AHPP runs its own working paper series and regularly contributes edited volumes that are distributed through the Walter H. Shorenstein Asia-Pacific Research Center’s publishing program. Our faculty and researchers also publish extensively in peer-reviewed academic journals and in scholarly and trade presses. Browse our publications below.
AHPP Working Paper Series
Introduction. This study investigated the intensity of cigarette consumption and its correlates in China among urban male factory workers, a cohort especially vulnerable to tobacco exposure, one that appears to have benefitted little from recent public health efforts to reduce smoking rates.
Methods. Data were collected from men working in factories of Kunming city, Yunnan, China, who are current daily smokers (N = 490). A multinomial logistic regression was conducted to examine the factors in association with smoking intensity in light, moderate, and heavy levels.
Results. Light smoking correlated with social smoking, smoking the first cigarette later in the day, self-reported health condition, and quit intention. Heavy smoking was associated with purchase of lower priced cigarettes, difficulty refraining from smoking, and prehypertensive blood pressure.
Conclusion. Even in regions where smoking is highly prevalent, even among cohorts who smoke heavily, variation exists in how cigarettes are consumed. Analyses of this consumption, with special consideration given to smoking intensity and its correlates, can help guide tobacco-control strategists in developing more effective interventions.
Much research has linked an increase in adult mortality with the socioeconomic transition of former European socialist societies after 1989. Few studies examine corresponding experiences in China, however. Using the death certificates of Shanghai residents, we examined any such sudden mortality change and crisis when China went through economic transformation. We explored trends in life expectancy at birth and age-specific mortality in Shanghai.
This paper investigates whether agricultural households in the rural Philippines insure their consumption against income shocks and whether they use migration, remittances, informal loans, or assets as ex post risk-coping mechanisms. Since these households have limited access to formal insurance and credit markets, any shocks to their volatile income can have substantial impacts. Using panel data, and rainfall shocks as the instrumental variable for income shocks, this paper finds little evidence of effective risk-sharing within the networks of family and friends.
Nutrition, physical activity, smoking, and alcohol consumption are major causes of morbidity and mortality related to noncommunicable diseases (NCDs). Hypertension, diabetes type II, cancer, and chronic pulmonary diseases cause 60 percent of deaths worldwide and will likely increase by 17 percent during the next 10 years. Eighty percent of deaths caused by NCDs are registered in low- and middle-income countries in the working-age population and contribute to the growth of poverty [1,2,3].
The share of increases in life expectancy realized after age 65 was only about 20 percent at the beginning of the 20th century for the United States and 16 other countries at comparable stages of development; but that share was close to 80 percent by the dawn of the 21st century, and is almost certainly approaching 100 percent asymptotically. This new demographic transition portends a diminished survival effect on working life. For high-income countries at the forefront of the longevity transition, expected lifetime labor force participation as a percent of life expectancy is declining.
The elderly share of China’s population is projected to grow well beyond the capacity of the nation’s social security system. Meanwhile, family care is being challenged by a decline in fertility and an increase in migration from rural to urban areas. This paper examines the short-, mid-, and long-term effects of family support on elderly well-being in rural China, using four-wave panel data on 1,456 persons aged 60 and above in the Chaohu region of China.
In tropical settings, malaria education at school is potentially useful, but textbook content related to malaria education has so far received little attention. This study aimed to examine whether school textbooks contain sufficient knowledge and skills to help children in primary and lower secondary schools and their family members to cope with malaria.
As China's economy grows so does the prevalence of social inequality. In a YaleGlobal Online article, a team of Shorenstein APARC China experts says the country must invest more now in education and public health programs for its rural children or it will face major growth challenges in the near future.
Emerging infectious diseases (EIDs) pose international security threats because of their potential to inflict harm upon humans, crops, livestock, health infrastructure, and economies. The following questions stimulated the research described in this paper: What infrastructure is necessary to enable EID surveillance in developing countries? What cultural, political, and economic challenges stand in the way of setting up such infrastructure? And are there general principles that might guide engagement with developing countries and support EID surveillance infrastructure?
What kind of a health care system do China’s 1.3 billion turn to when ill, injured, or in need of care? This article provides a brief overview of how China’s health system has transformed alongside China’s society and economy since the Mao era, including how the current system is financed, organized, regulated, and being reformed. It first provides a brief description of the Mao-era health system and China’s demographic and epidemiologic transitions.
This paper uses macro-level data between 1997 and 2008 to evaluate the effects of China’s pharmaceutical price regulations. We find that these regulations had short-run effects on medicine price indexes, reducing them by less than 0.5 percentage points. The effects could have been slightly reinforced when these regulations were imposed on more medicines. However, these regulations failed to reduce household health expenditures and the average profitability of the pharmaceutical industry, and firms on the break-even edge were worse off.
Consistent with the property rights theory of ownership incorporating soft budget constraints (SBCs), we find that controlling for SBCs, for-profit hospitals drop safety-net services more often and exhibit higher mortality rates, suggesting aggressive cost control that damages non-contractible quality.
Established in 2007, the Asia Health Policy Program (AHPP) promotes a comparative understanding of health and health policy in the Asia-Pacific region through research, collaboration with scholars throughout the region, a colloquium series on health and demographic change in the Asia-Pacific, and conferences and publications on comparative
health policy topics.
China’s economic growth over the past three decades is unprecedented. Although this growth is commonly attributed to a high domestic savings rate among “thrifty” Chinese, savings alone cannot promote economic growth unless productivity has continuously grown for such a long period. This article uses a one-sector, neoclassical growth model to calibrate the economy to Chinese data since 1952 and finds that measuring changes in total factor productivity between 1952 and 2005 can well capture the secular movements in the Chinese savings rate.
Health systems provide a rich field for testing hypotheses of institutional economics. The incentive structure of current healthcare delivery systems have deep historical and cultural roots, yet must cope with rapid technological change as well as market and government failures. This paper applies the economic approach of comparative and historical institutional analysis (Aoki, 2001; Greif, 2006) to health care systems by conceptualizing physician control over dispensing revenues as a social institution.
The economic reforms of the past two decades have initiated a major social transition in China, characterized by unprecedented social mobility and stratification. Meanwhile, the privatization of health care has increased costs to the consumer and further changed familial and social norms. While such changes would logically affect individuals’ psychological well-being, little attention has been paid to their impact in this regard.
Objective To investigate educational disparities in the care process and health outcomes among patients with diabetes in the context of South Korea's universal health insurance system.
Design Bivariate and multiple regression analyses of data from a cross-sectional health survey.
Setting A nationally representative and population-based survey, the 2005 Korea National Health and Nutrition Examination Survey.
Although U.S. health care expenditures reached 17.6 percent of GDP in 2009, quality measurement in this important service sector remains limited. Studying quality changes associated with 11 years of health care for patients with diabetes, the authors find that the value of reduced mortality and avoided treatment spending, net of the increase in annual spending, was $9,094 for the average patient. These results suggest that the unit cost of diabetes treatment, adjusting for the value of health outcomes, has been roughly constant.
We derived equations for predicting cardiovascular disease (CVD) risks for Thai men and women, separately, over a specific time period using associations between risk factors and CVD events from the Framingham cohort study. The equations were recalibrated against the cumulative risks estimated for Thailand. Equations were developed separately for predicting risks of ischemic heart disease (IHD) and stroke. Recalibration of the Framingham equations reduced the CVD risks predicted for Thai men by 97% and for Thai women by 10%. The correction was largest at younger ages.
In the past fifty years, two factors have led to global population aging: a decline in fertility to levels close to—or even below—replacement and a decline in mortality that has increased world average life expectancy by nearly 67 percent. As the population skews toward fewer young people and more elderly who live longer postretirement lives, demographic changes—labor force participation, savings, economic growth, living arrangements, marriage markets, and social policy—are transforming society in fundamental, irreversible ways.