Bruce Hollingsworth

• PhD
• Lancaster University

Background There is sparse evidence on the joint effects of ill-health, health shocks and social protection on the intensive margin of labour supply, particularly in developing countries. We interact ill-health and health shocks with access to social protection and estimate their joint effects on weekly hours of work. Methods We employ a zero-infl...

Despite the benefits of long-acting reversible contraceptives (LARCs), they are not being utilized in Zimbabwe as much as the short-acting reversible contraceptives (SARCs). The aim of the study was to explore factors associated with LARC usage among Zimbabwean adolescent girls and young women, using data from the 2015 Zimbabwe Demographic and Heal...

Despite voluntary medical male circumcision (VMMC) being a cost-effective intervention for preventing HIV transmission, its scale-up has faced challenges. Several interventions to address these challenges in priority countries, including Uganda, have not yielded the desired results. This cross-sectional qualitative study aimed to explore the factor...

Objectives The aim of this scoping review was to identify and provide an overview of the impact of sexual and reproductive health (SRH) interventions on reproductive health outcomes among young people in sub-Saharan Africa. Methods Searches were carried out in five data bases. The databases were searched using variations and combinations of the fo...

Background Several studies have explored the effects of ill health and health shocks on labour supply. However, there are very few systematic reviews and meta-analyses in this area. The current work aims to fill this gap by undertaking a systematic review and meta-analysis on the effects of ill health and health shocks on labour supply. Methods We...

Childhood obesity is one of the most concerning public health issues globally and its implications in mortality and morbidity in adulthood are increasingly important. This study uses a unique dataset of Australian children aged 4–16 to examine the impact of parental smoking on childhood obesity. It confirms a significant link between parental smoki...

Diabetes mellitus is a chronic and complex disease, increasing in prevalence and consequent health expenditure. Cost-effectiveness models with long time horizons are commonly used to perform economic evaluations of diabetes’ treatments. As such, prediction accuracy and structural uncertainty are important features in cost-effectiveness models of ch...

Background Unplanned critical care admissions following in-hospital deterioration in children are expected to impose a significant burden for carers across a number of dimensions. One dimension relates to the financial and economic impact associated with the admission, from both direct out-of-pocket expenditures, as well as indirect costs, reflecti...

Background The African continent has the highest burden of HIV and AIDS, with its response to HIV and AIDS largely donor supported. However, in the face of declining donor support, alternative ways to sustainably support HIV and AIDS responses in Africa are paramount. This systematic review explores the willingness to pay (WTP) for HIV services in...

Background Electronic early warning systems have been used in adults for many years to prevent critical deterioration events (CDEs). However, implementation of similar technologies for monitoring children across the entire hospital poses additional challenges. While the concept of such technologies is promising, their cost-effectiveness is not esta...

Background: Wide differences in health exist between places in the UK, underscored by economic inequalities. Preston, an economically disadvantaged city in England, implemented a new approach to economic development, known as the Community Wealth Building programme. Public and non-profit organisations modified their procurement policies to support...

Despite a growing literature about the mental health effects of COVID-19, less is known about the psychological costs of providing informal care during the pandemic. We examined longitudinal data from the UK's Understanding Society Survey, including eight COVID surveys, to estimate fixed effects difference-in-differences models combined with matchi...

Background The relationship between health and labour has received considerable attention. There have been several studies exploring the link between health shocks and labour supply. However, there are only few systematic reviews and meta-analyses in this area. The current work aims to fill the gap by undertaking a systematic review and meta-analys...

Background: While Africa is the continent most affected by HIV and AIDS, its response to HIV and AIDS remains largely donor supported. However, in the face of declining donor support, alternative ways to sustainably support HIV and AIDS responses in Africa are paramount. This systematic review explores the willingness to pay (WTP) for HIV services...

Background Urinary incontinence affects around half of stroke survivors in the acute phase, and it often presents as a new problem after stroke or, if pre-existing, worsens significantly, adding to the disability and helplessness caused by neurological deficits. New management programmes after stroke are needed to address urinary incontinence early...

This paper investigates the impact of introducing universal free formal personal care on informal caregiving behaviour in Scotland – in particular, we explore the extent to which free formal care might crowd out the supply of informal care. We estimate, in a difference-in-differences framework, that such a reform would: reduce the probability of co...

The use of planning policy to manage and create a healthy food environment has become a popular policy tool for local governments in England. To date there has been no evaluation of their short-term impact on the built environment. We assess if planning guidance restricting new fast food outlets within 400 m of a secondary school, influences the fo...

Background and purpose Neighbourhood exposure to takeaway (‘fast’-) food outlets selling different cuisines may be differentially associated with diet, obesity and related disease, and contributing to population health inequalities. However research studies have not disaggregated takeaways by cuisine type. This is partly due to the substantial reso...

This is a supplementary material for the article entitled "Measuring universal health coverage based on an index of effective coverage of health services in 204 countries and territories, 1990–2019"

Improving health outcomes of rural populations in low- and middle-income countries represents a significant challenge. A key part of this is ensuring access to health services and protecting households from financial risk caused by unaffordable medical care. In 2003, China introduced a heavily subsidised voluntary social health insurance programme...

Background Achieving universal health coverage (UHC) involves all people receiving the health services they need, of high quality, without experiencing financial hardship. Making progress towards UHC is a policy priority for both countries and global institutions, as highlighted by the agenda of the UN Sustainable Development Goals (SDGs) and WHO's...

Background: The study aimed to evaluate the validity and spatial accuracy of the Food Standards Agency Food Hygiene Rating online data through a field audit. Methods: A field audit was conducted in five Lower Layer Super Output Areas (LSOAs) in the North East of England. LSOAs were purposively selected from the top and bottom quintiles of the In...

Background Relatives caring for people with severe mental health problems find information and emotional support hard to access. Online support for self-management offers a potential solution. Objective The objective was to determine the clinical effectiveness and cost-effectiveness of an online supported self-management tool for relatives: the Re...

Background: The Relatives Education And Coping Toolkit (REACT) is an online supported self-management toolkit for relatives of people with psychosis or bipolar designed to improve access to NICE recommended information and emotional support. Aims: Our aim was to determine clinical and cost-effectiveness of REACT including a Resource Directory (R...

Background: Active monitoring of hospitalised adults, using handheld electronic physiological surveillance systems, is associated with reduced in-patient mortality in the UK. Potential also exists to improve the recognition and response to deterioration in hospitalised children. However, the clinical effectiveness, the clinical utility, and the co...

Many people drink more than the recommended level of alcohol, with some drinking substantially more. There is evidence that suggests that this leads to large health and social costs, and price is often proposed as a tool for reducing consumption. This paper uses quantile regression methods to estimate the differential price (and income) elasticitie...

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the safety, effectiveness and cost of incentive-based and non-incentive-based interventions for increasing blood donation. We are particularly interested in the following comparisons: Monetary versus non-monetary incentives. Monetary incentives versus...

In the U.S. military, chlamydia is the mostly commonly diagnosed bacterial sexually transmitted infection and the rates of pelvic inflammatory disease (PID) have remained high since the early 2000s. The relationship between the number of chlamydia diagnoses and risk of PID was investigated in a retrospective cohort analysis among chlamydia cases in...

Background Historically, sexually transmitted infections have affected the health of the U.S. military. To determine whether gonorrhea, bacterial vaginosis, genital herpes, and trichomoniasis are predictors of repeat chlamydia diagnoses among U.S. Army women, medical data reported into the Defense Medical Surveillance System during the 2006–2012 pe...

Lois Thomas, Christine Roffe, Joanne Booth, Christopher Chapple, Caroline Watkins, Brenda Roe, Christopher Sutton, Bruce Hollingsworth, Céu Mateus, David Britt, Cliff Panton and Kina Bennett; for the MRC Continence Programme and R&D Stroke and Incontinence Study

Background: HIV/AIDS has led to increased mortality and morbidity, negatively impacting adult labour especially in HIV/AIDS burdened Sub-Saharan Africa. There has been some exploration of the effects of HIV/AIDS on paid child labour, but little empirical work on children's non-paid child work. This paper provides quantitative evidence of how child...

Little information is known on the rate of repeat gonorrhea infection among U.S. military personnel. We analyzed all gonorrhea cases reported to the Defense Medical Surveillance System during 2006–2012 to determine the rate of repeat infection. During the seven-year study period, 17,602 active duty U.S. Army personnel with a first incident gonorrhe...

Systematic differences in the ways that people use and interpret response categories (differential item functioning, DIF) can introduce bias when using self-assessments to compare health or quality of life across heterogeneous groups. This paper reports on an exploratory analysis involving the use of anchoring vignettes to identify DIF in a commonl...

Introduction: Bacterial vaginosis (BV) is a common vaginal condition in women of reproductive age, which has been associated with Chlamydia trachomatis and Neisseria gonorrhoeae among commercial sex workers and women attending sexually transmitted infection clinics. Pathogen-specific associations between BV and other sexually transmitted infection...

Bacterial vaginosis (BV) is a common vaginal disorder in women of reproductive age. Since the initial work of Leopoldo in 1953 and Gardner and Dukes in 1955, researchers have not been able to identify the causative etiologic agent of BV. There is increasing evidence, however, that BV occurs when Lactobacillus spp., the predominant species in health...

This paper discusses two types of response-scale heterogeneity, which may impact upon the EQ-5D. Response-scale heterogeneity in reporting occurs when individuals systematically differ in their use of response scales when responding to self-assessments. This type of heterogeneity is widely observed in relation to other self-assessed measures but is...

Self-assessed measures of health using Likert-type scales are widely used to assess the health and well-being of populations, and are a feature of household surveys throughout the world. However, the self-reported and subjective nature of these measures means that different people will inherently respond in different ways - a concept known as repor...

We explore the existence of short- and long-term effects of retirement on health. Short-term effects are estimated with a regression discontinuity design which is robust to weak instruments and where the underlying assumptions of continuity of potential outcomes are uncontroversial. To identify the long-term effects we propose a parametric model wh...

This paper focuses on the self-reported responses given to survey questions of the form "Overall, how would you rate your health?" with typical response items being on a scale ranging from poor to excellent. Usually, the overwhelming majority of responses fall in either the middle category or the one immediately to the "right" of this (for example,...

This Lancet commentary aims at explaining some of the nuances behind such estimates and suggests some constructive ways going forward.

Relapse Prevention interventions for Bipolar Disorder are effective but implementation in routine clinical services is poor. Web based approaches offer a way to offer easily accessible access to evidence based interventions at low cost, and have been shown to be effective for other mood disorders. This protocol describes the development and feasibi...

Governments are routinely involved in the biosecurity of agricultural and food imports and exports. This involves controlling the complex ongoing threat of the broad range of zoonoses: endemic, exotic and newly emerging. Policy-related decision-making in these areas requires accurate information and predictions concerning the effects and potential...

Improving the productivity of the healthcare system, for example by taking advantage of scale economies or encouraging substitution of expensive specialist personnel with less expensive workers, is often seen as an attractive way to meet increasing demand within a constrained budget. Using data on 558 dentists participating in the Longitudinal Stud...

Understanding the socioeconomic gradient in physical inactivity is essential for effective health promotion. This paper exploits data on over one million individuals (1,002,216 people aged 16 and over) in England drawn from the Active People Survey (2004–11). We identify the separate associations between a variety of measures of physical inactivity...

This paper investigates the impact of sugar-sweetened beverages (SSB) taxes on consumption, bodyweight and tax burden for low-income, middle-income and high-income groups using an Almost Ideal Demand System and 2011 Household level scanner data. A significant contribution of our paper is that we compare two types of SSB taxes recently advocated by...

We extend the discrete data latent class literature by explicitly defining a latent variable for class membership as a function of both observables and unobservables, thereby allowing the equations defining the class membership and observed outcomes to be correlated. The procedure is then applied to modelling observed obesity outcomes, based upon a...

Papua New Guinea (PNG) faces enormous health challenges and information concerning how to allocate limited health resources efficiently is lacking. This article finds that geographical location is important in achieving higher efficiency scores. In addition, it compares efficiency scores against a range of quality indicators. The results demonstrat...

To quantify the association between complementary and alternative medicine (CAM) use and quality of life in a population with type 2 diabetes and/or cardiovascular disease, accounting for demographics, socioeconomic status, health and lifestyle factors. Data are from a purpose-designed survey of 2915 individuals aged 18 years and over, all with typ...

We estimate the effect on light, moderate and heavy consumers of alcohol from implementing a minimum unit price for alcohol (MUP) compared with a uniform volumetric tax. We analyse scanner data from a panel survey of demographically representative households (n = 885) collected over a one-year period (24 Jan 2010-22 Jan 2011) in the state of Victor...

This article discusses alternative means for measuring efficiency. The foundations of efficiency measurement are built upon in terms of the measurement of 'technical' and 'allocative' efficiency using the two main techniques available: 'data envelopment analysis' and 'stochastic frontier analysis'. The basis of these comes from work in economics pu...

Background: India currently has more than 60 million people with Type 2 Diabetes Mellitus (T2DM) and this is predicted to increase by nearly two-thirds by 2030. While management of those with T2DM is important, preventing or delaying the onset of the disease, especially in those individuals at 'high risk' of developing T2DM, is urgently needed, pa...

This paper analyses the productive efficiency of 141 public hospitals from 1998 to 2004 in two Canadian provinces; one a small province with a few small cities and a generally more rural population and the other a large province that is more urban in nature, with a population who mainly live in large cities. The relative efficiencies of the hospita...

This paper studies short-run cyclical behaviour of public (government and social) and private health expenditure and GDP using both time series and panel data techniques. First, national time series data have been used within a multivariate Beveridge-Nelson decomposition framework to construct the permanent and cyclical components. The correlation...

Using a 29-year (1978–2006) panel of provincial-level data from China, this article investigates the role of health capital in a human capital model of economic output. Robust evidence is found through panel cointegration analysis that health capital has a significant and positive effect on the Gross Regional Product in China; the effect being stro...

Smoking and obesity are two leading causes of preventable death. Further understanding of the relationship between these two risk factors can assist in reducing avoidable morbidity and mortality. This study investigates the empirical association between obesity and the propensity to smoke and to quit smoking, using a Seemingly Unrelated (SUR) probi...

Aim: To describe the key drivers and costs to individuals of complementary and alternative medicine (CAM) use in a population with type 2 diabetes and/or cardiovascular disease. Methods: Two datasets were utilized. The first derived from a purpose-designed survey of individuals in Australia, all with type 2 diabetes and/or cardiovascular disease (...

Objective: To report on two-year cardiovascular (CV) event rates and quantify the cost of cardiovascular disease using the Australian Reduction of Atherothrombosis for Continued Health (REACH) registry. Methods: Prospective registry of 2873 patients with multiple risk factors (MRF), coronary artery disease (CAD), cerebrovascular disease (CerVD)...

Smoking bans in public places are considered an important public health intervention. The impact of such bans on health, and especially self-reported health, has not been widely considered in the literature. This paper investigates the impact of a public smoking ban on self-reported health status in Great Britain. We find that there are benefits fo...

This is the protocol for a review and there is no abstract. The objectives are as follows: To assess the safety, effectiveness and cost of incentive-based and non-incentive-based interventions for increasing blood donation. We are particularly interested in the following comparisons: Monetary versus non-monetary incentives. Monetary incentives vers...

Abstract Social support in addition to antiretroviral therapy (ART) has been indicated to be beneficial to person living with HIV/AIDS (PLWHA) and their families, but very few ART service providers go beyond ART. This study investigates whether receipt of social support in addition to ART for PLWHA makes the households that they reside in better of...

In the current climate of burgeoning healthcare costs, pharmacoeconomics is becoming increasingly important, but knowledge about pharmacoeconomic methods is limited among most clinicians. This review provides an introduction to, and overview of, common methods used in pharmacoeconomic modelling: decision analysis, Markov modeling, discounting and u...

Objective: To investigate the influence of employment and work hours on weight gain and weight loss among middle-aged women. Design: Quantile regression techniques were used to estimate the influence of employment and hours worked on percentage weight change over 2 years across the entire distribution of weight change in a cohort of middle-aged...

Discrete variables that have an inherent sense of ordering across outcomes are commonly found in large datasets available to many economists, and are often the focus of research. However, assumptions underlying the standard Ordered Probit (which is usually used to analyse such variables) are not always justied by the data. This study provides a rev...

The objective of this study was to investigate the drivers of complementary and alternative medicine (CAM) use in the general population in Australia and to identify key policy implications. The National Health Survey 2007/2008, a representative survey of the Australian population, provides information on CAM use (practitioners and products) in the...

This paper discusses ways forward in terms of making efficiency measurement in the area of health care more useful. Options are discussed in terms of the potential introduction of guidelines for the undertaking of studies in this area, in order to make them more useful to policy makers and those involved in service delivery. The process of introduc...

In a multi-phase mixed method interdisciplinary study known as CAMELOT, we explored why people under treatment for type 2 diabetes and/or cardiovascular disease also presented to and used complementary or alternative medicine (CAM) practitioners or therapies in order to establish the relationship with adherence to their prescribed treatment. The pr...

This article explores the potential effects of retirement on mental health and health care utilisation isolating sources of potential heterogeneity in treatment effect. To estimate the effects of retirement, we devise a new identifying strategy that combines kink and regression discontinuity designs with panel data methods. Our method is then appli...

This research proposes that, in cases where threshold covariates are either unavailable or difficult to observe, practitioners should treat these characteristics as latent, and use simulated maximum likelihood techniques to control for them. Two econometric frameworks for doing so in a more flexible manner are proposed. The finite sample performanc...

Many Australians manage their health through the combined use of conventional medicine and complementary and alternative medicine, with substantial direct and indirect costs to government and consumers. Our interest was in the varied health practices of people with type 2 diabetes and cardiovascular disease, which are among the most prevalent chron...

The increased availability of panel data has made it possible to estimate and measure health dynamics for population subgroups who may have systematically different levels of dynamics. We use a straightforward hypothetical example to investigate the implications of different levels of health dynamics on health outcomes, considering in addition the...

Although few cardiovascular registries report the costs of illness or cost-effectiveness of health interventions, such information is critical to inform the effective and cost-effective management of cardiovascular disease, particularly if drawn from population-based registries, which more accurately reflect clinical practice and follow up patients...

Aims: To describe aspirin use in primary and secondary prevention and to determine the incremental costs-effectiveness ratio (ICER) per life year gain (LYG) of aspirin use among subjects with, or at high risk of atherothrombotic disease. Design and subjects: To project the cost-effectiveness of aspirin over 5 years of follow-up, a Markov state t...

To investigate the influence of employment patterns on weight gain and weight loss in young adult women. Study sample is 5164 participants in the Australian Longitudinal Study on Women's Health who completed surveys in 2003 and 2006. Logistic regression was used to estimate odds ratios of weight change. The adjusted odds of gaining weight, compared...

Coronary heart disease (CHD) and depression are leading causes of disease burden globally and the two often co-exist. Depression is common after Myocardial Infarction (MI) and it has been estimated that 15-35% of patients experience depressive symptoms. Co-morbid depression can impair health related quality of life (HRQOL), decrease medication adhe...

We estimate assimilation of immigrants’ body mass index (BMI) to the host population of Australia over one generation, conducting separate analyses for immigrants from 7 regions of Europe and Asia. We use quantile regressions to allow for differing impact of generational status across 19 quantiles of BMI from under-weight to morbidly obese individu...

Background: Complementary and alternative medicine (CAM) is an increasingly popular form of health care. It encompasses the use of CAM practitioners as well as many other therapies. Out-of-pocket expenditure on CAM in the United States is over $3 billion per year. However, the relationship between the use of conventional medicine and CAM by individ...

Cardiovascular disease (CVD) remains a leading cause of death across the world and poses a significant economic burden. Research regarding per-person use and cost of cardiovascular pharmaceuticals in Australia, as well as potential predictors of pharmaceutical costs in populations using the 'bottom up' costing approach, is limited. Previous studies...