Social science & medicine
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Social science & medicine · Oct 2019
Parent psychology and the decision to delay childhood vaccination.
The study of vaccine hesitancy identifies parental decisions to delay childhood vaccinations as an important public health issue, with consequences for immunization rates, the pursuit of nonmedical exemptions in states, and disease outbreaks. While prior work has explored the demographic and social underpinnings of parental decisions to delay childhood vaccinations, little is known about how the psychological dispositions of parents are associated with this choice. We analyze public opinion data to assess the role of psychological factors in reported parental decisions to delay childhood vaccination. ⋯ Parental decisions to delay childhood vaccinations are an important public health concern that are associated with conspiratorial thinking and needle sensitivity.
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Social science & medicine · Sep 2019
The tools at their fingertips: How settler colonial geographies shape medical educators' strategies for grappling with Anti-Indigenous racism.
Settler colonialism implicates settler and Indigenous populations differently within ongoing projects of settlement and nation building. The uneven distribution of benefits and harms is a primary consequence of settler colonialism. Indeed, it is a central organizing feature of the settler state's governance of Indigenous societies and is animated, in part, through pervasive settler ignorance and anti-Indigenous racism, which has manifested in persistent health disparities amongst Indigenous peoples. ⋯ Respondents were generally sympathetic and evinced an earnest desire to include more Indigenous-related content in the curriculum. What became clear over the course of the data collection and analysis, however, was that most respondents lacked the tools to engage critically with questions of race and racialization and how these are manifested in the context of asymmetrical settler colonial power. We argue that this inability, at best, limits the effectiveness of much needed efforts to incorporate more content relating to Indigenous health, but worse yet, risks re-entrenching anti-Indigenous racism and settler dominance.
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Social science & medicine · Sep 2019
Cultural engagement and mental health: Does socio-economic status explain the association?
There is a growing body of literature suggesting that the arts can support mental health. However, both arts participation and cultural engagement are unevenly patterned across the population, with a strong social gradient. This social gradient is also evident in mental health. ⋯ Overall, this confirms previous reports that cultural engagement is linked with a lower odds of depression amongst adults aged 50 + by demonstrating a robust association in a nationally-representative sample of older adults. While SES does explain around half of the association between cultural engagement and depression, we found no evidence that it either acts as a moderator or the main explanatory factor, with independent associations maintained across all three approaches. However, the fact that higher SES is associated with more frequent engagement indicates that, in population terms, SES is still an important determinant of the salutogenic impact of culture.
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Social science & medicine · Jul 2019
Meta AnalysisThe criterion validity of willingness to pay methods: A systematic review and meta-analysis of the evidence.
The contingent valuation (CV) method is used to estimate the willingness to pay (WTP) for services and products to inform cost benefit analyses (CBA). A long-standing criticism that stated WTP estimates may be poor indicators of actual WTP, calls into question their validity and the use of such estimates for welfare evaluation, especially in the health sector. Available evidence on the validity of CV studies so far is inconclusive. We systematically reviewed the literature to (1) synthesize the evidence on the criterion validity of WTP/willingness to accept (WTA), (2) undertake a meta-analysis, pooling evidence on the extent of variation between stated and actual WTP values and, (3) explore the reasons for the variation. ⋯ The evidence on the criterion validity for CV studies is more mixed than authors are representing because substantial differences in study design between hypothetical and actual WTP/WTA surveys are not accounted for.
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Social science & medicine · Jul 2019
Managing health expenditure inflation under a single-payer system: Taiwan's National Health Insurance.
As nations strive to achieve and sustain universal health coverage (UHC), they seek answers as to what health system structures are more effective in managing health expenditure inflation. A fundamental macro-level choice a nation has to make is whether to adopt a single- or a multiple-payer health system. Using Taiwan's National Health Insurance (NHI) as a case, this paper examines how a single-payer system manages its health expenditure growth and draws lessons for other countries whose socioeconomic development is similar to Taiwan's. ⋯ In particular, providers have incentives to increase use of services and drugs with positive profit margins. Furthermore, Taiwan demonstrates that its control of NHI expenditure growth might be leading it to inadequately meet the changing needs of the population, resulting in the rapid growth of private insurance to cover services excluded or not fully covered by the NHI. If this trend persists and results in a two-tier system, Taiwan's NHI may risk compromising the equity it has achieved in the past two decades.