“Political conditions and life expectancy in Europe, 1900-2008.” Summarized

European life expectancy has risen as an overall trend. Yet, the researchers involved with this study noticed that this process has happened on a country by country basis, and the rate at which life expectancy rose differed substantially. In order to identify the cause of this dissonance, the researchers hypothesized that the difference in life expectancy increases was related to political situations in Europe. The researchers narrowed the range of political situations to be studied to the creation and dissolution of states, large international alliances, and differences between political powers such as democratic vs. authoritarian non-communist and communist rule. Their method of research was based on the compilation of data from existing sources for the factors of life expectancy, cause-specific mortality and political conditions. Specifically, the relationship between political conditions and life expectancy were studied as a direct comparison. This was then organized into categories based on countries with different political conditions but similar starting levels of life expectancy. What the researchers found was that coming with or going away from the trend of rising life expectancy correlated to forming and dissolving different political powers. They also found that countries who were part of the Soviet Union had the largest divergence of life expectancy from the rest of Europe. Democratic state systems showed higher life expectancies than authoritarian states throughout the 1900’s. But, the difference in life expectancy for these government systems decreased between 1920 and 1960 due to improvement of infectious disease control in both respective systems. This gap increased after 1960 due to the quicker progress in democratic states against issues like heart disease, breast cancer, car accidents, etc. In effect, this study was able to determine that there was indeed a relationship between the political powers of Europe and the way in which life expectancy rose. These findings are important because they show some of the ways in which political systems have been successful in relation to the longevity of their people. Inversely, it shows the systematic failings that certain political states had for their people. This specific paper had an interesting premise, but there was so much information included in it that it seemed to drone on and become difficult to read. The information was complete though, and it gave a full explanation of many complex subjects like the political dynamics of different European countries.

Mackenbach, J. (2013). Political conditions and life expectancy in Europe, 1900-2008. Social Science & Medicine, 82, 134.

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“Unhealthy assimilation or persistent health advantage? A longitudinal analysis of immigrant health in the United States”

This study is based on the overall idea of how health compares for persons who were born in the United States to those who immigrated to the United States. This study was initiated based on the indications of existing evidence stating that immigrants have a health advantage over people who are native to the United States. The first task was to prove that immigrants really did have some kind of advantage as far as health. Expanding upon the assumption that the previous statement can be proven, the researchers believed that the initial health advantage that immigrants had decreased with time, and cross-sectional data did seem to suggest that this was true. To test the validity of this hypothesis, the researchers analyzed data collected from the Survey of Income and Program Participation. More specifically, four panels with information stemming from the years 1996, 2001, 2004, and 2008 was gathered and looked at; each panel held approximately 2-4 years of health data. What the researchers found was that the self rated health of immigrants was higher than the self rated health of those native to the United States. On top of this, it was found that the self rated health of immigrants remained steady over the time period studied while the self rated health for those born in the US went down in the same period of time. This result showed a distinct health advantage was indeed present. Further study showed that this was a pattern that remained true for immigrants who had lived here for different periods of time, and the pattern was more prominent for persons coming from Latin America or Asia. The researchers did disprove their original hypothesis, though. The health advantage that immigrants have does indeed remain after people assimilate. This study was limited though. It was based on self reported health surveys and therefore there may be some inaccuracies associated. This paper was formatted in a way that was understandable and complete. Of course some of the terminology that was used would be difficult to read for the average person. Also, most sections were concise in the way that information was presented, but the introduction was not. The introduction had some information that simply convoluted the beginning message and did not seem useful to the reader. Other than that, this paper was informative and interesting.

Lu, Denier, Wang, & Kaushal. (2017). Unhealthy assimilation or persistent health advantage? A longitudinal analysis of immigrant health in the United States. Social Science & Medicine, 195, 105-114.

“Successful deinstitutionalization of mental health care: increased life expectancy among people with mental disorders in Finland” Analysis

The overall goal of this study was to look at and assess what kind of impact deinstitutionalizing mental health care was having. The main purpose of this study was to determine if the change in mental health policy was a successful endeavor in having a positive affect on quality of life. The logical basis was in proving that the efforts to change the prescribed method of mental health treatment were either well worth it or to determine that they were ineffective and not worth it. And from this study, it could be determined the best form of treatment going forward. Other research has not determined the system level outcomes, or whether the implications of the mental health policy change is positive or negative. The hypothesis of this study is that there is in fact a difference in life quality outcomes from institutionalization versus a community integrated policy. The largest portion of data was taken from the Finnish Hospital Discharge Register kept by their National Institute for Health and Welfare between the years of 1981 and 2003. The Finnish Centre for Pensions provided secondary data from 1981-2003, and this is sourced from the National Pension Register. This study did exclude people treated for an organic mental disorder or for intellectual disability. In total there was data on 341,630 people that were 15 years of age or above. Information for death was derived from the Finnish Cause-of-Death Register from 1981–2003. This number came to be 91,445 people being dead before the 31st of December, 2003 in the study. The following groups were analyzed in order to study the population: mental and behavioral disorders due to psychoactive substance use; schizophrenia, schizotypal and delusional disorders; mood/affective disorder; and neurotic, stress-related and somatoform disorders. What this study found was that life expectancy was substantially shorter for people with serious mental disorder versus those in the general population. This study also found that life expectancy increased because of deinstitutionalization for people with schizophrenia and other psychotic disorders, mood disorders and neurotic disorders, but it did decrease for people with substance use disorders. Overall it was determined that deinstitutionalization and decentralization of mental health programs did not affect life expectancy negatively, but the policy changes for controlling alcohol and substance failed. This article was presented in a very concise, but also complete form. It was informative and interesting for the reader.

 

Westman, J., Gissler, M., & Wahlbeck, K. (2012). Successful deinstitutionalization of mental health care: Increased life expectancy among people with mental disorders in Finland. The European Journal of Public Health, 22(4), 604-606.

 

“Addressing childhood obesity at school entry: Qualitative experiences of school health professionals” Summarized

The main goal of this study was to look at the interactions that healthcare officials in a school setting were having with childhood obesity. It sought out the ways in which childhood obesity was being identified and then dealt with in schools in order to come up with shortcomings and specific areas of improvement. The study cited looking for potential reasons for low “unhealthy BMI” referral rates and understanding how the role of school health professionals can be maximized to address childhood obesity early as the main purposes for the study. The rationale was based in determining shortcomings in the identification of childhood obesity, along with seeking out the reasons why childhood obesity was not being addressed properly in schools. The hope was that if the shortcomings could be determined, then solutions to these issues could be made. The main hypothesis is that in one or more of the areas of study (the perceived role in addressing childhood obesity, the current practices for identifying and managing childhood obesity, confidence in addressing these issues with families, and/or the training needs of school health professionals for addressing it) there is an issue that is leading to low referral rates and improper addressing techniques. If these problems were to be solved, childhood obesity could be addressed more sufficiently. Twenty six health care professionals were studied. Among the 26, there were 3 service managers, 16 registered nurses with caseload responsibilities, and 7 registered nurses who supported school nurses in care but held no caseload responsibility. To study the population, semi-structured interviews were used on the three service managers, focus groups were used on 18 registered nurses (12 with caseload responsibilities and 6 without), and questionnaires were used on 5 registered nurses (4 with caseload responsibilities, 1 without). Based on this study’s responses, it was determined that school health professionals believe that playing a role in managing childhood obesity is necessary, but they are limited by lack of ability due to small numbers of staff, lack of clear protocols, challenges of engaging parents, and insufficient training in dealing with childhood obesity and related lifestyle issues. One caveat is that it was based in one geographic area within the United Kingdom. It was also limited by the fact that it encompassed two sections of the studied city, but it missed the third section due to participation refusal. If these problems were to be corrected by allocating more resources to school nurse training and creating specific protocols for identifying and dealing with childhood obesity, then childhood obesity may be lessened as an issue overall.

 

Turner, G. L., Owen, S., & Watson, P. M. (2016). Addressing childhood obesity at school entry.
Journal of Child Health Care, 20(3), 304-313. doi:10.1177/1367493515587061

“World health inequality: Convergence, divergence, and development” Summarized

The second half of the 1900’s is known to be a period in which the level of world health shows a trend of converging, or coming together. This particular study analyzed data on positive welfare outcomes. Positive welfare outcomes are described as being increased life expectancy and/or a reduced infant mortality rates. The  first question to be answered was if these outcomes were really beginning to converge worldwide. The second piece of analysis in this study was based on the relationship between welfare outcomes and economic development. This second analysis sought to prove that there was a definitive relationship between either positive or negative welfare incomes, and it was to explain the welfare outcomes. To preform this task, data was collected from 1955 through 2005 on the independent and dependent variables. The dependent variables that were looked at were life expectancy and infant mortality. The independent variables that were analyzed were GDP, time period, world region, HIV prevalence, school enrollment, fertility rate, urbanization, democratization, and capital formation. Each of the looked at independent variables had data from the four years previous to when each of the dependent variable’s information was recorded. Upon the careful analysis of all of the data points, it was determined that there was a convergence of life expectancy trends, yet there seemed to be a growing disparity with infant mortality. Economic development is cited as the reasoning behind both of the trends. The convergence trend of life expectancy and the divergence trend of infant mortality are explained by two truths that were contrived from analysis of data, the first being that the life expectancies of people in developing countries are being improved far more than the rate of infant mortality is being reduced. The second truth is that in countries with existing wealth, life expectancy is not increasing as much as infant mortality is being decreased. These trends, though they are contradictory, end up following something described as a “welfare Kuznets curve.” This curve seems to prove that the increasing economic development improves life expectancy as a whole. It also proves that economic development makes infant mortality a larger issue.

 

Rob Clark, World health inequality: Convergence, divergence, and development, In Social Science & Medicine, Volume 72, Issue 4, 2011, Pages 617-624, ISSN 0277-9536, https://doi.org/10.1016/j.socscimed.2010.12.008.
(http://www.sciencedirect.com/science/article/pii/S027795361000852X)
Keywords: Cross-national; Development; Health inequality; Life expectancy; Infant mortality