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Mortality and economic development over the course of modernization: an analysis of short-run fluctuations in Spain, 1850-1990.

Distributed lag models are used to explore the issue of the importance of economic factors for demographic performance over the course of the demographic and economic modernization of Spain. Mortality indicators are generated by age, sex, and cause and are assessed in terms of shifts in Gross Domestic Product. During the pre-transitional period, links between mortality and economic performance were simultaneous and rather weak but in the expected direction, declining to near 0 by the beginning of the twentieth century. Afterwards the importance of economic shifts for mortality fluctuations increased dramatically and delayed effects began to predominate, only disappearing after 1950. The paper explains the increase in the importance of economic factors and the change in the lag structure in terms of the greater economic volatility of the 1915-1950 period, the progressive implantation of more efficient public health systems and their sensitivity to economic fluctuations, and improving levels of nutrition and general health.

Economics↗

Economic development and the health care system in Hong Kong.

This article describes parallel developments of the Hong Kong economy and its health care system. The purpose is to illustrate how the Hong Kong health system evolved in response to external and internal pressures generated by economic prosperity. The Hong Kong system illustrates the importance of clear policy making in the face of these pressures. In particular, issues of investment, financing and distribution of health services are examined in relation to hospital cost control and service accessibility. In the past, health care costs in Hong Kong have been controlled at the expense of limited accessibility of health services. At present, Hong Kong policy-makers are faced with the challenge of maintaining a sharp focus on cost control as they face pressure to expand and improve health care coverage for the citizens. So far they have responded by emphasizing management efficiency through reorganization. It remains to be seen whether this strategy can be successful without passing increased health care costs to the consumers.

Cost Control↗

Economic development and health status among the poor in squatter settlements of Karachi.

OBJECTIVE: Socioeconomic status is an important determinant of health outcome measures. This study examines and presents some of the important health outcomes amongst the higher and lower socioeconomic groups within the urban poor. SETTING: Data analysis is based on a Health and Demographic Survey conducted in urban squatter settlements of Karachi in 1996. METHODS: A structured questionnaire was administered to all households in the catchment area. The indicator used to assess economic status is ownership of assets. RESULTS: Comparison between the two economic levels shows that the lower socio-economic group was more likely to experience child mortality, (CI; 1.02-1.29, p = 0.02) have lower contraceptive usage (CI; 2.11-2.64; p < 0.001) and childhood immunization rates (CI; 2.08-2.40, p < 0.001). No significant association was observed between economic levels and prevalence of diarrhea. The housing, literacy and employment status was consistently better in the higher economic stratum who were more likely to be Pushto-Punjabi speaking as compared to the Sindhi speaking population. CONCLUSION: To have sustainable improvement in the health status of the poor, those who are most vulnerable need to be identified and programs aiming to improve health should also undertake broader development initiatives like raising family income.

Child↗

Mortality from congenital abnormality in Malaysia 1991-1997: the effect of economic development on death due to congenital heart disease.

An analysis was done of available data from the Department of Statistics Malaysia, on the type of congenital abnormality contributing to death, to determine whether progress in health care over recent years was associated with any decline in mortality from congenital abnormality. A significant decline in death due to congenital abnormality was observed between 1991 and 1996. This was attributable to a decline in deaths due to congenital heart disease occurring because of improvements in cardiac surgical services for infants. In 1997 death due to congenital heart disease increased significantly. This could be attributed to improvements in the diagnosis of congenital heart disease in the neonate.

Congenital Abnormalities↗

Health patterns in New Zealand: class, ethnicity and the impact of economic development.

In the broad sweep the experience of New Zealand in health trends and patterns is similar to that of other advanced industrial societies, yet there are some important differences that draw on the country's colonial past and, more particularly, on its location in the South Pacific. Of special note is the historical experience of the indigenous Polynesian minority--the Maori--in their passage through the demographic transition to their current position in the modern urban environment. It is this dual phase of development--industrialisation for the European majority, 'westernisation' for the Polynesians--that provides the special interest of the New Zealand setting, particularly in the analysis of class and ethnicity in the shaping of health patterns.

Adolescent↗