Forest fires,air pollution,and mortality in Southeast Asia

I assess the population health effects in Malaysia of air pollution from a widespread series of fires that occurred in Indonesia between April and November of 1997. I describe how the fires occurred and why the associated air pollution was so widespread and long lasting. The main objective is to uncover any mortality effects and to assess how large and important they were. I also investigate whether the mortality effects were persistent or whether they represented a short-term, mortality-harvesting effect. The results show that the smoke haze from the fires had a deleterious effect on the health of the population in Malaysia.     

Women’s health and pregnancy outcomes: Do services make a difference?

We use data from the Indonesia Family Life Survey to investigate the impact of a major expansion in access to midwifery services on health and pregnancy outcomes for women of reproductive age. Between 1990 and 1998 Indonesia trained some 50,000 midwives. Between 1993 and 1997 these midwives tended to be placed in relatively poor communities that were relatively distant from health centers. We show that additions of village midwives to communities between 1993 and 1997 are associated with a significant increase in body mass index in 1997 relative to 1993 for women of reproductive age, but not for men or for older women. The presence of a village midwife during pregnancy is also associated with increased birthweight. Both results are robust to the inclusion of community-level fixed effects, a strategy that addresses many of the concerns about biases because of nonrandom program placement.     

雾霾污染对人口迁移的影响效应研究——基于人口普查和1%抽样调查资料的分析

文章将雾霾污染卫星遥感数据与全国人口普查数据相结合,采用网络自相关和空间重力模型等方法,实证揭示了雾霾污染对人口迁移的影响。结果表明,(1)人口迁移存在明显的网络自相关效应,迁出地之间的空间集聚最为明显。(2)雾霾污染对人口迁入和人口迁出均存在显著的负向影响,雾霾污染每提高1%致使人口迁出和人口迁入分别下降0.297%和0.355%;收入水平和教育程度等因素是人口迁移中最显著拉力,高校生数量和气候等因素为人口迁移中最显著推力。(3)稳健性检验和异质性分析表明,雾霾污染对人口迁入和人口迁出均表现为显著的负向影响。基于此,雾霾污染并非当前人口迁移的关键动因,提高收入水平和教育程度仍是地区人才竞争中有力的杠杆,但随着"十四五"时期以人为核心的城镇化不断推进,雾霾污染将发挥更大的制约作用,应尽早关注雾霾污染给人口迁移带来的潜在挑战。     

健康冲击、基本医疗保险与老年人“退而不休”

在我国进入深度老龄化、劳动力供给不足的背景下,探究健康以及基本医疗保险对老年人退而不休的影响对未来合理有效开发老年人力资源具有重要意义。本文使用四期CHARLS数据将健康冲击、医疗保险与老年人退而不休放在一个统一的分析框架中,分别考察了健康冲击、新农合以及城镇职工医疗保险对老年人退而不休的影响,并进一步探究了医疗保险对老年人退而不休影响的健康异质性。结果表明:健康冲击对老年人退而不休意愿和劳动时间均有显著正向促进效应,且对劳动时间的影响有明显城乡差异,对农村地区影响更大。新农合会明显激励农村老年人选择退而不休,发生比率提高为未参合时的3.59倍,但会降低劳动时间,全年平均减少了21.21天;而城镇职工医疗保险对老年人退而不休意愿没有显著影响,但会增加劳动时间,全年平均增加了13.92天,且对劳动时间供给更多的个体,其激励效应逐渐减弱。同时,医疗保险对老年人退而不休的影响还存在性别差异,其中新农合对女性退而不休意愿影响更大,但对劳动时间并没有显著的性别差异;而职工医疗保险对女性退而不休意愿、对男性劳动时间影响更大。此外,本文还发现医疗保险对老年人退而不休的影响存在健康异质性,对健康变差的群体影响更大。     

Health Insurance and the Aging: Evidence From the <Emphasis Type="Italic">Seguro Popular</Emphasis> Program in Mexico

Aimed at covering the large fraction of workers in the informal sector without access to a social security program, the Mexican public health insurance program Seguro Popular began in 2002 and now reaches more than 50 million individuals. We estimate impacts of Seguro Popular for the population aged 50 and older on a set of indicators related to health care including utilization, diagnostic/preventive tests, and treatment conditional on being ill. Using the longitudinal Mexican Health and Aging Study over the period 2001–2012, we conduct before and after difference-in-difference matching impact estimators. Our results suggest large and important effects of the Program on utilization and diagnostic tests. We find overall smaller effects on the probability of being in treatment for individuals with chronic diseases, but these effects are concentrated in rural areas with relatively more health services versus rural areas with lower levels of health services. These results suggest that, to the extent that health services become more available in rural areas lacking services, effects of health insurance may increase.     

农村公共事业与农民生活满意度

本文以6个省1586户农户的问卷调查结果为依据,运用序数Logistic模型,探讨农村公共事业、农民个人特征、家庭特征对农民生活满意度的影响。结果表明,农村公共事业发展对农民生活满意度影响显著,其中农村卫生事业发展对农民生活满意度的影响最大,其次是农村教育事业发展,农村文化事业发展对农民生活满意度的影响最小。根据分析结果,本文提出了以下政策建议:在今后的农村公共事业发展中,政府应渐进增加农村公共事业支出比重,不断调整农村公共事业支出结构,并随时更新文化娱乐活动内容,以适应广大农民的精神需要。     

医疗保险对农村居民家庭消费的影响分析--基于不同收入层级的跨地区比较

利用2009、2010农村固定观察点数据,分析了医疗保险对不同地区、不同收入层级的农村居民家庭医疗消费支出和非医疗消费支出的影响。实证结果表明：医疗保险对农村居民家庭的医疗类消费不存在显著影响,对非医疗类消费支出则存在显著的正向促进作用。分地区来看,医疗保险对东西部地区农村居民家庭医疗类消费的影响差异显著,对东中部地区农村居民家庭非医疗类消费支出的影响同样差异显著;分收入层级来看,医疗保险对家庭医疗类消费的影响在不同收入层级的农村居民家庭之间不存在显著差异,但对非医疗类消费支出的影响在不同收入层级之间差异显著。此外,商业医疗保险作为医疗保险体系的重要组成部分,对促进农村消费起到带动作用。最后,本文从加大政府补贴和完善保障机制两个方面提出政策建议以期有效降低农村居民家庭超常的预防性储蓄,促进农村居民家庭消费。     

农村计划生育与农民生活满意度研究

基于6个省1586户农户的问卷调查数据,运用次序Logit模型,探讨农村计划生育、农村卫生事业、区域环境特征、农民个人特征、家庭特征对农民生活满意度的影响。结果表明,农村计划生育的两个因素中只有是否享受奖扶政策对农民生活满意度有显著影响,是否受过超生惩罚对农民生活满意度没有显著影响,农村卫生事业的两个因素,参加新型合作医疗制度以后看病是否改善和医疗支出负担对农民生活满意度都有显著的影响。根据分析结果提出以下政策建议:在今后的农村公共事业发展中,政府应渐进增加农村公共事业支出比重,进一步完善利益导向政策体系,适当提高奖励扶助标准,加大对农村超生家庭的处罚力度,使惩罚标准与收入及财产相对应。     

Do Health Insurance and Residence Pattern the Likelihood of Tubal Sterilization among American Women?

American women have increasingly opted for tubal sterilization or tubal ligation surgery in recent decades. While research has begun to examine the unequal access to health care in the United States, little research has considered how this may impact whether women opt for a tubal ligation surgery. We first profile women with and without tubal ligations using bivariate analysis of the most recent data available, a nationally representative sample of 7,643 women from the National Survey of Family Growth, Cycle 6 (NSFG, Public use data file, 2002). We then use logistic regression models to examine the relationship between having tubal ligation and two focal variables: (1) type of health insurance (Medicaid compared with private, government or military, and no health insurance), and (2) rural or urban place of residence. We find that women on Medicaid are nearly twice as likely to have had a tubal sterilization compared with women who have private health insurance coverage. Also, women on Medicaid are substantially more likely to have a tubal sterilization than women with government or military insurance and women with no health insurance (26% and 36%, respectively). Further, we find that women living in rural areas are nearly twice as likely to have a tubal sterilization, compared with women in urban or suburban areas, all else being equal.     

Determinants of temporal and areal variation in infant mortality in Germany, 1871–1933

This article investigates how sociodemographic, economic, medical, and public health factors influence infant mortality by using data about German administrative areas from 1871 to 1933. Marital fertility has the largest impact on infant mortality, followed by illegitimacy, medical care, urbanization, and infant welfare centers. The variables considered here account for most of the variation in infant mortality. Some of the unexplained variance is due to factors associated with regions, such as breastfeeding patterns, and with time periods, such as national health insurance. The analyses found no evidence that advances in medical technology affected infant mortality or that the influence of economic development changed over time.     

老年人与子女同住 对老年健康的影响分析

随着我国老龄化程度的持续加深和疾病谱的转变,当前社会存在大量老年照料需求,尽管国家和社会在积极构建养老服务体系,但短期内与子女同住的家庭养老模式仍将发挥重要作用。与子女同住会对老年健康产生一定的影响,这种影响对于不同健康程度的老年人也存在差异。本文基于南加州大学经济与社会研究中心提供的Harmonized CHARLS 2013-2015年追踪数据,选取我国60岁及以上老年群体为研究对象,以虚弱指数表征健康结果,采用OLS回归和分位数回归的方法探讨与子女同住的居住模式对老年健康的影响及这一影响对不同虚弱程度的老年人是否匀质,通过滞后模型设计和倾向值匹配法控制可能存在的内生性问题。研究发现居住模式与虚弱指数存在显著的正向关系,表明居住模式会影响老年健康水平;与子女同住对老年人健康存在负面效应,而在父母附近分而不离的居住模式相较于与子女同住而言对老年人的健康更为有利;与子女同住对老年健康的这种负向影响对于不同虚弱程度的老年人而言是非线性、非匀质的,大致呈先增后降的倒U形分布,表明不同健康状况的老年人对子女的照料需求是不同的,这种影响在不同性别、城乡和年龄段的老年群体间各有差异。这就为与子女同住的居住模式提供了一些警示,与子女同住不能改变老年健康衰减的趋势,应尽量减少或规避可能增加老年人晚年健康负担的风险性因素,让"家"真正成为老年人安享晚年的港湾。     

Who Gets Held Back? An Analysis of Grade Retention Using Stratified Frailty Models

Racial/ethnic disparities in grade retention related to structural inequality are investigated using a quantitative theoretical model from the health literature. Data from the Early Childhood Longitudinal Study-Kindergarten Cohort are linked with segregation indices for dissimilarity and poverty interaction derived from the US Census 2000 data estimate the impact of individual and structural level variables on grade retention. Shared frailty models demonstrate that there are racial/ethnic differences in grade retention, much of which can be explained by structural inequality. Students who are white or African American have lower risk in areas with higher dissimilarity and poverty interaction. Parental involvement mediates the risk of retention.

     

Cross-Cultural Analyses of Determinants of Quality of Life and Mental Health: Results from the Eurohis Study

Recent projects on international instrument development have produced a wide array of health indicators that may be used for cross-cultural field-testing, however more information on their cross-cultural performance in relation to health determinants is necessary. The current study approaches one step for international conceptual validation by analysing the association between various health determinants and different types of health outcomes (mental health, quality of life) across a range of countries or geographical areas. The current study is based on the EUROHIS project that has been conducted in a sample of 4849 adults across 10 European countries. Results highlight that interactions between health determinants with subjective mental health, general health and quality of life (QoL) differ between Western European countries, Eastern European countries and the Newly Associated States as well as Israel. Using a MIMIC model approach, we were able to show that the impact of each of the sociodemographic variables cannot be interpreted on the basis of its single loading but only seeing the interacting with other indicators. Future studies should include sociodemographics in MIMIC models in each latent factor before carrying out regressions on a larger scale. Future investigations will require larger and representative samples to (a) test models on latent factors of mental health and QoL and (b) on the basis of these findings test overall structural models across countries.     

社会支持对农村老年女性孤独感的影响研究

利用2009年陕西省农村老年女性生活福利状况调查数据,定量分析了社会支持对农村老年女性孤独感的影响。孤独感已成为影响农村老年女性生活质量的重要的健康问题,社会支持对农村老年女性孤独感具有显著的负向影响,社会交往面广、代际情感支持丰富和日常生活照料周到是降低农村老年女性孤独感、促进老年女性身心健康、安度晚年的重要因素。研究结果为政府制定旨在改善农村老年女性群体心理福利的相关政策、进行有效的政策干预提供理论和现实依据。     

Health effects of child work: Evidence from rural Vietnam

We test whether work in childhood impacts on health. We focus on agricultural work, the dominant form of child work worldwide. Data are from the Vietnam Living Standards Survey, 1992–93 and 1997–98. We correct for both unobservable heterogeneity and simultaneity biases. Instruments are land holdings and commune labour market and school quality indicators. We examine three indicators of health: weight-for-age Z-score; reported illness; and, height growth. There is clear evidence of a healthy worker selection effect. We find little evidence of a contemporaneous negative impact of child work on health but, particularly for females, work undertaken during childhood raises the risk of illness up to five years later. For boys, the risk is increasing with the period of time in work. There is no evidence that work impedes the growth of the child. This work was undertaken as part of the Understanding Children's Work project, an inter-agency program between the International Labour Organisation, UNICEF and the World Bank. The views expressed are those of the authors alone and do not reflect positions of the sponsoring organisations. We are grateful to the Government of Vietnam for permission to use the data. We thank two referees for very helpful comments. Responsible editor: Alessandro Cigno.     

Internet对劳动力市场的影响——基于中国家庭动态跟踪调查（Gyps）数据的实证研究

信息化对于劳动力市场的影响正引起越来越多的关注。本文利用2008年中国家庭动态跟踪调查（CFPS）数据,以Internet使用为例,估计了信息技术的工资回报率,并探讨了其在农村和非农村劳动力市场上的异质性。研究发现,在排除了年龄、性别、教育、民族和婚姻等因素后,Internet的使用仍然能够带来约60％额外收入。其中农村地区约为78％,非农村地区约为38％。如果采用上网变量其他度量方法,或者采取趋势得分法（PSM）,仍然得到基本一致的实证发现。这充分表明,信息化对于个人生产率具有显著的提升作用;与非农村相比,农村的提升效果更强。     

Spatial Sampling Design for a Demographic and Health Survey

The recent advances in global position systems (GPS), geographic information systems (GIS), and remote sensing (RS) can be exploited for spatial sampling design for demographic and health surveys. These technologies are particularly useful when a sampling frame is unavailable and/or location (of household) is important for data collection (e.g., location of residence might greatly impact exposure to ambient air pollution among members of a population). Building on these technologies, this article presents a methodology of spatial sampling adopted for the respiratory health and demographic survey conducted in Delhi and its environs from January through April 2004. The overall goal of the survey was to select households that adequately represented exposure to ambient air pollution. The proposed methodology involved constructing a sampling frame of residential areas and the simulation of weighted random points within residential areas. The simulated locations were navigated with the aid of GPS to identify households at these locations and to acquire residents’ consent to participate in the survey; a total of 1,576 households at the 2,000 simulated locations were found suitable and participated in the survey. The average ambient air pollution at the sample sites was not significantly different from the average air pollution observed in the study area, which demonstrates the robustness of the proposed sampling method.     

How colonisation determines social justice and Indigenous health—a review of the literature

Disparities in health status persist for Indigenous people in Australia. In the bid to reduce the disparity gap, the concept of achieving social justice is central to advancing the services and systems that can challenge inequitable circumstances within a nation. Colonisation is well known as the underlying factor influencing the social injustices that result in inequitable health for Indigenous people. A literature review was conducted identifying how the colonial impact on social justice is described in the relationships with the health of Indigenous Australians. A comprehensive search strategy was developed, including four broad search terms of ‘Indigenous people’ and ‘health status’ and ‘colonisation’ or ‘social justice’, and applied within five databases. Publications were limited to Australia, dated from 1 January 2000 to 31 December 2014. The literature acknowledging the effect that colonisation has on Indigenous Australians includes evidence from oral and political histories, and social determinants frameworks. There was a general consensus that the impact of colonisation on the health of Indigenous people is highly complex and that the legacies are experienced intra-generationally and inter-generationally. There is paucity in the evidence that examines the associations of colonisation and its impact on social injustice. Because social justice is considered central to equitable practices across all sectors in society (health, education, legal etc.), questions are raised about the magnitude of the effect that colonisation has on health disparities and importantly how the desideratum to tackle disparities that have stemmed from colonisation are adequately addressed.     

Is the Relationship between Socioeconomic Status and Health Stronger for Older Children in Developing Countries?

Recent research on the relationship between child health and income in developed countries reveals a positive gradient that is more pronounced for older children, suggesting that the impact of income upon health accumulates. This article examines whether the same is true in a developing country. Using data from the Indonesian Family Life Survey on children aged 0 to 14 years, we find that although low income adversely affects health, its impact does not differ by age. This finding is robust to the use of both subjective and objective health measures, controlling for selective mortality, the use of alternative measures of households’ resources, and the inclusion of indicators of health at birth and parental health. One explanation for the constancy of the health-income relationship that we explore is the dominant role played by acute illness in determining the general health status of children in a developing-country context compared with the more central role played by chronic conditions in developed countries.     

A norm-referenced population health status index based on life expectancy and disability

This paper describes a population health status index for health services research and planning purposes. The H-index uses data on average life expectancy at birth and percent of the population free from disability, however defined. It is useful in comparing the health status of health services areas relative to that of the more healthy areas selected to serve as the norm. The statistical procedure used in deriving the H-index is centour analysis, by means of which the Euclidian distances of the service areas in the study sample in two-dimensional space to the centroid of the normative areas are reflected in the H values computed. The farther away from the centroid, the less resemblance the service area has to the norm and the lower its health status. A computational example with seven normative states and 10 states in the study sample is given.