Mental health economics: a prospective study on psychological flourishing and associations with healthcare costs and sickness benefit transfers in Denmark

Background: Escalating healthcare expenditures highlight the need to identify modifiable predictors of the use and costs of healthcare and sickness benefit transfers. We conducted a prospective analysis on Danish data to determine the costs associated with flourishing as compared to the below threshold level of flourishing. Methods: We used data from a 2016 Danish survey of 3508 adults, which was linked to Danish register data. Flourishing was assessed with a validated psychological well-being scale. A two-part regression model was used to predict 2017 costs while adjusting for 2016 costs, demographic variables, and health status, including psychiatric morbidity and health behaviours. Costs are expressed in USD PPP. Results: Applying criteria from prior literature, the prevalence of flourishing in Denmark (measured in 2016) was 34.7%. Flourishing was associated with significantly lower healthcare costs ($-687.7, 95$-1295.0, $-80.4) and sickness benefit transfers ($-297.8, 95% CI = $-551.5,$-44.0) per person in 2017, as compared to the below threshold level of flourishing. Extrapolated to the Danish population (4.1 M people aged 16+ years), flourishing was associated with lower healthcare costs and sickness benefit transfers amounting to $-1.2bn (95$-2.3 bn, $-149.0 M). Conclusions: Flourishing is associated with considerably lower health-related government expenditure. Substantial reductions could potentially be achieved by increasing the number of people who are flourishing in the population

Trends in health complaints from 2002 to 2010 in 34 countries and their association with health behaviours and social context factors at individual and macro-level

Publisher Copyright: © 2015 The Author. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.Background: This article describes trends and stability over time in health complaints in adolescents from 2002 to 2010 and investigates associations between health complaints, behavioural and social contextual factors at individual level and economic factors at macro-level. Methods: Comprising N = 510 876 11-, 13- and 15-year-old children and adolescents in Europe, North America and Israel, data came from three survey cycles of the international Health Behaviour in School-aged Children (HBSC) study. Age- and gender-adjusted trends in health complaints were examined in each country by means of linear regression. By using the country as the random effects variable, we tested to what extent individual and contextual variables were associated with health complaints. Results: Significant associations are stronger for individual level determinants (e.g. being bullied, smoking) than for determinants at macro-level (e.g. GDP, Gini), as can be seen by the small effect sizes (less than 5% for different trends). Health complaints are fairly stable over time in most countries, and no clear international trend in health complaints can be observed between 2002 and 2010. The most prominent stable determinants were being female, being bullied, school pressure and smoking. Conclusion: Factors associated with health complaints are more related to the proximal environment than to distal macro-level factors. This points towards intensifying targeted interventions, (e.g. for bullying) and also targeting specific risk groups. The comparably small effect size at country-level indicates that country-level factors have an impact on health and should not be ignored.publishersversionPeer reviewe

A First- and Second-Order Motion Energy Analysis of Peripheral Motion Illusions Leads to Further Evidence of “Feature Blur” in Peripheral Vision

Anatomical and physiological differences between the central and peripheral visual systems are well documented. Recent findings have suggested that vision in the periphery is not just a scaled version of foveal vision, but rather is relatively poor at representing spatial and temporal phase and other visual features. Shapiro, Lu, Huang, Knight, and Ennis (2010) have recently examined a motion stimulus (the “curveball illusion”) in which the shift from foveal to peripheral viewing results in a dramatic spatial/temporal discontinuity. Here, we apply a similar analysis to a range of other spatial/temporal configurations that create perceptual conflict between foveal and peripheral vision.To elucidate how the differences between foveal and peripheral vision affect super-threshold vision, we created a series of complex visual displays that contain opposing sources of motion information. The displays (referred to as the peripheral escalator illusion, peripheral acceleration and deceleration illusions, rotating reversals illusion, and disappearing squares illusion) create dramatically different perceptions when viewed foveally versus peripherally. We compute the first-order and second-order directional motion energy available in the displays using a three-dimensional Fourier analysis in the (x, y, t) space. The peripheral escalator, acceleration and deceleration illusions and rotating reversals illusion all show a similar trend: in the fovea, the first-order motion energy and second-order motion energy can be perceptually separated from each other; in the periphery, the perception seems to correspond to a combination of the multiple sources of motion information. The disappearing squares illusion shows that the ability to assemble the features of Kanisza squares becomes slower in the periphery.The results lead us to hypothesize “feature blur” in the periphery (i.e., the peripheral visual system combines features that the foveal visual system can separate). Feature blur is of general importance because humans are frequently bringing the information in the periphery to the fovea and vice versa

Twenty-one reasons for implementing the act-belong-commit—‘abcs of mental health’ campaign

While there has been increased attention worldwide on mental health promotion over the past two decades, what is lacking in many countries around the globe is practical knowledge of what constitutes a population-wide mental health promotion campaign, and how such a campaign can be implemented. This paper provides such knowledge based on the development, implementation and evaluation of the Act-Belong-Commit campaign, the world’s first comprehensive population-wide public mental health promotion campaign which was launched in 2008 in Western Australia. Given the learnings from the full-scale implementation and evaluation of the campaign in Western Australia and its expansion nationally and internationally, along with the continuing and expanding evidence base for the campaign constructs, we crystallise 21 reasons why jurisdictions who wish to achieve the goals of the WHO and adopt the recommendations of the European framework on mental health and wellbeing should consider adopting or adapting Act-Belong-Commit when considering implementing a public mental health promotion campaign

Three Models of Global Climate Governance: From Kyoto to Paris and Beyond

The Paris Agreement has emerged as one of the world's most important international treaties. Many believe that it offers a new approach to the problem of climate change, can contribute significantly to the goal of reducing emissions, and may hold lessons for how to govern other cross‐border issues. As a result, it has been the focus of considerable debate among scholars and policy makers. But how precisely does Paris seek to govern global warming and is it likely to work in practice? We address this question by contrasting the Paris ‘model’ of climate governance with earlier ones associated with the Kyoto Protocol and Copenhagen Accord. These models have taken different approaches to the problem of governing climate change, each with attendant advantages and limitations. The Paris model advances upon earlier efforts in certain respects, but also blends elements from earlier models. We then lay out the central axes of the debate that has emerged about the future of the Paris model, and discuss research illuminating how it may operate in practice. The agreement's success will depend on how the agreement is implemented, and on how the UNFCCC process interacts with the complementary approaches to climate governance appearing beyond it