Value Of Risk Reduction Research Articles

The economic burden of obesity in 2024: a cost analysis using the value of a statistical life

ABSTRACT In 2024, the economic burden of obesity remains a paramount global concern due to its escalating prevalence, which imposes substantial pressures on healthcare systems, hampers productivity, and detracts from the quality of life. This paper explores the evolving obesity epidemic and its economic ramifications, emphasizing the necessity of precise measurement techniques to inform policy development and resource allocation. The study adopts the Value of a Statistical Life (VSL) methodology, which provides an innovative approach to quantifying the monetary value of mortality risk reductions associated with obesity-related health conditions. This approach surpasses traditional cost analyses that focus on direct medical expenses by incorporating a willingness-to-pay metric, reflecting societal preferences for risk mitigation. Our findings present a comprehensive cost analysis for the year 2024, utilizing both total deaths and Disability-Adjusted Life Years (DALYs) within the VSL framework, highlighting the importance of such an approach in understanding the full economic impact of obesity on a global scale.

Impact of vaccination on COVID-19 severity during the second wave in Brunei Darussalam, 2021.

Coronavirus disease (COVID-19) vaccinations have been shown to prevent infection with efficacies ranging from 50% to 95%. This study assesses the impact of vaccination on the clinical severity of COVID-19 during the second wave in Brunei Darussalam in 2021, which was due to the Delta variant. Patients included in this study were randomly selected from those who were admitted with COVID-19 to the National Isolation Centre between 7 August and 6 October 2021. Cases were categorized as asymptomatic, mild (symptomatic without pneumonia), moderate (pneumonia), severe (needing supplemental oxygen therapy) or critical (needing mechanical ventilation) but for statistical analysis purposes were dichotomized into asymptomatic/mild or moderate/severe/critical cases. Univariate and multivariable analyses were conducted to identify risk factors associated with moderate/severe/critical disease. Propensity score-matched analysis was also performed to evaluate the impact of vaccination on disease severity. The study cohort of 788 cases (mean age: 42.1±14.6years; 400 males) comprised 471 (59.8%) asymptomatic/mild and 317 (40.2%) moderate/severe/critical cases. Multivariable logistic regression analysis showed older age group (≥45 years), diabetes mellitus, overweight/obesity and vaccination status to be associated with increased severity of disease. In propensity score-matched analysis, the relative risk of developing moderate/severe/critical COVID-19 for fully vaccinated (two doses) and partially vaccinated (one dose) cases was 0.33 (95% confidence interval [CI]: 0.16-0.69) and 0.62 (95% CI: 0.46-0.82), respectively, compared with a control group of non-vaccinated cases. The corresponding relative risk reduction (RRR) values were 66.5% and 38.4%, respectively. Vaccination was also protective against moderate/severe/critical disease in a subgroup of overweight/obese patients (RRR: 37.2%, P=0.007). Among those who contracted COVID-19, older age, having diabetes, being overweight/obese and being unvaccinated were significant risk factors for moderate/severe/critical disease. Vaccination, even partial, was protective against moderate/severe/critical disease.

Calculating the economic value of non-marginal mortality risk reductions

Benefit–cost analyses in public health typically calculate the benefits of mortality reduction interventions by multiplying the Value of a Statistical Life (VSL) and the expected decrease in fatalities. This procedure approximates the benefits of small mortality changes but is inaccurate for large risk changes because it holds constant the VSL—a marginal rate of substitution. Building on the theoretical framework of the VSL, we derive expressions to calculate the benefits of non-marginal mortality reductions with empirically calibrated compensating variations and illustrate their use.

Physical distancing versus testing with self-isolation for controlling an emerging epidemic

Two distinct strategies for controlling an emerging epidemic are physical distancing and regular testing with self-isolation. These strategies are especially important before effective vaccines or treatments become widely available. The testing strategy has been promoted frequently but used less often than physical distancing to mitigate COVID-19. We compared the performance of these strategies in an integrated epidemiological and economic model that includes a simple representation of transmission by “superspreading,” wherein a relatively small fraction of infected individuals cause a large share of infections. We examined the economic benefits of distancing and testing over a wide range of conditions, including variations in the transmissibility and lethality of the disease meant to encompass the most prominent variants of COVID-19 encountered so far. In a head-to-head comparison using our primary parameter values, both with and without superspreading and a declining marginal value of mortality risk reductions, an optimized testing strategy outperformed an optimized distancing strategy. In a Monte Carlo uncertainty analysis, an optimized policy that combined the two strategies performed better than either one alone in more than 25% of random parameter draws. Insofar as diagnostic tests are sensitive to viral loads, and individuals with high viral loads are more likely to contribute to superspreading events, superspreading enhances the relative performance of testing over distancing in our model. Both strategies performed best at moderate levels of transmissibility, somewhat lower than the transmissibility of the ancestral strain of SARS-CoV-2.

Response to Letter to the Editor from Modarressi and Derakhshan: "Effects of Coenzyme Q10 Supplementation on Lipid Profiles in Adults: A Meta-analysis of Randomized Controlled Trials".

To the Editor, We thank Dr. Modarressi and Dr. Derakhshan (1) for their interest in our recent publication (2). We appreciate their suggestion and respond to their letter here. In our article, we primarily found the beneficial effects of coenzyme Q10 (CoQ10) supplementation on lipid profiles. The main concern of Dr. Modarressi and Dr. Derakhshan was the potential effect of CoQ10 supplementation on cardiovascular diseases (CVDs) by reducing low-density lipoprotein cholesterol (LDL-C). In the Discussion section, we combined the relative risk reduction value obtained by the 2005 Cholesterol Treatment Trialists’ Collaboration data (3) with our results to explore the potential effect of CoQ10 supplementation on coronary mortality by reducing LDL-C. As Dr. Modarressi and Dr. Derakhshan mentioned, the relative risk reduction may be relatively low, but we believe that any significant effect of the nutritional supplements, such as CoQ10, should not be ignored at a population level because it could be used as daily supplement with minor side effects (4) compared with some drugs.

Edukasi Bencana Melalui Syair Didong Uten Karya Ceh Sali Gobal dalam Pengurangan Risiko Bencana di Kecamatan Kebayakan Kabupaten Aceh Tengah

Central Aceh district is an area that has a high risk index for landslides. Besides that, Central Aceh is also rich in local wisdom, one of which is didong which has many poems.This study aims to investigate the messages of local wisdom about disaster risk reduction in didong uten poetry and obtain an integration model of didong uten poetry in learning that can be accepted by teachers and students at high school. The research model used is the Etnografi research model by Spradley which broadly consists of five stages, namely: First, a) have an ethnographic project, b) ask an ethnographic question, c) collect ethnographic data, d) make ethnographic notes, e) analyzing ethnographic data. This study has validated media experts in the form of didong uten poetry and obtained an average score of 97.3% with the criteria "very feasible", material expert validation in the form of disaster education and disaster risk reduction obtained an average score of 66.6% with the "feasible". Based on the results of the implementation of the instrument, the final score on disaster education (knowledge) is 62.65, the value of disaster education (attitude) is 77.68, the final value of didong uten poetry is 53.98, and the final value of disaster risk reduction is 68.7. conclusion after conducting ethnographic research interviews from 5 resource persons is that didong uten poetry can be integrated into school subjects such as geography, sociology, Indonesian language, besides that didong uten poetry can also be extracurricular at school

Abstract A032: Probabilistic statistical-based model for determining individual cancer risk for making personal recommendations to prevent cancer

Abstract About 42% of cancer cases in the US are linked to modifiable risk factors, and thus could be preventable, says a study from American Cancer Society [1]. This proportion can be represented as the percentage by which an individual's possibility of developing cancer can be reduced. Having data on the prevalence of various types of cancer, it is possible to rank risk factors, and give an individual a personalized list of recommendations sorted by importance in terms of preventing cancer. For most commonly cancers, a set of modifiable risk factors is known: for example, for colon cancer these are the following: excess body weight, physical inactivity, smoking, high consumption of red or processed meat, alcohol intake, low intake of calcium, fruits and vegetables and whole-grain fiber, and the proportion of cases arising from modifiable factors is 54.6% [1]. Since we consider this number to be the percentage by which the risk of disease in an individual can be reduced, in the absence of modifiable factors, the likelihood of this cancer in a person will decrease by 54.6%, respectively. The contribution of each of the factors separately is also known: so, for colon cancer, physical inactivity causes 16.3% cases, alcohol intake – 12.8%, etc. Let’s reduce risks in proportion to each other so that their sum is equal to 54.6%. The total degree of fulfillment of risk factors will be the mathematical expectation of all individual risks, that is the sum of the products of the impact of each risk by its degree of presence. To determine the absolute risk and rank the risks in order of priority of occurrence for person, we take statistics on the probability of developing cancer [2]. So, for the colon cancer the probability of disease for men in the interval birth-49yrs is 0.4%. According to our assumption, this value can be reduced by a maximum of 54.6% provided that all risk factors are excluded. Let’s take a situation when a person has 50% modifiable risk factors. Then the absolute (posterior) risk of disease occurrence, provided that risk factors are reduced, will be calculated with Bayes' theorem, where the numerator will be the product of the a priori disease probability (0.4%) by the disease probability provided that all risk factors are excluded (100%-54.6 %=45.4%), and the denominator will be the total probability of the disease: 100% minus the product of risk reduction value (54.6%) multiplied by the degree of its presence (for us 50%). It will be equal to 0.25%. It's easy to check the correctness of the formula by substituting boundary values: for example, for the degree of presence of risks equal to 100%, the calculated absolute risk will not change and will be 0.4%, whereas in the absence of all risk factors the absolute risk will decrease by 54.6% and will be 0.18%.

A Case for Adoption of Industry-Wide Application of Solar Disinfection of Packaged Drinking Water Before Distribution in Nigeria

The study makes a case for adoption of an industry-wide application of solar disinfection (SODIS) in the disinfection of packaged water at the production stage. To do this, 60 samples, comprising 12 brands of bottled water and 18 brands of sachet-packaged water were randomly purchased from street vendors in Nsukka, Enugu State, Nigeria and investigated. One sample was hidden from sunlight while the other sample was exposed to a day of sunlight before the two samples were subjected to microbial analysis for the determination of total coliform (TC) using the method of multiple-tube fermentation technique (MPN). Results show that 63% of packaged water vended in Nsukka is not fit for consumption. The risk of contamination is about 44% higher in sachet water when compared with bottled water (relative risk = 1.44). Exposing packaged water to a day of sunlight reduces the risk of consuming contaminated water by about 97% (relative risk reduction value = 0.97). Advocacy of industry-wide application of SODIS may hold the key to ending widespread contamination of packaged water and the resulting life-threatening illnesses that have decimated the population of developing countries.

Modelling the effects of antimicrobial metaphylaxis and pen size on bovine respiratory disease in high and low risk fattening cattle

Bovine respiratory disease (BRD) dramatically affects young calves, especially in fattening facilities, and is difficult to understand, anticipate and control due to the multiplicity of factors involved in the onset and impact of this disease. In this study we aimed to compare the impact of farming practices on BRD severity and on antimicrobial usage. We designed a stochastic individual-based mechanistic BRD model which incorporates not only the infectious process, but also clinical signs, detection methods and treatment protocols. We investigated twelve contrasted scenarios which reflect farming practices in various fattening systems, based on pen sizes, risk level, and individual treatment vs. collective treatment (metaphylaxis) before or during fattening. We calibrated model parameters from existing observation data or literature and compared scenario outputs regarding disease dynamics, severity and mortality. The comparison of the trade-off between cumulative BRD duration and number of antimicrobial doses highlighted the added value of risk reduction at pen formation even in small pens, and acknowledges the interest of collective treatments for high-risk pens, with a better efficacy of treatments triggered during fattening based on the number of detected cases.

The Value of Risk Reduction for Mixed Risk Seekers/Averters Under Increasing Severity of Loss

The Value of Risk Reduction for Mixed Risk Seekers/Averters Under Increasing Severity of Loss

Pure altruism and misjudgement: A bad combination?

Stated preference studies on the value of health risk reductions have found valuations elicited from a private perspective to be both higher and lower compared to valuations elicited from a public perspective. Although relevant, the individual's ability to correctly predict the valuation that other individuals assign to the risk reduction has been insufficiently researched. We aim to verify whether individuals exhibit pure altruistic preferences and if this is the case, whether the presence of pure altruism leads to biased valuation of public risk reductions due to misjudgement about other individuals' preferences. We conduct a large-scale online incentivised experiment as a variant of a public good game in which the individual's final endowment is determined by choices made in the experiment. Results suggest that individuals act as pure altruists and hence try to account for the benefits obtained by others of being insured. The results also suggest that individuals fail to correctly predict other individuals' benefits from the insurance, which leads to non-optimal outcomes and biased valuations.

Risk of Micronutrient Inadequacy among Hispanic, Lactating Mothers: Preliminary Evidence from the Southern California Mother's Milk Study.

Micronutrients are dietary components important for health and physiological function, and inadequate intake of these nutrients can contribute to poor health outcomes. The risk of inadequate micronutrient intake has been shown to be greater among low-income Hispanics and postpartum and lactating women. Therefore, we aimed to determine the risk of nutrient inadequacies based on preliminary evidence among postpartum, Hispanic women. Risk of micronutrient inadequacy for Hispanic women (29–45 years of age) from the Southern California Mother’s Milk Study (n = 188) was assessed using 24 h dietary recalls at 1 and 6 months postpartum and the estimated average requirement (EAR) fixed cut-point approach. Women were considered at risk of inadequate intake for a nutrient if more than 50% of women were consuming below the EAR. The Chronic Disease Risk Reduction (CDRR) value was also used to assess sodium intake. These women were at risk of inadequate intake for folate and vitamins A, D, and E, with 87.0%, 93.4%, 43.8%, and 95% of women consuming less than the EAR for these nutrients, respectively. Lastly, 71.7% of women consumed excess sodium. Results from this preliminary analysis indicate that Hispanic women are at risk of inadequate intake of important micronutrients for maternal and child health.

Fair innings? The utilitarian and prioritarian value of risk reduction over a whole lifetime

The social value of risk reduction (SVRR) is the marginal social value of reducing an individual’s fatality risk, as measured by some social welfare function (SWF). This Article investigates SVRR, using a lifetime utility model in which individuals are differentiated by age, lifetime income profile, and lifetime risk profile. We consider both the utilitarian SWF and a “prioritarian” SWF, which applies a strictly increasing and strictly concave transformation to individual utility.We show that the prioritarian SVRR provides a rigorous basis in economic theory for the “fair innings” concept, proposed in the public health literature: as between an older individual and a similarly situated younger individual (one with the same income and risk profile), a risk reduction for the younger individual is accorded greater social weight even if the gains to expected lifetime utility are equal. The comparative statics of prioritarian and utilitarian SVRRs with respect to age, and to (past, present, and future) income and baseline survival probability, are significantly different from the conventional value per statistical life (VSL). Our empirical simulation based upon the U.S. population survival curve and income distribution shows that prioritarian SVRRs with a moderate degree of concavity in the transformation function conform to widely held views regarding lifesaving policies: the young should take priority but income should make no difference.

Evaluating Vaccination Programs That Prevent Diseases With Potentially Catastrophic Health Outcomes: How Can We Capture the Value of Risk Reduction?

In the last 5 years, guidelines have been developed for performing cost-effectiveness analyses (CEAs) for the economic evaluation of vaccination programs against infectious diseases. However, these cost-effectiveness guidelines do not provide specific guidance for including the value of reducing the risk of rare but potentially catastrophic health outcomes, such as mortality or long-term sequelae. Alternative economic evaluation methods, including extended CEA, the impact inventory, cost-benefit analyses, willingness to pay or the value of a statistical life, to capture the value of this risk reduction could provide more complete estimates of the value of vaccination programs for diseases with potentially catastrophic health and nonhealth outcomes. In this commentary, using invasive meningococcal disease as an example, we describe these alternative approaches along with examples to illustrate how the benefits of vaccination in reducing risk of catastrophic health outcomes can be valued. These benefits are not usually captured in CEAs that only include population benefits estimated as the quality-adjusted life-years gained and reduced costs from avoided cases.

Prioritization of non-revenue water reduction scenarios using a risk-based group decision-making approach

This study investigates the effectiveness of the reduction policies of the apparent and real losses of non-revenue water. For this purpose, using technique for order of preference by similarity to ideal solution (TOPSIS) model, a decision matrix is proposed, involving apparent and real losses risk reduction values induced by the implementation of each non-revenue water reduction policy. First, decision criteria, including technical, economic, and social criteria, were selected and introduced. Then, the technical criterion was calculated using a fuzzy Bayesian model. In the following, using group decision-making and analytic hierarchy process method, the criteria were weighted. In the next step, the bests of decision criteria were determined by the TOPSIS method. This method was applied in the water distribution network of district 4 of Tehran, Iran. The results indicated that the most basic non-revenue water reduction policy by risk-based group decision-making is to identify unauthorized connections in the apparent water loss sector and increase the speed and quality of maintenance and repairs in the real water loss sector.

Risk Management in Work Activities at Ammonia Plant Fertilizer Production Industry

Introduction: PT X is one of the companies in fertilizer production industry. There are two high-risk activities that endanger the safety and health of workers, namely supervision of welding and oil level checking in ammonia plant field of PT X. The purpose of this research was to apply risk management to the activities. Method: This research was a descriptive study which was carried out in observation using a cross sectional design. Variables in this study included hazard identification, basic risk analysis, risk control that has been done, existing risk analysis, and risk reduction assessment. The tools used for the data collection were observation sheets, interview guide sheets, and Job Safety Analysis sheets. Data that has been obtained through observation and interviews was processed using Fine (1971) semi quantitative technique. Results: The results of hazard identification were known to have as many as 6 potential hazards. The assessment results in the basic risk analysis showed that the initial risk level consisted of 3 risks with very high level, 2 risks with a substantial level and 1 risk with priority 3 level. After the risk control effort was applied, the results of the assessment in the existing risk analysis showed that the level of risk has decreased significantly. Conclusion: The value of risk reduction of each potential hazard results decreases by 95%, 88.89%, 85%, 93.33%, 66.67%, and 75%.Keywords: ammonia plant, fertilizer production industry, risk management

Prevalence and predictors of statin therapy in the general working-age population

Aim. To study the prevalence and predictors of statin therapy in the general working-age population.Materials and methods. As a part of the ESSE-RF study, we examined 1,600 people aged 25-64 years (women — 59%) from the general population. All subjects signed informed consent. Association analysis included blocks of socio-economic, psychosocial, behavioral, and medical variables. We used methods of univariate and multivariate statistics. Error probability < 5% was considered significant.Results. The prevalence of statin therapy in the general population was 3,3%: 5,5% in subjects ≥45 years, 8,1% in the group of 55-64 years old. We revealed that 2,5%, 2,9% and 10,9% of individuals with moderate, high and very high risk received statins, respectively. Among those receiving statins, 28,8% took it for primary prevention, 50% — due to cardiovascular diseases (CVD), and 21,2% — due to other disorders specifying risk. With priori indicators of very high risk, statins were taken more often than with SCORE ≥10 without risk indicators. According to multivariate model, older age, the presence of CVD + moderate and severe carotid atherosclerosis, antihypertensive therapy, stage 3 chronic kidney disease, and diabetes increased the likelihood of statin therapy, and SCORE ≥10 without risk indicators reduced it. The obtained data do not confirm the hypothesis about the significant role of sex, social gradient, and behavioral factors.Conclusion. Statins are one of the primary tools for primary and secondary prevention of CVD. Only a minor part of the population takes these drugs, in most cases due to CVD. Therefore, the prevention potential of statins at the population level has not yet been exhausted. More attention is required for individuals with SCORE ≥5 and without CVD who are less likely to receive therapy, but who may benefit more by taking statins. The decision to take statins for primary prevention of CVD should be based on the baseline risk, the value of absolute risk reduction, and how much this reduction justifies possible harm and long-term daily intake of the drug.

The Benefits and Costs of Flattening the Curve for COVID-19

We examine the net benefits of social distancing to slow the spread of COVID-19 in the United States. Social distancing saves lives but imposes large costs on society due to reduced economic activity. We use epidemiological and economic forecasting to perform a rapid benefit-cost analysis of controlling the COVID-19 outbreak. Assuming that social distancing measures can substantially reduce contacts among individuals, we find net benefits of about $5.2 trillion in our benchmark case. We examine the magnitude of the critical parameters that might imply negative net benefits, including the value of statistical life and the discount rate. A key unknown factor is the speed of economic recovery with and without social distancing measures in place. A series of robustness checks also highlight the key role of the value of mortality risk reductions and discounting in the analysis and point to a need for effective economic stimulus when the outbreak has passed.

The terrestrial example: Natural disasters as model for planetary defense planning

Imminent threats draw more attention and resources than the less immediate ones and defense against them is based on the assessment of prospective human and economic tolls. This appraisal allows the development of means for eliminating or reducing said tolls and insuring against the remaining risk. A newly recognized class of threats that has become more apparent in the last few decades are those posed by asteroids and comets. Impacts by sizable natural objects are exceedingly rare but are likely more catastrophic than most terrestrial threats. Lack of immediacy makes the parallel methodology to defend against such threats complex and reliant on developing technologies and untested techniques. Does this paradigm require a different discourse to facilitate an improved defense of increasingly integrated global economies and societies? Experience with common natural disasters and risks are examined to elucidate the question and point to options, while gradual development of technological solutions is appraised for its risk and damage reduction value. It is suggested that to defend against short-term warnings – less than a few years – a degree of readiness must be in place in advance of detection of a possible asteroid or comet impactor. Alternate methods of planetary defense technology that could broaden its value but require risk-informed appraisal, such as nuclear explosive devices, are also considered.

The Benefits and Costs of Using Social Distancing to Flatten the Curve for COVID-19

AbstractWe examine the net benefits of social distancing to slow the spread of COVID-19 in USA. Social distancing saves lives but imposes large costs on society due to reduced economic activity. We use epidemiological and economic forecasting to perform a rapid benefit–cost analysis of controlling the COVID-19 outbreak. Assuming that social distancing measures can substantially reduce contacts among individuals, we find net benefits of about $5.2 trillion in our benchmark case. We examine the magnitude of the critical parameters that might imply negative net benefits, including the value of statistical life and the discount rate. A key unknown factor is the speed of economic recovery with and without social distancing measures in place. A series of robustness checks also highlight the key role of the value of mortality risk reductions and discounting in the analysis and point to a need for effective economic stimulus when the outbreak has passed.