安徽省农村留守儿童健康状况的调查与分析

本文在对安徽省农村留守儿童的健康现状及可能影响其体质健康的因素进行实地调查的基础上,通过建立Ordered Logistic计量模型,定量分析了各因素对儿童体质健康的影响。研究结果表明:父亲外出务工会对留守儿童的体质健康产生不利影响,且其外出这一行为本身对儿童营养状况的负面影响显著;家庭特征层面上,父亲的体质状况会对儿童营养健康产生正面影响,且影响显著;食肉频率、锻炼频率及营养知识得分等变量对子女的体质都会产生影响,且在模型中显著;由于地区间存在差异,地区变量对儿童的体质状况也会产生影响。最后,依据分析结果,从家庭、学校和国家3个层面提出了改善我国农村留守儿童体质状况的有效途径。     

Childhood malnutrition and schooling in the Terai region of Nepal

Data on 350 primary school age children from subsistence farm households in the Terai (southern plains) region of Nepal are analyzed to assess the relationship between nutritional status and school participation. Only fifteen percent reported attending school; nutritional status, particularlyas measured by percent of median height-for-age, was found to be a significant determinant of both enrollment in school and age-adjusted grade attainment. It is concluded that local interventions or national policies designed to improved child nutritional status could have important educational as well as health benefits.     

POOR AND SICK: ESTIMATING THE RELATIONSHIP BETWEEN HOUSEHOLD INCOME AND HEALTH

This study evaluates the effect of the individual's household income on their health at the later stages of working life. A structural equation model is utilized in order to derive a composite and continuous index of the latent health status from qualitative health status indicators. The endogenous relationship between health status and household income status is taken into account by using IV estimators. The findings reveal a significant effect of individual household income on health before and after endogeneity is taken into account as well as a host of other factors known to influence health, including hereditary factors and the individual's locus of control. Importantly, it is also shown that the childhood socioeconomic position of the individual has long lasting effects on health as it appears to play a significant role in determining health during the later stages of working life.     

IDENTIFYING THE EFFECTS OF SIMULTANEOUS MONETARY POLICY SHOCKS

Many central banks, particularly in the developing world, aim for exchange rate stability as a macroeconomic goal. However, most are reluctant to relinquish monetary policy autonomy, so they end up operating through both interest rate and foreign exchange interventions. But the use of multiple policy instruments does not necessarily equip monetary authorities with better tools to achieve their targets. On the contrary, their effects can potentially offset each other. Using daily data from the Central Bank of Colombia during the period of 1999–2012, I study the effects of simultaneous policies by first deriving new measures of monetary shocks and then determining their impact on economic activity. The main findings indicate that (a) while interest rate interventions have a significant impact on real and nominal variables, foreign exchange interventions tend to have limited effects; and (b) empirical anomalies, such as the positive relationship between output growth, inflation, and the policy rate are eliminated when properly accounting for the systematic responses of policy. (JEL E43, E52, E58, F31)     

Interrelationships between income,health and the environment: extending the Environmental Kuznets Curve hypothesis

This paper examines the link between the health indicators and the environmental variables for a cross-section of countries widely dispersed on the economic development spectrum. While environment and income are seen to have an inverted-U shaped relationship (Environmental Kuznets Curve (EKC) hypothesis), it is also well established that environment and health are positively related. Our study focuses on the implications of this for the relationship between health and income. In the early phases of income growth, the gains in health and the losses in environmental quality could cancel each other out and this challenges the idea that as incomes increase health would always improve. To empirically analyse these issues, we estimate a two-stage least squares model that focuses on the impact of income and the environment on health status, with environment being an endogenous variable. Our results show that the environmental stress variable has a significant negative effect on health status. At the same time, gross national product (GNP) levels are shown to vary positively with health status variables. We find that the health gains obtained through improved incomes can be negated to a significant extent if the indirect effect of income acting via the environment is ignored. Research findings in this regard would be a useful policy instrument towards maximising both the environmental and health gains that come with economic growth and development.     

CHILDREN AND THE ENVIRONMENT: VALUING INDIRECT EFFECTS ON A CHILD'S LIFE CHANCES

Children can face disproportionately greater risk from environmental hazards because they are kids—smaller bodies, faster metabolisms, shorter attentions spans, less knowledge, and fewer resources. Environmental programs that reduce risks to children produce benefits to society that should be adequately represented so policy makers have more information to help them decide which policies are most worthwhile relative to their costs. The open question is just how exactly to value these reductions in risks to children, risks which can arise either from a direct effect on their health, or an indirect effect on their life chances because of illness in other family members or the degradation of the environment. This article focuses on valuing these indirect effects to a child's life chances. The question addressed here is whether standard benefits estimation adequately captures the indirect effects on healthy children. If policy makers presume caregivers make fully informed, rational choices when dealing with adverse family health, indirect effects are already accounted for in revealed and stated values: estimating indirect effects implies double counting of benefits. But if policy makers fear that caregivers face choice without complete information or experience, indirect effects might be understated. Then it becomes constructive to devote resources to explore the importance of these indirect effects.     

妇幼保健院规模与妇幼保健水平的关系:基于全国省级面板数据的研究

妇幼保健院在中国医疗卫生领域具有相当特殊的地位。在妇幼保健院对中国妇幼健康水平有积极作用的假设下,采用31个省级地区的面板数据构建实证模型,研究妇幼保健院规模对妇幼保健水平和医疗费用的影响。妇幼保健院床位数与孕产妇死亡率有显著的正相关,对活产数有显著的消极影响,出现这一现象的原因可能是妇幼保健院相对落后的医疗技术条件。同时,妇幼保健院床位数的增长对卫生机构支出存在正向影响,但对于居民家庭人均医疗支出则存在城乡差异。建议应重视妇幼保健院的发展,全面提升妇幼保健院的技术和服务水平,缓解大综型医疗机构接诊压力。     

Child malnutrition and school performance in China

Data on the height, weight, age and grade level of over 3,000 children in five quite different locations in China allow computation of how far behind in school each child is, relative to where he should be given his age, as well as of the nutritional status variables of height-for-age, weight-for-age and weight-for-height. This paper uses these data to estimate the impact of the nutritional variables on the available measure of school performance. Children tend to be about one grade further behind in rural areas than in the provincial capitals, and about one-half a grade further behind in the provincial capitals than in Beijing. Even after controlling for location, however, lower nutritional status (particularly height-for-age) was found to affect school performance adversely; a one standard deviation reduction in height-for-age, for example, would result in a child's being about one-third of a year further behind. Though results from a geographically limited sample should be generalized only with substantial caution, and alternative interpretations of the data are possible, it does appear likely that malnutrition in rural China remained sufficiently prevalent in 1979 to retard the school advancement of large numbers of children.     

Taxes and subsidies to change eating habits when information is not enough: an application to fish consumption

A calibrated model is used to determine the welfare impacts of various regulatory instruments for improving health. The results of a lab experiment are integrated in a partial equilibrium model representing demands for two kinds of fish, one with higher nutritional benefits (canned sardines) and one with higher contamination risks (canned tuna) in France. In the laboratory, information about health effects leads to a statistically significant decrease (increase) in the willingness to pay for tuna (sardines). Simulations with the laboratory results show that, for most cases, a per-unit tax on tuna and a per-unit subsidy on sardines without any information revealed to consumers lead to the highest welfare, because both the tax and subsidy directly internalize health characteristics. The information policy combined with a per-unit tax on tuna and a per-unit subsidy on sardines is socially profitable only if a large proportion of consumers (greater than 95%) receives health information.      

The Simple Analytics of Illicit Drug Policy

The impact of alternative drug policy objectives, specifically harm reduction/harm minimisation or prohibition, is unclear. The literature is confusing. This article conceptualises the causal connection between drug consumption and health harm (or reduced health status) then clarifies the implication of ‘drug related harm’. By applying some geometrical tools from economics, the choice of policy objective is analysed. The preferences of policy advocates are then incorporated. Policy advocates are conceived as arguing that decision‐makers and consumers should adopt their preferences between drugs and health harm. With this approach, the difference between alternative drug policies, in particular prohibition and harm minimisation/reduction, is demonstrated.     

健康教育对血液透析患者生存质量的影响

目的探讨健康教育对血液透析患者生存质量的影响。方法抽取本中心新加入规律血液透析患者共52例,随机分成两组,观察组和对照组各26例。对照组进行常规护理;观察组在对照组基础上实施健康教育护理干预,随访观察12个月后,对比两组患者的营养状况、心理情绪、社会角色、运动等生活质量相关指标的变化。结果观察组接受系统的健康教育后营养状况、心理健康、社会角色等各项相关生存质量有明显改善,差异均有统计学意义（均P〈0.05）。结论全面系统的健康教育,可明显提高规律血液透析患者的生存质量。     

Widowhood and health of elderly in India: examining the role of economic factors using structural equation modeling

Evidence on the association between widowhood and health is widely available in the literature. However, there is a dearth of analysis on the mechanism through which widowhood affects the health status of an individual, particularly in old age, specifically whether widowhood among the elderly affects their health through their economic conditions. This paper purports to establish both the direct and indirect effects of widowhood on self-reported health status among aged Indians. We examine the mediating effect of economic factors such as income, labor force participation, extent of economic independence and other economic factors in the relationship between widowhood and health status. Structural Equation Modeling (SEM) is employed to test specific hypotheses. We use unit level 60th round data for the year 2004 surveyed by the National Sample Survey Organization (NSSO). The results confirm that poor economic conditions have a mediating effect on the relationship between widowhood and health and, therefore, any policy to reduce the effect of widowhood on health must be based on economic factors.     

Health,Social Insurance and Income

Health, a form of human capital, can be defined by longevity and physical wellbeing. Social policy decisions require an understanding of the factors that contribute to the creation of health inequalities. To learn more about socioeconomic variables and health capital, this paper examines the relationship between three key variables: health, social insurance, and income, for the Swedish population. Using a randomized research survey design, data from 3,600 participants of a larger Swedish study, conducted in 2005, was analyzed. A linear model of Three Stage Least Squares was chosen to correct for simultaneous bias in the Health, Social Insurance, and Income (HSI) Model. Findings confirm the importance of socioeconomic, behavioral and environmental factors in explaining health inequalities. The results clearly show men, educated people, nonsmokers, individuals that exercise and youngsters possess higher health status than other people. The dependency on social insurance is mainly caused by poor health; a higher degree of social insurance dependency was offset by income increases due to age and higher professional level.      

拉萨市已婚育龄妇女的孩子价值观念分析——兼论妇女地位和生育文化对孩子价值的影响

拉萨市妇女的地位与孩子价值的关系正处于过渡期,一方面收入高于家庭平均收入的妇女减少了对孩子的需求,另一方面传统观念使妇女增加了对孩子工具性价值和精神性价值的需求。藏族和汉族,以及不同民族的婚配只在养儿防老方面有显著区别。相对于传宗接代,养儿防老才更有可能是出生性别比失调的原因之一。生育文化是可以转变的,出生性别比失调和妇女地位的关系更大。出生性别比失调的治理应该以提高妇女地位、转变择偶观念为突破口。     

Housing deprivation and health status: evidence from Spain

Living in inadequate housing conditions not only supposes a failure of a basic functioning. It also has effects on other essential aspects of well-being such as health. This study questions to what extent living in poor housing conditions can determine individuals’ health status once the possible influence of other factors is controlled for. By estimating a logistic model with individual effects and a housing deprivation index based on a latent variable model, we reach a number of relevant conclusions concerning the relationship between these two different dimensions of multidimensional well-being. We find a negative effect of housing deprivation on the individuals’ health, both when housing conditions are introduced in a disaggregated manner in the model and when they are combined in a latent variable.     

Relevance of barriers and facilitators in the use of health technology assessment in Colombia

Objectives: Several studies, mostly from developed countries, have identified barriers and facilitators with regard to the uptake of health technology assessment (HTA). This study elicited, using best-worst scaling (BWS), what HTA experts in Colombia consider to be the most important barriers and facilitators in the use of HTA, and makes a comparison to results from the Netherlands.

Methods: Two object case surveys (one for barriers, one for facilitators) were conducted among 18 experts (policymakers, health professionals, PhD students, senior HTA-researchers) from Colombia. Seven respondents were employees of the national HTA agency Instituto de Evaluación Tecnológica de Salud (IETS). In total, 22 barriers and 19 facilitators were included. In each choice task, participants were asked to choose the most and least important barrier/facilitator from a set of five. Hierarchical Bayes modeling was used to compute the mean relative importance scores (RIS) for each factor, and a subgroup analysis was conducted to assess differences between IETS and non-IETS respondents. The final ranking was further compared to the results from a similar study conducted in the Netherlands.

Results: The three most important barriers (RIS >6.00) were “Inadequate presentation format”, “Absence of policy networks”, and “Insufficient legal support”. The six most important facilitators (RIS >6.00) were “Appropriate timing”, “Clear presentation format”, “Improving longstanding relation”, “Appropriate incentives”, “Sufficient qualified human resources”, and “Availability to relevant HTA research”. The perceived relevance of the barriers and facilitators differed slightly between IETS and non-IETS employees, while the differences between the rankings in Colombia and the Netherlands were substantial.

Conclusion: The study suggests that barriers and facilitators related to technical aspects of processing HTA reports and to the contact and interaction between researchers and policymakers had the greatest importance in Colombia.     

Are price-based capital account regulations effective in developing countries?

In this article, we evaluate the effectiveness of policy measures adopted by Chile and Colombia aiming to mitigate the deleterious effects of pro-cyclical capital flows. In the case of Chile, according to our GMM analysis, capital controls succeeded in reducing net short-term capital flows, but did not affect long-term flows. As far as Colombia is concerned, the regulations were capable of affecting total flows and also long-term ones. In addition, our cointegration models indicate that the regulations did not have a direct effect on the real exchange rate in the Chilean case. Nonetheless, the model used for Colombia did detect a direct impact of the capital controls on the real exchange rate. Therefore, our results do not seem to support the idea that those regulations were easily evaded.     

Valuing Environmental Health Effects – An Economic Perspective

This paper provides an overview of some of the issues involved in comparing benefit-cost analysis and cost-effectiveness analysis based on quality-adjusted life-years as alternative approaches to assessing environmental policies that affect human health. It concludes that: (i) although QALYs have the advantage of reflecting policy impacts on both health status and longevity in a single scalar measure, they are not consistent with utility theory unless individuals’ preferences satisfy some restrictive conditions; (ii) they do not capture other important aspects of the valuation of changes in mortality and morbidity; (iii) cost-effectiveness analysis based on QALYs as a measure of effectiveness omits non-health related effects of environmental policy; and (iv) it leaves unanswered the important question of what level of environmental regulation is appropriate.     

Infant mortality,relative income and public policy

Do health outcomes depend on relative income as well as on an individual's absolute level of income? We use infant mortality as a health status indicator and find a significant and positive link between infant mortality and income inequality using cross-national data for 93 countries. Holding constant the income of each of the three poorest quintiles of a country's population, we find that an increase in the income of the upper 20% of the income distribution is associated with higher, not the lower infant mortality. Our results are robust and not just caused by the concave relationship between income and health. The estimates imply a decrease in infant mortality by 1.5% for a one percentage point decrease in the income share of the richest quintile. The overall results are sensitive to public policy: public health care expenditure, educational outcomes, and access to basic sanitation and safe water can explain the inequality–health relationship. Thus, our findings support the hypothesis of public disinvestment in human capital in countries with high income inequality. However, we are not able to determine whether public policy is a confounder or mediator of the relationship between income distribution and health. Relative deprivation caused by the income distance between an individual and the individual's reference group is another possible explanation for a direct effect from income inequality to health.     

Social determinates of health

The Aday Theory suggests that vulnerability, or increased risk of poor health outcomes, can be modeled by looking at ethical norms and values, health status, relative risk, resource availability, and policy (Aday, 2001). This theory looks at the tension between the rights and obligations of the individual versus the community while also recognizing the impact each has on the other.