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[The report of the Commission on Macroeconomics and Health: its relevance to the countries of Latin America and the Caribbean].

The Commission on Macroeconomics and Health (CMH) was established by the Director-General of the World Health Organization (WHO) to evaluate the role of health in economic development. On 20 December 2001 the CMH submitted its report to the WHO Director-General. Entitled Macroeconomics and Health: Investing in Health for Economic Development, the CMH report affirms that in order to reduce poverty; and achieve economic development, it is essential to improve the health of the poor; to accomplish this, it is necessary to expand the access that the poor have to essential health services. The Commission believes that more financial resources are needed, that the health expenditures of less-developed and low-income countries are insufficient for the challenges that these countries face, and that high-income countries must increase their financial assistance in order to help solve the main health problems of less-developed and low-income countries. This piece summarizes a report that was prepared by the Program on Public Policy and Health of the Division of Health and Human Development of the Pan American Health Organization (PAHO). The PAHO document analyzes the importance of the CMH report for the countries of Latin America and the Caribbean, focusing on some of the central arguments put forth in the CMH report as they relate to achieving better health conditions in the Americas. These arguments have been organized around three major themes in the CMH report: a) the relationships between health and economic growth, b) the principal health problems that affect the poor in low-income and low-middle-income#10; countries, and c) the gap between the funding needed to address the principal problems that affect these countries and the actual spending levels. #10;

Delivery of Health Care↗

Secular changes in the short-term preventive, positive, and temperature checks to population growth in Europe, 1460 to 1909.

"Annual variations in births, marriages, deaths, grain prices, and quarterly temperature series in England, France, Prussia, and Sweden [for the period 1460-1909] are analyzed using a distributed lag model. The results provide support for the existence of the short-term preventive, positive and temperature checks to population growth. Decreases in fertility and nuptiality are generally associated with increases in grain prices. Increases in mortality appear to be associated with high grain prices, cold winters and hot summers. Changes in these responses over time are examined within the context of economic development."

Climate↗

Hindsight bias in economic expectations: I knew all along what I want to hear.

Hindsight bias in economic expectations was investigated with particular focus on the moderating effects of attitudes. Stronger hindsight bias was expected for subjectively favorable economic developments. Six months before and after the introduction of the euro as the official book currency of the European Monetary Union, participants rated the probabilities of several economic developments. Results show that hindsight bias occurs with economic expectations and that it is moderated by attitudes. Euro supporters showed stronger hindsight bias for positive economic developments than for negative ones, whereas euro opponents showed the opposite pattern. The results support the notion that hindsight bias is a reconstruction bias in which self-serving tendencies can influence the reconstruction selectively for favorable and unfavorable outcomes.

Adult↗

Factor analysis of some socio-economic and demographic variables for Bangladesh.

The author carries out an exploratory factor analysis of some socioeconomic and demographic variables for Bangladesh using the classical or common factor approach with the varimax rotation method. The socioeconomic and demographic indicators used in this study include literacy, rate of growth, female employment, economic development, urbanization, population density, childlessness, sex ratio, proportion of women ever married, and fertility. The 18 administrative districts of Bangladesh constitute the unit of analysis. 3 common factors--modernization, fertility, and social progress--are identified in this study to explain the correlations among the set of selected socioeconomic and demographic variables.

Asia↗

Analysis of factors affecting the epidemiology of tuberculosis in China.

SETTING: The tuberculosis (TB) epidemic situation is both a public health problem and a socio-economic issue in China. OBJECTIVE: To examine the effects of socio-economic development and of the TB control strategy on the TB epidemic in China. METHODS: Based on the four National Epidemiological Surveys of TB and the indices of socio-economic development in China, correlation co-efficiency was used to analyse the relationship between changes in the TB epidemic situation, the socio-economic level and the Health V TB control Project. RESULTS: The prevalence of smear-positive TB had significant medium correlation with the per capita net income of the rural population, the consumption level of the urban population, the per capita GDP, the population density, and the proportion of rural to total population, among which the correlation with the first four was negative and with the last was positive. The decline in prevalence in the project areas was much greater than in the non-project areas (44.4% vs. 12.3%), while their GDP increases were similar. CONCLUSION: With socio-economic development, correlation between the socio-economic indices and the TB epidemic becomes more significant. The TB control project is vital to reduce the prevalence of TB in China.

China↗

[Migration and the business cycle in the Federal Republic of Germany since the 1960s].

The relationship between migration and economic development in the Federal Republic of Germany is explored. Questions considered include: "How does the economic development change the intensity of migration flows in short and long distance migrations? What kinds of migrations are especially sensitive to economic changes? How do these changes come about?" Migration patterns between West Germany and other European countries are analyzed in comparison with a time series of economic parameters, such as the labor market. Migrations between three West German cities and their surrounding regions are also analyzed in comparison with a different series of parameters, including new housing construction. (SUMMARY IN ENG)

Demography↗

Population concentration in less developed countries: new evidence.

Economic theory associates the increase in population concentration, i.e., the proportion of national population residing in the core economic region, with scale and agglomeration economies. Wheaton and Shishido (1981) estimated that these persist until real per capita national income reaches 5000 1985 US dollars (USD). After this point in a country's economic development, they predicted, population redistribution towards the core region will cease and the proportion of national population residing in the core region will commence to decline. The experience of developed countries (DCs) in the 1970s and 1980s broadly conformed to this pattern, albeit with exceptions. Evidence from less developed countries (LDCs) through the 1980 round of censuses led Vining (1986) to propose a weakened version of the USD 5000 rule in which this point is characterized only by a slowing of rate of population re-distribution towards the core, not by an outright reversal. This paper updates previously reported trends in population redistribution in LDCs and reports on many new countries. Taken as a whole, post-war data reinforce the need for caution of the sort expressed by Vining. While there is a weak negative correlation between the rate of net migration into the core region and per capita income, the share of population residing in the core region may continue to rise even when per capita income has grown to well beyond USD 5000.

Demography↗

The aging of China's population: perspectives and implications.

"China's efforts to accelerate the pace of modernization emphasize the promotion of economic development and the reduction of its population growth through the adoption of a one-child per family policy. However, that policy has implications for the eventual aging of the country's population. This article reviews the changes in the status of the elderly, explores the changes in size of the elderly population, and various related social and policy implications." Topics considered include socioeconomic changes, underlying population dynamics, the current situation of the elderly, some international comparisons, implications of aging, planning for support of the elderly, health care, living arrangements and family support, retirement, and the status of the widowed, divorced, and unmarried in the elderly population.

Adult↗

China's super-large cities: dominance and integration.

"This study is mainly intended to survey the ecological structure, particularly the dominance and integration [of economic development], of 20 super-large cities in China. Most of the statistics used in this study come from the China Statistical Yearbook (1984), according to which all the 20 cities have a population of more than two million."

Asia↗

Muslim divorce trends and patterns in Singapore.

"This paper attempts to discuss the general trends in the incidence of divorce among the Muslim population in Singapore since 1921 and the patterns of divorce in the 1980s when detailed statistics were made available.... The Singapore Muslims experienced an extremely high and steady incidence of divorce during the period up to 1958 when the procedures for processing divorce petitions were not well organised. Following the introduction of new legislation and the creation of the Syariah Court to handle marital disputes in 1958, there occurred an immediate and dramatic downturn in the rate of Muslim divorce. By 1970 the decline appeared to have stalled and a slight upturn has even taken place in the 1980s." The impact of rapid social and economic development is assessed. (SUMMARY IN FRE AND ITA)

Asia↗

The role of environmental and occupational hazards in the adult health transition.

In the course of economic development from the pre-industrial to the post-industrial stages, human communities go through major social and economic transitions. The demographic transition, a long established concept, refers to the change from a stage of high birth rates and mortality rates to one of low birth rates and mortality rates. The mortality rates have always decreased before the birth rates, giving rise to a period of rapid population growth in each society. The recently-coined term "health transition" provides a more detailed view of the different aspects of the mortality decline and of the changes in morbidity and causes of morbidity which also accompany economic development. The health transition is associated with major changes in exposure to environmental and occupational health hazards. The traditional hazards of the pre-industrial stage include unsafe drinking-water, poor sanitation, infected food, tropical disease vectors, indoor air pollution from biomass smoke, and accidents in agriculture and fishing. Gradually these are replaced by or overlap with the modern hazards, such as urban air pollution, tobacco smoking, pesticides, occupational hazards in new industries and traffic accidents. The health impact of these hazards depends very much on the preventive measures taken. For some hazards there is an increasing health risk, in parallel with the increasing occurrence of the hazard, which is followed by a decreasing health risk as preventive actions become effective. This intervention transition does not occur automatically with economic development, but requires specific policies and plans, as well as community involvement. The adult age group (15-59 years) is likely to be at particular risk for environmental and occupational hazards which emerge during the health transition.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Migration policy objectives for European East-West international migration.

"The study contains selected results of Delphi research (subjective judgements concerning the future on a collective expert basis) on international migration between Central/Eastern (C/EEc) and Western European countries. Taking part in the research were 109 scholars and officers....from all over Europe.... Results indicate growing problems and tensions in societies, the division of Europe into two parts, and the triggering rather than pacifying of further antagonisms and hostile anti-immigrant attitude on the Western side.... Concerning policy objectives, the two most important general aims were how to contribute to migration stabilization in the East, and how to maintain and further develop stable democratic order and promote economic development." (SUMMARY IN FRE AND SPA)

Attitude↗

Developing an economic IQ in primary care.

PURPOSE: To describe elements of an economic intelligence quotient (IQ) that can be used to enhance the nurse practitioner's (NP) fiscal viability in a primary care setting. DATA SOURCES: Anecdotal data from providers and administrators; clinical experiences of the authors; scientific and government publications and guidelines. CONCLUSIONS: In the United States, managed care cost-containment initiatives have led to competition among physicians and NPs for patients and jobs. An understanding of the economic base of a practice is essential to fiscal viability in this market. PRACTICE IMPLICATIONS: When turf and job competition are the norm, it is essential that the NP develop an economic IQ. Knowledge of coding, billing, reimbursement, and documentation are critical to identifying the NP's value to the practice and promoting job retention. The challenge is for the NP to give high-quality, cost-effective, and safe patient care and to be a productive provider.

Humans↗

A model on the escape from the Malthusian trap.

"We propose a model to capture the escape from the Malthusian trap in the longrun. Our aim is to emphasize the key role of endogenous technological progress--as initiated by population growth and education--for longrun economic development. In addition we stress the importance to consider the level of fertility and mortality as the determinants of economic development and not only the rate of population growth. In particular, we may observe different economic growth rates in countries with the same rate of population growth, but differing levels of birth and death rates."

Demography↗

Labor mobility, trade and structural change: the Philippine experience.

"This article addresses three questions: (1) Is the high rate of emigration of labor from the Philippines related to the country's trade policy? (2) Why have migration and accompanying remittances not made much of an impact on the growth and structure of the Philippine economy? (3) Would economic growth and structural change eventually curtail labor emigration? The Philippines' history of labor export and its economic development are contrasted with those of Asian NIEs [newly industrialized economies] which have adopted liberal trade regimes."

Asia↗

Health system in India: opportunities and challenges for improvements.

PURPOSE: The paper seeks to show that health and socio-economic developments are so closely intertwined that is impossible to achieve one without the other. DESIGN/METHODOLOGY/APPROACH: This paper sees that building health systems that are responsive to community needs, particularly for the poor, requires politically difficult and administratively demanding choices. Health is a priority goal in its own right, as well as a central input into economic development and poverty reduction. FINDINGS: The paper finds that, while the economic development in India has been gaining momentum over the last decade, the health system is at a crossroads today. Even though Government initiatives in public health have recorded some noteworthy successes over time, the Indian health system is ranked 118 among 191 WHO member countries on overall health performance. ORIGINALITY/VALUE: This working paper describes the status of the health system, discusses critical areas of management concerns, suggests a few health sector reform measures, and concludes by identifying the roles and responsibilities of various stakeholders for building health systems that are responsive to the community needs, particularly for the poor.

Community Health Planning↗

Community economic structure and individual well-being: a look behind the statistics.

This paper presents a model of the community economic development process with an emphasis on its implications for individual well-being. It is intended as a social epidemiology which can help explain empirical findings demonstrating a connection between indicators of individual and social dysfunction and indicators of economic change. The model is one of economic development in a market-oriented, profit-maximizing society. The underlying hypothesis is that changes in economic activity brought about by increases in the size of firms and scale of production place new demands upon local resources and labor markets. In response, families and social networks begin to change the ways they relate to individual members, changes that cause individuals to become more directly vulnerable to the stresses and strains generated by economic activity. The result is that dysfunction, as manifest in the incidence and prevalence of various pathologies, increases with both ups and downs in the economy. The paper discusses the ways in which these changes become manifest in the statistical series used for purposes of empirical analysis and suggests the limits of this approach to social research. It ends by presenting a policy prescription for economic development which places emphasis on social cost minimization rather than output maximization.

Community Mental Health Services↗