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A favorite icon for cigarette manufacturers across China since the mid-twentieth century has been the panda, with factories from Shanghai to Sichuan using cuddly cliché to market tobacco products. The proliferation of panda-branded cigarettes coincides with profound, yet poorly appreciated, shifts in the worldwide tobacco trade. Over the last fifty years, transnational tobacco companies and their allies have fueled a tripling of the world's annual consumption of cigarettes. At the forefront is the China National Tobacco Corporation, now producing forty percent of cigarettes sold globally. What's enabled the manufacturing of cigarettes in China to flourish since the time of Mao and to prosper even amidst public health condemnation of smoking? 

 

In Poisonous Pandas, an interdisciplinary group of scholars comes together to tell that story. They offer novel portraits of people within the Chinese polity—government leaders, scientists, tax officials, artists, museum curators, and soldiers—who have experimentally revamped the country's pre-Communist cigarette supply chain and fitfully expanded its political, economic, and cultural influence. These portraits cut against the grain of what contemporary tobacco-control experts typically study, opening a vital new window on tobacco—the single largest cause of preventable death worldwide today.

You can read the Introduction and Chapter 1 online.

About the editors

 
Matthew Kohrman is Associate Professor of Anthropology at Stanford University.
 
Gan Quan is the Director of Tobacco Control of the International Union Against Tuberculosis and Lung Disease.
 
Liu Wennan is Editor for the Institute of Modern History at the Chinese Academy of Social Sciences.

 

Robert N. Proctor is Professor of the History of Science at Stanford University.
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Stanford University Press
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Matthew Kohrman
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978-1503602-06-9
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Despite recent reductions in prevalence, China still faces a substantial tuberculosis (TB) burden, with future progress dependent on the ability of rural providers to appropriately detect and refer TB patients for further care. This study (a) provides a baseline assessment of the ability of rural providers to correctly manage presumptive TB cases; (b) measures the gap between provider knowledge and practice and; (c) evaluates how ongoing reforms of China’s health system—characterized by a movement toward “integrated care” and promotion of initial contact with grassroots providers—will affect the care of TB patients.

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PLOS Medicine
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Scott Rozelle
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Improving the quality of primary care may reduce avoidable hospital admissions. Avoidable admissions for conditions such as diabetes are used as a quality metric in the Health Care Quality Indicators of the Organization for Economic Cooperation and Development (OECD). Using the OECD indicators, we compared avoidable admission rates and spending for diabetes-related complications in Japan, Singapore, Hong Kong, and rural and peri-urban Beijing, China, in the period 2008–14. We found that spending on diabetes-related avoidable hospital admissions was substantial and increased from 2006 to 2014. Annual medical expenditures for people with an avoidable admission were six to twenty times those for people without an avoidable admission. In all of our study sites, when we controlled for severity, we found that people with more outpatient visits in a given year were less likely to experience an avoidable admission in the following year, which implies that primary care management of diabetes has the potential to improve quality and achieve cost savings. Effective policies to reduce avoidable admissions merit investigation.

 

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Health Affairs
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Karen Eggleston
616 Serra StreetEncina Hall E301Stanford, CA94305-6055
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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
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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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Karen Eggleston
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Rural areas of China have made remarkable progress in reducing adult mortality within the past 15 years yet broadened health insurance was not a casual factor in that decline, according to a new study by an international research team that includes Asia Health Policy Program Director Karen Eggleston.

The New Cooperative Medical Scheme (NCMS), a government-subsidized insurance program that began in 2002-03, expanded to cover all of rural China within a decade. Examining NCMS and cause-specific mortality data for a sample of 72 counties between 2004 and 2012, the researchers found that there were no significant effects of health insurance expansion on increased life expectancy.

The study, published in the September issue of Health Affairs, showed results consistent with previous studies that also did not find a correlation between insurance and survival, although much research confirms NCMS increased access to healthcare, including preventive services, and shielded families from high health expenditures.

Commenting on the study, Eggleston said population health policies remain central to China’s efforts to increase life expectancy and to bridge the gap between rural and urban areas.

Eggleston also noted that multiple factors beyond the availability of health care determine how long people live, and anticipates the research team will continue to explore the impacts of NCMS by extending the study to look at infants and youth.

Read the study (may require subscription) and view a related article on the Stanford Scope blog.

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Farmers dry star anise seeds in a country yard in Tanbin Township, China, Nov. 26, 2005.
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The Asia Health Policy Program at the Shorenstein Asia-Pacific Research Center, in conjunction with The Next World Program, is soliciting papers for a workshop, “Inequality & Aging,” held at the University of Hohenheim from May 4-5, 2018. The workshop will result in a special issue of the Journal of the Economics of Ageing, and aims to address topics such as:

  • Population dynamics and income distribution
  • The evolution of inequality over time and with respect to age
  • Health inequality in old age
  • The effects of social security systems and pension schemes on inequality
  • Policies to cope with demographic challenges and the challenges posed by inequality
  • Family backgrounds and equality of opportunities
  • Demographically induced poverty traps
  • Effects of automation and the digital economy in ageing societies
  • Flexible working time and careers, and their long-term implications
  • The dynamics of inheritances, etc.

Researchers who seek to attend the workshop are invited to submit a full paper or at least a 1-page extended abstract directly to Klaus Prettner and Alfonso Sousa-Poza by Sept. 30, 2017.

Authors of accepted papers will be notified by the end of October and completed draft papers will be expected by Jan. 31, 2018. Economy airfare and accommodation will be provided to one author associated with each accepted paper. A selection of the presented papers will be published in the special issue; the best paper by an author below the age of 35 will receive an award and be made available online as a working paper.

Researchers who do not seek to attend the workshop are also invited to submit papers for the special issue. Those papers can be submitted directly online under “SI Inequality & Ageing” by May 31, 2018.

For complete details, please click on the link below to view the PDF.

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