Xinzhi Zhang et al in Ethnicity and Disease: “Addressing minority health and health disparities has been a missing piece of the puzzle in Big Data science. This article focuses on three priority opportunities that Big Data science may offer to the reduction of health and health care disparities. One opportunity is to incorporate standardized information on demographic and social determinants in electronic health records in order to target ways to improve quality of care for the most disadvantaged populations over time. A second opportunity is to enhance public health surveillance by linking geographical variables and social determinants of health for geographically defined populations to clinical data and health outcomes. Third and most importantly, Big Data science may lead to a better understanding of the etiology of health disparities and understanding of minority health in order to guide intervention development. However, the promise of Big Data needs to be considered in light of significant challenges that threaten to widen health disparities. Care must be taken to incorporate diverse populations to realize the potential benefits. Specific recommendations include investing in data collection on small sample populations, building a diverse workforce pipeline for data science, actively seeking to reduce digital divides, developing novel ways to assure digital data privacy for small populations, and promoting widespread data sharing to benefit under-resourced minority-serving institutions and minority researchers. With deliberate efforts, Big Data presents a dramatic opportunity for reducing health disparities but without active engagement, it risks further widening them….(More)”
Solving a Global Digital Identity Crisis
Seth Berkley at MIT Technology Review:” In developing countries, one in three children under age five has no record of their existence. Technology can help….Digital identities have become an integral part of modern life, but things like e-passports, digital health records, or Apple Pay really only provide faster, easier, or sometimes smarter ways of accessing services that are already available.
In developing countries it’s a different story. There, digital ID technology can have a profound impact on people’s lives by enabling them to access vital and often life-saving services for the very first time….The challenge is that in poor countries, an increasing number of people live under the radar, invisible to the often archaic, paper-based methods used to certify births, deaths, and marriages. One in three children under age five does not officially exist because their birth wasn’t registered. Even when it is, many don’t have proof in the form of birth certificates. This can have a lasting impact on children’s lives, leaving them vulnerable to neglect and abuse.
In light of this, it is difficult to see how we will meet the SDG16 deadline without a radical solution. What we need are new and affordable digital ID technologies capable of working in poorly resourced settings—for example, where there is no reliable electricity—and yet able to leapfrog current approaches to reach everyone, whether they’re living in remote villages or urban slums.
Such technologies are already emerging as part of efforts to increase global childhood vaccination coverage, with small-scale trials across Africa and Asia. With 86 percent of infants now having access to routine immunization—where they receive all three doses of a diphtheria-pertussis-tetanus vaccine—there are obvious advantages of building on an existing system with such a broad reach.
These systems were designed to help the World Health Organization, UNICEF, and my organization, Gavi, the Vaccine Alliance, close the gap on the one in seven infants still missing out. But they can also be used to help us achieve SDG16.
One, called MyChild, helps countries transition from paper to digital. At first glance it looks like a typical paper booklet on which workers can record health-record details about the child, such as vaccinations, deworming, or nutritional supplements. But each booklet contains a unique identification number and tear-out slips that are collected and scanned later. This means that even if a child’s birth hasn’t been registered, a unique digital record will follow them through childhood. Developed by Swedish startup Shifo, this system has been used to register more than 95,000 infants in Uganda, Afghanistan, and the Gambia, enabling health workers to follow up either in person or using text reminders to parents.
Another system, called Khushi Baby, is entirely paperless and involves giving each child a digital necklace that contains a unique ID number on a near-field communication chip. This can be scanned by community health workers using a cell phone, enabling them to update a child’s digital health records even in remote areas with no cell coverage. Trials in the Indian state of Rajasthan have been carried out across 100 villages to track more than 15,000 vaccination events. An organization called ID2020 is exploring the use of blockchain technology to create access to a unique identity for those who currently lack one….(More)”
Community-based app gets Londoners walking
Springwise: “Apps that measure a user’s exercise have been 10-a-penny for some years, but Go Jauntly is set to offer something brand new and leans much more into crowdsourcing than its rivals. Launched by a new start-up of nature-loving digital experts, and co-developed with Transport for London, Go Jauntly is a community-based initiative that’s as much about exploration and sharing with fellow jaunt-lovers. It also had £10,000 backing from the Ordnance Survey’s Geovation fund that helps start ups using geo-based technology. Big players are involved.
It’s directly tapped into TFL’s dynamic open data, and keeps users informed of everything from congestion to pollution. According to statistics, some 3.6 million journeys a day are made in London using cars and public transport, all of which could have been walked.
“We’re hoping that with Go Jauntly we’re creating technology for good that has a positive impact on society from a health, wellness and environmental perspective,” explains Hana Sutch, CEO and co-founder. “We wanted to start something that would get people out of the house and more active. Our team at Go Jauntly are all nature-loving city dwellers who spend too much of our time deskbound and wanted to be a bit more active.”
Go Jauntly is available now on the App Store with a variety of walks including Richmond and Regent’s Parks, plus a selection of South East London’s cemeteries. This isn’t just a London-centric innovation, anyone in the UK can download it, walk-the-walk, and share their jaunt. The company is hoping to get an Android version out by the end of the year.
Other apps that encourage walking include Norway’s Traffic Agent, and the UK’s Walkability was also designed to get users on the hoof….(More)”
DIY gun control: The people taking matters into their own hands
Legislators have always struggled to address this problem. But in the first 100 days of Donald Trump’s administration, new gun legislation has only expanded, not restricted gun rights. In short order, lawmakers made it easier for certain people with mental illness to buy guns, and pushed to expand the locations where people can carry firearms.
Over the past few years, however, gun owners and sellers have started taking matters into their own hands and have come up with creative solutions to reduce the threat from guns.
From working with public health organisations so gun sellers can recognise the signs of depression in a prospective buyer to developing biometric gun locks, citizen scientists are cobbling together measures they hope will stave off the worst aspects of US gun culture.
The Federation of American Scientists estimates that 320 million firearms circulate in the US – about enough for every man, woman and child. According to the independent policy group Gun Violence Archive, there were 385 mass shootings in 2016, and it looks as if the numbers for 2017 will not differ wildly.
In the absence of regulations against guns, individual gun sellers and owners are trying to help”
Although the number of these incidents is alarming, it is dwarfed by the amount of suicides, which account for more than half of all firearms deaths (see graph, right). And last year, a report from the Associated Press and the USA Today Network showed that accidental shootings kill almost twice as many children as is shown in US government data.
In just one week in 2009, New Hampshire gun shop owner Ralph Demicco sold three guns that were ultimately used by their new owners to end their own lives. Demicco’s horror and dismay that he had inadvertently contributed to their deaths led him to start what has become known as the Gun Shop Project.
The project uses insights from the study of suicide to teach gun sellers to recognise signs of suicidal intent in buyers, and know when to avoid selling a gun. To do this, Demicco teamed up with Catherine Barber, an epidemiologist at the Harvard T. H. Chan School of Public Health.
Part of what the project does is challenge myths. With suicide, the biggest is that people plan suicides over a long period. But empirical evidence shows that people usually act in a moment of brief but extreme emotion. One study has found that nearly half of people who attempted suicide contemplated their attempt for less than 10 minutes. In the time it takes to find another method, a suicidal crisis often passes, so even a small delay in obtaining a gun could make a difference….Another myth that Demicco and Barber are seeking to dispel is that if you take away someone’s gun, they’ll just find another way to hurt themselves. While that’s sometimes true, Barber says, alternatives are less likely to be fatal. Gun attempts result in death more than 80 per cent of the time; only 2 per cent of pill-based suicide attempts are lethal.
Within a year of its launch in 2009, half of all gun sellers in New Hampshire had hung posters about the warning signs of suicide by the cash registers in their stores. The programme has expanded to 21 states, and Barber is now analysing data to see how well it is working.
Another grass-roots project is trying to prevent children from accidentally shooting themselves. Kai Kloepfer, an undergraduate at Massachusetts Institute of Technology, has been working on a fingerprint lock to prevent anyone other than the owner using a gun. He has founded a start-up called Biofire Technologies to improve the lock’s reliability and bring it into production….
Grass-roots schemes like the Gun Shop Project have a better chance of being successful, because gun users are already buying in. But it may take years for the project to become big enough to have a significant effect on national statistics.
Regulatory changes might be needed to make any improvements stick in the long term. At the very least, new regulations shouldn’t block the gun community’s efforts at self-governance.
Change will not come quickly, regardless. Barber sees parallels between the Gun Shop Project and campaigns against drink driving in the 1980s and 90s.
“One commercial didn’t change rates of drunk driving. It was an ad on TV, a scene in a movie, repeated over and over, that ultimately had an impact,” she says….(More)
Use of social media for e-Government in the public health sector: A systematic review of published studies
Review by Aizhan Tursunbayeva, Massimo Franco, and Claudia Pagliari: “Although the intersection between social media and health has received considerable research attention, little is known about how public sector health organizations are using social media for e-Government. This systematic literature review sought to capture, classify, appraise and synthesize relevant evidence from four international research databases and gray literature. From 2441 potentially relevant search results only 22 studies fully met the inclusion criteria. This modest evidence-base is mostly descriptive, unidisciplinary and lacks the theoretical depth seen in other branches of e-Government research. Most studies were published in the last five years in medical journals, focus on Twitter and come from high income countries. The reported e-Government objectives mainly fall into Bertot et al.’s (2010) categories of transparency/accountability, democratic participation, and co-production, with least emphasis on the latter. A unique category of evaluation also emerged. The lack of robust evidence makes it difficult to draw conclusions about the effectiveness of these approaches in the public health sector and further research is warranted….(More)”.
Can blockchain technology help poor people around the world?
Most simply, a blockchain is an inexpensive and transparent way to record transactions….A blockchain system, though, inherently enforces rules about authentication and transaction security. That makes it safe and affordable for a person to store any amount of money securely and confidently. While that’s still in the future, blockchain-based systems are already helping people in the developing world in very real ways.
Sending money internationally
In 2016, emigrants working abroad sent an estimated US$442 billion to their families in their home countries. This global flow of cash is a significant factor in the financial well-being of families and societies in developing nations. But the process of sending money can be extremely expensive….Hong Kong’s blockchain-enabled Bitspark has transaction costs so low it charges a flat HK$15 for remittances of less than HK$1,200 (about $2 in U.S. currency for transactions less than $150) and 1 percent for larger amounts. Using the secure digital connections of a blockchain system lets the company bypass existing banking networks and traditional remittance systems.
Similar services helping people send money to the Philippines, Ghana, Zimbabwe, Uganda, Sierra Leone and Rwanda also charge a fraction of the current banking rates.
Insurance
Most people in the developing world lack health and life insurance, primarily because it’s so expensive compared to income. Some of that is because of high administrative costs: For every dollar of insurance premium collected, administrative costs amounted to $0.28 in Brazil, $0.54 in Costa Rica, $0.47 in Mexico and $1.80 in the Philippines. And many people who live on less than a dollar a day have neither the ability to afford any insurance, nor any company offering them services….Consuelo is a blockchain-based microinsurance service backed by Mexican mobile payments company Saldo.mx. Customers can pay small amounts for health and life insurance, with claims verified electronically and paid quickly.
Helping small businesses
Blockchain systems can also help very small businesses, which are often short of cash and also find it expensive – if not impossible – to borrow money. For instance, after delivering medicine to hospitals, small drug retailers in China often wait up to 90 days to get paid. But to stay afloat, these companies need cash. They rely on intermediaries that pay immediately, but don’t pay in full. A $100 invoice to a hospital might be worth $90 right away – and the intermediary would collect the $100 when it was finally paid….
Humanitarian aid
Blockchain technology can also improve humanitarian assistance. Fraud, corruption, discrimination and mismanagement block some money intended to reduce poverty and improve education and health care from actually helping people.In early 2017 the U.N. World Food Program launched the first stage of what it calls “Building Block,” giving food and cash assistance to needy families in Pakistan’s Sindh province. An internet-connected smartphone authenticated and recorded payments from the U.N. agency to food vendors, ensuring the recipients got help, the merchants got paid and the agency didn’t lose track of its money.
…In the future, blockchain-based projects can help people and governments in other ways, too. As many as 1.5 billion people – 20 percent of the world’s population – don’t have any documents that can verify their identity. That limits their ability to use banks, but also can bar their way when trying to access basic human rights like voting, getting health care, going to school and traveling.
Several companies are launching blockchain-powered digital identity programs that can help create and validate individuals’ identities….(More)”
The opportunity in government productivity
The McKinsey Center for Government: “Governments face a pressing question: How to do more with less? Raising productivity could save $3.5 trillion a year—or boost outcomes at no extra cost.
Higher costs and rising demand have driven rapid increases in spending on core public services such as education, healthcare, and transport—while countries must grapple with complex challenges such as population aging, economic inequality, and protracted security concerns. Government expenditure amounts to more than a third of global GDP, budgets are strained, and the world public-sector deficit is close to $4 trillion a year.
At the same time, governments are struggling to meet citizens’ rising expectations. Satisfaction with key state services, such as public transportation, schools, and healthcare facilities, is less than half that of nonstate providers, such as banks or utilities.
Governments need a way to deliver better outcomes—and a better experience for citizens—at a sustainable cost. A new paper by the McKinsey Center for Government (MCG), Government productivity: Unlocking the $3.5 trillion opportunity, suggests that goal is within reach. It shows that several countries have achieved dramatic productivity improvements in recent years—for example, by improving health, public safety, and education outcomes while maintaining or even reducing spending per capita or per student in those sectors.
If other countries were to match the improvements already demonstrated in these pockets of excellence, the world’s governments could potentially save as much as $3.5 trillion a year by 2021—equivalent to the entire global fiscal gap. Alternatively, countries could choose to keep spending constant while boosting the quality of key services. For example, if all the countries studied had improved the productivity of their healthcare systems at the rate of comparable best performers over the past 5 years, they would have added 1.4 years to the healthy life expectancy of their combined populations. That translates into 12 billion healthy life years gained, without additional per capita spending…(More)”
Using a New Roadmap to Democratize Climate Change
Anne Glusker at Smithsonian: “…Grimsson’s group felt that due to changes in information technology and social transformations, the large organizations and structures that used to be necessary to effect change were now not needed. And thus was born Roadmap, a new crowdsourcing tool for anyone and everyone interested in climate action. Still in its very early stages, Roadmap’s founders envision it as a platform for those working on climate issues—from scientist and policymaker to farmer and fisherman—to facilitate the sharing of knowledge and ideas, methods and techniques.
“A new political model is possible—where everyone can be a doer, where you no longer need big government or big enterprises to bring about success,” Grimsson says.
This new model for social change that skips the usual cumbersome channels and processes has been seen everywhere from public health, where the Bill & Melinda Gates Foundation has redefined the sector, to the hospitality industry, which is working to combat the human trafficking that plagues its businesses, to perhaps most famously the Arab Spring, where the role of social media in bringing about political change is still being debated today.
And this new model is complemented by technological changes. “The innovation in energy technology is such that we no longer have to wait for the big energy breakthrough,” Grimsson says. “We already have the available technologies. Every individual, home, village, community, town and region can execute change. The good news from the climate point of view is that, in addition to the information technology revolution, there has now also taken place an energy revolution. A house can be a power station: If the people who live in that house have extra energy, they can sell their energy through the smart grid. The notion that every house can be a power station is as revolutionary as saying that every mobile phone can be a media company.”
Grimsson admits that it may seem odd for someone in his position to be advocating that ordinary citizens take action apart from the conventional corridors of governmental power.
“For me to say that these traditional political organizations and positions are somewhat outdated is perhaps a strange statement: I was a professor of political science, I’ve been a member of parliament, I’ve been a minister of finance, I was president for 20 years,” he says.
It was during Iceland’s financial meltdown that he first experienced this new kind of social change: “I saw this very strongly through the financial crisis in my own country, which led to a big social economic uprising. All those activities were engineered by unknown people, people who were not part of a big organization, who used Facebook and the information media to bring thousands of people together in one day.”
Right now, Roadmap consists of a website and a lofty manifesto that speaks of raising the value of “moral currency” and creating a “best practices warehouse.” Visitors to the site can fill out a form if they want to become part of its community of “doers.” The practical part of the manifesto speaks of identifying the best methodologies and models; implementing a “real-time system of measurement” and a way to “gauge and understand what is working, what is not, and exactly what is being achieved.” As the platform develops, it will be interesting to see exactly what form these gauges, measurement systems, and warehouses take….(More)”.
How maps and machine learning are helping to eliminate malaria
Allie Lieber at The Keyword: “Today is World Malaria Day, a moment dedicated to raising awareness and improving access to tools to prevent malaria. The World Health Organization says nearly half of the world’s population is at risk for malaria, and estimates that in 2015 there were 212 million malaria cases resulting in 429,000 deaths. In places with high transmission rates, children under five account for 70 percent of malaria deaths.
DiSARM (Disease Surveillance and Risk Monitoring), a project led by the Malaria Elimination Initiative and supported by the Bill and Melinda Gates Foundationand Clinton Health Access Initiative, is fighting the spread of malaria by mapping the places where malaria could occur. With the help of Google Earth Engine, DiSARM creates high resolution “risk maps” that help malaria control programs identify the areas where they should direct resources for prevention and treatment.
We sat down with Hugh Sturrock, who leads the DiSARM project and is an Assistant Professor of Epidemiology and Biostatistics in the University of California, San Francisco’s Global Health Group, to learn more about DiSARM’s fight against malaria, and how Google fits in….
How does DiSARM use Google Earth Engine to help fight malaria?
If we map where malaria is most likely to occur, we can target those areas for action. Every time someone is diagnosed with malaria in Swaziland and Zimbabwe, a team goes to the village where the infection occurred and collects a GPS point with the precise infection location. Just looking at these points won’t allow you to accurately determine the risk of malaria, though. You also need satellite imagery of conditions like rainfall, temperature, slope and elevation, which affect mosquito breeding and parasite development.
To determine the risk of malaria, DiSARM combines the precise location of the malaria infection, with satellite data of conditions like rainfall, temperature, vegetation, elevation, which affect mosquito breeding. DiSARM’s mobile app can be used by the malaria programs and field teams to target interventions.
Google Earth Engine collects and organizes the public satellite imagery data we need. In the past we had to obtain those images from a range of sources: NASA, USGS and different universities around the world. But with Google Earth Engine, it’s all in one place and can be processed using Google computers. We combine satellite imagery data from Google Earth Engine with the locations of malaria cases collected by a country’s national malaria control program, and create models that let us generate maps identifying areas at greatest risk.
The DiSARM interface gives malaria programs a near real-time view of malaria and predicts risk at specific locations, such as health facility service areas, villages and schools. Overlaying data allows malaria control programs to identify high-risk areas that have insufficient levels of protection and better distribute their interventions….(More)”
How Behavioral Economics Can Produce Better Health Care
Dhruv Khullar in the New York Times: “…We in the medical community have only recently started to explore how behavioral economics can improve health. As with any hot field, there’s always the possibility of hype. But these insights might be particularly valuable in health care because medical decision-making is permeated with uncertainty, complexity and emotion — all of which make it hard to weigh our options.
A leader of this movement is Dr. Kevin Volpp, a physician at the University of Pennsylvania and founding director of the Center for Health Incentives and Behavioral Economics. He designs randomized trials around some of health care’s most important challenges: nudging doctors to provide evidence-based care; ensuring patients take their medications; and helping consumers choose better health plans.
“There’s starting to be a broad recognition that decision-making environments in health care could better reflect how doctors and patients actually make decisions,” he said.
Dr. Volpp, whose work is used by both the public and private sector, recently collaborated with CVS Caremark to test which financial incentives are most effective for getting employees to quit smoking. Employees were randomly assigned to one of three groups. The first was “usual care,” in which they received educational materials and free smoking cessation aids. The second was a reward program: Employees could receive up to $800 over six months if they quit. The third was a deposit program, in which smokers initially forked over $150 of their money, but if they quit, they got their deposit back along with a $650 bonus.
Compared with the usual care group, employees in both incentive groups were substantially more likely to be smoke-free at six months. But the nature of the incentives mattered. Those offered the reward program were far more likely to accept the challenge than those offered the deposit program. But the deposit program was twice as effective at getting people to quit — and five times as effective as just pamphlets and Nicorette gum.
Parting with your own money is painful. But it is effective.
That’s also a lesson in Volpp-led research on getting people to lose weight and exercise more. One recent study gave incentives to patients by entering them into lotteries or into deposit contracts for meeting weight loss goals. Those in the lottery group were eligible for a daily lottery prize with frequent small payouts and occasional large rewards — but only if they clocked in at or below their weight loss goal. People in the deposit group invested their own money (generally a few dollars a day), which was then matched by researchers. They’d get their money back — and then some — if they met their goal at the end of the month….(More)”