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The chapter investigates: (1) Do married parents efficiently allocate time to children’s health care? (2) Are parents willing to sacrifice consumption for health improvements at an equal rate for all family members? (3) How does family structure affect health trade-offs parents make? (4) Are parental choices consistent with maximization of a single utility function?

A model is specified focusing on how parents allocate resources between consumption and goods that relieve acute illnesses for family members. Equivalent surplus functions measuring parental willingness to pay to relieve acute illnesses are estimated using data from a stated-preference survey.

Results provide limited support for the prediction that married parents allocate time to child health care according to comparative advantage. Valuations of avoided illness vary between family members and are inconsistent with the hypothesis that fathers’ and mothers’ choices reflect a common utility function.

Prior research on children’s health valuation has relied on a unitary framework that is rejected here. Valuation researchers have focused on allocation of resources between parents and children while ignoring allocation of resources among children, whereas results suggest significant heterogeneity in valuation of health of different types of children and of children in different types of households.

Results may provide a justification on efficiency grounds for policies to provide special protection for children’s health and suggest that benefit–cost analyses of policies affecting health should include separate estimates of the benefits of health improvements for children and adults.

Mental disorders collectively account for 4 of the 10 leading causes of disability and represent more than 15% of the overall burden of disease in the United States (SAMHSA, 1999). The first Surgeon General’s Report on Mental Health reported that in 1999 nearly 20 million American adults (9.5% of the population) were clinically depressed and that, at any one time, 1 in every 20 employees is experiencing depression (SAMHSA, 1999). The indirect costs of mental disorders to the American economy amounted to an estimated $79 billion in 1990, with loss of productivity because of illness accounting for about 80% of these costs ($63 billion) (Rice & Miller, 1996). Additionally, significant costs may accrue from decreased productivity due to symptoms that sap energy, affect work habits, and cause problems with concentration, memory, and decision-making (SAMHSA, 1999).

This paper uses economic analysis to develop the case for greater investment in mental health promotion. One example of a common mental health problem for which there is robust evidence of effective interventions is conduct disorder. The paper estimates that preventing conduct disorders in those children who are most disturbed would save around £150,000 per case (lifetime costs), and that promoting positive mental health in those children with moderate mental health would yield lifetime benefits of around £75,000 per case. Investment in support for parents is therefore the top priority in a provisional list of ‘best buys’ in promoting mental health.

The economic impact of ill‐health in employed individuals is largely experienced via absenteeism‐related and presenteeism‐related productivity loss. Using cognitive interviewing, the purpose of this paper is to evaluate a recently published interview method by which managers determine key job characteristics and their relationship to the cost of acute and chronic illness‐related absenteeism and presenteeism in the workplace: the team production approach.

Managers (n=20) from various industries in Australia completed the team production interview by telephone. Quantitative items measured replaceability, team production, time sensitivity of output and illness‐related absenteeism and presenteeism costs. Concurrent verbal probes followed five items which assessed the productivity impact of illness‐related presenteeism, identified as cognitively challenging.

Content analysis of interview outputs examined cognitive processes underlying managers’ responses and revealed difficulties understanding and quantifying chronic illness and presenteeism. Difficulties were categorised as misunderstanding of key concepts/terminology, inability to provide answers due to lack of knowledge, difficulty applying questions/scenarios to employees/workplaces and miscellaneous problems.

Interview modifications are proposed to address concerns of managers. These changes aim to minimise measurement error in future applications of the instrument and improve valuation of chronic illness and presenteeism in the workforce.

Improved understanding of chronic illness and presenteeism could enhance estimation of productivity loss recoverable via health management/promotion strategies and may increase managers’ willingness to implement such programs. Development of valuation methods in a manner acceptable to and informed by business leaders/employers ensures findings have “real‐world” value.

To the authors’ knowledge, this is the first use of cognitive interviewing to identify sources of response error in a productivity evaluation method.

Food safety is an important means for controlling food‐borne diseases. While there are various procedures for food safety, HACCP‐based procedure has been considered as an efficient method for food‐safety. In Australia the introduction of HACCP‐based food‐safety measures has been recommended in particular for meat and meat products to replace the traditional organoleptic meat inspection procedure. Aims to estimate the costs and benefits.

Employing tools of social cost benefit analysis, this paper estimates the worth of the HACCP‐based food‐safety program. The analysis was carried out assuming five alternative scenarios with 3, 5, and 7 per cent interest rates.

The results of this study show that the HACCP‐based food‐safety programs are expected to generate net benefit to the society if the effectiveness ranged between 20 and 90 per cent. However, at the 10 per cent level of effectiveness, net benefit turns into net social loss.

Provides details of the costs and benefits of the HACCP‐based food‐safety programs in Australia.

The sequence of stress, distress and somatization has occupied much of the late twentieth-century psychological research. The anatomy of stress can be viewed from interactional and hybrid theories that suggest that the individual relates with the surroundings by buffering the harmful effects of stressors. These acts or reactions are called coping strategies and are designed as protection from the stressors and adaptation to them. Failure to successfully adapt to stressors results in psychological distress. In some individuals, elevated levels of distress and failed coping are expressed in physical symptoms, rather than through feelings, words, or actions. Such “somatization” defends against the awareness of the psychological distress, as demonstrated in the psychosocial literature. The progression of behavior resulting from somatic distress moves from a private domain into the public arena, involving an elaborate medicalization process, is however less clear in sociological discourse. The invocation of a medical diagnosis to communicate physical discomfort by way of repeated use of health care services poses a major medical, social and economic problem. The goal of this paper is to clarify this connection by investigating the relevant literature in the area of women with breast cancer. This manuscript focuses on the relationship of psychological stress, the stress response of distress, and the preoccupation with one’s body, and proposes a new theoretical construct.

Emission of the suspended particulate matter (SPM) from cement factories results in a wide range of negative health effects to its workers. It induces substantial cost incurred by them in the form of wage loss and mitigation cost. Therefore, the purpose of this paper is to estimate emission-induced cost of illness (COI) and the share of this cost that could be saved through limiting the current emission level at national safety standard.

COI approach which accounts workers’ wage loss and mitigation cost due to emission-induced illness was used in this study. A sample of 120 workers from three factories followed by 40 from each was randomly surveyed for collecting information on their health status and mitigation cost. It covered almost 10 percent of cement factory workers in the south-west region of Bangladesh. In addition, factory-specific emission data were also collected from the Department of Environment for addressing the study objective.

It revealed that the average level of SPM emission by these factories which was almost three times higher than the national safety standard induced 34.39 million Bangladeshi Taka (BDT) (USD0.46 million) as COI paid by workers yearly. It accounted around 28 percent of their annual income of which 64 percent worth BDT22.16 (USD0.30) million could be saved by meeting the standard annually.

This study provides insights into the essence of regulating cement industrialists toward meeting the national safety standard of emission.

The purpose of this study was to see the impact of increased out-of-pocket expenditure oh health care exerting budget pressure on households, which leads to change in dietary consumption.

It was a hospital-based cross-sectional study comprising 414 patients with a chronic or major illness attending a large tertiary care public hospital at Delhi, India. Each patient represented a household with total number of family members of 2,550 in the study. Questionnaire was used to gather data on factors responsible for changes in consumption of 12 major food items.

Moderate decrease in food consumption of a household after major illness is associated with: rural residence (p < 0.001), decrease in savings (p < 0.001), more number of household items sold (p < 0.001), education of the children affected (p < 0.001), upper socio-economic status (SES) (p < 0.001) and children started working after illness in family (p = 0.043). In addition to decrease in food items, there was also deterioration in quality of food preparation. More than 80% of the families did not change the intake of cereals (rice and wheat), pulses and sugar. Food items that were decreased by most families were fruits, followed by milk and its products, vegetables, meat and egg, oils and ghee.

This study is a subset of other two studies previously published. The authors had not been able to cover this aspect fully in those two studies but understood the importance of impact of expenditure on illness on food consumption. The authors studied change in food consumption pattern (not amount) in subjects after illness. The impact of weather changes in food consumption on the impacted nutritional status of family has not been studied. The authors only collected cross-sectional, observational data and recall bias cannot be completely ruled out and corrected. With such data, only associations could be concluded, not causality. The illness condition of a household was measured by presence of chronic disease and inpatient treatment. Such measures did not take into account the types of illness and number of episodes. Data of this study cannot capture whether food intake of family prior to illness was sufficient/in excess/deficient. The Kuppuswamy scale, mostly used in urban and peri-urban settings, was also used for rural subjects in the study, which might have resulted in impaired capture of rural SES. The authors did not assess whether families were allocated food grains by schemes like public distribution system, which might have resulted in biased decrease in food consumption. Questionnaire used was not validated.

This study demonstrates the various factors that act as barriers to proper food consumption, including non-financial factors. The policy of user fee in government is hitting poorer section, and equity and access to health are compromised. Health expenditure should be increased by public sector policies to implement uniform healthcare. There is need for more studies to identify measures that could be put in place when designing policies and interventions for the uniform distribution of benefits.

The policy of user fee in government is hitting poorer section, and equity and access to health are compromised. Health expenditure should be increased by public-sector policies to implement uniform healthcare.

Major or chronic illness affects money acquisition and priorities of expenditure, resulting in deterioration in quality of food consumption and by a household.

Mental illness, in its various forms, is common in the United States. Tens of millions of Americans are afflicted by an episode of mental illness every year. Estimates of the 12-month prevalence of mental disorders in the U.S. (including alcohol and substance abuse or dependence) indicate that 22–30 persons per 100 in the adult population are afflicted each year.¹ An episode of a psychiatric disorder, like a physical disorder, is debilitating – often disrupting the ability of the afflicted to carry on normal personal, social, and work activities. Mental illness also commonly results in large medical expenses. In addition, a number of recent papers have found that mental illness imposes large labor market losses on the ill, decreasing the likelihood of employment and limiting earnings for the employed.² In particular, research by two of the authors indicates that depressive disorders cause significant reductions in the labor force participation of women and the earnings of both men and women.³

Costs estimation is essential and important to resource allocation and prioritizing different interventions in the health system. The purpose of this paper is to estimate the costs of lung cancer in Iran, in 2017.

This was a prevalence-based cost of illness study with a bottom-up approach costing conducted from October 2016 to April 2017. The sample included 645 patients who referred to Imam Reza hospital, Tabriz, Iran, in 2017. Follow-up interviews were every two months. Hospitalization costs extracted from the patient’s record and outpatient costs, nondirect medical costs and indirect costs collected using questionnaire. SPSS software version 22 was used for the data analysis.

Mean direct medical costs, nondirect medical costs and indirect costs amounted to 36,637.02 ± 23,515.13 PPP (2016) (251,313,217.83 Rials), 2,025.25 ± 3,303.72 PPP (2016) (16,613,202.53 Rials) and 48,348.55 ± 34,371.84 PPP (2016) (396,599,494.56 Rials), respectively. There was a significant and negative correlation between direct medical costs, direct nonmedical costs, indirect costs and age at diagnosis, and there was a significant and positive correlation between the length of hospital stay and direct medical cost.

As the cost of lung cancer is substantial and there have been little studies in this area, the objective of this study is to investigate the cost of lung cancer and present ways to tackle this.