Health and Medicine

FSI’s researchers assess health and medicine through the lenses of economics, nutrition and politics. They’re studying and influencing public health policies of local and national governments and the roles that corporations and nongovernmental organizations play in providing health care around the world. Scholars look at how governance affects citizens’ health, how children’s health care access affects the aging process and how to improve children’s health in Guatemala and rural China. They want to know what it will take for people to cook more safely and breathe more easily in developing countries.

FSI professors investigate how lifestyles affect health. What good does gardening do for older Americans? What are the benefits of eating organic food or growing genetically modified rice in China? They study cost-effectiveness by examining programs like those aimed at preventing the spread of tuberculosis in Russian prisons. Policies that impact obesity and undernutrition are examined; as are the public health implications of limiting salt in processed foods and the role of smoking among men who work in Chinese factories. FSI health research looks at sweeping domestic policies like the Affordable Care Act and the role of foreign aid in affecting the price of HIV drugs in Africa.

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More than 215 million people—approximately 3% of the world’s population—now live outside their country of birth (United Nations, 2009). Migration of individuals across international borders has socio-economic consequences both to the receiving and sending countries. One of the most important economic impacts of international migration is the amount of remittances sent home by migrants. World Bank (2011) estimated that developing countries received about $372 billion of remittances. Remittances serve as the second largest source of foreign reserves, next to exports of goods and services, for these countries. In addition, remittances benefit the poor households whose average income falls below the amount necessary to meet their most basic and non-food needs for the year.

This study focuses on the roles of international migration and remittances in the Philippines, which was ranked fourth in total international remittances received in 2009, after India, China, and Mexico (World Bank, 2012). The Philippine government refers to the temporary international workers or Overseas Filipino Workers (OFWs) as bagong bayani or new heroes. This epithet stems from the important roles that these migrant workers play: they often serve as the primary income providers for their families left in the Philippines, and their transfers are a source of foreign reserves for the Philippine economy.  

The colloquium presents evidence on three related research questions. The first is whether agricultural households in rural Philippines use remittances from OFWs, along with loans, and assets to mitigate the effect of negative shocks to their income. In particular, speaker Marjorie Pajaron will ask the question whether farmers depend on their network of family and friends when they encounter a natural disaster, like excessive rainfall or typhoon. The second is how migration affects the bargaining power within the household. Finally, she will discuss the remittance behavior of different types of migrants from the Philippines. 

Marjorie Pajaron joins the Walter H. Shorenstein Asia-Pacific Research Center during the 2012–13 academic year from the University of Hawai’i at Manoa Department of Economics where she served as a lecturer.

She took part for five years in the National Transfer Accounts project based in Honolulu. Her research focuses on the role of migrant remittances as a risk-coping mechanism, as well as the importance of bargaining power in the intra-household allocation of remittances in the Philippines. Pajaron received a PhD in economics from the University of Hawai’i at Manoa. 

Her recent working papers include: “Remittances, Informal Loans, and Assets as Risk-Coping Mechanisms: Evidence from Agricultural Households in Rural Philippines,” October 2012, Revise and Resubmit, Journal of Development Economics; “The Roles of Gender and Education on the Intra-household Allocations of Remittances of Filipino Migrant Workers,” June 2012; and “Are Motivations to Remit Altruism, Exchange, or Insurance? Evidence from the Philippines,” December 2011.

 

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Marjorie Pajaron Asia Health Policy Postdoctoral Fellow in Developing Asia Speaker Asia Health Policy Program, Stanford University
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David Relman, a Stanford microbiologist and professor of infectious diseases, has taken up the mantle as CISAC co-director alongside Stanford law professor Tino Cuéllar, both of whom intend to broaden the center’s research in biosecurity and the life sciences.

Relman, the Thomas C. and Joan M. Merigan Professor at Stanford’s School of Medicine and chief of infectious disease at the VA Palo Alto Healthcare System, has advised the U.S. government about pathogen diversity, dual-use technology and biosecurity. He also is the current president of the Infectious Diseases Society of America.

“The appointment of a life scientist who focuses on infectious diseases and biosecurity is an innovative step for our work in international security and cooperation,” said Gerhard Casper, president emeritus of Stanford University and director of CISAC’s umbrella organization, the Freeman Spogli Institute for International Studies.

Relman succeeds Siegfried S. Hecker, a nuclear scientist and director emeritus of the Los Alamos National Laboratory, who was the CISAC co-director since 2007. One of the world’s foremost experts on plutonium, nuclear weapons and nonproliferation, Hecker is on sabbatical in New Mexico and the Vienna Center for Disarmament and Non-Proliferation. He is working on a book about his historic efforts to foster collaboration between U.S. and Russian nuclear labs, as well as traveling to meet his nonproliferation counterparts in parts of Europe and Russia.

Hecker will return to CISAC this summer to resume his teaching in the Department of Management Science and Engineering, as well as his writing and research as a senior fellow at CISAC and FSI.

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Co-sponsored by the Center for South Asia, Stanford University

Human life expectancy improved more in the last 50 years than in the preceding 5000 years. Much of this recent progress arose from declines in childhood mortality, and most of this decline was due to scientific knowledge and technologies (defined widely as drugs, diagnostics, policies, strategies, and epidemiological knowledge). The dominant challenge of the 21st century is to apply scientific knowledge to reduce premature adult mortality, in particular from vascular and neoplastic disease but also from persistent infectious disease such as malaria. Reliable quantification of the causes of death is a key starting point for control of adult diseases, as shown by the early results from India's Million Death Study. Specific global attention is required to tobacco, as on current patterns there will be 1 billion deaths from smoking in the 21st century, as opposed to "only" 100 million deaths from smoking in the 20th century. Scientific research on adult mortality, paired with specific action, might well halve premature adult mortality worldwide in the next few decades.

Professor Prabhat Jha has been a key figure in epidemiology and economics of global health for the past decade. He is the University of Toronto Endowed Professor in Disease Control and Canada Research Chair at the Dalla Lana School of Public Health, and the founding Director of the Centre for Global Health Research at St. Michael's Hospital in Toronto. Professor Jha is a lead investigator of the Million Death Study in India, which quantifies the causes of premature mortality in over 1 million homes from 1997-2014 and which examines the contribution of key risk factors such as tobacco, alcohol, diet and environmental exposures. He is the author of several influential books on tobacco control, including two that helped enable a global treaty on tobacco control, now signed by over 160 countries.

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Prabhat Jha University of Toronto Endowed Professor in Disease Control and Canada Research Chair Speaker the Dalla Lana School of Public Health
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Currently, more than two-thirds of the population in Africa must leave their home to fetch water for drinking and domestic use. The time burden of water fetching has been suggested to influence the volume of water collected by households as well as time spent on income generating activities and child care. However, little is known about the potential health benefits of reducing water fetching distances. Data from almost 200 000 Demographic and Health Surveys carried out in 26 countries were used to assess the relationship between household walk time to water source and child health outcomes. To estimate the causal effect of decreased water fetching time on health, geographic variation in freshwater availability was employed as an instrumental variable for one-way walk time to water source in a two-stage regression model. Time spent walking to a household’s main water source was found to be a significant determinant of under-five child health. A 15-min decrease in one-way walk time to water source is associated with a 41% average relative reduction in diarrhea prevalence, improved anthropometric indicators of child nutritional status, and a 11% relative reduction in under-five child mortality. These results suggest that reducing the time cost of fetching water should be a priority for water infrastructure investments in Africa.

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Jenna Davis
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Abstract: 

CDDRL post-doctoral fellow Bilal Siddiqi will address the question of whether progressive, statutory legal reform can meaningfully affect the lives of the poor, using observational and experimental evidence from Liberia in a new study co-authored with Justin Sandefur at the Center for Global Development. The authors develop a simple model of forum choice and test it using new survey data on over 4,500 legal disputes taken to a range of customary and formal legal institutions in rural Liberia. Their results suggest that the poor would benefit most from access to low-cost, remedial justice that incorporates the progressive features of the formal law. They then present the results of a randomized controlled trial of a legal empowerment intervention in Liberia providing pro bono mediation and advocacy services, using community paralegals trained in the formal law. The authors find strong and robust impacts on justice outcomes, as well as significant downstream welfare benefits—including increases in household and child food security of 0.24 and 0.38 standard deviations, respectively. They interpret these results as preliminary evidence that there are large socioeconomic gains to be had from improving access to justice, not by bringing the rural poor into the formal domain of magistrates’ courts, government offices, and police stations, but by bringing the formal law into the organizational forms of the custom through third-party mediation and advocacy.

About the Speaker: 

Bilal Siddiqi is a postdoctoral scholar affiliated with the Empirical Studies of Conflict project (esoc.princeton.edu). His research focuses on micro-institutions, formal and informal legal systems, peace-building and state accountability in post-conflict settings. He is currently involved in several field experiments in Sierra Leone and Liberia, including a randomized controlled trial of two non-financial incentive mechanisms in Sierra Leone’s public health sector; experimental evaluations of community-based paralegal programs in Liberia and Sierra Leone; and a randomized controlled trial of a community reconciliation program in Sierra Leone. 

Bilal received his Ph.D. and M.Phil. in economics from Oxford University, where he studied as a Rhodes Scholar. Prior to Stanford, he was based at the Institute for International Economic Studies (IIES) at Stockholm as a Marie Curie / AMID Scholar; and has also spent time at the Center for Global Development in Washington, DC, where he worked on aid effectiveness in global health. He holds a B.Sc. (Hons) from the Lahore University of Management Sciences in Lahore, Pakistan.

 

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Minerva Postdoctoral Fellow (ESOC Project)
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Bilal Siddiqi is a postdoctoral scholar affiliated with the Empirical Studies of Conflict project (esoc.princeton.edu). His research focuses on micro-institutions, formal and informal legal systems, peace-building and state accountability in post-conflict settings. He is currently involved in several field experiments in Sierra Leone and Liberia, including a randomized controlled trial of two non-financial incentive mechanisms in Sierra Leone’s public health sector; experimental evaluations of community-based paralegal programs in Liberia and Sierra Leone; and a randomized controlled trial of a community reconciliation program in Sierra Leone.

Bilal received his Ph.D. and M.Phil. in economics from Oxford University, where he studied as a Rhodes Scholar. Prior to Stanford, he was based at the Institute for International Economic Studies (IIES) at Stockholm as a Marie Curie / AMID Scholar; and has also spent time at the Center for Global Development in Washington, DC, where he worked on aid effectiveness in global health. He holds a B.Sc. (Hons) from the Lahore University of Management Sciences in Lahore, Pakistan.

Bilal Siddiqi Post-doctoral fellow Speaker CDDRL
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This discussion will focus on the potential utility of innovative technology to address the governance obstacles to the provision of critical public services.  Using the challenge of maternal and child mortality reduction as an illustrative example, this discussion will outline the role political forces and governance failures play in shaping the public infrastructure of service provision and opportunities for reform.  Of special focus will be the potential role of technology to create and address these opportunities.  While there are numerous efforts underway to use new technologies to enhance the breadth and efficiency of health services in low-income settings, this discussion will focus on how these technologies could be “liberating” by being designed and used to address the political determinants of inadequate public service commitments and capacity. 

Dr. Paul Wise is the Richard E. Behrman Professor of Child Health and Society, Professor of Pediatrics at Stanford University School of Medicine, and Senior Fellow in the Freeman-Spogli Institute for International Studies at Stanford University.  He is Director of the Center for Policy, Outcomes and Prevention and a core faculty of the Centers for Health Policy and Primary Care Outcomes Research, at Stanford University.  Dr. Wise has served as Chair of the Steering Committee of the NIH Global Network for Women’s and Children’s Health, a member of the Secretary of the Department of Health and Human Service’s Advisory Committee on Genetics, Health and Society and currently serves on the National Advisory Council of the National Institute for Child Health and Human Development, NIH.  Dr. Wise’s research focuses on U.S and international child health policy, particularly the provision of technical innovation in resource-poor areas of
the world. 

 

 

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Richard E. Behrman Professor of Child Health and Society
Senior Fellow, Freeman Spogli Institute for International Studies
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Dr. Paul Wise is dedicated to bridging the fields of child health equity, public policy, and international security studies. He is the Richard E. Behrman Professor of Child Health and Society and Professor of Pediatrics, Division of Neonatology and Developmental Medicine, and Health Policy at Stanford University. He is also co-Director, Stanford Center for Prematurity Research and a Senior Fellow in the Center on Democracy, Development, and the Rule of Law, and the Center for International Security and Cooperation, Freeman Spogli Institute for International Studies, Stanford University. Wise is a fellow of the American Academy of Arts and Sciences and has been working as the Juvenile Care Monitor for the U.S. Federal Court overseeing the treatment of migrant children in U.S. border detention facilities.

Wise received his A.B. degree summa cum laude in Latin American Studies and his M.D. degree from Cornell University, a Master of Public Health degree from the Harvard School of Public Health and did his pediatric training at the Children’s Hospital in Boston. His former positions include Director of Emergency and Primary Care Services at Boston Children’s Hospital, Director of the Harvard Institute for Reproductive and Child Health, Vice-Chief of the Division of Social Medicine and Health Inequalities at the Brigham and Women’s Hospital and Harvard Medical School and was the founding Director or the Center for Policy, Outcomes and Prevention, Stanford University School of Medicine. He has served in a variety of professional and consultative roles, including Special Assistant to the U.S. Surgeon General, Chair of the Steering Committee of the NIH Global Network for Women’s and Children’s Health Research, Chair of the Strategic Planning Task Force of the Secretary’s Committee on Genetics, Health and Society, a member of the Advisory Council of the National Institute of Child Health and Human Development, NIH, and the Health and Human Secretary’s Advisory Committee on Infant and Maternal Mortality.

Wise’s most recent U.S.-focused work has addressed disparities in birth outcomes, regionalized specialty care for children, and Medicaid. His international work has focused on women’s and child health in violent and politically complex environments, including Ukraine, Gaza, Central America, Venezuela, and children in detention on the U.S.-Mexico border.  

Core Faculty, Center on Democracy, Development and the Rule of Law
Affiliated faculty at the Center for International Security and Cooperation
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He will preview some of the main arguments about the temptations of "solutionism" from his upcoming book "To Save Everything, Click Here." Now that everything is smart, hackable and trackable, it is very common to see big technology companies (as well as ordinary tech enthusiasts and geeks) embark on ambitious projects to "solve all of the world's problems." Obesity, climate change, dishonesty and hypocrisy in politcs, high crime rate: Silicon Valley can do it all. But where does this solutionist quest lead? What are the things that ought to be left "dumb" and "unhackable"? How do we learn to appreciate the imperfection - of both our lives and our social institutions - in a world, where it can be easily eliminated? Do we even have to appreciate it? 
 
 Evgeny Morozov is the author of The Net Delusion: The Dark Side of Internet Freedom. In 2010-2012 he was a visiting scholar at Stanford University's Liberation Technology program and a Schwartz fellow at the New America Foundation. In 2009-2010 he was a fellow at Georgetown University and in 2008-2009 he was a fellow at the Open Society Foundations (where he also sat on the board of the Information Program between 2008 and 2012).  Between 2006 and 2008 he was Director of New Media at Transitions Online.  Morozov has written for The New York Times, The Economist, The Wall Street Journal, The New Republic, Financial Times, London Review of Books, Times Literary Supplement, and other publications. His monthly Slate column is syndicaetd in El Pais, Corriere della Sera, Frankfurter Allgemeine Zeitung, Folha de S.Paulo and several other newspapers. 

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Evgeny Morozov Author and former Stanford Visiting Scholar Speaker
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