Chasing Success: Health Sector Aid and Mortality

As many cases studies show, successful public health measures are being implemented in many places around the globe, and country-level mortality has fallen significantly in recent decades in all but a few countries. Are the two linked? Does development assistance for health (DAH) improve, on balance, recipient countries’ mortality trajectory? Using a new data source containing DAH on 96 high mortality countries, the regression analysis shows no effect of DAH on mortality. Other types of aid, including water development, also have no effect. Economic growth, on the other hand, has a strong negative effect on mortality. These findings confirm and build upon recent work by Williamson (2008) and are shown to be robust to a variety of sensitivity analyses and alternative model specifications and estimation methods.This analysis also shows that the effectiveness of DAH has not increased over time, even as the level of that funding has increased fourfold, though spending on infectious diseases and family planning may have caused small reductions in mortality. Furthermore, even though it is encouraging that DAH has tended to go where the need is highest, it also goes to states that have experienced the greatest mortality reductions in the recent past. In other words, DAH appears to be following success, rather than causing it.     

Status and mortality: Is there a Whitehall effect in the United States?

The influential Whitehall studies found that top-ranking civil servants in Britain experienced lower mortality than civil servants below them in the organizational hierarchy due to differential exposure to workplace stress. I test for a Whitehall effect in the United States using a 1930 cohort of white-collar employees at a leading firm – General Electric (GE). All had access to a corporate health and welfare program during a critical period associated with the health transition. I measure status using position in the managerial hierarchy, attendance at prestigious management training camps and promotions, none of which is associated with a Whitehall-like rank-mortality gradient. Instead, senior managers and executives experienced a 3–5-year decrease in lifespan relative to those in lower levels, with the largest mortality penalty experienced by individuals in the second level of the hierarchy. I discuss generalizability and potential explanations for this reversal of the Whitehall phenomenon using additional data on the status and lifespan of top business executives and US senators.     

煤炭资源型城市经济发展对健康的影响

文章在Grossman健康需求模型以及实践研究的基础上,运用来自中国24个煤炭资源型城市的经济数据和死亡率数据进行实证分析,结果表明经济发展和人口死亡率之间存在着显著关系,并且部分城市死亡率随着经济发展呈现出先增长后下降的倒U趋势.文章还对煤炭资源型城市安徽省淮北市进行个案研究,以实地发放问卷为数据来源,以健康自评为衡量健康指标,考察各因素对居民健康影响,发现性别、教育和职业地位对健康影响显著.     

Urban mortality in Greece: Hermoupolis (1859–1940)

The paper examines mortality patterns in the city of Hermoupolis, on the Greek island of Syros, from 1859 to 1940. It produces important new insights into Mediterranean urban historical demography and is the first comprehensive study of urban mortality in Greece, utilising the largest and one of the longest time series at the individual level yet calculated from civil registration and census data. Abridged life tables were constructed for the first time for a Greek urban settlement, enabling the calculation of age-specific mortality rates and life expectancies. Hermoupolis experienced much higher mortality levels than the national average. The findings suggest that early childhood mortality started to decline rapidly from the late nineteenth century onwards, with declines in early adulthood and infancy following. The paper reinforces and confirms our limited knowledge about the timing of the mortality transition in Greece. It proposes that an urban penalty was clearly operating in the country even during the early twentieth century. Finally, this paper suggests that a combination of factors was responsible for the mortality decline in Hermoupolis, including wider access to water, which even when it was not clean enough to drink, nevertheless enabled improvements in personal hygiene among the residents of the city.     

Child mortality under Chinese reforms

This paper looks at the impact of China's economic reforms on its health performance. Based on an appropriate health outcomes indicator, the logit of infant survival, it appears that while still out-performing most countries, China's relative advance decreased during the reform period. Consistent with the fact that the health system had to rely increasingly on private expenditures, we find an increasing impact of income on infant survival. We also show that relative prices at the provincial level matter for infant survival: for a given increase in income per capita, a real currency depreciation lowers survival. Focusing on poverty reduction still seems to be a major means to significantly improve infant survival in China.     

New perspectives on the contribution of sanitary investments to mortality decline in English cities, 1845–1909

Health improved in English cities in the last third of the nineteenth century, in tandem with substantial increases in public spending on water supplies and sanitation. However, previous efforts to measure the contribution of public expenditures to mortality improvements have been hampered by difficulties in quantifying public health investments and the lack of mortality data for specifically urban populations. We improve upon the existing evidence base by (1) creating measures of the stock of urban district sanitary capital, by type, on the basis of capital expenditure flows, rather than loan stocks; (2) using mortality and capital stock data that relate to the same administrative units (urban districts), and (3) studying the period 1880–1909 as well as the earlier period from 1845. The stock of sewerage capital was robustly related to improvements in all-cause mortality after 1880. The size of this effect varied with the extent of public investment in water supplies, suggesting complementarity between the two assets. For the period 1845–84, investments in water were associated with declines in infant and child mortality but the effect was much smaller and less precisely estimated in later decades. Our results suggest that improvements in water and sewerage targeted different transmission pathways for faecal–oral diseases.     

Analysis on Chinese Inequity in Health between the Urban and the Rural

Firstly the paper introduces the concept of the inequity in health, the method of measurement of inequity in health which is usually used to measure the inequity of income. Then we statistically describe the inequity in health between the urban and the rural in China, and analyze the correlative of the variety of income allocation and the variety of inequity in health.     

From home to hospital: The evolution of childbirth in the United States, 1928-1940

This paper examines the shift in childbirth from home to hospital that occurred in the United States in the early 20th century. Using a panel of city-level data over the period 1928-1940, we examine the impact on maternal mortality resulting from the shift of childbirth from home to hospital. Results suggest that until the late 1930s when sulfa drugs were developed, medical intervention had a limited impact on maternal mortality. Post-sulfa, the medicalization of childbirth reduced maternal mortality. Regressions estimated separately by race provide mixed evidence as to whether blacks and whites benefited differentially from medical intervention.     

浅谈医学人类学对身体及心理健康的影响

国民健康已成为最大的社会问题。医学人类学是一门新兴交叉学科。利用医学人类学的研究领域,更新观念,树立健康教育是终生教育的思想,把其贯穿于学生的德、智、体、美、劳教育中,确保身体及心理健康教育工作的多样性和延续性。     

城乡居民基本医疗保险制度对居民健康公平性的影响研究——基于嘉兴市的调查分析

本文主要是研究城乡居民基本医疗保险制度下的城乡居民健康公平性,为完善医疗保障制度提供科学依据.本文主要利用集中指数测量反映和经济状况有关的健康结果的公平性.探究城乡居民医保参保人员两周患病率、慢性病患病率、自评健康不良情况各自反映的健康不公平.通过对农村和城镇居民的比较分析发现差异和出现健康不公平的原因并提出相关建议.