Average Annual Household Income Research Articles

Economics of production and marketing of apple (Malus domestica) in Mustang, Nepal

A study was carried out to assess the production and marketing status of apple in the Mustang district of Nepal in 2019. A total of 100 households were sampled by using simple random sampling technique and interviewed with a pre-tested semi-structured questionnaire. Descriptive statistics and independent-sample t-test was used for data analysis using SPSS and MS-Excel. Farmers were categorized into small farmers (n=68) and large farmers (n=32) based on the number of apple trees grown by farmers. The average area under apple cultivation was 6.64 ropani (0.3378 hactares). The overall average apple production was 2848 kg (2.84 Mt) and the large farmers had more apple production (7035 kg) as compared to small farmers (877 kg). The average annual household income from apple was NRs. 29,868 (248.90 USD). Apple farming was found to be a profitable farm enterprise with a benefit-cost ratio of 1.84. Two marketing channel was identified in the study area and Channel II was found more profitable. Education status of household head, ethnicity, number of economically active family members, experience on apple farming and visit of extension worker to apple farms were the significant factors that positively affected the production and marketing of apple. The satisfaction level of farmers from production and marketing of apple was found very poor (79%). Unavailability of inputs, lack of storage facilities, insect pest damage, poor technical knowledge and infrastructure were major production problems. Similarly, price variation, poor marketing infrastructure and linkage, high postharvest loss, poor bargaining power and low volume of production were the major marketing problems.

Multilevel Analysis of the Relationship between Ownership Structure and Technical Efficiency Frontier in the Spanish National Health System Hospitals.

Objective: To evaluate the relationship between the ownership structure of hospitals and the possibility of their being positioned on the frontier of technical efficiency in the economic crisis period 2010–2012, adjusting for hospital variables and regional characteristics in the areas where the Spanish National Health System (SNHS) hospitals are located. Methods: 230 National Health System hospitals were studied over the two-year period 2010–2012 according to their ownership structure—public hospitals, private hospitals and public–private partnership (PPP)—data envelopment analysis orientated to inputs was used to measure the overall technical efficiency, pure efficiency and efficiency of scale. A generalised linear mixed model (GLMM) with binomial distribution and logit link function was used to analyse the hospital and regional variables associated with positioning on the frontier. Results: There are substantial differences between the average pure technical efficiency of public, private and PPP hospitals, as well as a greater number of PPP models being positioned on the efficiency frontier (91.67% in 2012). The odds of being positioned on the frontier are 41.7 times higher in PPP models than in public hospitals. The average annual household income per region is related to the greater odds of hospitals being positioned on the frontier of efficiency. Conclusions: During the most acute period of recession in the Spanish economy, PPP formulas favoured hospital efficiency, by increasing the odds of being positioned on the frontier of efficiency when compared to private and public hospitals. The position on the frontier of efficiency of a hospital is related to the wealth of its region.

Glycated Hemoglobin A1c, Lung Function, and Hospitalizations Among Adults with Asthma

Insulin resistance and metabolic dysfunction have been associated with asthma risk and asthma severity. To examine the association between glycated hemoglobin A1c (HbA1c), asthma-related hospitalizations, and lung function measures among adults in the United Kingdom. A cross-sectional study was conducted of 47,606 adults aged 40 to 69 years who participated in the UK Biobank and had asthma but no diagnosis of diabetes mellitus. HbA1c level was analyzed as a continuous measure and also categorized as normal (<42 mmol/mol) or as consistent with prediabetes/diabetes (≥42 mmol/mol). An asthma-related hospitalization was defined as ever having had a hospitalization with an International Classification of Diseases, Ninth/Tenth Revision, Clinical Modification code of a main diagnosis compatible with asthma (International Classification of Diseases, Ninth Revision, Clinical Modification code 493.x or International Classification of Diseases, Tenth Revision, Clinical Modification codes J45.x and J46.x). Logistic or linear regression was used for the multivariable analysis of asthma hospitalizations and lung function measures (FEV1, forced vital capacity [FVC], and FEV1/FVC). All models were adjusted for age, sex, ethnic background, body mass index, average annual household income, current smoking status, pack-years of smoking, fasting time, and C-reactive protein level. Both HbA1c level (odds ratio, 1.03; 95% CI, 1.01-1.04) and an HbA1c level in the prediabetes/diabetes range (odds ratio, 1.68; 95% CI, 1.18-2.41) were associated with 1 or more asthma hospitalizations. Moreover, both HbA1c level and an HbA1c level in the prediabetes/diabetes range were significantly and inversely associated with FEV1 and FVC. HbA1c is linked to asthma-related hospitalizations and small decrements in FEV1 and FVC among British adults with asthma but no diagnosis of diabetes mellitus.

Economics of production and marketing of natural rubber (Hevea brasiliensis) in Jhapa, Nepal

A study was carried to assess the production and marketing status of natural rubber in Jhapa district in 2019, from a random sample of 70 households and 5 traders. Results were drawn using descriptive and inferential statistics employing SPSS and MS-Excel. The average area under natural rubber cultivation was 2.2 bigha and the productive area was 1.21 bigha. The average rubber sheet produced per household was 1167.092 kg and average yield was found to be 958.77 kg/bigha in the study area. The average annual household income from natural rubber was found to be NRs. 233418.57 which contributes 58.54 percent in the total household income. Three marketing channels were identified and the price spread ranged from NRs. 20 to 40. The producers’ share in consumers’ price ranged from 81.82% to 90.91%. The major production problem identified was the lodging by wind (0.80) and the major marketing problem faced by producers and traders was the absence of grading facility (0.82). Rubber farms were found to be a profitable farm enterprise with a discounted benefit-cost ratio of 1.88. The calculated NPV was 410992.40, IRR was 22% and PBP was 8.52 years respectively denoting the sustainability of rubber cultivation. RRIM 600, RRII 105 and GT1 were the major growing varieties of rubber in the study area. The cost of establishment in the first year (48.702%) is highest compared to the following years. The selling price of latex and sheet was found higher in 2015 and 2016 with a reduction of price in 2017 due to the high import of Indonesian rubber sheet. This research tries to present the general idea on the overall production and marketing status in the study area.

Impact of Irrigation Water Shortage on Yield, Income and Employment of Farm Households in Tungabhadra Command Area of Karnataka

The study examined the impact of irrigation water shortage on yield, income and employment of farm households in Tungabhadra command area in Gangavathi taluk of Karnataka. Based on the extent of net irrigated area under canal, Gangavathi taluk of Koppal district was selected for the study. A total of 120 households among which 40 respondents from each water access regimes (head reach, mid reach and tail-end reach) were selected. The required field data pertaining to the year 2016-17 was collected through personal interview. The average gross annual household income of head reach farmers before and after water shortage (2015) was INR 6,35,293 and INR 5,59,970, respectively. Whereas, in tail-end reach, the average gross annual household income before and after water shortage was INR 5,66,263 and INR 4,19,895, respectively. The annual household employment in all the three regimes was affected due to irrigation water deficits but it was more significant in middle-reach regime. Bore wells and ponds acted as a supplementary source of irrigation in periods of water shortages. A good coordination should be built between different line departments in managing the water resources in the Tungabhdra basin and it should be coordinated in proper direction. There is a need for common vision and plan for water management based on administrative boundaries.

The Relationship between Mental Health, Educational Attainment, Employment Outcomes, and Pain in Sickle Cell Disease

Sickle cell disease (SCD) is the most common genetic condition in the world and disproportionately affects African Americans in families with lower household incomes. SCD is characterized by a variety of complications including episodes of severe pain, chronic anemia, and end-organ damage. Morbidity from SCD begins in infancy and increases in frequency and severity with age. Complications during childhood and adolescence, both critical learning periods for youth, substantially impact educational attainment and life outcomes. SCD-related hospitalizations are associated with social determinants of health, such as socioeconomic status (SES), depression, health literacy, and educational outcomes. In youth with SCD, family and neighborhood SES are predictors of pain level, pain frequency, and overall quality of life. In addition to the physiological impacts of SCD, individuals with SCD experience emotional and stress related effects of the disease that may impact daily quality of life and frequency and severity of pain. Studies have found that hospital admission frequency has limited or no impact on academic outcomes in youth with SCD. Few studies have explicitly examined the relationship between SCD-related pain and educational, socioeconomic, and mental health outcomes. This is a cross-sectional study of patient survey data from a single site in the Sickle Cell Disease Implementation Science Consortium (SCDIC). The primary objective was to identify a relationship between educational attainment, employment status, mental health, and the frequency, severity, or length of pain crises for individuals with SCD. Multivariate analysis was used to assess the impact of patients' educational attainment, employment status, annual household income (low = less than $25,000, high = $75,001 and above), and self-reported depression on the frequency, length, and severity of SCD-related pain. Our central hypothesis was that individuals with a history of depression, lower educational attainment, periods of unemployment, and lower incomes experience more frequent, more severe, and longer pain crises. A total of 307 participants were included. The mean age was 27.4 years (range 15 to 45), 58.3% were female, and 99% were African American. Sixty-two percent had Hgb SS, the most severe form of SCD. About half of all patients (50.5%) reported they take pain medication every day for SCD and majority were on some form of disease modification (64.2% on hydroxyurea (HU), 20.2% on chronic blood transfusion). Slightly less than half (48.9%) reported their highest level of education as a high school diploma or lower. Most were unemployed (15.3%), students (22.8%), or disabled (21.5%), and 59.2% reported an average annual household income less than $25,000. Univariate analysis revealed statistically significant associations between employment status as unemployed or disabled and frequency of pain (p &amp;lt; .001), employment status as unemployed or disabled and severity of pain (p &amp;lt; .001), and employment status as disabled and length of pain &amp;gt; 4 days. Relationships between depression and frequency and severity of pain were statistically significant at the p &amp;lt; .001 level, and between depression and length of pain &amp;gt; 1 week at the p &amp;lt; .01 level. Multivariate analysis revealed positive statistically significant relationships between depression and high pain frequency (p &amp;lt; .001), employment status as disabled and severe pain (p &amp;lt; .01), depression and severe pain (p &amp;lt; .01), and employment status as disabled and length of pain &amp;gt;4 days (p &amp;lt; .05), Table 1. Educational attainment did not demonstrate statistically significant relationships with pain outcomes. No variables demonstrated statistically significant relationships with length of pain &amp;gt; 1 week and length of pain &amp;gt; 2 weeks. The only significant association with pain outcomes was that HU users were less likely to take daily opioids. Individuals with SCD who are disabled or have a history of depression are more likely to report more severe and frequent pain. No relationship emerged between educational attainment and pain outcomes. As the results are limited to the cross-sectional design, we cannot make statements of causality. For now, we know that people with SCD and these risk factors need further study for interventions. We plan to further assess study participants across all eight SCDIC sites in the next phase of this work. Disclosures King: Bioline: Consultancy; Amphivena Therapeutics: Research Funding; Incyte: Consultancy; Cell Works: Consultancy; Celgene: Consultancy; Magenta Therapeutics: Membership on an entity's Board of Directors or advisory committees; Novimmune: Research Funding; RiverVest: Consultancy; Tioma Therapeutics (formerly Vasculox, Inc.):: Consultancy; WUGEN: Equity Ownership.

Evaluating the early impact of adding a financial counselor to an Oncology Care Model pilot program.

67 Background: The Oncology Care Model (OCM) emphasizes the importance of patient costs. Our practice identified a need for patient financial counseling (Plan) and added a financial counselor to the care team (Do). Our objective is to describe the financial counseling process and evaluate (Study) the impact of adding a financial counselor to address financial burden among cancer patients. Methods: New treatment orders trigger a task to the financial counselor who mails a letter including personalized insurance benefit information (i.e., deductible, out of pocket maximum, amount met to date), estimated out of pocket cost for prescribed chemotherapy regimen, and additional financial resources. The health care team can also place referrals for identified needs. Data on patient characteristics, referral patterns, and services delivered was abstracted from the electronic medical record. Results: The financial counselor contacted 157 cancer patients from 4/2018-4/2019, including 134 (85%) OCM patients. The average age was 68 years old (range 22-91); 93 (59%) patients were female; 39 (25%) patients identified as black. Out of 32 patients with documented income, the average annual household income was $25,000. Most patients had Medicare Part D coverage (67/73, 92%) and secondary insurance (59/77, 77%). The financial counselor contacted patients by mail (52/77, 68%), phone (13/77, 17%), in-person at clinic (7/77, 9%), e-mail (1/77, 1%), or using multiple methods (4/77, 5%). Actions taken included mailing insurance benefit and estimated out of pocket cost letters (60/72, 83%), referring to social workers or lay navigators (5/72, 7%), or reviewing insurance benefits (4/72, 6%). Co-pay applications through foundation grants were submitted by the financial counselor for 27 patients of which most (23/27, 85%) were approved. Conclusions: Financial counselors provide diverse services to cancer patients to reduce financial burden, including to patients without secondary insurance who were noted to have additional financial needs. Patient satisfaction surveys and accounting for the dollar amount returned to patients and the health system represent next steps for our new program (Act).

The value of ecosystem services in the high altitude Spiti Valley, Indian Trans-Himalaya

The high mountain ranges of South and Central Asia are increasingly being exposed to large-scale development projects. These areas are home to traditional pastoralist communities and internationally important biodiversity including the endangered snow leopard Panthera uncia. Development projects rely on economic cost-benefit analysis, but the ecosystem services in the high Himalayas are poorly understood and are rarely accounted for. As a first step to fill this gap, we identified the main ecosystem services used by local people in the Trans-Himalayan Spiti Valley (7591 km2), a region important for conservation of snow leopards and high mountain biodiversity, and undertook an economic valuation. Stakeholders identified a range of services, though these were dominated by provisioning services identified by 90% of respondents. Only 5.4% of the respondents recognised regulatory services and 4.8% recognised cultural services. The mean economic value of provisioning services was estimated at US$ 3622 ± 149 HH−1 yr−1, which was 3.8 times higher than the average annual household income. Our results underscore the need to account for ecosystem services in the cost-benefit analyses of large-scale development projects in addition to assessments of their environmental and social impact.

Propensity to Migrate and Willingness to Pay Related to Air Pollution among Different Populations in Wuhan, China

ABSTRACTObjective: To understand parents’ propensity to migrate and willingness to pay with respect to outdoor air pollution, and to explore related affecting factors. Methods: This study used a convenience sample and subjects were collected from a community in Wuchang District and Children’s Hospital of Wuhan, respectively. A designed questionnaire was used for this study. Univariable and multivariable logistic regression models were applied to analyze the relationship between parents’ individual and familial characteristics and related behavioral intensions to air quality improvement. Statistical analysis was done with SAS 9.1. Results: The questionnaire was completed by 865 subjects (response rate = 86.5%). The number of people with migrant intent was 150(36.4%) from hospital group, and 139(30.7%) from community group. In the hospital group, subjects with higher knowledge of air quality (OR = 6.268, p < 0.05) and higher average annual household income (AAHI), which was equal or more than 50,000 Yuan (OR = 2.045, p < 0.01), were found to be more intent to migrate. AAHI (OR = 1.939, p < 0.05) was also the affecting factor in the community group correspondingly. Those willing to pay for air quality improvement included 297 people (72.1%) from the hospital group and 333 people (73.5%) from the community group, and affecting factors was the public responsibility for air quality improvement (hospital group: OR = 3.380, p < 0.01; community group: OR = 4.436, p < 0.01). Conclusions: This study indicated high tendency of propensity to migrate for avoiding poor air condition and willingness to pay to improve air quality in Wuhan. Local governments should pay more attention to parents’ knowledge of air pollution and attitudes towards government management of air quality, especially those willing to migrate.

Economic Contribution of Backyard Piggery in the Livelihood Security of Tribal Families of Assam

The present study has been carried out to assess the economic contribution of backyard piggery in the livelihood security of tribal families of Assam, India. Observation and personal interaction were done to collect the data from in 10 selected villages of two districts namely; Dhemaji district (North Bank Plain Zone) and Karbi Anglong distrcit (Hill Zone). Study revealed that the mean scores of the income generated by the respondents from backyard piggery came from two different agro climatic locales i.e. plain and hilly zones showed significant difference. The average annual income generated from backyard pig farming inclusive of family labour was calculated as ₹. 9,715 and the average household income was ₹. 69,397 in a year. The average annual income generation from backyard pig farming was calculated as ₹. 31,992 and average annual household income was ₹. 69,397 when family labour was not included in a year. The contribution of backyard pig farming to the total annual income was 13.99 per cent including family labour and 46.09 per cent while excluding family labour. Independent variables like; age, education, family size, land holding, experience in pig rearing, size of pig stock, mass media exposure, extension agency contact, innovation proneness and risk orientation were found to have positive and significant relationship with income generation from backyard piggery farming..

Socio-economic Development of Tribal Communities through Natural Rubber Cultivation in Odisha

The study was taken up in Baripada and Kaptipada blocks of Mayurbhanj district in Odisha where the Rubber Board in association with the Government of Odisha have implemented Rubber Block Plantation Projects for the socio-economically marginalized scheduled tribes. Primary data was collected from randomly selected 63 households of scheduled tribes with and without income from rubber cultivation, for comparison. The major findings of the study are presented below. • Average annual household income of the respondent households with income from rubber was 188 per cent higher than that of households without income from rubber. • Increased expenditure was noticed in personal conveyance, education of children and healthcare by those who had income from rubber. The average expenditure of households with income from rubber was 879 per cent, 491 per cent and 481 per cent higher than their counterparts without income from rubber for personal conveyance, education and healthcare, respectively. While 65 per cent of the children of the households with income from rubber were pursuing education, it was only 46 per cent in the case of households without income from rubber. • In all, 73 per cent of the households with income from rubber had made modifications to their houses. Sixty six per cent of the households with income from rubber invested in improving their houses from the traditional mud huts with thatched roofs to houses constructed using cement/burned bricks and asbestos roofs. • Open defecation was common in the region. While 66 per cent of the households with income from rubber had toileting facility, only 33 per cent of households without income from rubber had toilets. • A substantial change was observed in the items owned by the households influenced by the changed lifestyle and standard of living consequent to increased household income from rubber. • While 79 per cent of the households with income from rubber owned at least one motorbike, only 16 per cent of the households without income from rubber owned one. While 61 per cent of the households with income from rubber income owned a TV with DTH, only three per cent of the households without income from rubber owned it. Similarly, while 21 per cent of the households with income from rubber owned a radio, it was only three per cent for households without income from rubber. • While a few households having income from rubber owned items like refrigerator, water pump, LPG connection and a motor vehicle, none of the households without income from rubber owned these items which are normally associated with a higher standard of living. • Apparently, owing to assured income from rubber and increased repayment capacity, 30 per cent of the sample households with income from rubber had availed loans from institutional sources for increasing consumption expenditure, for agricultural purposes and as vehicle loans. Only 7 per cent of the respondents without income from rubber had availed loans due to poor repayment capacity. In conclusion, the study found that rubber cultivation had transformed the tribal households from a subsistence livelihood based system to a highly remunerative and sustainable livelihood system. The average income earned by the sample households with income from rubber was almost three times than that of their counterparts without income from rubber. This has substantially influenced their expenditure pattern and standard of living for the better.

Raw Garlic Consumption and Lung Cancer in a Chinese Population.

Evidence of anticancer properties of garlic for different cancer sites has been reported previously in in vitro and in vivo experimental studies but there is limited epidemiologic evidence on the association between garlic and lung cancer. We examined the association between raw garlic consumption and lung cancer in a case-control study conducted between 2005 and 2007 in Taiyuan, China. Epidemiologic data was collected by face-to-face interviews from 399 incident lung cancer cases and 466 healthy controls. We used unconditional logistic regression models to estimate crude and adjusted ORs (aOR) and their 95% confidence intervals (CI). Adjusted models controlled for age, sex, average annual household income 10 years ago, smoking, and indoor air pollution. Compared with no intake, raw garlic intake was associated with lower risk of development of lung cancer with a dose-response pattern (aOR for <2 times/week = 0.56; 95% CI, 0.39-0.81 and aOR for ≥2 times/week = 0.50; 95% CI, 0.34-0.74; Ptrend = 0.0002). Exploratory analysis showed an additive interaction of raw garlic consumption with indoor air pollution and with any supplement use in association with lung cancer. The results of the current study suggest that raw garlic consumption is associated with reduced risk of lung cancer in a Chinese population. This study contributes to the limited research in human population on the association between garlic and lung cancer and advocates further investigation into the use of garlic in chemoprevention of lung cancer. Cancer Epidemiol Biomarkers Prev; 25(4); 624-33. ©2016 AACR.

Adoption of improved citrus orchard management practices: a micro study from Drujegang growers, Dagana, Bhutan

Citrus ranks top among the agricultural export commodities of Bhutan both in terms of volume and value. However, citrus cultivation practices still remain traditional with very low yield and inferior fruit quality. This study adopted community approach to identify basic components of citrus orchard management. Citrus growers of Drujegang were trained on citrus orchard management and assessed the impact of training on the adoption of management technology and subsequent effect on the yield and household (HH) income for 40 randomly selected individuals. Statistical results showed significant difference both in terms of adoption of improved orchard management practices (p = 0.04) and HH income generation (p = 0.01). Adoption of improved management practices increased from 4.54 % (in 2012) to over 16 % (in 2014) with a mean yield increase of 27.5 % (212 kg acre−1) over previous year. Similarly, mean production increased from 5376 (2012) to 11,993 (2014) kg HH−1. Thus, average annual HH income from the sale of citrus increased from Nu. 82,641 (in 2012) to 164,307 (in 2014). Hands-on training on basic orchard management increased the rate of adoption and resulted in increased yield and production. Huge potential exists in enhancing the livelihood of citrus growers by taking forward the available orchard management technology to growers through appropriate research and extension intervention. Therefore, replication of similar participatory approach at community level is recommended in other parts of the country.

Knowledge, attitudes, and practices (KAP) of the relationship between air pollution and children's respiratory health in Shanghai, China.

To assess the status of, and factors associated with, residents’ knowledge, attitudes, and practices (KAP) related to air pollution and respiratory health of children in Shanghai, we conducted a cross-sectional survey. Demographic factors associated with residents’ knowledge were identified by multiple logistic regressions. The questionnaires were completed by 972 participants, half from the Shanghai Children Hospital and the other half from the Jiading communities. Half of the participants’ scores of knowledge and attitudes were equal or greater than 8.0 on a 9-point scale, over 75% of respondents’ practice scores were equal to or less than 4.0. Our studies demonstrated a significant difference of average knowledge scores between the two groups (t = 1.27, p < 0.05). The parents’ educational level (OR = 1.89, 2.48) and average annual household income (AAHI) (OR = 2.37, 2.40, 2.12) were the two strongest factors on knowledge awareness. In addition, statistical analysis revealed a significant difference between the two groups in their attitudes towards air quality and their perception of the government’s efforts to alleviate it. The hospital and community groups also showed significant differences in practices geared towards protecting their children’s health. Nearly 90% of the respondents agreed that improving air quality is the responsibility of every citizen, and the joint action of governments and all citizens should be utilized for enhanced control. In addition, more resources should be allocated towards providing citizens with appropriate practices to help lessen the effects of poor air quality.

An initiative to develop a new employment support facility for older job seekers in metropolitan areas

This study examined the possibility and necessity for expansion and diffusion of a new employment support facility for older job seekers in metropolitan areas based on health and welfare measures. This longitudinal study assessed questionnaire responses from older job seekers at a new facility established in Ota ward in the Tokyo metropolitan area as a compliment to the conventional system comprised of Hello Work and the Silver Human Resources Center. We offered questionnaires to job seekers at their first facility visit and asked them to return them by mail (baseline survey). Follow-up surveys of the same respondents were conducted after 2, 4, 8, and 12 weeks, with questions about demographics, personal status, social activities, mental health, and job search status. The surveys were administered from January 2013 to March 2014. We obtained 128 responses (average respondent age: 63.8 years) from 180 baseline survey questionnaires. The respondents included 82 males and 46 females. The response rates were over 90% for all follow-up surveys. Among respondents, 71.4% had less than a senior high school level of education. The average annual household income was less than 3 million yen and less than 1 million yen for 68.0% and 16.0% of the participants, respectively. The life circumstances were "hard" or "very hard" for 56.3% of respondents. Among respondents, 78.9% indicated that they were seeking employment for economic reasons. Women and those over 65 years of age were more likely to search for jobs for their well-being than men and respondents less than 65 years of age. The majority of respondents indicated that they wanted to make use of their abilities or experience and many hoped to work as garbage collectors, cooks, or apartment caretakers. We found that the main objective of older job seekers living at this facility was economic acquisition. Men and those less than 65 years of age were at particular risk for economic distress, poor mental health, and were more likely to be searching for regular employment. A relatively higher proportion of women and respondents over 65 years of age were seeking jobs for their well-being; a need for social relationships that may be more pronounced among women in this study population.

Arsenic Contamination of Drinking Water and Mental Health

This paper investigates the effect of drinking arsenic contaminated water on mental health. Drinking water with an unsafe arsenic level for a prolonged period can lead to arsenicosis, which includes symptoms such as black spots on the skin and subsequent illnesses such as various cancers. We collected household survey data from Bangladesh, a country with wide arsenic contamination of groundwater to construct several measures for arsenic contamination that include the actual arsenic level in the respondent’s tubewell (TW) and past institutional arsenic test results, as well as collected household members’ arsenicosis symptoms and their physical and mental health. We find that suffering from an arsenicosis symptom is strongly negatively related to mental health, even more so than from other illnesses. Furthermore, individuals drinking from an untested TW have lower mental health and having to walk a longer distance to a TW also decreases mental health. Calculations of the costs of arsenic contamination reveal that the average individual would need to be compensated for suffering from an arsenicosis symptom by an amount as high as the average annual household income.

Using Weather Forecasts to Help Manage Meningitis in the West African Sahel

Abstract Understanding and acting on the link between weather and meningitis in the Sahel could help improve vaccine distribution and save lives. People living there know that meningitis epidemics occur in the dry season and end after the start of the rainy season. Integrating and analyzing newly available epidemiological and meteorological data quantified this relationship, showing that that the risk of meningitis epidemics climbed from a background level of 2% to a maximum risk of 25% during the dry season. These data also suggested that, of all meteorological variables, relative humidity has the strongest correlation to cases of meningitis. Weather acts alongside a complex set of environmental, social, and economic drivers, and a complementary investigation of local and regional knowledge, attitudes, and practices suggested several additional interventions to manage meningitis. These include improved awareness of early meningitis symptoms and vaccinations for farmworkers who migrate seasonally. An economic survey showed that the cost of a single case of meningitis is 3 times the average annual household income, underscoring the need for improved vaccination strategy. Using these insights, meteorologists and public health workers developed a tool to guide vaccination decisions. Iterative development allowed a multinational team of public health officials to use the tool while guiding its refinement and directed research toward maximum practical use. That meant focusing on predicting areas where high humidity would naturally end epidemics so vaccines could be moved elsewhere. Using this tool and this approach could have prevented an estimated 24,000 cases of meningitis over a 3-yr period.

International Real Estate Review

The purpose of this paper is to clarify the housing acquisition process by providing profiles of residents in Shanghai. A questionnaire was prepared for residents in both public housing and commodity housing to analyze the relationship between the purchase prices of housing units and the annual household incomes of the buyers. The ability to purchase private condominium units depends on whether the purchasers already possess any real properties. In Shanghai, the number of condominiums supplied by private developers has been rapidly increasing in recent years and represented about 40% of the number of households in 2009. However, as these prices are about 9 to 14 times the average annual household income, we believe that a path from renting public housing to owning commercial housing, which was a relocation process commonly witnessed in the 1980s in Japan, is considerably difficult to be followed by regular residents in Shanghai.

Household's willingness to pay for arsenic safe drinking water in Bangladesh

This study examines willingness to pay (WTP) in Bangladesh for arsenic (As) safe drinking water across different As-risk zones, applying a double bound discrete choice value elicitation approach. The study aims to provide a robust estimate of the benefits of As safe drinking water supply, which is compared to the results from a similar study published almost 10 years ago using a single bound estimation procedure. Tests show that the double bound valuation design does not suffer from anchoring or incentive incompatibility effects. Health risk awareness levels are high and households are willing to pay on average about 5 percent of their disposable average annual household income for As safe drinking water. Important factors influencing WTP include the bid amount to construct communal deep tubewell for As safe water supply, the risk zone where respondents live, household income, water consumption, awareness of water source contamination, whether household members are affected by As contamination, and whether they already take mitigation measures.

High cancer drug prices in the United States: reasons and proposed solutions.

The increase in cancer drug prices in the last 15 years has many contributing factors and is harming our patients and our health care system. It represents to many cancer experts a crossing of a moral line between reasonable profits and profiteering, in a situation involving a human catastrophe: patients who have developed cancer, and who may die because they cannot afford the treatment. With typical out-of-pocket expenses of 20% to 30%, the financial burden of cancer treatment would be $20,000 to 30,000 a year, nearly half of the average annual household income in the United States. Many patients (estimated 10% to 20%) may decide not to take the treatment or may compromise significantly on the treatment plan. This difficult situation poses three relevant questions: (1) Are cancer drug prices too high? (2) Are they hurting patients and our health care system? and (3) Can we do something about it? The answer to each is affirmative. It is also our obligation as cancer doctors to keep patients from "harm and injustice." If high prices make drugs unaffordable and inaccessible, thus causing harm, then we should voice our concerns and advocate for solutions.