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21. Mirror, Mirror 2017: International Comparison Reflects Flaws and Opportunities fo

Author:
Michelle M. Doty, Arnav Shah, David Squires, Dana O. Sarnak, and Eric C. Schneider
Publication Date:
07-2017
Content Type:
Special Report
Institution:
Commonwealth Fund
Abstract:
The U.S. ranked last on performance overall, and ranked last or near last on the Access, Administrative Efficiency, Equity, and Health Care Outcomes domains. The top-ranked countries overall were the U.K., Australia, and the Netherlands. Based on a broad range of indicators, the U.S. health system is an outlier, spending far more but falling short of the performance achieved by other high-income countries. The results suggest the U.S. health care system should look at other countries’ approaches if it wants to achieve an affordable high-performing health care system that serves all Americans.
Topic:
Health and Health Care Policy
Political Geography:
United States and Global Focus

22. International Profiles of Health Care Systems

Author:
Elias Mossialos, Ana Djordjevic, Robin Osborn, and Dana O. Sarnak
Publication Date:
05-2017
Content Type:
Special Report
Institution:
Commonwealth Fund
Abstract:
This publication presents overviews of the health care systems of Australia, Canada, China, Denmark, England, France, Germany, India, Israel, Italy, Japan, the Netherlands, New Zealand, Norway, Singapore, Sweden, Switzerland, Taiwan, and the United States. Each overview covers health insurance, public and private financing, health system organization and governance, health care quality and coordination, disparities, efficiency and integration, use of information technology and evidence-based practice, cost containment, and recent reforms and innovations. In addition, summary tables provide data on a number of key health system characteristics and performance indicators, including overall health care spending, hospital spending and utilization, health care access, patient safety, care coordination, chronic care management, disease prevention, capacity for quality improvement, and public views.
Topic:
Health and Health Care Policy
Political Geography:
United States and Global Focus

23. Socio-cultural Factors Influencing the Ebola Virus Disease-related Stigma among African Immigrants in the United States

Author:
Guy-Lucien S. Whembolua, Donaldson Conserve, and Daudet Ilunga Tshiswaka
Publication Date:
12-2017
Content Type:
Research Paper
Institution:
Ìrìnkèrindò: a Journal of African Migration
Abstract:
African immigrants, one of the fastest-growing immigrant populations in the United States (U.S.), face many unique challenges. Since December 2013, the Ebola Virus Disease (EVD) has been claiming lives and altering the societies of origin of West and Central African immigrants. Using the PEN-3 cultural model, a thematic analysis of mainstream U.S. news media was conducted to assess the socio-cultural factors influencing EVD-related stigma experienced by African immigrants. Results of this analysis revealed the perceptions and enabling/nurturing factors that exacerbated or prevented EVD-related stigma. Future interventions designed to address stigma experienced by African immigrants should include EVD-related stigma.
Topic:
Health, Migration, Infectious Diseases, and Ebola
Political Geography:
Africa and United States

24. How High-Need Patients Experience the Health Care System in Nine Countries

Author:
Dana O. Sarnak and Jamie Ryan
Publication Date:
01-2016
Content Type:
Special Report
Institution:
Commonwealth Fund
Abstract:
U.S. health care costs are disproportionately concentrated among older adults with multiple chronic conditions or functional limitations—a population often referred to as “high-need” patients. This analysis uses data from the Commonwealth Fund 2014 International Health Policy Survey of Older Adults to investigate health care use, quality, and experiences among high-need patients in nine countries compared with other older adults. High-need patients use a greater amount of health care services and also experience more coordination problems and financial barriers to care compared with other older adults. Disparities are particularly pronounced in the United States. The comparative success of other countries, particularly in reducing financial barriers to care, may be a product of policies that specifically target high-need patients. Similarly focusing on these populations in the U.S. and effectively managing their care may improve their health status while reducing overall costs.
Topic:
Health and Health Care Policy
Political Geography:
United States and Global Focus

25. Antimicrobial Resistance as an Emerging Threat to National Security

Author:
Maxine Builder
Publication Date:
01-2015
Content Type:
Working Paper
Institution:
Atlantic Council
Abstract:
Growing rates of antimicrobial resistance (AMR) pose a threat to public health that could undo many of the medical advances made over the last seventy years, eroding the global medical safety net and posing a significant threat to national security. Diseases once eliminated by a single course of antibiotics show drug resistance, often to several different classes of drugs. Some of the implications of increasing rates of AMR are intuitive, such as longer duration of illness, extended hospital stays, and higher rates of mortality. But other effects of a postantibiotics world are less obvious, such as the inability to perform life-saving operations or the ability for a simple scratch on the arm to kill. Humanity could soon find itself living in a reality in which communicable diseases such as tuberculosis, cholera, pneumonia, and other common infections cannot be controlled. This potentially catastrophic problem still can be abated, and the global health community, including the World Health Organization (WHO), has highlighted AMR as a priority in global health. But all sectors of the international community, not simply those in public health, need to take immediate steps to reverse the current trends and eliminate the systematic misuse of antimicrobial drugs, especially in livestock, and restore the pipeline of new antimicrobial drugs. The significant health and economic costs of AMR are difficult to quantify due to incomplete data that often underreports the extent of the problem, since there are no standard metrics or consensus on methodology to measure rates of AMR. But even the piecemeal statistics that exist paint a bleak picture. In a 2013 report, the US Centers for Disease Control and Prevention (CDC) reports at least two million Americans acquire serious infections to one or more strains of AMR bacteria annually, and at least 23,000 people die of these infections.1 A 2008 study estimated the excess direct costs to the US medical system attributable to AMR infections at $20 billion, with additional estimated productivity losses to be as high as $35 billion.2 With the increase in resistant infections and continuing rise in medical costs, the cost to the American medical system no doubt also has increased. This trend is not a uniquely American problem; it is truly global in scope. The European Union (EU) reports about 25,000 deaths annually due to drug-resistant bacteria, at an overall, combined cost of $2 billion in healthcare costs and productivity losses.3 There were over 14.7 million incidents of moderate-to-severe adverse reactions to antibiotics each year between 2001 and 2005 in China. Of these, 150,000 patients died annually.4 The most recent available data on China estimates that treatment of AMR infections during that same time period cost at least $477 million, with productivity losses of more than $55 million each year.5 A 2005 study of the United Kingdom (UK) found that the real annual gross domestic losses due to AMR were between 0.4 and 1.6 percent.6 Although slightly outdated, this estimate may be a useful guide in assessing the global impact of AMR, and given the trend of increasing resistance, it is likely that the impact will also increase accordingly. That said, it is prudent to repeat that the disparities in the quality of data reporting standards across China, the United States, the United Kingdom, and the European Union make it difficult to directly compare the severity of the impacts AMR has on each entity. The primary cause of AMR globally is antibiotic overuse and misuse, be it from doctors inappropriately prescribing antibiotics to treat viral infections or individuals seeking over-the-counter antibiotics for self-treatment. But another driver, less obvious than overuse in humans, is the use of antimicrobials in livestock, and the ratio of use in animals as compared to humans is astounding. In the United States, about 80 percent of all antibiotics are consumed in either agriculture or aquaculture. Generally, these drugs are administered to livestock as growth promoters and are medically unnecessary. Resistance in livestock quickly spreads to humans, and many community-acquired infections are the result of a contaminated food supply. Although most infections are acquired in the community, most deaths attributed to resistant infections occur in healthcare settings, and healthcare-acquired (or nosocomial) infections are another driver of AMR. At this point, AMR does not pose an immediate and direct threat to national security. Rather, this is a creeping global security crisis. If current trends continue, these drugs upon which the world relies will lose effectiveness. The gains made in fighting infectious diseases will be reversed, and a wide range of routine surgeries and easily treatable infections will become much more dangerous and deadly. This will cause the health of the world's working population to deteriorate, and the economic productivity and social cohesion of the globe to decline. At any time, a “black swan” event—triggered by an outbreak of drug-resistant tuberculosis, cholera, or pneumonia, for example—could prove catastrophic, endangering the fabric of societies and our globalized economy, forcing a stop to international trade and travel to prevent further spread. The issue of AMR is a tragedy of the commons in which individual incentives lead to the overuse and eventual destruction of a shared resource. International cooperation is required to walk back from this ledge and avoid a postantibiotics world, even though it is impossible to completely reverse the damage already done.
Topic:
Health, National Security, Infectious Diseases, and Health Care Policy
Political Geography:
United States, China, United Kingdom, America, and Europe

26. Equatorial Guinea Plays a Leading Role in Combating Malaria

Author:
Mark L. Asquino
Publication Date:
09-2015
Content Type:
Journal Article
Journal:
The Ambassadors Review
Abstract:
In August 2014, I attended a ceremony at the Willard Hotel in Washington, DC that celebrated the tenth anniversary of the Bioko Island Malaria Control Project. Those speaking at the event included senior executives from Marathon Oil Corporation, Noble Energy Inc., and Atlantic Methanol Production Company, which are all US petroleum companies that operate in Equatorial Guinea. Teodoro Obiang Nguema Mbasogo, President of Equatorial Guinea, also delivered remarks. All of the speakers were enthusiastic about a dynamic project that has had a trans­formative effect on the health of generations of Equatoguineans by reducing the morbidity and mortality of malaria infection. What follows is an overview of the project’s history as well as the commitment to US innovation and a shared audacity to tackle one of human­kind’s most endemic and fatal diseases.
Topic:
Development, Health, Human Welfare, Infectious Diseases, and Health Care Policy
Political Geography:
United States and Equatorial Guinea

27. MyFitnessPal: How This Winner-Took-All by Helping People Lose

Author:
Emily Alonso
Publication Date:
03-2015
Content Type:
Working Paper
Abstract:
Up until about 10 years ago, when a person thought of fitness, health or weight loss, they did not necessarily associate those things with technology. However, as the world takes on a new digital landscape, health care industries from weight-loss to hospitals are becoming increasingly digitized. The idea behind this digitization of the health/fitness industries is that people able to quantify their health will be more likely to improve it (MacManus). Thus with the utilization of big data, big people will begin to no longer be an “epidemic” in our society. Though this is wishful thinking, digital platforms are making individual health related data processes more efficient, with quicker delivery than ever before possible and an enhanced user experience. Those willing to commit to their own positive physical change whilst utilizing assisting technologies are becoming healthier in a more efficient manner. (Chanelle)
Topic:
Health, Markets, Science and Technology, and Communications
Political Geography:
United States

28. Cholera and the Road to Modernity: Lessons from One Latin American Epidemic for Another

Author:
Jonathan Weigel and Paul Farmer
Publication Date:
03-2014
Content Type:
Journal Article
Journal:
Americas Quarterly
Institution:
Council of the Americas
Abstract:
Haiti is currently battling the world's largest cholera epidemic in half a century. An integrated, comprehensive response—including case-finding and rapid treatment, water and sanitation efforts, and vaccination—could bring cholera to heel on Hispaniola and help prevent its spread elsewhere in the region.1 But the local and international response has, to date, fallen short. Tens of thousands of cases and hundreds of deaths were reported in May and June of this year.2 If the disease had appeared in the United States or elsewhere in the developed world, all available control tools would have been deployed. But the safe, effective and inexpensive cholera vaccine has only recently become available in Haiti. In April, the Haitian Ministry of Health and two healthcare nonprofits began delivering vaccines to about 91,000 people in rural and urban Haiti.
Topic:
Development and Health
Political Geography:
United States and Latin America

29. The Health Financing Transition: A Conceptual Framework and Empirical Evidence

Author:
William Savedoff and Victoria Fan
Publication Date:
03-2014
Content Type:
Working Paper
Institution:
Center for Global Development (CGD)
Abstract:
Almost every country exhibits two important health financing trends: health spending per person rises and the share of out-of-pocket spending on health services declines. We describe these trends as a "health financing transition" to provide a conceptual framework for understanding health markets and public policy. Using data over 1995-2009 from 126 countries, we examine the various explanations for changes in health spending and its composition with regressions in levels and first differences. We estimate that the income elasticity of health spending is about 0.7, consistent with recent comparable studies. Our analysis also shows a significant trend in health spending - rising about 1 percent annually - which is associated with a combination of changing technology and medical practices, cost pressures and institutions that finance and manage healthcare. The out-of-pocket share of total health spending is not related to income, but is influenced by a country's capacity to raise general revenues. These results support the existence of a health financing transition and characterize how public policy influences these trends.
Topic:
Development, Economics, Health, and Governance
Political Geography:
United States

30. U.S.-Russia Health Engagement

Author:
Judyth L. Twigg
Publication Date:
03-2014
Content Type:
Working Paper
Institution:
Center for Strategic and International Studies (CSIS)
Abstract:
Over the last few years, Russia's relationship with the United States has traveled a swift and seemingly deliberate arc from partner to pariah. The current turmoil in Ukraine and near-certain resulting isolation of Russia culminate several years' worth of deteriorating ties. The Edward Snowden mess, disagreements over Syria and Iran, dismay over the eroding human rights environment in Russia, and now Russian annexation of Crimea have led the previously heralded "reset" to an unceremonious end. What are the implications of these and related developments for U.S.-Russia collaboration in medicine and public health? Should avenues of partnership remain open, even in such a frosty political context? Should the international community support Russia's health sector when ample resources exist within Russia itself? Is it even possible anymore?
Topic:
Development, Diplomacy, Economics, Health, Human Rights, Human Welfare, and Bilateral Relations
Political Geography:
Russia, United States, and North America