Insurance Gaps Research Articles

CONTRIBUTION OF INDUSTRIAL ALL RISKS INSURANCE TO THE GROWTH OF MANUFACTURING FIRMS IN KENYA

Purpose: Manufacturing firms are key to successful economic development, since they helps generate virtuous and cumulative linkages with other sectors of the economy, drives technological progress, and has the strongest potential for productivity gains. But, significant as they are, manufacturers face varied exposures with customers, employees, and operations. Innovation, from new technologies to expanding markets, can introduce opportunity but also potential vulnerabilities. The purpose of this work is to enhance the reader’s understanding on the various contribution of Industrial all risks insurance to the growth of manufacturing firms in Kenya.
 Methodology: A desktop literature review was used for this purpose. Relevant journal articles for the study were identified using search engines such as Google Scholar, Google Books, Semantic Scholar, Science.gov and Research Gate. Studies done between 2015 and 2022 were considered.
 Findings: From the findings, researchers have shown that subscribing to individual insurance covers can be expensive and might leave insurance gaps. The findings suggest that subscribing to all risk insurance policies have a direct impact on the growth and expansion of the firms in the manufacturing sector.
 Unique Contribution to Theory, Practice and Policy: The study recommends that all manufacturing firms in Kenya should seek Industrial all risks insurance coverage as it provides for protection against all potential incidents that can result to massive losses. Manufacturing firms should also seek Industrial all risks insurance coverage as an effort to restrict the loss to their balance sheets, and in that sense, helps them to stay solvent.

“Here it was waiting for me:” Diabetes Diagnosis Pathways and Implications for Health Policy

AbstractDiabetes in older adults is a growing public health concern with nearly 30% of Americans 65 and older having diabetes. This includes 2.6 million older adults with undiagnosed diabetes who are at high risk of microvascular and cardiovascular complications (Centers for Disease Control and Prevention, 2022). The majority of cases are Type‐2 diabetes. The past decade has witnessed an expansion in screening recommendations in an effort to reduce rates of undiagnosed older adults. Drawing on the sociology of diagnosis, we suggest further attention to the social factors that shape the diagnosis process is needed. We examine the diabetes diagnosis process from the perspective of older adults with type 2 diabetes. The data derive from diabetes illness narrative interviews with non‐Hispanic White and African American older adult men and women (age ≥50) with type 2 diabetes (N=83). Our thematic analysis reveals four pathways to diagnosis: 1. Annual wellness exam, 2. Workplace screening, 3. Community‐based opportunities, and 4. Health event or alarm. Diabetes' early symptoms are often normalized within daily life, with health insurance gaps, providers' dismissal of symptoms, and nonprescription medications reinforcing efforts to address initial symptoms within the home. Wellness visits, as well as worksite and community‐based screening, critically intercede in the unfolding of symptoms. In contrast, diagnosis in connection with a health event or alarm carries an additional toll on social and emotional well‐being. These findings have implications for national screening policies and local diabetes control efforts.

Improving Health Care Transitions for Children and Youth With Special Health Care Needs.

Health care transitions (HCT) from pediatric to adult health care remain a challenge for children and youth with special health care needs (CYSHCN), their families and their clinicians. While the HCT literature has expanded, gaps remain in how to improve health outcomes during transitions. HCTs broadly encompass three key domain areas: transition planning, transfer to adult health care clinicians or an adult model of care, and integration into an adult care/model of care. The CYSHCNet national research agenda development process, described in a previous article, prioritized several key research areas to address deficiencies in the HCT process. The highest priority questions identified were "What are the best models to accomplish youth-adult transition planning? How might this translate to other transitions (eg, to new clinicians, new settings, new schools, etc.)?" and "How do gaps in insurance and community supports during early adulthood effect CYSHCN health outcomes, and how can they be reduced?". Based upon these priorities, we describe the current state of transition research and recommendations for future investigation. Recommendations: The authors recommend 3 primary areas of investigation: 1) Understanding the optimal development and implementation of HCT service models in partnership with youth and families to improve transition readiness and transfer 2) Defining the process and outcome measures that capture adequacy of transition-related activities and 3) Evaluating fiscal policies that incentivize the processes of transition readiness development, transfer to adult health care services, and continuity of care within an adult health care setting. This article explores approaches within each research domain.

Estimating economic losses from cyber-attacks on shipping ports: An optimization-based approach

The Maritime Transportation System (MTS) accounts for more than 80% of global merchandise trade in volume and roughly one-sixth of the Total Gross Output of the United States. Given that national and global economies depend upon efficient supply chains, port stakeholders must develop security plans to respond to all hazards, natural and manmade. Given recent cyber-attacks affecting shipping ports, along with the multi-billion dollar cyber insurance gap, ports need to understand the tradeoffs between increased competitiveness and higher risk through investment in automation and advanced logistics technologies. This article addresses the need to understand the economic impact of cyber-attacks that affect shipping port operations and thereby enable risk assessments that holistically evaluate interactions among port Information Technology (IT) and Operational Technology (OT) systems. Using a Nearly-Orthogonal Latin Hypercube (NOLH) experimental design, we construct transportation disruption profiles based on actual cyber-attacks that specify the range of operational effects of IT/OT dependencies on stakeholder transportation assets. To capture the costs of the physical disruption, we extend Boland et al’s Dynamic Discretization Discovery (DDD) algorithm to capture capacity constraints and enable delay modeling to accommodate commodities arriving late due to disruption. Economic loss functions for seven commodity categories based on the willingness to pay literature are used to compute delay costs so that stakeholders can estimate the range of economic and operational impacts within a disruption profile. Results based on data for cyber-attacks on landlord port and terminal operator assets provided by Port Everglades, FL illustrate impacts at $80,000 and $1.2M on average during one week in October 2017 and at $141,000 and $2.8M for May 2017 respectively. The runtime performance of our enhanced DDD algorithm improves on the state of the art by an order of magnitude and on larger problem sizes based on real-world port networks.

Demand for Multi-Year Catastrophe Insurance Contracts: Experimental Evidence for Mitigating the Insurance Gap

Demand for Multi-Year Catastrophe Insurance Contracts: Experimental Evidence for Mitigating the Insurance Gap

Impact of Insurance Companies Investment on Bank Liquidity and Economic Growth of Nigeria

The study examined the impact of insurance companies’ investment on bank liquidity and economic growth of Nigeria. This is basically to determine the extent of insurance companies contribution to liquidity formation in the banking sector which has being the major cause of bank failures as a financial intermediary and a dealer in short-term securities thereby mobilizing resources for real economic sector. The population of the study is made up of the fifty-nine Nigeria (59) insurance companies in Nigeria. Time series data from the central bank statistical bulletin on total insurance business investment was the source for secondary data. The study employed both inferential and Descriptive Statistics. The E-view statistical package was used for data analysis and test for three (3) hypotheses. The study reveals that there is no significant relationship between short-term investments of insurance companies and banks liquidity, that there exist no significant relationship between short term investment of insurance companies and liquidity formation of the Nigerian money market. The study also reveals that there exist a positive but not significant relation between insurance premium and Gross Domestic product in Nigeria. The study concludes that insurance companies in Nigeria do not impact significantly on the liquidity of banks, money market and economic growth in Nigeria. The study recommends that insurance companies be recapitalized to afford them more resources to expand their investment portfolios to stimulate liquidity formation. That the insurance companies should be more innovative and provide more services to courte public attention and participation to close the insurance gap. The National Insurance Commission (NAICOM) should also ensure compliance and adherence to regulations in the industry.

Social issue of disability at the time of the coronavirus: a new tool the ‘Italian SIPPS Guide on disability protection’

This work give the example of synergic long-term approach to play a stabilizing role of the eco-system involved in the context of family with problems of disability. The Guide is the first initiatives aimed at making the eco-system grow by encouraging circulation of knowledge resulting from multidisciplinary skills. Between the highlights, there is a current insurance gap and the necessity to ensure the availability and affordability of new products and services. The Guide improve the concept of social sustainability within dialogue and concertation.

The social issue of disability at the time of the coronavirus: a new tool the ‘Italian SIPPS Guide on disability protection’

This work give the example of synergic long-term approach to play a stabilizing role of the eco-system involved in the context of family with problems of disability. The Guide is the first initiatives aimed at making the eco-system grow by encouraging circulation of knowledge resulting from multidisciplinary skills. Between the highlights, there is a current insurance gap and the necessity to ensure the availability and affordability of new products and services. The Guide improve the concept of social sustainability within dialogue and concertation.

“I’m Just Sitting Now. Wondering.”: Surviving the Wait for Disability

ABSTRACT In US states that have foregone Medicaid expansion, a disinvestment in general assistance programs has meant that disability benefits remain one of the few sources of cash assistance ostensibly available to uninsured working poor Americans. Yet among impoverished South Carolinians, economic hardship and ill-health often compound during the long, uncertain waits for a disability determination. Here I explore the peculiar vulnerabilities of working poor disability seekers living in an insurance gap of a state that has foregone Medicaid expansion; individuals that risk the protracted, injurious waiting for a chance at meaningful healthcare.

Continuous Eligibility for Medicaid Associated With Improved Child Health Outcomes.

Fluctuating insurance coverage, or churning, is a recognized barrier to health care access. We assessed whether state policies that allow children to remain covered in Medicaid for a 12-month period, regardless of fluctuations in income, are associated with health and health care outcomes, after controlling for individual factors and other Medicaid policies. This cross-sectional study uses a large, nationally representative database of children ages 0 to 17. Continuous eligibility was associated with improved rates of insurance, reductions in gaps in insurance and gaps due to application problems, and lower probability of being in fair or poor health. For children with special health care needs, it was associated with increases in use of medical care and preventive and specialty care access. However, continuous eligibility was not associated with health care utilization outcomes for the full sample. Continuous eligibility may be an effective strategy to reduce gaps in coverage for children and reduce paperwork burden on Medicaid agencies.

Who buys crop insurance? Predictors of the participation gap between organic and conventional farms

AbstractThis study examines the participation gap in crop insurance between organic and conventional producers. To solicit input from producers of organic and diversified crop production systems, we developed a national survey through the Organic Agriculture Research and Education Initiative (OREI) that resulted in over 1,000 valid responses, as well as data from the Agricultural Resource Management Survey (ARMS). Results suggest a high degree of correlation between crop insurance participation with respect to the degree of commercialization of a farm. Additionally, small and diversified operations report that the complexity and record keeping associated with crop insurance is often not worthwhile. This paper concludes with a discussion regarding future risk management education programs and how they can be better targeted by combining the use of crop insurance in conjunction with improved record keeping and a better understanding of loan requirements and documentation.

Health Care Reform in Greece: Progress and Reform Priorities

We review Greek public sector healthcare policies and health-related outcomes since 2010.We find that excess spending was successfully curtailed, elements of the institutional framework were modernized, and health outcomes have been relatively favorable. However, especially prior to Covid-19, public healthcare spending had been compressed to potentially unsustainable levels, with widening inequalities and large unmet needs, especially among the poor. Higher public spending and advancing structural healthcare reforms are needed to improve the efficiency and equity of the Greek healthcare system, including strengthening primary healthcare, reducing out-of-pocket payments, and eliminating remaining insurance gaps.

Timely preterm-birth prediction among pregnant women in Medicaid without preterm-birth history.

To develop and prospectively validate a novel model incorporating claims and community-level socioeconomic data to predict preterm birth at scale among pregnant Medicaid women with no history of preterm birth (PTB). A longitudinal Texas Medicaid cohort study, with 2-year retrospective model building (October 2015-October 2017) and a 1-year prospective model validation phase (January 2018-December 2018). Inclusion criteria were females aged 11 to 55 years with at least 1 live singleton birth and no history of PTB. The primary outcome was live singleton birth earlier than 35 weeks. Covariates were medical/mental/behavioral comorbidities, obstetric history, sociodemographic characteristics, and health services utilization. Of multiple models built, the most parsimonious was selected to classify pregnancies as very high, high, medium, and low risk. Model performance was evaluated using positive predictive value (PPV), sensitivity, case identification ratio (1 / PPV), and timing of prediction. The model was built on 6689 pregnancies and validated on 7855 pregnancies. PTB rate earlier than 35 weeks was approximately 3.3%. Significant risk predictors included prenatal visit attendance, insurance gap days, and medical/obstetrical comorbidities. Model PPV was approximately 4-fold higher for very high-risk women (14.7%) vs cohort (3.3%) and so was the case identification ratio (1:7 vs 1:30, respectively). Sensitivity was good, with 57% of PTBs classified as medium risk or higher. Timing of prediction was clinically relevant, with more than 80% of PTBs risk stratified before 24 weeks. We report a novel PTB prediction model among pregnant Medicaid women without PTB history, which is timely, accurate, practical, and scalable. We leverage Medicaid and community data readily accessible by Medicaid plans to support population-level interventions to prevent PTBs.

Macro- and meso-level contextual influences on health care inequities among American Indian elders

BackgroundAmerican Indian elders, aged 55 years and older, represent a neglected segment of the United States (U.S.) health care system. This group is more likely to be uninsured and to suffer from greater morbidities, poorer health outcomes and quality of life, and lower life expectancies compared to all other aging populations in the country. Despite the U.S. government’s federal trust responsibility to meet American Indians’ health-related needs through the Indian Health Service (IHS), elders are negatively affected by provider shortages, limited availability of health care services, and gaps in insurance. This qualitative study examines the perspectives of professional stakeholders involved in planning, delivery of, and advocating for services for this population to identify and analyze macro- and meso-level factors affecting access to and use of health care and insurance among American Indian elders at the micro level.MethodsBetween June 2016 and March 2017, we undertook in-depth qualitative interviews with 47 professional stakeholders in two states in the Southwest U.S., including health care providers, outreach workers, public-sector administrators, and tribal leaders. The interviews focused on perceptions of both policy- and practice-related factors that bear upon health care inequities impacting elders. We analyzed iteratively the interview transcripts, using both open and focused coding techniques, followed by a critical review of the findings by a Community Action Board comprising American Indian elders.ResultsFindings illuminated complex and multilevel contextual influences on health care inequities for elders, centering on (1) gaps in elder-oriented services; (2) benefits and limits of the Affordable Care Act (ACA); (2) invisibility of elders in national, state, and tribal policymaking; and (4) perceived threats to the IHS system and the federal trust responsibility.ConclusionsFindings point to recommendations to improve the prevention and treatment of illness among American Indian elders by meeting their unique health care and insurance needs. Policies and practices must target meso and macro levels of contextual influence. Although Medicaid expansion under the ACA enables providers of essential services to elders, including the IHS, to enhance care through increased reimbursements, future policy efforts must improve upon this funding situation and fulfill the federal trust responsibility.

Gender differences in health insurance coverage in China

BackgroundChina initiated a reform of the health insurance system in the late 1990s. The new insurance, Urban Employee Basic Medical Insurance (UEBMI), is employment-based, which makes it more difficult than it used to be for those unemployed or informal employed (most of whom are women) to be covered by health insurance.MethodsBased on three large sample of micro datasets, we first use statistical methods to identify gender differences in health insurance. Next, we construct a logistic regression model to capture the differences in insurance coverage across age groups using the parameter of interaction terms for gender and age groups.ResultsBased on data from a demographic survey that covers a large sample, we find that in the below 50 (in 2005) or 60 (in 2015) years age group, the coverage gap of UEBMI between men and women was relatively smaller, while a larger disparity existed in the above 50 (in 2005) or 60 (in 2015) group. Moreover, gender differences in health insurance were more significant in the low-education group, while no gender differences were found in the high-education group.ConclusionsThis paper explains the gender gap in health insurance and the reason for the wider gap among older people. Our study indicates that because the UEBMI in China mainly covers people with formal jobs, a lower labor participation rate (even much lower in formal jobs) of women has led to their greater difficulty in obtaining health insurance. Since the older women’s greater difficulty in obtaining jobs or susceptibility to lay-offs during the period of the UEBMI’s implementation, the possibility of being covered was even much lower. In fact, it was because of the combined effects of the UEBMI system and the labor market condition at that time that older women had a lower proportion of being covered under the UEBMI.

Demand for Multi-Year Catastrophe Insurance Contracts: Experimental Evidence for Mitigating the Insurance Gap

Demand for Multi-Year Catastrophe Insurance Contracts: Experimental Evidence for Mitigating the Insurance Gap

Estimating Economic Losses from Cyber-Attacks on Shipping Ports: An Optimization-Based Approach

The Maritime Transportation System (MTS) accounts for more than 80% of global merchandise trade in volume and roughly a sixth of the Total Gross Output of the United States. Given that national and global economies depend upon efficient supply chains, port stakeholders must develop security plans to respond to all hazards, natural and manmade. Given recent cyber attacks affecting shipping ports, along with the multi-billion dollar cyber insurance gap, ports need to understand the tradeoffs between increased competitiveness and increased risk through investment in automation and advanced logistics technologies. This article addresses the need to understand the economic impact of cyber attacks that affect shipping port operations and thereby enable risk assessments that holistically evaluate interactions among port Information Technology (IT) and Operational Technology (OT) systems. We extend Boland et al's Dynamic Discretization Discovery (DDD) algorithm to include capacity constraints and delay arcs to accommodate commodities arriving late due to disruption. Using a Nearly-Orthogonal Latin Hypercube (NOLH) experimental design, we construct disruption profiles based on actual cyber attacks that specify the range of operational effects of IT/OT dependencies on stakeholder transportation assets. Economic loss functions for seven commodity categories based on the willingness to pay literature are used to compute delay costs so that stakeholders can estimate the range of economic and operational impacts within a disruption profile. Results based on data provided by Port Everglades, FL, illustrate impacts at $80,000 and $1.2M on average for cyberattacks on landlord port and terminal operator assets during the first week in October, 2017. The runtime performance of our DDD algorithm improves on the state of the art by an order of magnitude and on larger problem sizes based on real-world port networks.

Key factors of the willingness of rural populations settling in cities (RPSC) from a Lacanian psychoanalysis theory perspective.

The migration of populations from rural to urban areas is a typical phenomenon of urbanization in developing countries. Based on Lacanian psychoanalysis theory, this study analyzes the decision-making mechanism of the willingness of rural populations settling in cities (RPSC), and analyzes the key factors that affect the willingness of RPSC by using the binary Logit regression method based on survey data in Changyi, China. The results show that the willingness of RPSC is a realistic choice under the joint action of the ‘mirrored’ incarnation and the ‘non-mirrored’ order. Among the factors, ‘age’, ‘ethnic groups’, ‘educational attainment’, and ‘social intercourse’, representing the ‘mirrored’ incarnation, and ‘communities’ safety gap’, ‘healthcare services policy’, ‘public housing policy’ and ‘employment insurance gap’, representing the ‘non-mirrored’ order, are significant in affecting the willingness of RPSC. These findings validate the adaptability of psychoanalysis to analyze the willingness of RPSC, and increases the understanding of individual willingness and behavioral choice in the context of a specific social background, which can provide decision-making reference for urban and rural planning and public policy makers.

Characteristics of US Adults Who Would Be Recommended for Lifestyle Modification Without Antihypertensive Medication to Manage Blood Pressure.

The 2017 American College of Cardiology / American Heart Association Guideline for blood pressure (BP) management newly classifies millions of Americans with elevated BP or stage 1 hypertension for recommended lifestyle modification alone (without pharmacotherapy). This study characterized these adults, including their cardiovascular disease risk factors, barriers to lifestyle modification, and healthcare access. This cross-sectional study examined nationally representative National Health and Nutrition Examination Survey data, 2013-2016, on 10,205 US adults aged ≥18, among whom 2,081 had elevated BP or stage 1 hypertension and met 2017 ACC/AHA BP Guideline criteria for lifestyle modification alone. An estimated 22% of US adults (52 million) would be recommended for lifestyle modification alone. Among these, 58% were men, 43% had obesity, 52% had low-quality diet, 95% consumed excess sodium, 43% were physically inactive, and 8% consumed excess alcohol. Many reported attempting lifestyle changes (range: 39%-60%). Those who reported receiving health professional advice to lose weight (adjusted prevalence ratio 1.21, 95% confidence interval 1.06-1.38), reduce sodium intake (2.33, 2.00-2.72), or exercise more (1.60, 1.32-1.95) were significantly more likely to report attempting changes. However, potential barriers to lifestyle modification included 28% of adults reporting disability, asthma, or arthritis. Additionally, 20% had no health insurance and 22% had no healthcare visits in the last year. One-fifth of US adults met 2017 ACC/AHA BP Guideline criteria for lifestyle modification alone, and many reported attempting behavior change. However, barriers exist such as insurance gaps, limited access to care, and physical impairment.

Predictors of Health Insurance, Life Insurance, and Retirement Savings Among NYC's Immigrant Taxi and For-Hire Vehicle Drivers.

Taxi and for-hire vehicle (FHV) drivers are a predominantly immigrant population facing a range of occupational stressors, including lack of workplace benefits and increasing financial strain from tumultuous industry changes and now COVID-19’s devastating impact. Bilingual research staff surveyed 422 New York City taxi/FHV drivers using a stratified sampling approach in driver-frequented locations to examine drivers’ health and financial planning behaviors for the first time. Drivers lacked health insurance at double the NYC rate (20% vs. 10%). Life insurance and retirement savings rates were lower than U.S. averages (20% vs. 60%, 25% vs. 58%, respectively). Vehicle ownership was a significant predictor of health insurance, life insurance, and retirement savings. Compared to South Asian drivers, Sub-Saharan African drivers were significantly less likely to have health insurance and North African, and Middle Eastern drivers were significantly less likely to have retirement savings. Although most drivers indicated the importance of insurance and benefits, < 50% understood how to use them. Drivers felt primary care coverage to be most important followed by other health-related coverage, retirement benefits, and life insurance. Results reveal compelling addressable gaps in insurance and benefits coverage and the need to implement accessible financial literacy with navigation and advising services and programs.