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1.
BMC Public Health ; 24(1): 1268, 2024 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-38720254

RESUMO

BACKGROUND: In Africa, approx. 675 million people were at risk of food insecurity. COVID-19 pandemic is likely to have exacerbated this situation, by damaging populations' access to and affordability of foods. This study is aimed at estimating the impacts of the COVID-19 pandemic on availability and prices of essential food commodities at 20 large markets in Ghana. METHODS: Data on food availability and food retail prices collected through weekly market-level data during the period from July 2017 to September 2020 were used in this study. We performed interrupted time-series analyses and estimated the percentage increases between the observed and predicted food prices by food group and by region to assess the impact of COVID-19 pandemic on food prices. RESULTS: As a result, the impact of COVID-19 on food availability was limited. However, the results of interrupted time-series analyses indicate a significant increase in overall mean food prices in Greater Accra, Eastern and Upper East regions. It was also found that mean price of starchy roots, tubers and plantains significantly increased across regions. DISCUSSION: The impact of COVID-19 pandemic on food availability and prices was significant but varied by food type and regions in Ghana. Continuous monitoring and responses are critical to maintain food availability and affordability.


Assuntos
COVID-19 , Comércio , Abastecimento de Alimentos , Análise de Séries Temporais Interrompida , Gana/epidemiologia , Humanos , COVID-19/epidemiologia , Abastecimento de Alimentos/estatística & dados numéricos , Abastecimento de Alimentos/economia , Comércio/estatística & dados numéricos , Comércio/economia , Insegurança Alimentar/economia , Pandemias/economia
2.
PLoS One ; 19(5): e0302746, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38728340

RESUMO

BACKGROUND: Long-term health conditions can affect labour market outcomes. COVID-19 may have increased labour market inequalities, e.g. due to restricted opportunities for clinically vulnerable people. Evaluating COVID-19's impact could help target support. AIM: To quantify the effect of several long-term conditions on UK labour market outcomes during the COVID-19 pandemic and compare them to pre-pandemic outcomes. METHODS: The Understanding Society COVID-19 survey collected responses from around 20,000 UK residents in nine waves from April 2020-September 2021. Participants employed in January/February 2020 with a variety of long-term conditions were matched with people without the condition but with similar baseline characteristics. Models estimated probability of employment, hours worked and earnings. We compared these results with results from a two-year pre-pandemic period. We also modelled probability of furlough and home-working frequency during COVID-19. RESULTS: Most conditions (asthma, arthritis, emotional/nervous/psychiatric problems, vascular/pulmonary/liver conditions, epilepsy) were associated with reduced employment probability and/or hours worked during COVID-19, but not pre-pandemic. Furlough was more likely for people with pulmonary conditions. People with arthritis and cancer were slower to return to in-person working. Few effects were seen for earnings. CONCLUSION: COVID-19 had a disproportionate impact on people with long-term conditions' labour market outcomes.


Assuntos
COVID-19 , Emprego , Humanos , COVID-19/epidemiologia , COVID-19/economia , Reino Unido/epidemiologia , Masculino , Feminino , Emprego/estatística & dados numéricos , Adulto , Pessoa de Meia-Idade , Pandemias/economia , SARS-CoV-2/isolamento & purificação , Adulto Jovem , Adolescente , Inquéritos e Questionários , Idoso , Renda/estatística & dados numéricos
3.
BMJ Glob Health ; 9(5)2024 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-38740495

RESUMO

The goal of Universal Health Coverage (UHC) is that everyone needing healthcare can access quality services without financial hardship. Recent research covering countries with UHC systems documents the emergence, and acceleration following the COVID-19 pandemic of unapproved informal payment systems by providers that collect under-the-table payments from patients. In 2001, Thailand extended its '30 Baht' government-financed coverage to all uninsured people with little or no cost sharing. In this paper, we update the literature on the performance of Thailand's Universal Health Coverage Scheme (UCS) with data covering 2019 (pre-COVID-19) through 2021. We find that access to care for Thailand's UCS-covered population (53 million) is similar to access provided to populations covered by the other major public health insurance schemes covering government and private sector workers, and that, unlike reports from other UHC countries, no evidence that informal side payments have emerged, even in the face of COVID-19 related pressures. However, we do find that nearly one out of eight Thailand's UCS-covered patients seek care outside the UCS delivery system where they will incur out-of-pocket payments. This finding predates the COVID-19 pandemic and suggests the need for further research into the performance of the UHC-sponsored delivery system.


Assuntos
COVID-19 , Acessibilidade aos Serviços de Saúde , SARS-CoV-2 , Cobertura Universal do Seguro de Saúde , Humanos , Tailândia , COVID-19/economia , Cobertura Universal do Seguro de Saúde/economia , Acessibilidade aos Serviços de Saúde/economia , Gastos em Saúde/estatística & dados numéricos , Financiamento Pessoal/economia , Pandemias/economia
5.
PeerJ ; 12: e17281, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38680897

RESUMO

COVID-19 has a deep impact on the economic, environmental, and social life of the global population. Particularly, it disturbed the entire agriculture supply chain due to a shortage of labor, travel restrictions, and changes in demand during lockdowns. Consequently, the world population faced food insecurity due to a reduction in food production and booming food prices. Low-income households face food security challenges because of limited income generation during the pandemic. Thus, there is a need to understand comprehensive strategies to meet the complex challenges faced by the food industry and marginalized people in developing countries. This research is intended to review the agricultural supply chain, global food security, and environmental dynamics of COVID-19 by exploring the most significant literature in this domain. Due to lockdowns and reduced industrial production, positive environmental effects are achieved through improved air and water quality and reduced noise pollution globally. However, negative environmental effects emerged due to increasing medical waste, packaging waste, and plastic pollution due to disruptions in recycling operations. There is extensive literature on the effects of COVID-19 on the environment and food security. This study is an effort to review the existing literature to understand the net effects of the pandemic on the environment and food security. The literature suggested adopting innovative policies and strategies to protect the global food supply chain and achieve economic recovery with environmental sustainability. For instance, food productivity should be increased by using modern agriculture technologies to ensure food security. The government should provide food to vulnerable populations during the pandemic. Trade restrictions should be removed for food trade to improve international collaboration for food security. On the environmental side, the government should increase recycling plants during the pandemic to control waste and plastic pollution.


Assuntos
Agricultura , COVID-19 , Segurança Alimentar , Abastecimento de Alimentos , COVID-19/epidemiologia , COVID-19/prevenção & controle , COVID-19/transmissão , Humanos , Agricultura/economia , Abastecimento de Alimentos/economia , SARS-CoV-2 , Pandemias/prevenção & controle , Pandemias/economia , Reciclagem , Meio Ambiente
6.
Glob Public Health ; 19(1): 2341403, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38659107

RESUMO

The COVID-19 pandemic has significantly impacted China's economic and social development. Understanding the direct and indirect effects of the epidemic on the economy is vital for formulating scientifically grounded epidemic management policies. This study assesses the economic losses and influence paths of a large-scale epidemic in China. We proposed three COVID-19 scenarios - serious, normal, and mild - to evaluate the direct economic impact on China's GDP from a demand perspective. An input-output model was used to estimate the indirect impact. Our findings show that China's GDP could lose 94,206, 75,365, and 56,524 hundred million yuan under serious, normal, and mild scenarios, respectively, with corresponding GDP decline rates of 9.27%, 7.42%, and 5.56%. Under the normal scenario, indirect economic loss and total loss are projected at 75,364 and 489,386 hundred million yuan, respectively. Additionally, the pandemic led to a reduction in carbon emissions: direct emissions decreased by 1,218.69 million tons, indirect emissions by 9,594.32 million tons, and total emissions by 10,813.01 million tons across various industries. This study provides a comprehensive analysis of the economic and environmental impacts of the pandemic.


Assuntos
COVID-19 , SARS-CoV-2 , COVID-19/epidemiologia , Humanos , China/epidemiologia , Pandemias/economia , Produto Interno Bruto
7.
Econ Hum Biol ; 53: 101378, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38593608

RESUMO

This paper evaluates the effects of economic shocks to current and expected income reduction on mental wellbeing. We use individual-level data from three East Asian countries; China, Japan, and South Korea, during the early phases of the pandemic when the COVID-induced economic shocks were severe. The findings reveal significant causal effects from current and expected income reduction on different aspects of mental health deterioration, including anxiety, trouble sleeping, boredom, and loneliness. Interestingly, we found that expectations of future income loss have a significantly larger effect on people's mental wellbeing compared to current falls in income. This has significant implications for the design of policies to support income during pandemics.


Assuntos
Ansiedade , COVID-19 , Renda , Saúde Mental , SARS-CoV-2 , Humanos , COVID-19/psicologia , COVID-19/economia , COVID-19/epidemiologia , Masculino , Feminino , Renda/estatística & dados numéricos , Adulto , Ansiedade/epidemiologia , Pessoa de Meia-Idade , República da Coreia/epidemiologia , Solidão/psicologia , Pandemias/economia , China/epidemiologia , Japão/epidemiologia , Idoso , Adulto Jovem , População do Leste Asiático
8.
BMC Res Notes ; 17(1): 112, 2024 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-38644484

RESUMO

OBJECTIVE: Acute lymphoblastic leukemia (ALL) is the most common childhood malignancy and among the most common malignancies in young adults and requires a unique pattern of healthcare utilization including an acute/emergent presentation and an intensive initial 8 months of therapy followed by two years of outpatient treatment. The COVID-19 pandemic caused massive global disruptions in healthcare use and delivery. This report aims to examine the effects of the COVID-19 pandemic on the presentation, diagnosis and continued management of childhood and young adult ALL in regard to utilization and cost of care among commercially insured individuals in the United States. RESULTS: Utilizing a commercial insurance claims database, 529 pediatric and young adult patients were identified who were diagnosed with ALL between January 2016 and March 2021. New diagnoses were evaluated by era and demographics. Utilization was measured by COVID-related era as number of inpatient and outpatient encounters, inpatient days, and cumulative cost during the initial 8 months of therapy. None of these cost or utilization factors changed significantly during or shortly after the pandemic. These findings reinforce that the necessary care for pediatric and young adult ALL was unwavering despite the massive shifts in the healthcare system caused by the COVID-19 pandemic. This provides a valuable benchmark as we further examine the factors that influence the pandemic's impact on health equity and access to care, especially in vulnerable pediatric and young adult populations. This is the first investigation of the effect of the COVID-19 pandemic on utilization and cost of care in pediatric and young adult cancer.


Assuntos
COVID-19 , Leucemia-Linfoma Linfoblástico de Células Precursoras , Humanos , COVID-19/epidemiologia , COVID-19/economia , Criança , Adolescente , Masculino , Feminino , Adulto Jovem , Leucemia-Linfoma Linfoblástico de Células Precursoras/terapia , Leucemia-Linfoma Linfoblástico de Células Precursoras/economia , Leucemia-Linfoma Linfoblástico de Células Precursoras/epidemiologia , Estados Unidos/epidemiologia , Pré-Escolar , Custos de Cuidados de Saúde/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Lactente , Adulto , SARS-CoV-2 , Pandemias/economia
9.
Bull World Health Organ ; 102(5): 314-322F, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38680465

RESUMO

Objective: To obtain insights into reducing the shortfall in financing for pandemic preparedness and response measures, and reducing the risk of another pandemic with social and economic costs comparable to those of the coronavirus disease. Methods: We conducted a systematic scoping review using the databases ScienceDirect, Scopus, JSTOR, PubMed® and EconLit. We included articles published in any language until 1 August 2023, and excluded grey literature and publications on epidemics. We categorized eligible studies according to the elements of a framework proposed by the World Health Organization Council on the Economy of Health for All: (i) root/structural causes; (ii) social position/foundations; (iii) infrastructure and systems; and (iv) communities, households and individuals. Findings: Of the 188 initially identified articles, we included 60 in our review. Most (53/60) were published after 2020, when academic interest had shifted towards global financing mechanisms. Most (37/60) addressed two or more of the council framework elements. The most frequently addressed element was infrastructure and systems (54/60), discussing topics such as health systems, financial markets and innovation ecosystems. The roots/structural causes were discussed in 25 articles; communities, households and individuals in 22 articles; and social positions/foundations in 11. Conclusion: Our review identified three important gaps: a formal definition of pandemic preparedness and response, impeding the accurate quantification of the financing shortfall; research on the extent to which financing for pandemic preparedness and response has been targeted at the most vulnerable households; and an analysis of specific financial instruments and an evaluation of the feasibility of their implementation.


Assuntos
COVID-19 , Pandemias , Humanos , COVID-19/epidemiologia , COVID-19/economia , COVID-19/prevenção & controle , Pandemias/economia , Saúde Global , SARS-CoV-2 , Financiamento da Assistência à Saúde , Preparação para Pandemia
10.
PLoS One ; 19(4): e0301526, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38687809

RESUMO

The importance of real estate development has been widely accepted by all countries. Through early warning and avoidance of real estate financial risks, it can effectively promote the healthy and healthy development of the real estate industry, avoiding the impact of accidental factors, such as the COVID-19 pandemic, and promoting the overall economic development. Based on multiple regression analysis and grey prediction methods, this article constructs a real estate financial risk estimation model, and the real estate financial risk is estimated using the relevant data of Liaoning Province from 2001 to 2020. Analyzing the research results of financial risks in Liaoning Province, we can find that the real estate financial risks reached the peak in 2013, and then the real estate financial risks gradually showed a slow decline trend. In general, the financial risks in Liaoning Province are controllable. The study of financial risks in Liaoning Province will help to judge the development of the real estate industry and promote the continuous improvement of the overall economy. The article, through the study of real estate financial risks in Liaoning Province, can promote the development of regional real estate in Liaoning Province and promote the overall economic development of Liaoning Province, which has strong practical significance. The study of real estate financial risks, relevant risk research theories can be enriched, the identification of financial risks can be improved, and the study of real estate financial risks can be strengthened. The article uses a combination of multivariate statistics and grey fuzzy theory to complete the study of real estate financial risks. Therefore, through the exploration of multivariate statistics and grey fuzzy theory, its application value can be elevated.


Assuntos
COVID-19 , China/epidemiologia , Humanos , COVID-19/epidemiologia , COVID-19/economia , Desenvolvimento Econômico , Análise Fatorial , SARS-CoV-2/isolamento & purificação , Pandemias/economia
11.
Gesundheitswesen ; 86(5): 389-393, 2024 May.
Artigo em Alemão | MEDLINE | ID: mdl-38316405

RESUMO

AIM OF THE STUDY: The aim of this work was to update the 2015 unit costs (UC) for the monetary valuation of health-related resource use from a societal perspective for the years 2019 and 2020 in Germany. METHODS: The update follows the methodology of Bock et al. 2015. Based on the newly established care levels, UC for care degree 1 to 5 are now provided. To account for change in price trends during the Covid-19 pandemic, average growth rates in UC are shown from 2011-2019 and compared to 2019-2020. RESULTS: Updates of UC for the outpatient medical sector, remedies and aids, hospitals, (in)formal care services, and rehabilitation for 2019 and 2020 are provided. CONCLUSION: The updated UC can be used as reference values for the monetary valuation of individual resource use in health economic evaluations in Germany.


Assuntos
COVID-19 , Custos de Cuidados de Saúde , Pandemias , Alemanha , COVID-19/economia , COVID-19/epidemiologia , Humanos , Custos de Cuidados de Saúde/estatística & dados numéricos , Pandemias/economia , SARS-CoV-2 , Análise Custo-Benefício
12.
Soc Sci Med ; 342: 116534, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38184966

RESUMO

What are the insights from historical pandemics for policymaking today? We carry out a systematic review of the literature on the impact of pandemics that occurred since the Industrial Revolution and prior to Covid-19. Our literature searches were conducted between June 2020 and September 2023, with the final review encompassing 169 research papers selected for their relevance to understanding either the demographic or economic impact of pandemics. We include literature from across disciplines to maximise our knowledge base, finding many relevant articles in journals which would not normally be on the radar of social scientists. Our review identifies two gaps in the literature: (1) the need to study pandemics and their effects more collectively rather than looking at them in isolation; and (2) the need for more study of pandemics besides 1918 Spanish Influenza, especially milder pandemic episodes. These gaps are a consequence of academics working in silos, failing to draw on the skills and knowledge offered by other disciplines. Synthesising existing knowledge on pandemics in one place provides a basis upon which to identify the lessons in preparing for future catastrophic disease events.


Assuntos
Política de Saúde , Pandemias , Humanos , COVID-19/epidemiologia , Influenza Humana/epidemiologia , Pandemias/economia , Pandemias/legislação & jurisprudência , Pandemias/prevenção & controle
13.
Hawaii J Health Soc Welf ; 83(1): 16-24, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38223464

RESUMO

The coronavirus disease 2019 (COVID-19) pandemic has resulted in rapid and drastic changes to daily lives, posing a threat to residents' mental health and well-being. Filipinos are disproportionately impacted by COVID-19 and have one of the highest COVID-19 prevalence in Hawai'i. The COVID-19 pandemic has been associated with a rise in mental health concerns, yet little is known about the impact on the mental health of Filipinos in Hawai'i. Using publicly available polling data from the SMS Community Pulse Survey, this study sought to describe the mental distress experienced by Filipino residents during the COVID-19 pandemic. Data were collected from an online panel of Hawai'i residents over 4 timepoints (May 5-10; June 11-17; July 31-August 8; October 19-31, 2020). Compared to non-Filipinos, a higher proportion of Filipinos reported feeling stress and sadness during 3 of the 4 timepoints. Across all timepoints, Filipinos were more likely to respond affirmatively to mental health indicators (62.5%). Similarly, Filipinos reported food insecurity in higher proportions relative to non-Filipinos in most timepoints, particularly notable in Timepoint 4 where 33.0% of Filipino respondents reported food insecurity. These findings suggest that Filipinos would benefit from social policy and community-supported initiatives to address social determinants of health, reduce chronic stress, and prevent further mental health disparities.


Assuntos
COVID-19 , Saúde Mental , Pandemias , Humanos , Povo Asiático , COVID-19/epidemiologia , Havaí/epidemiologia , Pandemias/economia
14.
Cultur Divers Ethnic Minor Psychol ; 30(2): 385-394, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37199960

RESUMO

OBJECTIVE: Sexual minority adults of Latinx descent faced compounded intersectional stressors during the COVID-19 pandemic across socioeconomic and health domains. Latinx people have experienced some of the highest COVID-19 infection, hospitalization, and mortality rates in the United States in addition to significant economic challenges. Yet, current data have not observed the unique pandemic-related experiences of sexual minority Latinx (SML) adults. We examined sexual identity differences in economic and household stress, social support, mental health symptomatology (depression, anxiety), alcohol, and substance use among sexual minority and nonsexual minority Latinx adults in the United States. METHOD: Primary data were collected via the AmeriSpeak panel, a national probability sample of U.S.-based 2,286 Latinx adults [sexual minority = .34% (n = 465)]. Data were collected from November 2020 to January 2021, during the third wave of the COVID-19 pandemic. RESULTS: SML adults endorsed higher levels of economic and household stress, mental health symptomatology, and alcohol and substance use than nonsexual minority Latinx adults. Economic stress was associated with increased mental health symptomatology, alcohol, and substance use among SML adults. Social support moderated the association between economic stress and mental health symptomatology and substance use, but not alcohol use. CONCLUSION: Findings highlighted unique intersectional considerations among SML adults during the COVID-19 pandemic, including the importance of social support and the negative toll of economic stress on mental health and substance use. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Assuntos
COVID-19 , Estresse Financeiro , Minorias Sexuais e de Gênero , Transtornos Relacionados ao Uso de Substâncias , Adulto , Humanos , COVID-19/epidemiologia , Heterossexualidade , Hispânico ou Latino/psicologia , Saúde Mental , Pandemias/economia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Estados Unidos/epidemiologia
15.
J Racial Ethn Health Disparities ; 10(4): 1597-1604, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-35689156

RESUMO

Black Americans are more likely to be essential workers due to racial capitalism. Because of the COVID-19 pandemic, essential workers are less able to adhere to social distancing and stay-at-home guidelines due to the nature of their work, because they are more likely to occupy crowded households, and are more likely to possess pre-existing health conditions. To assist Black essential workers in preventing infection or reducing the intensity of symptoms if contracted, vaccination against the virus is essential. Unfortunately, Black essential workers face considerable barriers to accessing vaccinations and are hesitant to receive the vaccine due to widespread misinformation and justified historical mistrust of the American medical system. The purpose of this work is to (1) describe the disproportionate impact of COVID-19 on Black essential workers due to racial capitalism, (2) outline the socioeconomic and racial barriers related to vaccination within this population, and (3) to suggest policy-related approaches to facilitate vaccination such as access to on-site vaccination opportunities, the funding of community outreach efforts, and the mandating of increased employee benefits.


Assuntos
População Negra , COVID-19 , Capitalismo , Controle de Doenças Transmissíveis , Equidade em Saúde , Racismo Sistêmico , Humanos , COVID-19/economia , COVID-19/epidemiologia , COVID-19/etnologia , COVID-19/prevenção & controle , Pandemias/economia , Políticas , Política de Saúde/economia , Vacinas contra COVID-19/economia , Vacinas contra COVID-19/provisão & distribuição , Acessibilidade aos Serviços de Saúde/economia , Equidade em Saúde/economia , Racismo Sistêmico/economia , Racismo Sistêmico/etnologia , Controle de Doenças Transmissíveis/economia , Controle de Doenças Transmissíveis/métodos
16.
Nature ; 611(7935): 332-345, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36329272

RESUMO

Despite notable scientific and medical advances, broader political, socioeconomic and behavioural factors continue to undercut the response to the COVID-19 pandemic1,2. Here we convened, as part of this Delphi study, a diverse, multidisciplinary panel of 386 academic, health, non-governmental organization, government and other experts in COVID-19 response from 112 countries and territories to recommend specific actions to end this persistent global threat to public health. The panel developed a set of 41 consensus statements and 57 recommendations to governments, health systems, industry and other key stakeholders across six domains: communication; health systems; vaccination; prevention; treatment and care; and inequities. In the wake of nearly three years of fragmented global and national responses, it is instructive to note that three of the highest-ranked recommendations call for the adoption of whole-of-society and whole-of-government approaches1, while maintaining proven prevention measures using a vaccines-plus approach2 that employs a range of public health and financial support measures to complement vaccination. Other recommendations with at least 99% combined agreement advise governments and other stakeholders to improve communication, rebuild public trust and engage communities3 in the management of pandemic responses. The findings of the study, which have been further endorsed by 184 organizations globally, include points of unanimous agreement, as well as six recommendations with >5% disagreement, that provide health and social policy actions to address inadequacies in the pandemic response and help to bring this public health threat to an end.


Assuntos
COVID-19 , Técnica Delphi , Cooperação Internacional , Saúde Pública , Humanos , COVID-19/economia , COVID-19/epidemiologia , COVID-19/prevenção & controle , Governo , Pandemias/economia , Pandemias/prevenção & controle , Saúde Pública/economia , Saúde Pública/métodos , Organizações , Vacinas contra COVID-19 , Comunicação , Educação em Saúde , Política de Saúde , Opinião Pública
18.
JAMA ; 328(4): 360-366, 2022 07 26.
Artigo em Inglês | MEDLINE | ID: mdl-35797033

RESUMO

Importance: The COVID-19 pandemic caused a large decrease in US life expectancy in 2020, but whether a similar decrease occurred in 2021 and whether the relationship between income and life expectancy intensified during the pandemic are unclear. Objective: To measure changes in life expectancy in 2020 and 2021 and the relationship between income and life expectancy by race and ethnicity. Design, Setting, and Participants: Retrospective ecological analysis of deaths in California in 2015 to 2021 to calculate state- and census tract-level life expectancy. Tracts were grouped by median household income (MHI), obtained from the American Community Survey, and the slope of the life expectancy-income gradient was compared by year and by racial and ethnic composition. Exposures: California in 2015 to 2019 (before the COVID-19 pandemic) and 2020 to 2021 (during the COVID-19 pandemic). Main Outcomes and Measures: Life expectancy at birth. Results: California experienced 1 988 606 deaths during 2015 to 2021, including 654 887 in 2020 to 2021. State life expectancy declined from 81.40 years in 2019 to 79.20 years in 2020 and 78.37 years in 2021. MHI data were available for 7962 of 8057 census tracts (98.8%; n = 1 899 065 deaths). Mean MHI ranged from $21 279 to $232 261 between the lowest and highest percentiles. The slope of the relationship between life expectancy and MHI increased significantly, from 0.075 (95% CI, 0.07-0.08) years per percentile in 2019 to 0.103 (95% CI, 0.098-0.108; P < .001) years per percentile in 2020 and 0.107 (95% CI, 0.102-0.112; P < .001) years per percentile in 2021. The gap in life expectancy between the richest and poorest percentiles increased from 11.52 years in 2019 to 14.67 years in 2020 and 15.51 years in 2021. Among Hispanic and non-Hispanic Asian, Black, and White populations, life expectancy declined 5.74 years among the Hispanic population, 3.04 years among the non-Hispanic Asian population, 3.84 years among the non-Hispanic Black population, and 1.90 years among the non-Hispanic White population between 2019 and 2021. The income-life expectancy gradient in these groups increased significantly between 2019 and 2020 (0.038 [95% CI, 0.030-0.045; P < .001] years per percentile among Hispanic individuals; 0.024 [95% CI: 0.005-0.044; P = .02] years per percentile among Asian individuals; 0.015 [95% CI, 0.010-0.020; P < .001] years per percentile among Black individuals; and 0.011 [95% CI, 0.007-0.015; P < .001] years per percentile among White individuals) and between 2019 and 2021 (0.033 [95% CI, 0.026-0.040; P < .001] years per percentile among Hispanic individuals; 0.024 [95% CI, 0.010-0.038; P = .002] years among Asian individuals; 0.024 [95% CI, 0.011-0.037; P = .003] years per percentile among Black individuals; and 0.013 [95% CI, 0.008-0.018; P < .001] years per percentile among White individuals). The increase in the gradient was significantly greater among Hispanic vs White populations in 2020 and 2021 (P < .001 in both years) and among Black vs White populations in 2021 (P = .04). Conclusions and Relevance: This retrospective analysis of census tract-level income and mortality data in California from 2015 to 2021 demonstrated a decrease in life expectancy in both 2020 and 2021 and an increase in the life expectancy gap by income level relative to the prepandemic period that disproportionately affected some racial and ethnic minority populations. Inferences at the individual level are limited by the ecological nature of the study, and the generalizability of the findings outside of California are unknown.


Assuntos
COVID-19 , Status Econômico , Etnicidade , Expectativa de Vida , Pandemias , Grupos Raciais , COVID-19/economia , COVID-19/epidemiologia , COVID-19/etnologia , California/epidemiologia , Status Econômico/estatística & dados numéricos , Etnicidade/estatística & dados numéricos , Humanos , Renda/estatística & dados numéricos , Expectativa de Vida/etnologia , Expectativa de Vida/tendências , Grupos Minoritários/estatística & dados numéricos , Pandemias/economia , Pandemias/estatística & dados numéricos , Grupos Raciais/estatística & dados numéricos , Estudos Retrospectivos , Fatores Socioeconômicos , Estados Unidos/epidemiologia
19.
Health Econ ; 31(9): 2050-2071, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35771194

RESUMO

Governments worldwide have issued massive amounts of debt to inject fiscal stimulus during the COVID-19 pandemic. This paper analyzes fiscal responses to an epidemic, in which interactions at work increase the risk of disease and mortality. Fiscal policies, which are designed to borrow against the future and provide transfers to individuals suffering economic hardship, can facilitate consumption smoothing while reduce hours worked and hence mitigate infections. We examine the optimal fiscal policy and characterize the condition under which fiscal policy improves social welfare. We then extend the model analyzing the static and dynamic pecuniary externalities under scale economies-the decrease in labor supply during the epidemic lowers the contemporaneous average wage rate while enhances the post-epidemic workforce health and productivity. We suggest that fiscal policy may not work effectively unless the government coordinates working time, and the optimal size of public debt is affected by production technology and disease severity and transmissibility.


Assuntos
COVID-19/economia , COVID-19/epidemiologia , Política Fiscal , Pandemias/economia , Seguridade Social/economia , COVID-19/prevenção & controle , Eficiência , Humanos , Pandemias/prevenção & controle , Pobreza , Salários e Benefícios , Fatores de Tempo , Fluxo de Trabalho , Recursos Humanos/economia , Carga de Trabalho/economia
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