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Abstract Summary Incorporating the voice of the child is essential for a holistic assessment that is used to guide social work interventions targeted at enhancing the well-being of children. In order to include children as key participants in understanding their worldview, social workers need to provide a space for children to voice out their subjective assessment of their current life experiences and conditions. This paper aims to bring attention to utilizing photo eliciting interviewing (PEI) as a means to access children's subjective well-being from low-income families. Findings By utilizing photoraphy and in-depth interviews sequentially to engage and gain access into children's worldviews, this study found that children from low-income families possessed agentic capabilities and are capable of contributing towards their well-being. Despite the financial constraints experienced by their families, children did not perceive their families to be poor. Instead, they took into account the family context and parental efforts in assessing the family's circumstances. Furthermore, children initiated strategies to create opportunities of happiness or to intervene in situations of sadness that stemmed from financial constraints. Application This study propose social workers to employ PEI as a complement to the objective measurement tools commonly utilized in social work assessments and interventions when working with children from low-income families. Other than constructing a holistic assessment of children's well-being, PEI also allows for the inclusion of children as integral partners in social work interventions and programme designs. Children possess the knowledge and ability to initiate and contribute solutions to problems, which when identified and tapped upon, promotes children's participation as change agents of their own lives. Highlights • This paper highlights the relevance of using Photo Elicitation Interviewing as a supplementary information gathering method for social work assessment in working with children. • Utilizing this method, this paper illustrates how it engaged children from low-income families by empowering them to use photography to express their views on their families' financial constraints. • From the results of using photos to elicit conversations, children were facilitated to voice their perspectives, world views and their sense of agency. • It is proposed that Photo Elicitation Interview can be a useful tool for social work assessment alongside with standardized assessment measurements and framework to access children's voice. [ABSTRACT FROM AUTHOR]

Rural areas in Indonesia are older relative to urban areas. This paper questions how levels of social engagement vary across among the elderly in rural Indonesia. A sample of 2750 respondents aged 60 and over was drawn from 10 purposely-selected relatively "old" villages. Our three measures of social engagement are: participation in income-generating activities, in communal activities, and in care work. While there are notable village-level differences in patterns of social engagement, the majority of our respondents are actively engaged in productive activities in their old age until they can no longer be so. A negative educational gradient in the likelihood of work participation suggests that needs for income security is a driver of the elderly's work participation. The notion of promoting active ageing, as typically understood in the Western and/or urban contexts, is of secondary importance to health care provision and managing old-age disability in these ageing rural communities. • Fertility decline and out-migration created pockets of ageing in rural Indonesia. • We analysed how social engagement varies among persons aged 60 + in 10 villages. • Living in poorer villages is associated with higher odds of social engagement. • Those with lower education have higher odds of working in old age. • Policy should focus on health care provision and managing old-age disability. [ABSTRACT FROM AUTHOR]

Abstract Our paper explores how legal status stratification shapes the health and health care of low-income patients with chronic illnesses in the U.S. healthcare safety net. Drawing on data from over two years of ethnographic fieldwork at urban safety-net clinics, we examine efforts by Complex Care Management (CCM) teams to stabilize patients with uncontrolled chronic illnesses through primary care-integrated support. We show that stratified citizenship and geographic variability correspond to different possibilities for health care. We suggest an approach to immigration as a structural determinant of health that accounts for the complex, stratified, and changing nature of citizenship status. We also highlight how geographical differences and interactions among local, state, and federal policies support the notion that citizenship is stratified across multiple tiers with distinctive possibilities and constraints for health. While county-based health plans at each of the study sites include residents with varying legal status, lack of formal legal status remains a substantial obstacle to care. Many immigrants are unable to take full advantage of primary and specialty care, resulting in unnecessary morbidity and mortality. In some cases, patients have returned to their country of origin to die. While CCM teams provide an impressive level of support to assist immigrant patients in navigating healthcare and immigration bureaucracies, legal and geographic stratification limit their ability to address broader aspects of these patients' social context. Highlights • Immigration status shapes the health of chronically ill U.S. safety net patients. • Local, state, and federal policies differentially stratify legal status and health. • Ethnography illustrates health impacts of stratified legal status. • Complex care management patients lacking legal status face obstacles to care. • Legal and geographic stratification impede immigrant CCM patients' health. [ABSTRACT FROM AUTHOR]

Abstract: There is growing interest in the influence of socioeconomic status (SES) on health. Individual SES has been shown to be closely related to mortality, morbidity, health-related behavior and access to health care services in Western countries. Whether the same set of social determinants accounts for higher rates of mortality or morbidity in Japan is questionable, because over the past decade the magnitude of the social stratification within the society has increased due to economic and social circumstances. SES must be interpreted within the economic, social, demographic and cultural contexts of a specific country. In this report we discuss the impact of individuals'' socioeconomic position on health in Japan with regard to educational attainment, occupational gradient/class, income level, and unemployment. This review is based mainly on papers indexed in Medline/PubMed between 1990 and 2007. We find that socioeconomic differences in mortality, morbidity and risk factors are not uniformly small in Japan. The majority of papers investigate the relationship between education, occupational class and health, but low income and unemployment are not examined sufficiently in Japan. The results also indicate that different socioeconomic contexts and inequality contribute to the mortality, morbidity, and biological and behavioral risk factors in Japan, although the pattern and direction of the relationships may not necessarily be the same in terms of size, pattern, distribution, magnitude and impact as in Western countries. In particular, the association between higher occupational status and lower mortality, as well as higher educational attainment and either mortality or morbidity, is not as strongly expressed among the Japanese. Japan is still one of the healthiest and most egalitarian nations in the world, and social inequalities within the population are less expressed. However, the magnitude of the social stratification has started to increase, and this is an alarming sign. [Copyright &y& Elsevier]

The COVID-19 pandemic disproportionately affected the health and well-being of marginalized communities, and it brought greater awareness to disparities in health care access and utilization. Addressing these disparities is difficult because of their multidimensional nature. Predisposing factors (demographic information, social structure, and beliefs), enabling factors (family and community) and illness levels (perceived and evaluated illness) are thought to jointly contribute to such disparities. Research has demonstrated that disparities in access and utilization of speech-language pathology and laryngology services are the result of racial and ethnic differences, geographic factors, sex, gender, educational background, income level and insurance status. For example, persons from diverse racial and ethnic backgrounds have been found to be less likely to attend or adhere to voice rehabilitation, and they are more likely to delay health care due to language barriers, longer wait times, a lack of transportation and difficulties contacting their physician. The purpose of this paper is to summarize existing research on telehealth, discuss how telehealth offers the potential to eliminate some disparities in the access and utilization of voice care, review its limitations, and encourage continued research in this area. A clinical perspective from a large volume laryngology clinic in a major city in northeastern United States highlights the use of telehealth in the provision of voice care by a laryngologist and speech-language pathologist during and after the COVID19 pandemic. [ABSTRACT FROM AUTHOR]

This paper presents a new stylized fact about the relationship between income and childhood vaccination. It shows vaccination rates first rise but then fall as income increases. This pattern is observed in WHO country-level panel data, and in US county-level panel and individual-level repeated cross-section data. This data pattern suggests that both low and high-income parents are less likely to follow the standard vaccination schedule, and that such behavior is reflected in the vaccination rate at the population level. I provide several alternative explanations as to why we observe this data pattern, including avoidance measures, medical care, and social segregation. [ABSTRACT FROM AUTHOR]

This paper examines how the relative shares of public and private health expenditures impact income inequality. We study a two period overlapping generation's growth model in which longevity is determined by both private and public health expenditure and human capital is the engine of growth. Increased investment in health, reduces mortality, raises return to education and affects income inequality. In such a framework we show that the cross-section earnings inequality is non-decreasing in the private share of health expenditure. We test this prediction empirically using a variable that proxies for the relative intensity of investments (private versus public) using vaccination data from the National Sample Survey Organization for 76 regions in India in the year 1986-87. We link this with region-specific expenditure inequality data for the period 1987-2012. Our empirical findings, though focused on a specific health investment (vaccines), suggest that an increase in the share of the privately provided health care results in higher inequality. [ABSTRACT FROM AUTHOR]

Health care practitioners are increasingly required to make more efficient decisions when it comes to allocating health care expenditure. This requires not only information relating to the costs of medical interventions, but also the benefits of such interventions on individual’s overall well-being. In order to calculate the well-being losses associated with health conditions, this study uses the compensating income variation approach (CIV), to calculate the amount of extra equivalent household income to make someone who suffers from one of 15 health conditions, as well off in terms of life satisfaction as someone who does not have these health conditions. To help put these findings into perspective, this study also calculates CIVs for many other factors commonly found to be significantly associated with subjective well-being (e.g. unemployment, widowhood, separation and indicators of social capital). This paper builds on previous work using CIVs in health by addressing the issue of income endogeneity in life satisfaction and also testing how robust the derived CIVs are to the inclusion of personality measures, namely the Big Five personality traits. The analysis suggests that health conditions significantly affect individual’s quality of life and that the amount needed to make someone with a health condition as well off as someone without those health conditions can be substantive, albeit less than is commonly reported in the literature using the CIV approach to date. [ABSTRACT FROM AUTHOR]

A number of behaviours influence health in a non-monotonic way. Physical activity and alcohol consumption, for instance, may be beneficial to one's health in moderate but detrimental in large quantities. We develop a demand-for-health framework that incorporates the feature of a physiologically optimal level. An individual may still choose a physiologically non-optimal level, because of the trade-off in his or her preferences for health versus other utility-affecting commodities. However, any deviation above or below the physiologically optimal level will be punished with respect to health. Distinguishing between two individual types we study (a) the qualitative properties of optimal time-paths of health capital and health-related behaviour, (b) the perturbations of the optimal time-paths that result from changes in exogenous parameters, and (c) steady state properties. Predictions of the model and the implications for empirical analysis are discussed at length. Some comments on potential future extensions conclude the paper. [ABSTRACT FROM AUTHOR]

Abstract: Premium subsidies have been advocated as an alternative to social health insurance. These subsidies are paid if expenditure on health insurance exceeds a given share of income. In this paper, we examine whether this approach is superior to social health insurance from a welfare perspective. We show that the results crucially depend on the correlation of health and productivity. For a positive correlation, we find that combining premium subsidies with social health insurance is the optimal policy. [Copyright &y& Elsevier]

Abstract: Although language and culture are important contributors to uninsurance among immigrants, one important contributor may have been overlooked – the ability of immigrants to return to their home country for health care. This paper examines the extent to which uninsurance (private insurance and Medicaid) is related to the ability of immigrants to return to Mexico for health care, as measured by spatial proximity. The data for this study are from the Mexican Migration Project. After controlling for household income, acculturation and demographic characteristics, arc distance to the place of origin plays a role in explaining uninsurance rates. Distance within Mexico is quite important, indicating that immigrants from the South of Mexico are more likely to seek care in their communities of origin (hometowns). [Copyright &y& Elsevier]

Abstract: This paper compares the extent to which the principle of “equal treatment for equal need”(ETEN) is maintained in the health care delivery systems of Hong Kong, South Korea and Taiwan. Deviations in the degree to which health care is distributed according to need are measured by an index of horizontal inequity. Income-related inequality in utilization is split into four major sources: (i) direct effect of income; (ii) need indicators (self-assessed health status, activity limitation, and age and gender interaction terms); (iii) non-need variables (education, work status, private health insurance coverage, employer-provided medical benefits, Medicaid status (low-income medical assistance), geographic region and urban/rural residency and (iv) a residual term. Service types studied include western doctor, licensed traditional medicine practitioner (LTMP), dental and emergency room (ER) visits, as well as inpatient admissions. Violations of the ETEN principle are observed for physician and dental services in Hong Kong . There is pro-rich inequity in western doctor visits. Unusually, this inequity exists for general practitioner but not specialist care. In contrast, South Korea appears to have almost comprehensively maintained ETEN although the better-off have preferential access to higher levels of outpatient care. Taiwan shows intermediate results in that the rich are marginally more likely to use outpatient services, but quantities of western doctor and dental visits are evenly distributed while there is modest pro-rich bias in the number of LTMP episodes. ER visits and inpatient admissions in Taiwan are either proportional or slightly pro-poor. Future work should focus on the evaluation of policy interventions aimed at reducing the observed unequal distributions. [Copyright &y& Elsevier]

The possible insensitivity of willingness-to-pay (WTP) values to changes in scale continues to cause concern within the contingent valuation (CV) literature. Although several reasons for this phenomenon have been suggested, empirical evidence both supports and refutes insensitivity. This paper presents data that suggest that insensitivity may be significantly determined by the individual's budget constraint: the higher the proportion of income the expressed WTP represents, the greater the insensitivity of that WTP to changes in the scale of the good, irrespective of changes in underlying marginal utility. The methodological implication for CV studies in health care is outlined. [ABSTRACT FROM AUTHOR]

In OECD countries, a considerable share of health care expenditure (HCE) is spent for the care of the terminally ill. This paper derives the demand for HCE in the last 2 years of life from a model that accounts for age, mortality risk and wealth. The empirical tests are based on data of deceased members of a major Swiss sick fund. The empirical evidence confirms most of the hypotheses derived from the model, i.e., (i) HCE increases with closeness to death, (ii) for retired individuals, HCE decreases with age, and (iii) low-income individuals, as compared to high-income individuals, incur lower HCE in the last months of life. [ABSTRACT FROM AUTHOR]

This paper presents a comparison of horizontal equity in health care utilization in 10 European countries and the US. It does not only extend previous work by using more recent data from a larger set of countries, but also uses new methods and presents disaggregated results by various types of care. In all countries, the lower-income groups are more intensive users of the health care system. But after indirect standardization for need differences, there is little or no evidence of significant inequity in the delivery of health care overall, though in half of the countries, significant pro-rich inequity emerges for physician contacts. This seems to be due mainly to a higher use of medical specialist services by higher-income groups and a higher use of GP care among lower-income groups. These findings appear to be fairly general and emerge in countries with very diverse characteristics regarding access and provider incentives. [ABSTRACT FROM AUTHOR]

The reductions in cancer morbidity and mortality afforded by population-based cancer screening programmes have led many low-income and middle-income countries to consider the implementation of national screening programmes in the public sector. Screening at the population level, when planned and organised, can greatly benefit the population, whilst disorganised screening can increase costs and reduce benefits. The International Cancer Screening Network (ICSN) was created to share lessons, experience, and evidence regarding cancer screening in countries with organised screening programmes. Organised screening programmes provide screening to an identifiable target population and use multidisciplinary delivery teams, coordinated clinical oversight committees, and regular review by a multidisciplinary evaluation board to maximise benefit to the target population. In this Series paper, we report outcomes of the first regional consultation of the ICSN held in Agartala, India (Sept 5-7, 2016), which included discussions from cancer screening programmes from Denmark, the Netherlands, USA, and Bangladesh. We outline six essential elements of population-based cancer screening programmes, and share recommendations from the meeting that policy makers might want to consider before implementation. [ABSTRACT FROM AUTHOR]