Search

Begin New Search Topic Mortality

1. Did Alcohol Policy Really Cause the Postsocialist Mortality Crisis? Revisiting the Rebound and Affordability Hypotheses

Author:
Aytalina Azarova, Gabor Scheiring, Michael Ash, and Lawrence King
Publication Date:
04-2021
Content Type:
Working Paper
Institution:
Political Economy Research Institute (PERI), University of Massachusetts Amherst
Abstract:
This paper reexamines the argument that alcohol policies were the major factor behind the mortality crisis in postsocialist Russia. We show that the correlation between the Gorbachev anti-alcohol campaign (rebound hypothesis), alcohol prices in the 1990s (affordability hypothesis), and mortality reported in previous analyses is not robust to splitting oblasts into Far- East and the rest of Russia. Our analysis conducted on a sample of 534 towns in the European part of Russia also finds no robust evidence supporting the two hypotheses. In contrast, findings linking privatization to mortality are robust to controlling for the anti-alcohol campaign and the affordability of alcohol.
Topic:
Health, Political Economy, Mortality, Alcohol, and Affordability
Political Geography:
Russia and Soviet Union

2. Deindustrialization and the Postsocialist Mortality Crisis

Author:
Gabor Scheiring, Aytalina Azarova, Darja Irdam, Katarzyna Doniec, and Martin McKee
Publication Date:
04-2021
Content Type:
Working Paper
Institution:
Political Economy Research Institute (PERI), University of Massachusetts Amherst
Abstract:
An unprecedented mortality crisis struck Eastern Europe during the transition from socialism to capitalism. Working-class men without a college degree suffered the most. Some argue that economic dislocation caused stress and despair, leading to adverse health behavior and ill health (dislocation-despair approach). Others suggest that hazardous drinking inherited as part of a dysfunctional working-class culture and populist alcohol policy were the key determinants (supply-culture approach). We enter this debate by performing the first quantitative analysis of the association between economic dislocation in the form of industrial employment decline and mortality in postsocialist Eastern Europe. We rely on a novel multilevel dataset, fitting survival and panel models covering 52 towns and 42,800 people in 1989-1995 in Hungary and 514 medium-sized towns in the European part of Russia. The results show that deindustrialization was significantly associated with male mortality in both countries directly and indirectly mediated by adverse health behavior as a dysfunctional coping strategy. Both countries experienced severe deindustrialization, but social and economic policies seem to have offset Hungary’s more immense industrial employment loss. The policy implication is that social and economic policies addressing the underlying causes of stress and despair can improve health.
Topic:
Employment, Capitalism, Mortality, Alcohol, Socialism, and Deindustrialization
Political Geography:
Europe, Eastern Europe, and Hungary

3. Building Resilient Health Systems: Experimental Evidence from Sierra Leone and the 2014 Ebola Outbreak

Author:
Bilal Siddiqi, Maarten Voors, Johannes Haushofer, Oeindrila Dube, and Darin Christensen
Publication Date:
03-2020
Content Type:
Working Paper
Institution:
Empirical Studies of Conflict Project (ESOC)
Abstract:
Developing countries are characterized by high rates of mortality and morbidity. A potential contributing factor is the low utilization of health systems, stemming from the low perceived quality of care delivered by health personnel. This factor may be especially critical during crises, when individuals choose whether to cooperate with response efforts and frontline health personnel. We experimentally examine efforts aimed at improving health worker performance in the context of the 2014–15 West African Ebola crisis. Roughly two years before the outbreak in Sierra Leone, we randomly assigned two accountability interventions to government-run health clinics — one focused on community monitoring and the other gave status awards to clinic staff. We find that over the medium run, prior to the Ebola crisis, both interventions led to improvements in utilization of clinics and patient satisfaction with the health system. In addition, child health outcomes improved substantially in the catchment areas of community monitoring clinics. During the crisis, the interventions also led to higher reported Ebola cases, as well as lower mortality from Ebola—particularly in areas with community monitoring clinics. We explore three potential mechanisms: the interventions (1) increased the likelihood that patients reported Ebola symptoms and sought care; (2) unintentionally increased Ebola incidence; or (3) improved surveillance efforts. We find evidence consistent with the first: by building trust and confidence in health workers, and improving the perceived quality of care provided by clinics prior to the outbreak, the interventions encouraged patients to report and receive treatment. Our results suggest that accountability interventions not only have the power to improve health systems during normal times, but can additionally make health systems resilient to crises that may emerge over the longer run.
Topic:
Health, Infectious Diseases, Health Care Policy, Mortality, Public Health, and Pandemic
Political Geography:
West Africa and Sierra Leone

4. Deindustrialization and Deaths of Despair: Mapping the Impact of Industrial Decline on Ill Health

Author:
Gabor Scheiring, David Stuckler, and Lawrence King
Publication Date:
11-2020
Content Type:
Working Paper
Institution:
Political Economy Research Institute (PERI), University of Massachusetts Amherst
Abstract:
A growing literature on deaths of despair has argued that workers’ declining life expectancy in deindustrialized rustbelt areas in the U.S. and the associated deepening of health inequalities signal the profound existential crisis of contemporary capitalism. Competing explanations downplay the negative consequences of “creative destruction” and focus instead on unhealthy lifestyles. This article contributes to this debate by presenting the first empirical analysis of the role of deindustrialization in the deaths of despair epidemic that hit Eastern Europe in the 1990s. Drawing on the thematic analysis of 82 semi-structured interviews in four deindustrialized towns in Hungary, the article constructs a general sociological framework for analyzing deaths of despair applicable to other rustbelt areas. Deindustrialization engenders individual and social processes that affect health by increasing stress and eroding coping resources. By conceptualizing deindustrialization as a fundamental cause of ill health, sociology has great potential to contribute to understanding the root causes of deaths of despair.
Topic:
Health, Political Economy, Capitalism, Mortality, Industry, and Deindustrialization
Political Geography:
Europe and Hungary

5. Life and Death During the First Six Months of the COVID-19 Pandemic

Author:
Lykke E. Andersen and Alejandra Gonzales Rocabado
Publication Date:
10-2020
Content Type:
Working Paper
Institution:
Institute for Advanced Development Studies (INESAD)
Abstract:
This study carries out a cross-country analysis of changes in quantity and quality of life during the first six months of the COVID-19 pandemic (11 March to 11 September 2020) for 124 countries. Changes in quantity of life are measured as life years lost to COVID-19, including excess deaths not officially reported as COVID-19 deaths. Changes in quality of life are proxied by the average change in daily mobility, compared to a pre-COVID baseline. We find a significant negative correlation between the two, meaning that the countries with the biggest reductions in mobility are also the countries with the biggest losses of life years. We calculate that about 15 million life years were lost during the first six months of the pandemic, corresponding to 0.006% of all expected life years. For comparison, at least three times more life years are lost every six months due to children dying of diarrhea. About 28 million life years are created every day from babies being born, so the first six months of the pandemic set us back about 14 hours in terms of quantity of life. The setbacks in terms of quality of life are several orders of magnitude larger. Some countries have suffered more than a 50% reduction in mobility sustained over half a year, with devastating effects on many aspects of quality of life. Globally, the equivalent of 400 million full-time jobs were lost. GDP is estimated to have been set back about three years, poverty about five years, and the tourism industry about 20 years. The already large inequalities in access to quality education have been further widened, leaving hundreds of millions of disadvantaged children farther behind. Even countries that have managed the pandemic relatively well are suffering large economic contractions due to the negative spill-over effects from other countries. We still have a long way to go before this pandemic is over, and we urgently need to course-correct in order not to cause even more harm than has already been done. The paper provides a series of recommendations on what needs to be done to minimize total harm.
Topic:
Political Economy, GDP, Mobility, Mortality, Coronavirus, Pandemic, COVID-19, and Quality of Life
Political Geography:
Latin America and Bolivia

6. Selective Mortality and the Long-term Effects of Early-life Exposure to Natural Disasters

Author:
Margaret Triyana and Xing Xia
Publication Date:
04-2018
Content Type:
Working Paper
Institution:
Walter H. Shorenstein Asia-Pacific Research Center
Abstract:
We analyze the effects of early-life shocks with varying degrees of severity on mortality and human capital outcomes in the Philippines. We exploit variations in typhoon exposure and the introduction of a short-term post-disaster relief policy. Severe typhoons are associated with increased mortality and adverse long-term outcomes. Before the disaster relief policy, mortality from in utero exposure to severe typhoons was 10 percent, and survivors exhibited similar levels of human capital as the unaffected. Once implemented, the policy appears to have mitigated the mortality effect of severe typhoons, and survivors have lower human capital in the long term.
Topic:
Disaster Relief, Natural Disasters, Human Capital, and Mortality
Political Geography:
Philippines

7. The Rise of the World’s Poorest Countries

Author:
Steven Radelet
Publication Date:
10-2015
Content Type:
Journal Article
Journal:
Journal of Democracy
Institution:
National Endowment for Democracy
Abstract:
For more than two decades now, the majority of the world’s poorest countries have been making some of the fastest and biggest development gains in history. The momentous progress achieved since the early 1990s is unprecedented. One-billion people have been lifted out of extreme poverty, the child death rate has been cut in half, life expectancy has increased significantly, millions more girls are enrolled in school, deaths in civil wars have dropped by three-quarters, average incomes have almost doubled, food production has increased by half, and democracy has spread like never before in the world’s poorest countries, notwithstanding with many setbacks, obstacles, and imperfections along the way. Some of these gains—especially the declines in poverty and child mortality—rank among the greatest achievements in human history. Yet few people are aware that this progress is even happening.
Topic:
Poverty, Economic Inequality, Mortality, and Quality of Life
Political Geography:
Global Focus

8. Explaining the Health Status of Children in Sierra Leone: Parental Socioeconomic Status and Demand for Health Inputs

Author:
Mohamed Jalloh and Santigie Mohamed Kargbo
Publication Date:
11-2012
Content Type:
Policy Brief
Institution:
African Economic Research Consortium (AERC)
Abstract:
In most developing countries, maternal and child health issues have received considerable attention in public health policies and pose formidable challenges. Several studies provide evidence of a strong relationship between socioeconomic factors such as economic growth, poverty, water and sanitation, education and gender and health outcomes. A good number of researchers have shown that a mother’s use of child health care is influenced by the risk of child mortality. It is thus been emphasized in the literature that the decision to obtain health inputs is confronted with the potential issue of self-selection and hence endogeneity.
Topic:
Economics, Health, Health Care Policy, Children, Child Poverty, Domestic Politics, and Mortality
Political Geography:
Africa and Sierra Leone