Health and Financial Fragility: Evidence from Car Crashes and Consumer Bankruptcy

This paper assesses the importance of adverse health shocks as triggers of bankruptcy filings. We view car crashes as a proxy for health shocks and draw on a large sample of police crash reports linked to hospital admission records and bankruptcy case files. We report two findings: (i) there is a strong positive correlation between an individual\u27s pre-shock financial condition and his or her likelihood of suffering a health shock, an example of behavioral consistency; and (ii) after accounting for this simultaneity, we are unable to identify a causal effect of health shocks on bankruptcy filing rates. These findings emphasize the importance of risk heterogeneity in determining financial fragility, raise questions about prior studies of medical bankruptcy, and point to important challenges in identifying the triggers of consumer bankruptcy. JEL Codes: D12, D14, K35

Health and Financial Fragility: Evidence from Car Crashes and Consumer Bankruptcy

This paper assesses the importance of adverse health shocks as triggers of bankruptcy filings. We view car crashes as a proxy for health shocks and draw on a large sample of police crash reports linked to hospital admission records and bankruptcy case files. We report two findings: (i) there is a strong positive correlation between an individual\u27s pre-shock financial condition and his or her likelihood of suffering a health shock, an example of behavioral consistency; and (ii) after accounting for this simultaneity, we are unable to identify a causal effect of health shocks on bankruptcy filing rates. These findings emphasize the importance of risk heterogeneity in determining financial fragility, raise questions about prior studies of medical bankruptcy, and point to important challenges in identifying the triggers of consumer bankruptcy

Perceptions of Violence against Women among College Students in the United States, Japan, India, Vietnam and China

Violence against women is a global health issue that threatens the health and human rights of women. Intimate partner violence (IPV) and sexual violence are the most common forms of violence against women. While previous studies examined incidence of IPV and other forms of violence against women in the United States (US), little is known about variations in the perceptions of violence against women among college students in other countries. This study explored differences in perceptions of violence against women among college students in the US, Japan, India, Vietnam and China. A total of 1,136 college students from these countries participated in a self-administered survey in 2012-2013. The students’ perceptions about the prevalence of domestic violence is in their country varied across countries. Furthermore, more than half of the students across the countries perceived alcoholism and drug addiction to be causes of domestic violence against women. It was also found that the levels of knowledge about laws on domestic violence in their country varied among the students. These findings show the importance of understanding country level variations that may affect violence against women. The results of this study provide important insights by documenting cross country variations in students’ perceptions about violence against women that can provide helpful inputs in framing country-specific programs and policies to prevent violence against women. Keywords: Violence against women, perceptions, college students, the United States, Japan, India, Vietnam, Chin

A Core Outcome Set for Pediatric Critical Care

Objectives: More children are surviving critical illness but are at risk of residual or new health conditions. An evidence-informed and stakeholder-recommended core outcome set is lacking for pediatric critical care outcomes. Our objective was to create a multinational, multistakeholder-recommended pediatric critical care core outcome set for inclusion in clinical and research programs.Design: A two-round modified Delphi electronic survey was conducted with 333 invited research, clinical, and family/advocate stakeholders. Stakeholders completing the first round were invited to participate in the second. Outcomes scoring greater than 69% “critical” and less than 15% “not important” advanced to round 2 with write-in outcomes considered. The Steering Committee held a virtual consensus conference to determine the final components.Setting: Multinational survey.Patients: Stakeholder participants from six continents representing clinicians, researchers, and family/advocates.Measurements and Main Results: Overall response rates were 75% and 82% for each round. Participants voted on seven Global Domains and 45 Specific Outcomes in round 1, and six Global Domains and 30 Specific Outcomes in round 2. Using overall (three stakeholder groups combined) results, consensus was defined as outcomes scoring greater than 90% “critical” and less than 15% “not important” and were included in the final PICU core outcome set: four Global Domains (Cognitive, Emotional, Physical, and Overall Health) and four Specific Outcomes (Child Health-Related Quality of Life, Pain, Survival, and Communication). Families (n = 21) suggested additional critically important outcomes that did not meet consensus, which were included in the PICU core outcome set—extended.Conclusions: The PICU core outcome set and PICU core outcome set—extended are multistakeholder-recommended resources for clinical and research programs that seek to improve outcomes for children with critical illness and their families

Ticketing aggressive cars and trucks (TACT): How does it work on city streets?

<p><b>Objective</b>: The purpose of this study was to determine the feasibility of modifying the Ticking Aggressive Cars and Trucks (TACT) program, originally designed to work on state highways, within a metropolitan area to reduce unsafe interactions and their related crashes between drivers of large trucks and passenger vehicles.</p> <p><b>Methods</b>: Using crash data, the driving behaviors most commonly associated with large truck and passenger vehicle crashes were identified. A public awareness campaign using media messaging and increased law enforcement was created targeting these associated behaviors. The frequency of these behaviors both before and after the public awareness campaign was determined through observation of traffic at 3 specific locations within the city. Each location had a sufficient volume of large truck and passenger traffic to observe frequent interactions. Pre- and postintervention data were compared using negative binomial regression with generalized estimating equations to evaluate whether the campaign was associated with a reduction in the identified driving behaviors.</p> <p><b>Results</b>: A comparison between crash data from before, during, and after the campaign and crashes during the same time periods in previous years did not show a significant difference (<i>P</i> =.081). The number of large trucks observed in traffic remained the same during pre- and postintervention periods (<i>P</i> =.625). The rates of negative interactions per 100 large trucks decreased for both large trucks and passenger vehicles after the intervention, with calculated rate ratios of 0.58 (95% confidence interval [CI], 0.48, 0.70) and 0.31 (95% CI, 0.20, 0.47). The greatest reduction was seen in passenger vehicles following too close, with a rate ratio of 0.21 (95% CI, 0.15, 0.30).</p> <p><b>Conclusions</b>: Although designed for reducing crashes on highways, the TACT program can be an effective approach for improving driver behaviors on city streets.</p

Health and Financial Fragility: Evidence from Car Crashes and Consumer Bankruptcy

This paper assesses the importance of adverse health shocks as triggers of bankruptcy filings. We view car crashes as a proxy for health shocks and draw on a large sample of police crash reports linked to hospital admission records and bankruptcy case files. We report two findings: (i) there is a strong positive correlation between an individual\u27s pre-shock financial condition and his or her likelihood of suffering a health shock, an example of behavioral consistency; and (ii) after accounting for this simultaneity, we are unable to identify a causal effect of health shocks on bankruptcy filing rates. These findings emphasize the importance of risk heterogeneity in determining financial fragility, raise questions about prior studies of medical bankruptcy, and point to important challenges in identifying the triggers of consumer bankruptcy

Sharp Edge Eye Syndrome (SEES): a Survey of Self-identified Individuals

Sharp edge eye syndrome (SEES) is an idiopathic condition in which the patient experiences mild to strong ocular pain when viewing or mentally picturing sharp objects and edges. The cause is unknown. Patients may present to an ophthalmologist, neurologist or neuro-ophthalmologist because they perceive the condition to represent an ophthalmic problem or a sign of a more serious, underlying neurologic condition

Health and Financial Fragility: Evidence from Car Crashes and Consumer Bankruptcy

This paper assesses the importance of adverse health shocks as triggers of bankruptcy filings. We view car crashes as a proxy for health shocks and draw on a large sample of police crash reports linked to hospital admission records and bankruptcy case files. We report two findings: (i) there is a strong positive correlation between an individual\u27s pre-shock financial condition and his or her likelihood of suffering a health shock, an example of behavioral consistency; and (ii) after accounting for this simultaneity, we are unable to identify a causal effect of health shocks on bankruptcy filing rates. These findings emphasize the importance of risk heterogeneity in determining financial fragility, raise questions about prior studies of medical bankruptcy, and point to important challenges in identifying the triggers of consumer bankruptcy

Suicides and Suicide Attempts Following Homicide Victim–Suspect Relationship, Weapon Type, and Presence of Antidepressants

This study used linked, official data for population-based surveillance of homicides, suicides, and homicide–suicides in four U.S. states and four counties. Among 1,503 homicide incidents, less than 5% ( n = 74) were followed by the perpetrator's suicide and 1% ( n = 18) by a nonfatal suicide attempt. However, among men who killed their female intimate partner with a firearm, 59% also took their own life. Homicide–suicide perpetrators did not test positive for an antidepressant more often than other male suicide decedents (15% vs. 19%). Most (54%) perpetrators of nonfirearm homicides who attempted suicide lived; nearly all (93%) firearm perpetrators who attempted suicide died. Among men who killed their female intimate partner with a firearm, homicide–suicide was the norm. Better enforcement of existing laws designed to protect abuse victims by removing firearms from domestic abusers may also prevent abusers' suicides