Valuation of childhood risk reduction: the importance of age, risk preferences, and perspective.

This article explores two problems analysts face in determining how to estimate values for children's health and safety risk reductions. The first addresses the question: Do willingness‐to‐pay estimates for health risk changes differ across children and adults and, if so, how? To answer this question, the article first examines the potential effects of age and risk preferences on willingness to pay. A summary of the literature reporting empirical evidence of differences between willingness to pay for adult health and safety risk reductions and willingness to pay for health and safety risk reductions in children is also provided. The second dimension of the problem is a more fundamental issue: Whose perspective is relevant when valuing children's health effects—society's, children's, adults‐as‐children, or parents'? Each perspective is considered, followed ultimately by the conclusion that adopting a parental perspective through an intrahousehold allocation model seems closest to meeting the needs of the estimation problem at hand. A policy example in which the choice of perspective affects the outcome of a regulatory benefit‐cost analysis rounds out the article and emphasizes the importance of perspective.     

Intimate relationships and changing patterns of money management at the beginning of the twenty-first century

Drawing on British data from two annual sweeps of the ISSP eight years apart in 1994 and 2002, for modules focusing on 'Family and Changing Gender Roles', this paper examines the extent to which changes in women's labour market participation, changing ideologies/discourses of gender and changing forms of intimate relationships are affecting the ways in which couples organize household money, and the implications of such changes for recent theories of intimate relationships. The analysis indicates that by 2002, the type of relationship respondents had established, together with their social class position, were both independently related to the ways in which they managed money, after controlling for socio-economic and cultural or discursive factors. Our findings also provide a degree of support for the thesis of a partial decline in the male breadwinner model of gender, as indicated by small declines in the use of the relatively inegalitarian female whole wage and housekeeping allowance systems which were most likely to be used by married couples and cohabiting fathers, expressing relatively traditional ideologies/discourses of breadwinning - and a slight increase in the use of the partial pool, which was most likely to be used by childless cohabiting couples in which male partners expressed less traditional ideologies of breadwinning and women were in middle-class jobs with incomes high enough to facilitate partially separate finances. We also suggest, however, that in so far as cohabiting couples earning different amounts define equality as contributing equally to household expenditure, it is possible that rather than being associated with shifts to greater equality in access to money for personal spending and saving, the partial pool may be associated with marked inequalities, because it may enable gender inequalities generated in the labour market to be more directly transposed into inequalities within households, despite the decline of traditional discourses of male breadwinning and the increasing importance of egalitarian ideologies of co-provisioning.     

Truth® ads,receptivity, and motivation to use or quit tobacco among college students

Abstract

Objective: Examine receptivity and motivation to use/quit tobacco among college students after viewing Truth ads. Participants: Random sample of 10,000 college students invited to complete online survey February 2016 (8.5% response rate). Methods: Quasi-experimental. Participants (N?=?854) watched four ads and answered survey items for each ad. Results: Students rated ad receptivity and decreased motivation to use tobacco higher for the Catmageddon ad than the others. Regardless of ad, men and current cigarette smokers reported lower receptivity. Younger age was associated with lower motivation to use tobacco for all ads. Tobacco users reported greater motivation to quit with the Catmageddon ad. Conclusions: College students were receptive to the Truth ads, and many indicated lower motivation to use tobacco. Men, older college students, and current cigarette smokers were less receptive to the ads, reinforcing the need to develop tailored campaigns to reach these subgroups.     

Internalising and externalising children's behaviour problems in Britain and the US: relationships to family resources1

A large sample of British children (n=994) of varying ages (7–18 years) and a large sample of American children (n=886) of varying ages (7–16 years) were rated by their mothers using respectively the Rutter Child Scale A and the Behaviour Problems Index both of which cover a variety of behavioural problems. Factor analysis of the behavioural scales distinguished externalising and internalising dimensions of behaviour in both countries. We examined whether children's experiences of family change, cognitive ability and family adversity including economic deprivation were associated with differences in the prevalence of the behavioural dimensions. Mean cognitive scores decreased significantly with increasing level of externalising behavioural problems in British and American children but showed no significant relationship to levels of internalising behaviour problems in either sample. Among American children internalising and externalising behavioural problems were related to experience of non‐intact family structures and measures of family adversity. Externalising behavioural problems were related to measures of family adversity among British boys and girls but were only related to experience of non‐intact family structures in the sample of British girls. Among British girls, internalising behavioural problems were also related to non‐intact family structures. The associations between non‐intact family structures and behavioural problems were independent of measures of economic deprivation in both samples of children. This study documents some of the background factors which affect children's behavioural and cognitive outcomes. Unlike children's family structure economic deprivation can be influenced through policy intervention, and the analysis supports the view that relieving economic deprivation would help improve children's behavioural outcomes. Copyright © 2000 John Wiley & Sons, Ltd.     

What influences respondents to behave consistently when asked to consent to health record linkage on repeat occasions?

This study constitutes the first longitudinal exploration of consent to link survey and administrative data. It examines variations in consent over time and explores the influence of the respondents’ characteristics (both observed and latent) and the impact of the interviewers on consent co-operation. Respondent inclination to consent is modelled as a latent construct. Most respondents behave consistently over time. However, this consistency is not driven by a strong inclination to consent but rather by the circumstances of the respondents at the time of the interview and by the impact of the interviewers themselves. The findings also show that the change in consent behaviour over time is a clear indication that consent should be treated as a dynamic phenomenon at the individual level.     

Self-directed health plans: alternatives to managed care enabled by new technologies

Few people believed the Internet would have much impact on the delivery of health care services. However, combined with technological advances in how computer systems are structured and implemented and knowing what doesn't work in managed care from bitter experience, the Internet is being used to create a new paradigm of alternative health insurance products. These products hold the potential to change for the better the face of health care as we know it. Self-directed health plans will be less expensive than managed care programs and offer greater predictability in health care spending. For health care providers, SDHPs' reliance upon episode allowances will create a new market for packaged or bundled services. Providers will be paid to provide solutions, not just treatment. This could represent a new model in which physicians accept a risk-adjusted payment and provide a warranty that they will do whatever necessary until the patient has reached the reasonably expected health status. This is a radical departure from the fee-for-service or capitation system.     

Distribution-free confidence bounds for pr y< when fx and gy = fx-6 are continuous and symmetric

For and continuous and symmetric and differing at most by a shift parameter, distribution-free confidence intervals for are obtained by means of the Chebyshev inequality and an upper bound for the variance of the Mann-Whitney statistic. The (two-sided) intervals are reliable for small samples and about 20 to 30 per cent shorter than those obtained by Ury for and completely unknown for equal sample sizes, with larger savings otherwise. They are also shorter than the upper bounds obtained by Birnbaum and McCarty (1958) when the confidence coefficient does not exceed 0.95.     

Preparing Community Health Workers for Their Role as Agents of Social Change: Experience of the Community Capacitation Center

Current efforts to better integrate Community Health Workers (CHWs) into the health and social service systems are promising, but may be less effective if they fail to support the role of CHWs as social change agents. The way CHWs are trained influences the roles they play. In this article, we review the literature on CHW training and summarize lessons learned to date. We describe how the Community Capacitation Center in Oregon uses a combination of content, methodology, and values to prepare CHWs to make an optimal contribution to health. Recommendations for CHW training programs and policy makers are provided.     

Price Competition in Pharmaceuticals: The Case of Anti-infectives

A fundamental question in industrial organization regards the relationship between price and the number of sellers. This relationship has been particularly important in the pharmaceutical industry where legislative changes were specifically designed to foster competition. Previous research on the pharmaceutical industry has shown generic entry has a mixed impact; generic prices fall rapidly with generic entry, whereas branded prices tend to increase or decrease only slightly. Using more complete data, focused on one segment of the pharmaceutical industry—anti-infectives—we find that the relationship between pharmaceutical prices and the number of sellers is more like that found in other industries. (JEL L11 , L65 , D4 )     

Researching Quality of Life in Early Old Age: The Importance of the Sociological Dimension

Measurement of quality of life has become a major feature of much social and epidemiological research in health and social care settings. It is seen as an important alternative to more process‐based outcome measures but remains poorly defined. A major weakness is the absence of any coherent theoretical underpinning whether sociological, psychological or philosophical. Into this conceptual vacuum proxies for quality of life have been introduced. Quality of life [QoL] research into older populations has focused on measures of health and illness as equivalents of QoL. This paper argues that this response is inadequate as it reduces old age to a dimension of health, disability and disease. Instead, we argue that it is necessary to create a theoretically based measure of QoL in early old age which relates to those aspects of later life that are not defined by health. We present a model of QoL that is derived from aspects of contemporary social theory as they relate to the ontology of late modernity. In particular, we utilize a model based upon needs satisfaction. The model contains four domains: Control, Autonomy, Pleasure and Self‐realization. The measure consists of a 19‐item scale. The four domains load on to a single latent QoL factor. We argue that the CASP 19 scale offers an approach to QoL that integrates a sociologically based model of quality of life with a meaningful and valid research instrument.