Health and Economic Consequences of Universal Paid Sick Leave Policies During the COVID-19 Pandemic

Importance: Universal paid sick-leave (PSL) policies have been implemented in jurisdictions to mitigate the spread of SARS-CoV-2. However empirical data regarding health and economic consequences of PSL policies is scarce. Objective: To estimate effects of a universal PSL policy in Ontario, Canada's most populous province. Design: An agent-based model (ABM) to simulate SARS-CoV-2 transmission informed by data from Statistics Canada, health administrative sources, and from the literature. Setting: Ontario from January 1st to May 1st, 2021. Participants: A synthetic population (1 million) with occupation and household characteristics representative of Ontario residents (14.5 million). Exposure: A base case of existing employer-based PSL alone versus the addition of a 3- or 10-day universal PSL policy to facilitate testing and self-isolation among workers infected with SARS-CoV-2 themselves or because of infected household members. Main Outcome(s) and Measure(s): Number of SARS-CoV-2 infections and COVID-19 hospitalizations, worker productivity, lost wages, and presenteeism (going to a workplace while infected).

Changes in Household Size and Depression: A Temporal Analysis

This study examines the relationship between changes in household size and depression through a temporal analysis using the Korean Welfare Panel Study. The number of household members at both t-1 and t year was measured and a generalized estimating equation was used. Households that increased in size after a year showed a lower prevalence of depression than the corresponding reference groups. On the contrary, when individuals from multi-person households inhabited single-person households after a year, their probability of experiencing depression increased by more than 70% in comparison to those who remained in single-person households throughout.

Everyday social support processes: Household members’ instrumental and emotional support of entrepreneurs

While it is well-established that entrepreneurs benefit from social support, little is known about how and when instrumental and emotional support from household members facilitate entrepreneurial action and persistence. Through a longitudinal, qualitative study, we develop a conceptual framework that shows how social support from the household becomes an integral part of the everyday activities of entrepreneurs. In contrast to the perception of social support as static, our findings illustrate it as a dynamic, ongoing process which is core to business start-up and growth over time. We also challenge the perspectives that households are simply repositories of resources and entrepreneurs passive recipients of support by demonstrating that social support is necessarily interactive, whereby entrepreneurs and households play a collaborative role in entrepreneurship. Finally, we join the debate concerning mechanisms of social support by suggesting that the main effect model and buffering hypothesis are not contradictory, but are instead interdependent.

Transmission of Onychomycosis and Dermatophytosis between Household Members: A Scoping Review

Onychomycosis is a common fungal infection of the nail, caused by dermatophytes, non-dermatophytes, and yeasts. Predisposing factors include older age, trauma, diabetes, immunosuppression, and previous history of nail psoriasis or tinea pedis. Though many biological risk factors have been well characterized, the role of the environment has been less clear. Studies have found evidence of transmission in 44% to 47% of households with at least one affected individual, but the underlying mechanisms and risk factors for transmission of onychomycosis between household members are incompletely understood. A scoping literature review was performed to characterize and summarize environmental risk factors involved in the transmission of onychomycosis within households. A total of 90 papers met the inclusion criteria, and extracted data was analyzed in an iterative manner. Shared household surfaces may harbor dermatophytes and provide sources for infection. Shared household equipment, including footwear, bedding, and nail tools, may transmit dermatophytes. The persistence of dermatophytes on household cleaning supplies, linen, and pets may serve as lasting sources of infection. Based on these findings, we provide recommendations that aim to interrupt household transmission of onychomycosis. Further investigation of the specific mechanisms behind household spread is needed to break the cycle of transmission, reducing the physical and social impacts of onychomycosis.

Household composition, smoking cessation and relapse: results from a prospective longitudinal Australian cohort

AimsTo examine the association between household members and their tobacco smoking behaviour on patterns of smoking cessation and relapse.Design and participantsData was sourced from 19 waves (years 2001 to 2019) of the nationally representative Household Income and Labour Dynamics in Australia (HILDA) survey, with all household members 15 years or older completing the survey annually. The final sample included, on average, 3,056 ex-smokers and 2,612 smokers per wave.MeasurementsSelf-reported annual smoking status was used to construct measures of smoking cessation and relapse. Information on household structure and relationships was then used to develop variables describing the presence of household members and their smoking status by relationship to the individual (i.e., child, parent, spouse, sibling, or other). Multivariate regression analyses were then used to predict the likelihood of smoking cessation and relapse controlling for the presence of other household members and their smoking status, sociodemographic characteristics, number of cigarettes smoked per day, previous quit attempts, and years abstained from smoking.FindingsIndividuals that lived with non-smokers were more likely to quit [OR1.22 (95%CI 1.11;1.34)] relative to those living alone. However, this favourable association was negated if living with another smoker, which was associated with a reduced likelihood of smoking cessation [OR0.77 (95%CI 0.72;0.83)] and a higher likelihood of relapse [1.37 (95%CI 1.22;1.53)]. In particular, living with a spouse or parent that smoked reduced the likelihood of smoking cessation [OR0.71 (95%CI 0.65;0.78) and OR0.71 (95%CI 0.59;0.84), respectively] and increased the likelihood of relapse [OR1.47 (95%CI 1.28;1.69) and OR1.39 (95%CI 1.00;1.94) respectively] relative to living with their non-smoking counterparts.ConclusionsHousehold composition and intrahousehold smoking behaviour should be considered when delivering, or estimating the benefits of, smoking cessation interventions. Interventions which encourage smoking cessation at the household level may assist individuals to quit and abstain from smoking.

Food Insecurity and Healthcare Utilization in Indonesia: Evidence from Indonesian National Household Surveys

Treatment for sicknesses in healthcare is a crucial determinant to improve health. In Indonesia, the unmet need for healthcare is common for people in the lower economic group. This study aims to examine how food insecurity affects outpatient care using the indicators of food insecurity to highlight individuals with high health risks and experiencing problems with limited resources. The data used in this study consisted of 159,236 individuals representing different age ranges from the 2017 National Socio-Economic Survey (SUSENAS) and the 2018 Village Potential Census (PODES). Data were analyzed using ivprobit to address bias due to the endogeneity in the food insecurity variables. The results indicate that a higher food insecurity score will increase the chances of not accessing modern healthcare for outpatient care when sick. Several variables like sex, types of residence, number of household members living together, access to healthcare, health insurance, social protection, and illness characteristic were also found to influence individual behavior in not utilizing modern healthcare for outpatient care. This study suggests that policymakers should pay attention to the utilization of modern healthcare, especially for outpatient care in groups experiencing food insecurity.

Covid-19, Rural Poverty, and Women’s Role in Decision-Making: Evidence from Khatlon Province in Tajikistan

The covid-19 pandemic has had devastating effects globally; it has caused health crises and economic recessions, leading unemployment to spike and disrupting food systems and supply chains. In the heavily remittance-dependent context of Tajikistan, however, migration has continued – and appears to have become increasingly dominated by men. In this context, what has happened to women’s perceptions of economic prospects, as well as the well-being of their households? How has women’s involvement in decision-making evolved? And to what extent do out-migration or in-migration of household members predict changes in women’s decision-making power? We consider these questions using a September – October 2020 phone survey deployed in Khatlon province, Tajikistan that successfully tracked 87% of households that had been surveyed in person in 2018. We find that both genders have similar expectations for their agricultural production (harvests), but women are slightly more likely to identify concerns with rising prices and a lack of access to financial services. Overall, we find little in the way of evidence that women’s involvement in intra-household decision-making declined as a result of the pandemic—though this is from a low base. However, we find that women are less likely than are men to report improvements in women’s decision-making authority. Further, we find that out-migration of household members, which is dominated by men, is associated with improvements in women’s decision-making power, particularly with respect to decisions about how to spend household income. Overall, our results point to the need for additional analyses of the gendered impacts of shocks on women in the Central Asia region.

Evaluating the Factors (Stress, Anxiety and Depression) Affecting the Mental Health Condition of Nurses During the COVID-19 Pandemic

This study aimed to determine the depression, anxiety and stress levels that have negatively impacted nurses’ mental health during the COVID-19 pandemic. A sample group of 826 nurses working in Turkey were asked to fill in an online questionnaire in order to evaluate their psychological responses and the related factors that have adversely affected their mental health during the COVID-19 pandemic. In total, 696 nurses (84.3%) showed symptoms of depression, 644 (78%) reported anxiety and 543 (65.74%) reported stress. This study also highlighted that the most concerning factor for the nurses was the risk of transmitting the COVID-19 infection to their household members (89.2%). The most important problems faced by the nurses during COVID-19 included equipment shortages (50.7%), administrative problems (38.5%) and issues such as accommodation and nutrition (27.4%). These were found to have a statistically significant correlation with the nurses’ levels of depression, anxiety and stress. The fear of losing a household member, the inability to their household’s social needs and the fear of death were among the factors that concerned nurses during the COVID-19 pandemic, significantly affecting their levels of depression, anxiety and stress. Taking the necessary measures to deal with the aforementioned problems and fears is important to protect the health, productivity and efficiency of nurses during the pandemic period.

Household financial burden associated with health care for older people in Viet Nam: A cross-sectional survey

Background Population ageing and the associated increase in the health care needs of older people are putting pressure on the health care system in Viet Nam. The country prioritizes health care for older people and has developed financial protection policies to mitigate financial hardship due to out-of-pocket health expenditures (OOPHEs) borne by their households. This study examines the level and determinants of the financial burden of OOPHE among households with people aged ≥60 years in Viet Nam. Methods A cross-sectional household survey was conducted among a sample of 1536 older people living in 1477 households in three provinces representing the North, Central and South regions of Viet Nam during 2019–2020. The financial outcomes were catastrophic health expenditure (CHE), using the World Health Organization's definition, and financial distress due to OOPHE. Multivariate binary logistic regression analysis was employed to determine the factors associated with these outcomes. Results OOPHE for older household members accounted for 86.3% of total household health expenditure. Of households with older people, 8.6% (127) faced CHE, and 12.2% (181) experienced financial distress due to OOPHE. Households were at a higher risk of incurring financial burdens related to health expenditures if they had fewer household members; included only older people; were in rural or remote, mountainous areas; and had older members with noncommunicable diseases. There was no significant association between health insurance coverage and financial burden. However, when older people sought tertiary care or private care, the possibility of a household facing CHE increased. Regardless of the type and level of care, health service utilization by older people results in a higher likelihood of a household encountering financial distress. Conclusions This study reveals that OOPHE for older people can impose substantial financial burdens on households, leading them to face CHE and financial distress. This study provides evidence to justify reforming financial protection policies and introducing policy interventions targeted at better protecting older people and their households from the financial consequences of OOPHE. There is also the need to strengthen the grassroots health facilities to provide primary care closer to home at lower costs, particularly for the management of noncommunicable diseases.

Determinants of Gender Disparity in Nutritional Intake among Children in Pakistan: Evidence from PDHS

The purpose of this study is to analyze early age malnutrition on a gender basis in Pakistan. Pakistan Demographic and Health Survey (PDHS) 2012–13 data related to households’ characteristics that affect the nutrition of children less than 5 years of age are used for the estimation of results. Gender disparity (measured by girl malnourished in household/boy malnourished in a household) is constructed for the measurement of gender disparity in early age child nutrition. After synthesizing the PDHS data set, 2119 observations are used for regression results of gender disparity. Regression results are analyzed at the level of 5% confidence interval otherwise insignificant. egression results for gender disparity show that households in good socioeconomic status, a greater number of household members, a mother’s higher level of education, mother employment, and the male head of the household, causes a decrease in gender disparity in nutrition intake of children.