How resource limitations and household economics may compromise efforts to safeguard children during outbreaks

Abstract

Background: Epidemiological models have been employed with great success to explore the efficacy of alternative strategies at combating disease outbreaks. These models have often incorporated an understanding of age-based susceptibility and severity of outcome, considering how to limit the adverse outcomes or disease burden relative to an age structure. Such models frequently recommend the preferential treatment/vaccination of children or the elderly, demonstrating how prevention of serious disease within these etiological subgroups can provide both protection within the subgroup itself and indirect protection to the broader population. However, it is most frequently the case that these target populations are consumers, rather than providers, of household resources. In areas of the globe where continued health of household members relies on continued provision of resources, these models may fail to provide the most effective overall strategies for health outcomes in both target populations and overall. This is particularly important for tropical diseases impacting rural and low-income areas in which the disease may be endemic or newly emergent, particularly in the wake of natural disasters. Methods: We propose a modified epidemiological model with targeted treatment in resource-limited populations. We evaluate the model over a broad parameter space. Results: This model demonstrates how economic limitations may shift the optimal strategy. It may be advantageous to treat populations at lesser direct risk if they are responsible for providing secondary protection to higher-risk population(s) by producing household resources. Evaluation of this model over the parameter space reveals that, in some cases, targeting treatment towards consumers may result in greater numbers of consumer infections. Conclusions: Our results demonstrate how household resource limitation can drastically affect the impact of targeted treatment strategies for limiting epidemics. Depending on the economic circumstances, it is possible that focusing treatment on consumers such as children can produce a counter-intuitive outcome in which more children contract the disease.

Association Between Family Context and Sleep Trajectory in Middle-Aged and Elderly Chinese Adults

“…Socio-economic status has become increasingly heterogeneous following the country's reform; household economic level and family health may be closely related. 9 In China, middle-aged and elderly have experienced tremendous social changes over the past decades, which might play a mediating effect on their lifestyle and bring about health challenges. 10 Since 2000, children's education has become the major socio-economic burden faced by Chinese families, and an association between the number of children and their gender with parents' sleep quality was observed.…”