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Open Access
Book part
Publication date: 6 May 2019

Heather Gage and Ekelechi MacPepple

The 30 MOCHA (Models of Child Health Appraised) countries are diverse socially, culturally and economically, and differences exist in their healthcare systems and in the scope and…

Abstract

The 30 MOCHA (Models of Child Health Appraised) countries are diverse socially, culturally and economically, and differences exist in their healthcare systems and in the scope and role of primary care. An economic analysis was undertaken that sought to explain differences in child health outcomes between countries. The conceptual framework was that of a production function for health, whereby health outputs (or outcomes) are assumed affected by several ‘inputs’. In the case of health, inputs include personal (genes, health behaviours) and socio-economic (income, living standards) factors and the structure, organisation and workforce of the healthcare system. Random effects regression modelling was used, based on countries as the unit of analysis, with data from 2004 to 2016 from international sources and published categorisations of healthcare system. The chapter describes the data deficiencies and measurement conundrums faced, and how these were addressed. In the absence of consistent indicators of child health outcomes across countries, five mortality measures were used: neonatal, infant, under five years, diabetes (0–19 years) and epilepsy (0–19 years). Factors found associated with reductions in mortality were as follows: gross domestic product per capita growth (neonatal, infant, under five years), higher density of paediatricians (neonatal, infant, under five years), less out-of-pocket expenditure (neonatal, diabetes 0–19), state-based service provision (epilepsy 0–19) and lower proportions of children in the population, a proxy for family size (all outcomes). Findings should be interpreted with caution due to the ecological nature of the analysis and the limitations presented by the data and measures employed.

Details

Issues and Opportunities in Primary Health Care for Children in Europe
Type: Book
ISBN: 978-1-78973-354-9

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Book part
Publication date: 10 November 2014

Matthias Cinyabuguma, William Lord and Christelle Viauroux

This paper addresses revolutionary changes in the education, fertility and market work of U.S. families formed in the 1870s–1920s: Fertility fell from 5.3 to 2.6; the graduation…

Abstract

This paper addresses revolutionary changes in the education, fertility and market work of U.S. families formed in the 1870s–1920s: Fertility fell from 5.3 to 2.6; the graduation rate of their children increased from 7% to 50%; and the fraction of adulthood wives devoted to market-oriented work increased from 7% to 23% (by one measure).

These trends are addressed within a unified framework to examine the ability of several proposed mechanisms to quantitatively replicate these changes. Based on careful calibration, the choices of successive generations of representative husband-and-wife households over the quantity and quality of their children, household production, and the extent of mother’s involvement in market-oriented production are simulated.

Rising wages, declining mortality, a declining gender wage gap, and increased efficiency and public provision of schooling cannot, individually or in combination, reduce fertility or increase stocks of human capital to levels seen in the data. The best fit of the model to the data also involves: (1) a decreased tendency among parents to view potential earnings of children as the property of parents and (2) rising consumption shares per dependent child.

Greater attention should be given the determinants of parental control of the work and earnings of children for this period.

One contribution is the gathering of information and strategies necessary to establish an initial baseline, and the time paths for parameters and targets for this period beset with data limitations. A second contribution is identifying the contributions of various mechanisms toward reaching those calibration targets.

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Factors Affecting Worker Well-being: The Impact of Change in the Labor Market
Type: Book
ISBN: 978-1-78441-150-3

Keywords

Book part
Publication date: 24 July 2012

Sheri R. Notaro

Purpose – This chapter discusses health disparities among African Americans living in urban spaces within the United States.Approach – This chapter provides an overview of health…

Abstract

Purpose – This chapter discusses health disparities among African Americans living in urban spaces within the United States.

Approach – This chapter provides an overview of health disparities in morbidity and mortality related to maternal and child health (maternal mortality rate, infant mortality, and low birth weight).

Practical implications – This chapter describes research and interventions that strive to increase our ability to understand and reduce health disparities. Eliminating health disparities not only is beneficial to these affected groups but also offers the opportunity to improve the health of the entire U.S. population.

Originality/value – This chapter adds to our understanding of the correlates of health disparities for African American women and children as well as successful interventions that have proven effective in ameliorating these disparities.

Details

Health Disparities Among Under-served Populations: Implications for Research, Policy and Praxis
Type: Book
ISBN: 978-1-78190-103-8

Keywords

Book part
Publication date: 2 August 2006

Hilary Silver and Peter Messeri

Studies repeatedly have found social disparities of health at many levels of spatial aggregation. A second body of empirical research, demonstrating relationships between an…

Abstract

Studies repeatedly have found social disparities of health at many levels of spatial aggregation. A second body of empirical research, demonstrating relationships between an area's racial and class composition and its environmental conditions, has led to the rise of an environmental justice movement. However, few studies have connected these two sets of findings to ask whether social disparities in health outcomes are due to local environmental disparities. This chapter investigates whether the association between racial and socioeconomic composition and multiple health conditions across New York City zip codes is partly mediated by neighborhood physical, built, and social environments.

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Community and Ecology
Type: Book
ISBN: 978-1-84950-410-2

Book part
Publication date: 30 September 2020

Dmitry V. Didenko

This chapter sheds light on long-term trends in the level and structural dynamics of investments in Russian human capital formation from government, corporations, and households…

Abstract

This chapter sheds light on long-term trends in the level and structural dynamics of investments in Russian human capital formation from government, corporations, and households. It contributes to the literature discussing theoretical issues and empirical patterns of modernization, human development, as well as the transition from a centralized to a market economy. The empirical evidence is based on extensive utilization of the dataset introduced in Didenko, Földvári, and Van Leeuwen (2013). Our findings provide support for the view expressed in Gerschenkron (1962) that in late industrializers the government tended to substitute for the lack of capital and infrastructure by direct interventions. At least from the late nineteenth century the central government's and local authorities' budgets played the primary role. However, the role of nongovernment sources increased significantly since the mid-1950s, i.e., after the crucial breakthrough to an industrial society had been made. During the transition to a market economy in the 1990s and 2000s the level of government contributions decreased somewhat in education, and more significantly in research and development, but its share in overall financing expanded. In education corporate funds were largely replaced by those from households. In health care, Russia is characterized by an increasing share of out-of-pocket payments of households and slow development of organized forms of nonstate financing. These trends reinforce obstacles to Russia's future transition, as regards institutional change toward a more significant and sound role of the corporate sector in such branches as R&D, health care, and, to a lesser extent, education.

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Research in Economic History
Type: Book
ISBN: 978-1-83909-179-7

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Book part
Publication date: 25 September 2015

Elaine Thomson

This chapter explores the inequalities and restrictions faced by women as they entered the medical profession in the United Kingdom. A case study in the first hospital in the…

Abstract

This chapter explores the inequalities and restrictions faced by women as they entered the medical profession in the United Kingdom. A case study in the first hospital in the United Kingdom to be founded and run by women, the Edinburgh Hospital for Women and Children, it demonstrates the importance of history for understanding women doctor’s early career choices and opportunities. The chapter begins with an outline of nineteenth-century notions of feminine propriety. It considers how middle-class women sought to subvert these restrictions and gain an active role in public life, and explores how this impacted upon arguments in favour of medical women. It reveals the significance of the changing nature of medical knowledge in this period, and considers how this contributed to the emergence of two distinct specialisms, both of which became the preserve of women doctors: maternal welfare schemes in the 1900s, and the treatment of VD in the inter-war period. The chapter concludes with its contribution to this edited collection.

Details

Gender, Careers and Inequalities in Medicine and Medical Education: International Perspectives
Type: Book
ISBN: 978-1-78441-689-8

Keywords

Book part
Publication date: 24 July 2012

Sheri R. Notaro

The interventions in section one (e.g., public policy initiatives, community-based intervention programs) discuss ways to reduce or alleviate health disparities among ethnic…

Abstract

The interventions in section one (e.g., public policy initiatives, community-based intervention programs) discuss ways to reduce or alleviate health disparities among ethnic populations and provide careful descriptions of factors that increased or decreased the success of these interventions (e.g., barriers, resiliency, protective factors, and cultural competence).

Details

Health Disparities Among Under-served Populations: Implications for Research, Policy and Praxis
Type: Book
ISBN: 978-1-78190-103-8

Book part
Publication date: 6 September 2018

Claire Chabot and Marc Ouimet

Purpose – Cross-national comparisons of crime across the world consistently show that homicide rates are higher in more impoverished countries. However, there is a debate on what…

Abstract

Purpose – Cross-national comparisons of crime across the world consistently show that homicide rates are higher in more impoverished countries. However, there is a debate on what aspect of poverty is related to violence. Economics aspects have been conceived as wealth, poverty, and inequality. Furthermore, the impact of economic determinants has never been studied against a second potential determinant, which is the quality of the formal social control mechanisms.

Design/methodology/approach – In this study, we use official data made available by international agencies as well as new and original data from the World Homicide Survey, based on the responses provided by 1,223 respondents located in 145 countries of the world.

Findings – Results show that the two main determinants of the homicide rate are economic inequality (Gini) and the quality of the formal social control mechanisms. However, this second dimension is dependent on the wealth of the nation (gross domestic product) and the prevalence of poverty.

Details

Homicide and Violent Crime
Type: Book
ISBN: 978-1-78714-876-5

Keywords

Book part
Publication date: 28 August 2023

Caroline Wolski, Kathryn Freeman Anderson and Simone Rambotti

Since the development of the COVID-19 vaccinations, questions surrounding race have been prominent in the literature on vaccine uptake. Early in the vaccine rollout, public health…

Abstract

Purpose

Since the development of the COVID-19 vaccinations, questions surrounding race have been prominent in the literature on vaccine uptake. Early in the vaccine rollout, public health officials were concerned with the relatively lower rates of uptake among certain racial/ethnic minority groups. We suggest that this may also be patterned by racial/ethnic residential segregation, which previous work has demonstrated to be an important factor for both health and access to health care.

Methodology/Approach

In this study, we examine county-level vaccination rates, racial/ethnic composition, and residential segregation across the U.S. We compile data from several sources, including the American Community Survey (ACS) and Centers for Disease Control (CDC) measured at the county level.

Findings

We find that just looking at the associations between racial/ethnic composition and vaccination rates, both percent Black and percent White are significant and negative, meaning that higher percentages of these groups in a county are associated with lower vaccination rates, whereas the opposite is the case for percent Latino. When we factor in segregation, as measured by the index of dissimilarity, the patterns change somewhat. Dissimilarity itself was not significant in the models across all groups, but when interacted with race/ethnic composition, it moderates the association. For both percent Black and percent White, the interaction with the Black-White dissimilarity index is significant and negative, meaning that it deepens the negative association between composition and the vaccination rate.

Research limitations/implications

The analysis is only limited to county-level measures of racial/ethnic composition and vaccination rates, so we are unable to see at the individual-level who is getting vaccinated.

Originality/Value of Paper

We find that segregation moderates the association between racial/ethnic composition and vaccination rates, suggesting that local race relations in a county helps contextualize the compositional effects of race/ethnicity.

Details

Social Factors, Health Care Inequities and Vaccination
Type: Book
ISBN: 978-1-83753-795-2

Keywords

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