Impact of chronic disease on the mid-age employment in Taiwan.

Chronic diseases, also known as non-communicable diseases (NCDs), have become the leading causes of deaths and disability around the world. Cardiovascular disease, cancer, and diabetes are also listed in the top 10 causes of deaths in Taiwan for decades. This study aims to investigate the relationship the chronic diseases and the mid-age employment in Taiwan. We estimate the impact of the chronic diseases on employment using the 2009 NHIS data of Taiwan using 2 kinds of probit model. In addition, we show that a usual probit model can underestimate the negative effect of NCDs on mid-age employment. To reduce the productivity loss from the NCDs, policymakers can increase the awareness of risk of these chronic diseases through media and the adult preventive care services, which is free for the people aged 40 and above in Taiwan.

Awareness and utilization of preventive care services among the elderly under National Health Insurance.

This empirical study investigates the factors affecting the awareness and the utilization of preventive care among the elderly in Taiwan. We use data obtained from the 2005 National Health Interview Survey. A recursive bivariate probit model is adopted to analyze the factors affecting the awareness and the utilization of preventive care. The probability of awareness of free preventive care under the National Health Insurance is higher for those who are younger, Mainlanders, have received more education, have a spouse, exercise regularly, have better self-rated health status, and have chronic diseases; the probability of awareness is lower for those who are aborigines and who live in the south and the east. Awareness of preventive care services, having a spouse, living alone, having better health status, and the existence of chronic diseases increase the probability of preventive care utilization; working reduces the probability of preventive care utilization. Our result supports the views in Arrow (Am Econ Rev 53(5):941-973, 1963) that health information is an important factor determining the demand for medical care. Policymakers may enhance such preventive care service utilization by increasing the awareness of such services among the elderly.

Association of unhealthy dietary behaviors with renal function decline in patients with diabetes.

OBJECTIVE: Balanced nutrition is important for patients with diabetes, and nutrition might well influence diabetes-related complications, although there is limited evidence for this supposition at present. Consequently, we investigate the association between dietary behaviors and renal function decline among patients with diabetes. RESEARCH DESIGN AND METHODS: From 2011 to 2013, a total of 2797 patients with type 2 diabetes participated in the Diabetes Shared Care Program at Chang Gung Memorial Hospital. All received nutritional consulting by dieticians and an eight-item list of unhealthy dietary behaviors, which included the excessive intake of carbohydrates, fats, protein, fruit, pickled foods, dessert and alcohol, as well as inadequate dietary vegetable. Estimated glomerular filtration rate (eGFR) decline ≥40% was defined as a surrogate end point for kidney damage. Independent dietary risk factors predicting poor renal outcomes were assessed. RESULTS: Stable mean glycated hemoglobin (A1c) (7.78% to 7.75%, p=0.151), improved cholesterol (174.04 to 170.13 mg/dL, p<0.001) and low-density lipoprotein (104.19 to 98.07 mg/dL, p<0.001) were found in patients throughout 2 years of therapy. However, significant eGFR decline was noted (94.20 to 88.08 mL/min/1.73 m2, p<0.001). A total of 125 subjects had eGFR decline ≥40% and 2672 had stable renal progression.In regression analysis, 625 stable renal patients (selected via propensity score matching) and 125 subjects with eGFR decline ≥40% demonstrated excessive pickled foods to be predictive of poor renal outcomes (OR 1.861, 95% CI 1.230 to 2.814, p=0.003). CONCLUSIONS: Our study suggests that excessive pickled foods deteriorate renal function more than other unhealthy dietary behaviors in patients with diabetes.

Economic Stress and Mental Health: The Relationship Between the Stock Market and Neurotic Disorder Doctor Visits.

This paper investigates the relationship between the stock market and the neurotic disorder doctor visits. We use aggregate data, partition the population by age and gender and examine the impact of changes in the stock market on neurotic disorders. Using doctor visits as a proxy measure of morbidity, we find evidence of some relationship between neurotic disorder morbidity and stock market variations. A stock market falling in a single day and the accumulation of daily stock market drops are both associated with more neurotic disorder doctor visits. We also observe more neurotic disorder doctor visits during periods of a low stock index for the elderly, regardless of gender. Copyright © 2016 John Wiley & Sons, Ltd.

Stock or stroke? Stock market movement and stroke incidence in Taiwan.

This paper investigates the impact of stock market movement on incidences of stroke utilizing population-based aggregate data in Taiwan. Using the daily data from the Taiwan Stock Exchange Capitalization Weighted Stock Index and from the National Health Insurance Research Database during 2001/1/1-2007/12/31, which consist of 2556 observations, we examine the effects of stock market on stroke incidence - the level effect and the daily change effects. In general, we find that both a low stock index level and a daily fall in the stock index are associated with greater incidences of stroke. We further partition the data on sex and age. The level effect is found to be significant for either gender, in the 45-64 and 65 ≥ age groups. In addition, two daily change effects are found to be significant for males and the elderly. Although stockholdings can increase wealth, they can also increase stroke incidence, thereby representing a cost to health.