Patient navigation (PN) is increasingly used to help people overcome barriers to accessing health care. In a recent trial, PN was added to motivational interviewing (MI) to help patients discharged from detoxification (detox) transition to follow-up care. The goal was to test whether PN in addition to MI increased transition rates and reduced subsequent readmissions into detox compared with MI alone. Results demonstrated little evidence of a treatment effect on either of these two outcomes, but post hoc exploratory analyses showed that patients who received PN were less likely to be arrested in the year following discharge than patients who did not receive PN. In addition, the group that received PN had fewer multiple arrests resulting in a lower average number of arrests per person. These findings are hypothesis-generating and need replication for conclusive inference. Nevertheless, economic analysis indicates that PN after detox could be a cost-beneficial intervention to reduce arrests among a population at high risk for involvement in the criminal justice system.

The personal experience of events such as financial crises and natural disasters can alter economic preferences. We administered a repeated cross-sectional preference survey during the early stages of the COVID-19 outbreak, collecting three bi-weekly samples from participants recruited through Amazon Mechanical Turk. The survey elicits economic preferences, self-reported fear of the pandemic, and beliefs about economic and health consequences. Preferences varied over time and across regions, and self-reported fear of the pandemic explains this variation. These findings suggest caution about the generalizability of some types of experimental work during times of heightened fear.

There is a need to value health technologies in a way that accommodates their broader economic impacts and competing approaches for doing so have emerged. The Pareto principle (PP) requires policymakers to resolve intrapersonal trade-offs by deferring to the preferences of the individuals facing those trade-offs. Many broad value frameworks such as cost-utility analysis and its extensions, health-centric multicriteria decision analysis, and poverty-free life expectancy are not sufficiently deferential to these preferences, violating PP. I propose using the health-augmented lifecycle model (HALM) to value health technologies in a way that flexibly incorporates the interactions among health and economic factors – specifically mortality and morbidity risks, paid and unpaid work, consumption, leisure, and public and private transfer inflows and outflows--over the life course. It relies on individual preferences, satisfying PP. It is compatible with cost-benefit analysis, social welfare functions, and equivalent income approaches. I calibrate the HALM for the US setting and apply it to a pediatric vaccine.

The world remains off-track for the sustainable development goal (SDG) target 3.4, which calls for a one-third reduction in noncommunicable diseases (NCDs) mortality by 2030. This paper presents benefit–cost analyses of various NCD interventions in low-income (LICs) and lower–middle-income (LMCs) countries. We looked at 30 interventions recommended by the Disease Control Priorities Project, including six intersectoral policies (e.g., taxes) and 24 clinical services. We used a previously published model to estimate intervention costs and benefits through 2030, discounted at 8%. We focused on interventions with benefit–cost ratios (BCRs) > 15 and their contribution toward achieving the SDG target. We found that intersectoral policies often provided great value for money, with BCRs ranging from 40 (trans-fat bans) to 100 (tobacco excise taxes). However, seven clinical interventions (e.g., basic treatment of cardiovascular disease or breast cancer) also had BCRs > 15. The overall population impact of clinical interventions over the 2023–2030 period would be much higher than that of the intersectoral policies, which can take many years to reach their peak effects. Fully implementing the best-investment interventions would accelerate progress toward SDG 3.4 everywhere, but only one in 10 countries would achieve the target. This strategy would require an additional US$ 2.4 billion annually across all LICs and LMCs. We conclude that there are several cost-beneficial opportunities to tackle NCDs in LICs and LMCs. In countries with very limited resources, the best-investment interventions could begin to address the major NCD risk factors and build greater health system capacity, with benefits continuing to accrue beyond 2030.

In the absence of government safety regulation in the field of nanotechnology, ISO standards are being used as the basis for establishing technical and management guidelines at an international level. There are more than 50 current ISO standards on nanotechnology. Some of these relate to the working environment and occupational risk management. In Latin America, entities that are members of ISO are enunciating national versions of the international standards. In this article, this context is analysed critically, starting from the Mexican standard on occupational risk management in the working environment. Even though risk management standards may guarantee better and safer working conditions, in the field of nanotechnology, they simultaneously unlock detrimental implications for workers and society. Reliance on such private and voluntary forms of industry self-regulation is identified as a by-product of global neoliberalism.

Households in the USA spend about $70 billion annually on pets. Dogs, the most common pet, can be found in nearly half of American households. An important shadow price in the analysis of policies affecting human mortality is the value of statistical life (VSL), which is imputed from how people make decisions involving tradeoffs between small mortality risks and other goods. The value of statistical dog life (VSDL) is also an important, but until now unavailable, shadow price for use in regulation of such goods as pet foods and environmental toxins. Additionally, an estimate of the VSDL would have uses outside the regulatory process in valuing programs involving zooeyia, in setting tort awards for wrongful dog death, and in property divisions in divorce settlements where joint custody of dogs is not feasible. In order to estimate the VSDL, we conducted a contingent valuation of a national sample of dog owners that elicited willingness-to-pay for changes in mortality risk for pet dogs. Specifically, respondents were asked about willingness-to-pay for a vaccine that would reduce the risk of canine influenza. The design included both quantity (different magnitudes of risk reduction from the offered vaccine) and quality (differences in nature of death from the influenza) treatments as scope tests. It also included treatments involving spillover effects to other dogs and a priming question about disposable income. Based on the analysis and consideration of its assumptions, we recommend $10,000 as the VSDL.

The objective of this study is to identify experimental economic tools that can be employed to explain the role of economic behavior in overweight and obesity in the household. We identify three economic experiments that can be used to understand how parent-child economic relationships relate to obesity. Loss aversion experiments are discussed as a tool to understand challenges some individuals face in achieving a healthy diet. Finally, testbed experiments are introduced as a means to test and understand new policies and incentives for better health at the household level.

Although Canada has developed an effective animal identification system, and the provinces are progressing toward a system that has full traceback capabilities, the U.S. and Mexico have made little or no progress. Contemporary U.S. proposals for state initiatives will not work. In the meantime, the U.S. livestock industry will continue to lose markets for its products and has little to no basis for complaining about lost sales and the lack of open markets. Also indentified are relevant economic and political principles that both underlie animal identification systems and the failure to make positive steps forward toward establishing a North American animal identification system.