Health Inequality

There are many reasons why poverty matters, but it is especially troubling that it affects such fundamental outcomes as health and access to health care. If poverty did not bring about all manner of health risks, we would likely be somewhat less troubled by it. But of course poverty and other forms of social and economic disadvantage do often translate into deficits in health and health care. The purpose of this brief is to examine long-term trends in American health and to lay out the current state of evidence on the extent to which health and health care are unequally distributed. We also note how the recent economic downturn affected these trends and disparities. The key backdrop to this assessment is the tripling of U.S. health expenditures since the 1960s. In 2012, per capita expenditures on health were $8,915, more than double those from 1995, though growth has slowed in the past 4 years.1 Some of this rise is attributable to population aging. Costs associated with Medicare, a program established in 1965 to subsidize health care for those aged 65 and older, have grown as the elderly population constitutes an ever-larger portion of the U.S. population. Still, overall U.S. health expenditures have increased faster than the growth of the elderly population and faster than health expenditures in other OECD countries.2 It is possible that such rising costs have led to a more unequal distribution of health and health care. At the same time, health inequalities may also be affected by the economy (e.g., recessions), changes in how insurance is provided, and any number of other factors. In this brief, our objective is not to attempt to tease out the causes of any possible changes in health inequalities, but rather to provide a descriptive summary of the current evidence on trends in (a) health, (b) foregone health care and insurance coverage, and (c) health risk factors. To preview our results, we find first that some health indicators, such as life expectancy, show an overall improvement. But not all indicators are improving. For example, an increasing number of Americans report delaying or foregoing health care, particularly during the recent economic recession. Second, economic and racial disparities in health indicators are often substantial, and when changes in these disparities are observed, they usually take the form of an increase in absolute size. Third, a large proportion of Americans still remain uninsured in 2012 (i.e., 15 percent), although the proportion of children who are uninsured declined by nearly 2 percentage points between the late 1990s and 2012

State of the States’ Health

Inequalities in access to health and health care are especially important forms of inequality because they speak to who lives long and who lives well. It is well known that, even though the United States spends more on health care per capita than any other country, it has some of the worst access and outcome results among wealthy nations.1 While important, such cross-country comparisons hide substantial health inequality within the United States. Even a cursory inspection of the data suggests that some states are indeed better performers on key health measures. For example, only one in ten adults in Utah smoke, whereas more than one in four do so in West Virginia. The purpose of this brief is to examine whether state differences of this magnitude are commonly found across various other health measures. We focus not just on average levels of health access, behaviors, and outcomes, but also on how unequally they are distributed. Although everyone would presumably prefer a state with high average health scores, it also matters whether the health disparities between the poor and relatively well-off are very large. If a state has a high mean level of health but also subjects its poor residents to a large “health penalty,” then anyone who is at risk of being poor would presumably want to avoid that state (at least insofar as the penalty is large enough to render them worse off than their counterparts in other states). Therefore, we examine two important features of a state’s health profile: the average level of health, behavioral, or access problems in the state; and the variation in the distribution of these outcomes by income

Quark fragmentation into vector and pseudoscalar mesons at LEP

Some data on the ratio of vector to vector + pseudoscalar mesons, V/(V+P), and the probability of helicity zero vector states, rho_00, are now available from LEP. A possible relation between these two quantities and their interpretation in terms of polarized fragmentation functions are discussed; numerical estimates are given for the relative occupancies of K and K*, D and D*, B and B* states.Comment: 5 pages, no figure

The weight-inclusive vs. weight-normative approach to health: Evaluating the evidence for prioritizing well-being over weight

Using an ethical lens, this review evaluates two methods of working within patient care and public health: the weight-normative approach (emphasis on weight and weight loss when defining health and well-being) and the weight-inclusive approach (emphasis on viewing health and well-being as multifaceted while directing efforts toward improving health access and reducing weight stigma). Data reveal that the weight-normative approach is not effective for most people because of high rates of weight regain and cycling from weight loss interventions, which are linked to adverse health and well-being. Its predominant focus on weight may also foster stigma in health care and society, and data show that weight stigma is also linked to adverse health and well-being. In contrast, data support a weight-inclusive approach, which is included in models such as Health at Every Size for improving physical (e.g., blood pressure), behavioral (e.g., binge eating), and psychological (e.g., depression) indices, as well as acceptability of public health messages. Therefore, the weight-inclusive approach upholds nonmaleficience and beneficience, whereas the weight-normative approach does not. We offer a theoretical framework that organizes the research included in this review and discuss how it can guide research efforts and help health professionals intervene with their patients and community

Efficient exploration of unknown indoor environments using a team of mobile robots

Whenever multiple robots have to solve a common task, they need to coordinate their actions to carry out the task efficiently and to avoid interferences between individual robots. This is especially the case when considering the problem of exploring an unknown environment with a team of mobile robots. To achieve efficient terrain coverage with the sensors of the robots, one first needs to identify unknown areas in the environment. Second, one has to assign target locations to the individual robots so that they gather new and relevant information about the environment with their sensors. This assignment should lead to a distribution of the robots over the environment in a way that they avoid redundant work and do not interfere with each other by, for example, blocking their paths. In this paper, we address the problem of efficiently coordinating a large team of mobile robots. To better distribute the robots over the environment and to avoid redundant work, we take into account the type of place a potential target is located in (e.g., a corridor or a room). This knowledge allows us to improve the distribution of robots over the environment compared to approaches lacking this capability. To autonomously determine the type of a place, we apply a classifier learned using the AdaBoost algorithm. The resulting classifier takes laser range data as input and is able to classify the current location with high accuracy. We additionally use a hidden Markov model to consider the spatial dependencies between nearby locations. Our approach to incorporate the information about the type of places in the assignment process has been implemented and tested in different environments. The experiments illustrate that our system effectively distributes the robots over the environment and allows them to accomplish their mission faster compared to approaches that ignore the place labels

Size Acceptance: A Discursive Analysis of Online Blogs

This document is an Accepted Manuscript of an article published by Taylor & Francis Group in Fat Studies on 25 May 2018, available online at: https://doi.org/10.1080/21604851.2018.1473704. Under embargo until 25 May 2019.Dominant discourses of “fatness” and “fat people” have implications for physical and mental health. Although alternative discourses such as “size acceptance” exist, there has been little consideration of the ways in which these alternative arguments (and speakers) may be positioned to be heard. Using a discursive thematic analysis, the authors demonstrate that size acceptance online bloggers have created a community online that enables them to persuasively provide alternative claims to “expertise,” which positions their views as credible and legitimate alternatives to those of more established authority figures—such as health professionals. This has implications not only for the lived experience of fat people, but also for researchers by emphasizing the importance of exploring not just what is said, but how, if we are to understand how different articulated positions are to be persuasive.Peer reviewe

To appear, AAAI-07, Integrated Intelligence Track 1 An Integrated Robotic System for Spatial Understanding and Situated Interaction in Indoor Environments

A major challenge in robotics and artificial intelligence lies in creating robots that are to cooperate with people in human-populated environments, e.g. for domestic assistance or elderly care. Such robots need skills that allow them to interact with the world and the humans living and working therein. In this paper we investigate the question of spatial understanding of human-made environments. The functionalities of our system comprise perception of the world, natural language, learning, and reasoning. For this purpose we integrate state-of-the-art components from different disciplines in AI, robotics and cognitive systems into a mobile robot system. The work focuses on the description of the principles we used for the integration, including cross-modal integration, ontology-based mediation, and multiple levels of abstraction of perception. Finally, we present experiments with the integrated “CoSy Explorer ” 1 system and list some of the major lessons that were learned from its design, implementation, and evaluation

SPH analysis of inkjet droplet impact dynamics

This paper presents a novel Smoothed Particle Hydrodynamics (SPH) framework for analysis of droplet impact dynamics in a 3D inkjet printing process. Results obtained are validated against experimentally derived high-speed imaging data. The numerical framework is based on the Smoothed Particle Hydrodynamics approach of Monaghan et al [1] which has been proven to be efficient and effective for analysis of dynamic fluid flow problems involving free surface interfaces. The SPH approach has been augmented through addition of the kernel gradient correction scheme proposed by Belytschko et al [2] and stabilization terms of Marrone et el [3]. This correction provides a more accurate approximation of the boundary forces including surface tension which dominate at typical inkjet droplet lengthscales (<100 µm). Analysis is expedited through adoption of the OpenACC programming paradigm to enable GPU based computation. Numerical analyses have been validated against analytical solutions, reference macroscale problems and through comparison with experimental high speed imaging data of the inkjet printing process. The experimental setup consisted of a Fuji Dimatix SL-128 inkjet printhead jetting an acrylate based 3D printing build material onto a glass substrate. Images of a single inkjet droplet impacting onto the glass slide were captured at a rate of 100,000 frames per second, with droplet diameter assessed using a weight test approach. Qualitative comparison of the numerical and experimental results showed a good agreement, indicating that the implemented framework is effective for analysis of the fluidic aspects of the printing process. The model is able to assist in tackling manufacturing issues that can detrimentally influence the quality of manufactured parts through provision of insight into the process

A cross-sectional controlled developmental study of neuropsychological functions in patients with glutaric aciduria type I

Background: Glutaric aciduria type I (GA-I) is an inherited metabolic disease due to deficiency of glutaryl-CoA dehydrogenase (GCDH). Cognitive functions are generally thought to be spared, but have not yet been studied in detail. Methods: Thirty patients detected by newborn screening (n = 13), high-risk screening (n = 3) or targeted metabolic testing (n = 14) were studied for simple reaction time (SRT), continuous performance (CP), visual working memory (VWM), visual-motor coordination (Tracking) and visual search (VS). Dystonia (n = 13 patients) was categorized using the Barry-Albright-Dystonia Scale (BADS). Patients were compared with 196 healthy controls. Developmental functions of cognitive performances were analysed using a negative exponential function model. Results: BADS scores correlated with speed tests but not with tests measuring stability or higher cognitive functions without time constraints. Developmental functions of GA-I patients significantly differed from controls for SRT and VS but not for VWM and showed obvious trends for CP and Tracking. Dystonic patients were slower in SRT and CP but reached their asymptote of performance similar to asymptomatic patients and controls in all tests. Asymptomatic patients did not differ from controls, except showing significantly better results in Tracking and a trend for slower reactions in visual search. Data across all age groups of patients and controls fitted well to a model of negative exponential development. Conclusions: Dystonic patients predominantly showed motor speed impairment, whereas performance improved with higher cognitive load. Patients without motor symptoms did not differ from controls. Developmental functions of cognitive performances were similar in patients and controls. Performance in tests with higher cognitive demand might be preserved in GA-I, even in patients with striatal degeneration