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This chapter pays tribute to Andrew Jones' research in health programme evaluation, health-risky behaviour and income-related health inequalities by reviewing policy-relevant empirical studies in these domains using Italian data. In the first section, We discuss the impact of reimbursement systems on healthcare behaviour, particularly the transition from incurred-cost-based to prospective systems in hospitals. We explore incentive-driven practices like up-coding and cream skimming, while also considering the potential advantages of primary care incentives and the mixed outcomes associated with cost-sharing schemes. The second section delves into health-risk behaviours in Italy, encompassing substance use, preventive healthcare and responses to health information. The last section presents some evidence on socioeconomic status (SES)-related health disparities and discusses the necessity of accounting for these factors in the Italian National Health Service (NHS)'s resource allocation formula in line with British NHS experience.

The aim of this chapter is to develop a conceptual model for the analysis of sustainable development and the ranking of cities based on selected standard criteria and metrics of smart cities. The conceptual framework contains standard and measurable indicators that influence the creation and survival of smart cities that could be self-sustaining, Green Resilient. We can measure the level of smartness of cities from two perspectives, first from the point of view of the degree of automation of services, infrastructure, buildings, transport, etc. and second from the point of view of planning the further development of the city in order to raise the quality of life of its citizens. Indicators should satisfy the principles of specificity, measurability, availability, relevance and timeliness (Schomaker, 1997). Researchers in the field of smart cities define different sets of characteristics, on which they construct a system of indicators that together describe the degree of development of a smart city. It must be taken into account the fact that there is no single set of indicators that would refer to the level of smartness of the city. It is a complex phenomenon, which occurs differently depending on the conceptual framework and the goal of classifying cities according to the complex characteristics of smartness, especially if you take into account the fact that the general well-being and quality of life of citizens are more important than only indicators of the quality of city services.

Multiple chronic conditions (MCCs) have attracted significant public policy and clinical attention. Whether MCCs determine other important outcomes, or are themselves the outcomes of health-producing activities or interventions, metrics based thereon have potential to be useful indicators of the health of populations and of differences between and among the health of subpopulations. While the attention MCCs are attracting in various policy circles is impressive, MCCs' potential roles as indicators of population health and of how health determinants influence population–health outcomes have received less attention. The purpose of this chapter is to direct attention towards questions that involve considerations of chronic condition (CC) patterns as health outcomes; specifically, this paper hopes to advance the consideration of patterns of MCCs as indicators of individual and population health. Using data from the United States (US) Behavioural Risk Factor Surveillance System (BRFSS), the chapter explores whether both the ‘intensity’ (i.e. the number or count) of CCs as well as their ‘composition’ (i.e. the patterns of particular CCs) might be jointly of interest when considering the prevalence of MCCs in populations and how the nature of MCCs may vary across subpopulations of interest. It is seen that information about intensity tells an incomplete story about MCC health outcomes.

Menstrual hygienic practices are an essential component in public health that significantly impact and, in turn, are affected by the economic and social status of women. This study aims to investigate the usage of hygienic menstrual products among young girls and women between the age group of 15 and 24 years. It also tries to explore various other socio-economic factors including regional disparities in menstrual hygiene management (MHM) practices. To analyze the relationship between these factors, a bivariate statistical analysis has been carried out. The results are based on a secondary dataset, that is, the National Family Health Survey, Fifth Round (NFHS-5), 2019–2021 for India. This study further examines the regional disparities across India, in terms of hygienic practices adopted by women to ensure menstrual health. The results show that there exists a positive relationship between hygienic methods of protection against bloodstains and the socio-economic status of women. This has been analyzed across four dimensions – educational attainment, access to sanitation, financial autonomy and exposure to mass media/mobile phones. A stark urban–rural gap has been observed in terms of the MHM practices in Western and Central Indian states. Therefore, enhancing the economic and social status of rural women requires a more holistic approach toward elevating MHM practices in these regions. The de-stigmatization of menstruation and greater involvement of men in doing so would prove to be pivotal. To accelerate the level of hygienic menstrual practices among rural women in these regions, existing policies need to focus on educational, financial and various other health-related aspects as means to reduce the rural–urban divide in India.

This chapter presents a mediation model that aims to disentangle the indirect from the direct effects of retirement on health, considering the mediating role of lifestyles. The model is applied to the risk of depression, and physical inactivity is assumed to potentially mediate the effect of retirement. The results indicate that there is a significant indirect effect via the mediator, albeit relatively small in comparison to the direct effect. The analysis highlights the importance of further exploring the influence of lifestyle factors in the relationship between retirement and health, in order to gain a better understanding of the potential pathways through which retirement impacts health.

Research is conducted to inform our understanding of broadly defined topics often described in terms that are used in common discourse. In order to carry out research, it is necessary to develop specific definitions which are also measurable. The way a concept is defined should be determined by the objectives of the research project, making it necessary for these objectives to be clearly stated. For example, if a research enterprise is undertaken to provide information to monitor whether policy commitments have been realised, the definitions used must be grounded in the frameworks that define those commitments. If this is not the case, the research findings cannot be used for their intended purpose. Transparency in how concepts are defined is also key to the ethical use of research findings. Given the complex and multidimensional nature of disability, definition is particularly important in disability research. This chapter will first review the need to clearly define disability when conducting disability research, and will discuss the need to identify the population or populations with disabilities in order to monitor full inclusion in society. The difference in the level of inclusion in society among those with, as compared to those without disability, is referred to as the ‘disability gap’. The Chapter will then address challenges in identifying the population with disabilities consistent with the social and human rights models of disability. Finally, this chapter will conclude with a presentation of the data collection tools developed by the Washington Group on Disability Statistics.

Ensuring adequate access to healthcare services is a priority across European countries. The EU has developed performance indicators to compare access using self-reported unmet need. Cross-country comparisons require adjustment for factors outside the health systems' control. We address two research questions to improve the comparability of unmet need for medical and dental care across the EU and the comparability of socio-economic inequalities in unmet need across the EU. First, we explore the role of risk adjustment for demographic and socio-economic factors, which are outside health systems' control, for both overall unmet need and unmet need due to affordability, waiting lists and distance. Second, we compare differences in unmet need by socio-economic status, and investigate whether different forms of risk adjustment affect such comparison. We show that adjusting for age, gender and chronic conditions reduces dispersion of unmet need for medical care across the EU. Controlling for income further reduces the dispersion, mostly due to affordability. When comparing socio-economic inequalities across countries, risk adjustment for age, gender and chronic conditions play a limited role. Socio-economic inequalities by income and education vary by reason of unmet need: the income gradient, even controlling for education, is mostly due to affordability rather than waiting list or distance. For dental care, the main reason for unmet need is affordability. Risk adjustment for age, gender, chronic conditions and education plays a limited role. The income and education gradients are more pronounced for dental than medical care.

Depression imposes substantial individual and societal economic costs, including lower productivity and higher healthcare use. However, while the relationship between employment and mental health has been explored, less is known about the potentially countervailing effects of different types of economic inactivity on depression among older individuals. The authors employ a series of models, including fixed effects panel data models and matching on rich data from the English Longitudinal Study of Ageing (ELSA) to investigate whether different types of inactivity might have heterogenous effects on depression. The authors find that whereas transitions to involuntary inactivity (unemployment) do not appear to have a perceivable effect on depression, transitions to voluntary inactivity (retirement) seem to decrease it.

This chapter considers the evolution of diet culture in the digital age, particularly focussing on the proliferation of anti-diet and holistic wellness sentiments, which paradoxically work to conceal the ongoing persistence of diet culture. A discourse analysis approach was conducted on ‘What I Eat In A Day’ (WIEIAD) YouTube videos to examine the ways in which diet choices are narrated and rationalised to achieve the illusion of the ‘disappearance’ of diet culture. The author explores how this has produced the pressure to have (or more accurately perform) a ‘healthy’ relationship with food. This is ambiguously defined and embodied online, but some recurring themes have been observed through my analysis. The author argues that these WIEIAD videos often risk obscuring the persistence of diet culture by positioning it in the past when, as this chapter will attempt to demonstrate, it is very much embedded in the current diet discourse. Weight loss and appearance are downplayed as motivations for engaging in health and wellness. However, they are very much still beneath the surface. While the conversation around dieting might be less overtly problematic than it was in the past, there continues to be a significant amount of vigilance and effort required for women to meet conventional beauty standards. In addition to the material practice of dieting, there is now the pressure to perform the emotional labour of ‘talking away’ accusations of disordered eating, upholding the premature ideal of a post-diet culture era.