Public Health
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John W. (Jack) Rowe MD, an expert on health care economics and healthy aging, will be the inaugural speaker for the Stanford Center on Longevity Distinguished Lecture Series. Rowe is professor of health policy and management, Columbia University Mailman School of Public Health and former CEO of Aetna Inc.

Rowe’s lecture, “Myths and Realities of an Aging Society,” will be from 6 to 7 p.m. (reception at 5:30 p.m.), Tuesday, April 13.

Frances C. Arrillaga Alumni Center

Columbia University, MSPH
Dept. of Health Policy & Mgmt.
600 West 168th Street, 6th Fl.
New York, NY 10032

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Professor, Department of Health Policy and Management, Joseph Mailman School of Public Health, Columbia University
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Dr. John Rowe is the Julius B. Richmond Professor of Health Policy and Aging at the Columbia University Mailman School of Public Health.  Previously, from 2000 until his retirement in late 2006, Dr. Rowe served as Chairman and CEO of Aetna, Inc., one of the nation's leading health care and related benefits organizations.  Before his tenure at Aetna, from 1998 to 2000, Dr. Rowe served as President and Chief Executive Officer of Mount Sinai NYU Health, one of the nation’s largest academic health care organizations. From 1988 to 1998, prior to the Mount Sinai-NYU Health merger, Dr. Rowe was President of the Mount Sinai Hospital and the Mount Sinai School of Medicine in New York City.

Before joining Mount Sinai, Dr. Rowe was a Professor of Medicine and the founding Director of the Division on Aging at the Harvard Medical School, as well as Chief of Gerontology at Boston’s Beth Israel Hospital.  He was Director of the MacArthur Foundation Research Network on Successful Aging and is co-author, with Robert Kahn, Ph.D., of Successful Aging (Pantheon, 1998). Currently, Dr. Rowe leads the MacArthur Foundation’s Network on An Aging Society .

Dr. Rowe was elected a Fellow of the American Academy of Arts and Sciences and a member of the Institute of Medicine of the National Academy of Sciences. He  serves on the Board of Trustees of the Rockefeller Foundation and is Chairman of the Board of Trustees at the Marine Biological Laboratory in Woods Hole, Massachusetts and the Board of Overseers of Columbia University’s Mailman School of Public Health. He is Chair of the Advisory Council of Stanford University’s Center on Longevity, and  was a founding Commissioner of the Medicare Payment Advisory Commission ( Medpac) and Chair of the board of Trustees of the University of Connecticut. 

Adjunct Affiliate at the Center for Health Policy and the Department of Health Policy
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John (Jack) Rowe Speaker
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Over the past decade, China has implemented reforms designed to expand access to health care in rural areas. Little objective evidence exists, however, on the quality of that care. This paper reports results from a standardized patient study designed to assess the quality of care delivered by village clinicians in rural China. To measure quality, we recruited individuals from the local community to serve as undercover patients and trained them to present consistent symptoms of two common illnesses (dysentery and angina). Based on 82 covert interactions between the standardized patients and local clinicians, we find that the quality of care is low as measured by adherence to clinical checklists and the rates of correct diagnoses and treatments. Further analysis suggests that quality is most strongly correlated with provider qualifications. Our results highlight the need for policy action to address the low quality of care delivered by grassroots providers. 

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Health Policy & Planning
Authors
Huan Wang
Alexis Medina
Scott Rozelle

Adherence rates to public health recommendations are low, and seem to be falling. DiMatteo (2004) found that on average, at least one quarter of patients and recipients of lifestyle advice do not follow the recommendations given; other studies estimate this rate as high as 90% (Burke & Dunbar-Jacob, 1995). One possible reason why people are not following these recommendations may be that they are not communicated in a way that motivates people, especially not older adults.

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We use retrospectively reported data on smoking behavior of residents of Mainland China and Taiwan to compare and contrast patterns in smoking behavior over the life-course of individuals in these two regions. Because we construct the life-history of smoking for all survey respondents, our data cover an exceptionally long period of time – up to fifty years in both samples. During this period, both societies experienced substantial social and economic changes. The two regions developed at much different rates and the political systems of the two areas evolved in very different ways. More importantly, governments in the two areas set policies that caused the flow of information about the health risks of smoking to differ across the regions and over time. We exploit these differences, using counts of articles in newspapers from 1951 to present, to explore whether and how the arrival of information affected life-course smoking decisions of residents in the two areas. We also present evidence that suggests how prices/taxes and key historical events might have affected decisions to smoke.

Dean Lillard received his PhD in economics from the University of Chicago in 1991. From 1991 to 2012, he was a faculty member and senior research associate in the Department of Policy Analysis and Management at Cornell University. In August 2012 he joined the Department Human Sciences at Ohio State University as an Associate Professor. He is Director and Project Manager of the Cross-National Equivalent File study that produces cross-national data. He is a member of the American Economics Association, the Population Association of America, the International Association for Research on Income and Wealth, the International Health Economics Association, the American Society for Health Economics, a Research Associate at the German Institute for Economic Research in Berlin, Germany, and a Research Associate of the National Bureau of Economic Research. He serves on the advisory board of the Danish National Institute for Social Research in Copenhagen, Denmark and the Cross-National Studies: Interdisciplinary Research and Training Program – a collaborative program run by the Polish Academy of Sciences (PAN), and together with the Mershon Centre at OSU.

Dean Lillard's current research focuses on health economics, the economics of schooling, and international comparisons of economic behavior. His research in health economics is primarily focused on the economics of the marketing and consumption of cigarettes and alcohol. His research on the economics of schooling includes studies of direct effects of policy on educational outcomes and on the role that education plays in other economic behaviors such as smoking, production of health, and earnings. His cross-national research ranges widely from comparisons of the role that obesity plays in determining labor market outcomes to comparisons of smoking behavior cross-nationally.

Philippines Conference Room

Dean R. Lillard Associate Professor, Department Human Sciences Speaker Ohio State University
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Despite their recent deterioration, village clinics have historically been an important source of health care for the poor and elderly in rural China. In this paper, we examine the current role of village clinics, the patients who use them and some of the services they provide. We focus specifically on the role of village clinics in meeting the health-care needs of the rural poor and elderly. We find that although clinics are continuing to decline financially, they remain a source of care for the rural elderly and poor. We estimate that the elderly are 10–15 percent more likely than young individuals to seek care at a clinic. We show that clinics provide many unique services to support the rural elderly (and the elderly poor), such asin-home patient care, the option for patients to pay on credit, and free and discounted services.

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China & World Economy
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Kim Babiarz
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Despite growing wealth and a strengthening commitment from the government to provide quality education, a significant share of students across rural China still have inadequate access to micronutrient-rich regular diets. Such poor diets can lead to nutritional problems, such as iron-deficiency anemia, that can adversely affect health, attention and cognitive ability. The overall goal of this paper is to assess the impact of multiple micronutrient supplementation on anemia and anxiety among students in poor areas of rural China. We report on the results of a randomized control trial (RCT) involving over 2700 fourth grade students, mostly aged 9 to 12, from 54 randomly-chosen elementary schools in 8 of the poorest counties in Shaanxi Province in China’s poor northwest region. The design called for random assignment of schools to one of two groups. One group received a daily multivitamin with mineral supplements, including 5 milligrams of iron, for 5 months while the other group was a non-intervention, control group. Anemia was defined as < 120 g/L. We found that 42.4 percent of students were anemic at baseline In the schools that received the multivitamins with mineral supplements, Hb levels rose by more than 1.7 g/L over the control schools. The test for anxiety showed that students that received the multivitamin with mineral supplements also improved significantly. Overall, these results should encourage further research on the interaction between nutrition and mental health in a development context.

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The Journal of Nutrition
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Scott Rozelle
Alexis Medina
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Abstract:
Armed conflict causes profound and widespread adverse consequences for health and human rights. It directly causes death as well as physical and mental disabilities among combatants and increasingly among non-combatants. It damages the health-supporting infrastructure of society, including public health services and medical care. It forces people to leave the safety and security of their homes and communities. It diverts human and financial resources away from activities that benefit society. It leads to further violence. And, in these and other ways, armed conflict violates human rights.  This presentation will provide examples of these adverse consequences of armed conflict and what can be done to minimize these consequences and to prevent armed conflict.

 

Dr.Barry Levy is a physician and epidemiologist who has edited books, written papers, and spoken widely on these issues. He is an Adjunct Professor of Public Health at Tufts University School of Medicine. Previously, he served as a medical epidemiologist for the CDC, a tenured professor at the University of Massachusetts Medical School, USAID coordinator for AIDS prevention in Kenya, executive director of the International Physicians for the Prevention of Nuclear War, and in other roles. He is a past president of the American Public Health Association and a recipient of its Sedgwick Memorial Medal. He has written more than 200 published papers and book chapters, many on the adverse effects of war. He has co-edited 17 books, including, with co-editor Dr. Victor Sidel and many contributing authors, two editions each of the books War and Public Health, Terrorism and Public Health, and Social Injustice and Public Health.    

Building 200 (History Corner)
Room 205
Stanford University

Barry S. Levy, M.D., M.P.H. Adjunct Professor of Public Health Speaker Tufts University School of Medicine
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The framework of "LGBT rights" can be critiqued as challenging tradition or as culturally specific, yet at the same time, it can be essential to one's sense of identity and justice.  Where can the discourse of "public health" help overcome barriers for LGBT people, both within the right to health and beyond? What are the limits to using public health to talk about human rights, LGBT or otherwise?  What are the dangers of conflating these distinct areas of concern?  We will explore these questions and focus on how academics and activists can most effectively navigate challenges to benefit both public health and LGBT rights.

Jessica Stern is the Executive Director of the International Gay and Lesbian Human Rights Commission. As the first researcher on lesbian, gay, bisexual and transgender (LGBT) human rights at Human Rights Watch, she conducted fact-finding investigations and advocacy around sexual orientation and gender identity in countries including Iran, Kyrgyzstan, South Africa, and the United Arab Emirates. As a Ralph Bunche Fellow at Amnesty International, she documented police brutality for what became its landmark report on police brutality in LGBT communities in the U.S., “Stonewalled.” She was a founding collective member and co-coordinator of Bluestockings, then New York’s only women’s bookstore. She has campaigned extensively for women’s rights, LGBT rights, and economic justice with the Center for Constitutional Rights, Control Ciudadano, the National Gay & Lesbian Task Force, and the Urban Justice Center. She holds a masters degree in human rights from the London School of Economics. She is frequently quoted in the Mail & Guardian, Al Jazeera English, the Associated Press, Reuters, Agence France Presse, Deutsche Welle, Voice of America, The Guardian and The BBC.

Building 200 (History Corner)
Room 205
Stanford University

Jessica Stern Executive Director Speaker International Gay and Lesbian Human Rights Commission
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The scope and complexity of global health can be overwhelming, making it difficult to form an inspiring and unified vision for the future. Mired in this complexity, the international community defines success disease by disease‹without a clear picture of what fundamental reform would actually look like. If the aspiration of global health with justice is the right goal, then answering three simple questions may pierce the haze.

First, what would global health look like? That is, given optimal priority-setting, funding, and implementation, to what level of health should we aspire, and with what provision of health-related services? Posing these three elementary questions, of course, oversimplifies a field that is fraught with tensions and trade offs. But I want to imagine a more ideal future for world health, with bold proposals to get there. After thinking about these three basic questions, I turn to an idea for innovative global governance for health‹a Framework Convention on Global Health.

Second, what would global health with justice look like? Global health seeks to improve all the major indicators of health, such as infant and maternal mortality and longevity. Global health with justice, however, requires that we look beyond improved health outcomes for the population as a whole. Although overall population health is vitally important, justice requires a significant reduction in health disparities between the well-off and the poor. Societies that achieve high levels of health and longevity for most, while the poor and marginalized die young, do not comport with social justice.

Third, what would it take to achieve global health with justice? That is, once we clearly state the goal, and meaning, of global health with justice, what concrete steps are required to reach this ambitious objective? This raises fundamental challenges, intellectually and operationally, as the response cannot be limited to ever-greater resources, but must also involve improved governance‹at the country and international level and across multiple sectors.

Lawrence O. Gostin is University Professor, Georgetown University’s highest academic rank conferred by the University President. Prof. Gostin directs the O’Neill Institute for National and Global Health Law and was the Founding O’Neill Chair in Global Health Law. He served as Associate Dean for Research at Georgetown Law from 2004 to 2008. He is Professor of Medicine at Georgetown University, Professor of Public Health at the Johns Hopkins University, and Director of the Center for Law & the Public’s Health at Johns Hopkins and Georgetown Universities.

 Prof. Gostin holds a number of international academic professorial appointments: Visiting Professor (Faculty of Medical Sciences) and Research Fellow (Centre for Socio-Legal Studies) at the University of Oxford, United Kingdom; the Claude Leon Foundation Distinguished Scholar and Visiting Professor at the University of Witwatersrand, Johannesburg, South Africa; and the Miegunyah Distinguished Visiting Fellow and Founding Fellow of the Centre for Advanced Studies (Trinity College), University of Melbourne. Prof. Gostin serves as Secretary and a member of the Governing Board of Directors of the Consortium of Universities for Global Health.

Building 200 (History Corner)
Room 205
Stanford University

Lawrence O. Gostin O'Neill Professor in Global Health Law Speaker Georgetown University
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