manafo, Elizabeth; Wong, Sharon

    2012-01-01

    Objective: To explore older adults' (55-70 years) health information-seeking behaviors. Methods: Using a qualitative methodology, based on grounded theory, data were collected using in-depth interviews. Participants were community-living, older adults in Toronto, Canada who independently seek nutrition and health information. Interview transcripts…

  5. The Mechanisms Linking Health Literacy to Behavior and Health Status

    PubMed Central

    Osborn, Chandra Y.; Paasche-Orlow, Michael K.; Bailey, Stacy Cooper; Wolf, Michael S.

    2011-01-01

    Objective To examine the mechanisms linking health literacy to physical activity and self-reported health. Methods From 2005–2007, patients (N=330) with hypertension were recruited from safety net clinics. Path analytic models tested the pathways linking health literacy to physical activity and self-reported health. Results There were significant paths from health literacy to knowledge (r=0.22, P<0.001), knowledge to self-efficacy (r=0.13, P<0.01), self-efficacy to physical activity (r=0.17, P<0.01), and physical activity to health status (r=0.17, P<0.01). Conclusions Health education interventions should be literacy sensitive and aim to enhance patient health knowledge and self-efficacy to promote self-care behavior and desirable health outcomes. PMID:20950164

  6. Can health care organizations improve health behavior and treatment adherence?

    PubMed

    Bender, Bruce G

    2014-04-01

    Many Americans are failing to engage in both the behaviors that prevent and those that effectively manage chronic health conditions, including pulmonary disorders, cardiovascular conditions, diabetes, and cancer. Expectations that health care providers are responsible for changing patients' health behaviors often do not stand up against the realities of clinical care that include large patient loads, limited time, increasing co-pays, and restricted access. Organizations and systems that might share a stake in changing health behavior include employers, insurance payers, health care delivery systems, and public sector programs. However, although the costs of unhealthy behaviors are evident, financial resources to address the problem are not readily available. For most health care organizations, the return on investment for developing behavior change programs appears highest when addressing treatment adherence and disease self-management, and lowest when promoting healthy lifestyles. Organizational strategies to improve adherence are identified in 4 categories: patient access, provider training and support, incentives, and information technology. Strategies in all 4 categories are currently under investigation in ongoing studies and have the potential to improve self-management of many chronic health conditions.

  7. Computational health economics for identification of unprofitable health care enrollees.

    PubMed

    Rose, Sherri; Bergquist, Savannah L; Layton, Timothy J

    2017-03-22

    Health insurers may attempt to design their health plans to attract profitable enrollees while deterring unprofitable ones. Such insurers would not be delivering socially efficient levels of care by providing health plans that maximize societal benefit, but rather intentionally distorting plan benefits to avoid high-cost enrollees, potentially to the detriment of health and efficiency. In this work, we focus on a specific component of health plan design at risk for health insurer distortion in the Health Insurance Marketplaces: the prescription drug formulary. We introduce an ensembled machine learning function to determine whether drug utilization variables are predictive of a new measure of enrollee unprofitability we derive, and thus vulnerable to distortions by insurers. Our implementation also contains a unique application-specific variable selection tool. This study demonstrates that super learning is effective in extracting the relevant signal for this prediction problem, and that a small number of drug variables can be used to identify unprofitable enrollees. The results are both encouraging and concerning. While risk adjustment appears to have been reasonably successful at weakening the relationship between therapeutic-class-specific drug utilization and unprofitability, some classes remain predictive of insurer losses. The vulnerable enrollees whose prescription drug regimens include drugs in these classes may need special protection from regulators in health insurance market design.

  8. Editorial: 3rd Special Issue on behavior change, health, and health disparities

    PubMed Central

    Higgins, Stephen T.

    2017-01-01

    This Special Issue of Preventive Medicine (PM) is the 3rd that we have organized on behavior change, health, and health disparities. This is a topic of critical importance to improving U.S. population health. There is broad scientific consensus that personal behaviors such as cigarette smoking, other substance abuse, and physical inactivity/obesity are among the most important modifiable causes of chronic disease and its adverse impacts on population health. Hence, effectively promoting health-related behavior change needs to be a key component of health care research and policy. There is also broad recognition that while these problems extend throughout the population, they disproportionately impact economically disadvantaged populations and other vulnerable populations and represent a major contributor to health disparities. Thus, behavior change represents an essential step in curtailing health disparities, which receives special attention in this 3rd Special Issue. We also devote considerable space to the longstanding challenges of reducing cigarette smoking and use of other tobacco and nicotine delivery products in vulnerable populations, obesity, and for the first time food insecurity. Across each of these topics we include contributions from highly accomplished policymakers and scientists to acquaint readers with recent accomplishments as well as remaining knowledge gaps and challenges. PMID:27693562

  9. Economic Stress, Emotional Quality of Life, and Problem Behavior in Chinese Adolescents with and without Economic Disadvantage

    ERIC Educational Resources Information Center

    Shek, Daniel T. L.

    2005-01-01

    The relationships between perceived economic stress (current economic hardship and future economic worry) and emotional quality of life (existential well-being, life satisfaction, self-esteem, sense of mastery, psychological morbidity) as well as problem behavior (substance abuse and delinquency) were examined in 1519 Chinese adolescents with and…

  10. 75 FR 25886 - Advisory Committee for Social, Behavioral, and Economic Sciences; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-10

    ... Advisory Committee for Social, Behavioral, and Economic Sciences; Notice of Meeting In accordance with... following meeting: Name: Advisory Committee for Social, Behavioral, and Economic Sciences ( 1171). Date/Time... pertaining to Social, Behavioral and Economic Sciences Directorate programs and activities. Agenda:...

  11. 77 FR 62538 - Advisory Committee for Social, Behavioral and Economic Sciences; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-15

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  12. 76 FR 24062 - Advisory Committee for Social, Behavioral and Economic Sciences; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-29

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  13. 76 FR 65219 - Advisory Committee for Social, Behavioral and Economic Sciences; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-20

    ... Advisory Committee for Social, Behavioral and Economic Sciences; Notice of Meeting In accordance with... following meeting: Name: Advisory Committee for Social, Behavioral and Economic Sciences ( 1171) Date/Time... pertaining to Social, Behavioral and Economic Sciences Directorate programs and activities. Agenda...

  14. 75 FR 50783 - Committee for Social, Behavioral, and Economic Sciences Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-17

    ... ADVISORY Committee for Social, Behavioral, and Economic Sciences Notice of Meeting In accordance with... following meeting: Name: Advisory Committee for Social, Behavioral, and Economic Sciences ( 1171). Date/Time... pertaining to Social, Behavioral and Economic Sciences Directorate programs and activities. Agenda:...

  15. A Systematic Review on Health Resilience to Economic Crises

    PubMed Central

    Glonti, Ketevan; Gordeev, Vladimir S.; Goryakin, Yevgeniy; Reeves, Aaron; Stuckler, David; McKee, Martin; Roberts, Bayard

    2015-01-01

    Background The health effects of recent economic crises differ markedly by population group. The objective of this systematic review is to examine evidence from longitudinal studies on factors influencing resilience for any health outcome or health behaviour among the general population living in countries exposed to financial crises. Methods We systematically reviewed studies from six electronic databases (EMBASE, Global Health, MEDLINE, PsycINFO, Scopus, Web of Science) which used quantitative longitudinal study designs and included: (i) exposure to an economic crisis; (ii) changes in health outcomes/behaviours over time; (iii) statistical tests of associations of health risk and/or protective factors with health outcomes/behaviours. The quality of the selected studies was appraised using the Quality Assessment Tool for Quantitative Studies. PRISMA reporting guidelines were followed. Results From 14,584 retrieved records, 22 studies met the eligibility criteria. These studies were conducted across 10 countries in Asia, Europe and North America over the past two decades. Ten socio-demographic factors that increased or protected against health risk were identified: gender, age, education, marital status, household size, employment/occupation, income/ financial constraints, personal beliefs, health status, area of residence, and social relations. These studies addressed physical health, mortality, suicide and suicide attempts, mental health, and health behaviours. Women’s mental health appeared more susceptible to crises than men’s. Lower income levels were associated with greater increases in cardiovascular disease, mortality and worse mental health. Employment status was associated with changes in mental health. Associations with age, marital status, and education were less consistent, although higher education was associated with healthier behaviours. Conclusions Despite widespread rhetoric about the importance of resilience, there was a dearth of studies

  16. Health care prices, the federal budget, and economic growth.

    PubMed

    Monaco, R M; Phelps, J H

    1995-01-01

    Rising health care spending, led by rising prices, has had an enormous impact on the economy, especially on the federal budget. Our work shows that if rapid growth in health care prices continues, under current institutional arrangements, real economic growth and employment will be lower during the next two decades than if health price inflation were somehow reduced. How big the losses are and which sectors bear the brunt of the costs vary depending on how society chooses to fund the federal budget deficit that stems from the rising cost of federal health care programs.

  17. Texting while driving as impulsive choice: A behavioral economic analysis

    PubMed Central

    Hayashi, Yusuke; Russo, Christopher T.; Wirth, Oliver

    2015-01-01

    The goal of the present study was to examine the utility of a behavioral economic analysis to investigate the role of delay discounting in texting while driving. A sample of 147 college students completed a survey to assess how frequently they send and read text messages while driving. Based on this information, students were assigned to one of two groups: 19 students who frequently text while driving and 19 matched-control students who infrequently text while driving but were similar in gender, age, years of education, and years driving. The groups were compared on the extent to which they discounted, or devalued, delayed hypothetical monetary rewards using a delay-discounting task. In this task, students made repeated choices between $1000 available after a delay (ranging from 1 week to 10 years) and an equal or lesser amount of money available immediately. The results show that the students who frequently text while driving discounted delayed rewards at a greater rate than the matched control students. The study supports the conclusions that texting while driving is fundamentally an impulsive choice made by drivers, and that a behavioral economic approach may be a useful research tool for investigating the decision-making processes underlying risky behaviors. PMID:26280804

  18. Texting while driving as impulsive choice: A behavioral economic analysis.

    PubMed

    Hayashi, Yusuke; Russo, Christopher T; Wirth, Oliver

    2015-10-01

    The goal of the present study was to examine the utility of a behavioral economic analysis to investigate the role of delay discounting in texting while driving. A sample of 147 college students completed a survey to assess how frequently they send and read text messages while driving. Based on this information, students were assigned to one of two groups: 19 students who frequently text while driving and 19 matched-control students who infrequently text while driving but were similar in gender, age, years of education, and years driving. The groups were compared on the extent to which they discounted, or devalued, delayed hypothetical monetary rewards using a delay-discounting task. In this task, students made repeated choices between $1000 available after a delay (ranging from 1 week to 10 years) and an equal or lesser amount of money available immediately. The results show that the students who frequently text while driving discounted delayed rewards at a greater rate than the matched control students. The study supports the conclusions that texting while driving is fundamentally an impulsive choice made by drivers, and that a behavioral economic approach may be a useful research tool for investigating the decision-making processes underlying risky behaviors.

  19. [Epidemiological research on environmental health risks and their economic consequences].

    PubMed

    Haucke, F; Holle, R; Wichmann, H E

    2009-12-01

    In environmental health research, methods for quantitative analysis of human population studies data are gaining importance. In recent years, it has been realized that they can also provide an important link to the economic view on environmental health effects. In this review, fundamental concepts and methods from environmental epidemiology and health economics are presented and it is shown how they can be linked in order to support environmental policy decisions. In addition, the characteristics of environmental epidemiology and the role of epidemiologic studies in risk assessment are discussed. From the economic point of view, cost-of-illness studies and cost effectiveness studies are the main approaches, and we have placed special focus on methods of monetary valuation of health effects that are generally proposed in the environmental context. Two conceptually differing strategies to combine epidemiologic and economic evidence are presented: the environmental attributable fraction model as a top-down approach and the impact pathway approach which follows a bottom-up analysis strategy. Finally, two examples are used to illustrate the application of these concepts and methods: health risks caused by fine particle air pollution and their costs, and the cost-effectiveness of radon exposure reduction policies.

  20. Economic crisis and health policy in the Netherlands.

    PubMed

    Juffermans, P

    1984-01-01

    Beginning with a brief historical overview of health policy in the Netherlands from 1945-1960 (a period of restoration of the capitalist economy after World War II) until 1960-1970 (a period of capitalist expansion), this paper discusses the health policy of the Dutch state under the present conditions of economic crisis. The main characteristics of this policy are growing state intervention, reorganization of the decision-making process, deinstitutionalization of health care, a laissez-faire policy with regard to services in the so-called first echelon of the health sector, reprivatization of health costs, and an ideological emphasis on individual responsibility for health and self-care. The paper concludes with a discussion of the various strategies proposed for the health sector by the Left and the connection between prevention and social struggle.

  1. Considerations for planning and evaluating economic analyses of telemental health.

    PubMed

    Luxton, David D

    2013-08-01

    The economic evaluation of telemental health (TMH) is necessary to inform ways to decrease the cost of delivering care, to improve access to care, and to make decisions about the allocation of resources. Previous reviews of telehealth economic analysis studies have concluded that there are significant methodological deficiencies and inconsistencies that limit the ability to make generalized conclusions about the costs and benefits of telehealth programs. Published economic evaluations specific to TMH are also limited. There are unique factors that influence costs in TMH that are necessary for those who are planning and evaluating economic analyses to consider. The purpose of this review is to summarize the main problems and limitations of published economic analyses, to discuss considerations specific to TMH, and to inform and encourage the economic evaluation of TMH in both the public and private sectors. The topics presented here include perspective of costs, direct and indirect costs, and technology, as well as research methodology considerations. The integration of economic analyses into effectiveness trials, the standardization of outcome measurement, and the development of TMH economic evaluation guidelines are recommended.

  2. Electronic health records: eliciting behavioral health providers' beliefs.

    PubMed

    Shank, Nancy; Willborn, Elizabeth; Pytlikzillig, Lisa; Noel, Harmonijoie

    2012-04-01

    Interviews with 32 community behavioral health providers elicited perceived benefits and barriers of using electronic health records. Themes identified were (a) quality of care, (b) privacy and security, and (c) delivery of services. Benefits to quality of care were mentioned by 100% of the providers, and barriers by 59% of providers. Barriers involving privacy and security concerns were mentioned by 100% of providers, and benefits by 22%. Barriers to delivery of services were mentioned by 97% of providers, and benefits by 66%. Most providers (81%) expressed overall positive support for electronic behavioral health records.

  3. Lifestyle Assessment: Helping Patients Change Health Behaviors

    PubMed Central

    Ciliska, Donna; Wilson, Douglas M. C.

    1984-01-01

    This article is the second in a series of six on lifestyle assessment and behavior change. The first article presented an assessment tool called FANTASTIC, which has been tested for reliability and is currently in wide use. After assessment, family physicians must help patients decide to change—and give them guidance on how to change—unhealthy behaviors. This article explains how the family physician can use educational, behavioral and relaxation strategies to increase patients' motivation, maintain their commitment and teach them the skills needed to effect changes in health behavior.

  4. Economic Evaluation of Environmental Health Interventions to Support Decision Making

    PubMed Central

    Hutton, Guy

    2008-01-01

    Environmental burden of disease represents one quarter of overall disease burden, hence necessitating greater attention from decision makers both inside and outside the health sector. Economic evaluation techniques such as cost-effectiveness analysis and cost-benefit analysis provide key information to health decision makers on the efficiency of environmental health interventions, assisting them in choosing interventions which give the greatest social return on limited public budgets and private resources. The aim of this article is to review economic evaluation studies in three environmental health areas—water, sanitation, hygiene (WSH), vector control, and air pollution—and to critically examine the policy relevance and scientific quality of the studies for selecting and funding public programmers. A keyword search of Medline from 1990–2008 revealed 32 studies, and gathering of articles from other sources revealed a further 18 studies, giving a total of 50 economic evaluation studies (13 WSH interventions, 16 vector control and 21 air pollution). Overall, the economic evidence base on environmental health interventions remains relatively weak—too few studies per intervention, of variable scientific quality and from diverse locations which limits generalisability of findings. Importantly, there still exists a disconnect between economic research, decision making and programmer implementation. This can be explained by the lack of translation of research findings into accessible documentation for policy makers and limited relevance of research findings, and the often low importance of economic evidence in budgeting decisions. These findings underline the importance of involving policy makers in the defining of research agendas and commissioning of research, and improving the awareness of researchers of the policy environment into which their research feeds. PMID:21572840

  5. Links between Socio-Economic Circumstances and Changes in Smoking Behavior in the Mexican Population: 2002–2010

    PubMed Central

    Beltrán-Sánchez, HIRAM; Thomas, DUNCAN; Teruel, GRACIELA; Wheaton, FELICIA; Crimmins, EILEEN M.

    2013-01-01

    While deleterious consequences of smoking on health have been widely publicized, in many developing countries, smoking prevalence is high and increasing. Little is known about the dynamics underlying changes in smoking behavior. This paper examines socio-economic and demographic characteristics associated with smoking initiation and quitting in Mexico between 2002 and 2010. In addition to the influences of age, gender, education, household economic resources and location of residence, changes in marital status, living arrangements and health status are examined. Drawing data from the Mexican Family Life Survey, a rich population-based longitudinal study of individuals, smoking behavior of individuals in 2002 is compared with their behavior in 2010. Logistic models are used to examine socio-demographic and health factors that are associated with initiating and quitting smoking. There are three main findings. First, part of the relationship between education and smoking reflects the role of economic resources. Second, associations of smoking with education and economic resources differ for females and males. Third, there is considerable heterogeneity in the factors linked to smoking behavior in Mexico indicating that the smoking epidemic may be at different stages in different population subgroups. Mexico has recently implemented fiscal policies and public health campaigns aimed at reducing smoking prevalence and discouraging smoking initiation. These programs are likely to be more effective if they target particular socio-economic and demographic sub-groups. PMID:23888371

  6. [THE GLOBAL AND ECONOMIC CRISIS. AND HEALTH MANAGEMENT].

    PubMed

    del Rey Calero, Juan

    2014-01-01

    The Global and economic crisis and Health Management The Health care process discussed are 4 steps: assessment, planing, intervention and evaluation. The identify association between social factors linked to social vulnerability (socio economic status, unemployed, poverty) and objective health relate quality of life. The poverty rate is 24.2%, unemployed 26.26%, youth unemployed 56.13%.ratio worker/retired 2.29. Debts 100% GDP The health inequality influence on health related quality of life. The Health System efficiency index. according Bloomber rate (2,013) Spain is 5 degrees in the world, points 68.3 on 100, for the life expectancy 82.3 years, the personal cost of health care 2,271€. Health care 10% GDP (public 7%,private 3%), SS protected population 92.4%, retired person cost 9.2% GDP, p. capita GDP 23,737€. Cost of Care: Hospital/specialist 54%, P. Care 15%, Pharmaceutical 19.8%, P. Health 3.1%.

  7. Investing in children's health: what are the economic benefits?

    PubMed Central

    Belli, Paolo C.; Bustreo, Flavia; Preker, Alexander

    2005-01-01

    This paper argues that investing in children's health is a sound economic decision for governments to take, even if the moral justifications for such programmes are not considered. The paper also outlines dimensions that are often neglected when public investment decisions are taken. The conclusion that can be drawn from the literature studying the relationship between children's health and the economy is that children's health is a potentially valuable economic investment. The literature shows that making greater investments in children's health results in better educated and more productive adults, sets in motion favourable demographic changes, and shows that safeguarding health during childhood is more important than at any other age because poor health during children's early years is likely to permanently impair them over the course of their life. In addition, the literature confirms that more attention should be paid to poor health as a mechanism for the intergenerational transmission of poverty. Children born into poor families have poorer health as children, receive lower investments in human capital, and have poorer health as adults. As a result, they will earn lower wages as adults, which will affect the next generation of children who will thus be born into poorer families. PMID:16283055

  8. Health-related economic costs of the Three-Mile Island accident.

    PubMed

    Hu, T W; Slaysman, K S

    1984-01-01

    On March 1979, a nuclear power station at Three-Mile Island (TMI) near Harrisburg, Pennsylvania, had a major breakdown. During the two-week period of the accident, about 150,000 residents were evacuated for reasons associated with safety and health. Many residents during and after the accident, regardless of whether they left or stayed, made mental and physical adjustments due to this accident. This paper is to estimate the economic costs incurred by individuals or communities as a result of a change in physical or mental health status and/or a change in health care services due to the TMI accident. The findings indicate that stress symptoms caused by the accident did affect the health-related behaviors of area residents. Of the costs examined, the economic costs of work days lost and physician visits are the largest cost items. There were some increases in consumption of alcohol, cigarettes, and tranquilizers immediately following the accident.

  9. Behavioral health leadership: new directions in occupational mental health.

    PubMed

    Adler, Amy B; Saboe, Kristin N; Anderson, James; Sipos, Maurice L; Thomas, Jeffrey L

    2014-10-01

    The impact of stress on mental health in high-risk occupations may be mitigated by organizational factors such as leadership. Studies have documented the impact of general leadership skills on employee performance and mental health. Other researchers have begun examining specific leadership domains that address relevant organizational outcomes, such as safety climate leadership. One emerging approach focuses on domain-specific leadership behaviors that may moderate the impact of combat deployment on mental health. In a recent study, US soldiers deployed to Afghanistan rated leaders on behaviors promoting management of combat operational stress. When soldiers rated their leaders high on these behaviors, soldiers also reported better mental health and feeling more comfortable with the idea of seeking mental health treatment. These associations held even after controlling for overall leadership ratings. Operational stress leader behaviors also moderated the relationship between combat exposure and soldier health. Domain-specific leadership offers an important step in identifying measures to moderate the impact of high-risk occupations on employee health.

  10. Why Economic Analysis of Health System Improvement Interventions Matters.

    PubMed

    Broughton, Edward Ivor; Marquez, Lani

    2016-01-01

    There is little evidence to direct health systems toward providing efficient interventions to address medical errors, defined as an unintended act of omission or commission or one not executed as intended that may or may not cause harm to the patient but does not achieve its intended outcome. We believe that lack of guidance on what is the most efficient way to reduce medical errors and improve the quality of health-care limits the scale-up of health system improvement interventions. Challenges to economic evaluation of these interventions include defining and implementing improvement interventions in different settings with high fidelity, capturing all of the positive and negative effects of the intervention, using process measures of effectiveness rather than health outcomes, and determining the full cost of the intervention and all economic consequences of its effects. However, health system improvement interventions should be treated similarly to individual medical interventions and undergo rigorous economic evaluation to provide actionable evidence to guide policy-makers in decisions of resource allocation for improvement activities among other competing demands for health-care resources.

  11. Home Economics/Health Grades 6-12. Program Evaluation.

    ERIC Educational Resources Information Center

    Des Moines Public Schools, IA. Teaching and Learning Div.

    Home economics programs are offered to students in grades 6-12 in the Des Moines INdependent Community School District (Iowa). Programs at the middle school level are exploratory, leading to occupational training in family and consumer science, child care, food service, and textile and fashion arts at the high school level. Health education…

  12. Health economic analyses of psoriasis management: a systematic literature search.

    PubMed

    Gutknecht, Mandy; Krensel, Magdalene; Augustin, Matthias

    2016-11-01

    In the course of the chronic skin disease psoriasis, where a variety of treatment interventions is available, a strong growth of health economic studies comparing treatment costs and benefits can be noticed. The objective was to identify health economic evaluations of psoriasis treatments that have been published to date. Of particular interest were the mostly used analysis and outcome parameters, the compared treatments, and the question, if available health economic studies may be used to perform a meta-analysis of qualitative findings. A systematic literature search using PubMed Medline, Ovid Medline, and Cochrane Library was performed for articles, published and available until mid of January 2016. Among the key words were the terms "psoriasis" and "cost-effectiveness". The search resulted in 318 articles without duplicates. Thereof 60 health economic analyses in psoriasis management were identified. Most of these are cost-effectiveness evaluations (45). The clinical parameter PASI (Psoriasis Area Severity Index) is the most often used cost-effectiveness outcome (33) followed by the Dermatology Life Quality Index (DLQI) (6). In case of cost-utility analyses, QALYs (quality-adjusted life-years) were mostly generated with the help of EuroQol five dimensions questionnaire (EQ-5D) (12), which was partly based on PASI and DLQI values. The majority of health economic studies is focusing on the direct medical and non-medical costs without consideration of productivity losses. Almost 70 % of 60 publications were conducted in Europe. Overall, most considered systemic treatments were the biological agents etanercept (36), adalimumab (27), and infliximab (26) followed by ustekinumab (17) and phototherapy (incl. UV-B, PUVA/psoralen combined with UV-A) (14). Comparisons including only topical treatments mostly focused on vitamin D treatment (14), corticosteroids (13), and coal tar products (6) followed by dithranol (5) and tazarotene (4). Given the setting, compared

  13. Prosocial Behavior Increases with Age across Five Economic Games.

    PubMed

    Matsumoto, Yoshie; Yamagishi, Toshio; Li, Yang; Kiyonari, Toko

    2016-01-01

    Ontogenic studies of human prosociality generally agree on that human prosociality increases from early childhood through early adulthood; however, it has not been established if prosociality increases beyond early adulthood. We examined a sample of 408 non-student residents from Tokyo, Japan, who were evenly distributed across age (20-59) and sex. Participants played five economic games each separated by a few months. We demonstrated that prosocial behavior increased with age beyond early adulthood and this effect was shown across all five economic games. A similar, but weaker, age-related trend was found in one of three social value orientation measures of prosocial preferences. We measured participants' belief that manipulating others is a wise strategy for social success, and found that this belief declined with age. Participants' satisfaction with the unilateral exploitation outcome of the prisoner's dilemma games also declined with age. These two factors-satisfaction with the DC outcome in the prisoner's dilemma games and belief in manipulation-mediated the age effect on both attitudinal and behavioral prosociality. Participants' age-related socio-demographic traits such as marriage, having children, and owning a house weakly mediated the age effect on prosociality through their relationships with satisfaction with the DC outcome and belief in manipulation.

  14. Applying the Health Belief Model to college students' health behavior

    PubMed Central

    Kim, Hak-Seon; Ahn, Joo

    2012-01-01

    The purpose of this research was to investigate how university students' nutrition beliefs influence their health behavioral intention. This study used an online survey engine (Qulatrics.com) to collect data from college students. Out of 253 questionnaires collected, 251 questionnaires (99.2%) were used for the statistical analysis. Confirmatory Factor Analysis (CFA) revealed that six dimensions, "Nutrition Confidence," "Susceptibility," "Severity," "Barrier," "Benefit," "Behavioral Intention to Eat Healthy Food," and "Behavioral Intention to do Physical Activity," had construct validity; Cronbach's alpha coefficient and composite reliabilities were tested for item reliability. The results validate that objective nutrition knowledge was a good predictor of college students' nutrition confidence. The results also clearly showed that two direct measures were significant predictors of behavioral intentions as hypothesized. Perceived benefit of eating healthy food and perceived barrier for eat healthy food to had significant effects on Behavioral Intentions and was a valid measurement to use to determine Behavioral Intentions. These findings can enhance the extant literature on the universal applicability of the model and serve as useful references for further investigations of the validity of the model within other health care or foodservice settings and for other health behavioral categories. PMID:23346306

  15. Managed behavioral health care carve-outs: past performance and future prospects.

    PubMed

    Frank, Richard G; Garfield, Rachel L

    2007-01-01

    As the managed behavioral health care market has matured, behavioral health carve-outs have solved many problems facing the delivery of behavioral health services; at the same time, they have exacerbated existing difficulties or created new problems. Carve-outs developed to address rising inpatient behavioral health costs and limited insurance coverage. They are based on the economic principles of economies of specialization, economies of scale, price negotiation, and selection. Literature shows that carve-outs have been successful in lowering costs and maintaining or improving access, but results on their impact on quality of care are mixed. In recent years, carve-outs have evolved to take on new roles within the health system, such as coordinating mental and physical health, addressing fragmented public financing systems, and using market power to implement quality improvement. Although not perfect, carve-outs have been instrumental in addressing long-standing challenges in utilization, access, and cost of behavioral health care.

  16. Behavioral Economic Decision Making and Alcohol-related Sexual Risk Behavior

    PubMed Central

    MacKillop, James; Celio, Mark A.; Mastroleo, Nadine R.; Kahler, Christopher W.; Operario, Don; Colby, Suzanne M.; Barnett, Nancy P.; Monti, Peter M.

    2014-01-01

    The discipline of behavioral economics integrates principles from psychology and economics to systematically characterize decision-making preferences. Two forms of behavioral economic decision making are of relevance to HIV risk behavior: delay discounting, reflecting preferences for immediate small rewards relative to larger delayed rewards (i.e., immediate gratification), and probability discounting, reflecting preferences for larger probabilistic rewards relative to smaller guaranteed rewards (i.e., risk sensitivity). This study examined questionnaire-based indices of both types of discounting in relation to sexual risk taking in an emergency department sample of hazardous drinkers who engage in risky sexual behavior. More impulsive delay discounting was significantly associated with increased sexual risk-taking during a drinking episode, but not general sexual risk-taking. Probability discounting was not associated with either form of sexual risk-taking. These findings implicate impulsive delay discounting with sexual risk taking during alcohol intoxication and provide further support for applying this approach to HIV risk behavior. PMID:25267115

  17. Nutrition economics - food as an ally of public health.

    PubMed

    Lenoir-Wijnkoop, I; Jones, P J; Uauy, R; Segal, L; Milner, J

    2013-03-14

    Non-communicable diseases (NCD) are a major and increasing contributor to morbidity and mortality in developed and developing countries. Much of the chronic disease burden is preventable through modification of lifestyle behaviours, and increased attention is being focused on identifying and implementing effective preventative health strategies. Nutrition has been identified as a major modifiable determinant of NCD. The recent merging of health economics and nutritional sciences to form the nascent discipline of nutrition economics aims to assess the impact of diet on health and disease prevention, and to evaluate options for changing dietary choices, while incorporating an understanding of the immediate impacts and downstream consequences. In short, nutrition economics allows for generation of policy-relevant evidence, and as such the discipline is a crucial partner in achieving better population nutritional status and improvements in public health and wellness. The objective of the present paper is to summarise presentations made at a satellite symposium held during the 11th European Nutrition Conference, 28 October 2011, where the role of nutrition and its potential to reduce the public health burden through alleviating undernutrition and nutrition deficiencies, promoting better-quality diets and incorporating a role for functional foods were discussed.

  18. UN study reports Asian economic crisis has hit women's health.

    PubMed

    Ciment, J

    1999-02-13

    A UN Population Fund report, "Southeast Asian Populations in Crisis," revealed that the economic crisis in Southeastern Asia has had a disproportionately adverse effect on the health of women and girls. This has occurred because the industries employing women have been hardest hit and because governments have reduced spending on health care and female education. Thailand, for example, has reduced its AIDS budget by 25% even as increasing numbers of women are pushed into the sex trade by economic necessity. Reproductive health services for adolescents have been hit just as shrinking family budgets are forcing adolescents to drop out of school. The report's authors are calling for a more detailed look at the situation.

  19. [Empirical standard costs for health economic evaluation in Germany -- a proposal by the working group methods in health economic evaluation].

    PubMed

    Krauth, C; Hessel, F; Hansmeier, T; Wasem, J; Seitz, R; Schweikert, B

    2005-10-01

    Measurement of health care costs is a crucial task in health economic evaluation. Various guidelines with different amount of details have been set up for costing methods in economic evaluation which, however, do not precisely stipulate how to value resource consumption. In this article we present a proposal for the standardisation of the monetary valuation of health care utilisation occurring in the follow up period after the actual intervention to be evaluated. From a societal perspective the primary direct and indirect cost components are considered, such as outpatient medical care, pharmaceuticals, non-physician health services, inpatient care, days of sick leave and early retirement due to sickness. The standard costs are based on administrative charges and rates or on official statistics. They are based on the most current data sources which are mainly from 2002 and 2003. This system of standard costs aims at an average valuation of resource consumption. This makes for the comparability of different health economic studies. Most standard costs are not based on market prices but on administratively specified charges and rates. This implies that institutional changes which are quite common in the health care system, may also affect the valuation rates, for example the introduction of DRGs. This should be taken into account when updating the system of standard costs.

  20. The measurement of contingent valuation for health economics.

    PubMed

    Bayoumi, Ahmed M

    2004-01-01

    In health economics, contingent valuation is a method that elicits an individual's monetary valuations of health programmes or health states. This article reviews the theory and conduct of contingent valuation studies, with suggestions for improving the future measurement of contingent valuation for health economics applications. Contingent valuation questions can be targeted to any of the following groups: the general population, to value health insurance premiums for programmes; users of a health programme, to value the associated programme costs; or individuals with a disease, to evaluate health states. The questions can be framed to ask individuals how much they would pay to obtain positive changes in health status or avoid negative changes in health status ('willingness to pay'; WTP) or how much they would need to be paid to compensate for a decrease in health status or for foregoing an improvement in heath status ('willingness to accept'; WTA). In general WTP questions yield more accurate and precise valuations than WTA questions. Payment card techniques, with follow-up bidding using direct interviews with visual aids, are well suited for small contingent valuation studies. Several biases may be operative when assessing contingent valuation, including biases in the way participants are selected, the way in which the questions are posed, the way in which individuals interpret probabilities and value gains relative to losses, and the way in which missing or extreme responses are interpreted. An important aspect of all contingent valuation studies is an assessment of respondents' understanding of the evaluation method and the valuation task. Contingent valuation studies should measure the potential influence of biases, the validity of contingent valuation tests as measures of QOL, and the reliability and responsiveness of responses. Future research should address equity concerns associated with using contingent valuation and explore contingent valuation as a

  1. Socioeconomic Status, Health Behaviors, Obesity and Self-Rated Health among Older Arabs in Israel.

    PubMed

    Khalaila, R N Rabia

    2017-03-01

    Socioeconomic inequalities in health are well documented. Recently, researchers have shown interest in exploring the mechanisms by which measures of SES operate through it to impact SRH, such as material, psychosocial and behavioral factors. To examine the relationships between SES indicators and self-rated health (SRH); and to determine whether health behaviors and obesity mediate the association between SES indicators and SRH. A secondary analysis of data previously collected through the third survey of socioeconomic and health status of the Arab population in Israel, in which the SRH of 878 Arab-Israelis age 50 or older were analyzed using logistic regression. The results showed that higher education level and current employment in old age are associated with better SRH. However, neither subjective economic status nor family income was associated with SRH. Greater physical activity was found to be related to good\\very good SRH, while obesity was associated with less than good SRH. Finally, health behaviors (physical activity) and obesity were revealed as mediators between SES indicators (education and employment status) and SRH. The results highlight the importance of high education level and employment status in old age to reduce health inequalities. The findings also show that the relationship between SES and SRH can operate through behavioral mechanisms (i.e., physical activity) and their consequences (i.e., obesity), that can, however, be changed in old age.

  2. Linking Human Health and Livestock Health: A “One-Health” Platform for Integrated Analysis of Human Health, Livestock Health, and Economic Welfare in Livestock Dependent Communities

    PubMed Central

    Thumbi, S. M.; Njenga, M. Kariuki; Marsh, Thomas L.; Noh, Susan; Otiang, Elkanah; Munyua, Peninah; Ochieng, Linus; Ogola, Eric; Yoder, Jonathan; Audi, Allan; Montgomery, Joel M.; Bigogo, Godfrey; Breiman, Robert F.; Palmer, Guy H.; McElwain, Terry F.

    2015-01-01

    Background For most rural households in sub-Saharan Africa, healthy livestock play a key role in averting the burden associated with zoonotic diseases, and in meeting household nutritional and socio-economic needs. However, there is limited understanding of the complex nutritional, socio-economic, and zoonotic pathways that link livestock health to human health and welfare. Here we describe a platform for integrated human health, animal health and economic welfare analysis designed to address this challenge. We provide baseline epidemiological data on disease syndromes in humans and the animals they keep, and provide examples of relationships between human health, animal health and household socio-economic status. Method We designed a study to obtain syndromic disease data in animals along with economic and behavioral information for 1500 rural households in Western Kenya already participating in a human syndromic disease surveillance study. Data collection started in February 2013, and each household is visited bi-weekly and data on four human syndromes (fever, jaundice, diarrhea and respiratory illness) and nine animal syndromes (death, respiratory, reproductive, musculoskeletal, nervous, urogenital, digestive, udder disorders, and skin disorders in cattle, sheep, goats and chickens) are collected. Additionally, data from a comprehensive socio-economic survey is collected every 3 months in each of the study households. Findings Data from the first year of study showed 93% of the households owned at least one form of livestock (55%, 19%, 41% and 88% own cattle, sheep, goats and chickens respectively). Digestive disorders, mainly diarrhea episodes, were the most common syndromes observed in cattle, goats and sheep, accounting for 56% of all livestock syndromes, followed by respiratory illnesses (18%). In humans, respiratory illnesses accounted for 54% of all illnesses reported, followed by acute febrile illnesses (40%) and diarrhea illnesses (5%). While controlling

  3. The Global Economic and Health Burden of Human Hookworm Infection

    PubMed Central

    Bartsch, Sarah M.; Hotez, Peter J.; Asti, Lindsey; Zapf, Kristina M.; Bottazzi, Maria Elena; Diemert, David J.; Lee, Bruce Y.

    2016-01-01

    Background Even though human hookworm infection is highly endemic in many countries throughout the world, its global economic and health impact is not well known. Without a better understanding of hookworm’s economic burden worldwide, it is difficult for decision makers such as funders, policy makers, disease control officials, and intervention manufacturers to determine how much time, energy, and resources to invest in hookworm control. Methodology/Principle Findings We developed a computational simulation model to estimate the economic and health burden of hookworm infection in every country, WHO region, and globally, in 2016 from the societal perspective. Globally, hookworm infection resulted in a total 2,126,280 DALYs using 2004 disability weight estimates and 4,087,803 DALYs using 2010 disability weight estimates (excluding cognitive impairment outcomes). Including cognitive impairment did not significantly increase DALYs worldwide. Total productivity losses varied with the probability of anemia and calculation method used, ranging from $7.5 billion to $138.9 billion annually using gross national income per capita as a proxy for annual wages and ranging from $2.5 billion to $43.9 billion using minimum wage as a proxy for annual wages. Conclusion Even though hookworm is classified as a neglected tropical disease, its economic and health burden exceeded published estimates for a number of diseases that have received comparatively more attention than hookworm such as rotavirus. Additionally, certain large countries that are transitioning to higher income countries such as Brazil and China, still face considerable hookworm burden. PMID:27607360

  4. Coping with the economic consequences of ill health in Indonesia.

    PubMed

    Sparrow, Robert; Van de Poel, Ellen; Hadiwidjaja, Gracia; Yumna, Athia; Warda, Nila; Suryahadi, Asep

    2014-06-01

    We assess the economic risk of ill health for households in Indonesia and the role of informal coping strategies. Using household panel data from the Indonesian socio-economic household survey (Susenas) for 2003 and 2004, and applying fixed effects Poisson models, we find evidence of economic risk from illness through medical expenses. For the poor and the informal sector, ill health events impact negatively on income from wage labour, whereas for the non-poor and formal sector, it is income from self-employed business activities which is negatively affected. However, only for the rural population and the poor does this lead to a decrease in consumption, whereas the non-poor seem to be able to protect current household spending. Borrowing and drawing on family network and buffers, such as savings and assets, seem to be key informal coping strategies for the poor, which may have negative long-term effects. While these results suggest scope for public intervention, the economic risk from income loss for the rural poor is beyond public health care financing reforms. Rather, formal sector employment seems to be a key instrument for financial protection from illness, by also reducing income risk.

  5. Incarceration, maternal hardship, and perinatal health behaviors.

    PubMed

    Dumont, Dora M; Wildeman, Christopher; Lee, Hedwig; Gjelsvik, Annie; Valera, Pamela; Clarke, Jennifer G

    2014-11-01

    Parental incarceration is associated with mental and physical health problems in children, yet little research directly tests mechanisms through which parental incarceration could imperil child health. We hypothesized that the incarceration of a woman or her romantic partner in the year before birth constituted an additional hardship for already-disadvantaged women, and that these additionally vulnerable women were less likely to engage in positive perinatal health behaviors important to infant and early childhood development. We analyzed 2006-2010 data from the Pregnancy Risk Assessment and Monitoring System to assess the association between incarceration in the year prior to the birth of a child and perinatal maternal hardships and behaviors. Women reporting incarceration of themselves or their partners in the year before birth of a child had .86 the odds (95 % CI .78-.95) of beginning prenatal care in the first trimester compared to women not reporting incarceration. They were nearly twice as likely to report partner abuse and were significantly more likely to rely on WIC and/or Medicaid for assistance during pregnancy. These associations persist after controlling for socioeconomic measures and other stressors, including homelessness and job loss. Incarceration of a woman or her partner in the year before birth is associated with higher odds of maternal hardship and poorer perinatal health behaviors. The unprecedented scale of incarceration in the US simultaneously presents an underutilized public health opportunity and constitutes a social determinant of health that may contribute to disparities in early childhood development.

  6. Health economics, equity, and efficiency: are we almost there?

    PubMed

    Ferraz, Marcos Bosi

    2015-01-01

    Health care is a highly complex, dynamic, and creative sector of the economy. While health economics has to continue its efforts to improve its methods and tools to better inform decisions, the application needs to be aligned with the insights and models of other social sciences disciplines. Decisions may be guided by four concept models based on ethical and distributive justice: libertarian, communitarian, egalitarian, and utilitarian. The societal agreement on one model or a defined mix of models is critical to avoid inequity and unfair decisions in a public and/or private insurance-based health care system. The excess use of methods and tools without fully defining the basic goals and philosophical principles of the health care system and without evaluating the fitness of these measures to reaching these goals may not contribute to an efficient improvement of population health.

  7. Economic Rationality in Choosing between Short-Term Bad-Health Choices and Longer-Term Good-Health Choices

    PubMed Central

    Campbell, David

    2013-01-01

    Non-contagious, chronic disease has been identified as a global health risk. Poor lifestyle choices, such as smoking, alcohol, drug and solvent abuse, physical inactivity, and unhealthy diet have been identified as important factors affecting the increasing incidence of chronic disease. The following focuses on the circumstance affecting the lifestyle or behavioral choices of Aboriginal and Torres Strait Islander peoples in remote-/very remote Australia. Poor behavioral choices are the result of endogenous characteristics that are influenced by a range of stressful exogenous variables making up the psychosocial determinants including social disenfranchisement, cultural loss, insurmountable tasks, the loss of volitional control and resource constraints. It is shown that poor behavioral choices can be economically rational; especially under highly stressful conditions. Stressful circumstances erode individual capacity to commit to long-term positive health alternatives such as self-investment in education. Policies directed at removing the impediments and providing incentives to behaviors involving better health choices can lead to reductions in smoking and alcohol consumption and improved health outcomes. Multijurisdictional culturally acceptable policies directed at distal variables relating to the psychosocial determinants of health and personal mastery and control can be cost effective. While the content of this paper is focused on the conditions of colonized peoples, it has broader relevance. PMID:24217181

  8. Weight-loss dieting behavior: an economic analysis.

    PubMed

    Rosin, Odelia

    2012-07-01

    In light of the widespread phenomena of diet failure and excessive dieting, this paper presents a theoretical economic analysis of the decision-making process of weight-loss dieting. The paper incorporates behavioral elements involved in the process of dieting: effort exerted in dieting, influence of social norms concerning body weight, time-inconsistent present biased preferences, and a distinction between naiveté and sophistication. The model explains cyclic dieting and provides interesting insights on the extent of weight-loss dieting. The extent of dieting is an increasing function of initial body weight and a decreasing function of the effort exerted in dieting and the strength of social norms concerning ideal weight. Income and diet strictness have an ambiguous effect. In addition, greater dieting efforts are not necessarily balanced against a slowdown in body metabolism or a higher initial body weight.

  9. Behavioral economics holds potential to deliver better results for patients, insurers, and employers.

    PubMed

    Loewenstein, George; Asch, David A; Volpp, Kevin G

    2013-07-01

    Many programs being implemented by US employers, insurers, and health care providers use incentives to encourage patients to take better care of themselves. We critically review a range of these efforts and show that many programs, although well-meaning, are unlikely to have much impact because they require information, expertise, and self-control that few patients possess. As a result, benefits are likely to accrue disproportionately to patients who already are taking adequate care of their health. We show how these programs could be made more effective through the use of insights from behavioral economics. For example, incentive programs that offer patients small and frequent payments for behavior that would benefit the patients, such as medication adherence, can be more effective than programs with incentives that are far less visible because they are folded into a paycheck or used to reduce a monthly premium. Deploying more-nuanced insights from behavioral economics can lead to policies with the potential to increase patient engagement and deliver dividends for patients and favorable cost-effectiveness ratios for insurers, employers, and other relevant commercial entities.

  10. Economic evaluation and health care. What does it mean?

    PubMed

    Robinson, R

    1993-09-11

    Ever since the concept of value for money in health care was introduced into the NHS, economic terms and jargon have become part of our everyday lives--but do we understand what the different types of economic evaluation all mean, particularly those that sound similar to the uninitiated? This article introduces readers to the purpose of economic evaluation, and briefly explains the differences between cost-minimisation analysis (used when the outcomes of the procedures being compared are the same); cost-effectiveness analysis (used when the outcomes may vary, but can be expressed in common natural units, such as mm Hg for treatments of hypertension); cost-utility analysis (used when outcomes do vary--for example, quality of life scales); and cost-benefit analysis (used when a monetary value is being placed on services received). Further articles will deal with each one in more detail.

  11. Behavioral Economic Predictors of Brief Alcohol Intervention Outcomes

    PubMed Central

    Murphy, James G.; Dennhardt, Ashley A.; Martens, Matthew P.; Yurasek, Ali M.; Skidmore, Jessica R.; MacKillop, James; McDevitt-Murphy, Meghan E.

    2015-01-01

    Objective The present study attempted to determine if behavioral economic indices of elevated alcohol reward value, measured before and immediately after a brief alcohol intervention, predict treatment response. Method Participants were 133 heavy drinking college students (49.6% female, 51.4% male; 64.3% Caucasian, 29.5% African American) who were randomized to one of three conditions: motivational interviewing plus personalized feedback (BMI), computerized personalized feedback intervention (e-CHUG), and assessment only. Results Baseline levels of alcohol demand significantly predicted drinks per week and alcohol problems at 1-month (demand intensity= maximum expenditure) and 6-month (relative discretionary expenditures on alcohol) follow-up. BMI and e-CHUG were associated with an immediate post-session reduction in alcohol demand (p < .001, ηρ2 = .29) that persisted at the 1-month follow-up, with greater post-session reductions in the BMI condition (p = .02, ηρ2 = .06). Reductions in demand intensity and Omax (maximum expenditure) immediately post-intervention significantly predicted drinking reductions at one-month follow up (p = .04, ΔR2 = .02 & p = .01, ΔR2 = .03, respectively). Reductions in relative discretionary expenditures on alcohol at 1-month significantly predicted drinking (p = .002, ΔR2 = .06,) and alcohol problem (p < .001, ΔR2 = .13) reductions at the 6-month follow-up. Conclusions These results suggest that behavioral economic reward value indices may function as risk factors for poor intervention response and as clinically-relevant markers of change in heavy drinkers. PMID:26167945

  12. A behavioral economic analysis of fat appetite in rats.

    PubMed

    Freed, D E; Green, L

    1998-12-01

    A behavioral economic analysis of rats' consumption of various fat and sweet solutions was conducted in order to assess whether rats' fat appetite is readily modifiable. According to economic demand theory, changes in the price of a reinforcer will produce substantial changes in its consumption under conditions in which a substitutable reinforcer is available. Results from income-compensated price changes revealed that sucrose, mineral oil and saccharin solutions substituted for a corn oil solution: increases in the price of the corn oil led to large decreases in its consumption and sizable increases in consumption of these alternatives. On the other hand, plain water did not substitute for the corn oil solution: increasing the price of the corn oil did not result in nearly as marked a change in its consumption nor in consumption of the water. Neither the strength of preference for the corn oil under baseline conditions nor the caloric content of the alternative solution predicted whether the alternative reinforcer substituted for the corn oil. Rather, palatability appeared to be a dimension along which substitution was based. These results suggest that fat appetite is modified when palatable alternatives are available, independent of how strongly the fat is preferred.

  13. The Behavioral Economics of Choice and Interval Timing

    PubMed Central

    Jozefowiez, J.; Staddon, J. E. R.; Cerutti, D. T.

    2009-01-01

    We propose a simple behavioral economic model (BEM) describing how reinforcement and interval timing interact. The model assumes a Weber-law-compliant logarithmic representation of time. Associated with each represented time value are the payoffs that have been obtained for each possible response. At a given real time, the response with the highest payoff is emitted. The model accounts for a wide range of data from procedures such as simple bisection, metacognition in animals, economic effects in free-operant psychophysical procedures and paradoxical choice in double-bisection procedures. Although it assumes logarithmic time representation, it can also account for data from the time-left procedure usually cited in support of linear time representation. It encounters some difficulties in complex free-operant choice procedures, such as concurrent mixed fixed-interval schedules as well as some of the data on double bisection, that may involve additional processes. Overall, BEM provides a theoretical framework for understanding how reinforcement and interval timing work together to determine choice between temporally differentiated reinforcers. PMID:19618985

  14. Improving utilization of and retention in PMTCT services: Can behavioral economics help?

    PubMed Central

    2013-01-01

    Background The most recent strategic call to action of the World Health Organization sets the elimination of pediatric HIV as a goal. While recent efforts have focused on building infrastructure and ensuring access to high-quality treatment, we must now turn our focus to the behavior change needed to eliminate vertical transmission. We make the case for the application of concepts from the field of behavioral economics to prevention of mother-to-child transmission (PMTCT) programs to more effectively address demand-side issues of uptake and retention. Discussion We introduce five concepts from the field of behavioral economics and discuss their application to PMTCT programs: 1) Mentor mothers who come from similar circumstances as PMTCT patients can serve as social references who provide temporally salient modeling of utilization of services and adherence to treatment. 2) Economic incentives, like cell phone minutes or food vouchers, that reward adherence to PMTCT protocols leverage present bias, the observation that people are generally biased toward immediate versus future awards. 3) Default bias, our preference for the default option, is already being used in many countries in the form of opt-out testing, and could be expanded to all PMTCT programs. 4) We are hardwired to avoid loss more than to pursue an equivalent gain. PMTCT programs can take advantage of loss aversion through the use of commitment contracts that incentivize mothers to return to the clinic in order to avoid both reputational and financial loss. Summary Eliminating vertical transmission of HIV is an ambitious goal. To close the remaining gap, innovations are needed to address demand for PMTCT services. Behavioral economics offers a set of tools that can be engineered into PMTCT programs to increase uptake and improve retention with minimal investment. PMID:24112440

  15. The challenges of economic evaluations of remote technical health interventions.

    PubMed

    Kennedy, Christine A

    2005-04-01

    There are many difficulties in applying standard economic evaluation techniques to health care services, and telemedicine services, being relatively new and diverse, pose particular challenges to evaluators. Blanket statements about the "cost-effectiveness" of programs cannot and should not be made. Indeed, the benefit of discussing CEA (cost-effectiveness analysis) ratios is in the comparison between programs and their alternatives. In the last few years attention has focused on the actual resource implications of existing and expanding telemedicine services such as teleradiology and telepsychiatry among others. Several Canadian case studies are available to illustrate various evaluation techniques and assumptions employed. Economic barriers to the diffusion of telemedicine remain; both with capital outlay costs and issues surrounding the reimbursement of physicians for telemedicine services. This paper reviews the main tenets of economic evaluations applied to health care services but uses case studies from telemedicine services to illustrate the possibility and importance of comparative analyses. Other broader policy issues of economic incentives and implications of reimbursement are also explored.

  16. Particulate matter in urban areas: health-based economic assessment.

    PubMed

    El-Fadel, M; Massoud, M

    2000-08-10

    The interest in the association between human health and air pollution has grown substantially in recent years. Based on epidemiological studies in several countries, there is conclusive evidence of a link between particulate air pollution and adverse health effects. Considering that particulate matter may be the most serious pollutant in urban areas and that pollution-related illness results in financial and non-financial welfare losses, the main objective of this study is to assess the economic benefits of reducing particulate air pollution in Lebanese urban areas. Accordingly, the extent and value of health benefits due to decreasing levels of particulate in the air are predicted. Health impacts are expressed in both physical and monetary terms for saved statistical lives, and productivity due to different types of morbidity endpoints. Finally, the study concludes with a range of policy options available to mitigate particulate air pollution in urban areas.

  17. The Economic Incidence of Health Care Spending in Vermont.

    PubMed

    Eibner, Christine; Nowak, Sarah A; Liu, Jodi L; White, Chapin

    2015-07-15

    In 2015, Vermont legislators may consider financing plans to implement Act 48, a law that aims to provide universal health care coverage to all Vermont residents starting in 2017. In this analysis, we estimate the economic incidence of payments for health care by Vermont residents and the value of health care benefits received by Vermont residents in 2012 and 2017, without the implementation of Act 48 reforms. The goal of the analysis was to understand how health care is currently paid for in Vermont, and to provide a baseline for understanding the possible effects of Act 48. We use data from the 2012 Vermont Household Health Interview Survey, the Vermont Health Care Uniform Evaluation and Reporting System, and administrative data on taxes to estimate payments in 2012. We then project these estimates forward to 2017, using the RAND COMPARE microsimulation to account for how health care coverage in Vermont will change as a result of the Affordable Care Act (ACA). We find that most Vermont residents receive more in health benefits than they pay for directly or through taxes. While lower-income individuals, on average, pay less than higher-income individuals, there is considerable variation across individuals in the level of payment for health care. Much of the current variation stems from the fractured nature of the health system, with some individuals receiving coverage through employers, some through the Exchange (i.e., the health insurance marketplace created by the ACA), and some through other sources. As Vermont considers health care reform, legislators may wish to consider options to reduce the degree of variation in payments made by individuals with similar income levels.

  18. Health care reform, behavioral health, and the criminal justice population.

    PubMed

    Cuellar, Alison Evans; Cheema, Jehanzeb

    2014-10-01

    The 2010 Patient Protection and Affordable Care Act (ACA) has a number of important features for individuals who are involved with the criminal justice system. Among the most important changes is the expansion of Medicaid to more adults. The current study estimates that 10% of the total Medicaid expansion could include individuals who have experienced recent incarceration. The ACA also emphasizes the importance of mental health and substance abuse benefits, potentially changing the landscape of behavioral health treatment providers willing to serve criminal justice populations. Finally, it seeks to promote coordinated care delivery. New care delivery and appropriate funding models are needed to address the behavioral health and other chronic conditions experienced by those in criminal justice and to coordinate care within the complex structure of the justice system itself.

  19. Repealing Federal Health Reform: Economic and Employment Consequences for States.

    PubMed

    Ku, Leighton; Steinmetz, Erika; Brantley, Erin; Bruen, Brian

    2017-01-01

    Issue: The incoming Trump administration and Republicans in Congress are seeking to repeal the Affordable Care Act (ACA), likely beginning with the law’s insurance premium tax credits and expansion of Medicaid eligibility. Research shows that the loss of these two provisions would lead to a doubling of the number of uninsured, higher uncompensated care costs for providers, and higher taxes for low-income Americans. Goal: To determine the state-by-state effect of repeal on employment and economic activity. Methods: A multistate economic forecasting model (PI+ from Regional Economic Models, Inc.) was used to quantify for each state the effects of the federal spending cuts. Findings and Conclusions: Repeal results in a $140 billion loss in federal funding for health care in 2019, leading to the loss of 2.6 million jobs (mostly in the private sector) that year across all states. A third of lost jobs are in health care, with the majority in other industries. If replacement policies are not in place, there will be a cumulative $1.5 trillion loss in gross state products and a $2.6 trillion reduction in business output from 2019 to 2023. States and health care providers will be particularly hard hit by the funding cuts.

  20. Behavioral Health Emergencies Managed by School Nurses Working with Adolescents

    ERIC Educational Resources Information Center

    Ramos, Mary M.; Greenberg, Cynthia; Sapien, Robert; Bauer-Creegan, Judith; Hine, Beverly; Geary, Cathy

    2013-01-01

    Background: As members of interdisciplinary teams, school nurses provide behavioral health services. Studies indicate that school nurses may lack sufficient continuing education in adolescent behavioral health and in the management of behavioral health emergencies, specifically. We conducted this study to describe the adolescent behavioral health…

  1. Factors Associated with Physician Discussion of Health Behaviors with Adolescents

    ERIC Educational Resources Information Center

    Choi, Won S.; Ellerbeck, Edward F.; Kaur, Harsohena; Nazir, Niaman; Ahluwalia, Jasjit S.

    2006-01-01

    Behaviors developed in adolescence influence health later in life. The purpose of this study was to investigate the frequency of health care provider's discussion of health behaviors with overweight and non-overweight adolescents and identify demographic and health behaviors related to exercise, hours of television viewing, and weight issues…

  2. The role of health economics in the evaluation of surgery and operative technologies.

    PubMed

    Taylor, Matthew

    2017-02-01

    Dr Matthew Taylor is the director of York Health Economics Consortium and leads the Consortium's health technology assessment program. The work of York Health Economics Consortium involves empirical research in health economics for both the private and public sectors. Dr Taylor is the scientific lead for the National Institute for Health and Care Excellence (NICE) Economic and Methodological Unit and a former member of NICE's Public Health Advisory Committee. He is also managing director (Europe) of Minerva, an international network of health economics consultancies.

  3. The behavioral- and neuro-economic process of temporal discounting: A candidate behavioral marker of addiction.

    PubMed

    Bickel, Warren K; Koffarnus, Mikhail N; Moody, Lara; Wilson, A George

    2014-01-01

    Addiction science would benefit from the identification of a behavioral marker. A behavioral marker could reflect the projected clinical course of the disorder, function as a surrogate measure of clinical outcome, and/or may be related to biological components that underlie the disorder. In this paper we review relevant literature, made possible with the early and sustained support by NIDA, to determine whether temporal discounting, a neurobehavioral process derived from behavioral economics and further explored through neuroeconomics, may function as a behavioral marker. Our review suggests that temporal discounting 1) identifies individuals who are drug-dependent, 2) identifies those at risk of developing drug dependence, 3) acts as a gauge of addiction severity, 4) correlates with all stages of addiction development, 5) changes with effective treatment, and 6) may be related to the biological and genetic processes that underlie addiction. Thus, initial evidence supports temporal discounting as a candidate behavioral marker. Additional studies will be required in several areas for a more conclusive determination. Confirmation that temporal discounting functions as a behavioral marker for addiction could lead to 1) a screen for new treatments, 2) personalization of prevention and treatment interventions, and 3) the extension of temporal discounting as a behavioral marker for other etiologically similar disorders. This article is part of a Special Issue entitled 'NIDA 40th Anniversary Issue'.

  4. Behavioral Economics and the Supplemental Nutrition Assistance Program:: Making the Healthy Choice the Easy Choice.

    PubMed

    Ammerman, Alice S; Hartman, Terry; DeMarco, Molly M

    2017-02-01

    The Supplemental Nutrition Assistance Program (SNAP) serves as an important nutritional safety net program for many Americans. Given its aim to use traditional economic levers to provide access to food, the SNAP program includes minimal nutritional requirements and restrictions. As food choices are influenced by more than just economic constraints, behavioral economics may offer insights and tools for altering food purchases for SNAP users. This manuscript outlines behavioral economics strategies that have potential to encourage healthier food choices within the SNAP program.

  5. The Behavioral Economics of Education: New Directions for Research

    ERIC Educational Resources Information Center

    Jabbar, Huriya

    2011-01-01

    Over the past several decades, researchers have used economics to understand a number of issues in education policy. This article argues that some education researchers have defined economics too narrowly, neglecting several areas of economics research that cut across disciplinary boundaries. One subdiscipline of economics that might be of use in…

  6. Panel V: Adaptive Health Behaviors Among Ethnic Minorities

    PubMed Central

    Bagley, Shirley P.; Angel, Ronald; Dilworth-Anderson, Peggye; Liu, William; Schinke, Steven

    2006-01-01

    Race, ethnicity, and cultural attitudes and practices are among the variables that influence health behaviors, including adaptive health behaviors. The following discussions highlight the important role of social conditions in shaping health behaviors and the central role of family in promoting health across the Asian, Hispanic, Native American, and African American ethnic groups. Factors that may lead to health-damaging behaviors are also discussed. The need for additional research that identifies correlations among physiological, social, and behavioral factors and health behaviors, as well as underlying mechanisms, is called for. PMID:8654341

  7. Incarceration, Maternal Hardship, and Perinatal Health Behaviors

    PubMed Central

    Dumont, Dora M.; Wildeman, Christopher; Lee, Hedwig; Gjelsvik, Annie; Valera, Pamela A.; Clarke, Jennifer G.

    2014-01-01

    Background Parental incarceration is associated with mental and physical health problems in children, yet little research directly tests mechanisms through which parental incarceration could imperil child health. We hypothesized that the incarceration of a woman or her romantic partner in the year before birth constituted an additional hardship for already-disadvantaged women, and that these additionally vulnerable women were less likely to engage in positive perinatal health behaviors important to infant and early childhood development. Methods We analyzed 2006-2010 data from the Pregnancy Risk Assessment and Monitoring System (PRAMS) to assess the association between incarceration in the year prior to the birth of a child and perinatal maternal hardships and behaviors. Results Women reporting incarceration of themselves or their partners in the year before birth of a child had 0.86 the odds (95% CI .78-.95) of beginning prenatal care in the first trimester compared to women not reporting incarceration. They were nearly twice as likely to report partner abuse and were significantly more likely to rely on WIC and/or Medicaid for assistance during pregnancy. These associations persist after controlling for socioeconomic measures and other stressors, including homelessness and job loss. Conclusions Incarceration of a woman or her partner in the year before birth is associated with higher odds of maternal hardship and poorer perinatal health behaviors. The unprecedented scale of incarceration in the U.S. simultaneously presents an underutilized public health opportunity and constitutes a social determinant of health that may contribute to disparities in early childhood development. PMID:24615355

  8. Health economics and the European Heart Rhythm Association.

    PubMed

    Vardas, Panos; Boriani, Giuseppe

    2011-05-01

    The management of healthcare is becoming extremely complex in developed countries, as a result of increasing age of the population and increasing costs of care, coupled with diminishing resources due to global financial crisis. This situation threatens access to appropriate care, and a more or less explicit rationing of some types of treatment may occur in 'real world' clinical practice. This is particularly true for those treatments or interventions with a relatively high up-front cost, such as cardioverter defibrillators, devices for cardiac resynchronization therapy or ablation procedures for atrial fibrillation. The European Heart Rhythm Association (EHRA) is strongly convinced that the skills of electrophysiologists and cardiologists responsible for the management of rhythm disorders have to evolve, also embracing the knowledge of health economics, clinical epidemiology, health-care management and outcome research. These disciplines do not belong to what is considered as the conventional cultural background of physicians, but knowledge of comparative cost effectiveness and of other economic approaches nowadays appears fundamental for a dialogue with a series of stakeholders, such as policy makers, politicians, and administrators, involved in budgeting the activity of hospitals and health-care services, as well as in approaching health technology assessment.

  9. Youth Risk Behavior Surveillance System: Selected 2011 National Health Risk Behaviors and Health Outcomes by Sex

    ERIC Educational Resources Information Center

    Centers for Disease Control and Prevention, 2011

    2011-01-01

    The national Youth Risk Behavior Survey (YRBS) monitors priority health risk behaviors that contribute to the leading causes of death, disability, and social problems among youth and adults in the United States. The national YRBS is conducted every two years during the spring semester and provides data representative of 9th through 12th grade…

  10. Understanding Differences in Health Behaviors by Education

    PubMed Central

    Cutler, David M.; Lleras-Muney, Adriana

    2009-01-01

    Using a variety of data sets from two countries, we examine possible explanations for the relationship between education and health behaviors, known as the education gradient. We show that income, health insurance, and family background can account for about 30 percent of the gradient. Knowledge and measures of cognitive ability explain an additional 30 percent. Social networks account for another 10 percent. Our proxies for discounting, risk aversion, or the value of future do not account for any of the education gradient, and neither do personality factors such as a sense of control of oneself or over one’s life. PMID:19963292

  11. Theory's role in shaping behavioral health research for population health.

    PubMed

    King, Abby C

    2015-11-26

    The careful application of theory often is used in the behavioral health field to enhance our understanding of how the world currently works. But theory also can help us visualize what the world can become, particularly through its potential impacts on population-wide health. Applying a multi-level ecological perspective can help in expanding the field's focus upward toward the population at large. While ecological frameworks have become increasingly popular, arguably such perspectives have fallen short of their potential to actively bridge conceptual constructs and, by extension, intervention approaches, across different levels of population impact. Theoretical and conceptual perspectives that explicitly span levels of impact offer arguably the greatest potential for achieving scientific insights that may in turn produce the largest population health effects. Examples of such "bridging" approaches include theories and models that span behavioral + micro-environment, behavioral + social/cultural, and social + physical environment constructs. Several recommendations are presented related to opportunities for leveraging theories to attain the greatest impact in the population health science field. These include applying the evidence obtained from person-level theories to inform methods for positively impacting the behaviors of community gatekeepers and decision-makers for greater population change and reach; leveraging the potential of residents as "citizen scientists"--a resource for enacting behavioral health changes at the individual, environmental, and policy levels; using empirical observations and theory in equal parts to build more robust, relevant, and solution-oriented behavior change programs; exploring moderators and mediators of change at levels of impact that go beyond the individual; and considering the circumstances in which applying conceptual methods that embrace a "complexity" as opposed to "causality" perspective may lead to more

  12. Methanol as an alternative fuel: Economic and health effects

    SciTech Connect

    Yuecel, M.K. )

    1991-09-01

    Switching from gasoline to methanol fuels has important economic and health effects. Replacing gasoline with methanol will affect oil markets by lowering the demand for oil and thus lowering oil prices. Increased demand for the natural gas feedstock will increase natural gas prices. Because methanol is more costly than gasoline, fuel prices will also increase. On the other hand, methanol use will reduce ozone pollution and some of the health risks associated with gasoline. Considering all three markets affected by the phasing-out of gasoline, the switch to methanol results in net gains. The health benefits from lower pollution and the lives saved from the switch from gasoline to methanol are in addition to these gains. Overall, the benefits of the policy far outweigh the costs. However, the gains in the oil market, arising from the US monopsony power in the world oil market, can be captured by other, more efficient policies. 21 refs., 2 figs., 3 tabs.

  13. Workforce competencies in behavioral health: an overview.

    PubMed

    Hoge, Michael A; Paris, Manuel; Adger, Hoover; Collins, Frank L; Finn, Cherry V; Fricks, Larry; Gill, Kenneth J; Haber, Judith; Hansen, Marsali; Ida, D J; Kaplan, Linda; Northey, William F; O'Connell, Maria J; Rosen, Anita L; Taintor, Zebulon; Tondora, Janis; Young, Alexander S

    2005-01-01

    Competency-based training approaches are being used more in healthcare to guide curriculum content and ensure accountability and outcomes in the educational process. This article provides an overview of the state of competency development in the field of behavioral health. Specifically, it identifies the groups and organizations that have conducted and supported this work, summarizes their progress in defining and assessing competencies, and discusses both the obstacles and future directions for such initiatives. A major purpose of this article is to provide a compendium of current competency efforts so that these might inform and enhance ongoing competency development in the varied behavioral health disciplines and specialties. These varied resources may also be useful in identifying the core competencies that are common to the multiple disciplines and specialties.

  14. A systematic review of economic evaluations of health and health-related interventions in Bangladesh

    PubMed Central

    2011-01-01

    Background Economic evaluation is used for effective resource allocation in health sector. Accumulated knowledge about economic evaluation of health programs in Bangladesh is not currently available. While a number of economic evaluation studies have been performed in Bangladesh, no systematic investigation of the studies has been done to our knowledge. The aim of this current study is to systematically review the published articles in peer-reviewed journals on economic evaluation of health and health-related interventions in Bangladesh. Methods Literature searches was carried out during November-December 2008 with a combination of key words, MeSH terms and other free text terms as suitable for the purpose. A comprehensive search strategy was developed to search Medline by the PubMed interface. The first specific interest was mapping the articles considering the areas of exploration by economic evaluation and the second interest was to scrutiny the methodological quality of studies. The methodological quality of economic evaluation of all articles has been scrutinized against the checklist developed by Evers Silvia and associates. Result Of 1784 potential articles 12 were accepted for inclusion. Ten studies described the competing alternatives clearly and only two articles stated the perspective of their articles clearly. All studies included direct cost, incurred by the providers. Only one study included the cost of community donated resources and volunteer costs. Two studies calculated the incremental cost effectiveness ratio (ICER). Six of the studies applied some sort of sensitivity analysis. Two of the studies discussed financial affordability of expected implementers and four studies discussed the issue of generalizability for application in different context. Conclusion Very few economic evaluation studies in Bangladesh are found in different areas of health and health-related interventions, which does not provide a strong basis of knowledge in the area. The

  15. Microeconomic Surplus in Health Care: Applied Economic Theory in Health Care in Four European Countries

    PubMed Central

    Walzer, S.; Nuijten, M.; Wiesner, C.; Kaier, K.; Johansson, P-O.; Oertel, S.

    2013-01-01

    Introduction: In economic theory economic surplus refers to two related quantities: Consumer and producer surplus. Applying this theory to health care “convenience” could be one way how consumer benefits might manifest itself. Methods: Various areas of economic surplus were identified and subsequently screened and analyzed in Germany, Spain, The Netherlands, and the UK: Cesarean births, emergency room visits (nights or weekends), drug availability after test results, and response surplus. A targeted literature search was being conducted to identify the associated costs. Finally the economic surplus (convenience value) was calculated. Results: The economic surplus for different health care areas was being calculated. The highest economic surplus was obtained for the example of response surplus IVF-treatments in The Netherlands. Conclusion: The analyzed examples in this article support the underlying hypothesis for this research: “Value of convenience defined as the consumer surplus in health care can be shown in different health care settings.” Again, this hypothesis should be accepted as a starting point in this research area and hence further primary research is strongly recommended in order to fully proof this concept. PMID:23423475

  16. Estimates of Preventability and Their Relation to Health Behavior.

    ERIC Educational Resources Information Center

    Poole, Gary D.

    It was hypothesized that a person's estimates of the preventability of health problems would be related to health behaviors such that a person who engages in healthful behavior should make higher estimates of preventability. A study was conducted to investigate the relationship between causal attribution of health problems and health-related…

  17. Posttraumatic stress disorder and health: a preliminary study of group differences in health and health behaviors

    PubMed Central

    2013-01-01

    Background Individuals with posttraumatic stress disorder (PTSD) are more likely to undertake harmful health behaviors like substance use. Less is known about the association of PTSD with healthful behaviors such as healthy diet and exercise. The purpose of this study was to examine differences across physical health indicators and health behaviors in individuals with and without PTSD. Methods A cross-sectional, case–control study of health indicators and self-reported health behaviors in a community and military veteran sample was used. Results Based on a structured psychiatric interview, 25 participants had PTSD, and the remaining 55 without PTSD served as the comparison group. Participants were 40 years old on average and 45% were female. Multivariate analysis of variance analyses revealed that participants with PTSD had significantly higher body mass index (p = 0.004), had more alcohol use (p = 0.007), and reported fewer minutes of vigorous exercise (p = 0.020) than those without PTSD. Chi-square analysis of diet content and eating behavior constructs found that individuals with PTSD ate fewer fruits (p = 0.035) and had more guilt after overeating (p = 0.006). Conclusions These findings replicate prior research on the link between PTSD and negative health outcomes and engagement in harmful health behaviors and highlight the need for further examination of the association between PTSD and other health behaviors like diet content, eating behaviors, and exercise. PMID:24070007

  18. Health economics in haemophilia: a review from the clinician's perspective.

    PubMed

    Escobar, M A

    2010-05-01

    Health economic evaluations provide valuable information for healthcare providers, facilitating the treatment decision-making process in a climate where demand for healthcare exceeds the supply. Although an uncommon disease, haemophilia is a life-long condition that places a considerable burden on patients, healthcare systems and society. This burden is particularly large for patients with haemophilia with inhibitors, who can develop serious bleeding complications unresponsive to standard factor replacement therapies. Hence, bleeding episodes in these patients are treated with bypassing agents such as recombinant activated FVII (rFVIIa) and plasma-derived activated prothrombin complex concentrates (pd-APCC). With the efficacy of these agents now well established, a number of health economic studies have been conducted to compare their cost-effectiveness for the on-demand treatment of bleeding episodes in haemophiliacs with inhibitors. In a cost-utility analysis, which assesses the effects of treatment on quality of life (QoL) and quantity of life, the incremental cost per quality-adjusted life-year (QALY) gained (US $44,834) indicated that rFVIIa was cost-effective. Similarly, eight of 11 other economic modelling evaluations found that rFVIIa was more cost-effective than pd-APCC in the on-demand treatment of bleeding episodes. These findings indicate that treating patients with haemophilia promptly and with the most effective therapy available may result in cost savings.

  19. Reproductive health, population growth, economic development and environmental change.

    PubMed

    Lincoln, D W

    1993-01-01

    World population will increase by 1000 million, or by 20%, within 10 years. Ninety-five per cent of this increase will occur in the South, in areas that are already economically, environmentally and politically fragile. Morbidity and mortality associated with reproduction will be greater in the current decade than in any period in human history. Annually, 40-60 million pregnancies will be terminated and 5-10 million children will die within one year of birth. AIDS-related infections, e.g. tuberculosis, will undermine health care in Africa (and elsewhere) and in places AIDS-related deaths will decimate the work-force. The growth in population and associated morbidity will inhibit global economic development and spawn new problems. The key issues are migration, the spread of disease, the supply of water and the degradation of land, and fiscal policies with respect to family planning, pharmaceuticals and Third-World debt. Full education, particularly of women, and more effective family planning in the South have the power to unlock the problem. Failure will see the developed countries, with their 800 million population, swamped by the health, economic and environmental problems of the South, with its projected population of 5400 million people for the year 2000.

  20. Health-risk behaviors in early adolescence.

    PubMed

    Rew, Lynn; Horner, Sharon D; Brown, Adama

    2011-01-01

    The major morbidities and mortalities of adolescents are related to preventable risky behaviors, but how, when, and in whom these behaviors develop in early adolescence is unknown. The purpose of this study was to determine which set of risk factors and protective resources of school-age children were best predictors of health-risk behaviors in early adolescence. A longitudinal, cohort sequential design was used with a diverse sample of 1,934 children in grades 4 through 8. Parents provided demographic and neighborhood data for children through a mailed survey. Children completed valid scales annually at schools, using audio-computer-assisted self-interviewing (A-CASI) technology. Significant gender and racial/ethnic differences were found in carrying a weapon and using alcohol. Higher perceived levels of stress increased the risk for alcohol use as did riding in a car with a driver who was drinking. Health behaviors exhibited while in 4th through 6th grades protected early adolescents from alcohol use and riding in a car with a driver who was drinking. A parent's education and perceived safety in neighborhood protected against carrying a weapon and smoking. Many findings are similar to those of national samples, but others show positive differences in this localized sample, over 50% of whom were Latino. Protective resources suggest numerous nursing interventions to promote healthy adolescent development.

  1. Designing and Undertaking a Health Economics Study of Digital Health Interventions.

    PubMed

    McNamee, Paul; Murray, Elizabeth; Kelly, Michael P; Bojke, Laura; Chilcott, Jim; Fischer, Alastair; West, Robert; Yardley, Lucy

    2016-11-01

    This paper introduces and discusses key issues in the economic evaluation of digital health interventions. The purpose is to stimulate debate so that existing economic techniques may be refined or new methods developed. The paper does not seek to provide definitive guidance on appropriate methods of economic analysis for digital health interventions. This paper describes existing guides and analytic frameworks that have been suggested for the economic evaluation of healthcare interventions. Using selected examples of digital health interventions, it assesses how well existing guides and frameworks align to digital health interventions. It shows that digital health interventions may be best characterized as complex interventions in complex systems. Key features of complexity relate to intervention complexity, outcome complexity, and causal pathway complexity, with much of this driven by iterative intervention development over time and uncertainty regarding likely reach of the interventions among the relevant population. These characteristics imply that more-complex methods of economic evaluation are likely to be better able to capture fully the impact of the intervention on costs and benefits over the appropriate time horizon. This complexity includes wider measurement of costs and benefits, and a modeling framework that is able to capture dynamic interactions among the intervention, the population of interest, and the environment. The authors recommend that future research should develop and apply more-flexible modeling techniques to allow better prediction of the interdependency between interventions and important environmental influences.

  2. Helping patients make better decisions: how to apply behavioral economics in clinical practice

    PubMed Central

    Courtney, Maureen Reni; Spivey, Christy; Daniel, Kathy M

    2014-01-01

    Clinicians are committed to effectively educating patients and helping them to make sound decisions concerning their own health care. However, how do clinicians determine what is effective education? How do they present information clearly and in a manner that patients understand and can use to make informed decisions? Behavioral economics (BE) is a subfield of economics that can assist clinicians to better understand how individuals actually make decisions. BE research can help guide interactions with patients so that information is presented and discussed in a more deliberate and impactful way. We can be more effective providers of care when we understand the factors that influence how our patients make decisions, factors of which we may have been largely unaware. BE research that focuses on health care and medical decision making is becoming more widely known, and what has been reported suggests that BE interventions can be effective in the medical realm. The purpose of this article is to provide clinicians with an overview of BE decision science and derived practice strategies to promote more effective behavior change in patients. PMID:25378915

  3. Heart rate, health, and hurtful behavior.

    PubMed

    Jennings, J Richard; Pardini, Dustin A; Matthews, Karen A

    2017-03-01

    Hostility is a risk factor for cardiovascular events. When challenged, individuals high on hostility exhibit a hyperreactive psychophysiological response to stressors, thereby increasing risk for developing cardiovascular disease. However, low resting heart rate (HR) is associated with physical aggression and hostility in children, adolescents, and adults. Based on a community sample of 296 men (mean age = 32.0), we (a) address whether aggression/hostility relates to physical health through relationships with cardiovascular levels at rest and in response to stressors, and (b) determine how relations between aggression and health are altered by including psychophysiological indices in statistical models. The Cook-Medley cynical/hostile attitudes and the Buss-Perry physical aggression and hostility measures assessed aggression. Health was assessed as systolic blood pressure (SBP), report of medical conditions, and a metabolic composite. Reactivity to stressors was assessed with HR, SBP, and diastolic blood pressure. Aggression was negatively related to both resting HR and reactivity. High resting HR and reactivity were, however, positively related to poor health. Thus, the relationship between aggression and HR and reactivity suppressed an overall relationship between high aggression/hostility and poor health. In the presence of covariates for socioeconomic status, race, health behaviors, and medications, the relationship between aggression and health was significantly strengthened when HR level and reactivity were included in models. In sum, at early midlife, low HR among aggressive and hostile individuals is related to less health risk. Aggression and hostility have a deleterious influence on health, but primarily among individuals with higher HR and possibly greater cardiovascular reactivity.

  4. Health impacts of rapid economic changes in Thailand.

    PubMed

    Tangcharoensathien, V; Harnvoravongchai, P; Pitayarangsarit, S; Kasemsup, V

    2000-09-01

    The economic crisis in Thailand in July 1997 had major social implications for unemployment, under employment, household income contraction, changing expenditure patterns, and child abandonment. The crisis increased poverty incidence by 1 million, of whom 54% were the ultra-poor. This paper explores and explains the short-term health impact of the crisis, using existing data and some special surveys and interviews for 2 years during 1998-99. The health impacts of the crisis are mixed, some being negative and some being positive. Household health expenditure reduced by 24% in real terms; among the poorer households, institutional care was replaced by self-medication. The pre-crisis rising trend in expenditure on alcohol and tobacco consumption was reversed. Immunization spending and coverage were sustained at a very high level after the crisis, but reports of increases in diphtheria and pertussis indicate declining programme quality. An increase in malaria, despite budget increases, had many causes but was mainly due to reduced programme effectiveness. STD incidence continued the pre-crisis downward trend. Rates of HIV risky sexual behaviour were higher among conscripts than other male workers, but in both groups there was lower condom use with casual partners. HIV serosurveillance showed a continuation of the pre-crisis downward trend among commercial sex workers (CSW, both brothel and non-brothel based), pregnant women and donated blood; this trend was slightly reversed among male STD patients and more among intravenous drug users. Condom coverage among brothel based CSW continued to increase to 97.5%, despite a 72% budget cut in free condom distribution. Poverty and lack of insurance coverage are two major determinants of absence of or inadequate antenatal care, and low birthweight. The Low Income Scheme could not adequately cover the poor but the voluntary Health Card Scheme played a health safety net role for maternal and child health. Low birthweight and

  5. Managing the physics of the economics of integrated health care.

    PubMed

    Zismer, Daniel K; Werner, Mark J

    2012-01-01

    The physics metaphor, as applied to the economics (and financial performance) of the integrated health system, seems appropriate when considered together with the nine principles of management framework provided. The nature of the integrated design enhances leaders' management potential as they consider organizational operations and strategy in the markets ahead. One question begged by this argument for the integrated design is the durability, efficiency and ultimate long-term survivability of the more "traditional" community health care delivery models, which, by design, are fragmented, internally competitive and less capital efficient. They also cannot exploit the leverage of teams, optimal access management or the pursuit of revenues made available in many forms. For those who wish to move from the traditional to the more integrated community health system designs (especially those who have not yet started the journey), the path requires: * Sufficient balance sheet capacity to fund the integration process-especially as the model requires physician practice acquisitions and electronic health record implementations * A well-prepared board13, 14 * A functional, durable and sustainable physician services enterprise design * A redesigned organizational and governance structure * Favorable internal financial incentives alignment design * Effective accountable physician leadership * Awareness that the system is not solely a funding strategy for acquired physicians, rather a fully -.. committed clinical and business model, one in which patient-centered integrated care is the core service (and not acute care hospital-based services) A willingness to create and exploit the implied and inherent potential of an integrated design and unified brand Last, it's important to remember that an integrated health system is a tool that creates a "new potential" (a physics metaphor reference, one last time). The design doesn't operate itself. Application of the management principles

  6. China's "market economics in command": footwear workers' health in jeopardy.

    PubMed

    Chen, M S; Chan, A

    1999-01-01

    This study of occupational safety and health (OSH) problems in the footwear industry in China, the world's largest shoemaker, is based on four years of research in China supplemented by research in Taiwan, Australia, and the United States. With the advent of the economic reforms of the early 1980s, the Chinese state is being driven by an economic imperative under which the profit motive overrides other concerns, causing a deterioration in OSH conditions. Footwear workers are being exposed to high levels of benzene, toluene, and other toxic solvents contained in the adhesives used in the shoe-making process. Many workers have been afflicted with aplastic anemia, leukemia, and other health problems. Most of China's current permissible exposure limits to toxins are either outdated or underenforced. As a result, the Chinese state's protection of footwear workers' health is inadequate. The article aims to draw the attention of the international OSH community to the importance of setting specific exposure standards for the footwear industry worldwide.

  7. [What type of welfare policy promotes health?: the puzzling interrelation of economic and health inequality].

    PubMed

    Hurrelmann, K; Richter, M; Rathmann, K

    2011-06-01

    In all highly developed countries, the overall health status of the population has significantly improved within the past 30 years. The most important reason for this is the increase in economic prosperity. Economic wealth, however, today is much more unequally distributed than it was 3 decades ago. Countries with relatively small disparities in the availability of material resources between socioeconomic groups, such as the Scandinavian countries, have better health outcomes on the population level. Health inequalities, however, have also reached a higher level than 30 years ago. As of today, we do not have convincing explanations for the interrelation of economic and health inequality. This paper gives an overview of existing research on a comparative basis. The research results are ambivalent. They show the puzzling result that the Scandinavian countries with their highly distributive welfare policy manage to achieve the comparatively highest level of economic, but not health, equity. Based on these results, we develop proposals for future research approaches. A central assumption is that in rich societies no longer only material, but more and more immaterial determinants are crucial for the formation of health inequality. The promotion of "salutogenic" self-management capabilities in socially disadvantaged groups is considered to be the central element in effective intervention strategies.

  8. Public health and economic impact of dampness and mold

    SciTech Connect

    Mudarri, David; Fisk, William J.

    2007-06-01

    The public health risk and economic impact of dampness and mold exposures was assessed using current asthma as a health endpoint. Individual risk of current asthma from exposure to dampness and mold in homes from Fisk et al. (2007), and asthma risks calculated from additional studies that reported the prevalence of dampness and mold in homes were used to estimate the proportion of U.S. current asthma cases that are attributable to dampness and mold exposure at 21% (95% confidence internal 12-29%). An examination of the literature covering dampness and mold in schools, offices, and institutional buildings, which is summarized in the appendix, suggests that risks from exposure in these buildings are similar to risks from exposures in homes. Of the 21.8 million people reported to have asthma in the U.S., approximately 4.6 (2.7-6.3) million cases are estimated to be attributable to dampness and mold exposure in the home. Estimates of the national cost of asthma from two prior studies were updated to 2004 and used to estimate the economic impact of dampness and mold exposures. By applying the attributable fraction to the updated national annual cost of asthma, the national annual cost of asthma that is attributable to dampness and mold exposure in the home is estimated to be $3.5 billion ($2.1-4.8 billion). Analysis indicates that exposure to dampness and mold in buildings poses significant public health and economic risks in the U.S. These findings are compatible with public policies and programs that help control moisture and mold in buildings.

  9. Intensive Care Nurses’ Belief Systems Regarding the Health Economics: A Focused Ethnography

    PubMed Central

    Heydari, Abbas; Vafaee-Najar, Ali; Bakhshi, Mahmoud

    2016-01-01

    Background: Health care beliefs can have an effect on the efficiency and effectiveness of nursing practices. Nevertheless, how belief systems impact on the economic performance of intensive care unit (ICU) nurses is not known. This study aimed to explore the ICU nurses’ beliefs and their effect on nurse’s: practices and behavior patterns regarding the health economics. Methods: In this study, a focused ethnography method was used. Twenty-four informants from ICU nurses and other professional individuals were purposively selected and interviewed. As well, 400 hours of ethnographic observations were used for data collection. Data analysis was performed using the methods described by Miles and Huberman (1994). Findings: Eight beliefs were found that gave meaning to ICU nurse’s practices regarding the health economics. 1. The registration of medications and supplies disrupt the nursing care; 2. Monitoring and auditing improve consumption; 3. There is a fear of possible shortage in the future; 4. Supply and replacement of equipment is difficult; 5. Higher prices lead to more accurate consumption; 6. The quality of care precedes the costs; 7. Clinical Guidelines are abundant but useful; and 8. Patient economy has priority over hospital economy. Maintaining the quality of patient care with least attention to hospital costs was the main focus of the beliefs formed up in the ICU regarding the health economics. Conclusions: ICU nurses’ belief systems have significantly shaped in relation to providing a high-quality care. Although high quality of care can lead to a rise in the effectiveness of nursing care, cost control perspective should also be considered in planning for improve the quality of care. Therefore, it is necessary to involve the ICU nurses in decision-making about unit cost management. They must become familiar with the principles of heath care economics and productivity by applying an effective cost management program. It may be optimal to implement the

  10. The impact of health economic evaluations in Sweden.

    PubMed

    Heintz, Emelie; Arnberg, Karl; Levin, Lars-Åke; Liliemark, Jan; Davidson, Thomas

    2014-01-01

    The responsibility for healthcare in Sweden is shared by the central government, county councils and municipalities. The counties and municipalities are free to make their own prioritizations within the framework of the state healthcare laws. To guide prioritization of healthcare resources in Sweden, there is consensus that cost-effectiveness constitutes one of the three principles. The objective of this paper is to describe how cost-effectiveness, and hence health economic evaluations (HEE), have a role in pricing decisions, reimbursement of pharmaceuticals as well as the overall prioritization and allocation of resources in the Swedish healthcare system. There are various organizations involved in the processes of implementing health technologies in the Swedish healthcare system, several of which consider or produce HEEs when assessing different technologies: the Dental and Pharmaceutical Benefits Agency (TLV), the county councils' group on new drug therapies (NLT), the National Board of Health and Welfare, the Swedish Council on Health Technology Assessment (SBU), regional HTA agencies and the Public Health Agency of Sweden. The only governmental agency that has official and mandatory guidelines for how to perform HEE is TLV (LFNAR 2003:2). Even though HEEs may seem to have a clear and explicit role in the decision-making processes in the Swedish healthcare system, there are various obstacles and challenges in the use and dissemination of the results.

  11. Declining fertility and economic well-being: do education and health ride to the rescue?

    PubMed

    Prettner, Klaus; Bloom, David E; Strulik, Holger

    2013-06-01

    It is widely argued that declining fertility slows the pace of economic growth in industrialized countries through its negative effect on labor supply. There are, however, theoretical arguments suggesting that the effect of falling fertility on effective labor supply can be offset by associated behavioral changes. We formalize these arguments by setting forth a dynamic consumer optimization model that incorporates endogenous fertility as well as endogenous education and health investments. The model shows that a fertility decline induces higher education and health investments that are able to compensate for declining fertility under certain circumstances. We assess the theoretical implications by investigating panel data for 118 countries over the period 1980 to 2005 and show that behavioral changes partly mitigate the negative impact of declining fertility on effective labor supply.

  12. Declining fertility and economic well-being: do education and health ride to the rescue?

    PubMed Central

    Prettner, Klaus; Bloom, David E.; Strulik, Holger

    2015-01-01

    It is widely argued that declining fertility slows the pace of economic growth in industrialized countries through its negative effect on labor supply. There are, however, theoretical arguments suggesting that the effect of falling fertility on effective labor supply can be offset by associated behavioral changes. We formalize these arguments by setting forth a dynamic consumer optimization model that incorporates endogenous fertility as well as endogenous education and health investments. The model shows that a fertility decline induces higher education and health investments that are able to compensate for declining fertility under certain circumstances. We assess the theoretical implications by investigating panel data for 118 countries over the period 1980 to 2005 and show that behavioral changes partly mitigate the negative impact of declining fertility on effective labor supply. PMID:26388677

  13. Working toward financial sustainability of integrated behavioral health services in a public health care system.

    PubMed

    Monson, Samantha Pelican; Sheldon, J Christopher; Ivey, Laurie C; Kinman, Carissa R; Beacham, Abbie O

    2012-06-01

    The need, benefit, and desirability of behavioral health integration in primary care is generally accepted and has acquired widespread positive regard. However, in many health care settings the economics, business aspects, and financial sustainability of practice in integrated care settings remains an unsolved puzzle. Organizational administrators may be reluctant to expand behavioral health services without evidence that such programs offer clear financial benefits and financial sustainability. The tendency among mental health professionals is to consider positive clinical outcomes (e.g., reduced depression) as being globally valued indicators of program success. Although such outcomes may be highly valued by primary care providers and patients, administrative decision makers may require demonstration of more tangible financial outcomes. These differing views require program developers and evaluators to consider multiple outcome domains including clinical/psychological symptom reduction, potential cost benefit, and cost offset. The authors describe a process by which a pilot demonstration project is being implemented to demonstrate programmatic outcomes with a focus on the following: 1) clinician efficiency, 2) improved health outcomes, and 3) direct revenue generation associated with the inclusion of integrated primary care in a public health care system. The authors subsequently offer specific future directions and commentary regarding financial evaluation in each of these domains.

  14. [Political ecology, ecological economics, and public health: interfaces for the sustainability of development and health promotion].

    PubMed

    Porto, Marcelo Firpo; Martinez-Alier, Joan

    2007-01-01

    This article proposes to focus contributions from political ecology and ecological economics to the field of collective health with a view towards integrating the discussions around health promotion, socio-environmental sustainability, and development. Ecological economics is a recent interdisciplinary field that combines economists and other professionals from the social, human, and life sciences. The field has developed new concepts and methodologies that seek to grasp the relationship between the economy and ecological and social processes such as social metabolism and metabolic profile, thereby interrelating economic, material, and energy flows and producing indicators and indexes for (un)sustainability. Meanwhile, political ecology approaches ecological issues and socio-environmental conflicts based on the economic and power dynamics characterizing modern societies. Collective health and the discussions on health promotion can expand our understanding of territory, communities, and the role of science and institutions based on the contributions of political ecology and ecological economics in analyzing development models and the distributive and socio-environmental conflicts generated by them.

  15. Health and problem behavior among people with intellectual disabilities.

    PubMed

    May, Michael E; Kennedy, Craig H

    2010-01-01

    Good health significantly improves a person's quality of life. However, people with intellectual disabilities disproportionately have more health problems than the general population. Further complicating the matter is that people with more severe disabilities often cannot verbalize health complications they are experiencing, which leads to health problems being undiagnosed and untreated. It is plausible these conditions can interact with reinforcement contingencies to maintain problem behavior because of the increased incidence of health problems among people with intellectual disabilities. This paper reviews common health problems influencing problem behavior and reinforcement processes. A clear implication of this review is the need for comprehensive functional assessments of problem behavior involving behavior analysts and health professionals.

  16. AIDS, empire, and public health behaviorism.

    PubMed

    Basu, Sanjay

    2004-01-01

    Much of the current health approach to designing HIV/AIDS interventions in resource-poor settings involves behavior-change initiatives, particularly those adopting education-based and "culturally competent" frameworks for the reduction of HIV-associated "risk behaviors." This article reviews the evidence and social assumptions behind this approach to preventing HIV transmission, and argues that these approaches are often inadequate or misguided, particularly in their conflation of the concept of "culture" with social circumstances. By analyzing the socioeconomic circumstances that constrain individual agency, and by combining data from prevention literature with analyses of international trade agreements and the controversies over antiretroviral drug distribution, the author argues that the movement of capital and the maintenance of inequality are central to the problems associated with behavior-change initiatives and must be addressed through new paradigms in order to respond appropriately to the global AIDS pandemic. Hardt and Negri's paradigm of "Empire"--that is, examining the system through which social inequalities are maintained not only between countries but also within them--offers prospects for the design of new interventions and targets for public health workers and social movements.

  17. [Attitudes and behavior for reproductive health].

    PubMed

    Salinas-Martínez, A M; Martinez-Sanchez, C; Perez-Segura, J

    1993-05-01

    Educational interventions represent an alternative for the reproductive well-being. The objective of this investigation was to identify in a mexican community, attitudes and behaviors related to reproductive health, with the goal of implementing a specific health education program. The study population consisted of women between 12 and 44 years old, living in non-residential areas of the Delegation Miguel Hidalgo, D.F. Variables of interest were analyzed only in women with parity (n = 300). Data were collected through interview. The mean age was 31 +/- 8 years. 93.3% were married or in consensual union. 63% had elementary, junior high or prevocational studies. 89% answered that would visit the doctor before considering a pregnancy (junior high+, p < .05), 99% would seek prenatal care if they were pregnant, and 92.7% would have a hospital delivery (parity < or = 3, p < .003). 69.5% had a preconceptional visit before their last pregnancy and 89.9% received prenatal care (junior high+, p < .008). 92.5% had only hospital deliveries (< or = 30 years, p < .05, junior high+, p < .0001, primigravida p < .002, with institutionalized medical services, p < .001), 1.7% had only out-of-hospital deliveries, and 5.8% both. Agreement between attitudes and behaviors are presented. An educational program consisting of confirmation and support to positive attitudes, values and beliefs, and reinforcement to decision making, will result in a final behavior: early assistance to medical care.

  18. Health Behaviors of Minority Childhood Cancer Survivors

    PubMed Central

    Stolley, Melinda R.; Sharp, Lisa K.; Tangney, Christy; Schiffer, Linda; Arroyo, Claudia; Kim, Yoonsang; Campbell, Richard; Schmidt, Mary Lou; Breen, Kathleen; Kinahan, Karen E.; Dilley, Kim; Henderson, Tara; Korenblit, Allen D.; Seligman, Katya

    2015-01-01

    Background Available data suggest that childhood cancer survivors (CCSs) are comparable to the general population on many lifestyle parameters. However, little is known about minority CCSs. This cross-sectional study describes and compares the body mass index (BMI) and health behaviors of African-American, Hispanic and White survivors to each other and to non-cancer controls. Methods Participants included 452 adult CCS (150 African-American, 152 Hispanic, 150 white) recruited through four childhood cancer treating institutions and 375 ethnically-matched non-cancer controls (125 in each racial/ethnic group) recruited via targeted digit dial. All participants completed a 2-hour in-person interview. Results Survivors and non-cancer controls reported similar health behaviors. Within survivors, smoking and physical activity were similar across racial/ethnic groups. African-American and Hispanic survivors reported lower daily alcohol use than whites, but consumed unhealthy diets and were more likely to be obese. Conclusions This unique study highlights that many minority CCSs exhibit lifestyle profiles that contribute to increased risk for chronic diseases and late effects. Recommendations for behavior changes must consider the social and cultural context in which minority survivors may live. PMID:25564774

  19. Global economic and health benefits of tobacco control: part 2.

    PubMed

    Wipfli, H; Samet, J M

    2009-09-01

    Although the risks of tobacco smoking have been known for decades, the pandemic of tobacco use continues. There are an estimated 1.3 billion smokers worldwide, along with millions more using various oral tobacco products. Recent global estimates place the mortality burden from tobacco use at over 6 million annually, with nearly two-thirds of these deaths occurring in developing countries. If current patterns persist, there will be an estimated 1 billion deaths from tobacco during the twenty-first century. Part 1 of this two-part paper provides an overview of the tobacco pandemic, the scope of the pandemic, and its economic and health consequences. Part 2 reviews the history of tobacco control to date and addresses the current global strategy, based on the World Health Organization's (WHO's) Framework Convention on Tobacco Control and the MPOWER package of interventions. Part 2 ends with a consideration of scenarios for the future of the pandemic.

  20. Impact of Health Behaviors and Health Management on Employment After SCI: Psychological Health and Health Management

    PubMed Central

    Meade, Michelle A.; Krause, James S.

    2016-01-01

    Objective: The purpose of this study was to examine the relationship between employment and psychological health and health management as described by individuals with spinal cord injury (SCI) who were employed at least once following injury. Methods: A qualitative approach used 6 focus groups at 2 sites with 44 participants who were at least 10 years post SCI. All had been employed at some point since injury. Heterogeneous and homogeneous groups were delineated based on specific characteristics, such as education, gender, or race. Group sessions followed a semi-structured interview format with questions about personal, environmental, and policy related factors influencing employment following SCI. All group sessions were recorded, transcribed, and coded into conceptual categories to identify topics, themes, and patterns. Inferences were drawn about their meaning. NVivo 10 software using the constant comparative method was used for data analysis. Results: Narratives discussed the relationship between employment and psychological and emotional health and health management. Four themes were identified: (1) adjustment and dealing with emotional reactions, (2) gaining self-confidence, (3) preventing burnout, and (4) attitudes and perspectives. Most themes reflected issues that varied based on severity of injury as well as stage of employment. Conclusions: Individuals with SCI who are successful in working following injury must determine how to perform the behaviors necessary to manage their health and prevent emotional or physical complications. The emotional consequences of SCI must be recognized and addressed and specific behaviors enacted in order to optimize employment outcomes.

  1. HERALD (Health Economics using Routine Anonymised Linked Data)

    PubMed Central

    2012-01-01

    Background Health economic analysis traditionally relies on patient derived questionnaire data, routine datasets, and outcomes data from experimental randomised control trials and other clinical studies, which are generally used as stand-alone datasets. Herein, we outline the potential implications of linking these datasets to give one single joined up data-resource for health economic analysis. Method The linkage of individual level data from questionnaires with routinely-captured health care data allows the entire patient journey to be mapped both retrospectively and prospectively. We illustrate this with examples from an Ankylosing Spondylitis (AS) cohort by linking patient reported study dataset with the routinely collected general practitioner (GP) data, inpatient (IP) and outpatient (OP) datasets, and Accident and Emergency department data in Wales. The linked data system allows: (1) retrospective and prospective tracking of patient pathways through multiple healthcare facilities; (2) validation and clarification of patient-reported recall data, complementing the questionnaire/routine data information; (3) obtaining objective measure of the costs of chronic conditions for a longer time horizon, and during the pre-diagnosis period; (4) assessment of health service usage, referral histories, prescribed drugs and co-morbidities; and (5) profiling and stratification of patients relating to disease manifestation, lifestyles, co-morbidities, and associated costs. Results Using the GP data system we tracked about 183 AS patients retrospectively and prospectively from the date of questionnaire completion to gather the following information: (a) number of GP events; (b) presence of a GP 'drug' read codes; and (c) the presence of a GP 'diagnostic' read codes. We tracked 236 and 296 AS patients through the OP and IP data systems respectively to count the number of OP visits; and IP admissions and duration. The results are presented under several patient stratification

  2. A Randomized Controlled Trial of a Behavioral Economic Supplement to Brief Motivational Interventions for College Drinking

    ERIC Educational Resources Information Center

    Murphy, James G.; Dennhardt, Ashley A.; Skidmore, Jessica R.; Borsari, Brian; Barnett, Nancy P.; Colby, Suzanne M.; Martens, Matthew P.

    2012-01-01

    Objective: Behavioral economic theory suggests that a reduction in substance use is most likely when there is an increase in rewarding substance-free activities. The goal of this randomized controlled clinical trial was to evaluate the incremental efficacy of a novel behavioral economic supplement (Substance-Free Activity Session [SFAS]) to a…

  3. Health Disparity Still Exists in an Economically Well-Developed Society in Asia

    PubMed Central

    Lee, Albert; Chua, Hoi-wai; Chan, Mariana; Leung, Patrick W. L.; Wong, Jasmine W. S.; Chuh, Antonio A. T.

    2015-01-01

    Background The socioeconomic inequalities in child health continue to widen despite improved economy. Objective To investigate the correlation between socio-economic factors and health risk behaviors and psychosocial well-being of children in Hong Kong. Hypothesis The null hypothesis is that for this particular developed region, there exists little or no correlation between social-economic factors and health risk behaviors and psychosocial well-being of children. Design Cross sectional territory wide survey. Participants Caregivers of 7,000 children in kindergartens in Hong Kong. Measuring tools Youth Risk Behavior Surveillance questionnaire, health-related knowledge and hygienic practice questionnaire, and Children Behavior Checklist (CBCL). Results Children were less likely to have somatic complaints and anxiety/depression as reflected by CBCL scores coming from families of higher income, not being recipients of social assistance, with fathers in employment, and with higher parental education. Children with only mother or father as caretakers had lower odds ratios (ORs) 0.71 (95% CI 0.58-0.89) and 0.53 (95% CI 0.33-0.84) respectively to have the habit of eating breakfast, whilst parental education at post-secondary level and higher family income had higher ORs 1.91 (95% CI 1.31-2.78), and 1.63 (95% CI 1.11-2.39). Fathers unemployed, relatives as main caretakers and living in districts with low median household inome incurred higher ORs, as 1.46 (95% CI 1.10-1.94),1.52 (95% CI 1.27-1.83) and 1.17 (95% CI 1.02-1.34) respectively, of watching television over two hours daily, whilst children with parental education at secondary level or above incurred lower OR 0.33 (95% CI 0.24-0.45). Children with parental education at post-secondary level and higher family income had lower ORs of 0.32 (95% CI 0.48-0.97) and 0.52 (95% CI 0.34-0.79) respectively, with regard to exposing to passive smoking, and reversed for those living in districts with lower median household income

  4. Cultural Adaptations of Behavioral Health Interventions: A Progress Report

    ERIC Educational Resources Information Center

    Barrera, Manuel, Jr.; Castro, Felipe G.; Strycker, Lisa A.; Toobert, Deborah J.

    2013-01-01

    Objective: To reduce health disparities, behavioral health interventions must reach subcultural groups and demonstrate effectiveness in improving their health behaviors and outcomes. One approach to developing such health interventions is to culturally adapt original evidence-based interventions. The goals of the article are to (a) describe…

  5. Health Behavioral Differences Between Low and Middle Social Class Students

    ERIC Educational Resources Information Center

    Dennison, Darwin

    1969-01-01

    Pretest comparisons on Health Behavior Inventory do not support hypothesis that low class students have less desirable health habits than do middle class ones. Differences occur on five specific items pertaining to weight control, social behavior, dental health, infection prevention, and responsibility for community health. (Author/CJ)

  6. Health Behavior Theory and cumulative knowledge regarding health behaviors: are we moving in the right direction?

    PubMed

    Noar, Seth M; Zimmerman, Rick S

    2005-06-01

    Although research on Health Behavior Theory (HBT) is being conducted at a rapid pace, the extent to which the field is truly moving forward in understanding health behavior has been questioned. This issue is examined in the current article. First, we discuss the problems within the HBT literature. Second, we discuss the proliferation of HBT and why theory comparison is essential to this area of research. Finally, we reflect on ways that the field might move forward by suggesting a new agenda for HBT research. It is argued that increased recognition of the similarity of health behavior constructs as well as increased empirical comparisons of theories are essential for true scientific progress in this line of inquiry.

  7. Uncertainty and validation of health economic decision models.

    PubMed

    Kim, Lois G; Thompson, Simon G

    2010-01-01

    Health economic decision models are based on specific assumptions relating to model structure and parameter estimation. Validation of these models is recommended as an indicator of reliability, but is not commonly reported. Furthermore, models derived from different data and employing different assumptions may produce a variety of results.A Markov model for evaluating the long-term cost-effectiveness of screening for abdominal aortic aneurysm is described. Internal, prospective and external validations are carried out using individual participant data from two randomised trials. Validation is assessed in terms of total numbers and timings of key events, and total costs and life-years. Since the initial model validates well only internally, two further models are developed that better fit the prospective and external validation data. All three models are then extrapolated to a life-time horizon, producing cost-effectiveness estimates ranging from pound1600 to pound4200 per life-year gained.Parameter uncertainty is now commonly addressed in health economic decision modelling. However, the derivation of models from different data sources adds another level of uncertainty. This extra uncertainty should be recognised in practical decision-making and, where possible, specifically investigated through independent model validation.

  8. The Impact of Health Care Economics on Surgical Education

    PubMed Central

    Margolin, David A.

    2012-01-01

    Just like the world economy in 2012, health care is in a state of flux. The current economic environment will impact not only current colorectal surgery residents, but also future generations of surgical trainees. To understand the economic impact of the current health care environment on colorectal surgery residencies, we need to know the basics of graduate medical education (GME) funding for all residents. Since the 1960s with the initiation of Medicare, the federal government through the Center for Medicare and Medicaid Services (CMS) has been the largest source of GME funding. There are two types of costs associated with GME. Direct GME (DME) funding covers costs directly attributed to the training of residents. These costs include residents' stipends, salaries, and benefits; cost of supervising faculty; direct program administration costs; overhead; and malpractice coverage. Indirect GME (IME) costs are payments to hospitals as an additional or add-on payment for the increased cost of care that is generally found in teaching hospitals. In 2010, President Barak Obama signed into law H.R. 3200, the Patient Protection and Affordable Care Act (PPACA). In 2011, the Supreme Court held that the majority of the PPACA is constitutional. Although the true impact of this bill is unknown, it will change the formula for Medicare GME reimbursement as well as shift unused residency positions to primary care. PMID:23997674

  9. Transferability indices for health economic evaluations: methods and applications.

    PubMed

    Antonanzas, Fernando; Rodríguez-Ibeas, Roberto; Juárez, Carmelo; Hutter, Florencia; Lorente, Reyes; Pinillos, Mariola

    2009-06-01

    In this paper, we have elaborated an index in two phases to measure the degree of transferability of the results of the economic evaluation of health technologies. In the first phase, we have considered the objective factors (critical and non-critical) to derive a general transferability index, which can be used to measure this internal property of the studies of economic evaluation applied to health technologies. In the second phase, with a more specific index, we have measured the degree of applicability of the results of a given study to a different setting. Both indices have been combined (arithmetic and geometric mean) to obtain a global transferability index. We have applied the global index to a sample of 27 Spanish studies on infectious diseases. We have obtained an average value for the index of 0.54, quite far from the maximum theoretical value of 1. We also found that 11 studies lacked some critical factor and were directly deemed as not transferable.

  10. The impact of health care economics on surgical education.

    PubMed

    Margolin, David A

    2012-09-01

    Just like the world economy in 2012, health care is in a state of flux. The current economic environment will impact not only current colorectal surgery residents, but also future generations of surgical trainees. To understand the economic impact of the current health care environment on colorectal surgery residencies, we need to know the basics of graduate medical education (GME) funding for all residents. Since the 1960s with the initiation of Medicare, the federal government through the Center for Medicare and Medicaid Services (CMS) has been the largest source of GME funding. There are two types of costs associated with GME. Direct GME (DME) funding covers costs directly attributed to the training of residents. These costs include residents' stipends, salaries, and benefits; cost of supervising faculty; direct program administration costs; overhead; and malpractice coverage. Indirect GME (IME) costs are payments to hospitals as an additional or add-on payment for the increased cost of care that is generally found in teaching hospitals. In 2010, President Barak Obama signed into law H.R. 3200, the Patient Protection and Affordable Care Act (PPACA). In 2011, the Supreme Court held that the majority of the PPACA is constitutional. Although the true impact of this bill is unknown, it will change the formula for Medicare GME reimbursement as well as shift unused residency positions to primary care.

  11. The current state of medical school education in bioethics, health law, and health economics.

    PubMed

    Persad, Govind C; Elder, Linden; Sedig, Laura; Flores, Leonardo; Emanuel, Ezekiel J

    2008-01-01

    Current challenges in medical practice, research, and administration demand physicians who are familiar with bioethics, health law, and health economics. Curriculum directors at American Association of Medical Colleges-affiliated medical schools were sent confidential surveys requesting the number of required hours of the above subjects and the years in which they were taught, as well as instructor names. The number of relevant publications since 1990 for each named instructor was assessed by a PubMed search. In sum, teaching in all three subjects combined comprises less than two percent of the total hours in the American medical curriculum, and most instructors have not recently published articles in the fields they teach. This suggests that medical schools should reevaluate their curricula and instructors in bioethics, health law, and health economics.

  12. Preference for reinforcers under varying schedule arrangements: A behavioral economic analysis

    PubMed Central

    Tustin, R. Don

    1994-01-01

    The field of behavioral economics combines concepts from economics and operant conditioning to examine the influence of schedules or price on preference for reinforcers. Three case studies are reported in which behavioral economic analyses were used to assess relative preference for reinforcers shown by people with intellectual disabilities when schedule requirements varied. The studies examined (a) preference for different reinforcers, (b) substitutability of reinforcers, and (c) changes in preference as a function of schedule requirements. PMID:16795840

  13. A behavioral economic analysis of the nonmedical use of prescription drugs among young adults.

    PubMed

    Pickover, Alison M; Messina, Bryan G; Correia, Christopher J; Garza, Kimberly B; Murphy, James G

    2016-02-01

    The nonmedical use of prescription drugs is a widely recognized public health issue, and young adults are particularly vulnerable to their use. Behavioral economic drug purchase tasks capture an individual's strength of desire and motivation for a particular drug. We examined young adult prescription drug purchase and consumption patterns using hypothetical behavioral economic purchase tasks for prescription sedatives/tranquilizers, stimulants, and opiate pain relievers. We also examined relations between demand, use frequency, and Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) substance use disorder (SUD) symptoms, and sex differences in these relations. Undergraduate students who endorsed past-year prescription drug use (N = 393) completed an online questionnaire for course credit. Measures assessed substance use frequency and DSM-5 SUD symptoms. Hypothetical purchase tasks for sedatives, stimulants, and pain relievers assessed participants' consumption and expenditure patterns for these substances across 25 prices. Past-year prescription sedative, stimulant, and pain reliever use was endorsed by 138, 258, and 189 participants, respectively. Among these users, consumption for their respective substance decreased as a function of ascending price, as expected. Demand indices for a prescription drug were associated with each other and with use frequency and SUD symptoms, with variability across substances but largely not by sex. In addition, demand for prescription pain relievers differentially predicted symptoms independent of use, with differences for females and males. In conclusion, hypothetical consumption and expenditure patterns for prescription drugs were generally well described by behavioral economic demand curves, and the observed associations with use and SUD symptoms provide support for the utility of prescription drug purchase tasks.

  14. Information and Communication Technologies in Behavioral Health

    PubMed Central

    Breslau, Joshua; Engel, Charles C.

    2016-01-01

    Abstract The dramatic evolution in information and communication technologies (ICTs) online and on smartphones has led to rapid innovations in behavioral health care. To assist the U.S. Air Force in developing a strategy for use of ICTs, the authors reviewed the scientific literature on their use to prevent and treat behavioral health conditions, such as major depression, posttraumatic stress disorder, and alcohol misuse. There is currently little scientific evidence supporting additional investment in ICT-based psychosocial programs for resilience or prevention of posttraumatic stress symptoms, depression, or anxiety. Instead, preventive interventions might prioritize problems of alcohol misuse and intimate partner violence. ICT applications that play a role in the treatment process may be used for patient education and activation, to improve decisionmaking by clinicians, to provide a therapy, to improve adherence to treatment, or to maintain treatment gains over time. However, partly due to the rapid pace of development of the technology, there is little or no evidence in the literature regarding the efficacy of the most recently developed types of ICTs, in particular those using smartphones. Despite the lack of solid research evidence to date, ICTs hold promise in addressing the challenges of mental health care. One promising avenue is development of reliable methods for patient-clinician communication between therapy sessions; another is Internet-based cognitive behavioral therapy. The authors recommend that the Air Force should take an incremental approach to adopting the use of ICTs—one that involves a program of measurement-based implementation and process and outcome monitoring rather than urgent dissemination. PMID:28083427

  15. Integrating behavioral economics and behavioral genetics: delayed reward discounting as an endophenotype for addictive disorders.

    PubMed

    MacKillop, James

    2013-01-01

    Delayed reward discounting is a behavioral economic index of impulsivity, referring to how much an individual devalues a reward based on its delay in time. As a behavioral process that varies considerably across individuals, delay discounting has been studied extensively as a model for self-control, both in the general population and in clinical samples. There is growing interest in genetic influences on discounting and, in particular, the prospect of discounting as an endophenotype for addictive disorders (i.e., a heritable mechanism partially responsible for conferring genetic risk). This review assembles and critiques the evidence supporting this hypothesis. Via numerous cross-sectional studies and a small number of longitudinal studies, there is considerable evidence that impulsive discounting is associated with addictive behavior and appears to play an etiological role. Moreover, there is increasing evidence from diverse methodologies that impulsive delay discounting is temporally stable, heritable, and that elevated levels are present in nonaffected family members. These findings suggest that impulsive discounting meets the criteria for being considered an endophenotype. In addition, recent findings suggest that genetic variation related to dopamine neurotransmission is significantly associated with variability in discounting preferences. A significant caveat, however, is that the literature is modest in some domains and, in others, not all the findings have been supportive or consistent. In addition, important methodological considerations are necessary in future studies. Taken together, although not definitive, there is accumulating support for the hypothesis of impulsive discounting as an endophenotype for addictive behavior and a need for further systematic investigation.

  16. Diets and Health: How Food Decisions Are Shaped by Biology, Economics, Geography, and Social Interactions

    PubMed Central

    Drewnowski, Adam; Kawachi, Ichiro

    2015-01-01

    Abstract Health is shaped by both personal choices and features of the food environment. Food-choice decisions depend on complex interactions between biology and behavior, and are further modulated by the built environment and community structure. That lower-income families have lower-quality diets is well established. Yet, diet quality also varies across small geographic neighborhoods and can be influenced by transportation, retail, and ease of access to healthy foods, as well as by attitudes, beliefs, and social interactions. The learnings from the Seattle Obesity Study (SOS II) can be usefully applied to the much larger, more complex, and far more socially and ethnically diverse urban environment of New York City. The Kavli HUMAN Project (KHP) is ideally positioned to advance the understanding of health disparities by exploring the multiple underpinnings of food decision making. By combining geo-localized food shopping and consumption data with health behaviors, diet quality measures, and biomarkers, also coded by geographic location, the KHP will create the first-of-its-kind bio-behavioral, economic, and cultural atlas of diet quality and health for New York City. PMID:26487989

  17. Diets and Health: How Food Decisions Are Shaped by Biology, Economics, Geography, and Social Interactions.

    PubMed

    Drewnowski, Adam; Kawachi, Ichiro

    2015-09-01

    Health is shaped by both personal choices and features of the food environment. Food-choice decisions depend on complex interactions between biology and behavior, and are further modulated by the built environment and community structure. That lower-income families have lower-quality diets is well established. Yet, diet quality also varies across small geographic neighborhoods and can be influenced by transportation, retail, and ease of access to healthy foods, as well as by attitudes, beliefs, and social interactions. The learnings from the Seattle Obesity Study (SOS II) can be usefully applied to the much larger, more complex, and far more socially and ethnically diverse urban environment of New York City. The Kavli HUMAN Project (KHP) is ideally positioned to advance the understanding of health disparities by exploring the multiple underpinnings of food decision making. By combining geo-localized food shopping and consumption data with health behaviors, diet quality measures, and biomarkers, also coded by geographic location, the KHP will create the first-of-its-kind bio-behavioral, economic, and cultural atlas of diet quality and health for New York City.

  18. Army Family Health Seeking Behavior and Satisfaction

    DTIC Science & Technology

    1989-08-10

    34 and five indicates "never." The independent variables are the ones discussed above to measure the family life course as well as a set of contrasts...STRONGLY M’EE 13. 1. have a lot of job satisfaction 1 2 3 4 .5 __________ 14. I am proud of this organization. 1 2 3 4 S ___________ 15. This is a well ...DTI# FLE COpy’_ "A"Do ARMY FAMILY HEALTH SEEKING BEHAVIOR AND SATISFACTION In ANNUAL REPORT 1 N OTTO VON MERING AUGUST 10, 1989 Supported by U.S

  19. The Dow is Killing Me: Risky Health Behaviors and the Stock Market.

    PubMed

    Cotti, Chad; Dunn, Richard A; Tefft, Nathan

    2015-07-01

    We investigate how risky health behaviors and self-reported health vary with the Dow Jones Industrial Average (DJIA) and during stock market crashes. Because stock market indices are leading indicators of economic performance, this research contributes to our understanding of the macroeconomic determinants of health. Existing studies typically rely on the unemployment rate to proxy for economic performance, but this measure captures only one of many channels through which the economic environment may influence individual health decisions. We find that large, negative monthly DJIA returns, decreases in the level of the DJIA, and stock market crashes are widely associated with worsening self-reported mental health and more cigarette smoking, binge drinking, and fatal car accidents involving alcohol. These results are consistent with predictions from rational addiction models and have implications for research on the association between consumption and stock prices.

  20. Quixotic medicine: physical and economic laws perilously disregarded in health care and medical education.

    PubMed

    Haburchak, David R; Mitchell, Bradford C; Boomer, Craig J

    2008-12-01

    Wise medical practice requires balancing the idealistic goals of medicine with the physical and economic realities of their application. Clinicians should know and employ the rules, maxims, and heuristics that summarize these goals and constraints. There has been little formal study of rules or laws pertaining to therapeutics and prognosis, so the authors postulate four physical and four economic laws that apply to health care: the laws of (1) finitude, (2) inertia, (3) entropy, and (4) the uncertainty principle; and the laws of (5) diminishing returns, (6) unintended consequences, (7) distribution, and (8) economizing. These laws manifest themselves in the absence of health, the pathogenesis of disease, prognosis, and the behaviors of participants in the health care enterprise. Physicians and the public perilously disregard these laws, frequently producing misdiagnoses, distraction, false expectations, unanticipated and undesirable outcomes, inequitable distribution of scarce resources, distrust, and cynicism: in short, quixotic medicine. The origins and public reinforcement of quixotic medicine make it deaf to calls for pragmatism. To achieve the Accreditation Council of Graduate Medical Education competency of systems-based practice, the authors recommend that premedical education return to a broader liberal arts curriculum and that medical education and training foster didactic and experiential knowledge of these eight laws.

  1. Diabetes, Diet-Health Behavior, and Obesity

    PubMed Central

    Anders, Sven; Schroeter, Christiane

    2015-01-01

    High-quality diets play an important role in diabetes prevention. Appropriate dietary adherence can improve insulin sensitivity and glycemic control, and thus contribute to lifestyle improvement. However, previous research suggests that dietary adherence is arguably among the most difficult cornerstones of diabetes management. The objectives of this study are (1) to estimate whether and to what extent individuals diagnosed with diabetes show significant differences in diet quality [healthy eating index (HEI)] compared to healthy individuals, (2) to quantify whether and to what extent diabetics experience significantly higher outcomes of body mass index (BMI), and (3) to estimate whether and to what extent dietary supplementation impacts diabetes patient’s diet quality and/or BMI outcomes. We use data from the 2007–2008 U.S. National Health and Nutrition Examination Survey (NHANES). The NHANES is the primary, randomized, and nationally representative survey used to assess the health and nutritional status in the U.S. We apply propensity score matching (PSM) to account for selection bias and endogeneity between self-reported diet and health behavir (treatment) and BMI outcomes. We control for an individual’s BMI as to capture the impact of past dietary behavior in its impact on HEI. Matching results suggest that regular dietary supplement consumption is associated with significant lower BMI outcomes of almost 1 kg/m2. The close relationship between diabetes and obesity has been at the center of the diet-health policy debate across Canada and the U.S. Knowledge about this linkage may help to improve the understanding of the factors that impact dietary choices and their overall health outcomes, which may lead to a more efficient and effective promotion of dietary guidelines, healthy food choices, and targeted consumer health and lifestyle policies. PMID:25852643

  2. Effects of Soldiers’ Deployment on Children’s Academic Performance and Behavioral Health

    DTIC Science & Technology

    2011-01-01

    Activity Schools,” Economics of Education Review, Vol. 29, Issue. 1, 2010, pp. 73–82. Ensminger, M., and A. Slusarcick, “Paths to High School Graduation or...and Behavioral Health Complaints,” Pediatrics, November 8, 2010. Hill, Carolyn J., Howard S. Bloom, Alison Rebeck Black, and Mark W. Lipsey ...Parental Absences and Household Relocations on Children’s Academic Achievement,” Journal of Labor Economics , Vol. 24, No. 2, 2006. Margolin, Gayla, and

  3. The Theory of Planned Behavior: A Review of Its Applications to Health-Related Behaviors.

    ERIC Educational Resources Information Center

    Godin, Gaston; Kok, Gerjo

    1996-01-01

    The literature review discussed here located 56 studies examining 87 behaviors that predicted future health-related behaviors using the theory of planned behavior. About 41% of variance in intentions and 34% of variance in future behavior were explained by the theory. Perceived behavioral control explained 11.5% of variance in behavior above…

  4. Health Care Waste Segregation Behavior among Health Workers in Uganda: An Application of the Theory of Planned Behavior

    PubMed Central

    2016-01-01

    Objective. The goal of this study was to assess the appropriateness of the theory of planned behavior in predicting health care waste segregation behaviors and to examine the factors that influence waste segregation behaviors. Methodology. One hundred and sixty-three health workers completed a self-administered questionnaire in a cross-sectional survey that examined the theory of planned behavior constructs (attitudes, subjective norms, perceived behavioral control, and intention) and external variables (sociodemographic factors, personal characteristics, organizational characteristics, professional characteristics, and moral obligation). Results. For their most recent client 21.5% of the health workers reported that they most definitely segregated health care waste while 5.5% did not segregate. All the theory of planned behavior constructs were significant predictors of health workers' segregation behavior, but intention emerged as the strongest and most significant (r = 0.524, P < 0.001). The theory of planned behavior model explained 52.5% of the variance in health workers' segregation behavior. When external variables were added, the new model explained 66.7% of the variance in behavior. Conclusion. Generally, health workers' health care waste segregation behavior was high. The theory of planned behavior significantly predicted health workers' health care waste segregation behaviors. PMID:28115950

  5. Health Care Waste Segregation Behavior among Health Workers in Uganda: An Application of the Theory of Planned Behavior.

    PubMed

    Akulume, Martha; Kiwanuka, Suzanne N

    2016-01-01

    Objective. The goal of this study was to assess the appropriateness of the theory of planned behavior in predicting health care waste segregation behaviors and to examine the factors that influence waste segregation behaviors. Methodology. One hundred and sixty-three health workers completed a self-administered questionnaire in a cross-sectional survey that examined the theory of planned behavior constructs (attitudes, subjective norms, perceived behavioral control, and intention) and external variables (sociodemographic factors, personal characteristics, organizational characteristics, professional characteristics, and moral obligation). Results. For their most recent client 21.5% of the health workers reported that they most definitely segregated health care waste while 5.5% did not segregate. All the theory of planned behavior constructs were significant predictors of health workers' segregation behavior, but intention emerged as the strongest and most significant (r = 0.524, P < 0.001). The theory of planned behavior model explained 52.5% of the variance in health workers' segregation behavior. When external variables were added, the new model explained 66.7% of the variance in behavior. Conclusion. Generally, health workers' health care waste segregation behavior was high. The theory of planned behavior significantly predicted health workers' health care waste segregation behaviors.

  6. Poverty dynamics in Germany: Evidence on the relationship between persistent poverty and health behavior.

    PubMed

    Aue, Katja; Roosen, Jutta; Jensen, Helen H

    2016-03-01

    Previous studies have found poverty to be related to lower levels of health due to poor health behavior such as unhealthy eating, smoking or less physical activity. Longer periods of poverty seem to be especially harmful for individual health behavior. Studies have shown that poverty has a dynamic character. Moreover, poverty is increasingly regarded as being a multidimensional construct and one that considers more aspects than income alone. Against this background this paper analyzes the relationship between health behavior and persistent spells of income poverty as well as a combined poverty indicator using data of the German Socio-Economic Panel (2000-2010). Next to cross-sectional logistic regression models we estimate fixed-effects models to analyze the effect of persistent poverty on dietary behavior, tobacco consumption, and physical activity. Cross-sectional results suggest that persistent poverty is related to poor health behavior, particularly regarding tobacco consumption and physical activity. Results also show that multidimensional and dynamic aspects of poverty matter. Complementary panel analyses reveal negative effects for the combined poverty indicator only for dietary behavior in the total sample. However, by analyzing the sample by gender we identify further effects of persistent poverty on health behavior. The analyses show that not only do individuals in poverty but also those in precarious situations show health-damaging behavior more often.

  7. Social Determinants and Health Behaviors: Conceptual Frames and Empirical Advances.

    PubMed

    Short, Susan E; Mollborn, Stefanie

    2015-10-01

    Health behaviors shape health and well-being in individuals and populations. Drawing on recent research, we review applications of the widely applied "social determinants" approach to health behaviors. This approach shifts the lens from individual attribution and responsibility to societal organization and the myriad institutions, structures, inequalities, and ideologies undergirding health behaviors. Recent scholarship integrates a social determinants perspective with biosocial approaches to health behavior dynamics. Empirical advances model feedback among social, psychological and biological factors. Health behaviors are increasingly recognized as multidimensional and embedded in health lifestyles, varying over the life course and across place and reflecting dialectic between structure and agency that necessitates situating individuals in context. Advances in measuring and modeling health behaviors promise to enhance representations of this complexity.

  8. Social Determinants and Health Behaviors: Conceptual Frames and Empirical Advances

    PubMed Central

    Short, Susan E.; Mollborn, Stefanie

    2015-01-01

    Health behaviors shape health and well-being in individuals and populations. Drawing on recent research, we review applications of the widely applied “social determinants” approach to health behaviors. This approach shifts the lens from individual attribution and responsibility to societal organization and the myriad institutions, structures, inequalities, and ideologies undergirding health behaviors. Recent scholarship integrates a social determinants perspective with biosocial approaches to health behavior dynamics. Empirical advances model feedback among social, psychological and biological factors. Health behaviors are increasingly recognized as multidimensional and embedded in health lifestyles, varying over the life course and across place and reflecting dialectic between structure and agency that necessitates situating individuals in context. Advances in measuring and modeling health behaviors promise to enhance representations of this complexity. PMID:26213711

  9. The economics of health and climate change: key evidence for decision making

    PubMed Central

    2011-01-01

    Background In responding to the health challenges of climate change, those responsible for health policies and resource allocations need to know the resource consequences of their decisions. This article examines the availability and strength of economic evidence for policy makers to draw on in making health policy decisions. Methods Relevant literature was obtained using a Medline and INTERNET search of key terms and institutions working in health and climate change. Eighteen available economic studies are presented under three categories of economic evidence: health damage cost, health adaptation cost and health economic evaluation. Results In economic studies valuing the predicted increased mortality from climate change, the health damages represent an important fraction of overall economic losses. Similarly, when considering broader health protection measures beyond the health sector (e.g. agriculture, water supply) health considerations are central. Global adaptation cost studies carried out so far indicate health sector costs of roughly US$2-5 billion annually (mid-estimates). However, these costs are expected to be an underestimate of the true costs, due to omitted health impacts, omitted economic impacts, and the costs of health actions in other sectors. No published studies compare the costs and benefits of specific health interventions to protect health from climate change. Conclusions More economic studies are needed examining the costs and benefits of adaptation measures to inform policy making. There is an urgent need for climate change-specific health economic guidelines to ensure robust methods are used, giving comparable results. Broader advocacy and focused training of decision makers is needed to increase the uptake of economic evidence in decision making. Until further climate change-specific economic studies have been conducted, decision makers should selectively draw on published studies of the costs and benefits of environmental health

  10. Impact of children's migration on health and health care-seeking behavior of elderly left behind

    PubMed Central

    2011-01-01

    Background Many countries are facing the burden of accelerated population aging and a lack of institutional support to meet the needs of older individuals. In developing countries, adult children are primarily responsible for the care of their elderly parents. However, out-migration of adult children is common in these countries. This study aims to explore the impact of migration on the health of the elderly left behind and their health care-seeking behavior. Methods This paper uses data from a national survey of older persons in Thailand conducted in 2007. The analysis is confined to those who were aged 60 years or above and who had at least one child (biological or step/adopted) (n = 28,677). Logistic regression was used to assess the net effect of migration of adult children on the health of the elderly left behind and their health care-seeking behavior, after controlling for other socio-demographic and economic variables. Results More than two-thirds of the elderly (67%) had at least one migrant child. About three-fifths (58%) reported that they had at least one symptom of poor mental health. Almost three in five elderly (56%) rated their health as poor, and 44% had experienced at least one chronic disease. About two-thirds of the elderly (65%) got sick during the 5 years preceding the survey. An overwhelming majority of elderly (88%) who got sick during the five years preceding the survey had sought treatment for their last illness. After controlling for socio-demographic and economic variables, our study found that those elderly who had a migrant child were more likely (OR = 1.10; 95% CI 1.05-1.17) to have symptoms of poor mental health than those whose children had not migrated. However, no significant association was observed among physical health, such as experience of chronic disease, perceived poor health, and illness of the elderly left behind. Interestingly, however, out-migration of adult children was independently associated with higher utilization

  11. A critical review of health-related economic evaluations in Australia: implications for health policy.

    PubMed

    Salkeld, G; Davey, P; Arnolda, G

    1995-02-01

    In Australia, as in many other countries, economic evaluation is increasingly seen by health care policy makers as a useful aid to priority setting and resource allocation. In Australia, economic evaluation is now a requirement for new drugs to be listed on the Pharmaceutical Benefits Scheme which provides a government subsidy on the price of listed drugs for purchasers. Yet, despite recognition of the importance of economic evaluation by policy makers, there is a paucity of published evaluations in Australia. We reviewed all of the 33 health-related economic evaluations conducted in Australia and subsequently published since 1978. This study assesses how well informed decision makers might be if they used the results and conclusions of published economic evaluations as an aid to resource allocation. The review highlights several issues: (i) it is difficult to interpret the conclusions or assess the generalisability of individual papers without information on the context of the original study; (ii) the choice of comparator(s) was often unexplained and most papers did not employ marginal analysis; (iii) in the absence of marginal analysis, the comparability of cost-effectiveness ratios in league tables must be questioned as well as the completeness (were all the relevant alternatives included?) of studies; and (iv) the quality of effectiveness evidence varies enormously, with some authors content to use the best available evidence (even if it is of poor quality). The development of standards for economic evaluation methods might ensure a more consistent and scientific approach to evaluative work, but they cannot guarantee it. A more concerted effort to disseminate the principles and methods of economic evaluation to policy makers and non-economist evaluators might be a more important precursor to improving the credibility and usefulness of economic evaluations in priority setting.

  12. Global health and development: conceptualizing health between economic growth and environmental sustainability.

    PubMed

    Borowy, Iris

    2013-07-01

    After World War II, health was firmly integrated into the discourse about national development. Transition theories portrayed health improvements as part of an overall development pattern based on economic growth as modeled by the recent history of industrialization in high-income countries. In the 1970s, an increasing awareness of the environmental degradation caused by industrialization challenged the conventional model of development. Gradually, it became clear that health improvements depended on poverty-reduction strategies including industrialization. Industrialization, in turn, risked aggravating environmental degradation with its negative effects on public health. Thus, public health in low-income countries threatened to suffer from lack of economic development as well as from the results of global economic development. Similarly, demands of developing countries risked being trapped between calls for global wealth redistribution, a political impossibility, and calls for unrestricted material development, which, in a world of finite land, water, air, energy, and resources, increasingly looked like a physical impossibility, too. Various international bodies, including the WHO, the Brundtland Commission, and the World Bank, tried to capture the problem and solution strategies in development theories. Broadly conceived, two models have emerged: a "localist model," which analyzes national health data and advocates growth policies with a strong focus on poverty reduction, and a "globalist" model, based on global health data, which calls for growth optimization, rather than maximization. Both models have focused on different types of health burdens and have received support from different institutions. In a nutshell, the health discourse epitomized a larger controversy regarding competing visions of development.

  13. 2011 Behavioral Health Risk Assessment Data Report (BH-RADR)

    DTIC Science & Technology

    2015-09-01

    Approved for public release, distribution unlimited General Medicine: 500A, Public Health Data 2011 Behavioral Health Risk Assessment Data...REPORT DATE 30 SEP 2015 2. REPORT TYPE Annual 3. DATES COVERED 01 JAN 2011 - 31 DEC 2011 4. TITLE AND SUBTITLE 2011 Behavioral Health Risk...ABSTRACT This publication describes characteristics of Soldiers who completed a behavioral health (BH) screening at the two post-deployment Touch Points

  14. Risk factors in road crossing among elderly pedestrians and readiness to adopt safe behavior in socio-economic comparison.

    PubMed

    Rosenbloom, Tova; Sapir-Lavid, Yael; Perlman, Amotz

    2016-08-01

    This research examines the Health Promotion Behavior (HPB) models regarding elderly pedestrians' behaviors and attitudes. We studied cognitive-psychological variables, such as risk estimation, self-efficacy and demographic variables and compared elderly pedestrians' attitudes and behaviors in a city with higher socio-economic level (Tel Aviv) versus a city with low socio-economic level (Beer Sheva). We expected to find more problematic behaviors among elderly pedestrians in the low socio-economic city compared to the high socio-economic city, and also less feeling of self-efficacy, and lessened awareness of the risks, that leads to lessened willingness to adopt preventive behaviors. The research was conducted in two studies. The first study was based on observations on 2591 pedestrians in six similar crosswalks in both cities. It revealed that pedestrians in the high socio-economic city demonstrated safer road crossing patterns than in the low socio-economic city and that elderly pedestrians reveal safer crossing patterns than younger pedestrians. We found an interaction of location and age due to greater gap of safe behaviors of elderly and young pedestrians in the high socio-economic city than in the low socio-economic city. In Tel Aviv elderly adhere to the crossing rules much more than the young while in Beer Sheva elderly and young people are almost similar in their crossing patterns. The second study used questionnaires that have been completed by 143 elderly in both cities. The questionnaires referred to (a) demographic variables such as gender, age, marital status, education, socio-economic level, (b) variables related to the affiliation to the main culture such as migration, date of migration, knowledge in Hebrew (local language) and connectivity to media and (c) cognitive as well as psychological variables related to the decline to adopt healthy behaviors based on Schwarzer and Fuchs (1995). This part also indicated that elderly in Tel Aviv have higher

  15. The impact of inclusion criteria in health economic assessments.

    PubMed

    Richter, Anke; Thieda, Patricia; Thaler, Kylie; Gartlehner, Gerald

    2011-05-01

    The debate surrounding whether the findings of efficacy studies are applicable to real-world treatment situations is ongoing. The issue of lack of applicability due to a lack of clinical heterogeneity could be addressed by employing less restrictive inclusion criteria. Given that health economic assessments based on cost-effectiveness measures are required by many governments and insurance providers, the impact of this choice may be far reaching. The objective of this article was to explore the use of a pilot study to examine the impact of inclusion criteria on cost-effectiveness results and clinical heterogeneity. A health economic assessment was conducted using QRISK®2 and simulation modelling of different population groups within the pilot study in Lower Austria. Patients were referred by their family physicians to 'Active Prevention' (Vorsorge Aktiv), a community-based lifestyle intervention focused on exercise and nutritional programmes. Cardiovascular risk factors were recorded before and after the intervention and translated to cardiovascular events. As expected, enforcing restrictive inclusion criteria produced stronger and more irrefutable computations - in the expected number of events, the number of deaths, the incremental cost per life-year saved and in the 95% confidence interval. These findings provide insight into the issues surrounding clinical heterogeneity and the need for restrictive inclusion criteria. This is not a full health economic assessment of the intervention. While inclusion criteria provide stronger results by limiting populations to those who would benefit the most, they must be enforced, both within and outside the clinical trial setting. Enforcement has costs, both monetary and arising from unintended negative consequences of enforcement mechanisms. All these considerations will affect the results realized by the payer organization. A pilot study can reveal whether an intervention may be cost effective 'enough' without restrictive

  16. Postdeployment Behavioral Health Screening: Face-to-Face Versus Virtual Behavioral Health Interviews

    DTIC Science & Technology

    2012-05-01

    Research Unit—Europe, Walter Reed Army Insti- tute of Research, Nachrichten Kaserne, Karlsruher Strasse 144, 69126 Heidelberg, Germany. †Behavioral Health...Division, Europe Regional Medical Command, Nachrichten Kaserne, Karlsruher Strasse 144, 69126 Heidelberg, Germany. The views expressed in this...Institute of Research, Nachrichten Kaserne,Karlsruher Strasse 144, 69126,Heidelberg, Germany, , 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING

  17. [Health economic evaluation in a local level government health care system].

    PubMed

    Sancho, Leyla Gomes; Vargens, José Muniz Costa

    2009-10-01

    This work aims to contribute to the discussion about the possibility of applying health economic evaluations at local level government healthcare system, and consequently use the results of this study into decision making. In order to subside this reflexion, it was analyzed the SAMU/192 Program costs evaluation in the city of Belo Horizonte, as well as data concerning effectiveness of the program and a review on electronic databases (SciELO and Medline) about the application of studies in decision making. The analysis showed that even for a simple evaluation on expenditure, there are still unsolved problems of data availability as well as of data effectiveness on information systems definition and association. It showed that decision makers do not use the result of studies for decision making either. So, we conclude that there is no possibility to apply a health economic evaluation research and have the results used in a local level government health care system.

  18. Health and innovation: economic dynamics and Welfare State in Brazil.

    PubMed

    Gadelha, Carlos Augusto Grabois; Braga, Patrícia Seixas da Costa

    2016-11-03

    The effective enforcement of the access to healthcare as fundamental right requires an important theoretical and political effort at linking the often contradictory economic and social dimensions of development. This study suggests the need for a systemic view of policies related to the industrial base and innovation in health and the construction of the Brazilian Unified National Health System (SUS). The authors investigate the relations between health, innovation, and development, seeking to show and update the political, economic, and social determinants of the recent Brazilian experience with the Health Economic-Industrial Complex (HEIC). They discuss how the agenda for innovation and domestic industrial production in health gained a central place in the project for construction of the SUS. The article thus seeks to link inherent issues from the agenda for development, production, and innovation to social policy in healthcare, as observed in recent years, and based on this analysis, points to political and conceptual challenges for implementing the SUS, especially as regards strengthening its technological and industrial base. As a byproduct, the article develops an analytical and factual focus on the consolidation of the HEIC in Brazil, both as a dynamic vector of industrial development, generating investment, income, employment, and innovations, and as a decisive element for reducing vulnerability and structural dependence in health. The authors aim to show that strengthening the SUS and orienting it to social needs is an essential part of building a social Welfare State in Brazil. Resumo: A efetivação da saúde como um direito fundamental exige importante esforço, teórico e político, de articulação das dimensões econômicas e sociais, por vezes contraditórias, do desenvolvimento. Este trabalho indica a necessidade de um olhar sistêmico das políticas relacionadas à base produtiva e de inovação em saúde e à construção do Sistema Único de Sa

  19. Early Adolescent Health Risk Behaviors, Conflict Resolution Strategies, and School Climate

    ERIC Educational Resources Information Center

    LaRusso, Maria; Selman, Robert

    2011-01-01

    Drawing upon an ethnically and socio-economically diverse sample of 323 7th grade students from twelve urban schools within one school district, this mixed method study examined early adolescents' self-reported health risk behaviors as related to their conflict resolution strategies and their school's conflict resolution climate. Survey data…

  20. Rural Behavioral Health Services for Children and Adolescents: An Ecological and Community Psychology Analysis

    ERIC Educational Resources Information Center

    Heflinger, Craig Anne; Christens, Brian

    2006-01-01

    While psychology has tended to focus on urban issues in research and practice, rural areas have undergone a series of changes in recent years that have increased the need for behavioral health services. A variety of social and economic factors has contributed both to the increasing needs and to the inability of the existing services to meet them.…

  1. Health-Seeking Behaviors among Latinas: Practices and Reported Difficulties in Obtaining Health Services

    ERIC Educational Resources Information Center

    Rojas-Guyler, Liliana; King, Keith A.; Montieth, Brigid A.

    2008-01-01

    Background: Latinos experience disproportionate negative health status and health care access. Expanding understanding of factors impacting Latino immigrant health is imperative. Purpose: This study identified health-seeking behaviors among Latinas in a large Midwestern city with rapid immigrant population growth. Health-seeking behaviors like…

  2. Associations Among Health Behaviors and Time Perspective in Young Adults

    PubMed Central

    Henson, James M.; Carey, Michael P.; Carey, Kate B.; Maisto, Stephen A.

    2008-01-01

    Previous research suggests that time perspective relates to health behavior; however, researchers have frequently employed inconsistent operational definitions and have often used projective or unpublished measures. The Zimbardo Time Perspective Inventory was created to provide a sound, objective measure of five distinct time perspective components. We examined the independent prediction of both risky and protective health behaviors from future, hedonistic, and fatalistic time perspective in 1,568 undergraduates using the ZTPI. Health behaviors included alcohol, drug, tobacco, and seat belt use, sex behaviors, and exercise. Future time perspective was related to increased protective and decreased risky health behaviors, whereas hedonism exhibited an opposite pattern though was a stronger predictor; fatalism was related only to health-destructive behaviors. Gender interactions reveal that hedonism is a stronger predictor of risky health behaviors for females. PMID:16421652

  3. Tutorial on health economics and outcomes research in nutrition.

    PubMed

    Philipson, Tomas; Linthicum, Mark T; Snider, Julia Thornton

    2014-11-01

    As healthcare costs climb around the world, public and private payers alike are demanding evidence of a treatment's value to support approval and reimbursement decisions. Health economics and outcomes research, or HEOR, offers tools to answer questions about a treatment's value, as well as its real-world effects and cost-effectiveness. Given that nutrition interventions have to compete for space in budgets along with biopharmaceutical products and devices, nutrition is now increasingly coming to be evaluated through HEOR. This tutorial introduces the discipline of HEOR and motivates its relevance for nutrition. We first define HEOR and explain its role and relevance in relation to randomized controlled trials. Common HEOR study types--including burden of illness, effectiveness studies, cost-effectiveness analysis, and valuation studies--are presented, with applications to nutrition. Tips for critically reading HEOR studies are provided, along with suggestions on how to use HEOR to improve patient care. Directions for future research are discussed.

  4. Behavioral Health Information Technology: From Chaos To Clarity.

    PubMed

    Ranallo, Piper A; Kilbourne, Amy M; Whatley, Angela S; Pincus, Harold Alan

    2016-06-01

    The use of health information technology (IT) in general health care has been shown to have significant potential to facilitate the delivery of safe, high-quality, and cost-effective care. However, its application to behavioral health care has been slow, limiting the extent to which consumers seeking care for mental health or substance use disorders can derive its benefits. The goal of this article is to provide an overview of the use of health IT in behavioral health and to describe some unique challenges experienced in that domain. We also highlight current obstacles to, and recommendations for, the use of health IT in improving the quality of behavioral health care. We conclude with recommendations for prioritizing the work that we believe will move the US health care system toward more effective, efficient, and patient-centric care in behavioral health.

  5. The Health and Economic Effects of Counterfeit Drugs

    PubMed Central

    Blackstone, Erwin A.; Fuhr, Joseph P.; Pociask, Steve

    2014-01-01

    Background Counterfeit drugs comprise an increasing percentage of the US drug market and even a larger percentage in less developed countries. Counterfeit drugs involve both lifesaving and lifestyle drugs. Objective To review the health and economic consequences of counterfeit drugs on the US public and on the healthcare system as a whole. Method This comprehensive review of the literature encompassed a search of MEDLINE/PubMed, Google Scholar, and ProQuest using the keywords “counterfeit drugs,” “counterfeit medicines,” “fake drugs,” and “fake medicines.” A search of the various FiercePharma daily newsletter series on the healthcare market was also conducted. In addition, the US Food and Drug Administration and the World Health Organization websites were reviewed for additional information. Discussion The issue of counterfeit drugs has been growing in importance in the United States, with the supply of these counterfeit drugs coming from all over the world. Innovation is important to economic growth and US competitiveness in the global marketplace, and intellectual property protections provide the ability for society to prosper from innovation. Especially important in terms of innovation in healthcare are the pharmaceutical and biopharmaceutical industries. In addition to taking income from consumers and drug companies, counterfeit drugs also pose health hazards to patients, including death. The case of bevacizumab (Avastin) is presented as one recent example. Internet pharmacies, which are often the source of counterfeit drugs, often falsely portray themselves as Canadian, to enhance their consumer acceptance. Adding to the problems are drug shortages, which facilitate access for counterfeits. A long and convoluted supply chain also facilitates counterfeits. In addition, the wholesale market involving numerous firms is a convenient target for counterfeit drugs. Trafficking in counterfeits can be extremely profitable; detection of counterfeits is

  6. Relationship between Health Literacy, Health-Related Behaviors and Health Status: A Survey of Elderly Chinese

    PubMed Central

    Liu, Yong-Bing; Liu, Liu; Li, Yan-Fei; Chen, Yan-Li

    2015-01-01

    Background: Despite the large volume of research dedicated to health-related behavior change, chronic disease costs continue to rise, thus creating a major public health burden. Health literacy, the ability to seek, understand, and utilize health information, has been identified as an important factor in the course of chronic conditions. Little research has been conducted on the relationship between health literacy and health-related behaviors and health status in elderly Chinese. The aim of this study was to elucidate the relationship between health literacy and health-related behaviors and health status in China. Methods: The subjects enrolled in this study were selected based on a stratified cluster random sampling design. Information involving >4500 older adults in 44 pension institutions in Urumqi, Changji, Karamay, and Shihezi of Xinjiang between September 2011 and June 2012 was collected. The Chinese Citizen Health Literacy Questionnaire (China Health Education Centre, 2008) and a Scale of the General Status were administered and the information was obtained through face-to-face inquiries by investigators. A total of 1452 respondents met the inclusion criteria. A total of 1452 questionnaires were issued and the valid response rate was 96.14% (1396 of 1452). Factors affecting health literacy and the relationship to health literacy were identified by one-way ANOVA and a multiple linear regression model. Results: The average health literacy level of the elderly in nursing homes was relatively low (71.74 ± 28.35 points). There were significant differences in the health literacy score among the factors of age, gender, race, education level, household income, marital conditions, and former occupation (p < 0.001). The health literacy score was significantly associated with smoking, drinking, physical exercise, and health examination (p < 0.001). The elderly with higher health literacy scores were significantly less likely to have risky behaviors (smoking, regular

  7. Individual health and the visibility of village economic inequality: Longitudinal evidence from native Amazonians in Bolivia.

    PubMed

    Undurraga, Eduardo A; Nica, Veronica; Zhang, Rebecca; Mensah, Irene C; Godoy, Ricardo A

    2016-12-01

    Mounting evidence suggests that income inequality is associated with worse individual health. But does the visibility of inequality matter? Using data from a horticultural-foraging society of native Amazonians in Bolivia (Tsimane'), we examined whether village inequality in resources and behaviors with greater cultural visibility is more likely to bear a negative association with health than village inequality in less conspicuous resources. We draw on a nine-year annual panel (2002-2010) from 13 Tsimane' villages for our main analysis, and an additional survey to gauge the cultural visibility of resources. We measured inequality using the Gini coefficient. We tested the robustness of our results using a shorter two-year annual panel (2008-2009) in another 40 Tsimane' villages and an additional measure of inequality (coefficient of variation, CV). Behaviors with low cultural visibility (e.g., household farm area planted with staples) were less likely to be associated with individual health, compared to more conspicuous behaviors (e.g., expenditures in durable goods, consumption of domesticated animals). We find some evidence that property rights and access to resources matter, with inequality of privately-owned resources showing a larger effect on health. More inequality was associated with improved perceived health - maybe due to improved health prospects from increasing wealth - and worse anthropometric indicators. For example, a unit increase in the Gini coefficient of expenditures in durable goods was associated with 0.24 fewer episodes of stress and a six percentage-point lower probability of reporting illness. A one-point increase in the CV of village inequality in meat consumption was associated with a 4 and 3 percentage-point lower probability of reporting illness and being in bed due to illness, and a 0.05 SD decrease in age-sex standardized arm-muscle area. In small-scale, rural societies at the periphery of market economies, nominal economic inequality in

  8. Integrating Behavioral Economics and Behavioral Genetics: Delayed Reward Discounting as an Endophenotype for Addictive Disorders

    PubMed Central

    MacKillop, James

    2013-01-01

    Delayed reward discounting is a behavioral economic index of impulsivity, referring to how much an individual devalues a reward based on its delay in time. As a behavioral process that varies considerably across individuals, delay discounting has been studied extensively as a model for self-control, both in the general population and in clinical samples. There is growing interest in genetic influences on discounting and, in particular, the prospect of discounting as an endophenotype for addictive disorders (i.e., a heritable mechanism partially responsible for conferring genetic risk). This review assembles and critiques the evidence supporting this hypothesis. Via numerous cross-sectional studies and a small number of longitudinal studies, there is considerable evidence that impulsive discounting is associated with addictive behavior and appears to play an etiological role. Moreover, there is increasing evidence from diverse methodologies that impulsive delay discounting is temporally stable, heritable, and that elevated levels are present in nonaffected family members. These findings suggest that impulsive discounting meets the criteria for being considered an endophenotype. In addition, recent findings suggest that genetic variation related to dopamine neurotransmission is significantly associated with variability in discounting preferences. A significant caveat, however, is that the literature is modest in some domains and, in others, not all the findings have been supportive or consistent. In addition, important methodological considerations are necessary in future studies. Taken together, although not definitive, there is accumulating support for the hypothesis of impulsive discounting as an endophenotype for addictive behavior and a need for further systematic investigation. PMID:23344986

  9. Health Promotion and Risk Behaviors among Adolescents in Turkey

    ERIC Educational Resources Information Center

    Ortabag, Tulay; Ozdemir, Serpil; Bakir, Bilal; Tosun, Nuran

    2011-01-01

    Adolescents experience the onset and development of several health-related behaviors. The purpose of this study is to determine health risk and promotion behaviors of adolescents between the ages of 11 and 19 who were attending and to test the reliability and validity analysis of the Turkish version of Adolescent Health Promotion Scale (AHPS). The…

  10. Early childhood health, reproduction of economic inequalities and the persistence of health and mortality differentials

    PubMed Central

    Palloni, Alberto; Milesi, Carolina; White, Robert G; Turner, Alyn

    2009-01-01

    The persistence of adult health and mortality socioeconomic inequalities and the equally stubborn reproduction of social class inequalities are salient features in modern societies that puzzle researchers in seemingly unconnected research fields. Neither can be satisfactorily explained with standard theoretical frameworks. In the domain of health and mortality, it is unclear if and to what an extent adult health and mortality disparities across socioeconomic status (SES) are the product of attributes of the positions themselves, the partial result of health conditions established earlier in life that influence both adult health and economic success, or the outcome of the reverse impact of health status on SES. In the domain of social stratification, the transmission of inequalities across generations has been remarkably resistant to satisfactory explanations. Although the literature on social stratification is by and large silent about the role played by early health status in shaping adult socioeconomic opportunities, new research on human capital formation suggests this is a serious error of omission. In this paper we propose to investigate the connections between these two domains. We use data from male respondents of the 1958 British Cohort to estimate (a) the influence of early health conditions on adult SES and (b) the contribution of early health status to observed adult health differentials. The model incorporates early conditions as determinants of traits that enhance (inhibit) social mobility and also conventional and unconventional factors that affect adult health and socioeconomic status. Our findings reveal that early childhood health plays a small, but non-trivial role as a determinant of adult SES and the adult socioeconomic gradient in health. These findings enrich current explanations of SES inequalities and of adult health and mortality disparities. PMID:19269728

  11. Time series clustering analysis of health-promoting behavior

    NASA Astrophysics Data System (ADS)

    Yang, Chi-Ta; Hung, Yu-Shiang; Deng, Guang-Feng

    2013-10-01

    Health promotion must be emphasized to achieve the World Health Organization goal of health for all. Since the global population is aging rapidly, ComCare elder health-promoting service was developed by the Taiwan Institute for Information Industry in 2011. Based on the Pender health promotion model, ComCare service offers five categories of health-promoting functions to address the everyday needs of seniors: nutrition management, social support, exercise management, health responsibility, stress management. To assess the overall ComCare service and to improve understanding of the health-promoting behavior of elders, this study analyzed health-promoting behavioral data automatically collected by the ComCare monitoring system. In the 30638 session records collected for 249 elders from January, 2012 to March, 2013, behavior patterns were identified by fuzzy c-mean time series clustering algorithm combined with autocorrelation-based representation schemes. The analysis showed that time series data for elder health-promoting behavior can be classified into four different clusters. Each type reveals different health-promoting needs, frequencies, function numbers and behaviors. The data analysis result can assist policymakers, health-care providers, and experts in medicine, public health, nursing and psychology and has been provided to Taiwan National Health Insurance Administration to assess the elder health-promoting behavior.

  12. Economic aspect of health care systems. Advantage and disadvantage incentives in different systems.

    PubMed

    Chen, G J; Feldman, S R

    2000-04-01

    European health care delivery systems illustrate the effect of economic incentives on health care delivery. Each country faces the issue of trying to balance the desire for economic efficiency with comprehensive, quality medical care. Without careful use of economic incentives achievable with central control, one gets to pick only two of the three desired goods--high quality, low cost, and comprehensive coverage. In the United States, payment approaches for health care have been undergoing tremendous changes since the early 1980s. These changes have escalated during the 1990s. The basic approach for reimbursing hospital care has been completely restructured by many payers for care, and payment approaches for physicians and long-term care providers also are being restructured. Financing approaches vary from provider to provider and payer to payer, and financing approaches will continue to evolve over time. In the traditional fee-for-service reimbursement system, the incentive to physicians is to do more because more services lead to more revenue. The use of incentives to influence health care practitioners' behavior is common. Incentives are generally financial in nature and expose health care providers to some risk or reward for certain patterns of behavior. Some common incentives used in managed care include capitation payment, in which a physician is paid a fixed fee, regardless of the number of services administered; bonus distribution; and withhold accounts, through which a practitioner stands to gain or lose some amount of money for overuse or underuse of medical resources against budget. In many countries, a strengthening of the position of primary care providers can be observed: Finland, Germany, Greece, Italy, the Netherlands, Norway, Sweden, the United Kingdom, and now the United States. General practitioners are assumed to function as a gatekeeper to second-line care, such as specialist care, prescription drugs, and hospital care. A further step is to

  13. Effects of Targeted Subsidies Policy on Health Behavior in Iranian Households: A Qualitative Study

    PubMed Central

    DOSHMANGIR, Leila; DOSHMANGIR, Parinaz; ABOLHASSANI, Nazanin; MOSHIRI, Esmaeil; JAFARI, Mehdi

    2015-01-01

    Background: This study aimed to explore the effects of national targeted subsidies policy on health behavior of Iranian households. Methods: In this qualitative study, data were collected between January 2012 and December 2013 through face-to-face interviews (23 experts in national and provincial levels of health system and 18 household heads) and through a comprehensive and purposive document analysis. The data was analyzed using a thematic analysis method (inductive-deductive) and assisted by Atlas-ti software. Results: Rising health care costs, removing some food subsidies and the increase in price of most goods and services due to the implementation of economic policy of targeted subsidies have led to significant changes in the demand for health services, changes in the consumption trends of goods and services affecting health as well as changes in the health habits of households. Conclusion: Targeted subsidies and the cash subsidy policy have some negative effects on population health behavior especially among poor people. Hence, maintaining or increasing the cash subsidy is not an efficient allocation of resources toward health care system. So, it is necessary to identify appropriate strategies and policies and apply interventions in order to moderate negative effects and enhance positive effects resulted from implementing this economic reform on population health behavior. PMID:26056676

  14. Optimizing Population Health and Economic Outcomes: Innovative Treatment for BPH

    PubMed Central

    2013-01-01

    Optimizing Population Health and Economic Outcomes: Innovative Treatment for Benign Prostatic Hyperplasia (BPH) Transcribed and adapted for publication by Janice L. Clarke, RN, BBA Editorial: David B. Nash, MD, MBA   S-2 Introduction   S-2 Benign Prostatic Hyperplasia (BPH)   S-3 • Overview   S-3• Current BPH Treatment Paradigm   S-4• BPH Continuum of Care: Bladder Health   S-5 New Treatment Option for BPH   S-5 • The UroLift® System   S-6• Positioning of UroLift® in BPH Treatment Paradigm   S-7 New Value Proposition   S-8 • Addressing Bladder Health: Breaking the Cycle   S-8• Cost Benefit Analysis: The Big Picture   S-8 Patient and Family Engagement   S-10 Summary   S-11 PMID:22823180

  15. Economic Evidence on the Health Impacts of Climate Change in Europe

    PubMed Central

    Hutton, Guy; Menne, Bettina

    2014-01-01

    BACKGROUND In responding to the health impacts of climate change, economic evidence and tools inform decision makers of the efficiency of alternative health policies and interventions. In a time when sweeping budget cuts are affecting all tiers of government, economic evidence on health protection from climate change spending enables comparison with other public spending. METHODS The review included 53 countries of the World Health Organization (WHO) European Region. Literature was obtained using a Medline and Internet search of key terms in published reports and peer-reviewed literature, and from institutions working on health and climate change. Articles were included if they provided economic estimation of the health impacts of climate change or adaptation measures to protect health from climate change in the WHO European Region. Economic studies are classified under health impact cost, health adaptation cost, and health economic evaluation (comparing both costs and impacts). RESULTS A total of 40 relevant studies from Europe were identified, covering the health damage or adaptation costs related to the health effects of climate change and response measures to climate-sensitive diseases. No economic evaluation studies were identified of response measures specific to the impacts of climate change. Existing studies vary in terms of the economic outcomes measured and the methods for evaluation of health benefits. The lack of robust health impact data underlying economic studies significantly affects the availability and precision of economic studies. CONCLUSIONS Economic evidence in European countries on the costs of and response to climate-sensitive diseases is extremely limited and fragmented. Further studies are urgently needed that examine health impacts and the costs and efficiency of alternative responses to climate-sensitive health conditions, in particular extreme weather events (other than heat) and potential emerging diseases and other conditions

  16. Current process and future path for health economic assessment of pharmaceuticals in France

    PubMed Central

    Toumi, Mondher; Rémuzat, Cécile; El Hammi, Emna; Millier, Aurélie; Aballéa, Samuel; Chouaid, Christos; Falissard, Bruno

    2015-01-01

    The Social Security Funding Law for 2012 introduced the Economic and Public Health Assessment Committee (Commission Evaluation Economique et de Santé Publique, or CEESP) in the Social Security Code as a specialised committee affiliated with the Haute Autorité de Santé in charge of providing recommendations and health economic opinions. This article provides an in-depth description of the CEESP's structure and working methods, and analyses the impact of health economic assessment on market access of drugs in France. It also points out the areas of uncertainty and the conflicting rules following the introduction of the health economic assessment in France. The authors also provide their personal opinion on the likely future of health economic assessment of drugs in France, including the possible merge of the CEESP and the Transparency Committee, the implementation of a French threshold, and the extension of health economic assessment to a larger number of products. PMID:27123173

  17. Current process and future path for health economic assessment of pharmaceuticals in France.

    PubMed

    Toumi, Mondher; Rémuzat, Cécile; El Hammi, Emna; Millier, Aurélie; Aballéa, Samuel; Chouaid, Christos; Falissard, Bruno

    2015-01-01

    The Social Security Funding Law for 2012 introduced the Economic and Public Health Assessment Committee (Commission Evaluation Economique et de Santé Publique, or CEESP) in the Social Security Code as a specialised committee affiliated with the Haute Autorité de Santé in charge of providing recommendations and health economic opinions. This article provides an in-depth description of the CEESP's structure and working methods, and analyses the impact of health economic assessment on market access of drugs in France. It also points out the areas of uncertainty and the conflicting rules following the introduction of the health economic assessment in France. The authors also provide their personal opinion on the likely future of health economic assessment of drugs in France, including the possible merge of the CEESP and the Transparency Committee, the implementation of a French threshold, and the extension of health economic assessment to a larger number of products.

  18. Health economics and European Renal Best Practice--is it time to bring health economics into evidence-based guideline production in Europe?

    PubMed

    Haller, Maria C; Vanholder, Raymond; Oberbauer, Rainer; Zoccali, Carmine; Van Biesen, Wim

    2014-11-01

    Medical management of patients with kidney disease is complex and resource intensive. In times of limited health care budgets, economic evaluations have become more important over the past few years in identifying interventions with a beneficial cost-effectiveness to maximize the benefits served from the available resources. However, integrating evidence from health-economic evaluations into clinical practice guidelines remains a challenge. European Renal Best Practice (ERBP), the official guideline body of the European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) herewith presents some lines of thought that need consideration in the discussion on incorporating health-economic considerations into clinical guideline development.

  19. An economic analysis of payment for health care services: the United States and Switzerland compared.

    PubMed

    Zweifel, Peter; Tai-Seale, Ming

    2009-06-01

    This article seeks to assess whether physician payment reforms in the United States and Switzerland were likely to attain their objectives. We first introduce basic contract theory, with the organizing principle being the degree of information asymmetry between the patient and the health care provider. Depending on the degree of information asymmetry, different forms of payment induce "appropriate" behavior. These theoretical results are then pitted against the RBRVS of the United States to find that a number of its aspects are not optimal. We then turn to Switzerland's Tarmed and find that it fails to conform with the prescriptions of economic contract theory as well. The article closes with a review of possible reforms that could do away with uniform fee schedules to improve the performance of the health care system.

  20. Individual Differences in Consumer Buying Patterns: A Behavioral Economic Analysis

    ERIC Educational Resources Information Center

    Cavalcanti, Paulo R.; Oliveira-Castro, Jorge M.; Foxall, Gordon R.

    2013-01-01

    Although previous studies have identified several regularities in buying behavior, no integrated view of individual differences related to such patterns has been yet proposed. The present research examined individual differences in patterns of buying behavior of fast-moving consumer goods, using panel data with information concerning purchases of…

  1. Economic Culture and Trading Behaviors in Information Markets

    ERIC Educational Resources Information Center

    Alhayyan, Khalid N.

    2012-01-01

    There are four main components for influencing traders' behaviors in an information market context: trader characteristics, organizational characteristics, market design, and external information. This dissertation focuses on investigating the impact of individual trader characteristics on trading behaviors. Two newly-developed constructs,…

  2. Economic Crisis, Restrictive Policies, and the Population’s Health and Health Care: The Greek Case

    PubMed Central

    Giannakopoulos, Stathis; Gavana, Magda; Ierodiakonou, Ioanna; Waitzkin, Howard; Benos, Alexis

    2013-01-01

    The global economic crisis has affected the Greek economy with unprecedented severity, making Greece an important test of the relationship between socioeconomic determinants and a population’s well-being. Suicide and homicide mortality rates among men increased by 22.7% and 27.6%, respectively, between 2007 and 2009, and mental disorders, substance abuse, and infectious disease morbidity showed deteriorating trends during 2010 and 2011. Utilization of public inpatient and primary care services rose by 6.2% and 21.9%, respectively, between 2010 and 2011, while the Ministry of Health’s total expenditures fell by 23.7% between 2009 and 2011. In a time of economic turmoil, rising health care needs and increasing demand for public services collide with austerity and privatization policies, exposing Greece’s population health to further risks. PMID:23597358

  3. Social capital and risk and protective behaviors: a global health perspective

    PubMed Central

    Kaljee, Linda M; Chen, Xinguang

    2011-01-01

    Social capital and health research has emerged as a focus of contemporary behavioral epidemiology, while intervention research is seeking more effective measures to increase health protective behaviors and decrease health-risk behaviors. In this review we explored current literature on social capital and health outcomes at the micro-, mesa-, and macro-levels with a particular emphasis on research that incorporates a social capital framework, and adolescent and young adult engagement in risk behaviors. These data indicate that across a broad range of socio-cultural and economic contexts, social capital can affect individuals’ risk for negative health outcomes and their engagement in risk behaviors. Further research is needed which should focus on differentiating and measuring positive and negative social capital within both mainstream and alternative social networks, assessing how social constructions of gender, ethnicity, and race – within specific cultural contexts – mediate the relationship between social capital and risk and/or protective behaviors. This new research should integrate the existing research within historical socioeconomic and political conditions. In addition, social capital scales need to be developed to be both culturally and developmentally appropriate for use with adolescents living in a diversity of settings. Despite the proliferation of social capital research, the concept remains underutilized in both assessment and intervention development for adolescents’ and young adults’ engagement in risk behaviors and their associated short- and long-term poor health outcomes. PMID:23243387

  4. Health seeking behavior during pregnancy and child birth among Muslim women of Biratnagar, Nepal.

    PubMed

    Pokhrel, B R; Sharma, P; Bhatta, B; Bhandari, B; Jha, N

    2012-06-01

    Maternal mortality remains one of the biggest public health challenges in Nepal. This paper explores the health seeking behavior, during pregnancy and child birth in certain ethnic group. The poverty, illiteracy, women's low status in the society, lack of access and difficult geographical terrain are major reasons for poor maternal health status in Nepal. Cross-sectional study was conducted among 200 Muslim women of ward # 7 of Biratnagar municipality. They were interviewed to understand their health seeking behavior during pregnancy and childbirth, factors associated with use of health services and their role in the family. Information's on usages of health services, education level, family stricture, and occupational status, information were collected using a pretested and structured questionnaire. The overall institutional delivery in study population was found 24.5%. Low socio-economic status, Illiteracy and poverty in women are the major challenging features of pregnancy and child birth.

  5. Political and Economic Behavior of Man: A Course of Study.

    ERIC Educational Resources Information Center

    Cooperative Curriculum Service Center, Centerville, MD.

    This curriculum guide is designed to assist teachers in using such innovative techniques in the new social studies as concept teaching and inquiry with below average students. It is divided into two non-sequential semesters. Each of eleven units emphasize a single concept, in economics: 1) consumption, consumer purchasing, credit, deception,…

  6. Incorporation of future costs in health economic analysis publications: current situation and recommendations for the future.

    PubMed

    Gros, Blanca; Soto Álvarez, Javier; Ángel Casado, Miguel

    2015-06-01

    Future costs are not usually included in economic evaluations. The aim of this study was to assess the extent of published economic analyses that incorporate future costs. A systematic review was conducted of economic analyses published from 2008 to 2013 in three general health economics journals: PharmacoEconomics, Value in Health and the European Journal of Health Economics. A total of 192 articles met the inclusion criteria, 94 of them (49.0%) incorporated future related medical costs, 9 (4.2%) also included future unrelated medical costs and none of them included future nonmedical costs. The percentage of articles including future costs increased from 2008 (30.8%) to 2013 (70.8%), and no differences were detected between the three journals. All relevant costs for the perspective considered should be included in economic evaluations, including related or unrelated, direct or indirect future costs. It is also advisable that pharmacoEconomic guidelines are adapted in this sense.

  7. Application of Economic Analysis to School-Wide Positive Behavior Support (SWPBS) Programs

    ERIC Educational Resources Information Center

    Blonigen, Bruce A.; Harbaugh, William T.; Singell, Larry D.; Horner, Robert H.; Irvin, Larry K.; Smolkowski, Keith S.

    2008-01-01

    The authors discuss how to use economic techniques to evaluate educational programs and show how to apply basic cost analysis to implementation of school-wide positive behavior support (SWPBS). A description of cost analysis concepts used for economic program evaluation is provided, emphasizing the suitability of these concepts for evaluating…

  8. Community Dental Health Promotion for Children: Integrating Applied Behavior Analysis and Public Health.

    ERIC Educational Resources Information Center

    Kramer, Kathryn D.; Geller, E. Scott

    1987-01-01

    The article examines community dental health promotion for children in terms of factors impacting children's dental health (water fluoridation, dental health education, behavior change strategies, use of dental services, and dental phobias). Proposed is a large scale behavior change approach to public dental health which integrates applied…

  9. Accuracy of Parents' Perceptions of Their College Student Children's Health and Health Risk Behaviors

    ERIC Educational Resources Information Center

    Bylund, Carma L.; Imes, Rebecca S.; Baxter, Leslie A.

    2005-01-01

    The authors compared parents' perceptions of their college student children's health and health risk behaviors with the college students' own reports. One hundred sixty-four parent-college student child dyads completed questionnaires regarding the students' health, illness status, and health risk behaviors. Parents tended to be overoptimistic…

  10. The economics of health care quality and medical errors.

    PubMed

    Andel, Charles; Davidow, Stephen L; Hollander, Mark; Moreno, David A

    2012-01-01

    Hospitals have been looking for ways to improve quality and operational efficiency and cut costs for nearly three decades, using a variety of quality improvement strategies. However, based on recent reports, approximately 200,000 Americans die from preventable medical errors including facility-acquired conditions and millions may experience errors. In 2008, medical errors cost the United States $19.5 billion. About 87 percent or $17 billion were directly associated with additional medical cost, including: ancillary services, prescription drug services, and inpatient and outpatient care, according to a study sponsored by the Society for Actuaries and conducted by Milliman in 2010. Additional costs of $1.4 billion were attributed to increased mortality rates with $1.1 billion or 10 million days of lost productivity from missed work based on short-term disability claims. The authors estimate that the economic impact is much higher, perhaps nearly $1 trillion annually when quality-adjusted life years (QALYs) are applied to those that die. Using the Institute of Medicine's (IOM) estimate of 98,000 deaths due to preventable medical errors annually in its 1998 report, To Err Is Human, and an average of ten lost years of life at $75,000 to $100,000 per year, there is a loss of $73.5 billion to $98 billion in QALYs for those deaths--conservatively. These numbers are much greater than those we cite from studies that explore the direct costs of medical errors. And if the estimate of a recent Health Affairs article is correct-preventable death being ten times the IOM estimate-the cost is $735 billion to $980 billion. Quality care is less expensive care. It is better, more efficient, and by definition, less wasteful. It is the right care, at the right time, every time. It should mean that far fewer patients are harmed or injured. Obviously, quality care is not being delivered consistently throughout U.S. hospitals. Whatever the measure, poor quality is costing payers and

  11. Mental health and socio-economic variations in Australian suicide.

    PubMed

    Taylor, Richard; Page, Andrew; Morrell, Stephen; Harrison, James; Carter, Greg

    2005-10-01

    This paper investigates the relationship between suicide rates and prevalence of mental disorder and suicide attempts, across socio-economic status (SES) groups based on area of residence. Australian suicide data (1996-1998) were analysed in conjunction with area-based prevalences of mental disorder derived from the National Survey of Mental Health and Well-Being (1997). Poisson regression models of suicide risk included age, quintile of area-based SES, urban-rural residence, and country of birth (COB), with males and females analysed separately. Analysis focussed on the association between suicide and prevalences of (ICD-10) affective disorders, anxiety disorders, substance use disorders and suicide attempts by SES group. Prevalences of other psychiatric symptomatology, substance use problems, health service utilisation, stressful life-events and personality were also investigated. Significant increasing gradients were evident from high to low SES groups for prevalences of affective disorders, anxiety disorders (females only), and substance use disorders (males only); sub-threshold drug and alcohol problems and depression; and suicide attempts and suicide (males only). Prevalences of mental disorder, other sub-threshold mental health items and suicide attempts were significantly associated with suicide, but in most cases associations were reduced in magnitude and became statistically non-significant after adjustment for COB, urban-rural residence, and SES. For male suicide the relative risk (RR) in the lowest SES group compared to the highest was 1.40 (95% CI 1.29-1.52, p<0.001) for all ages, and 1.46 (95% CI 1.27-1.67, p<0.001) for male youth (20-34 years). This relationship was not substantially modified in males when regression models included prevalences of affective disorders, and other selected mental health variables and demographic factors. From a population perspective, SES remained significantly associated with suicide after controlling for the

  12. Religion and health-promoting behaviors among emerging adults.

    PubMed

    Horton, Shalonda E B

    2015-02-01

    Studies suggest we capitalize upon religion's health benefits to prevent obesity. The purpose of this qualitative descriptive study was to determine how emerging adults used religion to manage their health. Two focus groups were conducted among White and African American participants. Content analysis of the data revealed categories about their attitudes regarding parental and religious influences, religion's influence on behavior, negative health effects of religion, barriers, obesity prevention, and health promotion programs. Society sends out "easy" solutions for unhealthy behaviors, but we should focus on healthy behavior benefits, remove barriers, and consider religion's part in health promotion (obesity prevention).

  13. Economic growth and health progress in Italy: 30 years of National Health Service.

    PubMed

    Vannelli, Alberto; Buongiorno, Massimo; Zanardo, Michele; Basilico, Valerio; Capriata, Giulio; Rossi, Fabrizio; Pruiti, Vincenzo; Battaglia, Luigi

    2012-01-01

    On December 23 of 1978, during first Italian recession since the end of World War II, Parliament voted for Law 833 that gives birth to the Italian National Public Health Services (SSN) as the new and alternative model of health care system. It was the beginning of the match of Italian health care with the world class level of the public health care. Each crisis requires solidarity and actions. Maintaining levels of health and other social expenditures is critical to protect life and livelihood and to boost productivity. The purpose of the present study is to establish an alternative point of view to demonstrate that Gross Domestic Product, is a function of health care expenditure. The chronology of the events was created by using the laws published on "Gazzetta Ufficiale" (GU). In order to analyze the corporate effectiveness and efficiency, we have divided the SSN into its three main components, namely resources (input), services (output) and performances (outcome). Health services have certainly been pioneers and are still today standard-bearers of a challenge which has borne its fruits. According to the "Organization for Economic Co-operation and Development", SSN ranks second in the world classification of the return on the health care services in 2000. The World Health Organization has published in 2005 the same result: SSN ranks second in the world for ability and quality of the health care in relationship to the resources invested The continuous reforms of health care system introduced stability to the Italian system more than others countries. Success of SSN function rooted in the ability of system to adapt assuring mechanism of positive feed-back correction. In the future SSN, will required new set of reforms, such as redefinition of structures and mechanisms of governance, strategic plans, clinical administrations.

  14. Help Preferences among Employees Who Wish to Change Health Behaviors

    ERIC Educational Resources Information Center

    Persson, Roger; Cleal, Bryan; Jakobsen, Mette Øllgaard; Villadsen, Ebbe; Andersen, Lars L.

    2014-01-01

    Objective: To examine the help preferences of employees in the Danish police who had acknowledged that they wished to change health behaviors. In addition, we explored whether preferences varied with age, gender, chronic health concerns, positive expectations of good health, and past experiences of in-house health promotion services (i.e.,…

  15. Maintenance of health behavior change in preventive cardiology. Internalization and self-regulation of new behaviors.

    PubMed

    Bellg, Albert J

    2003-01-01

    Long-term health behavior maintenance remains a challenge for patients and health behavior interventionists. Resource-intensive systems of external reinforcement and behavioral cues can support behavior maintenance; an alternative approach is to promote patient internalization and self-regulation of health behaviors. Based in part on organismic internalization theory, self-determination theory, and the experience of patients successful at maintaining health behaviors, the health behavior internalization model (HBIM) is proposed to describe motivational factors associated with internalization processes and hypothesizes that integrated internalization may be associated with long-term health behavior maintenance. The HBIM identifies four self-needs (ownership, self-determination, security, and support) and four behavior-related needs (preference, context, competence, and coping) as motivating health behavior internalization. Behavior change strategies promoting integrated internalization are identified from self-determination theory, motivational interviewing, and transtheoretical model interventions. Other health behavior change constructs are reviewed in relation to internalization processes, and potential limits to the model are discussed.

  16. Health economics and outcomes research fellowship practices reviewed.

    PubMed

    Suh, Kangho; Gabriel, Susan; Adams, Michelle A; Arcona, Steve

    2015-01-01

    The guidelines for health economics and outcomes research (HEOR) fellowship training programs devised by the American College of Clinical Pharmacy (ACCP) and the International Society of Pharmacoeconomics and Outcomes Research (ISPOR) suggest that continuous improvements are made to ensure that postgraduate training through didactic and professional experiences prepare fellows for HEOR research careers. The HEOR Fellowship Program at Novartis Pharmaceuticals Corporation was standardized to enhance the fellows' HEOR research understanding and align professional skill sets with the ACCP-ISPOR Fellowship Program Guidelines. Based on feedback from an internal task force comprised of HEOR employees and current and former fellows, the HEOR Fellowship Program was normatively and qualitatively assessed to evaluate the current curricular program. Fellowship program activities were instituted to ensure that the suggested minimum level requirements established by the guidelines were being met. Research opportunities enabling fellows to work hand-in-hand with other fellows and HEOR professionals were emphasized. Curricular enhancements in research methodology and professional training and development, and materials for a structured journal club focusing on specific methodological and HEOR research topics were developed. A seminar series (e.g., creating SMART Goals, StrengthsFinder 2.0) and professional courses (e.g., ISPOR short courses, statistics.com) were included to enhance the fellows' short- and long-term professional experience. Additional program attributes include an online reference library developed to enrich the current research facilities and a Statistical Analysis Software training program. Continuously assessing and updating HEOR fellowship programs keeps programs up-to-date in the latest HEOR concepts and approaches used to evaluate health care, both professionally and educationally.

  17. Economic and social dimensions of environmental behavior: balancing conservation and development in Bhutan.

    PubMed

    Brooks, Jeremy S

    2010-12-01

    One of the primary approaches to environmental conservation emphasizes economic development. This conservation-and-development approach often ignores how development affects sociocultural characteristics that may motivate environmental behaviors (actions that actively benefit or limit one's negative impacts on the environment). Evolutionary anthropologists espouse a theoretical perspective that supports the conservation-and-development approach. Others believe sociocultural factors are the foundation of environmental behavior and worry that development will erode the values and norms that may shape such behavior. My research assistants and I surveyed 170 individuals from eight villages in two communities in Bhutan to explore whether economic (wealth, market integration) or social (religious behaviors, environmental values, social capital) factors are better indicators of environmental behavior. I used multilevel modeling to analyze use of fuelwood, use of agricultural chemicals, and tree planting, and to determine whether social norms were associated with these behaviors. Although economic factors were more often associated with these behaviors than social factors, local conditions and control variables were the best indicators of behaviors. Furthermore, economic factors were not always associated with positive environmental outcomes. Instead, farmers attempted to make the best economic decisions given their circumstances rather than seeking to conserve resources. Although religion was not a strong predictor of any of the behaviors I examined, I found evidence that the understanding of Buddhist philosophy is growing, which suggests that social factors may play a more prominent role as Bhutan's development progresses. My results highlight the need for conservation planners to be aware of local conditions when planning and implementing policies aimed at motivating environmental behaviors and that economic and social motivations for conservation may not be mutually

  18. Determinants of Consumer eHealth Information Seeking Behavior.

    PubMed

    Sandefer, Ryan H; Westra, Bonnie L; Khairat, Saif S; Pieczkiewicz, David S; Speedie, Stuart M

    2015-01-01

    Patients are increasingly using the Internet and other technologies to engage in their own healthcare, but little research has focused on the determinants of consumer eHealth behaviors related to Internet use. This study uses data from 115,089 respondents to four years of the National Health Interview Series to identify the associations between one consumer eHealth behavior (information seeking) and demographics, health measures, and Personal Health Information Management (PHIM) (messaging, scheduling, refills, and chat). Individuals who use PHIM are 7.5 times more likely to search the internet for health related information. Just as health has social determinants, the results of this study indicate there are potential social determinants of consumer eHealth behaviors including personal demographics, health status, and healthcare access.

  19. Determinants of Consumer eHealth Information Seeking Behavior

    PubMed Central

    Sandefer, Ryan H.; Westra, Bonnie L.; Khairat, Saif S.; Pieczkiewicz, David S.; Speedie, Stuart M

    2015-01-01

    Patients are increasingly using the Internet and other technologies to engage in their own healthcare, but little research has focused on the determinants of consumer eHealth behaviors related to Internet use. This study uses data from 115,089 respondents to four years of the National Health Interview Series to identify the associations between one consumer eHealth behavior (information seeking) and demographics, health measures, and Personal Health Information Management (PHIM) (messaging, scheduling, refills, and chat). Individuals who use PHIM are 7.5 times more likely to search the internet for health related information. Just as health has social determinants, the results of this study indicate there are potential social determinants of consumer eHealth behaviors including personal demographics, health status, and healthcare access. PMID:26958251

  20. Demonstration of Replicable Dimensions of Health Behaviors

    DTIC Science & Technology

    1988-10-06

    the antecedents of these behavioral dimensions should help define potential targets for behavior modification programs and permit evaluations of those...defining observations that can be used for measurement. The behavior modification implications are linked to the assumption that behaviors which co-occur

  1. Health and Problem Behavior Among People With Intellectual Disabilities

    PubMed Central

    May, Michael E; Kennedy, Craig H

    2010-01-01

    Good health significantly improves a person's quality of life. However, people with intellectual disabilities disproportionately have more health problems than the general population. Further complicating the matter is that people with more severe disabilities often cannot verbalize health complications they are experiencing, which leads to health problems being undiagnosed and untreated. It is plausible these conditions can interact with reinforcement contingencies to maintain problem behavior because of the increased incidence of health problems among people with intellectual disabilities. This paper reviews common health problems influencing problem behavior and reinforcement processes. A clear implication of this review is the need for comprehensive functional assessments of problem behavior involving behavior analysts and health professionals. PMID:22532888

  2. Investigation of mental health in Indonesian health workers immigrating to Japan under the Economic Partnership Agreement.

    PubMed

    Sato, Fumiko; Hayakawa, Kazuo; Kamide, Kei

    2016-09-01

    The aim of this study was to assess the mental health status of Indonesian nurses and care workers who immigrated to Japan after the Economic Partnership Agreement was signed by the governments of Japan and Indonesia in 2008. From November 2012 to March 2013, questionnaires were mailed to 206 workers in 87 medical and caregiving facilities that openly accept Indonesian EPA immigrant workers. Responses were received from 71 workers in 35 facilities. Responses from 22.5% of workers suggested that they were at risk of developing mental health problems, and "gender" and "acquisition state of national qualifications" were the main factors influencing their mental health status. The results suggest that support after obtaining national qualifications is inadequate and that mid and long-term support systems that focus on the needs of immigrant healthcare workers after passing national examinations are necessary.

  3. Applying the Behavioral Economics Principle of Unit Price to DRO Schedule Thinning

    ERIC Educational Resources Information Center

    Roane, Henry S.; Falcomata, Terry S.; Fisher, Wayne W.

    2007-01-01

    Within the context of behavioral economics, the ratio of response requirements to reinforcer magnitude is called "unit price." In this investigation, we yoked increases in reinforcer magnitude with increases in intervals of differential reinforcement of other behavior (DRO) to thin DRO intervals to a terminal value. (Contains 1 figure.)

  4. Applying the behavioral economics principle of unit price to DRO schedule thinning.

    PubMed

    Roane, Henry S; Falcomata, Terry S; Fisher, Wayne W

    2007-01-01

    Within the context of behavioral economics, the ratio of response requirements to reinforcer magnitude is called unit price. In this investigation, we yoked increases in reinforcer magnitude with increases in intervals of differential reinforcement of other behavior (DRO) to thin DRO intervals to a terminal value.

  5. Towards integration of health economics into medical education and clinical practice in Saudi Arabia.

    PubMed

    Da'ar, Omar B; Al Shehri, Ali M

    2015-04-01

    In an era of expanding health sectors and rising costs, doctors are expected to have a working knowledge of health economics to better use resources and improve outcomes and quality of health care. This article recognizes the dearth of knowledge and application of economic analyses in medical education and clinical practice in Saudi Arabia. In particular, it highlights the desirability of knowledge of health economics in ensuring certain competencies in medical education and the rationale for inviting doctors to apply knowledge of economics in Saudi Arabia. In addition, the article discusses challenges that hinder integrating health economics into clinical practice. Furthermore, the article typifies some of the important economic phenomena that physicians need to discern. Besides, the article provides implications for incorporating economic analysis into medical education and clinical practice in Saudi Arabia. Finally, the article concludes by demonstrating how health economics can enhance doctors' knowledge and recommends the country to move towards integrating health economics into medical education and clinical practice for best practice.

  6. A lack of response of the financial behaviors of biodiversity conservation nonprofits to changing economic conditions

    PubMed Central

    Larson, Eric R; Boyer, Alison G; Armsworth, Paul R

    2014-01-01

    The effectiveness of conservation organizations is determined in part by how they adapt to changing conditions. Over the previous decade, economic conditions in the United States (US) showed marked variation including a period of rapid growth followed by a major recession. We examine how biodiversity conservation nonprofits in the US responded to these changes through their financial behaviors, focusing on a sample of 90 biodiversity conservation nonprofits and the largest individual organization (The Nature Conservancy; TNC). For the 90 sampled organizations, an analysis of financial ratios derived from tax return data revealed little response to economic conditions. Similarly, more detailed examination of conservation expenditures and land acquisition practices of TNC revealed only one significant relationship with economic conditions: TNC accepted a greater proportion of conservation easements as donated in more difficult economic conditions. Our results suggest that the financial behaviors of US biodiversity conservation nonprofits are unresponsive to economic conditions. PMID:25512840

  7. Health plans' disease management programs: extending across the medical and behavioral health spectrum?

    PubMed

    Merrick, Elizabeth Levy; Horgan, Constance M; Garnick, Deborah W; Hodgkin, Dominic; Morley, Melissa

    2008-01-01

    Although the disease management industry has expanded rapidly, there is little nationally representative data regarding medical and behavioral health disease management programs at the health plan level. National estimates from a survey of private health plans indicate that 90% of health plan products offered disease management for general medical conditions such as diabetes but only 37% had depression programs. The frequency of specific depression disease management activities varied widely. Program adoption was significantly related to product type and behavioral health contracting. In health plans, disease management has penetrated more slowly into behavioral health and depression program characteristics are highly variable.

  8. Health Economics of Dengue: A Systematic Literature Review and Expert Panel's Assessment

    PubMed Central

    Beatty, Mark E.; Beutels, Philippe; Meltzer, Martin I.; Shepard, Donald S.; Hombach, Joachim; Hutubessy, Raymond; Dessis, Damien; Coudeville, Laurent; Dervaux, Benoit; Wichmann, Ole; Margolis, Harold S.; Kuritsky, Joel N.

    2011-01-01

    Dengue vaccines are currently in development and policymakers need appropriate economic studies to determine their potential financial and public health impact. We searched five databases (PubMed, EMBASE, LILAC, EconLit, and WHOLIS) to identify health economics studies of dengue. Forty-three manuscripts were identified that provided primary data: 32 report economic burden of dengue and nine are comparative economic analyses assessing various interventions. The remaining two were a willingness-to-pay study and a policymaker survey. An expert panel reviewed the existing dengue economic literature and recommended future research to fill information gaps. Although dengue is an important vector-borne disease, the economic literature is relatively sparse and results have often been conflicting because of use of inconsistent assumptions. Health economic research specific to dengue is urgently needed to ensure informed decision making on the various options for controlling and preventing this disease. PMID:21363989

  9. Social, Behavioral and Economic Research in the Federal Context

    DTIC Science & Technology

    2009-01-01

    many states. Howev- er, retention practices have not been found to improve student performance. Timely interventions targeted to each child’s...early education for improving later edu- cational outcomes . Researchers working at the inter- section of cognitive science and information science...through social and behavioral avenues, in addition to pharmaceutical interventions . III. Policy Relevance Psychological Stress Increases Susceptibility

  10. Replacing Relative Reinforcing Efficacy with Behavioral Economic Demand Curves

    ERIC Educational Resources Information Center

    Johnson, Matthew W.; Bickel, Warren K.

    2006-01-01

    Relative reinforcing efficacy refers to the behavior-strengthening or maintaining property of a reinforcer when compared to that of another reinforcer. Traditional measures of relative reinforcing efficacy sometimes have led to discordant results across and within studies. By contrast, previous investigations have found traditional measures to be…

  11. Adulthood Predictors of Health Promoting Behavior in Later Aging

    ERIC Educational Resources Information Center

    Holahan, Carole K.; Suzuki, Rie

    2004-01-01

    This study investigated adulthood predictors of health-promoting behavior in later aging. The participants were 162 members of the Terman Study of the Gifted (Terman et al., 1925), who responded in 1999 at an average age of 86 to a mailout questionnaire which included questions concerning their positive health behavior. Adulthood variables were…

  12. Lifestyle and Clinical Health Behaviors and PSA Tests

    ERIC Educational Resources Information Center

    Norris, Cynthia; McFall, Stephanie

    2006-01-01

    This study assessed the association of lifestyle and clinical health behaviors with prostate specific antigen (PSA) tests. The study used cross-sectional data from the 2002 Behavioral Risk Factor Surveillance System (BRFSS). We used Stata 8.0 to take into account the complex sample design in analyses. Both lifestyle and clinical health behaviors…

  13. Rural Adolescent Health Risk Behaviors: Age, Gender, and Ethnic Differences.

    ERIC Educational Resources Information Center

    Salzman, Stephanie A.; Girvan, James T.

    A survey of health risk behaviors was administered to a representative sample of 7,776 Idaho students in grades 8-12. Respondents were 86% White, 6% Hispanic, 4% American Indian, 3% Asian, and 2% Black. These rural adolescents reported that they had engaged in some health risk behaviors at rates comparable to those of other U.S. adolescents: 57%…

  14. Implementing Social Norm Pedagogy to Impact Students' Personal Health Behavior

    ERIC Educational Resources Information Center

    Kramer, Mary M.; Stover, Sheri

    2015-01-01

    This quantitative exploratory research study describes the incorporation of Social Norms as a unique pedagogical method in an undergraduate Health Behaviors course (N = 32). With the use of an audience response system (clickers), students anonymously answered health-behavior related questions. Aggregate data from the class was compared to state…

  15. Estimating the monetary value of health care: lessons from environmental economics.

    PubMed

    Hanley, Nick; Ryan, Mandy; Wright, Robert

    2003-01-01

    In the recent past, considerable effort in health economics has been made on applying stated preference methods such as contingent valuation and choice experiments. Despite this increased use, there is still considerable scepticism concerning the value of these approaches. The application of contingent valuation in environmental economics has a long history and has been widely accepted. Whilst choice experiments were introduced to the environmental and health economics literature at a similar time, the wider acceptance of monetary measures of benefit in environmental economics has meant that they have also been more widely applied. The purpose of this paper is to identify some of the key issues and debates that have taken place in the environmental economics literature, summarise the state of the art with respect to these issues, and consider how health economists have addressed these issues. Important areas for future research in health economics are identified.

  16. Autoshaped choice in artificial neural networks: implications for behavioral economics and neuroeconomics.

    PubMed

    Burgos, José E; García-Leal, Óscar

    2015-05-01

    An existing neural network model of conditioning was used to simulate autoshaped choice. In this phenomenon, pigeons first receive an autoshaping procedure with two keylight stimuli X and Y separately paired with food in a forward-delay manner, intermittently for X and continuously for Y. Then pigeons receive unreinforced choice test trials of X and Y concurrently present. Most pigeons choose Y. This preference for a more valuable response alternative is a form of economic behavior that makes the phenomenon relevant to behavioral economics. The phenomenon also suggests a role for Pavlovian contingencies in economic behavior. The model used, in contrast to others, predicts autoshaping and automaintenance, so it is uniquely positioned to predict autoshaped choice. The model also contemplates neural substrates of economic behavior in neuroeconomics, such as dopaminergic and hippocampal systems. A feedforward neural network architecture was designed to simulate a neuroanatomical differentiation between two environment-behavior relations X-R1 and Y-R2, [corrected] where R1 and R2 denote two different emitted responses (not unconditionally elicited by the reward). Networks with this architecture received a training protocol that simulated an autoshaped-choice procedure. Most networks simulated the phenomenon. Implications for behavioral economics and neuroeconomics, limitations, and the issue of model appraisal are discussed.

  17. Dimensions of emotional intelligence related to physical and mental health and to health behaviors

    PubMed Central

    Fernández-Abascal, Enrique G.; Martín-Díaz, María Dolores

    2015-01-01

    In this paper the relationship between emotional intelligence (EI) and health is examined. The current work investigated the dimensions of EI are sufficient to explain various components of physical and mental health, and various categories of health-related behaviors. A sample of 855 participants completed two measures of EI, the Trait Meta-Mood Scale and trait emotional intelligence questionnaire, a measure of health, the Health Survey SF-36 Questionnaire (SF-36); and a measure of health-related behaviors, the health behavior checklist. The results show that the EI dimensions analyzed are better predictors of mental health than of physical health. The EI dimensions that positively explain the Mental Health Component are Well-Being, Self-Control and Sociability, and negatively, Attention. Well-Being, Self-Control and Sociability positively explain the Physical Health Component. EI dimensions predict a lower percentage of health-related behaviors than they do health components. Emotionality and Repair predict the Preventive Health Behavior category, and only one dimension, Self-Control, predicts the Risk Taking Behavior category. Older people carry out more preventive behaviors for health. PMID:25859229

  18. Social determinants of health--a question of social or economic capital? Interaction effects of socioeconomic factors on health outcomes.

    PubMed

    Ahnquist, Johanna; Wamala, Sarah P; Lindstrom, Martin

    2012-03-01

    Social structures and socioeconomic patterns are the major determinants of population health. However, very few previous studies have simultaneously analysed the "social" and the "economic" indicators when addressing social determinants of health. We focus on the relevance of economic and social capital as health determinants by analysing various indicators. The aim of this paper was to analyse independent associations, and interactions, of lack of economic capital (economic hardships) and social capital (social participation, interpersonal and political/institutional trust) on various health outcomes. Data was derived from the 2009 Swedish National Survey of Public Health, based on a randomly selected representative sample of 23,153 men and 28,261 women aged 16-84 year, with a participation rate of 53.8%. Economic hardships were measured by a combined economic hardships measure including low household income, inability to meet expenses and lacking cash reserves. Social capital was measured by social participation, interpersonal (horizontal) trust and political (vertical/institutional trust) trust in parliament. Health outcomes included; (i) self-rated health, (i) psychological distress (GHQ-12) and (iii) musculoskeletal disorders. Results from multivariate logistic regression show that both measures of economic capital and low social capital were significantly associated with poor health status, with only a few exceptions. Significant interactive effects measured as synergy index were observed between economic hardships and all various types of social capital. The synergy indices ranged from 1.4 to 2.3. The present study adds to the evidence that both economic hardships and social capital contribute to a range of different health outcomes. Furthermore, when combined they potentiate the risk of poor health.

  19. Economic, neurobiological, and behavioral perspectives on building America's future workforce.

    PubMed

    Knudsen, Eric I; Heckman, James J; Cameron, Judy L; Shonkoff, Jack P

    2006-07-05

    A growing proportion of the U.S. workforce will have been raised in disadvantaged environments that are associated with relatively high proportions of individuals with diminished cognitive and social skills. A cross-disciplinary examination of research in economics, developmental psychology, and neurobiology reveals a striking convergence on a set of common principles that account for the potent effects of early environment on the capacity for human skill development. Central to these principles are the findings that early experiences have a uniquely powerful influence on the development of cognitive and social skills and on brain architecture and neurochemistry, that both skill development and brain maturation are hierarchical processes in which higher level functions depend on, and build on, lower level functions, and that the capacity for change in the foundations of human skill development and neural circuitry is highest earlier in life and decreases over time. These findings lead to the conclusion that the most efficient strategy for strengthening the future workforce, both economically and neurobiologically, and improving its quality of life is to invest in the environments of disadvantaged children during the early childhood years.

  20. Homophily and health behavior in social networks of older adults.

    PubMed

    Flatt, Jason D; Agimi, Yll; Albert, Steve M

    2012-01-01

    A common network phenomenon, homophily, involves developing relationships with others who are similar to you. The intent of this study was to determine if older adults' health behaviors were shared within social networks. We interviewed older adults from low-income senior housing (egos) on egocentric social network characteristics and key health behaviors for themselves and for named social ties (alters). Findings suggest strong effects for homophily, especially for those who smoked and were physically inactive. Public health interventions for older adults should consider the influence that social relationships have on personal health behaviors. Network-based interventions may be required.

  1. The hidden cost of wildfires: Economic valuation of health effects of wildfire smoke exposure in Southern California

    USGS Publications Warehouse

    Richardson, L.A.; Champ, P.A.; Loomis, J.B.

    2012-01-01

    There is a growing concern that human health impacts from exposure to wildfire smoke are ignored in estimates of monetized damages from wildfires. Current research highlights the need for better data collection and analysis of these impacts. Using unique primary data, this paper quantifies the economic cost of health effects from the largest wildfire in Los Angeles County's modern history. A cost of illness estimate is $9.50 per exposed person per day. However, theory and empirical research consistently find that this measure largely underestimates the true economic cost of health effects from exposure to a pollutant in that it ignores the cost of defensive actions taken as well as disutility. For the first time, the defensive behavior method is applied to calculate the willingness to pay for a reduction in one wildfire smoke induced symptom day, which is estimated to be $84.42 per exposed person per day. ?? 2011.

  2. Antecedents of Philanthropic Behavior of Health Care Volunteers

    ERIC Educational Resources Information Center

    Alias, Siti Noormi; Ismail, Maimunah

    2015-01-01

    Purpose: This paper aims to propose a conceptual model of philanthropic behavior of volunteers in the health care sector. Design/methodology/approach: This study is based on an extensive review of past research on philanthropic behavior. To conduct the literature review, keywords such as philanthropy, philanthropic behavior, giving, donating,…

  3. Associations between Major Domains of Personality and Health Behavior

    DTIC Science & Technology

    1991-11-01

    lead to more effective, efficient health behavior modification programs. Aeoesson 7or ITI GRA&I DTIC TAB5 Unnnnoanced 5 SJu~ti:Icrti or D31tt ’bu𔃿iOn...further study, however, these barriers might be overcome by designing health behavior modification programs in which participants were assigned to... behavior modification programs matched to their personality predispositions. References Aho, W. R. (1979a). Participation of senior citizens in the

  4. Some reciprocal roles between behavior analysis and institutional economics in post-darwinian science

    PubMed Central

    Glenn, Sigrid S.

    1985-01-01

    Behavior analysis and institutional economics are viewed as having common origins in the early 20th century effort to benefit from the conceptual revolution spurred by Darwin's synthesis. Institutional economics, initiated by Thorstein Veblen, appears to have failed to develop a progressive scientific technology, while behavior analysis has done so. It is suggested that institutional economics has been held back by lack of a synthesizing scientific mechanism that elucidates the relation between technological and ceremonial processes, the two cultural forces described by Veblen. The theory of institutional economist C. E. Ayres, built on Veblen's distinction, is used to clarify the concepts of technological and ceremonial processes for the reader. An analysis of the behavioral processes that might underlie the cultural processes described by Veblen/Ayres suggests that the experimental analysis of behavior has provided concepts that might function as a synthesizing mechanism for the social sciences and, in particular, institutional economics. The Veblen/Ayres dichotomy, now seen in terms of underlying behavioral processes, is used to examine the field of behavior analysis in terms of its origins, its relation to psychology and its current state. The paper concludes with a few practical suggestions as to how behavior analysts might work to enhance survival. PMID:22478617

  5. Football and exchange rates: empirical support for behavioral economics.

    PubMed

    Eker, Gulin; Berument, Hakan; Dogan, Burak

    2007-10-01

    Recently, economic theory has been expanded to incorporate emotions, which have been assumed to play an important role in financial decisions. The present study illustrates this by showing a connection between the sports performance of popular national football teams (Besiktas, Fenerbahce, and Galatasaray) and performance of the Turkish economy. Specifically, a significant positive association was found between the success of three major professional Turkish football teams and the exchange rate of the Turkish lira against the U.S. dollar. The effect of the football success of several Turkish football teams on the exchange rate of the Turkish lira was examined using the simultaneous multiple regression model with predictor measures of wins, losses, and ties for different combinations of teams to predict the depreciation rate of the Turkish lira between the years 1987 and 2003. Wins by Turkish football teams against foreign (non-Turkish) rivals increased with exchange rate depreciation of the Turkish lira against the U.S. dollar.

  6. The Korean economic crisis and coping strategies in the health sector: pro-welfarism or neoliberalism?

    PubMed

    Kim, Chang-Yup

    2005-01-01

    In South Korea, there have been debates on the welfare policies of the Kim Dae-jung government after the economic crisis beginning in late 1997, but it is unquestionable that health and health care policies have followed the trend of neoliberal economic and social polices. Public health measures and overall performance of the public sector have weakened, and the private health sector has further strengthened its dominance. These changes have adversely affected the population's health status and access to health care. However, the anti-neoliberal coalition is preventing the government's drive from achieving a full success.

  7. Factors Influencing Health Knowledge and Behaviors among the Elderly in Rural China

    PubMed Central

    He, Zhifei; Cheng, Zhaohui; Shao, Tian; Liu, Chunyan; Shao, Piaopiao; Bishwajit, Ghose; Feng, Da; Feng, Zhanchun

    2016-01-01

    Objectives: Health knowledge and behaviors are the key elements that ensure high quality of health for the elderly. This study explored and determined the conditions and factors of health knowledge and behaviors that affect the elderly in rural China. Methods: A cross-sectional research approach and random stratified sampling method were used in 12 towns and 48 villages in the Chongqing Municipality, Henan, and Zhejiang Provinces in China from June to September 2013. The collected data included: (1) socio-demographic characteristics of 1593 elderly people; (2) accuracy rate on health knowledge of the elderly, which was analyzed and compared among the three sample areas by using Chi-square test; and (3) mean scores on the health behaviors of the elderly, which were analyzed and compared by using analysis of variance (ANOVA). The multiple-linear regression method was used to analyze the factors affecting the health knowledge and behaviors of the elderly. Results: Significant differences were observed among the nine items in the health knowledge questionnaire (p = 0.000 < 0.001). The average accuracy rate of the nine items was 57.43%. Significant differences were observed among the eleven items on the health behaviors of the elderly in the sample rural areas (p = 0.000 < 0.001). Age, economic level, degree of education, distance from home to medical institutions and disposable personal income (DPI) can affect the scores of the health knowledge and behaviors of the elderly (p = 0.000 < 0.001). Conclusions: Lack of health knowledge and poor health behaviors are common among the elderly in the sample areas of rural China. This deficiency poses a serious threat on the promotion of health conditions and the improvement of the level of health quality among the elderly. Different types of access to sources of health knowledge should be used to increase health knowledge scores of the elderly. Various potential intervening measures should also be adopted to improve their

  8. Intergenerational continuity in economic hardship, parental positivity, and positive parenting: The association with child behavior

    PubMed Central

    Jeon, Shinyoung; Neppl, Tricia K.

    2015-01-01

    The current study examined intergenerational continuity in economic hardship, parental positivity, and positive parenting across generations based on both the Family Stress Model and the Family Resilience Framework. The study included 220 generation one (G1) parents, their target youth (generation two: G2) who participated from adolescence through adulthood, and the target’s child (generation three: G3). Assessments included observational and self-report measures. Results indicated that G1 economic hardship negatively influenced both G1 positivity and G1 positive parenting. Similarly, G2 economic hardship was negatively related to both G2 positivity and G2 positive parenting which, in turn, was associated with G3 positive behavior to G2. For both G1 and G2, parental positivity mediated the association between economic hardship and positive parenting. G2 economic hardship was indirectly related to G3 positive behavior through G2 parental positivity and positive parenting. An important finding is that the intergenerational continuity of economic hardship, positivity, and positive parenting were transmitted from G1 to G2. Results suggest that even in times of economic adversity, parental positivity and positive parenting were transmitted from G1 parents to their G2 youth during adulthood. Such continuity seems to influence the positive behavior of the G3 children. PMID:26371448

  9. Intergenerational continuity in economic hardship, parental positivity, and positive parenting: The association with child behavior.

    PubMed

    Jeon, Shinyoung; Neppl, Tricia K

    2016-02-01

    The current study examined intergenerational continuity in economic hardship, parental positivity, and positive parenting across generations based on both the family stress model (FSM) and the family resilience framework. The study included 220 generation 1 (G1) parents, their target youth (generation 2: G2) who participated from adolescence through adulthood, and the target's child (generation 3: G3). Assessments included observational and self-report measures. Results indicated that G1 economic hardship negatively influenced both G1 positivity and G1 positive parenting. Similarly, G2 economic hardship was negatively related to both G2 positivity and G2 positive parenting, which in turn was associated with G3 positive behavior to G2. For both G1 and G2, parental positivity mediated the association between economic hardship and positive parenting. G2 economic hardship was indirectly related to G3 positive behavior through G2 parental positivity and positive parenting. An important finding is that the intergenerational continuity of economic hardship, positivity, and positive parenting were transmitted from G1 to G2. Results suggest that even in times of economic adversity, parental positivity and positive parenting were transmitted from G1 parents to their G2 youth during adulthood. Such continuity seems to influence the positive behavior of the G3 children.

  10. Health Status and Leisure Behavior of Sexual Assault Victims: Educational Opportunities for Health and Leisure Professionals.

    ERIC Educational Resources Information Center

    Sheffield, Emilyn A.; And Others

    The health status and leisure behavior of victims of sexual assault were studied. Data concerning present illness symptoms, past illness symptoms, negative health behavior, family health history, and female reproductive physiology illness symptoms were obtained and analyzed. Sexual assault victims were similar to nonvictims demographically except…

  11. Eco-Health Linkages: evidence base and socio-economic considerations for linking ecosystem goods and services to human health

    EPA Science Inventory

    Ecosystem goods and services (EGS) are thought to play a role in protecting human health, but the empirical evidence directly linking EGS to human health outcomes is limited, and our ability to detect Eco-Health linkages is confounded by socio-economic factors. These limitations ...

  12. Education Reform and Rural Economic Health: Policy Implications.

    ERIC Educational Resources Information Center

    Hobbs, Daryl

    This paper examines and questions popular ideas about education and its relationship to the economic well-being of individuals, communities, regions, and the nation. It suggests that the criteria used to develop economic and educational strategies have produced mixed results at best, especially in rural areas. Since family income is related to…

  13. 10th World IHEA and ECHE Joint Congress: health economics in the age of longevity.

    PubMed

    Jakovljevic, Mihajlo B; Getzen, Thomas E; Torbica, Aleksandra; Anegawa, Tomofumi

    2014-12-01

    The 10th consecutive World Health Economics conference was organized jointly by International Health Economics Association and European Conference on Health Economics Association and took place at The Trinity College, Dublin, Ireland in July 2014. It has attracted broad participation from the global professional community devoted to health economics teaching,research and policy applications. It has provided a forum for lively discussion on hot contemporary issues such as health expenditure projections, reimbursement regulations,health technology assessment, universal insurance coverage, demand and supply of hospital services, prosperity diseases, population aging and many others. The high-profile debate fostered by this meeting is likely to inspire further methodological advances worldwide and spreading of evidence-based policy practice from OECD towards emerging markets.

  14. Overutilization and underutilization of operating rooms - insights from behavioral health care operations management.

    PubMed

    Fügener, Andreas; Schiffels, Sebastian; Kolisch, Rainer

    2017-03-01

    The planning of surgery durations is crucial for efficient usage of operating theaters. Both planning too long and too short durations for surgeries lead to undesirable consequences, e.g. idle time, overtime, or rescheduling of surgeries. We define these consequences as operating room inefficiency. The overall objective of planning surgery durations is to minimize expected operating room inefficiency, since surgery durations are stochastic. While most health care studies assume economically rational behavior of decision makers, experimental studies have shown that decision makers often do not act according to economic incentives. Based on insights from health care operations management, medical decision making, behavioral operations management, as well as empirical observations, we derive hypotheses that surgeons' behavior deviates from economically rational behavior. To investigate this, we undertake an experimental study where experienced surgeons are asked to plan surgeries with uncertain durations. We discover systematic deviations from optimal decision making and offer behavioral explanations for the observed biases. Our research provides new insights to tackle a major problem in hospitals, i.e. low operating room utilization going along with staff overtime.

  15. Wealth and Health Behavior: Testing the Concept of a Health Cost

    PubMed Central

    Galama, Titus J.

    2014-01-01

    Wealthier individuals engage in healthier behavior. This paper seeks to explain this phenomenon by exploiting both inheritances and lottery winnings to test a theory of health behavior. We distinguish between the direct monetary cost and the indirect health cost (value of health lost) of unhealthy consumption. The health cost increases with wealth and the degree of unhealthiness, leading wealthier individuals to consume more healthy and moderately unhealthy, but fewer severely unhealthy goods. The empirical evidence presented suggests that differences in health costs may indeed partially explain behavioral differences, and ultimately health outcomes, between wealth groups. PMID:25530621

  16. Does the perception that God controls health outcomes matter for health behaviors?

    PubMed

    Karvinen, Kristina H; Carr, Lucas J

    2014-04-01

    The purpose of this study was to examine the associations between God Locus of Health Control, health behaviors, and beliefs utilizing a cross-sectional online survey (N = 549). Results indicated that God Locus of Health Control was correlated with alcohol use, physical activity, perceived risk of chronic disease, and beliefs that poor health behaviors contribute to chronic disease (all p values < .05). Multiple regression analyses including covariates and other locus of control variables revealed that God Locus of Health Control was only an independent correlate of the belief that physical inactivity contributed to chronic disease. Insights from this study may be important for future faith-based health behavior change interventions.

  17. Health behavior change: can genomics improve behavioral adherence?

    PubMed

    McBride, Colleen M; Bryan, Angela D; Bray, Molly S; Swan, Gary E; Green, Eric D

    2012-03-01

    The National Human Genome Research Institute recommends pursuing "genomic information to improve behavior change interventions" as part of its strategic vision for genomics. The limited effectiveness of current behavior change strategies may be explained, in part, by their insensitivity to individual variation in adherence responses. The first step in evaluating whether genomics can inform customization of behavioral recommendations is evidence reviews to identify adherence macrophenotypes common across behaviors and individuals that have genetic underpinnings. Conceptual models of how biological, psychological, and environmental factors influence adherence also are needed. Researchers could routinely collect biospecimens and standardized adherence measurements of intervention participants to enable understanding of genetic and environmental influences on adherence, to guide intervention customization and prospective comparative effectiveness studies.

  18. Development of a Medicaid Behavioral Health Case-Mix Model

    ERIC Educational Resources Information Center

    Robst, John

    2009-01-01

    Many Medicaid programs have either fully or partially carved out mental health services. The evaluation of carve-out plans requires a case-mix model that accounts for differing health status across Medicaid managed care plans. This article develops a diagnosis-based case-mix adjustment system specific to Medicaid behavioral health care. Several…

  19. Behavioral Systems Analysis in Health and Human Services

    ERIC Educational Resources Information Center

    McGee, Heather M.; Diener, Lori H.

    2010-01-01

    This article provides a behavioral systems approach to improve operational performance in health and human service organizations. This article provides six performance truths that are relevant to any organization and a case study from a community mental health network of agencies. A comprehensive analysis, as described here, will help health and…

  20. Sexual and Reproductive Health Behaviors of California Community College Students

    ERIC Educational Resources Information Center

    Trieu, Sang Leng; Bratton, Sally; Marshak, Helen Hopp

    2011-01-01

    Objective: To explore the sexual and reproductive health behaviors of students from 13 community college campuses in California. Participants: Heterosexual college students, ages 18 to 24, who have had sexual intercourse (N = 4,487). Methods: The American College Health Association's National College Health Assessment (ACHA-NCHA) survey was…

  1. Sexual Health Attitudes, Knowledge, and Clinical Behaviors: Implications for Counseling

    ERIC Educational Resources Information Center

    Russell, Elizabeth B.

    2012-01-01

    This article explores the impact of practitioners' attitudes and knowledge of sexual health on clinical behaviors. Sexual health topics are often areas of concern for clients of any age in counseling. Thus, counselors must be trained and equipped to address sexual health across the life span. This study explored whether child and adolescent…

  2. Ethical Theories for Promoting Health through Behavioral Change.

    ERIC Educational Resources Information Center

    O'Connell, Janelle K.; Price, James H.

    1983-01-01

    Arguments based on the philosophies of natural law, utilitarianism, paternalism, and distributive justice are examined for their pertinence to health behavior change strategies. Health educators should prepare individuals to make health-generating decisions but may need to limit the conditions under which they intervene. (Author/PP)

  3. Mental Health Issues and Students with Emotional and Behavioral Disorders

    ERIC Educational Resources Information Center

    DeLoach, Kendra P.; Dvorsky, Melissa; Miller, Elaine; Paget, Michael

    2012-01-01

    Students with emotional and behavioral challenges are significantly impacted by mental health issues. Teachers and other school staff need mental health knowledge to work more effectively with these students. Collaboration with mental health professionals and sharing of information is essential. [For complete volume, see ED539318.

  4. Peer Mentoring for Health Behavior Change: A Systematic Review

    ERIC Educational Resources Information Center

    Petosa, R. L.; Smith, Laureen H.

    2014-01-01

    Background: Peer mentoring can be a powerful complement to health instruction. Mentoring has been used to change health behaviors and promote sustainable lifestyle patterns in adults and, more recently, among adolescents. Purpose: This article reviews the use of peer mentoring to promote health practices and describes how this approach can be used…

  5. Investigating the Association of Health Literacy with Health Knowledge and Health Behavior Outcomes in a Sample of Urban Community College Undergraduates

    ERIC Educational Resources Information Center

    Hansen, Hardaye Ramsaroop; Shneyderman, Yuliya; Belcastro, Philip A.

    2015-01-01

    Background: There is a paucity of evidence associating health literacy metrics with adults' enhanced health knowledge, health status, health practices, or health behaviors. Purpose: Investigate whether health-literate undergraduates exhibit enhanced health knowledge, health status, health practices, or behaviors compared to non-health-literate…

  6. The Determinants of Child Health in Pakistan: An Economic Analysis

    ERIC Educational Resources Information Center

    Shehzad, Shafqat

    2006-01-01

    This paper estimates linear structural models using LISREL and employs MIMIC models to find out factors determining child health in Pakistan. A distinction has been made in permanent and transitory health states that lend support to Grossman's (1972) stock and flow concepts of health. The paper addresses the issue of health unobservability and…

  7. Lifecycle effects of a recession on health behaviors: Boom, bust, and recovery in Iceland.

    PubMed

    Ásgeirsdóttir, Tinna Laufey; Corman, Hope; Noonan, Kelly; Reichman, Nancy E

    2016-03-01

    This study uses individual-level longitudinal data from Iceland, a country that experienced a severe economic crisis in 2008 and substantial recovery by 2012, to investigate the extent to which the effects of a recession on health behaviors are lingering or short-lived and to explore trajectories in health behaviors from pre-crisis boom, to crisis, to recovery. Health-compromising behaviors (smoking, heavy drinking, sugared soft drinks, sweets, fast food, and tanning) declined during the crisis, and all but sweets continued to decline during the recovery. Health-promoting behaviors (consumption of fruit, fish oil, and vitamins/minerals and getting recommended sleep) followed more idiosyncratic paths. Overall, most behaviors reverted back to their pre-crisis levels or trends during the recovery, and these short-term deviations in trajectories were probably too short-lived in this recession to have major impacts on health or mortality. A notable exception is for binge drinking, which declined by 10% during the 2 crisis years, continued to fall (at a slower rate of 8%) during the 3 recovery years, and did not revert back to the upward pre-crisis trend during our observation period. These lingering effects, which directionally run counter to the pre-crisis upward trend in consumption and do not reflect price increases during the recovery period, suggest that alcohol is a potential pathway by which recessions improve health and/or reduce mortality.

  8. Actions to alleviate the mental health impact of the economic crisis.

    PubMed

    Wahlbeck, Kristian; McDaid, David

    2012-10-01

    The current global economic crisis is expected to produce adverse mental health effects that may increase suicide and alcohol-related death rates in affected countries. In nations with greater social safety nets, the health impacts of the economic downturn may be less pronounced. Research indicates that the mental health impact of the economic crisis can be offset by various policy measures. This paper aims to outline how countries can safeguard and support mental health in times of economic downturn. It indicates that good mental health cannot be achieved by the health sector alone. The determinants of mental health often lie outside of the remits of the health system, and all sectors of society have to be involved in the promotion of mental health. Accessible and responsive primary care services support people at risk and can prevent mental health consequences. Any austerity measures imposed on mental health services need to be geared to support the modernization of mental health care provision. Social welfare supports and active labour market programmes aiming at helping people retain or re-gain jobs can counteract the mental health effects of the economic crisis. Family support programmes can also make a difference. Alcohol pricing and restrictions of alcohol availability reduce alcohol harms and save lives. Support to tackle unmanageable debt will also help to reduce the mental health impact of the crisis. While the current economic crisis may have a major impact on mental health and increase mortality due to suicides and alcohol-related disorders, it is also a window of opportunity to reform mental health care and promote a mentally healthy lifestyle.

  9. Actions to alleviate the mental health impact of the economic crisis

    PubMed Central

    WAHLBECK, KRISTIAN; MCDAID, DAVID

    2012-01-01

    The current global economic crisis is expected to produce adverse mental health effects that may increase suicide and alcohol-related death rates in affected countries. In nations with greater social safety nets, the health impacts of the economic downturn may be less pronounced. Research indicates that the mental health impact of the economic crisis can be offset by various policy measures. This paper aims to outline how countries can safeguard and support mental health in times of economic downturn. It indicates that good mental health cannot be achieved by the health sector alone. The determinants of mental health often lie outside of the remits of the health system, and all sectors of society have to be involved in the promotion of mental health. Accessible and responsive primary care services support people at risk and can prevent mental health consequences. Any austerity measures imposed on mental health services need to be geared to support the modernization of mental health care provision. Social welfare supports and active labour market programmes aiming at helping people retain or re-gain jobs can counteract the mental health effects of the economic crisis. Family support programmes can also make a difference. Alcohol pricing and restrictions of alcohol availability reduce alcohol harms and save lives. Support to tackle unmanageable debt will also help to reduce the mental health impact of the crisis. While the current economic crisis may have a major impact on mental health and increase mortality due to suicides and alcohol-related disorders, it is also a window of opportunity to reform mental health care and promote a mentally healthy lifestyle. PMID:23024664

  10. Covariations of Adolescent Weight-Control, Health-Risk and Health-Promoting Behaviors.

    ERIC Educational Resources Information Center

    Rafiroiu, Anca Codruta; Sargent, Roger G.; Parra-Medina, Deborah; Drane, Wanzer J.; Valois, Robert F.

    2003-01-01

    Assessed the prevalence of dieting, investigating clusters of risk behaviors among adolescents. Data from the 1999 South Carolina Youth Risk Behavior Survey indicated that weight control behaviors related to several other important health behaviors. Differences existed between adolescents who used extreme weight loss measures and moderate dieters…

  11. ERISA preemption and its impact on behavioral health services.

    PubMed

    Simmons, P

    1997-06-01

    Recently, mental health parity provisions were passed and incorporated retroactively into the Health Insurance Portability and Accountability Act (PL 104-191). Although limited, these provisions were instrumental in focusing national attention and debate on people's need for and right to behavioral health services. A handful of states have also passed parity provisions, but their full impact on the insurance market cannot be assessed. This is because a majority of plans are preempted from compliance with many state insurance mandates by the Employee Retirement Income Security Act of 1974 (ERISA). ERISA is the primary obstacle to state behavioral health mandates, and it threatens the inclusion of behavioral health providers and settings in managed care plans integrating public and private healthcare systems. This article provides basic information on ERISA, its preemption clauses, and its impact on behavioral healthcare services.

  12. Using insights from behavioral economics and social psychology to help patients manage chronic diseases.

    PubMed

    Mogler, Braden K; Shu, Suzanne B; Fox, Craig R; Goldstein, Noah J; Victor, Ronald G; Escarce, José J; Shapiro, Martin F

    2013-05-01

    Despite a revolution in therapeutics, the ability to control chronic diseases remains elusive. We present here a conceptual model of the potential role of behavioral tools in chronic disease control. Clinicians implicitly accept the assumption that patients will act rationally to maximize their self-interest. However, patients may not always be the rational actors that we imagine. Major behavioral barriers to optimal health behavior include patients' fear of threats to health, unwillingness to think about problems when risks are known or data are ambiguous, the discounting of risks that are far in the future, failure to act due to lack of motivation, insufficient confidence in the ability to overcome a health problem, and inattention due to pressures of everyday life. Financial incentives can stimulate initiation of health-promoting behaviors by reducing or eliminating financial barriers, but may not produce long-term behavior change without additional interventions. Strategies have been developed by behavioral economists and social psychologists to address each of these barriers to better decision-making. These include: labeling positive behaviors in ways consistent with patient life goals and priorities; greater focus on more immediate risks of chronic diseases; intermediate subgoals as steps to a large health goal; and implementation of specific plans as to when, where, and how an action will be taken. Such strategies hold promise for improving health behaviors and disease control, but most have not been studied in medical settings. The effectiveness of these approaches should be evaluated for their potential as tools for the clinician.

  13. Health Risk Behavior and Sexual Assault Among Ethnically Diverse Women

    PubMed Central

    Littleton, Heather L.; Grills-Taquechel, Amie E.; Buck, Katherine S.; Rosman, Lindsey; Dodd, Julia C.

    2013-01-01

    Sexual assault is associated with a number of health risk behaviors in women. It has been hypothesized that these risk behaviors, such as hazardous drinking, may represent women's attempts to cope with psychological distress, such as symptoms of depression and anxiety. However, extant research has failed to evaluate these relationships among ethnic minority samples or identify the mechanisms responsible for this association. The current study examined sexual assault history and two health risk behaviors (hazardous drinking and engaging in sexual behavior to regulate negative affect) in a diverse sample of 1,620 college women. Depression and anxiety were examined as mediators of the relationship between sexual assault and health risk behaviors. There was evidence of moderated mediation, such that for European American women, but not for ethnic minority women, both forms of psychological distress were significant mediators of the sexual assault/hazardous drinking relationship. In contrast, among all ethnic groups, the relationship between sexual assault and both forms of psychological distress was mediated by the use of sexual behavior as an affect regulation strategy. Results support a need to evaluate the assault experiences of ethnically diverse women, as well as the impact of the assault on their postassault experiences including health risk behaviors and psychological adjustment. Additionally, results suggest that practitioners should carefully assess health risk behaviors among victims of sexual assault and be aware that there may be differences in the risk factors and motives for these behaviors among women of various ethnic backgrounds. PMID:24223467

  14. Complexity and reflexivity: two important issues for economic evaluation in health care.

    PubMed

    Lessard, Chantale

    2007-04-01

    Economic evaluations are analytic techniques to assess the relative costs and consequences of health care programmes and technologies. Their role is to provide rigorous data to inform the health care decision-making process. Economic evaluation may oversimplify complex health care decisions. These analyses often ignore important health consequences, contextual elements, relationships or other relevant modifying factors, which might not be appropriate in a multi-objective, multi-stakeholder issue. One solution would be to develop a new paradigm based on the issues of perspective and context. Complexity theory may provide a useful conceptual framework for economic evaluation in health care. Complexity thinking develops an awareness of issues including uncertainty, contextual issues, multiple perspectives, broader societal involvement, and transdisciplinarity. This points the economic evaluation field towards an accountability and epistemology based on pluralism and uncertainty, requiring new forms of lay-expert engagement and roles of lay knowledge into decision-making processes. This highlights the issue of reflexivity in economic evaluation in health care. A reflexive approach would allow economic evaluators to analyze how objective structures and subjective elements influence their practices. In return, this would point increase the integrity and reliability of economic evaluations. Reflexivity provides opportunities for critically thinking about the organization and activities of the intellectual field, and perhaps the potential of moving in new, creative directions. This paper argues for economic evaluators to have a less positivist attitude towards what is useful knowledge, and to use more imagination about the data and methodologies they use.

  15. Health spending slowdown is mostly due to economic factors, not structural change in the health care sector.

    PubMed

    Dranove, David; Garthwaite, Craig; Ody, Christopher

    2014-08-01

    The source of the recent slowdown in health spending growth remains unclear. We used new and unique data on privately insured people to estimate the effect of the economic slowdown that began in December 2007 on the rate of growth in health spending. By exploiting regional variations in the severity of the slowdown, we determined that the economic slowdown explained approximately 70 percent of the slowdown in health spending growth for the people in our sample. This suggests that the recent decline is not primarily the result of structural changes in the health sector or of components of the Affordable Care Act, and that-absent other changes in the health care system-an economic recovery will result in increased health spending.

  16. The economic crisis and its impact on health and health care in Latin America and the Caribbean.

    PubMed

    Musgrove, P

    1987-01-01

    The economic crisis that struck most Latin American and Caribbean countries beginning in 1982 has caused sharp reductions in domestic investment and in imports; domestic consumption has been less affected, while public sector spending has responded in different degrees in different countries. In general, public spending on health decreased, sometimes quite dramatically, but some countries were able to maintain the real value of noninvestment spending for health by central governments. It is much harder to tell what may have happened to output of health services, and still harder to know how health status has been affected. Scattered evidence suggests two conclusions. First, worsened economic conditions can seriously damage health status, with effects on infant mortality and on the patterns of disease and death, especially for children. Second, these repercussions do not have to occur, and public programs designed specifically to maintain basic health services and to assure adequate nutrition are effective in offsetting the worst consequences of economic hardship.

  17. Postdeployment behavioral health screening: face-to-face versus virtual behavioral health interviews.

    PubMed

    Sipos, Maurice L; Foran, Heather M; Crane, Maria L; Wood, Michael D; Wright, Kathleen M

    2012-05-01

    Virtual behavioral health (VBH) services are used frequently to address the high demand for behavioral health (BH) services in the military. Few studies have investigated the relationship between the use of VBH services and BH outcomes or preferences for the use of VBH technologies. In this article, we evaluated BH interviews conducted via video teleconferencing (VTC) or face-to-face in terms of BH symptoms, satisfaction rates, stigma, barriers to care, and preferences for future use of BH care. Soldiers (n = 307) from the headquarters element of an operational unit were surveyed 4 months following a 12-month deployment to Iraq. There were no significant differences in satisfaction rates based on interview modality, but significantly more soldiers preferred face-to-face interviews over VTC interviews in the future. Soldiers who preferred face-to-face interviews also reported higher levels of anxiety and depression symptoms than those who preferred VTC interviews. No significant age differences were found in terms of interview modality satisfaction or preference. Soldiers with greater deployment experience were more likely to report that they would not like using VTC if seeking BH care in the future than soldiers with less deployment experience. These findings highlight the importance of promoting choice in type of BH interview modality.

  18. The Behavioral Economics of Substance Use Disorders: reinforcement pathologies and their repair

    PubMed Central

    Bickel, Warren K.; Johnson, Matthew W.; Koffarnus, Mikhail N.; MacKillop, James; Murphy, James G.

    2015-01-01

    The field of behavioral economics has made important inroads into the understanding of substance use disorders through the concept of reinforcer pathology. Reinforcer pathology refers to the joint effects of (a) the persistently high valuation of a reinforcer, broadly defined to include tangible commodities and experiences, and/or (b) the excessive preference for the immediate acquisition or consumption of a commodity despite long-term negative outcomes. From this perspective, reinforcer pathology results from the recursive interactions of endogenous person-level variables and exogenous environment-level factors. The current review describes the basic principles of behavioral economics that are central to reinforcer pathology, the processes that engender reinforcer pathology, and the approaches and procedures that can repair reinforcement pathologies. The overall goal of this review is to present a new understanding of substance use disorders as viewed by recent advances in behavioral economics. PMID:24679180

  19. The behavioral economics of substance use disorders: reinforcement pathologies and their repair.

    PubMed

    Bickel, Warren K; Johnson, Matthew W; Koffarnus, Mikhail N; MacKillop, James; Murphy, James G

    2014-01-01

    The field of behavioral economics has made important inroads into the understanding of substance use disorders through the concept of reinforcer pathology. Reinforcer pathology refers to the joint effects of (a) the persistently high valuation of a reinforcer, broadly defined to include tangible commodities and experiences, and/or (b) the excessive preference for the immediate acquisition or consumption of a commodity despite long-term negative outcomes. From this perspective, reinforcer pathology results from the recursive interactions of endogenous person-level variables and exogenous environment-level factors. The current review describes the basic principles of behavioral economics that are central to reinforcer pathology, the processes that engender reinforcer pathology, and the approaches and procedures that can repair reinforcement pathologies. The overall goal of this review is to present a new understanding of substance use disorders as viewed by recent advances in behavioral economics.

  20. Economic stability and health status: evidence from East Asia before and after the 1990s economic crisis.

    PubMed

    Hopkins, Sandra

    2006-02-01

    The East Asian economies of Indonesia, Malaysia and Thailand suffered declines in their economic growth rates in 1997. The Indonesian and Thai government followed the World Bank prescription for adjustment, which included a cut-back in government spending at a time when there were significant job losses. Malaysia chose its own path to adjustment. Evidence presented in this paper shows that although the declines were short-lived that there was an impact on the health status measured by mortality rates for the populations of Indonesia and Thailand. There was little apparent impact on the health status of Malaysians. The lessons for other developing economies include the importance of social safety nets and the maintenance of government expenditure in minimising the impact of economic shocks on health.

  1. Smokers With Behavioral Health Comorbidity Should Be Designated a Tobacco Use Disparity Group

    PubMed Central

    Steinberg, Marc L.; Griffiths, Kim Gesell; Cooperman, Nina

    2013-01-01

    Smokers with co-occurring mental illness or substance use disorders are not designated a disparity group or priority population by most national public health and tobacco control groups. These smokers fulfill the criteria commonly used to identify groups that merit special attention: targeted marketing by the tobacco industry, high smoking prevalence rates, heavy economic and health burdens from tobacco, limited access to treatment, and longer durations of smoking with less cessation. A national effort to increase surveillance, research, and treatment is needed. Designating smokers with behavioral health comorbidity a priority group will bring much-needed attention and resources. The disparity in smoking rates among persons with behavioral health issues relative to the general population will worsen over time if their needs remain unaddressed. PMID:23865661

  2. The role of testosterone and estrogen in consumer behavior and social & economic decision making: A review.

    PubMed

    Stanton, Steven J

    2016-11-11

    This manuscript reviews the current literature on the actions of the steroid hormones testosterone and estradiol in shaping humans' behavior within two applied contexts, specifically consumer behavior and decision making (both social and economic). The theoretical argument put forth is that steroids shape these everyday behaviors and choices in service to being more competitive in achieving long-term goals related to resource acquisition, mating success, and social dominance. In addition, a discussion of the increased research focus on the role of steroids in other applied business domains will highlight the relevant applications of basic science discoveries in behavioral endocrinology.

  3. Physician Satisfaction With Integrated Behavioral Health in Pediatric Primary Care.

    PubMed

    Hine, Jeffrey F; Grennan, Allison Q; Menousek, Kathryn M; Robertson, Gail; Valleley, Rachel J; Evans, Joseph H

    2017-04-01

    As the benefits of integrated behavioral health care services are becoming more widely recognized, this study investigated physician satisfaction with ongoing integrated psychology services in pediatric primary care clinics. Data were collected across 5 urban and 6 rural clinics and demonstrated the specific factors that physicians view as assets to having efficient access to a pediatric behavioral health practitioner. Results indicated significant satisfaction related to quality and continuity of care and improved access to services. Such models of care may increase access to care and reduce other service barriers encountered by individuals and their families with behavioral health concerns (ie, those who otherwise would seek services through referrals to traditional tertiary care facilities).

  4. Stateline: Link Investment in Education to Economic Health

    ERIC Educational Resources Information Center

    Christie, Kathy

    2008-01-01

    In contrast to much of this year's frightening economic news, many states are investing in initiatives to strengthen local economies. This article describes how several states are improving education and training so they match business needs and the labor pool.

  5. Mental health, places and people: a multilevel analysis of economic inactivity and social deprivation.

    PubMed

    Fone, David L; Dunstan, Frank

    2006-09-01

    Using data on 24,975 respondents to the Welsh Health Survey 1998 aged 17-74 years, we investigated associations between individual mental health status measured using the SF-36 instrument, social class, economic inactivity and the electoral division Townsend deprivation score. In a multilevel modelling analysis, we found mental health was significantly associated with the Townsend score after adjusting for composition, and this effect was strongest in respondents who were economically inactive. Further contextual effects were shown by significant random variability in the slopes of the relation between mental health and economic inactivity at the electoral division level. Our results suggest that the places in which people live affect their mental health, supporting NHS policy that multi-agency planning to reduce inequalities in mental health status should address the wider determinants of health, as well as services for individual patients.

  6. [Justice in health care systems from an economic perspective].

    PubMed

    Schreyögg, J

    2004-01-01

    Due to rising health care expenditures international comparisons of health care systems are recently gaining more importance. These benchmarks can provide interesting information for improving health care systems. Many of these comparisons implicitly assume that countries have a universal understanding of justice. But this assumption is rather questionable. With regard to the existing cultural differences in the understanding of justice the transferability of elements of health care systems is not always assured. A transfer usually requires a thorough examination of the judicial systems in each country. This article analyses the influence of different judicial systems applying to health care. In this context theories of justice by Rawls, Nozick and Confucius representing the possible understanding of justice in different cultures are described and analysed with regards to their influence on health care systems. The example of financing health care shows that the three theories of justice have very different consequences for designing health care systems especially concerning the role of governments.

  7. INTEGRATING TECHNOLOGICAL ADVANCEMENTS IN BEHAVIORAL INTERVENTIONS TO PROMOTE HEALTH: UNPRECEDENTED OPORTUNITIES FOR BEHAVIOR ANALYSTS.

    PubMed

    Kurti, Allison N; Dallery, Jesse

    2014-09-01

    The use of mobile devices is growing worldwide in both industrialized and developing nations. Alongside the worldwide penetration of web-enabled devices, the leading causes of morbidity and mortality are increasingly modifiable lifestyle factors (e.g., improving one's diet and exercising more). Behavior analysts have the opportunity to promote health by combining effective behavioral methods with technological advancements. The objectives of this paper are (1) to highlight the public health gains that may be achieved by integrating technology with a behavior analytic approach to developing interventions, and (2) to review some of the currently, under-examined issues related to merging technology and behavior analysis (enhancing sustainability, obtaining frequent measures of behavior, conducting component analyses, evaluating cost-effectiveness, incorporating behavior analysis in the creation of consumer-based applications, and reducing health disparities). Thorough consideration of these issues may inspire the development, implementation, and dissemination of innovative, efficacious interventions that substantially improve global public health.

  8. INTEGRATING TECHNOLOGICAL ADVANCEMENTS IN BEHAVIORAL INTERVENTIONS TO PROMOTE HEALTH: UNPRECEDENTED OPORTUNITIES FOR BEHAVIOR ANALYSTS

    PubMed Central

    KURTI, ALLISON N.; DALLERY, JESSE

    2015-01-01

    The use of mobile devices is growing worldwide in both industrialized and developing nations. Alongside the worldwide penetration of web-enabled devices, the leading causes of morbidity and mortality are increasingly modifiable lifestyle factors (e.g., improving one’s diet and exercising more). Behavior analysts have the opportunity to promote health by combining effective behavioral methods with technological advancements. The objectives of this paper are (1) to highlight the public health gains that may be achieved by integrating technology with a behavior analytic approach to developing interventions, and (2) to review some of the currently, under-examined issues related to merging technology and behavior analysis (enhancing sustainability, obtaining frequent measures of behavior, conducting component analyses, evaluating cost-effectiveness, incorporating behavior analysis in the creation of consumer-based applications, and reducing health disparities). Thorough consideration of these issues may inspire the development, implementation, and dissemination of innovative, efficacious interventions that substantially improve global public health. PMID:25774070

  9. [Indicators to monitor the evolution of the economic crisis and its effects on health and health inequalities. SESPAS report 2014].

    PubMed

    Pérez, Glòria; Rodríguez-Sanz, Maica; Domínguez-Berjón, Felicitas; Cabeza, Elena; Borrell, Carme

    2014-06-01

    The economic crisis has adverse effects on determinants of health and health inequalities. The aim of this article was to present a set of indicators of health and its determinants to monitor the effects of the crisis in Spain. On the basis of the conceptual framework proposed by the Commission for the Reduction of Social Health Inequalities in Spain, we searched for indicators of social, economic, and political (structural and intermediate) determinants of health, as well as for health indicators, bearing in mind the axes of social inequality (gender, age, socioeconomic status, and country of origin). The indicators were mainly obtained from official data sources published on the internet. The selected indicators are periodically updated and are comparable over time and among territories (among autonomous communities and in some cases among European Union countries), and are available for age groups, gender, socio-economic status, and country of origin. However, many of these indicators are not sufficiently reactive to rapid change, which occurs in the economic crisis, and consequently require monitoring over time. Another limitation is the lack of availability of indicators for the various axes of social inequality. In conclusion, the proposed indicators allow for progress in monitoring the effects of the economic crisis on health and health inequalities in Spain.

  10. More Health Expenditure, Better Economic Performance? Empirical Evidence From OECD Countries.

    PubMed

    Wang, Fuhmei

    2015-01-01

    Recent economic downturns have led many countries to reduce health spending dramatically, with the World Health Organization raising concerns over the effects of this, in particular among the poor and vulnerable. With the provision of appropriate health care, the population of a country could have better health, thus strengthening the nation's human capital, which could contribute to economic growth through improved productivity. How much should countries spend on health care? This study aims to estimate the optimal health care expenditure in a growing economy. Applying the experiences of countries from the Organization for Economic Co-Operation and Development (OECD) over the period 1990 to 2009, this research introduces the method of system generalized method of moments (GMM) to derive the design of the estimators of the focal variables. Empirical evidence indicates that when the ratio of health spending to gross domestic product (GDP) is less than the optimal level of 7.55%, increases in health spending effectively lead to better economic performance. Above this, more spending does not equate to better care. The real level of health spending in OECD countries is 5.48% of GDP, with a 1.87% economic growth rate. The question which is posed by this study is a pertinent one, especially in the current context of financially constrained health systems around the world. The analytical results of this work will allow policymakers to better allocate scarce resources to achieve their macroeconomic goals.

  11. Behavioral economics perspectives on public sector pension plans.

    PubMed

    Beshears, John; Choi, James J; Laibson, David; Madrian, Brigitte C

    2011-04-01

    We describe the pension plan features of the states and the largest cities and counties in the U.S. Unlike in the private sector, defined benefit (DB) pensions are still the norm in the public sector. However, a few jurisdictions have shifted toward defined contribution (DC) plans as their primary savings plan, and fiscal pressures are likely to generate more movement in this direction. Holding fixed a public employee's work and salary history, we show that DB retirement income replacement ratios vary greatly across jurisdictions. This creates large variation in workers' need to save for retirement in other accounts. There is also substantial heterogeneity across jurisdictions in the savings generated in primary DC plans because of differences in the level of mandatory employer and employee contributions. One notable difference between public and private sector DC plans is that public sector primary DC plans are characterized by required employee or employer contributions (or both), whereas private sector plans largely feature voluntary employee contributions that are supplemented by an employer match. We conclude by applying lessons from savings behavior in private sector savings plans to the design of public sector plans.

  12. Behavioral economics perspectives on public sector pension plans

    PubMed Central

    BESHEARS, JOHN; CHOI, JAMES J.; LAIBSON, DAVID; MADRIAN, BRIGITTE C.

    2011-01-01

    We describe the pension plan features of the states and the largest cities and counties in the U.S. Unlike in the private sector, defined benefit (DB) pensions are still the norm in the public sector. However, a few jurisdictions have shifted toward defined contribution (DC) plans as their primary savings plan, and fiscal pressures are likely to generate more movement in this direction. Holding fixed a public employee’s work and salary history, we show that DB retirement income replacement ratios vary greatly across jurisdictions. This creates large variation in workers’ need to save for retirement in other accounts. There is also substantial heterogeneity across jurisdictions in the savings generated in primary DC plans because of differences in the level of mandatory employer and employee contributions. One notable difference between public and private sector DC plans is that public sector primary DC plans are characterized by required employee or employer contributions (or both), whereas private sector plans largely feature voluntary employee contributions that are supplemented by an employer match. We conclude by applying lessons from savings behavior in private sector savings plans to the design of public sector plans. PMID:21789032

  13. Work or place? Assessing the concurrent effects of workplace exploitation and area-of-residence economic inequality on individual health.

    PubMed

    Muntaner, Carles; Li, Yong; Ng, Edwin; Benach, Joan; Chung, Haejoo

    2011-01-01

    Building on previous multilevel studies in social epidemiology, this cross-sectional study examines, simultaneously, the contextual effects of workplace exploitation and area-of-residence economic inequality on social inequalities in health among low-income nursing assistants. A total of 868 nursing assistants recruited from 55 nursing homes in Kentucky, Ohio, and West Virginia were surveyed between 1999 and 2001. Using a cross-classified multilevel design, the authors tested the effects of area-of-residence (income inequality and racial segregation), workplace (type of nursing home ownership and managerial pressure), and individual-level (age, gender, race/ethnicity, health insurance, length of employment, social support, type of nursing unit, preexisting psychopathology, physical health, education, and income) variables on health (self-reported health and activity limitations) and behavioral outcomes (alcohol use and caffeine consumption). Findings reveal that overall health was associated with both workplace exploitation and area-of-residence income inequality; area of residence was associated with activity limitations and binge drinking; and workplace exploitation was associated with caffeine consumption. This study explicitly accounts for the multiple contextual structure and effects of economic inequality on health. More work is necessary to replicate the current findings and establish robust conclusions on workplace and area of residence that might help inform interventions.

  14. The Bangladesh paradox: exceptional health achievement despite economic poverty.

    PubMed

    Chowdhury, A Mushtaque R; Bhuiya, Abbas; Chowdhury, Mahbub Elahi; Rasheed, Sabrina; Hussain, Zakir; Chen, Lincoln C

    2013-11-23

    Bangladesh, the eighth most populous country in the world with about 153 million people, has recently been applauded as an exceptional health performer. In the first paper in this Series, we present evidence to show that Bangladesh has achieved substantial health advances, but the country's success cannot be captured simplistically because health in Bangladesh has the paradox of steep and sustained reductions in birth rate and mortality alongside continued burdens of morbidity. Exceptional performance might be attributed to a pluralistic health system that has many stakeholders pursuing women-centred, gender-equity-oriented, highly focused health programmes in family planning, immunisation, oral rehydration therapy, maternal and child health, tuberculosis, vitamin A supplementation, and other activities, through the work of widely deployed community health workers reaching all households. Government and non-governmental organisations have pioneered many innovations that have been scaled up nationally. However, these remarkable achievements in equity and coverage are counterbalanced by the persistence of child and maternal malnutrition and the low use of maternity-related services. The Bangladesh paradox shows the net outcome of successful direct health action in both positive and negative social determinants of health--ie, positives such as women's empowerment, widespread education, and mitigation of the effect of natural disasters; and negatives such as low gross domestic product, pervasive poverty, and the persistence of income inequality. Bangladesh offers lessons such as how gender equity can improve health outcomes, how health innovations can be scaled up, and how direct health interventions can partly overcome socioeconomic constraints.

  15. Reflections on the development of health economics in low- and middle-income countries

    PubMed Central

    Mills, Anne

    2014-01-01

    Health economics is a relatively new discipline, though its antecedents can be traced back to William Petty FRS (1623–1687). In high-income countries, the academic discipline and scientific literature have grown rapidly since the 1960s. In low- and middle-income countries, the growth of health economics has been strongly influenced by trends in health policy, especially among the international and bilateral agencies involved in supporting health sector development. Valuable and influential research has been done in areas such as cost–benefit and cost-effectiveness analysis, financing of healthcare, healthcare provision, and health systems analysis, but there has been insufficient questioning of the relevance of theories and policy recommendations in the rich world literature to the circumstances of poorer countries. Characteristics such as a country's economic structure, strength of political and social institutions, management capacity, and dependence on external agencies, mean that theories and models cannot necessarily be transferred between settings. Recent innovations in the health economics literature on low- and middle-income countries indicate how health economics can be shaped to provide more relevant advice for policy. For this to be taken further, it is critical that such countries develop stronger capacity for health economics within their universities and research institutes, with greater local commitment of funding. PMID:25009059

  16. Reflections on the development of health economics in low- and middle-income countries.

    PubMed

    Mills, Anne

    2014-08-22

    Health economics is a relatively new discipline, though its antecedents can be traced back to William Petty FRS (1623-1687). In high-income countries, the academic discipline and scientific literature have grown rapidly since the 1960s. In low- and middle-income countries, the growth of health economics has been strongly influenced by trends in health policy, especially among the international and bilateral agencies involved in supporting health sector development. Valuable and influential research has been done in areas such as cost-benefit and cost-effectiveness analysis, financing of healthcare, healthcare provision, and health systems analysis, but there has been insufficient questioning of the relevance of theories and policy recommendations in the rich world literature to the circumstances of poorer countries. Characteristics such as a country's economic structure, strength of political and social institutions, management capacity, and dependence on external agencies, mean that theories and models cannot necessarily be transferred between settings. Recent innovations in the health economics literature on low- and middle-income countries indicate how health economics can be shaped to provide more relevant advice for policy. For this to be taken further, it is critical that such countries develop stronger capacity for health economics within their universities and research institutes, with greater local commitment of funding.

  17. Leveraging Social Networks to Support Reproductive Health and Economic Wellbeing among Guatemalan Maya Women

    ERIC Educational Resources Information Center

    Prescott, Alexandra S.; Luippold-Roge, Genevieve P.; Gurman, Tilly A.

    2016-01-01

    Objective: Maya women in Guatemala are disproportionately affected by poverty and negative reproductive health outcomes. Although social networks are valued in many Indigenous cultures, few studies have explored whether health education programmes can leverage these networks to improve reproductive health and economic wellbeing. Design: This…

  18. 75 FR 23214 - HIPAA Privacy Rule Accounting of Disclosures Under the Health Information Technology for Economic...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-03

    ... Accounting of Disclosures Under the Health Information Technology for Economic and Clinical Health Act... Accountability Act of 1996 (HIPAA) Privacy Rule to receive an accounting of disclosures of protected health... entities and business associates of accounting for such disclosures, and other information that may...

  19. Substance Abuse and Mental Health Services Administration (SAMHSA) Behavioral Health Disaster Response App.

    PubMed

    Seligman, Jamie; Felder, Stephanie S; Robinson, Maryann E

    2015-10-01

    The Substance Abuse and Mental Health Services Administration (SAMHSA) in the Department of Health and Human Services offers extensive disaster behavior health resources to assist disaster survivors in preparing for, responding to, and recovering from natural and manmade disasters. One of SAMHSA's most innovative resources is the SAMHSA Behavioral Health Disaster Response App (SAMHSA Disaster App). The SAMHSA Disaster App prepares behavioral health responders for any type of traumatic event by allowing them to access disaster-related materials and other key resources right on their phone, at the touch of a button. The SAMHSA Disaster App is available on iPhone, Android, and BlackBerry devices.

  20. Maternal health-seeking behavior: the role of financing and organization of health services in Ghana.

    PubMed

    Aboagye, Emmanuel; Agyemang, Otuo Serebour

    2013-05-30

    This paper examines how organization and financing of maternal health services influence health-seeking behavior in Bosomtwe district, Ghana. It contributes in furthering the discussions on maternal health-seeking behavior and health outcomes from a health system perspective in sub-Saharan Africa. From a health system standpoint, the paper first presents the resources, organization and financing of maternal health service in Ghana, and later uses case study examples to explain how Ghana's health system has shaped maternal health-seeking behavior of women in the district. The paper employs a qualitative case study technique to build a complex and holistic picture, and report detailed views of the women in their natural setting. A purposeful sampling technique is applied to select 16 women in the district for this study. Through face-to-face interviews and group discussions with the selected women, comprehensive and in-depth information on health- seeking behavior and health outcomes are elicited for the analysis. The study highlights that characteristics embedded in decentralization and provision of free maternal health care influence health-seeking behavior. Particularly, the use of antenatal care has increased after the delivery exemption policy in Ghana. Interestingly, the study also reveals certain social structures, which influence women's attitude towards their decisions and choices of health facilities.

  1. College Selectivity and Young Adult Health Behaviors

    ERIC Educational Resources Information Center

    Fletcher, Jason M.; Frisvold, David E.

    2011-01-01

    Large literatures have shown important links between the quantity of completed education and health outcomes on one hand and the quality or selectivity of schooling on a host of adult outcomes, such as wages, on the other hand. However, little research attempts to produce evidence of the link between school quality and health. The paper presents…

  2. Activity-Based Micro-pricing: Realizing Sustainable Behavior Changes through Economic Incentives

    NASA Astrophysics Data System (ADS)

    Yamabe, Tetsuo; Lehdonvirta, Vili; Ito, Hitoshi; Soma, Hayuru; Kimura, Hiroaki; Nakajima, Tatsuo

    In this paper, we further develop the idea of combining pervasive computing techniques with electronic payment systems to create activity-based micro-incentives. Economic incentives are an effective way to influence consumer behavior, and are used in e.g. marketing and resource coordination. Our approach allows marketers and regulators to induce consumers to perform particular actions in new application domains by attaching micro-prices to a wider range of behaviors. A key challenge is designing incentive mechanisms that result in desired behavior changes. We examine two basic incentive models. Based on the results of preliminary experiments, we discuss how economic incentives can affect consumer attitudes and lead to sustainable behavior changes.

  3. Shaping end-of-life care: behavioral economics and advance directives.

    PubMed

    Halpern, Scott D

    2012-08-01

    A central but unmet challenge in health care delivery is to increase the probability that the care patients receive near the end of their life is consistent with their goals, values, and preferences. Providing patient-centered care at the end of life is challenging. In their final days, nearly a third of older Americans need critical decisions made regarding the use or nonuse of life-sustaining interventions, but the patients themselves cannot participate in those decisions. Although this observation highlights the promise of advance directives (ADs), to date ADs have not delivered on this promise. This article provides a new framework, based in behavioral economic theory, that may explain the current failures of ADs and point to potential solutions. Specifically, it discusses how five well-described cognitive biases that pervade human decision making (affective forecasting errors, optimism bias, present-biased preferences, focusing effects, and default options) may account for deficiencies in the uptake, efficacy, and patient-centeredness of ADs. The text suggests potential solutions in need of evaluation, discusses metrics for assessing these interventions' benefits, and considers alternatives to the approaches advocated.

  4. The Effect of Rural Hospital Closures on Community Economic Health

    PubMed Central

    Holmes, George M; Slifkin, Rebecca T; Randolph, Randy K; Poley, Stephanie

    2006-01-01

    Objective To examine the effect of rural hospital closures on the local economy. Data Sources U.S. Census Bureau, OSCAR, Medicare Cost Reports, and surveys of individuals knowledgeable about local hospital closures. Study Design Economic data at the county level for 1990–2000 were combined with information on hospital closures. The study sample was restricted to rural counties experiencing a closure during the sample period. Longitudinal regression methods were used to estimate the effect of hospital closure on per-capita income, unemployment rate, and other community economic measures. Models included both leading and lagged closure terms allowing a preclosure economic downturn as well as time for the closure to be fully realized by the community. Data Collection Information on closures was collected by contacting every state hospital association, reconciling information gathered with that contained in the American Hospital Association file and OIG reports. Principal Findings Results indicate that the closure of the sole hospital in the community reduces per-capita income by $703 (p<0.05) or 4 percent (p<0.05) and increases the unemployment rate by 1.6 percentage points (p<0.01). Closures in communities with alternative sources of hospital care had no long-term economic impact, although income decreased for 2 years following the closure. Conclusions The local economic effects of a hospital closure should be considered when regulations that affect hospitals' financial well-being are designed or changed. PMID:16584460

  5. Economic analysis of the health impacts of housing improvement studies: a systematic review

    PubMed Central

    Fenwick, Elisabeth; Macdonald, Catriona; Thomson, Hilary

    2013-01-01

    Background Economic evaluation of public policies has been advocated but rarely performed. Studies from a systematic review of the health impacts of housing improvement included data on costs and some economic analysis. Examination of these data provides an opportunity to explore the difficulties and the potential for economic evaluation of housing. Methods Data were extracted from all studies included in the systematic review of housing improvement which had reported costs and economic analysis (n=29/45). The reported data were assessed for their suitability to economic evaluation. Where an economic analysis was reported the analysis was described according to pre-set definitions of various types of economic analysis used in the field of health economics. Results 25 studies reported cost data on the intervention and/or benefits to the recipients. Of these, 11 studies reported data which was considered amenable to economic evaluation. A further four studies reported conducting an economic evaluation. Three of these studies presented a hybrid ‘balance sheet’ approach and indicated a net economic benefit associated with the intervention. One cost-effectiveness evaluation was identified but the data were unclearly reported; the cost-effectiveness plane suggested that the intervention was more costly and less effective than the status quo. Conclusions Future studies planning an economic evaluation need to (i) make best use of available data and (ii) ensure that all relevant data are collected. To facilitate this, economic evaluations should be planned alongside the intervention with input from health economists from the outset of the study. When undertaken appropriately, economic evaluation provides the potential to make significant contributions to housing policy. PMID:23929616

  6. Rethinking behavioral health processes by using design for six sigma.

    PubMed

    Lucas, Anthony G; Primus, Kelly; Kovach, Jamison V; Fredendall, Lawrence D

    2015-02-01

    Clinical evidence-based practices are strongly encouraged and commonly utilized in the behavioral health community. However, evidence-based practices that are related to quality improvement processes, such as Design for Six Sigma, are often not used in behavioral health care. This column describes the unique partnership formed between a behavioral health care provider in the greater Pittsburgh area, a nonprofit oversight and monitoring agency for behavioral health services, and academic researchers. The authors detail how the partnership used the multistep process outlined in Design for Six Sigma to completely redesign the provider's intake process. Implementation of the redesigned process increased access to care, decreased bad debt and uncollected funds, and improved cash flow--while consumer satisfaction remained high.

  7. Behavioral health and disasters: looking to the future.

    PubMed

    Palinkas, Lawrence A

    2015-01-01

    Along with other manmade and natural disasters, oil spills produce profound and long-term impacts on the behavioral health of their survivors. Although previous and ongoing research has focused on producing evidence of the breadth and depth of these impacts, future efforts must begin to translate this evidence into developing and implementing policies, programs, and practices that effectively contribute to their prevention and mitigation. Drawing upon a conceptual framework of the behavioral health impacts of oil spills developed from data collected in the aftermath of the Exxon Valdez oil spill in 1989, this paper examines potential interventions designed to prevent or mitigate biopsychosocial, interpersonal, and intrapersonal impacts on behavioral health. Future efforts to translate behavioral health research into effective practice will require the formation and maintenance of academic-community partnerships for the purpose of building resilience to these impacts and providing targeted services to those most vulnerable to their long-term consequences.

  8. Behavioral Health and Disasters: Looking to the Future

    PubMed Central

    Palinkas, Lawrence A.

    2014-01-01

    Along with other manmade and natural disasters, oil spills produce profound and long-term impacts on the behavioral health of their survivors. While previous and ongoing research has focused on producing evidence of the breadth and depth of these impacts, future efforts must begin to translate this evidence into developing and implementing policies, programs and practices that effectively contribute to their prevention and mitigation. Drawing upon a conceptual framework of the behavioral health impacts of oil spills developed from data collected in the aftermath of the Exxon Valdez oil spill in 1989, this paper examines potential interventions designed to prevent or mitigate biopsychosocial, interpersonal and intrapersonal impacts on behavioral health. Future efforts to translate behavioral health research into effective practice will require the formation and maintenance of academic-community partnerships for the purpose of building resilience to these impacts and providing targeted services to those most vulnerable to their long-term consequences. PMID:24443145

  9. Behavioral Health's Challenge to Academic, Scientific, and Professional Psychology.

    ERIC Educational Resources Information Center

    Matarazzo, Joseph D.

    1982-01-01

    Asserts that psychologists can contribute to a reduction in national health expenditures by focusing on such illness- and accident-causing behaviors as smoking, alcohol use, improper diet, and speeding and the nonuse of seat belts in cars. (GC)

  10. NASA Human Research Program: Behavioral Health and Performance Program Element

    NASA Technical Reports Server (NTRS)

    Leveton, Lauren B.

    2009-01-01

    This viewgraph presentation reviews the performance errors associated with sleep loss, fatigue and psychomotor factors during manned space flight. Short and long term behavioral health factors are also addressed

  11. Health behavior and college students: does Greek affiliation matter?

    PubMed

    Scott-Sheldon, Lori A J; Carey, Kate B; Carey, Michael P

    2008-02-01

    The college years offer an opportunity for new experiences, personal freedom, and identity development; however, this period is also noted for the emergence of risky health behaviors that place college students at risk for health problems. Affiliation with on-campus organizations such as fraternities or sororities may increase a students' risk given the rituals and socially endorsed behaviors associated with Greek organizations. In this study, we examined alcohol and drug use, smoking, sexual behavior, eating, physical activity, and sleeping in 1,595 college students (n = 265 Greek members, n = 1,330 non-Greek members). Results show Greek members engaged in more risky health behaviors (e.g., alcohol use, cigarette smoking, sexual partners, and sex under the influence of alcohol or drugs) than non-Greek members. Greek and non-Greek members did not differ in condom use, unprotected sex, eating, and physical activity behaviors. Implications for prevention and intervention strategies among Greek members are discussed.

  12. A behavior-analytic view of psychological health

    PubMed Central

    Follette, William C.; Bach, Patricia A.; Follette, Victoria M.

    1993-01-01

    This paper argues that a behavioral analysis of psychological health is useful and appropriate. Such an analysis will allow us to better evaluate intervention outcomes without resorting only to the assessment of pathological behavior, thus providing an alternative to the Diagnostic and Statistical Manual system of conceptualizing behavior. The goals of such an analysis are to distinguish between people and outcomes using each term of the three-term contingency as a dimension to consider. A brief review of other efforts to define psychological health is provided. Laboratory approaches to a behavioral analysis of healthy behavior are presented along with shortcomings in our science that impede our analysis. Finally, we present some of the functional characteristics of psychological health that we value. PMID:22478160

  13. Health economics: potential applications in HIV/AIDS control in Africa.

    PubMed

    Kirigia, Joses M; Sambo, Luis G; Anikpo, Emilienne; Karisa, Eddie; Mwabu, Germano

    2005-01-01

    There is growing evidence that HIV/ AIDS has enormous negative impact on health status and economic development of individuals, households, communities and nations in the African region. Thus, there is urgent need for various disciplines to demonstrate how they can contribute in curbing the spread of this deadly disease in the African region. This paper, using an extended version of Professor Alan Williams schema as the conceptual framework, attempts to demonstrate how health economics can be used to inform policy and managerial choices related to HIV/AIDS advocacy, prevention, treatment and management. It argues that the discipline of health economics (and economics generally) is extremely valuable in: measuring health impacts of the disease and interventions; evaluating the relationships between health care-seeking behaviour of individuals and health system specific attributes; the estimation of determinants of compliance of HIV/AIDS patients with treatment regimen; establishing of health institutions efficiency in combating AIDS; guiding choices of HIV/AIDS interventions; assessing the relationships between HIV/AIDS, development, poverty, and trade; programme planning, monitoring and evaluation; and assessing health system's overall performance. The paper is a modest attempt to show how the discipline of health economics can elucidate, and help in resolving practical and conceptual issues in HIV/AIDS control in Africa.

  14. Physicians' attitudes and behaviors toward home health care services.

    PubMed

    Javalgi, R; Joseph, W B

    1991-12-01

    The authors investigate physicians' attitudes, information-seeking behaviors, and behavioral intentions toward home health care programs. Survey results show that physicians favor the concept, but knowledge and awareness levels about available programs vary with the physicians' specialties. Evidence also is reported on specific problems encountered, sources of information used to make home care referrals, and physicians' perceptions of the impact of home care programs on their practice. Finally, policy implications are drawn for marketers of home health care programs.

  15. Revolution then evolution: the advance of health economic evaluation in Australia.

    PubMed

    Lopert, Ruth; Viney, Rosalie

    2014-01-01

    All governments face immense challenges in providing affordable healthcare for their citizens, and the diffusion of novel health technologies is a key driver of growth in expenditure for many. Although important methodological and process variations exist around the world, health economic evaluation is increasingly seen as an important tool to support decision-making around the introduction of new health technologies, interventions and programmes in countries of varying stages of economic development. In Australia, the assessment of the comparative cost-effectiveness of new medicines proposed for subsidy under the country's national drug subsidy programme, the Pharmaceutical Benefits Scheme, was introduced in the late 1980s and became mandatory in 1993, making Australia the first country to introduce such a requirement nationally. Since then the use of health economic evaluation has expanded and been applied to support decision-making across a broader range of health technologies, as well as to programmes in public health.

  16. Health Education and Behavior: Are School Health Educators in Denial?

    ERIC Educational Resources Information Center

    Governali, Joseph F.; Hodges, Bonni C.; Videto, Donna M.

    2005-01-01

    School health education has been and still is guided by a number of different and often competing philosophical orientations. The field seems to be moving toward a skills-based philosophy, but the adoption of this approach is taking place with little discussion or analysis in the professional health education literature. The purpose of this…

  17. Health economic evaluations in reimbursement decision making in the Netherlands: time to take it seriously?

    PubMed

    Franken, Margreet; Koopmanschap, Marc; Steenhoek, Adri

    2014-01-01

    Health technology assessment already informed Dutch policymaking in the early 1980s. Evidence of health economic evaluations is, however, only systematically used in drug reimbursement decision making. Outpatient drugs with an added therapeutic value and expensive specialist drugs require evidence from an economic evaluation. Due to many exemptions, however, the availability of evidence of health economic evaluations remains rather low. Although the Dutch reimbursement agency suggested a cost-effectiveness threshold range depending on the severity of the disease (i.e., €10,000 - 80,000 per Quality Adjusted Life Year), it was never confirmed nor endorsed by the Ministry of Health. It is highly questionable whether health economic evaluations currently play a role in actual Dutch reimbursement decision making. Although the requirements exist in policy procedures, recent cases show that Dutch policymakers experience great difficulties in putting restrictions on reimbursement based on evidence from health economic evaluations. The near future will show whether the need will increase to base decisions on societal value for money, and whether Dutch policymakers show the courage to take health economic evaluations seriously.

  18. Adolescents' expectations for the future predict health behaviors in early adulthood.

    PubMed

    McDade, Thomas W; Chyu, Laura; Duncan, Greg J; Hoyt, Lindsay T; Doane, Leah D; Adam, Emma K

    2011-08-01

    Health-related behaviors in adolescence establish trajectories of risk for obesity and chronic degenerative diseases, and they represent an important pathway through which socio-economic environments shape patterns of morbidity and mortality. Most behaviors that promote health involve making choices that may not pay off until the future, but the factors that predict an individual's investment in future health are not known. In this paper we consider whether expectations for the future in two domains relevant to adolescents in the U.S.-perceived chances of living to middle age and perceived chances of attending college-are associated with an individual's engagement in behaviors that protect health in the long run. We focus on adolescence as an important life stage during which habits formed may shape trajectories of disease risk later in life. We use data from a large, nationally representative sample of American youth (the US National Longitudinal Study of Adolescent Health) to predict levels of physical activity, fast food consumption, and cigarette smoking in young adulthood in relation to perceived life chances in adolescence, controlling for baseline health behaviors and a wide range of potentially confounding factors. We found that adolescents who rated their chances of attending college more highly exercised more frequently and smoked fewer cigarettes in young adulthood. Adolescents with higher expectations of living to age 35 smoked fewer cigarettes as young adults. Parental education was a significant predictor of perceived life chances, as well as health behaviors, but for each outcome the effects of perceived life chances were independent of, and often stronger than, parental education. Perceived life chances in adolescence may therefore play an important role in establishing individual trajectories of health, and in contributing to social gradients in population health.

  19. Assessing the Relationship Between Religious Involvement and Health Behaviors.

    PubMed

    Krause, Neal; Hill, Peter C; Emmons, Robert; Pargament, Kenneth I; Ironson, Gail

    2017-04-01

    A growing body of research suggests that people who are more deeply involved in religion may be more likely to adopt beneficial health behaviors. However, religion is a complex phenomenon, and as a result, religion may affect health behaviors in a number of ways. The purpose of the current study was to see whether a sacred view of the body (i.e., belief that the body is the temple of God) is associated with better health behavior. It was proposed that the relationship between a sacred body view and health behavior will emerge only among study participants who have a stronger sense of religiously oriented control (i.e., stronger God-mediated control beliefs). Five positive health behaviors were evaluated: more frequent strenuous exercise, more frequent moderate exercise, more frequent consumption of fruits and vegetables, higher quality sleep, and the adoption of healthy lifestyles. Data from a recent nationwide sample reveal that a sacred body view is associated with each health behavior, but only among study participants who have a strong religiously oriented sense of control.

  20. Adolescent Homosexual Behavior and the Health Educator.

    ERIC Educational Resources Information Center

    Chng, Chwee Lye

    1980-01-01

    Approaches for teaching about homosexuality as part of the school health curriculum are offered. Suggestions include discussion of popular values and stereotypes, teaching by example, and teaching through role playing. (JMF)

  1. Economic Benefits of Investing in Women’s Health: A Systematic Review

    PubMed Central

    Bloom, David E.

    2016-01-01

    Background Globally, the status of women’s health falls short of its potential. In addition to the deleterious ethical and human rights implications of this deficit, the negative economic impact may also be consequential, but these mechanisms are poorly understood. Building on the literature that highlights health as a driver of economic growth and poverty alleviation, we aim to systematically investigate the broader economic benefits of investing in women’s health. Methods Using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, we systematically reviewed health, gender, and economic literature to identify studies that investigate the impact of women’s health on micro- and macroeconomic outcomes. We developed an extensive search algorithm and conducted searches using 10 unique databases spanning the timeframe 01/01/1970 to 01/04/2013. Articles were included if they reported on economic impacts stemming from changes in women’s health (table of outcome measures included in full review, Table 1). In total, the two lead investigators independently screened 20,832 abstracts and extracted 438 records for full text review. The final review reflects the inclusion of 124 articles. Results The existing literature indicates that healthier women and their children contribute to more productive and better-educated societies. This study documents an extensive literature confirming that women’s health is tied to long-term productivity: the development and economic performance of nations depends, in part, upon how each country protects and promotes the health of women. Providing opportunities for deliberate family planning; healthy mothers before, during, and after childbirth, and the health and productivity of subsequent generations can catalyze a cycle of positive societal development. Conclusions This review highlights the untapped potential of initiatives that aim to address women’s health. Societies that prioritize women

  2. Using behavior modeling for supervisory development in health care settings.

    PubMed

    Decker, P J; Sullivan, E; Moore, R

    1982-01-01

    Behavior modeling is one training method found effective in helping health care managers deal with their day-to-day management problems. This article defines and explains the five basic steps of behavior modeling training, suggests the workshop format as its most effective mode of instruction, and presents examples of successful use of the method.

  3. Health Risk Behavior and Sexual Assault among Ethnically Diverse Women

    ERIC Educational Resources Information Center

    Littleton, Heather L.; Grills-Taquechel, Amie E.; Buck, Katherine S.; Rosman, Lindsey; Dodd, Julia C.

    2013-01-01

    Sexual assault is associated with a number of health risk behaviors in women. It has been hypothesized that these risk behaviors, such as hazardous drinking, may represent women's attempts to cope with psychological distress, such as symptoms of depression and anxiety. However, extant research has failed to evaluate these relationships among…

  4. Characteristics and Health Behavior of the Aged Population

    ERIC Educational Resources Information Center

    German, Pearl S.

    1975-01-01

    Reports that the elderly appear most influenced in health attitudes and behaviors by various factors within the setting so those who identify a major source of care tend to be higher utilizers, do less "shopping-around," and exhibit less negative behaviors such as needing care without seeking it. Discussion of the article follows. (Author)

  5. Transtheoretical model of health behavior change applied to voice therapy.

    PubMed

    van Leer, Eva; Hapner, Edie R; Connor, Nadine P

    2008-11-01

    Studies of patient adherence to health behavior programs, such as physical exercise, smoking cessation, and diet, have resulted in the formulation and validation of the Transtheoretical Model (TTM) of behavior change. Although widely accepted as a guide for the development of health behavior interventions, this model has not been applied to vocal rehabilitation. Because resolution of vocal difficulties frequently depends on a patient's ability to make changes in vocal and health behaviors, the TTM may be a useful way to conceptualize voice behavior change processes, including the patient's readiness for change. The purpose of this paper is to apply the TTM to the voice therapy process to: (1) provide an organizing framework for understanding of behavior change in voice therapy, (2) explain how treatment adherence problems can arise, and (3) provide broad strategies to improve treatment adherence. Given the significant role of treatment adherence in treatment outcome, considering readiness for behavior change should be taken into account when planning treatment. Principles of health behavior change can aid speech pathologists in such understanding and estimating readiness for voice therapy.

  6. Impact of reproductive health on socio-economic development: a case study of Nigeria.

    PubMed

    Adinma, J I B; Adinma, E D

    2011-03-01

    The link between reproductive health, sexual and reproductive right, and development was highlighted at the International Conference on Population and Development held in Egypt. Developmental disparities are related to socio-economic differences which have led to the identification of distinct socio-economic classifications of nations. Human development represents the socioeconomic standing of any nation, in addition to literacy status and life expectancy. Africa accounts for 25% of the world's landmass but remains the world's poorest continent. Nigeria, the most populous country in Africa, has policies and programmes geared towards the improvement of its socio-economic standing and overal development, with little positive result. Reproductive health is a panacea towards reversing the stalled socio-economic growth of Nigeria as evident from the linkage between reproductive health and development, highlighted in Millennium Development Goals 3, 4, 5 and 6. Fast tracking Nigeria's development requires implementation of reproductive health policies and programmes targeted on women and children.

  7. [The effects of economic crises on health care].

    PubMed

    Chang, Nai-Hsin; Huang, Chiu-Ling; Yang, Yu-O

    2010-08-01

    In September 2008, financial turmoil on Wall Street led to severe losses in that country's financial derivatives market and plunged the United States into the most severe financial crisis in over a decade. The backlash of this "financial tsunami" has affected countries around the world. The world economy, facing the most critical financial crisis since the 1930s, must deal with recession, severe unemployment and general fears of worse to come, which have, in turn, spawned a range of physical, psychological and spiritual problems. In this article we study the effects of the economic crisis on healthcare from several angles, including: decreasing incomes causing changing attitudes toward seeking healthcare; decreasing numbers of people covered by medical insurance; increasing impact on the job market of untreated illnesses; changing national healthcare policies in response to economic pressures; increasing physical, psychological and social problems resulting from economic problems; and the need for the nursing profession to respond to these and other rapid changes in the healthcare landscape. Nursing staff are sometimes unaware of social problems outside their profession. This article may, therefore, provide a general reference to medical and nursing staff on the effects of the economic crisis on healthcare.

  8. Integration of environmental stewardship and local economic development to enhance community health.

    PubMed

    Levine, Jay F

    2011-01-01

    Environmental groups working to preserve natural ecosystems and groups working to enhance local economic development often find themselves on philosophically opposite sides of the negotiation table. Case histories of cooperative engagement are provided that serve as examples of how environmental stewardship is compatible with local economic development and community health.

  9. Annotation: Economic Evaluations of Child and Adolescent Mental Health Interventions--A Systematic Review

    ERIC Educational Resources Information Center

    Romeo, Renee; Byford, Sarah; Knapp, Martin

    2005-01-01

    Background: Recognition has grown over recent years of the need for economic information on the impacts of child and adolescent mental health problems and the cost-effectiveness of interventions. Methods: A range of electronic databases were examined using a predefined search strategy to identify economic studies which focused on services,…

  10. Health economic burden that wounds impose on the National Health Service in the UK

    PubMed Central

    Guest, Julian F; Ayoub, Nadia; McIlwraith, Tracey; Uchegbu, Ijeoma; Gerrish, Alyson; Weidlich, Diana; Vowden, Kathryn; Vowden, Peter

    2015-01-01

    Objective To estimate the prevalence of wounds managed by the UK's National Health Service (NHS) in 2012/2013 and the annual levels of healthcare resource use attributable to their management and corresponding costs. Methods This was a retrospective cohort analysis of the records of patients in The Health Improvement Network (THIN) Database. Records of 1000 adult patients who had a wound in 2012/2013 (cases) were randomly selected and matched with 1000 patients with no history of a wound (controls). Patients’ characteristics, wound-related health outcomes and all healthcare resource use were quantified and the total NHS cost of patient management was estimated at 2013/2014 prices. Results Patients’ mean age was 69.0 years and 45% were male. 76% of patients presented with a new wound in the study year and 61% of wounds healed during the study year. Nutritional deficiency (OR 0.53; p<0.001) and diabetes (OR 0.65; p<0.001) were independent risk factors for non-healing. There were an estimated 2.2 million wounds managed by the NHS in 2012/2013. Annual levels of resource use attributable to managing these wounds and associated comorbidities included 18.6 million practice nurse visits, 10.9 million community nurse visits, 7.7 million GP visits and 3.4 million hospital outpatient visits. The annual NHS cost of managing these wounds and associated comorbidities was £5.3 billion. This was reduced to between £5.1 and £4.5 billion after adjusting for comorbidities. Conclusions Real world evidence highlights wound management is predominantly a nurse-led discipline. Approximately 30% of wounds lacked a differential diagnosis, indicative of practical difficulties experienced by non-specialist clinicians. Wounds impose a substantial health economic burden on the UK's NHS, comparable to that of managing obesity (£5.0 billion). Clinical and economic benefits could accrue from improved systems of care and an increased awareness of the impact that wounds impose on patients

  11. The Health Belief Model and the Contraceptive Behavior of College Women: Implications for Health Education.

    ERIC Educational Resources Information Center

    Hester, Nanci Robertson; Macrina, David M.

    1985-01-01

    This study was formulated to examine the contraceptive behavior of college women and to elucidate distinctions between contraceptive users and nonusers. A survey instrument, conceptually and theoretically based in the Health Belief Model, was designed to elicit self-reports of contraceptive behavior. Findings and implications for health education…

  12. A Test of the Economic Strain Model on Adolescents' Prosocial Behaviors

    ERIC Educational Resources Information Center

    Carlo, Gustavo; Padilla-Walker, Laura M.; Day, Randal D.

    2011-01-01

    The present study was designed to examine the links between economic strain, parental depression, parent-child connectedness, and adolescents' prosocial behaviors. The sample consisted of 478 participants (M age at Time 1=11.29 years, 51% male) recruited from the community who were mostly of European American descent (69%) and from mostly middle…

  13. An Organizational Behavior Analysis of Teacher Attitudes about Teaching High School Economics.

    ERIC Educational Resources Information Center

    Cobb, Steven L.; Foeller, William H.

    1992-01-01

    Presents study results focusing on the determinants of teacher work attitudes using organizational behavior theory. Explores job satisfaction as influenced by individual attributes and job characteristics. Concludes that additional economics training and expectations of motivated students favorably impact teacher satisfaction. Suggests that both…

  14. Dialectical thinking and health behaviors: the effects of theory of planned behavior.

    PubMed

    Jiang, Feng; Lu, Su; Hou, Yubo; Yue, Xiaodong

    2013-01-01

    The primary purpose of this study was to investigate whether the theory of planned behavior (TPB) mediated the relationship between dialectical thinking and health behaviors. A sample of 285 undergraduates was tested with a dialectical thinking styles scale, health promoting lifestyle profiles, and TPB questionnaires. Structural equation modeling was used for data analysis. Results indicated that all the three dimensions of thinking styles (belief in the connection, acceptance of change, and acceptance of contradiction) exerted significant effects on TPB constructs. Specifically, the connection and the change dimensions had positive effects on health behaviors mediated by TPB, whereas the contradiction dimension had a negative effect. Model 2 showed a satisfactory fit, demonstrating the influential pathways between dialectical thinking and health behaviors. Implications in issues of health promotion and future research are discussed.

  15. Hemophilia home treatment. Economic analysis and implications for health policy.

    PubMed

    Ross-Degnan, D; Soumerai, S B; Avorn, J; Bohn, R L; Bright, R; Aledort, L M

    1995-01-01

    This analysis describes the development of technology for home self-infusion of factor VII in the treatment of hemophilia and its clinical, economic, and social consequences, and uses the case study of such home care treatment to illustrate the potentials and pitfalls of formal economic analyses of programs to treat chronically ill children. A comprehensive review of all original data on hemophilia programs, their related costs, and outcomes, conducted from 1966 through 1993, examined the economic outcomes for two hypothetical cohorts, one aged 0-4 years and the other aged 30-34 years. Including the measurement of treatment effects on the productivity of parental caregivers substantially increases the benefit-cost relationship of an intervention directed at chronically ill children. Increased economic productivity and societal return resulting from such a program for young adults exceeds those for a cohort of children, primarily due to assumptions related to discounting. However, estimation of quality-adjusted life years favors the younger age cohort, since children survive for a longer period of time and with each year survived comes a higher quality of life. Unlike simpler instances in which economic benefits can be shown to outweigh resource costs, policy decisions concerning services for chronically ill children raise an additional set of complex analytic issues. Inclusion of the benefits in productivity experienced by family caregivers provides an important added dimension to such analyses. The development of cost-benefit or cost-effectiveness analyses of these programs illustrates the importance of careful measurement of outcomes and explicit statements of underlying assumptions. Such an analysis of home care for children with hemophilia therefore demonstrates both the strengths and the limitations of this approach.

  16. Gender & Economic Status Matter in Mental Health of Adolescents?

    ERIC Educational Resources Information Center

    Sharma, Namita; Dua, Radha

    2011-01-01

    Mental health is the ability to adjust oneself satisfactorily to the various strains of life. Mental health and Education are closely related to each other. Sound mental is prerequisite for the learner. In this era of severe competition to excel or to be on the top is pressurizing today's adolescents to the utmost. Besides a number of factors like…

  17. Arthritis Patient Education: How Economic Evaluations Can Inform Health Policy.

    ERIC Educational Resources Information Center

    Clarke, Ann E.

    1997-01-01

    A cost-effectiveness evaluation of an Arthritis Self-Management Program assessed direct and indirect costs through self-reporting of health services use. Diminished productivity and effectiveness were measured through a visual analog scale and the health status dimensions of the Canadian Medical Outcomes Study short form. (JOW)

  18. Mexico: The Socio-Economic and Cultural Environment for Health.

    ERIC Educational Resources Information Center

    Stambler, Moses

    Numerous factors influencing health status and health care in Mexico are reviewed in this paper. Part I covers socioeconomic influences including agricultural and land tenure patterns, oil production, population growth rate, and the extent of poverty. Part II discusses the political environment, emphasizing the effects of politics on strategies…

  19. [Health risks and economic costs associated with obesity requiring a comprehensive weight reduction program].

    PubMed

    Hainer, V; Kunesová, M; Parízková, J; Stunkard, A

    1997-06-12

    An increasing prevalence of obesity all over the world reflects a lack of effective measures in both prevention and treatment of obesity. Obesity as a disease has been underestimated by the lay-public as well as health care providers. However, obesity represents a substantial health problem associated with a decreased quality of life. Obesity is linked to numerous chronic diseases (cardiovascular diseases, diabetes, hyperlipidemia, gout, osteoarthritis, gall-stones, and bowel, breast and genitourinary cancers) that lead to premature disability and mortality. Health risks increase with a body mass index (BMI) over 25 in individuals 19-35 years of age and with a BMI over 27 in those 35 years of age and older. Health risks also increase with an excess accumulation of visceral fat manifested as an increase in waist circumference (> 100 cm) or in waist to hip ratio (> 0.85 for females and > 1.00 for males). According to studies carried out in different countries current economic costs of obesity represent 5-8% of all direct health costs. In contrast, effective treatment of obesity results in a substantial decrease in expenditures associated with pharmacotherapy of hypertension, diabetes, hyperlipidemia and osteoarthritis. Both scientists and clinicians involved in obesity research and treatment recommend to introduce the long-term weight management programs focussing more on the overall health of the participants than the weight loss per se. Therefore, it will be necessary to establish new realistic goals in the obesity management that reflect reasonable weights and recently experienced beneficial health effects of modest (5-10%) weight loss. Comprehensive obesity treatment consisting of low fat diet, exercise, behavioral modification, drug therapy and surgical procedures requires differentiated weight management programs modified according to the degree and type of obesity as well as to current health complications present. The Czech Society for the Study of Obesity

  20. [Oncological disease between economic ties and a health humanization policy].

    PubMed

    Cifaldi, Luciano; Felicetti, Viviana; Gareri, Roberta; Cristina, Giuseppe

    2008-01-01

    Since 1992 the Italian National Health Service has been characterized by the introduction of managerial concepts. The aim of this article is to analyze the content and impact of the implementation of management and the most significant changes in health care organization and the functioning of the system. The changing organization of health care requires the health care professional to deal with a variety of new demands and, in some cases, to alter his traditional professional practice: the respect of human dignity through empowerment. The general content involves pressures on the health care professional to adapt to the new corporate culture of managed care. At the same time, the expressed psychosocial needs of the cancer patient necessitates increased attention.