Health Equity: 07/25/11

Monday, July 25, 2011

[EQ] Social determinants and the health of Indigenous Australians

Closing the Gap — Editorial

Social determinants and the health of Indigenous Australians

Michael Marmot - University College London, London, UK.

MJA 2011; 194 (10): 512-513 - The Medical Journal of Australia

……..Health is dependent on conditions that enable people to live lives they would choose to live……

Available online at: http://bit.ly/oezvV4

“……Inequalities in health arise from inequalities in society. Small differences in society result in small health inequalities; large differences result in large health inequalities.1 Differences in access to health care matter, as do differences in lifestyle, but the key determinants of social inequalities in health lie in the circumstances in which people are born, grow, live, work, and age.

These, in turn, arise from differential access to power and resources. Such was the conclusion of the World Health Organization Commission on Social Determinants of Health (CSDH).2 The CSDH had an optimistic tone. Reviewing evidence from around the world, and reaching judgements on what works, it concluded that it is indeed possible to make great progress in closing health gaps — in a generation.

The much-discussed 17-year gap in life expectancy between Indigenous and non-Indigenous Australians bespeaks large social inequalities.3 One can think of two classes of influence to which the remarkably poor health of Australian Aboriginals and Torres Strait Islanders can be ascribed. The first is social disadvantage and the second (common to other Indigenous groups) is the particular relationship of Indigenous Australians to mainstream society……”

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[EQ] Demand and Pricing of Preventative Healthcare

Demand and Pricing of Preventative Healthcare

Sotiris Vandoros1, Katherine Grace Carman2

1 LSE Health, London School of Economics, UK

2 Department of Economics, Center and Netspar, Tilburg University, the Netherlands

Working Paper No. 23/2011

LSE Health - The London School of Economics and Political Science, May 2011

Available online at: http://bit.ly/qkWP4K

“…….This study introduces a theoretical framework for the economics of preventative healthcare.

Mathematical models are used to explain how the price and utilization of prevention change depending on demand, as well as factors such as the price of a cure, the probability of illness, the efficacy of treatment, the probability of illness and cost functions.
Different models are developed depending on the presence and level of health insurance and competition in preventative healthcare markets.

Findings show the effect of various factors on the price of preventative healthcare, reveal the marginal effects of a change in the parameters on prices and suggest that under certain circumstances prevention is not the optimal choice….”

“…..This paper sets out a simple model to compare prices of preventative care across various regimes. In an environment of rising health costs, prevention is very important as it decreases the likelihood of need to cure illnesses in the future.

However, prevention is not always the best solution, as costs may be too high compared to cure and disutility of illness, taking into account the probability of illness, while depending on the source of demand and the level of insurance cover, quantities of prevention purchased and the number of people covered may differ significantly…..”

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[EQ] New approaches to rewarding pharmaceutical innovation

New approaches to rewarding pharmaceutical innovation

Paul Grootendorst, Aidan Hollis, David K. Levine, Thomas Pogge, Aled M. Edwards

2010 Canadian Medical Association CMAJ

Available online at: http://bit.ly/nR2jQd

“…..Many observers take it as self-evident that patents are necessary for pharmaceutical drug innovation. Modern research, however, has raised questions about the effectiveness of patents in spurring innovative activity in general, and drug innovation in particular.1–3 Mechanisms that may be more effective have been proposed, including “push” programs (public subsidies of biomedical research and clinical trials) and “pull” programs (impact-based and royalty-based rewards for new drugs).

It is unclear whether these proposed alternatives — either alone or in combination — would spur drug research and development or could be integrated into the current systems of drug safety and efficacy regulation, insurance, and patent treaties. In this article, we review the limitations of the drug patent system, describe some promising alternatives to patents and propose a program of research to evaluate these alternatives….”

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[EQ] Impact Investing: A Framework for Policy Design and Analysis

Impact Investing: A Framework for Policy Design and Analysis

The Initiative for Responsible Investment (IRI) at the Hauser Center for Nonprofit Organization
Harvard University - Supported by The Rockefeller Foundation 2011

Available online PDF [104p.] at http://bit.ly/q8HSCP

Investments that effectively deliver social benefit invoke a strong case for government support.

“…..This publication represents a framework for thinking about the role government policy can play in creating an enabling environment for impact investing. This framework is based on, and illustrated by, 16 individual policies in 13 countries

The report presents a framework for considering the role of policy in impact investing, including three practical references for readers:

· A model that illustrates the opportunities for policy intervention in impact investing.
The model places policies within the context of impact investing market ecosystems, and helps identify specific paths by which policies are intended to catalyze private capital.

· Six criteria with which to evaluate the role of policy and its potential effectiveness. The criteria have been developed using case studies, literature review, and outreach to impact investing practitioners and stakeholder groups. The criteria provide a practical starting point for designing and researching impact investing policy.

· Sixteen case studies serve as examples of concrete interventions that shape and support Impact investing markets. The case studies draw from a range of issue areas, investment vehicles, and policy mechanisms and help to illustrate the complexity of related issues—socioeconomic, political, bureaucratic, and structural—that influence the outcomes of policy….”

Content:

Executive Summary
II. About This Research

III. Introduction
IV. The Role of Government in Impact Investing
V. Locating Policy in Impact Investing Markets
VI. The Investor Perspective: Issue Areas of Impact
VII Criteria for Evaluation
Conclusion

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