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.

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Migration and health are two areas that have each received significant amounts of attention in sociology. However, only recently have researchers begun to examine the links between these two population processes. There is growing yet incomplete evidence that migration and the health are intertwined in complex ways. Health itself can impact the decision to move, and migration may affect the health of those who move, those who stay, and those who host migrants. Using high quality longitudinal data from Indonesia, Lu's research makes a serious attempt to tackle important questions about the association between migration and health in the Indonesian context. In particular, she examines both how health may affect migration decisions, and how changing socioeconomic conditions associated with migration may have implications for the health of various populations involved, including not only migrants but also people left behind in sending communities. Lu will also discuss research underway on migration and health in China, including a new national survey with data to study that topic in the Chinese context.

Yao Lu is a Ph.D. candidate of Sociology, M.S. candidate of Public Health, and student affiliate at the California Center for Population Research at UCLA. She has a BS from Fudan University in China. Her research focuses on studying the causes and consequences of internal migration in developing countries, and modeling socioeconomic and behavioral factors as determinants of health. Her papers include studies based on data from China, Indonesia, and South Africa. She has a paper forthcoming in the American Sociological Review, and has received dissertation fellowships from the AAUW foundation and the Asia Institute at UCLA. She is currently completing her dissertation on the relationship between labor migration and health in Indonesia, while working on a national survey project on internal migration and health in China.

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Yao Lu PhD candidate in Sociology Speaker University of California-Los Angeles
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China's Harmonious Society colloquium series

co-sponsored by the Stanford China Program and the Center for East Asian Studies

Since 2006, the official doctrine of China's Communist Party calls for the creation of a "harmonious society" (HeXieSheHui). This policy, identified with the Hu Jintao leadership, acknowledges the new problems that have emerged as China continues its amazing economic growth. The economy is booming but so are tensions from rising inequality, environmental damage, health problems, diverse ethnicities, and attempts to break the "iron rice bowl." In this series of colloquia, leading authorities will discuss the causes of these tensions, their seriousness, and China's ability to solve these challenges.


Nancy Shulman's talk topic will be posted soon.

Nancy Shulman conducts laboratory and clinical research in the area of HIV therapeutics, with focus on antiretroviral resistance and treatment strategies of experienced patients, the impact of antiretroviral treatment on HIV co-receptor utilization, and HIV in China. she received her MD from Kansas University Medical School and holds a BA in biochemistry from University of Texas, Austin. She is a doctor specializing in internal medicine, pediatrics, and infectious diseases.

"Healthcare Coverage for 1.3 Billion: China's Odyssey"

Karen Eggleston

Media coverage as well as the academic literature give conflicting appraisals of China's reality: Is China's healthcare system on the verge of collapse? Why is healthcare so expensive and difficult to access in contemporary China? Have reforms 'marketizing' healthcare drastically undermined progress in assuring affordable access for all? Or do hospitals and other providers constitute a last bastion of state control and bureaucratized monopoly in the name of equal access? Chinese analysts and policy advisers have engaged in a sometimes acrimonious debate; some champion a government-led, National Health Service-like model, while others passionately argue that market forces should play a greater role. In this talk, Karen Eggleston will present a brief overview of China's health system reforms and current developments.

Karen Eggleston focuses her research on comparative healthcare systems during economic development and transition from central planning to market-based economies. Her interests include the impact of payment incentives on healthcare insurer and provider behavior; chronic disease management; and incentives surrounding health behaviors such as the spread of HIV/AIDS and tuberculosis, overuse of antibiotics, and smoking. She earned her PhD in public policy from Harvard University and has MA degrees in economics and Asian studies from the University of Hawaii.

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Senior Fellow at the Freeman Spogli Institute for International Studies
Center Fellow at the Center for Health Policy and the Center for Primary Care and Outcomes Research
Faculty Research Fellow of the National Bureau of Economic Research
Faculty Affiliate at the Stanford Center on China's Economy and Institutions
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Karen Eggleston is a Senior Fellow at the Freeman Spogli Institute for International Studies (FSI) at Stanford University and Director of the Stanford Asia Health Policy Program at the Shorenstein Asia-Pacific Research Center at FSI. She is also a Fellow with the Center for Innovation in Global Health at Stanford University School of Medicine, and a Faculty Research Fellow of the National Bureau of Economic Research (NBER). Her research focuses on government and market roles in the health sector and Asia health policy, especially in China, India, Japan, and Korea; healthcare productivity; and the economics of the demographic transition.

Eggleston earned her PhD in public policy from Harvard University and has MA degrees in economics and Asian studies from the University of Hawaii and a BA in Asian studies summa cum laude (valedictorian) from Dartmouth College. Eggleston studied in China for two years and was a Fulbright scholar in Korea. She served on the Strategic Technical Advisory Committee for the Asia Pacific Observatory on Health Systems and Policies and has been a consultant to the World Bank, the Asian Development Bank, and the WHO regarding health system reforms in the PRC.

Director of the Asia Health Policy Program, Shorenstein Asia-Pacific Research Center
Stanford Health Policy Associate
Faculty Fellow at the Stanford Center at Peking University, June and August of 2016
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Nancy Shulman Assistant Professor of Medicine (Infectious Diseases) Speaker School of Medicine, Stanford University
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Dr. Lee currently holds the Edward G. and Nancy S. Jordan Endowed Chair in Economics and is a professor in the Department of Demography at University of California - Berkeley (Berkeley). He has taught courses in economic demography, population theory, population and economic development, demographic forecasting, population aging, indirect estimation, and research design, as well as a number of pro-seminars.

Professor Lee is also the director of the Center on the Economics and Demography of Aging at Berkeley, funded by the National Institute of Aging. His current research includes including modeling and forecasting demographic time series, the evolutionary theory of life histories, population aging, Social Security, and intergenerational transfers.

He has received several honors, including Presidency of the Population Association of America, the Mindel C. Sheps Award for research in mathematical demography, the PAA Irene B. Taeuber Award for outstanding contributions in the field of demography. He is an elected member of the National Academy of Sciences, the American Association for the Advancement of Science, the American Academy of Arts and Sciences, and a Corresponding member of the British Academy. He has chaired the population and social science study section for NIH and the National Academy of Sciences Committee on Population, and served on the National Advisory Committee on Aging (NIA Council).

Professor Lee holds an MA in demography from the University of California, Berkeley, and a PhD in economics from Harvard University.

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Ronald Lee Director of the Center on the Economics and Demography of Aging Speaker University of California - Berkeley
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Throughout history, nations have waged war against epidemics from bubonic plague to pulmonary tuberculosis. Today we confront HIV/AIDS, SARS, and avian influenza, among other major infectious diseases. Scientists around the world scrutinize viruses and bacteria more intently than ever. Yet while scientific advances are crucial, they are insufficient. The world is not well prepared for the next health crisis.

This timely book argues that the battle against infectious disease epidemics must be fought on two fronts. The first, of course, is the laboratory. The second is the wider social context that involves ordinary individuals and groups, legislators, and the state. The failure to contain HIV/AIDS and the emergence of new infectious diseases highlight the inadequacies of current preventive and management approaches to deal with epidemics.

The authors of Crisis Preparedness offer perspectives from social science, epidemiology, and public health, collectively seeking to answer the question: How can we prepare for the next global epidemic?

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Cigarettes are producing an unprecedented worldwide health catastrophe. Global traffic in cigarettes has tripled in the last fifty years, in large part because governments have become addicted to tobacco taxes, international trade agencies have promoted tobacco sales, and marketers have devised ever more deceptive tactics. Meanwhile, tobacco-induced diseases are besieging local communities around the world. Whether in China, Brazil or Morocco, families are emptying bank accounts, often in vain, to treat smoking-caused illnesses, and then struggling with the shards of broken futures.

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Throughout history, nations have waged war against epidemics, from bubonic plague to pulmonary tuberculosis. Today, we confront HIV/AIDS, SARS, and avian influenza, among other major infectious diseases. The failure to contain HIV/AIDS, the longest contemporary pandemic, and the difficulties in dealing with the threat posed by avian influenza, show that the world is not well prepared for the next health crises. Because preventing and controlling these infectious diseases is a race against time, scientists around the world scrutinize viruses and bacteria more intently than ever. Yet while scientific advances are crucial, they are insufficient.

This timely book addresses the urgent need to study the governance of infectious disease epidemics, and argues that the battle must be fought on two fronts, simultaneously. The first is within the laboratory; the second is located in a wider social context that involves ordinary individuals, groups, communities, legislators, and the state. Research by medical sociologists and other social scientists indicates that many factors influence people's behavior and, in turn, the level of success in preventing and containing an infectious disease epidemic.

Using Asia as a case study, Crisis Preparedness discusses the inadequacies of current preventive and management approaches to deal with epidemics. The distinguished international contributors to this volume present perspectives from the fields of social science, epidemiology, and public health, and collectively seek to answer the pressing question: How can we prepare for the next global epidemic?

About the Editor: Stella R. Quah is professor of sociology at the National University of Singapore. She is on the advisory boards of the British Journal of Sociology, Health Sociology Review, and Asian Population Studies. She also serves as editor of the Health Systems Section, Encyclopedia of Public Health (Elsevier).

This title is now out of print. You may download individual chapters below:

Front matter and preface (includes chapter 1) 

  1. Governance of Epidemics: Is There a Reason for Concern? (Stella R. Quah)
  2. The Global Governance of Epidemics: Possibilities and Limitations (Jim Whitman)
  3. Responding to Epidemic Disease Threats in Burma and Lessons for China: Why Good Governance Matters (Chris Beyrer)
  4. Global and Local Strategies against HIV/AIDS in South and Southeast Asia: The Cases of India and Thailand (Graham Scambler)
  5. Taming the Tiger: The Success and Failure of HIV/AIDS Policies in Thailand, Cambodia, Vietnam, and China (Kari Hartwig)
  6. On Trust and Health Consensus-building in the Governance of Epidemics (Stella R. Quah)
  7. Global Public Health Research Preparedness against Emerging and Reemerging Infectious Diseases (Gabriel M. Leung)
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WASHINGTON, May 24 (IPS) - This year the Association of Southeast Asian Nations celebrates its 40th birthday, and it has big plans. After four decades of being largely a political and security alliance, ASEAN is accelerating its plans for economic integration.

ASEAN leaders are so eager to pull together into an economic community that they recently decided to move the goalposts. The economic benchmarks originally planned for 2020 have been moved up to 2015.

"The mission of this economic community is to develop a single market that is competitive, equitably developed, and well integrated in the global economy," says Worapot Manupipatpong, principal economist and director of the office of the Secretary-General in the ASEAN Secretariat. He was speaking last week at an Asian Voices seminar in Washington, DC, sponsored by the Sasakawa Peace Foundation.

The single market of 2015 would encompass all ten members of ASEAN: Brunei, Cambodia, Indonesia, Laos, Malaysia, Myanmar (Burma), Philippines, Singapore, Thailand, and Vietnam. According to the projections of the ASEAN Secretariat, the single market will be accomplished by removing all barriers to the free flow of goods, services, capital, and skilled labor. Rules and regulations will be simplified and harmonised. Member countries will benefit from improved economies of scale. Common investment projects, such as a highway network and the Singapore--Kunming rail link, will facilitate greater trade.

Although there will not be a single currency like the European Union's euro, the ASEAN countries will nevertheless aim for greater currency cooperation.

"ASEAN's process of economic integration was market-driven," says Soedradjad Djiwandono former governor of Bank Indonesia, and it was influenced by the "Washington consensus" favoring increased liberalisation. "It is a very different framework from the closed regionalism of the Latin American model," he continues. With multilateral talks on trade liberalisation stalled, efforts have largely shifted to bilateral negotiations. "There has been a proliferation of bilateral agreements that developed countries use as a way to push a program for liberalising different sectors," Djiwandono concludes.

So far, ASEAN points to increased trade within the ten-member community as an early sign of success. But, overall trade share -- 25 percent -- pales in comparison to the 46 percent share of the North American Free Trade Agreement countries or the 68 percent share of EU countries. And with intra-ASEAN foreign direct investment rather low -- only 6 percent in 2005 -- financial integration lags behind trade integration.

The ASEAN approach differs in several key respects from the EU model, which originated in a 1951 coal and steel agreement among six European nations. ASEAN's origins, in contrast, have been primarily political and security-oriented, observes Donald Emmerson, director of the South-east Asia Forum at the Shorenstein Asia-Pacific Research Center at Stanford. "The success attributed to ASEAN is that it presided over an inter-state peace ever since it was formed. There's never been a war fought between ASEAN members."

Also distinguishing ASEAN from EU is the latter's institutionalisation. "ASEAN is radically different," Emmerson continues. "The much discussed ASEAN way is consultation, not even voting, since if they vote, someone will lose. Sometimes the consultation goes on without result. Sometimes decisions are reduced to the lowest common denominator. It also means that rhetoric predominates." This consultative process will be tested in November, when ASEAN leaders gather to adopt a charter, something that the EU has so far failed to accomplish.

Another difference with Europe is the enormous economic disparities among the ASEAN members, with Singapore and Brunei among the richest countries in the world and Laos among the poorest. These economic disparities are reproduced within the countries as well.

Worapot Manupipatpong points to two ASEAN initiatives for closing the gap. There is help for small and medium-sized enterprises. And the Initiative for ASEAN Integration,"basically provides technical assistance to Cambodia, Laos, and Myanmar so that they can catch up with the rest of the ASEAN members," he says. "Attention will be paid to where these countries can participate in the regional networks, what comparative advantage they have, and how to enhance their capacities to participate in the regional development and supply chain."

Then there are ASEAN's efforts to address "public bads," according to Soedradjad Djiwandono. "When there is a tsunami or a pandemic," he argues, "the worst victims are the marginalised or the poor. Addressing that kind of issue has some positive impact on reducing inequality."

"The gap between the early joiners and the later joiners will continue to be substantial because ASEAN has always been more of a forum and less of a problem-solving organisation," observes Karl Jackson, director of the Asian Studies Program at the School for Advanced International Studies at Johns Hopkins University. "As a result one would expect that these gaps would be closed only as individual countries increase their rates of growth." He attributes the inequality within countries to the middle stage of growth experienced by almost all societies: "Inequality increases before the state becomes strong enough to redivide some of the pie and take care of the gross inequalities caused by rapid economic growth."

ASEAN is banking on financial and trade liberalisation increasing the overall regional pie. On paper it is an ambitious project. But "the low hanging fruit have been plucked," says Donald Emmerson. Tariffs on the "easy commodities" have already been reduced to less than 5 percent. But non-tariff barriers to trade remain, and member countries are very protective of certain sectors.

Also tempering the region's optimism is the memory of the Asian financial crisis. The crisis began in Thailand in 1997 and spread rapidly to other countries in the region. One school of thinking holds that capital mobility -- "hot money" -- either caused or considerably aggravated the crisis. Since the ASEAN integration promises greater capital mobility, will the region be at greater risk of another such crisis?

"One consequence of the economic dynamism of the Asia-Pacific region," notes Donald Emmerson, "is that the accumulation of vast foreign exchange reserves -- obviously in China, but in other countries too -- more than anything else represents an asset that can be brought into the equation as a stabilising factor in the event of a financial crisis." Also, he continues, as a result of the ASEAN plus Three network, which adds China, South Korea, and Japan to the mix, the 13 countries have "made serious headway toward establishing currency swap arrangements that would come into play in an emergency on the scale of an Asian financial crisis."

Karl Jackson also looks to currency reforms as a hedge against future crisis. The Thai baht and the Indonesian rupiah are now unpegged currencies. "You will not have a situation in which the central bank of Thailand loses 34 billion US dollars defending the baht," Jackson argues. "Instead, the baht will appreciate or depreciate according to market forces."

But Jackson still remains cautious about the future. He points to the large number of non-performing loans in the Chinese banking sector. Also, there is "this anomaly of the U.S. absorbing two-thirds of the savings coming out of Asia, plugging it mostly into consumption rather than direct investment," he observes. "Eventually there has to be some kind of readjustment. The real value of the dollar must fall." (END/2007)

Reprinted by permission from IPS Asia-Pacific.

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Dr. Karen Eggleston will join the Shorenstein Asia-Pacific Research Center as a center fellow on July 1, 2007. Dr. Eggleston will lead the center's program on comparative health care in East Asia.

Dr. Eggleston's research focuses on comparative healthcare systems and their link to broader social protection policies during economic development and transition from central planning to market-based economies; payment incentives and their impact on healthcare insurer and provider behavior; the market structure of healthcare, including competition, integration, ownership, and healthcare productivity; and incentives surrounding health behaviors such as the spread of HIV/AIDS, overuse of antibiotics, and smoking. She studied in China for two years and was a Fulbright scholar in Korea.

Eggleston earned her Ph.D. in public policy from Harvard University in 1999. She has an M.A. in economics and another in Asian studies from the University of Hawaii, Economics (August 1995 and May 1992, respectively.) She is currently an assistant professor of economics at Tufts University in Boston. Dr. Eggleston joined the faculty at Tufts in 1999.

Currently, Dr. Eggleston is a research associate at the Kennedy School of Government at Harvard University and an academic program coordinator at the Kennedy School Health Care Delivery Policy Program also at Harvard. Dr. Eggleson has been a research associate at the China Academy of Health Policy (CAHP) at Peking University, Beijing, China since 2003 and in the summer of 2004 she was a consultant to the World Bank on their project on health service delivery and the rural health sector.

"Karen will be a great addition to the center," says director of the center, Gi-Wook Shin.

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Dr. Linton was born in Philadelphia in 1950 and grew up in Korea, where his father was a third generation Presbyterian missionary. He is a visiting associate of the Korea Institute, Harvard University, for 2006-07. Linton is currently Chairman of The Eugene Bell Foundation, a not-for-profit organization that provides humanitarian aid to North Korea.

Dr. Linton's talk will focus on the Eugene Bell Foundation and its programs. Named for Rev. Eugene Bell, Lintonn's great-grandfather and a missionary who arrived in Korea in 1895, the Foundation serves as a conduit for a wide spectrum of business, governmental, religious and social organizations as well as individuals who are interested in promoting programs that benefit the sick and suffering of North Korea.

Since 1995, the Foundation strives primarily to bring medical treatment facilities in North Korea together with donors as partners in a combined effort to fight deadly diseases such as tuberculosis (TB). In 2005, the North Korean ministry of Public Health officially asked the Foundation to expand its work to include support programs for local hospitals. The Foundation currently coordinates the delivery of TB medication, diagnostic equipment, and supplies to one third of the North Korean population and approximately forty North Korean treatment facilities (hospitals and care centers).

Dr. Linton's credentials include: thirty years of teaching and research on Korea, twenty years of travel to North Korea (over fifty trips since 1979), and ten years of humanitarian aid work in North Korea. Dr. Linton received a Bachelor of Arts degree from Yonsei University in Seoul, Korea, a Masters of Divinity from Korea Theological Seminary, and a Masters of Philosophy and a Ph.D. in Korean Studies from Columbia University.

This public lecture is part of the conference "Public Diplomacy, Counterpublics, and the Asia Pacific." This conference is co-sponsored by The Asia Society Northern California; The Japan Society of Northern California; Business for Diplomatic Action; Center for International Security and Cooperation at Stanford University; and the Taiwan Democracy Program in the Center on Democracy Development, and the Rule of Law at Stanford University.

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Stephen Linton Chairman Speaker The Eugene Bell Foundation
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