How Corruption Influences Population Health

The study examines the link between corruption and mortality.

The authors find that corruption is associated with higher mortality, particularly in low-income countries. Corruption is also linked with weaker fiscal capacity, reduced government funding for health care, distorted resource allocation, and patterns consistent with misallocation of public funds. Additionally, the association between corruption and mortality varies across levels of public goods provision.

The study draws on country-level data from 102 countries spanning 2008-2018. They use econometric methods, including instrumental variables and the Mundlak approach. To mitigate endogeneity concerns, they employ an instrumental variable approach based on ancestry and oral tradition, using historical cultural factors plausibly related to contemporary corruption levels.

The study expands existing research on social determinants of health by highlighting the relevance of institutional and political factors for population health. Addressing corruption could be recognized as a public health priority, given its association with health financing and population health. The Sustainable Development Goals on combating corruption and improving health are found to be complementary. 

KYRIOPOULOS, I., MINOS, D., VANDOROS, S. and MOSSIALOS, E. (2026), How Corruption Influences Population Health. Milbank Quarterly., 104: 198-219. 

Open Access Article (2026)

photo Jordi Soldevila. Iteracions de la realitat en negre

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No health without peace. Nothing more to say.

The right to health was laid out in the Universal Declaration of Human Rights, reaffirmed in the Alma Ata declaration, and remains embedded in contemporary WHO priorities. There is no credible path to achieving it that can run through perpetual conflict. Responding to the health consequences of war is necessary, but it cannot substitute for the conditions required to build, protect, and sustain health systems. Ambitions for equity, resilience, preparedness, and universal access cannot be realised amid chronic insecurity. 

Peace is not adjacent to health—it is foundational.

The Lancet editorial (2026) (pdf Volume 407, Issue 10523, 1)

Photo Jordi Soldevila. Geometries de la injustícia. Desesperació.
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The Great Resignation: Why women health workers are leaving

The ‘Great Resignation’ of women health workers is impacting women and health systems globally, with a concerning ‘Great Migration’ trend. This exodus exacerbates the existing health worker shortage crisis, affecting countries striving to achieve universal health coverage.The report published in October 2023 by Women in Global Health explores these issues in depth and calls for gender-transformative solutions to address workforce imbalances.

Countries competing for increasingly scarce trained health workers challenge the principles of global solidarity and ethical international recruitment, enshrined in global agreements like the WHO Code (WHO Code on the Practice of International Recruitment of Health Personnel)

"The WHO Code encourages all member states to act in solidarity, produce sufficient health workers domestically and invest in supporting countries with vulnerable health systems to strengthen their health workforce"

Health workers take years, sometimes over a decade to train, so lead times are long for producing the millions of new health workers needed to fill the gap. The urgent issue now is retaining trained health workers and reversing attrition from the sector.

Replacing domestic health workers with international recruits may just be putting new recruits into the same broken systems that caused the domestic health workers to leave. Coordinated action by governments is needed urgently to address health worker attrition in the short term and plan longer term to fill health worker shortages sustainably without reliance on unethical international recruitment.

The central role played by women health workers in the pandemic, along with the health and psychological impacts they endured in the course of their work, has placed a spotlight on their needs. Gender transformational change is needed to fix health workforce inequities and retain and attract back the women who are leaving. 

Women in the health workforce need a new social contract based on equal leadership, safe, decent and fairly paid work, to enable them to deliver health for all.

Report (pdf): 

Photo Jordi Soldevila. Els Monstres d'Ingres. IV

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When you see your neighbor's beard peeling, soak yours.

The NHS turns 77 this year 2025. Until recently, it has been widely regarded as the “crown jewel” of the British welfare state. Throughout its history, the NHS has achieved significant successes, including providing financial protection against the costs of ill health, incorporating formal assessments of new medical technologies, and delivering generally well-received care once accessed. Moreover, the NHS has been a driving force in medical research and innovation, pioneering advancements in treatments, healthcare delivery, and disease prevention. However, over a decade of austerity funding, compounded by the impact of the COVID-19 pandemic, has exposed its vulnerabilities. The NHS has shown limited resilience to external shocks and appears increasingly unsustainable in the face of growing demand.

Waiting lists are at an all-time high, population health outcomes in the UK are worsening, staff shortages and dissatisfaction remain persistent, and public confidence in the institution is wavering. In short, the NHS is in crisis.

The Labour government has increased NHS funding, but not to a level that several experts—including the LSE-Lancet Commission—deem sufficient to meet rising demands. The government has also announced a new 10-year plan. But will these measures be enough?

This event organized by the LSE last june explored the current state of the NHS, assessed whether the government's responses are adequate, and discussed whether more radical reforms are necessary. The discussion provided both critical reflection and potential solutions to address the crisis.

• Podcast to listen to.
• Video of the event to watch
• Slides and Speakers: to download here.

Photo Jordi Soldevila. Homenatge a Toni Catany Mandarina

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Marmot places. An initiative that must be implemented in Catalonia

"Social Injustice is killing people on a grand scale’. (M.Marmot)

Health inequalities are the systematic differences in health between social groups. Where they are judged to be avoidable differences they are inequitable, unfair. 

Putting them right is a matter of social justice. Reducing these inequities requires actions to improve the social determinants of health – the social, economic, political, physical and cultural conditions that shape our lives and our behaviours.

 
The UCL Institute of Health Equity  established in 2011 and being led by Professor Sir Michael Marmot leads and collaborates on work that addresses the social determinants of health and improves health equity. The IHE created the concept of Marmot Places. 

A Marmot Place recognises that health and health inequalities are shaped by the social determinants of health (SDH) and takes action on these social determinants at a local level. 

Sometimes called the building blocks of health, these social determinants are the conditions in which people are born, grow, live, work and age, such as education, employment and housing, and lead to wide differences in people’s health and in their life expectancy. Many places across England and Wales have become Marmot Places putting health equity at the heart of their local strategies.

Becoming a Marmot Place: 

Marmot Places develop and deliver interventions and policies to improve health equity based on eight principles:

1. Give every child the best start in life. 
2. Enable all children, young people and adults to maximise their capabilities and have control over their lives. 
3. Create fair employment and good work for all. 
4. Ensure a healthy standard of living for all. 
5. Create and develop healthy and sustainable places and communities. 
6. Strengthen the role and impact of ill health prevention. 
7. Tackle racism, discrimination and their outcomes. 
8. Pursue environmental sustainability and health equity together.

Article: Public health and health inequalities: a half century of personal involvement Michael Marmot Journal of Public Health, 2022

LSE Health's Annual Lecture:: Social justice and health equity March 2025, M.Marmot

 

Photo Jordi Soldevila. Geometries de la injustícia II

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The generational differences: Health systems leaders need to modernize the workplace and workforce practices to reflect the values of younger health care workers.

Why new generations workers are leaving from healthcare sector?

Many younger workers cite toxic cultural dynamics, such as micromanagement, hierarchical structures, and lack of support from leadership, as significant contributors to dissatisfaction and burnout.

Younger health care workers (physicians, nurses, social care, data managers, economists, lawyers....,),  have different values than older health care workers like:

1. Work-Life Balance: Many new workers prioritize flexibility and mental health, yet the rigid schedules and high stress of healthcare roles often clash with these values.
2. Communication Challenges: New employees increasingly seek purpose-driven careers, and closing the loop on communication is crucial. Are new employees instructed on how to communicate?. The practice of medicine is based on human interaction and communication, as well as science. Balancing patient needs inside an environment of mutual respect is the goal. The deskless workforce in healthcare is high-touch, with patient and co-worker interaction at the center of service delivery. Knowing how to build trust and collaborate is key, across all generations.
3. Conflict with Traditional Structures: Many younger employees feel out of sync with the hierarchical and rigid structures common in healthcare organizations, preferring collaborative and innovative environments.

Health system leaders and administrators should consider new strategies to modernize the workplace and workforce practices to reflect the values of younger health care workers.

• Create an environment to report instances of discrimination, inequalities, and racism quickly and anonymously.
• Develop equity-centered hiring and retention practices. Including (DEI) practice: diversity, equity, and inclusion. Employees want to work at organizations that prioritize DEI practices.
• Design a healthy environment that prioritizes employee wellness. Early-career health care workers who began working during the COVID-19 pandemic endured unprecedented stress and pressure that likely influenced their outlook. Both early-career and longtime health care workers increasingly report feeling burnt out; health care leaders need to create work environments that support overall wellbeing and make workers feel heard and valued. 
• Promote empathy among the managers and leaders to understand the concerns, feelings, and thoughts of their teams.
• Provide employment opportunities for people with disabilities.
• Create a specific mentoring programms to increase awareness regarding gender, young and old, diversity, equity, and inclusion in an organization.
• Support its employees at every step in their career and promote also the accountability at every step: “Accountability breeds response-ability.”― Stephen R. Covey.

Source: 

1. Morenike Ayo-Vaughan and Laurie Zephyrin, “Young Health Care Workers See More Discrimination in the Workplace, Leading to Added Stress and Burnout,” To the Point (blog), Commonwealth Fund, May 29, 2024. Blog

2. Forbes 2024

Photo Jordi Soldevila. Seqüència Xostakòvitx. Quartet número núm  8,

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Is competitive pressure essential for sustaining quality in primary care services?

The authors Eduard Brüll, Davud Rostam-Afschar, and Oliver Schlenker study how the threat of entry affects service quantity and quality of general practitioners (GPs).

They leverage Germany’s needs-based primary care planning system, in which the likelihood of new GPs reduces by 20 percentage points when primary care coverage exceeds a cut-off. They compile novel data covering all German primary care regions and up to 30,000 GP-level observations from 2014 to 2019. Reduced threat of entry lowers patient satisfaction for incumbent GPs without nearby competitors but not in areas with competitors. They find no effects on working hours or quality measures at the regional level including hospitalizations and mortality.

While entry restrictions aim to ensure equitable access to care, they can unintentionally reduce service quality by weakening competition. Policymakers must navigate this trade-off carefully, ensuring that access does not come at the expense of quality. By preserving competitive incentives even in regulated markets, healthcare systems can achieve both equitable and high-quality care.

IZA Discussion Paper No. 17534

Access to working paper 2024 (pdf)

Photo Jordi Soldevila. Merry Christmas

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Centering Equity in the Implementation of Emerging Digital Health Technologies: AI, genomic medicine, digital media

Despite unprecedented spending on health in the United States and the rapid expansion in types and innovations of digital health technologies, many populations still get sick and die at higher rates than others. 

To address these persistent health inequities in the US, it will be crucial to center health equity in the implementation of digital health technologies, such as artificial intelligence or personalized genomic medicine. As the two nascent fields of health equity and digital equity find their footing after rapid implementation and scale-up in the post–coronavirus disease 2019 pandemic world, a focus on equitable implementation is particularly important to ensure that digital health technologies do not perpetuate or create new health inequities. However, to date, these fields have had a limited or siloed focus on equitable implementation.

This paper is the inaugural report in the RAND Center to Advance Racial Equity Policy Methods Volume series. This paper will be the first to center health equity in the implementation of digital health technologies by adapting a methodological framework for its implementation to support the planning and evaluation of digital health technologies. Without an explicit focus on equitable implementation, digital health technologies run the risk of further exacerbating existing health inequities or creating new ones. This paper offers approaches to policymakers, implementation scientists, clinical scientists, government regulatory bodies, and those working in the health and digital technology fields to take the lead in centering equity.

The paper, first describe the persistent health inequities in the United States and how the rapid adoption of digital health technologies can perpetuate those inequities. Then they discuss challenges and limitations of Implementation Science (IS) in centering equity in the rapid adoption of digital health technologies and translating these technologies into equitable improvements in public health. Next, they provide examples of how IS process and evaluation frameworks can be adapted to focus on digital and health equity to leverage emerging health technologies to course correct and address inequitable health outcomes.

Finally, they discuss how these adapted IS process and evaluation frameworks can be applied to address the pitfalls—and realize the promise—of three emerging fields at the intersection of racial and digital health equity: (1) genomic medicine, (2) artificial intelligence (AI) (specifically large language models [LLMs]), and (3) participatory digital media (e.g., blogs, digital stories).

Photo Jordi Soldevila. Gaza. Geometries de la injustícia

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What builds good health? An introduction to the building blocks of health

Health is our most precious asset. Good health and wellbeing enable us to live happy, fulfilling lives and free us up to achieve our potential, supporting positive social and economic outcomes for individuals and society. But we don’t all have the same opportunities to live healthy lives. Right now, in our country, some people are dying years earlier than they should. This isn’t inevitable. There is much we can do to reduce these unfair differences by improving the things that underpin our health.

Many aspects of our lives impact our health and how long we live. These include our jobs and homes, our access to education, public transport and safe green spaces with clean air, and whether we experience poverty or discrimination. These things are often referred to as the ‘wider determinants of health’, and they are all essential building blocks of our health.

Building a healthy society is like constructing a building. To succeed, we need all the right blocks in place. The building blocks of health are: the food we eat; the work; the family, friends and communities; the transport; the housing; the money and resources; the education and skills; and the surroundings.

The The Health Foundation from the UK has published a guide that it is a brief introduction to the building blocks of health. It explains how a person’s opportunity for health is influenced by much more than the NHS, and why people in the UK don’t all have the same chance to be healthy. It also sets out how action to strengthen the building blocks of health can lead to improvements in the health of the whole population, for the benefit of individuals, society and the economy.

Guide (pdf)

Photo Jordi Soldevila. Èxode. Geometries de la injustícia

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Human resources in the National Health System. SESPAS Report 2024

The Spanish Society of Public Health and Health Administration publishes in Gaceta Sanitaria its biennial SESPAS 2024 Report, which shows a series of artices analysing the current situation of the National Health System in terms of Human Resources.

• Human resources in the National Health System. Medical education. Felipe Rodríguez de Castro, Teresa Carrillo Díaz, Arcadi Gual i Sala, Jordi Palés Argullós
• Experiences in human resources planning for health: The case of physicians. Data and models. Patricia Barber Pérez, Beatriz González López-Valcárcel
• What do we know and what should we know about the imbalances of doctors in Spain? Diagnosis and proposals. Beatriz González López-Valcárcel, Patricia Barber Pérez
• Shortage of nurses in Spain: from the global case to particular situation. Paola Galbany-Estragués, Pere Millán-Martínez
• The challenges of human resources governance in public healthcare. Javier Hernández Pascual

Press conference video

Photo Jordi Soldevila. Homenatge a Toni Catany. Plats vells.

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Health is wealth? Can we substitute UK by Catalonia or Spain?

Andrew Haldane, Chief Executive of the RSA and former Chief Economist at the Bank of England, was invited by the REAL Centre to deliver the 2022 REAL Challenge lecture to generate fresh ideas and debate.

Health is wealth? explores why health is best seen as a societal asset before outlining some of the ways in which the resilience of health outcomes and systems might be strengthened for the benefit of all.

The UK continues to feel the consequences of the COVID-19 pandemic, both through its impact on the nation’s health, as well as the prolonged impact on the UK economy. The lecturer drew lessons from the pandemic and argued for a more holistic economic growth strategy where health and wealth are inextricably linked.

He believes... "the UK is suffering from a weakened, and weakening, societal immune system. As with biological immune systems, this is constraining both our capacity to grow and our resistance to shocks. A weak societal immune system explains why the UK has suffered anaemic growth, has been more prone to shocks and why it has had longer subsequent periods of convalescence than elsewhere – and than in the past. This weakened societal immune system in turn reflects a prolonged period of underinvestment in the sub-systems we rely on for growth and strength: from education and health care to housing and communities, to skills and innovation.

Rebuilding the resilience of these sub-systems holds the key to a strengthened societal immune system overall and, with it, improved growth, greater shock resistance and higher wellbeing for individuals. As society’s sub-systems are tightly coupled, each needs to be strengthened to secure system-wide success. The UK’s health system’s lack of resilience has contributed to the UK’s weakened immune system. But without a strengthening of other economic and social systems this, while necessary, will by itself be insufficient to strengthen society’s immune system".

How this resilience might be bolstered? He proposes a set of directions of travel for policy debate.

• Mesurement
• Stress testing
• Devolution
• Policy integration
• Placemaking
• Food standards
• Education
• Business
• Fiscal finance
• The social safety net

Article (pdf)  
Slides and Video


Photo Jordi Soldevila. Els Monstres d'Ingres. L'hivern

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War is hell: Mental health consequences of war #stopthewar

War has a catastrophic effect on the health and well being of nations. Studies have shown that conflict situations cause more mortality and disability than any major disease. War destroys communities and families and disrupts the social and economic development of nations.

The effects of war include long-term physical and psychological harm to children and adults, as well as reduction in material and human capital. Among the consequences of war, the impact on the mental health of the civilian population is one of the most significant. Other consequences, besides deaths include endemic poverty, malnutrition, disability, economic/social decline and psychosocial illness, to mention only a few.

Women are more affected than men. Other vulnerable groups are children, the elderly and the disabled.

This paper briefly reviews the evidence from published literature about the impact of war on the mental health of the general population, the refugees, the soldiers and specific vulnerable groups. The review presents data concerning some major wars/conflicts and then briefly outlines the risk factors emerging from the literature.

Prevalence rates are associated with the degree of trauma, and the availability of physical and emotional support. The use of cultural and religious coping strategies is frequent in developing countries.

Mental health and war: brief review (article pdf) (2006)

photo: Emilio Morenatti

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Recessions and health

Recessions are complex events that affect personal health and behavior via various potentially opposing mechanisms. While recessions are known to have negative effects on mental health and lead to an increase in suicides, it has been proven that they reduce mortality rates.

A general health policy agenda in relation to recessions remains ambiguous due to the lack of consistency between different individual- and country-level approaches. However, aggregate regional patterns provide valuable information, and local social planners could use them to design region-specific policy responses to mitigate the negative health effects caused by recessions.

Pros

1. Substantial country-level research shows that mortality declines (i.e. people live longer) during recessions.
2. Recessions can make more time available for individuals to lead a healthy lifestyle.
3. Motor vehicle deaths have been shown to decrease during recessions.
4. Some studies suggest that during recessions the stigma of being unemployed decreases.

Cons

1. A plethora of individual-level studies show that recessions lead to adverse mental health, especially for working-age and low-income people.
2. The number of suicides appears to increase during periods of recession.
3. Income loss due to recessions decreases investments in health-enhancing goods and services.
4. Austerity measures that may be common during recessions, such as budget cuts to social welfare, mainly affect vulnerable population groups and the long-term unemployed.

AUTHOR’S MAIN MESSAGE

Evaluations of the health-related impacts of economic recessions have shown inconsistent results. However, if recessions cause a greater deterioration in individuals’ mental health and a larger number of suicides, then governments should be motivated to work even harder to recover the world’s economies after downturns occur. 

Governments should acknowledge that the potential impact of recessions on people’s health depends on the extent to which people are protected from vulnerability. Welfare policies, such as labor market programs, debt relief programs, and access to health and mental health services, should thus play a significant role as a mediator in the relationship between recessions and health.

Nick Drydakis Professor in Economics and Director of the Centre for Pluralist Economics, Anglia Ruskin University, UK 

Article

photo: Joan Miró Couple d'amoureux aux jeux de fleurs d'amandier

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The benefits of Women's Health research

Women's health has suffered from insufficient research addressing women. The research community has not widely embraced the value of this research, and the impact of limited knowledge about women's health relative to men's is far-reaching. Without information on the potential return on investment for women's health research, research funders, policymakers, and business leaders lack a basis for altering research investments to improve knowledge of women's health.

As part of an initiative of the Women's Health Access Matters (WHAM) nonprofit foundation, RAND Corporation researchers examined the impact of increasing funding for women's health research, with a focus on the following three disease areas: brain health, immune and autoimmune disease, and cardiovascular disease. Using microsimulation analyses, the research team studied the societal cost impact of increasing research funding in three diseases that present a large disease burden for women: Alzheimer's disease and Alzheimer's disease–related dementias (AD/ADRD), coronary artery disease (CAD), and rheumatoid arthritis (RA).

Key Findings

• Investing in women's health research yields benefits beyond investing in general research
• The return on investment is higher for most scenarios in which research funding impact is assumed to be higher for women than men. Assuming an equal impact of research on women and men generally results in lower returns.
• Research investment yields benefits for all people, but the specific emphasis on women’s health can result in downstream socioeconomic benefits that improve on general research.
• Large societal gains may be possible by increasing investment in women's health research
• Savings include increased life years, reduced years with disease, fewer years of functional dependence, and reductions in disruptions to work productivity.

Recommendations

• Increase research funding directed at women's health. The potential gains from women-focused research are substantial, given the limitations in knowledge about disease development and impacts for women relative to men.
• Pursue research on the biology of disease in women, including early identification, and identify barriers to diagnosis in women.
• Expand research agendas to address the complicated relationships between disease and work productivity in women. Impacts include lost productivity for those with the disease and for informal caregivers, the majority of whom are women.
• Raise awareness of the potential value of investment in women's health research. The ways in which women's health research is disadvantaged relative to general research are multifaceted, with major implications for disease burdens.

Article (pdf) 

Authors: Baird, Matthew D., Melanie A. Zaber, Annie Chen, Andrew W. Dick, Chloe E. Bird, Molly Waymouth, Grace Gahlon, Denise D. Quigley, Hamad Al-Ibrahim, and Lori Frank, Research Funding for Women's Health: Modeling Societal Impact. Santa Monica, CA: RAND Corporation, 2021. https://www.rand.org/pubs/research_reports/RRA708-4.html.

photo: Lluïsa Vidal

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Integrated Care (IC) and utilization: some evidence

Is integration of primary, secondary and social care better for patients and is it cost effective? Andrew Street, Professor of Health Economics, discusses a recent paper he published with co-authors Anne Mason and Panagiotis Kasteridis, which evaluated the cost-effectiveness of integrated care (IC) programmes in South Somerset for people with long-term conditions.

Objectives: As part of the Vanguard programme, two integrated care models were introduced in South Somerset for people with complex care needs: the Complex Care Team and Enhanced Primary Care. The authors assessed their impact on a range of utilization measures and mortality. 

• Complex Care Team (CCT), provides senior medical input, care coordination, and a personalized care plan to support self-care.
• Staffed by GPs with expertise in chronic care management, complex care nurses and other keyworkers, the CCTs aim to prevent avoidable hospitalizations or, for those in hospital, to support appropriate inpatient care.

Methods: They used monthly individual-level linked primary and secondary care data from April 2014 to March 2018 to assess outcomes before and after the introduction of the care models. The analysis sample included 564 Complex Care Team and 841 Enhanced Primary Care cases that met specific criteria. 

They employed propensity score methods to identify out-of-area control patients and difference-in-differences analysis to isolate the care models’ impact. 

Results: They found no evidence of significantly reduced utilization in any of the Complex Care Team or Enhanced Primary Care cohorts. The death rate was significantly lower only for those in the first Enhanced Primary Care cohort. 

Conclusions: The integrated care models did not significantly reduce utilization nor consistently reduce mortality. Future research should test longer-term outcomes associated with the new models of care and quantify their contribution in the context of broader initiatives.

Watch Andrew Street explaining the article (5m) 

Article (pdf) Evaluating integrated care for people with complex needs (2021)

Photo Richard Long 2012 A circle in Antartica

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Economic leaders call for gender equality in pandemic recovery, june 2021

"Only if we seize on this opportunity to prioritise gender equality can we build a more prosperous world for all"

LSE Director Minouche Shafik has joined leaders from the International Monetary Fund, European Central Bank, World Trade Organisation, European Commission and United Nations to call on governments around the world to prioritise gender equality as they seek to recover from the economic impact of COVID-19.

The statement, published by LSE and shared by the Bill and Melinda Gates Foundation, has been signed by:

• Kristalina Georgieva, Managing Director of the International Monetary Fund
• Christine Lagarde, President of the European Central Bank
• Ursula von der Leyen, President of the European Commission
• Ngozi Okonjo-Iweala, Director-General of the World Trade Organisation
• Minouche Shafik, Director of The London School of Economics and Political Science;
• Vera Songwe, UN Under-Secretary General and Executive Secretary of the Economic Commission for Africa.

Within the statement, these leading figures highlight how women and girls from all parts of the world – both rich and poor – continue to face significant inequality, and bear the heaviest cost in times of economic hardship:

“From accepting gender pay gaps, to neglecting childcare, governments have not prioritised their needs. The result is a feeble, patchwork economic infrastructure - particularly in fields such as caregiving, retail, and tourism, where women are disproportionately represented - that leaves women struggling...

This inequality, they argue, has made countries weaker when faced with a crisis like a pandemic. But the response to COVID-19 also provides an opportunity to accelerate progress towards gender equality, and build stability and opportunity for everyone.

Three key policy areas
The statement calls for governments to focus on three key areas, “…to ensure that economic recovery prioritises women and girls, underpins an inclusive future, and ensures the world is prepared to withstand the next crisis.”

1. Governments must ensure that money, stimulus efforts, and social protection schemes get directly into the hands of women.
2. Countries must close gender data gaps and strengthen monitoring, evaluation, and data systems to support more effective public policy.
3. Governments must reduce the burden of unpaid care work and support better childcare to strengthen women’s labor force participation.

The statement concludes with a warning, “We have no time to waste … The risks of inaction cannot be overstated. Refusing to economically support women and girls will not just set this recovery back, it will leave our economies more vulnerable to future shocks.

Acces to the Full Statement (pdf) 

photo: Salvem lo Montsià rocblackblock

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Health care technology and COVID-19: what will happen in the long term?

Research published by the Health Foundation in march 2021 explores the challenges of implementing health care technologies and investigates patient and staff experiences of technology during the first phase of the coronavirus (COVID-19) pandemic. It draws on learning from the Health Foundation’s programmes and YouGov surveys of over 4,000 UK adults and over 1,000 NHS staff conducted in October 2020.

During the pandemic, there has been increased NHS use of both established and newer technologies to reduce face-to-face contact and manage demand. Phone consultations dominate, followed by some well-established uses of technology, such as booking appointments by phone or using the NHS website. But some emerging or less established uses of technology, including several explicitly promoted by national bodies, are also apparent. For example, accessing care records electronically, devices for home monitoring, video consultations, and the NHS app.

The research finds that while most of those who used technology more during the early phase of the pandemic found the experience positive, half of these users aged 55 and older (50%) and nearly half of those with a carer (46%) – groups that may have higher need for health care – thought these technology-enabled approaches made for worse quality of care.

Furthermore, the report finds that while 49% of the public and 61% of NHS staff surveyed thought the NHS should be looking to use technology-enabled approaches more in future, a significant minority of both public (36%) and NHS staff surveyed (31%) were unconvinced about the long-term use of these approaches.

While technologies were rolled out with impressive speed, some aspects of implementation – such as evaluation, co-design and customisation – will necessarily have been shortcut, and will need revisiting after the emergency phase of the pandemic is over. Furthermore, many technologies were rolled out specifically to serve pandemic response objectives such as social distancing, so will need to be ‘reoriented’ and developed to serve wider quality and productivity objectives in future.

Through a refresh of the NHS long term plan and other national strategies, policymakers will need to support front-line teams to revisit aspects of implementation and 'reorient' technology-based interventions to serve longer term quality and productivity objectives. Central to this will be evaluating their impact on care quality and developing a vision of ‘what good looks like’.

Access to pdf article (2021)

photo: Strawberry Thief, furnishing fabric, designed by William Morris, made by Morris & Co., 1883, © Victoria and Albert Museum, London 
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Florence Nightingale bicentenary 2020

Florence Nightingale "the Lady of the Lamp" was born on May 12, 1820, in Florence. This 2020 the worldwide celebrates of Florence Nightingale’s bicentenary. In her honour The World Health Organisation have named 2020 the Year of the Nurse and Midwife.

Despite family pressures to marry and live as a conventional wealthy woman, she considered her dedication to nursing to be a response to the call of God to care for the sick. Her success in radically lowering the death rate of wounded soldiers in the Crimean War led to society’s acceptance of her proposals for better sanitation and nutrition, accurate medical knowledge, and professionally trained nurses.

While Nightingale is best known worldwide for revolutionising nursing and healthcare through her campaigning for health reform, her far-reaching recommendations were based on impressive statistical work and popularised through pioneering data visualisation and her evidence-based approach to healthcare.

Florence Nigthtingale was the first female fellow in 1858 from Royal Statistical Society. The Significance magazine from Royal Statistical Society and American Statistical Association has published a special issue: Significance magazine, 2020, Volume 17, Issue 2: Florence Nightingale

More information:
Celebrating Nightingale 2020 Bicentenary
Mujeres con ciencia: Florence Nightingale (in spanish)
Florence Nightingale foundation
Guys and St Thomas Hospital

picture: Helping the wounded. Shutterstock/Everett Historical
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What Works to Prevent Violence Against Women and Girls (VAWG)

Violence against women and girls (VAWG) is preventable.

Over the last two decades, the global community has come to recognise the profound impact of violence on the lives of women and girls. This fundamentally undermines their health and well-being, and stands as a barrier to women’s full participation in global development and the economic and civic life of their communities.

What works to prevent violence published last january 2020 a brief where evaluated the design and implementation of diferent interventions designed to reduce VAWG. The interventions were included in four different groups:

• Community activism approaches to shift harmful gender attitudes, roles and social norms
• Combined gender transformation and economic empowerment interventions
• Couples’ interventions and special populations
• Prevention of violence among and against children

The brief show many examples of well-designed, well-implemented interventions of different modalities. Ten core elements of the design and implementations have contributed to their success.

Eight elements related to the design of the interventions:

1. Rigorously planned, with a robust theory of change, rooted in knowledge of local context.
2. Address multiple drivers of VAW, such as gender inequity, poverty, poor communication and marital conflict
3. Especially in highly patriarchal contexts, work with women and men, and where relevant, families.
4. Based on theories of gender and social empowerment that view behaviour change as a collective rather than solely individual process, and foster positive interpersonal relations and gender equity
5. Use group-based participatory learning methods, for adults and children, that emphasise empowerment, critical reflection, communication and conflict resolution skills building.
6. Age-appropriate design for children with a longer time for learning and an engaging pedagogy such as sport and play
7. Carefully designed, user-friendly manuals and materials supporting all intervention components to accomplish their goals.
8. Integrate support for survivors of violence.

Two elements related to the implementation of the interventions:

1. Optimal intensity: duration and frequency of sessions and overall programme length enables time for reflection and experiential learning
2. Staff and volunteers are selected for their gender equitable attitudes and non-violence behaviour, and are thoroughly trained, supervised and supported.

What Works to Prevent Violence Against Women and Girls is an innovative global programme working in 13 countries across the world building the evidence base on What Works to prevent violence in low-middle income settings.

Access article (pdf) 2020 What works brief

photo: Vivian Maier (1980)
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poverty and health

Michaela Benzeval et al. published in 2014 in The Joseph Rowntree Foundation the report How does money influence health?

The study explores the association between income and health throughout the life course and within families. Researchers reviewed theories from 272 wide-ranging papers, most of which examined the complex interactions between people’s income and their health throughout their lives.

The research identifies four main ways money affects people’s wellbeing:

1. Material: Money buys goods and services that improve health. The more money families have, the better the goods they can buy.
2. Psychosocial: Managing on a low income is stressful. Comparing oneself to others and feeling at the bottom of the social ladder can be distressing, which can lead to biochemical changes in the body, eventually causing ill health.
3. Behavioural: For various reasons, people on low incomes are more likely to adopt unhealthy behaviours – smoking and drinking, for example – while those on higher incomes are more able to afford healthier lifestyles.
4. Reverse causation (poor health leads to low income): Health may affect income by preventing people from taking paid employment. Childhood health may also affect educational outcomes, limiting job opportunities and potential earnings.

These pathways are all likely to be important and interact across people’s lives in a complex web of links between income and health. The broader context is also important. Living on a low income in a country with a well-developed welfare state is unlikely to have the same health-damaging effects as living in one with poorer provision for healthcare and education.

Given this complexity of interconnection between people’s income and health, a broad approach to improving the health of those with limited resources is important.
Acces full report

photo: Toni Catany

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