Pub Date : 2024-12-01DOI: 10.1016/j.ssmph.2024.101728
Cristina Gomez-Vidal , Ashley N. Palmer , Katherine Kitchens , G. Allen Ratliff , Genevieve Graaf
Local government policies and practices shape the context of the places that can alter a population's life chances through socioeconomic factors, built environments, and healthcare access. County governments, one of the most ubiquitous U.S. political structures, impact health outcomes within their jurisdiction through multiple policy levers and pathways. By identifying which political determinants within counties are associated with variation in life expectancy and premature death, we can better intervene on modifiable factors. One overlooked political determinant from public health studies is the county's responsibility as the primary local government for approximately a third of the U.S. population and 93% of land in unincorporated areas. To conduct an ecological study and assess associations between county population health and county responsibility for unincorporated areas and populations, we created and tested two county indicators of unincorporation. Multilevel multivariable regression results showed that larger proportions of unincorporated land within a county are associated with lower average county life expectancy. More testing of the measurement is needed to understand the relationship between unincorporation, county government, and population health outcomes.
{"title":"Unincorporation in counties as a political determinant of health: An exploration of five states","authors":"Cristina Gomez-Vidal , Ashley N. Palmer , Katherine Kitchens , G. Allen Ratliff , Genevieve Graaf","doi":"10.1016/j.ssmph.2024.101728","DOIUrl":"10.1016/j.ssmph.2024.101728","url":null,"abstract":"<div><div>Local government policies and practices shape the context of the places that can alter a population's life chances through socioeconomic factors, built environments, and healthcare access. County governments, one of the most ubiquitous U.S. political structures, impact health outcomes within their jurisdiction through multiple policy levers and pathways. By identifying which political determinants within counties are associated with variation in life expectancy and premature death, we can better intervene on modifiable factors. One overlooked political determinant from public health studies is the county's responsibility as the primary local government for approximately a third of the U.S. population and 93% of land in unincorporated areas. To conduct an ecological study and assess associations between county population health and county responsibility for unincorporated areas and populations, we created and tested two county indicators of unincorporation. Multilevel multivariable regression results showed that larger proportions of unincorporated land within a county are associated with lower average county life expectancy. More testing of the measurement is needed to understand the relationship between unincorporation, county government, and population health outcomes.</div></div>","PeriodicalId":47780,"journal":{"name":"Ssm-Population Health","volume":"28 ","pages":"Article 101728"},"PeriodicalIF":3.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142743341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Taiso is a Japanese term encompassing meanings akin to calisthenics. Taiso is a widely used exercise program in Japan but whether it prevents functional disability and dementia remains unclear. This study aimed to elucidate the association between practicing Taiso, especially focusing on the well-known Radio-Taiso, and functional disability and dementia in older adults in Japan.
Methods
This population-based prospective cohort study used data from the Japan Gerontological Evaluation Study (JAGES). The participants were 18,016 people aged 65 years or older who resided in 19 municipalities in Japan and were not certified as needing long-term care at the start of follow-up. The outcomes were all functional disability, moderate-to-severe functional disability, and dementia, during an average of 5.3 years of follow-up. Four groups were created based on type of Taiso practice (None, Radio-Taiso only, Other Taiso only, or Both). The Cox proportional hazards model adjusted for age, sex, equivalized income, educational attainment, household composition, employment status, diseases requiring treatment, activities of daily living, depression, cognitive impairment, and walking duration.
Results
The analysis included data from 11,219 individuals. The mean age of respondents was 74.2 years and 46.3% were men. Compared with the no-practice group, the Other Taiso only group showed a notably decreased risk of all functional disability (hazard ratio [95% CI] 0.87 [0.78–0.96]). The Other Taiso only group was associated with a significant reduction in the hazard ratio for moderate-to-severe functional disability (0.81 [0.70–0.93]). Decreases in the hazard ratio for dementia were also observed in the Radio-Taiso only (0.82 [0.68–0.9998]) and Other Taiso only groups (0.81 [0.70–0.93]).
Conclusions
Practicing Taiso, including Radio-Taiso, may reduce the risk of dementia in older adults, while practicing other types of Taiso may reduce the risk of functional disability.
{"title":"Taiso practice and risk of functional disability and dementia among older adults in Japan: The JAGES cohort study","authors":"Satoru Kanamori , Kenjiro Kawaguchi , Taishi Tsuji , Kazushige Ide , Hiroyuki Kikuchi , Kokoro Shirai , Mitsuya Yamakita , Yuko Kai , Ichiro Kawachi , Katsunori Kondo","doi":"10.1016/j.ssmph.2024.101731","DOIUrl":"10.1016/j.ssmph.2024.101731","url":null,"abstract":"<div><h3>Background</h3><div>Taiso is a Japanese term encompassing meanings akin to calisthenics. Taiso is a widely used exercise program in Japan but whether it prevents functional disability and dementia remains unclear. This study aimed to elucidate the association between practicing Taiso, especially focusing on the well-known Radio-Taiso, and functional disability and dementia in older adults in Japan.</div></div><div><h3>Methods</h3><div>This population-based prospective cohort study used data from the Japan Gerontological Evaluation Study (JAGES). The participants were 18,016 people aged 65 years or older who resided in 19 municipalities in Japan and were not certified as needing long-term care at the start of follow-up. The outcomes were all functional disability, moderate-to-severe functional disability, and dementia, during an average of 5.3 years of follow-up. Four groups were created based on type of Taiso practice (None, Radio-Taiso only, Other Taiso only, or Both). The Cox proportional hazards model adjusted for age, sex, equivalized income, educational attainment, household composition, employment status, diseases requiring treatment, activities of daily living, depression, cognitive impairment, and walking duration.</div></div><div><h3>Results</h3><div>The analysis included data from 11,219 individuals. The mean age of respondents was 74.2 years and 46.3% were men. Compared with the no-practice group, the Other Taiso only group showed a notably decreased risk of all functional disability (hazard ratio [95% CI] 0.87 [0.78–0.96]). The Other Taiso only group was associated with a significant reduction in the hazard ratio for moderate-to-severe functional disability (0.81 [0.70–0.93]). Decreases in the hazard ratio for dementia were also observed in the Radio-Taiso only (0.82 [0.68–0.9998]) and Other Taiso only groups (0.81 [0.70–0.93]).</div></div><div><h3>Conclusions</h3><div>Practicing Taiso, including Radio-Taiso, may reduce the risk of dementia in older adults, while practicing other types of Taiso may reduce the risk of functional disability.</div></div>","PeriodicalId":47780,"journal":{"name":"Ssm-Population Health","volume":"28 ","pages":"Article 101731"},"PeriodicalIF":3.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142756715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-22DOI: 10.1016/j.ssmph.2024.101732
Erin E. Harrington, Jarrod E. Bock
In recent years, more attention has been given to cultural predictors of Alzheimer's disease and related dementias (ADRD) risk. Yet, research has overlooked the potential risk conferred by U.S. cultures of honor. There is ample reason to suspect that honor-oriented states are at greater risk for ADRD, as many of the characteristics of honor-oriented states are also risk factors for ADRD (e.g., rurality, economic precariousness) and norms within honor cultures (e.g., risk taking, military enlistment, intimate partner violence) may elevate the chance of experiencing neurocognitive ADRD risk factors, like traumatic brain injury (TBI) and subjective cognitive decline (SCD). The present work examined the extent to which statewide honor-orientation predicted estimates of unintentional TBI deaths (2001–2019), SCD (2015–2019), and ADRD deaths (1999–2019) among non-Hispanic Whites. We controlled for period-matched variables known to be associated with honor cultures and ADRD (e.g., rurality, economic precariousness). After controlling for covariates, we observed that more honor-oriented states had higher unintentional TBI death rates (β = 0.39, p = .016), SCD (β = 0.58, p = .001), and ADRD death rates (β = 0.49, p = .030). Findings suggest that the norms and values of honor cultures may confer higher risk for TBI, SCD, and ADRD. Implications for educational, identification, and intervention efforts are discussed.
{"title":"Risk factors for Alzheimer's disease and related dementias in U.S. honor cultures","authors":"Erin E. Harrington, Jarrod E. Bock","doi":"10.1016/j.ssmph.2024.101732","DOIUrl":"10.1016/j.ssmph.2024.101732","url":null,"abstract":"<div><div>In recent years, more attention has been given to cultural predictors of Alzheimer's disease and related dementias (ADRD) risk. Yet, research has overlooked the potential risk conferred by U.S. cultures of honor. There is ample reason to suspect that honor-oriented states are at greater risk for ADRD, as many of the characteristics of honor-oriented states are also risk factors for ADRD (e.g., rurality, economic precariousness) and norms within honor cultures (e.g., risk taking, military enlistment, intimate partner violence) may elevate the chance of experiencing neurocognitive ADRD risk factors, like traumatic brain injury (TBI) and subjective cognitive decline (SCD). The present work examined the extent to which statewide honor-orientation predicted estimates of unintentional TBI deaths (2001–2019), SCD (2015–2019), and ADRD deaths (1999–2019) among non-Hispanic Whites. We controlled for period-matched variables known to be associated with honor cultures and ADRD (e.g., rurality, economic precariousness). After controlling for covariates, we observed that more honor-oriented states had higher unintentional TBI death rates (<em>β</em> = 0.39, <em>p</em> = .016), SCD (<em>β</em> = 0.58, <em>p</em> = .001), and ADRD death rates (<em>β</em> = 0.49, <em>p</em> = .030). Findings suggest that the norms and values of honor cultures may confer higher risk for TBI, SCD, and ADRD. Implications for educational, identification, and intervention efforts are discussed.</div></div>","PeriodicalId":47780,"journal":{"name":"Ssm-Population Health","volume":"28 ","pages":"Article 101732"},"PeriodicalIF":3.6,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142719765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-21DOI: 10.1016/j.ssmph.2024.101730
Gia Barboza-Salerno , Sharefa Duhaney , Hexin Yang
This study investigates the spatial accessibility of gun violence exposure along walkable routes to and from schools in Englewood, Chicago. Focusing on both direct and indirect forms of gun violence, the study uses acoustic detection technology to quantify the cumulative burden of gun violence exposure potentially encountered by students during their commute to and from school. We examined the spatial distribution of shooting incidents in proximity to schools using network-constrained kernel density estimation, secondary spatial analysis, and rapid realistic routing. G-function analysis revealed that shooting incidents cluster along streets, including safe passage routes, near schools. An average of 1.30 and 18.06 gunshots were reachable within 5- and 15-min commute times in the morning and afternoon, respectively Our findings underscore the urgent need to reframe the narrative around ‘school gun violence’ to consider exposures that occur in proximity to school boundaries to more effectively reduce violence exposure for youth who walk to school in violence-prone neighborhoods.
{"title":"Spatial accessibility to gun violence exposure on walkable routes to and from school","authors":"Gia Barboza-Salerno , Sharefa Duhaney , Hexin Yang","doi":"10.1016/j.ssmph.2024.101730","DOIUrl":"10.1016/j.ssmph.2024.101730","url":null,"abstract":"<div><div>This study investigates the spatial accessibility of gun violence exposure along walkable routes to and from schools in Englewood, Chicago. Focusing on both direct and indirect forms of gun violence, the study uses acoustic detection technology to quantify the cumulative burden of gun violence exposure potentially encountered by students during their commute to and from school. We examined the spatial distribution of shooting incidents in proximity to schools using network-constrained kernel density estimation, secondary spatial analysis, and rapid realistic routing. G-function analysis revealed that shooting incidents cluster along streets, including safe passage routes, near schools. An average of 1.30 and 18.06 gunshots were reachable within 5- and 15-min commute times in the morning and afternoon, respectively Our findings underscore the urgent need to reframe the narrative around ‘school gun violence’ to consider exposures that occur in proximity to school boundaries to more effectively reduce violence exposure for youth who walk to school in violence-prone neighborhoods.</div></div>","PeriodicalId":47780,"journal":{"name":"Ssm-Population Health","volume":"28 ","pages":"Article 101730"},"PeriodicalIF":3.6,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142702503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Relative deprivation is a critical mechanism for understanding how income inequality affects mental health. However, few studies have compared the effects of objective and subjective relative deprivation on health outcomes. This study compared how objective and subjective relative deprivation and their interaction relate to human flourishing measures, including health, happiness, life satisfaction, social relationships, and financial stability.
Methods
This cross-sectional study analyzed data from 1592 adults in Taiwan. The objective and subjective relative deprivation were measured using the Yitzhaki Index and the Personal Relative Deprivation Scale-Revised (PRDS-R), respectively. We conducted least-squares regression models to investigate the associations between these relative deprivation measures and human flourishing outcomes.
Results
The correlation between the Yitzhaki Index and PRDS-R was 0.16 (p < 0.001). After controlling for absolute income and covariates, the regression models showed that objective and subjective relative deprivation was negatively associated with all six human flourishing outcomes. Notably, subjective relative deprivation is strongly associated with outcomes than objective relative deprivation. Also, the Yitzhaki Index remained adversely associated with all human flourishing outcomes after accounting for the PRDS-R. Furthermore, the interaction between the Yitzhaki Index and PRDS-R was associated with additional risks to well-being, particularly affecting health, happiness, life satisfaction, and financial stability.
Conclusion
Both objective and subjective relative deprivation were negatively associated with multiple dimensions of human flourishing. Policies aimed at addressing relative deprivation and reducing income inequality could contribute to higher levels of health, happiness, life satisfaction, social relationships, and economic stability.
{"title":"Associations of objective and subjective relative deprivation with health, happiness, and life satisfaction","authors":"Chun-Tung Kuo , Duan-Rung Chen , Pei-Shan Liao , Ichiro Kawachi","doi":"10.1016/j.ssmph.2024.101727","DOIUrl":"10.1016/j.ssmph.2024.101727","url":null,"abstract":"<div><h3>Background</h3><div>Relative deprivation is a critical mechanism for understanding how income inequality affects mental health. However, few studies have compared the effects of objective and subjective relative deprivation on health outcomes. This study compared how objective and subjective relative deprivation and their interaction relate to human flourishing measures, including health, happiness, life satisfaction, social relationships, and financial stability.</div></div><div><h3>Methods</h3><div>This cross-sectional study analyzed data from 1592 adults in Taiwan. The objective and subjective relative deprivation were measured using the Yitzhaki Index and the Personal Relative Deprivation Scale-Revised (PRDS-R), respectively. We conducted least-squares regression models to investigate the associations between these relative deprivation measures and human flourishing outcomes.</div></div><div><h3>Results</h3><div>The correlation between the Yitzhaki Index and PRDS-R was 0.16 (p < 0.001). After controlling for absolute income and covariates, the regression models showed that objective and subjective relative deprivation was negatively associated with all six human flourishing outcomes. Notably, subjective relative deprivation is strongly associated with outcomes than objective relative deprivation. Also, the Yitzhaki Index remained adversely associated with all human flourishing outcomes after accounting for the PRDS-R. Furthermore, the interaction between the Yitzhaki Index and PRDS-R was associated with additional risks to well-being, particularly affecting health, happiness, life satisfaction, and financial stability.</div></div><div><h3>Conclusion</h3><div>Both objective and subjective relative deprivation were negatively associated with multiple dimensions of human flourishing. Policies aimed at addressing relative deprivation and reducing income inequality could contribute to higher levels of health, happiness, life satisfaction, social relationships, and economic stability.</div></div>","PeriodicalId":47780,"journal":{"name":"Ssm-Population Health","volume":"28 ","pages":"Article 101727"},"PeriodicalIF":3.6,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142702502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-08DOI: 10.1016/j.ssmph.2024.101725
Rachel Z. Wilkie , Eun Young Choi , Mateo P. Farina , Jinkook Lee , Jennifer A. Ailshire
Introduction
In recent decades, the global population has aged rapidly while socioeconomic inequalities in health have widened, with older adults who are most disadvantaged experiencing the poorest health. Functional limitations are key predictors of disability and quality of life and are therefore considered an important measure of how well individuals and populations are aging. We determine if educational inequalities in functioning have widened over time and across countries.
Methods
We used data from five nationally representative surveys of aging, covering 14 high- and middle-income countries, with harmonized measures of functional limitations. We examined change over time in the number of functional limitations among adults aged 50–64 and 65 and older in each country as well as changes in educational inequality in functional limitations over time for both age groups.
Results
In most high-income countries, the number of functional limitations decreased over time, but they increased in China and Mexico, with the largest increases occurring among adults 65 and older. Educational inequality in functional limitations among those aged 65 and older widened for several countries in our study, but for different reasons. In some countries, it widened due to increased limitations among the least-educated, while in others it widened due to declines in limitations among the most-educated.
Conclusion
Growing educational inequality in functional limitations for older adults in several high- and middle-income countries suggests that, despite improvements in health and mortality, socioeconomic differences in functional health among older adults are widening.
{"title":"Cross national patterns in educational inequalities in functional limitations among middle aged and older adults at two time points","authors":"Rachel Z. Wilkie , Eun Young Choi , Mateo P. Farina , Jinkook Lee , Jennifer A. Ailshire","doi":"10.1016/j.ssmph.2024.101725","DOIUrl":"10.1016/j.ssmph.2024.101725","url":null,"abstract":"<div><h3>Introduction</h3><div>In recent decades, the global population has aged rapidly while socioeconomic inequalities in health have widened, with older adults who are most disadvantaged experiencing the poorest health. Functional limitations are key predictors of disability and quality of life and are therefore considered an important measure of how well individuals and populations are aging. We determine if educational inequalities in functioning have widened over time and across countries.</div></div><div><h3>Methods</h3><div>We used data from five nationally representative surveys of aging, covering 14 high- and middle-income countries, with harmonized measures of functional limitations. We examined change over time in the number of functional limitations among adults aged 50–64 and 65 and older in each country as well as changes in educational inequality in functional limitations over time for both age groups.</div></div><div><h3>Results</h3><div>In most high-income countries, the number of functional limitations decreased over time, but they increased in China and Mexico, with the largest increases occurring among adults 65 and older. Educational inequality in functional limitations among those aged 65 and older widened for several countries in our study, but for different reasons. In some countries, it widened due to increased limitations among the least-educated, while in others it widened due to declines in limitations among the most-educated.</div></div><div><h3>Conclusion</h3><div>Growing educational inequality in functional limitations for older adults in several high- and middle-income countries suggests that, despite improvements in health and mortality, socioeconomic differences in functional health among older adults are widening.</div></div>","PeriodicalId":47780,"journal":{"name":"Ssm-Population Health","volume":"28 ","pages":"Article 101725"},"PeriodicalIF":3.6,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142702501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-08DOI: 10.1016/j.ssmph.2024.101726
Matthew Wallace , Sven Drefahl
International migrants and their children represent increasing shares of the populations of major host countries and have growing potential to affect estimates of national mortality. Yet, while many studies have observed mortality differences between migrants, their children, and the majority population, few have progressed beyond this point to quantify the actual impact of these differences upon national life expectancy levels. Studies that have, reveal that migrants increasingly enhance national life expectancy, but do not progress beyond a single average generational effect. Here, using established demographic methods, we aim to quantify and unpack the impact of migrants and the children of migrants on national life expectancy in Sweden, with emphasis on potential differences by age, generations, and migration background. Going “against the grain” relative to other countries, we reveal an initial negative effect of first-generation migrants on national life expectancy levels in Sweden, followed by a gradual waning and disappearance of this effect over time. This change is attributable to the transformation in origin composition of Sweden's migrant population from migrants born in Nordic countries (that have higher mortality than the majority population) to migrants born in non-Western countries (that have lower mortality than the majority population), particularly at working ages. For children of migrants, nearly all ages and migrant backgrounds contribute to an increasingly negative effect on national life expectancy over time. The unique and disparate mortality risks of migrants, the children of migrants, and the majority population suggest a need to monitor their mortality separately so as to maximise potential future gains in national life expectancy in Sweden.
{"title":"Against the grain: International migrants, the children of migrants and national life expectancy in Sweden, 1990–2019","authors":"Matthew Wallace , Sven Drefahl","doi":"10.1016/j.ssmph.2024.101726","DOIUrl":"10.1016/j.ssmph.2024.101726","url":null,"abstract":"<div><div>International migrants and their children represent increasing shares of the populations of major host countries and have growing potential to affect estimates of national mortality. Yet, while many studies have observed mortality differences between migrants, their children, and the majority population, few have progressed beyond this point to quantify the actual impact of these differences upon national life expectancy levels. Studies that have, reveal that migrants increasingly enhance national life expectancy, but do not progress beyond a single average generational effect. Here, using established demographic methods, we aim to quantify and unpack the impact of migrants and the children of migrants on national life expectancy in Sweden, with emphasis on potential differences by age, generations, and migration background. Going “against the grain” relative to other countries, we reveal an initial negative effect of first-generation migrants on national life expectancy levels in Sweden, followed by a gradual waning and disappearance of this effect over time. This change is attributable to the transformation in origin composition of Sweden's migrant population from migrants born in Nordic countries (that have higher mortality than the majority population) to migrants born in non-Western countries (that have lower mortality than the majority population), particularly at working ages. For children of migrants, nearly all ages and migrant backgrounds contribute to an increasingly negative effect on national life expectancy over time. The unique and disparate mortality risks of migrants, the children of migrants, and the majority population suggest a need to monitor their mortality separately so as to maximise potential future gains in national life expectancy in Sweden.</div></div>","PeriodicalId":47780,"journal":{"name":"Ssm-Population Health","volume":"28 ","pages":"Article 101726"},"PeriodicalIF":3.6,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142651516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-30DOI: 10.1016/j.ssmph.2024.101723
Jeremy Ko , Chun Kai Leung , Harry Fung Lee , Wai Kit Ming
International sanctions are often imposed with the aim of influencing the political behavior of target states, but they may have unintended consequences on public health. This study empirically examines the impact of international sanctions on child immunization rates in developing countries. Utilizing panel data from 76 developing countries between 2000 and 2019, the analysis explores how different types of sanctions, including those from the US, EU, and UN, as well as economic and unilateral sanctions, affect the immunization rates for DPT, Hepatitis B, and Measles vaccines. The findings indicate that sanctions, particularly those imposed by the US and EU, significantly reduce vaccination rates, with economic and unilateral sanctions showing the most substantial negative impact. Additionally, the study highlights the moderating role of health spending, revealing that increased healthcare investment can mitigate some of the adverse effects of sanctions. Poorer developing countries are disproportionately affected compared to their more affluent counterparts. The results underscore the need for policymakers to consider the broader public health implications of sanctions and for international efforts to ensure that essential medical resources remain accessible in sanctioned countries. This study contributes to the literature by providing comprehensive empirical evidence on the detrimental effects of international sanctions on child immunization, advocating for a balanced approach that protects public health while achieving geopolitical objectives.
{"title":"Barriers to child vaccination: The role of international sanctions","authors":"Jeremy Ko , Chun Kai Leung , Harry Fung Lee , Wai Kit Ming","doi":"10.1016/j.ssmph.2024.101723","DOIUrl":"10.1016/j.ssmph.2024.101723","url":null,"abstract":"<div><div>International sanctions are often imposed with the aim of influencing the political behavior of target states, but they may have unintended consequences on public health. This study empirically examines the impact of international sanctions on child immunization rates in developing countries. Utilizing panel data from 76 developing countries between 2000 and 2019, the analysis explores how different types of sanctions, including those from the US, EU, and UN, as well as economic and unilateral sanctions, affect the immunization rates for DPT, Hepatitis B, and Measles vaccines. The findings indicate that sanctions, particularly those imposed by the US and EU, significantly reduce vaccination rates, with economic and unilateral sanctions showing the most substantial negative impact. Additionally, the study highlights the moderating role of health spending, revealing that increased healthcare investment can mitigate some of the adverse effects of sanctions. Poorer developing countries are disproportionately affected compared to their more affluent counterparts. The results underscore the need for policymakers to consider the broader public health implications of sanctions and for international efforts to ensure that essential medical resources remain accessible in sanctioned countries. This study contributes to the literature by providing comprehensive empirical evidence on the detrimental effects of international sanctions on child immunization, advocating for a balanced approach that protects public health while achieving geopolitical objectives.</div></div>","PeriodicalId":47780,"journal":{"name":"Ssm-Population Health","volume":"28 ","pages":"Article 101723"},"PeriodicalIF":3.6,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142572649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-24DOI: 10.1016/j.ssmph.2024.101721
Enrico Ripamonti , Mikael Rostila , Jan Saarela
While bereavement, particularly the loss of a child, is a well-known risk factor for mental health in the short term, its long-term consequences on depressive mood in old age and across different welfare regimes have been investigated less. This study focused on the combined role of child loss and divorce on depressive symptoms, measured using the EURO-D scale in Central, Nordic, Southern, and Eastern European countries. We used data from the European SHARE project, covering 22,959 participants aged 50+ over a 16-year period. Using OLS regressions, we found that, compared to no child loss and no divorce, the association between depressive symptoms and child loss was significant ( = 0.22, 95% C.I. = [0.13, 0.30]), among both women and men. The absolute increase was even stronger when the mutual effect of child loss and divorce was considered ( = 0.34, 95% C.I. = [0.18, 0.48]). Employing Generalized Estimating Equations, we found that depressive symptoms related to divorce did not increase over time, regardless of past bereavement. Compared with people in the Nordic countries, those living in Southern Europe experienced more depressive symptoms related to child loss and no divorce, but fewer depressive symptoms related to the combined effect of child loss and divorce. In sum, our findings indicate that bereavement due to child loss may lead to more depressive symptoms among both women and men in old age, especially in combination with divorce. In the latter case, we posit that participants living in Southern European countries may be protected by higher levels of social support through family ties or informal social networks.
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Pub Date : 2024-10-22DOI: 10.1016/j.ssmph.2024.101722
Robert Rudolf , Najung Kim
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