What impact did social and health policy have on the healthcare system in the latter part of the twentieth century?

This study measures inequality and inequity in the distribution of clinical trials on cancer drug development between 1996 and 2016, comparing the number of clinical trials with cancer need, proxied by prevalence, incidence, or survival rates for both rare and non-rare cancers. We leverage a unique global database of clinical trials activity and costs between 1996 and 2016, constructed for 227 different cancer types to measure for rare and non-rare cancers: i) inequalities and inequity of clinical trial activity, considering all trials as well as split by R&D stage; ii) inequalities and inequity in R&D investment proxied by trial enrollment and duration; iii) evolution of inequity over time. Inequalities are measured with concentration curves and indices and inequities measured with the health inequity index. We find four important results. First, we show pro-low need inequity across cancer types for both rare and non-rare cancers, for all need proxies. Second, we show inequity differs across R&D stages and between rare and non-rare cancers. The distribution of clinical trials for non-rare cancers disproportionately favors low-need non-rare cancers from earlier to later stages of R&D, whilst for rare cancers this only occurs in Phase 2 trials. Third, inequity analyses in R&D investment show that only trial enrollment for rare cancers and trial duration for non-rare cancers are disproportionately concentrated among low-need cancers. Finally, while pro-low need inequity has persisted between 1996 and 2016 for non-rare cancers, it has faded for rare cancers post-EU orphan drugs’ legislation.

This study analyses the changes in mental health in the UK that occurred as a result of the 2016 referendum on UK membership of the EU (Brexit). Using the Household Longitudinal Study, we compare the levels of self-reported mental distress, mental functioning and life satisfaction be-fore and after the referendum. A linear fixed effects analysis revealed an overall decrease in mental health post-referendum with higher levels of mental distress, and a decline in the SF-12 Mental Component Summary score. Furthermore, the study does not find evidence of significant changes in overall life satisfaction in the two years after the referendum. Younger men, highly educated and Natives, especially those living in stronger “Remain areas”, seem to be the groups most affected by the Brexit in terms of mental health. Overall, the results of this study suggest that the outcome of the referendum and the economic uncertainty that it brought impacted the mental health of voters in a negative and diverging way.

Evidence on the role of father involvement in children's development from low-resource settings is very limited and historically has only relied on maternal reports of father's direct engagement activities such as reading to the child. However, fathers can also potentially influence their children's development via greater positive involvement with the mother, such as by offering interpersonal support or sharing decision-making duties. Such positive intrahousehold interactions can benefit maternal mental health and wellbeing, and ultimately children's development. We use data collected from mothers, fathers and children in the context of the cluster randomized controlled trial evaluation of Msingi Bora, a responsive parenting intervention implemented across 60 villages in rural western Kenya, to explore the various pathways through which fathers may influence their children's outcomes. In an endline survey in Fall 2019 among a sample of 681 two-parent households with children aged 16–34 months, fathers reported on measures of their behaviors towards children and with mothers, mothers reported on their wellbeing and behaviors, and interviewers assessed child cognitive and language development with the Bayley Scales. In adjusted multivariate regression analyses we found that greater father interpersonal support to mothers and greater participation in shared household decision-making were positively associated with children's development. These associations were partially mediated through maternal wellbeing and behaviors. We found no association between fathers' direct engagement in stimulation activities with children and children's outcomes. Inviting fathers to the program had no impact on their involvement or on any maternal or child outcomes, and fathers attended sessions at low rates. Overall, our results show the potential promises and challenges of involving fathers in a parenting intervention in a rural low-resource setting. Our findings do highlight the importance of considering intrahousehold pathways of influence in the design of parenting interventions involving fathers.

We provide a brief description of the demographics of the Hispanic or Latino population in the United States; point out the origin of the term Hispanic or Latino as standardized terminology in general including public health research; discuss the use of Latinx among the Hispanic or Latino population; and suggest recommendations for the use of Latinx in research including Hispanic or Latino populations. The Hispanic or Latino population is a heterogenous population familiar with name and/or labeling controversies since the introduction of the ethnicity category in the 1980 U.S. Census. Latinx, a term aiming to be gender-expansive, inclusive, and/or neutral, is being used to refer to the Hispanic or Latino population overall. However, only a small proportion of this population has heard or use the term. For research purposes, we recommend that 1) the population is referred to using the labels used during data collection for existing data; 2) when using Latinx, participants are explained the meaning of the term and other choices be provided; and 3) investigations using Latinx should interpret the results within the current context of the term and acknowledge the group (s) to which the findings apply. The latter will lead to accurately represent the Hispanic or Latino population. This correct identification is important to document and address health inequities across race and ethnicity in the U.S.

This study analyzed the relationship between parents' son preference in a person's childhood and their health when they become older, and tested whether childhood educational opportunities, health level, and care resources play mediating roles in this relationship.

China has entered a stage of aging population. The health of the elderly determines whether the government can successfully cope with the challenges brought about by the aging of the population. Chinese people are deeply influenced by Confucianism. The concept of “son preference” is related to residents' parenting strategies. Then, if one's parents exhibit a son preference in their childhood, will it affect one's health in old age?

Based on the data of China Health and Retirement Longitudinal Study collected in 2014, this paper uses the least square method to analyze the impact of parents’ preference in childhood for boys on the health of the elderly, and uses Karlson-Holm-Breen (KHB) to analyze the mediating effects of childhood educational opportunities, health level and care resources.

This study found that parents’ preference for boys had a positive impact on the health of male children when they became elderly but had a negative impact on the health of female children when they became elderly. Childhood educational opportunities, health level, and care resources mediated this relationship.

It is necessary to analyze the impact of parents' preference for sons in one's childhood on the health of elderly, and intervene the adverse factors affecting the health, to improve the health level and quality of life of the elderly.

Drug overdose is the leading cause of accidental death in the U.S. with deaths from opioid overdose occurring at a higher rate in rural areas. The gaps in the provision of healthcare services have been exacerbated by the opioid crisis leaving vulnerable populations without access to preventative care and education, harm reduction, both chronic and acute treatment of the symptoms of opioid use disorder (OUD), and long-term psychological support for those with OUD and their families. There has been a call in the literature -and a federal mandate-for increased access to opioid treatment facilities, but to date this access has not been operationalized using best practices in geography. Medication for Opioid Use Disorder (MOUD) with FDA-approved methadone or buprenorphine has been shown to increase treatment retention, reduce opioid use and associated health and societal harms, and reduce opioid related overdose, and as such is considered the most effective treatment for OUD. The objective of this study is to examine U.S. adults' spatial access to MOUD — specifically locations of certified Opioid Treatment Programs (OTPs) and DATA-waived Buprenorphine providers. A gravity-based variant of the enhanced two-step floating catchment area model is employed, where friction of distance is based on previously published willingness to travel distances for patients visiting OTPs, to assess how opioid agonist treatment accessibility varies across the nation. Findings suggest that there are extensive ‘treatment deserts’ where there is little to no physical access to MOUD, especially in rural areas. The significance of this work lies in the incorporation of treatment utilization behavior in the access metric, and the continued confirmation of gaps in access to OUD services despite federal efforts to improve accessibility.