Poverty in China as its Economy Nears High Income: Lessons from Japan, South Korea and the United States During Their Upper-Middle Income Transitions

Dependency theory argues that due to unequal economic relationships, including exports, multinational corporations, and loans from multilateral lending institutions, high-income nations exploit the labor and resources of low- and middle-income nations. We extend this line of reasoning to the United States Export–Import Bank, as it has recently come under scrutiny for its lending in the forestry sector of low- and middle-income nations. Although this concern has been raised, we are not aware of any cross-national research that empirically evaluates if their investments adversely impact forests. Therefore, we examine the impact of the United States Export–Import Bank lending in the forestry sector on forest loss. Using a two-stage instrumental variable regression model to account for possible donor selection bias as well as ordinary least squares regression to analyze data for 78 low- and middle-income nations, we find that export credit agency financing is related to increased forest loss from 2001 to 2014. Our findings are consistent with dependency theory ideas that economic linkages with high-income nations increase forest loss in low- and middle-income nations.

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Trends in Cancer Diseases Prevalence by Different Socioeconomic Strata in the United States

10.21203/rs.3.rs-1053429/v1 ◽

2021 ◽

Author(s):

Mingsi Wang ◽

Yi Ma ◽

Liangru Zhou ◽

Yi Cheng ◽

Yue Li ◽

...

Keyword(s):

United States ◽

Low Income ◽

Family Income ◽

Temporal Trends ◽

The United States ◽

High Income ◽

Poverty Level ◽

Middle Income ◽

Socioeconomic Strata ◽

Cancer Diseases

Abstract Background Income disparity among different socioeconomic strata in the United States has widened sharply in recent decades. Take into account the well-established link between income and health, this widening income gap may provide insight into the dynamics of the cancer disease burden in American adults. Assess the temporal trends of the 20-year predicted absolute cancer risk in American adults at different socioeconomic classes. Methods The cross-sectional analyses were carried out using data from adults aged 20 to 85 years between the 1999 and 2018 NHANES. Socioeconomic status was divided into three groups based on the family income to poverty ratio (PIR): high income (PIR ≥ 4), middle income (> 1 and <4), or at or below the federal poverty level (≤ 1). Results The analysis included 49 720 participants. The prevalence of lung cancer was lower in high-income participants than in middle-income participants (0.15% [n= 19] vs 0.35% [n= 92], p <0.001). For the low-income stratum, the prevalence of breast cancer was 1.12% [n = 117], but the number of adults in the middle (1.48% [n = 391], p = 0.009) and high-income levels (1.71% [n = 219], p <0.001) has increased. Conclusions The study found that the prevalence of cancer diseases was increasingly different among participants of different socioeconomic classes of NHANES from 1999 to 2018. Further research is required on the dynamics and health impact of income inequality, as well as public health policies and efforts to reduce these inequalities.

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Comparison of Catastrophic Out-of-Pocket Medical Expenditures in the US and South Korea

Innovation in Aging ◽

10.1093/geroni/igab046.3023 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 831-832

Author(s):

Narae Kim ◽

Mireille Jacobson

Keyword(s):

United States ◽

South Korea ◽

Health Care Expenditure ◽

The United States ◽

High Income ◽

Medical Expenditure ◽

System Level ◽

Medical Spending ◽

Significant Difference ◽

The Us

Abstract To date, relatively few studies have examined catastrophic out-of-pocket medical spending in the United States, especially in comparison to other high-income countries. We compared catastrophic out-of-pocket medical spending among adults age 65 and older in the United States versus South Korea, a high-income country with national health insurance that is often overlooked in cross-country comparisons. We defined catastrophic medical spending as health care expenditure for the past two years that exceeds 50% of one’s annual household income. Using data from the 2016 Health and Retirement Study (HRS) and Korean Longitudinal Study of Aging (KLoSA), we performed a logistic regression to examine the factors affecting catastrophic out-of-pocket medical spending for older adults in both countries. We also performed a Blinder-Oaxaca decomposition to compare the contribution of demographics factors versus health system-level factors to catastrophic out-of-pocket medical spending. The proportion of respondents with catastrophic out-of-pocket medical expenditure was higher in the US; the proportion was 5.8% and 3.0% in the US and South Korea, respectively. Both in the US and South Korea, respondents who were in the lower-income quartiles, who had experienced a stroke or had diabetes, and who rated their health as poor had higher odds of catastrophic out-of-pocket medical expenditure. The Blinder-Oaxaca non-linear decomposition showed that the significant difference in the rate of catastrophic out-of-pocket medical spending between the two countries was attributable to unobservable system-level factors, not observed differences in the sociodemographic characteristics between the two countries.

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Establishing healthy pharmaceutical regulations on statutory exclusivity: Lessons from the experience in the European Union, Canada, South Korea, Australia, and the United States

Journal of Generic Medicines The Business Journal for the Generic Medicines Sector ◽

10.1177/1741134318799385 ◽

2018 ◽

Vol 14 (4) ◽

pp. 167-174 ◽

Cited By ~ 3

Author(s):

Kyung-Bok Son

Keyword(s):

United States ◽

European Union ◽

International Trade ◽

South Korea ◽

Trade Agreements ◽

The United States ◽

The European Union ◽

Middle Income ◽

International Trade Agreements ◽

Middle Income Countries

Abstracts Objectives Recent international trade agreements require member countries a prolonged statutory exclusivity for biologics, and domestic legislation guarantees various forms of exclusivity for specific drugs, indications, or studies. This study notes prolonged exclusivity provisions for biologics in the United States and international trade agreements. We aim to review various exclusivity systems, including chemical entities, in selected high-income countries and to suggest implications for establishing the system specifically relevant for biologics in low- and middle-income countries. Methods We conducted a review of a comprehensive range of literature to develop the framework. Then, a comparative legal analysis was conducted to analyze the deviations among the systems in the European Union, Canada, South Korea, Australia, and the United States. Results There is constructive ambiguity in international trade agreements, specifically for provisions regarding biologics. Furthermore, the selected countries operate different statutory exclusivity systems in terms of eligibility for statutory exclusivity, specific measures for exclusivity, and other elements of exclusivity. In addition, market exclusivity, which is distinguished from data exclusivity, is not available in Korea and Australia. There are also various forms of statutory exclusivity for specific drugs, indications, or studies requested by the marketing authority. Conclusions Given constructive ambiguities in international agreements and variations in the manner of implementations of the systems in selected countries, statutory exclusivity for biologics could be established with cautions to mediate the harms. In this study, we suggest several solutions and alternatives for low- and middle-income countries.

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Status of the Prevention of Multidrug-Resistant Organisms in International Settings: A Survey of the Society for Healthcare Epidemiology of America Research Network

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2016.242 ◽

2016 ◽

Vol 38 (1) ◽

pp. 53-60 ◽

Cited By ~ 10

Author(s):

Nasia Safdar ◽

Sharmila Sengupta ◽

Jackson S. Musuuza ◽

Manisha Juthani-Mehta ◽

Marci Drees ◽

...

Keyword(s):

United States ◽

Low Income ◽

The United States ◽

Multidrug Resistant ◽

High Income ◽

Research Network ◽

Middle Income ◽

Stewardship Program ◽

Multidrug Resistant Organisms ◽

Healthcare Epidemiology

OBJECTIVETo examine self-reported practices and policies to reduce infection and transmission of multidrug-resistant organisms (MDRO) in healthcare settings outside the United States.DESIGNCross-sectional survey.PARTICIPANTSInternational members of the Society for Healthcare Epidemiology of America (SHEA) Research Network.METHODSElectronic survey of infection control and prevention practices, capabilities, and barriers outside the United States and Canada. Participants were stratified according to their country’s economic development status as defined by the World Bank as low-income, lower-middle-income, upper-middle-income, and high-income.RESULTSA total of 76 respondents (33%) of 229 SHEA members outside the United States and Canada completed the survey questionnaire, representing 30 countries. Forty (53%) were high-, 33 (43%) were middle-, and 1 (1%) was a low-income country. Country data were missing for 2 respondents (3%). Of the 76 respondents, 64 (84%) reported having a formal or informal antibiotic stewardship program at their institution. High-income countries were more likely than middle-income countries to have existing MDRO policies (39/64 [61%] vs 25/64 [39%],P=.003) and to place patients with MDRO in contact precautions (40/72 [56%] vs 31/72 [44%],P=.05). Major barriers to preventing MDRO transmission included constrained resources (infrastructure, supplies, and trained staff) and challenges in changing provider behavior.CONCLUSIONSIn this survey, a substantial proportion of institutions reported encountering barriers to implementing key MDRO prevention strategies. Interventions to address capacity building internationally are urgently needed. Data on the infection prevention practices of low income countries are needed.Infect Control Hosp Epidemiol.2016:1–8

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