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.
Testimony on China's healthcare sector
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On April 3, 2014, Karen Eggleston provided testimony before the U.S-China Economic and Security Review Commission at the "Hearing on China’s Healthcare Sector, Drug Safety, and the U.S.-China Trade in Medical Products."
Some of the questions addressed included:
- How has the nature of disease in China changed in recent decades? What kind of burden might it place on China's future development?
- If providers are "inducing" demand by overprescribing drugs, it this a public health crisis in the making?
- Can you outline the pros and cons of market reform in China's healthcare sector? What might be the proper role of the state of improving healthcare delivery?
- Kan bing nan, kan bing gui (inaccessible and unaffordable healthcare) is one of the top concerns of ordinary Chinese. Which groups are most affected? Is this a global problem, what lessons can we learn from China?
- The pharmaceuticals industry features in China's Medium and Long-term Plan for Science and Technology (2006-2020), as well as in more recent measures to promote indigenous innovation and industrial upgrading. Is it fair to say that the Chinese government is prioritizing domestic pharmaceutical companies, which foster economic growth, over the welfare of patients?
- What were major successes and failures of the 2009 healthcare reforms [in China]? How have those reforms been supplemented by more recent measures (e.g. last November's Third Plenum)?
- What aspects of China's healthcare reform should the U.S. government and U.S. companies pay most attention to?
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Testimonies
Publication Date
Overcoming Health Challenges Facing Mongolia: Medical and Entrepreneurial Perspectives
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Average life expectancy in Mongolia is 65 years, much shorter than that of other East Asian countries such as South Korea (78.5 years) and China (72.5 years). Furthermore, healthy life expectancy in Mongolia is even shorter, rendering the situation even more tragic. The World Health Organization estimates that the healthy life expectancy is 53 years for males and 58 years for females.
This colloquium will provide an overview of health in Mongolia and its healthcare system, with expertise from two speakers. First, Dr. Gendengarjaa Baigalimaa, Developing Asia Health Policy Fellow at Shorenstein APARC, will discuss her comparative study of how knowledge of cervical cancer risk factors has influenced behavior changes in Mongolia before and after the introduction of the National Cervical Cancer Program.
Second, Dr. Dashdorj will present on overview of the healthcare initiatives of the Onom Foundation, designed to mitigate excess and premature mortality of Mongolians via knowledge transfer and entrepreneurship. He will report on a March national health policy meeting in Mongolia’s capital and recent strides in health improvement made with the support of the Onom Foundation.
Gendengarjaa Baigalimaa joins the Walter H. Shorenstein Asia-Pacific Research Center (Shorenstein APARC) during the 2013-2014 academic year as the Developing Asia Health Policy Fellow. She joins APARC from the Mongolian National Cancer Center, where she serves as a Gynecological Oncologist.
During her appointment as Health Policy Fellow, she is completing her comparative study of how knowledge of cervical cancer risk factors has influenced behavior changes in Mongolia before and after the introduction of the National Cervical Cancer Program.
Baigalimaa is the Executive Director of Mongolian Society of Gynecological Oncologists and is also a member of the International Gynecological Cancer Society (IGCS) in Mongolia, Russia, and France.
Baigalimaa holds a MD from Minsk Belarussia Medical University. She also received a Masters in Health Science from Mongolian Medical University. She is fluent in both Russian and English.
Dr. Dashdorj hails from very humble beginnings. He was born and raised in the southwestern outskirts of Mongolia known as Gobi-Altay province, where the Altay Mountains border with the bare rock covered desert basins of the Gobi. Because of the unique upbringing, Dr. Dashdorj has a profound commitment for making a tangible difference in lives of fellow Mongols. At the same time, he strongly believes that entrepreneurship is the best vehicle for making a difference.
He obtained a Ph.D. in physics from Purdue University in 2005 and was a postdoctoral fellow at the US National Institutes of Health. His research using ultrafast optical spectroscopy and time-resolved x-ray imaging techniques is published in 17 original manuscripts in prominent, peer-reviewed scientific journals, such as the Proceedings of the National Academy of Sciences. In 2010, Dr. Dashdorj became a faculty member at the Argonne National Laboratory. Despite his successes in scientific research, he gave up his academic career in 2013 to pursue his entrepreneurial dreams, since he truly believed that he can make a tangible difference via entrepreneurship, experimenting with a model of subsidizing philanthropic actions by a certain percentage of equity and profits of a for-profit company.
Philippines Conference Room
Gendengarjaa Baigalimaa
Shorenstein APARC
Encina Hall E332
616 Serra Street
Stanford, CA 94305-6055
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baigal@stanford.edu
Developing Asia Health Policy Fellow
Gendengarjaa Baigalimaa joins the Walter H. Shorenstein Asia-Pacific Research Center (Shorenstein APARC) during the 2013-2014 acedemic year as the Asia Health Policy Program Fellow. She joins APARC from the Mongolian National Cancer Center, where she serves as a Gynecological Oncologist.
During her appointment as Health Policy Fellow, she will conduct a comparative study of how knowledge of cervical cancer risk factors has influenced behavior changes in Mongolia before and after the introduction of the National Cervical Cancer Program.
Baigalimaa is the Executive Director of Mongolian Society of Gynecological Oncologists and is also a member of the International Gynecological Cancer Society (IGCS) in Mongolia, Russia, and France.
Baigalimaa holds a MD from Minsk Belarussia Medical University. She also received a Masters in Health Science from Mongolian Medical University. She is fluent in both Russian and English.
Naranbaatar Dashdorj
Founder and Chairman of Onom Foundation and a 2014 Sloan Fellow at the Stanford Graduate School of Business
Speaker
Seminars
The Effects of Indonesia's Conditional Cash Transfer Program
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This study analyzes the effects of Indonesia's conditional cash transfer program on the local health care market in terms of price, utilization, and quality of care. The CCT program is associated with increased delivery fees and increased utilization of prenatal care and trained attendants for delivery assistance. Consequently, program participants experience improvements in prenatal care quality.
Margaret Triyana is the Asia Health Policy Post-doctoral fellow. Her main interests are inequality and human capital investments, particularly early health investments in developing countries.
Philippines Conference Room
Encina Hall 3rd Floor Central
616 Serra Street,
Stanford University
Margaret Triyana
Shorenstein APARC
Encina Hall C331
616 Serra Street
Stanford, CA 94305-6055
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mtriyana@stanford.edu
2013-2014 Asia Health Policy Postdoctoral Fellow
Margaret (Maggie) Triyana’s main research interests are inequality and human capital investments in developing countries. In particular, she is interested in the effects social policy changes on children’s health outcomes. As a Postdoctoral Fellow, she will analyze the effects of rural-urban migration in Indonesia and China, as well as the impact of health insurance expansion in Indonesia and Vietnam.
Triyana received a PhD in Public Policy from the University of Chicago in 2013.
Working Papers
“Do Health Care Providers Respond to Demand-Side Incentives? Evidence from Indonesia“
“The Effects of Community and Household Interventions on Birth Outcomes: Evidence from Indonesia”
“The Longer Term Effects of the ‘Midwife in the Village’ Program in Indonesia”
“The Sources of Wage Growth in a Developing Country” (with Ioana Marinescu)
Seminars
Appropriate Body Mass Index and Waist Circumference Cutoff for Overweight and Central Obesity among Adults in Cambodia
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Abstract
Background: Body mass index (BMI) and waist circumference (WC) are used in risk assessment for the development of noncommunicable diseases (NCDs) worldwide. Within a Cambodian population, this study aimed to identify an appropriate BMI and WC cutoff to capture those individuals that are overweight and have an elevated risk of vascular disease.
Methodology/Principal Findings: We used nationally representative cross-sectional data from the STEP survey conducted by the Department of Preventive Medicine, Ministry of Health, Cambodia in 2010. In total, 5,015 subjects between age 25 and 64 years were included in the analyses. Chi-square, Fisher’s Exact test and Student t-test, and multiple logistic regression were performed. Of total, 35.6% (n=1,786) were men, and 64.4% (n=3,229) were women. Mean age was 43.0 years (SD = 11.2 years) and 43.6 years (SD = 10.9 years) for men and women, respectively. Significant association of subjects with hypertension and hypercholesterolemia was found in those with BMI $23.0 kg/m2 and with WC .80.0 cm in both sexes. The Area Under the Curve (AUC) from Receiver Operating Characteristic curves was significantly greater in both sexes (all p-values, 0.001) when BMI of 23.0 kg/m2 was used as the cutoff point for overweight compared to that using WHO BMI classification for overweight (BMI $25.0 kg/m2) for detecting the three cardiovascular risk factors. Similarly, AUC was also significantly higher in men (p-value, 0.001) when using WC of 80.0 cm as the cutoff point for central obesity compared to that recommended by WHO (WC $94.0 cm in men).
Conclusion: Lower cutoffs for BMI and WC should be used to identify of risks of hypertension, diabetes, and hypercholesterolemia for Cambodian aged between 25 and 64 years.
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Publication Type
Journal Articles
Journal Publisher
PLoS ONE
Supplier-induced Demand in Newborn Treatment: Evidence from Japan
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We measure the degree of supplier-induced demand in newborn treatment, by exploiting changes in reimbursement arising from the introduction in Japan of the partial prospective payment system (PPS). Under the partial PPS, neonatal intensive care unit (NICU) utilization became relatively more profitable than other procedures, since it was excluded from prospective payments. We find that hospitals respond to PPS adoption by increasing NICU utilization and more frequently manipulating infants' reported birth weights -- the latter of which is a measure that determines the infant's maximum allowable length of stay in NICU. This induced demand substantially increases hospitals' reimbursements.
Hitoshi Shigeoka received a B.A. (2001) and an MA (2003) in chemical engineering from University of Tokyo, and master of international affairs (2006) and PhD in economics (2012) from Columbia University. Hitoshi’s research interests include health, labor, public economics, and experimental economics. His current research involves estimating the demand elasticity of health care utilization, examining the degree of supplier-induced demand by physicians and hospitals, examining the effects of competition and peer-to-peer teaching on learning, and investigating how the long-term incentives of mothers affect the timing of births.
Philippines Conference Room
Hitoshi Shigeoka
Assistant Professor
Speaker
Simon Fraser University
Seminars
Information, Development, and Life-course Smoking Pattern in Mainland China and Taiwan over 50 Years
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We use retrospectively reported data on smoking behavior of residents of Mainland China and Taiwan to compare and contrast patterns in smoking behavior over the life-course of individuals in these two regions. Because we construct the life-history of smoking for all survey respondents, our data cover an exceptionally long period of time – up to fifty years in both samples. During this period, both societies experienced substantial social and economic changes. The two regions developed at much different rates and the political systems of the two areas evolved in very different ways. More importantly, governments in the two areas set policies that caused the flow of information about the health risks of smoking to differ across the regions and over time. We exploit these differences, using counts of articles in newspapers from 1951 to present, to explore whether and how the arrival of information affected life-course smoking decisions of residents in the two areas. We also present evidence that suggests how prices/taxes and key historical events might have affected decisions to smoke.
Dean Lillard received his PhD in economics from the University of Chicago in 1991. From 1991 to 2012, he was a faculty member and senior research associate in the Department of Policy Analysis and Management at Cornell University. In August 2012 he joined the Department Human Sciences at Ohio State University as an Associate Professor. He is Director and Project Manager of the Cross-National Equivalent File study that produces cross-national data. He is a member of the American Economics Association, the Population Association of America, the International Association for Research on Income and Wealth, the International Health Economics Association, the American Society for Health Economics, a Research Associate at the German Institute for Economic Research in Berlin, Germany, and a Research Associate of the National Bureau of Economic Research. He serves on the advisory board of the Danish National Institute for Social Research in Copenhagen, Denmark and the Cross-National Studies: Interdisciplinary Research and Training Program – a collaborative program run by the Polish Academy of Sciences (PAN), and together with the Mershon Centre at OSU.
Dean Lillard's current research focuses on health economics, the economics of schooling, and international comparisons of economic behavior. His research in health economics is primarily focused on the economics of the marketing and consumption of cigarettes and alcohol. His research on the economics of schooling includes studies of direct effects of policy on educational outcomes and on the role that education plays in other economic behaviors such as smoking, production of health, and earnings. His cross-national research ranges widely from comparisons of the role that obesity plays in determining labor market outcomes to comparisons of smoking behavior cross-nationally.
Philippines Conference Room
Dean R. Lillard
Associate Professor, Department Human Sciences
Speaker
Ohio State University
Seminars