Navigating sustainable horizons: exploring the dynamics of financial stability, green growth, renewable energy, technological innovation, financial inclusion, and soft infrastructure in shaping sustainable development

This paper examines sustainable development, which employs an integrated approach to tackle environmental, social, and economic challenges. It provides a theoretical underpinning by examining sustainable development's inception, fundamental tenets, and conceptual structures. This study highlights the interdependence of social equity, economic prosperity, and environmental conservation, emphasizing the need for a comprehensive approach. Quantitative methodology is utilized in this study, and the dependent variable is sustainable development. Financial risk, green growth, technological innovation, renewable energy, financial inclusion, and soft infrastructure are all independent variables. The analysis is predicated on secondary data from the Organization for Economic Cooperation and Development and World Development Indicators databases spanning 2004 to 2019. An entropy-weighted method used for the green growth index is a metric that enhances the precision of variable indicators. Cointegration, correlation, VIF, cross-sectional dependency, and stationarity tests are among the diagnostic tests that inform the selection of methods for the panel data set. It is determined that fully modified ordinary least squares is the suitable technique. The findings suggest statistically significant positive correlations among greenhouse gases, financial inclusion, and soft infrastructure. Conversely, significant negative correlations exist between financial risk, green growth, renewable energy, and technological innovation. An estimated 55% long-run variance is present. The study's key finding is that financial risk has an adverse effect on sustainable development, while an impactful relationship where increased green growth is linked to decreased GHG emissions. This association is notably significant. Results show that renewable energy has a negative coefficient and significant negative impact on greenhouse gases, showing an active relation to enhancing sustainable development. In contrast, financial inclusion has a significant positive effect on sustainable development. The implications imply that providing incentives to institutions engaged in alternative energy, precisely renewable sources, could positively impact the environment. Government policies and funding regulations oriented toward sustainable development are indispensable for environmental sustainability. Government policies and incentives are pivotal in advancing an environmentally conscious and sustainable future. This study's contribution lies in elucidating the positive correlation between government interventions and promoting renewable energy adoption, thereby paving the way for a greener tomorrow.

Taxing energy to tackle greenhouse gases: evaluating the role of financial risk in high-income economies

Energy, a basic input to the economic system, plays a pivotal function in development; at the same time, it raises concerns and hurdles to global economies as a result of negative externalities associated with its usage. Economies set various measures to limit these negative externalities and encourage citizens toward renewable energy utilization. Considering a panel of high-income economies over the period of 1990-2020, we empirically examine whether energy-related tax policies (ENT) are helpful to tackle the issue of energy-related greenhouse gas emissions (ENGHGs). Furthermore, we also investigate the role of digitalization (DIG) and financial risk (FINR) for its possible impact on ENGHGs. The advanced econometric techniques include diagnostic tests, Method of Moment Quantile Regression (MMQR), for robustness validation quantile regression, and finally Dumitrescu and Hurlin panel causality check. The findings reveal that ENT policies of selected economies are not helpful to limit ENGHGs in 25th and 50th quantiles effectively. Nevertheless, due to the progressive rise in ENT in the 75th and 90th quantiles, ENT significantly helps to smoothen the path towards a sustainable future. Furthermore, GDP increases, while improvement in FINR decreases ENGHGs. As the selected economies are developed and high-income, it is suggested that a progressive rise in ENT may further limit the issue of ENGHGs.

Economic and non-economic drivers of tourism: bidirectional causality of tourism and environment for South Asian economies

This study explores the relationship between economic growth, tourism, and the environment in South Asian economies. It finds that factors such as GDP, human capital, globalization, and financial risk are interconnected and have long-term associations in these countries. The study employs various methodologies and tests to analyze the data. The author employs novel panel methodologies such as the method of moment of quantile regression analysis, slope heterogeneity, cross-section dependence test, and Westerlund cointegration. Additionally, a causality test along with the latest unit-root test is used. The results reveal important findings. As GDP expands, its impact on international tourism diminishes at higher quantiles, suggesting a decreasing effect. However, GDP still contributes positively to tourism across all quantiles. Human capital has a stronger effect on attracting tourists at lower quantiles, while globalization has varying impacts depending on the level of globalization in a country. Financial risk has a greater negative impact on tourism in larger economies compared to smaller ones. The study also examines the relationship between CO2 emissions and the variables under investigation. It finds that the effect of GDP on emissions decreases at higher quantiles, indicating a smaller contribution. Human capital has a larger effect on reducing emissions at lower quantiles, while the impact of globalization is more significant at higher quantiles. Moreover, an increase in financial risk leads to a decrease in emissions, particularly at lower quantiles. Based on these findings, the study suggests policy recommendations for South Asian economies. These include promoting sustainable tourism practices, investing in human capital development, encouraging responsible globalization, mitigating financial risks, and aligning tourism strategies with sustainable development goals.

Natural Resources Depletion, Financial Risk, and Human Well-Being: What is the Role of Green Innovation and Economic Globalization?

Human well-being is the top priority of all nations in the twenty-first century. However, depletion of natural resources and financial risk can negatively impact human well-being, which in turn can make it difficult to realize human well-being. Also, green innovation and economic globalization may play a significant role in human well-being. In this context, this study assesses the impacts of natural resources, financial risk, green innovation, and economic globalization on human well-being in emerging countries from 1990 to 2018. The empirical results from the Common Correlated Effects Mean Group estimator unveiled that natural resources and financial risk negatively affect the human well-being of emerging nations. Furthermore, the results show that green innovation and economic globalization positively contribute to human well-being. These findings are also verified using alternative methods. In addition, natural resources, financial risk, and economic globalization Granger cause human well-being but not the other way round. Furthermore, bidirectional causality exists between green innovation and human well-being. Considering these novel findings, sustainable utilization of natural resources and controlling financial risk are necessary strategies for realizing human well-being. More resources should be allocated for green innovation, and government should encourage economic globalization to attain sustainable development in emerging countries.

Graphical Abstract

Analyzing the nexus between financial risk and economic risk in India: Evidence through the lens of wavelet coherence and non-parametric approaches

The gravest challenge for economic sustainability is the undetermined growth in the financial and economic risks of the nation, which need to be overcome with adequate measures without compromising economic growth. The uncertainty of economic factors produces fluctuations in the financial sector and makes them more vulnerable. However, the existing literature has not significantly focused on the economic and financial risk challenge for sustainable economic growth. Therefore, to fill the gap, an in-depth study is imperative to explore the association between these risks. To do so, this study incorporates both economic and financial risk to determine how risks are interconnected across time (frequency) and how they are linked by utilizing quarterly data from 1984-Q1 to 2020-Q4 and by applying both the "wavelet power spectrum (WPS)" and "wavelet coherence (WTC)" approaches, to examine the time-frequency dependency of each variable on the other. The findings of WTC revealed that the economic and financial risks have a positive dependency on each other in India at high, medium, and low frequencies. Likewise, the wavelet power spectrum outcomes reflect the high economic and financial risks vulnerability during 1991, 1992, and 1996. In addition, for the robustness check, the study employed both the "quantile regression (QR)" and "quantile-on-quantile regression (QQR)". Both the QQR and QR endorsed the positive association between FR and ER. Hence, our paper is the first research of its kind for the Indian economy, and it extends to the existing literature by examining the link between the two most significant indicators in terms of both time and frequency dependency. The findings in our paper offer excellent perspectives for investors and policymakers to assess prospects for investment and policy changes if necessary.

Environmental degradation, renewable energy, and economic growth nexus: Assessing the role of financial and political risks?

Sustainable development goal (SDG), which focuses on affordable and sustainable energy, provides a practical solution to realize sustainable growth. In addition, this target can encourage the realization of SDG 13 (climate action). However, factors like political and financial risk can impact climate actions and renewable energy. Therefore, this research extends the debate on the ecological footprint (EF) mitigation and achievement of SDGs by evaluating the renewable energy, political risk, financial risk, and EF nexus in an Environment Kuznets Curve (EKC) framework from 1986 to 2018. Panel data for the Association of Southeast Asian Nations (ASEAN) is estimated using second-generation approaches. The CuP-FM test results indicated that the EKC is present in ASEAN in the context of renewable energy, financial risk, and political risk. Furthermore, the findings revealed that controlling political and financial risks is a useful mitigation strategy because EF decreases as these risks are reduced. Notably, a decrease in EF has been linked to the use of renewable energy. These results are verified by using CO2 emissions as an alternative proxy for environmental degradation. Moreover, both financial and political risk Granger cause renewable energy and economic growth indicating that controlling financial and political risk is necessary for sustainable development.

Economic risk framing increases intention to vaccinate among Republican COVID-19 vaccine refusers

OBJECTIVE

To determine if framing communications about COVID-19 vaccines in economic terms can increase Republicans' likelihood to get vaccinated.

METHODS

We examined Twitter posts between January 2020 and September 2021 by Democratic and Republican politicians to determine how they framed the COVID-19 pandemic. Based on these posts, we carried out a survey study between September and November 2021 to examine whether motivations for COVID-19 vaccine uptake matched message frames that were widely used by these politicians. Finally, we conducted a randomized controlled experiment to examine how these frames (economic vs. health) affected intentions to vaccinate by vaccine refusers in both parties.

RESULTS

Republican politicians were more likely to frame the pandemic in economic terms, whereas Democrats predominantly used health frames. Accordingly, vaccinated Republicans' choices were more likely to be motivated by economic consideration (β = 0.25, p = 0.02) and personal financial rationales (β = 0.24, p = 0.03). Among vaccine refusers, Republicans exposed to messages using economic rationales to encourage vaccination reported higher vaccination intentions compared to those exposed to messages using public health rationales (F_1,119 = 4.16, p = 0.04).

CONCLUSION

Messages highlighting economic and personal financial risks could increase intentions to vaccinate for vaccine-hesitant Republicans.

PUBLIC HEALTH IMPLICATIONS

Agencies should invest in developing messages that are congruent with frames that are already widely used by co-partisans. Social media may be helpful in eliciting these frames.

Are private equity and venture capital helping small and medium-sized enterprises during the COVID-19 pandemic? Evidence from China

The rapid spread of COVID-19 worldwide since 2020 has, undeniably, negatively influenced the global economy and environment. Small and medium-sized enterprises (SMEs) are among the worst-hit victims of COVID-19, particularly in developing countries. As primary channels financing SMEs, what roles have private equity and venture capital (PE/VC) played in this crisis? Using the 2010-2021 data of 4462 listed companies, we aimed to assess the impact of PE/VC on financial risk among Chinese SMEs. We constructed a capital structure selection model to assess the risk preference of PE/VC and explored the roles of PE/VC in the financial risk management of enterprises during COVID-19. Based on both theory and empirical evidence, PE/VC negatively impacts the financial risk of enterprises, implying that intervention by the management of PE/VC can aggravate the financial risk. However, in reality, PE/VC positively impacted enterprise financial risk during COVID-19. Thus, the government should implement some easing policies to stimulate access and investment policies of PE/VC as well as provide more practical policies to support investment institutions in China and other counties.

The criticality of financial risk to environment sustainability in top carbon emitting countries

This research examines the linkage between financial risk and carbon emissions using a quarterly dataset spanning from 1991 to 2019 for top carbon emitting countries. To achieve the study objective, this study apply quantile-on-quantile regression (QQR), the quantile regression (QR) approach for robustness check, and the nonparametric predictive test that identifies causality in mean and variance. Empirical findings from the QQR technique disclose the following: (i) financial risk decreases carbon emissions in the USA, Russia, Germany, and Canada; (ii) in China, India, Japan, Brazil, and Indonesia, financial risk enhances carbon emissions (iii) while we find mixed reactions in the case of South Korea. The outcomes of the conventional quantile regression also confirm the QQR outcomes, while that of nonparametric causality discloses evidence of causality in majority of quantiles from financial risk to carbon emissions. Based on these empirical outcomes, policymakers in the financial risk-induced-environmental degradation regions should consider implementing policies or reforms that would keep financial systems sound, in order to prevent shocks to the environment, and its attendant multiplier impact on the environmental sustainability targets implemented to protect both the immediate and the future generations.

New nonparametric measures for instantaneous and granger-causality tail co-dependence

We propose a new methodology to asses risk spillovers in a time-series framework. Firstly, we introduce an explicit nonparametric measure of cross-sectional conditional tail co-movement, which is intuitively comparable to the Conditional Value-at-Risk (CoVaR). We show that nonlinear CoVaR (NCoVaR) is able to capture even highly nonlinear dependence structures. Secondly, for the purpose of potential contagion analysis, we adapt the measure to be informative about the causality direction between the variables in the Granger causality sense. By showing that the natural estimators of the two metrics are U-statistics, we construct formal nonparametric tests for independence and Granger non-causality. Numerical simulations confirm that in common situations the nonparametric tests have better size and power properties than their parametric counterparts. The methodology is illustrated empirically by assessing risk transmissions between sovereigns and banking sectors in the euro area, which observed highly irregular co-movements between asset prices after the global financial crisis. The new measures seem to be less susceptible to these irregularities than their parametric analogues, providing a clearer overview of the underlying sovereign-bank risk feedback loops.

Financial risk of emergency abdominal surgery: a cross sectional study from Ethiopia

Background

The Lancet Commission on Global Surgery suggested six indicators every country should use to measure their surgical systems. One of these indicators, catastrophic expenditure (CE), is defined as money paid for service which amounts to more than 10% of the patient’s total annual expenditure, or more than 40% of annual non-food household expenditure. Ethiopian Ministry of Health has set a target of 100% protection from CE by 2030. However, so far there is lack of studies that assess financial risk of surgery.

Methods

Using a cross sectional study design, financial risk assessment was carried out on 142 patients from Yekatit 12 and Zewditu Memorial hospitals in Addis Ababa, Ethiopia from May 15 to September 15, 2021.

Results

Appendectomy (69.0%), emergency laparotomy (26.1%) and cholecystectomy (4.9%) resulted in mean direct medical expenditures of 111.7USD, 200.70USD and 224.60USD, respectively. Medications and imaging accounted for 60.8 and 13.9% of total treatment cost. By applying the two definitions of catastrophic expenditure, 67.6 and 62.7% of patients sustained CE, respectively Overall rates of CE across procedures were 67.3 and 59.1% for appendectomy, 70.2 and 70.2% for laparotomy, 57.0 and 71.2% for cholecystectomy. Thirty-five (24.6%) patients had some form of insurance, with Community Based Health Insurance being the most common form (57%). Insured patients were less likely to sustain CE with both definitions (AOR 0.09, p = 0.002 and AOR 0.10, p = 0.006 respectively).

Conclusion and recommendations

Substantial proportion of patients undergoing emergency abdominal surgery sustain CE in Addis Ababa. Medications and imaging take major share of total cost mainly because patients have to acquire them from private set ups. Policy makers should work on availing medications and imaging in public hospitals as well as expand insurance and other forms of surgical care financing to protect patients from CE.

Financial distress prediction using integrated Z-score and multilayer perceptron neural networks

The COVID-19 pandemic led to a great deal of financial uncertainty in the stock market. An initial drop in March 2020 was followed by unexpected rapid growth over 2021. Therefore, financial risk forecasting continues to be a central issue in financial planning, dealing with new types of uncertainty. This paper presents a stock market forecasting model combining a multi-layer perceptron artificial neural network (MLP-ANN) with the traditional Altman Z-Score model. The contribution of the paper is presentation of a new hybrid enterprise crisis warning model combining Z-score and MLP-ANN models. The new hybrid default prediction model is demonstrated using Chinese data. The results of empirical analysis show that the average correct classification rate of thew hybrid neural network model (99.40%) is higher than that of the Altman Z-score model (86.54%) and of the pure neural network method (98.26%). Our model can provide early warning signals of a company's deteriorating financial situation to managers and other related personnel, investors and creditors, government regulators, financial institutions and analysts and others so that they can take timely measures to avoid losses.

Network based evidence of the financial impact of Covid-19 pandemic

How much the largest worldwide companies, belonging to different sectors of the economy, are suffering from the pandemic? Are economic relations among them changing? In this paper, we address such issues by analyzing the top 50 S&P companies by means of market and textual data. Our work proposes a network analysis model that combines such two types of information to highlight the connections among companies with the purpose of investigating the relationships before and during the pandemic crisis. In doing so, we leverage a large amount of textual data through the employment of a sentiment score which is coupled with standard market data. Our results show that the COVID-19 pandemic has largely affected the US productive system, however differently sector by sector and with more impact during the second wave compared to the first.

Technological innovation and renewable energy consumption: a middle path for trading off financial risk and carbon emissions

Global carbon dioxide emissions are on an upward trend, but there have been declines in carbon emissions during financial crises. The possible negative correlation between financial risks and carbon emissions will cause policy makers to face a dilemma when formulating carbon neutral policies. Therefore, it is crucial to find a middle path that can control financial risks while addressing carbon emission reduction, which can help achieve the dual goals of stable economic development and environmental protection. This empirical research studies the linear and non-linear relationships between financial risk and carbon emissions in Organization for Economic Cooperation and Development (OECD) countries, using a panel fixed effects model and a panel threshold regression model. The study further investigates the role of technological innovation and renewable energy consumption in the risk-emission relationship. Key results were as follows. First, the fixed effects model results verify that financial risk has a negative impact on carbon emissions. This relationship may be influenced by technological innovation and energy transition. Second, there is a significant single-threshold effect between financial risk and carbon emissions. When research and development (R&D) expenditures and renewable energy consumption exceed the threshold, there is a significant decrease in the contribution of financial stability to carbon emissions. Third, the slow growth of technological innovation in OECD countries compared to renewable energy consumption highlights that the potential of technological innovation for carbon reduction needs to be further explored. These empirical findings indicate that encouraging technological innovation and accelerating energy transitions would be productive new ways of thinking about the trade-off between controlling financial risk and carbon emission reduction.

Loss of financial well-being in the COVID-19 pandemic: Does job stability make a difference?

This article aims to assess the loss of financial well-being in the COVID-19 pandemic. The developed theoretical model identifies the impacts of the perception of financial risk and financial anxiety on financial well-being. It also seeks, through a comparative analysis, to assess whether public servants, due to their status of job stability in Brazil, are less likely to have the effects of the pandemic than private employees. A survey was carried out on 1222 Brazilians with structural equation modeling and multi-group invariance tests. The results indicate that lower financial well-being is influenced by the level of financial anxiety and financial risk. Public servants perceive fewer losses in financial well-being, anxiety and risks than other professions. In the pandemic context, where the risks of unemployment and loss of income are increased, job stability works like an insurance, allowing public servants greater financial security and then minor losses of financial well-being. Evidence indicates that in countries where a large percentage of workers have temporary or informal jobs, the challenge of reducing the financial impacts of the pandemic will be great. Interventions to alleviating anxiety and public policies of income transfer and reduction of unemployment are instruments to reduce the loss of financial well-being.

Corporate immunity to the COVID-19 pandemic

We evaluate the connection between corporate characteristics and the reaction of stock returns to COVID-19 cases using data on more than 6,700 firms across 61 economies. The pandemic-induced drop in stock returns was milder among firms with stronger pre-2020 finances (more cash and undrawn credit, less total and short-term debt, and larger profits), less exposure to COVID-19 through global supply chains and customer locations, more corporate social responsibility activities, and less entrenched executives. Furthermore, the stock returns of firms controlled by families (especially through direct holdings and with non-family managers), large corporations, and governments performed better, and those with greater ownership by hedge funds and other asset management companies performed worse. Stock markets positively price small amounts of managerial ownership but negatively price high levels of managerial ownership during the pandemic.

Inaccurate Value at Risk Estimations: Bad Modeling or Inappropriate Data?

Forecasting accurate Value-at-Risk (VaR) estimations is a crucial task in applied financial risk management. Even though there have been significant advances in the field of financial econometrics, many crises have been documented throughout the world in the last decades. An explanation for this discrepancy is that many contemporary models are too complex and cannot be easily understood and implemented in the financial industry (Fama in Financ Anal J 51:75-80, 1995; Ross in AIMR conference proceedings, vol. 1993, no. 6, pp. 11-15, Association for Investment Management and Research, 1993). In order to bridge this theory-practice gap, we present a computational method based on the leverage effect. This method allows us to focus on financial theory and remove complexity. Examining the US stock market (2000-2020), we provide empirical evidence that our newly suggested approach, which uses only the most appropriate observation period, significantly increases the accuracy of the Conventional Delta Normal VaR model and generates VaR estimations which are as accurate as those of advanced econometric models, such as GARCH(1,1).

Conceptualizing the use of the term financial risk by non-academics and academics using twitter messages and ScienceDirect paper abstracts

A text mining technique, based on an Application Programming Interface (API) request-using narrative data from Twitter™ and ScienceDirect™-was used to identify how non-academics and academics conceptualize and evaluate sentiment indicators associated with the term financial risk in their communications. It was determined that unlike the day-to-day uses of the term-all of which tend to focus predominately on the business and technology aspects of risk taking-the academic definition of the term is expressed broadly. It was also determined that the term was mainly associated with negative emotions in daily conversations, whereas the term tended to be used in a positive way in research paper abstracts. Results from this study suggest that the way financial risk is conceptualized and applied in real-life settings primarily represents negative emotional contexts, while academic papers tend to represent positive emotional contexts. Information presented in this paper can help educators, researchers, and policy makers better understand the way non-academics objectively and subjectively evaluate and describe financial risk. This information may help lead to better investor educational interventions and decision outcomes.

Early Report on the Impact of COVID-19 Outbreak in Neurosurgical Practice Among Members of the Latin American Federation of Neurosurgical Societies

BACKGROUND

The COVID-19 pandemic has caused severe economic consequences by local governmental measures to contain the outbreak. We provide insight on the impact that health care restriction has made on neurosurgical activity in Latin Iberoamerica.

METHODS

We performed an internet-based survey among presidents and members of the societies of the Latin American Federation of Neurosurgical Societies (FLANC). We blindly analyzed information regarding local conditions and their impact on neurosurgical praxis using SPSS software.

RESULTS

Information came from 21 countries. Sixteen society presidents reported having suspended regular activities and deferring local scheduled congresses, 14 reported mandatory isolation by government, and 4 instituted a telemedicine project. Four-hundred eighty-six colleagues, mean age 49 years, reported a mean 79% reduction in their neurosurgical praxis. Seventy-six percent of neurosurgeons have savings to self-support for 3-6 months if restrictions are long lasting.

CONCLUSIONS

Stopping activities among societies of the FLANC, together with a drop of 79% of neurosurgical praxis, adds to deficits in provider's protection equipment and increasing demand for attention in the health care systems, representing a huge financial risk to their sustainability. Neurosurgeons should be involved in local policies to protect health and economy. Telemedicine represents an excellent solution, avoiding another pandemic of severe diseases across all-specialties as nonessential care can turn essential if left untreated. Financial support and ethics code review is needed to battle this new disease, designated the occupational disease of the decade, that continues to scrag the health care system. Times of crisis are times of great opportunities for humanity to evolve.

Financial risk of seeking maternal and neonatal healthcare in southern Ethiopia: a cohort study of rural households

INTRODUCTION

Ethiopian households' out-of-pocket healthcare payments constitute one-third of the national healthcare budget and are higher than the global and low-income countries average, and even the global target. Such out-of-pocket payments pose severe financial risks, can be catastrophic, impoverishing, and one of the causal barriers for low utilisation of healthcare services in Ethiopia. This study aimed to assess the financial risk of seeking maternal and neonatal healthcare in southern Ethiopia.

METHODS

A population-based cohort study was conducted among 794 pregnant women, 784 postpartum women, and their 772 neonates from 794 households in rural kebeles of the Wonago district, southern Ethiopia. The financial risk was estimated using the incidence of catastrophic healthcare expenditure, impoverishment, and depth of poverty. Annual catastrophic healthcare expenditure was determined if out-of-pocket payments exceeding 10% of total household or 40% of non-food expenditure. Impoverishment was analysed based on total household expenditure and the international poverty line of ≈ $1.9 per capita per day.

RESULTS

Approximately 93% (735) of pregnant women, 31% (244) of postpartum women, and 48% (369) of their neonates experienced illness. However, only 56 households utilised healthcare services. The median total household expenditure was $527 per year (IQR = 390: 370,760). The median out-of-pocket healthcare payment was $46 per year (IQR = 46: 46, 92) with two episodes per household, and shared 19% of the household's budget. The poorer households paid more than did the richer for healthcare, during pregnancy-related and neonatal illness. However, the richer paid more than did the poorer during postpartum illness. Forty-six percent of households faced catastrophic healthcare expenditure at the threshold of 10% of total household expenditure, or 74% at a 40% non-food expenditure, and associated with neonatal illness (aRR: 2.56, 95%CI: 1.02, 6.44). Moreover, 92% of households were pushed further into extreme poverty and the poverty gap among households was 45 Ethiopian Birr per day. The average household size among study households was 4.7 persons per household.

CONCLUSIONS

This study demonstrated that health inequity in the household's budget share of total OOP healthcare payments in southern Ethiopia was high. Besides, utilisation of maternal and neonatal healthcare services is very low and seeking such healthcare poses a substantial financial risk during illness among rural households. Therefore, the issue of health inequity should be considered when setting priorities to address the lack of fairness in maternal and neonatal health.

Survey measures versus incentivized measures of risk preferences: Evidence from sex workers' risky sexual transactions

Survey measures of risk attitudes are primarily used in the health literature, although incentivized measures of risk preferences are being increasingly used in other fields. We exploit the unique setting of commercial female sex workers in Bangladesh to investigate whether incentivized measures of risk preferences, or non-incentivized survey measures of risk preferences, best identify the risky commercial sex decisions that they make. The study uses survey data collected during February-April 2016, and October-November 2016 from eight brothels in Bangladesh. Wave 1 includes 1,332 female sex workers, Wave 2 includes 1,185 female sex workers. Our findings suggest that researchers can reliably use survey measures to elicit risk preferences on health.

Within- and between-person variation in morning testosterone is associated with economic risk-related decisions in athletic women across the menstrual cycle

Literature suggests that women experience ovulatory shifts in risk-taking behaviours across different domains, which might be partly attributed to changes in testosterone (T). Thus, we investigated associations between menstrual variability in T concentrations and economic risk-related decisions among athletic women. Thirty-five women were monitored across three consecutive menstrual cycles. Testing occurred on day seven (D7), 14 (D14) and 21 (D21) following the onset of menses. The morning (7 to 8 am) assessment of salivary T (sal-T) and cortisol (sal-C) was followed by the economic Hawk-Dove game (11 am to 12 pm) played in pairs, where hawk decisions were used to index risk. Morning sal-T concentration increased from D7 to D14, before decreasing on D21 (p < 0.001), representing moderate effect size (ES) changes of 0.6 to 0.8. Morning sal-C did not vary over time. Hawk choices paralleled the sal-T results, being elevated on D14 (p < 0.001) with large ES changes of 1.8. Regression analyses revealed that morning sal-T concentration was positively related (p ≤ 0.01) to the number of hawks chosen between- (beta = 0.47) and within-participants (beta = 0.10) when controlling for training hours and menstrual day. In summary, the risk-related choices of athletic women during a dyadic contest covaried with morning sal-T concentrations across the menstrual cycle. Both outcomes were positively correlated on a within- and between-person level. Confirming the major sources of T variation across the menstrual cycle, whilst discerning its relationship with other risk-related behaviours, would be worthwhile avenues for research.

The impact of subsidized private health insurance and health facility upgrades on healthcare utilization and spending in rural Nigeria

This paper analyzes the quantitative impact of an intervention that provides subsidized low-cost private health insurance together with health facility upgrades in Nigeria. The evaluation, which measures impact on healthcare utilization and spending, is based on a quasi-experimental design and utilizes three population-based household surveys over a 4-year period. After 4 years, the intervention increased healthcare use by 25.2 percentage points in the treatment area overall and by 17.7 percentage points among the insured. Utilization of modern healthcare facilities increased after 4 years by 20.4 percentage points in the treatment area and by 18.4 percentage points among the insured due to the intervention. After 2 years of program implementation, the intervention reduced healthcare spending by 51% compared with baseline, while after 4 years, spending resumed to pre-intervention levels.

Financial risk of increasing the follow-up period of breast cancer treatment currently covered by the Social Protection System in Health in México

Background

The objective of this work is to estimate the financial impact of increasing the monitoring period for breast cancer, which is financed by the Sistema de Protección Social en Salud (SPSS—Social Protection System in Health).

Methods

A micro-simulation model was developed to monitor a cohort of patients with breast cancer, and also an estimation was made on the probability of surviving the monitoring period financed by the SPSS. Using the Monte Carlo simulation, the maximum expected cost was estimated to broaden such monitoring. Morbimortality information of the Ministry of Health and cases of breast cancer treated by the SPSS were used.

Results

Between 2013 and 2026, the financial resources to provide monitoring during 10 years to women diagnosed with breast cancer would reach up to $3607.40 million pesos on a base scenario, $4151.79 million pesos on the pessimistic scenario and $3414.85 million pesos on an optimistic scenario. In the base scenario, additional expenditure represents an annual increase of 9.1% of resources allocated to treating this disease, and 3.0% of the availability of the resources for the Fondo de Protección contra Gastos Catastróficos (FPGC—Fund for Protection against Catastrophic Expenditure).

Conclusions

Increasing monitoring for patients with breast cancer would not represent a financial risk to the sustainability of the FPGC, and could increase patients survival and life quality.

The influence of mortality and socioeconomic status on risk and delayed rewards: a replication with British participants

Here, we report three attempts to replicate a finding from an influential psychological study (Griskevicius et al., 2011b). The original study found interactions between childhood SES and experimental mortality-priming condition in predicting risk acceptance and delay discounting outcomes. The original study used US student samples. We used British university students (replication 1) and British online samples (replications 2 and 3) with a modified version of the original priming material, which was tailored to make it more credible to a British audience. We did not replicate the interaction between childhood SES and mortality-priming condition in any of our three experiments. The only consistent trend of note was an interaction between sex and priming condition for delay discounting. We note that psychological priming effects are considered fragile and often fail to replicate. Our failure to replicate the original finding could be due to demographic differences in study participants, alterations made to the prime, or other study limitations. However, it is also possible that the previously reported interaction is not a robust or generalizable finding.

Assessing Risk in Graphically Presented Financial Series

It has been argued that traders use their natural sensitivity to the fractal properties of price graphs to assess risk and that they are better able to do this when given price change as well as price level information. This approach implies that risk assessments should be higher when the Hurst exponents are lower, that this relationship should be stronger in the presence of price change information and that risk assessment should depend more strongly on the Hurst exponent than on the standard deviation of the series. Participants in Experiment 1 decided which of two assets was riskier by inspecting graphs of their price series. Graphs with lower Hurst exponents were selected only by those who were less emotionally stable and hence more sensitive to risk. However, when both price series and price change series were presented, the assets with lower Hurst exponents were selected by all participants. In a second experiment, participants were given both price level and price change series for a number of assets and rated the risk of trading in each one. Ratings depended more strongly on Hurst exponents than on other measures of volatility. They also depended on indicators of potential loss. Human risk assessment deviates from the way that risk is measured in modern finance theory: it requires integration of information relevant to both uncertainty and loss aversion, thereby imposing high attentional demands on traders. These demands may impair risk assessment but they can be eased by adding displays of price change information.