Drunk driving policies and breath test refusal in Taiwan.

OBJECTIVE: Driving under the influence (DUI) is one of the major causes of traffic crashes in Taiwan, leading to huge medical expenditures and human capital loss. Although the authorities have enacted several policies to reduce drunk driving, most penalties are based on drunk drivers' alcohol levels. According to Taiwan regulations, drivers could pay a fine to refuse the breath test if they are not involved in a traffic collision, and there is no clear evidence showing that they are DUI. Therefore, increased sanctions for DUI may lead to increased breath test refusals. If breath tests for drunk driving could be refused with little or no punishments for drivers, then the detection of behavioral impairment would weaken, and the deterrent effect of DUI punishment would be limited. METHOD: This research uses interrupted time-series analysis (ITSA) to examine how policy reforms from 2007 to 2020 affected driver's breath refusal rate in Taiwan. RESULTS: We find that said reforms that exclusively increase the punishment of DUI offenders did raise the refusal rate immediately and persistently, suggesting that more drunk drivers would refuse a breath test to avoid more severe DUI punishment. Policy reforms that increase penalties for drivers refusing to take breath tests may instantly lower the refusal rate, but the long-term effects are contingent upon the DUI punishment. CONCLUSIONS: It appears that drunk drivers could still decide on breath test refusal to avoid a DUI conviction if the punishment for refusing the test is less severe than that for DUI. Aggravating penalties for refusing breath tests would decrease the refusal rate and help reinforce DUI's deterrent effect.

Tracheitis hospital admissions are associated with Asia dust storm.

The risks of tracheitis have been widely studied, but no investigation has yet to assess the impact of air pollutants on tracheitis hospital admissions. This research explores the relationship between Asia dust storm (ADS) and tracheitis hospital admissions, by using a Poisson time-series model on the 2000-2012 National Health Insurance Research Database (NHIRB) from Taiwan and linking air pollutants and temperature data. From a total of 126,013 tracheitis hospital admissions, the average number of daily tracheitis hospital admissions is 26.53 and increases 10% notably one day after ADS. The empirical result shows that ADS does significantly affect tracheitis hospital admissions 3 and 5 days after an event for the overall sample and 2-4 days after it for females. For the age group <45, the number significantly increases 3-4 days after ADS, revealing that ADS has a prolonged effect on tracheitis hospital admissions.

Do Internet Users Lead a Healthier Lifestyle?

Internet use has spread rapidly worldwide in recent years, but the proportion of older people who use it remains low in Taiwan. Meanwhile, due to population aging in the country, chronic diseases have become more prevalent among older people. This study explores the link between exposure to the Internet and adoption of a healthy lifestyle among the middle-aged and elderly people. Data are drawn from the Topic on Health of the 2011 Taiwan Social Change Survey. We use the logistic regression as the baseline model and apply the propensity-score weighting method to identify the effect of Internet use on exercising, vegetable and fruit eating, betel nut chewing, smoking, and heavy drinking. Our results show that people aged 40 years and older who use the Internet regularly are more likely to adopt an overall healthy lifestyle. The findings suggest that the Internet is a good channel to enhance people's health investment.

Sanction changes and drunk-driving injuries/deaths in Taiwan.

Driving under the influence (DUI) is one of the major causes of traffic accidents in Taiwan. About 5% of injuries involve DUI, and nearly 20% of deaths are due to alcohol-related crashes. During early 2006 to the end of 2014, the authorities in Taiwan increased the severity of fine and jail penalties for DUI offenders three times. At the same time, the monthly drunk-driving injures decreased nearly 40% and the monthly alcohol-related traffic death dropped more than 80%. In this paper, we examine the effects of sanction changes on the reduction of drunk-driving casualties during this period. We find that drunk-driving injuries and deaths significantly dropped after the statutory changes. The reduction was immediate following all sanction changes that raised the maximum fines or jail terms of DUI offenders. Policies that increased the maximum jail terms of DUI offenders seem to have a better gradual effect on the reduction of alcohol-related traffic casualties. Although increased sanctions are found to be effective in reducing drunk-driving casualties, we need more future research to examine the policy-to-perception and the policy-to-behavior links.

Influence of Asian dust storms on daily acute myocardial infarction hospital admissions.

OBJECTIVE: This study was the first to explore the relationship between Asian dust storm events (ADS) and acute myocardial infarction (AMI) hospital admissions by applying time series models. DESIGN AND SAMPLE: Nationwide population-based hospitalization claims data in Taiwan were used. There were 143,063 AMI admissions during 2000-2009. MEASURES: An autoregressive with exogenous variables (ARX) time series model was used to investigate the dynamic connection between AMI hospital admissions and ADS events. RESULTS: AMI hospitalizations significantly spiked on post-ADS day three. Among the total population, 3.2 more cases of AMI admissions occurred on post-ADS day three. When the data were stratified by age and gender, the same delayed effect was present in the male population, especially those aged 45-64 and over 74. CONCLUSIONS: Our study shows that although an ADS event does not cause an immediate incidence of AMI, storms may increase AMI incidence through a delayed effect. Hence, AMI prevention is not only important during a dust storm, but particularly so in subsequent days. During the days after an ADS, exposure to dust should be minimized by staying indoors as much as possible and by wearing a mask when exposure to dust is unavoidable. This is especially true for working and older adults. Nurses at local public health centers can increase awareness and promote public safety by providing health information to local communities regarding the link between dust storms and AMI.

Does prenatal care benefit maternal health? A study of post-partum maternal care use.

Most studies on prenatal care focus on its effects on infant health, while studying less about the effects on maternal health. Using the Longitudinal Health Insurance claims data in Taiwan in a recursive bivariate probit model, this study examines the impact of adequate prenatal care on the probability of post-partum maternal hospitalization during the first 6 months after birth. The results show that adequate prenatal care significantly reduces the probability of post-partum maternal hospitalization among women who have had vaginal delivery by 43.8%. This finding suggests that the benefits of prenatal care may have been underestimated among women with vaginal delivery. Timely and adequate prenatal care not only creates a positive impact on infant health, but also yields significant benefits for post-partum maternal health. However, we do not find similar benefits of prenatal care for women undergoing a cesarean section.