Equitable Reduction Research Articles

Post-growth Human–Computer Interaction

Human–Computer Interaction (HCI) researchers have increasingly been questioning computing’s engagement with unsustainable and unjust economic growth, pushing for identifying alternatives. Incorporating degrowth, post-development, and steady-state approaches, post-growth philosophy offers an alternative not rooted in growth but in improving quality of life. It recommends an equitable reduction in resource use through sensible distributive practices where fulfillment is based on values including solidarity, cooperation, care, social justice, and localized development. In this paper, we describe opportunities for HCI to take a post-growth orientation in research, design, and practice to reimagine the design of sociotechnical systems toward advancing sustainable, just, and humane futures. We aim for the critiques, concerns, and recommendations offered by post-growth to be integrated into transformative HCI practices for technology-mediated change.

Burden, Differentials and Causes of Stillbirths in India: A Systematic Review and Meta Analysis.

India contributes the highest absolute number of stillbirths in the world. This systematic review and meta-analysis was conducted to synthesize the burden, timing and causes of stillbirths in India. Forty-nine reports from 46 studies conducted in 21 Indian states and Union Territories were included. It was found that there was no uniformity/standardization in the definition of stillbirths and in the classification system used to assign the cause. The share of antepartum stillbirths was estimated to betwo-third while remaining were intrapartum stillbirths. Maternal conditions and fetal causes were found to bethe leading cause of stillbirth in India. The maternal condition was assigned as the commonest cause (25%) followed by fetal (14%), placental cause (13%), congenital malformation (6%) and intrapartum complications (4%). Approximately 20% of the stillbirths were assigned asunknown or unexplained. This review demonstrates that there is a paucity of quality stillbirth data in India. Other than thestate level differences in stillbirth rates, no other data is available on inequities in stillbirths in India. There is an urgent need for strengthening availability and quality of stillbirth data in India on both stillbirth rates as well as thecauses. There is a need to conduct additional research to know the timing of thestillbirths, causes of death and actual burden. India needs to strengthen stillbirth audits along with registry to find out the modifiable factors and delays for making country specific preventive strategies. The policy makers, academic community and researchers need to work together to ensure accelerated and equitable reduction in stillbirths in India.

Strategies to Reduce Low-Value Cardiovascular Care: A Scientific Statement From the American Heart Association.

Low-value health care services that provide little or no benefit to patients are common, potentially harmful, and costly. Nearly half of the patients in the United States will receive at least 1 low-value test or procedure annually, creating risk of avoidable complications from subsequent cascades of care and excess costs to patients and society. Reducing low-value care is of particular importance to cardiovascular health given the high prevalence and costs of cardiovascular disease in the United States. This scientific statement describes the current scope and impact of low-value cardiovascular care; reviews existing literature on patient-, clinician-, health system-, payer-, and policy-level interventions to reduce low-value care; proposes solutions to achieve meaningful and equitable reductions in low-value care; and suggests areas for future research priorities.

Reducing exposure to tobacco retailers with residential zoning policy: insights from a geospatial analysis of Wilmington, Delaware

ABSTRACT Cigarette use remains the leading preventable cause of premature mortality in the US, with declines in smoking rates slowing in recent years. One promising target for improved tobacco control is the expanded regulation of tobacco retailers. Evaluations of such policy attempts have largely produced mixed results to date. The objective of this study was to the assess the potential of using a novel, residentially-focused zoning approach to produce a more targeted and equitable reduction in tobacco retailers in high-risk urban settings. We focused on Wilmington, Delaware, a city characterized by high poverty rates, a majority Black population, a disparate number of tobacco retailers, and an elevated smoking prevalence. Through the use of geospatial analyses, we observed disproportionately higher counts of convenience store tobacco retailers in medium- and high-density residential zones in Wilmington relative to the surrounding county. By linking electronic health record (EHR) data from a local health care system and US Census Bureau data, we further found that approximately 80% of Wilmington smokers and 60% of Wilmington youth lived in these residential zones. These findings highlight the potential to more equitably reduce tobacco retailer exposure through a residentially-focused zoning approach. Tobacco control policy and research implications are considered.

Human Rights-based Approach to Maternal Health Policy and Implementation: An Analysis of Abiye Safe-Motherhood Policy of Ondo State Nigeria

A human rights-based approach that recognizes that women deserve the right to health is critical to achieving equitable reduction of maternal mortality in Nigeria, a country that is the second largest contributor to global maternal mortality. This study evaluated the extent to which the Abiye safe motherhood policy of the Ondo State government of Nigeria incorporated human rights-principles in its formulation and implementation. The study involved interviews and focus group discussions and the OHCHR human rights principles served as the basis for the thematic analysis of data. Findings indicate that the Abiye initiative exemplified the core principles of human rights-based approach to maternal health. Whereas, the initiative showed stronger practice in terms of the principles of participation, empowerment, non-discrimination and international assistance, there was limited indication of adherence to accountability, transparency, and sustainability principles. The Abiye safe motherhood initiative responded to maternal health needs in fairly acceptable and equitable ways; allowing the creation of opportunities and enabling conditions for the fulfillment of the health rights of reproductive-age women. It is recommended that governments at all levels should prioritize incorporating human rights-based standards into new or existing programs in a way that meets the core needs of respect and welfare of every woman in pregnancy and childbirth.

Temporal patterns of hospitalizations for diabetic ketoacidosis in children and adolescents.

ObjectivesTo examine the temporal patterns of hospitalizations with diabetic ketoacidosis (DKA) in the pediatric population and their associated fiscal impact.MethodsThe Texas Inpatient Public Use Data File was used to identify hospitalizations of state residents aged 1month-19 years with a primary diagnosis of DKA during 2005–2014. Temporal changes of population-adjusted hospitalization rates and hospitalization volumes were examined for the whole cohort and on stratified analyses of sociodemographic attributes. Changes in the aggregate and per-hospitalization charges were assessed overall and on stratified analyses.ResultsThere were 24,072 DKA hospitalizations during the study period. The population-adjusted hospitalization rate for the whole cohort increased from 31.3 to 35.9 per 100,000 between 2005–2006 and 2013–2014. Hospitalization volume increased by 30.2% over the same period, driven mainly by males, ethnic minorities, those with Medicaid insurance and uninsured patients. The aggregate hospital charges increased from approximately $69 million to $130 million between 2005–2006 and 2013–2014, with 66% of the rise being due to increased per-hospitalization charges.ConclusionsThere was progressive rise in pediatric DKA hospitalizations over the last decade, with concurrent near-doubling of the associated fiscal footprint. Marked disparities were noted in the increasing hospitalization burden of DKA, born predominantly by racial and ethnic minorities, as well as by the underinsured and the uninsured. Further studies are needed to identify scalable preventive measures to achieve an equitable reduction of pediatric DKA events.

Incremental Learned Hand Standard, Degrees of Negligence and Allocation of Damages: a Comparative Tort Law and Economics Approach

The incremental Learned Hand standard is recognized as the main contribution of the law and economics literature to legal practice, as an objective criterion of negligence assessment. Traditionally, negligence gradation has been a factor considered by legal technology to allocate the damages. However, one of the main problems in legal practice lies in the establishment of objective criteria for quantitative assessment of the reduction or increase in the indemnity-damage ratio, considering the degree of negligence of the injurer and of the victim. Withal, is it possible to use the incremental Learned Hand standard as criterion of negligence graduation in order to allocate the damages? Using the theoretical foundations of law and economics literature in conjunction with the traditional legal classification of negligence into severe, ordinary and slight, and considering the Brazilian tort system as analytical basis, the paper shows that the answer is positive. The basic idea is that the incremental Learned Hand standard is an algorithm which can be employed in legal practice to systematize the allocation of damages, performing, according to the degree of negligence of the injurer and of the victim, the full compensation or the decouple of the indemnity from the damages, streamlining the application of legal institutes such as comparative negligence, punitive damages, and equitable reduction of compensation (fairness).

ANALYSIS OF FACTORS AFFECTING POVERTY IN NORTH SUMATERA PROVINCE (CASE STUDY IN 33 DISTRICT / CITY)

The equitable poverty reduction in North Sumatera became one of the unresolved issues until now. The decreasing of poverty percentage in the last five years in North Sumatera can not represent the level of public welfare. In fact , in 2013, there were 22 out of 33 districts in North Sumatera which have the poverty percentage more than ten percent and known as hardcore poverty. The highest poverty percentage was found in North Nias and Gunung Sitoli by 30.94 %, while the lowest was found in Deli Serdang by 4.71 %. This research stated the problem “How is the influence of the economic growth, level of education, and the minimum regional wages toward the level of poverty in North Sumatera Province? The objective is to analyze the influence of economic growth, the level of education and the minimum wages toward the poor population in North Sumatera Province. This research used 165 samples that spread in 33 districts in North Sumatera from 2009 until 2013 with panel data and using Fixed Effect Model Method. The result of the Ordinary Least Square Method (LOS) through the multiple linear regretion estimated model showed that the economic growth and the minimum regional wages had negative influence, while the level of education had positive influence toward poverty in North Sumatera. The coefficient of determination (R2) is 0.948157 which means the variable of economic growth, minimum regional wages and level of education can define the poverty in North Sumatera by 94.82 %, and 5.18 % defined by other economic variables outside the model.

NHS Health Checks for people with mental ill-health 2013–2017: an observational study

People living with serious mental ill-health experience adverse cardiovascular outcomes causing some of the greatest health inequality gaps in England, UK. We describe uptake of the NHS Health Check programme in people with mental ill-health, and rates of new diagnoses and management of cardiovascular risk factors in those who attend NHS Health Checks in comparison to those people without mental ill-health. We used a large nationally representative database of people registered with general practitioners in England (QResearch). Between 2013 and 2017, we analysed attendance at NHS Health Checks and outcomes in the succeeding 12 months, in people with serious mental illness (SMI) including psychoses and in people prescribed long-term antidepressant medications (LTAD), with comparison to attendees who did not have these conditions. Hazard ratios (HR) were used to describe the association between outcomes and SMI and LTAD adjusting for sociodemographic variables. In those eligible for the NHS Health Check programme, we found a higher percentage of people with SMI attended an NHS Health Check (65 490, 19.8%) than those without SMI (524 728, 16.6%); adjusted HR 1.05 [95% confidence interval 1.02-1.08]. We also observed a higher percentage of attendance in people on LTAD (46 437, 20.1%) compared to people who were not prescribed LTAD (543 781, 16.7%); adjusted HR 1.10 (1.08-1.13). People with SMI were more likely to be identified with chronic kidney disease (CKD, HR 1.23, 1.12-1.34) and type 2 diabetes (HR 1.14, 1.03-1.25) within the 12 months following their NHS Health Check compared with those without SMI. People on LTAD were more likely to be identified with CKD (HR 1.55, 1.42-1.70) and type 2 diabetes (HR 1.45, 1.31-1.60) and also hypertension, cardiovascular disease, non-diabetic hyperglycaemia, familial hypercholesterolemia and dementia within the 12 months following their NHS Health Check. Statins were more likely to be prescribed to NHS Health Check attendees with SMI and those on LTAD than those without these conditions; HR 1.31 (1.25-1.38) and 1.91 (1.82-2.01), respectively. Antihypertensives were more likely to be prescribed to those on LTAD; HR 1.21 (1.14-1.29). We found evidence that people with SMI or on LTAD treatment were 5-10% more likely to access NHS Health Checks than people without these conditions. People with SMI or on LTAD treatment who attended NHS Health Checks had higher rates of diagnosis of CKD, type 2 diabetes and some other relevant co-morbidities and increased treatment with statins and also anti-hypertensive medication in people on LTAD. This is likely to contribute to equitable reduction in adverse cardiovascular events for people with mental ill-health.

ANALYSIS OF FACTORS AFFECTING POVERTY IN NORTH SUMATERA PROVINCE (CASE STUDY IN 33 DISTRICT / CITY)

The equitable poverty reduction in North Sumatera became one of the unresolved issues until now. The decreasing of poverty percentage in the last five years in North Sumatera can not represent the level of public welfare. In fact , in 2013, there were 22 out of 33 districts in North Sumatera which have the poverty percentage more than ten percent and known as hardcore poverty. The highest poverty percentage was found in North Nias and Gunung Sitoli by 30.94 %, while the lowest was found in Deli Serdang by 4.71 %. This research stated the problem “How is the influence of the economic growth, level of education, and the minimum regional wages toward the level of poverty in North Sumatera Province? The objective is to analyze the influence of economic growth, the level of education and the minimum wages toward the poor population in North Sumatera Province. This research used 165 samples that spread in 33 districts in North Sumatera from 2009 until 2013 with panel data and using Fixed Effect Model Method. The result of the Ordinary Least Square Method (LOS) through the multiple linear regretion estimated model showed that the economic growth and the minimum regional wages had negative influence, while the level of education had positive influence toward poverty in North Sumatera. The coefficient of determination (R2) is 0.948157 which means the variable of economic growth, minimum regional wages and level of education can define the poverty in North Sumatera by 94.82 %, and 5.18 % defined by other economic variables outside the model.

Degrowth dynamics: Modelling policy proposals with system dynamics

ABSTRACT Degrowth is most commonly defined as a socially sustainable and equitable reduction (and eventually stabilisation) of society’s throughput. Throughput refers to the materials and energy that society extracts, processes, transports, and distributes, in order to consume and return back to the environment as waste. This paper builds on well-established ideas of the degrowth community and explores policy proposals from a system dynamics perspective. To better understand the underlying causal structure, it was necessary to go beyond the information available in the literature. Experts in the field of degrowth were contacted by means of an online questionnaire and the information collected was analysed and used to develop a simulation model which we employed to study potential impacts of implementing degrowth policies in developed countries. Simulation results confirm many of the experts’ predictions but also point to some unexpected consequences which would need to be addressed if these policies are to be seriously considered in the future.

Limitations on Liability of Operator and Insurer to Favor Passenger

자동차손해배상 보장법은 교통사고에 의한 피해자를 보호하기 위하여 자동차의 운행자에게 무과실의 책임을 인정하고, 피해보상의 실효적 확보를 위하여 운행자가 분담한 보험료에 의해 책임보험자가 보험금을 직접 피해자에게 지급하도록 하기 위하여 보험가입을 강제하고 있다. 이와 같이 피해자의 보호를 위해 민법상 불법행위책임에 대한 특칙을 둔 자 동차손해배상 보장법상 인정된 운행자의 책임을 호의동승을 이유로 제한하는 것이 가능한지가 문제되고, 특히 2인 이상의 운전자가 쌍방과실에 의하여 교통사고를 일으킨 경우 무상으로 호의동승한 자가 과실 없이 손해를 입은 경우 동승 자동차의 운행자 이외에 상대 차량 운전자 및 그 보험자에 대하여도 피해자가 호의동승자임을 이유로 손해액의 감액을 허용할 것인지가 문제된다. 호의동승 자동차의 운행자는 호의동승 자체를 이유로 동승자에 대한 관계에서 책임이 면제되지 않는다. 또한 호의동승 사실 자체로는 동승자의 과실을 인정할 수 있는 사유로 삼을 수 없다. 다만, 호의관계라는 특별한 사정을 운행자가 부담하는 손해배상책임의 범위를 정함에 있어서 고려할 수 있는지, 즉 배상액의 감경을 허용할 것인지에 관하여 신의칙이나 형평의 원리를 근거로 구체적 상황을 살펴 감액을 허용하는 것이 판례의 입장이다. 그러나 호의 관계의 경우에 계약적 구속력을 배제하기로 한 호의제공자와 동승자의 의사에 근거하여 호의제공자의 책임을 제한을 인정하므로, 이와 마찬가지로 호의동승 자동차 운행자의 책임 감경 역시 호의동승자의 의사 해석을 통해 구체적 상황을 고려하여 책임을 감면하기로 한 의 사가 있었는지 여부에 따라 결정하는 것이 타당하다. 다만, 호의관계는 계약적 구속력을 배 제하는 것일 뿐이므로 특별한 사정이 없다면 호의동승자가 자동차 운행에 따른 위험을 인수 하거나 운행자의 불법행위책임을 면제하는 의사가 있다고 볼 수 없다. 따라서 동승의 경위와 인적 관계 등 제반 사정에 비추어 동승자가 교통사고에 따른 책임을 면제한 것으로 볼만한 특별한 사정이 있는 경우에 한하여 책임 감면을 인정하는 것이 타당하다. 대법원판결은 쌍방과실에 의한 교통사고로 호의동승자가 과실 없이 피해를 입은 경우라 도 동승 자동차 운행자와 특별한 신뢰관계가 존재하면 손해액 감액이 허용되므로, 공동불법 행위자인 상대방 운전자와 그 보험자도 신의칙에 의해 배상액의 감액이 인정된다고 한다. 그러나 신의칙에 의한 감액을 허용하더라도 특별한 신뢰관계가 존재하는 동승 자동차의 운행자와의 사이에 한정하여 상대적으로만 허용되어야 하고, 호의동승자와 아무런 인적 신뢰관계가 없고 오히려 자동차 이용자들이 부담하는 보험료를 재원으로 교통사고로 인한 피해자의 피해를 회복할 책임을 지는 자동차손해배상 보장법상 보험자에게 배상액의 감액을 인정하여서는 아니 된다. 신의칙은 특별한 신뢰관계를 전제로 인정되는 것이므로 호의동승자와 특별한 신뢰관계를 가지는 동승차량 운행자의 고유한 책임부분에 한정하여 책임의 감면이 인정되어야 하고 아무런 신뢰관계도 존재하지 아니하는 상대방 운전자 및 그 보험자에 대하여 신의칙을 확대하여 적용하는 것은 피해자의 과실이 없음에도 과실상계를 허용하는 것과 다름이 없어 오히려 형평에 반하는 결과가 되기 때문이다.In order to protect victims of traffic accident, the Act on Guarantee of Compensation for Loss Caused by Automobile (the ”Act”) recognizes and imposes strict liability on operators and mandates liability insurance for the benefit of the victims funded by premiums paid by operators. The Act therefore is a special rule in regard to the general tort principles, and as such, there is a question as to it is possible to limit such liabilities against passengers by favor. Further, especially when two or more operations cause an accident due to their joint negligence and a passenger who has not paid any fare is injured without any fault, an issues arises as to whether there shall be any limitations on compensation for the other drivers and their insurers for the reasons that the passenger is a favor passenger. The operator is not exempted from liability against the passenger even when the passenger has not paid any fare. Further, the no-payment of fare does not constitute any ground for the passenger’s fault. How ever, some cases have held that a reduction of compensation might be proper in cases of favor passengers, considering the principles of equity. In this regard, limitation on liability on the operator who offers a favor due to the parties’ intent to relive any legal liability is recognized. Therefore, in such cases, the limitation shall also be determined pursuant to the intents of the parties. Accordingly, such reductions are only p roper when there are special circumstances that indicate the passengers’ waiver of rights to compensation. The Supreme Court held that, if there was a special trust relationship between the operator and the passenger and two or more operations caused an accident due to their joint negligence and a passenger who had not paid any fare was injured without any fault, the other drivers and their insurers are jointly liable, and that therefore equitable reduction or allocation of damages might be permitted. However, even such reductions based on equitable doctrines of good faith should be allowed to cases with special trust relationships between the operator and the favor passengers. Accordingly, the insurer, who is liable with the funds paid by insureds, and who has no relationship with the favor passengers should not be entitled to any reduction. As the equitable reduction is based on special trust relationship, such reductions shall be permitted only to those operators with such relationships with favor passengers, allowing similar reductions to those operators or the insurers who do not have such relationship is actually against the doctrines of equity.

Socioeconomic Determinants of Sodium Intake in Adult Populations of High-Income Countries: A Systematic Review and Meta-Analysis

Background. A poorer quality diet among individuals with low socioeconomic status (SES) may partly explain the higher burden of noncommunicable disease among disadvantaged populations. Because there is a link between sodium intake and noncommunicable diseases, we systematically reviewed the current evidence on the social patterning of sodium intake. Objectives. To conduct a systematic review and a meta-analysis of the evidence on the association between SES and sodium intake in healthy adult populations of high-income countries. Search Methods. We followed the PRISMA-Equity guidelines in conducting a literature search that ended June 3, 2016, via MEDLINE, Embase, and SciELO. We imposed no publication date limits. Selection Criteria. We considered only peer-reviewed articles meeting the following inclusion criteria: (1) reported a measure of sodium intake disaggregated by at least 1 measure of SES (education, income, occupation, or any other socioeconomic indicator); (2) were written in English, Spanish, Portuguese, French, or Italian; and (3) were conducted in a high-income country as defined by the World Bank (i.e., per capita national gross income was higher than $12 746). We also excluded articles that exclusively sampled low-SES individuals, pregnant women, children, adolescents, elderly participants, or diseased patients or that reported results from a trial or intervention. Data Collection and Analysis. As summary measures, we extracted (1) the direction (positive, negative, or neutral) and the magnitude of the association between each SES indicator and sodium intake, and (2) the estimated sodium intake according to SES level. When possible and if previously unreported, we calculated the magnitude of the relative difference in sodium intake between high- and low-SES groups for each article, applying this formula: ([value for high-SES group – value for low-SES group]/[value for high-SES group]) × 100. We considered an association significant if reported as such, and we set an arbitrary 10% relative difference as clinically relevant and significant. We conducted a meta-analysis of the relative difference in sodium intake between high- and low-SES groups. We included articles in the meta-analysis if they reported urine-based sodium estimates and provided the total participant numbers in the low- and high-SES groups, the estimated sodium intake means for each group (in mg/day or convertible units), and the SDs (or transformable measures). We chose a random-effects model to account for both within-study and between-study variance. Main Results. Fifty-one articles covering 19 high-income countries met our inclusion criteria. Of these, 22 used urine-based methods to assess sodium intake, and 30 used dietary surveys. These articles assessed 171 associations between SES and sodium intake. Among urine-based estimates, 67% were negative (higher sodium intake in people of low SES), 3% positive, and 30% neutral. Among diet-based estimates, 41% were negative, 21% positive, and 38% neutral. The random-effects model indicated a 14% relative difference between low- and high-SES groups (95% confidence interval [CI] = –18, –9), corresponding to a global 503 milligrams per day (95% CI = 461, 545) of higher sodium intake among people of low SES. Conclusions. People of low SES consume more sodium than do people of high SES, confirming the current evidence on socioeconomic disparities in diet, which may influence the disproportionate noncommunicable disease burden among disadvantaged socioeconomic groups. Public Health Implications. It is necessary to focus on disadvantaged populations to achieve an equitable reduction in sodium intake to a population mean of 2 grams per day as part of the World Health Organization’s target to achieve a 25% relative reduction in noncommunicable disease mortality by 2025.

Socioeconomic Determinants of Sodium Intake in Adult Populations of High-Income Countries: A Systematic Review and Meta-Analysis.

A poorer quality diet among individuals with low socioeconomic status (SES) may partly explain the higher burden of noncommunicable disease among disadvantaged populations. Because there is a link between sodium intake and noncommunicable diseases, we systematically reviewed the current evidence on the social patterning of sodium intake. To conduct a systematic review and a meta-analysis of the evidence on the association between SES and sodium intake in healthy adult populations of high-income countries. We followed the PRISMA-Equity guidelines in conducting a literature search that ended June 3, 2016, via MEDLINE, Embase, and SciELO. We imposed no publication date limits. We considered only peer-reviewed articles meeting the following inclusion criteria: (1) reported a measure of sodium intake disaggregated by at least 1 measure of SES (education, income, occupation, or any other socioeconomic indicator); (2) were written in English, Spanish, Portuguese, French, or Italian; and (3) were conducted in a high-income country as defined by the World Bank (i.e., per capita national gross income was higher than $12 746). We also excluded articles that exclusively sampled low-SES individuals, pregnant women, children, adolescents, elderly participants, or diseased patients or that reported results from a trial or intervention. As summary measures, we extracted (1) the direction (positive, negative, or neutral) and the magnitude of the association between each SES indicator and sodium intake, and (2) the estimated sodium intake according to SES level. When possible and if previously unreported, we calculated the magnitude of the relative difference in sodium intake between high- and low-SES groups for each article, applying this formula: ([value for high-SES group - value for low-SES group]/[value for high-SES group]) × 100. We considered an association significant if reported as such, and we set an arbitrary 10% relative difference as clinically relevant and significant. We conducted a meta-analysis of the relative difference in sodium intake between high- and low-SES groups. We included articles in the meta-analysis if they reported urine-based sodium estimates and provided the total participant numbers in the low- and high-SES groups, the estimated sodium intake means for each group (in mg/day or convertible units), and the SDs (or transformable measures). We chose a random-effects model to account for both within-study and between-study variance. Fifty-one articles covering 19 high-income countries met our inclusion criteria. Of these, 22 used urine-based methods to assess sodium intake, and 30 used dietary surveys. These articles assessed 171 associations between SES and sodium intake. Among urine-based estimates, 67% were negative (higher sodium intake in people of low SES), 3% positive, and 30% neutral. Among diet-based estimates, 41% were negative, 21% positive, and 38% neutral. The random-effects model indicated a 14% relative difference between low- and high-SES groups (95% confidence interval [CI] = -18, -9), corresponding to a global 503 milligrams per day (95% CI = 461, 545) of higher sodium intake among people of low SES. People of low SES consume more sodium than do people of high SES, confirming the current evidence on socioeconomic disparities in diet, which may influence the disproportionate noncommunicable disease burden among disadvantaged socioeconomic groups. Public Health Implications. It is necessary to focus on disadvantaged populations to achieve an equitable reduction in sodium intake to a population mean of 2 grams per day as part of the World Health Organization's target to achieve a 25% relative reduction in noncommunicable disease mortality by 2025.

Segmentation and Job Mobility in the Indian Labour Market

The extent of mobility of the workers among different segments of a labour market plays a crucial role in the overall levels of poverty and inequality in the economy. Theoretical conceptualizations of the degree of mobility in the labour market have broadly been polarized into a segmented vs. integrated labour market debate. Within the segmented model frame-work the informal economy is considered an unfavorable sector and the informal workers queuing for better jobs in the formal economy. This view is countered by the legalist school who view the choice to be informal to be voluntary. Due to the importance of labour mobility equitable growth and poverty reduction and its significance in understanding the nature of the labour market, the present study analysis the patterns and consequences of labour mobility in India using the novel IHDS panel data. Our study finds significant mobility across sectors in the economy. We also find certain individual attributes being associated with movement into certain labour market segments. Finally, our study finds evidence of significant earnings differentials across paid work statuses. The study finds evidence of segmentation with regard to regular (or formal) vis-a-vis casual (or informal) wage employment. We also notice large-scale distress driven movements of works, especially from OAW and cultivation work into casual work. In contrast we also notice a large number of small businesses which have seen growth over the period. Given the results of our study suitable policy recommendations have been made.

Reduced burden of childhood diarrheal diseases through increased access to water and sanitation in India: A modeling analysis

Each year, more than 300,000 children in India under the age of five years die from diarrheal diseases. Clean piped water and improved sanitation are known to be effective in reducing the mortality and morbidity burden of diarrhea but are not yet available to close to half of the Indian population. In this paper, we estimate the health benefits (reduced cases of diarrheal incidence and deaths averted) and economic benefits (measured by out-of-pocket treatment expenditure averted and value of insurance gained) of scaling up the coverage of piped water and improved sanitation among Indian households to a near-universal 95% level. We use IndiaSim, a previously validated, agent-based microsimulation platform to model disease progression and individual demographic and healthcare-seeking behavior in India, and use an iterative, stochastic procedure to simulate health and economic outcomes over time. We find that scaling up access to piped water and improved sanitation could avert 43,352 (95% uncertainty range [UR] 42,201–44,504) diarrheal episodes and 68 (95% UR 62–74) diarrheal deaths per 100,000 under-5 children per year, compared with the baseline. We estimate a saving of (in 2013 US$) $357,788 (95% $345,509–$370,067) in out-of-pocket diarrhea treatment expenditure, and $1646 (95% UR $1603–$1689) in incremental value of insurance per 100,000 under-5 children per year over baseline. The health and financial benefits are highly progressive, i.e. they reach poorer households more. Thus, scaling up access to piped water and improved sanitation can lead to large and equitable reductions in the burden of childhood diarrheal diseases in India.

Reducing levels of urban passenger travel

ABSTRACTBoth the prospect of global oil depletion and the urgent need to address climate change will impact the sustainability of urban passenger transport, particularly in high-mobility Organisation for Economic Co-operation and Development (OECD) cities. Possible approaches for improving its sustainability include improving the fuel efficiency of all transport vehicles, shifting to alternative sources of energy, increasing the occupancy rate for all transport modes, shifting to more energy-efficient transport modes, and reducing the level of urban vehicular passenger travel. This study concentrates on the final approach and examines the various policies that could be adopted to achieve travel reductions. It finds that very high urban densities would reduce vehicular travel, but even if politically and economically feasible, would take decades and could conflict with overall urban sustainability. Similarly, raising the costs of car travel to a sufficiently high level would be effective but inequitable. This study argues that only by decreasing the convenience of urban car travel can large and equitable reductions in passenger travel be achieved.

Societal economics of the European Union liquid fuel consumption for road transportation

In order for the EU to achieve its goal of 10% biofuel for all EU motor vehicles by 2020, a substantial amount of biofuel as well as a biofuel feedstock would need to be imported largely from developing countries where the climate is warm and labor is inexpensive. But there may never be sufficient supply to fulfill the ever-growing demand for biofuel for road transportation in the EU, even as motor vehicles are increasingly becoming more fuel-efficient. The constraint to realizing an effective and equitable reduction in greenhouse-gas emission is the overbearing political economics of neoliberalism. A different remedial strategy is needed to address the dual problems of the excessive uses of motor fuels and greenhouse-gas emission.

Scheduling and Routing for a Bus-Based Evacuation with a Constant Evacuee Arrival Rate

This paper introduces a variant of the vehicle routing problem adapted for bus-based, regional evacuation planning, where evacuees arrive at predetermined pickup locations at constant, location-specific rates. This arrival process more realistically portrays evacuee arrival behavior, presenting an important distinction from the current transit-based evacuation literature. In this problem, capacity-constrained buses are routed, potentially multiple times, to transport all evacuees to a depot/shelter such that the last pickup, and the end of the arrival process, occurs at a location-specific time, determined by risk considerations. The problem seeks to minimize the total waiting time at these locations (total exposure) and exploits efficiencies by allowing service choice. The structural properties of this problem guide the choice for two important strategic parameters: the maximum number of pickups allowed on each location and the fleet size. It is shown that, depending on the problem instance, increasing the maximum number of pickups may reduce both the fleet size requirement and the total exposure and that, past a certain threshold, there exists a maximum number of pickups (or a range of potential values, if the problem cannot be solved to optimality) that guarantees an efficient usage of the available fleet and equitable reductions in exposure across pickup locations.

Welcome from the policies, socio-economic aspects, and health systems research section.

At BMC Obesity, the Policies, Socio-economic Aspects, and Health Systems Research Section provides an opportunity to submit research focussed on what we need to know to support implementation of obesity policies most likely to achieve substantial, sustainable and equitable reductions in the prevalence of obesity globally. Here, we present the aims and objectives of this section, hearing from each of the Associate Editors in turn. The ambition of the Policies, Socio-economic Aspects, and Health Systems Research Section is to foster innovative research combining scientific quality with real world experience. We envisage this will include research addressing the structural drivers of obesity, solution oriented research, research addressing socio-economic inequalities in obesity and obesity prevention in low and middle income countries. We look forward to stimulating research to advance both the methods and substance required to drive uptake of effective and equitable obesity reduction policies globally.