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Kirk R. Smith will speak about his current research on health-damaging and climate-changing air pollution from household energy use in developing Asia, including field measurement and health-effects studies in India, China, and Nepal, compared to other countries such as Mexico and Guatemala. The work encompasses developing and deploying small, smart, and cheap microchip-based monitors as well as tools for international policy assessments.

Dr. Smith is Professor of Global Environmental Health and Director of the Global Health and Environment Program at the School of Public Health at the University of California, Berkeley.  Previously, he was founder and head of the Energy Program of the East-West Center in Honolulu, where he still holds appointment as Adjunct Senior Fellow in Environment and Health after moving to Berkeley in 1995. He serves on a number of national and international scientific advisory committees including the Global Energy Assessment, National Research Council's Board on Atmospheric Science and Climate, the Executive Committee for WHO Air Quality Guidelines, and the International Comparative Risk Assessment. He participated along with many other scientists in the IPCC's 3rd and 4th assessments and thus shared the 2007 Nobel Peace Prize. He holds visiting professorships in India and China and bachelors, masters, and doctoral degrees from UC Berkeley. In 1997, he was elected a member of the US National Academy of Sciences. In 2009, he received the Heinz Prize in Environment.

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Kirk R. Smith Professor of Global Environmental Health and Director of the Global Health and Environment Program at the School of Public Health Speaker University of California, Berkeley
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Populous, economically dynamic, and rapidly urbanizing, the Asia Pacific both reflects and strongly shapes trends in global public health. A comparative assessment of chronic disease prevalence, risk factors, and policy responses in nine Pacific Rim cities shows that chronic diseases are rapidly becoming the leading cause of morbidity and mortality even in the lower income cities of the Pacific Rim. Policy responses are heterogeneous, with few sufficiently funded or adequately informed by evidence. Much could be learned from comparative research and rigorous evaluation of prevention and control initiatives in this region.

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Asia Health Policy Program working paper #21
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The objective of this paper is to estimate the causal effect of coresidence with an adult child on depressive symptoms among older widowed women in South Korea. Data from the first and second waves of the Korea Longitudinal Study of Aging were used. Analysis was restricted to widowed women aged ≥ 65 years with at least one living child (N=2,449). We use an instrumental variable approach that exploits the cultural setting where number of sons predicts the probability of an elderly woman's coresidence with an adult child but is not directly correlated with the mother's depressive symptoms. Our models adjust for age, education, total assets, residence, functional limitations, self-rated health, and various illnesses. Our robust estimation results indicate that, among older widowed women, coresidence with an adult child has a significant protective effect on depressive symptoms, but that this effect does not necessarily benefit those with clinically relevant depressive symptoms. Future demographic and social transitions in South Korea portend that older women’s increasing vulnerability to poor mental health is an important though less visible public health challenge.
Keywords: living arrangements, coresidence, depressive symptomatology, elderly, KLoSA

Published: Do, Young Kyung, and Chetna Malhotra. "The effect of coresidence with an adult child on depressive symptoms among older widowed women in South Korea: an instrumental variables estimation." The Journals of Gerontology Series B: Psychological Sciences and Social Sciences 67.3 (2012): 384-391.

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Asia Health Policy Program working paper #20
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Young Kyung Do
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In the past year, AHPP faculty affiliate Matthew Kohrman published in the Asia-Pacific Journal of Public Health a critical assessment of international anti-tobacco interventions. He has also been quoted in Science, Harvard Global Health Review, and Stanford University News regarding tobacco-control efforts in China and around the world.
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How will population aging impact the economies and social protection systems of Japan, South Korea, China, and India? This colloquium showcases research addressing that question by contributors to a new Shorenstein APARC book, Aging Asia, co-edited by Karen Eggleston and Shripad Tuljapurkar. Dr. Bloom discusses how aging of the baby boom generation, declines in fertility rates, and an increase in life expectancy imply several changes for the economies of the region. Notwithstanding the potential challenges, Bloom argues that population aging may have less of a negative effect on economic growth than some have predicted. Bloom will also discuss the longitudinal aging study in India.

David Bloom is Clarence James Gamble Professor of Economics and Demography at Harvard University, Chair of the Department of Global Health and Population at the Harvard School of Public Health, and Director of Harvard University’s Program on the Global Demography of Aging (funded by the National Institute of Aging). He is Research Associate at the National Bureau of Economic Research, where he serves as a member of three research programs: Labor Studies, Aging, and Health Economics. He co-chairs the Public Policy Committee of the American Foundation for AIDS Research. Bloom received a B.S. in Industrial and Labor Relations from Cornell University in 1976, an M.A. in Economics from Princeton University in 1978, and a Ph.D. in Economics and Demography from Princeton University in 1981.

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David Bloom Clarence James Gamble Professor of Economics and Demography Speaker Harvard University
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The prevalence of antimicrobial resistance (AR) limits the therapeutic options for treatment of infections, and increases the social benefit from disease prevention. Like an environmental resource, antimicrobials require stewardship. The effectiveness of an antimicrobial agent is a global public good. We argue for greater use of economic analysis as an input to policy discussion about AR, including for understanding the incentives underlying health behaviors that spawn AR, and to supplement other methods of tracing the evolution of AR internationally. We also discuss integrating antimicrobial stewardship into global health governance.The prevalence of antimicrobial resistance (AR) limits the therapeutic options for treatment of infections, and increases the social benefit from disease prevention. Like an environmental resource, antimicrobials require stewardship. The effectiveness of an antimicrobial agent is a global public good. We argue for greater use of economic analysis as an input to policy discussion about AR, including for understanding the incentives underlying health behaviors that spawn AR, and to supplement other methods of tracing the evolution of AR internationally. We also discuss integrating antimicrobial stewardship into global health governance.

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International Journal of Environmental Research and Public Health
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Karen Eggleston
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3141-3149
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With the rapid growth of the Chinese economy and transition from central planning to a more market-oriented structure since the 1980s, private health care providers have gained market share, especially in provision of primary health care, despite legal and administrative obstacles.  To reach the goals for universal health care coverage, access and quality announced in April 2009 as part of China’s new health reforms, effective government stewardship of non-state health care providers will be crucial. This presentation will give an overview of private providers in the grass roots health delivery system in urban and rural China, as well as evidence from field study. Policy trends in stewardship, contracting out and how private providers can better participate in universe health insurance are discussed.

Yan Wang is deputy director of the Disease Control Division for the Shandong Province Health Department, China, and a visiting scholar with the Asia Health Policy Program at the Shorenstein Asia Pacific Research Center at Stanford University in 2009-2010. She received her Ph.D. in public health from Shandong University and has been in charge of managing rural and urban community health services for Shandong’s 90 million residents for 10 years. Her research interests focus on evidence to improve policies for primary health care, health insurance, and health promotion.

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Shorenstein APARC
Stanford University
Encina Hall, Room E-301
Stanford, CA 94305-6055

(650) 391-7164 (650) 723-6530
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AHPP Visiting Scholar, 2009-2010
wy-photo.jpg PhD

Dr. Yan Wang is a visiting scholar at Shorenstein Asia-Pacific Research Center for 2009-2010. Her research focuses on tobacco control, primary health care system, health education and health promotion, and health insurance. She is currently also the group manager of Division of Grass-Root Health Services, Shandong Provincial Health Department, P.R.China, and is in charge of urban community health services, health education and health promotion. She has an MA in public health from Shandong Medical University and PhD in Social Medicine and Health Management from Shandong University. Dr. Yan Wang has been an adjunct professor at Weifang Medical University since 2008. She also engaged in academic association and public organizations related to health affair.

Yan Wang Deputy Director, Disease Control Division Speaker Shandong Province Health Department, China
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When one can circle the globe in less than the time of incubation of most infectious pathogens, it is clear every country relies to some extent on the health systems of other countries to prevent and protect their citizens from global health threats. Therefore, creating and maintaining a good health system in one country requires attention to interregional and international cooperation. Domestic and international spheres of public health policies are becoming more intertwined and inseparable.

PUBLISHED: Qiong Zhang, Karen Eggleston (翁笙和), and Michele Barry, 2009. “Pandemic Influenza and the Globalization of Public Health” (流感大流行与公共卫生全球化), Comparative Studies 比较 (42):  (Beijing: China CITIC Press): 47-52.

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Asia Health Policy Program working paper #11
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Karen Eggleston
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China continues to face great challenges in meeting the health needs of its large population. The challenges are not just lack of resources, but also how to use existing resources more efficiently, more effectively, and more equitably. Now a major unaddressed challenge facing China is how to reform an inefficient, poorly organized health care delivery system. The objective of this study is to analyze the role of private health care provision in China and discuss the implications of increasing private-sector development for improving health system performance.

This study is based on an extensive literature review, the purpose of which was to identify, summarize, and evaluate ideas and information on private health care provision in China. In addition, the study uses secondary data analysis and the results of previous study by the authors to highlight the current situation of private health care provision in one province of China.

This study found that government-owned hospitals form the backbone of the health care system and also account for most health care service provision. However, even though the public health care system is constantly trying to adapt to population needs and improve its performance, there are many problems in the system, such as limited access, low efficiency, poor quality, cost inflation, and low patient satisfaction. Currently, private hospitals are relatively rare, and private health care as an important component of the health care system in China has received little policy attention. It is argued that policymakers in China should recognize the role of private health care provision for health system performance, and then define and achieve an appropriate role for private health care provision in helping to respond to the many challenges facing the health system in present-day China.

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Asia Health Policy Program working paper #10
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