Wage Losses Research Articles

Employment precarization as a factor of wages differentiation and social wellbeing

Employment conditions (form of labor relations, social security, (un)stability of wages, informal payments, etc.) are a key factor of the social-economic differentiation in the contemporary Russian society, which determines the need to clarify the relationship between the workers position in the labor market and ones earnings. There are many empirical assessments of wage losses for various types of non-standard employment (informal, temporary, part-time, casual, etc.); however, each type is just one manifestation of precarization (as non-guaranteed and unstable employment), which does not present this phenomenon in general. The author considers the relationship between precarization and wages. Based on the data of the all-Russian survey of the working population (2018), the author argues that not all but some features of precarization (lack of indefinite term employment agreement, sick leave and vacation pay) are associated with a lower salary; only a high level of precarization (three or more its features together) significantly reduces wages. Despite the fact that this relationship is partly mediated by the level of education of the employee, precarization still has an independent negative impact on wages. Groups of workers with a high and low level of precarization are heterogeneous in wages which can compensate for the disadvantages of the unstable and non-guaranteed employment situation. Thus, workers can be divided into four groups according to their employment precarization and salaries, which determine their social well-being. The unstable group with wages below average shows the lowest level of subjective well-being and social optimism both in life in general and in assessing the labor sphere. The unstable group with wages above the average declares a lower level of social well-being than the stable group with wages below the average, i.e., higher wages do not compensate for the negative consequences of precarious employment which worsens social well-being even provided wages above the average.

The wage effects of overeducation across overall wage distribution on university graduates: incidence, heterogeneity and comparison

PurposeThis study aims to investigate the extent to which overeducation imposes wage effects on university graduates, taking into account the individual heterogeneity due to skills and innate ability.Design/methodology/approachUsing Graduates Occupation and Mobility Survey (GOMS) 2019 and Korea Dictionary of Occupations (KDOT) 2019, the overeducated and adequately educated graduates are differentiated by the job analysis (JA) measure. To unveil the masked results, the unconditional quantile regression (UQR) accompanying skills and field of study mismatches is adopted to explore the wage effects of overeducation across the overall wage distribution.FindingsEmpirical evidence shows that the incidence of overeducation is high; however, overeducated graduates only suffer a 6.5% wage loss relative to their adequately matched peers. The findings indicate that regardless of being derived from either overskilled or field of study mismatch, genuine overeducation impose a higher wage penalty at all percentiles relative to the apparent overeducation. Meanwhile, high-ability men suffer lower-wage penalties than their low-ability peers, whereas the inverted “U” pattern is exhibited for women. The theoretical hypotheses differ depending on the estimated results by gender.Research limitations/implicationsEach measure of educational mismatch has been criticized for its insurmountable shortcoming. The recent graduates are likely to overstate the job requires of skills.Originality/valueThis paper contributes to the insufficient evidence on the multiple aspects of wage effects of overeducation by providing new and rigorous examinations and by focusing on the country experiencing rapid economic growth, industrial upgrading and educational expansion.

Unemployment and its scarring effect on wages in Germany: evidence from linked employer-employee data

PurposeAssess and compare scarring effects of unemployment in Germany to other countries and to consider firm heterogeneity.Design/methodology/approachThe author uses linked employer-employee data to analyze the effect of unemployment and its duration on future wages in Germany. Using administrative data on workers and firms in Germany and considering registered and unregistered unemployment episodes, the results show long-lasting wage losses caused by unemployment incidences. Furthermore, the estimations indicate that unemployment duration as well as selectivity into firms paying lower wages is of particular relevance for the explanation of wage penalties of re-employed workers.FindingsUnemployment causes massive and persistent wage declines in the future, which depend on the unemployment duration. Furthermore, reduced options of unemployed workers and selectivity in firms contribute to a large part of unemployment scarring.Practical implicationsFindings are relevant for current debates on unemployment and can help design measures to avoid huge costs of unemployment.Originality/valueThis paper analyses long-term unemployment scarring by considering not only unemployment duration but also selectivity in firms and its effect on the scarring effect.

The Impact of COVID-19 on the Household Economy of India.

COVID-19 has disrupted the Indian economy. Government-enforced lockdown to restrict the spread of infection has impacted the household economy in particular. We combine aggregates from national income accounts and estimates from the microdata of a labour force survey covering more than 0.1 million households and 0.4 million individuals. The aggregate daily loss to households is USD 2.42 billion. While loss to earnings accounts for 72% of the total, the rest 28% is wage loss. Service-based activities account for two thirds of wage loss, and natural resource-based activities are responsible for most of the earning loss. The dominance of informal job contracts and job switching in labour markets intensifies this, with the most vulnerable group consisting of 57.8 million in casual engagement, who have a high degree of transition from one stream of employment to another on a daily basis. Supplementary InformationThe online version contains supplementary material available at 10.1007/s41027-021-00352-8.

Impact of COVID-19 on economic and working conditions in Italy. Data from PASSI and PASSI d’Argento

BackgroundHaving affected multiple life aspects globally, the COVID-19 pandemic will generate long-term consequences on productive sector and economy. The two Italian population-based surveillance systems PASSI (18-69yy) and PASSI d'Argento (65+) have annexed a COVID-module to the standard questionnaires' sections to investigate also changes of economic and working conditions related to the COVID-19 crisis.MethodsWe analysed data on a sample of 2,613 PASSI and 2,288 PASSI d'Argento interviews, collected between August and December 2020.ResultsAmong adults, 34% refers a worsening of their financial resources because of the COVID-19 crisis: above all if socially deprived people, with many difficulties (52%) or with a low educational level (41%). Despite keeping up working, 31% of employed people worked less due to the COVID crisis, with a lower wage; 5.5% lost the job and a certain number had to give it up. The worsening of economic resources correlates to changes in working conditions due to the pandemic crisis, but the latter did not fully determine the former. Economic losses are more frequent among people in search of employment (52% vs 35% of occupied or 28% of inactive), those who lost their job (76%) or, despite keeping up working, earn less (66%), but interest also individuals who have not undergone changes per the working condition and volume (19%). The association between worsened economic resources and social disadvantage (low education and economic difficulties) is significant, even adjusting for job or wage loss. Even among older persons, a lower but non-negligible quota (16%) declares economic worsening due to the pandemic-related crisis. The percentage triples (29%) on difficulty making ends meet.ConclusionsSince the analysis of preliminary findings, it emerges how the impact of this crisis is and will not be the same to all, but will emphasize inequalities, at the expense of the most vulnerable individuals, at any age.Key messages In Italy, the COVID-19 pandemic has affected the main social determinants of people health because it has worsened economic and working conditions.This crisis is emphasizing health inequalities, at the expense of the most vulnerable individuals, at any age.

IBD Disability Index Is Associated With Both Direct and Indirect Costs of Inflammatory Bowel Disease.

We aimed to determine both direct (medical) and indirect (lost wages) costs of IBD and the association between the degree of IBD-related disability and extent of IBD-related costs. Persons age 18-65 from the population-based University of Manitoba IBD Research Registry completed a survey including the IBD Disability Index (IBDDI) and questions related to employment, missed work (absenteeism), and reduced productivity at work (presenteeism). Administrative health data including surgeries, hospitalizations, physician claims, and prescriptions were linked to the survey and assessed. To calculate annual wage loss, number of days of missed work was multiplied by the average wage in Manitoba for the given occupation per Statistics Canada. Costs were adjusted to 2016-17 Canadian dollars. Using descriptive and regression analysis, we explored the association between IBDDI and annual direct and indirect costs associated with IBD. Average annual medical costs rose from $1918 among those with IBDDI 0-4 to $9,993 among those with IBDDI 80-86. Average annual cost of lost work rose from $0 among those with IBDDI 0-4 to $30,101 among those with IBDDI 80-86. Using linear regression, each additional unit of IBDDI was associated with an increase of $77 in annual medical cost (95% CI, $52-102; P < .001) and an increase of $341 in annual cost of lost wages (95% CI, $288-395; P < .001). Costs related to IBD are significantly associated with the degree of IBD-related disability. Among the approximate 30% of the IBD population with IBDDI scores ≥40, the indirect costs of absenteeism and presenteeism accounts for ~75% of the total IBD-related costs.

Costs and benefits of trade shocks: Evidence from Chilean local labor markets

We study Chile’s labor market responses to trade shocks during 1996–2006, exploiting spatial and time variations in trade exposure arising from initial differences in industry specialization across local labor markets and the evolution of shocks across industries. We take advantage of China’s supply and demand’s worldwide shocks to instrument for Chinese import competition and demand for Chilean exports. Our main finding is that increasing manufacturing import competition implied a significant rise in labor informality in more exposed local markets, especially among young and unskilled workers. These groups also suffered significant relative wage losses. Meanwhile, locations that benefited most from the increased demand for primary products experienced a relative increase in employment, particularly among young individuals, and reallocation from self-employment towards salaried jobs in the formal sector, along with relative wage gains among old-age workers. Interestingly, these areas experienced a smaller increase in tertiary education enrollment rates than less exposed areas.

Receptiveness and barriers to clinical trial participation for oncology patients from a public safety-net hospital.

83 Background: Oncologic clinical trial enrollment is low, particularly in underserved populations. Increasing enrollment of public safety-net hospital patients is important to ensure representation of the general population and reduces cancer outcome disparities. To tailor clinical trial outreach, we sought to characterize attitudes towards trial participation of oncology patients at Olive View—UCLA Medical Center (OVMC), a public safety-net hospital in Los Angeles County. Methods: We developed a 39-question survey (Qualtrics, Provo, UT). It was administered via tablets to a convenience sample of patients in OVMC’s medical oncology clinic and infusion center during 2020—2021. The survey was offered to patients fluent in English or Spanish. Results: Of 165 patients who were offered the survey, 11 declined due to illiteracy in any language, 4 did not finish the survey. Median age was 54 (range: 20-81); 63% were female. The majority (76%) reported an annual income below $25,000; 39% did not complete high school. Self-identified ethnicity was Hispanic/Latino (73%), non-Hispanic White (12%), Asian-Pacific Islander (9%), and Black (4%). Based on a 5-point Likert scale of comfort speaking English, 48% had English proficiency (EP). Overall, 69% of patients expressed interest in trials. When considering participation, patients would seek advice from their physician (86%), family (32%), other medical staff (14%), alternative medicine practitioner (7%), friend (6%), or religious leader (4%). Concerns regarding trial participation were lack of knowledge regarding trials (47%), fear of side effects (43%), frequent visits (25%), cost (20%), transportation (14%), wage loss (9%), and inability to determine own treatment (4%). Patients found the following modalities useful for learning about trials: website (43%), paper handout (39%), video (37%), discussion with prior participants (34%). Patients with annual income &gt; $25,000 were significantly more concerned about cost (33.3% v. 15.8%, p = 0.04) and treatment side effects (61.1% v. 36.8%, p = 0.02). EP patients were more likely to find a website (54.2% vs. 32.1%, p = 0.01) or discussion with prior participants (45.8% v. 23.1%, p &lt; 0.01) helpful compared to low EP patients. Conclusions: There is considerable interest in oncologic clinical trials in this predominantly Hispanic/Latino population. This population had significant trust in physicians for guidance on trial enrollment, and had minimal concern for out-of-pocket cost, wage loss, or transportation issues. The majority of patients did not find additional informational resources helpful. Structural barriers rather than patient-level variables are likely the primary drivers of low oncologic trial enrollment. Future efforts should focus on improving access to appropriate trials and leveraging the physician-patient relationship for increasing trial participation.

Improving Last-mile Delivery of COVID-19 Vaccines: The Cluster Strategy.

Vaccination against the COVID 19 virus is the most effective way to prevent infection and save lives. It is estimated that 285 million doses per month will be needed over the next five months to vaccinate all remaining adults by the end of 2021. To accelerate the vaccination coverage for its population, the state of Uttar Pradesh, North India, has planned a cluster approach to vaccination in rural areas. The cluster strategy is a micro-plan for vaccination by the government of U.P involving intensive mobilisation activities followed by vaccination at centres set up in schools, Panchayat Bhavans and other selected places. It is a people-centred and comprehensive approach, modelled on listening to the intended beneficiaries and stakeholders is vital. It will reduce expenses related to travel and loss of wages for those missing work while travelling far to get vaccinated. The cluster approach is also along the lines of the Near to Home COVID Vaccination Centres (NHCVC) for Elderly and Differently Abled Citizens. The main fear of the health workers regarding the cluster approach is concerning adverse events and their management at the peripheral level. This strategy is only practically possible if an adequate supply of vaccines is available. The cluster approach to vaccination ensures accessibility, includes community participation and is provided free of cost. This is thus in line with the concept of Primary Health Care (PHC) which is essential health care made universally accessible to individuals and families in the community by means acceptable to them, through their full participation and at a cost the community and country can afford. Popularising this strategy and applying it to other states in a tailored manner based on social and cultural practices can give the nation the necessary momentum to attain the target of herd immunity quickly and curb the COVID-19 pandemic.

Treatment Seeking Behavior, Treatment Cost and Quality of Life of Head and Neck Cancer Patients: A Cross-Sectional Analytical Study from South India.

Background:Head and neck cancer constitute one-third of all cancers. Due to the complex nature of Head and Neck Cancer treatment, expenditure on cancer treatment are higher and the Quality of Life of patients is also compromised. The objectives of the study were to determine the time taken by patients for seeking care from registered medical practitioners, time to definitive diagnosis and treatment initiation, expenditure incurred, and Quality of Life. Methods: The present study was a cross-sectional descriptive involving outpatient with head and neck cancer reported to the department of radiotherapy, regional cancer center, JIPMER. The quality of life was assessed using validated FACT-H and N scales. Results:The preferred first contact for seeking care for most was the private sector (52%). The median (IQR) presentation interval, diagnostic interval, and treatment initiation interval were 36.5 (16 - 65.7), 14 (7 - 31.5), and 65.5 (45 - 104) days respectively. The average indirect cost incurred was INR 8424 (4095-16570) in JIPMER, which was spent over an average duration of 240 days. The median (IQR) wage loss by the patients and/or caregivers was INR18000 (5250-61575). The source of expenditure was mainly from their family savings (56%). Functional well-being was severely impaired. The patients with occupation, head of the family, and early stage of cancer had a statistically significant quality of life. Conclusion:The majority of the patients were diagnosed in the regional cancer center, JIPMER although their preferred first point of contact was private practitioners. The average time interval from diagnosis to treatment initiation was more than two months. The expenditure during the treatment was mainly because of indirect cost and wage loss. The functional quality of life was severely impaired for the majority of the cases.

Explaining Wage Losses After Job Displacement: Employer Size and Lost Firm Wage Premiums

AbstractThis paper investigates whether wage losses after job displacement are driven by lost firm wage premiums or worker productivity depreciations. We estimate losses in wages and firm wage premiums, the latter being measured as firm effects from a two-way fixed-effects wage decomposition. Using new German administrative data on displacements from small and large employers, we find that wage losses are to a large extent explained by losses in firm wage premiums and that premium losses are largely permanent. We show that losses strongly increase with pre-displacement employer size. This provides an explanation for large and persistent wage losses reported in previous displacement studies typically focusing on large employers, only.

Monetizing the Burden of Childhood Asthma Due to Traffic Related Air Pollution in the Contiguous United States in 2010.

Background: Traffic-related air pollution (TRAP) refers to the wide range of air pollutants emitted by traffic that are dispersed into the ambient air. Emerging evidence shows that TRAP can increase asthma incidence in children. Living with asthma can carry a huge financial burden for individuals and families due to direct and indirect medical expenses, which can include costs of hospitalization, medical visits, medication, missed school days, and loss of wages from missed workdays for caregivers. Objective: The objective of this paper is to estimate the economic impact of childhood asthma incident cases attributable to nitrogen dioxide (NO2), a common traffic-related air pollutant in urban areas, in the United States at the state level. Methods: We calculate the direct and indirect costs of childhood asthma incident cases attributable to NO2 using previously published burden of disease estimates and per person asthma cost estimates. By multiplying the per person indirect and direct costs for each state with the NO2-attributable asthma incident cases in each state, we were able to estimate the total cost of childhood asthma cases attributable to NO2 in the United States. Results: The cost calculation estimates the total direct and indirect annual cost of childhood asthma cases attributable to NO2 in the year 2010 to be $178,900,138.989 (95% CI: $101,019,728.20–$256,980,126.65). The state with the highest cost burden is California with $24,501,859.84 (95% CI: $10,020,182.62–$38,982,261.250), and the state with the lowest cost burden is Montana with $88,880.12 (95% CI: $33,491.06–$144,269.18). Conclusion: This study estimates the annual costs of childhood asthma incident cases attributable to NO2 and demonstrates the importance of conducting economic impacts studies of TRAP. It is important for policy-making institutions to focus on this problem by advocating and supporting more studies on TRAP’s impact on the national economy and health, including these economic impact estimates in the decision-making process, and devising mitigation strategies to reduce TRAP and the population’s exposure.

Indirect costs associated with out-of-country referral for proton therapy: a survey of adult and pediatric patients in Alberta, Canada

BackgroundPatients in Alberta, Canada are referred to the United States (US) for proton treatment. The Alberta Ministry of Health pays for the proton treatment and the cost of flights to and from the United States. This study aimed to determine the out-of-pocket expenses incurred by patients or patients’ families.MethodsAn electronic survey was sent to 59 patients treated with proton therapy between January 2008 and September 2019. Survey questions asked about expenses related to travel to the US and those incurred while staying in the US, reimbursement of expenses, and whether any time away from work was paid or unpaid leave.ResultsSeventeen respondents (response rate, 29%) reported expenses of flights for family members (mean, CAD 1886; range CAD 0–5627), passports/visas and other travel costs (mean, CAD 124; range CAD 0–546), accommodation during travel to the US (mean, CAD 50; range CAD 0–563), food during travel to the US (mean, CAD 89; range CAD 0–338), accommodation in the US (rented home/apartment mean, CAD 7394; range CAD 3075-13,305; hotel mean, CAD 4730; range CAD 3564-5895; other accommodation mean CAD 2660; range CAD 0–13,842), transportation in the US (car mean, CAD 2760; range CAD 0–7649; bus/subway mean, CAD 413; range CAD 246–580), and food in the US (mean, CAD 2443; range 0–6921). Expenses were partially reimbursed or covered by not-for-profit organizations or government agencies for some patients (35%). Patients missed a mean of 59 days of work; accompanying family members missed an average of 34 days. For 29% this time away from work was paid, but unpaid for 71% of respondents.ConclusionsMultiple factors contributed to the expenses incurred including age of the patient, number of accompanying individuals, available accommodation, mode of transportation within the US, and whether the patient qualified for financial support. Added to this burden is the potential loss of wages for time away from work. The study showed a large variation in indirect costs for each family and supports actively seeking more opportunities for financial support for families with children with cancer.

Shocking gift exchange

We study how a gift exchange labor market reacts to the occurrence of negative shocks. One-round shocks may hit either workers’ wages or employers’ earnings (via worker productivity). In our model, other-regarding preferences suffice to predict gift exchange and wages above the competitive level. Wage rigidity is predicted if we add wage illusion and loss aversion. Using a real-effort laboratory experiment, we find support for the model. When there are no shocks, there is gift exchange. After a wage shock we see strong nominal wage rigidity and no impact on workers’ effort, as predicted. Rigidity is also observed after a productivity shock, but here we do observe increases in effort, especially at low wages. The latter is contrary to the model predictions and suggests that productivity shocks alter gift-exchange patterns. We conclude that the wage rigidity often observed in the field can be explained by boundedly rational workers with social preferences.

Prevalence of Healthcare-Associated Infections at the National Hospital During the COVID-19 Pandemic in Peru

Background: Healthcare-associated infections are important because they constitute a public health problem due to the increase in morbidity and mortality that they produce in hospitalized patients, increased hospitalization costs due to prolonged stay, expensive antibiotic treatments and surgical reinterventions, not counting the social costs due to loss of wages and production, among others. Methods: We report the specific prevalence of healthcare-associated infections (HCAIs) in Edgardo Rebagliati Martin National Hospital, Perú, in 2020. We performed a descriptive cross-sectional study from July 27 to July 31, 2020. The medical records of hospitalized patients were reviewed according to the inclusion criteria. STATA software was used for descriptive statistical analyses. Results: In total, 1,217 hospitalized patients were included in the study. The prevalence of HCAI was 12.2% (149 patients). The prevalence of HCAI in areas where patients with the diagnosis of COVID-19 were hospitalized was higher (8.1%) than in common hospitalization areas (4.1%). Men represented 92% of the total number of patients with HCAIs. The most frequent infections were clinically defined pneumonia (30.9%) and bloodstream infections (20.1%). The most frequently isolated microorganism was Pseudomonas aeruginosa. Conclusions: The prevalence of HCAI was 12.2%. The most frequent HCAIs were pneumonia and bloodstream infection.Funding: NoDisclosures: None

Estimation of the monetary burden of treated human cystic echinococcosis in Pakistan

Cystic echinococcosis (CE), caused by the larval stage of Echinococcus granulosus sensu lato tapeworms, continues to be a public health problem in many endemic countries, including Pakistan. Patient level data, including age, sex, and cyst(s) location for surgically managed CE patients for the years 2013-2016 from hospitals located in Punjab and Khyber Pakhtunkhwa provinces were obtained from medical charts. Direct and indirect costs associated with surgically managed CE patients treated in private and public hospitals were then estimated and applied to country-level case numbers estimated through the Global Burden of Disease Study. A total cost of US$4,068,666 (95% CI: US$3,097,684 – US$5,295,702) was estimated for the year 2017, with US$3,951,853 (95% CI: US$2,981,400 – US$5,177,610) attributable to direct diagnosis and treatment-related costs and US$117,137 (95% CI: US$91,841 – US$146, 979) attributable to wage losses during the treatment period. Mean direct cost per patient (US$1,056) was approximately 72% of the country's per capita gross domestic product (GDP). Surgical management continues to be the treatment of choice for CE patients in Pakistan. If physicians were to adhere to World Health Organization Informal Working Group on Echinococcosis (WHO-IWGE) cyst stage-specific treatment guidelines, it is likely that the number of surgical interventions would decrease as would treatment costs.

Absenteeism-Related Wage Loss Associated With Multimorbidity Among Employed Adults in the United States.

To estimate the incremental absenteeism-related wage loss associated with multimorbidity and examine the influence of paid sick leave policy (PSLP) on multimorbidity-associated absenteeism wage loss. We used the Medical Expenditure Panel Survey (MEPS) 2015 data. Two-part generalized linear models (GLM) were employed, using binomial distribution and gamma distribution with a log link. Nationally, multimorbidity was associated with a $9 billion incremental absenteeism-related wage loss annually among working adults. Absenteeism-related wage loss was higher among those with multimorbidity than those without multimorbidity. The incremental annual absenteeism-related wage loss associated with multimorbidity was lower in settings that offered paid sick leave than that did not offer paid sick leaves. Multimorbidity is associated with higher absenteeism-related wage loss. Paid sick leave policies can reduce the impact of multimorbidity on absenteeism-related wage loss.

Domestic violence and COVID-19: the twin pandemic

Background: The aim of the study was to evaluate why women inhabitants of the urban slums in Mumbai, Maharashtra are apprehensive and non-supportive of a second lock down.Methods: Our questionnaire-based study (October 2020 to February 2021) demonstrated that fewer women supported a re-lockdown. Individual, unstructured, non-directive interviews were carried out to ascertain why women of the urban slum were opposed to lockdown. Median and range were calculated for continuous variables, while categorical variables were represented as frequency and percentages. P value &lt;0.05 was statistically significant.Results: 189 women (53 who were opposed to the lockdown, and 136 who responded with “I don’t know” to the question “If COVID-19 cases rise authorities should lockdown the city”, who had previously agreed to be part of the questionnaire-based survey, were approached for an interview. A total of 68 women agreed to talk to our researchers. Of these, 47 were opposed to the lockdown, and 21 had responded with a “I don’t know”. Forty three out of 47 (91.5%), and 13 out of 21 women (61.9) revealed that the main reason for their opposition to the lockdown was domestic and intimate partner violence. The others cited the loss of wages as their primary reason (4 women, 8.5% and 8 women, 38.1%, respectively).Conclusions: While lockdowns have been shown to help control the pandemic, authorities in charge of health policy must remember the consequences of domestic violence on the physical and emotional health of women, and their children, when planning the next lockdown.

Clinical and economic impact of telemedicine in the management of pediatric asthma in Jordan: a pharmacist-led intervention

Objective Pediatric asthma is a major public health concern, considering its chronic nature and negative effects on quality of life of affected children. Telemedicine is efficacious in providing pharmaceutical care for patients with several chronic diseases, including asthma. This approach allows habitants of sparsely populated rural Jordanian areas to remotely access high-quality healthcare services. Pharmacist-provided asthma counseling has proven benefits in improving patient adherence rates and their understanding. This study evaluated clinical and economic impacts of pharmacist-led, interactive synchronous telemedicine counseling of pediatric asthma patients in Jordan. Methods A randomized, controlled, 12-week pre-post interventional study was conducted. Ninety patients with uncontrolled asthma aged 5–11 years were recruited and randomly assigned to two groups: intervention or control. Inhaler use was checked for both groups at baseline, along with assessment of clinical and economic measures. Counseling on proper inhaler use was provided by pharmacists. Telemedicine sessions for the intervention group were scheduled every 4 weeks, whereas the control group received standard care. Pertinent measures reflecting the level of disease control and relapse were tracked monthly. Results The intervention group showed more significant improvement in clinical and economic outcomes than the control group (the Childhood Asthma Control Test mean scores [P = 0.0134], decreased parental loss of wages [P = 0.0015], and decreased economic burden [P < 0.001]). Additionally, overall improvement in quality of life and satisfaction with the telemedicine sessions were reported. Conclusion Pharmacist-led telemedicine counseling could be a promising approach to deliver distant pharmaceutical care for patients with childhood asthma.

Rural China under the COVID‐19 pandemic: Differentiated impacts, rural–urban inequality and agro‐industrialization

AbstractWe use field data collected in a village in northern China to examine the impacts of the COVID‐19 pandemic on rural economy and livelihoods. The lockdown effectively protected the village from the pandemic, resulting in zero infection. The economic impacts were mostly negative but differentiated across economic sectors and livelihood strategies; some gained from the business opportunities arising from the pandemic. Wage loss for migrant workers was the most common negative impact but lasted less than 2 months. Overall, rural China has escaped the worst impacts of the pandemic found in other developing countries. We argue that the structure of inequalities in today's China, now primarily based on market differentiations, has become far more complex than the simplistic rural–urban dichotomy based on the household registration (hukou) status can possibly explain. Rather than exacerbating the hukou‐based rural–urban inequality, the true impacts of the pandemic on rural China are more likely to result from the reforms of the agri‐food system. The suspected link between the new pathogen and the food system has created a misinformed urgency for the government to accelerate the industrialization of the food system, which we think can backfire and increase the likelihood of the next outbreak.