This study analyzes the impact of Indonesia's Village Midwife program on health outcomes between 1993 and 1997 using data from the Indonesian Family Life Survey. The analysis finds that:
1) Villages that gained a midwife saw a significant increase in average BMI among women of reproductive age (19-45) but not in other groups.
2) This effect remained even after controlling for individual characteristics and differences in infrastructure between villages.
3) The results provide evidence that the Village Midwife program had a causal impact on improving health outcomes for its target population of reproductive-age women.
An Examination of The Relationship Among Obesity, Quality of Life And Job Per...QUESTJOURNAL
The document examines the relationship between obesity, quality of life, and job performance in health personnel. It found that:
1) There was no significant difference in quality of life or job performance between female and male health personnel.
2) Health personnel with normal weight had significantly higher quality of life and job performance than obese health personnel.
3) There was a positive significant relationship between the quality of life subdimensions and between quality of life and job performance. Higher quality of life was related to higher job performance.
D’Asia Overseas Education Consultants is the only reliable overseas education consultancy in Kochi doing admissions for premium colleges in Asia with job oriented courses. We at D’Asia Overseas Education Consultants offers not just study abroad programs, but also assist students in getting settled down and search for a job in foreign countries. Our delegates visit the students at their colleges and universities abroad after they join the course and enquire their things. Call D’Asia Overseas Education Consultants to discuss about your studies and jobs abroad.
ABC Systems is an IT and telecommunications company that provides quality services and solutions on time and on budget. They emphasize uncompromising quality, flexible solutions, integrity, and valuing their employees. ABC Systems has experience in networking, structured cabling, facilities management, telecommunications projects, and has provided services to many large clients.
The document provides an overview of the U.S. Rotary Club & District Liability Insurance Program. It discusses the various resources available, types of insurance coverage including general liability and directors' & officers' insurance, exclusions from coverage, how to obtain certificates of insurance, risk management best practices, and handles basic questions.
Dokumen tersebut membahas tentang dinamika litosfer, yang meliputi struktur lapisan kulit bumi, jenis-jenis batuan pembentuk permukaan bumi, dan tenaga yang mempengaruhi perubahan permukaan bumi seperti vulkanisme, gempa bumi, serta proses erosi. Dokumen ini juga menjelaskan dampak aktivitas litosfer terhadap kehidupan manusia.
This document summarizes a study that aims to improve an existing econometric model for estimating the causal impact of obesity on medical costs. The authors successfully replicate the original study's two-part model, which uses the BMI of a respondent's oldest child as an instrumental variable. They then make several modifications, including expanding the sample period, adding control variables for health status and insurance, and investigating potential time heterogeneity. The results suggest that the original study may have overestimated obesity's effect, with the marginal cost of obesity decreasing from $3,297 to $1,956 after controlling for additional health factors.
Quantifying the added societal value of public health interventions in reduci...cheweb1
This document discusses two projects conducted by NICE to estimate the health inequality impacts of public health interventions:
1. Plotting 134 NICE public health guideline interventions on a "health equity impact plane" based on their incremental population health benefits and reduction in health inequality. 71 interventions improved total health and reduced inequality.
2. A pilot study estimating the distributional cost-effectiveness of smoking cessation interventions. This involved adapting an existing model to incorporate evidence on how inputs like baseline risk, quit rates, and uptake vary by socioeconomic status.
The aggregate approach provides a simple feasible way to consider health inequality, but may miss differential effects. A bespoke approach can better capture differences but requires more data. Overall
An Examination of The Relationship Among Obesity, Quality of Life And Job Per...QUESTJOURNAL
The document examines the relationship between obesity, quality of life, and job performance in health personnel. It found that:
1) There was no significant difference in quality of life or job performance between female and male health personnel.
2) Health personnel with normal weight had significantly higher quality of life and job performance than obese health personnel.
3) There was a positive significant relationship between the quality of life subdimensions and between quality of life and job performance. Higher quality of life was related to higher job performance.
D’Asia Overseas Education Consultants is the only reliable overseas education consultancy in Kochi doing admissions for premium colleges in Asia with job oriented courses. We at D’Asia Overseas Education Consultants offers not just study abroad programs, but also assist students in getting settled down and search for a job in foreign countries. Our delegates visit the students at their colleges and universities abroad after they join the course and enquire their things. Call D’Asia Overseas Education Consultants to discuss about your studies and jobs abroad.
ABC Systems is an IT and telecommunications company that provides quality services and solutions on time and on budget. They emphasize uncompromising quality, flexible solutions, integrity, and valuing their employees. ABC Systems has experience in networking, structured cabling, facilities management, telecommunications projects, and has provided services to many large clients.
The document provides an overview of the U.S. Rotary Club & District Liability Insurance Program. It discusses the various resources available, types of insurance coverage including general liability and directors' & officers' insurance, exclusions from coverage, how to obtain certificates of insurance, risk management best practices, and handles basic questions.
Dokumen tersebut membahas tentang dinamika litosfer, yang meliputi struktur lapisan kulit bumi, jenis-jenis batuan pembentuk permukaan bumi, dan tenaga yang mempengaruhi perubahan permukaan bumi seperti vulkanisme, gempa bumi, serta proses erosi. Dokumen ini juga menjelaskan dampak aktivitas litosfer terhadap kehidupan manusia.
This document summarizes a study that aims to improve an existing econometric model for estimating the causal impact of obesity on medical costs. The authors successfully replicate the original study's two-part model, which uses the BMI of a respondent's oldest child as an instrumental variable. They then make several modifications, including expanding the sample period, adding control variables for health status and insurance, and investigating potential time heterogeneity. The results suggest that the original study may have overestimated obesity's effect, with the marginal cost of obesity decreasing from $3,297 to $1,956 after controlling for additional health factors.
Quantifying the added societal value of public health interventions in reduci...cheweb1
This document discusses two projects conducted by NICE to estimate the health inequality impacts of public health interventions:
1. Plotting 134 NICE public health guideline interventions on a "health equity impact plane" based on their incremental population health benefits and reduction in health inequality. 71 interventions improved total health and reduced inequality.
2. A pilot study estimating the distributional cost-effectiveness of smoking cessation interventions. This involved adapting an existing model to incorporate evidence on how inputs like baseline risk, quit rates, and uptake vary by socioeconomic status.
The aggregate approach provides a simple feasible way to consider health inequality, but may miss differential effects. A bespoke approach can better capture differences but requires more data. Overall
This document discusses social determinants of health and health inequalities. It will include an interactive game to illustrate social determinants and how unequal social conditions can influence health. Differences in health status and access to health resources between populations can lead to health inequalities, some of which may be considered unfair or avoidable. Addressing social factors like poverty, living and working conditions, rather than just healthcare access, can help reduce health inequities.
Evaluation of Childhood Obesity This is just an example do n.docxelbanglis
Evaluation of Childhood Obesity
This is just an example do not follow the citations etc…..
This is just to show you what we are looking for.
Childhood obesity is a rising problem worldwide problem. The World Health
Organization (WHO) believes that childhood obesity is one of the “most serious public health
challenges of the 21st century” (Howard, 2019). Obesity in children and adolescents is expected
to exceed the occurrence of those that are underweight and malnourished in the world by the year
2022 (Howard). According to the WHO, the number of obese children in the world increased
from 32 to 41 million over the past 25 years (“GHO”, n.d.). In 2016, the obesity rate in children
under the age of 5 in the United States was 22.7 and 18 percent in children over the age of five
(“GHO”). New Zealand’s rates of childhood obesity are very similar to the United States, with
20.6 percent of children under the age of 5 and 15 percent in the childhood population over 5
years old (“GHO”). The purpose of this paper is to discuss the global health impact of childhood
obesity as well as compare the United States with New Zealand on obesities impact, policy
implementation, and plans to improve this rising health dilemma.
Global Health Comparison Grid Template
Use this document to complete the Module 6 Assessment Global Healthcare Comparison Matrix and Narrative Statement
Global Healthcare Issue
Description
Country
United States
Describe the policy in each country related to the identified healthcare issue
What are the strengths of this policy?
What are the weaknesses of this policy?
Explain how the social determinants of health may impact the specified global health issue. (Be specific and provide examples)
How has each country’ government addressed cost, quality, and access to the selected global health issue?
How has the identified health policy impacted the health of the global population? (Be specific and provide examples)
Describe the potential impact of the identified health policy on the role of nurse in each country.
Explain how global health issues impact local healthcare organizations and policies in both countries. (Be specific and provide examples)
General Notes/Comments
EXAMPLE
A Plan for Social Change
The definition for obesity is not universal (Howard). However the problem still exists across the globe. Policies, laws, and regulations are necessary to create change and reduce obesity worldwide (Swinburn). Society across the globe has evolved. People tend to seek out opportunities to indulge in food for relaxation but have decreased efforts in work and physical activity (Swinburn). Lifestyles have become over burdened with tasks. People are on the go, always running to the next task. Technology has created a world where machines do simple tasks that man once had to complete. Food is more readily at our fingertips, but the quality and nutritional value of these products are falling (Swinbu ...
Evaluation of Childhood Obesity This is just an example do n.docxturveycharlyn
Evaluation of Childhood Obesity
This is just an example do not follow the citations etc…..
This is just to show you what we are looking for.
Childhood obesity is a rising problem worldwide problem. The World Health
Organization (WHO) believes that childhood obesity is one of the “most serious public health
challenges of the 21st century” (Howard, 2019). Obesity in children and adolescents is expected
to exceed the occurrence of those that are underweight and malnourished in the world by the year
2022 (Howard). According to the WHO, the number of obese children in the world increased
from 32 to 41 million over the past 25 years (“GHO”, n.d.). In 2016, the obesity rate in children
under the age of 5 in the United States was 22.7 and 18 percent in children over the age of five
(“GHO”). New Zealand’s rates of childhood obesity are very similar to the United States, with
20.6 percent of children under the age of 5 and 15 percent in the childhood population over 5
years old (“GHO”). The purpose of this paper is to discuss the global health impact of childhood
obesity as well as compare the United States with New Zealand on obesities impact, policy
implementation, and plans to improve this rising health dilemma.
Global Health Comparison Grid Template
Use this document to complete the Module 6 Assessment Global Healthcare Comparison Matrix and Narrative Statement
Global Healthcare Issue
Description
Country
United States
Describe the policy in each country related to the identified healthcare issue
What are the strengths of this policy?
What are the weaknesses of this policy?
Explain how the social determinants of health may impact the specified global health issue. (Be specific and provide examples)
How has each country’ government addressed cost, quality, and access to the selected global health issue?
How has the identified health policy impacted the health of the global population? (Be specific and provide examples)
Describe the potential impact of the identified health policy on the role of nurse in each country.
Explain how global health issues impact local healthcare organizations and policies in both countries. (Be specific and provide examples)
General Notes/Comments
EXAMPLE
A Plan for Social Change
The definition for obesity is not universal (Howard). However the problem still exists across the globe. Policies, laws, and regulations are necessary to create change and reduce obesity worldwide (Swinburn). Society across the globe has evolved. People tend to seek out opportunities to indulge in food for relaxation but have decreased efforts in work and physical activity (Swinburn). Lifestyles have become over burdened with tasks. People are on the go, always running to the next task. Technology has created a world where machines do simple tasks that man once had to complete. Food is more readily at our fingertips, but the quality and nutritional value of these products are falling (Swinbu.
1) The project aimed to improve maternal and newborn health in Uttar Pradesh, India by integrating a focus on gender and sexuality into an existing maternal health program.
2) It sought to increase community support for maternal health, enhance health systems, and address biases among health workers by discussing topics like gender roles and family planning.
3) Results suggested the approach improved some health behaviors like birth preparedness and facility deliveries, and helped shift attitudes around supporting women's empowerment.
Dual burden of underweight and overweight among women in bangladesh patterns...Farhad Kabir
This document summarizes a study examining the dual burden of underweight and overweight among women in Bangladesh. The study uses data from Bangladesh's 2011 Demographic and Health Survey to analyze the patterns, prevalence, and sociodemographic correlates of underweight, normal weight, pre-overweight, overweight, and obesity among ever-married women aged 15-49. The results show a co-existence of underweight and overweight, with prevalences of 24.1%, 46.7%, 12.8%, 13.5%, and 2.9% respectively. Multivariate analysis found that women from poorer households were more likely to be underweight and less likely to be overweight, while urban women were less likely to be under
The document discusses health inequalities and options for addressing them, including through screening programs and consideration of social determinants of health. It notes that those with greater social and economic disadvantages tend to have poorer health outcomes and less access to healthcare. Screening definitions and programs are reviewed, along with factors influencing individual, community and societal health. Disadvantaged groups, importance of addressing inequalities, and advocacy are discussed. Exercises on deprivation and obesity are included.
This document discusses obesity and related topics including definitions, causes, and health impacts. It defines obesity as abnormal or excessive fat accumulation that presents health risks. Obesity is generally caused by consuming more calories than are expended through exercise and physical activity. The document also reviews several related studies that examine trends in obesity prevalence and factors influencing obesity rates among populations in different regions and socioeconomic groups.
This document is a report on the economic benefits of worksite wellness programs. It discusses factors that influence an employer's likelihood of offering a wellness program and an employee's participation in one. It also analyzes specific wellness programs and meta-analyses of their effects. The report finds that wellness programs have been shown to reduce healthcare costs and decrease absenteeism and increase employee satisfaction, though the evidence is not conclusive due to a lack of robust data collection and analysis in many studies. The document provides an overview of worksite wellness programs and their goals of improving health and reducing costs.
Synopsis: Impact of Health Systems Strengthening on HealthHFG Project
Leaders in low- and middle-income countries (LMICs) require timely and compelling evidence about how to strengthen their health systems to improve the health and well-being of their citizens. Yet, evidence on how to strengthen health system performance to achieve sustainable health improvements at scale, particularly toward Ending Preventable Child and Maternal Deaths (EPCMD), fostering an AIDS-Free Generation (AFG), and Protecting Communities against Infectious Diseases (PCID) is limited. The evidence that does exist is scattered, insufficiently analyzed, and not widely disseminated. Without evidence, decision-makers lack a sound basis for investing scarce health funds in health systems strengthening (HSS) in an environment of competing investment options.
USAID is committed to advancing the evidence base on HSS and this commissioned report clearly demonstrates that HSS can improve health in LMICs.
This report, based on a review of systematic reviews of the effects on health of HSS, presents a significant body of evidence linking HSS interventions to measureable impact on health for vulnerable people in LMICs. Making decisions on who delivers health services and where and how these services are organized is important to achieve priority health goals such as EPCMD, AFG, and PCID. The findings of this report document the value of investing in HSS.
Kaouthar lbiati-health-composite-indicators as measures for equityKaouthar Lbiati (MD)
There is no consensus regarding conditions and circumstances where each individual rank-dependant indicator of socio-economic inequality is to be used. What emerges from this paper is that the concentration index approach needs to be confined to situations where the health variable is of ratio-scale type.
This document summarizes a study on rural health care in Thoubal District, Manipur, India. It finds that while India's constitution recognizes health as a primary duty, rural populations still lack adequate access to health care due to factors like poverty, lack of infrastructure, and social/psychological barriers. The study aims to evaluate health care facilities and services in Thoubal District, examine factors influencing access to primary health care, and assess the quality of services provided by health care workers to rural communities. It analyzes key health indicators for Manipur from the National Family Health Survey and finds that while material well-being is low, Manipur has relatively good public health outcomes, such as low infant mortality.
1. The document discusses social determinants of health and health inequalities, defining key terms like social determinants, absolute/relative inequalities, and inequity in health.
2. It identifies several key social determinants of health like poverty, social exclusion, discrimination, public policies, built environment, and health behaviors.
3. Achieving health equity requires addressing social determinants through public policies, equitable health services, and a life course perspective that considers vulnerabilities at different life stages.
1. The study analyzed weight gain data from ages 18 to 22 for young adults in the National Longitudinal Survey of Youth 1997.
2. College graduates gained an average of 1.6 kg/m2 (11 lbs) while non-college graduates gained 1.9 kg/m2 (13 lbs) on average.
3. College graduation was associated with 0.34 kg/m2 less weight gain (2 lbs less) compared to non-college graduates.
The document discusses how health inequalities are socially determined by differences in life chances rather than just lifestyles. It provides evidence from studies showing how stressful work environments and unemployment negatively impact health, with up to 40-64% of health inequalities reduced after adjusting for these social determinants of health. The document advocates for policies focused on improving life chances, such as increasing income, employment opportunities, and participation at work and in communities, as evidenced by some of Labour's past successes in reducing inequalities.
150 words as response to this post if in text cite use reference .docxRAJU852744
150 words as response to this post if in text cite use reference
Michael Donkersloot
Hello Class,
Healthcare reform has not had a noticeable effect on the quality of care that I received. This point of view comes from more than 20 years of service to our nation while receiving care in the military. Post-retirement medical care has come from a variety of both civilian and VA Medical Centers. Throughout nearly thirty years there has not been a time where a notable difference in the treatment of any of my defined medical ailments. Although the quality of care did not change the availably of care was addressed in 2019 where the VA made civilian care providers more accessible (VAntage Point, 2019). This healthcare reform allowed veterans to seek care outside of the confines of the VA medical system thanks to the MISSION Act (Dept of Veteran Affairs, 2021).
According to the Journal of General Internal Medicine, the VA has a higher quality of care than non-VA providers (O'Hanlon et al., 2017). To better define what quality is in relation to healthcare can be an individual assessment. Health.gov (2020) defined quality health care as care that is safe, effective, patient-centered, timely, efficient, and equitable, based on this definition, I have always enjoyed the benefit of quality care in and out of the military.
Based on the aforementioned definition of quality of care, one can assume most, if not all want a timelier approach to being seen, the MISSION Act helped with that for many veterans, however having a civilian provider this healthcare reform did not provide a noticeable effect for me. Having experienced the gambit of providers from Navy Corpsman to civilian neuro-surgeons there has been no noticeable effect on my care throughout the decades. This luxury is most likely due to the fact that my care was micro-managed based on my line of work. Post-military career care, has not changed either based on the fact that there are several avenues of care and providers available within several systems to benefit from. Understanding this is an atypical situation at face value, it does not take into consideration the unknown factors that are not available for discussion.
.
What can longitudinal research tell us about adolescent health and nutrition? Research findings from Young Lives
Elisabetta Aurino
(with Jere Behrman, Mary Penny
and Whitney Schott)
Young Lives conference on Adolescence, Youth and Gender
8-9 September 2016
This document summarizes Michel Boudreaux's dissertation research on the long-term effects of exposure to Medicaid in early childhood. The study uses variation in Medicaid adoption across states and over time to examine the impact on adult health and economic outcomes. The results show that exposure to Medicaid in early childhood significantly decreases the prevalence of adult chronic health conditions for individuals from low-income families, but does not find significant effects on long-term economic status. This suggests that providing health insurance early in life produces lasting health benefits for children from disadvantaged backgrounds.
This document discusses social determinants of health and health inequalities. It will include an interactive game to illustrate social determinants and how unequal social conditions can influence health. Differences in health status and access to health resources between populations can lead to health inequalities, some of which may be considered unfair or avoidable. Addressing social factors like poverty, living and working conditions, rather than just healthcare access, can help reduce health inequities.
Evaluation of Childhood Obesity This is just an example do n.docxelbanglis
Evaluation of Childhood Obesity
This is just an example do not follow the citations etc…..
This is just to show you what we are looking for.
Childhood obesity is a rising problem worldwide problem. The World Health
Organization (WHO) believes that childhood obesity is one of the “most serious public health
challenges of the 21st century” (Howard, 2019). Obesity in children and adolescents is expected
to exceed the occurrence of those that are underweight and malnourished in the world by the year
2022 (Howard). According to the WHO, the number of obese children in the world increased
from 32 to 41 million over the past 25 years (“GHO”, n.d.). In 2016, the obesity rate in children
under the age of 5 in the United States was 22.7 and 18 percent in children over the age of five
(“GHO”). New Zealand’s rates of childhood obesity are very similar to the United States, with
20.6 percent of children under the age of 5 and 15 percent in the childhood population over 5
years old (“GHO”). The purpose of this paper is to discuss the global health impact of childhood
obesity as well as compare the United States with New Zealand on obesities impact, policy
implementation, and plans to improve this rising health dilemma.
Global Health Comparison Grid Template
Use this document to complete the Module 6 Assessment Global Healthcare Comparison Matrix and Narrative Statement
Global Healthcare Issue
Description
Country
United States
Describe the policy in each country related to the identified healthcare issue
What are the strengths of this policy?
What are the weaknesses of this policy?
Explain how the social determinants of health may impact the specified global health issue. (Be specific and provide examples)
How has each country’ government addressed cost, quality, and access to the selected global health issue?
How has the identified health policy impacted the health of the global population? (Be specific and provide examples)
Describe the potential impact of the identified health policy on the role of nurse in each country.
Explain how global health issues impact local healthcare organizations and policies in both countries. (Be specific and provide examples)
General Notes/Comments
EXAMPLE
A Plan for Social Change
The definition for obesity is not universal (Howard). However the problem still exists across the globe. Policies, laws, and regulations are necessary to create change and reduce obesity worldwide (Swinburn). Society across the globe has evolved. People tend to seek out opportunities to indulge in food for relaxation but have decreased efforts in work and physical activity (Swinburn). Lifestyles have become over burdened with tasks. People are on the go, always running to the next task. Technology has created a world where machines do simple tasks that man once had to complete. Food is more readily at our fingertips, but the quality and nutritional value of these products are falling (Swinbu ...
Evaluation of Childhood Obesity This is just an example do n.docxturveycharlyn
Evaluation of Childhood Obesity
This is just an example do not follow the citations etc…..
This is just to show you what we are looking for.
Childhood obesity is a rising problem worldwide problem. The World Health
Organization (WHO) believes that childhood obesity is one of the “most serious public health
challenges of the 21st century” (Howard, 2019). Obesity in children and adolescents is expected
to exceed the occurrence of those that are underweight and malnourished in the world by the year
2022 (Howard). According to the WHO, the number of obese children in the world increased
from 32 to 41 million over the past 25 years (“GHO”, n.d.). In 2016, the obesity rate in children
under the age of 5 in the United States was 22.7 and 18 percent in children over the age of five
(“GHO”). New Zealand’s rates of childhood obesity are very similar to the United States, with
20.6 percent of children under the age of 5 and 15 percent in the childhood population over 5
years old (“GHO”). The purpose of this paper is to discuss the global health impact of childhood
obesity as well as compare the United States with New Zealand on obesities impact, policy
implementation, and plans to improve this rising health dilemma.
Global Health Comparison Grid Template
Use this document to complete the Module 6 Assessment Global Healthcare Comparison Matrix and Narrative Statement
Global Healthcare Issue
Description
Country
United States
Describe the policy in each country related to the identified healthcare issue
What are the strengths of this policy?
What are the weaknesses of this policy?
Explain how the social determinants of health may impact the specified global health issue. (Be specific and provide examples)
How has each country’ government addressed cost, quality, and access to the selected global health issue?
How has the identified health policy impacted the health of the global population? (Be specific and provide examples)
Describe the potential impact of the identified health policy on the role of nurse in each country.
Explain how global health issues impact local healthcare organizations and policies in both countries. (Be specific and provide examples)
General Notes/Comments
EXAMPLE
A Plan for Social Change
The definition for obesity is not universal (Howard). However the problem still exists across the globe. Policies, laws, and regulations are necessary to create change and reduce obesity worldwide (Swinburn). Society across the globe has evolved. People tend to seek out opportunities to indulge in food for relaxation but have decreased efforts in work and physical activity (Swinburn). Lifestyles have become over burdened with tasks. People are on the go, always running to the next task. Technology has created a world where machines do simple tasks that man once had to complete. Food is more readily at our fingertips, but the quality and nutritional value of these products are falling (Swinbu.
1) The project aimed to improve maternal and newborn health in Uttar Pradesh, India by integrating a focus on gender and sexuality into an existing maternal health program.
2) It sought to increase community support for maternal health, enhance health systems, and address biases among health workers by discussing topics like gender roles and family planning.
3) Results suggested the approach improved some health behaviors like birth preparedness and facility deliveries, and helped shift attitudes around supporting women's empowerment.
Dual burden of underweight and overweight among women in bangladesh patterns...Farhad Kabir
This document summarizes a study examining the dual burden of underweight and overweight among women in Bangladesh. The study uses data from Bangladesh's 2011 Demographic and Health Survey to analyze the patterns, prevalence, and sociodemographic correlates of underweight, normal weight, pre-overweight, overweight, and obesity among ever-married women aged 15-49. The results show a co-existence of underweight and overweight, with prevalences of 24.1%, 46.7%, 12.8%, 13.5%, and 2.9% respectively. Multivariate analysis found that women from poorer households were more likely to be underweight and less likely to be overweight, while urban women were less likely to be under
The document discusses health inequalities and options for addressing them, including through screening programs and consideration of social determinants of health. It notes that those with greater social and economic disadvantages tend to have poorer health outcomes and less access to healthcare. Screening definitions and programs are reviewed, along with factors influencing individual, community and societal health. Disadvantaged groups, importance of addressing inequalities, and advocacy are discussed. Exercises on deprivation and obesity are included.
This document discusses obesity and related topics including definitions, causes, and health impacts. It defines obesity as abnormal or excessive fat accumulation that presents health risks. Obesity is generally caused by consuming more calories than are expended through exercise and physical activity. The document also reviews several related studies that examine trends in obesity prevalence and factors influencing obesity rates among populations in different regions and socioeconomic groups.
This document is a report on the economic benefits of worksite wellness programs. It discusses factors that influence an employer's likelihood of offering a wellness program and an employee's participation in one. It also analyzes specific wellness programs and meta-analyses of their effects. The report finds that wellness programs have been shown to reduce healthcare costs and decrease absenteeism and increase employee satisfaction, though the evidence is not conclusive due to a lack of robust data collection and analysis in many studies. The document provides an overview of worksite wellness programs and their goals of improving health and reducing costs.
Synopsis: Impact of Health Systems Strengthening on HealthHFG Project
Leaders in low- and middle-income countries (LMICs) require timely and compelling evidence about how to strengthen their health systems to improve the health and well-being of their citizens. Yet, evidence on how to strengthen health system performance to achieve sustainable health improvements at scale, particularly toward Ending Preventable Child and Maternal Deaths (EPCMD), fostering an AIDS-Free Generation (AFG), and Protecting Communities against Infectious Diseases (PCID) is limited. The evidence that does exist is scattered, insufficiently analyzed, and not widely disseminated. Without evidence, decision-makers lack a sound basis for investing scarce health funds in health systems strengthening (HSS) in an environment of competing investment options.
USAID is committed to advancing the evidence base on HSS and this commissioned report clearly demonstrates that HSS can improve health in LMICs.
This report, based on a review of systematic reviews of the effects on health of HSS, presents a significant body of evidence linking HSS interventions to measureable impact on health for vulnerable people in LMICs. Making decisions on who delivers health services and where and how these services are organized is important to achieve priority health goals such as EPCMD, AFG, and PCID. The findings of this report document the value of investing in HSS.
Kaouthar lbiati-health-composite-indicators as measures for equityKaouthar Lbiati (MD)
There is no consensus regarding conditions and circumstances where each individual rank-dependant indicator of socio-economic inequality is to be used. What emerges from this paper is that the concentration index approach needs to be confined to situations where the health variable is of ratio-scale type.
This document summarizes a study on rural health care in Thoubal District, Manipur, India. It finds that while India's constitution recognizes health as a primary duty, rural populations still lack adequate access to health care due to factors like poverty, lack of infrastructure, and social/psychological barriers. The study aims to evaluate health care facilities and services in Thoubal District, examine factors influencing access to primary health care, and assess the quality of services provided by health care workers to rural communities. It analyzes key health indicators for Manipur from the National Family Health Survey and finds that while material well-being is low, Manipur has relatively good public health outcomes, such as low infant mortality.
1. The document discusses social determinants of health and health inequalities, defining key terms like social determinants, absolute/relative inequalities, and inequity in health.
2. It identifies several key social determinants of health like poverty, social exclusion, discrimination, public policies, built environment, and health behaviors.
3. Achieving health equity requires addressing social determinants through public policies, equitable health services, and a life course perspective that considers vulnerabilities at different life stages.
1. The study analyzed weight gain data from ages 18 to 22 for young adults in the National Longitudinal Survey of Youth 1997.
2. College graduates gained an average of 1.6 kg/m2 (11 lbs) while non-college graduates gained 1.9 kg/m2 (13 lbs) on average.
3. College graduation was associated with 0.34 kg/m2 less weight gain (2 lbs less) compared to non-college graduates.
The document discusses how health inequalities are socially determined by differences in life chances rather than just lifestyles. It provides evidence from studies showing how stressful work environments and unemployment negatively impact health, with up to 40-64% of health inequalities reduced after adjusting for these social determinants of health. The document advocates for policies focused on improving life chances, such as increasing income, employment opportunities, and participation at work and in communities, as evidenced by some of Labour's past successes in reducing inequalities.
150 words as response to this post if in text cite use reference .docxRAJU852744
150 words as response to this post if in text cite use reference
Michael Donkersloot
Hello Class,
Healthcare reform has not had a noticeable effect on the quality of care that I received. This point of view comes from more than 20 years of service to our nation while receiving care in the military. Post-retirement medical care has come from a variety of both civilian and VA Medical Centers. Throughout nearly thirty years there has not been a time where a notable difference in the treatment of any of my defined medical ailments. Although the quality of care did not change the availably of care was addressed in 2019 where the VA made civilian care providers more accessible (VAntage Point, 2019). This healthcare reform allowed veterans to seek care outside of the confines of the VA medical system thanks to the MISSION Act (Dept of Veteran Affairs, 2021).
According to the Journal of General Internal Medicine, the VA has a higher quality of care than non-VA providers (O'Hanlon et al., 2017). To better define what quality is in relation to healthcare can be an individual assessment. Health.gov (2020) defined quality health care as care that is safe, effective, patient-centered, timely, efficient, and equitable, based on this definition, I have always enjoyed the benefit of quality care in and out of the military.
Based on the aforementioned definition of quality of care, one can assume most, if not all want a timelier approach to being seen, the MISSION Act helped with that for many veterans, however having a civilian provider this healthcare reform did not provide a noticeable effect for me. Having experienced the gambit of providers from Navy Corpsman to civilian neuro-surgeons there has been no noticeable effect on my care throughout the decades. This luxury is most likely due to the fact that my care was micro-managed based on my line of work. Post-military career care, has not changed either based on the fact that there are several avenues of care and providers available within several systems to benefit from. Understanding this is an atypical situation at face value, it does not take into consideration the unknown factors that are not available for discussion.
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What can longitudinal research tell us about adolescent health and nutrition? Research findings from Young Lives
Elisabetta Aurino
(with Jere Behrman, Mary Penny
and Whitney Schott)
Young Lives conference on Adolescence, Youth and Gender
8-9 September 2016
This document summarizes Michel Boudreaux's dissertation research on the long-term effects of exposure to Medicaid in early childhood. The study uses variation in Medicaid adoption across states and over time to examine the impact on adult health and economic outcomes. The results show that exposure to Medicaid in early childhood significantly decreases the prevalence of adult chronic health conditions for individuals from low-income families, but does not find significant effects on long-term economic status. This suggests that providing health insurance early in life produces lasting health benefits for children from disadvantaged backgrounds.
Similar to Susan stata.project-village midwives (20)
1. Susan Chen
03/25/2011
Bidan Desa: Did It Work?
I. Research Design
Do government efforts to provide health care have an impact on the populations that the
programs target? This study explores the question in the context of Indonesia, analyzing the effects of
the Village Midwife (or Bidan Desa) program that began in the early 1990s. Analysis is conducted to
determine if provision of midwife services to reproductive age women would affect health outcomes.
The Village Midwife program places trained midwives in villages and townships in an effort
to increase women’s access to reproductive health care. Village midwives have a number of duties,
including provision of health and family planning services, promoting community participation in
health, working with traditional birth attendants, and referring complicated cases to health clinics and
hospitals (Government of India, 1989).
The quasi-experiment focuses on rural regions and uses data from the government-sponsored
longitudinal Indonesia Family Life Survey (IFLS). The IFLS is a panel survey of individuals, and
households. The first round of data (IFLS1) was collected in 1993 and included interviews with 7,224
households and with 22,347 individuals within those households (Frankenberg, 2001). The analysis
looks at a sample of 8824 individuals in 13 provinces. This large sample size should allow for
significant and robust analysis. Thirty-nine percent of participants (2926) were women between ages
19-45 (reproductive age), 22 percent (2017) were women over age 45, 25 percent (2132) were men
between ages 19-45, and 20 percent (1749) were men over age 45. In 1997, a survey (IFLS2) was
conducted to re-interview all IFLS1 individuals (International Household Survey Network, 2009).
The dependent variable in these analyses is health status, or the difference between the Body
Mass Index in 1997 and BMI in 1993. Positive values of the dependent variable represent a positive
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2. change in health status between 1993 and 1997.
II. Effect of Having Midwife on Average BMI
From 1993 to 1997, all villages—with and without midwives—showed statistically significant
overall gains in BMI. Thus, there is an overall improvement in health from 1993 to 1997.
Surprisingly, villages without midwives showed a significantly higher BMI than villages with
midwives. This appears to indicate that villages with midwives reduce BMI, and therefore are
detrimental to improving health outcomes. However, this conclusion neglects to consider the fact that
midwives were assigned to rural areas far away from health centers so the health of the population
tended to be worse than that of the urban population. As a result, these areas may already have a low
BMI to begin with (selection bias). The communities that gained a Village Midwife may be more
likely to have residents with low income and education or low levels of socioeconomic development.
The baseline characteristics (individual and community) may vary.
The ability to make a causal claim from this data alone is weak. First, while BMI is one
important health statistic, it is not adequate in itself as an overall health indicator. Statistics should
also take into account disease prevalence, for example. Thus, there is a construct validity problem
with using BMI to indicate health status. The study analysis also fails to consider omitted variables
that can affect BMI; for example, the changing economic environment and shift in food prices.
Because the Village Midwife program is not the only aspect of the health environment that
may have changed during the 1990s, it is important to control for other dimensions of the health
service environment, and for levels of infrastructure more generally. Therefore, the study has
constructed measures for health access. Access to the Village Midwife program is measured as
whether or not a Village Midwife was available in each year of the survey. Access to public clinics is
measured as the distance from the community to the nearest health center. Access to outreach efforts
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3. was measured by a variable indicating whether or not the community receives monthly visits from
health center staff. Physical infrastructure is measured by whether the community’s main road is
paved and whether a public phone is located in the community.
III. Changes in BMI 1993-1997
In considering how access to services affects behaviors or outcomes, one must consider that
services may be systematically placed to increase the likelihood that they reach people with particular
characteristics. For example, health centers may be targeted toward areas where the population is
poor. To address the issue of non-random placement of midwives, this study examines change in
health status as a function of whether the community gained a Village Midwife.
A difference in difference analysis shows no significant difference between villages that
gained a midwife and those that did not. Both villages increased BMI over the years. A difference in
difference analysis, by measuring changes in BMI, helps control for the fact that the villages selected
to receive midwives may have different initial health characteristics than those that did not.
This pre-post non-equivalent group design reduces, but does not eliminate, threats to internal
validity. For example, suppose national events affected urban areas differently than rural areas, BMI
differences can still reflect more than just the treatment effect. Furthermore, the construct validity
problem with using BMI to indicate health status lingers.
Table 1: Changes in BMI and Changes in Midwife Status
Midwife in Village No Midwife in Village Differences in BMI
Mean BMI 1993 20.83 (0.09) 21.37 (0.04) -.55** (0.1)
(SE in parenthesis) 1997 21.10 (0.05) 22.41 (0.06) -1.31** (0.08)
Gained Midwife Did Not Gain Midwife Difference in
Differences
Change in BMI +0.33** +0.37** -0.04
from 1993-1997 (0.03) (0.02) (0.03)
**Significant at 5% level
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4. IV. Effects of Gaining a Midwife on BMI Changes Among Different Demographic Groups
Indonesia’s midwivery program targets women of reproductive age. Therefore, health
outcomes (positive BMI changes) are expected to have largest effect on this subgroup with the
introduction of midwives. After conducting an OLS regression of 4 subgroups (women age 45 and
younger, older than 45, men age 45 and younger, older than 45), the results suggest that the Village
Midwife program has positively affected the health status of the group toward whom it is targeted:
women of reproductive age (age 45 and younger).
The fact that the positive effects of the program are limited to reproductive-age women adds
strength to the argument that the association is causal, rather than arising from some other factor that
has changed concurrently with changes in access to Village Midwives (if such a factor were driving
the improvements in health status, it would likely affect both women and men, rather than only
reproductive-age women).
Significant tests confirm that among subgroups gaining a midwife, the only significant
differences appear between young reproductive-age women and all the other subgroups. For women
older than 45, there is no impact on BMI of gaining a midwife. Nor is there any impact on BMI of
gaining a midwife for men. The interaction between gaining a Village Midwife and age is negative,
which implies that the health-enhancing effects of Village Midwives decline as women get older.
This finding in intuitive, since the services that Village Midwives typically offer (prenatal, delivery,
family planning services), are particularly relevant for younger women.
This pre-post non-equivalent group design reduces threats to internal validity and makes a
more confident statement of causality. However, some variables like disease may affect different
groups differently so causation claims are not unassailable.
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5. Table 2: Changes In BMI Among Different Subgroups
(SE in parenthesis) BMI Change BMI Change BMI Change Adjusted
Adjusted for for Individual and
Individual Community
Characteristics Characteristics
Did Not Gain Midwife
Women Age Over 45 -0.59** -0.55** -0.59**
N=2017 (0.06) (0.06) (0.06)
Men Age 45 and Below -0.31** -0.32** -0.31**
N=2132 (0.06) (0.06) (0.06)
Men Age Over 45 -0.63** -0.63** -0.65**
N=1749 (0.07) (0.07) (0.07)
Gained a Midwife
Women Age 45 and Below +0.11*** +0.15** +0.13**
N=1308 (0.06) (0.06) (0.06)
Women Age Over 45 -0.20** -0.20** -0.19**
N=929 (0.09) (0.09) (0.09)
Men Age 45 and Below -0.20** -0.21** -0.19**
N=964 (0.09) (0.09) (0.09)
Men Age Over 45 -0.26** -0.26** -0.26**
N=820 (0.10) (0.10) (0.10)
Reference Group
Women Age 45 and Below 0.70 0.56 0.56
Who Did Not Gain A (0.04) (0.05) (0.10)
Midwife, N=2926
**BMI change is significant at 0.05 level, ***BMI change is significant at 0.10 level
The dependent variable is specified as BMI(97)- BMI(93).
V. Midwife Gains and BMI Changes, Controlled for Individual Characteristics
Correlations at a point in time between characteristics of the health service environment and
health outcomes will be biased by failure to address the individual characteristics of the midwives.
By examining changes in health at the individual level as a function of changes in health programs,
the researchers hold constant aspects of the community in which an individual lives that may affect
both access to services and health status.
I further explored whether the effect of gaining a Village Midwife varies across subgroups,
adjusting for individual effects. In this analysis, after controlling for individual effects such as
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6. income and education, young women gaining midwives are still the subgroup that gains significantly
more than any other subgroup. These results further strengthen our causal claim because individual
differences are accounted for.
VI. Midwife Gains and BMI Changes, Controlled for Individual & Community Characteristics
A skeptic might argue that close proximity to a health care center or living in a community
that has a monthly visit from health center staff might affect health outcomes positively. Levels of
socioeconomic development vary by whether the community has a public phone and whether the
main road in the community is paved. The next analysis controls for both individual and the broader
community effects.
The results from this analysis further strengthen our causal claim in that young women
gaining midwives are still the subgroup that gains significantly more than any other subgroup, even
when adjusted for village-by-village differences in infrastructure.
In combination, the results from Parts IV, V, and VI indicate a strong causal claim between
gaining a midwife and increases in BMI among young women. The Village Midwife program was
implemented to address concerns about maternal health. To this extent, the study achieved its
intended affect. Accounting for individual and community characteristics, the study mitigates biased
estimates of the impact of services. The results suggest that efforts of the Ministry of Health to
rapidly expand access to midwifery services has had a pay off in terms of the health status of women
of reproductive age.
Nevertheless, there are still three threats to validity that might be problematic when
generalizing the results above.
1) Construct Validity: BMI is not the only indicator of overall health, although it is an important
one. Other outcomes such as infant mortality or disease rates might be relevant.
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7. 2) External Validity: This program targets poor, rural areas and cannot be generalized to urban
contexts without recognizing cultural differences in maternal attitudes and behaviors.
3) Internal Validity: The BMI variation among various subgroups might be due to differences in
collection times. People’s BMIs change at different times of the year. Young men might have
low BMIs if they have been farming in the Summer; young women might have low BMIs
when they are taking exams in the Spring.
VII. Hypothetical Time Series Analysis
To further strengthen the causal claim, we can control for time effects. A time series analysis
requires different observations for every individual. Consequently, each individual will have multiple
observations in the study, corresponding to the number of times they were surveyed. To conduct a
time-series analysis, I would collect data from a non-equivalent group design that observed many
comparison groups while considering the various arrival times of midwives. The data would be
collected 3-5 years before the arrival of midwives, to isolate health trends existing pre-arrival, and 3-
5 years after their arrival, to adjust for seasonal changes within one year (internal validity problem).
In addition, I can collect data on other health indicators such as infant mortality and disease
rates to remedy the construct validity concern with using solely the BMI measure. This extra control
will provide a fuller picture of health outcomes.
With these controls, I expect the results of the regression to be more confidently reflective of
the effects of the intervention. The effects from pre-existing health trends and seasonal changes will
be excluded. Thus, the study would increase the ability to make a causal claim about the intervention.
Hypothetical Regression Discontinuity Analysis
In regression discontinuity designs, participants are assigned to comparison groups solely on
the basis of a cutoff score. In this study, the Indonesian Ministry of Health would have to set a cutoff
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8. BMI average to determine whether or not a village would gain a midwife. For example, the Ministry
of Health can allocate a midwife to villages with an average BMI of below 19, and those villages
with an average BMI above 19 would not receive a midwife. Assuming this analysis is rigorously and
fully implemented by those assigning midwives to villages, this study can then compare villages that
received midwives and were within a short range of the baseline BMI cutoff. As an example, villages
with an average BMI of 18-19 can be compared with those with an average BMI of 19-20.
This type of analysis is beneficial for comparing groups that are just above the cutoff (control
group) with those that are just below the cutoff (treatment group). If we discover that villages on
opposing sides of the cutoff yielded different effects, this finding will strengthen the internal validity
of our study design and make a strong case that the intervention is the main causal driver. However,
there are a number of problems with this type of analysis. While the results of the study would
suggest a strong causal claim, the claim can only be extended to programs with an average cutoff
BMI of 19. The causal claim would be very strong for the given cutoff. However, the results cannot
be generalized to other cutoff levels (e.g. 18 or 20). Other studies may show significantly varied
effects for different subgroups. For example, one might predict that a similar village midwife
program will have more drastic results for those with a lower average BMI at baseline.
References
Frankenberg, Elizabeth and Duncan Thomas. "Women's Health and Pregnancy Outcomes: Do
Services Make a Difference?." Demography 38.2 (2001): 253-265.
Government of Indonesia. 1989. Panduan Bidan di Tingkat Desa. Jakarta: Direktorat Jenderal
Pembinaan Kesehatan Masyarakat.
International Household Survey Network (2009). IHSN - Indonesian Family Life Survey. Retrieved
March 20, 2011 from http://surveynetwork.org
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