FSI’s researchers assess health and medicine through the lenses of economics, nutrition and politics. They’re studying and influencing public health policies of local and national governments and the roles that corporations and nongovernmental organizations play in providing health care around the world. Scholars look at how governance affects citizens’ health, how children’s health care access affects the aging process and how to improve children’s health in Guatemala and rural China. They want to know what it will take for people to cook more safely and breathe more easily in developing countries.
FSI professors investigate how lifestyles affect health. What good does gardening do for older Americans? What are the benefits of eating organic food or growing genetically modified rice in China? They study cost-effectiveness by examining programs like those aimed at preventing the spread of tuberculosis in Russian prisons. Policies that impact obesity and undernutrition are examined; as are the public health implications of limiting salt in processed foods and the role of smoking among men who work in Chinese factories. FSI health research looks at sweeping domestic policies like the Affordable Care Act and the role of foreign aid in affecting the price of HIV drugs in Africa.
Health Care for One Billion: Experimenting with Incentives for the Supply of Health Care in Rural China
Despite successful economic reforms over the past two decades, China's health care system for the nearly one billion people that live and work in rural areas is broken. Having admitted that there is a crisis, the government is now committed to looking for solutions. In this proposal, we have two overall goals to help provide insights on part of the solution. Our first objective is to collect an updated wave of highly informative data in Year 1 to build on an existing set of data already collected by our study team (from 2004) to analyze the effects of key health policies and institutions that have emerged over the past several years, including the government's rural health insurance system, the privatization of rural clinics, and new investments into township hospitals. Our second, more forward-looking goal for Years 2 and 3 is to set up and introduce an initial experiment on incentives to study one of the most serious flaws in China's health system: the practice in which doctors both prescribe and derive significant profit from drugs. The main hypothesis to be tested is whether realigning doctors' financial incentives embedded in the current organization of China's rural health system influence: a) the way doctors treat and manage their patients; b) the time and effort doctors put into patient care; and c) patient satisfaction.
FSI International Conference brings scholars, policymakers to discuss global security threats
FSI convened its second annual international conference on November 16, bringing scholars from across the university together with visiting security experts, policymakers, members of the international community, and practitioners in the fields of political science, economics, law, business, and medicine. The theme of this year's conference was "A World at Risk," juxtaposing debate and discussion on hard security issues such as nuclear proliferation, terrorism, and failed states with problems presented by "softer" security threats such as pandemic diseases, energy shocks, natural disasters, and food security and the environment.
The conference opened with welcoming remarks from Stanford Provost John Etchemendy and FSI director Coit D. Blacker, who shared their perspectives on pressing global issues and their sense of how Stanford's mission of interdisciplinary research and teaching fits into a changing world. Rounding out the opening session were remarks from former secretary of defense William J. Perry and former secretaries of state Warren Christopher and George Shultz. Secretary Perry analyzed how security threats have evolved in the 10 years since he was secretary of defense, while Secretary Christopher addressed the strategic importance of the Middle East and need for renewed diplomacy and Secretary Shultz discussed the opportunity and imperative for the United States to assume a global leadership role. The three secretaries' institutional knowledge and experience collectively established a rich context for discussion in the plenary and breakout sessions that followed.
The morning and afternoon plenary sessions offered scholarly analysis of two types of risk, with the morning session focusing on systemic issues - measuring risk, managing the nuclear nonproliferation regime, and controlling fissile materials - and the afternoon, on human security issues - improving the resiliency of critical infrastructure and managing energy shocks to oil, natural gas, and electricity markets. Plenary I was moderated by Coit D. Blacker, with Elisabeth Paté-Cornell, Scott D. Sagan, and Siegfried S. Hecker as panelists; Plenary II was moderated by Michael A. McFaul, with Stephen E. Flynn and David G. Victor as panelists.
Drawing on Pate-Cornell's earlier discussion of statistical risk analysis, Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, assured conference participants over lunch that unlike other issues being debated that day, the risk of a human influenza pandemic "is one; it is going to happen...the issue is what will it mean when it happens." His assessment showed how our global just-in-time economy makes our world extremely vulnerable to an influenza pandemic. This vulnerability, Osterholm argued, will need to be managed on a local level through family preparedness, community leadership, and business preparedness and continuity.
Overlapping breakout sessions followed the morning and afternoon plenary sessions, allowing for interaction and dialogue in smaller, less formal settings. FSI's five centers and two of FSI's programs sponsored sessions that drilled down into some of the issues discussed in the larger forum throughout the day, including:
- Center for Environmental Science and Policy (CESP): "Food Security and the Environment"
Rosamond L. Naylor, Kenneth Cassman, and Scott Rozelle - Center for Health Policy/Center for Primary Care and Outcomes Research (CHP/PCOR): "Pandemics, Infectious Diseases, and Bioterrorism"
Alan M. Garber, Michael Osterholm, Douglas K. Owens, and Lawrence M. Wein - Center for International Security and Cooperation (CISAC): "Insurgencies, Failed States, and the Challenge of Governance"
Jeremy M. Weinstein, Larry Diamond, and Stephen J. Stedman - Center on Democracy, Development, and the Rule of Law (CDDRL): "Responding to a World at Risk: U.S. Efforts at Democracy Promotion in Russia, Iraq, and Iran"
Michael A. McFaul, Abbas Milani, David S. Patel, and Kathryn Stoner - Forum on Contemporary Europe (FCE): "The European Union: Politics, Economics, Terrorism"
Amir Eshel, Josef Joffe, Hugo Paemen, and James J. Sheehan - Program on Energy and Sustainable Development (PESD): "China's Rise: Implications for the World Economy and Energy Markets"
Thomas C. Heller, Fred Hu, and Edgard Habib - Walter H. Shorenstein Asia-Pacific Research Center (Shorenstein APARC): "Cross Currents: Nationalism and Regionalism in Northeast Asia"
Daniel C. Sneider, Michael H. Armacost, Gi-Wook Shin, and Xiyu Yang
The conference concluded with a cocktail reception and dinner. Peter Bergen, CNN's counterterrorism analyst and the first Western journalist to have interviewed Osama bin Laden, offered closing remarks on the successes and failures in the war on terrorism since 9/11.
Special film screening and discussion panel
On Tuesday, November 28, the International Initiative Human Well-being Working Group hosted a documentary film viewing and a scholarly panel discussion on "Endangered Childhood: Disease, Conflict, and Displacement." The film, Their Brothers' Keepers: Orphaned by AIDS, opened the session to provide insight into the plight of children orphaned by AIDS. Moderator Paul Wise and the other panelists spoke on the impact of conflict and displacement, the psychological effects on child health and development, and work done to assist children affected by AIDS. The session concluded with a Q&A session.
Presidential Fund for Innovation in International Studies awards second round of interdisciplinary international grants
A proposal to assess the societal and security implications of the female deficit in China, a study of the impact of higher education's rapid expansion in large developing economies, and incentives for provision of health care services for one billion people in rural China were among the new projects funded by Stanford's Presidential Fund for Innovation in International Studies (PFIIS) in mid-February. Planning grants for an international health and society initiative in the Indian subcontinent and psychosocial treatment for children orphaned by the tsunami in Indonesia were also awarded.
"These projects show great potential to advance human knowledge, help devise sustainable solutions, and build a better, more secure future for millions around the world," said Stanford President John Hennessy. "In launching The Stanford Challenge, we committed to marshal university resources to address some of the 21st century's great challenges in human health, international peace and security, and the environment."
The $3 million, intellectual venture capital fund was established by the Office of the President and the Stanford International Initiative in 2005 to encourage new cross-campus, interdisciplinary research and teaching among all seven schools at Stanford on three overarching global challenges: pursuing peace and security, improving governance, and advancing human well-being. The first $1 million was awarded in February 2006 to eight interdisciplinary faculty teams examining such issues as the HIV/AIDS treatment revolution in sub-Saharan Africa, why Latin America has been left behind in recent gains by developing countries, and food security and the environment.
"It's impressive to see the committed, collaborative, and innovative ways Stanford faculty are joining together in new interdisciplinary research and teaching to generate new understanding of the linkages among complex problems and train a new generation of leaders to address them effectively," said Freeman Spogli Institute Director Coit D. Blacker, chair of the International Initiative Executive Committee.
New projects qualifying for funding and their principal investigators are:
- Female Deficit and Social Stability in China: Implications for International Security. Melissa Brown, anthropological sciences; Marcus Feldman, biological sciences, and Matthew Sommer, history. As the number of surplus, marriage-age men in China approaches 47 million in 2050, this project will study factors that predict men's inability to marry before 30, the availability of social welfare to men and their families, their contribution to the floating population of rural-to- urban migrants, the labor-related migration of unmarried women, and the impact of this migration for domestic stability and international security.
- Potential Economic and Social Impacts of Rapid Higher Education Expansion in the World's Largest Developing Economies. Martin Carnoy, education; Amos Nur, geophysics; and Krishna Saraswat, electrical engineering. The development of higher education systems in Brazil, Russia, India, and China (BRIC) will have a major impact on their ability to transition to large, developed, knowledge-based economies. Is the way nation states expand and reform higher education in response to global pressures an important indicator of societal capacity to achieve sustained economic growth? This project will examine differing approaches of BRIC governments to higher-education growth and reform, and ask whether these reflect differing levels of state capacity to expand the knowledge base for economic and social development and whether differing approaches result in significant changes in formation of analytical skills in university graduates, particularly scientists and engineers.
- Health Care for One Billion: Experimenting with Incentives for the Supply of Health Care in Rural China. Scott Atlas, radiology; Scott Rozelle, the Walter H. Shorenstein Asia-Pacific Research Center, FSI. This project examines the effects of existing health policies and institutions in rural areas of China - including rural health insurance, privatization of rural clinics, and investment in township hospitals - and introduces a new experiment to study and realign incentives to address a serious flaw in China's health care system, the practice in which doctors both prescribe and derive significant profits from drugs.
Two planning grants were also awarded, as follows:
- Stanford International Health and Society Initiative: Proposal to Plan for an Initial Program in the Indian Subcontinent. Vinod K. Bhutani, pediatrics; Nihar Nayak, obstetrics and gynecology. This project seeks to improve unacceptably high maternal and childhood morbidity and mortality rates in the Indian subcontinent by devising innovative strategies to bridge existing social and access barriers in the micro- and macro- health environment. Includes leadership training and cooperative work on practice and policy strategies with experts from Stanford and the subcontinent.
- Psychosocial Treatment of Children Orphaned by the Asian Tsunami in Indonesia. Hugh Solvason, psychiatry; Donald Barr, sociology. This project's goal is to develop and implement changes to reduce the sense of dislocation, anxiety, and behavioral problems among tsunami orphans at the As-Syafi`iyah Orphanage in Jakarta. By arranging the children into more cohesive groups that can operate like "families" rather than their current state of random associations typically found in orphanages, the project will create a new and ordered social system. In addition, Solvason and Barr plan to develop a system of counseling interventions for the most severely symptomatic children (supervised by Stanford Psychiatry faculty). Translated measures of depression, anxiety, and PTSD will be used to assess the success of the intervention.
The projects will produce new field research, conferences, research papers, books, symposia, and courses for Stanford students.
A third round of project awards will be made in February 2008. A formal request for proposals will be issued in the fall of 2007, with proposals due by December 14, 2007. Priority is given to teams of faculty who do not typically work together, represent multiple disciplines, and address issues that fall broadly within the three primary research areas of the International Initiative. Projects are to be based on collaborative research and teaching involving faculty from two or more disciplines, and where possible, from two or more of Stanford's seven schools.
For additional information, contact Catharine Kristian, ckristian@stanford.edu.