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Inequities
Kinds of Inequities Selected AbstractsHealthcare financing reform and the new single payer system in the Republic of Korea: Social solidarity or efficiency?INTERNATIONAL SOCIAL SECURITY REVIEW, Issue 1 2003Soonman Kwon In July 2000, national health insurance in the Republic of Korea was transformed into a single insurer system. This major reform in healthcare financing resulted from the merger of more than 350 health insurance societies. Inequity in healthcare financing and the chronic financial situation of the health insurance societies for self,employed workers in rural areas have been the driving forces leading to the unified health insurance system. The unique institutional context together with political change opened the window of policy change, and various stakeholders such as politicians, rural self,employed workers, trade unions and civic groups were involved in the healthcare reform process. Fair income assessment of the self,employed and the role of the single insurer as a prudent purchaser of medical care will be vital for the new system to achieve its intended goal and improve social solidarity and efficiency of healthcare. [source] Disparity vs Inequity: Toward Reconceptualization of Pain Treatment DisparitiesPAIN MEDICINE, Issue 5 2008CRNP, Salimah H. Meghani PhD ABSTRACT Context., "Disparity" and "inequity" are two interdependent, yet distinct concepts that inform our discourse on ethics and morals in pain medicine practice and in health policy. Disparity implies a difference of some kind, whereas inequity implies unfairness and injustice. An overwhelming body of literature documents racial/ethnic disparities in health. The debate on health disparities is generally formulated using the principle of "horizontal equity," which requires that individuals having the same needs be treated equally. While some types of health treatments are amenable to the principle of horizontal equity, others may not be appropriately studied in this way. The existing research surrounding racial/ethnic disparities in pain treatment presents a conceptual predicament when placed within the framework of horizontal equity. Objective., Using pain treatment as a prototype, we advance the conceptual debate about racial/ethnic disparities in health. More specifically, we ask three questions: (1) When may disparities be considered inequities? (2) When may disparities not be considered inequities? (3) What are the uncertainties in the disparity,inequity discourse? Discussion., Significant policy implications may result from the manner in which health disparities are conceptualized. Increasingly, researchers and policy makers use the term disparity interchangeably with inequity. This usage confuses the meaning and application of these distinct concepts. In a given health care setting, different types of disparities may operate simultaneously, each requiring serious scrutiny to avoid categorical interpretation leading to misguided practice and policy. While the science of pain treatment disparities is still emerging, the authors present one perspective toward the conceptualization of racial/ethnic disparities in pain treatment. [source] Fantasies of Friendship in The Faerie Queene, Book IVENGLISH LITERARY RENAISSANCE, Issue 2 2007Melissa E. Sanchez For such members of the Sidney-Essex circle as Spenser, who supported monarchy as such but were uneasy about a number of specific policies, what historians have described as a move in the 1590s away from mid-century conciliar theories generated anxiety about the status of the nobility and the future of Protestantism. The erotic relations of the 1596 edition of The Faerie Queene register such concerns about the absolutist rhetoric of the last fifteen years of Elizabeth's reign, most noticeably in the revised ending of Book III. Whereas the 1590 Book of Chastity concludes with Scudamour and Amoret merging into a hermaphroditic figure of mutual devotion, the 1596 version replaces this scene of conjugal bliss with a protracted narrative of Scudamour's despairing suspicion and Amoret's continued affliction. The nature of Amoret's loyalty, moreover, is itself complicated by the concluding cantos of Book IV, which reveal that the husband for whom she has willingly suffered was in fact the first of her assailants. The disproportion between Amoret's fidelity and Scudamour's desert in the 1596 versions of Books III and IV suggests that idealized equations of love, virtue, and suffering may have lulled Amoret into complicity in her own abuse. This revision is thus crucial to Spenser's project of fashioning a virtuous subject, for in apprehending the discrepancy between idealized narratives of mutual devotion and actual structures of unilateral sacrifice, the reader of The Faerie Queene may likewise come to recognize and resist the contradictions and inequities of late sixteenth-century political practice. [source] After Cancún: what next for agricultural subsidies?EUROCHOICES, Issue 3 2003Tim Josling Summary After Cancún: what next for agriculturalsubsidies? The collapse of the Ministerial in Cancún highlighted the enhanced role of the developing countries in the WTO and the reduced ability of the US and the EU to manage the trade system. One aspect of these changes has been that developing countries have taken much more interest in the level of domestic support in developed countries. Developed countries believe that the shift of support from production-linked to decoupled instruments has had a positive impact on trade. Developing countries maintain that this reform has not helped them, and has perpetuated inequities in the trade system. Research suggests that the output effect of decoupled support is limited, if not negligible. Such decoupling may be necessary to reform domestic polices. Additionally, domestic policies are being challenged by developing countries using the trade litigation of the WTO. But such challenges risk undermining support for the WTO. Until agreement is reached on these issues there will be little progress in further agricultural trade reform. A political solution must be found that continues the slow process of improvement of domestic farm policies and at the same time offers hope to developing countries that they will benefit from the improvement in the trade conditions for agricultural products. Après Cancún:quel avenir pour les subventions? L'échec de la conférence ministérielle de Cancun met en évidence !e rôle accru des pays en voie de développement à l'OMC, ainsi que la faible aptitude des Etats-Unis et de l'Europe à gérer le système des échanges internationaux. Ces changements impliquent que les pays en voie de développement s'intéressent de plus en plus aux niveaux de protection internes des pays développés. Les pays développés croient que le glissement des aides vers plus de découplage aura eu un effet positif sur les échanges. Mais les pays en voie de développement continuent à penser que ces réformes ne les ont pas aidés, et qu'elles ont perpétué les inégalités du commerce mondial. Le travail présenté ici semble montrer que l'effet du découplage sur l'offre est très faible, voire nul. Peut-être le decouplage est-il utile pour la réforme des politiques internes. Mais, au delà, ces politiques internes sont mises en cause par les pays en voie de développement, qui utilisent à leur encontre les ressources de procédure mises à leur disposition par l'OMC. De telles mises en cause sont de nature à détruire le soutien de l'opinion à l'OMC. II ne faut pas s'attendre à beaucoup de progrès dans les réformes du commerce international agricole tant qu'on n'aura pas trouve un accord sur ces questions. II est done necessaire d'élaborer des solutions qui confortent le lent progrès des politiques internes des pays developpes, tout en offrant aux pays en voie de développement 1, espoir de bénéficier de l'amélioration des conditions des échanges agricoles. Nach Cancún: Was geschieht als nächstes mitAgrarsubventionen? Das Scheitern des Ministerialtreffensin Cancún hob die verbesserte Position der Entwicklungsländer in der WTO und die verminderte Fähigkeit der USA und der EU hervor, das Handelssystem zu lenken. Finer der Aspekte dieser Veränderungen bestand darin, dass die Entwicklungsländer ein sehr viel größeres Interesse am Ausmaß der Inlandsstützung in Industrieländern gezeigt haben. Die Industrieländer glauben, dass sich der Schritt von einer produktionsgebundenen Inlandsstützung hin zu einer entkoppelten Inlandsstützung positiv auf den Handel ausgewirkt hat. Die Entwicklungsländer behaupten jedoch, dass ihnen diese Reform nicht geholfen habe und dass so Ungerechtigkeiten im Handelssystem aufrecht erhalten würden. Forschungsergebnisse legen es nahe, dass sich die entkoppelte Inlandsstützung sehr begrenzt, möglicherweise nur geringfügig, auf die Produktion auswirkt. Eine solche Entkopplung ist möglicherweise notwendig, urn inländische Politikmaßnahmen zu reformieren. Zusátzlich werden die inländischen Politikmaßnahmen von den Entwicklungsländern zur Zeit im Rahmen der WTO-Verfahren zur Beilegung von Handelsstreitigkeiten angefochten. Solche Anfechtungen bergen jedoch immer das Risiko einer abgeschwächten Unterstützung für die WTO. Bis in diesen Punkten Einigkeit herrscht, wird es nur geringe Fortschritte für die Agrarhandelsreformen geben. Es muss eine politische Lösung gefunden werden, welche den langsamen Verbesserungsprozess bei den inländischen Agrarpolitikmaßnahmen voran treibt und welche die Entwicklungsländer zugleich hoffen lässt, von der Verbesserung der Handelsbedingungen für landwirtschaftliche Erzeugnisse profitieren zu können. [source] Indirect tax reform and the role of exemptionsFISCAL STUDIES, Issue 4 2001John Creedy Abstract This paper examines the question of whether indirect tax rates should be uniform, using four different modelling strategies. First, marginal tax reform is examined. This is concerned with the optimal direction of small changes in effective indirect tax rates and requires considerably less information than the calculation of optimal rates. Second, the welfare effects of a partial shift from the current indirect tax system in Australia towards a goods and services tax (GST) are considered, with particular emphasis on differences between household types and the role of exemptions. Third, in view of the stress on a distributional role for exemptions of certain goods from a GST, the potential limits to such redistribution are considered. The fourth approach examines the extent of horizontal inequity and reranking that can arise when there are non-uniform tax rates. These inequities arise essentially because of preference heterogeneity. [source] Exploring the Gaps between Meanings and Practices of Gender Equity in a Sport OrganizationGENDER, WORK & ORGANISATION, Issue 3 2007Larena Hoeber This article analyses the explanations organizational members used to make sense of the meanings and practices of gender equity. Studying gender equity as an organizational value provided a way of understanding how gender inequity is perpetuated and embedded in the culture of an organization. This study was informed by post-structuralist feminist theory as it provided a lens for understanding and critiquing the local meanings and production of gendered knowledge, and encouraged discussion of transforming meanings and practices. This study was situated in a Canadian university athletic department in which gender equity was an espoused organizational value, but gender inequities were evident. Data were collected from in-depth interviews with administrators, coaches and athletes, observations of practices and competitions, and the analysis of relevant documents. These data were coded and categorized using Atlas.ti. Respondents' explanations for the gap between what was espoused and what was enacted centred on two dominant, but contradictory, themes: a denial of gender inequities and a rationalization of gender inequities. These themes suggested respondents often understood inequities as expected, natural, or normal. [source] Academic Careers and Gender Equity: Lessons Learned from MIT1GENDER, WORK & ORGANISATION, Issue 2 2003Lotte Bailyn This article describes the experience at the Massachusetts Institute of Technology after the publication of its report A Study on the Status of Women Faculty in Science at MIT. It starts by describing aspects of the academic career that make it difficult for women, or anyone with responsibilities outside of their academic work. It then outlines three definitions of gender equity based on equality, fairness, and integration, and probes the reasons behind persisting inequities. The MIT results fit well into the first two definitions of gender equity, but fall short on the last. Finally, the article analyses the factors that came together at MIT to produce the outcome described and indicates the lessons learned and those still to be learned. [source] ISOLATING CONNECTIONS , CONNECTING ISOLATIONSGEOGRAFISKA ANNALER SERIES B: HUMAN GEOGRAPHY, Issue 4 2009Eric Clark ABSTRACT. The varied and distinct ways we connect can facilitate or impose isolation, our own or someone else's. Different forms of isolation are themselves interconnected and sometimes enrich our connecting. The relation between isolation and connection, we argue, is one of complementarity, like Calvino's ,two inseparable and complementary functions of life ,syntony, or participation in the world around us , [and] focalization or constructive concentration.' Solitude sought can enhance connections. Imposed isolation weakens connections in ways both obvious and subtle. This contrast between sought and imposed underscores the influence of hierarchy and socially produced inequities, excesses of which fragment the social ties that could constrain or diminish these same inequities. Deep inequity degrades the quality of both connections and isolation, at significant costs to our health, ecology, economy, cultural diversity, and political vitality. From this vantage point, we cull ways to improve our syntony and our focalization, fulfilling by expressing those shared egalitarian moral sentiments that motivate connections of solidarity partly in the interest of being "left alone". [source] Creating consumer satisfaction in maternity care: the neglected needs of migrants, asylum seekers and refugeesINTERNATIONAL JOURNAL OF CONSUMER STUDIES, Issue 2 2007Birgit Jentsch Abstract An estimated 190 million people are now living outside their countries of birth or citizenship, and the rate of this migration is expected to remain high. The resulting growing cultural and ethnic diversity in societies adds specific challenges to the requirement of delivering public services such as health care to consumers. Globally, about half of the migrant population are women. Migrants' outcomes of pregnancy are known to be poor, showing significant disparities when compared with those of native populations. Although these disparities have been noted, knowledge is limited regarding the availability and accessibility of healthcare services, as well as the acceptability of maternity care for women with experiences of free and forced migration. Healthcare research in general, and maternity care research specifically, have often neglected this population. This paper examines the existing international guidelines intended to address inequities in health outcomes, policies which have been introduced at national levels, and the widely used concepts of ,patient-centred' and ,woman-centred' health services. The ideals implicit in those guidelines and concepts are contrasted with the available evidence of many overseas nationals' experiences with healthcare provisions in general, and maternity care in particular. This is followed by reflections on deficiencies in current studies and on those methodological problems which make research on maternity care for migrant women particularly challenging. The conclusion considers the appropriateness and relevance of guidelines currently promoting equity in maternity care and suggests a future agenda for priority research. [source] Decentralization and health care in the former Yugoslav Republic of MacedoniaINTERNATIONAL JOURNAL OF HEALTH PLANNING AND MANAGEMENT, Issue 1 2006Sonia Menon Abstract Since its independence in 1991, the Republic of Macedonia became a highly centralized state, with most relevant decisions taken at the central level in Skopje, resembling the highly centralized system, which once characterized Former Yugoslavia. As agreed in the Framework Agreement, which ended six months of internal conflict, the Macedonian Government will decentralize public services delivery, including social protection, health, education, and infrastructure over the course of the next few years. Within health care, it is argued that by placing policy-making authority and operating control closer to the client, decentralization will reduce some of the inequities in service provision and inefficiencies present within the current centrally controlled system. In principle, local voters will have more information on the price and quality of services, thereby increasing competition in the sector and strengthening the private sector. The emphasis on market incentives resulting in greater efficiency and better management of health care institutions is viewed as one of the benefits of privatization. Critics of decentralization and the subsequent privatization of public services fear it may result in an erosion of quality and consistency across regions, leaving some regions, cities, villages and potentially vulnerable groups worse off than others. The paper argues that if the institutional weaknesses in Macedonia have not been addressed, decentralisation could result in further excluding the rural population from health care provision. Similarly, the need for a clear delineation of responsibilities and functions among different levels and institutions is outlined. Copyright © 2006 John Wiley & Sons, Ltd. [source] The Nurse Educator's clinical roleJOURNAL OF ADVANCED NURSING, Issue 1 2005Odette Griscti MHSc RN Aim., This paper reports a two-phase descriptive study exploring the clinical role of the nurse educator in Malta. Background., Previous studies indicate a number of similarities and differences in the clinical role of nurse educators by country of practice. These include importance assigned to the role, factors inhibiting/facilitating the role, means to eliminate barriers to the role, and perceptions of the ideal role. Design and methods., Data were collected using both quantitative and qualitative strategies. The quantitative phase involved asking all educators to fill in a time log of their academic and clinical activities for a 2-week period. In the qualitative phase, the first author interviewed five educators, five nurses and five students about their perceptions of factors which impact the nurse educator's clinical role, as well as what the ideal clinical role of the nurse educator should be. Findings., Maltese nurse educators allot minimal time to their clinical role. Main reasons cited included workload, perceived lack of control over the clinical area, and diminished clinical competence. Nurse educators who frequented the clinical settings (who were either university or joint university and health service employees) where the study took place perceived that employment inequities among the various categories of nurse educators played an important role in the amount of time dedicated by each group to their clinical roles, and the importance individuals in these groups assigned to that role. The majority of interviewees saw the current role of nurse educators in Malta as preparing students for successful completion of the didactic sections of their programme, rather than preparing them with all the knowledge and clinical skills necessary to be competent practitioners. Participants considered that, when in clinical areas, nurse educators did focus on their students, as they should. However, they also thought that they often did not take the opportunity to forge links with professional staff. Conclusion., The clinical role of the Maltese nurse educator needs to be more multifaceted in approach. [source] ,Came hell and high water': the intersection of Hurricane Katrina, the news media, race and povertyJOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY, Issue 6 2007Courte C. W. Voorhees Abstract The mass devastation and suffering left in the wake of Hurricane Katrina in the US Gulf Coast brought the intersection of media and community into sharp focus. The news media played a pivotal role in almost every aspect of the disaster and its aftermath, and was harshly criticized for its depiction of minorities and for sensationalizing a human and environmental disaster. The literature suggests that media often represents minorities in a negative light, ultimately reinforcing existing social inequalities. This paper examines the portrayal of minority groups in the media during and after the storm. Data were coded from news media broadcasts to determine the nature of minority representation. Interviews were conducted with individuals from New Orleans who survived the disaster to understand issues related to media trust, the accuracy of media reports and perception of the media's portrayal of minorities. The results indicate that minorities are disproportionately shown in a passive or ,victim' role and are rarely shown in positions of expertize. Further, storm survivors indicated a misrepresentation of minorities in media coverage of the disaster, as well as reporting low levels of media trust and accuracy. The broader implications of these findings in relation to media reinforcement of social inequities and media responsibility are discussed. Copyright © 2007 John Wiley & Sons, Ltd. [source] Prospective Registration of Clinical Trials in India: Strategies, Achievements & ChallengesJOURNAL OF EVIDENCE BASED MEDICINE, Issue 1 2009Prathap Tharyan Abstract Objective This paper traces the development of the Clinical Trial Registry-India (CTRI) against the backdrop of the inequities in healthcare and the limitations in the design, conduct, regulation, oversight and reporting of clinical trials in India. It describes the scope and goals of the CTRI, the data elements it seeks and the process of registering clinical trials. It reports progress in trial registration in India and discusses the challenges in ensuring that healthcare decisions are informed by all the evidence. Methods A descriptive survey of developments in clinical trial registration in India from publications in the Indian medical literature supplemented by firsthand knowledge of these developments and an evaluation of how well clinical trials registered in the CTRI up to 10 January, 2009 comply with the requirements of the CTRI and the World Health Organization's International Clinical Trial Registry (WHO ICTRP). Results Considerable inequities exist within the Indian health system. Deficiencies in healthcare provision and uneven regulation of, and access to, affordable healthcare co-exists with a large private health system of uneven quality. India is now a preferred destination for outsourced clinical trials but is plagued by poor ethical oversight of the many trial sites and scant information of their existence. The CTRI's vision of conforming to international requirements for transparency and accountability but also using trial registration as a means of improving trial design, conduct and reporting led to the selection of registry-specific dataset items in addition to those endorsed by the WHO ICTRP. Compliance with these requirements is good for the trials currently registered but these trials represent only a fraction of the trials in progress in India. Conclusion Prospective trial registration is a reality in India. The challenges facing the CTRI include better engagement with key stakeholders to ensure increased prospective registration of clinical trials and utilization of existing legislative opportunities to complement these efforts. [source] Disentangling the racial test score gap: Probing the evidence in a large urban school districtJOURNAL OF POLICY ANALYSIS AND MANAGEMENT, Issue 1 2007Leanna Stiefel We examine the size and distribution of the gap in test scores across races within New York City public schools and the factors that explain these gaps. While gaps are partially explained by differences in student characteristics, such as poverty, differences in schools attended are also important. At the same time, substantial within-school gaps remain and are only partly explained by differences in academic preparation across students from different race groups. Controlling for differences in classrooms attended explains little of the remaining gap, suggesting little role for within-school inequities in resources. There is some evidence that school characteristics matter. Race gaps are negatively correlated with school size,implying small schools may be helpful. In addition, the trade-off between the size and experience of the teaching staff in urban schools may carry unintended consequences for within-school race gaps. © 2006 by the Association for Public Policy Analysis and Management. [source] Assessing evidence of environmental inequities: A meta-analysisJOURNAL OF POLICY ANALYSIS AND MANAGEMENT, Issue 2 2005Evan J. RingquistArticle first published online: 4 MAR 200 Over the past decade activists, academics, and policymakers have devoted a great deal of attention to "environmental equity," or the notion that sources of potential environmental risk may be concentrated among racial and ethnic minorities and the poor. Despite these efforts, the existence and extent of environmental inequities is still the subject of intense scholarly debate. This manuscript reports the results from a meta-analysis of 49 environmental equity studies. The analysis demonstrates that while there is ubiquitous evidence of environmental inequities based upon race, existing research does not support the contention that similar inequities exist with respect to economic class. © 2005 by the Association for Public Policy Analysis and Management [source] Identifying Children with Dental Care Needs: Evaluation of a Targeted School-based Dental Screening ProgramJOURNAL OF PUBLIC HEALTH DENTISTRY, Issue 2 2004David Locker BDS Abstract Objectives: It has been suggested that changes in the distribution of dental caries mean that targeting high-risk groups can maximize the cost effectiveness of dental health programs. This study aimed to assess the effectiveness of a targeted school-based dental screening program in terms of the proportion of children with dental care needs it identified. Methods: The target population was all children in junior and senior kindergarten and grades 2, 4, 6, and 8 who attended schools in four Ontario communities. The study was conducted in a random sample of 38 schools stratified according to caries risk. Universal screening was implemented in these schools. The parents of all children identified as having dental care needs were sent a short questionnaire to document the sociodemographic and family characteristics of these children. Children with needs were divided into two groups: those who would and who would not have been identified had the targeted program been implemented. The characteristics of the two groups were compared. Results: Overall, 21.0 percent of the target population were identified as needing dental care, with 7.4 percent needing urgent care. The targeted program would have identified 43.5 percent of those with dental care needs and 58.0 percent of those with urgent needs. There were substantial differences across the four communities in the proportions identified by the targeted program. Identification rates were lowest when the difference in prevalence of need between the high- and low-risk groups was small and where the low-risk group was large in relation to the high-risk group. The targeted program was more effective at identifying children from disadvantaged backgrounds. Of those with needs who lived in households receiving government income support, 59.0 percent of those with needs and 80.1 percent of those with urgent needs would be identified. Conclusions: The targeted program was most effective at identifying children with dental care needs from disadvantaged backgrounds. However, any improvements in cost effectiveness achieved by targeting must be balanced against inequities in access to public health care resources. [source] Demonstrating Successful Aging Using the International Collaborative Study for Oral Health OutcomesJOURNAL OF PUBLIC HEALTH DENTISTRY, Issue 4 2000Kathryn A. Atchison DDS Abstract As the lifespan increases and people are faced with 15 to 20 years of "old age," we ask what one considers successful aging with respect to oral health. We propose a comprehensive combination of outcome variables, maintenance of teeth, manageable periodontal condition, positive perceived oral health, satisfaction with their access to and receipt of dental services, and minimal functional problems, that together comprise a definition of successful aging. The International Collaborative Study for Oral Health Outcomes provides a data set for exploring the oral health of a diverse sample of older adults in US and international sites using the modified Andersen Behavioral Model. The percent of adults who report no natural teeth ranged from 16 percent in San Antonio to 59 percent in New Zealand. Seventy percent or more of the adults from each site rated their oral health as good/fair or better except in Poland. The current cohort of older adults is faring better on some indicators than others; nevertheless, ethnic minorities and poorer countries still demonstrate inequities. Dentistry must attempt to educate individuals early in their lifespan that a combination of personal oral health practices and current dental techniques offers the potential for successful oral health throughout one's lifetime. [source] The Erosion of Racial Equality in the Context of Cuba's Dual EconomyLATIN AMERICAN POLITICS AND SOCIETY, Issue 3 2007Sarah A. Blue ABSTRACT Scholars of Cuba have long linked Afro-Cubans' fate to the revolutionary government. As the government's influence on people's daily lives has declined over the past decade, the question arises of whether Afro-Cubans have sustained the gains they achieved in the revolution's first 30 years. This article uses survey data, collected in December 2000 from 334 Cuban families in Havana, to assess the impact of the post-1993 economic reforms on rising racial inequality in Cuba. It asks whether racial inequities occur in accessing dollars through state employment, self-employment, or remittances, and whether educational gains are tied to higher income. Results indicate that the structural means through which racial discrimination was once virtually eliminated through equal access to education and employment, and through which income levels became equalized according to educational level regardless of racial group, has lost its equalizing force in contemporary Cuba. [source] Low-income mothers, nutrition and health: a systematic review of qualitative evidenceMATERNAL & CHILD NUTRITION, Issue 4 2005Pamela Attree phd Abstract Diet is a key issue for UK health policies, particularly in relation to poorer socio-economic groups. From a public health perspective, the government's role is to help low-income families to make healthy food choices, and to create the conditions to enable them to make healthy decisions. Arguably, however, current policy on nutrition and health is influenced by individualist and behavioural perspectives, which fail to take into account the full impact of structural factors on food choices. This paper draws on a systematic review of qualitative studies that prioritize low-income mothers' accounts of ,managing' in poverty, synthesizing a subset of studies that focus on diet, nutrition and health in poor families. Synthesis findings are explored in the context of dominant discourses concerning individual responsibility for health and gendered societal values concerning ,good' mothering. The paper concludes that a shift in emphasis in health policies, affording a higher priority to enabling measures that tackle the underlying determinants of health, would be advantageous in reducing nutritional inequities for low-income mothers and their children. [source] Devolution, equity and the English question,NATIONS AND NATIONALISM, Issue 4 2008CHRISTOPHER G. A. BRYANT ABSTRACT. Following devolution to Scotland, Wales and Northern Ireland, does England need a stronger political voice and/or constitutional changes to safeguard its identity and interests? (the ,English question'). Polling and other evidence suggests that it does, albeit more to redress inequities associated with voting in parliament (the ,West Lothian question') and the distribution of public spending (the ,Barnett formula') than to safeguard its identity. Although campaigners for English devolution have had little impact, and alternative institutional responses to the English question are all problematic, it would be imprudent of the major parties to do nothing. The least difficult course would be adoption of English votes on English matters and reform or replacement of the Barnett formula. [source] A four-step faculty compensation model: From equity analysis to adjustmentNEW DIRECTIONS FOR INSTITUTIONAL RESEARCH, Issue 140 2008Serge Herzog A four-step statistical process is proposed to take faculty compensation analysis from identification of possible inequities to potential salary adjustment options. [source] Regression methods for correcting salary inequities between groups of academic employeesNEW DIRECTIONS FOR INSTITUTIONAL RESEARCH, Issue 115 2002Ronald L. Oaxaca This chapter explores some of the ways in which an institution can make salary adjustments to remove salary inequities for individuals. A new approach is developed for correcting salary inequities. [source] Continuing the dialogue: postcolonial feminist scholarship and Bourdieu , discourses of culture and points of connectionNURSING INQUIRY, Issue 3 2007JM Anderson Continuing the dialogue: postcolonial feminist scholarship and Bourdieu , discourses of culture and points of connection Postcolonial feminist theories provide the analytic tools to address issues of structural inequities in groups that historically have been socially and economically disadvantaged. In this paper we question what value might be added to postcolonial feminist theories on culture by drawing on Bourdieu. Are there points of connection? Like postcolonial feminists, he puts forward a position that aims to unmask oppressive structures. We argue that, while there are points of connection, there are also epistemologic and methodologic differences between postcolonial feminist perspectives and Bourdieu's work. Nonetheless, engagement with different theoretical perspectives carries the promise of new insights , new ways of ,seeing' and ,understanding' that might enhance a praxis-oriented theoretical perspective in healthcare delivery. [source] Implementing a postcolonial feminist perspective in nursing research related to non-Western populationsNURSING INQUIRY, Issue 2 2003Louise Racine Implementing a postcolonial feminist perspective in nursing research related to non-Western populations In this article, I argue that implementing a postcolonial feminist perspective in nursing research transcends the limitations of modern cultural theories in exploring the health problems of non-Western populations. Providing nursing care in pluralist countries like Canada remains a challenge for nurses. First, nurses must reflect on their ethnic background and stereotypes that may impinge on the understanding of cultural differences. Second, dominant health ideologies that underpin nurses' everyday practice and the structural barriers that may constrain the utilization of public healthcare services by non-Western populations must be further examined. Postcolonial feminism is aimed at addressing health inequities stemming from social discriminative practices. I will draw on extant literature and data of an ongoing ethnography exploring the Haitian caregivers' ways of caring for ageing relatives at home to unveil how the larger social and cultural world has an impact on caregivers' everyday lives. Marginalized locations represent privileged sites from which health problems, intersecting with power, race, gender, and social classes, can be addressed. Postcolonial feminism provides the analytic lens to look at the impact of these factors in shaping health experiences. It also suggests redirecting nursing cultural research and practice to achieve social justice in the healthcare system. [source] Culture theorizing past and present: trends and challengesNURSING PHILOSOPHY, Issue 4 2010Helen E.R. Vandenberg RN MSc (Nursing) Abstract Over the past several decades, nurses have been increasingly theorizing about the relationships between culture, health, and nursing practice. This culture theorizing has changed over time and has recently been subject to much critical examination. The purpose of this paper is to identify the challenges impeding nurses' ability to build theory about the relationships between culture and health. Through a historical overview, I argue that continued support for the essentialist view of culture can maintain a limited view of complex race relations. I also argue that attempts to apply culture theory, without knowledge of important historical, political, and economic factors, has often resulted in oversimplified versions of what was originally intended. Furthermore, I argue that individual-level interventions alone will be insufficient to address health inequities related to culture. Despite new critical conceptualizations of culture and the uptake of cultural safety, nursing scholars must better address the broader organizational, population, and political interventions needed to address inequities in health. I conclude with suggestions for how nurses might proceed with culture theorizing given these challenges. [source] Critical inquiry and knowledge translation: exploring compatibilities and tensionsNURSING PHILOSOPHY, Issue 3 2009Sheryl Reimer-Kirkham PhD RN Abstract Knowledge translation has been widely taken up as an innovative process to facilitate the uptake of research-derived knowledge into health care services. Drawing on a recent research project, we engage in a philosophic examination of how knowledge translation might serve as vehicle for the transfer of critically oriented knowledge regarding social justice, health inequities, and cultural safety into clinical practice. Through an explication of what might be considered disparate traditions (those of critical inquiry and knowledge translation), we identify compatibilities and discrepancies both within the critical tradition, and between critical inquiry and knowledge translation. The ontological and epistemological origins of the knowledge to be translated carry implications for the synthesis and translation phases of knowledge translation. In our case, the studies we synthesized were informed by various critical perspectives and hence we needed to reconcile differences that exist within the critical tradition. A review of the history of critical inquiry served to articulate the nature of these differences while identifying common purposes around which to strategically coalesce. Other challenges arise when knowledge translation and critical inquiry are brought together. Critique is one of the hallmark methods of critical inquiry and, yet, the engagement required for knowledge translation between researchers and health care administrators, practitioners, and other stakeholders makes an antagonistic stance of critique problematic. While knowledge translation offers expanded views of evidence and the complex processes of knowledge exchange, we have been alerted to the continual pull toward epistemologies and methods reminiscent of the positivist paradigm by their instrumental views of knowledge and assumptions of objectivity and political neutrality. These types of tensions have been productive for us as a research team in prompting a critical reconceptualization of knowledge translation. [source] Cultural safety and the challenges of translating critically oriented knowledge in practiceNURSING PHILOSOPHY, Issue 3 2009Annette J. Browne PhD RN Abstract Cultural safety is a relatively new concept that has emerged in the New Zealand nursing context and is being taken up in various ways in Canadian health care discourses. Our research team has been exploring the relevance of cultural safety in the Canadian context, most recently in relation to a knowledge-translation study conducted with nurses practising in a large tertiary hospital. We were drawn to using cultural safety because we conceptualized it as being compatible with critical theoretical perspectives that foster a focus on power imbalances and inequitable social relationships in health care; the interrelated problems of culturalism and racialization; and a commitment to social justice as central to the social mandate of nursing. Engaging in this knowledge-translation study has provided new perspectives on the complexities, ambiguities and tensions that need to be considered when using the concept of cultural safety to draw attention to racialization, culturalism, and health and health care inequities. The philosophic analysis discussed in this paper represents an epistemological grounding for the concept of cultural safety that links directly to particular moral ends with social justice implications. Although cultural safety is a concept that we have firmly positioned within the paradigm of critical inquiry, ambiguities associated with the notions of ,culture', ,safety', and ,cultural safety' need to be anticipated and addressed if they are to be effectively used to draw attention to critical social justice issues in practice settings. Using cultural safety in practice settings to draw attention to and prompt critical reflection on politicized knowledge, therefore, brings an added layer of complexity. To address these complexities, we propose that what may be required to effectively use cultural safety in the knowledge-translation process is a ,social justice curriculum for practice' that would foster a philosophical stance of critical inquiry at both the individual and institutional levels. [source] Workers are people too: Societal aspects of occupational health disparities,an ecosocial perspectiveAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 2 2010Nancy Krieger PhD Abstract Workers are people too. What else is new? This seemingly self-evident proposition, however, takes on new meaning when considering the challenging and deeply important issue of occupational health disparities,the topic that is the focus of 12 articles in this special issue of the American Journal of Industrial Medicine. In this commentary, I highlight some of the myriad ways that societal determinants of health intertwine with each and every aspect of occupation-related health inequities, as analyzed from an ecosocial perspective. The engagement extends from basic surveillance to etiologic research, from conceptualization and measurement of variables to analysis and interpretation of data, from causal inference to preventive action, and from the political economy of work to the political economy of health. A basic point is that who is employed (or not) in what kinds of jobs, with what kinds of exposures, what kinds of treatment, and what kinds of job stability, benefits, and pay,as well as what evidence exists about these conditions and what action is taken to address them,depends on societal context. At issue are diverse aspects of people's social location within their societies, in relation to their jointly experienced,and embodied,realities of socioeconomic position, race/ethnicity, nationality, nativity, immigration and citizen status, age, gender, and sexuality, among others. Reviewing the papers' findings, I discuss the scientific and real-world action challenges they pose. Recommendations include better conceptualization and measurement of socioeconomic position and race/ethnicity and also use of the health and human rights framework to further the public health mission of ensuring the conditions that enable people,including workers,to live healthy and dignified lives. Am. J. Ind. Med. 53:104,115 2010. © 2009 Wiley-Liss, Inc. [source] The origins of American physical anthropology in PhiladelphiaAMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY, Issue S49 2009Alan Mann Abstract With its location on a river with easy access to the sea, its central placement between the English speaking colonies to the north and south and its trading connections with the western frontier, there were many reasons Philadelphia became one of the most important towns of prerevolutionary America. In the early 1770s, it was the site of the first meeting organized to deal with the perceived inequities of the British government toward the colonies. It was where Thomas Jefferson wrote much of the Declaration of Independence, whose soaring statements reflecting the Age of Enlightenment spoke of the equality of all men. It was to this debate, centered on just who was included in this declaration that the origins of physical anthropology in America can be traced. Notable men in the early phases of this disputation included Samuel Stanhope Smith and especially Samuel George Morton, considered the founder of American physical anthropology. The American School of Anthropology, which argued for the polygenic origins of human races was substantially founded on Morton's work. Recent accusations that Morton manipulated data to support his racist views would appear unfounded. The publication of The Origin of Species in 1859 and the issuing of the Emancipation Proclamation in 1862-63 effectively ended the earlier debates. By the time of the American Civil War, 1861-65, physical anthropology was beginning to explore other topics including growth and development and anthropometry. Yrbk Phys Anthropol 52:155,163, 2009. © 2009 Wiley-Liss, Inc. [source] Annotation: Pathways to care for children with mental health problemsTHE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 7 2006Kapil Sayal Background:, Although many children with mental health problems are in contact with primary health care services, few receive appropriate help. Methods:, Using a pathways to care model, this paper systematically reviews the literature relating to access to services. It separates out the various stages of help-seeking: parental perception of problems, use of primary care services, recognition within primary care, and referral to or use of specialist health services. Results:, Following parental awareness of child symptoms, parental perception of problems is the key initial step in the help-seeking process. Although children with mental health problems or disorders are regular attenders within primary care and most parents acknowledge that it is appropriate to discuss concerns about psychosocial issues in this setting, few children are presented with mental health symptoms even if their parents have such concerns. Subsequently, less than half of children with disorders are recognised in primary care. Amongst recognised children, about half are referred to specialist services. Overall, up to one-third of children with disorders receive services for mental health problems. Factors such as the type and severity of disorder, parental perceptions, child age and gender, and family and social background factors determine which affected children access services. Conclusions:, As there are inequities in patterns of service use, a greater emphasis on developing resources at population and primary care levels is required. Barriers involving parental perceptions and expression of concerns within consultations should be minimised at these levels. This requires both public education approaches and improved training and specialist support for primary care services to enhance their ability to provide for these children. [source] | |||||||||||||||||||||||||