The Human and Planetary Health initiative at the Stanford Woods Institute for the Environment is hosting a dialogue with Chris Field, Director of the Stanford Woods Institute for the Environment and Reginaldo Haslett-Marroquin, an expert in regenerative poultry production and practicing regenerative farmer. Learn more and register on the event page.

Co-sponsored by Peking University Institute for Global Health and Development, and the Asia Health Policy Program

Plastic pollution and antibiotic resistance are significant threats to human health. The overuse of plastic products and antibiotics, often driven by individual behaviors, plays a major role in these challenges. The presence of externalities leads to further overuse, intensifying the problem. In this webinar, we will present two research studies that employ the nudge strategy to explore its effectiveness as a low-cost method in promoting socially desirable behaviors. We will focus on the contexts of disposable cutlery consumption and antibiotic utilization, providing insights into how subtle behavioral interventions can have a meaningful impact.

Title 1: Reducing single-use cutlery with green nudges: Evidence from China’s food-delivery industry

Rising consumer demand for online food delivery has increased the consumption of disposable cutlery, leading to plastic pollution worldwide. In this work, we investigate the impact of green nudges on single-use cutlery consumption in China. In collaboration with Alibaba’s food-delivery platform, Eleme (which is similar to Uber Eats and DoorDash), we analyzed detailed customer-level data and found that the green nudges—changing the default to “no cutlery” and rewarding consumers with “green points”— increased the share of no-cutlery orders by 648%. The environmental benefits are sizable: If green nudges were applied to all of China, more than 21.75 billion sets of single-use cutlery could be saved annually, equivalent to preventing the generation of 3.26 million metric tons of plastic waste and saving 5.44 million trees. 

Title 2: The Impact of Self- or Social-regarding Messages: Experimental Evidence on Antibiotics Purchases in China

We study two interventions in Beijing, China, that provide patients with information on antibiotic resistance via text message to discourage the overuse of antibiotics. The messages were sent once a month for five months. One intervention emphasizes the threat to the recipient's own health and is found to have negligible effects. The other intervention, which highlights the overall threat to society, reduces antibiotics purchases by 17% in dosage without discouraging healthcare visits and other medicine purchases. The results demonstrate that prosocial messaging can have the potential to address public health issues that require collective action.

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Yuhang Pan's research fields include environmental economics, health economics, and development economics, with a particular focus on using causal inference approach to study the impact of environmental pollution, public policy, and climate change on health and social welfare. His works have been published in both economics and scientific journals, such as Science, Nature Sustainability, and the Journal of Environmental Economics and Management. Dr. Pan obtained his undergraduate degree from Beijing Normal University in 2015 and his doctoral degree from the Hong Kong University of Science and Technology in 2021. Prior to joining Peking University, he worked as a postdoctoral researcher at the Faculty of Business and Economics at the University of Hong Kong.

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Jianan Yang's primary research fields are health economics and development economics, with specific interests in health policy reform, medical behavior, and pharmaceutical innovation. She employs both experimental and quasi-experimental methods to explore policy-related questions, particularly examining their impact on patient welfare. She has published in top journals like the Journal of Development Economics. She earned her bachelor’s degrees in Economics and Mathematics from Renmin University of China in 2016, and her Ph.D. in Economics from the University of California, San Diego in 2022. Before joining Peking University, she was the 2022-2023 Developing Asia Health Policy Postdoctoral Fellow at Stanford University. 

In this hybrid seminar, Professor Lee will reflect on her pioneering and collaborative research on late-life cognition and dementia across multiple settings. Drawing on empirical evidence and carefully harmonized surveys of health and aging (e.g., for Korea, Japan, China, India, the US and Europe), Professor Lee will assess the state of knowledge and evidence regarding risk and resilience factors and the potential for preventing cognitive decline. Her talk will conclude with discussion of current initiatives and global dialogues (political, academic, and industry) about healthy brain aging.

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Dr. Jinkook Lee is a Research Professor of Economics and the Program Director of Global Aging, Health, and Policy at the University of Southern California. Her research focuses on the economics of aging, with interdisciplinary training and expertise in large-scale population surveys. As the Principal Investigator on several NIH-funded grants, she laid the groundwork for studying Alzheimer’s Disease and Related Dementia and their risk factors and impacts in low and middle-income countries. She has developed the country’s first and only population representative dementia study in India and helped developing sister studies in China, Kenya, Nepal, Pakistan, and Malawi. She provides scientific advice for WHO, OECD, World Bank, and Asia Development Bank and serves on the editorial boards for several scientific journals. She previously held a professorship at Ohio State University and the Pardee RAND Graduate School. She received her Ph.D. from Ohio State University and B.S. from Seoul National University.

AHPP 2023-24 Colloquium series, “Technology, Trust, and Healthy Aging”

Patient trust is an important driver of the demand for healthcare. But it may also impact supply: doctors who realize that patients may not trust them may adjust their behavior in response. We assemble a large dataset that assesses clinical performance using standardized-patients (akin to audit studies in economics) in low-income countries to investigate this possibility; most of these data are on healthcare providers who practice in the private sector on a fee-for-service basis. 

We establish that patients receive low quality of care, with a generous definition suggesting that fewer than 50% of cases are correctly managed, and between 70% and 90% of expenditures are medically unnecessary. Strikingly, and in contrast to the literature suggesting that the main problem with fee-for-service provision is over-treatment, the majority of these unnecessary expenditures are incurred because patients are incorrectly rather than over-treated. 

We then rule out two plausible explanations for low quality of care: low levels of medical knowledge and low market incentives to invest effort. In our data, there are many healthcare providers who know how to correctly treat the patient and could substantially increase their revenue by doing so given the price-quality gradients we estimate, but still treat the patient incorrectly. 

A model of the patient-provider relationship in which patients have incomplete information about the quality of providers generates predictions consistent with our findings. The theory additionally suggests that issuing a credible signal of quality should raise the average quality of care among providers, even if their underlying ability remains unchanged. 

We assess this prediction through an evaluation of a highly publicized training program with informal healthcare providers in West Bengal, India. The program has no impact on knowledge, yet substantially raises the quality of care, leading to an increase in the likelihood of correct treatment, a 19% decline in unnecessary expenditures for patients and a 9% increase in revenues for providers. We conclude that low trust undermines clinical performance in an economically and medically significant manner.

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Reshmaan Hussam is an assistant professor of business administration in the Business, Government and International Economy Unit at Harvard University's Business School, a Faculty Research Fellow at the National Bureau of Economic Research (NBER), and a faculty affiliate at the Abdul Latif Jameel Poverty Action Lab (J-PAL) and the Bureau for Research and Economic Analysis of Development (BREAD).

Her research explores questions at the intersection of development and behavioral economics, with research in three areas: migration, health, and finance.  Her most recent work engages refugee populations including the Rohingya in Bangladesh, examining the psychosocial value of employment in contexts of mass unemployment, the role of home in migration decision-making, and refugee preferences for repatriation, integration, and resettlement. In her work in health, which involves field experiments across South Asia, she considers the puzzle of the ubiquitously low adoption of low-cost, high-return goods, behaviors, and technologies in the developing world, exploring the role of learning and habit formation in behavior change. Her work in finance explores how to identify high-return microentrepreneurs using local community knowledge in India and how to increase credit access and returns to capital among refugee communities in Uganda.

Prior to joining HBS, Professor Hussam was a postdoctoral fellow at the Economic Growth Center at Yale University. She received her SB and PhD in economics from MIT.

Co-sponsored by Peking University Institute for Global Health and Development, and the Asia Health Policy Program

July 11th, 5-6 pm PST; July 12th, 2023, 8-9 am Beijing Time

Scientific evidence documents an ongoing mass extinction of species, caused by human activity. Allocating conservation resources is difficult due to scarce evidence on the damages from losing specific species. This paper studies the collapse of vultures in India, triggered by the expiry of a patent on a painkiller. Our results suggest the functional extinction of vultures --- efficient scavengers who removed carcasses from the environment --- increased human mortality by over 4% because of a large negative shock to sanitation. These effects are comparable to estimates of heat deaths from climate change. We quantify damages at $69.4 billion per-year.

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Eyal Frank is an Assistant Professor at the Harris School of Public Policy and the Energy Policy Institute (EPIC) at the University of Chicago. He works at the intersection of economics and conservation, addressing three broad questions: (i) how do natural inputs, namely animals, contribute to different production functions of interest, (ii) how do market dynamics reduce natural habitats and lead to declining wildlife population levels, and (iii) what are the costs, indirect ones in particular, of conservation policies. To overcome causal inference challenges—as manipulating ecosystems and species at large scales is often infeasible—his work draws on natural experiments from ecology and policy, and uses econometric techniques to advance our understanding regarding the social cost of biodiversity losses.

Zoom Meeting:
Meeting ID: 849 6673 1656
Passcode: 110194

Co-sponsored by Peking University Institute for Global Health and Development, and the Asia Health Policy Program

Child marriage remains common even where female schooling and employment opportunities have grown. We experimentally evaluate a financial incentive to delay marriage alongside a girls’ empowerment program in Bangladesh. While girls eligible for two years of incentive are 19% less likely to marry underage, the empowerment program failed to decrease adolescent marriage. We show that these results are consistent with a signaling model in which bride type is imperfectly observed but preferred bride types (socially conservative girls) have lower returns to delaying marriage. Consistent with our theoretical prediction, we observe substantial spillovers of the incentive on untreated non-preferred types.

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Erica Field is a Professor of Economics and Global Health at Duke University specializing in the fields of Development Economics, Health Economics and Economic Demography. Professor Field’s work examines the microeconomics of household poverty and health in developing countries, with an emphasis on the study of gender and development. She has written papers on several topics in development in many different parts of the world, including microfinance contract design and social networks in India, marriage markets in Bangladesh, micronutrient deficiencies in Tanzania, health insurance for the poor in Nicaragua, household bargaining over fertility in Zambia.  Her work has been published in several leading peer-reviewed journals, including the Quarterly Journal of Economics, Journal of Political Economy and the American Economic Journal. Professor Field received her Ph.D. from Princeton University in 2003. Prior to joining the Economics Department at Duke, she was a John L. Loeb Associate Professor of Economics at Harvard University. 

Join Zoom Meeting
https://us06web.zoom.us/j/85156177922?pwd=RzFaKzlMVUdleVF2N0M3YUFBd3ZlZz09
Meeting ID: 851 5617 7922
Passcode: 410360

The third installment in a special event series on the occasion of Shorenstein APARC's 40th Anniversary, "Asia in 2030, APARC@40"

Hosted by APARC's Asia Health Policy Program

The Asia Health Policy Program (AHPP) aims to help empower health systems and policymakers in the Asia-Pacific region to improve their proactive, evidence-based responses to population health problems. This webinar brings together former postdoctoral fellows and visiting scholars from the program to explore their contributions to guiding healthcare providers and policy audiences toward a better understanding of health and demographic issues and the delivery of disease management and other health services. In celebrating the 40th anniversary of the Shorenstein Asia-Pacific Research Center, these scholars and practitioners will also share their reflections on how the center and the program have shaped their research and professional careers.

Speakers

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Brian Chen, JD, PhD. Dr. Chen is an associate professor at the Arnold School of Public Health, University of South Carolina. He brings with him a global perspective on health and well-being, having lived and worked in health-related industries in Taiwan, Japan, and France. Using the tools of economic analysis, his research focuses on the organization and delivery of health care as well as the social determinants of health in Asia and the United States. A particular focus of his work is on the impact of laws and economic incentives on healthcare treatment decisions. His doctoral dissertation, published in the Journal of Public Economics, explored how Taiwan’s separating policy that mandated the separation of diagnosing from drug dispending affected physician prescribing behavior, and whether such changes had an impact on observable health outcomes.

Dr. Chen continues to work on economics- and health law-related research, investigating the impact of opioid regulations on prescribing behavior and subsequent health consequences. His new project aims to understand how the introduction of a novel class of therapeutics may have affected the undertreatment of osteoporosis, an important question in aging societies in Asia, the United States, and around the world.

Dr. Chen received his BA summa cum laude in Linguistics with Computer Science from Harvard College (1992), JD from Stanford Law School (1997), and his PhD in Business Administration from the University of California at Berkeley (2009). He was a postdoctoral fellow at the Walter H. Shorenstein Asia-Pacific Research Center at Stanford from 2009 to 2011.

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Wasin Laohavinij, MD. Wasin Laohavinij is a medical doctor with an interest in quality improvement and program evaluation. He was a visiting scholar at the Asia Health Policy Program, Walter H. Shorenstein Asia Pacific Research Center, Stanford University in the United States in the Autumn of 2019.

Currently, He is a preventive medicine physician concentrating on non-communicable diseases and serves as a Chief of Data Management and Cost Evaluating Center, at King Chulalongkorn Memorial Hospital, Thailand. His work focuses on reducing healthcare costs while maintaining the quality-of-care patients receive. Furthermore, he is also interested in evaluating the efficacy and cost-effectiveness of health interventions.

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Phyu Phyu Thin Zaw, MBBS, MPP, PhD. Phyu Phyu Thin Zaw, who is a Burmese national, is a medical doctor, epidemiologist, and health systems researcher currently working as a Lecturer in the School of Public Health at the Li Ka Shing Faculty of Medicine, University of Hong Kong. She is also a member of the Steering Committee of the Science in Exile initiative, which brings together at-risk, displaced, and refugee scientists along with like-minded organizations who work together to strengthen systems that support, protect and integrate such affected scientists.

Phyu Phyu’s research interests are equity, health and education policies, Southeast Asia health systems and policies, sexual and reproductive health, gender equality, poverty eradication, and human rights issues. Thin Zaw is also a public health and policy consultant giving technical advice to think tanks and non-governmental organizations.

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Margaret Triyana, PhD. Dr Triyana is a Senior Economist at the World Bank's Office of the Chief Economist, South Asia Region. Her main research area examines human capital formation over the life cycle, with an emphasis on how policies and environmental factors affect different dimensions of human capital in low and middle-income countries. She also examines the distributional impacts of both environmental risks and policies.

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Siyan Yi, MD, MHSc, PhD. Dr. Yi is a medical doctor and an infectious disease epidemiologist by training. He received his PhD from the School of International Health of the University of Tokyo in Japan in 2010. He was a postdoctoral fellow at the Asia Health Policy Program, Walter H. Shorenstein Asia Pacific Research Center, Stanford University from 2011-2012. He is an Assistant Professor and Director of the Integrated Research Program at Saw Swee Hock School of Public Health, National University of Singapore. He also serves as Director of KHANA Center for Population Health Research in Cambodia and Adjunct Associate Professor at Touro University California, the United States. His implementation research program focuses on developing and evaluating community-based innovative interventions for improving access to prevention, treatment, and care services for HIV/AIDS, tuberculosis, sexual and reproductive health, and maternal and child health among vulnerable and marginalized populations in Southeast Asia.

Co-sponsored by Peking University Institute for Global Health and Development, and the Asia Health Policy Program

Depression is the most common mental disorder and is more prevalent among people who live in poverty. Emerging economic literature studies the ways that depression may affect economic decision-making and contribute to intergenerational poverty. Dr. Bennett will describe recent developments in the literature and discuss his recent study of the socioeconomic impacts of depression treatment among underpriviledged adults in Karnataka, India.

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Daniel Bennett is an economist at the Center for Economic and Social Research and the Department of Economics at the University of Southern California. He studies economic development and global health in Africa and South Asia. Recent work examines the relationship between poverty and poor mental health, as well as the indirect consequences of the HIV/AIDS epidemic in Sub-Saharan Africa. Other work considers sanitation and hygiene behavior and the organization of pharmaceutical markets. Dr. Bennett collects primary data and uses both experimental and quasi-experimental methods. He received his Ph.D. in 2008 from Brown University.