Immigration and obesity among lower income blacks

Objective: Our objective was to examine the associations of nativity, immigrant generation, and language acculturation with obesity among lower income black adult men and women. Research Methods and Procedures: Data from 551 black adult men and women were collected from participants in the Healthy Directions‐Health Centers Study. Race/ethnicity and nativity were self‐reported. Language acculturation was defined using participants’ first language, preferred reading language, and language spoken at home. Mixed model logistic regression models were estimated to account for within‐health center clustering. Results: Foreign‐born blacks had a lower obesity risk, compared with all U.S.‐born participants, in multivariable analyses [odds ratio (OR) = 0.57, 95% confidence interval (CI), 0.38, 0.84]. Among U.S.‐born participants, those with foreign‐born parents were significantly less likely to be obese than individuals with U.S.‐born parents (OR = 0.54; 95% CI, 0.37, 0.80). Low‐moderate language acculturation also decreased the odds of being obese (OR = 0.45; 95% CI, 0.23, 0.88). Discussion: Our findings suggest a protective effect of foreign‐born status and low‐moderate language acculturation on obesity risk among lower income black immigrants. These data highlight the importance of more frequently examining nativity in obesity‐related research conducted among blacks.     

Ecological footprint and real income: Panel data evidence from the 27 highest emitting countries

This study examines the effects of real income, financial development and trade openness on the ecological footprint (EF) of consumption using a panel data of leading world EF contributors during the period 1991–2012. A number of panel unit root tests confirm that the data are first-difference stationary. Results from Pedroni co-integration tests show that the variables are co-integrated. The panel dynamic ordinary least squares (DOLS) method is then employed to estimate the long run association between the variables. The results indicate a positive and significant association between ecological footprint (EF) and real income, and a negative and insignificant impact of trade openness on EF. Financial development is also observed to reduce EF. Afterwards, the group-mean fully modified ordinary least squares method is applied to check the robustness of the DOLS estimates. The findings are partially robust as only real income confirms the positive significant impact on EF. In addition, the vector error correction model supports a unidirectional causal impact running from real income to EF. Finally, findings from variance decomposition analysis and impulse response functions reveal that real income will have an increasing effect on EF for the selected countries into the future.     

Estimating diarrhea mortality among young children in low and middle income countries

Background

Diarrhea remains one of the leading causes of morbidity and mortality among children under 5 years of age, but in many low and middle-income countries where vital registration data are lacking, updated estimates with regard to the proportion of deaths attributable to diarrhea are needed.

Methods

We conducted a systematic literature review to identify studies reporting diarrhea proportionate mortality for children 1–59 mo of age published between 1980 and 2009. Using the published proportionate mortality estimates and country level covariates we constructed a logistic regression model to estimate country and regional level proportionate mortality and estimated uncertainty bounds using Monte-Carlo simulations.

Findings

We identified more than 90 verbal autopsy studies from around the world to contribute data to a single-cause model. We estimated diarrhea proportionate mortality for 84 countries in 6 regions and found diarrhea to account for between 10.0% of deaths in the Americas to 31.3% of deaths in the South-east Asian region.

Discussion

Diarrhea remains a leading cause of death for children 1–59 mo of age. Published literature can be used to create a single-cause mortality disease model to estimate mortality for countries lacking vital registration data.     

Economic well-being, the distribution of income and species imperilment

Mikkelson et al.’s (PLoS One 2(5):e444, 2007) empirical finding of a positive relationship between income inequality and species imperilment in an international context is less-than-compelling for 3 reasons: (a) findings for their limited sample size, which constitutes a relatively small fraction of all countries, may not hold in the context of a more encompassing sample of countries, (b) their aggregate analysis, which includes amphibians, birds, mammals, reptiles, and vascular plants, may mask important taxa-level differences, and (c) the absence of controls for spatial autocorrelation between countries. Using data from 133 countries, we estimate models of factors that influence species imperilment and, controlling for cross-border effects, we reproduce the Mikkelson et al. findings, then demonstrate that they are sensitive to inclusion of additional countries, model specification, and to data aggregation.     

Economic returns to investment in AIDS treatment in low and middle income countries

Since the early 2000s, aid organizations and developing country governments have invested heavily in AIDS treatment. By 2010, more than five million people began receiving antiretroviral therapy (ART)--yet each year, 2.7 million people are becoming newly infected and another two million are dying without ever having received treatment. As the need for treatment grows without commensurate increase in the amount of available resources, it is critical to assess the health and economic gains being realized from increasingly large investments in ART. This study estimates total program costs and compares them with selected economic benefits of ART, for the current cohort of patients whose treatment is cofinanced by the Global Fund to Fight AIDS, Tuberculosis and Malaria. At end 2011, 3.5 million patients in low and middle income countries will be receiving ART through treatment programs cofinanced by the Global Fund. Using 2009 ART prices and program costs, we estimate that the discounted resource needs required for maintaining this cohort are $14.2 billion for the period 2011-2020. This investment is expected to save 18.5 million life-years and return $12 to $34 billion through increased labor productivity, averted orphan care, and deferred medical treatment for opportunistic infections and end-of-life care. Under alternative assumptions regarding the labor productivity effects of HIV infection, AIDS disease, and ART, the monetary benefits range from 81 percent to 287 percent of program costs over the same period. These results suggest that, in addition to the large health gains generated, the economic benefits of treatment will substantially offset, and likely exceed, program costs within 10 years of investment.