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Noa Ronkin
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As the COVID-19 pandemic remains a crucial global public health threat, pandemic control measures such as lockdowns and mobility restrictions continue to disrupt the provision of health services, leading to reduced healthcare use. Indeed, evidence shows the pandemic has emerged as a particular challenge for people with chronic conditions such as diabetes and hypertension. Yet there is limited data comparing the pandemic’s impact on access to care and the severity of chronic disease symptoms at the population level across Asia.

Now a new collaborative study, published by the Asia Pacific Journal of Public Health, addresses this limitation. The study co-authors, including APARC’s Asia Health Policy Program Director and FSI Senior Fellow Karen Eggleston, offer the first report comparing the impacts of the COVID-19 pandemic and its associated mobility restrictions on people with chronic conditions at different stages of socio-demographic and economic transitions in five Asian regions — India, China, Hong Kong, Korea, and Vietnam.

The findings show that the pandemic has disproportionately disrupted healthcare access and worsened diabetes symptoms among marginalized and rural populations in Asia. Moreover, the pandemic’s broad social and economic impact has adversely affected population health well beyond those directly suffering from COVID-19, with the resulting delayed and foregone care leading to uncertain longer-term effects.


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Unintended Adverse Consequences

Routine screening, risk factor control, and continuity of care for non-communicable diseases are a global challenge. The COVID-19 pandemic has exacerbated the challenge even further. Existing reports show the pandemic has particularly adverse impacts on essential prevention and treatment services for people with chronic conditions. These reductions in health services arose from pandemic-associated factors such as mobility restrictions, lack of public transport, and lack of health workforce.

Eggleston and a group of colleagues set out to provide evidence on how the pandemic has impacted chronic disease care in diverse settings across Asia during COVID-19-related lockdowns. Using standardized questionnaires, the researchers surveyed 5672 participants aged 55.9 to 69.3 years with chronic conditions in India, China, Hong Kong, Korea, and Vietnam. The researchers collected data on participants’ demographic and socio-economic status, comorbidities, access to healthcare, employment status, difficulty in accessing medicines due to financial and nonfinancial (COVID-19 related) reasons, treatment satisfaction, and severity of their chronic condition symptoms.

If no immediate actions are taken to mitigate pandemic impacts, the Asia-Pacific region will struggle to achieve the 2030 Sustainable Development Goal target 3.4 to reduce premature mortality from non-communicable diseases […] and to promote mental health and wellbeing.
Karen Eggleston et al.

The results show that the pandemic’s broad social and economic impact has adversely affected population health well beyond those directly suffering from COVID-19. Study participants with chronic conditions faced significant challenges in managing their symptoms during the pandemic. They experienced a loss of income and difficulties in accessing healthcare or medications, with the resulting delayed and foregone care leading to uncertain longer-term effects. For a nontrivial portion of participants, these factors are associated with the worsening of diabetes symptoms. The threat is twofold among people living in rural populations with limited access, availability, and affordability of healthcare services.

A Global Health Priority

The unintended adverse consequences of the COVID-19 pandemic on chronic disease care may also further aggravate inequality in health outcomes. “If the trend continues and no immediate actions are taken to mitigate pandemic impacts,” Eggleston and her colleagues caution, then “the Asia-Pacific region will struggle to achieve the 2030 Sustainable Development Goal (SDG) target 3.4 to reduce premature mortality from non-communicable diseases by a third relative to 2015 levels and to promote mental health and wellbeing.”

Addressing the pandemic’s unintended negative social and economic impacts on chronic disease care is a global health priority, determine the researchers. They propose several measures to help provide timely care for people with chronic conditions in resource-constrained settings. These include implementing innovations in healthcare delivery models to improve the adoption of healthy lifestyle changes and self-management of chronic disease and mild COVID-19 symptoms, increasing investment in interventions to provide social and economic support to disadvantaged populations, and strengthening primary healthcare infrastructure and support of healthcare providers.

The study was supported in part by funding from Shorenstein APARC’s faculty research award, Stanford King Center for Global Development, and a seed grant from the Stanford Center for Asian Health Research and Education.

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In the first report of its kind comparing the impacts of the pandemic on people with chronic conditions in five Asian regions, researchers including APARC’s Karen Eggleston document how the pandemic’s broad social and economic consequences negatively affected population health well beyond those directly suffering from COVID-19.

For winter quarter 2022, CISAC will be hosting hybrid events. Many events will offer limited-capacity in-person attendance for Stanford faculty, staff, fellows, visiting scholars, and students in accordance with Stanford’s health and safety guidelines, and be open to the public online via Zoom. All CISAC events are scheduled using the Pacific Time Zone. 

REGISTRATION

(Stanford faculty, visiting scholars, staff, fellows, and students only)

                                                                                           

 

About the Event: In Nigeria today, frequent conflicts, disappearances and mass violence, especially in the Northern region of the country, have amounted to large-scale destruction of human life and the displacement of large populations as unarmed civilians are caught in the crossfire. The effects of climate change on the Lake Chad basin are key triggers of conflict as herders migrate to other parts of the region to find fodder and water for their cattle. Existing responses to conflict and mass violence in Nigeria have been beset by challenges. The migration patterns of nomadic communities have begun to signal security concerns beyond the immediately impacted regions. In late 2017, state governments within the western and southern parts of the country began to set up community policing strategies to address growing security challenges around their states, including those relating to the (perceived) threats associated with the movement of cattle herders. Complicating this situation, the presence of large groups of cattle has incentivized “conflict entrepreneurship” as armed groups of young men across north-central, north-west and southern parts of the country engage in cattle rustling. Government efforts at various levels, ranging from the creation of legal and policy frameworks to programs on-the-ground, have been inadequate to protect civilians and have led to the development new mechanisms for human protection.  For example, interventions by the Nigerian Federal Government have, at times, accelerated conflict, as with the passage of an anti-grazing law that has fueled controversy over implementation at state and local levels of government. Local civil society initiatives have continued to emerge to address the gap and attempt to mitigate ever growing security concerns in the region. One such strategy has involved the development of Early Warning and Early Response Systems (EWER) using geospatial technologies and other forms of crowd sourcing imagery to enhance local resilience in the face of security threats and strengthen the ability of communities to protect themselves in a sustainable way. However, the potential of such technologies depends on the ability to “see” particular phenomena and render other phenomena illegible. This paper will argue that such geospatial technology’s interpretive power is concerned with assigning to future violence an interpretive code based on its baseline values.  As an act of decoding that is anticipatory, the power of EWER processes lies in its decoding potential. These interpretive code processes provide participants with the potential to engage in analyses that involve mapping patterns and potential risk that have the ability to produce indicators that have material effects. It is these material effects, drawn from visual codes, that are used to justify action that is life preserving as well as render other relations illegible and therefore invisible to intervention.  This paper explores the emergence of EWER strategies used to address widespread violence and the challenge of illegibility that is central to it.

 

About the Speaker: M. Kamari Clarke is the Distinguished Professor of Transnational Justice and Sociolegal Studies at the University of Toronto where she teaches in the Centre for Criminology and Sociolegal Studies and the Centre for Diaspora and Transnational Studies. Over her career she has worked at The University of California Los Angeles (2018-2021), Carleton University (2015-2018), The University of Pennsylvania (2013-2015) Yale University (1999-2013), and at Yale she was the former chair of the Council on African Studies from 2007- 2010 and the co-founder of the Yale Center for Transnational Cultural Analysis.  For more than twenty years, Professor Clarke has conducted research on issues related to legal institutions, human rights and international law, religious nationalism and the politics of globalization. For more than 20 years, Professor Clarke has conducted research on issues related to legal institutions, international legal domains, religious nationalism, and the politics of globalization and race. She  is the author of nine books and over fifty peer reviewed articles and book chapters, including her 2009 publication of Fictions of Justice: The International Criminal Court and the Challenge of Legal Pluralism in Sub-Saharan Africa (Cambridge University Press, 2009) and Affective Justice (with Duke University Press, 2019), which won the finalist prize for the American Anthropological Association’s 2020 Elliot P. Skinner Book Award for the Association for Africanist Anthropology.  Clarke has also been the recipient of other research and teaching awards, including Carleton University’s 2018 Research Excellence Award.  During her academic career she has held numerous prestigious fellowships, grants and awards, including multiple grant awards from the National Science Foundation and from The Social Sciences and the Humanities Research Council of Canada (SSHRCC), the Rockefeller Foundation, the Wenner-Gren Foundation for Anthropological Research and, very recently, the 2021 Guggenhiem Award for Career Excellence.

Virtual to Public. Only those with an active Stanford ID with access to William J Perry Conference Room in Encina Hall may attend in person. 

Kamari Clarke University of Toronto / UCLA
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For winter quarter 2021, CISAC will be hosting hybrid events. Many events will offer limited-capacity in-person attendance for Stanford faculty, staff, fellows, visiting scholars, and students in accordance with Stanford’s health and safety guidelines, and be open to the public online via Zoom. All CISAC events are scheduled using the Pacific Time Zone. 

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Rolf Nikel
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For winter quarter 2021, CISAC will be hosting hybrid events. Many events will offer limited-capacity in-person attendance for Stanford faculty, staff, fellows, visiting scholars, and students in accordance with Stanford’s health and safety guidelines, and be open to the public online via Zoom. All CISAC events are scheduled using the Pacific Time Zone. 

SEMINAR RECORDING

This event is virtual only. This event will not be held in person.

Michael Kofman
Seminars
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For winter quarter 2021, CISAC will be hosting hybrid events. Many events will offer limited-capacity in-person attendance for Stanford faculty, staff, fellows, visiting scholars, and students in accordance with Stanford’s health and safety guidelines, and be open to the public online via Zoom. All CISAC events are scheduled using the Pacific Time Zone. 

SEMINAR RECORDING

This event is virtual only. This event will not be held in person.

Rose Gottemoeller
James Goldgeier
Seminars
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For winter quarter 2021, CISAC will be hosting hybrid events. Many events will offer limited-capacity in-person attendance for Stanford faculty, staff, fellows, visiting scholars, and students in accordance with Stanford’s health and safety guidelines, and be open to the public online via Zoom. All CISAC events are scheduled using the Pacific Time Zone. 

SEMINAR RECORDING

This event is virtual only. This event will not be held in person.

Shirin Sinnar Professor of Law & John A. Wilson Faculty Scholar Stanford Law School
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For winter quarter 2022, CISAC will be hosting hybrid events. Many events will offer limited-capacity in-person attendance for Stanford faculty, staff, fellows, visiting scholars, and students in accordance with Stanford’s health and safety guidelines, and be open to the public online via Zoom. All CISAC events are scheduled using the Pacific Time Zone. 

SEMINAR RECORDING

                                                                                           

 

About the Event: How do states communicate internally about foreign policy and how does this change over time? Applying concepts from linguistics to a novel corpus of all President’s Daily Briefs from 1961 to 1977, we analyze change over time in the variety of terms used in national security writing (“lexical diversity”). We find a consistently declining level of lexical diversity across presidential administrations and despite variation in exogenous changes in foreign affairs. We argue that this increasingly homogenized language reflects a larger process of bureaucratization in American national security institutions in the 1960s and 1970s. We build on the concept of “organizational sensemaking” and argue that bureaucratization directly and indirectly compresses the terminological range used by individual bureaucrats and homogenizes the language of its outputs. One key payoff is shedding light on what is “lost in translation” when bureaucratic experts communicate with leaders and the foreign policy mistakes and misperceptions that may follow. Our research contributes to work on bureaucracy and perceptions in IR by identifying a subtle shift in the spectrum of terms with which the state interprets the world – a finding that is only tractable by combining computational and linguistic techniques with a large corpus of formerly classified intelligence materials.

 

About the Speaker: Eric Min is Assistant Professor of Political Science at UCLA. He received his Ph.D. in Political Science from Stanford University, where he was the Zukerman Postdoctoral Fellow at the Center for International Security and Cooperation for the 2017-2018 academic year. He is a 2020 Henry Frank Guggenheim Foundation Distinguished Scholar. His research interests focus on the application of machine learning, text, and statistical methods to the analysis of interstate war, diplomacy, decision-making, and conflict management. His research has been published or is forthcoming in American Political Science Review, International Organization, Journal of Conflict Resolution, Journal of Peace Research, and Journal of Strategic Studies.

Virtual to Public. Only those with an active Stanford ID with access to William J Perry Conference Room in Encina Hall may attend in person. 

Seminars
-

For winter quarter 2021, CISAC will be hosting hybrid events. Many events will offer limited-capacity in-person attendance for Stanford faculty, staff, fellows, visiting scholars, and students in accordance with Stanford’s health and safety guidelines, and be open to the public online via Zoom. All CISAC events are scheduled using the Pacific Time Zone. 

SEMINAR RECORDING

This event is virtual only. This event will not be held in person.

David Sloss Professor of Law Santa Clara University
Seminars
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Following the 2021 Taihe Civilizations Forum, the Taihe International Communications Center hosted an online discussion on October 8 that captures the candid and profound reflections of senior officials whose actions have shaped the course of ties between China and the United States.

Dr. Thomas Fingar, Shorenstein APARC Fellow in the Freeman Spogli Institute for International Studies at Stanford University, former Chairman of the National Intelligence Council, and former Assistant Secretary of State, and Senior Colonel Zhou Bo (ret.), Senior Fellow at Center for International Security and Strategy at Tsinghua University, China Forum Expert, and former Director of Center for Security Cooperation of the Office for International Military Cooperation of Ministry of National Defense, were invited to join this dialogue.

During their conversation, Dr. Fingar and Senior Colonel Zhou exchanged ideas on important topics such as the current state of China-U.S. relations, the future development of the two countries' bilateral ties, the rationale behind the US foreign policy and the American alliance system, as well as the "extreme competition" that China and the U.S. are trapped in. 

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A Dialogue between Dr. Thomas Fingar and Senior Colonel Zhou Bo (ret.) on the Current State of China-U.S. Relations
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Thomas Fingar
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*For fall quarter 2021, CISAC will be hosting hybrid events. Many events will offer limited-capacity in-person attendance for Stanford faculty, staff, fellows, visiting scholars, and students in accordance with Stanford’s health and safety guidelines, and be open to the public online via Zoom. All CISAC events are scheduled using the Pacific Time Zone.

 

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Seminar Recording

About the Event: The Afghan government’s collapse in August demonstrated that two decades of donor-driven state-building efforts failed to build a foundation for a stable, democratic, and prosperous Afghanistan. Why did the United States and its allies fail, and what should donors learn for similar state-building efforts in the future, both large and small?

Spanning the U.S. government’s problematic strategies, inappropriate timelines, and poor understanding of the Afghan context, lessons learned reports by the Special Inspector General for Afghanistan Reconstruction (SIGAR) have warned for years that the Afghan government was exceptionally fragile and that many of the gains alleged by the U.S. officials were hollow and unsustainable. This CISAC seminar will detail how and why the U.S. government should reform its own institutions to more effectively stabilize conflict-affected environments around the world. 

Download SIGAR’s 20th anniversary report, What We Need to Learn (2021)

Download SIGAR’s report, Stabilization: Lessons from the U.S. Experience in Afghanistan (2018)

 

About the Speaker: David H. Young is a supervisory research analyst at the Special Inspector General for Afghanistan Reconstruction and a conflict and governance advisor with experience in six conflict/post-conflict environments: Afghanistan, the Sahel, Israel/Palestine, the Balkans, the Caucasus, and Northern Ireland. At SIGAR, he was the lead author of three comprehensive lessons learned reports: 1) A study of U.S. efforts to stabilize contested Afghan communities, 2) A review of U.S. efforts to build credible and transparent Afghan electoral institutions, and 3) the agency’s 20th anniversary report, What We Need to Learn. He was a civilian advisor to ISAF in Nuristan and Laghman provinces during the Afghanistan surge and subsequently served as a governance advisor to the World Bank, the U.S. Institute of Peace, and Afghanistan's Independent Directorate of Local Governance. His writing and commentary has appeared in the New York Times, the Atlantic, the Christian Science Monitor, Foreign Policy, and the Daily Beast, among others.

Virtual Only. This event will not be held in person.

David Young Special Inspector General for Afghanistan Reconstruction
Seminars
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