JoVE Visualize What is visualize?
Stop Reading. Start Watching.
Advanced Search
Stop Reading. Start Watching.
Regular Search
Find video protocols related to scientific articles indexed in Pubmed.
Reducing Added Sugars in the Food Supply Through a Cap-and-Trade Approach.
Am J Public Health
PUBLISHED: 11-03-2014
Show Abstract
Hide Abstract
Objectives. We estimated the effect of a simulated cap-and-trade policy to reduce added sugar in the food supply. Methods. Using nationally representative data on added-sugar content and consumption, we constructed a mathematical model of a cap-and-trade policy and compared its health implications to those of proposals to tax sugar sweetened beverages or added sugars. Results. Capping added-sugar emissions into the food supply by food manufacturers at a rate of 1% per year would be expected to reduce the prevalence of obesity by 1.7 percentage points (95% confidence interval [CI]?=?0.9, 2.4; a 4.6% decline) and the incidence of type 2 diabetes by 21.7 cases per 100?000 people (95% CI?=?12.9, 30.6; a 4.2% decline) over 20 years, averting approximately $9.7 billion in health care spending. Racial and ethnic minorities would be expected to experience the largest declines. By comparison, equivalent price penalties through excise taxes would be expected to generate smaller health benefits. Conclusions. A cap-and-trade policy to reduce added-sugar intake may reduce obesity and type 2 diabetes to a greater extent than currently-proposed excise taxes.
Related JoVE Video
The inverse equity hypothesis: Does it apply to coverage of cancer screening in middle-income countries?
J Epidemiol Community Health
PUBLISHED: 10-15-2014
Show Abstract
Hide Abstract
It is uncertain whether the inverse equity hypothesis-the idea that new health interventions are initially primarily accessed by the rich, but that inequalities narrow with diffusion to the poor-holds true for cancer screening in low and middle income countries (LMICs).This study examines the relationship between overall coverage and economic inequalities in coverage of cancer screening in four middle-income countries.
Related JoVE Video
Social protection and tuberculosis control in 21 European countries, 1995-2012: a cross-national statistical modelling analysis.
Lancet Infect Dis
PUBLISHED: 10-12-2014
Show Abstract
Hide Abstract
WHO stresses the need to act on the social determinants of tuberculosis. We tested whether alternative social protection programmes have affected tuberculosis case notifications, prevalence, and mortality, and case detection and treatment success rates in 21 European countries from 1995 to 2012.
Related JoVE Video
Economic shocks, resilience, and male suicides in the Great Recession: cross-national analysis of 20 EU countries.
Eur J Public Health
PUBLISHED: 10-08-2014
Show Abstract
Hide Abstract
During the 2007-11 recessions in Europe, suicide increases were concentrated in men. Substantial differences across countries and over time remain unexplained. We investigated whether increases in unaffordable housing, household indebtedness or job loss can account for these population differences, as well as potential mitigating effects of alternative forms of social protection.
Related JoVE Video
Global, regional, and national incidence and mortality for HIV, tuberculosis, and malaria during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.
Christopher J L Murray, Katrina F Ortblad, Caterina Guinovart, Stephen S Lim, Timothy M Wolock, D Allen Roberts, Emily A Dansereau, Nicholas Graetz, Ryan M Barber, Jonathan C Brown, Haidong Wang, Herbert C Duber, Mohsen Naghavi, Daniel Dicker, Lalit Dandona, Joshua A Salomon, Kyle R Heuton, Kyle Foreman, David E Phillips, Thomas D Fleming, Abraham D Flaxman, Bryan K Phillips, Elizabeth K Johnson, Megan S Coggeshall, Foad Abd-Allah, Semaw Ferede Abera, Jerry P Abraham, Ibrahim Abubakar, Laith J Abu-Raddad, Niveen Me Abu-Rmeileh, Tom Achoki, Austine Olufemi Adeyemo, Arsène Kouablan Adou, José C Adsuar, Emilie Elisabet Agardh, Dickens Akena, Mazin J Al Kahbouri, Deena Alasfoor, Mohammed I Albittar, Gabriel Alcalá-Cerra, Miguel Angel Alegretti, Zewdie Aderaw Alemu, Rafael Alfonso-Cristancho, Samia Alhabib, Raghib Ali, François Alla, Peter J Allen, Ubai Alsharif, Elena Alvarez, Nelson Alvis-Guzmán, Adansi A Amankwaa, Azmeraw T Amare, Hassan Amini, Walid Ammar, Benjamin O Anderson, Carl Abelardo T Antonio, Palwasha Anwari, Johan Arnlöv, Valentina S Arsic Arsenijevic, Ali Artaman, Rana J Asghar, Reza Assadi, Lydia S Atkins, Alaa Badawi, Kalpana Balakrishnan, Amitava Banerjee, Sanjay Basu, Justin Beardsley, Tolesa Bekele, Michelle L Bell, Eduardo Bernabé, Tariku Jibat Beyene, Neeraj Bhala, Ashish Bhalla, Zulfiqar A Bhutta, Aref Bin Abdulhak, Agnes Binagwaho, Jed D Blore, Berrak Bora Basara, Dipan Bose, Michael Brainin, Nicholas Breitborde, Carlos A Castañeda-Orjuela, Ferrán Catalá-López, Vineet K Chadha, Jung-Chen Chang, Peggy Pei-Chia Chiang, Ting-Wu Chuang, Mercedes Colomar, Leslie Trumbull Cooper, Cyrus Cooper, Karen J Courville, Benjamin C Cowie, Michael H Criqui, Rakhi Dandona, Anand Dayama, Diego De Leo, Louisa Degenhardt, Borja del Pozo-Cruz, Kebede Deribe, Don C Des Jarlais, Muluken Dessalegn, Samath D Dharmaratne, Ugur Dilmen, Eric L Ding, Tim R Driscoll, Adnan M Durrani, Richard G Ellenbogen, Sergey Petrovich Ermakov, Alireza Esteghamati, Emerito Jose A Faraon, Farshad Farzadfar, Seyed-Mohammad Fereshtehnejad, Daniel Obadare Fijabi, Mohammad H Forouzanfar, Urbano Fra Paleo, Lynne Gaffikin, Amiran Gamkrelidze, Fortuné Gbètoho Gankpé, Johanna M Geleijnse, Bradford D Gessner, Katherine B Gibney, Ibrahim Abdelmageem Mohamed Ginawi, Elizabeth L Glaser, Philimon Gona, Atsushi Goto, Hebe N Gouda, Harish Chander Gugnani, Rajeev Gupta, Rahul Gupta, Nima Hafezi-Nejad, Randah Ribhi Hamadeh, Mouhanad Hammami, Graeme J Hankey, Hilda L Harb, Josep Maria Haro, Rasmus Havmoeller, Simon I Hay, Mohammad T Hedayati, Ileana B Heredia Pi, Hans W Hoek, John C Hornberger, H Dean Hosgood, Peter J Hotez, Damian G Hoy, John J Huang, Kim M Iburg, Bulat T Idrisov, Kaire Innos, Kathryn H Jacobsen, Panniyammakal Jeemon, Paul N Jensen, Vivekanand Jha, Guohong Jiang, Jost B Jonas, Knud Juel, Haidong Kan, Ida Kankindi, Nadim E Karam, André Karch, Corine Kakizi Karema, Anil Kaul, Norito Kawakami, Dhruv S Kazi, Andrew H Kemp, André Pascal Kengne, Andre Keren, Maia Kereselidze, Yousef Saleh Khader, Shams Eldin Ali Hassan Khalifa, Ejaz Ahmed Khan, Young-Ho Khang, Irma Khonelidze, Yohannes Kinfu, Jonas M Kinge, Luke Knibbs, Yoshihiro Kokubo, S Kosen, Barthélemy Kuate Defo, Veena S Kulkarni, Chanda Kulkarni, Kaushalendra Kumar, Ravi B Kumar, G Anil Kumar, Gene F Kwan, Taavi Lai, Arjun Lakshmana Balaji, Hilton Lam, Qing Lan, Van C Lansingh, Heidi J Larson, Anders Larsson, Jong-Tae Lee, James Leigh, Mall Leinsalu, Ricky Leung, Yichong Li, Yongmei Li, Graça Maria Ferreira De Lima, Hsien-Ho Lin, Steven E Lipshultz, Shiwei Liu, Yang Liu, Belinda K Lloyd, Paulo A Lotufo, Vasco Manuel Pedro Machado, Jennifer H MacLachlan, Carlos Magis-Rodríguez, Marek Majdan, Christopher Chabila Mapoma, Wagner Marcenes, Melvin Barrientos Marzan, Joseph R Masci, Mohammad Taufiq Mashal, Amanda J Mason-Jones, Bongani M Mayosi, Tasara T Mazorodze, Abigail Cecilia Mckay, Peter A Meaney, Man Mohan Mehndiratta, Fabiola Mejia-Rodriguez, Yohannes Adama Melaku, Ziad A Memish, Walter Mendoza, Ted R Miller, Edward J Mills, Karzan Abdulmuhsin Mohammad, Ali H Mokdad, Glen Liddell Mola, Lorenzo Monasta, Marcella Montico, Ami R Moore, Rintaro Mori, Wilkister Nyaora Moturi, Mitsuru Mukaigawara, Kinnari S Murthy, Aliya Naheed, Kovin S Naidoo, Luigi Naldi, Vinay Nangia, K M Venkat Narayan, Denis Nash, Chakib Nejjari, Robert G Nelson, Sudan Prasad Neupane, Charles R Newton, Marie Ng, Muhammad Imran Nisar, Sandra Nolte, Ole F Norheim, Vincent Nowaseb, Luke Nyakarahuka, In-Hwan Oh, Takayoshi Ohkubo, Bolajoko O Olusanya, Saad B Omer, John Nelson Opio, Orish Ebere Orisakwe, Jeyaraj D Pandian, Christina Papachristou, Angel J Paternina Caicedo, Scott B Patten, Vinod K Paul, Boris Igor Pavlin, Neil Pearce, David M Pereira, Aslam Pervaiz, Konrad Pesudovs, Max Petzold, Farshad Pourmalek, Dima Qato, Amado D Quezada, D Alex Quistberg, Anwar Rafay, Kazem Rahimi, Vafa Rahimi-Movaghar, Sajjad Ur Rahman, Murugesan Raju, Saleem M Rana, Homie Razavi, Robert Quentin Reilly, Giuseppe Remuzzi, Jan Hendrik Richardus, Luca Ronfani, Nobhojit Roy, Nsanzimana Sabin, Mohammad Yahya Saeedi, Mohammad Ali Sahraian, Genesis May J Samonte, Monika Sawhney, Ione J C Schneider, David C Schwebel, Soraya Seedat, Sadaf G Sepanlou, Edson E Servan-Mori, Sara Sheikhbahaei, Kenji Shibuya, Hwashin Hyun Shin, Ivy Shiue, Rupak Shivakoti, Inga Dora Sigfusdottir, Donald H Silberberg, Andrea P Silva, Edgar P Simard, Jasvinder A Singh, Vegard Skirbekk, Karen Sliwa, Samir Soneji, Sergey S Soshnikov, Chandrashekhar T Sreeramareddy, Vasiliki Kalliopi Stathopoulou, Konstantinos Stroumpoulis, Soumya Swaminathan, Bryan L Sykes, Karen M Tabb, Roberto Tchio Talongwa, Eric Yeboah Tenkorang, Abdullah Sulieman Terkawi, Alan J Thomson, Andrew L Thorne-Lyman, Jeffrey A Towbin, Jefferson Traebert, Bach X Tran, Zacharie Tsala Dimbuene, Miltiadis Tsilimbaris, Uche S Uchendu, Kingsley N Ukwaja, Selen Begüm Uzun, Andrew J Vallely, Tommi J Vasankari, N Venketasubramanian, Francesco S Violante, Vasiliy Victorovich Vlassov, Stein Emil Vollset, Stephen Waller, Mitchell T Wallin, Linhong Wang, Xiaorong Wang, Yanping Wang, Scott Weichenthal, Elisabete Weiderpass, Robert G Weintraub, Ronny Westerman, Richard A White, James D Wilkinson, Thomas Neil Williams, Solomon Meseret Woldeyohannes, John Q Wong, Gelin Xu, Yang C Yang, Yuichiro Yano, Gokalp Kadri Yentur, Paul Yip, Naohiro Yonemoto, Seok-Jun Yoon, Mustafa Younis, Chuanhua Yu, Kim Yun Jin, Maysaa El Sayed Zaki, Yong Zhao, Yingfeng Zheng, Maigeng Zhou, Jun Zhu, Xiao Nong Zou, Alan D Lopez, Theo Vos.
Lancet
PUBLISHED: 07-22-2014
Show Abstract
Hide Abstract
The Millennium Declaration in 2000 brought special global attention to HIV, tuberculosis, and malaria through the formulation of Millennium Development Goal (MDG) 6. The Global Burden of Disease 2013 study provides a consistent and comprehensive approach to disease estimation for between 1990 and 2013, and an opportunity to assess whether accelerated progress has occured since the Millennium Declaration.
Related JoVE Video
Job loss, wealth and depression during the Great Recession in the USA and Europe.
Int J Epidemiol
PUBLISHED: 06-18-2014
Show Abstract
Hide Abstract
To examine whether late-career job loss increased depression among older workers approaching retirement in the USA and Europe.
Related JoVE Video
Ending SNAP subsidies for sugar-sweetened beverages could reduce obesity and type 2 diabetes.
Health Aff (Millwood)
PUBLISHED: 06-04-2014
Show Abstract
Hide Abstract
To reduce obesity and type 2 diabetes rates, lawmakers have proposed modifying Supplemental Nutrition Assistance Program (SNAP) benefits to encourage healthier food choices. We examined the impact of two proposed policies: a ban on using SNAP dollars to buy sugar-sweetened beverages; and a subsidy in which for every SNAP dollar spent on fruit and vegetables, thirty cents is credited back to participants' SNAP benefit cards. We used nationally representative data and models describing obesity, type 2 diabetes, and determinants of food consumption among a sample of over 19,000 SNAP participants. We found that a ban on SNAP purchases of sugar-sweetened beverages would be expected to significantly reduce obesity prevalence and type 2 diabetes incidence, particularly among adults ages 18-65 and some racial and ethnic minorities. The subsidy policy would not be expected to have a significant effect on obesity and type 2 diabetes, given available data. Such a subsidy could, however, more than double the proportion of SNAP participants who meet federal vegetable and fruit consumption guidelines.
Related JoVE Video
Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013.
Marie Ng, Tom Fleming, Margaret Robinson, Blake Thomson, Nicholas Graetz, Christopher Margono, Erin C Mullany, Stan Biryukov, Cristiana Abbafati, Semaw Ferede Abera, Jerry P Abraham, Niveen M E Abu-Rmeileh, Tom Achoki, Fadia S AlBuhairan, Zewdie A Alemu, Rafael Alfonso, Mohammed K Ali, Raghib Ali, Nelson Alvis Guzman, Walid Ammar, Palwasha Anwari, Amitava Banerjee, Simón Barquera, Sanjay Basu, Derrick A Bennett, Zulfiqar Bhutta, Jed Blore, Norberto Cabral, Ismael Campos Nonato, Jung-Chen Chang, Rajiv Chowdhury, Karen J Courville, Michael H Criqui, David K Cundiff, Kaustubh C Dabhadkar, Lalit Dandona, Adrian Davis, Anand Dayama, Samath D Dharmaratne, Eric L Ding, Adnan M Durrani, Alireza Esteghamati, Farshad Farzadfar, Derek F J Fay, Valery L Feigin, Abraham Flaxman, Mohammad H Forouzanfar, Atsushi Goto, Mark A Green, Rajeev Gupta, Nima Hafezi-Nejad, Graeme J Hankey, Heather C Harewood, Rasmus Havmoeller, Simon Hay, Lucia Hernandez, Abdullatif Husseini, Bulat T Idrisov, Nayu Ikeda, Farhad Islami, Eiman Jahangir, Simerjot K Jassal, Sun Ha Jee, Mona Jeffreys, Jost B Jonas, Edmond K Kabagambe, Shams Eldin Ali Hassan Khalifa, André Pascal Kengne, Yousef Saleh Khader, Young-Ho Khang, Daniel Kim, Ruth W Kimokoti, Jonas M Kinge, Yoshihiro Kokubo, Soewarta Kosen, Gene Kwan, Taavi Lai, Mall Leinsalu, Yichong Li, Xiaofeng Liang, Shiwei Liu, Giancarlo Logroscino, Paulo A Lotufo, Yuan Lu, Jixiang Ma, Nana Kwaku Mainoo, George A Mensah, Tony R Merriman, Ali H Mokdad, Joanna Moschandreas, Mohsen Naghavi, Aliya Naheed, Devina Nand, K M Venkat Narayan, Erica Leigh Nelson, Marian L Neuhouser, Muhammad Imran Nisar, Takayoshi Ohkubo, Samuel O Oti, Andrea Pedroza, Dorairaj Prabhakaran, Nobhojit Roy, Uchechukwu Sampson, Hyeyoung Seo, Sadaf G Sepanlou, Kenji Shibuya, Rahman Shiri, Ivy Shiue, Gitanjali M Singh, Jasvinder A Singh, Vegard Skirbekk, Nicolas J C Stapelberg, Lela Sturua, Bryan L Sykes, Martin Tobias, Bach X Tran, Leonardo Trasande, Hideaki Toyoshima, Steven van de Vijver, Tommi J Vasankari, J Lennert Veerman, Gustavo Velásquez-Meléndez, Vasiliy Victorovich Vlassov, Stein Emil Vollset, Theo Vos, Claire Wang, Xiaorong Wang, Elisabete Weiderpass, Andrea Werdecker, Jonathan L Wright, Y Claire Yang, Hiroshi Yatsuya, Jihyun Yoon, Seok-Jun Yoon, Yong Zhao, Maigeng Zhou, Shankuan Zhu, Alan D Lopez, Christopher J L Murray, Emmanuela Gakidou.
Lancet
PUBLISHED: 05-29-2014
Show Abstract
Hide Abstract
In 2010, overweight and obesity were estimated to cause 3·4 million deaths, 3·9% of years of life lost, and 3·8% of disability-adjusted life-years (DALYs) worldwide. The rise in obesity has led to widespread calls for regular monitoring of changes in overweight and obesity prevalence in all populations. Comparable, up-to-date information about levels and trends is essential to quantify population health effects and to prompt decision makers to prioritise action. We estimate the global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013.
Related JoVE Video
A metabolic-epidemiological microsimulation model to estimate the changes in energy intake and physical activity necessary to meet the Healthy People 2020 obesity objective.
Am J Public Health
PUBLISHED: 05-15-2014
Show Abstract
Hide Abstract
We combined a metabolic and an epidemiological model of obesity to estimate changes in calorie intake and physical activity necessary to achieve the Healthy People 2020 objective of reducing adult obesity prevalence from 33.9% to 30.5%.
Related JoVE Video
Comparing decisions for malaria testing and presumptive treatment: a net health benefit analysis.
Med Decis Making
PUBLISHED: 05-14-2014
Show Abstract
Hide Abstract
Rapid tests for malaria are being distributed through vendors to individual patients, presenting the dilemma of determining how individuals are incentivized to pursue testing for malaria, versus the traditional approach of presumptively treating fevers with antimalarial drugs.
Related JoVE Video
Global, regional, and national levels and causes of maternal mortality during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.
Nicholas J Kassebaum, Amelia Bertozzi-Villa, Megan S Coggeshall, Katya A Shackelford, Caitlyn Steiner, Kyle R Heuton, Diego Gonzalez-Medina, Ryan Barber, Chantal Huynh, Daniel Dicker, Tara Templin, Timothy M Wolock, Ayse Abbasoglu Ozgoren, Foad Abd-Allah, Semaw Ferede Abera, Ibrahim Abubakar, Tom Achoki, Ademola Adelekan, Zanfina Ademi, Arsène Kouablan Adou, José C Adsuar, Emilie E Agardh, Dickens Akena, Deena Alasfoor, Zewdie Aderaw Alemu, Rafael Alfonso-Cristancho, Samia Alhabib, Raghib Ali, Mazin J Al Kahbouri, François Alla, Peter J Allen, Mohammad A AlMazroa, Ubai Alsharif, Elena Alvarez, Nelson Alvis-Guzmán, Adansi A Amankwaa, Azmeraw T Amare, Hassan Amini, Walid Ammar, Carl A T Antonio, Palwasha Anwari, Johan Arnlöv, Valentina S Arsic Arsenijevic, Ali Artaman, Majed Masoud Asad, Rana J Asghar, Reza Assadi, Lydia S Atkins, Alaa Badawi, Kalpana Balakrishnan, Arindam Basu, Sanjay Basu, Justin Beardsley, Neeraj Bedi, Tolesa Bekele, Michelle L Bell, Eduardo Bernabé, Tariku J Beyene, Zulfiqar Bhutta, Aref Bin Abdulhak, Jed D Blore, Berrak Bora Basara, Dipan Bose, Nicholas Breitborde, Rosario Cárdenas, Carlos A Castañeda-Orjuela, Ruben Estanislao Castro, Ferrán Catalá-López, Alanur Cavlin, Jung-Chen Chang, Xuan Che, Costas A Christophi, Sumeet S Chugh, Massimo Cirillo, Samantha M Colquhoun, Leslie Trumbull Cooper, Cyrus Cooper, Iuri da Costa Leite, Lalit Dandona, Rakhi Dandona, Adrian Davis, Anand Dayama, Louisa Degenhardt, Diego De Leo, Borja del Pozo-Cruz, Kebede Deribe, Muluken Dessalegn, Gabrielle A deVeber, Samath D Dharmaratne, Ugur Dilmen, Eric L Ding, Rob E Dorrington, Tim R Driscoll, Sergei Petrovich Ermakov, Alireza Esteghamati, Emerito Jose A Faraon, Farshad Farzadfar, Manuela Mendonca Felicio, Seyed-Mohammad Fereshtehnejad, Graça Maria Ferreira De Lima, Mohammad H Forouzanfar, Elisabeth B França, Lynne Gaffikin, Ketevan Gambashidze, Fortuné Gbètoho Gankpé, Ana C Garcia, Johanna M Geleijnse, Katherine B Gibney, Maurice Giroud, Elizabeth L Glaser, Ketevan Goginashvili, Philimon Gona, Dinorah González-Castell, Atsushi Goto, Hebe N Gouda, Harish Chander Gugnani, Rahul Gupta, Rajeev Gupta, Nima Hafezi-Nejad, Randah Ribhi Hamadeh, Mouhanad Hammami, Graeme J Hankey, Hilda L Harb, Rasmus Havmoeller, Simon I Hay, Ileana B Heredia Pi, Hans W Hoek, H Dean Hosgood, Damian G Hoy, Abdullatif Husseini, Bulat T Idrisov, Kaire Innos, Manami Inoue, Kathryn H Jacobsen, Eiman Jahangir, Sun Ha Jee, Paul N Jensen, Vivekanand Jha, Guohong Jiang, Jost B Jonas, Knud Juel, Edmond Kato Kabagambe, Haidong Kan, Nadim E Karam, André Karch, Corine Kakizi Karema, Anil Kaul, Norito Kawakami, Konstantin Kazanjan, Dhruv S Kazi, Andrew H Kemp, André Pascal Kengne, Maia Kereselidze, Yousef Saleh Khader, Shams Eldin Ali Hassan Khalifa, Ejaz Ahmed Khan, Young-Ho Khang, Luke Knibbs, Yoshihiro Kokubo, Soewarta Kosen, Barthélemy Kuate Defo, Chanda Kulkarni, Veena S Kulkarni, G Anil Kumar, Kaushalendra Kumar, Ravi B Kumar, Gene Kwan, Taavi Lai, Ratilal Lalloo, Hilton Lam, Van C Lansingh, Anders Larsson, Jong-Tae Lee, James Leigh, Mall Leinsalu, Ricky Leung, Xiaohong Li, Yichong Li, Yongmei Li, Juan Liang, Xiaofeng Liang, Stephen S Lim, Hsien-Ho Lin, Steven E Lipshultz, Shiwei Liu, Yang Liu, Belinda K Lloyd, Stephanie J London, Paulo A Lotufo, Jixiang Ma, Stefan Ma, Vasco Manuel Pedro Machado, Nana Kwaku Mainoo, Marek Majdan, Christopher Chabila Mapoma, Wagner Marcenes, Melvin Barrientos Marzan, Amanda J Mason-Jones, Man Mohan Mehndiratta, Fabiola Mejia-Rodriguez, Ziad A Memish, Walter Mendoza, Ted R Miller, Edward J Mills, Ali H Mokdad, Glen Liddell Mola, Lorenzo Monasta, Jonathan de la Cruz Monis, Julio Cesar Montañez Hernandez, Ami R Moore, Maziar Moradi-Lakeh, Rintaro Mori, Ulrich O Mueller, Mitsuru Mukaigawara, Aliya Naheed, Kovin S Naidoo, Devina Nand, Vinay Nangia, Denis Nash, Chakib Nejjari, Robert G Nelson, Sudan Prasad Neupane, Charles R Newton, Marie Ng, Mark J Nieuwenhuijsen, Muhammad Imran Nisar, Sandra Nolte, Ole F Norheim, Luke Nyakarahuka, In-Hwan Oh, Takayoshi Ohkubo, Bolajoko O Olusanya, Saad B Omer, John Nelson Opio, Orish Ebere Orisakwe, Jeyaraj D Pandian, Christina Papachristou, Jae-Hyun Park, Angel J Paternina Caicedo, Scott B Patten, Vinod K Paul, Boris Igor Pavlin, Neil Pearce, David M Pereira, Konrad Pesudovs, Max Petzold, Dan Poenaru, Guilherme V Polanczyk, Suzanne Polinder, Dan Pope, Farshad Pourmalek, Dima Qato, D Alex Quistberg, Anwar Rafay, Kazem Rahimi, Vafa Rahimi-Movaghar, Sajjad Ur Rahman, Murugesan Raju, Saleem M Rana, Amany Refaat, Luca Ronfani, Nobhojit Roy, Tania Georgina Sánchez Pimienta, Mohammad Ali Sahraian, Joshua A Salomon, Uchechukwu Sampson, Itamar S Santos, Monika Sawhney, Felix Sayinzoga, Ione J C Schneider, Austin Schumacher, David C Schwebel, Soraya Seedat, Sadaf G Sepanlou, Edson E Servan-Mori, Marina Shakh-Nazarova, Sara Sheikhbahaei, Kenji Shibuya, Hwashin Hyun Shin, Ivy Shiue, Inga Dora Sigfusdottir, Donald H Silberberg, Andrea P Silva, Jasvinder A Singh, Vegard Skirbekk, Karen Sliwa, Sergey S Soshnikov, Luciano A Sposato, Chandrashekhar T Sreeramareddy, Konstantinos Stroumpoulis, Lela Sturua, Bryan L Sykes, Karen M Tabb, Roberto Tchio Talongwa, Feng Tan, Carolina Maria Teixeira, Eric Yeboah Tenkorang, Abdullah Sulieman Terkawi, Andrew L Thorne-Lyman, David L Tirschwell, Jeffrey A Towbin, Bach X Tran, Miltiadis Tsilimbaris, Uche S Uchendu, Kingsley N Ukwaja, Eduardo A Undurraga, Selen Begüm Uzun, Andrew J Vallely, Coen H van Gool, Tommi J Vasankari, Monica S Vavilala, N Venketasubramanian, Salvador Villalpando, Francesco S Violante, Vasiliy Victorovich Vlassov, Theo Vos, Stephen Waller, Haidong Wang, Linhong Wang, Xiaorong Wang, Yanping Wang, Scott Weichenthal, Elisabete Weiderpass, Robert G Weintraub, Ronny Westerman, James D Wilkinson, Solomon Meseret Woldeyohannes, John Q Wong, Muluemebet Abera Wordofa, Gelin Xu, Yang C Yang, Yuichiro Yano, Gokalp Kadri Yentur, Paul Yip, Naohiro Yonemoto, Seok-Jun Yoon, Mustafa Z Younis, Chuanhua Yu, Kim Yun Jin, Maysaa El Sayed Zaki, Yong Zhao, Yingfeng Zheng, Maigeng Zhou, Jun Zhu, Xiao Nong Zou, Alan D Lopez, Mohsen Naghavi, Christopher J L Murray, Rafael Lozano.
Lancet
PUBLISHED: 05-02-2014
Show Abstract
Hide Abstract
The fifth Millennium Development Goal (MDG 5) established the goal of a 75% reduction in the maternal mortality ratio (MMR; number of maternal deaths per 100,000 livebirths) between 1990 and 2015. We aimed to measure levels and track trends in maternal mortality, the key causes contributing to maternal death, and timing of maternal death with respect to delivery.
Related JoVE Video
Global, regional, and national levels of neonatal, infant, and under-5 mortality during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.
Haidong Wang, Chelsea A Liddell, Matthew M Coates, Meghan D Mooney, Carly E Levitz, Austin E Schumacher, Henry Apfel, Marissa Iannarone, Bryan Phillips, Katherine T Lofgren, Logan Sandar, Rob E Dorrington, Ivo Rakovac, Troy A Jacobs, Xiaofeng Liang, Maigeng Zhou, Jun Zhu, Gonghuan Yang, Yanping Wang, Shiwei Liu, Yichong Li, Ayse Abbasoglu Ozgoren, Semaw Ferede Abera, Ibrahim Abubakar, Tom Achoki, Ademola Adelekan, Zanfina Ademi, Zewdie Aderaw Alemu, Peter J Allen, Mohammad AbdulAziz AlMazroa, Elena Alvarez, Adansi A Amankwaa, Azmeraw T Amare, Walid Ammar, Palwasha Anwari, Solveig Argeseanu Cunningham, Majed Masoud Asad, Reza Assadi, Amitava Banerjee, Sanjay Basu, Neeraj Bedi, Tolesa Bekele, Michelle L Bell, Zulfiqar Bhutta, Jed D Blore, Berrak Bora Basara, Soufiane Boufous, Nicholas Breitborde, Nigel G Bruce, Linh Ngoc Bui, Jonathan R Carapetis, Rosario Cárdenas, David O Carpenter, Valeria Caso, Ruben Estanislao Castro, Ferrán Catalá-López, Alanur Cavlin, Xuan Che, Peggy Pei-Chia Chiang, Rajiv Chowdhury, Costas A Christophi, Ting-Wu Chuang, Massimo Cirillo, Iuri da Costa Leite, Karen J Courville, Lalit Dandona, Rakhi Dandona, Adrian Davis, Anand Dayama, Kebede Deribe, Samath D Dharmaratne, Mukesh K Dherani, Ugur Dilmen, Eric L Ding, Karen M Edmond, Sergei Petrovich Ermakov, Farshad Farzadfar, Seyed-Mohammad Fereshtehnejad, Daniel Obadare Fijabi, Nataliya Foigt, Mohammad H Forouzanfar, Ana C Garcia, Johanna M Geleijnse, Bradford D Gessner, Ketevan Goginashvili, Philimon Gona, Atsushi Goto, Hebe N Gouda, Mark A Green, Karen Fern Greenwell, Harish Chander Gugnani, Rahul Gupta, Randah Ribhi Hamadeh, Mouhanad Hammami, Hilda L Harb, Simon Hay, Mohammad T Hedayati, H Dean Hosgood, Damian G Hoy, Bulat T Idrisov, Farhad Islami, Samaya Ismayilova, Vivekanand Jha, Guohong Jiang, Jost B Jonas, Knud Juel, Edmond Kato Kabagambe, Dhruv S Kazi, André Pascal Kengne, Maia Kereselidze, Yousef Saleh Khader, Shams Eldin Ali Hassan Khalifa, Young-Ho Khang, Daniel Kim, Yohannes Kinfu, Jonas M Kinge, Yoshihiro Kokubo, Soewarta Kosen, Barthélemy Kuate Defo, G Anil Kumar, Kaushalendra Kumar, Ravi B Kumar, Taavi Lai, Qing Lan, Anders Larsson, Jong-Tae Lee, Mall Leinsalu, Stephen S Lim, Steven E Lipshultz, Giancarlo Logroscino, Paulo A Lotufo, Raimundas Lunevicius, Ronan Anthony Lyons, Stefan Ma, Abbas Ali Mahdi, Melvin Barrientos Marzan, Mohammad Taufiq Mashal, Tasara T Mazorodze, John J McGrath, Ziad A Memish, Walter Mendoza, George A Mensah, Atte Meretoja, Ted R Miller, Edward J Mills, Karzan Abdulmuhsin Mohammad, Ali H Mokdad, Lorenzo Monasta, Marcella Montico, Ami R Moore, Joanna Moschandreas, William T Msemburi, Ulrich O Mueller, Magdalena M Muszyńska, Mohsen Naghavi, Kovin S Naidoo, K M Venkat Narayan, Chakib Nejjari, Marie Ng, Jean de Dieu Ngirabega, Mark J Nieuwenhuijsen, Luke Nyakarahuka, Takayoshi Ohkubo, Saad B Omer, Angel J Paternina Caicedo, Victoria Pillay-van Wyk, Dan Pope, Farshad Pourmalek, Dorairaj Prabhakaran, Sajjad U R Rahman, Saleem M Rana, Robert Quentin Reilly, David Rojas-Rueda, Luca Ronfani, Lesley Rushton, Mohammad Yahya Saeedi, Joshua A Salomon, Uchechukwu Sampson, Itamar S Santos, Monika Sawhney, Jürgen C Schmidt, Marina Shakh-Nazarova, Jun She, Sara Sheikhbahaei, Kenji Shibuya, Hwashin Hyun Shin, Kawkab Shishani, Ivy Shiue, Inga Dora Sigfusdottir, Jasvinder A Singh, Vegard Skirbekk, Karen Sliwa, Sergey S Soshnikov, Luciano A Sposato, Vasiliki Kalliopi Stathopoulou, Konstantinos Stroumpoulis, Karen M Tabb, Roberto Tchio Talongwa, Carolina Maria Teixeira, Abdullah Sulieman Terkawi, Alan J Thomson, Andrew L Thorne-Lyman, Hideaki Toyoshima, Zacharie Tsala Dimbuene, Parfait Uwaliraye, Selen Begüm Uzun, Tommi J Vasankari, Ana Maria Nogales Vasconcelos, Vasiliy Victorovich Vlassov, Stein Emil Vollset, Stephen Waller, Xia Wan, Scott Weichenthal, Elisabete Weiderpass, Robert G Weintraub, Ronny Westerman, James D Wilkinson, Hywel C Williams, Yang C Yang, Gokalp Kadri Yentur, Paul Yip, Naohiro Yonemoto, Mustafa Younis, Chuanhua Yu, Kim Yun Jin, Maysaa El Sayed Zaki, Shankuan Zhu, Theo Vos, Alan D Lopez, Christopher J L Murray.
Lancet
PUBLISHED: 05-02-2014
Show Abstract
Hide Abstract
Remarkable financial and political efforts have been focused on the reduction of child mortality during the past few decades. Timely measurements of levels and trends in under-5 mortality are important to assess progress towards the Millennium Development Goal 4 (MDG 4) target of reduction of child mortality by two thirds from 1990 to 2015, and to identify models of success.
Related JoVE Video
Cardiovascular risk assessment in low-resource settings: a consensus document of the European Society of Hypertension Working Group on Hypertension and Cardiovascular Risk in Low Resource Settings.
J. Hypertens.
PUBLISHED: 03-01-2014
Show Abstract
Hide Abstract
The Global Burden of Diseases, Injuries, and Risk Factors Study 2010 confirms ischemic heart disease and stroke as the leading cause of death and that hypertension is the main associated risk factor worldwide. How best to respond to the rising prevalence of hypertension in resource-deprived settings is a topic of ongoing public-health debate and discussion. In low-income and middle-income countries, socioeconomic inequality and cultural factors play a role both in the development of risk factors and in the access to care. In Europe, cultural barriers and poor communication between health systems and migrants may limit migrants from receiving appropriate prevention, diagnosis, and treatment. To use more efficiently resources available and to make treatment cost-effective at the patient level, cardiovascular risk approach is now recommended. In 2011, The European Society of Hypertension established a Working Group on 'Hypertension and Cardiovascular risk in low resource settings', which brought together cardiologists, diabetologists, nephrologists, clinical trialists, epidemiologists, economists, and other stakeholders to review current strategies for cardiovascular risk assessment in population studies in low-income and middle-income countries, their limitations, possible improvements, and future interests in screening programs. This report summarizes current evidence and presents highlights of unmet needs.
Related JoVE Video
Governance and health in the Arab world.
Lancet
PUBLISHED: 01-20-2014
Show Abstract
Hide Abstract
Since late 2010, the Arab world has entered a tumultuous period of change, with populations demanding more inclusive and accountable government. The region is characterised by weak political institutions, which exclude large proportions of their populations from political representation and government services. Building on work in political science and economics, we assess the extent to which the quality of governance, or the extent of electoral democracy, relates to adult, infant, and maternal mortality, and to the perceived accessibility and improvement of health services. We compiled a dataset from the World Bank, WHO, Institute for Health Metrics and Evaluation, Arab Barometer Survey, and other sources to measure changes in demographics, health status, and governance in the Arab World from 1980 to 2010. We suggest an association between more effective government and average reductions in mortality in this period; however, there does not seem to be any relation between the extent of democracy and mortality reductions. The movements for changing governance in the region threaten access to services in the short term, forcing migration and increasing the vulnerability of some populations. In view of the patterns observed in the available data, and the published literature, we suggest that efforts to improve government effectiveness and to reduce corruption are more plausibly linked to population health improvements than are efforts to democratise. However, these patterns are based on restricted mortality data, leaving out subjective health metrics, quality of life, and disease-specific data. To better guide efforts to transform political and economic institutions, more data are needed for health-care access, health-care quality, health status, and access to services of marginalised groups.
Related JoVE Video
Insights into the preservation of the homomorphic sex-determining chromosome of Aedes aegypti from the discovery of a male-biased gene tightly linked to the M-locus.
Genome Biol Evol
PUBLISHED: 01-09-2014
Show Abstract
Hide Abstract
The preservation of a homomorphic sex-determining chromosome in some organisms without transformation into a heteromorphic sex chromosome is a long-standing enigma in evolutionary biology. A dominant sex-determining locus (or M-locus) in an undifferentiated homomorphic chromosome confers the male phenotype in the yellow fever mosquito Aedes aegypti. Genetic evidence suggests that the M-locus is in a nonrecombining region. However, the molecular nature of the M-locus has not been characterized. Using a recently developed approach based on Illumina sequencing of male and female genomic DNA, we identified a novel gene, myo-sex, that is present almost exclusively in the male genome but can sporadically be found in the female genome due to recombination. For simplicity, we define sequences that are primarily found in the male genome as male-biased. Fluorescence in situ hybridization (FISH) on A. aegypti chromosomes demonstrated that the myo-sex probe localized to region 1q21, the established location of the M-locus. Myo-sex is a duplicated myosin heavy chain gene that is highly expressed in the pupa and adult male. Myo-sex shares 83% nucleotide identity and 97% amino acid identity with its closest autosomal paralog, consistent with ancient duplication followed by strong purifying selection. Compared with males, myo-sex is expressed at very low levels in the females that acquired it, indicating that myo-sex may be sexually antagonistic. This study establishes a framework to discover male-biased sequences within a homomorphic sex-determining chromosome and offers new insights into the evolutionary forces that have impeded the expansion of the nonrecombining M-locus in A. aegypti.
Related JoVE Video
Do girls have a nutritional disadvantage compared with boys? Statistical models of breastfeeding and food consumption inequalities among Indian siblings.
PLoS ONE
PUBLISHED: 01-01-2014
Show Abstract
Hide Abstract
India is the only nation where girls have greater risks of under-5 mortality than boys. We test whether female disadvantage in breastfeeding and food allocation accounts for gender disparities in mortality.
Related JoVE Video
Averting obesity and type 2 diabetes in India through sugar-sweetened beverage taxation: an economic-epidemiologic modeling study.
PLoS Med.
PUBLISHED: 01-01-2014
Show Abstract
Hide Abstract
Taxing sugar-sweetened beverages (SSBs) has been proposed in high-income countries to reduce obesity and type 2 diabetes. We sought to estimate the potential health effects of such a fiscal strategy in the middle-income country of India, where there is heterogeneity in SSB consumption, patterns of substitution between SSBs and other beverages after tax increases, and vast differences in chronic disease risk within the population.
Related JoVE Video
Palm oil taxes and cardiovascular disease mortality in India: economic-epidemiologic model.
BMJ
PUBLISHED: 10-24-2013
Show Abstract
Hide Abstract
To examine the potential effect of a tax on palm oil on hyperlipidemia and on mortality due to cardiovascular disease in India.
Related JoVE Video
Complexity in mathematical models of public health policies: a guide for consumers of models.
PLoS Med.
PUBLISHED: 10-01-2013
Show Abstract
Hide Abstract
Sanjay Basu and colleagues explain how models are increasingly used to inform public health policy yet readers may struggle to evaluate the quality of models. All models require simplifying assumptions, and there are tradeoffs between creating models that are more "realistic" versus those that are grounded in more solid data. Indeed, complex models are not necessarily more accurate or reliable simply because they can more easily fit real-world data than simpler models can. Please see later in the article for the Editors Summary.
Related JoVE Video
Differential impact of the economic recession on alcohol use among white British adults, 2004-2010.
Eur J Public Health
PUBLISHED: 09-20-2013
Show Abstract
Hide Abstract
Background: Unlike other west European countries, there is a long-term trend of rising alcohol consumption and mortality in England. Whether drinking will rise or fall during the current recession is widely debated. We examined how the recession affected alcohol use in adults in England using individual-level data. Methods: We analysed a nationally representative sample of non-institutionalized white persons aged 20-60 years from seven waves of the Health Survey for England, 2004-2010 (n = 36 525), to assess trends in alcohol use and frequency before, during and after the recession and in association with unemployment, correcting for possible changes in sample composition and socio-demographic confounders. The primary analysis compared 2006/7 with 2008/9, following the official onset of the UK recession in early 2008. Results: During Englands recession, there was a significant decrease in frequent drinking defined as drinking four or more days in the past week (27.1% in 2006 to 23.9% in 2009, P < 0.001), the number of units of alcohol imbibed on the heaviest drinking day (P < 0.01) and the number of days that individuals reported drinking over the past seven days (P < 0.01). However, among current drinkers who were unemployed there was a significantly elevated risk of binge drinking in 2009 and 2010 (odds ratio = 1.64, 95% confidence interval: 1.22-2.19, P = 0.001) that was not previously observed in 2004-2008 (1.03, 0.76-1.41; test for effect heterogeneity: P = 0.036). Conclusions: Englands recession was associated with less hazardous drinking among the population overall, but with rises in binge drinking among a smaller high-risk group of unemployed drinkers.
Related JoVE Video
Disability and Chronic Disease Among Older Adults in India: Detecting Vulnerable Populations Through the WHO SAGE Study.
Am. J. Epidemiol.
PUBLISHED: 09-18-2013
Show Abstract
Hide Abstract
Chronic noncommunicable diseases (NCDs) are now prevalent in many low- and middle-income countries and confer a heightened risk of disability. It is unclear how public health programs can identify the older adults at highest risk of disability related to NCDs within diverse developing country populations. We studied nationally representative survey data from 7,150 Indian adults older than 50 years of age who participated in the World Health Organization Study on Global Aging and Adult Health (2007-2010) to identify population subgroups who are highly disabled. Using machine-learning algorithms, we identified sociodemographic correlates of disability. Although having 2 or more symptomatic NCDs was a key correlate of disability, the prevalence of symptomatic, undiagnosed NCDs was highest among the lowest 2 wealth quintiles of Indian adults, contrary to prior hypotheses of increased NCDs with wealth. Women and persons from rural populations were also disproportionately affected by nondiagnosed NCDs, with high out-of-pocket health care expenditures increasing the probability of remaining symptomatic from NCDs. These findings also indicate that NCD prevalence surveillance studies in low- and middle-income countries should expand beyond self-reported diagnoses to include more extensive symptom- and examination-based surveys, given the likely high rate of surveillance bias due to barriers to diagnosis among vulnerable populations.
Related JoVE Video
The political economy of austerity and healthcare: Cross-national analysis of expenditure changes in 27 European nations 1995-2011.
Health Policy
PUBLISHED: 07-24-2013
Show Abstract
Hide Abstract
Why have patterns of healthcare spending varied during the Great Recession? Using cross-national, harmonised data for 27 EU countries from 1995 to 2011, we evaluated political, economic, and health system determinants of recent changes to healthcare expenditure. Data from EuroStat, the IMF, and World Bank (2013 editions) were evaluated using multivariate random- and fixed-effects models, correcting for pre-existing time-trends. Reductions in government health expenditure were not significantly associated with magnitude of economic recessions (annual change in GDP, p=0.31, or cumulative decline, p=0.40 or debt crises (measured by public debt as a percentage of GDP, p=0.38 or per capita, p=0.83)). Nor did ideology of governing parties have an effect. In contrast, each $100 reduction in tax revenue was associated with a $2.72 drop in health spending (95% CI: $1.03-4.41). IMF borrowers were significantly more likely to reduce healthcare budgets than non-IMF borrowers (OR=3.88, 95% CI: 1.95 -7.74), even after correcting for potential confounding by indication. Exposure to lending from international financial institutions, tax revenue falls, and decisions to implement cuts correlate more closely than underlying economic conditions or orientation of political parties with healthcare expenditure change in EU member states.
Related JoVE Video
The effect of tobacco control measures during a period of rising cardiovascular disease risk in India: a mathematical model of myocardial infarction and stroke.
PLoS Med.
PUBLISHED: 07-01-2013
Show Abstract
Hide Abstract
We simulated tobacco control and pharmacological strategies for preventing cardiovascular deaths in India, the country that is expected to experience more cardiovascular deaths than any other over the next decade.
Related JoVE Video
Nutritional policy changes in the supplemental nutrition assistance program: a microsimulation and cost-effectiveness analysis.
Med Decis Making
PUBLISHED: 06-28-2013
Show Abstract
Hide Abstract
Some experts have proposed limiting the use of Supplemental Nutrition Assistance Program (SNAP) benefits, for calorie-dense foods or subsidizing SNAP purchases of healthier foods.
Related JoVE Video
Does investment in the health sector promote or inhibit economic growth?
Global Health
PUBLISHED: 06-14-2013
Show Abstract
Hide Abstract
Is existing provision of health services in Europe affordable during the recession or could cuts damage economic growth? This debate centres on whether government spending has positive or negative effects on economic growth. In this study, we evaluate the economic effects of alternative types of government spending by estimating "fiscal multipliers" (the return on investment for each $1 dollar of government spending).
Related JoVE Video
Social epidemiology of hypertension in middle-income countries: determinants of prevalence, diagnosis, treatment, and control in the WHO SAGE study.
Hypertension
PUBLISHED: 05-13-2013
Show Abstract
Hide Abstract
Large-scale hypertension screening campaigns have been recommended for middle-income countries. We sought to identify sociodemographic predictors of hypertension prevalence, diagnosis, treatment, and control among middle-income countries. We analyzed data from 47 443 adults in all 6 middle-income countries (China, Ghana, India, Mexico, Russia, and South Africa) sampled in nationally representative household assessments from 2007 to 2010 as part of the World Health Organization Study on Global Aging and Adult Health. We estimated regression models accounting for age, sex, urban/rural location, nutrition, and obesity, as well as hypothesized covariates of healthcare access, such as income and insurance. Hypertension prevalence varied from 23% (India) to 52% (Russia), with between 30% (Russia) and 83% (Ghana) of hypertensives undiagnosed before the survey and between 35% (Russia) and 87% (Ghana) untreated. Although the risk of hypertension significantly increased with age (odds ratio, 4.6; 95% confidence interval, 3.0-7.1; among aged, 60-79 versus <40 years), the risk of being undiagnosed or untreated fell significantly with age. Obesity was a significant correlate to hypertension (odds ratio, 3.7; 95% confidence interval, 2.1-6.8 for obese versus normal weight), and was prevalent even among the lowest income quintile (13% obesity). Insurance status and income also emerged as significant correlates to diagnosis and treatment probability, respectively. More than 90% of hypertension cases were uncontrolled, with men having 3 times the odds as women of being uncontrolled. Overall, the social epidemiology of hypertension in middle-income countries seems to be correlated to increasing obesity prevalence, and hypertension control rates are particularly low for adult men across distinct cultures.
Related JoVE Video
Financial crisis, austerity, and health in Europe.
Lancet
PUBLISHED: 03-27-2013
Show Abstract
Hide Abstract
The financial crisis in Europe has posed major threats and opportunities to health. We trace the origins of the economic crisis in Europe and the responses of governments, examine the effect on health systems, and review the effects of previous economic downturns on health to predict the likely consequences for the present. We then compare our predictions with available evidence for the effects of the crisis on health. Whereas immediate rises in suicides and falls in road traffic deaths were anticipated, other consequences, such as HIV outbreaks, were not, and are better understood as products of state retrenchment. Greece, Spain, and Portugal adopted strict fiscal austerity; their economies continue to recede and strain on their health-care systems is growing. Suicides and outbreaks of infectious diseases are becoming more common in these countries, and budget cuts have restricted access to health care. By contrast, Iceland rejected austerity through a popular vote, and the financial crisis seems to have had few or no discernible effects on health. Although there are many potentially confounding differences between countries, our analysis suggests that, although recessions pose risks to health, the interaction of fiscal austerity with economic shocks and weak social protection is what ultimately seems to escalate health and social crises in Europe. Policy decisions about how to respond to economic crises have pronounced and unintended effects on public health, yet public health voices have remained largely silent during the economic crisis.
Related JoVE Video
Association between smoke-free workplace and second-hand smoke exposure at home in India.
Tob Control
PUBLISHED: 03-23-2013
Show Abstract
Hide Abstract
BACKGROUND: The implementation of comprehensive smoke-free laws has been associated with reductions in second-hand smoke exposure at home in several high income countries. There is little information on whether these benefits extend to low income and middle income countries with a growing tobacco-related disease burden such as India. METHODS: State and individual-level analysis of cross-sectional data from the Global Adult Tobacco Survey India, 2009/2010. Associations between working in a smoke-free indoor environment and living in a smoke-free home were examined using correlation at the state level, and multivariate logistic regression at the individual level. RESULTS: The percentage of respondents employed indoors (outside the home) working in smoke-free environments who lived in a smoke-free home was 64.0% compared with 41.7% of those who worked where smoking occurred. Indian states with higher proportions of smoke-free workplaces had higher proportions of smoke-free homes (rs=0.54, p<0.005). In the individual-level analysis, working in a smoke-free workplace was associated with a significantly higher likelihood of living in a smoke-free home (adjusted OR=2.07; 95% CI 1.64 to 2.52) after adjustment for potential confounders. CONCLUSIONS: Implementation of smoke-free legislation in India was associated with a higher proportion of adults reporting a smoke-free home. These findings further strengthen the case for accelerated implementation of Article 8 of the Framework Convention on Tobacco Control (FCTC) in low and middle income countries.
Related JoVE Video
Relationship of soft drink consumption to global overweight, obesity, and diabetes: a cross-national analysis of 75 countries.
Am J Public Health
PUBLISHED: 03-14-2013
Show Abstract
Hide Abstract
We estimated the relationship between soft drink consumption and obesity and diabetes worldwide.
Related JoVE Video
The relationship of sugar to population-level diabetes prevalence: an econometric analysis of repeated cross-sectional data.
PLoS ONE
PUBLISHED: 01-29-2013
Show Abstract
Hide Abstract
While experimental and observational studies suggest that sugar intake is associated with the development of type 2 diabetes, independent of its role in obesity, it is unclear whether alterations in sugar intake can account for differences in diabetes prevalence among overall populations. Using econometric models of repeated cross-sectional data on diabetes and nutritional components of food from 175 countries, we found that every 150 kcal/person/day increase in sugar availability (about one can of soda/day) was associated with increased diabetes prevalence by 1.1% (p <0.001) after testing for potential selection biases and controlling for other food types (including fibers, meats, fruits, oils, cereals), total calories, overweight and obesity, period-effects, and several socioeconomic variables such as aging, urbanization and income. No other food types yielded significant individual associations with diabetes prevalence after controlling for obesity and other confounders. The impact of sugar on diabetes was independent of sedentary behavior and alcohol use, and the effect was modified but not confounded by obesity or overweight. Duration and degree of sugar exposure correlated significantly with diabetes prevalence in a dose-dependent manner, while declines in sugar exposure correlated with significant subsequent declines in diabetes rates independently of other socioeconomic, dietary and obesity prevalence changes. Differences in sugar availability statistically explain variations in diabetes prevalence rates at a population level that are not explained by physical activity, overweight or obesity.
Related JoVE Video
Alcohol use during the great recession of 2008-2009.
Alcohol Alcohol.
PUBLISHED: 01-29-2013
Show Abstract
Hide Abstract
The aim of this study was to assess changes in alcohol use in the USA during the Great Recession.
Related JoVE Video
An alternative mechanism for international health aid: evaluating a Global Social Protection Fund.
Health Policy Plan
PUBLISHED: 01-17-2013
Show Abstract
Hide Abstract
Several public health groups have called for the creation of a global fund for social protection-a fund that produces the international equivalent of domestic tax collection and safety net systems to finance care for the ill and disabled and related health costs. All participating countries would pay into a global fund based on a metric of their ability to pay and withdraw from the common pool based on a metric of their need for funds. We assessed how alternative strategies and metrics by which to operate such a fund would affect its size and impact on health system financing. Using a mathematical model, we found that common targets for health funding in low-income countries require higher levels of aid expenditures than presently distributed. Some mechanisms exist that may incentivize reduction of domestic health inequalities, and direct most funds towards the poorest populations. Payments from high-income countries are also likely to decrease over time as middle-income countries economies grow.
Related JoVE Video
Socioeconomic inequalities in non-communicable diseases prevalence in India: disparities between self-reported diagnoses and standardized measures.
PLoS ONE
PUBLISHED: 01-01-2013
Show Abstract
Hide Abstract
Whether non-communicable diseases (NCDs) are diseases of poverty or affluence in low-and-middle income countries has been vigorously debated. Most analyses of NCDs have used self-reported data, which is biased by differential access to healthcare services between groups of different socioeconomic status (SES). We sought to compare self-reported diagnoses versus standardised measures of NCD prevalence across SES groups in India.
Related JoVE Video
Projected effects of tobacco smoking on worldwide tuberculosis control: mathematical modelling analysis.
BMJ
PUBLISHED: 10-06-2011
Show Abstract
Hide Abstract
Almost 20% of people smoke tobacco worldwide--a percentage projected to rise in many poor countries. Smoking has been linked to increased individual risk of tuberculosis infection and mortality, but it remains unclear how these risks affect population-wide tuberculosis rates.
Related JoVE Video
Whos afraid of noncommunicable diseases? Raising awareness of the effects of noncommunicable diseases on global health.
J Health Commun
PUBLISHED: 09-16-2011
Show Abstract
Hide Abstract
Public-health priorities are in part driven by fear, yet fear has long been recognized as posing a threat to effective public health interventions. In this article, the authors review the role of fear in global health by focusing on the leading global cause of death and disability: noncommunicable diseases. Taking an historical perspective, first the authors review Samuel Adams 1911 analysis of the role of fear in generating public health priority and his recommendations about mass educating the public. Next, they show that Adams analysis still applies today, drawing on contemporary responses to H1N1 and HIV, while illustrating the ongoing neglect of long-term threats such as noncommunicable diseases. Then, they pose the question, "Is it possible, necessary, or useful to create a fear factor for noncommunicable diseases?" After reviewing mixed evidence about the effects of fear on social change (on individual behaviors and on building a mass movement to achieve collective action), the authors conclude by setting out an evidence-based, marketing strategy to generate a sustained, rational response to the noncommunicable disease epidemic.
Related JoVE Video
The impact of economic crises on communicable disease transmission and control: a systematic review of the evidence.
PLoS ONE
PUBLISHED: 05-11-2011
Show Abstract
Hide Abstract
There is concern among public health professionals that the current economic downturn, initiated by the financial crisis that started in 2007, could precipitate the transmission of infectious diseases while also limiting capacity for control. Although studies have reviewed the potential effects of economic downturns on overall health, to our knowledge such an analysis has yet to be done focusing on infectious diseases. We performed a systematic literature review of studies examining changes in infectious disease burden subsequent to periods of crisis. The review identified 230 studies of which 37 met our inclusion criteria. Of these, 30 found evidence of worse infectious disease outcomes during recession, often resulting from higher rates of infectious contact under poorer living circumstances, worsened access to therapy, or poorer retention in treatment. The remaining studies found either reductions in infectious disease or no significant effect. Using the paradigm of the "SIR" (susceptible-infected-recovered) model of infectious disease transmission, we examined the implications of these findings for infectious disease transmission and control. Key susceptible groups include infants and the elderly. We identified certain high-risk groups, including migrants, homeless persons, and prison populations, as particularly vulnerable conduits of epidemics during situations of economic duress. We also observed that the long-term impacts of crises on infectious disease are not inevitable: considerable evidence suggests that the magnitude of effect depends critically on budgetary responses by governments. Like other emergencies and natural disasters, preparedness for financial crises should include consideration of consequences for communicable disease control.
Related JoVE Video
Democracy and growth in divided societies: A health-inequality trap?
Soc Sci Med
PUBLISHED: 04-06-2011
Show Abstract
Hide Abstract
Despite a tremendous increase in financial resources, many countries are not on track to achieve the child and maternal mortality targets set out in the Millennium Development Goals 4 and 5. It is commonly argued that two main social factors - improved democratic governance and aggregate income - will ultimately lead to progress in reducing child and maternal mortality. However, these two factors alone may be insufficient to achieve progress in settings where there is a high level of social division. To test the effects of growth and democratisation, and their interaction with social inequalities, we regressed data on child and maternal mortality rates for 192 countries against internationally used indexes of income, democracy, and population inequality (including income, ethnic, linguistic, and religious divisions) covering the period 1970-2007. We found that a higher degree of social division, especially ethnic and linguistic fractionalisation, was significantly associated with greater child and maternal mortality rates. We further found that, even in democratic states, greater social division was associated with lower overall population access to healthcare and lesser expansion of health system infrastructure. Perversely, while greater democratisation and aggregate income were associated with reduced maternal and child mortality overall, in regions with high levels of ethnic fragmentation the health benefits of democratisation and rising income were undermined and, at high levels of inequality reversed, so that democracy and growth were adversely related to child and maternal mortality. These findings are consistent with literature suggesting that high degrees of social division in the context of democratisation can strengthen the power of dominant elite and ethnic groups in political decision-making, resulting in health and welfare policies that deprive minority groups (a health-inequality trap). Thus, we show that improving economic growth and democratic governance are insufficient to achieve child and maternal health targets in communities with high levels of persistent social inequality. To reduce child and maternal mortality in highly divided societies, it will be necessary not only to increase growth and promote democratic elections, but also empower disenfranchised communities.
Related JoVE Video
Banking crises and mortality during the Great Depression: evidence from US urban populations, 1929-1937.
J Epidemiol Community Health
PUBLISHED: 03-24-2011
Show Abstract
Hide Abstract
Previous research suggests that the Great Depression led to improvements in public health. However, these studies rely on highly aggregated national data (using fewer than 25 data points) and potentially biased measures of the Great Depression. The authors assess the effects of the Great Depression using city-level estimates of US mortality and an underlying measure of economic crisis, bank suspensions, at the state level.
Related JoVE Video
Transmission dynamics and control of cholera in Haiti: an epidemic model.
Lancet
PUBLISHED: 03-15-2011
Show Abstract
Hide Abstract
Official projections of the cholera epidemic in Haiti have not incorporated existing disease trends or patterns of transmission, and proposed interventions have been debated without comparative estimates of their effect. We used a mathematical model of the epidemic to provide projections of future morbidity and mortality, and to produce comparative estimates of the effects of proposed interventions.
Related JoVE Video
International Monetary Fund and aid displacement.
Int J Health Serv
PUBLISHED: 02-16-2011
Show Abstract
Hide Abstract
Several recent papers find evidence that global health aid is being diverted to reserves, education, military, or other sectors, and is displacing government spending. This is suggested to occur because ministers of finance have competing, possibly corrupt, priorities and deprive the health sector of resources. Studies have found that development assistance for health routed to governments has a negative impact on health spending and that similar assistance routed to private nongovernmental organizations has a positive impact. An alternative hypothesis is that World Bank and IMF macro-economic policies, which specifically advise governments to divert aid to reserves to cope with aid volatility and keep government spending low, could be causing the displacement of health aid. This article evaluates whether aid displacement was greater when countries undertook a new borrowing program from the IMF between 1996 and 2006. As found in existing studies, for each $1 of development assistance for health, about $0.37 is added to the health system. However, evaluating IMF-borrowing versus non-IMF-borrowing countries reveals that non-borrowers add about $0.45 whereas borrowers add less than $0.01 to the health system. On average, health system spending grew at about half the speed when countries were exposed to the IMF than when they were not. It is important to take account of the political economy of global health finance when interpreting data on financial flows.
Related JoVE Video
Site-specific integration and expression of an anti-malarial gene in transgenic Anopheles gambiae significantly reduces Plasmodium infections.
PLoS ONE
PUBLISHED: 01-25-2011
Show Abstract
Hide Abstract
Diseases transmitted by mosquitoes have a devastating impact on global health and this is worsening due to difficulties with existing control measures and climate change. Genetically modified mosquitoes that are refractory to disease transmission are seen as having great potential in the delivery of novel control strategies. Historically the genetic modification of insects has relied upon transposable elements which have many limitations despite their successful use. To circumvent these limitations the Streptomyces phage phiC31 integrase system has been successfully adapted for site-specific transgene integration in insects. Here, we present the first site-specific transformation of Anopheles gambiae, the principal vector of human malaria. Mosquitoes were initially engineered to incorporate the phiC31 targeting site at a defined genomic location. A second phase of genetic modification then achieved site-specific integration of Vida3, a synthetic anti-malarial gene. Expression of Vida3, specifically in the midgut of bloodfed females, offered consistent and significant protection against Plasmodium yoelii nigeriensis, reducing average parasite intensity by 85%. Similar protection was observed against Plasmodium falciparum in some experiments, although protection was inconsistent. In the fight against malaria, it is imperative to establish a broad repertoire of both anti-malarial effector genes and tissue-specific promoters for their expression, enabling those offering maximum effect with minimum fitness cost to be identified. In the future, this technology will allow effective comparisons and informed choices to be made, potentially leading to complete transmission blockade.
Related JoVE Video
Health care capacity and allocations among South Africas provinces: infrastructure-inequality traps after the end of apartheid.
Am J Public Health
PUBLISHED: 01-21-2011
Show Abstract
Hide Abstract
We assessed the determinants of health care funding allocations among South Africas provinces and their effects on health care from 1996 through 2007.
Related JoVE Video
Addressing institutional amplifiers in the dynamics and control of tuberculosis epidemics.
Am. J. Trop. Med. Hyg.
PUBLISHED: 01-08-2011
Show Abstract
Hide Abstract
Tuberculosis outbreaks originating in prisons, mines, or hospital wards can spread to the larger community. Recent proposals have targeted these high-transmission institutional amplifiers by improving case detection, treatment, or reducing the size of the exposed population. However, what effects these alternative proposals may have is unclear. We mathematically modeled these control strategies and found case detection and treatment methods insufficient in addressing epidemics involving common types of institutional amplifiers. Movement of persons in and out of amplifiers fundamentally altered the transmission dynamics of tuberculosis in a manner not effectively mitigated by detection or treatment alone. Policies increasing the population size exposed to amplifiers or the per-person duration of exposure within amplifiers potentially worsened incidence, even in settings with high rates of detection and treatment success. However, reducing the total population size entering institutional amplifiers significantly lowered tuberculosis incidence and the risk of propagating new drug-resistant tuberculosis strains.
Related JoVE Video
Does recession reduce global health aid? Evidence from 15 high-income countries, 1975-2007.
Bull. World Health Organ.
PUBLISHED: 01-06-2011
Show Abstract
Hide Abstract
To test the hypothesis that economic recessions lead to reduced global development assistance for health (DAH).
Related JoVE Video
Raising the priority of preventing chronic diseases: a political process.
Lancet
PUBLISHED: 11-16-2010
Show Abstract
Hide Abstract
Chronic diseases, especially cardiovascular diseases, diabetes, cancer, and chronic obstructive respiratory diseases,are neglected globally despite growing awareness of the serious burden that they cause. Global and national policies have failed to stop, and in many cases have contributed to, the chronic disease pandemic. Low-cost and highly effective solutions for the prevention of chronic diseases are readily available; the failure to respond is now a political, rather than a technical issue. We seek to understand this failure and to position chronic disease centrally on the global health and development agendas. To identify strategies for generation of increased political priority for chronic diseases and to further the involvement of development agencies, we use an adapted political process model. This model has previously been used to assess the success and failure of social movements. On the basis of this analysis,we recommend three strategies: reframe the debate to emphasise the societal determinants of disease and the interrelation between chronic disease, poverty, and development; mobilise resources through a cooperative and inclusive approach to development and by equitably distributing resources on the basis of avoidable mortality; and build one merging strategic and political opportunities, such as the World Health Assembly 2008–13 Action Plan and the high level meeting of the UN General Assembly in 2011 on chronic disease. Until the full set of threats—which include chronic disease—that trap poor households in cycles of debt and illness are addressed, progress towards equitable human development will remain inadequate.
Related JoVE Video
Turning a blind eye: the mobilization of radiology services in resource-poor regions.
Global Health
PUBLISHED: 09-12-2010
Show Abstract
Hide Abstract
While primary care, obstetrical, and surgical services have started to expand in the worlds poorest regions, there is only sparse literature on the essential support systems that are required to make these operations function. Diagnostic imaging is critical to effective rural healthcare delivery, yet it has been severely neglected by the academic, public, and private sectors. Currently, a large portion of the worlds population lacks access to any form of diagnostic imaging. In this paper we argue that two primary imaging modalities--diagnostic ultrasound and X-Ray--are ideal for rural healthcare services and should be scaled-up in a rapid and standardized manner. Such machines, if designed for resource-poor settings, should a) be robust in harsh environmental conditions, b) function reliably in environments with unstable electricity, c) minimize radiation dangers to staff and patients, d) be operable by non-specialist providers, and e) produce high-quality images required for accurate diagnosis. Few manufacturers are producing ultrasound and X-Ray machines that meet the specifications needed for rural healthcare delivery in resource-poor regions. A coordinated effort is required to create demand sufficient for manufacturers to produce the desired machines and to ensure that the programs operating them are safe, effective, and financially feasible.
Related JoVE Video
Responding to the economic crisis: a primer for public health professionals.
J Public Health (Oxf)
PUBLISHED: 08-24-2010
Show Abstract
Hide Abstract
Does the current economic crisis require the deep cuts in public spending announced in the June 2010 emergency budget, with potential implications for public health? The arguments for and against such cuts in response to economic recession are complex, but if public health professionals are to engage in debates about future public spending, they should be informed by relevant evidence. In this perspective, we note that opinions among politicians and economists about how to respond to economic downturns are divided, while other EU countries, many with greater levels of debt than the UK, are protecting public expenditure unless required to do so by the International Monetary Fund. Current UK debt may in fact be viewed as sustainable given current information about interest rates, inflation and economic growth. Before accepting large cuts in public spending, it is important to contrast the lack of evidence for such short-term fixes with potentially dire repercussions for population health and welfare.
Related JoVE Video
Financing the Millennium Development Goals for health and beyond: sustaining the Big Push.
Global Health
PUBLISHED: 06-27-2010
Show Abstract
Hide Abstract
Many of the Millennium Development Goals are not being achieved in the worlds poorest countries, yet only five years remain until the target date. The financing of these Goals is not merely insufficient; current evidence indicates that the temporary nature of the financing, as well as challenges to coordinating its delivery and directing it to the most needy recipients, hinder achievement of the Goals in countries that may benefit most. Traditional approaches to providing development assistance for health have not been able to address both prevalent and emergent public health challenges captured in the Goals; these challenges demand sustained forms of financial redistribution through a coordinated mechanism. A global social health protection fund is proposed to address recurring failures in the modern aid distribution mechanism. Such a Fund could use established and effective strategies for aid delivery to mitigate many financial problems currently undermining the Millennium Development Goals initiative.
Related JoVE Video
Mining and risk of tuberculosis in sub-Saharan Africa.
Am J Public Health
PUBLISHED: 06-01-2010
Show Abstract
Hide Abstract
We estimated the relationship between mining and tuberculosis (TB) among countries in sub-Saharan Africa.
Related JoVE Video
Combining mathematics and empirical data to predict emergence of RNA viruses that differ in reservoir use.
Philos. Trans. R. Soc. Lond., B, Biol. Sci.
PUBLISHED: 05-19-2010
Show Abstract
Hide Abstract
RNA viruses may be particularly capable of contributing to the increasing biomedical problem of infectious disease emergence. Empirical studies and epidemiological models are informative for the understanding of evolutionary processes that promote pathogen emergence, but rarely are these approaches combined in the same study. Here, we used an epidemiology model containing observations of pathogen productivity in reservoirs, as a means to predict which pathogens should be most prone to emerge in a primary host such as humans. We employed as a model system a collection of vesicular stomatitis virus populations that had previously diverged in host-use strategy: specialists, directly selected generalists and indirectly selected (fortuitous) generalists. Using data from experiments where these viral strategists were challenged to grow on unencountered novel hosts in vitro, logistic growth models determined that the directly selected generalist viruses tended to grow best on model reservoirs. Furthermore, when we used the growth data to estimate average reproductive rate across secondary reservoirs, we showed that the combined approach could be used to estimate relative success of the differing virus strategists when encountering a primary host. Our study suggests that synergistic approaches combining epidemiological modelling with empirical data from experimental evolution may be useful for developing efforts to predict which types of pathogens pose the greatest probability of emerging in the future.
Related JoVE Video
An evaluation of the International Monetary Funds claims about public health.
Int J Health Serv
PUBLISHED: 05-06-2010
Show Abstract
Hide Abstract
The International Monetary Funds recent claims concerning its impact on public health are evaluated against available data. First, the IMF claims that health spending either does not change or increases with IMF-supported programs, but there is substantial evidence to the contrary. Second, the IMF claims to have relaxed strict spending requirements in response to the 2008-9 financial crisis, but there is no evidence supporting this claim, and some limited evidence from the Center for Economic Policy Research contradicting it. Third, the IMF states that wage ceilings on public health are no longer part of its explicit conditionalities to poor countries, as governments can choose how to achieve public spending targets; but in practice, ministers are left with few viable alternatives than to reduce health budgets to achieve specific IMF-mandated targets, so the result effectively preserves former policy. Fourth, the IMFs claim that it has increased aid to poor countries also seems to be contradicted by its policies of diverting aid to reserves, as well as evidence that a very small fraction of the Funds new lending in response to the financial crisis has reached poor countries. Finally, the IMFs claim that it follows public health standards in tobacco control contrasts with its existing policies, which fail to follow the guidelines recommended by the World Bank and World Health Organization. The authors recommend that the IMF (1) become more transparent in its policies, practices, and data to allow improved independent evaluations of its impact on public health (including Health Impact Assessment) and (2) review considerable public health evidence indicating a negative association between its current policies and public health outcomes.
Related JoVE Video
Is wealthier always healthier? The impact of national income level, inequality, and poverty on public health in Latin America.
Soc Sci Med
PUBLISHED: 03-31-2010
Show Abstract
Hide Abstract
Despite findings indicating that both national income level and income inequality are each determinants of public health, few have studied how national income level, poverty and inequality interact with each other to influence public health outcomes. We analyzed the relationship between gross domestic product (GDP) per capita in purchasing power parity, extreme poverty rates, the gini coefficient for personal income and three common measures of public health: life expectancy, infant mortality rates, and tuberculosis (TB) mortality rates. Introducing poverty and inequality as modifying factors, we then assessed whether the relationship between GDP and health differed during times of increasing, decreasing, and decreasing or constant poverty and inequality. Data were taken from twenty-two Latin American countries from 1960 to 2007 from the December 2008 World Bank World Development Indicators, World Health Organization Global Tuberculosis Database 2008, and the Socio-Economic Database for Latin America and the Caribbean. Consistent with previous studies, we found increases in GDP have a sizable positive impact on population health. However, the strength of the relationship is powerfully influenced by changing levels of poverty and inequality. When poverty was increasing, greater GDP had no significant effect on life expectancy or TB mortality, and only led to a small reduction in infant mortality rates. When inequality was rising, greater GDP had only a modest effect on life expectancy and infant mortality rates, and no effect on TB mortality rates. In sharp contrast, during times of decreasing or constant poverty and inequality, there was a very strong relationship between increasing GDP and higher life expectancy and lower TB and infant mortality rates. Finally, inequality and poverty were found to exert independent, substantial effects on the relationship between national income level and health. Wealthier is indeed healthier, but how much healthier depends on how increases in wealth are distributed.
Related JoVE Video
Drivers of inequality in Millennium Development Goal progress: a statistical analysis.
PLoS Med.
PUBLISHED: 01-27-2010
Show Abstract
Hide Abstract
Many low- and middle-income countries are not on track to reach the public health targets set out in the Millennium Development Goals (MDGs). We evaluated whether differential progress towards health MDGs was associated with economic development, public health funding (both overall and as percentage of available domestic funds), or health system infrastructure. We also examined the impact of joint epidemics of HIV/AIDS and noncommunicable diseases (NCDs), which may limit the ability of households to address child mortality and increase risks of infectious diseases.
Related JoVE Video
The International Monetary Funds effects on global health: before and after the 2008 financial crisis.
Int J Health Serv
PUBLISHED: 11-26-2009
Show Abstract
Hide Abstract
In April 2009, the G20 countries committed US $750 billion to the International Monetary Fund (IMF), which has assumed a central role in global economic management. The IMF provides loans to financially ailing countries, but with strict conditions, typically involving a mix of privatization, liberalization, and fiscal austerity programs. These loan conditions have been extremely controversial. In principle, they are designed to help countries balance their books. In practice, they often translate into reductions in social spending, including spending on public health and health care delivery. As more countries are being exposed to IMF policies, there is a need to establish what we know and do not know about the IMFs effects on global health. This article introduces a series in which contributors review the evidence on the relationship between the IMF and public health and discuss potential ways to improve the Funds effects on health. While more evidence is needed for some regions, there is sufficient evidence to indicate that IMF programs have been significantly associated with weakened health care systems, reduced effectiveness of health-focused development aid, and impeded efforts to control tobacco, infectious diseases, and child and maternal mortality. Reforms are urgently needed to prevent the current wave of IMF programs from further undermining public health in financially ailing countries and limiting progress toward the health Millennium Development Goals.
Related JoVE Video
The public health effect of economic crises and alternative policy responses in Europe: an empirical analysis.
Lancet
PUBLISHED: 07-07-2009
Show Abstract
Hide Abstract
There is widespread concern that the present economic crisis, particularly its effect on unemployment, will adversely affect population health. We investigated how economic changes have affected mortality rates over the past three decades and identified how governments might reduce adverse effects.
Related JoVE Video
The production of consumption: addressing the impact of mineral mining on tuberculosis in southern Africa.
Global Health
PUBLISHED: 06-23-2009
Show Abstract
Hide Abstract
Miners in southern Africa experience incident rates of tuberculosis up to ten times greater than the general population. Migration to and from mines may be amplifying tuberculosis epidemics in the general population.
Related JoVE Video
The health implications of financial crisis: a review of the evidence.
Ulster Med J
PUBLISHED: 06-16-2009
Show Abstract
Hide Abstract
What will the current economic crisis mean for the health of the people of Northern Ireland? We review the experience of three major economic crises in the 20(th) century: the Great Depression (1929), the Post-communist Depression (early 1990 s) and the East Asian financial crisis (late 1990 s). Available evidence suggests that health is at risk in times of rapid economic change, in both booms and busts. However the impact on mortality is exacerbated where people have easy access to the means to harm themselves and is ameliorated by the presence of strong social cohesion and social protection systems. On this basis, Northern Ireland may escape relatively unscathed in the short term but as every crisis also provides an opportunity, this is an appropriate time for the Northern Ireland Executive to reflect on whether they are making a sufficient investment in the long term health of their population.
Related JoVE Video
Averting epidemics of extensively drug-resistant tuberculosis.
Proc. Natl. Acad. Sci. U.S.A.
PUBLISHED: 04-13-2009
Show Abstract
Hide Abstract
Extensively drug-resistant tuberculosis (XDR TB) has been detected in most provinces of South Africa, particularly in the KwaZulu-Natal province where several hundred cases have been reported since 2004. We analyzed the transmission dynamics of XDR TB in the region using mathematical models, and observed that nosocomial transmission clusters of XDR TB may emerge into community-based epidemics under the public health conditions of many South African communities. The effective reproductive number of XDR TB in KwaZulu-Natal may be around 2. Intensified community-based case finding and therapy appears critical to curtailing transmission. In the setting of delayed disease presentation and high system demand, improved diagnostic approaches may need to be employed in community-based programs rather than exclusively at tertiary hospitals. Using branching process mathematics, we observed that early, community-based drug-susceptibility testing and effective XDR therapy could help curtail ongoing transmission and reduce the probability of XDR TB epidemics in neighboring territories.
Related JoVE Video
Treatment outcomes among patients with multidrug-resistant tuberculosis: systematic review and meta-analysis.
Lancet Infect Dis
PUBLISHED: 02-28-2009
Show Abstract
Hide Abstract
Multidrug-resistant (MDR) tuberculosis is a growing clinical and public-health concern. To evaluate existing evidence regarding treatment regimens for MDR tuberculosis, we used a Bayesian random-effects meta-analysis of the available therapeutic studies to assess how the reported proportion of patients treated successfully is influenced by differences in treatment regimen design, study methodology, and patient population. Successful treatment outcome was defined as cure or treatment completion. 34 clinical reports with a mean of 250 patients per report met the inclusion criteria. Our analysis shows that the proportion of patients treated successfully improved when treatment duration was at least 18 months, and if patients received directly observed therapy throughout treatment. Studies that combined both factors had significantly higher pooled success proportions (69%, 95% credible interval [CI] 64-73%) than other studies of treatment outcomes (58%, 95% CI 52-64%). Individualised treatment regimens had higher treatment success (64%, 95% CI 59-68%) than standardised regimens (54%, 95% CI 43-68%), although the difference was not significant. Treatment approaches and study methodologies were heterogeneous across studies. Many important variables, including patients HIV status, were inconsistently reported between studies. These results underscore the importance of strong patient support and treatment follow-up systems to develop successful MDR tuberculosis treatment programmes.
Related JoVE Video
The evolution of tuberculosis virulence.
Bull. Math. Biol.
PUBLISHED: 01-07-2009
Show Abstract
Hide Abstract
The evolution of Mycobacterium tuberculosis presents several challenges for public health. HIV and resistance to antimycobacterial medications have evolutionary implications for how Mycobacterium tuberculosis will evolve, as these factors influence the host environment and transmission dynamics of tuberculosis strains. We present an evolutionary invasion analysis of tuberculosis that characterizes the direction of tuberculosis evolution in the context of different natural and human-driven selective pressures, including changes in tuberculosis treatment and HIV prevalence. We find that the evolution of tuberculosis virulence can be affected by treatment success rates, the relative transmissibility of emerging strains, the rate of reactivation from latency among hosts, and the life expectancy of hosts. We find that the virulence of tuberculosis strains may also increase as a consequence of rising HIV prevalence, requiring faster case detection strategies in areas where the epidemics of HIV and tuberculosis collide.
Related JoVE Video
Universal health coverage: a quest for all countries but under threat in some.
Value Health
Show Abstract
Hide Abstract
Over the past 50 years, health care has been making a growing contribution to population health in many countries. Yet its benefits are still denied to many people worldwide. This article describes how many countries, both developed and developing, have pursued the quest to achieve universal health care. This has been an explicitly political process. In Europe, it emerged from a belief in solidarity, a fear of revolution, and a changing view of the role of the state. In developing countries, progress was more erratic, characterized by debates about the affordability of universal health care, until it was realized that functioning health systems were essential to deliver development goals. Throughout, the United States has been an exception. An analysis of progress toward universal health care, combining a review of existing theories and new empirical analysis, identifies five factors as important: the strength of organized labor and left-wing parties, adequate economic resources, absence of societal divisions, weakness of institutions that might oppose it (such as organized medicine), and windows of opportunity. Having noted the substantial benefits accruing from universal health care, the article concludes with an analysis of how universal health care is under threat in some European countries and a warning about the risks posed by current radical austerity policies.
Related JoVE Video
Is passive diagnosis enough? The impact of subclinical disease on diagnostic strategies for tuberculosis.
Am. J. Respir. Crit. Care Med.
Show Abstract
Hide Abstract
Tuberculosis (TB) is characterized by a subclinical phase (symptoms absent or not considered abnormal); prediagnostic phase (symptoms noticed but diagnosis not pursued); and clinical phase (care actively sought). Diagnostic capacity during these phases is limited.
Related JoVE Video
Six concerns about the data in aid debates: applying an epidemiological perspective to the analysis of aid effectiveness in health and development.
Health Policy Plan
Show Abstract
Hide Abstract
Is aid helping, hindering, or having no effect on development and health? The answer to this question is highly contested, with proponents on all sides adhering strongly to their competing interpretations. We ask how it is possible for those who are often using the same data to hold such divergent views. Here, we employ an epidemiological perspective and find that, in many cases, the arguments are characterised by methodological weaknesses. There may be selective citation of results and failure to account for bias and confounding, such as where an extraneous factor influencing the outcome is correlated with increased aid or, in confounding by indication, where increased aid is a consequence of a country being in an especially adverse situation. Studies may also lack external validity, whereby lack of data (a widespread problem) or similar considerations mean that analyses are undertaken on an unrepresentative subset of countries. Multiple outcome measures can also be problematic, where the main outcome of interest is not specified in advance. Many studies fail to account for differential time lags between changes in aid and the outcomes being studied. Some studies may also be underpowered to detect an association where one exists. Although, ideally, this debate should be informed by large scale randomised controlled trials, this will often be unfeasible. Given this limitation, it is essential that those engaged in it are cognisant of the many methodological issues that face any observational study.
Related JoVE Video
The mental health risks of economic crisis in Spain: evidence from primary care centres, 2006 and 2010.
Eur J Public Health
Show Abstract
Hide Abstract
Nearly all European countries have been affected by the economic crisis that began in 2007, but the consequences have been among the worst in Spain. We investigated the associations of the recession on the frequency of mood, anxiety, somatoform, alcohol-related and eating disorders among those visiting Spanish primary care settings.
Related JoVE Video
The effect of healthcare delivery privatisation on avoidable mortality: longitudinal cross-regional results from Italy, 1993-2003.
J Epidemiol Community Health
Show Abstract
Hide Abstract
During the 1990s, Italy privatised a significant portion of its healthcare delivery. The authors compared the effectiveness of private and public sector healthcare delivery in reducing avoidable mortality (deaths that should not occur in the presence of effective medical care).
Related JoVE Video
Dietary salt reduction and cardiovascular disease rates in India: a mathematical model.
PLoS ONE
Show Abstract
Hide Abstract
Reducing salt intake has been proposed to prevent cardiovascular disease in India. We sought to determine whether salt reductions would be beneficial or feasible, given the worry that unrealistically large reductions would be required, worsening iodine deficiency and benefiting only urban subpopulations.
Related JoVE Video
Comparative performance of private and public healthcare systems in low- and middle-income countries: a systematic review.
PLoS Med.
Show Abstract
Hide Abstract
Private sector healthcare delivery in low- and middle-income countries is sometimes argued to be more efficient, accountable, and sustainable than public sector delivery. Conversely, the public sector is often regarded as providing more equitable and evidence-based care. We performed a systematic review of research studies investigating the performance of private and public sector delivery in low- and middle-income countries.
Related JoVE Video
Nutritional determinants of worldwide diabetes: an econometric study of food markets and diabetes prevalence in 173 countries.
Public Health Nutr
Show Abstract
Hide Abstract
Ageing and urbanization leading to sedentary lifestyles have been the major explanations proposed for a dramatic rise in diabetes worldwide and have been the variables used to predict future diabetes rates. However, a transition to Western diets has been suggested as an alternative driver. We sought to determine what socio-economic and dietary factors are the most significant population-level contributors to diabetes prevalence rates internationally.
Related JoVE Video

What is Visualize?

JoVE Visualize is a tool created to match the last 5 years of PubMed publications to methods in JoVE's video library.

How does it work?

We use abstracts found on PubMed and match them to JoVE videos to create a list of 10 to 30 related methods videos.

Video X seems to be unrelated to Abstract Y...

In developing our video relationships, we compare around 5 million PubMed articles to our library of over 4,500 methods videos. In some cases the language used in the PubMed abstracts makes matching that content to a JoVE video difficult. In other cases, there happens not to be any content in our video library that is relevant to the topic of a given abstract. In these cases, our algorithms are trying their best to display videos with relevant content, which can sometimes result in matched videos with only a slight relation.