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Purpose: In spite of the apparent increases in family and community violence, research into its effects on adolescent mental health has received limited attention in Cambodia. This study examines the association between exposure to violence and depressive symptoms among adolescents controlling for the effects of several factors in family and school domains.

Methods: We randomly selected 993 male and 950 female students proportionally from 11 junior high schools and high schools in Battembang provincial city. Students were questioned about the violence to which they were subjected and which they witnessed in their family and community. The Asian Adolescent Depression Scale was used to measure depressive symptoms.

Results: In this study, 27.9 % of male students and 21.5 % of female students had been victimized in at least one case of family violence, while 18.0 % of male and 5.8 % of female students had been victimized in at least one case of community violence. After adjustment, increased levels of depressive symptoms were significantly associated with being the victim of or witnessing family or community violence among both male and female students. However, the positive association between the levels of depressive symptoms and being a witness to community violence was found only in female students.

Conclusions: Efforts to prevent depression in adolescent students should focus on reducing family and community violence; such efforts should also consider gender differences.

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Social Psychiatry and Psychiatric Epidemiology
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Siyan Yi
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Population aging in Asian societies is accompanied by changes in intergenerational living arrangements, which can have substantial health and economic implications for the elderly parents and their adult children. Dr. Young Kyung Do will present some of his recent works related to elderly living arrangements in South Korea. These works include the effect of coresidence with an adult child on depressive symptoms among older widowed women; the relationship between adult children's coresidence with parents and their labor force participation; and interrelations between expectations about bequests and informal care with special emphasis on the role of intergenerational coresidence. In these studies, Dr. Do attempted to account for a common methodological issue: living arrangements are not always randomly assigned but may be jointly decided with the outcome of interest taken into account by either the elderly parents or their adult children. While this seminar will focus on the South Korean context, the significance and implications apply to many other Asian societies undergoing population aging and marked transitions in elderly living arrangements.

Dr. Young Kyung Do is an assistant professor at the Duke-National University of Singapore Graduate Medical School (Duke-NUS), Program in Health Services and Systems Research. His research interests include the economic and health system impact of population aging and noncommunicable disease; interactions between self-care, informal care, and formal care interfaces; and health, education, and labor market outcomes over the life course. He received his MD (1997) and master of public health (2003) degrees from Seoul National University, subsequently completing his PhD in Health Policy and Management (2008) at the University of North Carolina at Chapel Hill. He was the inaugural Asia Health Policy postdoctoral fellow at the Shorenstein Asia-Pacific Research Center,(2008−9).

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Postdoctoral Fellow in Asia Health Policy Program, 2008-09
Do.JPG MD, PhD

Young Kyung Do is the inaugural Postdoctoral Fellow in the Asia Health Policy Program at the Walter H. Shorenstein Asia-Pacific Research Center. He completed his Ph.D. in health policy and administration at the University of North Carolina at Chapel Hill School of Public Health in August 2008. He has also earned M.D. and Master of Public Health degrees from Seoul National University (in 1997 and 2003, respectively). He earned board certification in preventive medicine from the Korean Medical Association in 2004. His research interests include population aging and health care, comparative health policy, health and development, quality of care, program evaluation, and quantitative methods in health research.

He received the First Prize Award in the Graduate Student Paper Competition in the Korea Labor and Income Panel Study Conference in 2007. He also is the recipient of the Harry T. Phillips Award for Outstanding Teaching by a Doctoral Student from the UNC Department of Health Policy and Administration in 2007. In May 2008, he was selected as a New Investigator in Global Health by the Global Health Council.

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Young Kyung Do Assistant Professor Speaker the Duke-National University of Singapore Graduate Medical School Singapore (Duke-NUS)
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The Asia Health Policy Program (AHPP) at Stanford’s Shorenstein Asia-Pacific Research Center (Shorenstein APARC) looks forward to welcoming its incoming 2012–13 research fellows from Mongolian Medical University, the University of Hawai’i, and Harvard. AHPP’s new fellows specialize in research topics including cervical cancer prevention, migrant remittances, and the political economy of support for the elderly.
 

Developing Asia Health Policy Fellows

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Baigalimaa Gendendarjaa

Baigalimaa Gendendarjaa will be joining AHPP from the Mongolian National Cancer Center. Her research includes 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. She holds a master’s degree in medicine from Mongolian Medical University.

 

 


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Marjorie Pajaron
Marjorie Pajaron took part for five years in the National Transfer Accounts project based in Honolulu. Her research focuses on the role of migrant remittances as a risk-coping mechanism, as well as the importance of bargaining power in the intra-household allocation of remittances in the Philippines. Pajaron received a PhD in economics from the University of Hawai’i at Mānoa.

 

 

 


Asia Health Policy Postdoctoral Fellow 

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Yuki Takagi

Yuki Takagi earned her PhD in government from Harvard University and is completing a postdoctoral fellowship at Princeton. Her dissertation research focuses on the political economy of support for the elderly and intergenerational family transfers, such as nursing and childcare, focusing on Japan. Takagi holds bachelor of economics and master of law degrees from the University of Tokyo.

 

 

Throughout the academic year the AHPP fellows will present seminars, take part in individual and collaborative research projects, and participate in campus events.

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The recent South China Sea standoff between China and the Philippines calls into question the U.S. role and commitment in the Asia-Pacific region. Stanford experts Donald K. Emmerson and Thomas Fingar speak about the nuances of the Obama administration's Asia policy.
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Hillary Clinton departs a U.S. navy ship docked in Manila Bay, November 2011.
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Scarborough Shoal, a tiny rocky outcropping and lagoon off the west coast of the Philippines, sits at the center of the latest South China Sea tug-of-war. Protesters took to the streets in Manila on May 11 to criticize China’s support of fishermen who entered the disputed territory a month ago and sparked a yet unresolved naval standoff between the Philippines and China. On May 9, while ships from both sides maneuvered in the area, Manila's secretary of defense assured Filipinos that if Beijing attacked, Washington would come to the country’s defense.  

That expectation had been strengthened in Manila in November 2011 when the visiting American secretary of state, Hillary Clinton, referred to the South China Sea as the “West Philippine Sea.” Clinton’s slip of the tongue was not a major diplomatic incident. But some Flipinos saw it as a sign of U.S. support for their government's maritime claims.

Washington’s refusal to side with any of the claimant states had not changed. What had changed was the level of American concern. In the November 2011 issue of Foreign Policy Clinton had defended the idea of a “pivot” toward Asia, meaning a renewed U.S. focus on Asia after a decade of intense military activity in Afghanistan and Iraq.

The term “pivot” has fallen out of favor in Washington, but the Obama administration’s heightened interest in Asia is real and ongoing, says Donald K. Emmerson, director of Stanford’s Southeast Asia Forum. He recently discussed the nuances of what he describes as an important but “lopsided pivot.”

How does the pivot fit into the larger global picture?

In the continuing debate as to whether the United States is in decline, the key question is: relative to what? Certainly, if we compare the situation now with the period immediately after World War II, the United States is less powerful relative to the power of other states. But 1945 ushered in a uniquely unipolar moment in American history. Americans had escaped the physical devastation wreaked on Europe and much of Asia. Germany and Japan lay in ruins. Twenty million Russians were dead. China’s long-running civil war would soon resume. Suddenly America had no credible competitors for global power.

Today? Conventional wisdom holds that Asia has become the center of gravity in the global economy. Yet even if we use purchasing power parity rather than exchange rates to measure the American share of world GDP, that share has only modestly decreased. Meanwhile, China’s remarkable rise may be leveling off. The evidence is less that the United States is in secular decline than that the world is changing in ways to which Americans need to adapt if they are to regain economic health. If the pivot facilitates that adaptation, it will have been a success.

Do you interpret the pivot to the Asia-Pacific as more hype or reality?

The pivot is definitely a reality, but the reality is partly about symbolism and atmospherics. The pivot conveys reassurance, particularly to Southeast Asia, that the United States cares about the Asia-Pacific region and that it is willing to cooperate more than before with the Association of Southeast Asian Nations (ASEAN). Part of that is simply “showing up”—a willingness to attend ASEAN regional meetings. Another part of the pivot, however, involves raising the American security profile in the region, which has so far strengthened ASEAN’s diplomatic hand in dealing with China’s sweeping claim to the South China Sea.

How has the pivot been received and interpreted in Asia?

Generally speaking, the pivot has been welcomed in Southeast Asia, despite worries that if it becomes an effort to contain China, a Sino-American cold war could result. The specific responses of Southeast Asian governments have differed, however, on a spectrum from passive acquiescence to active support.

In Japan, the rotation of prime ministers in and out of office has understandably focused that country’s politics more on domestic concerns, and the still not fully resolved disposition of U.S. forces on Okinawa has drawn energy from the bilateral relationship.

As a “middle power,” South Korea has been supportive of multilateral frameworks and solutions. Seoul is pleased to see a renewed American interest in working with Asians in multilateral settings such as ASEAN and the East Asia Summit.

China’s response has varied between cool and hostile. The foreign ministry has treated the pivot with some equanimity compared with the hostility of those in the People’s Liberation Army who view increased American involvement in Asia as a threat to Chinese aims and claims, especially regarding the South China Sea. China’s foreign policy is the outcome of contestation between various groups inside the country that do not necessarily see eye to eye on how best to handle the United States.

What do you see as the main implications, repercussions, and complications of the pivot?

The pivot, as Hillary Clinton advertised it in her Foreign Policy article, signals a shift in U.S. priorities away from Iraq and Afghanistan. For a time following the 9/11 attacks on America in 2001, the United States tended either to neglect Southeast Asia or to treat it as a second front in the “war on terror.” Economically, the pivot implies an acknowledgment that if America is to prosper in this century it will have to pay closer attention to Asia as an engine of global economic growth. Diplomatically, the pivot implies that with regard to Asian states, Washington cannot merely manage its relations bilaterally as the hub where their spokes meet, but must cultivate multilateral diplomacy as well. Militarily, the pivot implies that even while the American global force posture is drawn down in some parts of the world, it needs to be upgraded in Asia in response to Asian and American concerns over the terms on which China’s rise will take place.

A major constructive repercussion of the pivot has been the evolution of China’s own diplomacy in Southeast Asia. Previously China had disavowed multilateral diplomacy with Southeast Asians over claims to the South China Sea—a bilateralist strategy that in Southeast Asian eyes resembled an effort to “divide and rule.” America’s willingness to reach out to ASEAN and take part in ASEAN events has helped diplomats in any one Southeast Asian country to resist having to face China alone. Multilateral discussions, involving China and meant to prepare the way toward an eventual Code of Conduct, are now underway.

But as we saw recently during Hillary Clinton’s visit to the Philippines, it is important for Washington to maintain its independence and impartiality while facilitating peace in the region.

Complications? Yes, there is a danger that Washington could be dragged into supporting, or appearing to support, the claims of one of the Southeast Asian parties to the dispute. The Obama administration is aware of this risk, however, and I strongly doubt that an American official will again refer to the “West Philippine Sea.” 

A more serious complication in the longer run may arise from the pivot’s emphasis to date on Asian-Pacific security, and its relative lack of attention to creating and cultivating American economic opportunities in Asia.

China’s economic footprint in Asia is large and growing. It has moved up to become the main trading partner of many countries that used to trade proportionally more with the United States. An unbalanced relationship in which China saves and lends what Americans borrow and spend is unhealthy for both countries, and it cannot last. The pivot should forestall an invidious division of labor whereby Washington through the Seventh Fleet subsidizes the regional peace that enables Asians to prosper doing business with China. A higher priority needs to be placed on promoting American trade and investment in Asia, including China.

The Obama administration is hoping to persuade more Asian economies to join an arrangement called the Trans-Pacific Strategic Economic Partnership (TPP), but the bar that it sets is high. The TPP’s strict protections for the environment, labor, and intellectual property rights and its comprehensive cuts in both tariff and non-tariff barriers to trade have raised its quality but lowered its appeal, especially to the region’s larger economies. Meanwhile, anticipated cuts in American budgets for defense will only intensify the need to refocus the pivot on economic as well as military access to Asia.

Related Resources

Foreign Policy: “America’s Pacific Century”
November 2011 article by Hillary Clinton introducing the concept of the "Asia pivot."

Stanford Daily: "Obama pivots policy toward Asia"
Summary of Donald K. Emmerson's May 1, 2012 talk.

LinkAsia: "Treat Scarborough Shoal Incident as a 'Wake Up Call'"

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