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Search Results: 1 - 10 of 52990 matches for " David Stuckler "
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Big Food, Food Systems, and Global Health
David Stuckler ,Marion Nestle
PLOS Medicine , 2012, DOI: 10.1371/journal.pmed.1001242
Malignant Neglect: The Failure to Address the Need to Prevent Premature Non-communicable Disease Morbidity and Mortality
David Stuckler ,Sanjay Basu
PLOS Medicine , 2013, DOI: 10.1371/journal.pmed.1001466
Where There Is No Health Research: What Can Be Done to Fill the Global Gaps in Health Research?
Martin McKee ,David Stuckler,Sanjay Basu
PLOS Medicine , 2012, DOI: 10.1371/journal.pmed.1001209
International Monetary Fund Programs and Tuberculosis Outcomes in Post-Communist Countries
David Stuckler ,Lawrence P King,Sanjay Basu
PLOS Medicine , 2008, DOI: 10.1371/journal.pmed.0050143
Abstract: Background Previous studies have indicated that International Monetary Fund (IMF) economic programs have influenced health-care infrastructure in recipient countries. The post-communist Eastern European and former Soviet Union countries experienced relatively similar political and economic changes over the past two decades, and participated in IMF programs of varying size and duration. We empirically examine how IMF programs related to changes in tuberculosis incidence, prevalence, and mortality rates among these countries. Methods and Findings We performed multivariate regression of two decades of tuberculosis incidence, prevalence, and mortality data against variables potentially influencing tuberculosis program outcomes in 21 post-communist countries for which comparative data are available. After correcting for confounding variables, as well as potential detection, selection, and ecological biases, we observed that participating in an IMF program was associated with increased tuberculosis incidence, prevalence, and mortality rates by 13.9%, 13.2%, and 16.6%, respectively. Each additional year of participation in an IMF program was associated with increased tuberculosis mortality rates by 4.1%, and each 1% increase in IMF lending was associated with increased tuberculosis mortality rates by 0.9%. On the other hand, we estimated a decrease in tuberculosis mortality rates of 30.7% (95% confidence interval, 18.3% to 49.5%) associated with exiting the IMF programs. IMF lending did not appear to be a response to worsened health outcomes; rather, it appeared to be a precipitant of such outcomes (Granger- and Sims-causality tests), even after controlling for potential political, socioeconomic, demographic, and health-related confounders. In contrast, non-IMF lending programs were connected with decreased tuberculosis mortality rates (?7.6%, 95% confidence interval, ?1.0% to ?14.1%). The associations observed between tuberculosis mortality and IMF programs were similar to those observed when evaluating the impact of IMF programs on tuberculosis incidence and prevalence. While IMF programs were connected with large reductions in generalized government expenditures, tuberculosis program coverage, and the number of physicians per capita, non-IMF lending programs were not significantly associated with these variables. Conclusions IMF economic reform programs are associated with significantly worsened tuberculosis incidence, prevalence, and mortality rates in post-communist Eastern European and former Soviet countries, independent of other political,
Global Health Philanthropy and Institutional Relationships: How Should Conflicts of Interest Be Addressed?
David Stuckler ,Sanjay Basu,Martin McKee
PLOS Medicine , 2011, DOI: 10.1371/journal.pmed.1001020
Drivers of Inequality in Millennium Development Goal Progress: A Statistical Analysis
David Stuckler ,Sanjay Basu,Martin McKee
PLOS Medicine , 2010, DOI: 10.1371/journal.pmed.1000241
Abstract: Background Many low- and middle-income countries are not on track to reach the public health targets set out in the Millennium Development Goals (MDGs). We evaluated whether differential progress towards health MDGs was associated with economic development, public health funding (both overall and as percentage of available domestic funds), or health system infrastructure. We also examined the impact of joint epidemics of HIV/AIDS and noncommunicable diseases (NCDs), which may limit the ability of households to address child mortality and increase risks of infectious diseases. Methods and Findings We calculated each country's distance from its MDG goals for HIV/AIDS, tuberculosis, and infant and child mortality targets for the year 2005 using the United Nations MDG database for 227 countries from 1990 to the present. We studied the association of economic development (gross domestic product [GDP] per capita in purchasing-power-parity), the relative priority placed on health (health spending as a percentage of GDP), real health spending (health system expenditures in purchasing-power-parity), HIV/AIDS burden (prevalence rates among ages 15–49 y), and NCD burden (age-standardised chronic disease mortality rates), with measures of distance from attainment of health MDGs. To avoid spurious correlations that may exist simply because countries with high disease burdens would be expected to have low MDG progress, and to adjust for potential confounding arising from differences in countries' initial disease burdens, we analysed the variations in rates of change in MDG progress versus expected rates for each country. While economic development, health priority, health spending, and health infrastructure did not explain more than one-fifth of the differences in progress to health MDGs among countries, burdens of HIV and NCDs explained more than half of between-country inequalities in child mortality progress (R2-infant mortality = 0.57, R2-under 5 mortality = 0.54). HIV/AIDS and NCD burdens were also the strongest correlates of unequal progress towards tuberculosis goals (R2 = 0.57), with NCDs having an effect independent of HIV/AIDS, consistent with micro-level studies of the influence of tobacco and diabetes on tuberculosis risks. Even after correcting for health system variables, initial child mortality, and tuberculosis diseases, we found that lower burdens of HIV/AIDS and NCDs were associated with much greater progress towards attainment of child mortality and tuberculosis MDGs than were gains in GDP. An estimated 1% lower HIV prevalence or 10% lower
The hope and the promise of the UN Resolution on non-communicable diseases
George Alleyne, David Stuckler, Ala Alwan
Globalization and Health , 2010, DOI: 10.1186/1744-8603-6-15
Abstract: First, it is important to describe the genesis of the UN Resolution, because it reflects an unprecedented level of support for action on NCDs from countries of all regions. The driving force behind the resolution is the countries of the Caribbean Community (CARICOM), which, in collaboration with other countries, drafted the resolution. Their work built on two recent, important events: first, the Doha Declaration, adopted at the Ministerial Meeting on NCDs and Development, organized by the United Nations Department of Economic and Social Affairs and WHO in Doha, Qatar, in May 2009; and second, the subsequent discussions during the High-Level segment of the United Nations Social and Economic Council in July 2009, which recognized that NCDs in developing countries pose a major threat to development and called for urgent action to implement the World Health Organization Action Plan for the Global Strategy for the Prevention and Control of Non-communicable Diseases. The UN Resolution is co-sponsored by 78 countries, as well as Cameroon on behalf of the African States, including support from all geographic regions as well as representatives of the G-8 and 16 leading foreign aid donor countries.Second, in re-framing the global discussion about NCDs, which often mistakenly focuses on 'blaming the individual' for unhealthy choices, the UN Resolution emphasises the underlying social and environmental drivers of NCDs, and their implications for poverty. As the Resolution notes, "the conditions in which people live...influence their health... and quality of life and that the most prominent non-communicable diseases are linked to common risk factors...[that] have economic, social, gender, political, behavioural and environmental determinants, and in this regard stressing the need for a multisectoral response to combat non-communicable diseases" [1]. Further, the Resolution records the "threat [NCDs] pose to the economies of Member States, leading to increasing inequalities betwe
Public Health in Europe: Power, Politics, and Where Next?
Stuckler David,Basu Sanjay,McKee, Martin
Public Health Reviews , 2010,
Abstract: Health policy in Europe is at a crossroads. Longstanding challenges, such as persisting social and geographical inequalities, ageing populations, and rising burdens of chronic diseases, are being compounded by new, global threats, such as pandemic influenza and crises in the world’s financial markets. Significant improvement in the health of Europe’s population has been driven by factors both inside and outside the health sector. Key obstacles to improving population health in Europe result from underlying failures to overcome political and economic issues, including those shaping healthcare financing and delivery systems. How can the public health community respond to these challenges? This paper discusses three examples of how power and politics have shaped the world in which public health works. The focus on individual risk factors diverts attention from underlying determinants, such as the dominance of the market in healthcare, and the political decision to favour a rapid transition from communism in the 1990s. Effective public health policy requires addressing these political forces, seeking to understand the dominant paradigms, how they have been defined and shaped, and how they might be changed. Their effects are often subtle but powerful, shaping the language that is used, the assumptions that are made, and the rules that are implied. We can formulate key policy options to help improve health outcomes by reshaping the critical forces that affect public health risk factors among those populations currently most burdened by significant disease in Europe today.
Manufacturing Epidemics: The Role of Global Producers in Increased Consumption of Unhealthy Commodities Including Processed Foods, Alcohol, and Tobacco
David Stuckler ,Martin McKee,Shah Ebrahim,Sanjay Basu
PLOS Medicine , 2012, DOI: 10.1371/journal.pmed.1001235
Dietary Salt Reduction and Cardiovascular Disease Rates in India: A Mathematical Model
Sanjay Basu, David Stuckler, Sukumar Vellakkal, Shah Ebrahim
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0044037
Abstract: Background Reducing salt intake has been proposed to prevent cardiovascular disease in India. We sought to determine whether salt reductions would be beneficial or feasible, given the worry that unrealistically large reductions would be required, worsening iodine deficiency and benefiting only urban subpopulations. Methods and Results Future myocardial infarctions (MI) and strokes in India were predicted with a Markov model simulating men and women aged 40 to 69 in both urban and rural locations, incorporating the risk reduction from lower salt intake. If salt intake does not change, we expect ~8.3 million MIs (95% CI: 6.9–9.6 million), 830,000 strokes (690,000–960,000) and 2.0 million associated deaths (1.5–2.4 million) per year among Indian adults aged 40 to 69 over the next three decades. Reducing intake by 3 g/day over 30 years (?0.1 g/year, 25% reduction) would reduce annual MIs by 350,000 (a 4.6% reduction; 95% CI: 320,000–380,000), strokes by 48,000 (?6.5%; 13,000–83,000) and deaths by 81,000 (?4.9%; 59,000–100,000) among this group. The largest decline in MIs would be among younger urban men, but the greatest number of averted strokes would be among rural men, and nearly one-third of averted strokes and one-fifth of averted MIs would be among rural women. Only under a highly pessimistic scenario would iodine deficiency increase (by <0.0001%, ~1600 persons), since inadequate iodized salt access—not low intake of iodized salt—is the major cause of deficiency and would be unaffected by dietary salt reduction. Conclusions Modest reductions in salt intake could substantially reduce cardiovascular disease throughout India.
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