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3.
BMC Health Serv Res ; 21(1): 1051, 2021 Oct 05.
Artigo em Inglês | MEDLINE | ID: mdl-34610841

RESUMO

BACKGROUND: Many tuberculosis (TB) patients incur catastrophic costs. Active case finding (ACF) may have socio-protective properties that could contribute to the WHO End TB Strategy target of zero TB-affected families suffering catastrophic costs, but available evidence remains limited. This study measured catastrophic cost incurrence and socioeconomic impact of an episode of TB and compared those socioeconomic burdens in patients detected by ACF versus passive case finding (PCF). METHODS: This cross-sectional study fielded a longitudinal adaptation of the WHO TB patient cost survey alongside an ACF intervention from March 2018 to March 2019. The study was conducted in six intervention (ACF) districts and six comparison (PCF) districts of Ho Chi Minh City, Viet Nam. Fifty-two TB patients detected through ACF and 46 TB patients in the PCF cohort were surveyed within two weeks of treatment initiation, at the end of the intensive phase of treatment, and after treatment concluded. The survey measured income, direct and indirect costs, and socioeconomic impact based on which we calculated catastrophic cost as the primary outcome. Local currency was converted into US$ using the average exchange rates reported by OANDA for the study period (VND1 = US$0.0000436, 2018-2019). We fitted logistic regressions for comparisons between the ACF and PCF cohorts as the primary exposures and used generalized estimating equations to adjust for autocorrelation. RESULTS: ACF patients were poorer than PCF patients (multidimensional poverty ratio: 16 % vs. 7 %; p = 0.033), but incurred lower median pre-treatment costs (US$18 vs. US$80; p < 0.001) and lower median total costs (US$279 vs. US$894; p < 0.001). Fewer ACF patients incurred catastrophic costs (15 % vs. 30 %) and had lower odds of catastrophic cost (aOR = 0.17; 95 % CI: [0.05, 0.67]; p = 0.011), especially during the intensive phase (OR = 0.32; 95 % CI: [0.12, 0.90]; p = 0.030). ACF patient experienced less social exclusion (OR = 0.41; 95 % CI: [0.18, 0.91]; p = 0.030), but more often resorted to financial coping mechanisms (OR = 5.12; 95 % CI: [1.73, 15.14]; p = 0.003). CONCLUSIONS: ACF can be effective in reaching vulnerable populations and mitigating the socioeconomic burden of TB, and can contribute to achieving the WHO End TB Strategy goals. Nevertheless, as TB remains a catastrophic life event, social protection efforts must extend beyond ACF.


Assuntos
Tuberculose , Estudos Transversais , Custos de Cuidados de Saúde , Humanos , Renda , Vietnã/epidemiologia
4.
J Urban Health ; 98(Suppl 1): 31-40, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34472014

RESUMO

The expansion in the scope, scale, and sources of data on the wider social determinants of health (SDH) in the last decades could bridge gaps in information available for decision-making. However, challenges remain in making data widely available, accessible, and useful towards improving population health. While traditional, government-supported data sources and comparable data are most often used to characterize social determinants, there are still capacity and management constraints on data availability and use. Conversely, privately held data may not be shared. This study reviews and discusses the nature, sources, and uses of data on SDH, with illustrations from two middle-income countries: Kenya and the Philippines. The review highlights opportunities presented by new data sources, including the use of big data technologies, to capture data on social determinants that can be useful to inform population health. We conducted a search between October 2010 and September 2020 for grey and scientific publications on social determinants using a search strategy in PubMed and a manual snowball search. We assessed data sources and the data environment in both Kenya and the Philippines. We found limited evidence of the use of new sources of data to study the wider SDH, as most of the studies available used traditional sources. There was also no evidence of qualitative big data being used. Kenya has more publications using new data sources, except on the labor determinant, than the Philippines. The Philippines has a more consistent distribution of the use of new data sources across the HEALTHY determinants than Kenya, where there is greater variation of the number of publications across determinants. The results suggest that both countries use limited SDH data from new data sources. This limited use could be due to a number of factors including the absence of standardized indicators of SDH, inadequate trust and acceptability of data collection methods, and limited infrastructure to pool, analyze, and translate data.


Assuntos
Países em Desenvolvimento , Determinantes Sociais da Saúde , Humanos , Renda , Armazenamento e Recuperação da Informação , Quênia
5.
PLoS One ; 16(9): e0256921, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34525120

RESUMO

Using a nationwide survey of primary grocery shoppers conducted in August 2020, we examine household food spending when the economy had partially reopened and consumers had different spending opportunities in comparison to when the Covid-19 lockdown began. We estimate the impact of Covid-19 on household spending using interval and Order Probit regressions. Income levels, age, access to grocery stores and farmers markets, household demographic information, along with other independent variables are controlled in the model. Findings show that middle-class households (with income below $50,000, or with income between $50,000 and $99,999) are less likely to increase their grocery expenditures during the pandemic. Households with children or elderlies that usually require higher food quality and nutrition intakes had a higher probability of increasing their spending during Covid-19 than before. Furthermore, consumers' spending behaviors were also significantly affected by their safe handing levels and the Covid-19 severity and food accessibility in their residences.


Assuntos
COVID-19/prevenção & controle , Controle de Doenças Transmissíveis/economia , Características da Família , Alimentos/estatística & dados numéricos , Inquéritos e Questionários/estatística & dados numéricos , Idoso , COVID-19/epidemiologia , COVID-19/virologia , Criança , Comportamento do Consumidor/estatística & dados numéricos , Custos e Análise de Custo , Epidemias/prevenção & controle , Habitação/normas , Habitação/estatística & dados numéricos , Humanos , Renda/estatística & dados numéricos , SARS-CoV-2/fisiologia , Fatores de Tempo , Estados Unidos
6.
Proc Natl Acad Sci U S A ; 118(39)2021 09 28.
Artigo em Inglês | MEDLINE | ID: mdl-34544863

RESUMO

Lower socioeconomic status (SES) harms psychological well-being, an effect responsible for widespread human suffering. This effect has long been assumed to weaken as nations develop economically. Recent evidence, however, has contradicted this fundamental assumption, finding instead that the psychological burden of lower SES is even greater in developed nations than in developing ones. That evidence has elicited consternation because it suggests that economic development is no cure for the psychological burden of lower SES. So, why is that burden greatest in developed nations? Here, we test whether national religiosity can explain this puzzle. National religiosity is particularly low in developed nations. Consequently, developed nations lack religious norms that may ease the burden of lower SES. Drawing on three different data sets of 1,567,204, 1,493,207, and 274,393 people across 156, 85, and 92 nations, we show that low levels of national religiosity can account for the greater burden of lower SES in developed nations. This finding suggests that, as national religiosity continues to decline, lower SES will become increasingly harmful for well-being-a societal change that is socially consequential and demands political attention.


Assuntos
Adaptação Psicológica , Países em Desenvolvimento/estatística & dados numéricos , Saúde Global , Pobreza/psicologia , Qualidade de Vida , Religião e Psicologia , Fatores Socioeconômicos , Humanos , Renda
7.
J Environ Manage ; 299: 113635, 2021 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-34481375

RESUMO

The Association of Southeast Asian Nations (ASEAN) member countries are lagging behind the United Nations' Sustainable Development Goals (SDGs) to increase the share of renewable energy use and to reduce income inequality. Therefore, this study scrutinises the asymmetric effect of income inequality on renewable energy consumption in order to assess the possibility of the major ASEAN-5 countries adopting the carbon neutrality goal. The study employs a nonlinear panel autoregressive distributed lag (ARDL) model, from 1990 to 2015. By using four income inequality proxies, the empirical results show, firstly, that an alleviation of income inequality promotes the consumption of renewable energy in the long run, and vice versa. Secondly, the asymmetric effect is found and confirms that the positive shock (worsening of inequality) of income inequality generates a larger impact on the consumption of renewable energy compared to the result from negative shock (improvement of inequality). Lastly, the Hatemi-J asymmetric Granger causality tests reveal bidirectional causality between the positive inequality shock and the consumption of renewable energy. Consequently, in terms of policy implication, there is a strong argument to reduce the degree of income inequality in ASEAN-5 in order to promote the consumption of renewable energy and to increase the feasibility of adoption of carbon neutrality targets in the region.


Assuntos
Carbono , Desenvolvimento Econômico , Dióxido de Carbono , Renda , Energia Renovável
8.
Int J Equity Health ; 20(1): 208, 2021 09 15.
Artigo em Inglês | MEDLINE | ID: mdl-34526041

RESUMO

BACKGROUND: Cycling for transport provides many health and social benefits - including physical activity and independent access to jobs, education, social opportunities, health care and other services (accessibility). However, some population groups have less opportunity to reach everyday destinations, and public transport stops, by bicycle - owing in part to their greater aversion to riding amongst motor vehicle traffic. Health equity can therefore be improved by providing separated cycleway networks that give more people the opportunity to access places by bicycle using traffic-free routes. The aim of this study was to assess the health equity benefits of two bicycle infrastructure development scenarios - a single cycleway, and a complete network of cycleways - by examining the distributions of physical activity and accessibility benefits across gender, age and income groups. METHODS: Travel survey data collected from residents in Sydney (Australia) were used to train a predictive transport mode choice model, which was then used to forecast the impact of the two intervention scenarios on transport mode choice, physical activity and accessibility. The latter was measured using a utility-based measure derived from the mode choice model. The distributions of the forecast physical activity and accessibility benefits were then calculated across gender, age and income groups. RESULTS: The modelled physical activity and accessibility measures improve in both intervention scenarios. However, in the single cycleway scenario, the benefits are greatest for the male, high-income and older age groups. In the complete network scenario, the benefits are more equally distributed. Forecast increases in cycling time are largely offset by decreases in walking time - though the latter is typically low-intensity physical activity, which confers a lesser health benefit than moderate-intensity cycling. CONCLUSIONS: Separated cycleway infrastructure can be used to improve health equity by providing greater opportunities for transport cycling in population groups more averse to riding amongst motor vehicle traffic. Disparities in the opportunity to access services and economic/social activities by bicycle - and incorporate more physical activity into everyday travel - could be addressed with connected, traffic-free cycleway networks that cater to people of all genders, ages and incomes.


Assuntos
Ciclismo , Planejamento Ambiental , Exercício Físico , Equidade em Saúde , Adolescente , Adulto , Austrália , Planejamento Ambiental/estatística & dados numéricos , Feminino , Humanos , Renda/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
9.
Int J Equity Health ; 20(1): 151, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34465351

RESUMO

BACKGROUND: In Korea, the universal health system offers coverage to all members of society. Despite this, it is unclear whether risk of death from hepatocellular carcinoma (HCC) varies depending on income. We evaluated the impact of low income on HCC mortality. METHODS: The Korean National Health Insurance sampling cohort was used to identify new HCC cases (n = 7325) diagnosed between 2004 and 2008, and the Korean Community Health Survey data were used to investigate community-level effects. The main outcome was 5-year all-cause mortality risk, and Cox proportional hazard models were applied to investigate the individual- and community-level factors associated with the survival probability of HCC patients. RESULTS: From 2004 to 2008, there were 4658 new HCC cases among males and 2667 new cases among females. The 5-year survival proportion of males was 68%, and the incidence per person-year was 0.768; the female survival proportion was 78%, and the incidence per person-year was 0.819. Lower income was associated with higher hazard ratio (HR), and HCC patients with hepatitis B (HBV), alcoholic liver cirrhosis, and other types of liver cirrhosis had higher HRs than those without these conditions. Subgroup analyses showed that middle-aged men were most vulnerable to the effects of low income on 5-year mortality, and community-level characteristics were associated with survival of HCC patients. CONCLUSION: Having a low income significantly affected the overall 5-year mortality of Korean adults who were newly diagnosed with HCC from 2004 to 2008. Middle-aged men were the most vulnerable. We believe our findings will be useful to healthcare policymakers in Korea as well as to healthcare leaders in countries with NHI programs who need to make important decisions about allocation of limited healthcare resources according to a consensually accepted and rational framework.


Assuntos
Carcinoma Hepatocelular , Disparidades nos Níveis de Saúde , Renda , Neoplasias Hepáticas , Adulto , Idoso , Carcinoma Hepatocelular/mortalidade , Feminino , Humanos , Renda/estatística & dados numéricos , Neoplasias Hepáticas/mortalidade , Masculino , Pessoa de Meia-Idade , Mortalidade/tendências , República da Coreia/epidemiologia
10.
Int J Equity Health ; 20(1): 213, 2021 09 26.
Artigo em Inglês | MEDLINE | ID: mdl-34565389

RESUMO

BACKGROUND: During the past four decades, China's total health expenditure and health expenditure per capita have both experienced a dramatic increase in growth rate. This study aims to explore the determinants of health expenditure growth and the influencing mechanism of these determinants, with considering the productivity efficiency represented by Baumol's cost disease. METHODS: Based on the longitudinal data of 30 provincial-level administrative regions in China, from 2010 to 2017, multi-variates regression models were constructed to assess the determinants, including demography, income, Baumol's cost disease, technology, their effects on per capital total health expenditure growth and the three financing sources: government, society and out-of-pocket health expenditure. Moreover, the Spatial Durbin Model was used to analyze the influence mechanism of determinants on the increase of health expenditure across provinces. RESULTS: Among 210 province-year growth rate observations, all of the average growth rate of total health expenditure (12.78%) was much higher than the growth rate of per capita GDP (8.06%). According to the statistical analysis, we found that:(1) Income and Baumol's cost disease have a significant positive impact on health expenditure growth(P < 0.01). The impact of technical factors on government health expenditure is significantly positive. (2) The determinants affected the growth of health costs in different regions variably; the eastern region is mainly driven by Baumol's cost disease and technical factors, while the central and western regions are mainly affected by income factors and Baumol's cost disease. (3) There is a significant spatial spillover effect on the health expenditure growth between regions. The income factor and Baumol's cost disease have a positive impact on the health expenditure growth in its own region as well as in other regions. CONCLUSIONS: Income and Baumol's cost disease significantly contributed to China health expenditure growth. The health expenditure determinants showed spatial varies effect and space spillover effect on the neighborhood areas. Which indicates that a reasonable salary system should be contrasted to meet the changeling from the Baumol's cost disease, and the necessity of equity in health resource allocation among provinces in China.


Assuntos
Gastos em Saúde , China , Efeitos Psicossociais da Doença , Gastos em Saúde/estatística & dados numéricos , Humanos , Renda/estatística & dados numéricos
11.
BMJ Glob Health ; 6(9)2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34493531

RESUMO

PURPOSE: People who are distinct from the dominant ethnic group within a country can experience a variety of barriers to accessing eyecare services. We conducted a scoping review to map published interventions aimed at improving access to eyecare for non-Indigenous, non-dominant ethnic groups residing in high-income countries. METHODS: We searched MEDLINE, Embase and Global Health for studies that described an intervention to promote access to eyecare for the target population. Two authors independently screened titles and abstracts followed by review of the full text of potentially relevant sources. For included studies, data extraction was carried out independently by two authors. Findings were summarised using a combination of descriptive statistics and thematic analysis. RESULTS: We screened 5220 titles/abstracts, of which 82 reports describing 67 studies met the inclusion criteria. Most studies were conducted in the USA (90%), attempted to improve access for Black (48%) or Latinx (28%) communities at-risk for diabetic retinopathy (42%) and glaucoma (18%). Only 30% included the target population in the design of the intervention; those that did tended to be larger, collaborative initiatives, which addressed both patient and provider components of access. Forty-eight studies (72%) evaluated whether an intervention changed an outcome measure. Among these, attendance at a follow-up eye examination after screening was the most common (n=20/48, 42%), and directly supporting patients to overcome barriers to attendance was reported as the most effective approach. Building relationships between patients and providers, running coordinated, longitudinal initiatives and supporting reduction of root causes for inequity (education and economic) were key themes highlighted for success. CONCLUSION: Although research evaluating interventions for non-dominant, non-Indigenous ethnic groups exist, key gaps remain. In particular, the paucity of relevant studies outside the USA needs to be addressed, and target communities need to be involved in the design and implementation of interventions more frequently.


Assuntos
Grupos Étnicos , Renda , Atenção à Saúde , Países Desenvolvidos , Necessidades e Demandas de Serviços de Saúde , Humanos
12.
Artigo em Inglês | MEDLINE | ID: mdl-34444114

RESUMO

Some U.S.-based park equity studies reveal that affluent and White neighborhoods have privileged access to greenspace. In such studies in the U.S. and elsewhere, park access indicators are typically examined in relation to measures of income, housing tenure, and broad race/ethnicity categories (e.g., Hispanic/Latino, Black, and White in the U.S.). The treatment of people as monolithic ethnic groups in park equity research is potentially misleading, particularly in global cities where ethnic populations are highly heterogeneous. In this study, we assess inequities in access to park space within the diverse Hispanic/Latino population of the Miami Metropolitan Statistical Area (MSA) based on national origin. We specified multivariable generalized estimating equations to examine social correlates of area-weighted park access at the census tract level. Our first model includes a variable for the proportion of the tract population of Hispanic/Latino ethnicity, which we substitute in the second model with variables representing the proportions of the tract population from the most populous country-of-origin groups in the MSA applicable to the Hispanic/Latino population. Our first model indicates robust negative relationships for the proportion Hispanic/Latino and Black/African American variables with area-weighted park access, adjusting for median household income, renter-occupancy, and old and young population composition. Our second model indicates negative relationships based on Cuban and Venezuelan neighborhood composition, while the four other country-of-origin subgroup variables exhibit statistically non-significant associations with area-weighted park access. Study findings have implications for the analysis of ethnicity categories in park equity research and interventions to promote park equity, especially in global cities.


Assuntos
Grupos Étnicos , Hispano-Americanos , Afro-Americanos , Humanos , Renda , Características de Residência
14.
JAMA ; 326(7): 637-648, 2021 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-34402830

RESUMO

Importance: The elimination of racial and ethnic differences in health status and health care access is a US goal, but it is unclear whether the country has made progress over the last 2 decades. Objective: To determine 20-year trends in the racial and ethnic differences in self-reported measures of health status and health care access and affordability among adults in the US. Design, Setting, and Participants: Serial cross-sectional study of National Health Interview Survey data, 1999-2018, that included 596 355 adults. Exposures: Self-reported race, ethnicity, and income level. Main Outcomes and Measures: Rates and racial and ethnic differences in self-reported health status and health care access and affordability. Results: The study included 596 355 adults (mean [SE] age, 46.2 [0.07] years, 51.8% [SE, 0.10] women), of whom 4.7% were Asian, 11.8% were Black, 13.8% were Latino/Hispanic, and 69.7% were White. The estimated percentages of people with low income were 28.2%, 46.1%, 51.5%, and 23.9% among Asian, Black, Latino/Hispanic, and White individuals, respectively. Black individuals with low income had the highest estimated prevalence of poor or fair health status (29.1% [95% CI, 26.5%-31.7%] in 1999 and 24.9% [95% CI, 21.8%-28.3%] in 2018), while White individuals with middle and high income had the lowest (6.4% [95% CI, 5.9%-6.8%] in 1999 and 6.3% [95% CI, 5.8%-6.7%] in 2018). Black individuals had a significantly higher estimated prevalence of poor or fair health status than White individuals in 1999, regardless of income strata (P < .001 for the overall and low-income groups; P = .03 for middle and high-income group). From 1999 to 2018, racial and ethnic gaps in poor or fair health status did not change significantly, with or without income stratification, except for a significant decrease in the difference between White and Black individuals with low income (-6.7 percentage points [95% CI, -11.3 to -2.0]; P = .005); the difference in 2018 was no longer statistically significant (P = .13). Black and White individuals had the highest levels of self-reported functional limitations, which increased significantly among all groups over time. There were significant reductions in the racial and ethnic differences in some self-reported measures of health care access, but not affordability, with and without income stratification. Conclusions and Relevance: In a serial cross-sectional survey study of US adults from 1999 to 2018, racial and ethnic differences in self-reported health status, access, and affordability improved in some subgroups, but largely persisted.


Assuntos
Atenção à Saúde/etnologia , Acesso aos Serviços de Saúde/tendências , Nível de Saúde , Disparidades em Assistência à Saúde/tendências , Adolescente , Adulto , Idoso , Custos e Análise de Custo , Estudos Transversais , Atenção à Saúde/tendências , Feminino , Disparidades nos Níveis de Saúde , Inquéritos Epidemiológicos , Disparidades em Assistência à Saúde/etnologia , Humanos , Renda , Masculino , Pessoa de Meia-Idade , Estados Unidos , Adulto Jovem
15.
Artigo em Inglês | MEDLINE | ID: mdl-34360084

RESUMO

(1) Background: We aim to measure the urban-rural inequality of opportunity in healthcare in China based on the theory of Equality of Opportunity (EOp). (2) Methods: Following the compensation principle, we establish a decomposition strategy for the fairness gap, which we use for the measurement of the inequality of opportunity in urban-rural healthcare utilization. We then use China Health and Nutrition Survey (CHNS) data from 1997 to 2006 to calculate the fairness gap. (3) Results: Empirical analysis using CHNS data shows that the ratio of the fairness gap to the directly observed average urban-rural difference in healthcare was 1.167 for 1997-2000 and 1.744 for 2004-2006. The average urban-rural difference observed directly from original statistical data may have underestimated the degree of this essential inequity. (4) Conclusions: Our findings suggest that upgrading urban-rural reimbursement ratios may not be sufficient in eliminating the inequality of opportunity in healthcare utilization between urban and rural residents. Within the context of an urban-rural dualistic social structure and widening of the urban-rural income gap, a shift to a pro-disadvantaged policy will be a more effective approach in promoting equality of opportunity in healthcare.


Assuntos
Disparidades em Assistência à Saúde , População Rural , China , Humanos , Renda , Fatores Socioeconômicos
16.
Artigo em Inglês | MEDLINE | ID: mdl-34360228

RESUMO

Variations in social policy between countries provide opportunities to assess the impact of these policies on health inequities. This study compares the risk of low birth weight in Brussels and Montreal, according to household composition, and discusses the impact of income support policies. For each context, we estimated the impact of income support policies on the extent of poverty of welfare recipients, using the model family method. Based on the differences found, we tested hypotheses on the association between low birth weight and household composition, using administrative data from the birth register and social security in each region. The extent of poverty of welfare families differs according to household composition. In Quebec, the combination of low welfare benefits and larger family allowances widens the gap between households with children and those without children. The risk of LBW also differs between these two contexts according to the number of children. Compared to children born into large welfare families, first-born children are more at risk in Montreal than in Brussels. In addition to the usual comparative studies on the topic, our study highlights the importance of an evaluative perspective that considers the combination of different types of income support measures to better identify the most vulnerable households.


Assuntos
Renda , Pobreza , Criança , Características da Família , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Política Pública
17.
Artigo em Inglês | MEDLINE | ID: mdl-34360341

RESUMO

The question of how the income inequality of residents affects the level of environmental regulation in the context of official corruption was the core research issue of this study. We analyzed this problem using the panel threshold regression model from 26 provinces in China from 1995 to 2017. We found that when there is no official corruption, the widening of the residents' income inequality promotes stricter environmental regulations; when the corruption problem is serious, the expansion of the residents' income inequality leads to the decline in environmental standards; that is, the impact of residents' income inequality on environmental regulation has a threshold effect due to corruption. In addition, the threshold effect due to corruption of all residents' income inequality on environmental regulation is mainly generated by the urban residents' income inequality and the urban-rural income inequality. This paper contributes to the literature that concentrates on the relationship between income inequality and environmental regulation, and shows that corruption is a key factor that can deeply influence that relationship. The research conclusion shows that increasing anti-corruption efforts can not only maintain national political stability, social fairness, and justice, but also be a powerful measure for environmental pollution governance.


Assuntos
Poluição Ambiental , Renda , China , Humanos , População Rural , Justiça Social , Fatores Socioeconômicos
18.
Artigo em Inglês | MEDLINE | ID: mdl-34360383

RESUMO

Numerous studies have investigated the relationship between income inequality and objective environmental pollution, but few focus on the nexus between income inequality and subjective environmental pollution (SEP). Using micro data from the Chinese General Society Survey (CGSS) in 2013 and official statistical data at the provincial level, this paper tests the impact of individual-level income inequality on subjective environmental pollution in China. The results show that individual-level income inequality has an inverted U-shape relationship with subjective environmental pollution, which indicates that increasing the income inequality at the individual level will first rise and then reduce their perceived subjective environmental pollution after reaching the peak. For about 84% of respondents, their subjective environmental pollution decreases with the increase of individual-level income inequality. Furthermore, the heterogeneity analyses show that the income inequality of urban residents and of the locals have an inverted U-shape effect on SEP, and the SEP of females and of individuals with positive environmental attitude are more sensitive to the effect of income inequality. Additionally, we find that subjective well-being plays a mediating role in the relation between income inequality and SEP. Individual income inequality decreases their self-reported well-being, and an increase in well-being has a negative effect on their subjectively perceived environmental quality. We also find non-television media exposures, such as newspaper, magazine, broadcasting, Internet, and mobile custom messages, will amplify the effect of individual-level income inequality on subjective environmental pollution.


Assuntos
Poluição Ambiental , Renda , China , Feminino , Humanos , Fatores Socioeconômicos , Inquéritos e Questionários
19.
Rev Med Inst Mex Seguro Soc ; 59(3): 260-261, 2021 Aug 13.
Artigo em Espanhol | MEDLINE | ID: mdl-34375045

RESUMO

This article is dedicated to the memory of doctor Francisco Olvera Esnaurrizar (1929-2019), first editor of the Revista Médica del Instituto Mexicano del Seguro Social -Medical Journal of the Mexican Institute for Social Security- (1962-1973).


Assuntos
Academias e Institutos , Médicos , Humanos , Renda , México , Previdência Social
20.
AMIA Annu Symp Proc ; 2021: 644-652, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34457180

RESUMO

Medicaid is a significant health insurance plan providing healthcare coverage to up to a third of the population of the United Sates. We describe two different formats of Medicaid data within Center for Medicare and Medicaid Services Virtual Research Data Center. We analyze record length, age and enrollment justification among patients for both data formats. As of December 2016, the total size of Medicaid population available from CMS is 92,953,389; 45% of patients are aged 0 to 18, 26.6% are aged 19-35 and 23.2% are aged 36-64. In terms of Medicaid eligibility, 35.6% qualify due to (child) age and 26.8% qualify due to income. We also compare the volume of Medicaid to Medicare for year 2016. We conclude that Medicaid data includes patients with significant record lengths and relatively well documented enrollment justification, which are high value assets for data reuse researchers that are willing to balance known data limitations with careful analysis design and interpretation.


Assuntos
Medicaid , Medicare , Adulto , Idoso , Centers for Medicare and Medicaid Services, U.S. , Criança , Definição da Elegibilidade , Humanos , Renda , Cobertura do Seguro , Estados Unidos
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