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Finkelstein EA, Ozdemir S, Huynh VA, Chay J, Mühlbacher A, Tan HK. Navigating Public Policy Responses to a Pandemic: The Balancing Act Between Physical Health, Mental Health, and Household Income. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2024; 27:1121-1129. [PMID: 38718978 DOI: 10.1016/j.jval.2024.04.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 04/09/2024] [Accepted: 04/23/2024] [Indexed: 05/29/2024]
Abstract
OBJECTIVE During COVID-19, governments imposed restrictions that reduced pandemic-related health risks but likely increased personal and societal mental health risk, partly through reductions in household income. This study aimed to quantify the public's willingness to accept trade-offs between pandemic health risks, household income reduction, and increased risk of mental illness that may result from future pandemic-related policies. METHODS A total of 547 adults from an online panel participated in a discrete choice experiment where they were asked to choose between hypothetical future pandemic scenarios. Each scenario was characterized by personal and societal risks of dying from the pandemic, experiencing long-term complications, developing anxiety/depression, and reductions in household income. A latent class regression was used to estimate trade-offs. RESULTS Respondents state a willingness to make trade-offs across these attributes if the benefits are large enough. They are willing to accept 0.8% lower household income (0.7-1.0), 2.7% higher personal risk of anxiety/depression (1.8-3.6), or 3.2% higher societal rate of anxiety/depression (1.7-4.7) in exchange for 300 fewer deaths from the pandemic. CONCLUSION Results reveal that individuals are willing to accept lower household income and higher rates of mental illness, both personal and societal, if the physical health benefits are large enough. Respondents placed greater emphasis on maintaining personal, as opposed to societal, mental health risk and were most interested in preventing pandemic-related deaths. Governments should consider less restrictive policies when pandemics have high morbidity but low mortality to avoid the prospect of improving physical health while simultaneously reducing net social welfare.
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Affiliation(s)
- Eric Andrew Finkelstein
- Signature Programme in Health Services and System Research, Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore; Department of Population Health Sciences, Duke University, Durham, NC, USA.
| | - Semra Ozdemir
- Signature Programme in Health Services and System Research, Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore; Department of Population Health Sciences, Duke University, Durham, NC, USA
| | - Vinh Anh Huynh
- Signature Programme in Health Services and System Research, Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
| | - Junxing Chay
- Signature Programme in Health Services and System Research, Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
| | | | - Hiang Khoon Tan
- Division of Surgery and Surgical Oncology, National Cancer Centre, Singapore; Future Health System, Singapore General Hospital, Singapore
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Abadie R, Habecker P, Carrasco KG, Chiou KS, Fernando S, Bennett SJ, Valentin-Acevedo A, Dombrowski K, West JT, Wood C. Employing Respondent Driven Sampling (RDS) to recruit people who inject drugs (PWID) and other hard-to-reach populations during COVID-19: Lessons learned. Front Psychiatry 2022; 13:990055. [PMID: 36262631 PMCID: PMC9574048 DOI: 10.3389/fpsyt.2022.990055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 09/12/2022] [Indexed: 01/12/2023] Open
Abstract
Background Respondent Driven Sampling (RDS) is an effective sampling strategy to recruit hard-to-reach populations but the impact of the COVID-19 pandemic on the use of this strategy in the collection of data involving human subjects, particularly among marginalized and vulnerable populations, is not known. Based on an ongoing study using RDS to recruit and study the interactions between HIV infection, injection drug use, and the microbiome in Puerto Rico, this paper explores the effectiveness of RDS during the pandemic and provided potential strategies that could improve recruitment and data collection. Results RDS was employed to evaluate its effectiveness in recruiting a group of people who inject drugs (PWID) and controls (N = 127) into a study in the midst of the COVID-19 pandemic. The participants were distributed among three subsets: 15 were HIV+ and PWID, 58 were HIV- PWID, and 54 were HIV+ and not PWID. Findings Results show that recruitment through peer networks using RDS was possible across all sub-groups. Yet, while those in the HIV+ PWID sub-group managed to recruit from other-sub groups of HIV- PWID and HIV+, this occurred at a lower frequency. Conclusion Despite the barriers introduced by COVID-19, it is clear that even in this environment, RDS continues to play a powerful role in recruiting hard-to-reach populations. Yet, more attention should be paid at how future pandemics, natural disasters, and other big events might affect RDS recruitment of vulnerable and hard-to-reach populations.
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Affiliation(s)
- Roberto Abadie
- School of Global and Integrative Studies, University of Nebraska-Lincoln, Lincoln, NE, United States
| | - Patrick Habecker
- Department of Sociology, University of Nebraska-Lincoln, Lincoln, NE, United States
| | | | - Kathy S. Chiou
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE, United States
| | - Samodha Fernando
- Department of Animal Science, University of Nebraska-Lincoln, Lincoln, NE, United States
| | - Sydney J. Bennett
- School of Biological Sciences, University of Nebraska-Lincoln, Lincoln, NE, United States
- Department of Interdisciplinary Oncology, Louisiana State University Health Sciences Center, Louisiana Cancer Research Center, New Orleans, LA, United States
| | - Aníbal Valentin-Acevedo
- Department of Microbiology and Immunology, Universidad Central del Caribe, Bayamón, PR, United States
| | | | - John T. West
- Department of Interdisciplinary Oncology, Louisiana State University Health Sciences Center, Louisiana Cancer Research Center, New Orleans, LA, United States
| | - Charles Wood
- School of Biological Sciences, University of Nebraska-Lincoln, Lincoln, NE, United States
- Department of Interdisciplinary Oncology, Louisiana State University Health Sciences Center, Louisiana Cancer Research Center, New Orleans, LA, United States
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