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.
Kohrman to speak about cigarette factory mapping and policy
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At present, the tobacco industry annually produces some six trillion cigarettes worldwide. A third of all these sticks were produced in China last year. During a Jan. 30 seminar, Matthew Kohrman will introduce the Cigarette Citadels project, an innovative application of participatory GIS, and discuss its implications for public health policy and social theory about the state and the politics of life.
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Packages of several brands of Chinese cigarettes.
Flickr/Franco Rabazzo
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Health Care for 1.3 Billion: An Overview of China’s Health System
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What kind of a health care system do China’s 1.3 billion turn to when ill, injured, or in need of care? This article provides a brief overview of how China’s health system has transformed alongside China’s society and economy since the Mao era, including how the current system is financed, organized, regulated, and being reformed. It first provides a brief description of the Mao-era health system and China’s demographic and epidemiologic transitions. Then it gives an overview of China’s contemporary health care system, including the dramatic expansion of health insurance over the last eight years and the progress of national health system reforms initiated in 2009.
A condensed and revised version of this paper is published in The Milken Institute Review 2012 second quarter: 16-27.
Published: Eggleston, Karen. "Health care for 1.3 billion: An overview of China’s health system." (2012).
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Asia Health Policy Program working paper # 28
Cigarette Citadels, Remapping Theory and Policy, Cigarette Factories in and Outside of China
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At present, the tobacco industry produces some six trillion cigarettes worldwide every year. Six trillion cigarettes per annum, each ready to release smoke filled with highly addictive nicotine and powerful carcinogens. A third of all these sticks were produced in China last year. In 2011, the world’s largest cigarette maker by volume, the China National Tobacco Corporation, contributed an all-time high of U.S. $214 billion in profits and taxes to the Chinese government, up 22 percent year-on-year. Currently the greatest cause of preventable death in the world, the cigarette is likely to kill ten times as many people in the 21st century as it did in the 20th century, epidemiologists tell us, with China bearing the largest burden. Until now, much global health research and intervention has focused with limited success on the cigarette consumer—addressing how one or another variable prompts people to take up or quit smoking, whether the cue for the consumer is biological, psychological, spatial, financial or symbolic. What though of the industrial sources of tobacco-related diseases? Where are the six trillion cigarettes that are released into circulation each year manufactured? Where are they rolled, wrapped, and boxed for shipment? This presentation will introduce the Cigarette Citadels Project, an innovative application of participatory GIS. With special attention given to China’s network of cigarette factories, Matthew Kohrman will explain how the Cigarette Citadels Project not only reveals conceptual roadblocks in public health policy but also lacuna in social theory pertaining to the state and the politics of life.
Matthew Kohrman joined Stanford’s faculty in 1999. His research and writing bring multiple methods to bear on the ways health, culture, and politics are interrelated. Focusing on the People's Republic of China, he engages various intellectual terrains such as governmentality, gender theory, political economy, critical science studies, and embodiment. His first monograph, Bodies of Difference: Experiences of Disability and Institutional Advocacy in the Making of Modern China, examines links between the emergence of a state-sponsored disability-advocacy organization and the lives of Chinese men who have trouble walking. In recent years, Kohrman has been conducting research projects aimed at analyzing and intervening in the biopolitics of cigarette smoking and production. These projects expand upon analytical themes of Kohrman’s disability research and engage in novel ways techniques of public health.
This event is part of the China's Looming Challenges series.
Philippines Conference Room
Matthew Kohrman
Stanford University
Department of Anthropology
Building 50, Central Quad
Stanford, California 94305-2034
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kohrman@stanford.edu
Associate Professor of Anthropology
Senior Fellow, by courtesy, at the Freeman Spogli Institute for International Studies
Faculty Affiliate at the Walter H. Shorenstein Asia-Pacific Research Center
Faculty Affiliate at the Stanford Center on China's Economy and Institutions
Matthew Kohrman joined Stanford’s faculty in 1999. His research and writing bring multiple methods to bear on the ways health, culture, and politics are interrelated. Focusing on the People's Republic of China, he engages various intellectual terrains such as governmentality, gender theory, political economy, critical science studies, and embodiment. His first monograph, Bodies of Difference: Experiences of Disability and Institutional Advocacy in the Making of Modern China, examines links between the emergence of a state-sponsored disability-advocacy organization and the lives of Chinese men who have trouble walking. In recent years, Kohrman has been conducting research projects aimed at analyzing and intervening in the biopolitics of cigarette smoking and production. These projects expand upon analytical themes of Kohrman’s disability research and engage in novel ways techniques of public health.
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Trauma and Healing in Stricken Japan
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The triple disasters in Japan in March 2011 have created overwhelming trauma in the stricken areas for people of all ages. The mental health needs are immense, both immediate and long term, and ripple out into Japanese society. Members of the Nichibei Care Network, a group of mental health professionals in the Bay Area who organized to assist relief activities, will offer their reflections on the trauma suffered. They will also report on the heroic efforts that are taking place daily as people rebuild lives through compassion and caring.
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Special Japan Studies Program and CEAS Series: Winter-Spring 2011-12
Looking Back, Looking Forward: Japan's March 11 Disasters One Year Later
The earthquake, tsunami, and nuclear disaster that hit Japan in March 2011 had both immediate catastrophic consequences and long term repercussions. Fundamental areas of Japan’s environment, economy, society, and collective national psyche were deeply affected, giving rise to a broad range of urgent issues. These include economic debates about how to meet the country’s energy demands with nuclear power plants offline, and what path to take for the country’s energy future; political crises, including criticism of the government’s disaster response; the psychological challenges of coping with trauma and grief; a daunting environmental clean-up; and social developments, including a new wave of civil society activism. This series brings together scholars and activists from a wide range of specialties to take stock of how the Japanese have been affected by the disasters, and to assess the efforts of residents, volunteers, and policy makers to recover and move forward.
Philippines Conference Room
William Masuda
Reverend
Speaker
Palo Alto Buddhist Temple
Stephen Murphy-Shigematsu
Speaker
Stanford School of Medicine
George Kitahara Kich, PhD
Psychologist and Litigation Consultant and Adjunct Faculty
Speaker
California Institute of Integral Studies
Mio Yamashita
Art Therapist/Marriage and Family Therapist
Speaker
Seminars
Socioeconomic Correlates of Inpatient Spending for Patients with Type 2 Diabetes Mellitus in China: Evidence from Hangzhou
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Aims:
We evaluated the factors associated with inpatient costs including total costs, pharmaceutical costs and laboratory costs for diabetes-related admissions.
Patients and Methods:
Using data for 960 adult patients admitted between May 2005 and April 2008 with a primary or secondary diagnosis of type 2 diabetes mellitus (DM) at Sir Run Run Shaw Hospital affiliated with Zhejiang University Medical School (SRRSH) in Hangzhou, China, we evaluate the association between patient characteristics and inpatient costs with multivariable regression analyses.
Results:
Total inpatient costs were positively associated with age, higher UKPDS stroke risk score, and presence of any complication. A regression that included patient socioeconomic and clinical characteristics explained 21.5% of the variation in total inpatient costs; regression estimates indicate that patients with coronary artery disease, retinopathy, nephropathy, neuropathy, and diabetic foot had inpatient costs that were respectively 93.7%, 14.0%, 17.5%, 11.5% and 89.0% higher than otherwise similar patients without those complications. Pharmaceutical costs did not differ by insurance coverage. Insured patients spent 7-16% more on laboratory tests than otherwise similar patients did.
Conclusions:
Clinical factors, especially presence of diabetes-related complications, appear to be the primary determinants of variation in inpatient costs for patients with type 2 DM in China. To mitigate the health costs increases associated with China's DM epidemic, policymakers should focus on cost-effective ways to manage patients in outpatient settings to prevent the complications associated with diabetes.
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Experimental and Clinical Endocrinology & Diabetes
Pharmaceutical Price Regulation: Macro-Level Evidence from China between 1997 and 2008
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This paper uses macro-level data between 1997 and 2008 to evaluate the effects of China’s pharmaceutical price regulations. We find that these regulations had short-run effects on medicine price indexes, reducing them by less than 0.5 percentage points. The effects could have been slightly reinforced when these regulations were imposed on more medicines. However, these regulations failed to reduce household health expenditures and the average profitability of the pharmaceutical industry, and firms on the break-even edge were worse off. Finally, although these regulations have no significant effects on the price of substitutes or complements for medicines, they increased expensive medicine imports.
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Asia Health Policy Program working paper #26
Soft Budget Constraints and Ownership: Empirical Evidence from U.S. Hospitals
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Consistent with the property rights theory of ownership incorporating soft budget constraints (SBCs), we find that controlling for SBCs, for-profit hospitals drop safety-net services more often and exhibit higher mortality rates, suggesting aggressive cost control that damages non-contractible quality.
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Elsevier
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Getting to the roots of the tobacco industry
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Tobacco now kills 90 times more people each year than HIV/AIDS in China. China's tobacco industry is closely tied to the global industry, and the Asia Health Policy Program is working to establish a new field of research on its history, beginning with a Mar. 2012 conference at the new Stanford Center at Peking University. Robert Proctor, a Stanford historian and author of a groundbreaking new book on the global tobacco industry, will take part.
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Beauty and smoking are paired in this vintage-style cigarette poster in China, Nov. 2005.
Flickr/Yeap Ku
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Economic, social, and security implications of East Asia's demographic transition
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Asia’s demographic landscape is changing in a big way. Japan’s population is shrinking, as people are living longer, marrying later, and choosing to have fewer or no children. Korea is moving in the same direction, while China and the countries of South and Southeast Asia face similar issues in the coming decades. As this takes place, more people are moving to, from, and across Asia for job, education, and marriage opportunities.
These demographic changes present policymakers with new challenges and questions, including: What are the interrelationships between population aging and key macroeconomic variables such as economic growth? How will it impact security? What are the effects on employment policy and other national institutions? How have patterns of migration affected society and culture? What lessons can Asia, the United States, and Europe learn from one another to improve the policy response to population aging?
The Walter H. Shorenstein Asia-Pacific Research Center (Shorenstein APARC) focused its third annual Stanford Kyoto Trans-Asian Dialogue on addressing the possible economic, social, and security implications of Asia’s unprecedented demographic transition. Thirty scholars, government figures, journalists, and other opinion leaders from Stanford, the United States, and countries across the Asia-Pacific region gathered September 8–9, 2011, in Kyoto, Japan, to discuss key issues related to the question of demographic change.
Comparative Demographics and Policy Responses
Japan’s shrinking workforce calls for labor policy changes, stressed presenters during the opening Dialogue session. Stanford Center for Population Research director Shripad Tuljapurkar stated that Japan’s population could decrease by as much as 25 percent and that its government has a window of approximately 40 years in which to act. In describing Japan’s demographic shift, Ogawa Naohiro, director of the Nihon University Population Research Institute, also emphasized the importance of good financial education for individuals as life expectancy increases.
Macroeconomic Implications
Economists Masahiko Aoki and Cai Fang addressed changes to East Asia’s economic landscape. Aoki, an FSI senior fellow, spoke of the transition from agriculture to industry that has occurred at different stages in Japan, Korea, and China and of the increasing cost of human capital that has followed. Cai, a Chinese Academy of Social Sciences labor and population expert, stated that after several decades of industrial growth China is now at a turning point in terms of its global competitiveness.
Labor and Migration
Scott Rozelle, codirector of Stanford’s Rural Education Action Program (REAP), opened the next day with a discussion of China’s rural human capital investment. Offering Mexico’s situation after the mid-1990s peso crisis as a comparison, he emphasized the immediate need for allocating more health and education resources to China’s rural areas. Ton-Nu-Thi Ninh, president of Tri Viet University, discussed the socioeconomic and cultural aspects of labor migration—a growing trend in Asia—and advocated that governments factor it more into their foreign policy development.
Security
The security impact of Asia’s demographic transition will take several decades to understand, but it will eventually lead to the need for significant policy re-strategization, stated Yu Myung Hwan, Korea’s former minister of foreign affairs and trade, during the closing Dialogue session. He suggested focusing on impacts that could result from the major changes taking place in fertility, urbanization, and migration. Concurring with many of Yu’s views, Stanford’s Shorenstein Distinguished Fellow Michael H. Armacost also noted the current lack of literature on the link between security and demography. In addition, he emphasized the need for the United States to continue pursuing good relations with China and Russia during this time of transition.
“Low fertility rates are not because women are all out there working. In fact, a number of countries have lots of females in the labor force and have achieved a resurgence of fertility. Achieving work-life balance is important, not just for women, but for men as well, and might play a role in lessening the gap in life expectancy between men and women.”
-Karen Eggleston, Director, Asia Health Policy Program
Throughout the event, Dialogue participants unanimously acknowledged the serious challenges facing policymakers as they look for ways to meet the evolving needs of individuals, families, and organizations. The demographic outlook is not entirely gloomy, however. Numerous participants also pointed to the potential for exciting advances and innovations in technology and international cooperation.
As in previous years, the event concluded with a lively public symposium and reception attended by students from Stanford and local universities, Shorenstein APARC guests and affiliates, and members of the general public. Speaking during the reception, Kadokawa Daisaku, mayor of Kyoto, and Kim Hyong-O, member and former speaker of the Korean National Assembly, acknowledged the significance of the Stanford Kyoto Trans-Asian Dialogue as a forum for addressing issues of mutual importance to the United States and Asia.
The Dialogue is made possible through the generosity of the City of Kyoto, FSI, and Yumi and Yasunori Kaneko. To read the final report from this and previous Dialogues, visit the event series page below.
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A worker stands on steel rods at a superblock construction site in Jakarta in February 2010. Increasing urbanization is one of many aspects of Asia's demographic change.
REUTERS/Beawiharta
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