Hasil untuk "Insurance"

Zongxia Liang, Jiayu Zhang, Zhou Zhou et al.

This paper develops a dynamic insurance market model comprising two competing insurance companies and a continuum of insureds, and examines the interaction between strategic underreporting by the insureds and competitive pricing between the insurance companies under a Bonus-Malus System (BMS) framework. For the first time in an oligopolistic setting, we establish the existence and uniqueness of the insureds' optimal reporting barrier, as well as its continuous dependence on the BMS premiums. For the 2-class BMS case, we prove the existence of Nash equilibrium premium strategies and conduct an extensive sensitivity analysis on the impact of the model parameters on the equilibrium premiums.

Guillaume Bernis, Cristina Di Girolami, Simone Scotti

This paper investigates the form of optimal reinsurance contracts in the case of clusters of losses. The underlying insured risk is represented by a marked Hawkes process, where the intensity of the jumps depends not only on the occurrence of previous jumps but also on the size of the jumps, which represents the financial magnitude of the loss. The reinsurance contracts are applied to each loss at the time of occurrence, but their structure is assumed to be constant. We derive closed-form formulas within the meanvariance framework. Additionally, we demonstrate that the optimal contract is not the classical excess-loss (deductible) form. The optimal contract is piecewise linear with three ranges: first, no reinsurance below a certain threshold; second, reinsurance with a slope greater than 1; and finally, full reinsurance. When the marked process converges to a Poisson process, we recover the optimality of the deductible form.

Mark-Oliver Wolf

The Solvency Capital Requirement (SCR) calculation is computationally intensive, relying on the market-consistent estimation of own funds. While Solvency II prioritizes the direct valuation method, it theoretically yields the same value as the indirect method. This paper evaluates their practical performance within a risk-neutral pricing framework. First, we present a simplified proof that direct and indirect estimators converge to the same value. For $T$ being the number of time steps in the simulation, we then introduce a novel family of $2^T$ mixed estimators including both methods as edge cases, integrating them into a control variate framework for significant variance reduction. This framework is further extended to incorporate market frictions for real-world applicability. Evaluating these estimators on three life insurance asset-liability management models demonstrates that their performance is fundamentally driven by the degree of asset-liability coupling. While stronger coupling in realistic settings consistently favors the indirect method, neither baseline estimator is universally superior. Furthermore, this coupling directly impacts the success of our proposed control variates. They can dramatically reduce variance to one-tenth of the standard direct estimator, but their efficacy remains model-dependent. The source code is publicly available on https://gitlab.cc-asp.fraunhofer.de/itwm-fm-lv-public/wolf-estimation-of-own-funds.

Maryna V. Kovbatiuk, Ivanna I. Strilok, Viktoriya V. Shklyar et al.

Modern realities indicate that improving the efficiency of management processes is impossible without the use of information and software that should be integrated into the management system. Therefore, the article explores the importance of this integration in the context of globalized markets, emphasizing its role in increasing competitiveness, introducing innovations and making operational and strategic decisions. It is noted that the main advantages of integration are: increased management efficiency through automation of routine tasks, increased control over own operations; improved coordination between departments through the use of a single database, simplification of information exchange and promotion of more effective cooperation; informed decision-making through access to real-time data; reduction of costs for personnel, paper and other resources; gaining competitive advantages in such areas as marketing, sales, production and logistics. It is emphasized that the information support of international enterprises has moved to a new level, where information has not only become an information resource, but also performs important functions in management. By using advanced analytics and business intelligence tools, international companies can gain strategic insights for further development, identify market trends, and make informed operational decisions that meet their current and global goals. The existing unified software of the leading ERP-systems vendors that can be used in the management of an enterprise, in particular, an international company, is analyzed. Given that the changing conditions of enterprise functioning require an individual approach and the creation of a custom-made product, a comparative characterization of unified and individual software products is carried out. An example of individual software products that take into account the specifics of certain enterprises is the software developed with the participation of the authors for enterprises in the water transport and insurance industries. With a view to optimizing the process of using information and software in the management of an international enterprise, the authors propose an appropriate mechanism. For its successful implementation, it is necessary to take into account that the integration of information technology is a complex process that requires careful planning and implementation, in particular, the factor of financing and staff training. As modern international businesses continue to evolve and adapt to change, the use of information and software is becoming a critical success factor. High-tech management solutions allow companies to respond effectively to global market challenges and remain competitive in an ever-changing business environment.

Hye Yoon Park, Jaesub Park, Daeyoung Roh et al.

ABSTRACT Background Despite growing interest in home‐based transcranial direct current stimulation (tDCS) as a scalable treatment for depression, real‐world evidence regarding its effectiveness, cognitive impact, and safety remains limited. Moreover, the optimal stimulation duration for home‐based tDCS has not been clearly established. This study aimed to compare the clinical effects of two home‐based tDCS protocols—one with 3 weeks of active stimulation followed by 3 weeks of sham stimulation (3WA) and another with 6 weeks of active stimulation (6WA)—in patients with major depressive disorder (MDD). Methods In this randomized controlled trial, participants diagnosed with MDD were assigned to either the 3WA or 6WA group. Depressive symptoms were measured using the Beck Depression Inventory‐II (BDI) and the Montgomery–Åsberg Depression Rating Scale (MADRS). Cognitive function was assessed with the Digit Symbol Substitution Test (DSST). Adverse events were systematically monitored, and the relationship between psychotropic medication use and adverse event frequency was analyzed using logistic regression. Results Both groups showed significant improvements in depressive symptoms and cognitive performance across four assessment points (baseline, Weeks 3, 6, and 12). Linear mixed‐effects models revealed a significant main effect of time for both BDI (F = 33.67, p < 0.001) and MADRS scores (F = 34.50, p < 0.001), with no significant group‐by‐time interaction, indicating comparable efficacy between protocols. Model‐derived mean changes from baseline to Week 12 were −7.53 (95% CI −9.85 to −5.21) for BDI and −6.61 (95% CI −8.73 to −4.49) for MADRS. DSST scores also improved significantly over time (F = 55.8, p < 0.001), with a mean increase of +6.62 points (95% CI +5.17 to +8.05), again showing no significant group difference. Regarding safety, non‐medicated participants reported fewer adverse events, whereas those taking tianeptine experienced significantly more side effects compared with other medication groups. Conclusions Both 3‐week and 6‐week active tDCS protocols were associated with improvements in depressive symptoms and cognitive function over time in this naturalistic clinical context; however, as the study did not include a sham control, these changes should be interpreted as comparative rather than causal effects. The 3‐ and 6‐week protocols demonstrated similar therapeutic outcomes, suggesting that shorter courses may be sufficient. These findings support the real‐world applicability of at‐home tDCS and highlight the need to consider concurrent pharmacotherapy when evaluating tolerability and safety. Trial Registration ClinicalTrials.gov identifier: NCT05539131

Katsuyuki Konnai, Hiroyuki Fujiwara, Masakazu Kitagawa et al.

Abstract Background In April 2020, insurance coverage for risk-reducing salpingo-oophorectomy (RRSO) for breast cancer patients with hereditary breast and ovarian cancer (HBOC) syndrome and BRCA testing were started in Japan. We investigated the impact of insurance coverage on the number of RRSO and BRCA tests performed. Methods The subjects were 370 breast cancer patients and 23 of their relatives who received genetic counseling at our institution between April 2014 and December 2021. Finally, 349 patients and 15 relatives were analyzed. We retrospectively compared the number of BRCA tests, RRSO, insurance status, and co-payment of medical expenses before and after insurance coverage based on medical records. Results In the 6-year pre-coverage period, 226 patients (mean: 37/year) received genetic counseling and 106 (17/year) received BRCA testing. In the 21-month post-coverage period, 161 patients (92/year) received genetic counseling and 127 (72/year) received BRCA testing. The rate of testing/counseling significantly increased in the post-coverage period (46.9% vs. 78.8%; p < .001). The number of patients who were diagnosed with HBOC were 24 (4/year) and 18 (10/year) and RRSO was performed for 7 (1/year) and 11 (6/year) patients in the pre- and post-coverage periods, respectively. The rate of RRSO/HBOC was significantly increased in the post-coverage period (29.1% vs. 61.1%; p = 0.039). RRSO patients' co-payment rates decreased from 64% to 25% pre- and post-coverage. Conclusions Our findings suggest that decreased co-payments were the primary reason for these increases. Insurance coverage is an important factor when promoting preventive medical services such as RRSO.

Sushila Paudel, Aliza K C Bhandari, Stuart Gilmour et al.

Abstract Background The COVID-19 pandemic has highlighted the need for global unity and timely access to healthcare for all including multilingual and intercultural societies. This study aimed to identify barriers to healthcare access due to the COVID-19 crisis among Nepalese migrants in Japan and explore ways to counter these barriers, both in routine and crisis situations. Methods This study used an exploratory sequential mixed-methods study design. The researchers conducted 11 focus group discussions including 89 participants and an online survey involving 937 respondents. The integration of focus group discussions and logistic regression analysis from the survey was reported via a ‘joint display’. Results Twenty-six themes on barriers to and six on facilitators of healthcare accessibility were identified by the focus group discussions among which 17 barriers like lack of knowledge of health insurance, language barriers, lack of hotline services, unawareness of available services, fear of discrimination etc. had significant association in our logistic regression analysis after adjusting for all confounders. Similarly, the only facilitator that had a significant impact, according to the multivariable logistic regression analysis, was receiving health information from Nepali healthcare professionals (OR = 1.36, 95% CI = (1.01 – 1.82), p-value < 0.05). Conclusion The study suggests the need for a crisis information hub which could be coordinated by the Nepal embassy or concerned authorities, flexible policies for active deployment of Nepalese health workers and volunteers, accessible hotlines in the Nepali language, and incorporation of Nepali telehealth services in Japan.

Ruth Donkoh, Wing On Lee, Ahotovi Thomas Ahoto et al.

To ensure inclusive, equitable quality education, and encourage educational opportunities for lifelong learning worldwide; the United Nations set sustainable development goals (SDG) to achieve quality education. Thus, using SDG 4 quality education and system theory, this research seeks to identify the effects of educational management on quality education in rural and urban primary schools in Ghana. Moreover, the mediating role of internet facilities in educational management and quality education relationhsip has been discussed. Thus, 745 urban and 471 rural head teachers and teachers from Ghana participated in an online survey. The data was compiled and executed by structural equation model using SPSS-AMOS. The result reveals that educational management has a positive effect on quality education in urban and rural schools. In addition, urban schools have more quality education than rural schools. Although internet facilities have a positive effect on quality education their absence weakens the quality of education in urban and rural schools. Moreover, it is recommended that the Ministry of Education should arrange professional training for supervisors and head teachers to boost their monitoring and supervision strategies. Furthermore, Parents Teacher Associations can provide funding to support the monitoring and supervision activities to achieve success. Lastly, quality internet facilities should be built with limited charges in rural and urban schools.

Murat Belke, Mohsin Shabir, Özcan Işık

This study aims at determining the causal link between financial performance and premium production of non-life insurance companies. The relation between the financial performance and premium production is explored employing data from the 2011-2019 period for eight Turkish non-life insurance companies. In the first stage of the analysis, a hybrid model including LOPCOW, SWARA II, and MARCOS methods is proposed to determine companies’ financial performance values. In this stage, a novel integrated weighting method for calculating criterion weights is applied based on objective information and judgements of decision-makers. In the second stage, the association between financial performance and premium production is investigated by correlation analysis. In the last stage, the causality linkage between the two variables is estimated using a panel causality test developed by Dumitrescu and Hurlin (2012). According to the results obtained from the panel causality test, the bidirectional causality relation exists between financial performance and premium production. Besides, the individual panel causality results reveal that bidirectional causality is valid for only Allianz and Anadolu insurance companies, which had an average share of over 35% in total non-life premium production during the analysis period. The paper provides fresh evidence on the association between the financial performance and premium production, particularly from the Turkish context.

Rasoul Jamshidi, Mohammad Ebrahim Sadeghi

Purpose: In addition to playing an important role in creating economic security and investment development, insurance companies also invest. The country's insurance industry as one of the country's financial institutions has a special place in the investment process and special attention to appropriate investment policies in the field of insurance industry is essential. So that the efficiency of this industry in allocating the existing budget stimulates other economic sectors. This study seeks to model investment in the performance of dynamic networks of insurance companies. Methodology: In this paper, a new investment model is designed to examine the dynamic network performance of insurance companies in Iran. The designed model is implemented using GAMS software and the outputs of the model are analyzed based on regression method. The required information has been collected based on the statistics of insurance companies in Iran between 1393 and 1398. Findings: After evaluating these units, out of 15 companies evaluated, 6 companies had unit performance and were introduced as efficient companies. The average efficiency of insurance companies is 0.78 and the standard deviation is 0.2. The results show that the increase in the value of investments is due to the large reduction in costs and in terms of capital and net profit of companies is a large number that has a clear and strong potential for insurance companies. Originality/Value: In this paper, investment modeling is performed to examine the performance of dynamic networks of insurance companies in Iran.

Mengist Dessie A, Fenta Feleke S, Getaye Workie S et al.

Anteneh Mengist Dessie,1 Sefineh Fenta Feleke,2 Sewnet Getaye Workie,3 Tiruayehu Getinet Abebe,1 Yonas Mossu Chanie,4 Anteneh Kassa Yalew5 1Department of Public Health, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia; 2Department of Public Health, College of Health Science, Woldia University, Woldia, Ethiopia; 3Department of Public Health, College of Medicine and Health Science, Debre Berhan University, Debre Berhan, Ethiopia; 4Yigem Health Center, Menz Mama Worda, North Shoa, Ethiopia; 5Department of Public Health, College of Medicine and Health Science, Wolkite University, Wolkite, EthiopiaCorrespondence: Anteneh Mengist Dessie, Email anteneh150@gmail.comBackground: Skin disease affects people of all ages, yet children are one of the most common victims of it. Although some data indicate a high prevalence of skin disorders among Ethiopian primary schoolchildren, little is known regarding it, particularly in the study area. Hence, the study aimed to investigate the prevalence of skin disease and its associated factors among primary schoolchildren in Debre Berhan town, North Shoa, Ethiopia.Methods: Institutional-based cross-sectional study was conducted. The samples were chosen using a multistage stratified random sampling technique. Data were collected using both a self-administered and an interviewer-administered questionnaire. Children were clinically examined to detect and record the dermatological findings. A potassium hydroxide test was used to confirm some doubtful cases. The data were entered in Epi Info version 3.5.1 and analyzed using SPSS version 20.0. Variables with a p-value < 0.05 were designated as having statistical significance.Results: The overall point prevalence of any skin disease was 61.2% (95% CI: 56.4– 66.1). In a multivariable logistic regression model, a significant association between skin diseases and the occupation of the father being a farmer (AOR: 4.21, 95% CI: 1.06– 16.63), bad personal hygiene (AOR: 1.78, 95% CI: 1.03– 4.38), previous history of skin disease (AOR: 2.74, 95% CI: 1.41– 5.30), exchange of clothes and towels with other family members (AOR: 1.50, 95% CI: 1.09– 2.85), presence of trauma in the last one month (AOR: 2.09, 95% CI: 1.18– 3.72) and not being a member of health insurance (AOR: 1.95, 95% CI: 1.16– 3.28) has been found.Conclusion: The point prevalence of any skin disorder is alarmingly high. The commonest disorders found in this study were simple and could usually be cured easily. Hence, preventive and curative health services should be provided for these schoolchildren to achieve a considerable reduction in the prevalence of skin disorders.Keywords: Debre Berhan town, Ethiopia, prevalence, primary schoolchildren, skin disease

Tobias Fissler, Michael Merz, Mario V. Wüthrich

A main difficulty in actuarial claim size modeling is that there is no simple off-the-shelf distribution that simultaneously provides a good distributional model for the main body and the tail of the data. In particular, covariates may have different effects for small and for large claim sizes. To cope with this problem, we introduce a deep composite regression model whose splicing point is given in terms of a quantile of the conditional claim size distribution rather than a constant. To facilitate M-estimation for such models, we introduce and characterize the class of strictly consistent scoring functions for the triplet consisting a quantile, as well as the lower and upper expected shortfall beyond that quantile. In a second step, this elicitability result is applied to fit deep neural network regression models. We demonstrate the applicability of our approach and its superiority over classical approaches on a real accident insurance data set.

Robert Matthijs Verschuren

Bonus-Malus Systems traditionally consider a customer's number of claims irrespective of their sizes, even though these components are dependent in practice. We propose a novel joint experience rating approach based on latent Markovian risk profiles to allow for a positive or negative individual frequency-severity dependence. The latent profiles evolve over time in a Hidden Markov Model to capture updates in a customer's claims experience, making claim counts and sizes conditionally independent. We show that the resulting risk premia lead to a dynamic, claims experience-weighted mixture of standard credibility premia. The proposed approach is applied to a Dutch automobile insurance portfolio and identifies customer risk profiles with distinctive claiming behavior. These profiles, in turn, enable us to better distinguish between customer risks.

John Dagpunar

In this paper I extend the work of Bernhardt and Donnelly (2019) dealing with modern explicit tontines, as a way of providing income under a specified bequest motive, from a defined contribution pension pot. A key feature of the present paper is that it relaxes the assumption of fixed proportions invested in tontine and bequest accounts. In making the bequest proportion an additional control function I obtain, hitherto unavailable, closed-form solutions for the fractional consumption rate, wealth, bequest amount, and bequest proportion under a constant relative risk averse utility. I show that the optimal bequest proportion is the product of the optimum fractional consumption rate and an exponentiated bequest parameter. I show that under certain circumstances, such as a very high bequest motive, a life-cycle utility maximisation strategy will necessitate negative mortality credits analogous to a member paying life insurance premiums. Typical scenarios are explored using UK Office of National Statistics life tables.

Benjamin Avanzi, Hayden Lau, Bernard Wong

We consider the general class of spectrally positive Lévy risk processes, which are appropriate for businesses with continuous expenses and lump sum gains whose timing and sizes are stochastic. Motivated by the fact that dividends cannot be paid at any time in real life, we study $\textit{periodic}$ dividend strategies whereby dividend decisions are made according to a separate arrival process. In this paper, we investigate the impact of fixed transaction costs on the optimal periodic dividend strategy, and show that a periodic $(b_u,b_l)$ strategy is optimal when decision times arrive according to an independent Poisson process. Such a strategy leads to lump sum dividends that bring the surplus back to $b_l$ as long as it is no less than $b_u$ at a dividend decision time. The expected present value of dividends (net of transaction costs) is provided explicitly with the help of scale functions. Results are illustrated.

Gąsiorkiewicz Lech

The significance of insurance activity is constantly growing, generating new problems and posing new challenges. One of these challenges is meeting the growing requirements and expectations of customers. This requires the efficient management of insurance companies, which means the necessity to resort to modern management concepts, particularly the concept of process management and its related instruments. The article presents the results of research carried out at the Faculty of Management of the Warsaw University of Technology regarding process management in insurance companies. The distinctness of insurance activity and its financial management is discussed and its following aspects presented: the identification of insurance activity processes encompassing the management of basic and auxiliary processes; the model of the financial management process of insurance companies; the relationship between the financial management process and other processes implemented in insurance companies; financial situation assessment measures for insurance companies, and the financial management process.

Chih-Hsiang Chang, Chee-Jen Chang, Yi-Chun Wang et al.

Objectives: Hip fractures mostly require surgical treatment and are associated with increased health-care costs and mortality rates. Patients with cirrhosis have low bone marrow density and inferior immune status which contribute to a higher fracture rate and higher surgical complication rate. This population-based study evaluated the prevalence, complication, and mortality rates due to hip fractures in cirrhotic patients. Methods: Taiwan National Health Insurance Research Database data were used. The study group included 117,129 patients with hip fractures diagnosed from 2004 to 2010, including 4048 patients with cirrhosis. The overall prevalence, morbidity, and mortality rates of the cirrhosis group with hip fractures were compared with the rates of a general group with hip fractures. Results: The cirrhosis group patients were younger than the general group patients (71.2 vs. 73.96 years, p < 0.001). The annual incidence of hip fractures in the cirrhosis and general groups was 46–54 and 7–7.5 per 10,000 person-years, respectively, with an incidence rate ratio of 6.95 (95% confidence interval 6.74–7.18). The rates of infection, urinary tract infection, and peptic ulcer disease were higher in the cirrhosis group (3.46% vs. 1.91%, 9.56% vs. 9.11%, and 8.05% vs. 3.55%, respectively; all p < 0.001). The mortality rate after hip fracture was also higher in the cirrhosis group than in the general group (within 3 months: 8.76–12.64% vs. 4.96–5.30% and within 1 year: 29.72–37.99% vs. 12.84–14.57%). Conclusion : Cirrhotic patients with hip fractures were relatively younger; had a seven times higher annual hip fracture incidence; had higher complication rates of infection, urinary tract infection, and peptic ulcer disease; and had two to three times higher a mortality rate at 3 months and 1 year. Clinicians should pay particular attention to the possibility of osteoporosis and hip fractures in patients with liver cirrhosis. Level of Evidence: Level III, case–control study

Thomas Bernhardt, Catherine Donnelly

We introduce a new pension product that offers retirees the opportunity for a lifelong income and a bequest for their estate. Based on a tontine mechanism, the product divides pension savings between a tontine account and a bequest account. The tontine account is given up to a tontine pool upon death while the bequest account value is paid to the retiree's estate. The values of these two accounts are continuously re-balanced to the same proportion, which is the key feature of our new product. Our main research question about the new product is what proportion of pension savings should a retiree allocate to the tontine account. Under a power utility function, we show that more risk averse retirees allocate a fairly stable proportion of their pension savings to the tontine account, regardless of the strength of their bequest motive. The proportion declines as the retiree becomes less risk averse for a while. However, for the least risk averse retirees, a high proportion of their pension savings is optimally allocated to the tontine account. This surprising result is explained by the least risk averse retirees seeking the potentially high value of the bequest account at very old ages.

Anjali Kumar, Dana Cernigliaro, Mary E. Northridge et al.

Abstract Background Interest in aqueous silver diamine fluoride (SDF) has been growing as a treatment for caries arrest. A cross-sectional study was conducted to identify factors associated with caregiver acceptance of SDF treatment for children presenting with caries at 8 Federally Qualified Health Centers. The study purpose was to examine associations between caregiver acceptance of SDF treatment for children with caries and (1) sociodemographic and acculturation characteristics of caregivers and (2) clinical assessments of the children by dentists. Methods A caregiver survey collected information on: sociodemographic characteristics; acculturation characteristics, measured using the validated Short Acculturation Scale for Hispanics (SASH); perceived benefits and barriers of SDF treatment, including caregiver comfort; and perceived health-related knowledge. Chart reviews were conducted to assess: the medical / dental insurance of pediatric patients; cumulative caries experience, measured using decayed, missing, filled teeth total scores (dmft / DMFT); whether operating room treatment was needed; and a record of caregiver acceptance of SDF treatment (the outcome measure). Standard logistic regression models were developed for caregiver acceptance of SDF treatment for their children as the binary outcome of interest (yes / no) to calculate unadjusted odds ratios (OR) and adjusted ORs for covariates of interest. Results Overall, 434 of 546 caregivers (79.5%) accepted SDF treatment for their children. A U-shaped relationship between caregiver odds of accepting SDF treatment and age group of pediatric patients was present, where caregivers were most likely to accept SDF treatment for their children who were either < 6 years or 9–14 years, and least likely to accept SDF treatment for children 6 to < 9 years. The relationship between acculturation and caregiver acceptance of SDF treatment depended upon whether or not caregivers were born in the United States: greater acculturation was associated with caregiver acceptance of SDF treatment among caregivers born in this country, and lower acculturation was associated with caregiver acceptance of SDF treatment among caregivers born elsewhere. Conclusions Caregiver acceptance of SDF treatment is high; child’s age and caregiver comfort are associated with acceptance. Providers need to communicate the risks and benefits of evidence-based dental treatments to increasingly diverse caregiver and patient populations.

Sweta Bhoopatiraju

Jesuit universities often espouse a goal of care for the entire person’s mind, body, and spirit. However, some Jesuit institutions contradict this goal, since they do not currently provide contraceptives and birth control prescriptions for pregnancy prevention, and some do not provide contraceptive educational resources for students. Despite the merits of some arguments that requiring Jesuit universities to provide on-campus contraception violates religious freedom, Jesuit universities should provide on-campus contraception. The high rates of unintended pregnancies in college-aged students, women’s generally positive perceptions of contraception, the need to combat discrimination against women, and women’s rights as detailed by international treatises all necessitate such a decision. Even though Jesuit universities’ health insurance plans abide by the Patient Protection and Affordable Care Act’s (PPACA’s) Contraceptive Mandate, which requires employers and health insurers to cover contraceptive costs within insurance plans, some universities’ policies prevent students from reaping the plan’s benefits on campus. These policies can be better understood through the example of Saint Louis University’s (SLU) on-campus contraception policies, since SLU is a Jesuit university. For example, SLU’s Student Health Center claims to abide by “Jesuit Catholic beliefs regarding family planning” and does not provide contraceptives or prescription medication for pregnancy prevention. If a student wishes to receive birth control for pregnancy prevention, the person must obtain it off-campus. Even if a student is interested in obtaining birth control off-campus, however, the person often cannot receive on-campus education on proper birth control use or options. For example, the SLU Wellness Initiative is prohibited from providing information about contraception. By denying students on-campus access to contraceptive services, Jesuit universities deny students full bodily autonomy and restrict their ability to act upon decisions they feel will enhance their bodily and mental health, both of which are central to core Jesuit principles. Unintended pregnancies are prevalent in college-aged women, constituting 58.5% of all pregnancies for women aged 20-24. College-aged women also have the highest rates of abortions (Henshaw 1998). However, as access to contraceptives increased in recent years, unintended pregnancy rates declined, implying that increased contraceptive usage may play a role in successfully preventing pregnancies. One study concluded that to decrease the abortion rate, access to contraception should be promoted (Henshaw 1998). The Catholic background of Jesuit universities sanctifies the life of the unborn and condemns abortion. Pope Francis, leader of the Catholic Church, stated that birth control, when compared to abortions, is “the lesser of two evils” and “not an absolute evil.” If Jesuit universities seek to lower the abortion rate in their student populations, they should make contraception and more accessible to students. Apart from easily accessible birth control, education on birth control is fundamental for effective use and lower unintended pregnancy and abortion rates. One study showed that 65% of unplanned pregnancies occurred when contraception was used. Reasons for this included contraception misuse or failure to withdraw (Bajos, Leridon, Goulard, Oustry, & Job-Spira 2003). If university programs that are effective in their outreach, like the SLU Wellness Initiative, provide education on birth control, then students might become aware of resources available to them so that they can make informed decisions about their bodies, curbing abortion rates. Like all universities, Jesuit universities have an obligation to serve the interests of their students and provide for their well-being. Women, who university contraception policy disproportionately affects, generally share positive attitudes about contraception. Women feel that bodily and reproductive control are important to some degree and should be available to women. This sentiment may explain why women report more benefits of condom use and costs of unprotected sex than vice versa (Parsons, Halkitis, Bimbi, & Borkowski 2000). Also, students at universities whose college health centers provide emergency contraceptive pills (ECPs) praised these services and expressed gratitude to the clinical staff, noting the convenience and inexpensiveness of the on-campus services. Though it is true that sexually active female students are less likely to use contraception if they are religious, many religious college-aged women still feel that reproductive control is important to some degree and should be available to women. Among religious female students, 48% chose abortions as a solution to an unwanted pregnancy (Notzer, Levran, Mashiach, & Soffer 1984). Thus, allowing access to birth control will allow Jesuit universities to better serve their students. Even though Jesuit universities’ Catholic principles and ideals focus on serving the most vulnerable and marginalized communities, some on-campus contraception policies discriminate disproportionately against women and even more harshly against vulnerable groups of women, including those with disabilities. Women with invisible and/or visible disabilities face difficulties when seeking contraceptive care and report a lack of access to health information. This lack of access can impact these women’s ability to obtain appropriate birth control, especially since they live in a culture that questions their sexuality, as well as their capacity and desire for sexual activity (Kaplan 2006). Additionally, people with disabilities face barriers, physical and otherwise, that make receiving contraception and information at farther off locations inconvenient. On-campus contraception, however, might make contraception more accessible and convenient for students. This policy would be less discriminatory towards students with disabilities. By not providing contraception on campus, universities also discriminate against women of lower socioeconomic status, many of whom are women are color. These women have a higher risk than others of contraceptive misuse and nonuse, since they are less likely to have received proper education of birth control options and methods and are less likely to have afforded and used contraception previously. They are also more likely to receive abortions. Increasing access to and promoting long-acting reversible contraceptives, however, have been effective in lowering fertility and abortion rates among young women of low socioeconomic status (Forrest 1994). The women involved in programs promoting contraceptive use expressed a higher level of well-being, noting improved ability to continue and complete their education and obtain jobs without having to care for children (Forrest 1994). If Jesuit universities wish to achieve their ideals and combat systemic disadvantages women of color and low socioeconomic status face in both higher education and the job market, they must provide resources like birth control and birth control education so that these women can reap the value of their education and better control their futures. Providing contraceptives and contraceptive education also protects the religious freedoms of students who may not identify with the Christian faith. Jesuit universities are often diverse communities of people from different religious and nonreligious backgrounds. Preventing easy access to birth control and appropriate education permits the more powerful administration to force its religious views onto less powerful students and deny them useful services they might have otherwise utilized. To truly embrace and serve their diverse student body, universities must protect the religious freedoms of its less powerful students and allow them to act according to their own beliefs in choosing to use or not use contraception (Corbin & Smith 2013). It does not suffice that some students seeking to obtain contraception have the means to obtain it off-campus and have costs covered by insurance. Denying service to someone based on that person’s identity is humiliating, frustrating, and dehumanizing, all of which are characterizations of discrimination (Lim & Melling 2014). The remedy for this sort of injustice, then, is recognition rather than redistribution. In the context of Jesuit universities’ contraception policy, women are discriminated against. Refusal to provide contraception and educational resources through campus directives can be humiliating to the lifestyle choices of women, whose sexual and reproductive health needs have historically been neglected. Instead of denying services on-campus and simply providing birth control elsewhere (a policy that stigmatizes a woman’s choice to use contraceptives by limiting its accessibility), universities must recognize the dignity in a woman’s choice to control her body and offer contraceptives on-campus. In considering the rights of vulnerable groups, it is also important to consider the conclusions of revered international organizations like the United Nations. The United Nations’ Convention on the Elimination of All Forms of Discrimination Against Women of 1979 and the United Nations’ International Conference on Population and Development of 1994 both responded to historical and systemic discrimination against women globally (Shalev 2000). They identified women’s rights as human rights and stressed the importance of rights to easy access to contraception, access to health care and education, and rights to liberty and foundation of families (Cook 1993). The refusal of some universities to not provide on-campus contraceptives for pregnancy prevention limits contraception accessibility and prohibits preventative family planning measures and contraceptive education, which are central to the United Nations’ conclusions. Thus, the historical and systemic discrimination against women is perpetuated through some Jesuit universities’ refusal to provide on-campus contraception. Additionally, while it is true that Jesuit universities’ missions and goals are grounded in and shaped by Jesuit principles and ideals, the institutions do not function primarily as a space for people to express their religion through community, as is done in houses of worship like churches and mosques. The university consists of students and staff from diverse religious (or nonreligious) backgrounds, and SLU’s main purpose is to provide students with an education in exchange for their money. Thus, Jesuit universities arguably function more like corporations than houses of worship, and their religious freedom is not violated under the Religious Freedom and Restoration Act (RFRA), a federal law that protects interests in religious freedom. This is because only individuals can have substantial burden of religious conscience (Corbin & Smith 2013). This interpretation is supported by the Supreme Court, which has repeatedly ruled that First Amendment rights of corporations differ from those of humans. For example, even though the Supreme Court ruled in Citizens United v. FEC that the Free Speech Clause protects corporate speech, it did so to affirm people’s right to hear all points of view regardless of source—not because corporations have a First Amendment-protected right to speak (Corbin & Smith 2013). Also, corporations and owners are separate legal entities, as ruled in Cedric Kushner Promotions, Ltd. v. King (Corbin & Smith 2013). This implies that the Catholic founders of Jesuit universities and the university itself are different legal entities, and that because of this, its founders cannot speak on behalf of the institution. The university’s rights are not the founders’ or administration’s rights. Thus, because universities function less like houses of worship and more like corporations, which cannot experience substantial burden of religious conscience, accessibility to on-campus contraception does not violate religious freedom protected by the RFRA. Requiring on-campus accessibility to contraceptives and contraceptive education is necessary for Jesuit universities to ensure that all students are treated fairly and that their needs are attended to. While it is true that some Catholic beliefs clash with modern mainstream feminism, values like serving the most vulnerable populations and working towards the greater good, seem to connect well with feminism. As the Catholic Church slowly embraces increasingly modern interpretations of Catholic theology, Jesuit schools must reevaluate their commitments and policies and understand that the manifestation of the Jesuit goal of care for the entire person can be different for everyone. Bibliography Bajos, Nathalie, Henri Leridon, Helene Goulard, Pascale Oustry, Nadine Job-Spira. “Contraception: from accessibility to efficiency,” Human Reproduction 18, no. 5 (May 2003): 994-999 https://doi.org/10.1093. Cook, Rebecca. “International Human Rights and Women's Reproductive Health,” Studies in Family Planning 24, no. 2 (1993): 73-86. https://doi.org:10.2307/2939201. Corbin, Caroline Mala and Steven D. Smith. “Debate: The Contraception Mandate and Religious Freedom,” University of Pennsylvania Law Review Online 161, no. 261 (2013). Forrest, Jacqueline Darroch. “Epidemiology of unintended pregnancy and contraceptive use,” American Journal of Obstetrics & Gynecology 170, no. 5 (1994): 1485-9. https://doi.org/10.1016/S0002-9378(12)91804-9. Henshaw, Stanley K. “Unintended Pregnancy in the United States,” Family Planning Perspectives 30, no. 1 (1998): 24-29. Kaplan, Clair. “Special Issues in Contraception: Caring for Women with Disabilities,” Journal of Midwifery & Women’s Health 51, no. 6 (2006): 450-456. Lim, Marvin and Louise Melling. “Inconvenience or Indignity Religious Exemptions to Public Accommodations Laws,” Journal of Law and Policy 22, no. 2 (2014): 705-726. Miller, Laura. “Emergency Contraceptive Pill (ECP) Use and Experiences at College Health Centers in the Mid- Atlantic United States: Changes Since ECP Went Over-the-Counter,” Journal of American College Health 59, no. 8 (2001): 683-689. Notzer, Notzer, David Levran, Shlomo Mashiach, Sarah Sqffer. “Effect of religiosity on sex attitudes, experience and contraception among university students,” Journal of Sex and Marital Therapy 10, no. 1 (2008): 57-62. https://doi.org/10.1080/00926238408405790. Parsons, Jeffrey, Perry Halkitis, David Bimbi, Thomas Borkowski. “Perceptions of the benefits and costs associated with condom use and unprotected sex among late adolescent college students,” Journal of Adolescence 23, no. 4 (2000): 377-391. Shalev, Carmel. “Rights to Sexual and Reproductive Health: The ICPD and the Convention on the Elimination of All Forms of Discrimination against Women,” Health and Human Rights 4, no. 2 (2000): 38-66. https://doi.org/10.2307/4065196.