Stanford University

Health and Medicine

FSI’s researchers assess health and medicine through the lenses of economics, nutrition and politics. They’re studying and influencing public health policies of local and national governments and the roles that corporations and nongovernmental organizations play in providing health care around the world. Scholars look at how governance affects citizens’ health, how children’s health care access affects the aging process and how to improve children’s health in Guatemala and rural China. They want to know what it will take for people to cook more safely and breathe more easily in developing countries.

FSI professors investigate how lifestyles affect health. What good does gardening do for older Americans? What are the benefits of eating organic food or growing genetically modified rice in China? They study cost-effectiveness by examining programs like those aimed at preventing the spread of tuberculosis in Russian prisons. Policies that impact obesity and undernutrition are examined; as are the public health implications of limiting salt in processed foods and the role of smoking among men who work in Chinese factories. FSI health research looks at sweeping domestic policies like the Affordable Care Act and the role of foreign aid in affecting the price of HIV drugs in Africa.

Substance Abuse Policy in Thailand: Current Challenges and Future Strategies

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Abstract
Substance abuse has been an important social and public health problem in Thailand for decades. The National Household Survey on Substance and Alcohol Use in Thailand, which has been conducted six times, shows that substance abuse has steadily increased.
Extrapolated country-wide in recent data, the estimated number of people who have used at least one addictive substance at some time in their lives was 2,964,444 or 5.8% of the total population aged 12 - 65 years. Kratom, Methamphetamine, methamphetamine hydrochloride crystal (ice), and cannabis were the most prevalent substances of abuse.

Historical documentation and policy reports were used in this study. The objectives of this study were to complete a document review, determine the effectiveness of previous measures to control illegal substance abuse in Thailand, and consider options for the future.

Controlling illegal substance abuse in the future and minimizing total harm requires a delicate balance of efforts to reduce the prevalence, quantity, and harmful effects of substances. Drug policy interventions should be continually evaluated for their effectiveness.
The strategies relevant to drug policy, apart from primary prevention, are health services for chronic drug users, reform of criminal sanctions against drug addicts, and legalization of kratom.

Keywords: substance abuse policy, Thailand

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Asia Health Policy Program working paper # 45
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Global Type 2 diabetes – More Than What Meets the Eye

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The Asia Health Policy Program hosted jointly with the School of Medicine,

Health Research and Policy Department, Division of Epidemiology

venkat

Speaker bio: K.M. Venkat Narayan, MD, MSc, MBA. Is Ruth and O.C. Hubert Chair of Global Health, Director, Emory Global Diabetes Research Center and Professor of Medicine & Epidemiology at Emory University in Atlanta, USA.  He was formerly, chief of the diabetes science branch at the US Centers for Disease Control and Prevention (CDC), and intramural scholar at the US National Institutes of Health (NIH). Noted for substantial, multidisciplinary work in diabetes, he has published more than 430 peer-reviewed papers, including several high-impact studies. Narayan’s work exemplifies his leadership in diabetes public health, and he is a member of the US National Academy of Medicine. His other honors include the American Diabetes Associations’ Kelly West award for outstanding achievement in epidemiology, Danish Diabetes Academy Visiting Professor award, Government of India, Nehru Chair 2016, Emory University’s Mentor of the Year award, and   Marion Creekmore award for Internationalization.

Li Ka Shing Center, LK120

Stanford School of Medicine

K. M. Venkat Narayan, MD, MSc, MBA Director, Emory Global Diabetes Research Center Professor of Medicine and Epidemiology Emory University
Seminars

Patient Cost Sharing and Healthcare Utilization in Early Childhood: Evidence from a Regression Discontinuity Design

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This seminar exploits longitudinal claims data and a cost-sharing subsidy that has exempted copayment and coinsurance of healthcare service for children under the age of 3 in Taiwan.  We conduct a regression discontinuity design by comparing the use of healthcare for children just before and just after their third birthdays. Our results show that lower level of cost sharing increases outpatient visits and discourages patients’ price-shopping behavior. In contrast, the utilization of inpatient care for children is price insensitive. Finally, we find little evidence on the impact of the cost-sharing subsidy on children’s short-run or long-run health.

hsien ming lien
Hsien-Ming Lien is currently a visiting Fellow at the Center for Advanced Study in the Behavioral Sciences (CASBS) and a Fulbright Scholar at Stanford University. He is also the Director of the Taiwan Study Center, and Professor in the Department of Public Finance, National Chen-Chi University and an adjunct Professor in the Department of Economics at National Taiwan University, where he teaches health systems, health economics, and econometrics. He earned his B.S. from National Taiwan University, and Ph. D. from Boston University.

Prof Lien’s research focuses on 1) physicians’ behavior; 2) the impact of the National Health Insurance program on the health care market; and 3) the impact of copayments on health care use. Prof Lien is a recipient of the Minister Wang Jin Naw Memorial Award for Best Paper in Health Care Management presented by the Kimma Chang Foundation in 2002, and the Golden Paper Award presented by the Chuang Yi-Chou Foundation in 2009. Prof. Lien has published papers in Health Services Research, Journal of Health Economics, Economic Inquiry, and other journals.  

 

Hsien-Ming Lien Visiting Fellow at the Center for Advanced Study in the Behavioral Sciences (CASBS) and a Fulbright Scholar, Stanford University
Seminars

Welfare Analysis of the Universal Health Care Program in Thailand

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I estimate and decompose the welfare benefit of Thailand's universal health care policy, also known as the “30 Baht program”. The total welfare impact of the 30 Baht program is defined as the amount of consumption that an enrollee would need to give up so as to leave her with the same expected utility as without the 30 Baht program. I find that the total welfare benefit is approximately 75 cents per dollar of government spending. The main source of the welfare effect can be attributed to improved consumption smoothing rather than increases in the consumption level. Using the difference in differences method, I find that the effect of the 30 Baht program on income is significantly positive, while the effect on consumption is slightly negative but not significant. This implies that the 30 Baht program has a positive impact on savings and future consumption, rather than current consumption.

natt 4x6
Natt Hongdilokkul joins the Walter H. Shorenstein Asia-Pacific Research Center (APARC) during the 2017-2018 academic year as a postdoctoral scholar in Developing Asia Health policy. His research interests concern the effect of universal health care on household outcomes and welfare using micro-level panel data in Thailand. He received a PhD and an MA in Economics from Simon Fraser University, Canada, and another MA and a BA in Economics from Thammasat University, Thailand.

Natt Hongdilokkul

616 Serra StreetEncina Hall E301Stanford, CA94305-6055
0
natt_hongdilokkul.jpg Ph.D.

Natt Hongdilokkul joins the Walter H. Shorenstein Asia-Pacific Research Center (APARC) during the 2017-2018 academic year as a postdoctoral scholar in Developing Asia Health policy. His research interests concern the effect of universal health care on household outcomes and welfare using micro-level panel data in Thailand. He received a PhD and an MA in Economics from Simon Fraser University, Canada, and another MA and a BA in Economics from Thammasat University, Thailand.

Developing Asia Health Policy Postdoctoral Fellow, 2017-18
Developing Asia Health Policy Postdoctoral Fellow, 2017-18
Seminars

Boys, Girls, and Grandparents: The Impact of the Sex of Preschool-Age Children on Family Living Arrangements and Maternal Labour Supply

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Abstract

This paper considers household decision making on living arrangements and maternal labor supply in an extended family with young children. In such a context, the decision making is driven by the concern that the companionship of children is a household public good and that family members share childcare and related domestic duties. The incentive to share children’s companionship is affected by son preference, whereas the economic motive of labor division hinges on the potential wage rate of the mother. Both channels play important roles in households with mothers whose wage rates are high,  while sharing the companionship of (grand)sons is the main driving force in households with mothers whose wage rates are low. Using China Health and Nutrition Survey (CHNS) data, we find that among less-educated mothers, the incidence of a family co-residing with the paternal grandmother is at least 8.6 percentage points higher if the firstborn is a boy. At the same time, maternal labor supply increases by 2.9 days per month. By contrast, for educated mothers, the propensity for co-residence is higher, and the working hours are longer than for less-educated mothers, and the impact of the child’s sex is not significant. This paper not only provides a better understanding of the demographic and economic factors determining co-residence and intra-household time allocations, but also lends empirical support to policies aiming to increase female labor supply and improve the well-being of girls.

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Asia Health Policy Program working paper # 44
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Strategies and Tactics to Address the Chronic Disease Burden in India

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In this public colloquium, a leading expert on public health in India discusses strategies and tactics to address the chronic disease burden in India. Drawing from the cutting edge research of the Centre for Chronic Disease Control, D. Prabhakaran will discuss the prevention and management of chronic diseases in India and the developing world, including initiatives to create solutions for cardiovascular disease through translational research and human resource development.

dorairaj prabhakaran

Professor D. Prabhakaran is a cardiologist and epidemiologist by training. He is an internationally renowned researcher and is currently the Vice President- Research & Policy, Public Health Foundation of India, Executive Director of Centre for Chronic Disease Control, New Delhi, India and Professor (Epidemiology) London School of Hygiene and Tropical Medicine, UK. He heads the Centre for Control of Chronic Conditions at PHFI which is a joint initiative of four leading institutions (Public Health Foundation of India, London School of Hygiene and Tropical Medicine, All India Institute of Medical Sciences, New Delhi and Emory University). His work spans from mechanistic research to understand the causes for increased propensity of cardiovascular diseases (CVD) among Indians, to developing solutions for CVD. Prof. Prabhakaran is a Fellow of the Royal College of Physicians, UK, Fellow of the National Academy of Sciences, India, and an Adjunct Professor at the Emory University. He is member of Executive Council of the International Society of Hypertension (ISH) and Chair of the International Society of CVD Epidemiology and Prevention (ISCEP). He has received funding from NHLBI, Wellcome Trust, European Commission and several other international and national funding bodies.  He has mentored over 40 post-doctoral and doctoral students so far. He has authored several chapters and over 375 scholarly papers with an H index of 59. He is the lead editor of the Cardiovascular Disease Volume of the latest Disease Control Priorities Project.

About the Colloquia:

In 2016, the Walter H. Shorenstein Asia-Pacific Research Center, in collaboration with the Stanford Center for South Asia, launched a series of public lectures to broaden our understanding and discussion of contemporary India — its enormous domestic potential and problems, its place in the region and the world, and the ambitious agenda of the new Modi administration. Building on the strong engagement of those issues from across the university community and beyond, we are continuing the series, with generous support from the U.S. India Business Council, in the 2017-2018 academic year. We will  draw business, political, diplomatic and academic experts from the U.S. and India to explore topics including India’s innovation economy, India-China relations, India’s pivotal role in global health, and U.S.-India relations. 

 

This Colloquia is co-sponsored with the U.S.-India Business Council 

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  and the Stanford Center for South Asia

 

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Philippines Conference Room

Encina Hall, 3rd floor, Central

D. Prabhakaran Vice President (Research & Policy), Public Health Foundation of India, Executive Director of Centre for Chronic Disease Control, New Delhi, India
Seminars

Disease Control and Big Data Platforms for Health Policy in China: Experiences from Zhejiang Province

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Co-sponsored by the Center for East Asian Studies and the Asia Health Policy Program

With rapid economic development, changes in lifestyle, epidemiologic transition and the ageing of the population, China’s primary health challenge has become Non-Communicable Diseases (NCDs). Zhejiang province—one of the wealthiest and longest-lived—illustrates how China is responding to this challenge. In Zhejiang, NCDs account for 85% of deaths; the prevalence of hypertension and diabetes are 26.7 % and 7.4%, respectively; and the age of onset of diabetes is getting progressively younger. This seminar will focus on two inter-related strategies: strengthening primary care management of chronic disease, and leveraging newly created regional “big data” platforms to improve policy. Drawing on collaborative research with Stanford’s Asia Health Policy Program, Dr. Zhong will discuss management of hypertension and diabetes patients in community health centers, as well as how Ningbo City of Zhejiang exemplifies the experience of many local governments (municipalities or counties) in building their own regional health information platforms. By gradually collecting all administrative data and other health-related information for their residents from birth to death, including medical claims, vaccination records, lifestyle behaviors, environmental and meteorological factors, and so on, more and more local policymakers seek to analyze big data to explore potential risk factors, pilot targeted interventions, and support evidence-based health policies.

zhong jieming
Zhong, Jieming graduated from the school of public health of Zhejiang University and received his master's degree in public health (MPH) from the Chinese Center for Disease Control and Prevention. He is the director of the Department of Non-communicable Disease (NCD) Control and Prevention in the Zhejiang CDC. He served as deputy director of the Department of Tuberculosis Control and Prevention in Zhejiang CDC during 2008-2014. He is a member of the Zhejiang Preventive Medicine Association and has engaged in and chaired several international cooperation and local research projects. He has in-depth research on NCDs and TB control and prevention, and has published over 30 scientific papers in related fields.

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Zhong Jieming Director of the Department of NCD Control and Prevention, Zhejiang CDC, China.
Seminars

Call for applications: 2018-19 Postdoctoral fellowship in contemporary Asia

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The Shorenstein Asia-Pacific Research Center (APARC) at Stanford is now accepting applications for the Shorenstein Postdoctoral Fellowship in Contemporary Asia, an opportunity made available to two junior scholars for research and writing on Asia.

Fellows conduct research on contemporary political, economic or social change in the Asia-Pacific region, and contribute to Shorenstein APARC’s publications, conferences and related activities. To read about this year’s fellows, please click here.

The fellowship is a 10-mo. appointment during the 2018-19 academic year, and carries a salary rate of $52,000 plus $2,000 for research expenses.

For further information and to apply, please click here. The application deadline is Dec. 20, 2017.

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Natt Hongdilokkul

616 Serra StreetEncina Hall E301Stanford, CA94305-6055
0
natt_hongdilokkul.jpg Ph.D.

Natt Hongdilokkul joins the Walter H. Shorenstein Asia-Pacific Research Center (APARC) during the 2017-2018 academic year as a postdoctoral scholar in Developing Asia Health policy. His research interests concern the effect of universal health care on household outcomes and welfare using micro-level panel data in Thailand. He received a PhD and an MA in Economics from Simon Fraser University, Canada, and another MA and a BA in Economics from Thammasat University, Thailand.

Developing Asia Health Policy Postdoctoral Fellow, 2017-18

Mortality In Rural China Declined As Health Insurance Coverage Increased, But No Evidence The Two Are Linked

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Health insurance holds the promise of improving population health and survival and protecting people from catastrophic health spending. Yet evidence from lower- and middle-income countries on the impact of health insurance is limited. We investigated whether insurance expansion reduced adult mortality in rural China, taking advantage of differences across Chinese counties in the timing of the introduction of the New Cooperative Medical Scheme (NCMS). We assembled and analyzed newly collected data on NCMS implementation, linked to data from the Chinese Center for Disease Control and Prevention on cause-specific, age-standardized death rates and variables specific to county-year combinations for seventy-two counties in the period 2004–12. While mortality rates declined among rural residents during this period, we found little evidence that the expansion of health insurance through the NCMS contributed to this decline. However, our relatively large standard errors leave open the possibility that the NCMS had effects on mortality that we could not detect. Moreover, mortality benefits might arise only after many years of accumulated coverage.

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Health Affairs
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Karen Eggleston
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