Unequal access to healthcare and inadequate financing have highlighted the need for healthcare reform to increase efficiency while ensuring equity in healthcare financing worldwide. Our study evaluates the capacity of Kazakhstan's healthcare system reform, transitioning from a tax-financed system to compulsory social health insurance (CSHI), to address equity in healthcare financing. Using quarterly Household Budget Surveys from 2017-Q1 to 2020-Q4 in a staggered difference-in-difference estimation technique, we analyze the impact of the transition on the incidence and intensity of catastrophic health expenditure (CHE) and impoverishment. Our findings show that while the transition from a tax-financed to a CSHI system in the short run lowers both the incidence and intensity of catastrophic health expenditure, it does not alleviate impoverishment. In particular, the reform predominantly benefits wealthier households, with no effect on the relatively poor population. We speculate that the positive outcomes observed from the reform in the short run are largely attributed to the exceptionally high insurance coverage during the transition period. The success of the transition from a tax-based to an insurance-based system is heavily dependent on the rate of insurance coverage of the population, as well as the quality of healthcare services and available finances.

• Klíčová slova
• Catastrophic health expenditure, Health insurance, Impoverishment, Inequity, Kazakhstan,
• MeSH
• financování zdravotní péče * MeSH
• lidé MeSH
• pojistné krytí statistika a číselné údaje   ekonomika   MeSH
• reforma zdravotní péče * ekonomika   MeSH
• vážná nemoc ekonomika   MeSH
• výdaje na zdravotnictví * statistika a číselné údaje   MeSH
• zdravotní pojištění ekonomika   statistika a číselné údaje   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Kazachstán MeSH

Based on 16 months of fieldwork in a Chinese psychiatric hospital from 2017 to 2019, this study applies Myers's concept of moral agency to explore the efforts of three women with mental illness in their pursuits of a better life, examining their actions and interactions with social workers throughout the process. It enriches our understanding of moral agency by demonstrating that its actualization requires not only freedom, intention, and access to their life plans, but also patients' reflections on the relationships between themselves and the others. The study provides an example to comprehend the recovery of moral agency within a family-centered context, where patients' aspirations for a better life may be constrained by cultural expectations. This study also suggests that hospital social workers should establish trusting relationships with patients to accurately assess their genuine understanding of a good life and navigate the institutional constraints with the patients.

• MeSH
• dospělí MeSH
• duševní poruchy * psychologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mravy * MeSH
• ústavy pro duševně nemocné MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Čína MeSH

Roma represent one of the largest ethnic groups facing marginalization worldwide. However, significant knowledge gaps persist regarding: A) the social mechanisms supporting health-endangering practices among Roma; B) the social mechanisms adversely affecting their use of health services; and C) the social determinants underlying both above pathways. To fill these gaps, we conducted a series of four explorative ethnographic studies spanning over ten years. Beginning in 2004, the series involved 260 participants, including segregated Roma and health services staff in Slovakia. Of the four studies, two addressed gap A, two addressed gap B, and all addressed gap C. Regarding pathway A, we found that Roma in segregated Roma enclaves can be socialized into ethnically framed racialized ideologies that oppose the cultural standards of local non-Roma life, including certain healthy practices. This adherence to counter-cultural ideals of Roma identity increases specific health and care challenges. Regarding pathway B, we discovered that health service frontliners frequently lack any organizational support to better understand and accommodate the current living conditions and practices of segregated Roma, as well as their own and others' racism and professional expectations regarding equity. This lack of support leads many frontliners to become cynical about segregated Roma over their careers, resulting in health services being less effective and exacerbating health problems for both Roma and the frontliners themselves. Concerning pathway C, we found that the societal omnipresence of antigypsyism - racist and racialized anti-Roma ideas and sentiments - serves as a prominent driver of both the above pathways. We conclude that much of the unfavorable health status of Roma can be understood via a systems perspective that embraces structural racism.

• Klíčová slova
• Discrimination, Ethnic health inequalities, Healthcare, Marginalized Roma, Racism, Slovakia, Social determinants of health,
• MeSH
• dospělí MeSH
• kulturní antropologie * metody   MeSH
• lidé MeSH
• rasismus psychologie   MeSH
• Romové * psychologie   statistika a číselné údaje   MeSH
• sociální determinanty zdraví etnologie   MeSH
• sociální marginalizace psychologie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Slovenská republika MeSH

Although Covid-19 was not the first pandemic, it was unique in the scale and intensity with which societies responded. Countries reacted differently to the threat posed by the new virus. The public health crisis affected European societies in many ways. It also influenced the way the media portrayed vaccines and discussed factors related to vaccine hesitancy. Europeans differed in their risk perceptions, attitudes towards vaccines and vaccine uptake. In European countries, Covid-19-related discourses were at the centre of media attention for many months. This paper reports on a media analysis which revealed significant differences as well as some similarities in the media debates in different countries. The study focused on seven European countries and considered two dimensions of comparison: between the pre-Covid period and the beginning of the Covid pandemic period, and between countries. The rich methodological approach, including linguistics, semantic field analysis and discourse analysis of mainstream news media, allowed the authors to explore the set of meanings related to vaccination that might influence actors' agency. This approach led the authors to redefine vaccine hesitancy in terms of characteristics of the "society in the situation" rather than the psychological profile of individuals. We argue that vaccine hesitancy can be understood in terms of agency and temporality. This dilemma of choice that transforms the present into an irreversible past and must be taken in relation to an uncertain future, is particularly acute under the pressure of urgency and when someone's health is at stake. As such, it is linked to how vaccine meaning is co-produced within public discourses.

• MeSH
• COVID-19 * epidemiologie   prevence a kontrola   MeSH
• lidé MeSH
• nejistota MeSH
• sociální média * MeSH
• vakcinace MeSH
• vakcíny * terapeutické užití   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Evropa epidemiologie   MeSH
• Názvy látek
• vakcíny * MeSH

To respond to the COVID-19 pandemic, governments frequently resorted to declaring the state of emergency, fuelling contestations over the abuse of public powers and effectiveness of the measures to induce compliance. This article examines how the denial of the political nature of emergency governance known as depoliticisation undermines government credibility and may suit anti-democratic actors. We contribute to understanding the relationship between depoliticisation and democracy by showing how Slovak coalition parties during key parliamentary debates on the state of emergency during the COVID-19 pandemic insisted on depoliticising the pandemic while parliamentary opposition parties with anti-democratic leanings successfully opted for its repoliticisation. Repoliticising a key decision on managing the public health emergency granted credibility to illiberal political actors at the expense of the government, cautioning against depoliticisation strategies to be invoked by democrats in fragile democracies. Instead, accepting that such decisions are political may prevent the loss of credibility due to unsuccessful rhetorical practices of depoliticisation.

• MeSH
• COVID-19 * MeSH
• lidé MeSH
• pandemie prevence a kontrola   MeSH
• politika MeSH
• veřejné zdravotnictví MeSH
• vláda MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Climate change is a threat to the mental and emotional wellbeing of all humans, but young people are particularly vulnerable. Emerging evidence has found that young people's awareness of climate change and the danger it poses to the planet can lead to negative emotions. To increase our understanding about this, survey instruments are needed that measure the negative emotions young people experience about climate change. RESEARCH QUESTIONS: (1) What survey instruments are used to measure negative emotional responses to climate change in young people? (2) Do survey instruments measuring young people's negative emotional responses to climate change have evidence of reliability and validity? (3) What factors are associated with young people's negative emotional responses to climate change? METHODS: A systematic review was conducted by searching seven academic databases on November 30, 2021, with an update on March 31, 2022. The search strategy was structured to capture three elements through various keywords and search terms: (1) negative emotions, (2) climate change, and (3) surveys. RESULTS: A total of 43 manuscripts met the study inclusion criteria. Among the 43 manuscripts, 28% focused specifically on young people, while the other studies included young people in the sample but did not focus exclusively on this population. The number of studies using surveys to examine negative emotional responses to climate change among young people has increased substantially since 2020. Survey instruments that examined worry or concern about climate change were the most common. CONCLUSION: Despite growing interest in climate change emotions among young people, there is a lack of research on the validity of measures of such emotions. Further efforts to develop survey instruments geared to operationalize the emotions that young people are experiencing in relation to climate change are needed.

• Klíčová slova
• Adolescents, Climate change, Emotions, Measurement, Surveys, Youth,
• MeSH
• emoce * MeSH
• klimatické změny * MeSH
• lidé MeSH
• mladiství MeSH
• průzkumy a dotazníky MeSH
• psychometrie MeSH
• reprodukovatelnost výsledků MeSH
• Check Tag
• lidé MeSH
• mladiství MeSH
• Publikační typ
• časopisecké články MeSH
• systematický přehled MeSH

This article analyses the politicisation of public health debates by focusing on vaccination and mental health care in the Czech Republic. The mainstream understanding of politicisation commonly refers to politics-as-sphere, linked with the political instrumentalisation of health care controversies as part of electoral campaigning and power struggles. In our analysis, we conceive politicisation more broadly, as politics-as-activity, which encompasses the role of civic engagement and the involvement of patients in these processes. We thus view politicisation as a process which encompasses a plurality of political actors and, in addition to politicians, includes patients, users, carers, citizens, and experts. Our analysis draws on extensive empirical evidence, consisting of observations, semi-structured interviews, and a review of available documents. The study took place in the Czech Republic from 2017 to 2019. We conclude that politicisation takes place alongside four dimensions: (1) contingency, (2) agency, (3) a plurality of opinions and approaches, and (4) visibility. We further argue that the contingent nature of biomedical controversies is articulated in three different, possibly interconnected layers. Thus, the politicisation of the two Czech analysed cases refers to (a) uncertainties and problematic aspects of biomedical objects of controversy; to (b) social rights, economic needs, and legal aspects as well as social representations of illness and vaccinations in the public debate; and to (c) the political processes which determine the previous two layers of politicisation, labelled as meta-politicisation. Last but not least, we stress the dynamic and non-linear nature of politicisation processes, the varieties of connections between the third sector and expertise, and the necessity to analyse the politicisation of public health controversies hand in hand with its connection to depoliticisation and repoliticisation.

• Klíčová slova
• Civic engagement, Depoliticisation, Mental health care reform, Meta-politicisation, Politicisation, Repoliticisation, Vaccination,
• MeSH
• lidé MeSH
• politika * MeSH
• reforma zdravotní péče * MeSH
• vakcinace MeSH
• veřejné zdravotnictví MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH
• Geografické názvy
• Česká republika MeSH

Studies from single countries suggest that local labour market conditions, including rates of employment, tend to be associated with the health of the populations residing in those areas, even after adjustment for individual characteristics including employment status. The aim of this study is to strengthen the cross-national evidence base on the influence of regional employment levels and individual worklessness on health during the period of the Great Recession. We investigate whether higher regional employment levels are associated with better health over and above individual level employment. Individual level data (N = 23,078 aged 15-64 years) were taken from 16 countries (Austria, Belgium, Czech Republic, Denmark, Finland, France, Germany, Hungary, Ireland, Netherlands, Norway, Poland, Portugal, Spain, Sweden and United Kingdom) participating in the 2014 European Social Survey. Regional employment rates were extracted from Eurostat, corresponding with the start (2008) and end (2013) of the Great Recession. Health outcomes included self-reported heart or circulation problems, high blood pressure, diabetes, self-rated health, depression, obesity and allergies (as a falsification test). We calculated multilevel Poisson regression models, which included individuals nested within regions, controlling for potential confounding variables and country fixed effects. After adjustment for individual level socio-demographic factors, higher average regional employment rates (from 2008 to 2013) were associated with better health outcomes. Individual level worklessness was associated with worsened health outcomes, most strongly with poor self-rated health. In models including both individual worklessness and the average regional employment rate, regional employment remained associated with heart and circulation problems, depression and obesity. There was evidence of an interaction between individual worklessness and regional employment for poor self-rated health and depression. The findings suggest that across 16 European countries, for some key outcomes, higher levels of employment in the regional labour market may be beneficial for the health of the local population.

• Klíčová slova
• Cross-national, Employment, Geography, Health inequality, Recession, Worklessness,
• MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• zaměstnanost * MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Belgie MeSH
• Česká republika MeSH
• Evropa epidemiologie   MeSH
• Finsko MeSH
• Francie MeSH
• Irsko MeSH
• Maďarsko MeSH
• Německo MeSH
• Nizozemsko MeSH
• Norsko MeSH
• Polsko MeSH
• Portugalsko epidemiologie   MeSH
• Rakousko MeSH
• Španělsko MeSH
• Spojené království MeSH
• Švédsko MeSH

Using data from Spain, we show the impact of significant health-sector budget cuts introduced in 2012 on the rates of cesarean sections and on infant health outcomes at birth, which we use as a proxy for the quality of birth centers. Exploiting a difference-in-differences fixed-effects approach at the hospital level, we estimate a 3% increase in C-sections as a result of the budget restrictions, with no significant consequences on health outcomes at birth. Given the additional evidence in the literature on the negative short- and long-term effects of non-medically indicated C-sections, our paper provides important policy implications for population health.

• Klíčová slova
• Cesarean sections, Health spending cuts, Inappropriate healthcare,
• MeSH
• císařský řez * MeSH
• kojenec MeSH
• lidé MeSH
• porod * MeSH
• rozpočty MeSH
• těhotenství MeSH
• Check Tag
• kojenec MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Španělsko MeSH

The friction cost approach (FCA) estimates the productivity costs of disease from an employer's perspective but the lack of estimates of friction periods in different countries limits its use. Our aim was to use labour market aggregates to generate two alternative estimates of the friction period for European countries and to apply the FCA to illustrate the impact on cancer-related lost productivity costs. We included thirty countries (EU 27 + the United Kingdom, Switzerland and Norway). Base-case Method 1BC used annual Dutch vacancy stock and flow data (2001-2019) to estimate friction periods for this country. A regression model was employed using Dutch data and country-specific vacancy and unemployment rates to generate country-specific friction period estimates for the other 29 countries. Alternative Method 2ALT used country-specific newly occupied jobs as a proxy vacancy flow variable and vacancy stock data to generate friction period estimates. These were applied, within the FCA, to premature cancer mortality data (from GLOBOCAN2018) for all cancers combined for Western European countries. Costs are in €2018. Method 1BC estimated friction periods in 2018 ranged from 70.8 days for Greece to 145.9 days for the Czech Republic, with a mean duration of 95.3 days. Method 2ALT produced a mean friction period of 80.0 days. On average, across countries, Method 2ALT friction periods were 15.4 days (-18.5%) shorter than Method 1BC estimates. Friction period estimates over the last decade were shorter than those for 2018 reflecting lower vacancy rates. Total cancer premature mortality costs according to FCA Method 1BC amounted to €1.0 billion in 2018 for Western Europe compared to €0.99 billion for Method 2ALT. We developed two alternative - and viable - methods to estimate country-specific friction periods. These approaches will enable researchers to apply the FCA to estimate the productivity cost of diseases across Europe from an employer's perspective.

• Klíčová slova
• Cancer, Europe, Friction cost approach, Productivity costs, Societal costs,
• MeSH
• lidé MeSH
• náklady na zdravotní péči * MeSH
• osobní újma zaviněná nemocí * MeSH
• tření MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH
• Evropa MeSH
• Norsko MeSH
• Řecko MeSH
• Spojené království MeSH
• Švýcarsko MeSH