Matjasko, Jennifer L.; Cawley, John H.; Baker-Goering, Madeleine M.; Yokum, David V.
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
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.
van der Swaluw, Koen; Lambooij, Mattijs S; Mathijssen, Jolanda J P; Zeelenberg, Marcel; Polder, Johan J; Prast, Henriëtte M
Many people aim to change their lifestyle, but have trouble acting on their intentions. Behavioral economic incentives and related emotions can support commitment to personal health goals, but the related emotions remain unexplored. In a regret lottery, winners who do not attain their health goals do not get their prize but receive feedback on what their forgone earnings would have been. This counterfactual feedback should provoke anticipated regret and increase commitment to health goals. We explored which emotions were actually expected upon missing out on a prize due to unsuccessful weight loss and which incentive-characteristics influence their likelihood and intensity. Participants reported their expected emotional response after missing out on a prize in one of 12 randomly presented incentive-scenarios, which varied in incentive type, incentive size and deadline distance. Participants primarily reported feeling disappointment, followed by regret. Regret was expected most when losing a lottery prize (vs. a fixed incentive) and intensified with prize size. Multiple features of the participant and the lottery incentive increase the occurrence and intensity of regret. As such, our findings can be helpful in designing behavioral economic incentives that leverage emotions to support health behavior change.
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.
Hanoch, Yaniv; Finkelstein, Eric Andrew
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. PsycINFO Database Record (c) 2013 APA, all rights reserved.
Niileksela, Christopher R.; Kaplan, Brent A.
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
Bickel, Warren K.; Moody, Lara; Higgins, Stephen T.
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. PMID:27283095
Bickel, Warren K; Moody, Lara; Higgins, Stephen T
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. Copyright © 2016 Elsevier Inc. All rights reserved.
In this thesis I apply the concepts of Behavioral Economics to the analysis of the individual health care behavior. In the first chapter I provide a theoretical explanation of the link between loss aversion and health anxiety leading to infrequent preventive testing. In the second chapter I analyze this link empirically based on the general population questionnaire study. In the third chapter I theoretically explore the effects of motivational crowding-in and crowding-out induced by external ...
In this thesis I apply the concepts of Behavioral Economics to the analysis of the individual health care behavior. In the first chapter I provide a theoretical explanation of the link between loss aversion and health anxiety leading to infrequent preventive testing. In the second chapter I analyze this link empirically based on the general population questionnaire study. In the third chapter I theoretically explore the effects of motivational crowding-in and crowding-out induced by external ...
Reisch, Lucia A.; Sunstein, Cass R.
Behavioral economics explores why people sometimes fail to make rational decisions, and how their behavior departs from the predictions of standard economic models. Insights gained from studies in behavioral economics are used in consumer research and consumer policy to understand and improve ind...... individuals' decisions about health, wealth, and happiness....
Tuinstra, J; Groothoff, JW; Van den Heuvel, WJA; Post, D
Socio-economic differences in risk behaviors in adolescence can be seen as a prelude to the re-emergence of socio-economic health differences in adulthood. We studied whether or not socio-economic differences in health risk behaviors are present in male and female adolescents in The Netherlands. The
Sendhil Mullainathan; Richard H. Thaler
Behavioral Economics is the combination of psychology and economics that investigates what happens in markets in which some of the agents display human limitations and complications. We begin with a preliminary question about relevance. Does some combination of market forces, learning and evolution render these human qualities irrelevant? No. Because of limits of arbitrage less than perfect agents survive and influence market outcomes. We then discuss three important ways in which humans devi...
Geckova, AM; van Dijk, JP; Honcariv, R; Groothoff, JW; Post, D
Aim. To investigate the role of health risk behavior, such as smoking and alcohol consumption, in the explanation of socio-economic health differences among adolescents. The hypothesis of different exposure and the hypothesis of different vulnerability were explored. Method. In the study carried out
Matjasko, Jennifer L; Cawley, John H; Baker-Goering, Madeleine M; Yokum, David V
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. Copyright © 2016 American Journal of Preventive Medicine. All rights reserved.
King, Dominic; Greaves, Felix; Vlaev, Ivo; Darzi, Ara
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.
Volpp, K G; Asch, D A
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. © The Author 2016. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: email@example.com.
Chambers, David W
It is human nature to overestimate how rational we are, both in general and even when we are trying to be. Such irrationality is not random, and the search for and explanation of patterns of fuzzy thinking is the basis for a new academic discipline known as behavioral economics. Examples are given of some of the best understood of our foibles, including prospect theory, framing, anchoring, salience, confirmation bias, superstition, and ownership. Humans have two cognitive systems: one conscious, deliberate, slow, and rational; the other fast, pattern-based, emotionally tinged, and intuitive. Each is subject to its own kind of error. In the case of rational thought, we tend to exaggerate our capacity; for intuition, we fail to train it or recognize contexts where it is inappropriate. Humans are especially poor at estimating probabilities, or even understanding what they are. It is a common human failing to reason backwards from random outcomes that are favorable to beliefs about our power to predict the future. Five suggestions are offered for thinking within our means.
dissemination of relaxation procedures is evident in industrialized countries since about 1970 both inside the medical healthcare system and as NGO-settings in a market-alike competition. However, a serious barrier to the dissemination of meditative de-stressing is the lack of general knowledge of the action...... for explanation of the neural dynamics of normal decision making. Secondly, the literature is reviewed for evidence on hypothesized applications of NeM in behavioral health. Results I. The present bias as documented by neuroeconomic game-trials is explained by NeM as rooted in the basal activation of Amygdala...... - a key center in our emotional arousal (limbic system) - as shaped in the elder stone-age with many acute threats. II. In general, the Hawthorne-effect of human-relations management is explained as the result of supportive job-relations relaxing Amygdala for better emotional integration...
Baicker, Katherine; Congdon, William J; Mullainathan, Sendhil
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. 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. 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. 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. © 2012 Milbank Memorial Fund.
- a key center in our emotional arousal (limbic system) - as shaped in the elder stone-age with many acute threats. II. In general, the Hawthorne-effect of human-relations management is explained as the result of supportive job-relations relaxing Amygdala for better emotional integration...... some are rooted in the religious tradition while other aim to be post-religious. Medical meditation across settings combines savings on health care costs with de-stressing benefits as reduced anxiety, less use of stimulants and a reduction of blood pressure which in all increase life...... is met by a meso-strategy aiming the formation of an international, multidisciplinary network which might organize regional workshops for representatives for all involved parties in order to prepare local implementation projects. Regarding de-stressing by medical meditation a relatively fast...
Ásgeirsdóttir, Tinna Laufey; Corman, Hope; Noonan, Kelly; Ólafsdóttir, Þórhildur; Reichman, Nancy E
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. Copyright © 2013 Elsevier B.V. All rights reserved.
Sharan, Alok D; Schroeder, Gregory D; West, Michael E; Vaccaro, Alexander R
As spinal care transitions from individual practitioners working in a volume-based reimbursement system toward multidisciplinary health care organizations working in a population-based model with value-based reimbursement, it is critical that insurance companies, administrators, and spine care provider have a clear understanding of how incentives change physician behavior. This article will introduce the concept of behavior economics, and discuss 9 principles relevant to physician decision-making.
Shuval, Kerem; Leonard, Tammy; Drope, Jeffrey; Katz, David L; Patel, Alpa V; Maitin-Shepard, Melissa; Amir, On; Grinstein, Amir
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;67:233-244. © 2017 American Cancer Society. © 2017 American Cancer Society.
Horii, Naoko; Habi, Oumarou; Dangana, Alio; Maina, Abdou; Alzouma, Souleymane; Charbit, Yves
Early initiation of breastfeeding after birth is a key behavioral health factor known to decrease neonatal mortality risks. Yet, few demographic studies examined how a community-based intervention impacts postpartum breastfeeding among the socio-economically deprived population in Sub-Saharan Africa. A post-intervention evaluation was conducted in 2011 to measure the effect of a UNICEF-led behavior change communication program promoting child health care in rural Niger. A quantitative survey is based on a post hoc constitution of two groups of a study sample, exposed and unexposed households. The sample includes women aged 15-49 years, having at least one child less than 24 months born with vaginal delivery. Rate ratio for bivariate analysis and multivariate logistic regression were applied for statistical analysis. The outcome variable is the initiation of breastfeeding within the first hour of birth. Independent variables include other behavioral outcome variables, different types of communication actions, and socio-demographic and economic status of mothers. The gaps in socio-economic vulnerability between the exposed and unexposed groups imply that mothers deprived from accessing basic health services and hygiene facilities are likely to be excluded from the communication actions. Mothers who practiced hand washing and used a traditional latrine showed 2.0 times more likely to initiate early breastfeeding compared to those who did not (95 % CI 1.4-2.7; 1.3-3.1). Home visits by community volunteers was not significant (AOR 1.2; 95 % CI 0.9-1.5). Mothers who got actively involved in exclusive breastfeeding promotion as peers were more likely to initiate breastfeeding within the first hour of birth (AOR 2.0; 95 % CI 1.4-2.9). A multi-sectorial approach combining hygiene practices and optimal breastfeeding promotion led to supporting early initiation of breastfeeding. A peer promotion of child health care suggests a model of behavior change communication strategy
Reisch, Lucia A.; Sunstein, Cass R.
Behavioral economics explores why people sometimes fail to make rational decisions, and how their behavior departs from the predictions of standard economic models. Insights gained from studies in behavioral economics are used in consumer research and consumer policy to understand and improve...
Moura Soares, Nara Michelle
Design The social, cultural, and economic context can be an important variable in the perception and adoption of risk behaviors in adolescents. Objective The purpose of this study was to identify the prevalence of simultaneous health risk behaviors and associated socioeconomic factors in adolescents living in the metropolitan region of Aracaju, State of Sergipe, Brazil. Methods The sample consisted of 2,207 high school students aged 13–18 years. The risk behaviors measured were “low levels of physical activity,” “excessive daily TV time,” “high consumption of alcoholic beverages on a single occasion,” “involvement in fights,” “smoking cigarettes,” “carrying firearms,” and “marijuana consumption.” Information was obtained through self-administered questionnaire. Results Considering the results, it was observed that female adolescents and those aged up to 16 years were less likely to have two or more health risk behaviors compared to males and those aged 17 years or more, respectively. It was also found that both high- and middle-income level adolescents had higher prevalence of having two or more health risk behaviors. Conclusions It was concluded that male adolescents older than 16 years with better socioeconomic level were more exposed to the simultaneous presence of several health risk behaviors. PMID:28815196
Arley Santos Leão
Full Text Available Design. The social, cultural, and economic context can be an important variable in the perception and adoption of risk behaviors in adolescents. Objective. The purpose of this study was to identify the prevalence of simultaneous health risk behaviors and associated socioeconomic factors in adolescents living in the metropolitan region of Aracaju, State of Sergipe, Brazil. Methods. The sample consisted of 2,207 high school students aged 13–18 years. The risk behaviors measured were “low levels of physical activity,” “excessive daily TV time,” “high consumption of alcoholic beverages on a single occasion,” “involvement in fights,” “smoking cigarettes,” “carrying firearms,” and “marijuana consumption.” Information was obtained through self-administered questionnaire. Results. Considering the results, it was observed that female adolescents and those aged up to 16 years were less likely to have two or more health risk behaviors compared to males and those aged 17 years or more, respectively. It was also found that both high- and middle-income level adolescents had higher prevalence of having two or more health risk behaviors. Conclusions. It was concluded that male adolescents older than 16 years with better socioeconomic level were more exposed to the simultaneous presence of several health risk behaviors.
Over the past twenty years, the emphasis of reform attempts to improve efficiency within the English National Health Service (NHS) has oscillated between markets and targets. Both strategies are informed by standard economic theory but thus far have achieved varying degrees of success. Behavioral economics is currently in vogue and offers an alternative (or, in some cases, a complement) to standard economic theory on what motivates human behavior. There are many aspects to behavioral economics, but space constraints allow just three to be considered here: identity, loss aversion, and hyperbolic discounting. An attempt is made in this article to speculate on the extent to which these three concepts can explain the success or otherwise of the NHS market and target policies of the last two decades, and some suggestions are offered as to how policies might be usefully designed in the future. Arguably the key points are that people are more likely to be motivated if they identify with the ethos of the policy; the threat of losses will often provoke more of a response than the promise of gains; and the "immediate moment" matters enormously to individuals, so policies that require human action should be designed to make that moment as enjoyable (or as pain free) as possible.
Rosser, J Barkley; Rosser, Marina V
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.
Mattei, Giorgio; De Vogli, Roberto; Ferrari, Silvia; Pingani, Luca; Rigatelli, Marco; Galeazzi, Gian Maria
Evidence exists supporting the impact of the Great Recession on health-related behaviors internationally, though few studies are available concerning the Italian population. To assess the impact of the late 2000s economic crisis on health-related behaviors linked to population mental health in Italy. Descriptive study. Health indicators came from the Italian Institute of Statistics database (years 2000-2015). Statistics performed by means of linear regression models. Increased smokers (β = 1.68, p = .03), heavy smokers, that is, people smoking 11-20 cigarettes per day (β = 2.18, p = .04) or more than 20 cigarettes per day (β = 1.04, p < .01) and mean number of smoked cigarettes per day (β = 0.56, p = .02) were noticeable. Also, prevalence of overweight increased (β = 0.91, p = .04), while the Italian families' expenditure for alcoholic beverages decreased (β = -812.80, p = .01). Alcohol consumption decreased (β = -0.60, p < .01), especially in men (β = -0.95, p < .01); binge drinking increased in years 2009-2010. No change was noticeable in the diet indicators collected. The economic crisis may have increased smoking, overweight and binge drinking in Italy (though data on the latter phenomenon are not conclusive), and reduced overall alcohol consumption.
“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.
Economic evaluation is a comparative analysis of costs and consequences of at least two or more interventions into HIV/AIDS, for example. There are ﬁve main economic evaluation methods: cost minimization analysis; output maximization analysis; cost-effectiveness analysis; cost-utility analysis; and cost-beneﬁt analysis.
The economics literature presents a growing number of studies focusing on risky health behaviors such as tobacco use or cannabis use. One of the most important characteristics of these risky health behaviors is that they harm the users and the people around the users, causing great social and
Koch, Alexander Karl; Nafziger, Julia; Nielsen, Helena Skyt
During the last decade knowledge about human behavior from psychology and sociology has enhanced the field of economics of education. By now research recognizes cognitive skills (as measured by achivement tests) as equally important drivers of later economic outcomes, and skills are seen as multi......-dimensional rather than one-dimensional. Explicitly accounting for soft skills often implies departing from the standard economic model by integrating concepts studied in behavioral and experimental economics, such as self-control, willingness to compete, intrinsic motivation, and self-confidence. We review how...... approaches from behavioral economics help our understanding of the complexity of educational investments and outcomes, and we discuss what insights can be gained from such concepts in the context of education....
Trzesniewski, Kali H.; Donnellan, M. Brent; Moffitt, Terrie E.; Robins, Richard W.; Poulton, Richie; Caspi, Avshalom
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…
Haff, Nancy; Patel, Mitesh S; Lim, Raymond; Zhu, Jingsan; Troxel, Andrea B; Asch, David A; Volpp, Kevin G
To evaluate the use of behavioral economics to design financial incentives to promote health behavior change and to explore associations with demographic characteristics. Studies performed by the Center for Health Incentives and Behavioral Economics at the University of Pennsylvania published between January 2006 and March 2014. Randomized, controlled trials with available participant-level data. Studies that did not use financial incentives to promote health behavior change were excluded. Participant-level data from seven studies were pooled. Meta-analysis on the pooled sample using a random-effects model with interaction terms to examine treatment effects and whether they varied by incentive structure or demographic characteristics. The pooled study sample comprised 1403 participants, of whom 35% were female, 70% were white, 24% were black, and the mean age was 48 years (standard deviation 11.2 years). In the fully adjusted model, participants offered financial incentives had higher odds of behavior change (odds ratio [OR]: 3.96; p financial incentives and gender, age, race, income, or education. When further adjusting for incentive structure, blacks had higher odds than whites of achieving behavior change (OR: 1.67; p Financial incentives designed using concepts from behavioral economics were effective for promoting health behavior change. There were no large and consistent relationships between the effectiveness of financial incentives and observable demographic characteristics. Second-order examinations of incentive structure suggest potential relationships among the effectiveness of financial incentives, incentive structure, and the demographic characteristics of race and income.
Matthew O. Jackson
Recent analyses of social networks, both empirical and theoretical, are discussed, with a focus on how social networks influence economic behavior, as well as how social networks form. Some challenges of such research are discussed as are some of the important considerations for the future.
This study explored cross-country differences in the additive effects of socio-economic characteristics, health behaviors and medical comorbidities on subjective health of patients with diabetes. The study analyzed data from the Research on Early Life and Aging Trends and Effects (RELATE). The participants were 9,179 adults with diabetes who were sampled from 15 countries (i.e. China, Costa Rica, Puerto Rico, United States, Mexico, Argentina, Barbados, Brazil, Chile, Cuba, Uruguay, India, Ghana, South Africa, and Russia). We fitted three logistic regressions to each country. Model I only included socio-economic characteristics (i.e. age, gender, education and income). In Model II, we also included health behaviors (i.e. smoking, drinking, and exercise). Model III included medical comorbidities (i.e. hypertension, respiratory disease, heart disease, stroke, and arthritis), in addition to the previous blocks. Our models suggested cross-country differences in the additive effects of socio-economic characteristics, health behaviors and comorbidities on perceived health of patients with diabetes. Comorbid heart disease was the only condition that was consistently associated with poor subjective health regardless of country. Countries show different profiles of social and behavioral determinants of subjective health among patients with diabetes. Our study suggests that universal programs that assume that determinants of well-being are similar across different countries may be over-simplistic. Thus instead of universal programs that use one protocol for health promotion of patients in all countries, locally designed interventions should be implemented in each country.
Ammerman, Alice S; Farrelly, Matthew A; Cavallo, David N; Ickes, Scott B; Hoerger, Thomas J
Economic analysis is an important tool in deciding how to allocate scarce public health resources; however, there is currently a dearth of such analysis by public health researchers. Public health researchers and practitioners were surveyed to determine their current use of health economics and to identify barriers to use as well as potential strategies to decrease those barriers in order to allow them to more effectively incorporate economic analyses into their work. Data collected from five focus groups informed survey development. The survey included a demographic section and 14 multi-part questions. Participants were recruited in 2006 from three national public health organizations through e-mail; 294 academicians, practitioners, and community representatives answered the survey. Survey data were analyzed in 2007. Despite an expressed belief in the importance of health economics, more than half of the respondents reported very little or no current use of health economics in their work. Of those using health economics, cost-benefit and cost-effectiveness analysis and determination of public health costs were cited as the measures used most frequently. The most important barriers were lack of expertise, funding, time, tools, and data, as well as discomfort with economic theory. The resource deemed most important to using health economics was collaboration with economists or those with economic training. Respondents indicated a desire to learn more about health economics and tools for performing economic analysis. Given the importance of incorporating economic analysis into public health interventions, and the desire of survey respondents for more collaboration with health economists, opportunities for such collaborations should be increased.
Thorgeirsson, Tryggvi; Kawachi, Ichiro
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. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
Robinson, Lisa A; Hammitt, James K
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. © 2011 Society for Risk Analysis.
Rogowski, Wolf; John, Jürgen; IJzerman, Maarten Joost; Scheffler, Richard M.
Translational health economics (THE) can be defined as the use of theoretical concepts and empirical methods in health economics to bridge the gap between the decision to fund and use a new health technology in clinical practice (the backend of translational medicine) and the decision to invest into
Marc Le Menestrel
This paper argues that economic rationality and ethical behavior cannot be reduced one to the other, casting doubts on the validity of formulas like 'profit is ethical' or 'ethics pays'. In order to express ethical dilemmas as opposing economic interest with ethical concerns, we propose a model of rational behavior that combines these two irreducible dimensions in an open but not arbitrary manner. Behaviors that are neither ethical nor profitable are considered irrational (non-arbitrariness)....
Pantalone, David W; Czajkowski, Stephanie E; Taylor, S Wade
In this chapter, we will describe the state of the literature on behavioral health, which includes mental health and substance use problems, and the available treatment interventions to ameliorate these problems, for older adults living with HIV (OALH). The scientific literature on the behavioral health of OALH is highly underdeveloped, especially in terms of the creation of empirically supported interventions to alleviate psychological distress. From the literature that does exist, there are a number of salient factors that emerge, including stereotypes (i.e., older adults are not sexually active), stigmatization (of those who are HIV-positive), social isolation, unique psychosocial needs for newly-infected OALH, and elevated rates of emotional distress and concomitant disorders - especially, depression. These factors persist alongside findings that OALH have fewer sources of social or institutional support, fewer surviving peers, and a lack of family to care for them. Additionally, many OALH report problems with substance use, both as a function of their 'baby-boomer' generational status (i.e., people born between 1946 and 1964) and in terms of the life experiences associated with their HIV-positive status. Overall, it is unclear how mental health and substance use problems affect combination antiretroviral therapy adherence, multimorbidity, polypharmacy, or treatment outcomes in this population, and further study is needed. © 2017 S. Karger AG, Basel.
Just, David R; Payne, Collin R
Consumers regularly and predictably behave in ways that contradict standard assumptions of economic analysis such that they make decisions that prevent them from reaching rationally intended goals. These contradictions play a significant role with respect to consumers' food decisions and the effect these decisions have on their health. Food decisions that are rationally derived include those that trade short-term gains of sensory pleasure (hedonic) for longer term gains of health and wellness (utilitarian). However, extra-rational food decisions are much more common. They can occur because of the contexts in which they are made--such as being distracted or pressed for time. In these contexts, heuristics (or rules of thumb) are used. Because food decisions are made with little cognitive involvement, food policies designed to appeal to highly cognitive thought (e.g., fat taxes, detailed information labels) are likely to have little impact. Furthermore, food marketing environments influence not only what foods consumers buy but also how much. As a general principle, when individuals do not behave in their own interest, markets will feed perverse and sub-optimal behaviors. Given the limited ability of individuals to retain and use accurate health information coupled with varying levels of self control, profit motivations of marketers can become predatory--though not necessarily malicious. Alternative policy options that do not restrict choice are outlined, which enable consumers to make better decisions. These options allow for profit motivations of marketers to align with the long-term well being of the consumer.
274. 39 Icek Ajzen and Martin Fishbein, “The Influence of Attitudes on Behavior,” in The Handbook of Attitudes, ed. Dolores Albarracín, Blair...ROBERTSON ET AL. 1. Description Robertson et al. attempted to evaluate the efficacy of television commercial campaigns to encourage seat belt use.296...This study was conducted in a community whose television cable system had been modified to permit controlled marketing studies.297 All 13,800 homes
Leonard, Tammy; Shuval, Kerem; de Oliveira, Angela; Skinner, Celette Sugg; Eckel, Catherine; Murdoch, James C.
Purpose To examine the relationship between physical activity stages of change and preferences for financial risk and time. Design A cross-sectional, community-based study. Setting A low-income, urban, African American neighborhood. Subjects 169 adults Measures Self-reported physical activity stages of change—precontemplation to maintenance, objectively measured BMI and waist circumference, and economic preferences for time and risk measured via incentivized economic experiments. Analysis Multivariable ordered logistic regression models were used to examine the association between physical activity stages of change and economic preferences while controlling for demographic characteristics of the individuals. Results Individuals who are more tolerant of financial risks (OR=1.31, p<0.05) and whose time preferences indicate more patience (OR=1.68, p<0.01) are more likely to be in a more advanced physical activity stage (e.g. from preparation to action). The likelihood of being in the maintenance stage increases by 5.6 and 10.9 percentage points for each 1 unit increase in financial risk tolerance or 1 unit increase in the time preference measure, respectively. Conclusions Greater tolerance of financial risk and more patient time preferences among this low-income ethnic minority population are associated with a more advanced physical activity stage. Further exploration is clearly warranted in larger and more representative samples. PMID:23448410
Leonard, Tammy; Shuval, Kerem; de Oliveira, Angela; Skinner, Celette Sugg; Eckel, Catherine; Murdoch, James C
To examine the relationship between physical activity stages of change and preferences for financial risk and time. A cross-sectional, community-based study. A low-income, urban, African-American neighborhood. One hundred sixty-nine adults. Self-reported physical activity stages of change-precontemplation to maintenance, objectively measured body mass index and waist circumference, and economic preferences for time and risk measured via incentivized economic experiments. Multivariable ordered logistic regression models were used to examine the association between physical activity stages of change and economic preferences while controlling for demographic characteristics of the individuals. Individuals who are more tolerant of financial risks (odds ratio [OR] = 1.31, p < .05) and whose time preferences indicate more patience (OR = 1.68, p < .01) are more likely to be in a more advanced physical activity stage (e.g., from preparation to action). The likelihood of being in the maintenance stage increases by 5.6 and 10.9 percentage points for each one-unit increase in financial risk tolerance or one-unit increase in the time preference measure, respectively. Greater tolerance of financial risk and more patient time preferences among this low-income ethnic minority population are associated with a more advanced physical activity stage. Further exploration is clearly warranted in larger and more representative samples.
Full Text Available Background Previous studies have mostly focused on socio-demographic and health-related determinants of health-related behaviors. Although comprehensive health insurance coverage could discourage individual lifestyle improvement due to the ex-ante moral hazard problem, few studies have examined such effects. This study examines the association of a comprehensive set of factors including socio-demographic, health status, health insurance, and perceived change in health insurance coverage with health-related behaviors and their dynamics (ie, changes in behavior. Methods Using Survey of Health, Aging, and Retirement in Europe (SHARE data (a European aging survey among 50+ years old for the Netherlands in 2004 and 2007 (sample size: 1745, binary and multinomial logit models are employed to study health-related behaviors (daily smoking, excessive alcohol use, and physical inactivity in 2004 and their corresponding changes (stopping or starting unhealthy behavior between 2004 and 2007. Results Our findings show that being older, being female, having higher education and living with a partner increase the likelihood not to be a daily smoker or to stop daily smoking. At the same time, being older (OR = 3.02 [1.31, 6.95] and being female (OR = 1.77 [1.05, 2.96] increases the likelihood to be or to become physically inactive. We also find that worse perceived health insurance coverage in 2007 is associated with a lower likelihood (OR = 0.19 [0.06, 0.57] of stopping excessive alcohol use in that year. However, we do not find a strong association between the type of health insurance and health behavior. Conclusion Our findings show that all above mentioned factors (ie, socio-demographic and health status factors are associated with health-related behavior but not in a consistent way across all behaviors. Moreover, the dynamics of each behavior (positive or negative change is not necessarily determined by the same factors that determine the state of that
Sunstein, Cass R.; Reisch, Lucia A.
In recent years, there has been a great deal of discussion of uses of behavioral economics in policy circles, with a focus on empirical, conceptual and ethical questions. On the basis of data from many nations, our forthcoming book asks and answers a question pressing in democratic and nondemocra......In recent years, there has been a great deal of discussion of uses of behavioral economics in policy circles, with a focus on empirical, conceptual and ethical questions. On the basis of data from many nations, our forthcoming book asks and answers a question pressing in democratic...
Carroll, Kathryn A; Samek, Anya; Zepeda, Lydia
Displaying bundles of healthy foods at the grocery store is a health nudge that simplifies shopping and may have the potential for increasing fruit and vegetable (F&V) purchasing. To evaluate the impact of food bundling, we conduct an artefactual field experiment with community participants in a laboratory set up as a grocery store. Dual-self theory suggests that food choices may differ depending on whether shoppers are under cognitive load - in our experiment, we exogenously vary whether bundles are displayed (with and without a price discount) and whether shoppers are under cognitive load. Our findings align with prior studies that suggest unhealthy options are more likely to be selected when cognitive resources are constrained. When bundles are displayed, we observe increased F&V purchasing. We also observe a significant interaction between cognitive load and price discounting. We find discounted bundles are more effective in the absence of cognitive load, but non-discounted bundles are more effective when shoppers are under cognitive load. Although more research is warranted, our findings suggest that when shopping under cognitive load, it is possible that discounts impose additional cognitive strain on the shopping experience. For retailers and policymakers, our results point to the potential power of bundling as a strategy for increasing healthy food purchasing. Copyright © 2017 Elsevier Ltd. All rights reserved.
Behavioral economics has recently been the subject of considerable research with the consequence that theories in behavioral economics and finance have complementarily developed to comprise a research field known as 'behavioral finance'. Subsequent studies seeking to integrate game theory and behavioral economics come under the 'behavioral game theory' umbrella, while those wanting to integrate contract theory and behavioral economics fall under 'behavioral contract theory'. Given such circum...
Full Text Available The economic crisis, which struck in Europe since 2008, has raised concerns about the health of the less privileged, vulnerable and poor people of the continent - the ordinary people of Europe. There is currently sufficient evidence for the negative and, in certain countries, devastating effects of austerity policies on the financing of health and other services of general interest, essential to promote the proper functioning of our economies and the cohesion of our societies. This evidence proves that health and social services are seriously impaired.
Jha, Saurabh; Powell, Adam
The article will introduce radiologists to decision making under uncertainty to foster a better understanding of the overutilization of imaging. Understanding the precepts of the expanding field of behavioral economics has relevance for health care in general and radiology in particular.
Erev, Ido; Roth, Alvin E
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.
Lunze, Karsten; Paasche-Orlow, Michael K
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. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
Williams, Andrew M; Liu, Peggy J; Muir, Kelly W; Waxman, Evan L
Diabetic retinopathy is a common microvascular complication of diabetes mellitus and is the leading cause of new blindness among working-age adults in the United States. Timely intervention to prevent vision loss is possible with early detection by regular eye examinations. Unfortunately, adherence to recommended annual diabetic eye exams is poor. Public health interventions have targeted traditional barriers to care, such as cost and transportation, with limited success. Behavioral economics provides an additional framework of concepts and tools to understand low screening rates and to promote regular diabetic eye exams for populations at risk. In particular, behavioral economics outlines biases and heuristics that affect decision-making and underlie pervasive barriers to care, such as not viewing diabetic eye exams as a priority or perceiving oneself as too healthy to need an examination. In this review, we examine the literature on the use of behavioral economics interventions to promote regular diabetic eye exams. From the results of the included studies, we outline how concepts from behavioral economics can improve eye examination rates. In particular, the default bias, present bias, and self-serving bias play a significant role in precluding regular diabetic eye examinations. Potential tools to mitigate these biases include leveraging default options, using reminder messages, providing behavioral coaching, applying commitment contracts, offering financial incentives, and personalizing health messages. When combined with traditional public health campaigns, insights from behavioral economics can improve understanding of pervasive barriers to care and offer additional strategies to promote regular preventive eye care for patients with diabetes. Copyright © 2018 Elsevier Inc. All rights reserved.
John D Salamone
Full Text Available Abstract. 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.
Rivarola, Martin E.; Bergallo, Juan E.
In this work, the economical behavior of the Uranium Enrichment Plants, built using the Gaseous Isotopic Separation using Advanced Methods (SIGMA) (Separacion Isotopica Gaseosa por Metodos Avanzados) technology is analyzed. The calculations were made using an integrated computer code, where the cost of each main component of the plant is estimated. The program computes the production cost for several configurations of enrichment cascades, each one corresponding to a production rate. The program also includes a numerical optimizer and it seeks the SIGMA optimal configuration for a given set of design parameters. The present work does not contemplate the model and calculation of the auxiliary system costs. The total amortization cost is obtained by using the cascade capital cost and assuming that the auxiliary system represents a fixed part of the total cost.The results obtained show that the SIGMA technology for Enrichment Uranium Plants could achieve economical competition in a much lower production scale than the conventional Gaseous Diffusion Enrichment Plants. (author)
Marilisa Carneiro Leão Gabardo
Full Text Available The aim of this study was to investigate the association between sociodemographic, socioeconomic, psychosocial, and behavioral variables and oral health as assessed using the 14-question short version of the Oral Health Impact Profile (OHIP-14. A cross-sectional study was performed with 1095 adult residents from 38 census tracts in the municipality of São Leopoldo, State of Rio Grande do Sul, Brazil. Responses to the OHIP-14 were dichotomized, and bivariate (Chi-square and multivariate analysis (logistic regression and Wald's test were performed. In the bivariate analysis, the worse effects were reported by female individuals, the elderly, those with low family income, less schooling, those reporting a lower quality of life and social support, and smokers. In the multivariate analysis the following variables maintained their statistical significance: gender (female, age (50-59 years, family income (low, quality of life (low, social support (low, moderate, and smoking (smokers. Individuals' self-perception of their oral health was related to sociodemographic, socioeconomic, psychosocial, and behavioral variables, thus confirming that emphasis should be placed on social factors when addressing oral health problems.
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).
Full Text Available The turning point in economic science has now come, marked especially by triggering the biggest crisis since the Great Depression of '29-'33, has called into question the need to reconsider the status of economic science and finding ways in which it can increase its practical foundations. In the elaboration of this study I’ve took into account the fact that beyond any abstract, formal and mathematical model, economics is a science, having the man in its center. Furthermore, every economic process is based on the human being. But the way individuals behave does not follow precisely the pattern predicted by classical and neoclassical models, but most of the time they are making decisions under the influence of psychological factors. Starting from these assumptions I considered important to highlight a real need for psychology in economic research. Therefore, the aim of this work is exclusively theoretical meant to show that the study of psychological factors is necessary in economic research, because it allows a better explanation of the economic problems and lead to obtaining results closer to reality than those who only take into consideration economic factors. In this way I appealed to behavioral economics. This represents a new trend of economic thinking that reunites psychology with economy. The thing that I observed after finishing the study is that behavioral economics can increase the explanatory power of economics by providing more realistic psychological bases, because human behavior is not only the subject matter of economics but psychology too.
Reed, Derek D; Niileksela, Christopher R; Kaplan, Brent A
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.
Reconciling Psychology with Economics: Obesity, Behavioral Biology, and Rational Overeating Abstract: The modern phenomenon of obesity is an archetypal example of a behavior whose explanation simultaneously falls within the purview of psychology, economics, and the biological sciences. While psychologists and advocates of public health have long viewed overeating as a weakness or disease in need of treatment, economists have pointed out that "like any other consumer behavior" choices about di...
Chang, Leslie L; DeVore, Adam D; Granger, Bradi B; Eapen, Zubin J; Ariely, Dan; Hernandez, Adrian F
Behavioral challenges are often present in human illness, so behavioral economics is increasingly being applied in healthcare settings to better understand why patients choose healthy or unhealthy behaviors. The application of behavioral economics to healthcare settings parallels recent shifts in policy and reimbursement structures that hold providers accountable for outcomes that are dependent on patient behaviors. Numerous studies have examined the application of behavioral economics principles to policy making and health behaviors, but there are limited data on applying these concepts to the management of chronic conditions, such as heart failure (HF). Given its increasing prevalence and high associated cost of care, HF is a paradigm case for studying novel approaches to improve health care; therefore, if we can better understand why patients with HF make the choices they do, then we may be more poised to help them manage their medications, influence daily behaviors, and encourage healthy decision making. In this article, we will give a brief explanation of the core behavioral economics concepts that apply to patients with HF. We will also examine how to craft these concepts into tools such as financial incentives and social networks that may improve the management of patients with HF. We believe that behavioral economics can help us understand barriers to change, encourage positive behaviors, and offer additional approaches to improving the outcomes of patients with HF. © 2017 American Heart Association, Inc.
Zandstra, Elizabeth H; Miyapuram, Krishna P; Tobler, Philippe N
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. Copyright © 2013 Elsevier B.V. All rights reserved.
Greenwald, Mark K.
Summary The field of behavioral economics suggests that food and activity choices are governed by costs, available alternatives, and reinforcement. Here, we review basic and translational research using a behavioral economic (BE) framework with overweight or obese children up to age 18. We address BE concepts and methods, discuss developmental issues, the continuum of BE intervention approaches, findings of studies focused on increasing the cost of unwanted behaviors (i.e., energy-dense food intake and sedentary behavior) and decreasing the cost of desired behaviors (i.e., healthy food intake and PA), and our team's recent basic behavioral studies using BE approaches with minority adolescents. PMID:27261543
Udsen, Flemming Witt
for decision making meant to inform adaptation of the health economic evaluation approach. Based on developments in realist evaluation and experiences with conducting the evaluation of TeleCare North, four principles for health economic evaluation of complex telehealthcare interventions is outlined in order....... The results from the TeleCare North trial were used directly in a national decision to implement the telehealthcare solution to patients with severe COPD in Denmark and lead to considerable debate nationally. This debate could be viewed as an actual account of the usefulness of health economic evaluation...... to facilitate future health economic designs of telehealthcare that should ultimately answer if telehealthcare is cost-effective, for whom, why and under what circumstances....
There is a growing volume of literature on health economic evaluation, with this form of analysis becoming increasingly influential at the decision-making level worldwide. The purpose of this study was to review the current state of health economic evaluation in Greece, with a view to uncovering reasons why its use in this country is limited. A search of the NHS Economic Evaluation Database was undertaken. The search included cost, cost-of-illness, cost-minimization, cost-effectiveness, cost-consequences, cost-utility, and cost-benefit analyses and was narrowed only to Greek authors undertaking solo or joint health economic evaluation in Greece. The search revealed that, in Greece, very little health economic evaluation has been undertaken. The main reason for the lack of interest is that the current chaotic healthcare system structure and financing does not provide the appropriate incentives to stimulate a powerful interest in this type of research. This condition is a result of the lack of a long-term national health policy and the hesitation of the present and past Greek governments to date to proceed to large-scale reforms because of political considerations. The Greek governments have also been content with the good health indicators being achieved. Even if it is accepted that good health prevails in Greece, slower economic growth rates, an ageing population, and the continuous immigration will place increasing pressure on healthcare resources and will necessitate a more rational use of these resources. Health economic evaluation, by weighing benefits against costs, therefore, has an important role to play.
Full Text Available In the first part of the article I have dealt with the role and place of behavioral economics in the economic sciences. Classical economic theories are criticized by the behavioral economy. We think we are rational beings and that we make logical decisions based on the information we have at our disposal. In fact, we have our own cognitive limitations that can lead to hasty decisions or confusing judgments; the real individual is a complex person, with actions that result in failures and incomprehensible behaviors for the economics Behavioral economics is trying to explain why individuals often make irrational choices, and why decisions they take do not follow exactly the patterns predicted by classical and neoclassical economic models. This paper is trying to assess the individual behavior involved in the decision making process in the university space. This article describes aloso a series of experiments on behavioral economics. The experiments are from university life and contest the hypothesis of the perfectly rational person's existence in making decisions and the neoclassical economic theories and models that are based only on the premise of the existence of homo oeconomicus rationalis. Observations and experiments conducted with students at Constantin Brancusi University in Târgu-Jiu are relevant in challenging the hypothesis of perfect rationality, preference stability, perfect information and market efficiency. The research method used in this article is the experiment. Study results are useful for academic management.
Until the beginning of 1950s, the economic theory in general, and the microeconomic theory in particular, relied totally on the deterministic character of economic phenomena. Nowadays microeconomic models are built on uncertain elements in a competitive environment that is affected by risk and uncertainty. Two centuries later, traditional microeconomics, also known as derived microeconomics, continues to be based on Adam Smith’s theory. As individuals are interested in participating in commer...
Heukelom, F.; Emmett, R.; Biddle, J.E.
George Loewenstein, a prominent behavioral economist, recalls thatIn 1994, when Thaler, Camerer, Rabin, Prelec and I spent the year at the Center for Advanced Study in the Behavioral Sciences, we had a meeting to make a kind of final decision about what to call what we were doing. Remarkably, at
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. Copyright © 2014. Published by Elsevier GmbH.
Full Text Available Economics provides insight into how entrepreneurship influences growth and development and, on the other hand, how the macro structure of a region or country impacts the type and abundance of entrepreneurship. Economic analysis provides insights for scholars, guides practitioners and policymakers. From a broader perspective, economic theories guide the understanding of human behaviors and the constant quest toward realization, comprehension and improvement of human condition. Moreover, behavioral economics combines insights of psychology, sociology and economics in trying to better understand and predict human decision-making. At the intersection of economic studies with social sciences, behavioral economics succeeds to demonstrate, using laboratory tests and experiments, that on a shorter term people are quite capable to perform profitable economic computations and adopt rational behaviors, but on a long term run they easily become fallible in performing rational mental accounting and are vulnerable to several factors such as emotions, certain mass-manipulation techniques, lack of self control or procrastination, etc. Extended research in the field of behavioral economics reports many other various behavioral anomalies that may have the ability to explain seemingly irrational and unpredictable responses of individuals, in general, and entrepreneurs, in particular – especially when finding themselves in conditions of risk, uncertainty or incomplete information. Furthermore, the elevated consistency of these abnormalities suggests that they are divergent only to our traditional models, but that they could otherwise be the norm. The present article seeks to explain how such insights from behavioral economics may help us better understand and enhance our perspective on entrepreneurship, what are some of the most frequent biases characteristic to entrepreneurial behavior and decision-making, accounting as most notable for the field of
Murphy, James G; Dennhardt, Ashley A
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. Copyright © 2016 Elsevier Inc. All rights reserved.
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.
Amir, O; Ariely, D; Cooke, A; Dunning, D; Epley, N; Gneezy, U; Koszegi, B; Lichtenstein, D; Mazar, N; Mullainathan, S; Prelec, D; Shafir, E; Silva, J
Economics has typically been the social science of choice to inform public policy and policymakers. In the current paper we contemplate the role behavioral science can play in enlightening policymakers. In particular, we provide some examples of research that has and can be used to inform policy, reflect on the kind of behavioral science that is important for policy, and approaches for convincing policy-makers to listen to behavioral scientists. We suggest that policymakers are unlikely to in...
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. Copyright © 2014 Elsevier Ltd. All rights reserved.
Green, L W
The literatures on both behavior modification and behavioral development have engendered innovations in public health programs, addressing problems of patient adherance to preventive and therapeutic regimens, delay in seeking diagnosis of illness symptoms, risk-taking behavior, and other aspects of lifestyle associated with health. Because most of this literature derives from psychology, there has been a distinct bias in the construction of interventions, pointing them directly at individuals, usually in a counseling or small group mode of delivery. These developments served public health well enough during a decade or so when the preoccupation was with utilization of health services and medical management of chronic diseases. With the publication of the Lalonde Report in Canada in 1974, the passage of Public Law 94-317 in 1976 in the United States, and similar initiatives in other English-speaking and European countries, the recognition of the greater complexities of lifestyle development and modification in the absence of symptoms has taken hold. Policy makers and public health workers seek a more efficient and equitable set of strategies to meet the behavioral health challenges of modern society without placing the entire weight of responsibility for behavior on the individual or on therapeutic practitioners. Concurrently, on a more global scale and in the developing countries, a concern has emerged for strategies that give individuals, families, and communities a greater role in deciding their own health priorities. The convergence of these two trends--one seeking to distribute responsibility for lifestyle more equitably and the other seeking to distribute responsibility for planning health programs more equitably --calls for policies, strategies, and interventions that will place similar emphasis on health education and organizational, economic, and environmental supports for health behavior. The combination of these elements of support for behavior calls, in
Kukubajska, Marija Emilija; Koceva, Sonja
Economic disadvantage in less developed regions of the world is expected to result into higher illiteracy rate, among children in particular. Some developed countries do not follow this pattern. A paradox indicates: they pay special attention to nutrition and dietetics, yet record surprising illiteracy. Poor regions welcome new concepts of healthy nutrition and healthy education, while they also integrate existing traditional nutrition, just as developed societies promote health agricultural ...
Jha, Saurabh; Baker, Tom
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. Copyright © 2012 American College of Radiology. Published by Elsevier Inc. All rights reserved.
Full Text Available Abstrac The purpose of this study to analyze the relationship between social capital affects economic behavior in producing coffee plants in improving coffee farmers income. This study was conducted in the district of Bantaeng South Sulawesi. Subdistrict Tampobulu selected purposively. The study lasted for four months of April to July 2014. The data used in this study consist of primary data and secondary data. It can be concluded that social capital is trust networking and institutions affect economic behavior namely the production of coffee plants. Trust improving technology adoption Robusta and Arabica coffee cuttings while distrust led to rampant theft of coffee is still green. Networking affect the price of coffee and institutions influence the behavior of farmers in obtaining venture capital through middlemen. It is expected that future studies should be focused on the factors that influence the innovative behavior in increasing the production of coffee plants.
I. Lenoir-Wijnkoop (Irene); M. Dapoigny; D. Dubois; E. Ganse (Éric); I. Gutiérrez-Ibarluzea (Iñaki); J. Hutton; P. Jones; T. Mittendorf (Thomas); M.J. Poley (Marten); S. Salminen (Seppo); M.J.C. Nuijten (Mark)
textabstractThere 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
García-Romero, Maria T; Geller, Alan C; Kawachi, Ichiro
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. Copyright © 2015 Elsevier Inc. All rights reserved.
Hursh, Steven R.; Roma, Peter G.
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…
Mosekilde, Erik; Sterman, J.D.
The paper reviews the characteristic features of the main economic cycles and discusses the behavioral foundation for each mode at the microlevel. The analysis continues to illustrate some of the nonlinear dynamic phenomena that can arise through interaction between the various modes and through...
Strang, S; Park, S Q; Strombach, T; Kenning, P
According to standard economic theory higher monetary incentives will lead to higher performance and higher effort independent of task, context, or individual. In many contexts this standard economic advice is implemented. Monetary incentives are, for example, used to enhance performance at workplace or to increase health-related behavior. However, the fundamental positive impact of monetary incentives has been questioned by psychologists as well as behavioral economists during the last decade, arguing that monetary incentives can sometimes even backfire. In this chapter, studies from proponents as well as opponents of monetary incentives will be presented. Specifically, the impact of monetary incentives on performance, prosocial, and health behavior will be discussed. Furthermore, variables determining whether incentives have a positive or negative impact will be identified. © 2016 Elsevier B.V. All rights reserved.
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
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.
Operario, Don; Kuo, Caroline; Sosa-Rubí, Sandra G; Gálarraga, Omar
This article 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. 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 and behavioral economics can be combined into new approaches for HIV prevention. 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 sexually transmitted infection (STI) prevalence, HIV testing, HIV medication adherence, and drug use. 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. PsycINFO Database Record (c) 2013 APA, all rights reserved.
Operario, Don; Kuo, Caroline C.; Sosa-Rubí, Sandra G.; Gálarraga, Omar
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
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.
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. PMID:20220113
Health economic analyses quantify the costs and benefits of specific public health choices or interventions compared to current practice, thus informing decisions on the responsible use of scarce health care resources. The application of health economic evaluations to inform blood safety decisions
Behavioral Economics aims at understanding the decision of economic agents who are not necessarily monetary utility maximizers and accounts for the fact that agents may have other concerns next to economic gain. This thesis contributes to the literature by studying the behavior of economic agents
Choi, Seung Hee; Duffy, Sonia A
The objective of this article was to review the utility of established behavior theories, including the Health Belief Model, Theory of Reasoned Action, Theory of Planned Behavior, Transtheoretical Model, and Health Promotion Model, for addressing multiple health behaviors among people who smoke. It is critical to design future interventions for multiple health behavior changes tailored to individuals who currently smoke, yet it has not been addressed. Five health behavior theories/models were analyzed and critically evaluated. A review of the literature included a search of PubMed and Google Scholar from 2010 to 2016. Two hundred sixty-seven articles (252 studies from the initial search and 15 studies from the references of initially identified studies) were included in the analysis. Most of the health behavior theories/models emphasize psychological and cognitive constructs that can be applied only to one specific behavior at a time, thus making them not suitable to address multiple health behaviors. However, the Health Promotion Model incorporates "related behavior factors" that can explain multiple health behaviors among persons who smoke. Future multiple behavior interventions guided by the Health Promotion Model are necessary to show the utility and applicability of the model to address multiple health behaviors.
Rudmik, Luke; Drummond, Michael
To discuss health economic evaluation and improve the understanding of common methodology. This article discusses the methodology for the following types of economic evaluations: cost-minimization, cost-effectiveness, cost-utility, cost-benefit, and economic modeling. Topics include health-state utility measures, the quality-adjusted life year (QALY), uncertainty analysis, discounting, decision tree analysis, and Markov modeling. Economic evaluation is the comparative analysis of alternative courses of action in terms of both their costs and consequences. With increasing health care expenditure and limited resources, it is important for physicians to consider the economic impact of their interventions. Understanding common methodology involved in health economic evaluation will improve critical appraisal of the literature and optimize future economic evaluations. Copyright © 2012 The American Laryngological, Rhinological and Otological Society, Inc.
Victor Sidel; Barry S Levy
The current global economic crisis seriously threatens the health of the public. Challenges include increases in malnutrition; homelessness and inadequate housing; unemployment; substance abuse, depression, and other mental health problems; mortality; child health problems; violence; environmental and occupational health problems; and social injustice and violation of human rights; as well as decreased availability, accessibility, and affordability of quality medical and dental care. Health p...
Linnemayr, Sebastian; O'Hanlon, Claire; Uscher-Pines, Lori; Van Abel, Kristin; Nelson, Christopher
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).
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.
McLaughlin, Nancy; Ong, Michael K; Tabbush, Victor; Hagigi, Farhad; Martin, Neil A
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.
Purnell, Jason Q; Thompson, Tess; Kreuter, Matthew W; McBride, Timothy D
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.
Thomas P. Holmes; Randall A. Kramer
Economic valuations of changes in ecosystem health can provide quantitative information for social decisions. However, willingness to pay for ecosystem health may be motivated by an environmental ethic regarding the right thing to do. Counterpreferential choices based on an environmental ethic are inconsistent with the normative basis of welfare economics. In this...
Full Text Available The current global economic crisis seriously threatens the health of the public. Challenges include increases in malnutrition; homelessness and inadequate housing; unemployment; substance abuse, depression, and other mental health problems; mortality; child health problems; violence; environmental and occupational health problems; and social injustice and violation of human rights; as well as decreased availability, accessibility, and affordability of quality medical and dental care. Health professionals can respond by promoting surveillance and documentation of human needs, reassessing public health priorities, educating the public and policymakers about health problems worsened by the economic crisis, advocating for sound policies and programs to address these problems, and directly providing necessary programs and services.
LEVINE, David K.
Behavioral economics is an effort to bring psychological and emotional aspects of human behavior into economic theory. Critics of existing theory, including many psychologists and behavioral economists, poorly understand modern equilibrium and learning theory. That theory explains most phenomena of interest to economists. In some cases, however, it lacks predictive power. If there is a role for behavioral economics it is not in supplanting the existing theory, but in strengthening it to give ...
While it is well documented that economic expansions provide widespread and immediate financial benefits, the evidence on how an economic downturn affects individual's health behaviors is surprisingly mixed. In this paper, we take a structural approach to investigate the effects of wages and working hours on health behaviors of low-educated persons using variations in wages and hours caused by changes in local economic activity. In the empirical analysis, we adopt a two-sample instrumental variables approach to combine the data on individual health behaviors from the Behavioral Risk Factor Surveillance System (BRFSS) and the National Health Interview Survey (NHIS) with the data on individual employment from the Current Population Survey (CPS). The total sample size of the combined CPS-BRFSS data for the time period of 1984-2005 is 967,594, while that of the combined CPS-NHIS data for the time period of 1976-2001 is 364,078. We find that increases in wages caused by economic expansions are associated with greater consumption of cigarettes in the United States. We also find that increases in hours of work caused by economic expansions are associated with more cigarette consumption, but less physical activity and physician visits. More importantly, the evidence suggests that most of such effects associated with changes in hours of work can be attributed to the changes at the extensive margin of employment, meaning the changes in employment status, rather than the changes at the intensive margin, meaning changes in hours of work conditional on being employed. These findings imply that changes in employment may have heterogeneous impacts on time-intensive and less time-intensive health behaviors and also provide additional evidence on the importance of time in health production, particularly for time-intensive activities. Copyright © 2012 Elsevier Ltd. All rights reserved.
Full Text Available Recent years have witnessed much progress in the incorporation of economic considerations into the evaluation of public health interventions. In England, the Centre for Public Health Excellence within the National Institute for Health and Care Excellence works to develop guidance for preventing illness and assessing which public health interventions are most effective and provide best value for money...
Oppong, Raymond; Mistry, Hema; Frew, Emma
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.
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
Herrera, Ana Maria
This dissertation examines the relationship between oil price shocks and aggregate economic behavior in the U.S. The first chapter addresses the effects of changes in the price of crude oil on the manufacturing sector in VAR regressions and in a structural linear quadratic inventory model. It finds that oil price increases lead to reductions in manufacturing activity while oil price falls are not followed by booms. This asymmetry in the response of the manufacturing activity, the changes in the composition of the demand, and the large variations in sales of key investment and consumption goods favor a multi-channel transmission mechanism. The analysis shows that differences in the response of the various industrial sectors are determined by the cost structure of the industry as well as by the dynamics of the demand, cost and oil shocks. Positive oil price shocks are first transmitted from the transportation equipment industry to sectors such as primary metals products, rubber and plastics and textiles, later affecting the remaining sectors and the aggregates. In the short run inventories act as a buffer however, one and a half years after the shock significant production cuts do take place. Sluggishness in the response of aggregate output can be accounted by the behavior of inventories as well as by the time lags implied in the propagation from one industry to the remaining sectors and the aggregate. The second chapter studies the role of oil prices and monetary policy in accounting for business cycles in an identified VAR framework. It finds that the slowdown in GDP growth that follows an oil shock can not be solely explained by the response of the Fed's monetary policy. An "exogenous" monetary policy that holds the fed funds rate fixed would exert a large expansionary effect. Nevertheless, conditional on this policy, the reduction in economic activity persists and the price level increases leading to a sharp reduction in the short-term interest rate. In addition
Alcocer, Luis; Cueto, Liliana
The economic aspects of hypertension are critical to modern medicine. The medical, economic, and human costs of untreated and inadequately controlled hypertension are enormous. Hypertension is distributed unequally and with iniquity in different countries and regions of the world. Treatment of hypertension requires an investment over many years to prolong disease-free quality years of life. The high prevalence and high cost of the disease impacts on the microeconomics and macroeconomics of countries and regions. The criteria used for inclusion in clinical guidelines for hypertension impact on the cost and cost/utility of diagnosis or treatment.
U.S. Department of Health & Human Services — A list of VHA hospitals with behavioral health measure data. VHA reports data on a set of core performance measures for Hospital-Based Inpatient Psychiatric Services...
Renwick, Matthew J; Mossialos, Elias
Crowdfunding is an expanding form of alternative financing that is gaining traction in the health sector. This article presents a typology for crowdfunded health projects and a review of the main economic benefits and risks of crowdfunding in the health market. We use evidence from a literature review, complimented by expert interviews, to extend the fundamental principles and established theories of crowdfunding to a health market context. Crowdfunded health projects can be classified into four types according to the venture's purpose and funding method. These are projects covering health expenses, fundraising health initiatives, supporting health research, or financing commercial health innovation. Crowdfunding could economically benefit the health sector by expanding market participation, drawing money and awareness to neglected health issues, improving access to funding, and fostering project accountability and social engagement. However, the economic risks of health-related crowdfunding include inefficient priority setting, heightened financial risk, inconsistent regulatory policies, intellectual property rights concerns, and fraud. Theorized crowdfunding behaviours such as signalling and herding can be observed in the market for health-related crowdfunding. Broader threats of market failure stemming from adverse selection and moral hazard also apply. Many of the discussed economic benefits and risks of crowdfunding health campaigns are shared more broadly with those of crowdfunding projects in other sectors. Where crowdfunding health care appears to diverge from theory is the negative externality inefficient priority setting may have towards achieving broader public health goals. Therefore, the market for crowdfunding health care must be economically stable, as well as designed to optimally and equitably improve public health. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.
Full Text Available The paper provides a critical appraisal of the normative program of behavioral economics known as ‘new paternalism’. First, it explores the theoretical foundations of behavioral economics, describes major behavioral anomalies associated with bounded rationality of economic agents and discusses its normative principles and political implications. It then discusses the main empirical and conceptual drawbacks of new paternalism and provides arguments for the alternative non-welfarist normative tradition based on the idea of freedom.
Cutler, David M.
Health care is one of the economy's biggest industries, so it is natural that the health care industry should play some role in the teaching of introductory economics. There are many ways that health care can appear in such a context: in the teaching of microeconomics, as a macroeconomic issue, to learn about social welfare, and even to learn how…
Ettema, Jehan Frans; Kudahl, Anne Braad; Sørensen, Jan Tind
Animal health economics deals with quantifying the economic effects of animal disease, decision support tools in animal health management and further analysis of the management's impact at animal, herd or national level. Scientists from The Netherlands, France and Sweden have since 1988 organised...... informal workshops to exchange their knowledge and expertise in this field of science. This report contains the summary of the presentations given by 12 PhD students and 2 senior scientists of the Animal Health Economics workshops which was held on the 9th and 10th of November, 2006 at the Research Centre...... Foulum in Denmark. Different disciplines and approaches within Animal Health Economics are dealt with by the different scientists and the report contains a variety of novel results and projects. The resulting discussion is summarized in the report....
Full Text Available Abstract 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.
Martin, Greg; Grant, Alexandra; D'Agostino, Mark
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.
Azar, Ofer H.
Journal quality is a major consideration for authors, readers, and promotion and tenure committees, among others. Unfortunately, most behavioral economics and socio-economics journals are not included in published rankings or in Journal Citation Reports. Consequently, no objective ranking of these journals exists. To address this need, a list of journals in behavioral economics and socio-economics was compiled, and the number of articles that cited each journal was recorded for the periods 20...
Jeantet, Marine; Lopez, Alain
Health technology assessment consists in evaluating the incremental cost-benefit ratio of a medicine, a medical device, a vaccine, a health strategy, in comparison to alternative health technologies. This form of socio-eoonomic evaluation aims at optimizing resource allocation within the health system. By setting the terms of valid alternatives, it is useful to highlight public choices, but it cannot in itself make the decision as regards the public funding of patient's access to the considered technology. The decision to include such technology in the basket of health goods and sercices covered, the levels and conditions of the coverage, also result from budget constraints, from economic situation and from a political vision about health policy, social protection and public expenditure. Accordingly, health economic analysis must be implemented on specific and targeted topics. The decision making process, with its health, economic and ethical stakes, calls for a public procedure and debate, based on shared information and argument. Otherwise, health system regulation, confronted with radical and costly innovations in the coming years, will become harder to handle. This requires the development of health economic research teams able to contribute to this assessment exercise.
Benatar, Solomon R; Gill, Stephen; Bakker, Isabella
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.
Small, Neil; Mannion, Russell
Mainstream health economics labours under a misleading understanding of the nature of the topic area and suffers from a concomitant poverty of thinking about theory and method. The purpose here is to explore this critical position and argue that health economics should aspire to being more than a technical discipline. It can, and should, engage with transformative discourse. It is argued that the hermeneutic sciences, emphasising interpretation not instrumentality or domination, offer a route into the change to which one seeks to contribute. The article specifically focuses on the way Habermas provides insights in his approach to knowledge, reason and political economy. How he emphasises complexity and interaction within cultural milieu is explored and primacy is given to preserving the life-world against the encroachments of a narrow rationalization. The argument for a critical re-imagining of health economics is presented in three stages. First, the antecedents, current assumptions and critical voices from contemporary economics and health economics are reviewed. Second, the way in which health is best understood via engaging with the complexity of both the subject itself and the society and culture within which it is embedded is explored. Third, the contribution that hermeneutics, and Habermas' critical theory, could make to a new health economics is examined. The paper offers a radical alternative to health economics. It explores the shortcomings of current thinking and argues an optimistic position. Progress via reason is possible if one reframes both in the direction of communication and in the appreciation of reflexivity and communality. This is a position that resonates with many who challenge prevailing paradigms, in economics and elsewhere.
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…
Richards, Michael R; Sindelar, Jody L
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. 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. 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. 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. © 2013 Milbank Memorial Fund.
Cruz, Luciane; Lima, Ana Flavia Da Silva; Graeff-Martins, Ana; Maia, Carlos Renato Moreira; Ziegelmann, Patricia; Miguel, Sandoro; Fleck, Marcelo; Polanczyk, Carisi
As the responsibility and demand on health care grows and resources do not increase at the same pace, the healthcare system has been forced to reconsider the benefits and costs of their actions, to ensure a rational and effective decision-making process regarding the adoption of interventions and allocation of resources. Cost-effectiveness (CE) studies represent one of the basic tools to achieve this goal. To present the current state of Health Technology Assessment (HTA) and health economics in mental health in Brazil and its importance to the decision-making process. Descriptive paper on HTA and health economics in Brazil. Databases from government and universities as well as some scientific databases to assess the information are presented. Economic analysis to evaluate interventions in mental health care is a relatively recent addition to the field of health economics; in Brazil, it is also considered a topic within Epidemiology research area. There have been an increased number of studies developed in high-income countries. However, there are fewer CE studies in low- and middle-income ones. Psychiatric disorders represent a significant burden in developing countries, where resources devoted to health care are even scarcer.
Linnemayr, Sebastian; Stecher, Chad
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 behavioral biases and the associated suboptimal adherence.
Bickel, W K; Snider, S E; Quisenberry, A J; Stein, J S
Understanding the abuse liability of novel drugs is critical to understanding the risk these new compounds pose to society. Behavioral economics, the integration of psychology and economics, can be used to predict abuse liability of novel substances. Here, we describe the behavioral economic concept of reinforcer pathology and how it may predict the use of novel drugs in existing drug-users and initiation of use in the drug-naive. © 2016 American Society for Clinical Pharmacology and Therapeutics.
David S. Murphy
Full Text Available Traditional economic theory postulates that people are rational. This implies that people make decisions to maximize their utility functions and to do this, that they have fully and correctly evaluated their preferences and limitations. Behavioral economics recognizes that this is not always true, that sometimes information is incomplete. This article is examines some of the effects of behavioral economics (which come largely from cognitive psychology in decision-making by investors in the stock exchanges.
F. Kokabisaghi (Fatemeh)
markdownabstract__Background:__ In the recent years economic sanctions have been very often applied in order to force states to change their behavior at international level and conform to the international law. Many studies show that sanctions are associated with deterioration of people’s enjoyment
Full Text Available Introduction: Health status and health-related quality of life of postmenopausal women are issues, which nowadays pose a serious challenge to many domains of science. Climacteric symptoms which occur at this stage of life, lower its quality and make a negative contribution to self-reported health status, are mostly observed in a particular group of women. Evaluation of health behaviors performed using a standardized questionnaire, the Health Behavior Inventory (HBI, may help establish a comprehensive diagnosis of women’s health, and thus select effective interventions. A systemic approach to menopause assumes that full fitness of women and good quality of their lives can be maintained not only by means of pharmacotherapy but also other forms of action, especially health education oriented towards changes in the lifestyle and promotion of healthy behaviors. The aim of this study is to perform a HBI-based assessment of women’s health behaviors in such categories as healthy eating habits (HEH, preventive behaviors (PB, positive mental attitudes (PMA, and health practices (HP. Material and methods: The study involved 151 healthy postmenopausal women. A research tool was a standardized questionnaire, the Health Behavior Inventory (HBI. Results: The surveyed women obtained 70% of the maximum score on average, which suggests a medium level of health behaviors in this group. The levels of health behaviors in the categories of positive mental attitudes and health practices significantly differed between older women and their younger counterparts (higher levels were observed among older respondents. There were also significant differences in the levels of healthy behaviors between women with secondary and higher education (those better educated declared healthy behaviors more often. There was no correlation between the level of health behaviors and the BMI of the surveyed women. Conclusions : Older women attached greater
According to the final consensus of a panel of intense discussions, the health care system should/can not be excluded from the economic laws of efficiency. Appropriate adaptation of various methods and instruments of economics make these tools applicable for use in the health care system. Due to errors in the implementation of economic methods, though, the question arises who is economically responsible in the health care system. The answer is found at three different levels of the health care system. The physician plays a leading role, both personally and professionally, in being primarily responsible for the direct medical treatment of the patient. The physician's dependence, however, on the health care system reduces his independence, which markedly affects his decision-making and treatment. Management of and in health care institutions is largely independent of the profession learned. Managers and physicians acting as managers must be appropriately and duly educated in the necessary specific talents and knowledge. The organisation of a health care system should also be reserved for trained specialists where the physicians as well as other professionals are obliged to acquire the skills necessary.
Haddad, F S; McLawhorn, A S
Health economic evaluations potentially provide valuable information to clinicians, health care administrators, and policy makers regarding the financial implications of decisions about the care of patients. The highest quality research should be used to inform decisions that have direct impact on the access to care and the outcome of treatment. However, economic analyses are often complex and use research methods which are relatively unfamiliar to clinicians. Furthermore, health economic data have substantial national, regional, and institutional variability, which can limit the external validity of the results of a study. Therefore, minimum guidelines that aim to standardise the quality and transparency of reporting health economic research have been developed, and instruments are available to assist in the assessment of its quality and the interpretation of results. The purpose of this editorial is to discuss the principal types of health economic studies, to review the most common instruments for judging the quality of these studies and to describe current reporting guidelines. Recommendations for the submission of these types of studies to The Bone & Joint Journal are provided. Cite this article: Bone Joint J 2016;98-B:147-51. ©2016 The British Editorial Society of Bone & Joint Surgery.
This PhD thesis contributes to the growing economic literature which studies effects of social and cultural variables on economic behavior of older adults in Europe. Landes, cited in Guiso et al. (2006), states that "if we learn anything from the history of economic development, it is that culture makes all the difference” (p. 29). Indeed, in the recent years economists put an effort to apply their analytical frameworks and empirical tools to study the role of culture on economic outcomes (Gu...
Kristina M. Rabarison
Full Text Available Contemporary public health professionals must address the health needs of a diverse population with constrained budgets and shrinking funds. Economic evaluation contributes to evidence-based decision making by helping the public health community identify, measure, and compare activities with the necessary impact, scalability, and sustainability to optimize population health. Asking how do investments in public health strategies influence or offset the need for downstream spending on medical care and /or social services? is important when making decisions about resource allocation and scaling of interventions.
Allgood, Sam; Bosshardt, William; van der Klaauw, Wilbert; Watts, Michael
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…
Leone, Frank T; Evers-Casey, Sarah; Graden, Sarah; Schnoll, Robert
Physicians self-report high adherence rates for Ask and Advise behaviors of tobacco dependence treatment but are much less likely to engage in "next steps" consistent with sophisticated management of chronic illness. A variety of potential explanations have been offered, yet each lacks face validity in light of experience with other challenging medical conditions. Conduct a preliminary exploration of the behavioral economics of tobacco treatment decision-making in the face of uncertain outcomes, seeking evidence that behaviors may be explained within the framework of Prospect Theory. Four physician cohorts were polled regarding their impressions of the utility of tobacco use treatment and their estimations of "success" probabilities. Contingent valuation was estimated by asking respondents to make monetary tradeoffs relative to three common chronic conditions. Responses from all four cohorts showed a similar pattern of high utility of tobacco use treatment but low success probability when compared with the other chronic medical conditions. Following instructional methods aimed at controverting cognitive biases related to tobacco, this pattern was reversed, with success probabilities attaining higher valuation than for diabetes. Important presuppositions regarding the potential "success" of tobacco-related patient interactions are likely limiting physician engagement by favoring the most secure visit outcome despite the limited potential for health gains. Under these conditions, low engagement rates would be consistent with Prospect Theory predictions. Interventions aimed at counteracting the cognitive biases limiting estimations of success probabilities seem to effectively reverse this pattern and provide clues to improving the adoption of target clinical behaviors.
Kahneman and Tversky and their behavioral economics stand in a long tradition of applying mathematics to human behavior. In the seventeenth century, attempts to describe rational behavior in mathematical terms run into problems with the formulation of the St. Petersburg paradox. Bernoulli’s
McGill, Bronwyn; O'Hara, Blythe J; Bauman, Adrian; Grunseit, Anne C; Phongsavan, Philayrath
To identify the behavioral economics (BE) conceptual underpinnings of lifestyle financial incentive (FI) interventions. A mapping review of peer-reviewed literature was conducted by searching electronic databases. Inclusion criteria were real-world FI interventions explicitly mentioning BE, targeting individuals, or populations with lifestyle-related behavioral outcomes. Exclusion criteria were hypothetical studies, health professional focus, clinically oriented interventions. Study characteristics were tabulated according to purpose, categorization of BE concepts and FI types, design, outcome measures, study quality, and findings. Data Synthesis and Analysis: Financial incentives were categorized according to type and payment structure. Behavioral economics concepts explicitly used in the intervention design were grouped based on common patterns of thinking. The interplay between FI types, BE concepts, and outcome was assessed. Seventeen studies were identified from 1452 unique records. Analysis showed 76.5% (n = 13) of studies explicitly incorporated BE concepts. Six studies provided clear theoretical justification for the inclusion of BE. No pattern in the type of FI and BE concepts used was apparent. Not all FI interventions claiming BE inclusion did so. For interventions that explicitly included BE, the degree to which this was portrayed and woven into the design varied. This review identified BE concepts common to FI interventions, a first step in providing emergent and pragmatic information to public health and health promotion program planners.
Baio, Gianluca; Dawid, A Philip
Health economic evaluations have recently become an important part of the clinical and medical research process and have built upon more advanced statistical decision-theoretic foundations. In some contexts, it is officially required that uncertainty about both parameters and observable variables be properly taken into account, increasingly often by means of Bayesian methods. Among these, probabilistic sensitivity analysis has assumed a predominant role. The objective of this article is to review the problem of health economic assessment from the standpoint of Bayesian statistical decision theory with particular attention to the philosophy underlying the procedures for sensitivity analysis. © The Author(s) 2011.
Spencer, Rachael A.; Komro, Kelli A.
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 U.S., 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 wellbeing. 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 wellbeing. PMID:28176020
Spencer, Rachael A; Komro, Kelli A
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.
Full Text Available The current economic and financial crisis gave room for the theoretical debates to reemerge. The economic reality challenged the mainstream neoclassical approach leaving the opportunity for the Austrian School, Post Keynesianism or Institutionalists to bring in front theories that seem to better explain the economic crisis and thus, leaving space for more efficient economic policies to result. In this context, the main assumptions of the mainstream theoretical approach are challenged and reevaluated, behavioral economics is one of the main challengers. Without developing in an integrated school of thought yet, behavioral economics brings new elements within the framework of economic thinking. How are the main theoretical approaches integrating these new elements and whether this process is going to narrow the theory or enrich it to be more comprehensive are questions to which this paper tries to answer, or, at least, to leave room for an answer.
Different applications of synthetic biology are alike in that their possible negative consequences are highly uncertain, potentially catastrophic, and perhaps irreversible; therefore, they are also alike in that public attitudes about them are fertile ground for behavioral economic phenomena. Findings from behavioral economics suggest that people may not respond to such applications according to the normal rules of economic evaluation, by which the value of an outcome is multiplied by the mathematical probability that the outcome will occur. Possibly, then, synthetic biology applications challenge the normative postulates of the standard approach, too. I want to first consider how some of the phenomena described by behavioral economists-and behavioral scientists more broadly-might affect people's perceptions of the uncertainties associated with synthetic biology. My analysis will be far from complete, however, because behavioral economics is essentially the study of human behavior, and thus its reach is potentially vast and its development longstanding and ongoing. Nonetheless, I hope to give an indicative perspective on how some aspects of behavioral economics might affect the assessment and perceived acceptability of synthetic biology. I will then consider the issue of agency. Should policy-makers respect people's reactions to synthetic biology when those reactions are known to be driven by behavioral economic phenomena rather than following the normative postulates of rational choice theory? Or should policy-makers dismiss these reactions as inherently biased? I will argue that the normative force of these human reactions (probably) depends on phenomenon and context. © 2018 The Hastings Center.
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.
Robinson, J C
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.
van Winden, F.; Ash, E.
This paper examines the implications of the brain sciences’ mechanistic model of human behavior for our understanding of crime. The rational crime model is replaced with a behavioral approach, which proposes a decision model comprising cognitive and emotional decision systems. According to the
Machalaba, Catherine; Smith, Kristine M; Awada, Lina; Berry, Kevin; Berthe, Franck; Bouley, Timothy A; Bruce, Mieghan; Cortiñas Abrahantes, Jose; El Turabi, Anas; Feferholtz, Yasha; Flynn, Louise; Fournié, Giullaume; Andre, Amanda; Grace, Delia; Jonas, Olga; Kimani, Tabitha; Le Gall, François; Miranda, Juan Jose; Peyre, Marisa; Pinto, Julio; Ross, Noam; Rüegg, Simon R; Salerno, Robert H; Seifman, Richard; Zambrana-Torrelio, Carlos; Karesh, William B
Global economic impacts of epidemics suggest high return on investment in prevention and One Health capacity. However, such investments remain limited, contributing to persistent endemic diseases and vulnerability to emerging ones. An interdisciplinary workshop explored methods for country-level analysis of added value of One Health approaches to disease control. Key recommendations include: 1. systems thinking to identify risks and mitigation options for decision-making under uncertainty; 2. multisectoral economic impact assessment to identify wider relevance and possible resource-sharing, and 3. consistent integration of environmental considerations. Economic analysis offers a congruent measure of value complementing diverse impact metrics among sectors and contexts. © The Author 2017. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.
Ivanov Roman V.
Full Text Available The main purpose of the publication is to study formation of the household economic behavior modeling in the context of development of economic thought and methods of the economic-mathematical modeling. The study was carried out under the assumption that, when studying the development of theoretical and methodological foundations of the economic behavior of households one must take into account not only the history of development of economic theory, but also the transformation of attitudes in other areas of human knowledge, in particular the paradigm shift in scientific thinking. It has been specified that the massive use of mathematical methods in economics is associated with formation of the marginal theory and at the same time – with the proliferation of the marginal analysis. At the present stage, the economic behavior of households is being analyzed in the terms of concepts such as neoclassicism, institutionalism and behaviorism. But by dividing the concepts of «individual» and «household», it can be argued that precisely the institutionalism in conjunction with synergistic approach provide the basis for elaboration of strategies for the economic behavior of households, ensuring their economic security.
Bismarck, E; Schmitz-Dräger, B J; Schöffski, O
Medicine has changed dramatically in the past ten decades thanks to the introduction of innovative diagnostic and therapeutic procedures. However, besides the unmistakable advances achieved in medicine, the costs of all health care systems have risen dramatically. In contrast to the escalation in expenditures, only moderate gains in proceeds have been accomplished. This situation requires that future financial resources be judiciously expended. The field of health economics has set as its goal the analysis of medical measures in terms of costs and benefits to be able to provide information on these parameters to those involved in the public health sector. The emerging problems are diverse and extend from assessment of effects and side effects to difficulties in standardizing analytical procedures and comparing results between different health care systems.In the context of this manuscript an attempt has been made to illustrate the methodological approaches to health economics based on current issues in the diagnosis and treatment of prostate cancer. This contribution intends to motivate stakeholders to view health economics as a tool to promote improvements in medical care and not as a means to regulating and rationing medical measures.
This thesis deals with a range of topics in health and labor economics. The first part examines the validity of a method that aims at improving the interpersonal comparability of self-reports in surveys. The second part is concerned with the question how the demand for medical care is related to
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...
Knoll, Melissa A Z
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.
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.
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 ...
This thesis consists of four essays dealing with topics that are relevant for the public sector. The essays cover diverse issues of economics partly overlapping with political science. The topics reach from the taxation of labor over monetary policy to preferences over voting institutions.
Behavioral law and economics applies the conceptual tools of behavioral economics to the analysis of legal problems and legal intervention. These models, and the experiments to test them, assume an institution free state of nature. In modern societies, the law's subjects never see this state of nature. However a rich arrangement of informal and formal institutions creates generalized trust. If individuals are sufficiently confident that nothing too bad will happen, they are freed up to intera...
Full Text Available The theory of classical economics treats entrepreneurs as subjects who make rational economic decisions. Empirical surveys prove the fact that daily economic decisions made by a separate economic entity can be explained by concepts of behavioral economics rather than classical economics. The economic behavior of entrepreneurs happens to be based on bounded rationality instead of financial justification. The objective of an economic activity presented as economically efficient can turn out to be socially important to a specific entrepreneur and not to national economy as a whole. In the EU countries, agriculture is a subsidised industry of national economy. In this light, status consumption and purchase of positional goods should create a special interest among economists. The objective of this article is to present true reasons of economic decisions made by rural entrepreneurs and to analyse the value hierarchy of Latvian rural entrepreneurs through carrying out a field work and with the help of set of instruments developed by modern economics theory.
This article proposes that equity in health is inseparable from social equity in its broadest sense. An equitable system allows the lowest income sectors to have access to an acceptable level of basic goods and services. Equity in health thus entails decreasing the differences in access to, and use of all health services. Globalization, on the other hand, means the process by which economic power is expanding and increasingly concentrated in the hands of corporations that are progressively entering national economies worldwide through the international free-market ideology. Explored in this article were some ways in which globalization leads to inequities.
Svetlana, V. Belikova
Full Text Available An attempt has been made to substantiate the behavioral features of the economic choice of an economic entity in the context of the decision-making environment transformation, and also to study their influence on the forming subjective preferences. At the same time, the behavioral paradigm is identified as a basic theoretical construct, which makes it possible to identify the main irrationalizing factors. Based on the study of the conceptual provisions of the behavioral paradigm, it was concluded that the preferences of the economic entity in the process of implementing the economic choice are formed under the influence of motivational and cognitive predictors, which limit the rationality of the economic entity. Deviating from rational criteria towards irrational, the economic entity shapes its preferences on the basis of economic and non-economic criteria, systematically making mistakes in the context of the influence of cognitive distortions manifested in decision-making under modern conditions. Based on the findings, the author constructs a model of economic choice, taking into account behavioral predictors. Among the most important cognitive distortions are herd instinct, professional deformation, "curse of knowledge", bias toward information retrieval, error of substantiation of assessment, bias of confirmation, neglect of formalized methods of cognition, conservatism, preferences of personified trust and heuristics of asymmetric perception.
... 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... and policies pertaining to Social, Behavioral and Economic Sciences Directorate programs and...
Human beings make decisions all the time. We decide what to eat when we are hungry, if we want to donate money to a charity, and what to do when facing moral temptations to cheat and lie for material gains. When it comes to understanding behavior, it is important to look at what people actually do...
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
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.
Shuval, Kerem; Stoklosa, Michal; Pachucki, Mark C; Yaroch, Amy L; Drope, Jeffrey; Harding, Matthew
To examine the relationship between economic time preferences and frequency of fast food and full-service restaurant consumption among U.S. adults. Participants included 5871U.S. adults who responded to a survey conducted in 2011 pertaining to the lifestyle behaviors of families and the social context of these behaviors. The primary independent variable was a measure of time preferences, an intertemporal choice assessing delay discounting. This was elicited via responses to preferences for an immediate dollar amount or a larger sum in 30 (30-day time horizon) or 60days (60-day time horizon). Outcomes were the frequency of fast food and full-service restaurant consumption. Ordered logistic regression was performed to examine the relationship between time preferences and food consumption while adjusting for covariates (e.g. socio-demographics). Multivariable analysis revealed that higher future time preferences were significantly related to less frequent fast food intake for both the 30- and 60-day time horizon variables (P for linear trend fast food than those with very low future time preferences (30-day: OR=0.74, 95%CI: 0.62-0.89; and 60-day: OR=0.86, 95%CI: 0.74-1.00). In comparison, higher future time preferences were not significantly associated with full-service restaurant intake (30-day: p for linear trend=0.73; 60-day: p for linear trend=0.83). Higher future time preferences were related to a lower frequency of fast food consumption. Utilizing concepts from behavioral economics (e.g. pre-commitment contracts) to facilitate more healthful eating is warranted using experimental studies. Copyright © 2016 Elsevier Inc. All rights reserved.
Full Text Available Traditional theory of the consumer explains development of demand through changes in prices and income. Consumer tastes and preferences are considered to be constant, stable, therefore does not take account of them in explaining market participants behavior. Indeed, from scientific point of view, can only be explained a behavior by a hypothesis relating to individual tastes or preferences since it would be impossible to subject to such a hypothesis to the test of facts. If your preferences are stable, how we interpret fast transformation of modes of consumption? The increase of income can explain an increase in volume for consumption, but not the changes in its structure. At the limit, relative prices could explain budget allocation between existing goods and services, but not the incessant occurrence of new goods and services, which they come to satisfy what current language means that new needs.
Koch, Carsten Allan
Whenever actors participate in transactions they expose themselves to risks of various kinds. Some of these risks are attributable to events outside the control of the participants and are unavoidable. Others originate in, or are aggrevated by, opportunistic actions undertaken by contract partners...... and other co-operators. This paper is concerned with the latter type of risk and the protection against it. Six protective mechanisms, which may serve as safeguards against opportunistic behavior, are presented and discussed. Special attention is paid to reputation effects. It is noted that such effects may...... account for the lack of opportunistic behavior with which networks are often credited. No protective mechanism is, however, effective under all circumstances....
Stoler, Avraham; Meltzer, David
There are theoretical reasons to expect that high risk of mortality or morbidity during young adulthood decreases investment in human capital. However, investigation of this hypothesis is complicated by a variety of empirical challenges, including difficulties in inferring causation due to omitted variables and reverse causation. For example, to compare two groups with substantially different mortality rates, one typically has to use samples from different countries or periods, making it difficult to control for other relevant variables. Reverse causation is important because human capital investment can affect mortality and morbidity. To counter these problems, we collected data on human capital investments, fertility decisions, and other economic choices of people at risk for Huntington's disease. Huntington's disease is a fatal genetic disorder that introduces a large and exogenous risk of early mortality and morbidity. We find a strong negative relation between mortality and morbidity risks and human capital investment. Copyright © 2012 John Wiley & Sons, Ltd.
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.
Allgood, Sam; Bosshardt, William; van der Klaauw, Wilbert; Watts, Michael
Studies regularly link levels of educational attainment to civic behavior and attitudes, but only a few investigate the role played by specific coursework. Using data collected from students who attended one of four public universities in our study, we investigate the relationship between economics coursework and civic behavior after graduation.…
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…
C-L. Chang (Chia-Lin); M.J. McAleer (Michael); W.-K. Wong (Wing-Keung)
textabstractThis Opinion article briefly reviews some of the literature in behavioural and financial economics that are related to health & medical economics. We then discuss some of the research on behavioural and financial economics that could be extended to health & medical economics beyond the
Chang, Chia-Lin; McAleer, Michael; Wong, Wing-Keung
textabstractThis Opinion article briefly reviews some of the literature in behavioural and financial economics that are related to health & medical economics. We then discuss some of the research on behavioural and financial economics that could be extended to health & medical economics beyond the existing areas in theory, statistics and econometrics.
This study analyzes leading research in behavioral economics to see whether it contains advocacy of paternalism and whether it addresses the potential cognitive limitations and biases of the policymakers who are going to implement paternalist policies. The findings reveal that 20.7% of the studied articles in behavioral economics propose paternalist policy action and that 95.5% of these do not contain any analysis of the cognitive ability of policymakers. This suggests that behavioral politic...
Ryan R J. McAllister
Full Text Available Policy design is largely informed by the traditional economic viewpoint that humans behave rationally in the pursuit of their own economic welfare, with little consideration of other regarding behavior or reciprocal altruism. New paradigms of economic behavior theory are emerging that build an empirical basis for understanding how humans respond to specific contexts. Our interest is in the role of human relationships in managing natural resources (forage and livestock in semiarid systems, where spatial and temporal variability and uncertainty in resource availability are fundamental system drivers. In this paper we present the results of an economic experiment designed to explore how reciprocity interacts with variability and uncertainty. This behavior underpins the Australian tradable grazing rights, or agistment, market, which facilitates livestock mobility as a human response to a situation where rainfall is so variable in time and space that it is difficult to maintain an economically viable livestock herd on a single management unit. Contrary to expectations, we found that variability and uncertainty significantly increased transfers and gains from trade within our experiment. When participants faced variability and uncertainty, trust and reciprocity took time to build. When variability and uncertainty were part of the experiment trust was evident from the onset. Given resource variability and uncertainty are key drivers in semiarid systems, new paradigms for understanding how variability shapes behavior have special importance.
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
Pócs, Dávid; Hamvai, Csaba; Kelemen, Oguz
Public health data show that early mortality in Hungary could be prevented by smoking cessation, reduced alcohol consumption, regular exercise, healthy diet and increased adherence. Doctor-patient encounters often highlight these aspects of health behavior. There is evidence that health behavior change is driven by internal motivation rather than external influence. This finding has led to the concept of motivational interview, which is a person-centered, goal-oriented approach to counselling. The doctor asks targeted questions to elicit the patient's motivations, strengths, internal resources, and to focus the interview around these. The quality and quantity of the patient's change talk is related to better outcomes. In addition, the interview allows the patient to express ambivalent feelings and doubts about the change. The doctor should use various communication strategies to resolve this ambivalence. Furthermore, establishing a good doctor-patient relationship is the cornerstone of the motivational interview. An optimal relationship can evoke change talk and reduce the patient's resistance, which can also result in a better outcome. The goal of the motivational interview is to focus on the 'why' to change health behavior rather than the 'how', and to utilize internal motivation instead of persuasion. This is the reason why motivational interview has become a widely-accepted evidence based approach. Orv Hetil. 2017; 158(34): 1331-1337.
First page Back Continue Last page Overview Graphics. HEALTH NEEDS SUSTAINABLE DEVELOPMENT, NOT MORE ECONOMIC GROWTH. The pursuit of carbon-emitting economic growth has not provided economic and social stability – key determinants of health - for much of the world's population. Better health for all ...
Soim Horatiu Florin
Full Text Available The cyclical path of economy is a common place in the economic theory. The economic crisis that started in 2007 was not only one of the most severe since the WWII but it came unexpectedly. The cause of the crises and of the surprise consists in the economic models and theories that were founded on the rationality and maximization behavior of the economic actor. People lack the rationality the mainstream economics assume. This is why both economists and simple people do not act as theory predicts and finally economy does not tend toward equilibrium but suffers recurrent crises. This crisis started as a financial one, because of the subprime loans made in USA, but have spread in production sector because of credit frozen, is now in transforming into a social crisis because of austerity measures taken by governments. The paper analyzes the theoretical foundation of economic theory and how the facts that characterize the recent economic evolution fit with the non mainstream theories. It presents the figures of the economic evolution in the last 3 years and explains them based of the agentâ€™s behavior described by Herbert Simon and Daniel Kahneman. Their challenge of mainstream economics is based on an analyze of human behavior. Herbert Simon introduced the concept of bounded rationality as opposed to perfect rationality postulated by neoclassic economics and Daniel Kahneman realized experiments that proved that people cannot stick with the performances assumed by mainstream economics. Their conclusion permit to understand the approach of George Soros who says that people actions are bounded by reflexivity and as a consequences sometimes economy move not toward but far from equilibrium, creating bubbles that end in financial and economic crises. As Akerlof mention the cause of the crisis is the reliance of a false theory which said that we are safe. The conclusion is that we need new theories more close to the real life and an agent description
Reed, Derek D; Kaplan, Brent A; Becirevic, Amel; Roma, Peter G; Hursh, Steven R
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. © 2016 Society for the Experimental Analysis of Behavior.
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.
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…
Jozefowiez, J.; Staddon, J. E. R.; Cerutti, D. T.
The authors 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…
Himmelstein, David U; Ariely, Dan; Woolhandler, Steffie
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.
Gili, Margalida; García Campayo, Javier; Roca, Miquel
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. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.
Tamba, B I; Azoicăi, Doina; Druguş, Daniela
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.
Wang, Ho-Wei; Chen, Duan-Rung
Obesity is highly correlated with the development of chronic diseases and has become a critical public health issue that must be countered by aggressive action. This study determined whether data from Google Trends could provide insight into trends in obesity-related search behaviors in Taiwan. Using Google Trends, we examined how changes in economic conditions-using business cycle indicators as a proxy-were associated with people's internet search behaviors related to obesity awareness, health behaviors, and fast food restaurants. Monthly business cycle indicators were obtained from the Taiwan National Development Council. Weekly Taiwan Stock Exchange (TWSE) weighted index data were accessed and downloaded from Yahoo Finance. The weekly relative search volumes (RSV) of obesity-related terms were downloaded from Google Trends. RSVs of obesity-related terms and the TWSE from January 2007 to December 2011 (60 months) were analyzed using correlation analysis. During an economic recession, the RSV of obesity awareness and health behaviors declined (r=.441, P<.001; r=.593, P<.001, respectively); however, the RSV for fast food restaurants increased (r=-.437, P<.001). Findings indicated that when the economy was faltering, people tended to be less likely to search for information related to health behaviors and obesity awareness; moreover, they were more likely to search for fast food restaurants. Macroeconomic conditions can have an impact on people's health-related internet searches. ©Ho-Wei Wang, Duan-Rung Chen. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 06.04.2018.
Scheffler, Richard M; Brown, Timothy T
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.
Lee, Shoou-Yih D.; Tsai, Tzu-I; Tsai, Yi-Wen; Kuo, Ken N.
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…
Reed, Derek D; Partington, Scott W; Kaplan, Brent A; Roma, Peter G; Hursh, Steven R
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. © Society for the Experimental Analysis of Behavior.
Wang, Li Yan; Nichols, Lauren P; Austin, S Bryn
To assess the economic effect of the school-based obesity prevention program Planet Health on preventing disordered weight control behaviors and to determine the cost-effectiveness of the intervention in terms of its combined effect on prevention of obesity and disordered weight control behaviors. On the basis of the intervention's short-term effect on disordered weight control behaviors prevention, we projected the number of girls who were prevented from developing bulimia nervosa by age 17 years. We further estimated medical costs saved and quality-adjusted life years gained by the intervention over 10 years. As a final step, we compared the intervention costs with the combined intervention benefits from both obesity prevention (reported previously) and prevention of disordered weight control behaviors to determine the overall cost-effectiveness of the intervention. Middle schools. A sample of 254 intervention girls aged 10 to 14 years. The Planet Health program was implemented during the school years from 1995 to 1997 and was designed to promote healthful nutrition and physical activity among youth. Intervention costs, medical costs saved, quality-adjusted life years gained, and cost-effectiveness ratio. An estimated 1 case of bulimia nervosa would have been prevented. As a result, an estimated $33 999 in medical costs and 0.7 quality-adjusted life years would be saved. At an intervention cost of $46 803, the combined prevention of obesity and disordered weight control behaviors would yield a net savings of $14 238 and a gain of 4.8 quality-adjusted life years. Primary prevention programs, such as Planet Health, warrant careful consideration by policy makers and program planners. The findings of this study provide additional argument for integrated prevention of obesity and eating disorders.
Promberger, Marianne; Marteau, Theresa M
To review existing evidence on the potential of incentives to undermine or "crowd out" intrinsic motivation, in order to establish whether and when it predicts financial incentives to crowd out motivation for health-related behaviors. We conducted a conceptual analysis to compare definitions and operationalizations of the effect, and reviewed existing evidence to identify potential moderators of the effect. In the psychological literature, we find strong evidence for an undermining effect of tangible rewards on intrinsic motivation for simple tasks when motivation manifest in behavior is initially high. In the economic literature, evidence for undermining effects exists for a broader variety of behaviors, in settings that involve a conflict of interest between parties. By contrast, for health related behaviors, baseline levels of incentivized behaviors are usually low, and only a subset involve an interpersonal conflict of interest. Correspondingly, we find no evidence for crowding out of incentivized health behaviors. The existing evidence does not warrant a priori predictions that an undermining effect would be found for health-related behaviors. Health-related behaviors and incentives schemes differ greatly in moderating characteristics, which should be the focus of future research. PsycINFO Database Record (c) 2013 APA, all rights reserved.
Behavioral economics and neuroeconomics bring together perspectives and methods from psychology, economics, and cognitive neuroscience to understand decision making and choice behavior. Extending an operant behavioral theoretical framework, these perspectives have increasingly been applied to understand the alcohol use disorders (AUDs), and this review surveys the theory, methods, and findings from this approach. The focus is on 3 key behavioral economic concepts: delay discounting (i.e., preferences for smaller immediate rewards relative to larger delayed rewards), alcohol demand (i.e., alcohol's reinforcing value), and proportionate alcohol-related reinforcement (i.e., relative amount of psychosocial reinforcement associated with alcohol use). Delay discounting has been linked to AUDs in both cross-sectional and longitudinal studies and has been investigated cross-sectionally using neuroimaging. Alcohol demand and proportionate alcohol-related reinforcement have both been robustly associated with drinking and alcohol misuse cross-sectionally, but not over time. Both have also been found to predict treatment response to brief interventions. Alcohol demand has also been used to enhance the measurement of acute motivation for alcohol in laboratory studies. Interventions that focus on reducing the value of alcohol by increasing alternative reinforcement and response cost have been found to be efficacious, albeit in relatively small numbers of randomized controlled trials (RCTs). Mediators and moderators of response to these interventions have not been extensively investigated. The application of behavioral economics and neuroeconomics to AUDs has given rise to an extensive body of empirical work, although significant gaps in knowledge remain. In particular, there is a need for more longitudinal investigations to clarify the etiological roles of these behavioral economic processes, especially alcohol demand and proportionate alcohol reinforcement. Additional RCTs are
MacKillop, James; Celio, Mark A; Mastroleo, Nadine R; Kahler, Christopher W; Operario, Don; Colby, Suzanne M; Barnett, Nancy P; Monti, Peter M
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.
action undertaken by individuals who perceive themselves to have a health problem or to be ill for the purpose of ... health behavior theories: 1. The Health Belief Model where the concept is the 'perceived ... Montaño DE, Kasprzyk D. Theory of reasoned action, theory of planned behavior, and the integrated behavioral ...
Madden, Gregory J.; Smethells, John R.; Ewan, Eric E.; Hursh, Steven R.
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,…
Madden, Gregory J.; Smethells, John R.; Ewan, Eric E.; Hursh, Steven R.
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…
Pennings, J.M.E.; Garcia, P.; Hendrix, E.M.T.
Based on recent findings from economics and the neurosciences, we present a conceptual decision-making model that provides insight into human decision-making and illustrates how behavioral outcomes are transformed into phenomena. The model may be viewed as a bridge between the seemingly disparate
Goeree, Ron; Diaby, Vakaramoko
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. Copyright © 2013 Elsevier Ltd. All rights reserved.
Pratt, Bridget; Loff, Bebe
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.
Guthrie, Joanne F
Nutrition education has a long history of being informed by economic thinking, with the earliest nutrition education guides incorporating household food budgeting into nutrition advice. Behavioral economics research goes beyond that traditional role to provide new insights into how consumers make choices. These insights have numerous potential applications for nutrition interventions to promote healthy food choices consistent with the US Dietary Guidelines for Americans. Research to test the value of such applications can contribute to the development of evidence-based nutrition education practice called for in federal nutrition education programs. Published by Elsevier Inc.
McClure, Christopher Bruce; Saemundsson, Sigurður Rúnar
The effects of economic recessions on dental health behaviors and care utilization are vastly unexamined. Thus, we aimed to ascertain changes in dental health behaviors and checkup frequency from before to after the start of the 2008 Icelandic economic collapse using a nationally representative, prospective cohort - the Health and Wellbeing in Iceland cohort. Participants in the cohort (n = 4100) were contacted first from October to December of 2007 and again from November to December of 2009. The questionnaires assessed respondent's demographics, dental behaviors (brushing, flossing), and dental checkup frequency. We present odds ratios derived from multivariate logistic regression of visiting a dentist annually after the collapse compared with before, as well as odds ratios of daily brushing and flossing habits. Overall, there was no strong evidence for drastic changes in dental health behaviors as from 2007 to 2009. However, employed men (odds ratio 1.29; 95% confidence interval 1.07-1.54) - as well as unemployed women (1.98; 1.00-3.92) - experienced increased odds of visiting a dentist at least annually. Additionally, men were more likely to brush (1.42; 1.05-1.93) and floss daily (1.20; 1.03-1.42) after the collapse compared with before. Overall, it seems as if the collapse did not have drastic negative effects on dental health behaviors of the population in Iceland. Our findings suggest that men may have opted for healthier dental health behaviors following the national economic collapse in 2008. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
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…
Care of the newborn: Community perceptions and health seeking behavior. ... Ethiopian Journal of Health Development ... national Safe Motherhood Community-Based Survey was carried out on behalf of the Family Health Department to explore community practices surrounding newborn health and care seeking behavior.
Full Text Available Behaviourists believe human capital is seen as the potential in people. They believe that the human resource in the organization are intangible assets embodied in the employees, not the people themselves. Behavioral economics emphasizes that people aren’t owned by the company, only their abilities and skills made available to the employer on the basis of certain legal relations which holds it to manage these assets in a rational way. Recognition of behavioral economics also highlights the aspects of development and human capital perspective, which appear in the may resource Staff in the future. These may be limited to: raise, awareness of capacity, internal aspirations, motives. Human capital management is nothing but a recognition of the relevant characteristics of the potential held within the company Staff and correct its use. As a consequence, it can bring tangible benefits to the organization.
Larissa Margareta BĂTRÂNCEA
Full Text Available The paper reviews the models of tax compliance with an emphasis on economic and behavioral perspectives. Although the standard tax evasion model of Allingham and Sandmo and other similar economic models capture some important aspects of tax compliance (i.e., taxpayers’ response to increases in tax rate, audit probability, penalty rate they do not suffice the need for an accurate prediction of taxpayers’ behavior. The reason is that they do not offer a comprehensive perspective on the sociological and psychological factors which shape compliance (i.e., attitudes, beliefs, norms, perceptions, motivations. Therefore, the researchers have considered examining taxpayers’ inner motivations, beliefs, perceptions, attitudes in order to accurately predict taxpayers’ behavior. As a response to their quest, behavioral models of tax compliance have emerged. Among the sociological and psychological factors which shape tax compliance, the ‘slippery slope’ framework singles out trust in authorities and the perception of the power of authorities. The aim of the paper is to contribute to the understanding of the reasons for which there is a need for a tax compliance model which incorporates both economic and behavioral features and why governments and tax authorities should consider these models when designing fiscal policies.
Orlistat with behavioral weight loss for obesity with versus without binge eating disorder: randomized placebo-controlled trial at a community mental health center serving educationally and economically disadvantaged Latino/as.
Grilo, Carlos M; White, Marney A
This study was a randomized placebo-controlled trial testing the addition of orlistat to behavioral weight loss for obesity in Spanish-speaking-only Latino/as with versus without binge eating disorder (BED) performed at a community mental health center serving educationally- and economically-disadvantaged patients. Latino/as have high rates of obesity but are under-represented in obesity treatment studies and despite comparable-to-or-higher rates of BED than Whites, Latino/as are under-represented in BED treatment studies. BED is associated with obesity but whether it predicts/moderates treatment outcomes remains uncertain. Thus, this study also tested whether BED prospectively predicts/moderates outcomes. Seventy-nine obese Spanish-speaking-only Latino/as with BED (N=40) versus without BED (N=39) at a community mental health center were randomly assigned to four-months of orlistat-plus-BWL or placebo-plus-BWL. BWL was culturally-enhanced modification of Diabetes-Prevention-Program delivered in weekly sessions in Spanish. Orlistat (120 mg tid) and matching-placebo delivered with standard clinical-management. Participants were assessed independently throughout treatment, post-treatment, and six-month follow-up. 78% completed treatments; completion rates did not differ significantly by medication or BED. Intent-to-treat mixed-models analyses revealed significant improvements in binge eating, eating-psychopathology, and depression, and significant--albeit modest--weight-loss. Overall, the addition of orlistat to BWL was not associated with greater improvements; however, BED moderated weight-loss: orlistat-plus-BWL produced significantly greater weight-loss in non-BED group but not in BED. Improvements were maintained through 6-month follow-up; BED significantly predicted/moderated increases in eating concerns and depression following treatment. Within BED-group, binge-eating remission rates were 65% (post-treatment) and 50% (follow-up). In this controlled trial
Birkimer, John C.; And Others
Discovers a high correlation between positive emotional states, supportive self talk, and specific healthy behaviors in college students. The correlated health behaviors were vigorous exercise, mild exercise, seat belts, and avoidance of alcohol and junk food. Considers the impact of negative self talk on the avoidance of negative behavior. (MJP)
Madrian, Brigitte C
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.
Loza, Cesar; Castillo-Portilla, Manuel; Rojas, José Luis; Huayanay, Leandro
Health Economics is an essential instrument for health management, and economic evaluations can be considered as tools assisting the decision-making process for the allocation of resources in health. Currently, economic evaluations are increasingly being used worldwide, thus encouraging evidence-based decision-making and seeking efficient and rational alternatives within the framework of health services activities. In this review, we present an overview and define the basic types of economic evaluations, with emphasis on complete Economic Evaluations (EE). In addition, we review key concepts regarding the perspectives from which EE can be conducted, the types of costs that can be considered, the time horizon, discounting, assessment of uncertainty and decision rules. Finally, we describe concepts about the extrapolation and spread of economic evaluations in health.
Behmann, M; Brandes, I; Walter, U
On 1 October 2003 the 9th Medical Practice Act came into effect and implemented the teaching subjects "health economics, health-care system, public health" in the medical curriculum. The purpose of the study was to define the content of teaching. Interviews were conducted with professors in charge of "health economics, health-care system, public health-at 36 German medical faculties. On the basis of the guidelines produced by the German association for social medicine and prevention (DGSMP), the course contents of the education programmes were evaluated in terms of relevance and integration into the lessons. The response rate was 78% (28 questionnaires). Seminars and lectures are most commonly used. The subject is taught at the end of the study (8th-10th terms). The issue "public health" has the lowest time slice, "health-care system" and "health economics" dominate the education. "Financing the health-care system", "basic principles (health economics)" and "stakeholders in the health care system" were stated to be the most important and most frequently taught topics. With the teaching of the subject, medical students become sensitised to efficiency and other topics beyond the natural sciences. The collaboration between physicians and other professionals promotes the ability to be critical in an economic and public health context. Implementing the subject students expand their knowledge of the health-care system thereby contributing to professionalism of the medical profession. © Georg Thieme Verlag KG Stuttgart · New York.
Skidmore, Jessica R; Murphy, James G; Martens, Matthew P
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. PsycINFO Database Record (c) 2014 APA, all rights reserved.
Bloem, S.; Stalpers, J.
This paper describes the key role of the subjective experience of health as the driver of health related behavior. Individuals vary greatly in terms of behaviors related to health. Insights into these interindividual differences are of great importance for all parties involved in health care,
Liviana Andreea Niminet
Full Text Available Behavioral are crucial for understanding both the consumer’s attitude and firms’ attitude as well as for understanding the market outcomes. The past ten years brought a lot of attention from researchers and policy-makers on the behavioral economics issue. Classical, traditional economic models rely on the assumptions of rationality and ordered preferences. Behavioral economics explores interactions between demand and supply including information framing, the use of heuristics in decision-making and time-inconsistent preferences. The research on behavioral economics has led to an extensive debate about the relative merits of both traditional and behavioral economics. First of all we propose to highlight the advantages and disadvantages of behavioral economics versus traditional economics on a very sensitive issue: the competition policy. Then we address market issues that can be solved by means of behavioral economics afterwards turning out attention to the remedies of behavioral economics and ,last but not least, the United Kingdom successful model on the matter of competition policy.
Full Text Available This paper examines the link between health indicators, environmental variables and economic development, and th e consequences of this relationship on economic convergence for a large sample of rich and poor countries. While in economic literature income and environment are seen to have an inverted-U shaped relationship (Environment Kuznets Curve hypothesis, it is also well established that an improvement in environmental quality is positively related to health. Our study focuses on the implications of this relationship for economic convergence. In the early stage of economic development, the gain from income growth could be cancelled or mitigated by environmental degradation through populations' health (and other channels and create a vicious circle in economic activity unlike in developed countries. This in turn could slow down economic convergence. To empirically assess these issues, we proceeded to an econometric analysis through three equations: a growth equation, a health equation and an environment equation. We found that health is a channel through which environment impacts economic growth. When we take into account the effect of environment quality on economic growth, the speed of convergence tends to increase slightly. This shows that environmental quality could be considered as a constraint for economic convergence.
"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.
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.
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. PMID:20797310
Full Text Available AIM: Women should be healthy and have health promotion behaviors, so they can accomplish both their maternal and social tasks. This descriptive study was conducted to determine the healthy life-style behaviors of married women and the factors which could affect those behaviors. METHOD: The population comprised all married women older than 15 years and who live in Ankara Kale region. Three hundred-sixty five married women were included in the study. The questionnaire form and the healthy life-style behaviors scale was used for data collection. RESULTS: The mean score taken from scale was 112.2±19.4. The scores of the women who graduated from middle school / high school, who have sufficient income and good socio-economic status, who have a perception of physical health fairly good and who have any chronic disease in their families, have significantly higher mean scores from healthy life-style behaviors scale and subgroups (p<0.05 CONCLUSION: Health promotion behaviors of the women was low and some factors like education level, income, socioeconomic status, perception of health, having any chronic illness and using regular medicine affected healthy life-style behaviors. It is recommended that nurses, who have education and consultation roles, should inform the women about health promotion behaviors and encourage them to use that information in their lives. [TAF Prev Med Bull 2009; 8(6.000: 497-502
Glied, Sherry A; Miller, Erin A
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. © The Author(s) 2015.
Mihaela Andreea STROE
Full Text Available The new economic approach starts from the idea that the individual does not need food, but feels the need to feed, or do not require newspapers, but feels the need of information. In this way, those who changes are not human preferences, but the way we satisfy them. At this stage of the paper, we explain the inconsistency in consumer preferences and the exceptions to the standard theory by making light upon what is called in behavioral economics: the effects of property, loss aversion and framing effects. In which concerns the standard economic model, it seems that there are discrepancies between objective measures of sources of comfort / discomfort and measures reported subjective sensations. Many defenders of classical model would argue that the measures are not reported subjective feelings of economic phenomena and therefore are not of interest to economists. However, when such feelings and sensations affect or may affect future decisions, things become relevant for the economy. Limited Rationality implies both that the agent is imperfectly informed decision-making in a complex and dynamic environment, and a limited ability processing.
Gipson, Christine S
This article provides a conceptual definition of the concept trigger within the context of health behaviors and applies it to the highly significant health issue of obesity. Healthy behaviors are essential to life and happiness, but they do not just happen. They are triggered, and an inner drive keeps them alive. To help patients gain and retain optimal health, nurses must understand the triggers of healthy behaviors. Walker and Avant's (2011) method of concept analysis is used as the basis for defining the concept of trigger. The antecedents, defining attributes, and consequences of trigger are identified. Findings suggest that nurses can play a role in triggering health behavior change through simple motivational efforts.
Sherman, Bruce; Block, Lori
More and more employers recognize the business impact of behavioral health concerns in the workplace. This article provides insights into some of the current innovations in behavioral health benefits, along with their rationale for development. Areas of innovation include conceptual and delivery models, technological advance- ments, tools for engaging employees and ways of quantifying the business value of behavioral health benefits. The rapid growth of innovative behavioral health services should provide employers with confidence that they can tailor a program best suited to their priorities, organizational culture and cost limitations.
Dolfin, M; Leonida, L; Outada, N
The complex interactions between human behaviors and social economic sciences is critically analyzed in this paper in view of possible applications of mathematical modeling as an attainable interdisciplinary approach to understand and simulate the aforementioned dynamics. The quest is developed along three steps: Firstly an overall analysis of social and economic sciences indicates the main requirements that a contribution of mathematical modeling should bring to these sciences; subsequently the focus moves to an overview of mathematical tools and to the selection of those which appear, according to the authors bias, appropriate to the modeling; finally, a survey of applications is presented looking ahead to research perspectives. Copyright © 2017 Elsevier B.V. All rights reserved.
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Ana Flávia Barros da Silva Lima
Full Text Available Objective: Technological advances in medicine have given rise to a dilemma concerning the use of new health technologies in a context of limited financial resources. In the field of psychiatry, health economic evaluation is a recent method that can assist in choosing interventions with different cost and/or effectiveness for specific populations or conditions. This article introduces clinicians to the fundamental concepts required for critical assessment of health economic evaluations. Methods: The authors conducted a review with systematic methods to assess the essential theoretical framework of health economic evaluation and mental health in Brazil through textbooks and studies indexed in the PubMed, Cochrane Central, LILACS, NHS CRD, and REBRATS databases. A total of 334 studies were found using the specified terms (MeSH - Mental Health AND Economic, Medical and filters (Brazil AND Humans; however, only five Brazilian economic evaluations were found. Results and conclusions: Economic evaluation studies are growing exponentially in the medical literature. Publications focusing on health economics as applied to psychiatry are increasingly common, but Brazilian data are still very incipient. In a country where financial resources are so scarce, economic analyses are necessary to ensure better use of public resources and wider population access to effective health technologies.
Westeneng, J.; D'Exelle, B.S.H.
This article uses data from Northern Tanzania to analyse how economic empowerment helps women reduce their reproductive health (RH) vulnerability. It analyses the effect of women's employment and economic contribution to their household on health care use at three phases in the reproductive cycle:
Impact of Reproductive Health on Socio-economic Development: A Case Study of Nigeria. ... African Journal of Reproductive Health ... 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.
Cooper, Keith; Shepherd, Jonathan; Picot, Jo; Jones, Jeremy; Kavanagh, Josephine; Harden, Angela; Barnett-Page, Elaine; Clegg, Andrew; Hartwell, Debbie; Frampton, Geoff; Price, Alison
Reducing sexually transmitted infections (STI) and teenage pregnancy through effective health education is a high priority for health policy. Behavioral interventions which teach skills to practice safer sex may reduce the incidence of STIs. We evaluated the cost-effectiveness of school-based behavioral interventions in young people. We developed an economic model to estimate the total number of STI cases averted, consequent gain in health related quality of life (HRQoL) and savings in medical costs, based on changes in sexual behavior. The parameters for the model were derived from a systematic literature search on the intervention effectiveness, epidemiology of STIs, sexual behavior and lifestyles, HRQoL and health service costs. The costs of providing teacher-led and peer-led behavioral interventions were €5.16 and €18 per pupil, respectively. For a cohort of 1000 boys and 1000 girls aged 15 years, the model estimated that the behavioral interventions would avert two STI cases and save 0.35 Quality Adjusted Life Years (QALYs). Compared to standard education, the incremental cost-effectiveness of the teacher-led and peer-led interventions was €24,268 and €96,938 per QALY gained, respectively. School-based behavioral interventions which provide information and teach young people sexual health skills can bring about improvements in knowledge and increased self-efficacy, though these may be limited in terms of impact on sexual behavior. There was uncertainty around the results due to the limited effect of the intervention on behavioral outcomes and paucity of data for other input parameters.
Cortès-Franch, Imma; González López-Valcárcel, Beatriz
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. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.
Nuijten, Mark; Lenoir-Wijnkoop, Irene
The role of nutrition to optimize the use of scarce resources through its linkage with health and welfare should be considered of interest by healthcare decision makers. A favorable impact of food on non-communicable disorders and general health status will improve healthcare expenditure and quality of life.In health economics, an analysis of the costs and effects of a healthcare technology by means of a cost-effectiveness analysis has become an established tool. Projections about the effectiveness and expected costs of an intervention can be modeled using realistic and explicit assumptions based on outcomes from randomized clinical studies. However, the use of health economic techniques to assess costs and effects is not solely restricted to classic healthcare products such as medicines. To illustrate this we used two published cost-effectiveness studies, which consider respectively a preventive treatment against severe respiratory syncytial virus infection in children at high risk of hospitalization and the use of prebiotics for the primary prevention of atopic dermatitis.These examples illustrate that there is a parallel between the methodologies for extrapolation of intermediate outcomes to long-term outcomes between a cost-effectiveness analysis for pharmaceutical or nutrition, as long as the clinical evidence for nutrition fulfils the requirements for pharmaceuticals. Another requirement is that there is clinical widely accepted evidence that matches a comparable level of epidemiological observations about the link between short-term and long-term outcomes.Better understanding of how nutritional status and behavior may interplay with the socioeconomic environment will ultimately contribute to preserving the sustainability of healthcare provisions. Copyright © 2011 Elsevier B.V. All rights reserved.
Shek, Daniel T. L.
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…
Chen, Frederick; Stevens, Ryan
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. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: firstname.lastname@example.org.
Full Text Available Tourist’s behavior research is focused on understanding and explaining the factors that affect tourist’s preferences and holiday destination choice. In this paper is analyzed the impact of the global economic crisis on the preferences toward leisure travels of the residents from Serbia. The paper is based on researches conducted in 2006-2009, through travel agencies and in 2011 on the general population major of age with support of TNS Medium Gallupa. Better understanding of the perception process and how tourists react to certain factor can give more accurate information on the dynamics of tourism demand and its dependence on tourist’s perception.
, and where women's health status is low, economic growth is low. In conclusion, we must ensure women's health, not only for the sake of ethics, but also for the sake of building economically strong countries where all people can thrive.
H. Al-Janabi (Hareth); N.J.A. van Exel (Job); W.B.F. Brouwer (Werner); J. Coast (Joanna)
textabstractHealth 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
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.
José Jonas Alves Correia
Full Text Available Psychology of Economics addresses issues far beyond market research. Thus, studies in this area also observe variables such as work, unemployment, decisions about purchases and savings, investments, financing, responses to advertising, among others. The present research was carried out with the objective of analyzing, through the fundamentals of consumer behavior, its relation to the propensity for compulsive or superfluous consumption. This quantitative study relates, using as means of phenomena and variables a description of the consumers behavior through the statistical tool Propensity Score Matching of Stata software. A semi-structured questionnaire was used to collect the data, which was applied online from April to August in 2016. Data analysis was performed by the Ordinary Least Squares (OLS regression with controlled dummy variables (dependent variable, whether or not it belongs to the consumer group Compulsive by the set of explanatory (independent variables. The results showed that the average monthly spending of compulsive consumers increases, and the higher the income of individuals, the greater the spending on unnecessary or superfluous consumption. Considering the gender variable, male individuals have higher levels of unnecessary spending and are prone to superfluous consumption. Thus, consumption is composed of influences for purchase and that the consumer determines consumption, according to economic position (income factor and cultural factors (customs, needs, impulsivities within the society.
Full Text Available 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.
Natalya Vasilyevna Krivenko
Full Text Available In the article, the definitions of the concept organizational and economic changes in institution problems of changes in public health service, the purpose and issues of the management system of organizational and economic changes in the field are considered. The combined strategy of development and innovative changes in management is offered. The need of resource-saving technologies implementation is shown. Expediency of use of marketing tools in a management system of organizational and economic changes is considered the mechanism of improvement of planning and pricing in public health service is offered. The author’s model of management of organizational and economic changes in health services supporting achievement of medical, social, economic efficiency in Yekaterinburg's trauma care is presented. Strategy of traumatism prevention is determined on the basis of interdepartmental approach and territorial segmentation of health care market
Dang, Amit; Likhar, Nishkarsh; Alok, Utkarsh
Health economic studies provide information to decision makers for efficient use of available resources for maximizing health benefits. Economic evaluation is one part of health economics, and it is a tool for comparing costs and consequences of different interventions. Health technology assessment is a technique for economic evaluation that is well adapted by developed countries. The traditional classification of economic evaluation includes cost-minimization, cost-effectiveness analysis, cost-utility analysis, and cost-benefit analysis. There has been uncertainty in the conduct of such economic evaluations in India, due to some hesitancy with respect to the adoption of their guidelines. The biggest challenge in this evolutionary method is lack of understanding of methods in current use by all those involved in the provision and purchasing of health care. In some countries, different methods of economic evaluation have been adopted for decision making, most commonly to address the question of public subsidies for the purchase of medicines. There is limited evidence on the impact of health insurance on the health and economic well-being of beneficiaries in developing countries. India is currently pursuing several strategies to improve health services for its population, including investing in government-provided services as well as purchasing services from public and private providers through various schemes. Prospects for future growth and development in this field are required in India because rapid health care inflation, increasing rates of chronic conditions, aging population, and increasing technology diffusion will require greater economic efficiency into health care systems. Copyright Â© 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.
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.
Wang, Fuhmei; Wang, Jung-Der; Huang, Yu-Xiu
Countries with limited resources in economic downturns often reduce government expenditures, of which spending on preventive healthcare with no apparent immediate health impact might be cut down first. This research aims to find the optimum share of preventive health expenditure to gross domestic product (GDP) and investigate the implications of preventive health services on economic performance and the population's wellbeing. We develop the economic growth model to undertake health-economic analyses and parameterize for Taiwan setting. Based on the US experiences over the period from 1975 to 2013, this research further examines the model's predictions on the relationship between preventive health expenditure and economic performance. Theoretical analysis and numerical simulations show that an inverse U-shaped relationship exists between the proportion of GDP spent on prevention and social welfare, as well as between the proportion spent on prevention and economic growth. Empirical analysis shows an under-investment in prevention in Taiwan. The spending of preventive healthcare in Taiwan government was 0.0027 GDP in 2014, while the optimization levels for economic development and social welfare would be 0 · 0119 and 0 · 0203, respectively. There is a statistically significant nonlinear relationship between health expenditure on prevention and the estimated real impact of economic performance from US experiences. The welfare-maximizing proportion of preventive expenditure is usually greater than the proportion maximizing economic growth, indicating a conflict between economic growth and welfare after a marginal share. Our findings indicate that it is worthwhile increasing investment on prevention up until an optimization level for economic development and social welfare. Such levels could also be estimated in other economies.
Rothgang, H; Staber, J
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.
Beltrán-Sánchez, HIRAM; Thomas, DUNCAN; Teruel, GRACIELA; Wheaton, FELICIA; Crimmins, EILEEN M.
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
Full Text Available Introduction: A very important role in the protection of human health is their life style, their habits and patterns of conduct. Early adulthood is the best period to achieve long-term benefits from a selection of healthy living. However, the results of studies on health-related behavior of youth in Poland and in the world are not satisfactory. The purpose of the study: The purpose of the research was to assess the health behaviors of students of higher education in Bydgoszcz. Material: The study involved 272 students (124 women and 148 men Bydgoszcz higher education students in the following fields of study: physiotherapy, nutrition, logistics and national security. The Inventory of Health-Related Behavior by Zygfryd Juczyński has been used in the research. The statistical analysis was performed using the package PQ Stat 1.6.2. Results: Throughout the treatment group an average level of health-related behavior has been shown. The results of the different categories of health-related behavior were lower than the results of the standardization groups. A higher level of health behavior has been shown in a group of medical students compared to non-medical students. The results for women were higher than men's results. Conclusions: The results of personal research and the research findings of other authors demonstrate that there is a need for implementation of programs of health promotion and health education in all fields of study.
Vicente Caballero de la Torre
Full Text Available This paper presents the origin of the issue of empathy in the History of Ideas and its importance in economics, as well as its revitalization. It concludes that it is not the study of empathy, so fashionable today, but the study of decision making the place where Economics can find the nature of emotions in relation to human behavior. This nature is its power to inhibit behavior. The study of repentance is itself more interesting and helpful for the economy than the study of empathy. Finally, the institutional approach is presented as the best in order to understand the issues related to economic human behavior
African Health Economics and Policy Research Capacity Building and Dissemination. As African countries move toward universal health coverage, it is clear there is a shortage of African experts with applied research skills in health financing such as fiscal space analysis, needs-based resource allocation methods, and ...
Rijlaarsdam, Jolien; Stevens, Gonneke W J M; van der Ende, Jan; Hofman, Albert; Jaddoe, Vincent W V; Mackenbach, Johan P; Verhulst, Frank C; Tiemeier, Henning
This study aimed to establish potential mechanisms through which economic disadvantage contributes to the development of young children's internalizing and externalizing problems. Prospective data from fetal life to age 3 years were collected in a total of 2,169 families participating in the Generation R Study. The observed physical home environment, the provision of learning materials in the home, maternal depressive symptoms, parenting stress, and harsh disciplining practices were all analyzed as potential mediators of the association between economic disadvantage and children's internalizing and externalizing problem scores. Findings from structural equation modeling showed that for both internalizing and externalizing problems, the mechanisms underlying the effect of economic disadvantage included maternal depressive symptoms, along with parenting stress and harsh disciplining. For internalizing but not for externalizing problem scores, the lack of provision of learning materials in the home was an additional mechanism explaining the effect of economic disadvantage. The current results suggest that interventions that focus solely on raising income levels may not adequately address problems in the family processes that emerge as a result of economic disadvantage. Policies to improve the mental health of mothers with young children but also their home environments are needed to change the economic gradient in child behavior.
Benning, Tim M; Alayli-Goebbels, Adrienne F G; Aarts, Marie-Jeanne; Stolk, Elly; de Wit, G Ardine; Prenger, Rilana; Braakman-Jansen, Louise M A; Evers, Silvia M A A
Attention is increasing on the consideration of broader non-health outcomes in economic evaluations. It is unknown which non-health outcomes are valued as most relevant in the context of health promotion. The present study fills this gap by investigating the relative importance of non-health outcomes in a health promotion context. We investigated the relative importance of ten non-health outcomes of health promotion programs not commonly captured in QALYs. Preferences were elicited from a sample of the Dutch general public (N = 549) by means of a ranking task. These preferences were analyzed using Borda scores and rank-ordered logit models. The relative order of preference (from most to least important) was: self-confidence, insights into own (un)healthy behavior, perceived life control, knowledge about a certain health problem, social support, relaxation, better educational achievements, increased labor participation and work productivity, social participation, and a reduction in criminal behavior. The weight given to a particular non-health outcome was affected by the demographic variables age, gender, income, and education. Furthermore, in an open question, respondents mentioned a number of other relevant non-health outcomes, which we classified into outcomes relevant for the individual, the direct social environment, and for society as a whole. The study provides valuable insights in the non-health outcomes that are considered as most important by the Dutch general population. Ideally, researchers should include the most important non-health outcomes in economic evaluations of health promotion.
Schoeni, Robert F; Dow, William H; Miller, Wilhelmine D; Pamuk, Elsie R
Higher educational attainment is associated with better health status and longer life. This analysis estimates the annual dollar value of the benefits that would accrue to less-educated American adults if they experienced the lower mortality rates and better health of those with a college education. Using estimates of differences in mortality among adults aged ≥ 25 years by educational attainment from the National Longitudinal Mortality Survey and of education-based differentials in health status from published studies based on the Medical Expenditure Panel Survey, combined with existing estimates of the economic value of a healthy life year, the economic value of raising the health of individuals with less than a college education to the health of the college educated is estimated. The annual economic value that would accrue to disadvantaged (less-educated) Americans if their health and longevity improved to that of college-educated Americans is $1.02 trillion. This modeling exercise does not fully account for the social costs and benefits of particular policies and programs to reduce health disparities; rather, it provides a sense of the magnitude of the economic value lost in health disparities to compare with other social issues vying for attention. The aggregate economic gains from interventions that improve the health of disadvantaged Americans are potentially large. Copyright © 2011 American Journal of Preventive Medicine. All rights reserved.
Wylie, David A; Gallagher, Helen L
The aim of this study was to explore self-reported transformational leadership behavior profiles within the six largest allied health profession groups in the National Health Service in Scotland and to determine whether factors such as seniority of grade, locus of employment, and/or leadership training have a positive influence on transformational leadership behaviors. A postal survey comprising the shorter version of the Multifactorial Leadership Questionnaire (MLQ) and contextual demographic information was completed by 753 allied health professionals from four Health Board areas across Scotland who were randomly selected through a modified cluster sampling technique. The MLQ contains 36 items that measure nine identified leadership factors; however, only the responses to the five transformational leadership factors are reported here. The study identified significant differences in transformational leadership behaviors between individual allied health professions. Radiographers and podiatrists scored consistently lower than the other professional groups across the range of transformational behaviors. Seniority of grade significantly influenced the scores, with higher-graded staff reporting greater leadership behaviors (p leadership training also positively influenced transformational behaviors (p transformational leadership behaviors between individual allied health professions, indicating that some professional groups are inherently advantaged in embracing the modernization agenda. This highlights an as-yet missed opportunity for effectively targeting and evaluating multidisciplinary leadership training programs across the allied health professions.
Wagmiller, Robert L., Jr.; Lennon, Mary Clare; Kuang, Li
The life course perspective emphasizes that past economic experiences and stage in the life course influence a family's ability to cope with negative life events such as poor health. However, traditional analytic approaches are not well-suited to examine how the impact of negative life events differs based on a family's past economic experiences,…
African Research Review ... In the South eastern states of Nigeria, health cannot be said to be making any significant impact in economic growth. ... There will be a meaningful economic improvement if ever there is a combined proactive engagement in healthcare delivery by the state governments and the citizens.
This paper examined the various socio-economic attributes (average income, educational ... Jakarta Indonesia, using three (3) areas of classified risk factors; ... It also attempts to evaluate the degree of relationship between socio-economic variable and environmental related health problems in the area. Study Area. Usually ...
Pérez, Glòria; Martí-Pastor, Marc; Gotsens, Mercè; Bartoll, Xavier; Diez, Elia; Borrell, Carme
to Describe perceived health, mental health and certain health-related behaviors according to sexual attraction and behavior in the population residing in Barcelona in 2011. Perceived health, mental health, chronic conditions and health-related behaviors were analyzed in 2675 people aged 15 to 64 years. The Barcelona Health Survey for 2011 was used, which included questions on sexual attraction and behavior. Multivariate robust Poisson regression models were fitted to obtain adjusted prevalence ratios. People feeling same-sex attraction reported a higher prevalence of worse perceived and mental health. These people and those who had had sex with persons of the same sex more frequently reported harmful health-related behaviors. Lesbian, gay, transgender and bisexual people may have health problems that should be explored in depth, prevented, and attended. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.
J. Müller (Julia); C. Schwieren (Christiane)
textabstractGrowing interest in using personality variables in economic research leads to the question whether personality as measured by psychology is useful to predict economic behavior. Is it reasonable to expect values on personality scales to be predictive of behavior in economic games? It is
Debrand, Thierry; Dourgnon, Paul
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.
Derumeaux-Burel, Hélène; Derancourt, Christian; Rambhojan, Christine; Branchard, Olivier; Hayes, Nathalie; Bénard, Antoine
The aim of health economic evaluation is to maximize health gains from limited resources. By definition, health economic evaluation is comparative, based on average costs and outcomes of compared interventions. Incremental costs and outcomes are used to calculate the cost-effectiveness ratio, which represents the average incremental cost per gained unit of effectiveness (i.e.: a year of life) with the evaluated intervention compared to the reference. The health economic rationale applies to all health domains. We cannot spend collective resources (health insurance) without asking ourselves about their potential alternative uses. This reasoning is useful to caregivers for understanding resources allocation decisions and healthcare recommandations. Caregivers should grab this field of expertise because they are central in this strategic reflection for defining the future French healthcare landscape. Copyright © 2016 Elsevier Masson SAS. All rights reserved.
The study then suggested the introduction of standard yardstick policy, which could be used to measure socio-economic status of residents in relation to their health status determinants in this country. African Research Review Vol. 2 (3) 2008: pp.
There is a wide variety of ethical arguments for public financing of health care that share a common structure built on a series of four logically related propositions regarding: (1) the ultimate purpose of a human life or human society; (2) the role of health and its distribution in society in advancing this ultimate purpose; (3) the role of access to or utilisation of health care in maintaining or improving the desired level and distribution of health among members of society, and (4) the role of public financing in ensuring the ethically justified access to and utilisation of health care by members of society. This paper argues that economics has much to contribute to the development of the ethical foundations for publicly financed health care. It focuses in particular on recent economic work to clarify the concepts of access and need and their role in analyses of the just distribution of health care resources, and on the importance of economic analysis of health care and health care insurance markets in demonstrating why public financing is necessary to achieve broad access to and utilisation of health care services. Key Words: Ethics • economics • health care financing PMID:11479353
Kathleen L. Wolf; Alicia S.T. Robbins
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,...
Ikefuji, M.; Magnus, J.R.; Sakamoto, H.
This paper studies the interplay between climate, health, and the economy in a stylized world with four heterogeneous regions, labeled ‘West’ (cold and rich), ‘China’ (cold and poor), ‘India’ (warm and poor), and ‘Africa’ (warm and very poor). We introduce health impacts into a simple integrated
Full Text Available Stefan Walzer,1,2 Daniel Droeschel,1,3 Mark Nuijten,4 Hélène Chevrou-Séverac5 1MArS Market Access and Pricing Strategy GmbH, Weil am Rhein, Germany; 2State University Baden-Wuerttemberg, Loerrach, Germany; 3Riedlingen University, SRH FernHochschule, Riedlingen, Germany; 4Ars Accessus Medica BV, Amsterdam, the Netherlands, 5Nestlé Health Science, Vevey, Switzerland Background: Medical nutrition is a specific nutrition category either covering specific dietary needs and/or nutrient deficiency in patients or feeding patients unable to eat normally. Medical nutrition is regulated by a specific bill in Europe and in the US, with specific legislation and guidelines, and is provided to patients with special nutritional needs and indications for nutrition support. Therefore, medical nutrition products are delivered by medical prescription and supervised by health care professionals. Although these products have existed for more than 2 decades, health economic evidence of medical nutrition interventions is scarce. This research assesses the current published health economic evidence for medical nutrition by performing a systematic literature review related to health economic analysis of medical nutrition. Methods: A systematic literature search was done using standard literature databases, including PubMed, the Health Technology Assessment Database, and the National Health Service Economic Evaluation Database. Additionally, a free web-based search was conducted using the same search terms utilized in the systematic database search. The clinical background and basis of the analysis, health economic design, and results were extracted from the papers finally selected. The Drummond checklist was used to validate the quality of health economic modeling studies and the AMSTAR (A Measurement Tool to Assess Systematic Reviews checklist was used for published systematic reviews. Results: Fifty-three papers were identified and obtained via PubMed, or directly
Onarheim, Kristine Husøy; Iversen, Johanne Helene; Bloom, David E
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. 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. 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. This review highlights the untapped potential of initiatives that aim to address women's health. Societies that prioritize women's health will likely have better population health
Kristine Husøy Onarheim
Full Text Available 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.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.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.This review highlights the untapped potential of initiatives that aim to address women's health. Societies that prioritize women's health will likely have better
Kaspin, Lisa C; Gorman, Kathleen M; Miller, Ross M
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.
Al-Janabi, Hareth; van Exel, Job; Brouwer, Werner; Coast, Joanna
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. PMID:26377370
Al-Janabi, Hareth; van Exel, Job; Brouwer, Werner; Coast, Joanna
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. © The Author(s) 2015.
Bound, John; Stinebrickner, Todd; Waidmann, Timothy
We specify a dynamic programming model that addresses the interplay among health, financial resources, and the labor market behavior of men late in their working lives. We model health as a latent variable, for which self reported disability status is an indicator, and allow self-reported disability to be endogenous to labor market behavior. We use panel data from the Health and Retirement Study. While we find large impacts of health on behavior, they are substantially smaller than in models that treat self-reports as exogenous. We also simulate the impacts of several potential reforms to the Social Security program.
Gadelha, Carlos Augusto Grabois; Costa, Laís Silveira; Maldonado, José
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.
Teixeira, Pedro J; Marques, Marta M
Health behavior change is central in obesity management. Due to its complexity, there has been a growing body of research on: i) the factors that predict the adoption and maintenance of health behaviors, ii) the development and testing of theories that conceptualize relationships among these factors and with health behaviors, and iii) how these factors can be implemented in effective behavior change interventions, considering characteristics of the content (techniques) and delivery. This short review provides an overview of advances in behavior change science theories and methods, focusing on obesity management, and includes a discussion of the main challenges imposed by this research field. © 2017 The Author(s) Published by S. Karger GmbH, Freiburg.
Taylor, Nicholas Kenji; Buttenheim, Alison M
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. 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. 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.
Osborn, Chandra Y.; Paasche-Orlow, Michael K.; Bailey, Stacy Cooper; Wolf, Michael S.
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, Pphysical activity (r=0.17, Pphysical activity to health status (r=0.17, Pliteracy sensitive and aim to enhance patient health knowledge and self-efficacy to promote self-care behavior and desirable health outcomes. PMID:20950164
Terre, Lisa; And Others
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…
Frahm-Falkenberg, S.; Ibsen, Rikke; Kjellberg, J.
, gender, geographical area and civil status. Direct health costs included primary and secondary sector contacts, medical procedures and medication. Indirect costs included the effect on labor supply. All cost data were extracted from national databases. The entire cohort was followed for the entire period......Background and purpose: Dementia causes morbidity, disability and mortality, and as the population ages the societal burden will grow. The direct health costs and indirect costs of lost productivity and social welfare of dementia were estimated compared with matched controls in a national register......- and health-related vulnerability was identified years prior to diagnosis. The average annual additional cost of direct healthcare costs and lost productivity in the years before diagnosis was 2082 euros per patient over and above that of matched controls, and 4544 euros per patient after the time...
Rahman, Mizanur; Curtis, Siân L; Chakraborty, Nitai; Jamil, Kanta
Bangladesh has made significant social, economic, and health progress in recent decades, yet many reproductive health indicators remain weak. Access to television (TV) is increasing rapidly and provides a potential mechanism for influencing health behavior. We present a conceptual framework for the influence of different types of TV exposure on individual's aspirations and health behavior through the mechanisms of observational learning and ideational change. We analyze data from two large national surveys conducted in 2010 and 2011 to examine the association between women's TV watching and five reproductive health behaviors controlling for the effects of observed confounders. We find that TV watchers are significantly more likely to desire fewer children, are more likely to use contraceptives, and are less likely to have a birth in the two years before the survey. They are more likely to seek at least four antenatal care visits and to utilize a skilled birth attendant. Consequently, continued increase in the reach of TV and associated growth in TV viewing is potentially an important driver of health behaviors in the country.
Full Text Available Bangladesh has made significant social, economic, and health progress in recent decades, yet many reproductive health indicators remain weak. Access to television (TV is increasing rapidly and provides a potential mechanism for influencing health behavior. We present a conceptual framework for the influence of different types of TV exposure on individual’s aspirations and health behavior through the mechanisms of observational learning and ideational change. We analyze data from two large national surveys conducted in 2010 and 2011 to examine the association between women’s TV watching and five reproductive health behaviors controlling for the effects of observed confounders. We find that TV watchers are significantly more likely to desire fewer children, are more likely to use contraceptives, and are less likely to have a birth in the two years before the survey. They are more likely to seek at least four antenatal care visits and to utilize a skilled birth attendant. Consequently, continued increase in the reach of TV and associated growth in TV viewing is potentially an important driver of health behaviors in the country.
Suka, Machi; Odajima, Takeshi; Okamoto, Masako; Sumitani, Masahiko; Igarashi, Ataru; Ishikawa, Hirono; Kusama, Makiko; Yamamoto, Michiko; Nakayama, Takeo; Sugimori, Hiroki
To examine the relationship between health literacy (HL), health information access, health behavior, and health status in Japanese people. A questionnaire survey was conducted at six healthcare facilities in Japan. Eligible respondents aged 20-64 years (n=1218) were included. Path analysis with structural equation modeling was performed to test the hypothesis model linking HL to health information access, health behavior, and health status. The acceptable fitting model indicated that the pathways linking HL to health status consisted of two indirect paths; one intermediated by health information access and another intermediated by health behavior. Those with higher HL as measured by the 14-item Health Literacy Scale (HLS-14) were significantly more likely to get sufficient health information from multiple sources, less likely to have risky habits of smoking, regular drinking, and lack of exercise, and in turn, more likely to report good self-rated health. HL was significantly associated with health information access and health behavior in Japanese people. HL may play a key role in health promotion, even in highly educated countries like Japan. In order to enhance the effects of health promotion interventions, health professionals should aim at raising HL levels of their target population groups. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Loewenstein, George; Asch, David A; Volpp, Kevin G
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.
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…
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Wolf, Michael S; Gazmararian, Julie A; Baker, David W
Limited health literacy is associated with poorer physical and mental health, although the causal pathways are not entirely clear. In this study, the association between health literacy and the prevalence of health risk behaviors was examined among older adults. A cross-sectional survey of 2923 new Medicare, managed-care enrollees was conducted in four U.S. metropolitan areas (Cleveland OH; Houston TX; Tampa FL; Fort Lauderdale-Miami FL). Health literacy was measured using the short form of the Test of Functional Health Literacy in Adults. Behaviors investigated included self-reported cigarette smoking, alcohol consumption, physical activity, body mass index, and seat belt use. Individuals with inadequate health literacy were more likely to have never smoked (46.7% vs. 38.6, p =0.01); to completely abstain from alcohol (75.6% vs. 57.9, p health literacy. No significant differences were noted by mean body mass index or seat belt use. In multinomial logistic regression models that adjusted for relevant covariates, inadequate health literacy was not found to be significantly associated with any of the health risk behaviors investigated. Among community-dwelling elderly, limited health literacy was not independently associated with health risk behaviors after controlling for relevant covariates.
Smith, Peter C; Ginnelly, Laura; Sculpher, Mark J
.... Choices about the use of health care budgets are inescapable and difficult. A number of countries have sought to strengthen their approach to priority setting by drawing on research-based evidence on the cost and effectiveness of different treatments. This book brings together leading experts in the field to summarize and analyse the experienc...
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
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.
Staats, Susan; Robertson, Douglas
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.…
Mizumoto, Kaori; Murakami, Genki; Oshidari, Kenro; Trisnantoro, Laksono; Yoshiike, Nobuo
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.
Wong, Germaine; Howard, Kirsten; Webster, Angela C; Morton, Rachael L; Chapman, Jeremy R; Craig, Jonathan C
Decision making is complex and difficult in clinical practice. Clinicians are often faced with a large range of possible alternative decision options, each with their own consequences and trade-offs. Health economics methods enable informed decision making on how best to allocate limited resources that could lead to most health gains. Economic evaluation in particular is highly relevant in transplantation medicine. Transplantation is an expensive intervention, but it improves the quality of life and survival of people with chronic diseases. The balance between health care resource use and the optimal health gains is useful not only to decision-makers, but also to consumers, clinicians, and researchers. This article is an overview of the concepts of economic evaluation in the setting of transplantation and highlights the applicability of these concepts in clinical transplantation.
Jooma, R; Khan, A; Khan, A A
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.
Paxson, Christina; Schady, Norbert
The effect of macroeconomic crises on child health is a topic of great policy importance. This article analyzes the impact of a profound crisis in Peru on infant mortality. It finds an increase of about 2.5 percentage points in the infant mortality rate for children born during the crisis of the late 1980s, which implies that about 17,000 more children died than would have in the absence o...
Full Text Available Maureen Reni Courtney,1 Christy Spivey,2 Kathy M Daniel1 1College of Nursing, 2College of Business, University of Texas at Arlington, Arlington, TX, USA Abstract: 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.Keywords: nursing, message framing, defaults, incentives, social norms, commitment devices, health care
Oosterhoff, Marije; van der Maas, Marloes E; Steuten, Lotte M G
Diagnostic biomarkers have multiple applications along the care process and have a large potential in optimizing treatment decisions. However, many diagnostic biomarkers struggle to gain market access and obtain appropriate coverage because of a lack of evidence on their health economic impact. The aim was to review the (methodological) characteristics of recent economic evaluations on diagnostic biomarkers and examine whether these studies dealt with specific issues such as different payer perspectives, preference heterogeneity, and multiple applications in subpopulations. The PubMed database and the National Health Service Economic Evaluation Database were searched. Full economic evaluations published after 2009 assessing diagnostic biomarkers for the main non-communicable diseases in middle-income or high-income countries were considered eligible. Empirical and methodological study characteristics were summarized, as was the handling of specific issues related to the economic evaluation of personalized medicine. Thirty-three economic evaluations were included, of which 25 were model-based analyses. The number of strategies compared ranged from two to 17 per study, and was especially large in studies assessing genetic testing in patients and their relatives. Cost-effectiveness results were most sensitive to test accuracy and costs of the biomarker (N = 7), the relative risk of an event (N = 4), and the proportion of people accepting genetic testing (N = 2). One study incorporated patient preferences, and none of the studies considered different payer perspectives, cost sharing arrangements or variable opportunity costs due to population density variability. Published health economic evaluations of biomarkers used for diagnosing, staging diseases, and guiding treatment selection are characterized by a large number of comparators to model the potential clinical applications and to determine their value. Assessing outcomes beyond health as well as specific
Wang, Zhi-chun; Yang, Xue-ying; Kang, Wen-long; Wang, Wen-jing
To take intervention measures for health promotion after investigation of occupational health needs among employees, to analyze the economic input and output of the intervention measures, and to analyze the feasibility of health promotion through cost-effectiveness analysis and cost-benefit analysis. A survey was conducted in an enterprise using a self-designed questionnaire to investigate the general information on enterprise, occupational history of each employee, awareness of occupational health knowledge, awareness of general health knowledge, awareness of hypertension, acquired immune deficiency syndrome, etc., lifestyle, and needs for health knowledge. Intervention measures were taken in the enterprise according to the investigation results, and then investigation and economic analysis of investment in health promotion, economic benefit, and absence of employees were performed using the questionnaire. After intervention, the awareness rate of the Code of Occupational Disease Prevention increased from 4.5% to 15.3%, the awareness rate of the definition of occupational diseases increased from 4.5% to 73.5%, and the awareness rate of the prevention and control measures for occupational diseases increased from 38.4% to 85.8%. Before intervention, 25.4%of all employees thought salt intake needed to be reduced, and this proportion increased to 92.5% after intervention. After the control strategy for health promotion, the benefit of health promotion that results from avoiding absence of employees and preventing occupational diseases was more than ten times the investment in health promotion, suggesting a significant benefit of health promotion conducted in the enterprise. The return on health promotion's investment for enterprise is worth. Health promotion really not just contribute to improve hygienic knowledge but increase the economic benefit.
CONCLUSIONS: Health promoting behaviors were found to be in moderate level among cement factory workers. In our country, health protection and development programs at the national level would be useful to standardize for employees in the industrial sector. [TAF Prev Med Bull 2015; 14(2.000: 153-162
Manafo, Elizabeth; Wong, Sharon
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…
Koch, Carsten Allan
The assumption of opportunistic behavior, familiar from transaction cost economics, has been and remains highly controversial. But opportunistic behavior, albeit undoubtedly an extremely important form of motivation, is not a necessary condition for the contractual problems studied by transaction...
Peters, Dorothee T.J.M.; Verweij, Stefan; Grêaux, K.; Stronks, Karien; Harting, Janneke
Improving health requires changes in the social, physical, economic and political determinants of health behavior. For the realization of policies that address these environmental determinants, intersectoral policy networks are considered necessary for the pooling of resources to implement different
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
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. 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. 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 for household size, the
S M Thumbi
Full Text Available 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.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.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 for household
Harianto, S.; Imron, A.; Setiawan, K. G.; Sadewo, F. X. S.
One of the changes in the suburban area is marked by changes in land conversion, from agriculture pattern to non-farming pattern, which also affects changes in people’s livelihoods and occupation such as a craftsman and shoe trader. Using a qualitative approach, this study focuses to examine how changes in social and economic behavior of suburban communities as a result of urban development. This study founded that there was a change of livelihood in village people occupation from farmers to craftsmen and slippers traders. These changes have an impact on changing patterns of social relationships such as social interaction, social awareness, and social solidarity. In addition, the increase in income of village residents also impact on lifestyle changes such as diet and entertainment. Thus it can be concluded that urban development has an impact on suburban societies in social relations and income generation. The results of this study can be used as a reference for the city government and district governments in arranging the layout and build prosperity of the community suburban.
Saffer, Henry; Dave, Dhaval; Grossman, Michael
This paper presents a new empirical study of the effects of televised alcohol advertising and alcohol price on alcohol consumption. A novel feature of this study is that the empirical work is guided by insights from behavioral economic theory. Unlike the theory used in most prior studies, this theory predicts that restriction on alcohol advertising on TV would be more effective in reducing consumption for individuals with high consumption levels but less effective for individuals with low consumption levels. The estimation work employs data from the National Longitudinal Survey of Youth, and the empirical model is estimated with quantile regressions. The results show that advertising has a small positive effect on consumption and that this effect is relatively larger at high consumption levels. The continuing importance of alcohol taxes is also supported. Education is employed as a proxy for self-regulation, and the results are consistent with this assumption. The key conclusion is that restrictions on alcohol advertising on TV would have a small negative effect on drinking, and this effect would be larger for heavy drinkers. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.
de Pouvourville, Gérard; Ulmann, Philippe; Nixon, John; Boulenger, Stéphanie; Glanville, Julie; Drummond, Michael
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.
Sidorov, Aleksandr I.; Beregovaya, Irina B.; Khanzhina, Olga A.
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.
Svetlana V. Mareeva
Full Text Available Based on the data of national representative surveys carried out by IS RAS in 2014-2016, the author presents analysis of consumption specifics in middle-income groups in times of current economic crisis. It is shown that although in modern Russian society middle income groups make up the majority of population, they cannot be directly correlated with the middle class defined in class theory framework. Middle-income groups are heterogeneous in different aspects, including their consumption specifics. Their standard of living remains quite modest, although it is significantly higher than the “survival standard”. New economic conditions led to widespread economy practices among them - primarily on consumption, followed by economy on hobbies and vacations. Economy practices also seriously affected middle-income strata investments in human capital – usage of paid educational and health services (this type of economy was more widespread among lower middle-income group than higher. Although representatives of the middle-income strata are quite actively using paid medical services (and relatively rarely – paid educational services, the reason for this more often lies in inaccessibility of free analogues rather than in search for the higher quality. Process of durables renewal in middle strata during the crisis was not as active, but their standard set of durable goods still widened over the past two years - primarily due to the relatively complex technological durables that they are gradually transferred from the category of innovation goods to the extended standard. In this regard, the upper middle income group successfully performs the function of the innovative consumer.
Weaver, Robert R; Lemonde, Manon; Payman, Naghmeh; Goodman, William M
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
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.
Bender, Bruce G
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.
O'Reilly, Daria; Tarride, Jean-Eric; Goeree, Ron; Lokker, Cynthia; McKibbon, K Ann
To conduct a systematic review and synthesis of the evidence surrounding the cost-effectiveness of health information technology (HIT) in the medication process. Peer-reviewed electronic databases and gray literature were searched to identify studies on HIT used to assist in the medication management process. Articles including an economic component were reviewed for further screening. For this review, full cost-effectiveness analyses, cost-utility analyses and cost-benefit analyses, as well as cost analyses, were eligible for inclusion and synthesis. The 31 studies included were heterogeneous with respect to the HIT evaluated, setting, and economic methods used. Thus the data could not be synthesized, and a narrative review was conducted. Most studies evaluated computer decision support systems in hospital settings in the USA, and only five of the studied performed full economic evaluations. Most studies merely provided cost data; however, useful economic data involves far more input. A full economic evaluation includes a full enumeration of the costs, synthesized with the outcomes of the intervention. The quality of the economic literature in this area is poor. A few studies found that HIT may offer cost advantages despite their increased acquisition costs. However, given the uncertainty that surrounds the costs and outcomes data, and limited study designs, it is difficult to reach any definitive conclusion as to whether the additional costs and benefits represent value for money. Sophisticated concurrent prospective economic evaluations need to be conducted to address whether HIT interventions in the medication management process are cost-effective.
Choe, Myoung Ae; Yi, Myungsun; Choi, Jung An; Shin, Gisoo
The purpose of this study was to identify health knowledge, health promoting behavior and factors influencing health promoting behavior of North Korean defectors in South Korea. Participants in this study were 410 North Korean defectors, over 20 years of age residing in Seoul. They were recruited by snowball sampling. Data were collected from April to June, 2010. Health knowledge, health promoting behavior, self-efficacy, perceived barriers to health promoting behavior and social support were measured by structured questionnaires, and perceived physical and mental health status were measured by one item with 10-point numeric rating scale. The data were analyzed using t-test, ANOVA, and multiple regression. Health knowledge, health promoting behavior, and perceived barriers to health promoting behavior were moderate while self-efficacy and social support were high. Factors influencing health promoting behavior of the participants were found to be self-efficacy, social support and perceived barrier to health promoting behavior. The results of this study indicate that nursing intervention programs enhancing self-efficacy, social support and reducing perceived barriers to health promoting behavior need to be developed for North Korean defectors in South Korea.
Murphy, James G.; Dennhardt, Ashley A.; Skidmore, Jessica R.; Borsari, Brian; Barnett, Nancy P.; Colby, Suzanne M.; Martens, Matthew P.
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…
Franken, Margreet; Heintz, Emelie; Gerber-Grote, Andreas; Raftery, James
A response to the challenge of high-cost treatments in health care has been economic evaluation. Cost-effectiveness analysis presented as cost per quality-adjusted life-years gained has been controversial, raising heated support and opposition. To assess the impact of economic evaluation in decisions on what to fund in four European countries and discuss the implications of our findings. We used a protocol to review the key features of the application of economic evaluation in reimbursement decision making in England, Germany, the Netherlands, and Sweden, reporting country-specific highlights. Although the institutions and processes vary by country, health economic evaluation has had limited impact on restricting access of controversial high-cost drugs. Even in those countries that have gone the furthest, ways have been found to avoid refusing to fund high-cost drugs for particular diseases including cancer, multiple sclerosis, and orphan diseases. Economic evaluation may, however, have helped some countries to negotiate price reductions for some drugs. It has also extended to the discussion of clinical effectiveness to include cost. The differences in approaches but similarities in outcomes suggest that health economic evaluation be viewed largely as rhetoric (in D.N. McCloskey's terms in The Rhetoric of Economics, 1985). This is not to imply that economics had no impact: rather that it usually contributed to the discourse in ways that differed by country. The reasons for this no doubt vary by perspective, from political science to ethics. Economic evaluation may have less to do with rationing or denial of medical treatments than to do with expanding the discourse used to discuss such issues. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.
Full Text Available The economic aspect of ethnicity represents a wide topic of research which still hasn’t been extensively studied in Serbian ethnology and anthropology. It encompasses numerous kinds of relationships between people who belong to the same ethnic group, as well as all kinds of economic discrimination or economic favorizing based on ethnic identity. In this paper I shall attempt to highlight some of the basic characteristics of this issue, and to point out the interconnectedness of economic behavior and ethnic identity, based on one case study. I shall also demonstrate some of the specifics of the socio-economic system within which the studied topic was considered (USA, as well as the complex and ambiguous influence that this system has had on ethnic identity through certain economic actions. The paper focuses on the economic aspect of ethnicity of the Serbian Diaspora in the US, and certain specific issues are considered through the example of the economic behavior of one Serbian immigrant from Romania.
Al'bitskii, V Iu; Makeev, N I
The article deals with the results of study of health preserving behavior of 310 students of senior classes of high schools of town of Jukovsky of Moskovskaya oblast. The higher level of prevalence of harmful habits among adolescents is revealed. It is emphasized that among girls the prevalence of harmful habits is not at large lower than among boys. The lower level of medical activities of respondents is explained by mistrusting physicians of curative preventive establishments, fear of queues, self-confidence in one's own knowledge and low level of medical awareness. The priority of physical culture and sport in the life of adolescents is reducing. The reorientation of trends in modern fashion to the behavior stereotypes with motional activities restriction occurs. The making of conditions to develop consistent health preserving behavior can become the most important reserve of preservation and enhancement of adolescents' health.
Puff, Jayme; Renk, Kimberly
In a time of economic recession, identifying how economic stress may be related to parenting stress, to the parenting behaviors used by mothers and fathers, and to young children's behavior problems may provide insight into interventions that may best assist families through their own economic crises. As part of this study, 124 culturally diverse parents with young children who ranged in age from 2- to 6-years rated their own economic, life, and parenting stress; their parenting behaviors; and their young children's behavior problems. Hierarchical regression analyses suggested that negative economic events and parenting stress provide unique incremental variance in predicting young children's internalizing problems, whereas life stress and parenting stress provide unique incremental variance in predicting young children's externalizing problems. With closer examination, parenting stress fully mediated the relationship between parents' financial cutbacks and young children's internalizing problems and the relationship between parents' negative economic events and young children's externalizing problems. These findings suggested that these variables are important to examine collectively.
Aston, Elizabeth R; Farris, Samantha G; MacKillop, James; Metrik, Jane
Drug demand, or relative value, can be assessed via analysis of behavioral economic purchase task performance. Five demand indices are typically obtained from drug purchase tasks. The goal of this research was to determine whether metrics of marijuana reinforcement from a marijuana purchase task (MPT) exhibit a latent factor structure that efficiently characterizes marijuana demand. Participants were regular marijuana users (n = 99; 37.4% female, 71.5% marijuana use days [5 days/week], 15.2% cannabis dependent) who completed study assessments, including the MPT, during a baseline session. Principal component analysis was used to examine the latent structure underlying MPT indices. Concurrent validity was assessed via examination of relationships between latent factors and marijuana use, past quit attempts, and marijuana expectancies. A two-factor solution was confirmed as the best fitting structure, accounting for 88.5% of the overall variance. Factor 1 (65.8% variance) reflected "Persistence," indicating sensitivity to escalating marijuana price, which comprised four MPT indices (elasticity, O max , P max , and breakpoint). Factor 2 (22.7% variance) reflected "Amplitude," indicating the amount consumed at unrestricted price (intensity). Persistence factor scores were associated with fewer past marijuana quit attempts and lower expectancies of negative use outcomes. Amplitude factor scores were associated with more frequent use, dependence symptoms, craving severity, and positive marijuana outcome expectancies. Consistent with research on alcohol and cigarette purchase tasks, the MPT can be characterized with a latent two-factor structure. Thus, demand for marijuana appears to encompass distinct dimensions of price sensitivity and volumetric consumption, with differential relations to other aspects of marijuana motivation.
Kim, Jiyeon; Jung, Minsoo
Abstract Background Although vaccinations are critical for preventing emerging infectious diseases, scant research has been conducted on risk communication. With socio-economic characteristics, health behavior, and underlying diseases under control, we investigated associations between media use, health information-seeking behavior, health information type, and vaccination in the population. Methods This study relied on a national survey of Korean adults (n = 1367). Participants were adult ma...
Suarez-Almazor, M E
Social marketing uses marketing techniques to promote healthy attitudes and behaviors. As in traditional marketing, the development and implementation of social marketing programs is based on the four P's: product, price, place, and promotion, but it also incorporates the partnership and participation of stakeholders to enhance public health and engage policy makers. The "product" in social marketing is generally a behavior, such as a change in lifestyle (e.g., diet) or an increase in a desired health practice (e.g., screening). In order for people to desire this product, it must offer a solution to a problem that is weighed with respect to the price to pay. The price is not just monetary, and it often involves giving something up, such as time (e.g., exercising) or a wanted, satisfying behavior (e.g., smoking). In its development phase, social marketing incorporates qualitative methods to create messages that are powerful and potentially effective. The implementation of the programs commonly involves mass campaigns with advertisement in various media. There have been a few social media campaigns targeting bone health that have been disseminated with substantial outreach. However, these have not been systematically evaluated, specifically with respect to change in behavior and health outcomes. Future campaigns should identify target behaviors that are amenable to change such as bone mass measurement screening or exercise. Audience segmentation will be crucial, since a message for young women to increase peak bone mass would be very different from a message for older individuals who have just experienced a fracture. Campaigns should involve key stakeholders, including policy makers, health providers, and the public. Finally, success must be carefully evaluated, not just by the outreach of the campaign, but also by a change in relevant behaviors and a decrease in deleterious health outcomes.
Strickland, Justin C; Lile, Joshua A; Stoops, William W
Few studies have simultaneously evaluated delay discounting and behavioral economic demand to determine their unique contribution to drug use. A recent study in cannabis users found that monetary delay discounting uniquely predicted cannabis dependence symptoms, whereas cannabis demand uniquely predicted use frequency. This study sought to replicate and extend this research by evaluating delay discounting and behavioral economic demand measures for multiple commodities and including a use quantity measure. Amazon.com's Mechanical Turk was used to sample individuals reporting recent cannabis use (n=64) and controls (n=72). Participants completed measures of monetary delay discounting as well as alcohol and cannabis delay discounting and demand. Cannabis users and controls did not differ on monetary delay discounting or alcohol delay discounting and demand. Among cannabis users, regression analyses indicated that cannabis delay discounting uniquely predicted use severity, whereas cannabis demand uniquely predicted use frequency and quantity. These effects remained significant after controlling for other delay discounting and demand measures. This research replicates previous outcomes relating delay discounting and demand with cannabis use and extends them by accounting for the contribution of multiple commodities. This research also demonstrates the ability of online crowdsourcing methods to complement traditional human laboratory techniques. Copyright © 2017 Elsevier B.V. All rights reserved.
Lieberthal, Robert D.; Leon, Juan
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…
Higgins, Stephen T
This Special Issue of Preventive Medicine (PM) is the 4th in a series on behavior change, health, and health disparities, a topic of critical importance to improving U.S. population health. The U.S. ranks near the bottom on measures of population health relative to other industrialized countries despite spending orders of magnitude more on health care than any other nation. Population health experts agree that the area of personal behavior, or lifestyle, such as substance abuse, physical inactivity/obesity, and non-adherence with medical regimens is the single largest contributor to this situation. These unhealthy behavior patterns 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 improving population health generally and curtailing health disparities more specifically. While perhaps more severe in the U.S., other industrialized countries are facing similar challenges with personal behavior patterns, adverse health impacts, and health disparities. Thus the topics discussed in this series have implications well beyond the U.S. In this 4th Special Issue we address (a) the potential health impacts of liberalizing laws on recreational marijuana use; (b) the ongoing challenge of tobacco use in vulnerable populations; and (b) the importance of weight management and physical activity in caring for vulnerable medical populations. Across each of these topics we include contributions from accomplished policymakers and scientists to acquaint readers with recent accomplishments and remaining knowledge gaps and challenges in these important topic areas. Copyright © 2017. Published by Elsevier Inc.
Spruijt-Metz, Donna; Hekler, Eric; Saranummi, Niilo; Intille, Stephen; Korhonen, Ilkka; Nilsen, Wendy; Rivera, Daniel E; Spring, Bonnie; Michie, Susan; Asch, David A; Sanna, Alberto; Salcedo, Vicente Traver; Kukakfa, Rita; Pavel, Misha
Adverse and suboptimal health behaviors and habits are responsible for approximately 40 % of preventable deaths, in addition to their unfavorable effects on quality of life and economics. Our current understanding of human behavior is largely based on static "snapshots" of human behavior, rather than ongoing, dynamic feedback loops of behavior in response to ever-changing biological, social, personal, and environmental states. This paper first discusses how new technologies (i.e., mobile sensors, smartphones, ubiquitous computing, and cloud-enabled processing/computing) and emerging systems modeling techniques enable the development of new, dynamic, and empirical models of human behavior that could facilitate just-in-time adaptive, scalable interventions. The paper then describes concrete steps to the creation of robust dynamic mathematical models of behavior including: (1) establishing "gold standard" measures, (2) the creation of a behavioral ontology for shared language and understanding tools that both enable dynamic theorizing across disciplines, (3) the development of data sharing resources, and (4) facilitating improved sharing of mathematical models and tools to support rapid aggregation of the models. We conclude with the discussion of what might be incorporated into a "knowledge commons," which could help to bring together these disparate activities into a unified system and structure for organizing knowledge about behavior.
Full Text Available Three decades of rapid economic development in China have not only benefited millions of Chinese by improving their living standards but have also dramatically increased the number of people who are part of the country's aging population. However, economic growth has not been accompanied by sufficient attention given to important public health issues, including an increase in the incidence of chronic diseases and a decline in physical activity (PA that comes with an aging population. The rapid growth in China's older population will soon exert an impact on the nation's economy, population health status, and health behaviors, and will increase stress on its healthcare system. This review article provides a broad perspective on the impact of rapid economic development, industrialization, and urbanization on health-related behaviors, with a specific focus on PA among older adults. Specifically, the article offers an overview of the demographic context, significant public health challenges, evidence on PA and exercise interventions, and knowledge gaps and future directions for research.
Hu, T W; Slaysman, K S
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.
Niu, Yue; Chen, Renjie; Kan, Haidong
As the largest developing country in the world, China is now facing one of the severest air pollution problems. The objective of this section is to evaluate the disease burden and corresponding economic loss attributable to ambient air pollution in China. We reviewed a series of studies by Chinese or foreign investigators focusing on the disease burden and economic loss in China. These studies showed both the general air pollution and haze episodes have resulted in substantial disease burden in terms of excess number of premature deaths, disability-adjusted life-year loss, and years of life lost. The corresponding economic loss has accounted for an appreciable proportion of China's national economy. Overall, the disease burden and health economic loss due to ambient air pollution in China is greater than in the remaining parts of the world, for one of the highest levels of air pollution and the largest size of exposed population. Consideration of both health and economic impacts of air pollution can facilitate the Chinese government to develop environmental policies to reduce the emissions of various air pollutants and protect the public health.
Full Text Available 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.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.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.Despite widespread rhetoric about the importance of resilience, there was a dearth of studies which operationalised resilience
Glonti, Ketevan; Gordeev, Vladimir S; Goryakin, Yevgeniy; Reeves, Aaron; Stuckler, David; McKee, Martin; Roberts, Bayard
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. 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. 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. Despite widespread rhetoric about the importance of resilience, there was a dearth of studies which operationalised resilience factors
Glonti, Ketevan; Gordeev, Vladimir S.; Goryakin, Yevgeniy; Reeves, Aaron; Stuckler, David; McKee, Martin; Roberts, Bayard
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
Nina Vladimirovna Zaytseva
Full Text Available This paper proposes a method of economic assessment of population health risk as a tool of life qualitymanagement and qualityof labor resources in the region (as factors of a region’s economic security. The technique is based on the cost of reducing the period of disability in the implementation of population health risk and takes into account the effects of risk prevention on levels of the budgetary system of the Russian Federation. The method intends to support making decisions on planning measures to reduce population health risk at the level of regions, territories and separate objects to assess their cost-performance, optimization of investment and operating costs to reduce the population health risk and sustainable development of the territory
Bentzley, Brandon S.; Jhou, Thomas C.; Aston-Jones, Gary
Development of new treatments for drug addiction will depend on high-throughput screening in animal models. However, an addiction biomarker fit for rapid testing, and useful in both humans and animals, is not currently available. Economic models are promising candidates. They offer a structured quantitative approach to modeling behavior that is mathematically identical across species, and accruing evidence indicates economic-based descriptors of human behavior may be particularly useful biomarkers of addiction severity. However, economic demand has not yet been established as a biomarker of addiction-like behavior in animals, an essential final step in linking animal and human studies of addiction through economic models. We recently developed a mathematical approach for rapidly modeling economic demand in rats trained to self-administer cocaine. We show here that economic demand, as both a spontaneous trait and induced state, predicts addiction-like behavior, including relapse propensity, drug seeking in abstinence, and compulsive (punished) drug taking. These findings confirm economic demand as a biomarker of addiction-like behavior in rats. They also support the view that excessive motivation plays an important role in addiction while extending the idea that drug dependence represents a shift from initially recreational to compulsive drug use. Finally, we found that economic demand for cocaine predicted the efficacy of a promising pharmacotherapy (oxytocin) in attenuating cocaine-seeking behaviors across individuals, demonstrating that economic measures may be used to rapidly identify the clinical utility of prospective addiction treatments. PMID:25071176
Adler, Amy B; Saboe, Kristin N; Anderson, James; Sipos, Maurice L; Thomas, Jeffrey L
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.
Shemilt, Ian; Mugford, Miranda; Drummond, Michael; Eisenstein, Eric; Mallender, Jacqueline; McDaid, David; Vale, Luke; Walker, Damian
Provision of evidence on costs alongside evidence on the effects of interventions can enhance the relevance of systematic reviews to decision-making. However, patterns of use of economics methods alongside systematic review remain unclear. Reviews of evidence on the effects of interventions are published by both the Cochrane and Campbell Collaborations. Although it is not a requirement that Cochrane or Campbell Reviews should consider economic aspects of interventions, many do. This study aims to explore and describe approaches to incorporating economics methods in a selection of Cochrane systematic reviews in the area of health promotion and public health, to help inform development of methodological guidance on economics for reviewers. The Cochrane Database of Systematic Reviews was searched using a search strategy for potential economic evaluation studies. We included current Cochrane reviews and review protocols retrieved using the search that are also identified as relevant to health promotion or public health topics. A reviewer extracted data which describe the economics components of included reviews. Extracted data were summarised in tables and analysed qualitatively. Twenty-one completed Cochrane reviews and seven review protocols met inclusion criteria. None incorporate formal economic evaluation methods. Ten completed reviews explicitly aim to incorporate economics studies and data. There is a lack of transparent reporting of methods underpinning the incorporation of economics studies and data. Some reviews are likely to exclude useful economics studies and data due to a failure to incorporate search strategies tailored to the retrieval of such data or use of key specialist databases, and application of inclusion criteria designed for effectiveness studies. There is a need for consistency and transparency in the reporting and conduct of the economics components of Cochrane reviews, as well as regular dialogue between Cochrane reviewers and economists to
Kim, Hak-Seon; Ahn, Joo
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
Belli, Paolo C.; Bustreo, Flavia; Preker, Alexander
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
The widespread economic crisis has resulted in a fall in living standards in the western hemisphere of over 9% (1981-83) and in Sub-Saharan Africa they have fallen to the level of 1970. Food production in the African countries most seriously affected by drought dropped by 15% between 1981 and 1983. Living standards also fell in some countries in Europe and in some of the poorest countries of Asia. The high cost of fuel, the heavy burden of interest payments and unfavourable terms of trade in Africa and Latin America led to serious unemployment, devaluation of national currencies and formidable austerity policies. While some countries have succeeded in protecting their health services from cuts in public expenditure, in many others cuts in health budgets have been substantial. The effects of the crisis in some countries have amounted to the virtual disintegration of rural health services. There are limited data available to show what has been happening to levels of expenditure on health, but those presented here demonstrate that levels of health expenditure per head have fallen in many countries. The cumulative effects on health of increased poverty, unemployment, underemployment and famine, and the reduced capacity of health services to respond to health problems can be documented with facts for a number of countries in Latin America and Africa. Malnutrition has increased and improvements in infant mortality have been checked or reversed. The economic crisis has placed at risk the health of the most vulnerable.
Edward Ivor Broughton
Full Text Available 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 adverse events 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 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 resources allocation for improvement activities among other competing demands for health care resources.
Carlos Augusto Grabois Gadelha
Full Text Available Abstract: 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.
Effect of economic and security challenges on the Nigerian health sector. Folashade T Alloh1, Pramod R Regmi1,2. 1. ... oil accounts for 75% of Nigeria's economy, so the fall in oil prices, therefore, has a significant impact on ... corruption surrounding many of the country's lawmakers in different scandals over the years have ...
Maynou, Laia; Saez, Marc
The recent economic crisis has been a major shock not only to the economic sector, but also to the rest of society. Our main objective in this paper is to show the impact of the economic crisis on convergence, i.e. the reduction or equalising of disparities, among the EU-27 countries in terms of health. The aim is to observe whether the economic crisis (from 2008 onwards) has in fact had an effect on health inequalities within the EU. We estimate convergence by specifying a dynamic panel model with random-effects (time, regions and countries). We are particularly interested in σ-convergence. As dependent variables, we use life expectancy, total mortality and (cause-specific) mortality in the regions of the EU-27 countries over the period 1995-2011. The results of the analysis show that, in terms of health, there has been a catching-up process among the EU regions. However, we find no reduction, on average, in dispersion levels as the σ-convergence shows. The main finding of this paper has been the sharp increase in disparities in 2010 for all health outcomes (albeit less abrupt for cancer mortality). This increase in disparities in 2010 coincides with the austerity measures implemented in the EU countries. Our main conclusion is that these austerity measures have had an impact on socioeconomic inequalities.
Neumann, Peter J; Bliss, Sarah K
To investigate Food and Drug Administration (FDA) regulatory actions against drug companies' health economic promotions from 2002 through 2011 to understand how frequently and in what circumstances the agency has considered such promotions false or misleading. We reviewed all warning letters and notices of violation ("untitled letters") issued by the FDA's Division of Drug Marketing, Advertising and Communications (DDMAC) to pharmaceutical companies from January 2002 through December 2011. We analyzed letters containing a violation related to "health economic promotion," defined according to one of several categories (e.g., implied claims of cost savings due to work productivity or economic claims containing unsupported statements about effectiveness or safety). We also collected information on factors such as the indication and type of media involved and whether the letter referenced Section 114 of the Food and Drug Administration Modernization Act. Of 291 DDMAC letters sent to pharmaceutical companies during the study period, 35 (12%) cited a health economic violation. The most common type of violation cited was an implied claim of cost savings due to work productivity or functioning (found in 20 letters) and economic claims containing unsubstantiated comparative claims of effectiveness, safety, or interchangeability (7 letters). The violations covered various indications, mostly commonly psychiatric disorders (6 letters) and pain (6 letters). No DDMAC letter pertained to Food and Drug Administration Modernization Act Section 114. The FDA has cited inappropriate health economic promotions in roughly 12% of the letters issued by the DDMAC. The letters highlight drug companies' interest in promoting the value of their products and the FDA's concerns in certain cases about the lack of supporting evidence. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.
B. Douglas Bernheim; Antonio Rangel
This paper has two goals. First, we discuss several emerging approaches to applied welfare analysis under non-standard (“behavioral”) assumptions concerning consumer choice. This provides a foundation for Behavioral Public Economics. Second, we illustrate applications of these approaches by surveying behavioral studies of policy problems involving saving, addiction, and public goods. We argue that the literature on behavioral public economics, though in its infancy, has already fundamentally ...
Pickover, Alison M; Messina, Bryan G; Correia, Christopher J; Garza, Kimberly B; Murphy, James G
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. PsycINFO Database Record (c) 2016 APA, all rights reserved.
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…
Ariane Alves Barros
Full Text Available This study aimed to identify the lifestyle of hypertensive patients, focusing on their health behaviors in light of the Health Belief Model. This is a descriptive cross-sectional study with a sample of 133 patients over 18 years old, with hypertension, registered in the Clinical Management System for Hypertension and Diabetes Mellitus in Primary Care, and monitored in five health centers in Fortaleza, CE, Brazil, chosen randomly and probabilistically. Data collection happened through a structured interview that was designed based on the Health Belief Model, from March to December 2013. Participants perceived the disease’s severity and felt susceptible to develop complications from hypertension. They reported receiving treatment correctly; however, the values of blood pressure, waist-hip ratio, and body mass index were high. Thus, it is necessary that health professionals implement strategies that favor hypertensive patients who are undergoing treatment to have healthy behavior.
Full Text Available Abstract Background Possible accumulative effects of a combined economic hardship's measure, including both income and non-income related economic hardships measures, on mental health has not been well investigated. The aim of this paper was to investigate; (i independent associations between multiple measures of economic hardships and mental health problems, and (ii associations between a combined economic hardships measure and mental health problems. Methods We analysed data from the 2009 Swedish National Survey of Public Health comprising a randomly selected representative national sample combined with a randomly selected supplementary sample from four county councils and three municipalities consisting of 23,153 men and 28,261 women aged 16-84 years. Mental health problems included; psychological distress (GHQ-12, severe anxiety and use of antidepressant medication. Economic hardship was measured by a combined economic hardships measure including low household income, inability to meet expenses and lacking cash reserves. Results The results from multivariate adjusted (age, country of birth, educational level, occupational status, employment status, family status and long term illness logistic regression analysis indicate that self-reported current economic difficulties (inability to pay for ordinary bills and lack of cash reserves, were significantly associated with both women's and men's mental health problems (all indicators, while low income was not. In addition, we found a statistically significant graded association between mental health problems and levels of economic hardships. Conclusions The findings indicate that indicators of self-reported current economic difficulties seem to be more strongly associated with poor mental health outcomes than the more conventional measure low income. Furthermore, the likelihood of mental health problems differed significantly in a graded fashion in relation to levels of economic hardships.
Lenoir-Wijnkoop, I; Jones, P J; Uauy, R; Segal, L; Milner, J
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.
Selin, N E; Nam, K M; Reilly, J M; Paltsev, S; Prinn, R G; Webster, M D; Wu, S
We assess the human health and economic impacts of projected 2000-2050 changes in ozone pollution using the MIT Emissions Prediction and Policy Analysis - Health Effects (EPPA-HE) model, in combination with results from the GEOS-Chem global tropospheric chemistry model of climate and chemistry effects of projected future emissions. We use EPPA-HE to assess the human health damages (including mortality and morbidity) caused by ozone pollution, and quantify their economic impacts in sixteen world regions. We compare the costs of ozone pollution under scenarios with 2000 and 2050 ozone precursor and greenhouse gas emissions (using the Intergovernmental Panel on Climate Change (IPCC) Special Report on Emissions Scenarios (SRES) A1B scenario). We estimate that health costs due to global ozone pollution above pre-industrial levels by 2050 will be $580 billion (year 2000$) and that mortalities from acute exposure will exceed 2 million. We find that previous methodologies underestimate costs of air pollution by more than a third because they do not take into account the long-term, compounding effects of health costs. The economic effects of emissions changes far exceed the influence of climate alone.
Nguyen, Timothy K.; Goodman, Chris D. [Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada); Boldt, R. Gabriel [London Health Sciences Centre, London, Ontario (Canada); Warner, Andrew; Palma, David A. [Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada); Rodrigues, George B. [Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada); Department of Epidemiology and Biostatistics, Western University, London, Ontario (Canada); Lock, Michael I. [Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada); Mishra, Mark V. [Department of Radiation Oncology, University of Maryland, Baltimore, Maryland (United States); Zaric, Gregory S. [Department of Epidemiology and Biostatistics, Western University, London, Ontario (Canada); Ivey Business School, Western University, London, Ontario (Canada); Louie, Alexander V., E-mail: Dr.email@example.com [Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada); Department of Epidemiology and Biostatistics, Western University, London, Ontario (Canada)
Purpose: Despite the rising costs in radiation oncology, the impact of health economics research on radiation therapy practice analysis patterns is unclear. We performed a systematic review of cost-effectiveness analyses (CEAs) and cost-utility analyses (CUAs) to identify trends in reporting quality in the radiation oncology literature over time. Methods and Materials: A systematic review of radiation oncology economic evaluations up to 2014 was performed, using MEDLINE and EMBASE databases. The Consolidated Health Economic Evaluation Reporting Standards guideline informed data abstraction variables including study demographics, economic parameters, and methodological details. Tufts Medical Center CEA registry quality scores provided a basis for qualitative assessment of included studies. Studies were stratified by 3 time periods (1995-2004, 2005-2009, and 2010-2014). The Cochran-Armitage trend test and linear trend test were used to identify trends over time. Results: In total, 102 articles were selected for final review. Most studies were in the context of a model (61%) or clinical trial (28%). Many studies lacked a conflict of interest (COI) statement (67%), a sponsorship statement (48%), a reported study time horizon (35%), and the use of discounting (29%). There was a significant increase over time in the reporting of a COI statement (P<.001), health care payer perspective (P=.019), sensitivity analyses using multivariate (P=.043) or probabilistic methods (P=.011), incremental cost-effectiveness threshold (P<.001), secondary source utility weights (P=.010), and cost effectiveness acceptability curves (P=.049). There was a trend toward improvement in Tuft scores over time (P=.065). Conclusions: Recent reports demonstrate improved reporting rates in economic evaluations; however, there remains significant room for improvement as reporting rates are still suboptimal. As fiscal pressures rise, we will rely on economic assessments to guide our practice decisions
Nguyen, Timothy K; Goodman, Chris D; Boldt, R Gabriel; Warner, Andrew; Palma, David A; Rodrigues, George B; Lock, Michael I; Mishra, Mark V; Zaric, Gregory S; Louie, Alexander V
Despite the rising costs in radiation oncology, the impact of health economics research on radiation therapy practice analysis patterns is unclear. We performed a systematic review of cost-effectiveness analyses (CEAs) and cost-utility analyses (CUAs) to identify trends in reporting quality in the radiation oncology literature over time. A systematic review of radiation oncology economic evaluations up to 2014 was performed, using MEDLINE and EMBASE databases. The Consolidated Health Economic Evaluation Reporting Standards guideline informed data abstraction variables including study demographics, economic parameters, and methodological details. Tufts Medical Center CEA registry quality scores provided a basis for qualitative assessment of included studies. Studies were stratified by 3 time periods (1995-2004, 2005-2009, and 2010-2014). The Cochran-Armitage trend test and linear trend test were used to identify trends over time. In total, 102 articles were selected for final review. Most studies were in the context of a model (61%) or clinical trial (28%). Many studies lacked a conflict of interest (COI) statement (67%), a sponsorship statement (48%), a reported study time horizon (35%), and the use of discounting (29%). There was a significant increase over time in the reporting of a COI statement (P<.001), health care payer perspective (P=.019), sensitivity analyses using multivariate (P=.043) or probabilistic methods (P=.011), incremental cost-effectiveness threshold (P<.001), secondary source utility weights (P=.010), and cost effectiveness acceptability curves (P=.049). There was a trend toward improvement in Tuft scores over time (P=.065). Recent reports demonstrate improved reporting rates in economic evaluations; however, there remains significant room for improvement as reporting rates are still suboptimal. As fiscal pressures rise, we will rely on economic assessments to guide our practice decisions and policies. We recommend improved adherence to
Nguyen, Timothy K.; Goodman, Chris D.; Boldt, R. Gabriel; Warner, Andrew; Palma, David A.; Rodrigues, George B.; Lock, Michael I.; Mishra, Mark V.; Zaric, Gregory S.; Louie, Alexander V.
Purpose: Despite the rising costs in radiation oncology, the impact of health economics research on radiation therapy practice analysis patterns is unclear. We performed a systematic review of cost-effectiveness analyses (CEAs) and cost-utility analyses (CUAs) to identify trends in reporting quality in the radiation oncology literature over time. Methods and Materials: A systematic review of radiation oncology economic evaluations up to 2014 was performed, using MEDLINE and EMBASE databases. The Consolidated Health Economic Evaluation Reporting Standards guideline informed data abstraction variables including study demographics, economic parameters, and methodological details. Tufts Medical Center CEA registry quality scores provided a basis for qualitative assessment of included studies. Studies were stratified by 3 time periods (1995-2004, 2005-2009, and 2010-2014). The Cochran-Armitage trend test and linear trend test were used to identify trends over time. Results: In total, 102 articles were selected for final review. Most studies were in the context of a model (61%) or clinical trial (28%). Many studies lacked a conflict of interest (COI) statement (67%), a sponsorship statement (48%), a reported study time horizon (35%), and the use of discounting (29%). There was a significant increase over time in the reporting of a COI statement (P<.001), health care payer perspective (P=.019), sensitivity analyses using multivariate (P=.043) or probabilistic methods (P=.011), incremental cost-effectiveness threshold (P<.001), secondary source utility weights (P=.010), and cost effectiveness acceptability curves (P=.049). There was a trend toward improvement in Tuft scores over time (P=.065). Conclusions: Recent reports demonstrate improved reporting rates in economic evaluations; however, there remains significant room for improvement as reporting rates are still suboptimal. As fiscal pressures rise, we will rely on economic assessments to guide our practice decisions
Sparrow, Robert; Van de Poel, Ellen; Hadiwidjaja, Gracia; Yumna, Athia; Warda, Nila; Suryahadi, Asep
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. Copyright © 2013 John Wiley & Sons, Ltd.
Khalaila, R N Rabia
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.
Objective: Neuroeconomics integrates economics, psychology and neuroscience. Recently, this line of research is summarized in a neuroeconomic model (NeM) which addresses the rehabilitation of important chronic conditions from a new angle as surveyed in this study. Data and Method: Firstly, Ne...... with de-stressing benefits as reduced anxiety, less use of stimulants and a reduction of blood pressure which in all increase life-expectancy. Conclusion: Neuroeconomics helps economists to identify dominant health economic interventions that may be overlooked by traditional discipålines [i] This part...
Full Text Available The effects of financial crisis are strongly felt in Romania, which already face with asignificant slowdown in economic growth or even economic recession. The current and internationalsituation remains still difficult, and requires high budget constraints. Under these conditions, thehealth system in Romania has become one of the most inefficient in Europe, mainly characterized bylack of transparency in the allocation of funds and inefficiency in resource use. The lack of clear andcoherent criteria to evaluate the performance of health institutions results in a difficultimplementation of efficient managerial systems to reward the efficient manager.
Khang, Young-Ho; Cho, Sung-Il; Yang, Seungmi; Lee, Moo-Song
This study examined the socioeconomic differentials for the health and health related behaviors among South Korean middle school students. A nationwide cross-sectional interview survey of 3,449 middle school second-grade students and their parents was conducted using a stratified multi-stage cluster sampling method. The response rate was 93.3%. The socioeconomic position indicators were based on self-reported information from the students and their parents: parental education, father's occupational class, monthly family income, out-of-pocket expenditure for education, housing ownership, educational expectations, educational performance and the perceived economic hardships. The outcome variables that were measured were also based on the self-reported information from the students. The health measures included self-rated health conditions, psychological or mental problems, the feelings of loneliness at school, the overall satisfaction of life and the perceived level of stress. The health related behaviors included were smoking, alcohol drinking, sexual intercourse, violence, bullying and verbal and physical abuse by parents. Socioeconomic differences for the health and health related behaviors were found among the eighth grade boys and girls of South Korea. However, the pattern varied with gender, the socioeconomic position indicators and the outcome measures. The prevalence rates of the overall dissatisfaction with life for both genders differed according to most of the eight socioeconomic position indicators. All the health measures were significantly different according to the perceived economic hardship. However, the socioeconomic differences in the self-rated health conditions and the psychosocial or mental problems were not clear. The students having higher socioeconomic position tended to be a perpetrator of bullying while those students with lower socioeconomic position were more likely to be a victim. The perceived economic hardships predicted the health
Radu, Paul; Purcărea, Victor; Popa, Florian
The Romanian health care system is facing a period of deep transformations, having in the last years some clear achievements, but also some acknowledged problems. Once the world's economic crisis appeared and manifested its first effects in Romanian economy, there will be some consequences in the health sector too. Regarding the Romanian social health insurance scheme, it's possible to assist to greater financial constraints in 2009 due to reduced contributions and a weaker economy. There are two possible solutions to face this challenge: diminishing the basic health services covered by the social health insurance system (difficult to be accepted by politicians and population) and better use of available resources based on an improvement of allowance and technical efficiency. The authors have made a critical analysis of the Romanian health care system facing the forecasted effects of the economic crisis and have proposed some interventions and solutions to reduce the effects at the level of the patient. In order to increase allowance efficiency clear measures are necessary to be taken at central and local level: improvement of financing mechanisms, alignment of the incentives used by the payment mechanisms for different type of providers, development of guides and protocols based on available resources, etc. For increased technical efficiency there is a need for adequate incentives within the financing and organization mechanisms in order to make the public providers more active in obtaining greater outputs from the available resources. The economic constraints will lead to the growth of the quality of medical services. This is the reason why the health system needs the development of the accreditation systems for providers. The audit of medical activities and reporting represents a mechanism which needs to be developed. Regarding the new health technologies' use new institutions and mechanisms need to be implemented. They will allow making certain decisions on
Ammerman, Alice S; Hartman, Terry; DeMarco, Molly M
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. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
Bureau, Alexander T; Razon, Selen; Saville, Bryan K; Tokac, Umit; Judge, Lawrence W
According to the Dualistic Model of Passion (39), passion entails valuing, liking, and spending time on an activity. The Dualistic Model also posits two types of passion for activities: harmonious passion (individual voluntarily engages in the activity) and obsessive passion (individual is compelled to engage in the activity). The purpose of the present study was to examine the possible links between college students' passion for academic activities and problematic health behaviors including smoking, excessive drinking, exercise addiction, disordered eating, and sleepiness, which is a possible indicator of sleep deprivation. Participants (n = 502) completed a survey gauging passion type and health behaviors. Regression analyses revealed obsessive passion for academic activities was positively associated with scores on measures of excessive drinking (β = .15, p= .008), exercise addiction (β = .19, psleep deprivation (β = .07, p = .15). Harmonious passion for academic activities, in contrast, was negatively associated with excessive drinking behavior (β = -.16, p = .002) and sleep deprivation (β = -.13, p = .007) but was not associated with exercise addiction (β = .002, p = .97) and disordered eating (β = -.04, p = .37). These findings provide further support for the Dualistic Model of Passion. Students who are obsessively passionate about their academic activities are more likely to engage in poor health behaviors and, in turn, may experience greater negative outcomes than students who are harmoniously passionate about their academics.
Public health interventions using narratives, or stories, as a means for encouraging behavior change are common, especially in the developing world. Entertainment-education (EE) is perhaps the most widely researched form of such "narrative intervention," but many other kinds of interventions, or parts of interventions, rely on stories to convey information about behavior risk and to model risk avoidance. Although narrative interventions are often grounded in social-cognitive theory and in commonsense assumptions about the power of storytelling, they are generally undertaken without much regard for the philosophical and cognitive bases for narrative about which much has been written. Many aspects of narrative intervention in behavior and public health could be better understood in light this literature. These include the 1) challenges inherent in creating and building on a discourse around behavior change in non-Western contexts; 2) current emphasis in public health on production rather than reception and the fundamental problem of interpretation; 3) differences between messaging versus providing an alternative worldview, and finally; 4) issues surrounding the appropriate approach to the evaluation of a narrative intervention.
Fetchenhauer, D.; Azar, O.H.; Antonides, G.; Dunning, D.; Frank, R.H.; Lea, S.; Ölander, F.
Recent years have seen increased cooperation between psychologists and economists. This is mirrored in interdisciplinary journals (like the Journal of Economic Psychology or the Journal of Socio-Economics) as well as in interdisciplinary conferences. During one of these conferences, The IAREP/SABE
Ramos, Mary M.; Greenberg, Cynthia; Sapien, Robert; Bauer-Creegan, Judith; Hine, Beverly; Geary, Cathy
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…
de Goeij, Moniek C M; Suhrcke, Marc; Toffolutti, Veronica; van de Mheen, Dike; Schoenmakers, Tim M; Kunst, Anton E
Economic crises are complex events that affect behavioral patterns (including alcohol consumption) via opposing mechanisms. With this realist systematic review, we aimed to investigate evidence from studies of previous or ongoing crises on which mechanisms (How?) play a role among which individuals (Whom?). Such evidence would help understand and predict the potential impact of economic crises on alcohol consumption. Medical, psychological, social, and economic databases were used to search for peer-reviewed qualitative or quantitative empirical evidence (published January 1, 1990-May 1, 2014) linking economic crises or stressors with alcohol consumption and alcohol-related health problems. We included 35 papers, based on defined selection criteria. From these papers, we extracted evidence on mechanism(s), determinant, outcome, country-level context, and individual context. We found 16 studies that reported evidence completely covering two behavioral mechanisms by which economic crises can influence alcohol consumption and alcohol-related health problems. The first mechanism suggests that psychological distress triggered by unemployment and income reductions can increase drinking problems. The second mechanism suggests that due to tighter budget constraints, less money is spent on alcoholic beverages. Across many countries, the psychological distress mechanism was observed mainly in men. The tighter budget constraints mechanism seems to play a role in all population subgroups across all countries. For the other three mechanisms (i.e., deterioration in the social situation, fear of losing one's job, and increased non-working time), empirical evidence was scarce or absent, or had small to moderate coverage. This was also the case for important influential contextual factors described in our initial theoretical framework. This realist systematic review suggests that among men (but not among women), the net impact of economic crises will be an increase in harmful
Chronic primary insomnia is a major public health problem causing significant burden for those affected. Rising health care costs may cause increased financial pressures on governments and private payers, forcing stricter cost-control measures and, as a result, insomnia, often considered a lifestyle condition, may not receive the proper attention it deserves. In order to highlight the benefits that can be achieved through successful treatment of insomnia, there is a need for further comparative studies of existing and emerging treatments, cost burden of illness and cost-effectiveness analyses. Health economic assessment of insomnia and its treatments is an emerging area. The development of comprehensive assessment of insomnia treatments, however, has been hindered by complexities and gaps in the available data. Health economic models of insomnia, such as the one detailed here, should enable researchers to better address the effects of different treatments on clinical and economic measures for insomnia and related comorbidities. It is apparent that research into the cost-effectiveness of therapies for insomnia is in its infancy and further work is needed.
Ferraz, Marcos Bosi
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. PMID:25709481
Greiner, Wolfgang; Klose, Kristina
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). Copyright © 2014. Published by Elsevier GmbH.
One of the company's actions for strengthening human capital is the protection of health and safety of its employees. Its implementation needs financial resources, therefore, employers expect tangible effectiveness in terms of health and economics. Business plan as an element of company planning can be a helpful tool for new health interventions management. The aim of this work was to elaborate a business plan framework for occupational health interventions at the company level, combining occupational health practices with company management and economics. The business plan of occupational health interventions was based on the literature review, the author's own research projects and meta-analysis of research reports on economic relations between occupational health status and company productivity. The study resulted in the development of the business plan for occupational health interventions at the company level. It consists of summary and several sections that address such issues as the key elements of the intervention discussed against a background of the company economics and management, occupational health and safety status of the staff, employees' health care organization, organizational plan of providing the employees with health protection, marketing plan, including specificity of health interventions in the company marketing plan and financial plan, reflecting the economic effects of health care interventions on the overall financial management of the company. Business plan defines occupational health and safety interventions as a part of the company activities as a whole. Planning health care interventions without relating them to the statutory goals of the company may have the adverse impact on the financial balance and profitability of the company. Therefore, business plan by providing the opportunity of comparing different options of occupational health interventions to be implemented by employers is a key element of the management of employees
Pattanayak, S K; Kramer, R A; Vincent, J R
Several recent initiatives such as Planetary Health , EcoHealth and One Health claim that human health depends on flourishing natural ecosystems. However, little has been said about the operational and implementation challenges of health-oriented conservation actions on the ground. We contend that ecological-epidemiological research must be complemented by a form of implementation science that examines: (i) the links between specific conservation actions and the resulting ecological changes, and (ii) how this ecological change impacts human health and well-being, when human behaviours are considered. Drawing on the policy evaluation tradition in public economics, first, we present three examples of recent social science research on conservation interventions that affect human health. These examples are from low- and middle-income countries in the tropics and subtropics. Second, drawing on these examples, we present three propositions related to impact evaluation and non-market valuation that can help guide future multidisciplinary research on conservation and human health. Research guided by these propositions will allow stakeholders to determine how ecosystem-mediated strategies for health promotion compare with more conventional biomedical prevention and treatment strategies for safeguarding health.This article is part of the themed issue 'Conservation, biodiversity and infectious disease: scientific evidence and policy implications'. © 2017 The Authors.
Cavalcanti, Paulo R.; Oliveira-Castro, Jorge M.; Foxall, Gordon R.
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…
Alhayyan, Khalid N.
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,…
Tuti N Mohd-Dom
Full Text Available Objective: This study aimed to determine the level of oral health literacy and behavior among health sciences. Methods: The method used descriptive cross-sectional survey involving 609 students from Faculty of Medicine, Dentistry, Pharmacy and Allied Health Sciences in the Universiti Kebangsaan Malaysia. Oral health literacy level and behaviour was assessed with a validated and pretested self-administered questionnaire using the Newest Vital Sign (NVS tool and modified Oral Health Adult Literacy Questionnaire (OHL-AQ. Results: A total of 509 participants involved in the study (83.6%. The overall mean oral health literacy score was 10.27 (95% CI 7.92, 12.62, which found dental students showing statistically significant higher scores (mean=11.36, 95% CI 9.70, 13.02 compared to medical (mean=10.72, 95% CI 8.67, 12.77, allied health sciences (mean=9.89, 95% CI 7.34, 12.44 and pharmacy (mean=9.55, 95% CI 7.23, 11.87. Almost all respondents are non-smokers (99.8% and non-drinkers (97.2%. Only 19.1% pay regular dental visits every 6-12 months while 51.1% visit dentist only when they have dental pain. Conclusion: There appears to be a positive relationship between oral health literacy and oral health behavior. Health science university students should be provided substantial dental health education in their curriculum as they show good potential as strategic partners in oral health.DOI: 10.14693/jdi.v22i2.404
F.F.H. Rutten (Frans); J.-W. van der Linden (J.)
textabstractThis article discusses the role of economic appraisal in insurance based health care systems, taking the case of the Netherlands as an example. The public health insurance system in this country is governed by the Health Insurance Executive Board, which policies are firmly based on the
Wolf, C A
Economics provides a framework for understanding management decisions and their policy implications for the animal health system. While the neoclassical economic model is useful for framing animal health decisions on the farm, some of its assumptions and prescriptive results may be unrealistic. Institutional and behavioural economics address some of these potential shortcomings by considering the role of information, psychology and social factors in decisions. Framing such decisions under contract theory allows us to consider asymmetric information between policy-makers and farmers. Perverse incentives may exist in the area of preventing and reporting disease. Behavioural economics examines the role of internal and external psychological and social factors. Biases, heuristics, habit, social norms and other such aspects can result in farm decision-makers arriving at what might be considered irrational or otherwise sub-optimal decisions. Framing choices and providing relevant information and examples can alleviate these behavioural issues. The implications of this approach for disease policy and an applied research and outreach programme to respond to animal diseases are discussed.
Conger, John Janeway
The paper views the emerging role of behavioral medicine and health psychology, addressing: (1) the impact of social change on health and behavioral factors; (2) the growth of a developmental perspective in behavioral medicine and health psychology; and (3) work and health, including the effects of job stress and unemployment. (Author/JDD)
Witiw, Christopher D; Smieliauskas, Fabrice; Fehlings, Michael G
Degenerative cervical myelopathy (DCM) is the leading cause of spinal cord impairment worldwide. Surgical intervention has been demonstrated to be effective and is becoming standard of care. Spine surgery, however, is costly and value needs to be demonstrated. This review serves to summarize the key health economic concepts as they relate to the assessment of the value of surgery for DCM. This is followed by a discussion of current health economic research on DCM, which suggests that surgery is likely to be cost effective. The review concludes with a summary of future questions that remain unanswered, such as which patient subgroups derive the most value from surgery and which surgical approaches are the most cost effective. Copyright © 2017 Elsevier Inc. All rights reserved.
Madden, Lynne; King, Lesley; Shiell, Alan
Government anticipates that health economic analysis will contribute to evidence-based policy development. Early examples in Australia where this expectation has been met include the economic evaluations of breast and cervical screening. However, the level of integration of health economics within health services that require this advice appears uneven. We sought to describe how government health departments in Australia use specialist health economic advice to inform policy and planning and the mechanisms through which they access this advice. Information describing the arrangements for gaining health economics input into health decision-making was sought through interviews with a purposeful sample of economists and non-economists employed by all departments of health in Australia (state, territories and national). The survey was undertaken in August 2004. To aid interpretation of the results eight health economic functions were identified. As a comparison, four other government departments in NSW provided information about their access to economic advice. All health departments except one reported being current users of health economics expertise. A variety of arrangements were described to source this, from building organisational capacity with self-sufficient in-house units to forging links with external sources. However, specialist positions for economists or health economists employed within health were few. A framework mapping these arrangements for sourcing advice with the eight common health economic functions to be met is presented. All other non-health government departments approached accessed economic advice, with three having in-house units. A small health economics capacity in Australia has been established over the past 30 years through a variety of structural and strategic mechanisms. Health departments value health economic advice and use a variety of arrangements to obtain this. These arrangements have strengths and weaknesses depending upon the
Cordoba, Juan Carlos; Ripoll, Marla
We document various limitations of the expected utility model for the study of health and longevity. The model assumes individuals are indifferent between early and late resolution of uncertainty. This assumption gives rise to predictions regarding the economic value of life that are inconsistent with relevant evidence. For example, poor individuals would price life below the present value of foregone income or even negatively. We show that a non-expected utility model disentangling intertemp...
The projections for the rising cost of healthcare have spurred robust dialogue, and among the many targets for cost control are specialty drugs. An important question thus becomes: Are behavioral economic factors driving physician prescribing? This article presents a review of leading behavioral economic theories and their application to the results of an Oncology Medical Home pilot that reversed incentives from drug administration to patient care. A host of these theories may explain the irrational economic actors in regard to physician prescribing, including heuristics, framing, and defaults. Ultimately, the complex interplay of behavioral economics may result in reimbursement methodology alternatives to the prevailing fee-for-service payment system having less impact on prescribing behavior than has been conjectured.
To summarize previous adult research on behavioral economics (BE) and consider the largely unexplored relevance of BE for promoting adherence to pediatric regimens across a wide variety of illnesses. Literature review. Default bias, loss aversion, overestimation of rare events, and social norms are four BE concepts that have not been fully incorporated in adherence research for pediatric regimens yet offer promising opportunities for novel intervention development. The possible applications of these four strategies are offered in regards to asthma, cystic fibrosis, migraines, and diabetes, respectively. BE offers pediatric psychology not only low-intensity approaches for promoting adherence but also highly attractive ways of obtaining the attention of health care administrators and policymakers. © The Author 2014. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org.
BUREAU, ALEXANDER T.; RAZON, SELEN; SAVILLE, BRYAN K.; TOKAC, UMIT; JUDGE, LAWRENCE W.
According to the Dualistic Model of Passion (39), passion entails valuing, liking, and spending time on an activity. The Dualistic Model also posits two types of passion for activities: harmonious passion (individual voluntarily engages in the activity) and obsessive passion (individual is compelled to engage in the activity). The purpose of the present study was to examine the possible links between college students? passion for academic activities and problematic health behaviors including ...
Whiteis, D G
The growing corporate dominance in U.S. medical care has been a major factor in the increasingly inequitable distribution of health care resources and the declining public health conditions in poor and minority urban communities. Alongside this trend has been a parallel phenomenon of economic disinvestment and political neglect in these same at-risk neighborhoods. This article analyzes these trends as related components of austerity, retrenchment, and capital consolidation policies that have characterized the U.S. political economy for several decades. Emphasized are the relationships among corporatization, capital consolidation, deindustrialization of the workforce, and medical indigence; the resulting economic stress placed upon community hospitals and other caregivers in poor and minority communities; and the marked discrepancy between conditions of development and underdevelopment in American cities. It is argued that the effects of these policies are pathogenic in nature: they place populations at risk for disease and social dysfunction, they reduce access to necessary preventive and curative services, and they weaken coping mechanisms. Community economic development, empowerment, and a direct challenge to the growing concentration of wealth and power in the corporate class are proposed as essential elements of public health policy.
The objective of this paper is to describe the applications of health economic theory to medical nutrition. The published literature provides evidence that medical nutrition, e.g. oral nutritional supplements, is an effective treatment for patients with disease related malnutrition. Malnutrition is associated with mortality risk and complication rates, including infections. Malnutrition is not a new problem and with an ageing population it continues to become a major public health concern as increasing age is associated with an increased risk of malnutrition. This overview shows that in the case RCTs are providing the clinical evidence, there is no methodological difference between a cost-effectiveness analysis for pharmaceutical or nutrition. However, in nutrition the evidence may not always come from RCT data, but will be more often based on observational data. Therefore the clinical evidence of nutrition in itself is not the issue, but the handling of clinical evidence from observational studies. As the link between the consumption of a food product and a resulting health status is often more difficult to establish than the effect of a drug treatment it requires the further development of adapted methodologies in order to correctly predict the impact of food-related health effects and health economic outcomes from a broader perspective. © 2015 Nestec Ltd., Vevey/S. Karger AG, Basel.
The author analyzes the price dynamics of shares listed in the Russian Trading System (RTS). Preferences for speculative versus strategic investments in the Russian capital market are studied by dividing the risk associated with each share into a general component, which depends on economic fundamentals, and an individual (speculative) component associated with holding that particular asset.
Blonigen, Bruce A.; Harbaugh, William T.; Singell, Larry D.; Horner, Robert H.; Irvin, Larry K.; Smolkowski, Keith S.
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…
Streat, Stephen; Munn, Stephen
Formal health economics and health technology assessment (HTA)processes, including cost-effectiveness and cost-utility analysis, are variably used to inform decisions about public and private health service funding and service provision. In general, pharmaceuticals have been subject to more sophisticated health economic analyses and HTAs and for a longer time than either devices or procedures. HTA has been performed by a number of different entities. While HTA shares many common features across the world, its uses, approaches, applications,and impact differ throughout the world. This article will discuss some of the general attributes of HTA and will focus on its specific applications in Australia and New Zealand.
Bhandari, Pratibha; Kim, MiYoung
Health-promoting behaviors assist individuals to prevent disease, promote health, increase longevity, and enjoy a better quality of life. A number of interpersonal, social, and environmental factors have been shown to influence health-promoting behaviors. Little empirical evidence exists about the predictors of health-promoting behaviors among migrant workers. This study uses Pender's health promotion model to describe and identify the predictors of health-promoting behaviors in Nepalese migrant workers in Korea. A cross-sectional research design was used. Nepalese migrants who had been working in South Korea (n = 169) for over 6 months were surveyed between July and December 2012. Self-efficacy was measured using the Perceived Health Competence Scale, the Health-Promoting Lifestyle Profile II was used to measure health-promoting lifestyle behaviors, and perceived health status was measured using a single-item question. Descriptive statistics, correlation analysis, and multiple regression analysis were used to analyze data. Spiritual activity was the highest reported health-promoting behavior, whereas physical activity was the least practiced behavior. Self-efficacy was the only significant predictor of health-promoting behavior. The results of this study suggest that future health-promoting interventions should enhance the self-efficacy of target populations for individual health behaviors. Factors such as working conditions, culture, and economic background that may affect the health-promoting behaviors of migrant workers must be considered when planning nursing interventions. Multicultural nursing structures and policies are needed to reach out proactively to all adult migrant groups.
Aronsson, Thomas; Schöb, Ronnie
Economic models of climate policy (or policies to combat other environmental problems) typically neglect psychological adaptation to changing life circumstances. People may adapt or become more sensitive, to different degrees, to a deteriorated environment. The present paper addresses these issues in a simple model of tax policy to combat climate change and elaborates on the consequences for optimal climate policies. Furthermore, it argues from a normative point of view that psychological ada...
Informal care is non-financed care outside the realm of formal healthcare, which represents an increasing challenge for aging societies. Informal care has frequently been neglected in health economic analyses, while in recent years its coverage has increased considerably in the international scientific literature. This review summarizes the methodology of the health-economic assessment of informal care, including the objective and subjective metrics of caregiver burden, its financial and non-financial valuation and practical applications, with special emphasis on the introduction of care-related quality of life instruments (e.g. Care Related Quality of Life - CarerQoL instrument). Care-related quality of life is a different entity from health-related quality of life, the two cannot be combined, so their joint evaluation requires multi-criteria decision analysis methods. Therefore, it is important to determine the societal preferences of care-related quality of life versus health-related quality of life, and map the relationship of care-related quality of life with time. The local validation of tools measuring care-related quality of life, its more widespread practical application and the analysis of its effect on decision making are also important part of the future research agenda. Orv Hetil. 2017; 158(35): 1363-1372.
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. Copyright © 2016 Elsevier Inc. All rights reserved.
Shemilt, Ian; Mugford, Miranda; Drummond, Michael; Eisenstein, Eric; Mallender, Jacqueline; McDaid, David; Vale, Luke; Walker, Damian
Background Provision of evidence on costs alongside evidence on the effects of interventions can enhance the relevance of systematic reviews to decision-making. However, patterns of use of economics methods alongside systematic review remain unclear. Reviews of evidence on the effects of interventions are published by both the Cochrane and Campbell Collaborations. Although it is not a requirement that Cochrane or Campbell Reviews should consider economic aspects of interventions, many do. This study aims to explore and describe approaches to incorporating economics methods in a selection of Cochrane systematic reviews in the area of health promotion and public health, to help inform development of methodological guidance on economics for reviewers. Methods The Cochrane Database of Systematic Reviews was searched using a search strategy for potential economic evaluation studies. We included current Cochrane reviews and review protocols retrieved using the search that are also identified as relevant to health promotion or public health topics. A reviewer extracted data which describe the economics components of included reviews. Extracted data were summarised in tables and analysed qualitatively. Results Twenty-one completed Cochrane reviews and seven review protocols met inclusion criteria. None incorporate formal economic evaluation methods. Ten completed reviews explicitly aim to incorporate economics studies and data. There is a lack of transparent reporting of methods underpinning the incorporation of economics studies and data. Some reviews are likely to exclude useful economics studies and data due to a failure to incorporate search strategies tailored to the retrieval of such data or use of key specialist databases, and application of inclusion criteria designed for effectiveness studies. Conclusion There is a need for consistency and transparency in the reporting and conduct of the economics components of Cochrane reviews, as well as regular dialogue between
Full Text Available Abstract Background Provision of evidence on costs alongside evidence on the effects of interventions can enhance the relevance of systematic reviews to decision-making. However, patterns of use of economics methods alongside systematic review remain unclear. Reviews of evidence on the effects of interventions are published by both the Cochrane and Campbell Collaborations. Although it is not a requirement that Cochrane or Campbell Reviews should consider economic aspects of interventions, many do. This study aims to explore and describe approaches to incorporating economics methods in a selection of Cochrane systematic reviews in the area of health promotion and public health, to help inform development of methodological guidance on economics for reviewers. Methods The Cochrane Database of Systematic Reviews was searched using a search strategy for potential economic evaluation studies. We included current Cochrane reviews and review protocols retrieved using the search that are also identified as relevant to health promotion or public health topics. A reviewer extracted data which describe the economics components of included reviews. Extracted data were summarised in tables and analysed qualitatively. Results Twenty-one completed Cochrane reviews and seven review protocols met inclusion criteria. None incorporate formal economic evaluation methods. Ten completed reviews explicitly aim to incorporate economics studies and data. There is a lack of transparent reporting of methods underpinning the incorporation of economics studies and data. Some reviews are likely to exclude useful economics studies and data due to a failure to incorporate search strategies tailored to the retrieval of such data or use of key specialist databases, and application of inclusion criteria designed for effectiveness studies. Conclusion There is a need for consistency and transparency in the reporting and conduct of the economics components of Cochrane reviews, as
King, Abby C
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
Glied, Sherry; Frank, Richard G
Mental illnesses provide a difficult set of challenges to American health and social institutions. Those challenges have been a continuous concern of David Mechanic's over the course of his career. In this article we trace the development of modern economic and organizational structures that drive the delivery of mental health care in the early part of the twenty-first century. We show how the nature of mental disorders themselves and the treatment for addressing those illnesses pose fundamental difficulties to health care organizational and financing structures. We analyze the factors that have caused the dramatic changes in how American society has addressed mental illnesses over the past fifty years. Specifically, we note the central influence that mainstream health, income support, and disability programs have had in shaping mental health care. We argue that the interaction of the unique features of mental illnesses and changes in mainstream health and social policy led mental health care to evolve so differently from general medical care. Copyright © 2016 by Duke University Press.
Zahran, Sammy; Peek, Lori; Snodgrass, Jeffrey G; Weiler, Stephan; Hempel, Lynn
We investigate the relationship between exposure to Hurricanes Katrina and/or Rita and mental health resilience by vulnerability status, with particular focus on the mental health outcomes of single mothers versus the general public. We advance a measurable notion of mental health resilience to disaster events. We also calculate the economic costs of poor mental health days added by natural disaster exposure. Negative binomial analyses show that hurricane exposure increases the expected count of poor mental health days for all persons by 18.7% (95% confidence interval [CI], 7.44-31.14%), and by 71.88% (95% CI, 39.48-211.82%) for single females with children. Monthly time-series show that single mothers have lower event resilience, experiencing higher added mental stress. Results also show that the count of poor mental health days is sensitive to hurricane intensity, increasing by a factor of 1.06 (95% CI, 1.02-1.10) for every billion (U.S.$) dollars of damage added for all exposed persons, and by a factor of 1.08 (95% CI, 1.03-1.14) for single mothers. We estimate that single mothers, as a group, suffered over $130 million in productivity loss from added postdisaster stress and disability. Results illustrate the measurability of mental health resilience as a two-dimensional concept of resistance capacity and recovery time. Overall, we show that natural disasters regressively tax disadvantaged population strata. © 2011 Society for Risk Analysis.
This dissertation consists of four empirical essays that study decisions on insurance, consumption and the accumulation and decumulation of wealth. The studies pay due attention to behavioral factors that may limit rationality, such as complexity and intertemporal choice. The first essay looks at
Thaler, Richard H.; Benartzi, Shlomo
As firms switch from defined-benefit plans to defined-contribution plans, employees bear more responsibility for making decisions about how much to save. The employees who fail to join the plan or who participate at a very low level appear to be saving at less than the predicted life cycle savings rates. Behavioral explanations for this behavior…
In the 1950s and 1960s, mathematical psychology and behavioral decision research arose in the unique context of the University of Michigan. These two psychological programs gave rise to Daniel Kahneman and Amos Tversky's famous research of the 1970s. In the early 1980s, Kahneman and Tversky's
Johnson, Matthew W.; Bickel, Warren K.
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…
Roane, Henry S.; Falcomata, Terry S.; Fisher, Wayne W.
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.)
Blumenthal-Barby, Jennifer S; McGuire, Amy L; Green, Robert C; Ubel, Peter A
Failure to consider lessons from behavioral economics in the case of whole genome sequencing may cause us to run into the 'last mile problem' - the failure to integrate newly developed technology, on which billions of dollars have been invested, into society in a way that improves human behavior and decision-making.
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
Ehrhardt-Martinez, Karen; Laitner, John A. ' Skip' (ACEEE, American Council for an Energy-Efficient Economy, Washington, D.C. (United States))
Energy concerns are increasingly on people's minds. According to a recent Gallup poll, nearly 30 percent of American's reported that energy prices were the most important financial problem facing their families today. But are these new concerns likely to translate into long-term behavioral changes and more energy-efficient behavior? Research suggests that it will take more than high prices to achieve maximum energy savings. People may like to think of themselves as rational economic actors, but a variety of studies by social-psychologists and behavioral economists reveal that people often act in ways that may be better described as 'socially-rational' and 'predictably irrational'. Despite these findings, many residential energy programs and most policy assessments continue to model potential energy savings as a function of existing technologies and the cost of those energy resources. This paper explores the ways in which individual behavior is shaped by the social context within which people operate and presents an alternative framework for modeling efficiency behavior. The alternative model recognizes that while individuals may not always behave in economically-rational ways, their behavior may be entirely rational from other vantage points. In fact, individuals often behave as rational social actors, determining what is and isn't 'appropriate' behavior by gleaning information from their own observations, from their peers, and from interactions within their sphere of social influence. As such, this paper explores the ways in which social rules, resources and context shape individual patterns of energy consumption. This alternative approach has important implications for program designs and policy recommendations.
Montoya, I D; Atkinson, J S; Trevino, R A
This note first presents a summary of four main behavioral models that are used to explain behavioral motivation and change. Three models are based on psychosocial theory. They are: 1) the Theory of Reasoned Action, 2) the Theory of Planned Behavior, and 3) the Theory of Stages-of-Change. The fourth model is based on economic theory and is known as the Rational Addiction Model. Each model is analyzed for its strengths and weaknesses. The note concludes by arguing for the usefulness of integrating the economic and the psychosocial models to study drug use. Specific examples and suggestions are presented.
Cost-of-illness (COI) was the first economic evaluation technique used in the health field. The principal aim was to measure the economic burden of illness to society. Its usefulness as a decision-making tool has however been questioned since its inception. The main criticism came from welfare economists who rejected COIs because they were not grounded in welfare economics theory. Other attacks related to the use of the human capital approach (HCA) to evaluate morbidity and mortality costs since it was said that the HCA had nothing to do with the value people attach to their lives. Finally, objections were made that COI could not be of any help to decision makers and that other forms of economic evaluation (e.g. cost-effectiveness, cost-benefit analysis) would be much more useful to those taking decisions and ranking priorities. Conversely, it is here suggested that COI can be a good economic tool to inform decision makers if it is considered from another perspective. COI is a descriptive study that can provide information to support the political process as well as the management functions at different levels of the healthcare organisations. To do that, the design of the study must be innovative, capable of measuring the true cost to society; to estimate the main cost components and their incidence over total costs; to envisage the different subjects who bear the costs; to identify the actual clinical management of illness; and to explain cost variability. In order to reach these goals, COI need to be designed as observational bottom-up studies.
Mendoza, Roger Lee
We explore the behavioral methodology and "revolution" in economics through the lens of medical economics. We address two questions: (1) Are mainstream economic assumptions of utility-maximization realistic approximations of people's actual behavior? (2) Do people maximize subjective expected utility, particularly in choosing from among the available options? In doing so, we illustrate-in terms of a hypothetical experimental sample of patients with dry eye diagnosis-why and how utility in pharmacoeconomic assessments might be valued differently by patients when subjective psychological, social, cognitive, and emotional factors are considered. While experimentally-observed or surveyed behavior yields stated (rather than revealed) preferences, behaviorism offers a robust toolset in understanding drug, medical device, and treatment-related decisions compared to the optimizing calculus assumed by mainstream economists. It might also do so more perilously than economists have previously understood, in light of the intractable uncertainties, information asymmetries, insulated third-party agents, entry barriers, and externalities that characterize healthcare. Behavioral work has been carried out in many sub-fields of economics. Only recently has it been extended to healthcare. This offers medical economists both the challenge and opportunity of balancing efficiency presumptions with relatively autonomous patient choices, notwithstanding their predictable, yet seemingly consistent, irrationality. Despite its comparative youth and limitations, the scientific contributions of behaviorism are secure and its future in medical economics appears to be promising.
Burgos, José E; García-Leal, Óscar
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. Copyright © 2015 Elsevier B.V. All rights reserved.
Stylianou, Amanda Mathisen; Postmus, Judy L; McMahon, Sarah
Recent attention has been given by researchers to exploring economic abuse strategies used by abusers. However, little research has been conducted to understanding how to conceptualize economic abuse in relation to other forms of abuse. This article examines the factor structure of abusive items from the Scale of Economic Abuse--12 and the Abusive Behavior Inventory through confirmatory factor analyses using data collected with 457 female survivors of abuse. The findings provide evidence for conceptualizing economic abuse as a unique form of abuse moderately correlated with psychological, physical, and sexual forms of abuse.
Murphy, Sean M; Leff, Jared A; Linas, Benjamin P; Morgan, Jake R; McCollister, Kathryn; Schackman, Bruce R
Health economic evaluation findings assist stakeholders in improving the quality, availability, scalability, and sustainability of evidence-based services, and in maximizing the efficiency of service delivery. The Center for Health Economics of Treatment Interventions for Substance Use Disorders, HCV, and HIV (CHERISH) is a NIDA-funded multi-institutional center of excellence whose mission is to develop and disseminate health-economic research on healthcare utilization, health outcomes, and health-related behaviors that informs substance use disorder treatment policy, and HCV and HIV care of people who use substances. We designed a consultation service that is free to researchers whose work aligns with CHERISH's mission. The service includes up to six hours of consulting time. After prospective consultees submit their request online, they receive a screening call from the consultation service director, who connects them with a consultant with relevant expertise. Consultees and consultants complete web-based evaluations following the consultation; consultees also complete a six-month follow-up. We report on the status of the service from its inception in July 2015 through June 2017. We have received 28 consultation requests (54% Early Stage Investigators, 57% MD or equivalent, 28% PhD, 61% women) on projects typically related to planning a study or grant application (93%); 71% were HIV/AIDS-related. Leading topics included cost-effectiveness (43%), statistical-analysis/econometrics (36%), cost (32%), cost-benefit (21%), and quality-of-life (18%). All consultees were satisfied with their overall experience, and felt that consultation expectations and objectives were clearly defined and the consultant's expertise was matched appropriately with their needs. Results were similar for consultants, who spent a median of 3 hours on consultations. There is a need for health-economic methodological guidance among substance use, HCV, and HIV researchers. Lessons learned
achieve intellectual and creative heights–as in, for ex- ample, the Italian Renaissance –and how can these pe- riods be sustained? SBE scientists are...end in the laboratory, which makes its study more complex. III. Policy Relevance The Italian Renaissance was a period of remarkable scientific...through psychological and anatomical experiments, examina- tion of the effects of traumatic head injuries or brain surgery , abnormal behavior and
Philip Armour; Mary C. Daly
Long gone are the days when most American workers could rely on their employers to manage their retirement savings. Today, most people handle their retirement portfolios themselves, gaining the right and responsibility to determine their own best strategies. Research on retirement planning suggests, however, that many fall short of consensus targets for optimal savings and investment. While part of the shortfall is explained by information gaps and income constraints, research in behavioral e...
Full Text Available Threats to animal and plant health by invading organisms are increasing due to trade liberalisation and increased movement of goods and people. This paper conceptualises an economic approach to protecting plant health against invasive organisms, specifically addressing a multidisciplinary audience involved in plant health research and in governmental policy-making process. We discuss the conceptual framework and present some generally available management options. We also build a basic model dealing with pre-emptive and reactive control, followed by a numerical illustration to the case of Colorado potato beetle in Finland. The analysis undertaken supports the notion that pre-emptive control is a viable strategy. Reactive control should be considered only if very low invasion magnitude combines with a low level of damage. However, the strategy choice implies also distributional impacts that warrant attention. The analysis results in a solution for a given set of numbers only. Uncertainty is incorporated through sensitivity analysis. The approach presented demonstrates the basic economic thinking behind the issue, and the concepts described allow further development of more sophisticated forms of analysis.;
Chen, M S; Chan, A
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.
Breslau, Joshua; Engel, Charles C.
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
Full Text Available Objective. Mental health service users experience high rates of cardiometabolic disorders and have a 20–25% shorter life expectancy than the general population from such disorders. Clinician-led health behavior programs have shown moderate improvements, for mental health service users, in managing aspects of cardiometabolic disorders. This study sought to potentially enhance health initiatives by exploring (1 facilitators that help mental health service users engage in better health behaviors and (2 the types of health programs mental health service users want to develop. Methods. A qualitative study utilizing focus groups was conducted with 37 mental health service users attending a psychosocial rehabilitation center, in Northern British Columbia, Canada. Results. Four major facilitator themes were identified: (1 factors of empowerment, self-value, and personal growth; (2 the need for social support; (3 pragmatic aspects of motivation and planning; and (4 access. Participants believed that engaging with programs of physical activity, nutrition, creativity, and illness support would motivate them to live more healthily. Conclusions and Implications for Practice. Being able to contribute to health behavior programs, feeling valued and able to experience personal growth are vital factors to engage mental health service users in health programs. Clinicians and health care policy makers need to account for these considerations to improve success of health improvement initiatives for this population.
Heydari, Abbas; Vafaee-Najar, Ali; Bakhshi, Mahmoud
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
Koehlmoos Tracey P
Full Text Available Abstract 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
Mudarri, David; Fisk, William J.
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.
Machado, Márcio; Iskedjian, Michael; Einarson, Thomas R
Health economic analyses have become important to healthcare systems worldwide. No studies have previously examined South America's contribution in this area. To survey the literature with the purpose of reviewing, quantifying, and assessing the quality of published South American health economic analyses. A search of MEDLINE (1990-December 2004), EMBASE (1990-December 2004), International Pharmaceutical Abstracts (1990-December 2004), Literatura Latino-Americana e do Caribe em Ciências da Saúde (1982-December 2004), and Sistema de Informacion Esencial en Terapéutica y Salud (1980-December 2004) was completed using the key words cost-effectiveness analysis (CEA), cost-utility analysis (CUA), cost-minimization analysis (CMA), and cost-benefit analysis (CBA); abbreviations CEA, CUA, CMA, and CBA; and all South American country names. Papers were categorized by type and country by 2 independent reviewers. Quality was assessed using a 12 item checklist, characterizing scores as 4 (good), 3 (acceptable), 2 (poor), 1 (unable to judge), and 0 (unacceptable). To be included in our investigation, studies needed to have simultaneously examined costs and outcomes. We retrieved 25 articles; one duplicate article was rejected, leaving 24 (CEA = 15, CBA = 6, CMA = 3; Brazil = 9, Argentina = 5, Colombia = 3, Chile = 2, Ecuador = 2, 1 each from Peru, Uruguay, Venezuela). Variability between raters was less than 0.5 point on overall scores (OS) and less than 1 point on all individual items. Mean OS was 2.6 (SD 1.0, range 1.4-3.8). CBAs scored highest (OS 2.8, SD 0.8), CEAs next (OS 2.7, SD 0.7), and CMAs lowest (OS 2.0, SD 0.5). When scored by type of question, definition of study aim scored highest (OS 3.0, SD 0.8), while ethical issues scored lowest (OS 1.5, SD 0.9). By country, Peru scored highest (mean OS 3.8) and Uruguay had the lowest scores (mean OS 2.2). A nonsignificant time trend was noted for OS (R2 = 0.12; p = 0.104). Quality scores of health economic analyses
PUBLISHED For many years it was a challenge in teaching health economics to find a textbook that exactly fits the needs of a class, not least because the needs of student are so diverse. To an extent, this remains the case despite the appearance of several new and useful contributions in the last few years. At times it seemed like cable television ? lots of choices, but nothing that is quite what you want. Cullis and West (1979) worked well for many groups, but was allowed to get out of da...
activation of Amygdala - a key center in our emotional arousal (limbic system) - as shaped in the elder stone-age with many acute threats. II. In general, the Hawthorne-effect of management is explained as the result of supportive job-relations reinforcing the homeostatic properties of the limbic system...... with de-stressing benefits as reduced anxiety, less use of stimulants and a reduction of blood pressure which in all increase life-expectancy. Conclusion: Neuroeconomics helps economists to identify dominant health economic interventions that may be overlooked by traditional discipålines [i] This part...
Pronk, Nicolaas P.
Objective To describe integrated worker health protection and promotion (IWHPP) program characteristics, to discuss the rationale for integration of OSH and WHP programs, and to summarize what is known about the impact of these programs on health and economic outcomes. Methods A descriptive assessment of the current state of the IWHPP field and a review of studies on the effectiveness of IWHPP programs on health and economic outcomes. Results Sufficient evidence of effectiveness was found for IWHPP programs when health outcomes are considered. Impact on productivity-related outcomes is considered promising, but inconclusive, whereas insufficient evidence was found for health care expenditures. Conclusions Existing evidence supports an integrated approach in terms of health outcomes but will benefit significantly from research designed to support the business case for employers of various company sizes and industry types. PMID:24284747
Worley, Matthew J; Shoptaw, Steven J; Bickel, Warren K; Ling, Walter
Research grounded in behavioral economics has previously linked addictive behavior to disrupted decision-making and reward-processing, but these principles have not been examined in prescription opioid addiction, which is currently a major public health problem. This study examined whether pre-treatment drug reinforcement value predicted opioid use during outpatient treatment of prescription opioid addiction. Secondary analyses examined participants with prescription opioid dependence who received 12 weeks of buprenorphine-naloxone and counseling in a multi-site clinical trial (N=353). Baseline measures assessed opioid source and indices of drug reinforcement value, including the total amount and proportion of income spent on drugs. Weekly urine drug screens measured opioid use. Obtaining opioids from doctors was associated with lower pre-treatment drug spending, while obtaining opioids from dealers/patients was associated with greater spending. Controlling for demographics, opioid use history, and opioid source frequency, patients who spent a greater total amount (OR=1.30, peconomic resources to drugs, reflects propensity for continued opioid use during treatment among individuals with prescription opioid addiction. Future studies should examine disrupted decision-making and reward-processing in prescription opioid users more directly and test whether reinforcer pathology can be remediated in this population. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Eker, Gulin; Berument, Hakan; Dogan, Burak
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.
Jarron M. Saint Onge
Full Text Available Existing research that studies individual health behaviors and conceive of behaviors as simplistically reflecting narrow intentions toward health may obscure the social organization of health behaviors. Instead, we examine how eight health behaviors group together to form distinct health behavior niches. Using nationally-representative data from U.S. adults aged 18 and over from the 2004–2009 National Health Interview Survey (NHIS, we use Latent Class Analysis to identify classes of behavior based on smoking status, alcohol use, physical activity, physician visits, and flu vaccination. We identify 7 distinct health behavior classes including concordant health promoting (44%, concordant health compromising (26%, and discordant classes (30%. We find significant race/ethnic, sex, regional, and age differences in class membership. We show that health behavior classes are associated with prospective mortality, suggesting that they are valid representations of health lifestyles. We discuss the implications of our results for sociological theories of health behaviors, as well as for multiple behavior interventions seeking to improve population health.
McNamee, Paul; Murray, Elizabeth; Kelly, Michael P; Bojke, Laura; Chilcott, Jim; Fischer, Alastair; West, Robert; Yardley, Lucy
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. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
Ahmad H. Juma'h
Full Text Available Cash dividend policy is affected by financial and behavioral factors. Available information in the financial markets reduces the uncertainty and leads to better decisions for the performance and organizational effectiveness. Companies face uncertainty with respect to the world-wide policy, growth, stability, technology and the changes in consumers’ tastes. The determinants and factors that influence the decision to pay dividends include the stakeholders’ perceptions on dividends announcements, the pattern of dividends payments, the opportunities of investments, the effects on share price, the effects of taxes, and the companies’ size.
Full Text Available The socioeconomic inequalities in child health continue to widen despite improved economy.To investigate the correlation between socio-economic factors and health risk behaviors and psychosocial well-being of children in Hong Kong.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.Cross sectional territory wide survey.Caregivers of 7,000 children in kindergartens in Hong Kong.Youth Risk Behavior Surveillance questionnaire, health-related knowledge and hygienic practice questionnaire, and Children Behavior Checklist (CBCL.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, lower family income and recipient of CSSA with ORs 1.24 (95% CI 1
Lee, Albert; Chua, Hoi-wai; Chan, Mariana; Leung, Patrick W. L.; Wong, Jasmine W. S.; Chuh, Antonio A. T.
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
Knobloch-Westerwick, S.; Johnson, B.K.; Westerwick, A.
Reaching target audiences is of crucial importance for the success of health communication campaigns, but individuals may avoid health messages if they challenge their beliefs or behaviors. A lab study (N=419) examined effects of messages' consistency with participants' behavior and source
Djawadi, Behnud Mir; Fahr, René; Turk, Florian
Medical nonpersistence is a worldwide problem of striking magnitude. Although many fields of studies including epidemiology, sociology, and psychology try to identify determinants for medical nonpersistence, comprehensive research to explain medical nonpersistence from an economics perspective is rather scarce. The aim of the study was to develop a conceptual framework that augments standard economic choice theory with psychological concepts of behavioral economics to understand how patients' preferences for discontinuing with therapy arise over the course of the medical treatment. The availability of such a framework allows the targeted design of mechanisms for intervention strategies. Our conceptual framework models the patient as an active economic agent who evaluates the benefits and costs for continuing with therapy. We argue that a combination of loss aversion and mental accounting operations explains why patients discontinue with therapy at a specific point in time. We designed a randomized laboratory economic experiment with a student subject pool to investigate the behavioral predictions. Subjects continue with therapy as long as experienced utility losses have to be compensated. As soon as previous losses are evened out, subjects perceive the marginal benefit of persistence lower than in the beginning of the treatment. Consequently, subjects start to discontinue with therapy. Our results highlight that concepts of behavioral economics capture the dynamic structure of medical nonpersistence better than does standard economic choice theory. We recommend that behavioral economics should be a mandatory part of the development of possible intervention strategies aimed at improving patients' compliance and persistence behavior. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.
I Wayan Sukadana
Full Text Available The paper analyzes subject’s behavior in evolutionary process of entry game. The experiment is designed to analyze the behavior of the subject. The experiment is set in sequential entry games. Process of the game was conducted under asymmetric information, uncertainty, payoff perturbation and random matching. The subjects of the experiment were students of the Universitas Udayana, Bali, Indonesia. Subjects who play as new-entrance firms tend to choose “stay-out” strategy when the uncertainty and the amount of loss increase. Meanwhile, the subjects who play as an incumbent firm, which set to have more information about the game (market rather than the new-entrances, most of the time abuse their position by choose “threat” strategy, which not a credible strategy for some of them. Experimental studies shows that New-entrance tend to weight more on lost when the risk increase (from risk averse setting to risk seeking setting, and tend to choose sure value over a lotteries although the expected value from lotteries is higher or the same. These findings support the reason that Indonesian youngsters tend to choose a job as a PNS or employee of existing firms. The results also support the reason that Indonesian businessman is more willing to open a new business if they have a guarantee for their losses.
Akulume, Martha; Kiwanuka, Suzanne N
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 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.
Full Text Available 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.
Monson, Samantha Pelican; Sheldon, J Christopher; Ivey, Laurie C; Kinman, Carissa R; Beacham, Abbie O
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.
Nozais, J P; Gentilini, M
If the usefulness of industrial development of the Third World is not really discussed, nevertheless it appears more and more necessary to evaluate carefully its advantages and disadvantages on the health status and the well being of the population concerned. Indeed, the evil consequences are well known: new outbreak of bilharziosis, malaria, onchocerciasis, but also arbovirosis, tuberculosis and S.T.D. On the other hand, we must consider the positive aspects of economic development: improvement of hygiene, constructions of health centers, increased food production. In order to minimize the drawbacks, some measures have to be taken, f.i.: to set up the sanitary files of the population to be displaced, the organization of the redwelling zones. For all these reasons, the cost evaluation must take into account the sanitary sector, keeping in mind the difficulty to appraise the consequential effects on climate and fauna.
Speidel, J Joseph; Grossman, Richard A
Although obstetrician-gynecologists recognize the importance of managing fertility for the reproductive health of individuals, many are not aware of the vital effect they can have on some of the world's most pressing issues. Unintended pregnancy is a key contributor to the rapid population growth that in turn impairs social welfare, hinders economic progress, and exacerbates environmental degradation. An estimated 215 million women in developing countries wish to limit their fertility but do not have access to effective contraception. In the United States, half of all pregnancies are unplanned. Voluntary prevention of unplanned pregnancies is a cost-effective, humane way to limit population growth, slow environmental degradation, and yield other health and welfare benefits. Family planning should be a top priority for our specialty.
Husain, Muhammad J; Brophy, Sinead; Macey, Steven; Pinder, Leila M; Atkinson, Mark D; Cooksey, Roxanne; Phillips, Ceri J; Siebert, Stefan
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. 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. 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 schemes based on disease
Husain Muhammad J
Full Text Available Abstract 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
Zavras, Dimitris; Tsiantou, Vasiliki; Pavi, Elpida; Mylona, Katerina; Kyriopoulos, John
Financial crisis and worsened socio-economic conditions are associated with greater morbidity, less utilization of health services and deteriorated population's health status. The aim of the present study was to investigate the determinants of self-rated health in Greece. Two national cross-sectional surveys conducted in 2006 and 2011 were combined, and their data were pooled giving information for 10 572 individuals. The sample in both studies was random and stratified by gender, age, degree of urbanization and geographic region. Logistic regression analysis was used to determine the impact of several factors on self-rated health. Poor self-rated health was most common in older people, unemployed, pensioners, housewives and those suffering from chronic disease. Men, individuals with higher education and those with higher income have higher probability to report better self-rated health. Furthermore, the probability of reporting poor self-rated health is higher at times of economic crisis. Our findings confirm the association of self-rated health with economic crisis and certain demographic and socio-economic factors. Given that the economic recession in Greece deepens, immediate and effective actions targeting health inequalities and improvements in health status are deemed necessary.
Pyle Donald N
Full Text Available Abstract Background Appalachia is characterized by poor health behaviors, poor health status, and health disparities. Recent interventions have not demonstrated much success in improving health status or reducing health disparities in the Appalachian region. Since one's perception of personal health precedes his or her health behaviors, the purpose of this project was to evaluate the self-rated health of Appalachian adults in relation to objective health status and current health behaviors. Methods Appalachian adults (n = 1,576 were surveyed regarding health behaviors - soda consumer (drink ≥ 355 ml/d, or non-consumer (drink 30 min > 1 d/wk and sedentary (exercise Results Respondents reported being healthy, while being sedentary (65%, hypertensive (76%, overweight (73%, or hyperlipidemic (79%. Between 57% and 66% of the respondents who considered themselves healthy had at least two disease conditions or poor health behaviors. Jaccard Binary Similarity coefficients and odds ratios showed the probability of reporting being healthy when having a disease condition or poor health behavior was high. Conclusions The association between self-rated health and poor health indicators in Appalachian adults is distorted. The public health challenge is to formulate messages and programs about health and health needs which take into account the current distortion about health in Appalachia and the cultural context in which this distortion was shaped.
Aue, Katja; Roosen, Jutta; Jensen, Helen H
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. Copyright © 2016 Elsevier Ltd. All rights reserved.
Bernardus Bala de Rosari
Full Text Available This research aimed at analysing the demand and allocation of credit and capital supports by farm household and impact on production, consumption, and investment. The research was conducted in East Nusa Tenggara Timur (ENT Province, one of targeted region of credit and capital supports policy of the government. Data collection was conducted from April to June 2013 by sampling for 178 households of farmers in Kupang District and Timor Tengah Selatan (TTS District. The result of this research showed that the allocation of credit and capital supports caused increaseof cattle production, consumption expenditure, and investment. The usage of credit and capital supports was depend on economical situation of the household itself. The decision of farm household on using credit and capital supports had impact on overall economical behavior of household, i.e. production, consumption and investment behavior. The transmission use was reciprocally interacted. Finally, the policy of credit and capital supports scheme for farmers should be adjusted with the context of farm household economics.
Cotti, Chad; Dunn, Richard A; Tefft, Nathan
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. Copyright © 2014 John Wiley & Sons, Ltd.
Drewnowski, Adam; Kawachi, Ichiro
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.
Yamey, Gavin; Beyeler, Naomi; Wadge, Hester; Jamison, Dean
Developing country governments and aid agencies face difficult decisions on how best to allocate their finite resources. Investments in many different sectors -including education, water and sanitation, transportation, and health- can all reap social and economic benefits. This report focuses specifically on the health sector. It presents compelling evidence of the value of scaling-up health investments. The economic case for increasing these investments in health has never been stronger. Having made progress in reducing maternal and child mortality, and deaths from infectious diseases, it is essential that policymakers do not become complacent. These gains will be quickly reversed without sustained health investments. Scaled-up investments will be needed to tackle the emerging non-communicable disease (NCD) burden and to achieve universal health coverage (UHC). The value of investment in health far beyond its performance is reflected in economic prosperity through gross domestic product (GDP). People put a high monetary value on the additional years of life that health investments can bring -an inherent value to being alive for longer, unrelated to productivity. Policymakers need to do more to ensure that spending on health reflects people's priorities. To make sure services are accessible to all, governments have a clear role to play in financing health. Without public financing, there will be some who cannot afford the care they need, and they will be forced to choose sickness -perhaps even death- and financial ruin; a devastating choice that already pushes 150 million people into poverty every year. In low-income countries (LICs) and middle-income countries (MICs), public financing should be used to achieve universal coverage with a package of highly cost-effective interventions ('best buys'). Governments failing to protect the health and wealth of their people in this way will be unable to reap the benefits of long-term economic prosperity and growth. Public
Liu, Yong-Bing; Liu, Liu; Li, Yan-Fei; Chen, Yan-Li
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. 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. 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 literacy score was significantly associated with smoking, drinking, physical exercise, and health examination (p literacy scores were significantly less likely to have risky behaviors (smoking, regular drinking, and lack of physical exercise), and in turn significantly more likely to undergo
Porto, Marcelo Firpo; Martinez-Alier, Joan
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.
Noar, Seth M; Mehrotra, Purnima
Traditional theory testing commonly applies cross-sectional (and occasionally longitudinal) survey research to test health behavior theory. Since such correlational research cannot demonstrate causality, a number of researchers have called for the increased use of experimental methods for theory testing. We introduce the multi-methodological theory-testing (MMTT) framework for testing health behavior theory. The MMTT framework introduces a set of principles that broaden the perspective of how we view evidence for health behavior theory. It suggests that while correlational survey research designs represent one method of testing theory, the weaknesses of this approach demand that complementary approaches be applied. Such approaches include randomized lab and field experiments, mediation analysis of theory-based interventions, and meta-analysis. These alternative approaches to theory testing can demonstrate causality in a much more robust way than is possible with correlational survey research methods. Such approaches should thus be increasingly applied in order to more completely and rigorously test health behavior theory. Greater application of research derived from the MMTT may lead researchers to refine and modify theory and ultimately make theory more valuable to practitioners. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
LaRusso, Maria; Selman, Robert
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…
Stebbins, K R
This paper examines the expanding presence of multinational cigarette companies into almost every country in the world, and discusses the health implications of this global penetration. Cigarettes deserve special attention because tobacco is the only legally available consumer product that is harmful to one's health when used as intended. A temptation exists to blame governments for the existence of health-threatening products within their borders. However, this paper illustrates the extent to which extra-national forces influence domestic policies and circumstances. Cigarette smokers are often blamed for their lethal habit, despite billion-dollar promotional schemes which attract people to smoking, obscuring the harmful consequences of consuming a highly addictive drug. Multinational cigarette companies are increasingly targeting Asian and Third World populations. To facilitate this market penetration, political avenues are often pursued with considerable success, disregarding the health implications associated with cigarette tobacco. The use of tobacco in development programs (e.g. the U.S. 'Food for Peace' program) has political and economic implications for donor and recipient countries, and lucrative advantages for the tobacco companies. However, this paper recommends that corporate profits and foreign policy should not be pursued at the expense of tobacco-related diseases and premature deaths among Third World peoples.
Reilly, J.; Yang, T.; Paltsev, S.; Wang, C.; Prinn, R.; Sarofim, M.
Climate change and air pollution are intricately linked. The distinction between greenhouse substances and other air pollutants is resolved at least for the time being in the context of international negotiations on climate policy through the identification of CO2, CH4, N2O, SF6 and the per- and hydro- fluorocarbons as substances targeted for control. Many of the traditional air pollutant emissions including for example CO, NMVOCs, NOx, SO2, aerosols, and NH3 also directly or indirectly affect the radiative balance of the atmosphere. Among both sets of gases are precursors of and contributors to pollutants such as tropopospheric ozone, itself a strong greenhouse gas, particulate matter, and other pollutants that affect human health. Fossil fuel combustion, production, or transportation is a significant source for many of these substances. Climate policy can thus affect traditional air pollution or air pollution policy can affect climate. Health effects of acute or chronic exposure to air pollution include increased asthma, lung cancer, heart disease and bronchitis among others. These, in turn, redirect resources in the economy toward medical expenditures or result in lost labor or non-labor time with consequent effects on economic activity, itself producing a potential feedback on emissions levels. Study of these effects ultimately requires a fully coupled earth system model. Toward that end we develop an approach for introducing air pollution health impacts into the Emissions Prediction and Policy Analysis (EPPA) model, a component of the MIT Integrated Global Systems Model (IGSM) a coupled economics-chemistry-atmosphere-ocean-terrestrial biosphere model of earth systems including an air pollution model resolving the urban scale. This preliminary examination allows us to consider how climate policy affects air pollution and consequent health effects, and to study the potential impacts of air pollution policy on climate. The novel contribution is the effort to
Full Text Available As a basis for information recovery in open dynamic microeconomic systems, we emphasize the connection between adaptive intelligent behavior, causal entropy maximization and self-organized equilibrium seeking behavior. This entropy-based causal adaptive behavior framework permits the use of information-theoretic methods as a solution basis for the resulting pure and stochastic inverse economic-econometric problems. We cast the information recovery problem in the form of a binary network and suggest information-theoretic methods to recover estimates of the unknown binary behavioral parameters without explicitly sampling the configuration-arrangement of the sample space.
Villas-Boas, Sofia B.; Fu, Qiuzi; Judge, George
In this paper, we focus on the first significant digit (FSD) distribution of European micro income data and use information theoretic-entropy based methods to investigate the degree to which Benford's FSD law is consistent with the nature of these economic behavioral systems. We demonstrate that Benford's law is not an empirical phenomenon that occurs only in important distributions in physical statistics, but that it also arises in self-organizing dynamic economic behavioral systems. The empirical likelihood member of the minimum divergence-entropy family, is used to recover country based income FSD probability density functions and to demonstrate the implications of using a Benford prior reference distribution in economic behavioral system information recovery.
Bickel, Warren K; Johnson, Matthew W; Koffarnus, Mikhail N; MacKillop, James; Murphy, James G
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.
Bickel, Warren K.; Johnson, Matthew W.; Koffarnus, Mikhail N.; MacKillop, James; Murphy, James G.
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
Full Text Available Developing country governments and aid agencies face difficult decisions on how best to allocate their finite resources. Investments in many different sectors –including education, water and sanitation, transportation, and health– can all reap social and economic benefits. This report focuses specifically on the health sector. It presents compelling evidence of the value of scaling-up health investments. The economic case for increasing these investments in health has never been stronger. Having made progress in reducing maternal and child mortality, and deaths from infectious diseases, it is essential that policymakers do not become complacent. These gains will be quickly reversed without sustained health investments. Scaled-up investments will be needed to tackle the emerging non-communicable disease (NCD burden and to achieve universal health coverage (UHC. The value of investment in health far beyond its performance is reflected in economic prosperity through gross domestic product (GDP. People put a high monetary value on the additional years of life that health investments can bring –an inherent value to being alive for longer, unrelated to productivity. Policymakers need to do more to ensure that spending on health reflects people’s priorities. To make sure services are accessible to all, governments have a clear role to play in financing health. Without public financing, there will be some who cannot afford the care they need, and they will be forced to choose sickness –perhaps even death– and financial ruin; a devastating choice that already pushes 150 million people into poverty every year. In low-income countries (LICs and middle-income countries (MICs, public financing should be used to achieve universal coverage with a package of highly cost-effective interventions (‘best buys’. Governments failing to protect the health and wealth of their people in this way will be unable to reap the benefits of long
Nigg, Claudio R; Amato, Katie
Health behaviors during childhood may influence adolescent health behaviors and be related to other important outcomes, but no longitudinal research has examined this in a multicultural population in Hawaii to date. This study investigated if childhood moderate to vigorous physical activity (MVPA), fruit and vegetable consumption, and sedentary behavior influence adolescent (1) MVPA, fruit and vegetable consumption, and sedentary behavior; (2) body mass index (BMI) percentile, general health, and stress; and (3) school marks and school absenteeism. Three cohorts of public elementary school children (fourth to sixth graders) who participated in a state-mandated after-school program in 2004, 2005, and 2006 completed baseline (demographics, MVPA, fruit and vegetable consumption, and sedentary behavior) and 5-year follow-up surveys (demographics, MVPA, fruit and vegetable consumption, and sedentary behavior; BMI, general health, stress, school marks, and absenteeism; combined follow-up n = 334; 14.76 ± 0.87 years old; 55.1% female; 53% Asian, 19.8% Native Hawaiian/other Pacific Islander, 15.3% White, and 11.9% other). Regressions found that childhood MVPA (mean [m] = 45.42, standard deviation [SD] = 31.2 min/day) and fruit and vegetable consumption (m = 6.96, SD = 4.54 servings/day) predicted these behaviors in adolescence (m = 47.22, SD = 27.04 min/day and m = 4.63, SD = 3.03 servings/day, respectively, p Childhood sedentary behavior (m = 3.85, SD = 2.85 h/day)) predicted adolescent BMI percentile (m = 60.93, SD = 28.75, p Childhood fruit and vegetable consumption and sedentary behavior negatively predicted adolescent marks (B average, p Childhood health behaviors do influence adolescent health behaviors, some health outcomes, and some academic indicators in this population, especially childhood sedentary behavior, which underlines the importance of sedentary behavior interventions.
As the leading economic forum in the Asia-Pacific region, APEC facilitates economic growth and prosperity in the Asia-Pacific region through trade and investment liberalization, business facilitation, and economic and technical cooperation.
Rtveladze, Ketevan; Marsh, Tim; Barquera, Simon; Sanchez Romero, Luz Maria; Levy, David; Melendez, Guillermo; Webber, Laura; Kilpi, Fanny; McPherson, Klim; Brown, Martin
Along with other countries having high and low-to-middle income, Mexico has experienced a substantial change in obesity rates. This rapid growth in obesity prevalence has led to high rates of obesity-related diseases and associated health-care costs. Micro-simulation is used to project future BMI trends. Additionally thirteen BMI-related diseases and health-care costs are estimated. The results are simulated for three hypothetical scenarios: no BMI reduction and BMI reductions of 1 % and 5 % across the population. Mexican Health and Nutrition Surveys 1999 and 2000, and Mexican National Health and Nutrition Survey 2006. Mexican adults. In 2010, 32 % of men and 26 % of women were normal weight. By 2050, the proportion of normal weight will decrease to 12 % and 9 % for males and females respectively, and more people will be obese than overweight. It is projected that by 2050 there will be 12 million cumulative incidence cases of diabetes and 8 million cumulative incidence cases of heart disease alone. For the thirteen diseases considered, costs of $US 806 million are estimated for 2010, projected to increase to $US 1·2 billion and $US 1·7 billion in 2030 and 2050 respectively. A 1 % reduction in BMI prevalence could save $US 43 million in health-care costs in 2030 and $US 85 million in 2050. Obesity rates are leading to a large health and economic burden. The projected numbers are high and Mexico should implement strong action to tackle obesity. Results presented here will be very helpful in planning and implementing policy interventions.
Akulume, Martha; Kiwanuka, Suzanne N.
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 externa...
Beshears, John; Choi, James J; Laibson, David; Madrian, Brigitte C
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.
Franklin, Monica D; Schlundt, David G; McClellan, Linda H; Kinebrew, Tunu; Sheats, Jylana; Belue, Rhonda; Brown, Anne; Smikes, Dorlisa; Patel, Kushal; Hargreaves, Margaret
To examine the association between religious fatalism and health care utilization, health behaviors, and chronic illness. As part of Nashville's REACH 2010 project, residents (n=1273) participated in a random telephone survey that included health variables and the helpless inevitability subscale of the Religious Health Fatalism Questionnaire. Religious health fatalism was higher among African Americans and older participants. Some hypotheses about the association between fatalism and health outcomes were confirmed. Religious fatalism is only partially predictive of health behaviors and outcomes and may be a response to chronic illness rather than a contributor to unhealthy behaviors.
Turbin, M S; Jessor, R; Costa, F M
Relations among measures of adolescent behavior were examined to determine whether cigarette smoking fits into a structure of problem behaviors-behaviors that involve normative transgression-or a structure of health-related behaviors, or both. In an ethnically and socioeconomically diverse sample of 1782 male and female high school adolescents, four first-order problem behavior latent variables-sexual intercourse experience, alcohol abuse, illicit drug use, and delinquency-were established and together were shown to reflect a second-order latent variable of problem behavior. Four first-order latent variables of health-related behaviors-unhealthy dietary habits, sedentary behavior, unsafe behavior, and poor dental hygiene-were also established and together were shown to reflect a second-order latent variable of health-compromising behavior. The structure of relations among those latent variables was modeled. Cigarette smoking had a significant and substantial loading only on the problem-behavior latent variable; its loading on the health-compromising behavior latent variable was essentially zero. Adolescent cigarette smoking relates strongly and directly to problem behaviors and only indirectly, if at all, to health-compromising behaviors. Interventions to prevent or reduce adolescent smoking should attend more to factors that influence problem behaviors.
Full Text Available This paper presents the second part of results from a survey-based market research of Bulgarian households. In the first part of the paper the author analyzes the changes of consumer behavior in times of economic crisis in Bulgaria. Here, the author presents market segmentation from the point of view of consumer behavior changes in times of economic crisis. Four segments (clusters were discovered, and profiled. The similarities/dissimilarities between clusters are presented through the technique of multidimensional scaling (MDS The research project is planned, organized and realized within the Scientific Research Program of University of National and World Economy, Sofia, Bulgaria.
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.
Myles, Nicholas; Large, Matthew; Myles, Hannah; Adams, Robert; Liu, Dennis; Galletly, Cherrie
There have been substantial changes in workforce and employment patterns in Australia over the past 50 years as a result of economic globalisation. This has resulted in substantial reduction in employment in the manufacturing industry often with large-scale job losses in concentrated sectors and communities. Large-scale job loss events receive significant community attention. To what extent these mass unemployment events contribute to increased psychological distress, mental illness and suicide in affected individuals warrants further consideration. Here we undertake a narrative review of published job loss literature. We discuss the impact that large-scale job loss events in the manufacturing sector may have on population mental health, with particular reference to contemporary trends in the Australian economy. We also provide a commentary on the expected outcomes of future job loss events in this context and the implications for Australian public mental health care services. Job loss due to plant closure results in a doubling of psychological distress that peaks 9 months following the unemployment event. The link between job loss and increased rates of mental illness and suicide is less clear. The threat of impending job loss and the social context in which job loss occurs has a significant bearing on psychological outcomes. The implications for Australian public mental health services are discussed.
Mogler, Braden K; Shu, Suzanne B; Fox, Craig R; Goldstein, Noah J; Victor, Ronald G; Escarce, José J; Shapiro, Martin F
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.
van Berkel, Kelly; Reeves, Brenda
Problem: While stress is universal for graduate students, the difference in terms of stress symptoms and the effects on health behavior is how students cope. While numerous research studies have linked stress and negative health behaviors, few studies have objectively assessed these variables. Purpose: Utilize current health and fitness technology…
Bertrand, J T; Bertrand, W E
Vivamos Mejor (Let's Live Better) is a health education program conducted in Colombia for low-income people who needed knowledge about nutrition, preventive medicine, family planning, sex education, and child raising. A 3-3 1/2 hour lecture and slide presentation (discussion, movies, puppet shows) is held at 6 p.m. in a local school. Attendance is encouraged by nurse-auxiliary extension workers who extend written invitations in a given neighborhood. A 40-page color booklet recapping the lecture information is given to those who attend. A study was conducted to determine if this program was actually effective in the community, Siloe, compared to one which had no program. Of the 128 respondents to a questionnaire, 38.3% (49) had been invited but only 21.9% (28) had attended. The initial goal of 80% coverage was overambitious. Knowledge of health concepts, hazards, and changes in health related behaviors were affected by the lectures. Women who had been to the lecture scored higher on all topics than nonattendants from Siloe or the control group from Terron Colorado. A greater percentage of the exposed population displayed desirable health practices. Women were more likely to have had their children vaccinated, prepare fresh vegetables, use meat, if they had attended the program than the nonexposed groups. 39% of those exposed to the program were using birth control compared to 33% of the nonexposed.
Gadelha, Carlos Augusto Grabois; Braga, Patrícia Seixas da Costa
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
Dwinnells, Ronald; Misik, Lauren
Efficient and effective integration of behavioral health programs in a community health care practice emphasizes patient-centered medical home principles to improve quality of care. A prospective, 3-period, interrupted time series study was used to explore which of 3 different integrative behavioral health care screening and management processes were the most efficient and effective in prompting behavioral health screening, identification, interventions, and referrals in a community health practice. A total of 99.5% ( P behavioral health screenings; brief intervention rates nearly doubled to 83% ( P behavioral health care coordination.
Rundle, Andrew G; Revenson, Tracey A; Friedman, Michael
Assess associations between business travel and behavioral and mental health. Cross-sectional analyses of de-identified electronic medical record data from EHE International, Inc. a provider of corporate wellness programs. Higher levels of business travel were associated with poorer outcomes. Compared to traveling 1-6 nights/month for work, those who traveled 21 + nights were more likely to: smoke (prevalence ratio = 3.74, 95% CI 2.56, 5.46), report trouble sleeping (PR = 1.37, 95% CI 1.09, 1.71), be sedentary (PR = 1.95, 95%CI 1.56, 2.43) and score above clinical thresholds for alcohol dependence (CAGE score>1: PR = 2.04, 95% CI 1.26, 3.29), and mild or worse anxiety (GAD-7 Score>4: PR = 1.69, 95% CI 1.29, 2.21) and depression symptoms (PHQ-9 Score>4: PR = 2.27, 95%CI 1.70, 3.03). Employers should provide programs to help employees manage stress and maintain health while traveling for work.
Blackstone, Erwin A; Fuhr, Joseph P; Pociask, Steve
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. To review the health and economic consequences of counterfeit drugs on the US public and on the healthcare system as a whole. 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. 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 difficult, and the penalties are modest. Counterfeit
Full Text Available Background: Any activity undertaken for the purpose of health enhancing behavior is an important element of taking care of one's health. The aim of this paper was to analyze the frequency of health enhancing behaviors and avoiding health-risk behaviors among teachers and other school staff by gender and age. Material and Methods: The sample consisted of 750 teachers and 259 individuals of non-teaching staff of 22 health promoting schools. A questionnaire that included Positive Health Behaviors Scale for Adults and questions on avoiding risk behaviors were used as a research tool. Results: Of the 32 analyzed health enhancing (positive behaviors, only 11 were undertaken by teachers and 10 by non-teaching staff at a desirable frequency (always or almost always in a group of more than 50% of respondents. Almost one third of health enhancing behaviors were undertaken with this frequency by less than 20% of respondents. The highest deficits concerned physical activity, nutrition and mental health-related behaviors, and the lowest concerned safety. Deficits in all positive health behaviors were smaller in teachers than in non-teaching staff, in women than in men and in older than in younger teachers. The majority of respondents, mostly teachers, irrespective of gender and age did not undertake risk behaviors. Conclusions: There was a lot of deficits in the healthy lifestyle of teachers and other school workers what is alarming from the point of view of school workers' health, their tasks and their role in shaping positive health behavior in children and adolescents. There is a great need for taking actions to improve the situation, such as the development of health promotion programs addressed to teachers and other school staff, including issues concerning healthy lifestyles in teacher's pre- and in-service training, counselling in the area of healthy lifestyle in preventive health care of school staff. Med Pr 2013;64(5:659–670
Yang, Chi-Ta; Hung, Yu-Shiang; Deng, Guang-Feng
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.
Stanley, Christopher T.; Stanley, Lauren H. K.
An individual's identity related to health is critically important in terms of the adoption and maintenance of health behaviors, and guides approaches to health change across the lifespan. This article presents a review of the literature and proposes a health socialization and health identity framework, which may be used to clarify challenges in…
Undurraga, Eduardo A; Nica, Veronica; Zhang, Rebecca; Mensah, Irene C; Godoy, Ricardo A
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
Full Text Available INTRODUCTION: Higher and lower-middle income countries are increasingly affected by obesity. Obesity-related diseases are placing a substantial health and economic burden on Brazil. Our aim is to measure the future consequences of these trends on the associated disease burden and health care costs. METHOD: A previously developed micro-simulation model is used to project the extent of obesity, obesity-related diseases and associated healthcare costs to 2050. In total, thirteen diseases were considered: coronary heart disease, stroke, hypertension, diabetes, osteoarthritis, and eight cancers. We simulated three hypothetical intervention scenarios: no intervention, 1% and 5% reduction in body mass index (BMI. RESULTS: In 2010, nearly 57% of the Brazilian male population was overweight or obese (BMI ≥25 kg/m(2, but the model projects rates as high as 95% by 2050. A slightly less pessimistic picture is predicted for females, increasing from 43% in 2010 to 52% in 2050. Coronary heart disease, stroke, hypertension, cancers, osteoarthritis and diabetes prevalence cases are projected to at least double by 2050, reaching nearly 34,000 cases of hypertension by 2050 (per 100,000. 1% and 5% reduction in mean BMI will save over 800 prevalence cases and nearly 3,000 cases of hypertension by 2050 respectively (per 100,000. The health care costs will double from 2010 ($5.8 billion in 2050 alone ($10.1 billion. Over 40 years costs will reach $330 billion. However, with effective interventions the costs can be reduced to $302 billion by 1% and to $273 billion by 5% reduction in mean BMI across the population. CONCLUSION: Obesity rates are rapidly increasing creating a high burden of disease and associated costs. However, an effective intervention to decrease obesity by just 1% will substantially reduce obesity burden and will have a significant effect on health care expenditure.
Full Text Available Abstract Background The economic determinants of health have been widely recognised as crucial factors affecting health; however, to date, no comprehensive review has been undertaken to summarise these factors and the ways in which they can influence health. We conceptualise the economy as a complex system made up of underlying approaches, regulation from institutions, markets, finance, labour, the public-private balance as well as production and distributional effects, which collectively impact on health through the effect of moderators. This protocol details the methods for an umbrella review to explore the macro-economic factors, strategies, policies and interventions that affect health outcomes and health inequalities. Methods We will identify relevant systematic reviews using search terms derived from the Journal of Economic Literature classification. Reviews will be included if they meet the Database of Abstracts and Reviews of Effects criteria for systematic reviews. Reviews of studies with and without controls will be included; both association and intervention studies will be included. Primary outcomes will include but are not limited to morbidity, mortality, prevalence and incidence of conditions and life expectancy. Secondary outcomes will include health inequalities by gender, ethnicity or socio-economic status. Six databases will be searched using tailored versions of our piloted search strategy to locate relevant reviews. Data will be extracted using a standardized pro forma, and the findings will be synthesized into a conceptual framework to address our review aim. Discussion Our umbrella review protocol provides a robust method to systematically appraise the evidence in this field, using new conceptual models derived specifically to address the study question. This will yield important information for policymakers, practitioners and researchers at the local, national and international level. It will also help set the future
Chiou, Shu-Ti; Chiang, Jen-Huai; Huang, Nicole; Chien, Li-Yin
Background Staff health behaviors affect not only their own health but also their provision of health promotion services to their patients. Although different occupational groups work in hospitals, few studies have compared health behaviors among them. The objectives of this study were to examine health behaviors, including physical activity, eating 5 portions of fruits and vegetables per day (5 a day), and stress adaptation, and participation in hospital-based health promotion activities by ...
Full Text Available Abstract Background Although the association between health and unemployment has been well examined, less attention has been paid to the health of the economically inactive (EI population. Scotland has one of the worst health records compared to any Western European country and the EI population account for 23% of the working age population. The aim of this study is to investigate and compare the health outcomes and behaviours of the employed, unemployed and the EI populations (further subdivided into the permanently sick, looking after home and family [LAHF] and others in Scotland. Methods Using data from the 2003 Scottish Health Survey, the differences in health and health behaviours among the employed, unemployed and the subgroups of the EI population were examined. Results Both low educational attainment and residence in a deprived community were more likely in the permanently sick group. The LAHF and the unemployed showed worse self-reported health and limiting longstanding illness compared to the employed but no significant differences were observed between these groups. The permanently sick group had significantly poorer health outcomes than all the other economic groups. Similar to the unemployed and LAHF they are more likely to smoke than the employed but less likely (along with LAHF and ‘others’ to exhibit heavy alcohol consumption. Interestingly, the LAHF showed better mental health than the rest of the EI group, but a similar mental health status to the unemployed. On the physical health element of lung function, the LAHF were no worse than the employed. Conclusion While on-going health promotion and vocational rehabilitation efforts need to be directed towards all, our data suggests that the EI group is at higher risk and policies and strategies directed at this group may need particular attention.
Full Text Available Abstract Background Although vaccinations are critical for preventing emerging infectious diseases, scant research has been conducted on risk communication. With socio-economic characteristics, health behavior, and underlying diseases under control, we investigated associations between media use, health information-seeking behavior, health information type, and vaccination in the population. Methods This study relied on a national survey of Korean adults (n = 1367. Participants were adult males and females age 20 and older. Web and face-to-face surveys were conducted throughout July 2014. The main outcome was vaccination (categorized as yes or no. Independent variables were time spent on media, frequency of health information-seeking behavior, and types of health information sought. Results Controlling for co-variates, logistic regression analysis was conducted to identify factors that influence Korean adults being vaccinated. Results revealed that accessible information about emerging infectious diseases, listening to the radio, and reading the newspaper were associated with increased odds of being vaccinated. Active seeking health information as well as being female and of higher socio-economic status were positively correlated with Korean adults being vaccinated. Conclusion It is critical to promote health information-seeking behavior and use diverse media channels to increase acceptance and awareness of emerging infectious diseases and vaccinations. Because there are differences in vaccination awareness depending on social class, it is critical to reduce communication inequality, strengthen accessibility to vaccinations, and devise appropriate risk communication strategies that ensure Korean adults receive vaccinations.
Kim, Jiyeon; Jung, Minsoo
Although vaccinations are critical for preventing emerging infectious diseases, scant research has been conducted on risk communication. With socio-economic characteristics, health behavior, and underlying diseases under control, we investigated associations between media use, health information-seeking behavior, health information type, and vaccination in the population. This study relied on a national survey of Korean adults (n = 1367). Participants were adult males and females age 20 and older. Web and face-to-face surveys were conducted throughout July 2014. The main outcome was vaccination (categorized as yes or no). Independent variables were time spent on media, frequency of health information-seeking behavior, and types of health information sought. Controlling for co-variates, logistic regression analysis was conducted to identify factors that influence Korean adults being vaccinated. Results revealed that accessible information about emerging infectious diseases, listening to the radio, and reading the newspaper were associated with increased odds of being vaccinated. Active seeking health information as well as being female and of higher socio-economic status were positively correlated with Korean adults being vaccinated. It is critical to promote health information-seeking behavior and use diverse media channels to increase acceptance and awareness of emerging infectious diseases and vaccinations. Because there are differences in vaccination awareness depending on social class, it is critical to reduce communication inequality, strengthen accessibility to vaccinations, and devise appropriate risk communication strategies that ensure Korean adults receive vaccinations.
Full Text Available BACKGROUND. It is generally recognized that those poorer and less educated are more likely to have unhealthy behaviors. These disparities by socio-economic status (SES are observed with regards to different behaviors known to influence health outcomes in terms of diseases and deaths. However, this consistent pattern was found in population-wide studies in developed countries, while in certain demographic groups it was not seen. So the objective was to check if the SES-behavior association pattern was present in available data collected in Ukraine.METHODS. For current study, all available datasets were considered if they included data on SES, education, and gender. Outcomes were measurements of health behaviors including use of psychoactive substances, food consumption, and physical activity.RESULTS. Prevalence of many health behaviors differs in men and women in Ukraine. More men than women use legal and illegal drugs. With regard to education and SES, Ukrainian data reveals either absence of association found in developed countries or its inverted pattern: till recently, women with university education were more likely to smoke than those less educated; teenagers from more affluent families use alcohol more likely than those from poorer ones.CONCLUSION. Inconsistency of SES-behavior association patterns in Ukraine with those seen in the West may be due to a different perception of health behaviors in people who grew up in the former Soviet Union. Behaviors pertinent to men were considered rather masculine and risky than those health-related. We theorize that the revealed absence of SES-behavior association may be because the behaviors are not perceived as those related to health which is an important resource for life. If a behavior is not known as a ‘health behavior’, the society is less likely to stratify with regard to its practicing. So, if the hypothesis is correct, there may be more disparities in younger cohorts than in older ones
Jiang, Han; Petersen, Poul Erik; Peng, Bin
effect of socio-behavioral risk factors on perceived dental health, perceived need for dental care, and experience of dental symptoms. A cross-sectional survey of 2662 adolescents was conducted in eight capital cities in China; the response rate was 92%. The study population was chosen by multistage......-based health promotion programs in China is urgently needed, and promotion of oral health lifestyles should be integrated with other general health actions....
Engelen, Peter Jan|info:eu-repo/dai/nl/304832227; Lander, Michel W.; van Essen, Marc|info:eu-repo/dai/nl/357514491
Research on crime has by no means reached a definitive conclusion on which factors are related to crime rates. We contribute to the crime literature by providing an integrated empirical model of economic and sociological theories of criminal behavior and by using a very comprehensive set of
Tucker, Jalie A.; Vuchinich, Rudy E.; Black, Bethany C.; Rippens, Paula D.
This study investigated whether a behavioral economic index of the value of rewards available over different time horizons improved prediction of drinking outcomes beyond established biopsychosocial predictors. Preferences for immediate drinking versus more delayed rewards made possible by saving money were determined from expenditures prior to…
G. Dominioni (Goran)
textabstractThis thesis contributes to various streams of literature in the behavioral law and economics of tort law and judicial decisionmaking. Each chapter addresses a selected topic in this area from either a theoretical or an empirical perspective. The overarching theme of the thesis is the
Tucker, Jalie A.; Roth, David L.; Vignolo, Mary J.; Westfall, Andrew O.
Data were pooled from 3 studies of recently resolved community-dwelling problem drinkers to determine whether a behavioral economic index of the value of rewards available over different time horizons distinguished among moderation (n = 30), abstinent (n = 95), and unresolved (n = 77) outcomes. Moderation over 1- to 2-year prospective follow-up…
Carlo, Gustavo; Padilla-Walker, Laura M.; Day, Randal D.
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…
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.
Park, Hyunjeong; Walton-Moss, Benita
Parental guidance is critical to the development of children's health-related behaviors. The purpose of this study was to look at the relationship between parenting factors, including parenting style and parenting stress, and children's health-related behaviors. In this descriptive, correlational study, 284 parents of preschool children were interviewed using the Child Rearing Questionnaire and the Korean Parenting Stress Index-Short Form. Parent distress, authoritative and permissive parenting styles, family income, and mother's education were significantly associated with children's health-related behaviors. These findings suggest that higher levels of warmth, characteristics of both parenting styles, may be a critical factor in the development of health-related behaviors.
Hsu, Sheng-Hsun; Hsiao, Cheng-Fu; Tsai, Sang-Bing
Numerous factors affect how people choose a fine dining restaurant, including food quality, service quality, food safety, and hedonic value. A conceptual framework for evaluating restaurant selection behavior has not yet been developed. This study surveyed 150 individuals with fine dining experience and proposed the use of mental accounting and axiomatic design to construct a consumer economic behavior model. Linear and logistic regressions were employed to determine model correlations and the probability of each factor affecting behavior. The most crucial factor was food quality, followed by service and dining motivation, particularly regarding family dining. Safe ingredients, high cooking standards, and menu innovation all increased the likelihood of consumers choosing fine dining restaurants.
Full Text Available The existing incentive mechanisms of crowdsourcing construct the expected utility function based on the assumption of rational people in traditional economics. A large number of studies in behavioral economics have demonstrated the defects of the traditional utility function and introduced a new parameter called loss aversion coefficient to calculate individual utility when it suffers a loss. In this paper, combination of behavioral economics and a payment algorithm based on the loss aversion is proposed. Compared with usual incentive mechanisms, the node utility function is redefined by the loss aversion characteristic of the node. Experimental results show that the proposed algorithm can get a higher rate of cooperation with a lower payment price and has good scalability compared with the traditional incentive mechanism.
E. D. Lazarus
Full Text Available Developed coastal areas often exhibit a strong systemic coupling between shoreline dynamics and economic dynamics. "Beach nourishment", a common erosion-control practice, involves mechanically depositing sediment from outside the local littoral system onto an actively eroding shoreline to alter shoreline morphology. Natural sediment-transport processes quickly rework the newly engineered beach, causing further changes to the shoreline that in turn affect subsequent beach-nourishment decisions. To the limited extent that this landscape/economic coupling has been considered, evidence suggests that towns tend to employ spatially myopic economic strategies under which individual towns make isolated decisions that do not account for their neighbors. What happens when an optimization strategy that explicitly ignores spatial interactions is incorporated into a physical model that is spatially dynamic? The long-term attractor that develops for the coupled system (the state and behavior to which the system evolves over time is unclear. We link an economic model, in which town-manager agents choose economically optimal beach-nourishment intervals according to past observations of their immediate shoreline, to a simplified coastal-dynamics model that includes alongshore sediment transport and background erosion (e.g. from sea-level rise. Simulations suggest that feedbacks between these human and natural coastal processes can generate emergent behaviors. When alongshore sediment transport and spatially myopic nourishment decisions are coupled, increases in the rate of sea-level rise can destabilize economically optimal nourishment practices into a regime characterized by the emergence of chaotic shoreline evolution.
Background If Public Health is the science and art of how society collectively aims to improve health, and reduce inequalities in health, then Public Health Economics is the science and art of supporting decision making as to how society can use its available resources to best meet these objectives and minimise opportunity cost. A systematic review of published guidance for the economic evaluation of public health interventions within this broad public policy paradigm was conducted. Methods Electronic databases and organisation websites were searched using a 22 year time horizon (1990–2012). References of papers were hand searched for additional papers for inclusion. Government reports or peer-reviewed published papers were included if they; referred to the methods of economic evaluation of public health interventions, identified key challenges of conducting economic evaluations of public health interventions or made recommendations for conducting economic evaluations of public health interventions. Guidance was divided into three categories UK guidance, international guidance and observations or guidance provided by individual commentators in the field of public health economics. An assessment of the theoretical frameworks underpinning the guidance was made and served as a rationale for categorising the papers. Results We identified 5 international guidance documents, 7 UK guidance documents and 4 documents by individual commentators. The papers reviewed identify the main methodological challenges that face analysts when conducting such evaluations. There is a consensus within the guidance that wider social and environmental costs and benefits should be looked at due to the complex nature of public health. This was reflected in the theoretical underpinning as the majority of guidance was categorised as extra-welfarist. Conclusions In this novel review we argue that health economics may have come full circle from its roots in broad public policy economics. We may
Edwards, Rhiannon Tudor; Charles, Joanna Mary; Lloyd-Williams, Huw
If Public Health is the science and art of how society collectively aims to improve health, and reduce inequalities in health, then Public Health Economics is the science and art of supporting decision making as to how society can use its available resources to best meet these objectives and minimise opportunity cost. A systematic review of published guidance for the economic evaluation of public health interventions within this broad public policy paradigm was conducted. Electronic databases and organisation websites were searched using a 22 year time horizon (1990-2012). References of papers were hand searched for additional papers for inclusion. Government reports or peer-reviewed published papers were included if they; referred to the methods of economic evaluation of public health interventions, identified key challenges of conducting economic evaluations of public health interventions or made recommendations for conducting economic evaluations of public health interventions. Guidance was divided into three categories UK guidance, international guidance and observations or guidance provided by individual commentators in the field of public health economics. An assessment of the theoretical frameworks underpinning the guidance was made and served as a rationale for categorising the papers. We identified 5 international guidance documents, 7 UK guidance documents and 4 documents by individual commentators. The papers reviewed identify the main methodological challenges that face analysts when conducting such evaluations. There is a consensus within the guidance that wider social and environmental costs and benefits should be looked at due to the complex nature of public health. This was reflected in the theoretical underpinning as the majority of guidance was categorised as extra-welfarist. In this novel review we argue that health economics may have come full circle from its roots in broad public policy economics. We may find it useful to think in this broader
Zweifel, Peter; Tai-Seale, Ming
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.
Robinson, Cendrine; Seaman, Elizabeth L; Montgomery, LaTrice; Winfrey, Adia
African-American children and adolescents experience an undue burden of disease for many health outcomes compared to their White peers. More research needs to be completed for this priority population to improve their health outcomes and ameliorate health disparities. Integrating hip hop music or hip hop dance into interventions may help engage African-American youth in health interventions and improve their health outcomes. We conducted a review of the literature to characterize hip hop interventions and determine their potential to improve health. We searched Web of Science, Scopus, PsycINFO, and EMBASE to identify studies that assessed hip hop interventions. To be included, studies had to (1) be focused on a psychosocial or physical health intervention that included hip hop and (2) present quantitative data assessing intervention outcomes. Twenty-three articles were identified as meeting all inclusion criteria and were coded by two reviewers. Articles were assessed with regards to sample characteristics, study design, analysis, intervention components, and results. Hip hop interventions have been developed to improve health literacy, health behavior, and mental health. The interventions were primarily targeted to African-American and Latino children and adolescents. Many of the health literacy and mental health studies used non-experimental study designs. Among the 12 (of 14) health behavior studies that used experimental designs, the association between hip hop interventions and positive health outcomes was inconsistent. The number of experimental hip hop intervention studies is limited. Future research is required to determine if hip hop interventions can promote health.
Hamilton, L.D.; Manne, A.S.
National energy policy requires realistic totalling of costs in assessing energy alternatives. The Biomedical and Environmental Assessment Division (BEAD) at Brookhaven is estimating health and environmental costs of energy production and use. It was estimated that the production of electric power from all sources in the USA in 1975 was associated with 2000-19,000 deaths and 29,000-48,000 disabilities; this is roughly 0.2-2% of total deaths in the USA for ages 1-74. The estimated health effects associated with a total fuel cycle standardized to produce 10 10 kWh electric power were: from coal, estimated deaths 10-200, estimated disabilities 300-500; from oil, estimated deaths 3-150, estimated disabilities 150-300; from gas, estimated deaths 0.2, estimated disabilities 20; from nuclear power, estimated deaths 1-3, estimated disabilities 8-30. The differences in the year 2000 between health impacts of the US energy system under normal growth expectations and under conditions of a nuclear moratorium were estimated. On the assumption that the nuclear moratorium would require 200 additional 1000-MW(e) coal-fired power plants and that, with improved control technology, sulphur emissions were equivalent to 0.5% sulphur coal (12,500Btu/lb), additional estimated deaths were 1500-18,000 annually. By the same assumptions, it turns out that a nationwide nuclear moratorium could lead to low economic losses initially that would rise rapidly after the year 2000, so that the cost to the USA in 2010 would be US $109x10 9 . Summing the costs for 1975 through 2050, the present value of these losses would be US $77x10 9 or US $595x10 9 , depending on whether public decisions are to be based on a 10% or 5% discount rate. (author)
van Hulst, Marinus; Smit Sibinga, Cees Th. Smit; Postma, Maarten J.
Background and objectives. Health economics provides a standardised methodology for valid comparisons of interventions in different fields of health care. This review discusses the health economic evaluations of strategies to enhance blood product safety in sub-Saharan Africa Methods. We reviewed