A Prepandemic Nutrition-Sensitive Social Protection Program Has Sustained Benefits for Food Security and Diet Diversity in Myanmar during a Severe Economic Crisis.

BACKGROUND: One-third of preschool children in Myanmar were stunted in 2015-2016, and three-quarters of children 6-23 mo had inadequate diet diversity. In response, a large-scale nutrition-sensitive social protection program was implemented over 2016-2019. In 2020, however, Myanmar's economy was hit hard by the COVID-19 pandemic and harder still by a military takeover in 2021. OBJECTIVE: The objective of this study was to examine whether former beneficiaries of this program experienced better food security, food consumption, and diet diversity outcomes in the wake of major economic shocks. METHODS: In a previous cluster-randomized controlled trial conducted over 2016-2019, pregnant women and their children aged <2 y were randomly assigned to either: 1) CASH; 2) CASH + social and behavioral change communication (SBCC); or 3) a control group. Subsamples of these former participants were then resurveyed 10 times from June 2020 to December 2021 during Myanmar's protracted economic crisis. Randomized treatment exposure was used in a regression analysis to test for postprogram impacts on Food Insecurity Experience Scale indicators, household food consumption, and maternal and child diet diversity. We also examined the impacts on household income as a secondary outcome and potential impact pathway. RESULTS: Both intervention arms reported lower food insecurity, more frequent consumption of nutritious foods, and more diverse maternal and child diets compared with households in the control group. However, the improved dietary outcomes were larger for mothers and children exposed to CASH+SBCC compared with CASH, as was their monthly household income. CONCLUSIONS: The findings suggest that a program combining cash transfers with nutrition-related education can yield sustained benefits 1-2 y after the program was completed. This strengthens the evidence to support the expansion and scale-up of nutrition-sensitive social welfare programs to redress chronic malnutrition and enhance nutritional resilience in the face of a severe economic crisis.

A scoping review on the impact of austerity on healthcare access in the European Union: rethinking austerity for the most vulnerable.

BACKGROUND: There is consensus that the 2008 financial and economic crisis and related austerity measures adversely impacted access to healthcare. In light of the growing debt caused by the COVID-19 crisis, it is uncertain whether a period of austerity will return. OBJECTIVE: This study aims to provide a structured overview of the impact of austerity policies in the EU-28 zone, applied in response to the Great Recession, on access to health care for the adult population, using the five access dimensions by Levesque et al. (2013). METHODS: This study followed the PRISMA extension for Scoping Reviews guideline. Medline (PubMed) and Web of Science were searched between February 2021 and June 2021. Primary studies in the English language published after the 1st of January 2008 reporting on the possible change in access to the healthcare system for the adult population induced by austerity in an EU28 country were included. RESULTS: The final search strategy resulted in 525 articles, of which 75 studies were reviewed for full-text analysis, and a total of 21 studies were included. Results revealed that austerity policy has been primarily associated with a reduction in access to healthcare, described through four main categories: i) Increase in rates of reported unmet needs (86%); ii) Affordability (38%); iii) Appropriateness (38%); iv) and Availability and Accommodation (19%). Vulnerable populations were more affected by austerity measures than the general population when specific safeguards were not in place. The main affected adult vulnerable population groups were: patients with chronic diseases, elderly people, (undocumented) migrants, unemployed, economically inactive people and individuals with lower levels of education or socioeconomic status. CONCLUSION: Austerity measures have led to a deterioration in access to healthcare in the vast majority of the countries studied in the EU-28 zone. Findings should prompt policymakers to rethink the fiscal agenda across all policies in times of economic crisis and focus on the needs of the most vulnerable populations from the health perspective.

Effectiveness of Network Relations in Poland during the Economic Crisis Caused by COVID-19: Interorganizational Network Viewpoints.

The global pandemic triggered by the SARS-CoV-2 virus has caused marked changes in the economic landscape in essentially every branch of the economy. The pandemic has disordered lives across all countries in the world and also affected the public sector in interesting ways. Our empirical research, of which selected elements are presented in this paper, was conducted under pandemic conditions. This paper aims to identify the relationships between selected distinguishing features of the oncological interorganizational network (exchange, engagement, reciprocity) and determine their effectiveness under the conditions of the economic crisis caused by the COVID-19 pandemic. A side thread, which concludes the article, is the introduction of the category "economic virus" into management terminology; i.e., a set of factors causing economic crises with a microbiological genesis. Of particular importance are considerations regarding the uncertainty of the length and depth of the health crisis-related economic effects in financial markets and corporate decision making.

Access to support services for individuals who experience intimate partner violence during stressful life events (SLEs) in high-income countries: Protocol for a scoping review.

BACKGROUND: Women, gender minorities and their children are at heightened risk of intimate partner violence (IPV) following stressful life events (SLE). The increase in IPV during the global pandemic of the Novel Coronavirus (COVID-19) is recent evidence. Studies have linked IPV to poor health, resulting in lower mental, physical, sexual, and reproductive health outcomes. IPV has also been shown as a barrier to labour force participation, leading to negative socioeconomic outcomes (i.e., low or no employment). Formal and informal supports help individuals who experience IPV, but it is unclear if and how these are being accessed during SLEs such as environmental disasters, pandemics, and economic recessions. Accessibility to programs is an issue in normal times because of stigma, social norms, and lack of knowledge; this has been further amplified by situations where individuals who experience violence are isolated physically and emotionally, as well as face controlling behaviours by their perpetrators of violence. This scoping review will be used to conduct a comprehensive review of literature and address the research question: What is known in published literature about access to services by individuals who experience IPV during stressful life events in high-income countries? METHODS: The following electronic databases will be searched for relevant publications: MEDILINE (OVID), Embase (OVID), PsychINfo (OVID), CINAHL (EBSCO), Global Health (EBSCO), Gender Watch (ProQuest), Web of Science and Applied Social Sciences Index & Abstracts (ProQuest). Key terms and medical subject headings (MeSH) will be based on previous literature and consult with an expert librarian. The major concepts include 'stressful life events' AND intimate partner violence' AND 'access to services'. Google, Google Scholar, and the WHO website will be used to search for grey literature, books/chapters, and programme reports as well as references of relevant reviews. Studies will be screened and extracted by two reviewers and conflicts resolved through discussion or a third reviewer. Both quantitative and qualitative analysis of relevant data will outline key findings. DISCUSSION: The scoping review will provide synthesized and summarized findings on literature regarding access to informal and formal social supports by victims of IPV during SLEs (i.e., pandemics and natural/environmental disasters/emergencies, economic recessions) where possible, highlighting key barriers, facilitators and lessons learned. Findings have potential to inform programs, policies, and interventions on accessibility to necessary support and health services during disasters.

Dissociative experiences among Lebanese university students: Association with mental health issues, the economic crisis, the COVID-19 pandemic, and the Beirut port explosion.

BACKGROUND: Dissociative experiences are psychological manifestations characterized by a loss of connection and continuity between thoughts, emotions, environment, behavior, and identity. Lebanon has been facing indescribable events in the last few years, including the COVID-19 pandemic, the Beirut explosion, a crushing economic crisis with the highest inflation rate the country has known in over three decades. The aim of this study was to evaluate the correlation between dissociative experiences and post-traumatic stress symptoms from the economic crisis, the Beirut blast, the COVID-19 pandemic, and other mental health issues in a sample of Lebanese university students. METHODS: This cross-sectional study enrolled 419 active university students (18-35 years) from all over Lebanon (May and August 2021). The respondents received the online soft copy of a survey by a snowball sampling technique through social media and messaging apps. The questionnaire included sociodemographic data, the Dissociative Experience Scale (DES-II), the PTSD Checklist Specific Version (PCL-S), the Financial Wellbeing Scale, the Beirut Distress Scale, the Lebanese Anxiety Scale, the Patient Health Questionnaire. RESULTS: The two-factor model of the DES fitted best according to CFI, RMSEA and χ2/df values, but modestly according to TLI. The two factors were absorption and amnesia/depersonalization. Higher stress (Beta = 0.95) and more PTSD from the Beirut blast (Beta = 0.29) and from the economic crisis (Beta = 0.23) were significantly associated with more absorption. A personal history of depression (Beta = 6.03), higher stress (Beta = 0.36) and more PTSD from the Beirut blast (Beta = 0.27) and from the COVID-19 pandemic (Beta = 0.16) were significantly associated with more amnesia/depersonalization. CONCLUSION: Significant rates of dissociative experiences and their sub-manifestations (amnesia/depersonalization and absorption) were found among Lebanese university students, with remarkable co-occurrence of a traumatic/stressful pattern, whether on an individual (history of PTSD) or a collective level (Post-traumatic manifestations from Beirut blast, COVID-19 pandemic and/or economic crisis), or whether correlated to an acute single event or to certain chronic stressors, or even to a personal history of depression. Such findings must raise the attention to serious mental and psychosocial alteration in the Lebanese national identity.

How to cushion economic recession caused by the COVID-19 pandemic: Fiscal or monetary policies?

The outbreak of the COVID-19 pandemic has brought the global economy to a crisis: how to choose the optimal policy tools to cope with the external impacts has attracted worldwide attention. The research evaluates the effects of China's fiscal and monetary policies in promoting economic recovery by establishing a CGE model. Five representative countermeasures such as exempting value-added tax (VAT) and cutting loan rates are studied. The results indicate that: from the aspect of fiscal policies, increasing investment shows a better effect in boosting economy compared with exempting VAT and increasing medical care expenditures; however, the policy also causes price inflation (+0.45%) and crowding-out of enterprise investment (-0.03%). From the aspect of monetary policies, providing targeted loans to enterprises has a better boosting effect on economy compared with cutting loan rates. In the choice between fiscal or monetary policies, fiscal policies exert better effects (household income, +0.95%) when taking the improvement of residents' welfare as the objective. If taking promoting recovery of enterprises and boosting the economy as objectives, monetary policies are found to be better (GDP, +1.99%). Therefore, fiscal and monetary policies should be guided by different objectives and allowed to work in a synergistic manner.

Улучшать показатели здоровья и благополучия для жителей малых стран в Европейском регионе ВОЗ: Черногорское заявление: Восьмое совещание высокого уровня Инициативы для малых стран, 2–3 июня 2022 г., Бечичи (Будва), Черногория

Пандемия COVID-19 оказала беспрецедентное негативное воздействие на системы здравоохранения и экономики стран, при этом она особенно тяжело сказалась на положении 11 малых стран в Европейском регионе ВОЗ, поскольку для многих из них туризм был и остается весьма значительной частью их национальной экономики. В ходе Восьмого совещания высокого уровня Инициативы ЕРБ ВОЗ для малых стран министры здравоохранения и делегаты этих стран утвердили смелое перспективное видение, которое ляжет в основу процесса восстановления после пандемии COVID-19. В ходе этого двухдневного мероприятия, прошедшего 2–3 июня 2022 г. в Бечичи (Черногория), министры и их представители обсудили два ключевых вопроса: как малые страны могут успешно восстановиться после пандемии и как они могут сделать охрану здоровья одной из основных составляющих своих секторов туризма. В завершение совещания делегаты стран единогласно приняли “Черногорское заявление” – документ, в котором изложены ключевые обязательства в отношении дальнейших действий.

Auf dem Weg zu mehr Gesundheit und Wohlbefinden in den kleinen Ländern der Europäischen Region der WHO: die Erklärung von Montenegro: Achte hochrangige Tagung der Initiative kleiner Länder, 2.–3. Juni 2022, Bečići (Budva, Montenegro)

Die COVID-19-Pandemie hatte beispiellose Auswirkungen auf die Gesundheitssysteme und Volkswirtschaften der Länder, doch für die 11 kleinsten Länder in der Europäischen Region der WHO – von denen viele wirtschaftlich zu einem großen Teil vom Tourismus abhängig sind – waren die Folgen besonders schwerwiegend. Im Rahmen der Achten hochrangigen Tagung der Initiative kleiner Länder von WHO/Europa stimmten die Gesundheitsminister und Delegierten dieser Länder einer mutigen Zukunftsvision zu, um den Wiederaufbau nach der COVID-19-Pandemie voranzutreiben. Bei der zweitägigen Veranstaltung, die am 2. und 3. Juni 2022 in Bečići (Montenegro) abgehalten wurde, erörterten die Minister und ihre Vertreter zwei zentrale Themen: wie kleine Länder sich erfolgreich von der Pandemie erholen und wie sie das Thema Gesundheit in den Mittelpunkt ihrer Tourismuswirtschaft rücken können. Am Ende der Tagung nahmen die Delegierten der Länder einstimmig die Erklärung von Montenegro an, in der die zentralen Verpflichtungen für das künftige Vorgehen dargelegt werden.

Vers une meilleure santé et un meilleur bien-être dans les petits États de la Région européenne de l’OMS : déclaration du Monténégro : Huitième Réunion de haut niveau de l’Initiative des petits États, 2-3 juin 2022, Bečići (Budva), Monténégro

Si la pandémie de COVID-19 a eu des effets sans précédents sur les économies et les systèmes de santé nationaux, son impact sur les 11 plus petits États de la Région européenne de l’OMS (l’économie de la majorité d’entre eux étant largement dépendante du tourisme) a été particulièrement grave. Rassemblés à l’occasion de la Huitième Réunion de haut niveau de l’Initiative des petits États de l’OMS/Europe, les ministres de la Santé et les délégués des pays concernés ont approuvé une vision audacieuse pour favoriser le relèvement post- COVID-19. Au cours de cet événement de deux jours organisé les 2 et 3 juin 2022 à Bečići (Monténégro), les ministres et leurs représentants se sont penchés sur deux questions essentielles : comment les petits États peuvent-ils réussir à se remettre de la pandémie, et comment peuvent-ils placer la santé au cœur de leur secteur touristique ? À la fin de la réunion, les délégués nationaux ont adopté à l’unanimité la Déclaration du Monténégro qui présente les principaux engagements pour aller de l’avant.

Towards better health and well-being in Small Countries in the WHO European Region: the Montenegro statement: Eighth high-level meeting of the Small Countries Initiative, 2–3 June 2022, Bečići (Budva), Montenegro

The COVID-19 pandemic has had an unprecedented impact on countries’ health systems and economies, but its impact on the 11 smallest countries in the WHO European Region – many of which rely on tourism as a large part of their national economy – has been particularly severe. Meeting at the Eighth high-level meeting of the WHO/Europe Small Countries Initiative, the countries’ health ministers and delegates endorsed a bold vision to drive recovery in the post-COVID-19 era. The two-day event, held on 2–3 June 2022 in Bečići, Montenegro, saw the ministers and their representatives discuss two key issues: how small countries can successfully recover from the pandemic, and how they can place health at the heart of their tourism sectors. At the end of the meeting, the countries’ delegates unanimously adopted the Montenegro statement, which outlines key commitments for moving forward.

Rate and correlates of post-traumatic stress disorder (PTSD) following the Beirut blast and the economic crisis among Lebanese University students: a cross-sectional study.

BACKGROUND: Post-traumatic stress disorder (PTSD) is a mental illness that develops in some people after they have experienced a stunning, scary, or dangerous incident. Due to major disasters like as the Economic Crisis and the Beirut Blast, Lebanese people are struggling with a variety of mental health issues. The study objectives were to find the rate of PTSD and its association with stress, anxiety, depression, financial well-being and coping strategies among university students in Lebanon. METHODS: This is a cross-sectional study, conducted between May and August 2021, which enrolled 419 university students from all districts of Lebanon. The PTSD Checklist-Specific Version (PCL-S) was used to evaluate manifestation of PSTD. RESULTS: The results showed that 132 (31.5%), 109 (26.0%) and 169 (40.3%) had PTSD from COVID, Beirut blast and economic crisis respectively. More avoidant coping (Beta = 0.52) and more anxiety (Beta = 0.62) were significantly associated with more PTSD from the Beirut Blast. More avoidant coping (Beta = 0.56), depression (Beta = 0.40) and anxiety (Beta = 0.49) were significantly associated with more PTSD from the economic crisis, whereas more financial wellbeing (Beta = - 0.31) was significantly associated with less PTSD from the economic crisis. CONCLUSION: Significant rates of PTSD were found in our sample of Lebanese university students, whether from the Beirut blast, or from the current economic crisis. Significant correlations of these PTSD rates were found with factors such as avoidant coping, depression, anxiety and financial wellbeing. Such findings must raise the attention to serious mental and psychosocial alteration endured by Lebanese youth that are still under fatal cumulative traumatic events, that were and even may be, intergenerationally and unintentionally transmissible, therefore, affecting not only the present, but also the future of a whole nation.

Do Coastal Areas Experience More Recession during the Economic Crisis-Evidence from China.

The notion of resilience has been increasingly adopted in economic geography, concerning how regions resist and recover from all kinds of shocks. Most of the literature on the resilience of coastal areas focuses on biophysical stressors, such as climate change and some environmental factors. In this research, we analyze the regional economic resilience characteristics responding to the Great Financial Crisis in 2008 and its main determinants. We conclude that the coastal areas encountered more recession (or less growth) in the long term, and the secondary industry showed higher resilience than the tertiary industry. The influential factors of regional economic resilience varied across different stages of the crisis, and for the long term, good financial arrangement and governance ability could prompt the regional resilience to the crisis. Finally, some policy implications are proposed which may benefit dealings with major shocks such as economic crises and COVID-19.

The association of COVID-19 nexus on China's economy: A financial crisis or a health crisis?

This paper analyses the interaction between the novel coronavirus pandemic (COVID-19), unemployment rate, stock market, consumer confidence index (CCI), and economic policy uncertainty (EPU) index in China within a time-frequency framework. We compare the changes in economic indicators during the global financial crisis (GFC) and study the different impacts of the two events on China's economy. An unprecedented impact of COVID-19 shocks on the unemployment rate, CCI, EPU index, and stock market volatility over the low frequency bands is uncovered by applying the coherence wavelet method to China monthly data. The COVID-19 effect on the stock market volatility and the EPU index is substantially higher than on the unemployment rate and the CCI. On the contrary, the GFC's impact on the unemployment rate is much greater than that on the EPU index and CCI. Additionally, the impact of the GFC on the economy is more cyclical in the long-term, while the COVID-19 pandemic is a short-term shock with a relatively short oscillation cycle. This study concludes that the economic impact of COVID-19 will not spread into a financial crisis for China and believe that the COVID-19 pandemic is more of a health event than an economic crisis for Chinese economy.

Children mirror adults for the worse: evidence of suicide rates due to air pollution and unemployment.

BACKGROUND: Every year, more than 700,000 people die due to suicide, one of the most common reasons for youth death. While many studies have revealed two main factors for suicidal behavior: impulsive suicidal behavior due to mental illness and financial stress, it is not clear what happens if individuals face deterioration of mental health and economic recession. This paper attempts to answer this question and how suicide rates are correlated with these factors. METHODS: We empirically investigate whether economic recessions and air pollution trigger suicides by examining Japan, a country with one of the highest suicide rates, from 2014 to 2021. We take advantage of the characteristics of the COVID-19 pandemic and the periods before the pandemic, when both economic recessions and reductions in air pollution occurred simultaneously. Using monthly and municipal- level data, we construct a triple difference model that takes air pollution and unemployment as treatments. RESULTS: Our findings show that high (upper half of each period) levels of air pollution and unemployment have substantial impacts on the suicide rates of adults (22.9% in the short term) and children (42.7% in the short term, 36.0% in the long term), indicating that the increase in suicide rates among children is almost twice as high as that among adults. Our study finds that unemployment and air pollution alone are not associated with increased suicide rates but their simultaneous occurrence triggers suicides during the pandemic. CONCLUSIONS: Our study urges suicide prevention, particularly among children, as an essential consideration for public health. Furthermore, our results indicate the need for the government to allocate resources to recover air quality and the economy simultaneously during a recession to reduce suicide mortality of both child and adults.

What Affects the Economic Resilience of China's Yellow River Basin Amid Economic Crisis-From the Perspective of Spatial Heterogeneity.

This paper contributes to the study of regional economic resilience by analyzing the dynamic characteristics and influence mechanisms of resilience from the perspective of spatial heterogeneity. This paper focuses on the resistance and recoverability dimensions of resilience and analyzed the dynamic changes in economic resilience in China's Yellow River Basin in response to the 2008 economic crisis. The multi-scale geographical weighted regression model was utilized to examine the effect of key factors on regional economic resilience. Our findings show the following: (1) The resistance of the Yellow River Basin to the financial crisis was high; however, the recoverability decreased significantly over time. (2) The spatial heterogeneity of driving factors was significant, and they had different effect scales on economic resilience. Related variety, government agency, environment, and opening to the global economy had a significant effect on economic resilience only in a specific small range. Specialization, unrelated variety, and location had opposite effects in different regions of the Yellow River Basin. (3) Specialization limited the area's resistance to shock but enhanced the recoverability. Related variety improved regional economic resilience. Unrelated variety was not conducive to regional resistance to shock and had opposite effects on the recoverability in different regions. (4) Government agency and financial market promoted regional economic resilience. Environment pollution and resource-based economic structure limited regional economic resilience. Opening to the global economy and urban hierarchy limited regional resistance to shock, but strong economic development had the opposite effect of improved regional resistance. The location in the east of the Yellow River Basin enhanced the recoverability; however, the location in the west limited the recoverability.

A Qualitative Scoping Review of the Impacts of Economic Recessions on Mental Health: Implications for Practice and Policy.

In a follow-up to our 2021 scoping review of the quantitative literature on the impacts of economic recessions on mental health, this scoping review summarizes qualitative research to develop a descriptive understanding of the key factors that transmute the socioeconomic stressors of a recession into poorer mental health. The previous study identified 22 qualitative studies from 2008 to 2020, which were updated with search results from six databases for articles published between 2020 and 2021. After inclusion and exclusion criteria were applied to the total 335 identified studies, 13 articles were included. These were peer-reviewed, qualitative studies in developed economies, published from 2008 to 2021, and available online in English. Participants perceived that financial hardship and unemployment during recessions increased stress and led to feelings of shame, loss of structure and identity, and a perceived lack of control, which increased interpersonal conflict, social isolation, maladaptive coping, depression, self-harm, and suicidal behavior. Participants struggled with accessing health and social services and suggested reforms to improve the navigation and efficiency of services and to reduce the perceived harms of austerity measures. Providers should screen for mental distress and familiarize themselves with health and social resources in their community to help patients navigate these complex systems. Policy makers should be aware of the potential protective nature of unemployment safeguards and consider other low-cost measures to bolster mental health supports and informal social networks. Research in this area was limited. Further research would be beneficial given the impacts of the ongoing COVID-19 recession.

Economic change and population health: lessons learnt from an umbrella review on the Great Recession.

OBJECTIVES: Worldwide, the COVID-19 pandemic triggered the sharpest economic downturn since the Great Recession. To prepare for future crises and to preserve public health, we conduct an overview of systematic reviews to examine the evidence on the effect of the Great Recession on population health. METHODS: We searched PubMed and Scopus for systematic reviews and/or meta-analyses focusing specifically on the impact of the Great Recession on population health (eg, mental health). Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines were followed throughout this review and critical appraisal of included systematic reviews was performed using Assessing the Methodological Quality of Systematic Reviews. RESULTS: Twenty-one studies were identified and consistently showed that the Great Recession was most risky to health, the more a country's economy was affected and the longer strict austerity policies were in place. Consequently, a deterioration of health was highest in countries that had implemented strict austerity measures (eg, Greece), but not in countries that rejected austerity measures (eg, Germany). Moreover, the impact of the Great Recession fell disproportionately on the most vulnerable groups such as people in unemployment, at risk of unemployment and those living in poverty. CONCLUSIONS: The experiences of the last economic crisis show that it is possible to limit the consequences for health. Prioritising mental healthcare and prevention, foregoing austerity measures in the healthcare system and protecting vulnerable groups are the most important lessons learnt. Moreover, given the further aggravating social inequalities, a health in all policies approach, based on a comprehensive Health Impact Assessment, is advised.