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1.
Acta Med Hist Adriat ; 18(2): 355-374, 2021 12.
Artículo en Inglés, Croata | MEDLINE | ID: mdl-33535767

RESUMEN

Economic crises throughout history have often given an impetus for health and social reforms leading to the introduction of general healthcare systems and social equality in a large number of countries. The aim of this paper is to present the major economic crises and their effect on healthcare and social system chronologically. Bismarck's and Beveridge's model, the two most prominent healthcare models, which emerged primarily as a response to major economic crises, constitute the basis for the functioning of most health care systems in the world. An overview of historical events and experiences may be valuable in predicting future developments and potential effects of the crisis on healthcare systems and health in general. An analysis of past crises as well as current health and economic crisis caused by the COVID-19 pandemic and their impact on the healthcare system can facilitate the comprehension of the mechanisms of action and consequences of economic recession. It may also help identify guidelines and changes that might reduce the potential damage caused by future crises. The historical examples presented show that a crisis could trigger changes, which, in theiressence, are not necessarily negative. The response of society as a whole determines the direction of these changes, and it is up to society to transform the negative circumstances brought about by the recession into activities that contribute to general well-being and progress.


Asunto(s)
/economía , Prestación de Atención de Salud/organización & administración , Recesión Económica , Modelos Organizacionales , Prestación de Atención de Salud/economía , Guías como Asunto , Humanos , Italia , Factores Socioeconómicos
2.
BMC Public Health ; 21(1): 334, 2021 02 11.
Artículo en Inglés | MEDLINE | ID: mdl-33573632

RESUMEN

BACKGROUND: The outbreak of COVID-19 has caused mental health problems and increased unemployment due to the economic recession. This survey aimed to assess the psychological impact of the state of emergency. We estimated changes in mental health, quality of life, and unemployment experience for general workers during the first COVID-19 outbreak in Japan. METHODS: We conducted a nationwide follow-up study. During the periods of March 26 to April 6, 2020 and June 26 to July 2, 2020, we used the internet to survey general workers aged 15 to 59 years in Japan. The questionnaire items covered employment status and socioeconomic factors, and we used the Center for Epidemiologic Studies Depression Scale (CES-D) and EQ-5D-5L to assess depression and health-related quality of life (HR-QOL), respectively. The differences in outcomes of permanent and non-permanent workers were analyzed using propensity score analysis. A multiple linear regression analysis was performed to examine the relationship between unemployment and CES-D scores. RESULTS: We included 2351 subjects in the analysis. Changes in both CES-D scores and utility were not significantly different between the two groups. However, a significant difference was found regarding the rate of unemployment, which was associated with higher CES-D scores. CONCLUSIONS: The present study demonstrated that the mental health of non-permanent workers was not negatively affected following the state of emergency due to COVID-19 in Japan. Unemployment is an important factor that influences the mental health of general workers.


Asunto(s)
/epidemiología , Brotes de Enfermedades , Trastornos Mentales/epidemiología , Desempleo/psicología , Adolescente , Adulto , Recesión Económica , Femenino , Estudios de Seguimiento , Humanos , Japón/epidemiología , Masculino , Persona de Mediana Edad , Calidad de Vida , Factores Socioeconómicos , Encuestas y Cuestionarios , Desempleo/estadística & datos numéricos , Adulto Joven
3.
Sci Adv ; 7(6)2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33547077

RESUMEN

Despite numerous journalistic accounts, systematic quantitative evidence on economic conditions during the ongoing COVID-19 pandemic remains scarce for most low- and middle-income countries, partly due to limitations of official economic statistics in environments with large informal sectors and subsistence agriculture. We assemble evidence from over 30,000 respondents in 16 original household surveys from nine countries in Africa (Burkina Faso, Ghana, Kenya, Rwanda, Sierra Leone), Asia (Bangladesh, Nepal, Philippines), and Latin America (Colombia). We document declines in employment and income in all settings beginning March 2020. The share of households experiencing an income drop ranges from 8 to 87% (median, 68%). Household coping strategies and government assistance were insufficient to sustain precrisis living standards, resulting in widespread food insecurity and dire economic conditions even 3 months into the crisis. We discuss promising policy responses and speculate about the risk of persistent adverse effects, especially among children and other vulnerable groups.


Asunto(s)
/economía , Países en Desarrollo/economía , Empleo/tendencias , Renta/tendencias , Pandemias/economía , Adulto , África/epidemiología , Agricultura/economía , Asia/epidemiología , Niño , Colombia/epidemiología , Violencia Doméstica , Recesión Económica , Composición Familiar , Femenino , Programas de Gobierno/economía , Humanos , Masculino , Estaciones del Año , Encuestas y Cuestionarios
6.
PLoS One ; 16(1): e0244920, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33417613

RESUMEN

BACKGROUND: The COVID-19 virus impacts human health and the world economy, causing in Peru, more than 800 thousand infected and a strong recession expressed in a drop of -12% in its economic growth rate for 2020. In this context, the objective of the study is to analyze the dynamics of the short-term behavior of economic activity, as well as to explain the causal relationships in a Pandemic context based on the basic number of spread (Re) of COVID-19 per day. METHODS: An Autoregressive Distributed Lags (ARDL) model was used. RESULTS: A negative and statistically significant impact of the COVID-19 shock was found on the level of economic activity and a long-term Cointegration relationship with an error correction model (CEM), with the expected sign and statistically significant at 1%. CONCLUSION: The Pandemic has behaved as a systemic shock of supply and aggregate demand at the macroeconomic level, which together have an impact on the recession or level of economic activity. The authors propose changing public health policy from an indiscriminate suppression strategy to a targeted, effective and intelligent mitigation strategy that minimizes the risk of human life costs and socioeconomic costs, in a context of uncertainty about the end of the Pandemic and complemented by economic, fiscal and monetary policies that mitigate the economic recession, considering the underlying structural characteristics of the Peruvian economy.


Asunto(s)
/economía , Desarrollo Económico , Recesión Económica , Modelos Económicos , Costo de Enfermedad , Humanos , Pandemias , Perú
7.
Fam Med ; 53(1): 48-53, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33471922

RESUMEN

The COVID-19 pandemic, together with its resultant economic downturn, has unmasked serious problems of access, costs, quality of care, inequities, and disparities of US health care. It has exposed a serious primary care shortage, the unreliability of employer-sponsored health insurance, systemic racism, and other dysfunctions of a system turned on its head without a primary care base. Fundamental reform is urgently needed to bring affordable health care that is accessible to all Americans. Over the last 40-plus years, our supposed system has been taken over by corporate stakeholders with the presumption that a competitive unfettered marketplace will achieve the needed goal of affordable, accessible care. That theory has been thoroughly disproven by experience as the ranks of more than 30 million uninsured and 87 million underinsured demonstrates. Three main reform alternatives before us are: (1) to build on the Affordable Care Act; (2) to implement some kind of a public option; and (3) to enact single-payer Medicare for All. It is only the third option that can make affordable, comprehensive health care accessible for our entire population. As the debate goes forward over these alternatives during this election season, the likelihood of major change through a new system of national health insurance is becoming increasingly realistic. Rebuilding primary care and public health is a high priority as we face a new normal in US health care that places the public interest above that of corporate stakeholders and Wall Street investors. Primary care, and especially family medicine, should become the foundation of a reformed health care system.


Asunto(s)
Medicina Familiar y Comunitaria , Reforma de la Atención de Salud , Sector de Atención de Salud , Disparidades en Atención de Salud/etnología , Atención Primaria de Salud , Calidad de la Atención de Salud , Cobertura Universal del Seguro de Salud , Recesión Económica , Empleo , Tabla de Aranceles , Instituciones Privadas de Salud , Disparidades en Atención de Salud/estadística & datos numéricos , Humanos , Seguro de Salud , Medicare , National Health Insurance, United States , Médicos de Familia/provisión & distribución , Médicos de Atención Primaria/provisión & distribución , Desempleo , Estados Unidos
9.
Ann Ig ; 33(1): 103-104, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33354700

RESUMEN

The new Coronavirus is spreading rapidly around the world these days, and many countries are heavily infected with it. Corona is a large family of viruses that cause respiratory infections, from the common cold to the SARS epidemic that broke out in 2003, and now the newest member of the family (SARS-Cov-2) is present in Iran. Like other countries, it is expanding rapidly. Currently, COVID-19 pandemic is one of the most important health issues in Iran and around the World (1-4). The "Corona crisis" has led to various effects in the World, including economic, political, educational, cultural, lifestyle, and so on. But over time, the Corona outbreak appears to have led to an economic shock in the World. According to economists, there are three types of economic shocks caused by the virus; type L economic shock, in which economic growth slows and never improves; type U economic shock, in which economic growth decreases and subsequently improves, but never returns to its previous state; and type V economic shock, in which economic growth gradually decreases, but gradually returns to normal (5-8). It seems, in Iran, due to COVID-19 crisis, the hospitals as a heart of health services providing system were faced with the L type of economic shock.


Asunto(s)
/economía , Economía Hospitalaria , Pandemias/economía , /epidemiología , Países en Desarrollo , Recesión Económica , Economía Hospitalaria/estadística & datos numéricos , Humanos , Irán/epidemiología
11.
Health Syst Reform ; 6(1): e1847991, 2020 12 01.
Artículo en Inglés | MEDLINE | ID: mdl-33337274

RESUMEN

Pacific Island countries (PIC) have emerged as among the most at-risk globally from the collateral economic damage resulting from the COVID-19 pandemic, despite being largely spared its direct health effects so far. Current projections indicate that all PIC will experience an economic contraction in 2020, ranging from -1.0% in Tuvalu to -21.7% in Fiji, worse than most countries globally on average. Given that more than 80% of financing for health in the Pacific comes from domestic and external public sources, the net impact of the economic contraction on resources for health will depend on whether overall public spending can offset the decline in economic activity and how health will be prioritized in government budgets relative to other sectors. Without active reprioritization, most countries could see a slowdown or even decline in per capita levels of public spending for health in the region, risking gains made in advancing universal health coverage in recent years. If health ministries do not act quickly and in consort with other ministries (particularly ministries of finance), including by taking active steps to improve the efficient use of existing resources and other measures to mitigate the economic effects of the crisis on resources for health, it is likely that current economic circumstances will result in unplanned changes. These changes may not deliver the health outcomes that the health ministries would select themselves and may result in a reversal of hard-fought health gains.


Asunto(s)
/economía , Recesión Económica , Financiación de la Atención de la Salud , Humanos , Islas del Pacífico/epidemiología
12.
PLoS One ; 15(12): e0244130, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33326495

RESUMEN

The coronavirus pandemic led to a severe economic shock in the United States. This paper uses a unique survey data collected early on in the pandemic to measure economic deprivation among individuals. The Federal Reserve Board fielded a Survey of Household Economics and Decision-making (SHED) in April 2020. This survey is used to compile data on four indicators of economic deprivation, namely: i) Overall financial condition, ii) Loss of employment, iii) Reduction in income and iv) Inability to pay bills in full. Data on these indicators is compiled for each individual and is used in a novel way to construct a set of multidimensional deprivation indices. These indices measure the overlap of deprivations experienced by an individual. Results show that almost 25 percent of the respondents faced hardships in at least two of the four indicators. More than 13 percent of adults reported their inability to pay monthly bills and struggled to make ends meet financially. One in four respondents had lower income compared to income from previous month. The economic shock affected Hispanics in a more profound way. More than 37 percent Hispanics reported hardship in two or more indicators and 8 percent reported hardship in all four indicators. Higher proportion of young adults and those without a college degree suffered multiple hardships. The paper highlights the plight of Americans during the early months of the economic crisis set in motion amid the coronavirus pandemic and sheds light on how economic disparities deepened along racial/ethnic lines.


Asunto(s)
/patología , Recesión Económica/estadística & datos numéricos , Adolescente , Adulto , /virología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Pobreza/etnología , Análisis de Regresión , Estados Unidos/epidemiología , Adulto Joven
13.
Global Health ; 16(1): 118, 2020 12 17.
Artículo en Inglés | MEDLINE | ID: mdl-33334370

RESUMEN

BACKGROUND: Since 2016 Venezuela has seen a collapse in its economy and public health infrastructure resulting in a humanitarian crisis and massive outward migration. With the emergence of the novel coronavirus SARS-CoV-2 at the end of 2019, the public health emergency within its borders and in neighboring countries has become more severe and as increasing numbers of Venezuelans migrants return home or get stuck along migratory routes, new risks are emerging in the region. RESULTS: Despite clear state obligations to respect, protect and fulfil the rights to health and related economic, social, civil and political rights of its population, in Venezuela, co-occurring malaria and COVID-19 epidemics are propelled by a lack of public investment in health, weak governance, and violations of human rights, especially for certain underserved populations like indigenous groups. COVID-19 has put increased pressure on Venezuelan and regional actors and healthcare systems, as well as international public health agencies, to deal with a domestic and regional public health emergency. CONCLUSIONS: International aid and cooperation for Venezuela to deal with the re-emergence of malaria and the COVID-19 spread, including lifting US-enforced economic sanctions that limit Venezuela's capacity to deal with this crisis, is critical to protecting rights and health in the country and region.


Asunto(s)
/prevención & control , Emigración e Inmigración/estadística & datos numéricos , Derechos Humanos/normas , Malaria/transmisión , /epidemiología , Recesión Económica/estadística & datos numéricos , Derechos Humanos/tendencias , Humanos , Malaria/epidemiología , Refugiados/estadística & datos numéricos , Venezuela/epidemiología
14.
PLoS One ; 15(11): e0241990, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33175882

RESUMEN

COVID-19 emerged in November 2019 leading to a global pandemic that has not only resulted in widespread medical complications and loss of life, but has also impacted global economies and transformed daily life. The current rapid response study in a convenience online sample quickly recruited 2,065 participants across the United States, Canada, and Europe in late March and early April 2020. Cross-sectional findings indicated elevated anxiety and depressive symptoms compared to historical norms, which were positively associated with COVID-19 concern more strongly than epidemiological data signifying risk (e.g., world and country confirmed cases). Employment loss was positively associated with greater depressive symptoms and COVID-19 concern, and depressive symptoms and COVID-19 concern were significantly associated with more stringent self-quarantine behavior. The rapid collection of data during the early phase of this pandemic is limited by under-representation of non-White and middle age and older adults. Nevertheless, these findings have implications for interventions to slow the spread of COVID-19 infection.


Asunto(s)
Infecciones por Coronavirus/patología , Recesión Económica , Conductas Relacionadas con la Salud , Neumonía Viral/patología , Adolescente , Adulto , Anciano , Ansiedad/epidemiología , Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/virología , Estudios Transversales , Depresión/epidemiología , Femenino , Humanos , Estilo de Vida , Masculino , Salud Mental , Persona de Mediana Edad , Pandemias , Neumonía Viral/epidemiología , Neumonía Viral/virología , Cuarentena/psicología , Aislamiento Social , Encuestas y Cuestionarios , Adulto Joven
16.
PLoS One ; 15(10): e0241017, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33104705

RESUMEN

BACKGROUND: Economic recessions carry an impact on population health and access to care; less is known on how health systems adapt to the conditions brought by a downturn. This particularly matters now that the COVID-19 epidemic is putting health systems under stress. Brazil is one of the world's most affected countries, and its health system was already experiencing the aftermath of the 2015 recession. METHODS: Between 2018 and 2019 we conducted 46 semi-structured interviews with health practitioners, managers and policy-makers to explore the impact of the 2015 recession on public and private providers in prosperous (São Paulo) and impoverished (Maranhão) states in Brazil. Thematic analysis was employed to identify drivers and consequences of system adaptation and coping strategies. Nvivo software was used to aid data collection and analysis. We followed the Standards for Reporting Qualitative Research to provide an account of the findings. RESULTS: We found the concept of 'health sector crisis' to be politically charged among healthcare providers in São Paulo and Maranhão. Contrary to expectations, the public sector was reported to have found ways to compensate for diminishing federal funding, having outsourced services and adopted flexible-if insecure-working arrangements. Following a drop in employment and health plans, private health insurance companies have streamlined their offer, at times at the expenses of coverage. Low-cost walk-in clinics were hit hard by the recession, but were also credited for having moved to cater for higher-income customers in Maranhão. CONCLUSIONS: The 'plates' of a health system may shift and adjust in unexpected ways in response to recessions, and some of these changes might outlast the crisis. As low-income countries enter post-COVID economic recessions, it will be important to monitor the adjustments taking place in health systems, to ensure that past gains in access to care and job security are not eroded.


Asunto(s)
Personal Administrativo/psicología , Betacoronavirus , Infecciones por Coronavirus , Recesión Económica , Sector de Atención de Salud/economía , Administradores de Instituciones de Salud/psicología , Personal de Salud/psicología , Pandemias , Neumonía Viral , Sector Privado/economía , Sector Público/economía , Instituciones de Atención Ambulatoria/economía , Actitud del Personal de Salud , Brasil , Servicios de Salud Comunitaria/economía , Países en Desarrollo , Humanos , Reembolso de Seguro de Salud , Entrevistas como Asunto , Médicos/psicología , Investigación Cualitativa , Telemedicina , Desempleo
17.
PLoS One ; 15(10): e0240876, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33108374

RESUMEN

Many different countries have been under lockdown or extreme social distancing measures to control the spread of COVID-19. The potentially far-reaching side effects of these measures have not yet been fully understood. In this study we analyse the results of a multi-country survey conducted in Italy (N = 3,504), Spain (N = 3,524) and the United Kingdom (N = 3,523), with two separate analyses. In the first analysis, we examine the elicitation of citizens' concerns over the downplaying of the economic consequences of the lockdown during the COVID-19 pandemic. We control for Social Desirability Bias through a list experiment included in the survey. In the second analysis, we examine the data from the same survey to predict the level of stress, anxiety and depression associated with being economically vulnerable and having been affected by a negative economic shock. To accomplish this, we have used a prediction algorithm based on machine learning techniques. To quantify the size of this affected population, we compare its magnitude with the number of people affected by COVID-19 using measures of susceptibility, vulnerability and behavioural change collected in the same questionnaire. We find that the concern for the economy and for "the way out" of the lockdown is diffuse and there is evidence of minor underreporting. Additionally, we estimate that around 42.8% of the populations in the three countries are at high risk of stress, anxiety, and depression, based on their level of economic vulnerability and their exposure to a negative economic shock.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/economía , Recesión Económica , Trastornos Mentales/etiología , Pandemias/economía , Neumonía Viral/economía , Adolescente , Adulto , Anciano , Ansiedad/epidemiología , Ansiedad/etiología , Control de Enfermedades Transmisibles/economía , Control de Enfermedades Transmisibles/métodos , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/psicología , Depresión/epidemiología , Depresión/etiología , Femenino , Humanos , Italia/epidemiología , Masculino , Trastornos Mentales/economía , Persona de Mediana Edad , Pandemias/prevención & control , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Neumonía Viral/psicología , Análisis de Componente Principal , Cuarentena/economía , España/epidemiología , Estrés Psicológico/epidemiología , Estrés Psicológico/etiología , Encuestas y Cuestionarios , Reino Unido/epidemiología , Adulto Joven
18.
Artículo en Inglés | MEDLINE | ID: mdl-33008097

RESUMEN

Research shows that bullying is a significant workplace issue. A previous study showed increased sickness-related absences among municipality employees during the Icelandic economic crisis in 2008. This led to the following research questions: has bullying and/or harassment increased between the time points of the study up to seven years after the crisis? Did bullying and/or harassment change depending on downsizing? Are quantitative job demands, role conflicts and social support connected to bullying and/or harassment at work and if so, how? The study is based on a four-wave longitudinal balanced panel dataset consisting of those who work within the education and care services operated by Icelandic municipalities. It was seen that bullying and harassment had increased between the time points of the study. Furthermore, employees in downsized workplaces, workplaces with higher quantitative job demands, more role conflicts and less support were more likely to experience bullying and/or harassment than employees in other workplaces. Since the effects may prevail for several years, the study demonstrates that the consequences of downsizing need to be carefully considered and that managers must be supported in that role. As economic crises tend to occur periodically, presently due to COVID-19, the knowledge is both of theoretical and practical importance.


Asunto(s)
Acoso Escolar , Recesión Económica , Reducción de Personal , Lugar de Trabajo/psicología , Humanos , Islandia
19.
Artículo en Inglés | MEDLINE | ID: mdl-32899994

RESUMEN

Several studies have described a decreasing trend in amenable mortality, as well as the existence of socioeconomic inequalities that affect it. However, their evolution, particularly in small urban areas, has largely been overlooked. The aim of this study is to analyse the socioeconomic inequalities in amenable mortality in three cities of the Valencian Community, namely, Alicante, Castellon, and Valencia, as well as their evolution before and after the start of the economic crisis (2000-2007 and 2008-2015). The units of analysis have been the census tracts and a deprivation index has been calculated to classify them according to their level of socioeconomic deprivation. Deaths and population were also grouped by sex, age group, period, and five levels of deprivation. The specific rates by sex, age group, deprivation level, and period were calculated for the total number of deaths due to all causes and amenable mortality and Poisson regression models were adjusted in order to estimate the relative risk. This study confirms that the inequalities between areas of greater and lesser deprivation in both all-cause mortality and amenable mortality persisted along the two study periods in the three cities. It also shows that these inequalities appear with greater risk of death in the areas of greatest deprivation, although not uniformly. In general, the risks of death from all causes and amenable mortality have decreased significantly from one period to the other, although not in all the groups studied. The evolution of death risks from before the onset of the crisis to the period after presented, overall, a general pro-cyclical trend. However, there are population subgroups for which the trend was counter-cyclical. The use of the deprivation index has made it possible to identify specific geographical areas with vulnerable populations in all three cities and, at the same time, to identify the change in the level of deprivation (ascending or descending) of the geographical areas throughout the two periods. It is precisely these areas where more attention is needed in order to reduce inequalities.


Asunto(s)
Recesión Económica , Mortalidad , Neoplasias/mortalidad , Factores Socioeconómicos , Ciudades , Femenino , Humanos , Masculino , Embarazo , Riesgo , España/epidemiología , Poblaciones Vulnerables
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