Global Health

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Global Health

Interdisciplinary research on global health problems through the lenses of economics, nutrition and politics.

Research Spotlight

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Ethics and Governance of Digital Epidemiology

Many countries have taken digital epidemiology to the next level in responding to COVID-19. Focusing on core public health functions of case detection, contact tracing, and isolation and quarantine, the authors explore ethical concerns raised by digital technologies and new data sources in public health surveillance during epidemics.
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Owning Handgun Associated With Dramatically Higher Risk of Suicide

Men who own handguns are eight times more likely to die of suicide by handgun than men who don’t have one — and women who own handguns are 35 times more likely than women who don’t, according to startling new research led by SHP's David Studdert.
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Does Diversity Matter for Health? Experimental Evidence from Oakland

African-American men have the lowest life expectancy of any major demographic group in the United States and live on average 4.5 fewer years than non-Hispanic white men. This paper finds that the mortality disparity is partly related to underutilized preventive healthcare services.

Featured Scholars

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Michelle Mello

Professor of Medicine
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Michelle Mello

Professor of Medicine
Professor of Law
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Doug Owns

Senior Fellow at the Freeman Spogli Institute for International Studies
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Doug Owns

Senior Fellow at the Freeman Spogli Institute for International Studies
Professor of Medicine
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Maya Rossin-Slater

Assistant Professor, Medicine
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Maya Rossin-Slater

Assistant Professor, Medicine
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Paul Wise

Senior Fellow at the Freeman Spogli Institute for International Studies
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Paul Wise

Senior Fellow at the Freeman Spogli Institute for International Studies
Professor of Child Health and Society

Upcoming Events

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Publications

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Journal Article

Yasmin Rafiei, Michelle Mello
New England Journal of Medicine, 2020

On August 17, 2020, the Los Angeles Unified School District launched a program to test more than 700,000 students and staff for SARS-CoV-2. The district is paying a private contractor to provide next-day, early-morning results for as many as 40,000 tests daily. As of October 4, a total of 34,833 people had been tested at 42 sites. The program is notable not only because it’s ambitious, but also because it’s unusual: testing is conspicuously absent from school reopening plans in many other districts.

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Journal Article

Yasmin Rafiei, Michelle Mello
New England Journal of Medicine, 2020

On August 17, 2020, the Los Angeles Unified School District launched a program to test more than 700,000 students and staff for SARS-CoV-2. The district is paying a private contractor to provide next-day, early-morning results for as many as 40,000 tests daily. As of October 4, a total of 34,833 people had been tested at 42 sites. The program is notable not only because it’s ambitious, but also because it’s unusual: testing is conspicuously absent from school reopening plans in many other districts.

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Journal Article

Josip Car, Gerald Choon-Huat Koh, Pin Sim Foong, C. Jason Wang
The British Medical Journal, 2020

Even before the covid-19 pandemic, virtual consultations (also called telemedicine consultations) were on the rise, with many healthcare systems advocating a digital-first approach. At the start of the pandemic, many GPs and specialists turned to video consultations to reduce patient flow through healthcare facilities and limit infectious exposures. Video and telephone consultations also enable clinicians who are well but have to self-isolate, or who fall into high risk groups and require shielding, to continue providing medical care. The scope for video consultations for long term conditio

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Journal Article

Rachel Schwartz, Susan M. Frayne, Sarah Friedman, Yasmin Romodan, Eric Berg, Sally Haskell, Jonathan Shaw
Journal of General Internal Medicine , 2020

When an experienced provider opts to leave a healthcare workforce (attrition), there are significant costs, both direct and indirect. Turnover of healthcare providers is underreported and understudied, despite evidence that it negatively impacts care delivery and negatively impacts working conditions for remaining providers. In the Veterans Affairs (VA) healthcare system, attrition of women’s health primary care providers (WH-PCPs) threatens a specially trained workforce; it is unknown what factors contribute to, or protect against, their attrition.

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Journal Article

Maimuna S. Majumder, Sherri Rose
Health Affairs, 2020

Although health care billing claims data have been widely used to study health care use, spending, and policy changes, their use in the study of infectious disease has been limited. Other data sources, including from the Centers for Disease Control and Prevention (CDC), have provided timelier reporting to outbreak experts.

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Journal Article

Nirav R. Shah, Debbie Lai, C. Jason Wang
Journal of General Internal Medicine , 2020

Epidemiological modeling has emerged as a crucial tool to help decision-makers combat COVID-19, with calls for non-pharmaceutical interventions such as stay-at-home orders and the wearing of masks. But those models have become ubiquitous and part of the public lexicon — so Nirav Shah and Jason Wang write that they should follow an impact-oriented approach.

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Journal Article

Alyssa Bilinski , Farzad Mostashari, Joshua Salomon
JAMA Network Open, 2020

Stanford Health Policy’s Joshua Salomon, a professor of medicine and senior fellow at the Freeman Spogli Institute for International Studies, and colleagues developed a mathematical model to examine the potential for contact tracing to reduce the spread of the coronavirus.

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Journal Article

Mark A. Hall, Michelle Mello, David Studdert
New England Journal of Medicine , 2020

In March 2020, when many U.S. states and localities issued their first emergency orders to address Covid-19, there was widespread acceptance of the government’s legal authority to respond quickly and aggressively to this unprecedented crisis. Today, that acceptance is fraying. As initial orders expire and states move to extend or modify them, legal challenges have sprouted. The next phase of the pandemic response will see restrictions dialed up and down as threat levels change.  As public and political resistance grows, further legal challenges are inevitable.

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Journal Article

Michelle Mello, Govind Persad , Douglas B. White
New England Journal of Medicine, 2020

In times of emergency, many legal strictures can flex. For example, to enable hospitals to respond to Covid-19, the Department of Health and Human Services (HHS) recently waived a swath of federal regulatory requirements. But though officials’ emergency powers are extensive, the ability to discard antidiscrimination protections is not among them. A hallmark of our legal system is that our commitment to prohibiting invidious discrimination remains steadfast even in times of emergency.

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Journal Article

Deparati Guha-Sapir , Maria Moitinho de Almeida, Mory Keita, Gregg Greenough, Eran Bendavid
Science Magazine , 2020

Nearly 120 million children in 37 countries are at risk of missing their measlescontaining vaccine (MCV) shots this year, as preventive and public health campaigns take a back seat to policies put in place to contain coronavirus disease 2019 (COVID-19). In March, the World Health Organization (WHO) issued guidelines indicating that mass vaccination campaigns should be put on hold to maintain physical distancing and minimize COVID-19 transmission.

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Journal Article

Rebecca L. Haffajee, Michelle Mello
New England Journal of Medicine, 2020

Covid-19 has exposed major weaknesses in the United States’ federalist system of public health governance, which divides powers among the federal, state, and local governments. SARS-CoV-2 is exactly the type of infectious disease for which federal public health powers and emergencies were conceived: it is highly transmissible, crosses borders efficiently, and threatens our national infrastructure and economy. Its prevalence varies around the country, with states such as Washington, California, and New York hit particularly hard, but cases are mounting nationwide with appalling velocity.

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Journal Article

C. Jason Wang, Henry Bair, Ching-Chuan Yeh
Journal of Hospital Medicine , 2020

During the severe acute respiratory syndrome (SARS) outbreak in 2003, Taiwan reported 346 confirmed cases and 73 deaths. Of all known infections, 94% were transmitted inside hospitals. Nine major hospitals were fully or partially shut down, and many doctors and nurses quit for fear of becoming infected. The Taipei Municipal Ho-Ping Hospital was most severely affected.

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Journal Article

Joshua M. Sharfstein, Scott J. Becker, Michelle Mello
JAMA Network, 2020

Controversies over diagnostic testing have dominated US headlines about severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the novel coronavirus responsible for coronavirus disease 2019 (COVID-19). Technical challenges with the first test developed by the Centers for Disease Control and Prevention (CDC) left the nation with minimal diagnostic capacity during the first few weeks of the epidemic. The CDC also initially limited access to testing to a narrow group of individuals with known exposure.

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Journal Article

C. Jason Wang, Chun Y. Ng, Robert H. Brook
JAMA Network, 2020

Taiwan is 81 miles off the coast of mainland China and was expected to have the second highest number of cases of coronavirus disease 2019 (COVID-19) due to its proximity to and number of flights between China. The country has 23 million citizens of which 850 000 reside in and 404 000 work in China. In 2019, 2.71 million visitors from the mainland traveled to Taiwan. As such, Taiwan has been on constant alert and ready to act on epidemics arising from China ever since the severe acute respiratory syndrome (SARS) epidemic in 2003.

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Journal Article

Jennifer Burney
Nature Sustainability, 2020

The recent shift in the United States from coal to natural gas as a primary feedstock for the production of electric power has reduced the intensity of sectoral carbon dioxide emissions, but—due to gaps in monitoring—its downstream pollution-related effects have been less well understood. Here, I analyse old units that have been taken offline and new units that have come online to empirically link technology switches to observed aerosol and ozone changes and subsequent impacts on human health, crop yields and regional climate.

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Journal Article

Rosamond L. Naylor, Ryan Edwards, Matt Higgins, Walter P. Falcon
World Development Journal, 2019

The economic costs of Indonesia’s 2015 forest fires are estimated to exceed US $16 billion, with more than 100,000 premature deaths. On several days the fires emitted more carbon dioxide than the entire United States economy. Here, we combine detailed geospatial data on fire and local climatic conditions with rich administrative data to assess the underlying causes of Indonesia’s forest fires at district and village scales. We find that El Niño events explain most of the year-on-year variation in fire.

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Journal Article

Hai Fang, Karen Eggleston, Kara Hanson, Ming Wu
BMJ, 2019
China started comprehensive health system reforms in 2009. An important goal of China’s health system reforms was to achieve universal health coverage through building a social health insurance system. Universal health coverage means that all individuals and communities should get the quality health services they need without incurring financial hardship.
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Working Paper

Rosamond L. Naylor, et al.
Aspen Global Change Institute, 2018

Increased intake of fruits and vegetables (F&V) is recommended for most populations across the globe. However, the current state of global and regional food systems is such that F&V availability, the production required to sustain them, and consumer food choices are all severely deficient to meet this need.

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Journal Article

Haibin Wu, Karen Eggleston, Jieming Zhong, Ruying Hu, Chunmei Wang, Kaixu Xie, Yiwei Chen, Xiangyu Chen, Min Yu
BMJ Open, 2018
Objective To evaluate type 2 diabetes mellitus (T2DM)-related direct medical costs by complication type and complication number, and to assess the impacts of complications as well as socioeconomic factors on direct medical costs.
 
Design A cross-sectional study using data from the region’s diabetes management system, social security system and death registry system, 2015.
 
Setting Tongxiang, China.
 
Participants Individuals diagnosed with T2DM in the local dia
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Journal Article

Christopher Weyant, Margaret L. Brandeau, Marshall Burke, David Lobell, Eran Bendavid, Sanjay Basu
PLOS Medicine, 2018

Rising atmospheric carbon dioxide concentrations are anticipated to decrease the zinc and iron concentrations of crops. The associated disease burden and optimal mitigation strategies remain unknown. We sought to understand where and to what extent increasing carbon dioxide concentrations may increase the global burden of nutritional deficiencies through changes in crop nutrient concentrations, and the effects of potential mitigation strategies.

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Journal Article

Sam Heft-Neal, Jennifer Burney, Eran Bendavid, Marshall Burke (198750)
Nature, 2018

Poor air quality is thought to be an important mortality risk factor globally

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Book

Matthew Kohrman, Gan Quan, Liu Wennan, Robert Proctor
2018
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Journal Article

Sean Sylvia, Hao Xue, Chengchao Zhou, Yaojiang Shi, Hongmei Yi, Huan Zhou, Scott Rozelle, Madhukar Pai, Jishnu Das
PLoS Medicine, 2017

Despite recent reductions in prevalence, China still faces a substantial tuberculosis (TB) burden, with future progress dependent on the ability of rural providers to appropriately detect and refer TB patients for further care. This study (a) provides a baseline assessment of the ability of rural providers to correctly manage presumptive TB cases; (b) measures the gap between provider knowledge and practice and; (c) evaluates how ongoing reforms of China’s health system—characterized by a movement toward “integrated care” and promo- tion of initial contact with grassroots providers—will affect the care of TB patients.

 

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Policy Brief

2017
Using agricultural and economic characteristics in African nations as test cases, new research by David Lobell and Marshall Burke demonstrates the use of satellite data to address the long-standing problem of accurate data collection in developing countries. An often cited challenge in achieving development goals aimed at poverty and hunger reduction is the lack of reliable on-the-ground data.
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Journal Article

Qiulin Chen , Karen Eggleston, Wei Zhang, Jiaying Zhao
The China Quarterly, 2017

It has been well established that better educated individuals enjoy better health and longevity. In theory, the educational gradients in health could be flattening if diminishing returns to improved average education levels and the influence of earlier population health interventions outweigh the gradient-steepening effects of new medical and health technologies. This paper documents how the gradients are evolving in China, a rapidly developing country, about which little is known on this topic.

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