We evaluated whether Nurse-Family Partnership might serve as a cost-effective social policy for improving health. Using data from studies of randomized controlled trials as well as real-world data, we conducted a Monte Carlo simulation to estimate cost-effectiveness of Nurse-Family Partnership in a hypothetical cohort of first-born children in the United States. Analyses were conducted in 2015. Were all new mothers eligible for Nurse-Family Partnership, the program would produce 0.11 QALYs (95% confidence interval [CI]=0.06, 0.17) at an additional cost of $1,021 (95% CI=-$2,831, $4,414) per nurse-visited child's lifetime relative to the comparison-group children or $14,642 (95% CI = Savings, $71,877) per QALY gained. However, if applied to high-risk mothers, it would generate 0.19 QALYs (95% CI = 0.09, 0.44) and a net benefit of $2,764 (95% CI =-$1,210, $7,092) per nurse-visited child. Nurse-Family Partnership should be considered as a policy investment, particularly in an era of investments in the social determinants of health.

Background: The rising prevalence of depression in China, coupled with a tightening job market, highlights concern for the workforce’s mental health. Although socioeconomic inequalities in depression have been well documented in high-income countries, the association between socioeconomic status (SES) and depression, along with its work-related mediators, has not been sufficiently studied in China.Methods: The study participants are 6,536 non-agriculturally employed working adults from the 2020 China Family Panel Studies (CFPS). We build linear regression models to examine the relationship between SES and depression, using education and income as indicators of SES. We also apply a framework based on seemingly unrelated estimation (SUEST) to assess how job conditions, which include job demands and job resources, mediate this relationship.Results: Both education and income are negatively associated with depression, with education’s association with depression remaining net of income. Mediation analysis reveals that the well-educated tend to occupy less demanding work with shorter working hours and lower probability of on-call duty, which partially helps explain the education-based depression gap. Higher earners experience more demanding work with longer working hours and higher probability of on-call duty, which potentially masks the income-based depression gap. Greater job resources including moderate schedule flexibility and better job security, appear to contribute to explaining the depression gap across SES.Limitation: The cross-sectional design of this study precludes causal inferences. Not all typical job demands and resources could be included due to data limitations.Conclusion: Our study provides insights into socioeconomic inequalities in mental health in the Chinese working population, with implications for policies aimed at preventing depression and improving mental health equity.

Urbanization is believed to result in a transition towards energy-dense diets, sedentary lifestyles, and a subsequent increase in the burden of hypertension (HTN) and other cardiovascular diseases (CVDs) in developing countries. However, the extent to which this occurs is likely dependent on social contexts. We performed multilevel logistic regression models to examine whether the association between incident HTN and the degree to which a community exhibits urban features varied by region (the Northeast, East Coast, Central, and West) within China and period. We used longitudinal data from the China Health and Nutrition Survey (1991–2015) and stratified analyses by sex. Among women, the positive association between medium-to-high urbanicity and HTN onset generally shifted to negative between 1991 and 2015. The high urbanicity was associated with lower odds of developing HTN in the East Coast from the early 1990s. The negative association between high urbanicity and HTN occurrence became statistically significant during 1991–2015 in the Northeastern and Central Regions, while the association remained positive and non-significant in the West. Among men, the relationship between urbanicity and incident HTN was generally non-significant, except for the East Coast in which the negative association between high urbanicity and HTN occurrence became statistically-significant in more recent years. Our findings suggest that, when a subnational region or the society as a whole has become more economically developed, higher urbanicity might turn out to be a protective factor of cardiovascular health. Moreover, improvements made to communities’ urban features might be more effective in preventing HTN for women than for men.