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.

-

A tremendous amount of radioactive products were discharged as a result of the accident at the Fukushima nuclear power plant in March 2011, which resulted in radioactive contamination of the plant and surrounding areas. While geographical distribution of radioactive iodine, tellurium, and cesium in the surface soils was smoothly (but not always systematically) widespread all over the region, health risk information by the government, media, and other organizations is most likely to be given in terms of administrative boundaries (cf. prefectures, municipalities, etc.) and/or distance from the radiation source.

This paper estimates the effect of such health risk information rather than the actual health risks of radiation on land and other prices in different locations. We find that the prefecture and municipality border effects – but not the distance effect from the nuclear power plant – are significantly related to a reduction in land and other prices after the accident. This shows that people responded to health risk information based on administrative boundaries rather than the actual health risk of radiation after the disaster. Although health risk information based on prefecture and municipality boundaries has an obvious advantage of distilling large and complex risk information into a simple one, the government, media, and other organizations need to recognize and carefully examine the potential of misclassifying non-contaminated areas into contaminated prefectures. Doing so will avoid unintentional consequences to the region’s economy.

Hiroaki Matsuura is currently Departmental Lecturer in the Economy of Japan in the School of Interdisciplinary Area Studies, University of Oxford and a Junior Research Fellow of St. Antony’s College. His main interests are health economics and demography, with a special interest in the relation between laws and population health. Hiroaki received his B.A. in Economics from Keio University, M.A. in Social Science from the University of Chicago, M.S. in Project Management from Northwestern University’s McCormick School of Engineering and Applied Science, and Sc.D. in Global Health and Population (Economics track) from Harvard University’s School of Public Health. In the past, he was affiliated with Institute of Quantitative Social Sciences, Human Rights in Development, and Takemi Program in International Health at Harvard University. He also worked as a research assistant at the National Bureau of Economic Research. His doctoral dissertation research explores a right to health or to health care in national constitutions of 157 countries and state constitutions of the 50 U.S. states and estimates the impact of introducing (or removing) a right to health or to health care into national and state constitutions on health system and population health outcomes. His most recent article, “The Right to Health in Japan: Challenges of a Super Aging Society and Implication from Its 2011 Public Health Emergency” (with Eriko Sase) will be appeared on “Advancing the Human Right to Health”, edited by José M. Zuniga, Stephen P. Marks, and Lawrence O. Gostin, Oxford University Press, 2013. 

Daniel and Nancy Okimoto Conference Room

Hiroaki Matsuura Departmental Lecturer in the Economy of Japan in the School of Interdisciplinary Area Studies Speaker University of Oxford
Seminars
Paragraphs

Background: For the past two decades, more and more women in certain European countries, Japan, and the United States are giving birth to their first child at a considerably later age than ever before. It remains unclear as to what extent this age-related general fertility decline is affected by changing social and cultural norms.

Method: The Global Centers of Excellence Survey was conducted by Osaka University in Japan (n=5313) in 2009. Multivariate regression analyses were conducted to examine the impact of psychosocial norms, cultural differences, and economic conditions on the perception of childbearing.

Results: The findings suggest that a subjective measure of happiness has a significant influence on childbearing. A society with income inequalities between classes discourages childbearing. It is observed that women’s higher labor force participation generates a negative impact on mother-child relations which causes discouragement of childbearing. A higher female labor force participation stemmed from a transition of a traditional society into a modern and market-oriented society discourages childbearing.

Conclusions/implications: A woman’s decision to delay childbearing is based on her perception of psychosocial norms with surrounding economic environment and her own value of opportunity in the market oriented society. Childbearing also imposes psycho-economic burdens on the working population under mix of a traditional, patriarchal society, and a modern market oriented framework. Childbearing incentives could be a strategic policy to encourage positive attitudes of childbearing in general and proper welfare policy, labor law(s), employment conditions, and social security system for a working mother with a child or children.

Key words: Childbearing, socioeconomic factors, psychosocial norms, subjective happiness

All Publications button
1
Publication Type
Working Papers
Publication Date
Journal Publisher
Asia Health Policy Program working paper # 36
Authors
-

Co-sponsored by the Center of East Asian Studies, Stanford University

Prominent health policy expert—Rachel Lu from Taiwan—will share her view on recent health policy developments in the region, drawing on her extensive research and policy background.

Jui-fen Rachel Lu, Sc.D., is a Professor in the Department of Health Care Management, at Chang Gung University (CGU) in Taiwan, where she teaches comparative health systems, health economics, and health care financing and has served as department chair (2000-2004), Associate Dean (2009-2010) and Dean of College of Management (2010-2013).  She earned her B.S. from National Taiwan University, and her M.S. and Sc.D. from Harvard University, and she was also a Takemi Fellow at Harvard (2004-2005) and is an Honorary Professor at Hong Kong University (2007-2014), a guest professor at Huazhong University of Science and Technology (2010-2013), and an adjunct professor at Xi’an Jiaotong University (2011-2014) in China.  Her devotion to teaching driven by her firm belief in the value of education and investment in human minds was recognized by the Award of Excellence in Teaching conferred by CGU in both 2002 and 2013.

Her research focuses on 1) the equity issues of the health care system; 2) impact of the NHI program on health care market and household consumption patterns; 3) comparative health systems in Asia-Pacific region.  She is a long-time and active member of Equitap (Equity in Asia-Pacific Health Systems) research network and is currently the coordinator for the catastrophic payment component of Equitap II research project which involves 21 country teams and is jointly funded by IDRC, AusAID, and ADB.  Professor Lu has also been appointed to serve as a member on various government committees dealing with health care issues in Taiwan, such as National Health Insurance Supervisory Committee (DOH), Hospital Management Committee(DOH), and Hospital Global Budget Payment Committee (BNHI), etc.  Dr. Lu received the Minister Wang Jin Naw Memorial Award for Best Paper in Health Care Management presented by Kimma Chang Foundation in 2002 and was the recipient of IBM Faculty Award in 2009.  She has published papers in Health Affairs, Medical Care, Journal of Health Economics, Health Economics, Social Science and Medicine, Health Economics, Policy and Law, Osteoporosis International, Health and Quality of Life Outcomes, and Taiwan Economic Review etc, and is the author of “Health Economics”(a textbook in Chinese) and various book chapters.  

Philippines Conference Room
Encina Hall 3rd Floor Central
616 Serra Street, CA 94305

Jui-fen Rachel Lu Professor in the Department of Health Care Management Speaker Chang Gung University in Taiwan
Seminars
Paragraphs

China's population of 1.34 billion is now 50 percent urban, over 13 percent above age 60, and with 118 boys born for every 100 girls. For such a large population at a relatively low level of per capita income, how will aging interact with substantial gender imbalance and rapid urbanization?

Will Demographic Change Slow China’s Rise? In the eponymous article recently published in the Journal of Asia Studies, five Stanford scholars of political science, sociology, and economics based at the Shorenstein Asia-Pacific Research Center — Karen Eggleston, Jean C. Oi, Scott Rozelle, Andrew Walder, and Xueguang Zhou, with a former postdoctoral fellow Ang Sun — discuss how the intertwined demographic changes pose an unprecedented challenge to social and economic governance, contributing to and magnifying the effects of a slower rate of economic growth.

The authors touch upon a wide range of topics of policy import:
· China must overhaul rural education quickly if it is going to avoid producing tens of millions of workers who will be marginalized in the nation's future high-wage, high-skill economy.
· Growth slowdowns are almost always productivity growth slowdowns. Many forces impinge on multi-factor productivity; the stability and predictability of markets and governance are lynchpins. Discontent with widening disparities in China could undermine this fundamental foundation of growth.
· Demographic change will fundamentally challenge the conventional governance structures in China. Efforts to impose a bureaucratic solution to the intertwined social challenges China faces will almost inevitably stoke tensions between the society and the state. In both urban and rural areas, expansion of the bureaucratic state may become the central target of popular contention.
· China's high savings rate is partly explained by low fertility and parents' need to save for their own old-age support. Initiation of rural pensions and significant expansion of health insurance coverage and are examples of the social policy responses that China has undertaken to prepare for “growing old before becoming rich.” But much remains to be done.
· China's increasing burden of chronic disease further exacerbates the growth-slowing potential of a more elderly population and its associated medical expenditure burden.
· Although reducing precautionary savings and increasing domestic consumption as an engine of economic growth are widely acknowledged goals for China's economy, a rapid decline in savings could also imperil China's future economic growth by jeopardizing the current basis of the financial system.
· Demographic change will shape almost every aspect of how China copes with a slowing rate of economic growth, and may play a decisive role in the future social stability of China, with spillover effects for the region and the rest of the world.
The research is one product of a 3-year project analyzing Asian demographic change which will conclude in 2014 with a conference and edited book on demographic change and urbanization in China, in comparative international perspective.

All Publications button
1
Publication Type
Journal Articles
Publication Date
Journal Publisher
The Journal of Asian Studies
Authors
Karen Eggleston
Jean C. Oi
Scott Rozelle
Andrew G. Walder
Xueguang Zhou
Ang Sun
-

In this session of the Shorenstein APARC Corporate Affiliate Visiting Fellows Research Presentations, the following will be presented:

 

Sanat Deshpande, "Best Practices in Pharmaceutical Supply Chain Management"

The pharmaceutical supply chain is very complex and highly responsible to ensure that the right drug reaches the right person at the right time in the right condition to meet the medical needs to fight against disease.  Anything less than 100% service level is unacceptable.  The pharmaceutical industry is facing a series of challenges such as counterfeiting and cold chain management.  In addition to these challenges, developed countries like the United States are also dealing with the patent cliff and healthcare reforms.  There is a growing oversight by the regulatory authorities across the world to ensure patient safety when it comes to pharmaceuticals.  In his presentation, Deshpande will discuss the growth of the pharmaceutical industry focusing on the challenges faced by the supply chain and key areas where companies can improve for the future.

 

Ryo Masuda, "What Can the Cable TV Industry Learn from the Strengths of Over-The-Top Providers"

One of the biggest concerns for the cable TV (CATV) industry in the United States has been the competition with Over-the-Top providers (OTT).  OTT providers like Netflix and Hulu have been successful in penetrating its service in recent years by providing customers with TV content over the internet for a cheaper monthly flat rate.  Masuda has analyzed the current fundamental differences in service strategies of CATV and OTT providers and their customer behavior. In his research presentation, Masuda tries to answer the question – “Can the CATV industry really compete with OTT providers and what can we learn from those strengths to develop services in the future?” 

 

Wei Shi, "A Comparison Between the U.S. and China's Credit Card Markets - The Englightenment to the Development of ICBC's Credit Card Business"

Based on a statement of the basic information of China’s credit card market development and a comparison to that of the United States, Shi has researched the main problems that China’s credit card industry currently faces.  He has focused especially on the case for the Industrial and Commercial Bank of China (ICBC) by studying market conditions, credit environment, management risks, and regulatory policy, as well as the reasons and causes of these conditions.  Based on his findings, Shi proposes suggested solutions that will help to further develop the credit card business at ICBC. 

Philippines Conference Room

Sanat Deshpande Speaker Reliance Life Sciences
Ryo Masuda Speaker Sumitomo Corporation
Wei Shi Speaker Industrial and Commercial Bank of China
Seminars
Authors
News Type
Q&As
Date
Paragraphs

Homesickness, long hours, and demanding employers—many Filipinos who migrate to another country for temporary employment make personal sacrifices and face daunting working conditions.

To their family members receiving much-needed supplemental income and to the Philippine government bolstering its foreign reserves, they are the “new heroes.” Remittances from Overseas Filipino Workers (OFWs), as they are officially called, are now the country’s second largest source of foreign reserves, beating out foreign direct investment in terms of percentage of GDP. The government has even established an annual award to honor its most distinguished OFWs.

Marjorie Pajaron, the current Asia Health Policy Postdoctoral Fellow in Developing Asia, has been studying the significant economic benefit of OFW remittances to Philippine families and to the economy. She spoke recently with Shorenstein APARC about her research, which she will present at a seminar on May 9.

How many people from the Philippines are going abroad for temporary employment, and where are they finding work?

In 2008, OFWs numbered 2 million—representing 2 percent of the country’s total population. Fifty-one percent of these migrants were male, and 49 percent were female. Twenty percent went to Saudi Arabia; 14 percent to the Arab Emirates, Singapore, Hong Kong, Japan, Qatar, and Taiwan; 9 percent to Europe; and 8 percent to North and South America.

Where OFWs work depends on gender, education, and the type of employment. Many men go to the Middle East for construction-, mining-, and oil-related jobs. Women tend to go to Southeast and East Asia for caretaking and domestic jobs. In North America, most Filipino migrants work in professional jobs, including as nurses, doctors, and as other types of healthcare workers.

What is the “typical” profile of an Overseas Filipino Worker?

It often depends on the type of job. Healthcare professionals, for example, tend to be younger because they go abroad directly after graduation. Most of the nursing schools in the Philippines are linked to hospitals in the United States or Europe.

In general, overseas workers range from recent graduates to the median working age, from approximately 20 to 45 years old. Because of the large fixed cost associated with temporary overseas employment, families that are better off or who have the means to raise funds are those that are able to send family members abroad.

Most OFWs come from Manila or the surrounding urban areas. In the study I conducted, only 17 percent of rural households could afford to send a family member abroad. Usually several village families will pool together their resources, with the informal agreement that they will be repaid.

On average, male migrant remittances equal twice the amount sent by female migrants, who more frequently work in unskilled positions. For example, a well-educated man working in the Middle East in the construction and transportation industries earns higher than a woman working in a domestic position in Singapore. Some OFWs are overqualified in terms of education, but because of economic opportunity they decide to work abroad.

Do remittances provide short- or long-term economic benefits for families?

The benefits are both short and long term. Remittances can provide immediate assistance as needed, such as rebuilding after a natural disaster. From a longer-term perspective, many remittances in the Philippines go toward education, which is a form of human capital investment. Many families also invest in real estate, buying houses and land, and they also purchase durable goods, such as cars and appliances.

How do remittances benefit the country’s economy?

After exports, foreign remittances are actually the second largest source of foreign reserves in the Philippines. In 2006, remittances ranked even higher than foreign direct investment in terms of percentage of GDP. Some scholars have conjectured that OFWs have helped close the gap between the poor and the wealthy in the Philippines by contributing to a growing middle class. This is why migrant workers are called the “new heroes.” They sacrifice a lot by working in what are often unfavorable conditions. Because of the system of helping their families, they are also helping the entire country.

In your research, you have also looked at how rural farmers cope with natural disasters. What motivated you to study this issue, and what have you found based on recent years?

Farmers are the poorest of the poor in the Philippines, and since the country is in the Pacific Ring of Fire it is frequently hit by natural disasters, including earthquakes, typhoons, and drought. Filipino farmers are very vulnerable because most cannot afford to install irrigation. Instead, they have to depend on rain and their crops are continually susceptible to changes in the weather. There is limited government assistance available to them, and they do not have any formal insurance. In addition, they cannot take out loans because they do not have the collateral. So, I have been looking at how they survive after a natural disaster. The only possible explanation is that they depend on their networks of family and friends.

I had expected to find that they also depend on their family members abroad, but I have discovered that very few have been able to send relatives abroad in the first place. So this cannot be considered a reliable source of support. Instead, they seem to mainly rely on family members who have migrated to Manila and other cities.

There is much more work to be done on this issue. Studying how rural residents survive is important given they have limited access to formal credit, capital, and insurance markets; and government aid and transfers may also be limited or non-existent.

Hero Image
AbsenteeVoting LOGO
Overseas workers from the Philippines line up to register as absentee voters in Hong Kong. East Asia is a major destination for temporary migrant workers from the Philippines.
Wikimedia Commons / Longscocoking
All News button
1
Paragraphs

"Old while not affluent" situation, together with an unsustainable high investment rate and high dependency on foreign trade, spurs hot debates on the challenges of a fast-aging population and the exploitation of the second demographic dividend in today’s China. Literature related to elderly health in countries other than China often starts with medical concepts and then dwells on economic issues, mainly focusing on socioeconomic, behavioral, and environmental factors and their effects on the health of the elderly. This article reviews economic research on these topics and then discusses possible implications for the economic analysis of aging China.

All Publications button
1
Publication Type
Working Papers
Publication Date
Journal Publisher
Asia Health Policy Program working paper # 34
Authors
Subscribe to Health and Medicine