Lecture 5 Flashcards
What does the production function of health define?
Relationship between health and health inputs needed to produce healt
What factors affect health status?
Lifestyle, Environment, Human Biology
Health status increases as more and more health care inputs are added to the production process also some of the factors that influence health is listed above
Is health status an increasing function of health care?
Yes
Health status increases as more and more health care inputs are added to the production process
Production Function of Health
What leads to a movement along the curve or a shift in the curve?
Improvements in lifestyle, environment, or human biology
An Upward shift
What is Total Product?
Health status increases as more health care inputs are added.
What is the relationship between health status and health care?
Health status is an increasing function of health care.
What does an upward shift in the curve represent?
Improvements in Lifestyle, Environment, or Human Biology.
What are some indicators of health status?
number of healthy days, mortality rates, morbidity rates, disability days
- Healthy Life Expectancy at Birth
- Quality Adjusted Life Years:
- Disability Adjusted Life Years
- Life expectancy at birth
- Mortality rate
- Morbidity rate
What is Healthy Life Expectancy at Birth?
average years expected to live in full health
by taking into account years lived in less than full health due to disease and/or injury
What are Quality Adjusted Life Years (QALYs)?
Measure of years of life lived in less than perfect health
An individual will have more QALYs the longer he or she lives and the better health he or she enjoys during those years
How are QALYs calculated?
Taking into consideration both length of life and health during those years
QALYs are therefore a measure of health gain, which is a ‘good’ of which an individual wishes to have as much as possible
What do QALYs measure?
Health gain and desirable amount of health
What do Disability Adjusted Life Years (DALYs) measure?
Healthy time lost caused by diseases
This indicator combines the life years lost due to premature death with years lived in a health state less than full health.
What does the Disability Adjusted Life Years (DALYs) indicator combine?
Life years lost due to premature death and years lived in a health state less than full health
What are DALYs?
An individual will suffer a larger burden of DALYs lost, the shorter he or she lives and the worse health he or she experiences.
Measure of health gap between actual health and a defined ideal for health achievement.
This gap is a bad which an individual or population would strive to minimize.
What does life expectancy at birth measure?
Average years expected to live if current mortality rates continue to apply.
What is mortality rate?
Number of deaths per 100,000 of the population.
What is morbidity rate?
Number of persons with an illness or disease per 100,000 of the population.
What is diminishing marginal product?
Increments in health status diminish as more health care inputs are added.
Which is most relevant from a public policy perspective, total product or marginal product?
Marginal product.
For example, no one seriously recommends that society eliminate all health care spending.
No one seriously recommends to eliminate all health care spending.
Is it reasonable to ask whether society would be better off if it could reduce health care expenditures by $1 billion and invest those funds in another productive use?
such as housing, education, transportation, defense or other consumption
Yes
We could even reasonably ask if health itself could be improved by transferring the marginal $1 billion to environmental or lifestyle improvements.
What are some alternative uses for the $1 billion if health care expenditures could be reduced?
Housing, education, transportation, defense, or other consumption
Could health be improved by transferring the marginal $1 billion to environmental or lifestyle improvements?
Yes
Where should the extra dollar go?
To where the marginal product is highest
Which Group of countries are more likely to have the marginal product of healthcare spending to be much lower?
Developed countries
In a developed economy, you would probably be on the flat portion of the production function, so the marginal product is low.
Which Group of countries are more likely to have the marginal product of healthcare spending to be much Higher?
Developing countries
In a developing economy, you would probably be on the increase part of the production function, so marginal product is high. As healthcare spending increases, the marginal product falls.
What is an important input for health?
Medical care
Medical care This is an obvious input, and probably the one that most people would think would be the most important. However, medical care can also create some negative externalities (e.g. the inappropriate use of a tuberculosis test can make people worse off; pain killer addiction; side effects of some medical treatments)
What negative externalities can medical care create?
Inappropriate use, addiction, side effects
Did medical care play a significant role in the historical decline in population mortality rates?
No
What did Victor Fuchs note about infant mortality rates in New York City from 1900 to 1930?
Improved markedly
Medical care played almost no role in this decline
While we do not know the precise causes, it is believed that rising living standards, the spread of literacy and education, and a substantial fall in the birth rate all played a part
According to Victor Fuchs, did medical care play a role in the decline of infant mortality rates?
Almost no role
What factors are believed to have played a part in the decline of infant mortality rates?
Rising living standards, spread of literacy and education, and fall in birth rate
What does the graph for measles show?
Fall in the Standardized Death Rate per 1,000 Population for Four Common Infectious Diseases in Relation to Specific Medical Measures for the United States
Decline in measles incidence
Measles incidence dropped significantly from 1900 to 1960
The decrease occurred before the introduction of themeasles vaccine
What does the graph for scarlet fever show?
Fall in the Standardized Death Rate per 1,000 Population for Four Common Infectious Diseases in Relation to Specific Medical Measures for the United States
Similar pattern of decline
These graphs indicate that most of the major declines in the prevalence of many infectious diseases occurred before the introduction of drugs used to treat them.
What trend does the graph for tuberculosis follow?
Fall in the Standardized Death Rate per 1,000 Population for Four Common Infectious Diseases in Relation to Specific Medical Measures for the United States
Similar trend to measles and scarlet fever
Four Common Infectious Diseases:
What initiatives could explain declines in the figures?
- Public health initiatives
- Nutrition
e.g., clean drinking water
i.e., higher calorie intake
When is medical care most effective in reducing death rates?
Less than 1 year and especially less than 1 month (neonatal)
since the death rates at these ages have decreased dramatically
Why does medical care matter more at older ages?
Higher incidence of heart disease and cancer
Generally, treatments for heart disease and cancer have improved, although with cancer much really depends on the pathology of the tumors
What are lifestyle factors in relation to medical care?
Preventive measures
e.g., you have a healthy lifestyle and it makes you less likely to need medical care.
What are some lifestyle factors that can be complementary for medical care?
nutrition counseling, exercise instructions
E.g., if you have diabetes you might get nutrition counseling as well as instructions about exercise; if you have heart disease you might be asked to cut back on saturated fats, sodium and cholesterol
What changes to diet may be suggested for managing heart disease?
reduce saturated fats, sodium, cholesterol
What are the health risks associated with smoking?
Smoking would also be a lifestyle factor
Cancers, respiratory diseases, cardiovascular disease
How can occupation affect health?
Exposure to hazardous materials can increase risk of health problems
Firefighters have a higher risk of lung and some other cancers.
Which occupation has a higher risk of lung and some other cancers?
Firefighters
oal miners also have a higher risk of respiratory disease.
Lifestyle Socioeconomic Status and Health
What is one stylized fact of health that is common to all countries in the world?
People with lower socioeconomic status have poorer health
This is often referred to as the gradient in socioeconomic status
While there is a great deal of evidence on the gradient, the mechanism for how it works is not clear; e.g., could it be that lower socioeconomic status is correlated with lower levels of education (and its effect on health) or is it related to environmental factors.
According to Fuchs (1995), during the period (1959-1961), what were the average death rates in Nevada compared to Utah?
Greater in Nevada.
Although they shared about the same levels of income and medical care and are alike in many other respects.
According to Fuchs (1995), what was the main reason for the substantial differences in death rates between Nevada and Utah?
Lifestyle
The inhabitants in Utah did not use tobacco or alcohol and in general led stable, quiet lives.
What were the key lifestyle differences between the inhabitants of Utah and Nevada?
Utah inhabitants did not use tobacco or alcohol, and led stable, quiet lives .Nevada, on the other hand, is a state with high rates of cigarette and alcohol consumption and very high indexes of marital and geographical instability
What are all the health inputs?
- Medical care
- Lifestyle
- Environment
- Human Biology
Environment as a health input involve?
Access to clean drinking water
can reduce the spread of diseases such as cholera and dysentery
What percentage of the decline in mortality rates in U.S. cities between 1900 and 1936 was water filtration and chlorination?
43%
Environment Air pollution
What is the cause of air pollution in urban areas?
urban areas can have higher rates of air pollution
respiratory problems
What is inter-generational links for some diseases?
4- Human Biology Genetics
Human Biology
Black men have a higher risk of what type of cancer?
prostate cancer
South Asians have a higher risk of diabetes
What is the bigger role of the government in most countries?
Production of health
Who is involved in providing medical care?
the government
whether paying for it with taxes or with subsidies to individuals .
What can the government have an effect on the other inputs?
Except for human biology
public health programs and health promotion
What type of biology does the government have an effect on?
human biology
DO governments provide programs related to the environment?
Government initiatives to provide clean drinking water and immunization programs.
What is about bringing attention to some sort of illness?
health promotion
(i.e., early screening or testing)
or some sort of lifestyle changes that would improve health
Public Health or Health Promotion?
- Sewage Treatment and water purification
- Quarantines; Social Distancing
- Promoting Healthy lifestyles, better
nutrition and getting people to exercise
more. - Raising awareness about diseases
- Controlling pollution to maintain the
quality of drinking water and air quality - Controlling smoking
- Food safety
- Public Health
➢Sewage Treatment and water purification
➢Quarantines; Social Distancing
➢Controlling pollution to maintain the quality of drinking water and air quality
➢Food safety - Health Promotion
➢Promoting Healthy lifestyles, better nutrition and getting people to exercise more.
➢Controlling smoking
➢Raising awareness about diseases
The role of the government
The effects of Quarantines or Social
Distancing
- Cruises and flights canceled
- Public schools closing
- Colleges and universities sending students home to watch lectures online
- Concerts, parades, festivals and sporting events postponed.
Impact of protective measures graph:
What is X-Axis and the Y-Axis?
Represents time and represents the number of infections respectively
Impact of protective measures graph:
What is the name of the thin Curve?
Without Measures
The tall, skinny curve is bad – it means that a lot of people will get sick at once, in a short period of time because we don’t take enough steps to prevent the virus from spreading from person to person
Impact of protective measures graph:
What does the high peak of the graph without measures represents?
Infections
Most people won’t get sick enough to need a hospital. But those who do could overwhelm the number of beds and care teams that our nation’s hospitals have available.
Impact of protective measures graph:
What is the curve With Measures (Blue Curve)
This curve represents the impact of implementing measures such as quarantines or social distancing.
The curve has a lower peak as of a lower increase in infections
What are the Benefits of Measures?
Delaying the Epidemic
How can healthcare systems manage the influx of patients?
Reducing strain on hospitals and resources
What does the tall, skinny curve mean that a lot of people will get sick at once in a short period of time?
A vaccine
