Malaria eradication and economic outcomes in sub-Saharan Africa: Evidence from Uganda.

This study evaluates the economic consequences of a 1959-1960 malaria eradication campaign in southwestern Uganda. The effort constitutes a rare, large-scale, and well-documented attempt to eliminate malaria in sub-Saharan Africa and produced an immediate disease reduction. We use this quasi-experimental health shock to identify long-term changes in educational and economic outcomes. Comparing the treatment district to a similar synthetic control, we find malaria eradication raised educational attainment by about a half year for both males and females, increased primary school completion among females and generated an almost 40% rise in the likelihood of male wage employment.

[The Association Between Food Prices and the Blood Glucose Level of US Adults With Type 2 Diabetes]. / Asociación entre el precio de los alimentos y la glucemia en adultos estadounidenses con diabetes de tipo 2.

OBJECTIVES: We estimated the association between the price of healthy and less-healthy food groups and blood sugar among US adults with type 2 diabetes. METHODS: We linked 1999-2006 National Health and Nutrition Examination Survey health information to food prices contained in the Quarterly Food-at-Home Price Database. We regressed blood sugar levels on food prices from the previous calendar quarter, controlling for market region and a range of other covariates. We also examined whether the association between food prices and blood sugar varies among different income groups. RESULTS: The prices of produce and low-fat dairy foods were associated with blood sugar levels of people with type 2 diabetes. Specifically, higher prices for produce and low-fat dairy foods were associated with higher levels of glycated hemoglobin and fasting plasma glucose 3 months later. Food prices had a greater association with blood sugar for low-income people than for higher-income people, and in the expected direction. CONCLUSIONS: Higher prices of healthy foods were associated with increased blood sugar among people with type 2 diabetes. The association was especially pronounced among low-income people with type 2 diabetes.

Asociación entre el precio de los alimentos y la glucemia en adultos estadounidenses con diabetes de tipo 2 / The Association Between Food Prices and the Blood Glucose Level of US Adults With Type 2 Diabetes

OBJETIVOS: Calculamos la asociación entre el precio de diversas categorías de alimentos saludables y menos saludables y la glucemia en adultos estadounidenses con diabetes de tipo 2. MÉTODOS: Vinculamos la información de salud contenida en la Encuesta Nacional de Salud y Nutrición 1999-2006 y el precio de los alimentos a partir de la base trimestral de datos de precios de los alimentos. Aplicamos una regresión de los valores de glucemia con respecto al precio de los alimentos en el trimestre anterior, con control de la región del mercado y otras covariables. Examinamos asimismo si la asociación entre el precio de los alimentos y la glucemia variaba entre distintos grupos de ingresos. RESULTADOS: Tanto el precio de las frutas y verduras como el precio de los productos lácteos magros se asocian a la glucemia en las personas con diabetes de tipo 2. En concreto, un precio mayor de las frutas y verduras y de los productos lácteos se asocia a valores más altos de glu-cohemoglobina y de glucemia en ayunas tres meses después. La asociación entre el precio de los alimentos y la glucemia es mayor en las personas de ingresos bajos que en las de ingresos elevados, en la dirección esperada. CONCLUSIONES: Un precio mayor de los alimentos saludables se asocia a cifras más elevadas de glucemia en las personas con diabetes de tipo 2. Esta asociación fue especialmente pronunciada en las personas con diabetes de tipo 2 con ingresos bajos.

OBJECTIVES: We estimated the association between the price of healthy and less-healthy food groups and blood sugar among US adults with type 2 diabetes. METHODS: We linked 1999-2006 National Health and Nutrition Examination Survey health information to food prices contained in the Quarterly Food-at-Home Price Database. We regressed blood sugar levels on food prices from the previous calendar quarter, controlling for market region and a range of other covariates. We also examined whether the association between food prices and blood sugar varies among different income groups. RESULTS: The prices of produce and low-fat dairy foods were associated with blood sugar levels of people with type 2 diabetes. Specifically, higher prices for produce and low-fat dairy foods were associated with higher levels of glycated hemoglobin and fasting plasma glucose 3 months later. Food prices had a greater association with blood sugar for low-income people than for higherincome people, and in the expected direction. CONCLUSIONS: Higher prices of healthy foods were associated with increased blood sugar among people with type 2 diabetes. The association was especially pronounced among low-income people with type 2 diabetes.

The causal effect of childhood measles vaccination on educational attainment: A mother fixed-effects study in rural South Africa.

BACKGROUND: Because measles vaccination prevents acute measles disease and morbidities secondary to measles, such as undernutrition, blindness, and brain damage, the vaccination may also lead to higher educational attainment. However, there has been little evidence to support this hypothesis at the population level. In this study, we estimate the causal effect of childhood measles vaccination on educational attainment among children born between 1995 and 2000 in South Africa. METHODS AND FINDINGS: We use longitudinal data on measles vaccination status and school grade attainment among 4783 children. The data were collected by the Wellcome Trust Africa Centre Demographic Information System (ACDIS), which is one of Africa's largest health and demographic surveillance systems. ACDIS is located in a poor, predominantly rural, Zulu-speaking community in KwaZulu-Natal, South Africa. Using mother fixed-effects regression, we compare the school grade attainment of siblings who are discordant in their measles vaccination status but share the same mother and household. This fixed-effects approach controls for confounding due to both observed and unobserved factors that do not vary between siblings, including sibling-invariant mother and household characteristics such as attitudes toward risk, conscientiousness, and aspirations for children. We further control for a range of potential confounders that vary between siblings, such as sex of the child, year of birth, mother's age at child's birth, and birth order. We find that measles vaccination on average increases school grade attainment by 0.188 grades (95% confidence interval, 0.0424-0.334; p=0.011). CONCLUSIONS: Measles vaccination increased educational attainment in this poor, largely rural community in South Africa. For every five to seven children vaccinated against measles, one additional school grade was gained. The presence of a measles vaccination effect in this community is plausible because (i) measles vaccination prevents measles complications including blindness, brain damage, and undernutrition; (ii) a large number of number of children were at risk of contracting measles because of the comparatively low measles vaccination coverage; and (iii) significant measles transmission occurred in the community where this study took place during the study observation period. Our results demonstrate for the first time that measles vaccination affects human development not only through its health effects but also through its effects on education.

The association between food prices and the blood glucose level of US adults with type 2 diabetes.

OBJECTIVES: We estimated the association between the price of healthy and less-healthy food groups and blood sugar among US adults with type 2 diabetes. METHODS: We linked 1999-2006 National Health and Nutrition Examination Survey health information to food prices contained in the Quarterly Food-at-Home Price Database. We regressed blood sugar levels on food prices from the previous calendar quarter, controlling for market region and a range of other covariates. We also examined whether the association between food prices and blood sugar varies among different income groups. RESULTS: The prices of produce and low-fat dairy foods were associated with blood sugar levels of people with type 2 diabetes. Specifically, higher prices for produce and low-fat dairy foods were associated with higher levels of glycated hemoglobin and fasting plasma glucose 3 months later. Food prices had a greater association with blood sugar for low-income people than for higher-income people, and in the expected direction. CONCLUSIONS: Higher prices of healthy foods were associated with increased blood sugar among people with type 2 diabetes. The association was especially pronounced among low-income people with type 2 diabetes.

The effect of a vaccination program on child anthropometry: evidence from India's Universal Immunization Program.

BACKGROUND: Childhood vaccination may protect children's nutritional status and lead to improved child growth in developing countries. This study evaluates the effect of India's childhood vaccination program Universal Immunization Program (UIP) on the growth of children <4 years of age. METHODS: Regression models were estimated to examine the effect of UIP on vaccination status and children's anthropometric outcomes, as well as to test whether UIP's effect was uniform across various subpopulations of Indian children. RESULTS: UIP increased height-for-age and weight-for-age among children. This effect constituted a 22-25% reduction in the height-for-age deficit and a 15% reduction in the weight-for-age deficit of the average child. The program appears to have had no effect on other anthropometric indicators or vaccination status. UIP also led to differential changes in anthropometry and vaccination status, based on differences in wealth, maternal education and scheduled-caste status. CONCLUSIONS: UIP led to improved child growth. This suggests that vaccination programs-in addition to being a major intervention for reducing child mortality-might be considered a tool for mitigating undernutrition in developing countries. This study also adds to the growing evidence that childhood vaccination programs are high-return investments because they produce long-term health benefits for children.

Profits and plagiarism: the case of medical ghostwriting.

This paper focuses on medical ghostwriting in the United States. I argue that medical ghostwriting often involves plagiarism and, in those cases, can be treated as an act of research misconduct by both the federal government and research institutions. I also propose several anti-ghostwriting measures, including: 1) journals should implement guarantor policies so that researchers may be better held accountable for their work; 2) research institutions and the federal government should explicitly prohibit medical ghostwriting and outline appropriate penalties; and 3) a publicly available database should be created to record researchers' ethics violations.