Smoking prevalence and economic crisis in Brazil

ABSTRACT OBJECTIVE To estimate the impact of the 2015-2018 economic crisis on tobacco consumption in Brazil. METHODS This is an interrupted time series analysis conducted with data from 27 cities collected by VIGITEL, using linear regression models to account for first-order autocorrelation. Analyses were conducted based on gender, age group, and education level. RESULTS Smoking rates decreased between 2006 and 2018, decelerating after the crisis onset. Differently than women, men showed an immediate but transient increase in smoking, followed by a decelerated decrease. Those over 65 also showed increased smoking rates immediately after the economic crisis onset, but decline accelerated later on. In turn, we found a trend reversal among those aged 31-44. Rates also decreased among those with lower education levels, but decelerated among those with more years of schooling. CONCLUSION An economic crisis have varied impacts on the smoking habits of different population groups. Tobacco control policies should entail a detailed understanding of smoking epidemiology, especially during an economic crisis.

The political economy of austerity and healthcare:Cross-national analysis of expenditure chan-ges in 27 European nations 1995-2011 / 中国卫生政策研究

Why have patterns of healthcare spending varied during the Great Recession? Using cross-national, harmonized data for 27 EU countries from 1995 to 2011, we evaluated political, economic, and health system deter-minants of recent changes to healthcare expenditure. Data from Euro Stat, the IMF, and World Bank (2013 editions) were evaluated using multivariate random-and fixed-effects models, correcting for pre-existing time-trends. Reductions in government health expenditure were not significantly associated with magnitude of economic recessions. Nor did ideology of governing parties have an effect. In contrast, each $100 reduction in tax revenue was associated with a$2. 72 drop in health spending. IMF borrowers were significantly more likely to reduce healthcare budgets than non-IMF borrowers, even after correcting for potential confounding by indication. Exposure to lending from international financial institutions, tax revenue falls, and decisions to implement cuts correlate more closely than underlying eco-nomic conditions or orientation of political parties with healthcare expenditure change in EU member states.

Mejorando la evidencia de intervenciones y programas efectivos diseñados para aumentar el consumo de frutas y verduras a nivel mundial

Este artículo de revisión sistemática de literatura, discute las implicancias de políticas futuras y de investigación científica sobre la efectividad de las intervenciones y programas promoviendo el consumo de frutas y verduras en ambos adultos y niños a lo largo del mundo, realizadas en 2004. Los resultados indican que pequeños aumentos en el consumo de frutas y verduras son posibles en subgrupos poblacionales y que estos cambios pueden ser alcanzados desde varios acercamientos (a niveles individual, poblacional y desarrollo de políticas macro e intervenciones ambientales) tanto en niños como en adultos. Mientras muchos programas de promoción de frutas y verduras han sido conducidos o iniciados en todas las regiones del mundo, nuestro artículo muestra que los diseños de estudio utilizados han sido frecuentemente sub-óptimos para evaluar efectividad, particularmente en países menos desarrollados. Aunque es necesario mayor esfuerzo para mejorar el diseño y la evaluación de dichas intervenciones a lo largo del mundo, estos resultados son estimulantes y sugieren que los gobiernos deben seguir desarrollando políticas para mejorar la nutrición que tengan un énfasis fuerte en el consumo de frutas y verduras.