Oxford Research Encyclopedia of Global Public Health最新文献

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Operationalizing Human Rights in Sexual and Reproductive Health and Rights Programming: An Example from a Global Family Planning Partnership 在性健康和生殖健康及权利方案编制中落实人权:以全球计划生育伙伴关系为例
Oxford Research Encyclopedia of Global Public Health Pub Date : 2021-08-31 DOI: 10.1093/acrefore/9780190632366.013.239
K. Hardee
{"title":"Operationalizing Human Rights in Sexual and Reproductive Health and Rights Programming: An Example from a Global Family Planning Partnership","authors":"K. Hardee","doi":"10.1093/acrefore/9780190632366.013.239","DOIUrl":"https://doi.org/10.1093/acrefore/9780190632366.013.239","url":null,"abstract":"The International Conference on Population and Development (ICPD), which has guided programming on sexual reproductive health and rights (SRHR) for 25 years, reinforced that governments have a role to play in addressing population issues but in ways that respect human rights and address social and gender inequities. The shift at ICPD was partly in response to excesses that had occurred in some family planning programs, resulting in human rights abuses. The 2012 London Summit on Family Planning refocused attention on family planning as a crucial component of SRHR and, in part due to significant pushback on the announcement of a goal of reaching an additional 120 million women and girls with contraception by 2020 in the world’s poorest countries, ignited work to ensure that programming to achieve this ambitious goal would be grounded in respecting, protecting, and fulfilling human rights. This attention to human rights has been maintained in Family Planning 2030 (FP2030), the follow on to Family Planning 2020 (FP2020). While challenges remain, particularly in light of pushback on reproductive rights, widespread work over the past decade to identify human rights principles and standards related to family planning, integrate them into programming, strengthen accountability, and incorporate rights into monitoring and evaluation has improved family planning programs.","PeriodicalId":342682,"journal":{"name":"Oxford Research Encyclopedia of Global Public Health","volume":"60 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122963976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Urban Homelessness Policy in OECD Nations 经合组织国家的城市无家可归政策
Oxford Research Encyclopedia of Global Public Health Pub Date : 2021-08-31 DOI: 10.1093/acrefore/9780190632366.013.319
C. Willison, Amanda I. Mauri
{"title":"Urban Homelessness Policy in OECD Nations","authors":"C. Willison, Amanda I. Mauri","doi":"10.1093/acrefore/9780190632366.013.319","DOIUrl":"https://doi.org/10.1093/acrefore/9780190632366.013.319","url":null,"abstract":"Homelessness is a public health challenge for modern governments. Homelessness emerged as a formal policy problem for rich nations in the mid- to late 20th century as nations developed stable economies and democracies, including housing and job markets, and social welfare mechanisms to protect citizens from disenfranchisement. In early 21st-century Organisation for Economic Co-operation and Development (OECD) nations, homelessness arises most often among at-risk or vulnerable populations, such as historically marginalized groups and/or persons with constrained access to welfare state mechanisms, such as immigrants or refugees. Thus, homelessness in OECD nations is very different from informal housing or mass poverty in poor nations and/or non-democratic regimes.\u0000 Homelessness affects individual and population health, requiring complex policy solutions across multiple domains of health, as well as intergovernmental coordination. Policy responses to homelessness vary across OECD nations in their approach and efficacy. There are four key factors influencing how OECD nations respond to homelessness: (a) the strength and inclusivity of the welfare state; (b) degrees of decentralization in homeless policy governance; (c) the strength, capacity, and inclusivity of the health and behavioral healthcare systems; and (d) the role of federated structures in health and welfare state policy. Overall, nations with weaker welfare states and health/behavioral healthcare systems face greater risks of homelessness. The inclusivity of these systems also shapes who may be eligible for protection or experience homelessness. Local governments, especially those in large metropolitan areas, are the frontline providers of homelessness services. Yet local governments are constrained at both ends: Policies designed, delivered, and funded at larger units of government—such as welfare state provisions—influence many of the determinants of homelessness, such as housing, and the resources available to subnational actors to combat homelessness. Local actors are also constrained by the degree of decentralization. Devolution of homelessness policy to smaller units of government or even solely to nongovernmental actors, through federated mechanisms or decentralization, may create barriers to locally tailored solutions by perpetuating disparities across jurisdictions and/or constraining authority and resources necessary to design or deliver homeless policy.","PeriodicalId":342682,"journal":{"name":"Oxford Research Encyclopedia of Global Public Health","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124774827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Social and Environmental Determinants of Health Among People With Disabilities 影响残疾人健康的社会和环境因素
Oxford Research Encyclopedia of Global Public Health Pub Date : 2021-08-31 DOI: 10.1093/acrefore/9780190632366.013.325
E. Emerson
{"title":"Social and Environmental Determinants of Health Among People With Disabilities","authors":"E. Emerson","doi":"10.1093/acrefore/9780190632366.013.325","DOIUrl":"https://doi.org/10.1093/acrefore/9780190632366.013.325","url":null,"abstract":"There is extensive evidence that people with disabilities experience significantly poorer health than their nondisabled peers. These are, in part, health inequities (differences in health status that are avoidable, unjust, and unfair) resulting from increased rates of exposure of people with disabilities to a range of well-established social (and environmental) determinants of poor health, including poverty, reduced access to effective education, lack of employment or employment under hazardous or precarious conditions, social disconnectedness, violence, discrimination, and poor healthcare. They also include environmental determinants of poor health that are a direct result of human activity (e.g., outdoor air pollution resulting from industrial processes and transportation). In addition, people with disabilities are often less likely than their peers to have access to many of the resources (power, wealth, social support, problem-solving skills) that have been linked to increased resilience in the face of adversity. As such, it would appear reasonable to expect that the health of people with disabilities is as likely, if not more so, to deteriorate, when exposed to social determinants, than the health of their nondisabled peers. Future research needs to focus on two key issues. First, given that most of the current evidence has been generated in high-income countries, it is critical for future research to focus on the situation of people with disabilities living in middle- and low-income countries. Second, more needs to be known about the determinants of the resilience and/or vulnerability of people with disabilities.\u0000 Some significant limitations remain in the current evidence base, but it is clear that existing knowledge is sufficient to drive and guide changes in policy and practice that could reduce the health inequities faced by people with disabilities. These include (a) improving the visibility of people with disabilities in local, national, and international health surveillance systems; (b) making “reasonable accommodations” to the operation of healthcare systems to ensure that people with disabilities are not exposed to systemic discrimination in access to and the quality of healthcare; and (c) ensuring that people with disabilities are included in and benefit equally from local and national strategies to reduce population levels of exposure to well-established social determinants of health.","PeriodicalId":342682,"journal":{"name":"Oxford Research Encyclopedia of Global Public Health","volume":"70 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121707682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Sex and Conception Probability 性别与受孕概率
Oxford Research Encyclopedia of Global Public Health Pub Date : 2021-08-31 DOI: 10.1093/acrefore/9780190632366.013.179
J. Konje, O. Ladipo
{"title":"Sex and Conception Probability","authors":"J. Konje, O. Ladipo","doi":"10.1093/acrefore/9780190632366.013.179","DOIUrl":"https://doi.org/10.1093/acrefore/9780190632366.013.179","url":null,"abstract":"Central to the survival of any species is the ability to procreate. In most cases, procreation is sexual, involving a process that ensures appropriate and timed contact between the male and female gametes. Successful human reproduction is premised on sexual intercourse occurring at a time when there is a receptive endometrium as well as an ovum ready for fertilization by spermatozoa. This time window of the menstrual cycle known as the fertile or fecund window is poorly defined and highly variable from one individual to another. Furthermore, while spermatogenesis is a continuous process, the impact of too frequent intercourse (defined as that occurring more than every 2 to 3 days) on fertilization has often been thought to be associated with a decreased fertilization potential of spermatozoa. Current evidence challenges previously held views on the fertile window and how it is determined, the timing of intercourse and how it is related to conception and miscarriages, the length of the luteal phase, and the precise time period during which the chances of fertilization are highest in any given menstrual cycle. The ability of spermatozoa to survive in the female genital tract for 5 days means fertilization can occur up to 5 days from sexual intercourse. During each menstrual cycle, there is a window of 5 to 6 days for fertilization to occur, and this period is defined not by the length of the cycle but by the timing of ovulation, with the chances of fertilization highest with intercourse occurring 1 to 2 days before ovulation.","PeriodicalId":342682,"journal":{"name":"Oxford Research Encyclopedia of Global Public Health","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129898957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Collective Health: Theory and Practice. Innovations From Latin America 集体健康:理论与实践。拉丁美洲的创新
Oxford Research Encyclopedia of Global Public Health Pub Date : 2021-08-31 DOI: 10.1093/acrefore/9780190632366.013.240
Lígia Maria Vieira-da-Silva
{"title":"Collective Health: Theory and Practice. Innovations From Latin America","authors":"Lígia Maria Vieira-da-Silva","doi":"10.1093/acrefore/9780190632366.013.240","DOIUrl":"https://doi.org/10.1093/acrefore/9780190632366.013.240","url":null,"abstract":"Throughout history, knowledge and practices on the health of populations have had different names: medical police, public health, social medicine, community health, and preventive medicine. To what extent is the Brazilian collective health, established in the 1970s, identified with and differentiated from these diverse movements that preceded it? The analysis of the socio-genesis of a social field allows us to identify the historical conditions that made possible both theoretical formulations and the achievement of technical and social practices. Collective health, a product of transformations within the medical field, constituted a rupture in relation to preventive medicine and public health and hygiene, being part of a social medicine movement in Latin America that, in turn, had identification with European social medicine in the 19th century. Focused on the development of a social theory of health that would support the process of sanitary reform, collective health has been built as a space involving several fields: scientific, bureaucratic, and political. Thus, it brought together health professionals and social scientists from universities, health care services, and social movements. Its scientific subfield has developed, and the sanitary reform project has had several successes related to the organization of a unified health system, which has ensured universal coverage for the population in Brazil. It has incorporated into and dialogued with several reformist movements in international public health, such as health promotion and the pursuit of health equity. Its small relative autonomy stems from subordination to other dominant fields and its dependence on the state and governments. However, its consolidation corresponded to the strengthening of a pole focused on the collective and universal interest, where health is not understood as a commodity, but as a right of citizenship.","PeriodicalId":342682,"journal":{"name":"Oxford Research Encyclopedia of Global Public Health","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130186178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Where Is Disability in Global Public Health? 残疾在全球公共卫生中的地位如何?
Oxford Research Encyclopedia of Global Public Health Pub Date : 2021-06-28 DOI: 10.1093/acrefore/9780190632366.013.287
G. Krahn
{"title":"Where Is Disability in Global Public Health?","authors":"G. Krahn","doi":"10.1093/acrefore/9780190632366.013.287","DOIUrl":"https://doi.org/10.1093/acrefore/9780190632366.013.287","url":null,"abstract":"Accounting for about 15% of the world’s population, persons with disabilities constitute a critical population. Despite a substantial knowledge base in disability and public health, persons with disabilities have been remarkably invisible within general global public health. Public health’s view of disability is shifting from regarding disability only as an outcome to prevent, to using disability as a demographic characteristic that identifies a population experiencing a range of inequities. Alternative models of disability reflect how disability has been viewed over time. These models vary in their underlying values and assumptions, whether the locus of disability is the individual or the environment or their interaction, who designates “disability,” and the focus of intervention outcomes.\u0000 The United Nations flagship report on Disability and Sustainable Development Goals, 2018 documents that, as a group, the lives of persons with disabilities are marked by large disparities in Sustainable Development Goal indicators. These include increased likelihood of experiencing poverty, hunger, poor health, and unemployment, and greater likelihood of encountering barriers to education and literacy, clean water and sanitation, energy, and information technology. Overall, persons with disabilities experience greater inequalities, and this is particularly experienced by women and girls with disabilities. The COVID-19 pandemic and other disasters have highlighted the gaps in equality and consequent vulnerability of this population.\u0000 Global disability data have improved dramatically during the decade from 2010 to 2020 with the advent of standardized disability question sets (Washington Group) and model surveys (Model Disability Survey). New studies from the Global South and North identify areas and strategies for interventions that can effectively advance the Sustainable Development Goals.\u0000 This call-to-action outlines strategies for increasing visibility and improving wellbeing of persons with disabilities, particularly in the Global South. Increased visibility of the disability population within the global public health community can be achieved through active engagement of persons with disabilities. Improved collection of disability data and routine analysis by disability status can provide information vital to planning and policies. A twin-track approach can provide direction for interventions—inclusion in mainstream programs where possible, use of disability-specific and rehabilitation approaches where necessary. The article ends by outlining ways that multiple roles can increase the inclusion of persons with disabilities in global public health.","PeriodicalId":342682,"journal":{"name":"Oxford Research Encyclopedia of Global Public Health","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122962936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
The Health Impact of Water and Sanitation Utilities Privatization and Regulation in Sub-Saharan Africa 撒哈拉以南非洲水和卫生设施私有化和管制对健康的影响
Oxford Research Encyclopedia of Global Public Health Pub Date : 2021-06-28 DOI: 10.1093/acrefore/9780190632366.013.315
Lisa Bagnoli, Salvador Bertoméu-Sánchez, A. Estache
{"title":"The Health Impact of Water and Sanitation Utilities Privatization and Regulation in Sub-Saharan Africa","authors":"Lisa Bagnoli, Salvador Bertoméu-Sánchez, A. Estache","doi":"10.1093/acrefore/9780190632366.013.315","DOIUrl":"https://doi.org/10.1093/acrefore/9780190632366.013.315","url":null,"abstract":"As of 2017, the urban access rate to safe water sources in 2017 stood at 84% while rural access was still around 45%. The rates for sanitation were 44% and 22%, respectively. Since the 1980s many high-profile reforms supported by international organizations have been implemented in the region in an attempt to close the access gaps in the water and sanitation sector (WSS). Two recommendations with high international exposure were an increased role for large-scale private sector participation in the management and financing of national or regional utilities and the creation of separate sector regulatory agencies to increase the independence of regulation. Both reforms seemed to contribute to improved water access rates, at least for the urban population, but not enough to catch up with the demands of a fast-growing population; and both failed to deliver on sanitation. The progress these initiatives allowed was correlated with improvements in the average health outcomes for some indicators (i.e., under-five mortality associated to diarrhea) but once again, it was not enough and was not fairly distributed. Indeed, improvements seem to have mostly benefited upper- and middle-income groups. Unfortunately, an evaluation of the health effects of these two reforms have not yet been fully established empirically, which is why it seems prudent to talk about correlations rather than causal effects. Most of the statistically robust evidence on the impact of utilities and regulatory reforms on health is incomplete because details of several dimensions of these reforms and their context are not measured consistently across countries or within countries. In addition, the small amount of econometric evidence available is based on pre-2010 data for SSA. The imperfect data is however solid enough to suggest that without further governance changes in the region, the health risks are likely to increase. This is because due to the high population growth rate of the region, closing the access gaps is likely to get tougher considering current investment levels and technological choices. The necessary changes require improving the match between policy and technological choices, including service delivery technologies that are consistent with the ability to pay and the tariff and subsidy levels adopted to ensure cost recovery without excluding any category of users.","PeriodicalId":342682,"journal":{"name":"Oxford Research Encyclopedia of Global Public Health","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129272207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Inequalities and Inequities in the Health of People With Intellectual Disabilities 智力残疾者健康方面的不平等和不公平现象
Oxford Research Encyclopedia of Global Public Health Pub Date : 2021-06-28 DOI: 10.1093/acrefore/9780190632366.013.326
E. Emerson
{"title":"Inequalities and Inequities in the Health of People With Intellectual Disabilities","authors":"E. Emerson","doi":"10.1093/acrefore/9780190632366.013.326","DOIUrl":"https://doi.org/10.1093/acrefore/9780190632366.013.326","url":null,"abstract":"Children and adults with intellectual disabilities have poorer health and are more likely to die sooner than their non–intellectually disabled peers. There is growing evidence that some of these inequalities in health are avoidable, unjust, and unfair, given that they are driven by the higher rates of exposure of people with intellectual disabilities to well-established social determinants of poor health. People with intellectual disabilities are more likely than their peers to: live in poverty, not be employed (or if employed to work under precarious conditions), be exposed to discrimination and violence, face significant barriers in accessing effective health care, and be less resilient when exposed to adversities. In other words, they are examples of health inequities that arise from “the societal conditions in which people are born, grow, live, work and age, referred to as social determinants of health. These include early years’ experiences, education, economic status, employment and decent work, housing and environment, and effective systems of preventing and treating ill health” (World Health Organization).\u0000 Future research needs to address three key issues. First, most of the existing evidence is based on the experiences of people with intellectual disabilities in the world’s high-income countries. In contrast, the vast majority of the world’s population live in middle- and low-income countries. The limited evidence available suggests that children with intellectual disabilities growing up in middle- and low-income countries are much more likely than their peers to be growing up in poverty and to be exposed to specific social determinants of poorer health associated with poverty such as undernutrition, poor sanitation, low levels of parental stimulation, violent parental discipline, and hazardous forms of child labor. Second, little research has focused on health inequalities and inequities among two important groups of people with intellectual disabilities: people with intellectual disabilities from minority ethnic communities and people with mild intellectual disabilities. Third, very little research has attempted to test the proposition that people with intellectual disabilities may be more or less resilient than their peers when exposed to social determinants of health.\u0000 While much remains to be learned about the inequalities and inequities faced by people with intellectual disabilities, the existing knowledge is sufficient to guide and drive changes in policy and practice that could reduce the health inequities faced by people with intellectual disabilities. These include: improving the visibility of people with intellectual disabilities in local, national, and international health surveillance systems; making “reasonable accommodations” to the operation of health care systems (e.g., introducing annual health checks into primary care services, making “easy read” materials available, employing intellectual disabilities liaison nurses ","PeriodicalId":342682,"journal":{"name":"Oxford Research Encyclopedia of Global Public Health","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123961525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Fetal Deaths in High-Income Countries 高收入国家的胎儿死亡
Oxford Research Encyclopedia of Global Public Health Pub Date : 2021-05-26 DOI: 10.1093/acrefore/9780190632366.013.198
S. Lisonkova, K. Joseph
{"title":"Fetal Deaths in High-Income Countries","authors":"S. Lisonkova, K. Joseph","doi":"10.1093/acrefore/9780190632366.013.198","DOIUrl":"https://doi.org/10.1093/acrefore/9780190632366.013.198","url":null,"abstract":"Fetal death refers to the death of a post-embryonic product of conception while in utero or during childbirth, and it is one of the most distressing events faced by women and families. Birth following spontaneous fetal death is termed “miscarriage” if it occurs early in gestation, and “stillbirth,” if it occurs beyond the point of viability. There are substantial between-country differences in the criteria used for reporting stillbirths and these differences compromise international comparisons of stillbirth rates.\u0000 In high-income countries, a majority of fetal deaths occur due to genetic causes, fetal infection, or other pregnancy complications. Congenital anomalies, placental insufficiency, and/or intrauterine growth restriction are frequent antecedents of fetal death. Maternal risk factors include advanced maternal age, high body mass index, smoking and substance use during pregnancy, prior stillbirth, chronic morbidity, and multifetal pregnancy. Disparities in education and socioeconomic status and other factors influencing maternal health also contribute to elevated rates of stillbirth among vulnerable women.","PeriodicalId":342682,"journal":{"name":"Oxford Research Encyclopedia of Global Public Health","volume":"7 1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127249463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Do Households Respond to the Marginal or Average Price of Piped Water Services? 家庭对自来水服务的边际价格或平均价格有反应吗?
Oxford Research Encyclopedia of Global Public Health Pub Date : 2021-05-26 DOI: 10.1093/acrefore/9780190632366.013.244
J. Cook, Daniel A. Brent
{"title":"Do Households Respond to the Marginal or Average Price of Piped Water Services?","authors":"J. Cook, Daniel A. Brent","doi":"10.1093/acrefore/9780190632366.013.244","DOIUrl":"https://doi.org/10.1093/acrefore/9780190632366.013.244","url":null,"abstract":"Water utilities commonly use complex, nonlinear tariff structures to balance multiple tariff objectives. When these tariffs change, how will customers respond? Do customers respond to the marginal volumetric prices embedded in each block, or do they respond to an average price? Because empirical demand estimation relies heavily on the answer to this question, it has been discussed in the water, electricity, and tax literatures for over 50 years. To optimize water consumption in an economically rational way, consumers must have knowledge of the tariff structure and their consumption. The former is challenging because of nonlinear tariffs and inadequate tariff information provided on bills; the latter is challenging because consumption is observed only once and with a lag (at the end of the period of consumption). A large number of empirical studies show that, when asked, consumers have poor knowledge about tariff structures, marginal prices, and (often) their water consumption.\u0000 Several studies since 2010 have used methods with cleaner causal identification, namely regression discontinuity approaches that exploit natural experiments across changes in kinks in the tariff structure, changes in utility service area borders, changes in billing periods, or a combination. Three studies found clear evidence that consumers respond to average volumetric price. Two studies found evidence that consumers react to marginal prices, although in both studies the change in price may have been especially salient. One study did not explicitly rule out an average price response. Only one study examined responsiveness to average total price, which includes the fixed, nonvolumetric component of the bill.\u0000 There are five messages for water professionals. First, inattention to complex tariff schedules and marginal prices should not be confused with inattention to all prices: customers do react to changes in prices, and prices should remain an important tool for managing scarcity and increasing economic efficiency. Second, there is substantial evidence that most customers do not understand complex tariffs and likely do not respond to changes in marginal price. Third, most studies have failed to clearly distinguish between average total price and average volumetric price, highlighting the importance of fixed charges in consumer perception. Fourth, evidence as of late 2020 pointed toward consumers’ responding to average volumetric price, but it may be that this simply better approximates average total price than marginal or expected marginal prices; no studies have explicitly tested this. Finally, although information treatments can likely increase customers’ understanding of complex tariffs (and hence marginal price), it is likely a better use of resources to simplify tariffs and pair increased volumetric charges with enhanced customer assistance programs to help poor customers, rather than relying on increasing block tariffs.","PeriodicalId":342682,"journal":{"name":"Oxford Research Encyclopedia of Global Public Health","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123425329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
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