International Journal of Finance & Managerial Accounting

International Journal of Finance & Managerial Accounting

Sustainability-Driven Financial Stability: Empirical Insights from the Iranian Listed Manufacturing Companies

Document Type : Original Article

Authors
1 Department of Accounting Jo. C., Islamic Azad University, Joybar, Iran.
2 Department of Planning & Management, Tarbiat Modares University, Tehran, Iran.
10.22034/ijfma.2025.77720.2135
Abstract
Sustainability performance has gained considerable attention in recent years as corporations increasingly highlight their environmental, social, and economic (ESE) achievements to demonstrate their dedication to sustainable practices. However, the impact of such performance on corporate financial performance remains a topic of debate, especially in emerging economies. This study examines the link between ESE sustainability practices and financial stability among manufacturing companies listed on the Tehran Stock Exchange from 2015 to 2022. Using Global Reporting Initiative (GRI) indicators, a dataset from 130 listed manufacturing companies was analyzed through multivariate regression. Fi-nancial stability, represented by the possibility of bankruptcy, is measured using the Z-Score index. Results show that sustainability performance, encompassing environmental, social, and economic aspects, significantly mitigates bank-ruptcy risk and enhances financial stability. These findings support the importance of sustainability performance for investors, encourage management to prioritize sustainability, and guide regulatory bodies and stock exchanges in im-proving sustainability disclosures and practices.
Keywords

1.       Akrout, M.M., Ben Othman, H., 2016. Environmental disclosure and stock market liquidity: evidence from Arab MENA emerging markets. Appl. Econ. 48 (20), 1840-1851. Doi: 10.1080/00036846.2015.1109041
2.       Al-Banna, H., Jannah, S., 2023. What drives Muslim investors to be Sri? The role of religiosity. Interdisciplinary J. Manag. Stud17 (1), 147-168. http://doi.org/10.22059/ijms.2023.349029.675396
3.       Allen, A.M., Peloza, J., 2015. Someone to watch over me: The integration of privacy and corporate social responsibility. Bus Horiz 58 (6), 635-642. https://doi.org/10.1016/j.bushor.2015.06.007
4.       Alsahlawi, A.M., Chebbi, K., Ammer, M.A., 2021. The impact of environmental sustainability disclosure on stock return of Saudi listed firms: The moderating role of financial constraints. Int. J. Financ. Stud. 9 (1), 4. https://doi.org/10.3390/ijfs9010004
5.       Alshehhi, A., Nobanee, H., Khare, N., 2018. The impact of sustainability practices on corporate financial performance: Literature trends and future research potential. Sustainability 10 (2), 494. https://doi.org/10.3390/su10020494
6.       Anvary Rostamy, A.A., Rajabzadeh Ghatari, A., In press. An expert system to evaluate the impacts of health, safety, and environment system implementation on firms’ financial performance using analytic network process and Promethee techniques. Green and Low Carbon Economy. https://doi.org/10.47852/bonviewGLCE32021448   
7.       Becchetti, L., Palestini, A., Solferino, N., Tessitore, M.E., 2014. The socially responsible choice in a duopolistic market: A dynamic model of “ethical product” differentiation. Econ. Model. 43, 114-123. https://doi.org/10.1016/j.econmod.2014.07.039
8.       Benlemlih, M., Gired Potin, I., 2017. Corporate social responsibility and firm financial risk reduction: On the moderating role of the legal environment. J. Bus. Financ. Account. 44 (7-8), 1137-1166. https://doi.org/10.1111/jbfa.12251
9.       Bhandari, A., Javakhadze, D., 2017. Corporate social responsibility and capital allocation efficiency. J. Corp. Finance 43, 354–377. https://doi.org/10.1016/j.jcorpfin.2017.01.012
10.    Breuer, W., Müller, T., Rosenbach, D., Salzmann, A., 2018. Corporate social responsibility, investor protection, and cost of equity: A cross-country comparison. J. Bank. Financ 96, 34–55. https://doi.org/10.1016/j.jbankfin.2018.07.018
11.    Brine, M., Brown, R., Hackett, G., 2007. Corporate social responsibility and financial performance in the Australian context. Econ. Round-up 2, 47–58. https://EconPapers.repec.org/RePEc:tsy:journl:journl_tsy_er_2007_2_1
12.    Brockett, A., Rezaee, Z., 2012. Corporate Sustainability: Integrating Performance and Reporting. John Wiley and Sons Press. https://doi.org/10.1002/9781119202899
13.    Brooks, C., Oikonomou, I., 2018. The effects of environmental, social and governance disclosures and performance on firm value: a review of the literature in accounting and finance. Br. Account. Rev. 50 (1), 1-15. https://doi.org/10.1016/j.bar.2017.11.005
14.    Campbell, J.Y., Hentschel, L., 1992. No news is good news: an asymmetric model of changing volatility in stock returns. J. Financ. Econ. 31 (3), 281-318. https://doi.org/10.1016/0304-405X(92)90037-X
15.    Carp, M., Păvăloaia, L., Afrăsinei, M.-B., 2019. Georgescu, I.E. Is sustainability reporting a business strategy for firm’s growth? Empirical study on the Romanian capital market. Sustainability 11 (3), 658. https://doi.org/10.3390/su11030658
16.    Carroll, A.B., 2016. Carroll’s pyramid of CSR: Taking another look. Int. J. Corporate Soc. Responsibility 1, 3. https://doi.org/10.1186/s40991-016-0004-6
17.    Ceurstemont, B., Bolton, T., Capps, C., 2001. Current Practice in Environmental Reporting: the Chemicals Industry. Woodhead Publishing Ltd., Cambridge. https://www.amazon.com.au/Current-Practice-Environmental-Reporting-Chemicals/dp/1855734710
18.    Chae, S. J., Nakano, M., Fujitatni, R., 2020. Financial reporting opacity, audit quality and crash risk: evidence from Japan. J. Asian Finance Econ. Bus. 7 (1), 9-17. http://koreascience.or.kr/article/JAKO202014862061701.page
19.    Cheung, Y.L., Jiang, P., Tan, W., 2010 A transparency disclosure index measuring disclosures: Chinese listed companies. J. Account. Public Policy 29 (3), 259–280. https://doi.org/10.1016/j.jaccpubpol.2010.02.001
20.    Cho, S. Y., Lee, C., & Pfeiffer, R. J. (2013). Corporate social responsibility performance and information asymmetry. J. Account. Public Policy, 32, 7183. https://doi.org/10.1016/j.jaccpubpol.2012.10.005
21.    Dehaliwal, D.S., Li, O.Z., Tsang, A., Yang, Y.G., 2011. Voluntary nonfinancial disclosure and the cost of equity capital: The initiation of corporate social responsibility reporting. Account. Rev. 86 (1), 59–100. https://doi.org/10.2308/accr.00000005
22.    De­ Villiers, C., Low, M., Samkin, G., 2014. The institutionalization of mining company sustainability disclosures. J. Clean. Prod. 84, 51–58. https://doi.org/10.1016/j.jclepro.2014.01.089
23.    Diebecker, J., Sommer, F., 2017. The impact of corporate sustainability performance on information asymmetry: the role of institutional differences. Rev. Manage. Sci. 11, 471-517.https://doi.org/10.1007/s11846-016-0195-y
24.    Dissanayake, D., Tilt, C., Xydias-Lobo M., 2016. Sustainability reporting by publicly listed companies in Sri Lanka. J. Clean. Prod. 129:169–182. https://doi.org/10.1016/j.jclepro.2016.04.086
25.    Du, S., Bhattacharya, C.B., Sen, S., 2011. Corporate social responsibility and competitive advantage: Overcoming the trust barrier. Manage. Sci. 57 (9), 1528–1545. https://doi.org/10.1287/mnsc.1110.1403
26.    Ehnert, I., Parsa, S., Roper, I., Wagner, M., Muller-Camen, M., 2016. Reporting on sustainability and HRM: A comparative study of sustainability reporting practices by the world’s largest companies. Int. J. Hum. Resour. Manag. 27 (1), 88–108. https://doi.org/10.1080/09585192.2015.1024157
27.    Endrikat, J., Guenther, E., Hoppe, H., 2014. Making sense of conflicting empirical findings: A meta-analytic review of the relationship between corporate environmental and financial performance. Eur. Manag. J. 32 (5), 735-751. https://doi.org/10.1016/j.emj.2013.12.004
28.    Ferrer, E., López‐Arceiz, F.J., Del Rio, C., 2020. Sustainability disclosure and financial analysts' accuracy: the European case. Bus Strategy Environ. 29 (8), 2939-2952.https://doi.org/10.1002/bse.2549
29.    Fonseca, A., McAllister, M.L., Fitzpatrick, P., 2012. Sustainability reporting among mining corporations: a constructive critique of the GRI approach. J. Clean. Prod. 84 (1), 70–83. DOI: 10.1016/j.jclepr.2012.11.05
30.    Frundlieb, M., Teuteberg, F., 2013. Corporate social responsibility reporting: A transnational analysis of online corporate social responsibility reports by market-listed firms: Contents and their evolution. Int. J. Sustain. Dev. 7 (1), 1–26. https://doi.org/10.1504/IJISD.2013.052117
31.    Gao, S.S., Heravi, S., Xiao, J.Z., 2005. Determinants of corporate social and environmental reporting in Hong Kong: A research note. Account. Forum 29 (2), 233-242. https://doi.org/10.1016/j.accfor.2005.01.002
32.    Garrido‐Miralles, P., Zorio‐Grima, A., 2016. García‐Benau, M.A. Sustainable development, stakeholder engagement and analyst forecasts’ accuracy: positive evidence from the Spanish setting. Sustain. Dev. 24 (2), 77-88.https://doi.org/10.1002/sd.1607
33.    Giannarakis, G., 2014. The determinants influencing the extent of CSR disclosure. Int. J. Law Manag. 56, 393-416. https://doi.org/10.1108/IJLMA-05-2013-0021
34.    Godfrey, P.C., 2005. The relationship between corporate philanthropy and shareholder wealth: a risk management perspective. Acad. Manag. Rev. 30 (4), 777–798. https://doi.org/10.5465/amr.2005.18378878
35.    Gong, Y., Ho, K-C., 2017. Does corporate social responsibility matter for corporate stability? Evidence from China. Qual. Quant. 52, 2291-2319. https://doi.org/10.1007/s11135-017-0665-6
36.    GRI and SASB, 2021. Practical Guide to Sustainability Reporting Using GRI and SASB Standards. Produced by GRI and SASB with support from PWC, The impact of Management Project and Climate works Foundation, 2021. https://www.globalreporting.org/media/mlkjpn1i/gri-sasb-joint-publication-april-2021.pdf
37.    Goss A., Roberts, G.S., 2011 The impact of corporate social responsibility on the cost of bank loans. J. Bank. Financ.  35(7), 1794–1810. https://doi.org/10.1016/j.jbankfin.2010.12.002
38.    Grinblatt, M., Hwang, C.Y., 1989. Signaling and the pricing of new issues. J. Finance 44 (2), 393 – 420. https://doi.org/10.2307/2328596
39.    Gupta, K., Krishnamurti, C., 2016. Does corporate social responsibility engagement benefit distress firms? The role of moral and exchange capital. Pacific Basin Financ. J. 50, 249-262. https://doi.org/10.1016/j.pacfin.2016.10.010
40.    Habek, P., 2014. Evaluation of sustainability reporting practices in Poland. Qual. Quant. 48, 1739–1752. https://doi.org/10.1007/s11135-013-9871-z
41.    Hackston, D., Milne, M.J., 1996. Some determinants of social and environmental disclosures in New Zealand companies. Account. Audit. Account. 9 (1), 77-108. https://doi.org/10.1108/09513579610109987
42.    Harmadji, D.E., Subroto, B., Saraswati, E., Prihatiningtias, Y.W., 2020. Strategy, practice and quality of sustainability reports on stock price crash risk. Int. Res. J. Bus. Soc. Sci. 9 (3), 34-49.https://doi.org/10.20525/ijrbs.v9i3.681
43.    Herva, M., Franco, A., Carrasco, E.F., Roca, E., 2011. Review of corporate environmental indicators. J. Clean Prod. 19 (15), 1687-1699. DOI: 10.1016/j.jclepro.2011.05.019Get rights and content
44.    Höck, A., Klein, C., Landau, A., 2020. The effect of environmental sustainability on credit risk. J. Asset Manag. 21, 85–93. https://doi.org/10.1057/s41260-020-00155-4
45.    Hummel, K., Schlick, C., 2016. The relationship between sustainability performance and sustainability disclosure–reconciling voluntary disclosure theory and legitimacy theory. J. Account. Public Policy 35 (5), 455-476.https://doi.org/10.1016/j.jaccpubpol.2016.06.001
46.    Hutton, A., Marcus, A., Tehranian, H., 2009. Opaque financial reports and the distribution of stock returns. J. Financ. Econ. 94 (1), 67-86. https://doi.org/10.1016/j.jfineco.2008.10.003
47.    Ioannou, I., Serafeim, G., 2017. The consequences of mandatory corporate sustainability reporting. Working Paper, Harvard Business School Research No. 11-100, Harvard University, USA. https://ssrn.com/abstract=1799589
48.    Jebran, K., Chen, S., Zhang, R., 2020. Board diversity and stock price crash risk. Res Int. Bus. Finance 51, 101-122. https://doi.org/10.1016/j.ribaf.2019.101122
49.    Jensen, M.C., Meckling, W.H., 1976. Theory of the firm: Managerial behavior, agency costs and ownership structure, J. Financ. Econ. 3 (4), 305-360. https://doi.org/10.1016/0304-405X(76)90026-X
50.    Jha, A., Cox, J., 2015. Corporate social responsibility and social capital. J. Bank. Financ. 60, 252–270. https://doi.org/10.1016/j.jbankfin.2015.08.003
51.    Jin, L., Myers, S.C., 2006. R2 around the world: new theory and new tests. J. Financ. Econ. 79 (2), 257-292.https://doi.org/10.1016/j.jfineco.2004.11.003
52.    Jiraporn, P., Jiraporn, N., Boeprasert, A., Chang, K., 2014. Does corporate social responsibility (CSR) improve credit ratings? Evidence from geographic identification. Financ. Manag 43 (3), 505–531. https://doi.org/10.1111/fima.12044 
53.    Jo, H., Na, H., 2012. Does CSR reduce firm risk? Evidence from controversial industry sectors. J. Bus Ethics 110, 441–456. https://doi.org/10.1007/s10551-012-1492-2
54.    Kamalirezaei, H., Anvary Rostamy, A.A., Saeedi, A., & Khodaei Valeh Zaghard, M., 2020. Corporate social responsibility and bankruptcy probability: Exploring the role of market competition, intellectual capital, and equity cost. J. Corp. Account. Finance. 31 (1), 53-63. https://doi.org/10.1002/jcaf.22417
55.    Kılıç, M., Kuzey, C., Uyar, A., 2015. The impact of ownership and board structure on corporate social responsibility (CSR) in the Turkish banking industry. Corp. Gov. 15 (3), 357–374. https://doi.org/10.1108/CG-02-2014-0022
56.    Kim, Y., Park, M.S., Wier, B., 2012. Is earnings quality associated with corporate social responsibility? Account. Rev. 87 (3), 761–796. https://doi.org/10.2308/accr-10209
57.    Kim, J.B., Li, L., Lu, L.Y., Yu, Y., 2021. Financial statement comparability and managers’ use of corporate resources. Account. Finance, 61(S1), 1697-1742. https://doi.org/10.1111/acfi.12642
58.    Krüger, P., 2015. Corporate goodness and shareholder wealth. J. Financ. Econ. 115 (2), 304–329. https://doi.org/10.1016/j.jfineco.2014.09.008
59.    Kuranchie-Pong, L., Bokpin, G.A., Andoh, C., 2016. Empirical evidence on disclosure and risk-taking of banks in Ghana. J. Financ. Regul. Compliance 24 (2),197–212. https://doi.org/10.1108/JFRC-05-2015-0025
60.    Kuzey, C., Uyar, A., 2017. Determinants of sustainability reporting and its impact on firm value: Evidence from the emerging market of Turkey. J. Clean. Prod. 143, 27–39. https://doi.org/10.1016/j.jclepro.2016.12.153
61.    Laeven, L., Levine, R., 2009. Bank governance, regulation and risk taking. J. Financ. Econ. 93 (2), 259–275. https://doi.org/10.1016/j.jfineco.2008.09.003
62.    Lantos, G.P., 2001. The boundaries of strategic corporate social responsibility. J. Consum. Mark. 18, 595–632. https://doi.org/10.1108/07363760110410281
63.    Leuz, C., Wysocky, P., 2006. Capital market effects of corporate disclosures and disclosure regulation. Working Paper 16737, National Bureau of Economic Research. https://www.nber.org/system/files/working_papers/w16737/revisions/w16737.rev2.pdf
64.    Levin, A., Chien-Fu, L., Chia-Shang, J.C., 2002. Unit root tests in panel data: asymptotic and finite-sample properties. J. Econom. 108 (1), 1-24. https://doi.org/10.1016/S0304-4076(01)00098-7
65.    Lin, W.L., Ho, J.A., Lee, C., Ng, S.I., 2020. Impact of positive and negative corporate social responsibility on automotive firms' financial performance: A market-based asset perspective. Corp. Soc. Responsib. Environ. Manag. 27 (4), 1761-1773. https://doi.org/10.1002/csr.1923
66.    Lozano, R., Huisingh, D., 2011. Inter-linking issues and dimensions in sustainability reporting. J. Clean. Prod. 19, 99–107. https://doi.org/10.1016/j.jclepro.2010.01.004
67.    Lozano, R., Carpenter, A., Huisingh, D., 2015. A review of “theories of the firm” and their contributions to corporate sustainability. J. Clean. Prod., 106, 430-442. https://doi.org/10.1016/j.jclepro.2014.05.007
68.    Lys, T., Naughton, J.P., Wang, C., 2015. Signaling through corporate accountability reporting. J. Account. Econ., 60(1), 56-72. https://doi.org/10.1016/j.jacceco.2015.03.001
69.    Matthiesen, M.L., Salzmann, A.J., 2017. Corporate social responsibility and firms’ cost of equity: How does culture matter? Cross Cult. Strateg. Manag. 24 (1), 105–124. https://doi.org/10.1108/CCSM-11-2015-0169
70.    McCarthy, S., Oliver, B., Song, S., 2017. Corporate social responsibility and CEO confidence. J. Bank. Financ. 75, 280-291. https://doi.org/10.1016/j.jbankfin.2016.11.024
71.    Mostafa Monzur, H., Ahsan, H., 2017. Corporate life cycle, organizational financial resources and corporate social responsibility. J. Contemp. Account. Econ. 13 (1), 20–36. https://doi.org/10.1016/j.jcae.2017.01.002
72.    Nekhili, M., Nagati, H., Chtioui, T., Rebolledo, C., 2017. Corporate social responsibility disclosure and market value: Family versus nonfamily firms. J. f Bus. Res. 77, 41–52. https://doi.org/10.1016/j.jbusres.2017.04.001
73.    Ng, C.A., Rezaee, Z., 2012. Sustainability disclosures and cost of capital. SSRN Electron. J. http://dx.doi.org/10.2139/ssrn.2038654
74.    Orazalin, I., Mahmood, M., 2018. Economic, environmental, and social performance indicators of sustainability reporting: Evidence from the Russian oil and gas industry. Energy Policy 121, 70-79. https://doi.org/10.1016/j.enpol.2018.06.015
75.    Orazalin, I., Mahmood, M., Narbaev, T., 2019. The impact of sustainability performance indicators on financial stability: Evidence from the Russian oil and gas industry. Environ. Sci. Pollut. Res 26, 8157-8168. https://doi.org/10.1007/s11356-019-04325-9
76.    Pahlavan, M., Anvary Rostamy, A.A., Darabi, R., 2023. Impacts of environmentally sustainable performance reporting on the stock price crash risk and liquidity: The mediating role of predictability and comparability, J. Corp. Account Finance. 34 (3), 144-157. https://doi.org/10.1002/jcaf.22618
77.    Palit, D., 2013. Solar energy programs for rural electrification: Experiences and lessons from South Asia.  J. Sustain. Energy Dev. 17 (3), 270–279. https://doi.org/10.1016/j.esd.2013.01.002
78.    Petrovits, C., 2006. Corporate-sponsored foundations and earnings management. J. Account. Econ. 41 (3), 335–362. https://doi.org/10.1016/j.jacceco.2005.12.001
79.    Preston, L.E., O’Bannon, D., 1997. The Corporate social-financial performance relationship. Bus. Soc. 36 (4), 419-429. https://doi.org/10.1177/000765039703600406
80.    Qiu, Y., Shaukat, A., Tharyan, R., 2016. Environmental and social disclosures: link with corporate financial performance. Br. Account. Rev. 48 (1), 102–116. https://doi.org/10.1016/j.bar.2014.10.007
81.    Rahdari, A.H., Anvary Rostamy, A.A., 2015. Designing a general set of sustainability indicators at the corporate level. J. Clean. Prod. 108 (Part A), 757-771. https://doi.org/10.1016/j.jclepro.2015.05.108
82.    Rajgopal, S., Venkatachalam, M., 2011. Financial reporting quality and idiosyncratic return volatility. J. Account Econ. 51 (1-2), 1–20. https://doi.org/10.1016/j.jacceco.2010.06.001
83.    Rezaee, Z., 2017. Corporate sustainability: Theoretical and integrated strategic imperative and pragmatic approach. J. Bus. Inq. 16 (1), 60-87. https://journals.uvu.edu/index.php/jbi/article/view/77
84.    Roberts, M.L., Albright, T.L., Hibbets, A.L., 2004. Debasing balanced scorecard evaluations. Behav. Res. Account. 16 (1), 75-88. https://doi.org/10.2308/bria.2004.16.1.75
85.    Sartori, S., Witjes, S., Campos, L.M.S., 2017. Sustainability performance for Brazilian electricity power industry: an assessment integrating social, economic and environmental issues. Energy Policy, 111, 41–51. https://doi.org/10.1016/j.enpol.2017.08.054
86.    Selcuk, O., Karakas, H., Cizel, B., Ciftci, S.F., & Coskun Oksuz, F., 2021. Comparative analysis of residents’ attitudes toward sustainable tourism development using a multi-criterion decision-making technique Interdiscip. J. Manag. Stud.14(3), 585-607. Doi:10.22059/ijms.2020.304663.674108
87.    Servaes, H., Tamayo, A., 2013. The impact of corporate social responsibility on the value of the firm: The role of customer awareness. Manag. Sci. 59 (5), 1045–1061. http://dx.doi.org/10.1287/mnsc.1120.1630
88.    Sun, W., Cui, K., 2014. Linking corporate social responsibility to firm default risk. Eur. Manag. J. 32 (2), 275–287. https://doi.org/10.1016/j.emj.2013.04.003
89.    Tilling, M.V., 2004. Some thoughts on legitimacy theory in social and environmental accounting. Soc. Environ. Account. J. 24 (2), 3-7. https://doi.org/10.1080/0969160X.2004.9651716
90.    Torjai, L., Nagy, J., Bai, A., 2015. Decision hierarchy, competitive priorities and indicators in large-scale herbaceous biomass to energy supply chains. Biomass and Bioenergy 80, 321–329. https://doi.org/10.1016/j.biombioe.2015.06.013
91.    Trisnawati, R., Setiawati, E., 2016. Sustainability reporting and earning management: Empirical studies in the companies that participated in the Indonesian sustainability reporting award (ISRA). Int. J. Bus. Econ. L. 11 (1), 11-16. https://doi.org/10.2478/rput-2023-0008
92.    Vaddock, S., Graves, S., 1997. The corporate social performance financial performance link. Strateg Manag. J. 18 (4), 303–319. Doi: 10.1002/(SICI)1097-0266(199704)18:4<303:AID-SMJ869>3.0.CO,2-G
93.    Wang Verrocchio, R.E., 2001. Essays on disclosure. J. Account. Econ 32 (3), 97-180. http://dx.doi.org/10.2139/ssrn.276699
94.    Wang Verrocchio, F., Zhang, Z., Xu, L., 2020. Corporate social responsibility and financial statement comparability: Evidence from China. Corp. Soc. Responsib. Environ. Manag 27 (3), 1375-1394. https://doi.org/10.1002/csr.1890
95.    Williams, S.M., 1999. Voluntary environmental and social accounting disclosure practices in the Asia-Pacific region: An international empirical test of political economy theory. Int. J. Account. 34 (2), 209-238. https://doi.org/10.1016/S0020-7063(99)00006-0
96.    Wood, D.J., 1991. Corporate social performance revisited. Acad. Manag. Rev 16 (4), 691–718. https://doi.org/10.2307/258977
97.     Yoon, B., Chung, Y., 2018. The effects of corporate social responsibility on firm performance: A stakeholder approach. J. Hosp. Tour. Manag. 37, 89–96. https://doi.org/10.1016/j.jhtm.2018.10.005