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This article investigates the association between sense of community belonging and health among settlements of different size and across the urban to rural continuum in Canada. Using data from the recent 2007/08 Canadian Community Health Survey (CCHS), the objective is to identify the major health, social and geographic determinants of sense of community belonging and to consider policy options aimed at improving sense of belonging among certain segments of the population. The research found a significant and consistent association between sense of belonging and health, particularly mental health, even when controlling for geography and socio-economic status. At the same time, sense of community belonging improved progressively across the urban to rural continuum with remarkably high levels of belonging evident in the outer most regions of Canada. Despite the health deficit that exists in rural and small-town Canada, the paper postulates that these communities are able to overcome health challenges to create conditions conducive to a positive sense of belonging. Overall, sense of belonging was also found to be highest among seniors, people residing in single-detached homes and among couples with children and was lowest among youth, residents of high-rise apartments and among single-parents. Finally, in the context of addressing deficiencies in sense of belonging, the paper examines several recent policy developments aimed at improving mental health services in Canada.

From a recent Ethiopian representative household survey this paper empirically operationalizes concepts from the capability approach to shed light on the relationship between conversion factors, capability inputs and health functionings. The subjects of the study are women in partnership. The results suggest their health functionings are responsive to specific household bargaining power conversion factors and capability inputs. The paper also tests the extent to which women who take more decisions achieve better health functioning. The model offers evidence that decision-making and health functionings follow a complex pattern as women who took more decisions were not always better off. The conclusion of the paper is that health functioning may be improved by inducing changes to household decision-making patterns. (Contains 28 footnotes, 10 tables, and 3 figures.)

This paper follows up an unexpected finding from a community survey that identified drinking and smoking as the most important tuberculosis (TB) risk factor, far ahead of ones commonly associated with TB such as poverty, overcrowded living conditions, and HIV-positive status. It reports perceptions of drinking and smoking from a three-phased study of the stigma associated with TB, consisting of a qualitative pilot study using focus-group discussions (2006), a larger-scale community survey (2007), and follow-up group discussions (2009). The community attitude survey was conducted with a sample of 1,020 adults living in a low-income township in the Eastern Cape Province, South Africa. The study found that the moral and the biomedical understanding of TB risk are intertwined. In the community survey, perceptions of drinking and smoking as TB risk were predicted by fear of contracting TB and being a self-reported born-again Christian. In the follow-up study, heavy drinking and smoking in shebeens (unlicensed township liquor outlets) was associated with a risky lifestyle that can spread both TB and HIV. The paper discusses the similarities and differences in the roles of church and shebeen in providing social support to township dwellers to cope with problems of daily life. It is tentatively concluded that the stereotypical shebeen "drinkers and smokers", alternatively pitied and maligned by moral society, might serve as the scapegoat that deflects pollution from the "new" TB linked to the AIDS epidemic.

This paper estimates multidimensional poverty in China by applying the Alkire-Foster methodology to the China Health and Nutrition Survey 2000-2009 data. Five dimensions are included: income, living standard, education, health and social security. Results suggest that rapid economic growth has resulted not only in a reduction in income poverty but also in a reduction in multidimensional poverty in the last decade, both in terms of its prevalence and intensity. However, many challenges remain. There are wide disparities across provinces and between urban and rural areas, with poverty being 1.5 times higher in rural areas than in urban ones in 2009. Moreover, rising deprivation in education in rural and less developed provinces should also be a policymaking concern.

How can social indicator research improve understanding of community health as well as inform stakeholders about the assets disadvantaged communities have for coping with disparities? This paper describes the development and evolution of the Partnership for Assessment of Communities (PAC) and its best practices for social indicator research. The PAC will be of interest to researchers across multiple disciplines for a number of reasons. First, PAC is a working model of best practices for multidisciplinary scholarly inquiry. Second, it has developed an integrated model of quantitative and qualitative methodology to define and measure community health as compared to traditional quality-of-life indicators. Third, it serves as an example of "action research," in that the findings have the potential to make an impact on community stakeholders and policy outcomes in the greater Central San Joaquin Valley of California, a region characterized by deep social and economic disparities. (Contains 2 tables and 3 footnotes.)

Research on the effects of socioeconomic well-being on health is important for policy makers in developing countries, where limited resources make it crucial to use existing health care resources to the best advantage. This paper develops and tests a set of measures of socioeconomic status indicators for predicting health status in developing countries. We construct socioeconomic indexes that capture both household and community attributes so as to allow us to separate the social from the purely economic dimensions of the socioeconomic status within a cross-national perspective, with applications to data from Demographic and Health Surveys (DHS) fielded in five African countries in the 1990s. This study demonstrates the distinctive contributions of socioeconomic indexes measured at the household vs. community level in understanding inequalities in health and survival and underlines the importance of going beyond the purely economic view of socioeconomic status to cover the multidimensional as well as multilevel concept of economic and social inequality.

While there are many cross-sectional studies that provide data on gambling behaviour and the characteristics of those who gamble, there are few large-scale population based longitudinal studies of gambling. This is a serious limitation. It is increasingly being recognised that longitudinal data is required to properly understand gambling behaviour, trajectories, risks and consequences. This paper makes use of a large-scale longitudinal survey that includes questions on gambling behaviour in Australia: the Household, Income and Labour Dynamics in Australia (HILDA) survey. Although the HILDA survey currently provides data on gambling at a single point in time in 2015, there are data on the individuals, in the majority of cases, back to 2001. This paper analyses the trajectories of a range of social, health and economic outcomes according to self-reported risk of experiencing gambling related problems. The analysis clearly shows that problem gamblers experience significantly worse outcomes than those without gambling problems, and poor outcomes go back a number of years. In a number of cases, outcomes are becoming progressively poorer, which may suggest either increasingly risky gambling behaviour or the cumulative effects of a sustained period of gambling problems. The long-term nature of the poor health and social outcomes experienced by problem gamblers strongly suggests that programs designed to address gambling problems will have to be cognisant of, and address these underlying issues. Effective treatment is thus likely to be long-term and challenging. It also suggests that restricting access to gambling via mechanisms such as pre-commitment or self-exclusion will be effective. [ABSTRACT FROM AUTHOR]

COVID-19 has had a disproportionate impact on the elderly, who are over-represented among those who suffered severe illness or death. The obvious implication is that the share of the elderly in the population significantly affects the impact of COVID-19 on the overall health of a country. More generally, the elderly share has far-reaching economic and social ramifications. In this paper, we perform empirical analysis of cross-country data from 1970 to 2018 to identify the determinants of the share of the elderly—i.e., those aged 65 and over—in a country's population. We find that the quality of health care, life expectancy, and female labor participation increases the elderly share while higher fertility and female education attainment lower the elderly share. In addition, we find that the share is higher for high income countries and countries in Europe and Central Asia. [ABSTRACT FROM AUTHOR]

Trickle-down has been addressed, so far, using income-based measures of inequality and poverty. However concerns over the inequality in access to other dimensions important for quality of life remains. I revisit trickle-down using the Alkire and Foster (J Public Econ 95(7-8), 2011) class of measures to estimate multidimensional poverty in India. Using NSS data estimates are presented for the 16 major states and are compared to income-based measures. Adding dimensions in poverty measurement results in the reversal of several income-based conclusions about poverty across regions. The paper also finds that contrary to income-based findings, Muslims are less poor than Hindus under the multidimensional criteria. [ABSTRACT FROM AUTHOR]

This paper empirically examines factors related to social, economic, demographic and health care services that affect health status in Pakistan. The analysis is conducted using ARDL bound testing approach on annual data ranging from 1960 to 2014. It is estimated that health spending has a significant impact on health status, specifically, development health spending and income are robust predictors of health status for the population in Pakistan and is seen to affect female life expectancy positively in both the short and in long run, however, it is important to note that the impact of income per capita is relatively stronger than that of public health spending. Total fertility rate (fr) appears to have a significant effect on child mortality rate (cmr) with a negative sign both in the short and in long-run. This result is especially important for developing countries like Pakistan where population growth is high and infant deaths are frequent. Bidirectional causality exists between infant and child mortality and fertility rate; these results are supported by the modern economic theory of population. The effect of medical personnel availability on health status, particularly in reducing infant and child mortality, remains statistically non-significant despite the bidirectional causal relationship between this variable and the infant and child mortality. Nutrition appears to be causally related to life expectancy and child mortality. Thus, it is important for the Government of Pakistan to design its policies based on the development targets in addition to the growth targets that have been set in place for the country. [ABSTRACT FROM AUTHOR]

This paper examines the impact of trade openness and foreign direct investment (FDI) on life expectancy using time series data over the period of 1972-2013. We have applied structural break unit root as well as cointegration tests to examine integrating properties of the variables and cointegration among the variables. The causal linkage between the variables has been tested by applying the VECM Granger causality. The empirical evidence confirms the presence of cointegration amid the variables. Moreover, trade openness and FDI increase population health measured by life expectancy in the long-run. Furthermore, the analysis suggests that trade openness and FDI cause life expectancy in the short-run. These findings have several policy implications to improve life expectancy for the people of Pakistan in particular and other developing countries in general. [ABSTRACT FROM AUTHOR]

There is a growing interest in quality of life (QoL) as an integrated approach to addressing key social, environmental and economic determinants of health. The University of Saskatchewan’s Community-University Institute for Social Research (CUISR) has examined the process and results of a multi-stakeholder approach to the ongoing sustainability of Saskatoon, Saskatchewan as a healthy city with an improving and a more equitably distributed QoL. Using quantitative and qualitative analysis, this research has examined QoL across three locales in Saskatoon—representing Low, Middle and High socio-economic status neighbourhoods. Two large telephone surveys were conducted with residents of the city in 2001 and 2004. This paper presents the major findings from these two surveys according to four overarching research questions posed by the CUISR QoL team. The questions relate to a number of QoL issues including the socio-demographic characteristics of respondents, place related measures, aspects influencing excellent or very good QoL in Saskatoon and feelings of a strong sense of place. The paper also assesses the changes in the results of the four questions between 2001 and 2004. [ABSTRACT FROM AUTHOR]

Social welfare systems face major challenges, particularly in a context of social transformation, austerity and growing inequalities. This process is highly visible in the health sector. In this context, many voices ask for public sector reforms and community action for health as a relevant practice. However, analyses and evaluations of this kind of practices are still limited, particularly beyond the cases of single community health actions or interventions. We still need to identify key indicators for measuring and characterising what community action for health consists of, as well as to what degree this kind of intervention has been developed across a city. Based on a research about 49 neighborhoods in Barcelona, this paper creates an index to measure and characterize community action for health, using different indicators: citizen engagement programs in community health, organizational transformation of the health and social protection systems, stable participatory structures with specific teams, and urban health policies. We apply the index to the case of Barcelona and build a map of community action for health in the city using 4 categories: strong community health development (one neighbourhood), middle (9 neighborhoods), emergent (25 neighborhoods) and without specific community health promotion (14 neighbourhoods). We find that community action for health is extensive within the city of Barcelona, have great potential as a response to the need for change in the relationship between the public (health) sector and the citizenry, but is still implemented unequally across the urban territory in terms of types and methods. [ABSTRACT FROM AUTHOR]

Past literature has reported the ubiquitous differences in health outcomes associated with socioeconomic status across different international settings. Due to the absence of fine level aggregated data, however, rather limited studies have been conducted to explore the neighborhood social determinants of public health in developing countries, especially in China. Using district level official data in 2010, this study examines the neighborhood social determinants of three prevalent non-communicable diseases (NCDs) in Shenzhen, China. In total, 22 exploratory social variables are selected from five domains: employment, education, housing, demographic structure and income. Spatial regression in binary and stepwise form is used to recognize the most influential social determinants. Results indicate the social determinants vary with the three NCDs and they have some general similarities. Spatial binary regression identifies four principle social determinants of NCDs prevalence: employment, income, housing and demographic structure. One essential social determinant (percentage of the floating population) is identified for all the three diseases by stepwise regression. Our study highlights that the main social determinant related to the incidence rates of all NCDs is the indicator of demographic structure denoting percentage of the floating population. This paper advances the understanding of the essential social determinants of NCDs in China. [ABSTRACT FROM AUTHOR]

This paper designs a multidimensional index of well-being for 20 Italian regions, based on a set of 41 indicators organized in an original hierarchical structure, a decision-tree whose four main pillars are Economy, Society, Environment and Health. Our novel approach combines the objective dimension of the evaluation (a comprehensive set of statistical indicators) within a flexible non-additive aggregation model (the Choquet integral) characterized with the preferences of informed Italian stakeholders. Adopting the Choquet integral allows us to overcome the well-known limitations embedded in the linear models, by assigning a weight (capacity) to any coalitions of dimensions, and by allowing a different degree of substitutability within each decision node in the tree. The weights and the parameters for the aggregation are elicited through a computer-based nominal group technique, a method which reduces the occurrences of drastically dissenting valuations and the potential expert-selection bias. Our results show that experts' perception of synergies and redundancies is quite heterogeneous between levels and nodes in the tree. Moreover, well-being measures are much influenced by the degree of substitutability embedded in the experts' preferences. Overall, the Italian picture looks more heterogeneous when analysed through the Choquet integral, with respect to a linear model. [ABSTRACT FROM AUTHOR]

COVID19 pandemic has put the global health emergency response to the test. Providing health and socio-economic justice across communities/regions helps in resilient response. In this study, a Geographic Information Systems-based framework is proposed and demonstrated in the context of public health-related hazards and pandemic response, such as in the face of COVID19. Indicators relevant to health system (HS) and socio-economic conditions (SC) are utilized to compute a response readiness index (RRI). The frequency histograms and the Analysis of Variance approaches are applied to analyze the distribution of response readiness. We further integrate spatial distributional models to explore the geographically-varying patterns of response readiness pinpointing the priority intervention areas in the context of cross-regional health and socio-economic justice. The framework's application is demonstrated using Pakistan's most developed and populous province, namely Punjab (districts scale, n = 36), as a case study. The results show that ~ 45% indicators achieve below-average scores (value < 0.61) including four from HS and five from SC. The findings ascertain maximum districts lack health facilities, hospital beds, and health insurance from HS and more than 50% lack communication means and literacy-rates, which are essential in times of emergencies. Our cross-regional assessment shows a north–south spatial heterogeneity with southern Punjab being the most vulnerable to COVID-like situations. Dera Ghazi Khan and Muzaffargarh are identified as the statistically significant hotspots of response incompetency (95% confidence), which is critical. This study has policy implications in the context of decision-making, resource allocation, and strategy formulation on health emergency response (i.e., COVID19) to improve community health resilience. [ABSTRACT FROM AUTHOR]

There is a growing interest in quality of life as an integrated approach to addressing key social, environmental and economic determinants of health. The University of Saskatchewan’s Community-University Institute for Social Research, funded by the Social Sciences and Humanities Research Council (grant #410-2004-0669) has examined the process and results of a multi-stakeholder approach to the ongoing sustainability of Saskatoon, Canada as a healthy city with an improving and a more equitably distributed quality of life. Using quantitative and qualitative analysis, together with GIS technology, this research has examined the quality of life across three locales in Saskatoon—representing Low, Middle and High socio-economic status in both 2001 and 2004. The participatory action research approach used in this work ensures the value of the outputs to the stakeholders. Given the strong recognition of the importance of interfacing policy, research and community, and the growing impatience with the limited application of research findings to social and health practices and policies, this project has undertaken four major knowledge translation/transfer strategies, above and beyond the traditional academic channels: (1) engagement of local media on a consistent basis, (2) implementing community policy forums to ensure continued community readiness and uptake, (3) facilitation of and successful functioning of a steering committee, and (4) employment of an action researcher to operate as a policy entrepreneur. This paper will review and discuss each of these strategies and outline the evaluative research being done to document the success of these strategies. [ABSTRACT FROM AUTHOR]

This paper estimates linear structural models using LISREL and employs MIMIC models to find out factors determining child health in Pakistan. A distinction has been made in permanent and transitory health states that lend support to Grossman’s (1972) stock and flow concepts of health. The paper addresses the issue of health unobservability and finds out that latent variables using MIMIC models best represent underlying child health states. To overcome problems of poor income data, factor analysis is applied to extract measures of housing and durables as indicators of socio-economic well-being of children in Pakistan. The results of the study show that child health states, both permanent and transitory, are affected significantly by factors such as parental education, socio-economic conditions, and health care variables. [ABSTRACT FROM AUTHOR]

The prevalence of non-communicable chronic diseases (NCDs) worldwide poses an alarming threat to public health. Recent literature has embraced the opinion that incorporating the social factors should advance the understanding of NCDs prevalence. In this context, examining the NCDs prevalence in association with area social deprivation should provide critical implications for coping with public health risks. However, few empirical studies have examined this specific issue, especially in the developing countries. Using the principal component analysis, an area social deprivation index (ASDI) is established for the Shenzhen city (China) by integrating ten indicators from four dimensions: education, housing, socially disadvantaged population, and economically disadvantaged population. The geographically weighted regression (GWR) is employed to analyze the associations between ASDI and the incidence rate of three prevalent NCDs at district scale. Spatial non-stationary relationships are identified for the three diseases. More specifically, prevalence of the three diseases is all positively correlated with the ASDI. Strength of the associations presents the geography that it generally decreases from the central city to the suburb. These findings suggest that greater possibility of NCDs prevalence would be expected in districts with higher social deprivation. Besides, the impact of social deprivation on NCDs prevalence is much stronger in the central city. The spatial stationarity can facilitate the formulation of location-specific preventive measurements. This paper is believed to provide an innovative insight for social indicators research. [ABSTRACT FROM AUTHOR]

Today health is an indicator of progress and social and economic development. There are many different methods for measuring public health. Experience of public health researches reveals different trends. In this paper we proposed and used integral index-the public health index (PHI), which integrate most objective indicators of public health: infant mortality rate, life expectancy at birth for men and for women. These indicators have several important advantages: there is data for almost all countries, they do not require expert assessment and they are reliable. Calculated the PHI for Russia, we got a picture of the dynamics of public health in Russia for 22 years-from the end of the Soviet period and the beginning of the transition to a new model of socio-economic development (1992) until the end of 2012. This index clearly illustrates changes in the public health. [ABSTRACT FROM AUTHOR]

In recent years, almost all countries around the world face budget cuts in health spending, which force public and private hospitals in these countries to use their resources effectively and to provide more efficient health care. In this context, the present study evaluates hospital efficiency across 29 OECD countries between 2000 and 2010 and investigates the determinants affecting hospitals' activities. In the first stage of the two-stage performance analysis, efficiency scores of the hospitals were measured by data envelopment analysis (DEA) while, in the second stage, Panel Tobit Analysis was used to identify the environmental factors that affect the efficiency scores obtained in the first stage. The paper also explores the changes in the factor efficiency compared to the previous years by decomposition through the Malmquist Productivity Index. In the first stage, it was found that the efficiency scores achieved after 2000 began to decline in 2004 and reached their lowest levels between 2009 and 2010. The highest slack values were found in the figures regarding tomography, MR, and nurses, respectively. In the second stage, due to the censored nature of the dependent variable obtained by DEA, in order to achieve consistent and unbiased estimators, the use of Panel Tobit Analysis was proposed. Estimations showed that, among the environmental factors that secondarily affect hospital efficiency, income, education and number of private hospitals affect efficiency in a positive way, while the effects of public and private health expenses and the number of public hospitals on such efficiency was negative. [ABSTRACT FROM AUTHOR]

Well-being is a contentious concept, and related measurements are socially and culturally sensitive. This paper examines the concept of well-being from the perspective of Lao people. The conceptual framework of the study is based on a framework well-being is comprised of three modes; 'having', 'thinking' and 'doing'. The researcher engaged 15 key informants were in-depth interviewed and 35 representatives of households in focus group discussions to ascertain well-being indicators. It is argued that the Lao concept of well-being is entrapped in a dichotomous concept of subjective and objective well-being. This study proposes that well-being indicators of Lao PDR are comprised of 5 components, and 39 indicators; including family well-being (4 indicators), community unity well-being (9 indicators), health well-being (7 indicators), forest and environment well-being (9 indicators), and having enough for sustaining living well-being (10 indicators). [ABSTRACT FROM AUTHOR]

Statistics Canada's General Social Survey (GSS) and Canadian Community Health Survey (CCHS) offer a valuable opportunity to examine the stability of life satisfaction responses and their correlates from year to year within a consistent analytical framework. Capitalizing on the strengths of these surveys, this paper addresses two questions. First, how much variability is observed from year to year and across surveys in the distribution of life satisfaction responses and what accounts for it? Second, how much variability is observed in the direction and magnitude of the correlation between life satisfaction and a consistent set of socioeconomic characteristics? The study shows that the mean level of life satisfaction reported varies from year to year in the GSS but remains stable in the CCHS. This pattern in variability is associated with survey content preceding the life satisfaction question. In contrast, the direction and magnitude of the relationships between life satisfaction and common socioeconomic characteristics is generally consistent between the two surveys and over time. [ABSTRACT FROM AUTHOR]

How can social indicator research improve understanding of community health as well as inform stakeholders about the assets disadvantaged communities have for coping with disparities? This paper describes the development and evolution of the Partnership for Assessment of Communities (PAC) and its best practices for social indicator research. The PAC will be of interest to researchers across multiple disciplines for a number of reasons. First, PAC is a working model of best practices for multidisciplinary scholarly inquiry. Second, it has developed an integrated model of quantitative and qualitative methodology to define and measure community health as compared to traditional quality-of-life indicators. Third, it serves as an example of 'action research,' in that the findings have the potential to make an impact on community stakeholders and policy outcomes in the greater Central San Joaquin Valley of California, a region characterized by deep social and economic disparities. [ABSTRACT FROM AUTHOR]

The weightings of the four component indicators of the UNDP’s Human Development Index HDI appear to be arbitrary and have not been given justification. This paper develops a variant of the HDI, calculated to reflect peoples’ revealed evaluations of education and the productivity of work. The resulting Calibrated human Development Index CDI has a simpler structure, places greater weight on life expectancy and lesser weight on education. It is validated by high correlation with life evaluations from the World Values Survey. The CDI ranks countries much like the HDI. More importantly, its provenance permits it to be used to assess specific policies, regulations, safety standards, life-saving interventions and health-care alternatives. The CDI is a unified tool for policy evaluation and decision support. [ABSTRACT FROM AUTHOR]

Methodology for making cross-national comparisons is an area of increasing interest in social and public health related research. When studying socio-economic differences in health outcomes cross-nationally, there are several methodological issues of concern, especially when data is derived from self-reported questionnaires. Health Behaviour in School-aged Children (Currie et al. ) is a WHO cross-national study using school samples. HBSC provides comparable data, and thereby a unique opportunity to study associations between social indicators and health outcomes within an international perspective. In 2001/02 data was collected from a total of 162,323 children in 32 countries (Austria, Belgium, Canada, Croatia, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Greenland, Hungary, Ireland, Israel, Italy, Latvia, Lithuania, Macedonia, Malta, Netherlands, Norway, Poland, Portugal, Russia, Slovenia, Spain, Sweden, Switzerland, Ukraine, United Kingdom, USA.). Studies of social inequalities requires that a comparable measure of socio-economic position (SEP) is in use. HBSC has developed a proxy for social position measuring material wealth, the Family Affluence Scale (FAS). This paper studies FAS and whether it is comparable across population subgroups defined by country, age and gender. Initial analysis revealed that an item measuring perceived family wealth was a valid FAS item. Including this item in the FAS score will improve the reliability of FAS. Graphical log-linear Rasch models (GLLRM) showed that FAS contain differential item functioning (DIF) with respect to country, age, and gender as well as local dependency (LD) between items. During the analysis, test equating techniques where used to adjust for the test bias generated by DIF. We recommend that the equated scores are used whenever FAS is included as a variable. This study suggests that HBSC-FAS should contain five items (additional item: perceived family wealth) when analysing data from HBSC 2001/02, and furthermore that each country should adjust for the DIF or make use of the converted FAS scores provided. If using FAS as a proxy for social position at an international level, it is not advised to compare the absolute levels of FAS, but weigh the scale by ridit transformation. [ABSTRACT FROM AUTHOR]

This study investigates the empirical validity of the material deprivation indices (MDIs) using a partial criterion variable, namely UHCNIR (unmet health care need due to inadequate resources). This alternative approach helps to assess absolute validity (Type I and II errors) and sources of error in the measurement of poverty for a specific aspect of poverty (in this case inability to receive adequate health care due to affordability problems). A simple mismatch analysis identifies a sizable group, around 1% of the adult EU population, missed by MDIs despite being in UHCNIR. A majority of this 1% experiences not only UHCNIR but also multiple other deprivations, commonly reports having some difficulties making ends meet, and prevalently has a disability or a chronic health problem. The analysis reveals that MDIs miss specifically those 'unhealthy poor' since these measures do not include a relevant item, and thus cannot adjust for different needs and costs in health care and account for the distinct poverty experiences of these people. Therefore, the main methodological assumption of MDIs, identifying the people in poverty with only a limited set of key deprivation indicators is not supported by this empirical analysis. [ABSTRACT FROM AUTHOR]

With the closure of schools due to the Covid-19-pandemic, parents of schoolchildren had to quickly adapt their daily schedules by taking over responsibilities of homeschooling for their children, while arranging their own schedule. This study first identifies the parents who are most challenged by having to ensure homeschooling responsibilities and then assesses how homeschooling affects different dimensions of parents' wellbeing. Analyzing data from a large general population-representative panel survey in Switzerland, we compare subjective wellbeing before the Covid-19-outbreak to wellbeing at the end of the semi-lockdown. Almost one fifth of parents report being sometimes overwhelmed by homeschooling obligations for their children. Women, mid-aged and lower-educated individuals as well as those with young children and a lower income are particularly overwhelmed. Being sometimes overwhelmed by homeschooling does not cause changes in life satisfaction, stress and negative affect. Yet, it leads to a decrease in positive affect. We derive recommendations for educational and public health policies. [ABSTRACT FROM AUTHOR]

Democracy is generally associated with governmental accountability, better public policy choices and public health. However, there is limited evidence about how political regime transition impacts public health. We use two samples of the states around the world to trace the impact of regime transition on public health: the first sample comprises 29 post-communist states, along with 20 consolidated democracies, for the period of 1970–2014; the second sample is a subsample of the same 29 post-communist states but only for the period of transition, 1990–2014. We find that the post-communist states experienced some decline in life expectancy in the first few years of transition (1990–1995). Yet, with a steady increase in the measure of democracy from 1995 onwards, life expectancy significantly improved and infant mortality decreased. Therefore, in the long run, democratization has had a positive impact on both the life expectancy and infant mortality of citizens of the post-communist states. [ABSTRACT FROM AUTHOR]

In this article, we report statistical properties of two classes of generalized Gini coefficients (G1 and G2). The theoretical results were assessed via Monte Carlo simulations. Further, we used G1 and G2 on life expectancy to measure health inequalities among the provinces of China and the states of the United States. For China, the results indicated that there was statistically significant health inequality by both G1 and G2. However, for the US, the results showed that there was significant health inequality by G1 but no statistical significance was found in health inequality by G2. Overall, from our study, China has higher health inequality than the United States. [ABSTRACT FROM AUTHOR]

This paper extends and further validates the quality-of-life/ community-healthcare model and measures developed by Rahtz and Sirgy (2000). The quality of life (QOL) model is based on the theoretical notion that community residents' satisfaction with healthcare services available within their community affects community quality of life and life satisfaction. This study extends the model and, in keeping with past research, posits that the bottom-up spillover from community QOL to life satisfaction is greater for those individuals with low personal health satisfaction, lower income, and old age. Data were collected from 1094 community residents in the East-Coast area of the United States. The results provide good support of the new model. Managerial implications and applications for the new model are discussed. [ABSTRACT FROM AUTHOR]

Quality assessment is a crucial issue in the strategic management of the public health sector. The objective of this study is to investigate the patients' perception of the health system quality and explore the relationships between doctors and long-term cancer patients. The data under study have been collected during a survey conducted with long-term cancer patients who follow an oncological therapy in a Public Hospital. In the study, exploratory factorial analysis is developed and two structural equation models are proposed. The first model describes the service quality as perceived by the patients, which is influenced by four important factors, namely tangible aspects, reliability, empathy (doctor–patient human relations) and hospital organization. The second model describes the relationship between doctors and long-term cancer patients, which is influenced by three factors, that is reliability, empathy and hospital organization. The discussion highlights the contribution that the results of the study may make to the investigation of the possible strategies for improving health care service quality. [ABSTRACT FROM AUTHOR]

Empirical evidence regarding the relationship between social capital and health in China is relatively limited. This study aims to examine the impact of different types of social capital, including bonding, bridging and linking capitals, on physical, mental and general health of Chinese residents. 2985 cases from the Chinese General Social Survey 2010 were selected and hierarchical linear model analysis was performed. We found that at the individual level, bonding and bridging social capitals were positively associated with mental health in rural, urban and global China, but with general health in urban and global China only; linking social capital, which was measured by political participation and political efficacy in China for the first time, had significant positive impact on mental health in rural, urban and global China. At the county level, bonding social capital could only improve physical and general health in rural and global China, while bridging social capital would damage mental health in urban and global China. Furthermore, bridging social capital showed a passive cross-level interaction effect on physical health in urban and global China, and general health in global China. Our results also suggest that in order to exert positive impacts of social capital on health, efforts should be made to cultivate specific social capital in specific place and to promote equal distribution of related resources countrywide. [ABSTRACT FROM AUTHOR]

General life satisfaction (GLS) is a strong health correlate and can be conceptualized as an aggregate of satisfactions in different life domains and as a proxy for quality of life. Little is known about which life domains—measured as domain satisfactions—contribute most to GLS and are the best predictors of self-rated health (SRH) and whether these associations differ between countries and/or language areas. We used stepwise logistic regression models to investigate how domain satisfactions, GLS and SRH are interrelated and compared German-speaking and French/Italian-speaking Switzerland with the corresponding neighboring countries of Germany, Austria, France and Italy. The associations of domain satisfactions with GLS and SRH varied significantly in magnitude and between countries and language areas. GLS was strongly related to self-rated health in all populations, but more so in the German-speaking than the French/Italian-speaking regions. Adjusted for all domain satisfactions, satisfaction with one’s financial situation and job satisfaction showed independent effects on SRH and were the most important predictors of GLS, although no clear geographical pattern emerged. Domain-specific satisfactions were similarly associated with GLS and SRH, but the strength of the association varied between German-, French- and Italian-speaking populations. Any similarity between Swiss language areas and neighboring countries was limited to German-speaking populations. Country- and language-specific life domain satisfactions may provide useful pointers for targeting policies in the respective domains. [ABSTRACT FROM AUTHOR]

The inverse relationship between socioeconomic and health status has been well established in the literature. Disparities in health status due to socioeconomic conditions are unfair and can be prevented through appropriate health and social policies. The relation between socioeconomic factors and health outcomes can be proven at both the individual and geographic level. In this study, we follow the second stream of literature. The objective of the study is to measure how deprivation changes over time in an urban context, finding out whether socioeconomic inequalities association with health outcomes endure over time. To do so, a census-based deprivation index (GDI—Genoa Deprivation Index) have been developed using three aggregation methods—additive, Mazziotta-Pareto, and Pena distance. The innovation of the work is the attempt to evaluate deprivation over time, trying to formalize a methodological path replicable in other situation. Health status has been assessed using the standardized (premature) mortality ratios. The findings reveal that although deprivation inequalities continue to exist in Genoa, global levels have been decreasing. In addition, the rate of premature mortality has shown improvements. Despite this, GDI scores continue to be associated with premature deaths: individuals living in deprived areas report consistently high standardised mortality ratios. [ABSTRACT FROM AUTHOR]

Social stratification and life course approaches are enlisted to study the effects of health and social events on early adult welfare use. Given the strong link between individual and parental economic disadvantage, the mechanisms by which social context affects welfare use are examined. This unique approach is made possible by the linkage of several administrative databases in Manitoba, Canada, allowing for the follow-up of a large population (n = 42,598) and subpopulation of siblings (n = 7920) from birth to age 26. Gradients of inequality were found for many of the predictors. Regardless of background, improved educational achievement and better childhood and adolescent mental health seem likely to decrease the use of welfare in early adulthood. Addressing the risk factors identified in this study would reduce inequities and lower the need for welfare in early adulthood. [ABSTRACT FROM AUTHOR]

The last decades have witnessed an increasing international concern in assessing how efficiently health care resources are used in producing health. At a country level, comparing the efficiency of regional health systems and ranking the regions accordingly promotes transparency policies and represents an important incentive for the design and implementation of specific programs aimed at improving the quality of health care services within the country. The use of data envelopment analysis (DEA) as a tool for efficiency analysis in the health sector is well-established, but its use with a ranking purpose is discouraged due to lack of discrimination and comparability issues. Using data from the competent health authority in Spain, the purpose of this study is to assess the efficiency of the regional health systems in Spain and identify those regions that are using their health care inputs more efficiently than others, given the observed level of health outcomes. To this aim, a DEA-based model that operates under a common weights basis is used in order to improve discrimination and establish a common scale for a proper comparison of the regional health systems in Spain that can be subsequently ranked by their efficiency score. [ABSTRACT FROM AUTHOR]

Although the World Health Assembly emphasized as early as in 1996 the need for violence prevention, there is still no generally accepted index for interpersonal destructiveness in a society. Hereby we propose a Societal Index of Interpersonal Destructiveness (SIID) that could be used to compare interpersonal violence in different societies. SIID is a composite of two sub-indices: (1) Index of Interpersonal Destructiveness Prerequisites, and (2) Index of Interpersonal Destructiveness Consequences. This study addresses the construction and internal consistency analysis of SIID. The Indices for periods 1989-1993, 1994-1999, 1999-2004, 2005-2007 and 2008-2010 are computed and for 28-48 countries, depending on availability of high quality and comparative data across time. We conclude that SIID has considerable potential as an internally consistent yardstick for evaluating and comparing the level of interpersonal destructiveness of societies worldwide. [ABSTRACT FROM AUTHOR]

The increasing burden of communicable and non-communicable diseases are imposing unavoidable costs on Indians. As a consequence it exacerbate poverty and drag many poor further down by heavy medical expenses. This study aims to estimate the extent of healthcare expenditure on the individuals who were hospitalized due to various diseases. Further, this study examines the burden of healthcare expenditure on impoverishment level in India. The unit level record of the 71st round of the National Sample Survey Office (NSSO) is used in the analysis. The result reveals, cost of hospitalization due to non-communicable diseases is three times higher than communicable diseases in India. Therefore, an overall level of impoverishment has been increased by 1.61 percent/year which shows the high financial risk for the people surviving at the threshold of poverty. [ABSTRACT FROM AUTHOR]

The article focuses on the relationship between well-being and a socially-engaged lifestyle among Europeans aged 64 and above, in which topics discussed include the impact of activity participation on older people's health, and how the findings compared with data from the first Wave of the Survey of Health, Aging and Retirement in Europe. Also mentioned are activities that fall under the socially and productively oriented category and the definition of well-being.

Young people aged 15-24 years constitute a huge proportion of Nigeria's population and have enormous potential for socio-economic development. However, the fulfillment of that potential is dependent on how society meets their present needs and aspirations. We examined the evidence from 2003 to 2013 to establish whether there has been improvement in social conditions and opportunities for young people in Nigeria. We used the 2003, 2008 and 2013 Nigerian DHS data to estimate young people's wellbeing. Indicators of wellbeing were: unemployment rate, uneducated and unemployed young people, literacy rate; support for schooling, young people not graduating secondary school on time, young people in households where either parent lacks secondary education, teenage pregnancy and young people not covered by health insurance. We used bi-variate statistics and logistic regression to highlight determinants of wellbeing. Unemployment rate increased from 57.0 % in 2008 to 59.2 % in 2013 while the proportion of those who were both uneducated and unemployed was 12.6 % in 2013 (vs. 13.0 and 14.1 % in 2003 and 2008, respectively). Only 0.6 and 0.5 % of young people received support for schooling in 2008 and 2013, respectively. Literacy rate increased from 50.9 % (measured for only women) in 2003 to 71.0 % in 2013. Nearly all young people were not covered by health insurance. There is improvement in young people's wellbeing during the under considered, although progress is still unsatisfactory, with more efforts required. [ABSTRACT FROM AUTHOR]

How to determine if a population group has better overall (multidimensional) health status than another is a central question in the health and social sciences. We apply a multidimensional first order dominance concept that does not rely on assumptions about the relative importance of each dimension. In particular, we show how one can explore the 'depth' of dominance relations by gradually refining the health dimensions to see which dominance relations persist. We analyze a Danish health survey with many health indicators. These are initially collapsed into a single composite health dimension and then refined to four, seven, and ten health dimensions, each representing an (increasingly refined) area of health. Overall we find that younger age groups dominate older age groups in up to four dimensions, but no dominance relations are present with a more refined view of health. Comparing education groups, we often see dominance relations in four and seven dimensions, but the depth of the dominance vary considerably. We also compare groups based on gender, marital status, region, and ethnicity, where we generally find less dominance relations. Our empirical illustration shows that it is possible to operationalize and meaningfully apply the multidimensional first order dominance concept with gradual refinements of health status in up to ten health dimensions. [ABSTRACT FROM AUTHOR]

Despite increasing recognition that community-level socioeconomic factors are critical to individual health outcomes globally, guidance on their measurement remains limited in low and middle income countries. We outline the steps needed to develop and validate a theory-based, multidimensional index of community-level socioeconomic composition using information that is often available in global settings. Census indicators describing human and social capital were analyzed using principal components analysis to construct a community socioeconomic composition index (CSCI) for 30 communities in the Southern plains of Nepal. The index was validated against subsequent child nutrition, household assets, and village infrastructure using data from 1822 children and their households. At the community-level, the CSCI was positively correlated with child height-for-age, and child weight-for-age, household assets, and community infrastructure (r = 0.54, 0.58, 0.85, 0.67, respectively). In multilevel analyses, +1SD of the CSCI was associated with +0.14SD of the household asset index ( p < 0.01) after adjusting for confounders. These results suggest that an exclusively census-based strategy to measure socioeconomic composition has construct validity in this setting. This approach to measuring community-level socioeconomic composition may be feasibly reproduced in other resource-constrained settings where census data are available, potentially expanding the scope of place and health research globally. [ABSTRACT FROM AUTHOR]

There is consensus over the possibility of improved wealth situation leading to fertility decline. However, the likelihood of fertility decline leading to a significant improvement in wealth situation remains a subject of intense debate. This study examines the current pattern of linkages between fertility behaviour and wealth situation in Nigeria in an attempt to contribute to the debate. The study used the 2013 Nigeria Demographic and Health Survey data. Analysis involved use of descriptive statistical tools at univariate and bivariate levels while at multivariate level we used ordinary least square and hierarchical regression techniques. Results suggest that the contribution of the fertility behaviour indicators to the variance in wealth status, demonstrated through the R-square change in women and men hierarchical regression models that controlled for selected confounding variables, was almost zero percent (1 %). Although the individual fertility behaviour indicators exhibited some significant association with wealth status, the beta coefficients were visibly small in magnitude compared to the magnitude observed in the unadjusted OLS regression models. Thus, the current data suggest that the role of fertility behaviour in wealth status in Nigeria among women and men is not as important as other social, spatial and economic forces prevailing in the country. The study concludes that we have to seek explanation for the poor wealth situation in Nigeria in other factors other than fertility behaviour. [ABSTRACT FROM AUTHOR]

Lack of access to potable water and good sanitation is still one of the most challenging public health concerns of the twenty-first century despite steady progress over recent decades. Almost a billion people globally lack access to safe water; over two billion live without adequate sanitation facilities. The challenge is even more daunting for Sub-Saharan Africa where coverage levels for both potable water and sanitation remain critically low. The urgent need to address the issue calls for adequate understanding of the socio-economic dimensions. Using the 2008 Ghana Demographic and Health Survey, we investigated the socio-economic and demographic factors associated with access to potable water and improved sanitation facilities. Our generalized linear models reveal that income, education, household size, and region are significant predictors of improved water and sanitation access. Our discussion and conclusion sections highlight the implications of the study results for water policy formulation and implementation in Ghana, and broadly for other developing countries. [ABSTRACT FROM AUTHOR]

We examine the European Union (EU) countries and within-country areas (i.e., large urban areas, small urban areas, and rural areas) that are the most disadvantageous with respect to multidimensional poverty and in each of the investigated dimensions, i.e., health, education, and living standards. To this end, we construct the Multidimensional Poverty Index and its sub-indices: the Poverty in Health Index, Poverty in Education Index, and Poverty in Standard of Living Index. All of these indices provide information regarding the fraction of people who live in poverty, as well as information on the poverty intensity experienced by the poor. Our results indicate that the scale of poverty in the EU countries is diversified, with Denmark and Sweden being the most affluent countries, and Latvia, Bulgaria, and Romania being the most disadvantageous. We demonstrate that there are countries with no differences in the levels of poverty within a country, such as Denmark, Sweden, Spain, Finland, and the Czech Republic, and countries, usually less affluent ones such as Romania, Bulgaria and Lithuania, where considerable geographical inequality is present. In general, in countries with a high and moderately high number of poor, the worst situation with respect to the scale of poverty is observed in rural areas, and the best situation is observed in large urban areas, with the exception of Greece, Italy, and Portugal, where in large urban areas, the situation is the worst. In countries with a low number of poor, in general, the poverty is relatively higher in large urban areas. [ABSTRACT FROM AUTHOR]