Health and Medicine

FSI’s researchers assess health and medicine through the lenses of economics, nutrition and politics. They’re studying and influencing public health policies of local and national governments and the roles that corporations and nongovernmental organizations play in providing health care around the world. Scholars look at how governance affects citizens’ health, how children’s health care access affects the aging process and how to improve children’s health in Guatemala and rural China. They want to know what it will take for people to cook more safely and breathe more easily in developing countries.

FSI professors investigate how lifestyles affect health. What good does gardening do for older Americans? What are the benefits of eating organic food or growing genetically modified rice in China? They study cost-effectiveness by examining programs like those aimed at preventing the spread of tuberculosis in Russian prisons. Policies that impact obesity and undernutrition are examined; as are the public health implications of limiting salt in processed foods and the role of smoking among men who work in Chinese factories. FSI health research looks at sweeping domestic policies like the Affordable Care Act and the role of foreign aid in affecting the price of HIV drugs in Africa.

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Junior high dropout rates are up to 25% in poor, rural areas of China. Although existing studies have examined how factors such as high tuition and opportunity costs contribute to dropout, fewer studies have explored the relationship between dropout rates and mental health in rural China. The overall goal of this study is to examine the relationship between dropout and mental health problems in rural Chinese junior high schools. Correlational analysis was conducted among 4,840 students across 38 junior high schools in rural China. Ordinary least squares (OLS) regressions were used to determine the types of students most at risk for mental health problems and whether mental health problems are correlated with dropout behavior. Our measure for mental health is based on the Children’s Manifest Anxiety Scale. Mental health problems are widespread in the sample of rural children, with 74% of students at risk for mental health problems. The student and family characteristics that correlate with dropout (poverty and low achievement) also correlate with mental health problems. More importantly, even after controlling for these background characteristics, mental health problems remain correlated with dropout rates. Mental health problems, especially among low-achieving poor students, may be contributing to the high dropout rates in rural China today. This finding suggests that interventions focusing on mental health in rural areas may also help reduce dropout.

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International Journal of Educational Development
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Huan Wang
James Chu
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"Growth has helped millions to avoid malnutrition but it still threatens to hold back a generation of rural Chinese."

A recent article in The Economist about malnutrition in rural China cites REAP's research on anemia.

“The propaganda message, scrawled in white paint on the side of a wood-frame house, could hardly be more blunt: ‘Cure stupidity, cure poverty’. The cure for both, in one of China’s poorest counties, seems to be a daily nutritional supplement for children. At a pre-school centre in Songjia, as in more than 600 other poor villages across China, children aged three to six gather to get the stuff with their lunch. If China is to narrow its urban-rural divide, thousands more villages will need to do this much, or more....

"'Babies are probably 50% malnourished' in poor rural areas, says Scott Rozelle, co-director of the Rural Education Action Programme (REAP), a research outfit at Stanford University which has done extensive tests on anaemia in rural China. 'But almost no mums are malnourished.' Mr Rozelle says that in one of his surveys rural mothers showed a better understanding of how to feed pigs than babies: 71% said pigs need micronutrients, whereas only 20% said babies need them."

Read more here.

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REAP's Gansu eyeglasses project was featured on CNN's Global Public Square, a program that invites international thinkers and leading journalists to discuss global issues .

When asked about his theory to "think small," Stephen Dubner, the co-author of "Think Like a Freak," said, "We write about these economists who wanted to help education like a lot of people do, and they were in China doing some research and they noticed something very small, which was that if you look at a class picture of these kids in Gang Su province in China, which is rural and poor generally, none of the kids were wearing glasses. And they thought well, that's either because they need them and they don't have them or there, you know, there's no myopia here. And so they did some tests and they found there was plenty of myopia, plenty of kids needed them, but they didn't have them.

"So, they thought let's run an experiment. Just take something as simple as providing free glasses. Half the kids they gave them to, the other half they left as a control group, they left them as is. And after one year, the kids who got the glasses were basically a full grade ahead. Does that solve the education problem? Of course not. But it's an example of how whoever is out there hearing this, whatever realm they're working on, if you peel off a small piece where you can actually get data, figure out what's going on, you can make some progress. I would rather have 100 smart people working on small versions of one big problem than 100 people shouting at each other about the big problem and getting nowhere."

Watch the full clip here.

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Empirical evidence suggests that the prevalence of soil-transmitted helminth (STH) infections in remote and poor rural areas is still high among children, the most vulnerable to infection. There is concern that STH infections may detrimentally affect children’s healthy development, including their cognitive ability, nutritional status, and school performance. Medical studies have not yet identified the exact nature of the impact STH infections have on children. The objective of this study is to examine the relationship between STH infections and developmental outcomes in 2,180 school-aged children in seven nationally-designated poverty counties in rural China. We conducted a large-scale survey in Guizhou province in southwest China in May, 2013. Overall, 42 percent of elementary school-aged children were infected with one or more of the three types of STH—Ascarislumbricoides (ascaris), Trichuris trichuria (whipworm) and the hookworms Ancylostoma duodenaleor Necator americanus. After controlling for socioeconomic status, we observed that children infected with one or more STHs have worse cognitive ability, worse nutritional status, and worse school performance than their uninfected peers.

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Alexis Medina
Scott Rozelle
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