Minor - Week 7 Flashcards
Exposome
Environmental factors that collectively influence your behavior
outside the individual
Genome
All genetic factors that influence your health
What is the role of the environment in encouraging or discouraging PA?
Environment influences us much in Physical behavior but realtion is complex
Green spaces
- Playgrounds
- Sport facilitues
- Facilities daily use
A compound measure for PA
Prevention paradox
The small high risk group that is targeted doens’t affect the average as much
People at moderate risk are influence the outcome most
- Riks you also need distribution
- Shift the whole distribution to the left
Environmental food rotterdam
Unhealthy food outlets increased by 24%
- Increased in neighbours with low SES
Environmental measures on health effect
- Little on individual level
- High on population level; as it targets the middle risks
Contextual factors that in LMIC that influence health decision making
- Little knowledge of health decisions
- fewer resources, more disease burden
- Low financial resources to spend on healthcare
Leads to more health decisions with fewer resources, lead to suboptimal decisions
Traditional interventions assumptions
Context little influence (time consistent and consistent preferences)
- Enough information
- Decisons that maximize utiity
- Self-interested
- Consistent preferences
Interventions targeted towards; information, incentives, pricing interventions and regulation
Traditional interventions - Informational
Correct problem of incomplete health
- lowers uptake to preventive health behaviors
Traditional interventions - Financial incentvies
Influence undesirable behaviors
- Conditional cash transfer; cash when applying
- contraints removed by poor households
Traditional interventions - Pricing interventions
Pricing interventions targets mostly the poorer
- can be good type of intervention in LMICC
Context factors influence outcomes in LMIC
- Money; react on incentives and pricing
- Information; little as people are illiterate
Why behavioral insights in LMIC
Stress of poverty changes cognition and preferences
- Relying more on system 1
Error prone
Mental shortcuts sometimes lead to inefficient decision making, where in circumstances important aspects of a problem are being missed
Behavioral insight LMIC - Commitment savings account
Tackles present bias
- Commitment improved the savings and tackles present bias
- Used; commitment vs. marketing information
Behavioral insight LMIC - Nudging (testing HIV)
Tackles not being tested
- Immediate incentive
- Information alone
- Delayed incentive
- Soft commitment
Incentive works best
Challenges behavioral interventions LMIC!
- Structural; weak infrastructure (limited supply)
- Replication and generalizability; BI are designed in west an must find other practice in other countries with other environments and cues
- Significant differences in society configured
(cultural context and how mobiles shape health in these countries) - Scale (sustaiable); risk of stalling after start
Causes of increasing obesity
- Genetics not (gene pool doesn’t change so fast…)
-Food industry; high calorie intake promote - Food price trends; cheap food
- Changing lifestyles (sedentary jobs, heating and AC, automobile)
- participation of women;
The costs of obesity
Health losses
- Riks of chronic disease
- reduced
- lower QOL
- Reduced physical functioning
Lower wages
Social stigma
Higher health expenses
behavioral insights by obesity
- Behavior leads to illness
- Ilness to health consumption
- Health comsumption to costs
- Prevention on unhealthy behavior
True? People smoke and obese cost more than healthy living people and therefore forced to pay more premium
No !
- People with obesity and smoke died earlier
- Obesity and smoking shorter illness and then die earlier. Lead to fewer costs
- Healthy people live longer and therefore make more healthcare costs
The expenses of smoking are paid by themselfses
Biggest cost of unhealthy lifestyle are borne by those with an unhealthy lifestyle, not by others, that are
- Long term perspective
- Social stigma
- Lower wages
- Health losses
Healthcare costs, why smokers and obesity people pay for their own and for healthy?
- Long term perspective
- Unhealthy individuals pay equal premiums.
- Shorter lives lead to lower lifetime healthcare costs.
- Leaves more of their premiums for healthy, longer-living individuals.
short term and long term perspective
Short
- Healthy people pay for the sick to cover medical expenses
Life perspective; smokers and obeesity
- Shorter lives
- Use less healthcare
- Less expenses
lifetime implications for unhealthy behaviors
- May contribute more on premiums
- Live shorter
- financed the healthy
Public social perspective obesity as a health crisis
- Pooled insurance; costs felt lower for unhealthy
- start acting unhealthy
- Inducing moral hazard
- Negative externalities; higher costs, demand curve shift
- Reduce social welfare
(more demand, higher expenses, with fewer resources)
How do lifestyle changes affect health demand from an individual’s perspective?
Private costs
- Personal health risks
- Stigma
- Lower wages
How do lifestyle changes affect health demand from an insurer?
- Unhealthy behaviors
- Lead to higher premiums for everyone
- Cross susidization
When government intervention
When there are externalities impacting the social welfare
insurance and price of unhealthy habits
- Lowered by cross subisization.
Reduced the price of unhealthy habits through pooling
Imagine Homer’s elasticity of demand for donuts with respect to pooled insurance is zero. If so, pooled insurance does not change Homer’s behavior,
- Elasticity is zero
- No demand change due to insurance
- No Behavior change
- No moral hazard
- No wellfare loss
No public health crisis
Public point view public health intervention
- No harm others (externalities)
- respect autonomy
Justifications for public health intervention
- Inadequate nutritional information
- Childhood obesity
(wellfare economics; what is best for them, childeren not the case, no long term thinking) - Impatience and addiction; Wellfare economics opposite behavior of it
