High-income Asian Countries Research Articles

The Impact of Dementia on the Psychosocial Well-Being of Informal Caregivers in Asia: A Scoping Review Comparing High-Income and Low–Middle-Income Countries

The need for informal caregiving has become a crucial topic for researchers and policymakers. This review explores the psychosocial impact on caregivers providing dementia care in high-income and low–middle-income Asian countries. A scoping review was undertaken following the Joanna Briggs Institute (JBI) protocol. A systematic search of four databases (PubMed, ProQuest, Medline, and Medline Complete) was conducted. Articles were screened following the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. Fourteen articles (11 cross-sectional, 1 longitudinal, 1 case-control, and 1 descriptive phenomenological study) were selected for the final analysis. The most frequently reported findings from low–middle-income countries were dementia caregivers working longer hours and experiencing financial issues, poor physical health, and lower life satisfaction, which progressively and collectively affected caregivers’ psychosocial well-being and quality of life. However, the impact was less significant in high-income Asian countries, particularly those where efforts are being made to identify the burdens associated with caring for people with dementia and providing appropriate support. This review demonstrates clear evidence that caring for people with dementia may affect informal caregivers’ quality of life, particularly in low–middle-income Asian countries. Systematic reviews and meta-analyses may be needed to confirm these findings.

Retirement and healthcare utilization: Evidence from pension eligibility ages in South Korea

This paper investigates how crossing the normal pension eligibility age affects retirement status and healthcare utilization by using the exogenous rule for the public pension benefit and a dataset for the elderly population from South Korea — one of the high-income Asian countries. To overcome selection bias, I rely on a regression discontinuity design (RDD) to compare the outcomes of those barely above and below eligibility age thresholds. By using aggregate measures of healthcare utilization, I find that retirement increases inpatient care utilization, while it has a negative but statistically insignificant effect on outpatient care utilization. These results are qualitatively consistent with the existing evidence in the developing country documenting that retirement positively impacts inpatient care utilization.

Mortality-to-incidence ratio of early-onset colorectal cancer in high-income Asian and Middle Eastern countries: A systemic analysis of the Global Burden of Diseases Study 2019.

The incidence of early-onset colorectal cancer (EO-CRC) has been consistently rising leading to a significant cancer burden among younger adults in Asian and Middle Eastern high-income countries. The study aims to investigate the survival outcomes of EO-CRC among high-income Asian and Middle Eastern populations from 1990 to 2019 using the mortality-to-incidence ratio, with a focus on examining the differences in gender. This is a systematic analysis of the Global Burden of Disease (GBD) 2019 study. We include individuals aged 15 to 49 years old in high-income Asian and the Middle Eastern countries. The colorectal cancer mortality-to-incidence ratio (MIR) was calculated for both genders by dividing the age-specific mortality rate per 100,000 for colorectal cancer by the age-specific incidence rate per 100,000 for each nation in the sample for a given year. An overall decline in male and female MIR was observed from 1990 to 2019 in Asian and Middle Eastern countries. Ten out of thirteen Asian and Middle Eastern countries had a higher female MIR compared to their male counterparts. The global male MIR was found to be significantly higher than that of female (p-value 0.008, coefficient estimate: 1.51). In Middle Eastern countries, Saudi Arabia had a significantly higher female MIR compared to their male counterparts (p < 0.0001, coefficient estimate: 12.65). This research addresses the knowledge gap concerning gender-based differences in EO-CRC survival outcomes in high-income Asian and Middle Eastern countries, providing insights into the factors influencing these disparities in these regions. Policymakers should focus on developing targeted prevention and treatment programs for women, and addressing cultural and social barriers that may prevent women from seeking timely medical care.

A causal link between financialization and ecological status: a novel framework for Asian countries?

Sustainable finance and green trade are essential to accomplish the green growth agenda. Though the literature prevails, little is known about the inclusive influence of financialization and trade openness on ecological status rather than just focusing on air pollution or inconclusive element. This study aims to analyze the role of financial dimensions and trade openness with environmental performance in the context of three panels of Asian countries consisting of low, middle, and high-income over the period 1990-2020. The estimated outcomes from the novel panel, the Granger non-causality technique, demonstrate that financialization further contributes to environmental deterioration instead of preserving the environmental quality. Regarding the low and middle-income economies, the authorities should enhance gains from trade openness to develop energy efficiency and ecological status policies. In the case of high-income Asian countries, they are even more desperate to consume energy and ignore the ecological challenges. The findings of this research offer various policy suggestions to accomplish sustainable development objectives.

The efficiency of natural resource consumption and government administration concerning green economic growth in Asian countries

This paper seeks the relationship between natural resources, public administration, and green economic growth in 30 Asian economies divided into two different income level groups over 2010–2021 by the FMOLS technique. The preliminary results confirmed that the efficiency of natural resource consumption and government administration in Asian countries has a significant positive effect. Moreover, fossil fuel consumption in both groups of countries has a negative and significant effect on economic growth. Furthermore, the green finance market and patent applications have a significant positive effect only in high-income Asian countries. In high-income Asian economies, there are bi-directional causality linkages among green economic growth, natural resource utilization efficiency, and public administration quality. In contrast, green economic growth in low-income economies cannot cause natural resource consumption efficiency and more suitable quality of public administration. Green multilateralism and establishing a green value chain are recommended as practical policies.

The impacts of energy resource and tourism on green growth: Evidence from Asian economies

In recent years, the discourse of "Green growth" has been expanded among scholars as an approach to reach environmental protection and a long-term solution to the climate change challenge. The primary purpose of this paper is to explore the impacts of tourism and energy resources (fossil fuels and renewable energy) on green economic growth from 2000 to 2021 for the case of Asian countries divided by the proxy of income level. The findings confirmed that in high-income Asian countries, the long-term impact of the sector of tourism on sustainable GDP (Gross Domestic Product) growth is positive. In contrast, tourism progress is an obstacle to long-term green economic growth in low-income Asian economies. In addition, the consumption of fossil fuels harms the sustainable GDP growth for both groups of examined economies. The recommended practical policies for low-income level Asian economies are enhancing ecotourism policy, green regionalism, and developing a green financial market. The high-income Asian countries should try to have financial and tax support for SMEs and develop green projects guaranteed by green bonds.

Impact of natural resource rents and economic growth on environmental degradation in the context of COP-26: Evidence from low-income, middle-income, and high-income Asian countries

This study investigates the influence of natural resource rents and economic growth on environmental degradation by using the three classifications of the Asian countries based on per capita income. A panel data from 1990 to 2018 is analyzed to determine the cointegration relationship through Mean Group (MG) regression. The calculations indicate that there is a strong positive correlation between natural resource rents and carbon emissions, particularly in the group of low-income countries. The results indicate a positive correlation between economic growth and carbon emissions for the middle and low-income groups while there is a negative relationship found in the group of high-income countries. The study suggests that to achieve the targets of COP-26, joint efforts of high, middle, and low-income countries are required on urgent basis to reduce carbon emissions. The group of high-income countries is required to improve the resource rents policies such as the search for alternative renewable sources, plantation of trees on a large scale, judicious way of energy preservation, and use of biofuels at the household level. The group of middle and low-income countries needs to adopt environment-friendly economic growth along with the aforementioned policies to preserve natural resources.

Global Myeloma Trial Participation and Drug Access in the Era of Novel Therapies.

PURPOSEThe globalization of clinical trials has accelerated recent advances in multiple myeloma (MM). However, it is unclear whether trial enrollment locations are reflective of the global burden of MM and whether access to novel therapies is timely and equitable for countries that participate in those trials.METHODSTo assess this, we characterized where MM trials that led to US Food and Drug Administration (FDA) approvals were conducted and determined how often and quickly these drug regimens received approval in their participating trial countries on the basis of country income level and geographic region.RESULTSA systematic review was conducted to identify all MM clinical trials that met their primary endpoint, enrolled patients outside the United States, and resulted in FDA approval from 2005 to 2019. A total of 18 pivotal MM clinical trials were identified. High-income countries enrolled patients in 100% (18/18) of the trials identified, whereas upper-middle and lower-middle-income countries were represented in 61% (11/18) and 28% (5/18) of trials, respectively. No patients from low-income countries were enrolled. One trial enrolled patients in sub-Saharan Africa, and no trials enrolled patients in South Asia/Caribbean. For drugs/regimens that were approved in their participating countries, the median time from FDA approval to approval was 10.9 months. There were no drugs approved in lower-middle-income trial countries. MM trials leading to FDA approval are generally run in high-income, European, and Central Asian countries.CONCLUSIONThere are substantial disparities in where novel therapies are evaluated and where they are ultimately approved for use on the basis of income level and geography.

Opportunities and challenges for advance care planning in strongly religious family-centric societies: a Focus group study of Indonesian cancer-care professionals

BackgroundMost studies on advance care planning in Asia originate in high-income Asian countries. Indonesia is a middle-income Asian country characterized by its religious devoutness and strong family ties. This study aims to explore the perspectives and experiences of Indonesian healthcare professionals on advance care planning for cancer patients.MethodsFocus-group discussions were conducted in July and August 2019 and were analysed using thematic content analysis enhanced by dual coding and exploration of divergent views. Purposive sampling of physicians and nurses actively engaged in cancer care in a national cancer centre and a national general hospital.ResultsWe included 16 physicians and 16 nurses. These participants were open to the idea of advance care planning. We further identified four aspects of this planning that the participants considered to be important: 1) the family’s role in medical decision-making; 2) sensitivity to communication norms; 3) patients’ and families’ religious beliefs regarding the control and sanctity of life; and 4) the availability of a support system for advance care planning (healthcare professionals’ education and training, public education, resource allocation, and formal regulation). Participants believed that, although family hierarchical structure and certain religious beliefs may complicate patients’ engagement in advance care planning, a considerate approach to involving family and patients’ religious perspectives in advance care planning may actually facilitate their engagement in it.ConclusionIndonesian healthcare professionals believed that, for culturally congruent advance care planning in Indonesia, it was essential to respect the cultural aspects of collectivism, communication norms, and patients’ religious beliefs.

Does English proficiency support the economic development of non-English-speaking countries? The case of Asia

In this study, the relationship between the English proficiency and economic development of Asian countries is analyzed using panel data regression. The results indicate that English proficiency exerts a significant effect on economic development, but the effect is fully mediated by economic policies. Additionally, moderation effect analysis reveals that the policy of English as an official language is not a determinant of economic development for high-income Asian countries. Therefore, non-English-speaking countries with no history of colonization by an English-speaking country should prioritize English education reforms, which are more practical than enacting a bilingual nation policy.

Nexus Between Human Capital, Technology and Economic Growth: The Role of Stages of Economic Development in Asian Countries

This paper explores the effect of human capital and technology on economic growth in Asian countries while considering economic development. The paper expands the Solow Growth model by further incorporating the import of machinery and equipment reflecting total factor productivity. Panel data for 30 Asian countries has been used over 1995-2015. Due to the endogeneity problem in human capital and other variables, the System Generalized Method of Moment (GMM) is used to address this problem. Empirical results reveal that human capital and technology have increased economic growth in the total sample of Asian countries. Furthermore, the sample has been disaggregated into high-income (HI) and low-income (LI) Asian countries. Our findings determine that human capital and technology are reflecting a positive and statistically significant role in enhancing economic growth in both samples of countries. However, the magnitude of the impact is high in HI Asian countries relative to LI Asian countries, respectively. When the import of machinery and equipment are replaced with patents, a positive and insignificant results are obtained for LI countries because these countries have lacked legal systems, but a positive and statistically significant relationship is observed for HI Asian countries.

Fighting COVID-19: Patterns in International Data, Expanded

This paper provides an empirical evaluation of countries’ performance in fighting COVID-19, utilizing a performance index (which we call the Disaster Index) based on four health and economic indicators: deaths per population size, deaths per confirmed cases, and quarterly real GDP and monthly unemployment rate relative to pre-pandemic values. International data patterns are studied for these four indicators and the Disaster index to analyze trends and basic empirical relationships. The approach is descriptive and primarily based on graphs, scatter diagrams, and correlation analysis. The ten best performers based on the Disaster Index for the first half of 2020 were (best #1 to #10): Singapore, Taiwan, Belarus, Korea, New Zealand, Japan, Norway, Israel, Czechia, and Lithuania. The worst twelve performers were (bad to worst): Sweden, US, Canada, Philippines, France, Columbia, Spain, Belgium, United Kingdom, Ecuador, Italy, and Peru. Thus, high-income Asian countries performed relatively better than low-income Asian countries, European, and American countries in the first half of 2020. Reasons for this geographical divide are very important and must be studied more carefully and closely, as successful methods in better performing countries will provide some lessons for other countries. It also would be interesting to see how this Disaster Index profile shifts in 2021 as vaccination and economic relief accelerate in countries like the United States. The pandemic exhibited the vulnerabilities in the world and reemphasized the vital significance of international coordination and cooperation in a globalized world. Recent trends show that most countries still have a long way to go to control the virus. Vaccination is a reassuring fresh hope, a potential game-changer, though requiring careful, painstaking, and timely implementation.

Analysis of the impact of information communication technology on economic growth: empirical evidence from Asian countries

PurposeThis study examines the causal relationship between information communication technology (ICT) and economic growth in high-income and middle-income Asian countries.Design/methodology/approachThis study utilises a high-quality data from 25 Asian countries from 2000 to 2018. This study presents the robustness results by employing panel cointegration and estimation procedures to account for the endogeneity and cross-sectional dependence issues.FindingsThe results illustrate that high-income Asian countries have achieved positive and significant economic development from high Internet penetration. Additionally, the middle-income countries have started to benefit from ICT Internet. The findings show that the telephone line and mobile phone penetration is highly capable of promoting economic growth in middle-income Asian countries.Practical implicationsIn high-income Asia countries, an appropriate ICT infrastructure policy will support feasible ICT penetration, which may drive the processes of economic development and innovation that contribute to economic growth. Moreover, in middle-income Asian countries, the establishment of better-quality ICT service and infrastructure is more critical. Policymakers should accommodate sufficient support to establish the ICT infrastructure and expand ICT penetration.Originality/valueThis study reveals that high-income Asian countries have been more proactive and effective than middle-income countries in embracing ICT to foster economic growth. Examining the case of high-income and middle-income Asian countries provides comprehensive insight for policymakers regarding the relevance of ICT in boosting economic growth through the advantages of technology expansion.

Fighting COVID-19: patterns in international data

This paper provides an empirical evaluation of countries’ performance in !ghting COVID-19, utilizing a performance index (which we call the Disaster Index) based on four health and economic indicators: deaths per population size, deaths per con!rmed cases, and quarterly real gross domestic product (GDP) and monthly unemployment rate relative to pre-pandemic values. International data patterns are studied for these four indicators and the Disaster Index to analyze trends and basic empirical relationships. The approach is descriptive and primarily based on graphs, scatter diagrams, and correlation analysis. The ten best performers based on the Disaster Index for the !rst half of 2020 were (ranked 1st to 10th): Singapore, Taiwan, Belarus, Korea, New Zealand, Japan, Norway, Israel, Czechia, and Lithuania. The worst twelve performers were (bad to worst): Sweden, US, Canada, Philippines, France, Columbia, Spain, Belgium, United Kingdom, Ecuador, Italy, and Peru. Thus, high-income Asian countries performed relatively better than low-income Asian countries, European, and American countries in the !rst half of 2020. Reasons for this geographical divide are very important and must be studied more carefully and closely, as successful methods in better performing countries will provide some lessons for other countries. It also would be interesting to see how this Disaster Index pro!le shifts in 2021 as vaccination and economic relief accelerate in countries like the United States. The pandemic exhibited the vulnerabilities in the world and reemphasized the vital signi!cance of international coordination and cooperation in a globalized world. Recent trends show that most countries still have a long way to go to control the virus. Vaccination is a reassuring fresh hope, a potential game-changer, though requiring careful, painstaking, and timely implementation

Examining sociopolitical elements of health system reform: The experience of Singapore and Taiwan.

This essay suggests five sociopolitical dimensions that influence the success of health system reforms. It examines the experience of two high-income Asian countries, Singapore and Taiwan, and illustrates how these five dimensions matter. These five sociopolitical dimensions are public trust, perceived government performance, political legitimacy, equity/solidarity, and demand for choice. Public trust in government, perceived government performance, and the legitimacy of political authorities were necessary for governments in both countries to enact key reforms. Public perceptions of government capacity combined with public conceptions of equity were deliberated and clarified as stakeholders sought to reach consensus based on values upheld by segments of each society. Nevertheless, these elements alone are not enough to sustain major institutional reforms in light of ongoing social, political, and demographic changes. This essay provides a different approach to traditional policy cycle models and seeks to emphasize stewardship and governance in health systems.

Interventions to support family caregivers of people living with dementia in high, middle and low-income countries in Asia: a scoping review

IntroductionDespite increasing numbers of persons living with Alzheimer’s disease and Alzheimer’s-related dementias (AD/ADRD) in Asia, particularly in low-income countries (LIC) and middle-income countries (MIC), surprisingly little is known about the...

The obesity transition: stages of the global epidemic

Summary The global prevalence of obesity has increased substantially over the past 40 years, from less than 1% in 1975, to 6–8% in 2016, among girls and boys, and from 3% to 11% among men and from 6% to 15% among women over the same time period. Our aim was to consolidate the evidence on the epidemiology of obesity into a conceptual model of the so-called obesity transition. We used illustrative examples from the 30 most populous countries, representing 77·5% of the world's population to propose a four stage model. Stage 1 of the obesity transition is characterised by a higher prevalence of obesity in women than in men, in those with higher socioeconomic status than in those with lower socioeconomic status, and in adults than in children. Many countries in south Asia and sub-Saharan Africa are presently in this stage. In countries in stage 2 of the transition, there has been a large increase in the prevalence among adults, a smaller increase among children, and a narrowing of the gap between sexes and in socioeconomic differences among women. Many Latin American and Middle Eastern countries are presently at this stage. High-income east Asian countries are also at this stage, albeit with a much lower prevalence of obesity. In stage 3 of the transition, the prevalence of obesity among those with lower socioeconomic status surpasses that of those with higher socioeconomic status, and plateaus in prevalence can be observed in women with high socioeconomic status and in children. Most European countries are presently at this stage. There are too few signs of countries entering into the proposed fourth stage of the transition, during which obesity prevalence declines, to establish demographic patterns. This conceptual model is intended to provide guidance to researchers and policy makers in identifying the current stage of the obesity transition in a population, anticipating subpopulations that will develop obesity in the future, and enacting proactive measures to attenuate the transition, taking into consideration local contextual factors.

Considerable international variation exists in blood pressure control and antihypertensive prescription patterns in chronic kidney disease

Although blood pressure control is a major goal in chronic kidney disease, no worldwide overview of either its achievement or antihypertensive prescriptions is currently available. To evaluate this we compared crude prevalence of uncontrolled blood pressure among 17 cohort studies, including 34 602 individuals with estimated glomerular filtration rate under 60 ml/min/1.73 m2 and treated hypertension across four continents, and estimated observed to expected prevalence ratios, adjusted for potential confounders. Crude prevalence of blood pressure of 140/90 mmHg or more varied from 28% to 61% and of blood pressure of 130/80 or more from 54% to 84%. Adjusted prevalence ratios indicated poorer hypertension control than expected in cohorts from European countries, India, and Uruguay, and better control in patients from North American and high-income Asian countries. Four antihypertensive drug classes or more were prescribed to more than 30% of participants in North American and some European cohorts, but this practice was less common elsewhere. Renin angiotensin-aldosterone system inhibitors were the most common antihypertensive drugs, prescribed for 54% to 91% of cohort participants. Differences for other drug classes were much stronger, ranging from 11% to 79% for diuretics, 22% to 70% for beta-blockers, and 27% to 75% for calcium-channel blockers. The confounders studied explain only a part of the international variation in blood pressure control among individuals with chronic kidney disease. Thus, considerable heterogeneity in prescription patterns worldwide calls for further investigation into the impact of different approaches on patient outcomes.

Export diversification, specialisation and inequality: Evidence from Asian and Western countries

ABSTRACTThis paper examines the dynamic effect of globalization at the disaggregated level of sectoral export diversification and manufacturing specialization on income inequality using a panel data set of 52 Asian and Western countries from 1988 to 2014. The paper uses dynamic panel data models applying the System Generalized Method of Moments (GMM) estimations that provide more accurate and better results than those obtained with static panel data models. The results suggest that there is no statistically significant relationship between manufacturing specialization and inequality while sectoral export diversification has been the driving force of inequality. For sub-groups of countries, higher sectoral export diversification increases inequality and higher manufacturing specialization decreases inequality in high-income Asian countries and European Union (EU) member states. Moreover, the study finds insignificant effects in low-income Asian countries and Anglo-Saxon countries.

The relationship between per capita GDP and road accidents in Sri Lanka: an ARDL bound test approach

The objective of this study is to examine the relationship between road accidents and per capita GDP in Sri Lanka during the period of 1977 to 2016. The study examines the existence of Kuznets curve relationship between number of road accidents and per capita GDP in Sri Lanka, and the relationship of some other variables such as merchandise imports from various regions and different age group of population as well. The Auto Regressive Distributed Lags (ARDL) bound test approach is employed to analyse the time series data. The findings of this study confirm the existence of the Kuznets curve relationship between road accidents and per capita GDP. The results further reveal that there is a long-run relationship between road accidents and merchandise imports from high income and East Asian countries, urban population and age group of population 30-34 and 35-39. Coefficients of these variables are statistically significant at 1% level and positively associated with number of accidents in Sri Lanka.