FINANCIAL IMPACT OF MENTAL ILLNESS AND HOW TO MEASURE THE CONSEQUENCES

This article shows the economic impact of mental illness, as well as various cost-estimating approaches. To assess the burden of mental diseases, there are three different ways: the human capital, the economic growth and the value of statistical life approach. The first focuses on indirect and direct costs. Moreover, the effect of mental illness on economic development can only be approximated implicitly. Thus, the lack of production is primary estimated for somatic conditions compared to their corresponding quantity of disability-adjusted life years (DALYs). The total economic productivity drop associated with mental illnesses between 2011 and 2030 is rated to be US$16.3 trillion globally. Furthermore, the value of statistical life (VSL) method suggests that trade-offs between risks and capital should be used to assess the probability of injury or death due to psychiatric illness. This computation is equivalent to that of cardiovascular disease and bigger than that of cancer. However, greater activism is required to better the existing condition.

Value of statistical life year in extreme poverty: a randomized experiment of measurement methods in rural Burkina Faso

Background Value of a Statistical Life Year (VSLY) provides an important economic measure of an individual’s trade-off between health risks and other consumption, and is a widely used policy parameter. Measuring VSLY is complex though, especially in low-income and low-literacy communities. Methods Using a large randomized experiment (N = 3027), we study methodological aspects of stated-preference elicitation with payment cards (price lists) in an extreme poverty context. In a 2 × 2 design, we systematically vary whether buying or selling prices are measured, crossed with the range of the payment card. Results We find substantial effects of both the pricing method and the list range on elicited VSLY. Estimates of the gross domestic product per capita multiplier for VSLY range from 3.5 to 33.5 depending on the study design. Importantly, all estimates are economically and statistically significantly larger than the current World Health Organization threshold of 3.0 for cost-effectiveness analyses. Conclusions Our results inform design choice in VSLY measurements, and provide insight into the potential variability of these measurements and possibly robustness checks.

Economic Impacts on Human Health Resulting from the Use of Mercury in the Illegal Gold Mining in the Brazilian Amazon: A Methodological Assessment

Artisanal small-scale gold mining (ASGM) in the Amazon results in the dumping of tons of mercury into the environment annually. Despite consensus on the impacts of mercury on human health, there are still unknowns regarding: (i) the extent to which mercury from ASGM can be dispersed in the environment until it becomes toxic to humans; and (ii) the economic value of losses caused by contamination becomes evident. The main objective of this study is to propose a methodology to evaluate the impacts of ASGM on human health in different contexts in the Brazilian Amazon. We connect several points in the literature based on hypotheses regarding mercury dispersion in water, its transformation into methylmercury, and absorption by fish and humans. This methodology can be used as a tool to estimate the extent of environmental damage caused by artisanal gold mining, the severity of damage to the health of individuals contaminated by mercury and, consequently, can contribute to the application of fines to environmental violators. The consequences of contamination are evaluated by dose-response functions relating to mercury concentrations in hair and the development of the following health outcomes: (i) mild mental retardation, (ii) acute myocardial infarction, and (iii) hypertension. From disability-adjusted life years and statistical life value, we found that the economic losses range from 100,000 to 400,000 USD per kilogram of gold extracted. A case study of the Yanomami indigenous land shows that the impacts of mercury from illegal gold mining in 2020 totaled 69 million USD, which could be used by local authorities to compensate the Yanomami people.

Lockdowns Save People from Air Pollution: Evidence from Daily Global Tropospheric NO2 Satellite Data

Motivated by the global fear of the Coronavirus-19 (COVID-19) pandemic, we investigated whether lockdowns save people from air pollution, notably from Nitrogen Dioxide (NO2). Using daily satellite data from the National Aeronautics and Space Administration (NASA), we first found that the global NO2 tropospheric vertical column density (TVCD) decreased by 16.5% after the Coronavirus-19 (COVID-19) outbreak. Then, we calculated the global health benefits, as the monetized value of life, using the value of a statistical life (VSL). The total global health benefits were approximately 8.73 trillion USD, accounting for 10% of the global GDP; such benefits would be the largest in China, followed by the United States, Japan and Germany. Our results suggest that lockdowns may bring benefits to countries that policy interventions cannot easily bring, thus highlighting the importance of social distancing.

Prediction of statistical life time for unidirectional CFRTP under water absorption

Carbon fiber reinforced plastics (CFRP) with the matrix of thermoplastic resin called as carbon fiber reinforced thermoplastics (CFRTPs) has been widely used in the industrial fields. Recently, a thermoplastic epoxy resin (TP-EP resin) has been developed as the matrix of CFRTP and carbon fiber reinforced TP-EP strands (CF/TP strands) molded by pultrusion method began to be used as tension rods for infrastructure under water absorption. On the other hand, an accelerated testing methodology (ATM) for predicting statistically long-term creep and fatigue strengths of CFRP was established by the authors. This study examines the prediction of statistical life time for these developed CF/TP strands at creep and fatigue tension loadings under the wet condition of water absorption with comparison to similar prediction under a dry condition by using our developed ATM. First, the static, creep, and fatigue tensile strengths of CF/TP strands were measured statistically at various constant temperatures under wet and dry conditions. The statistical long-term creep and fatigue tensile strengths for CF/TP strands under wet and dry conditions are predicted by substituting the measured data into the formulations of these strengths on our developed ATM. Finally, the influences of water absorption on the statistical long-term creep and fatigue strengths of CF/TP strands are cleared. In particular, the degradation of relaxation modulus of matrix TP-EP resin with increasing of elapsed time is accelerated with the water absorption, and the degradation of creep strength of CF/TP strand with increasing of elapsed time is also accelerated with the water absorption in the similar manner of matrix resin. On the other hand, the fatigue strength of CF/TP strand decreases scarcely with water absorption although this fatigue strength depends remarkably on the number of cycles to failure.

Mandatory Public Health Measures for Coronavirus-19 Are Associated With Improved Mortality, Equity and Economic Outcomes

The impact of public health measures on the coronavirus-2019 pandemic was analyzed by comparing mandatory versus voluntary nonpharmaceutical interventions between 2 comparable European countries and among 3 U.S. states. Using an ecological retrospective cohort study design, we examine differences in mortality, economic impact, and equity. Compared to voluntary policies, mandatory shelter-in-place policies were associated with a 3- to 5-fold lower population-adjusted mortality in the U.S. model and between 11- to 12-fold lower in the European one. Voluntary shelter-in-place measures were associated with overall increased mortality cost, as measured by value of a statistical life; somewhat greater decreases in gross domestic product; and substantial negative impacts on minority communities, who experienced markedly increased mortality rates (the percentage of minority deaths was 2.3 and 4 times greater in the U.S. model and 14.5 times higher in the European one) and mortality cost (2.7- and 4.5-fold higher in the U.S. model and 11.1-fold higher in the European one). We conclude that voluntary policies are less effective than mandatory ones, based on historical precedent and the current analysis. Negative effects on health equity mirrored the increased mortality outcomes of voluntary policies, and there was no apparent economic benefit associated with voluntary measures.

Welfare economics of managing an epidemic: an exposition

This paper reviews recent findings on the normative analysis of private and governmental countermeasures against infectious diseases, focusing on COVID-19. Based on a model that relates the economic activity to infectious disease epidemics, policies that maximize social welfare are considered. Lockdowns in many countries are measures that restrict economic activity over a wide area, and the economic damage they cause is extremely large. Existing studies on the net benefit of lockdown implemented in 2020 have reached mixed conclusions as to whether it is warranted or not. Although the estimates of costs and effects are relatively stable, the setting of the value of a statistical life for converting effects into benefits has a wide range and is also likely to overestimate benefits. Therefore, a careful procedure for setting is particularly crucial to obtain a reliable evaluation of countermeasures. Compared to uniform restriction of activities, taking measures to restrict activities by selecting targets may improve efficiency. Attributes that can be used to select targets include those that can be identified at little or no cost, such as age and industry, and those that can only be identified at a cost, such as close contact with infectious individuals and the presence of pathogens. In comparison to lockdown, these measures may reduce human suffering and economic suffering. No trade-off exists between uniform activity restrictions and selective activity restrictions.

Estimation of the cost-effective threshold of a quality-adjusted life year in China based on the value of statistical life

Cost-effective threshold (CET) is essential for health technology assessment and decision-making based on health economic evaluations. Recently, it has been argued that the commonly used once and three times of gross domestic product (GDP) per capita CETs of a quality-adjusted life year (QALY) are not necessarily empirically supported in all countries. Therefore, we aimed to estimate the CET of a QALY as times of GDP per capita in China, of which the reimbursement coverage decisions are increasingly engaging economic evaluations. Estimates on the value of statistical life (VSL) in China were identified from several studies in the literature and converted to times of GDP per capita, the weighted average of which was used for subsequent calculation. By pooling data on population mortality, health utility, and age distribution, we estimated the value of a statistical QALY (VSQ) from VSL using an established mathematical process, which represented the theoretical upper bound of CET. The corresponding point estimate and theoretical lower bound were obtained using their numerical relationships with the upper bound. Scenarios analyses were also conducted. The estimated CET, its upper bound, and its lower bound were 1.45, 2.90, and 1.16 times of GDP per capita in China, respectively. In different scenarios, the estimated CET varied but was greater than once GDP per capita in most cases. As such, the CET of a QALY in China is close to 1.5 times of GDP per capita, which should be benchmarked for future ICER-based coverage decisions.

The value of statistical life in the context of road safety: new evidence on the contingent valuation/standard gamble chained approach

This study estimates the value of statistical life (VSL) on a road traffic accident using the Contingent Valuation/Standard Gamble chained approach. A large representative sample (n = 2020) is used to calculate a VSL for use in the evaluation of road safety programmes in Spain. The paper also makes some methodological contributions, by providing new evidence about the consistency of the chained method. Our main results are: (1) A range from 1.3 million euro to 1.7 million euro is obtained for the VSL in Spain in the context of road accidents. This range is in line with the values used in the same context in other European countries, although it is lower than those obtained in different contexts and with other methods. (2) The method performs much better in terms of scope sensitivity than the traditional contingent valuation method, which asks subjects about their willingness to pay for very small reductions in the risk of death. (3) We introduce a new ‘indirect’ chaining approach which reduces (but does not remove) the disparity between direct and indirect chaining approaches. More extreme VSL estimates are still obtained with this indirect method than with the direct one. (4) VSL estimates depend on the injury used. More specifically, we obtained a lower VSL when a more severe injury is used. (5) Framing the risk of death in the modified standard gamble question as “10n in 10,000” instead of “n in 1000” influences the value of VSL. We attribute this effect to the Ratio Bias.

Is prevention of suicide worth less? A comparison of the value per statistical life

This paper compares the value per statistical life (VSL) in the context of suicide prevention to that of prevention of traffic fatalities. We conducted a contingent valuation survey with questions on willingness to pay (WTP) in both contexts by administering a web questionnaire to 1038 individuals aged 18 to 80. We conjectured that WTP for a given impact on the number of fatalities would be lower for suicide prevention because suicide, at least to some degree, is the result of individuals’ own decisions. However, this hypothesis was not supported by the within- or between-sample estimates of WTP or by responses to direct questions. Hence, no support is provided for the use of a lower valuation of the impact of suicide prevention than for risk-reducing programs in other fields, such as traffic safety. This implies that the same VSL should be used for evaluating suicide prevention interventions and for risk-reducing programs in other policy areas and funds for the prevention of fatalities should be directed to the area with the lowest cost per life saved.