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This research aims to analyze the configuration, distribution, and equity of nursing human resources in Sichuan Province, China, providing a reference for the future development of nursing care in the region. A descriptive analysis was conducted to describe the configuration of nursing human resources in 2010, 2015, and 2020. The Lorenz curve, Gini coefficient, health resource density index, and distribution density maps were used as resources and methodology to evaluate the changes and equity in the configuration of nursing human resources. The result of this research determined that the nurse-to-population ratio was 1.17, 2.09, and 3.42 in 2010, 2015, and 2020, and nursing staff accounted for 24%, 49%, and 35% of technical health personnel. The nurse-to-physician ratio was 1:0.72, 1:1.05, and 1:1.22 in the three years. The Gini coef- ficients of nursing resource allocation for permanent population and area were 0.24, 0.20, and 0.12 and 0.74, 0.72, and 0.72, respectively. The nursing resource density index was 0.50, 0.91, and 1.42, respectively. In conclusion, the study shows that the equity of nursing resources based on population increased, while the equity based on region still showed disparity, with a sustained increase in nursing human resource density from 2010 to 2020. However, it is necessary to continue increasing the number of nurses and improving the geographical accessibility of nursing care. [ABSTRACT FROM AUTHOR]

In 2019, the Los Angeles Department of Transportation’s (LADOT) micromobility program brought together the agency, scooter operators, and other stakeholders to create a holistic regulatory framework that established operational requirements and expectations to promote the safe and effective use of micromobility scooters, primarily dockless e-scooters, and e-bikes. While the program has effectively expanded the usage of micromobility and mitigated externalities associated with dockless vehicle programs, it has been less effective at ensuring access, particularly in underserved neighborhoods such as the Equity-Focused Mobility Development Districts. In a mixed-methods approach, we combine micromobility data from LADOT, interviews with private operators and community-based organizations, and case studies of micromobility equity programs in other US cities to inform our three policy recommendations for LADOT. The three key policy levers are a reduction in the number of operators allowed within the program, strengthened outreach requirements with enforcement from LADOT, and a modification to the penalty schedule that does not deter deployment in the San Fernando Valley. These policies would create more favorable market conditions for increasing operator deployment in the equity zones while advancing LADOT’s goal of improving access to shared mobility.

Mayor Garcetti launched the temporary Al Fresco Program in the City of Los Angeles to allow outdoor dining to support economically distressed eateries in response to the COVID-19 Pandemic and stay-at-home orders. Since the program's inception, the City of Los Angeles has had a goal of a 50% participation rate in disadvantaged communities. The report aims to explore barriers disadvantaged communities face to apply to the L.A. Al Fresco program and finds solutions to increase program participation in these communities. The researcher conducted an eligibility survey of 7 and from that group 5 in-depth interviews with food and beverage establishment owners to understand the barriers to participating in the L.A. Al Fresco Program and the impact of COVID. Along with qualitative analysis, the report found that 27% of active eateries in the City of Los Angeles currently participate in the L.A. Al Fresco program. Interviewees expressed how they are still recovering economically from COVID-19, which has been compounded by inflation, leaving no interest in expanding their business through outdoor dining. The report recommends that the L.A. Al Fresco Program create a small restaurant outreach strategy through an L.A. Al Fresco ambassador program and develop partnerships with local economic development organizations to increase specialized support services for small businesses in under-invested communities to ensure access to the program without barriers.

Rapidly increasing urbanization in recent decades has elevated the subway as the primary public transportation mode in metropolitan areas. Indoor air quality (IAQ) inside subways is an important factor that influences the health of commuters and subway workers. This review discusses the subway IAQ in different cities worldwide by comparing the sources and abundance of particulate matter (PM2.5 and PM10) in these environments. Factors that affect PM concentration and chemical composition were found to be associated with the subway internal structure, train frequency, passenger volume, and geographical location. Special attention was paid to air pollutants, such as transition metals, volatile/semi-volatile organic compounds (VOCs and SVOCs), and bioaerosols, due to their potential roles in indoor chemistry and causing adverse health impacts. In addition, given that the IAQ of subway systems is a public health issue worldwide, we calculated the Gini coefficient of urban subway exposure via meta-analysis. A value of 0.56 showed a significant inequity among different cities. Developed regions with higher per capita income tend to have higher exposure. By reviewing the current advances and challenges in subway IAQ with a focus on indoor chemistry and health impacts, future research is proposed toward a sustainable urban transportation systems.

ObjectiveTo evaluate the current status and equity of older adult resource allocation in the 31 provinces (autonomous regions and municipalities) of mainland China, and to offer recommendations for the optimization of these allocations.MethodsFour key indicators, namely, the number of older adult institutions, employees, professionals, and beds in mainland China in the year 2020, were used and analyzed using various methods and tools, including agglomeration analysis, the Gini coefficient, and the Lorenz Curve. These methods were applied to evaluate the equity of older adult resource allocation across the different provinces (autonomous regions and municipalities) and regions of China, using two dimensions, namely, the geographical area and the older adult population.ResultsOverall, the number of older adult resource allocations was found to be increasing in China, while the number of employees with educational levels of junior college or above was relatively low and the population structure was aging. In terms of the equity of older adult resource allocation, the results showed that this was good according to the dimensions of the older adult population but was on the low side based on the dimension of geographical area, and the Gini coefficient of the western region, in particular, was in an alarming state. Different provinces (autonomous regions and municipalities) were found to have an uneven allocation of resources for older adults, with large differences, with some areas having a serious under-allocation of resources, while others showed resource over-allocation.ConclusionWhile China’s allocation of older adult resources is relatively equitable, there is nevertheless a need to take into account recent changes in the older adult population and strengthen the construction of a reasonably structured, high-quality team of professionals and technicians, as well as consider factors such as geographical area and the older adult population, and rationally allocate older adult resources in the eastern, middle, and western regions, to achieve a balanced allocation in terms of equity and efficiency and enhance social capital, to better satisfy the demands for older adult services in older adults at multiple levels.

Access to opportunity is the idea that people have the means and ability to reach a destination that would in turn benefit them in a positive manner - this can include jobs, education, healthcare, and recreation. The purpose of this report is to inform and advise Los Angeles Metro and their stakeholders on ways in which access to opportunity can be measured and analyzed to improve services to positively impact marginalized communities. The guiding research questions of this project seek to identify how Metro can effectively and practically communicate and implement future programs in Los Angeles County and how Metro programs and projects impact access to social services, economic opportunities, and mobility options for communities throughout Los Angeles County.

The rise in the capital allocated and investor focus attributed to ESG investing over the past several years has been significant. However, the current literature is not settled regarding the value that ESG risk measures and reporting has on investments and valuations. If this risk is essential, then this risk should be incorporated to account for the presence or the lack of ESG-related risk in valuation models. However, with the relative newness and difficulty of quantifying ESG risk, there is little practical guidance on incorporating this risk into valuation estimates. We provide evidence that ESG-related risk scores are positively associated with the cost of equity. Building upon that result, we operationalize the positive relationship to adjust the cost of equity in free cash flow to equity valuation models. Firms with higher ESG risk have a higher required return, while firms with lower ESG risk have a lower discount rate. Our approach is a practical guide for investors and analysts to account for ESG risk adjustments in valuation models. [ABSTRACT FROM AUTHOR]

Intermittent water supply (IWS) is a frequent operation approach in developing countries. A number of factors contribute to IWS, such as leakage and water shortage, leading to inequitable water distribution. A way to reduce the inequity in IWS systems is by planning or adapting the network for equitable water distribution, which requires software capable of describing IWS conditions, including not only pressurized flow but also free-surface. In this paper, a new index for equity analysis is presented and compared with the existing indices available in scientific literature. The comparison is based on the EPA-SWMM modelling framework and standard IWS operations, including pipe emptying and filling, have been considered. Results reveal that EPA-SWMM has great potential in simulating IWS systems, especially in the application for equity analyses, as it provides a more realistic description of the pipe filling and emptying operations compared to standard water distribution modelling software. Furthermore, a novel equation called volumetric coefficient was developed which has a significant advantage in identifying the nodes with a higher impact on network equity, and ensuring the fair distribution of supply along the distribution network, considering the relevance of nodal demand, which none of the other indexes in the literature were addressed. HIGHLIGHTS A novel equation was developed for calculating the supply equity in the network, named volumetric coefficient (VC).; The findings indicate that the VC has an advantage over other equations found in recent literature, on the analysis of equity in intermittent supply.; Simulation of flow patterns in the network during filling and emptying operations was analysed using EPA-SWMM.;

Abstract Background Diabetes is a chronic non-communicable disease that causes a substantial economic burden on diabetic suffers and their households. The aim of this study was to explore the prevalence, equity, and determinants of catastrophic health expenditure (CHE) among households with people with diabetes in Northwest China. Methods A total of 3,000 households were included in the 6th Health services survey in Gansu Province, China of which 270 households with people with diabetes. The equity of CHE was evaluated by concentration curve and concentration index (CI). We adopted the Pareto chart to analyze the main economic intervals of the occurrence of CHE. Finally, we combined the decision tree and logistic model and analyzed the determinants of the occurrence of CHE. Results The incidence of CHE at 15%, 25% and 40% were 75.19%, 58.89% and 35.19%, respectively. CHE tended to occur in households with a lower economic level, with the phenomenon being more pronounced at Z = 40%. The Pareto chart showed that households in the group with an annual per capita income of 0–740 USD (0–5,000 Chinese Yuan) were most likely to experience CHE. Both decision tree and logistic models suggested that economic level, comorbidities, and small household size were potential risk factors. In addition, the decision tree model also suggested the interaction between the influencing factor of health checks in the past 12 months and the number of chronic diseases. Conclusions In summary, Households with people with diabetes were more likely to incur CHE. It is essential to focus on low- and middle-income households with people with diabetes, strengthen the management of patients with diabetes, and provide timely health interventions to reduce the occurrence of chronic comorbidity and the risk of CHE in households.

Background: Diabetes is a chronic non-communicable disease that causes a substantial economic burden on diabetic suffers and their households. The aim of this study was to explore the prevalence, equity, and determinants of catastrophic health expenditure (CHE) among households with people with diabetes in Northwest China. Methods: A total of 3,000 households were included in the 6th Health services survey in Gansu Province, China of which 270 households with people with diabetes. The equity of CHE was evaluated by concentration curve and concentration index (CI). We adopted the Pareto chart to analyze the main economic intervals of the occurrence of CHE. Finally, we combined the decision tree and logistic model and analyzed the determinants of the occurrence of CHE. Results: The incidence of CHE at 15%, 25% and 40% were 75.19%, 58.89% and 35.19%, respectively. CHE tended to occur in households with a lower economic level, with the phenomenon being more pronounced at Z = 40%. The Pareto chart showed that households in the group with an annual per capita income of 0–740 USD (0–5,000 Chinese Yuan) were most likely to experience CHE. Both decision tree and logistic models suggested that economic level, comorbidities, and small household size were potential risk factors. In addition, the decision tree model also suggested the interaction between the influencing factor of health checks in the past 12 months and the number of chronic diseases. Conclusions: In summary, Households with people with diabetes were more likely to incur CHE. It is essential to focus on low- and middle-income households with people with diabetes, strengthen the management of patients with diabetes, and provide timely health interventions to reduce the occurrence of chronic comorbidity and the risk of CHE in households. [ABSTRACT FROM AUTHOR]

The international literature has provided significant contributions to recognise the important role of transport and social equity, particularly in the context of participating in key life-activities, and in the quality of life. However, little has been done on the relationship between long-distance rail transport, such as High Speed Rail (HSR), and social equity assessment. The objective of this manuscript is to fill this gap, by recognising that policy makers should be aware about possible effects of disparities brought by the interventions. Indeed, when planning the introduction of similar infrastructures or managing their impacts, they should focus on integrative solutions taking into account that the gap between primary and peripheral areas should not increase. Through a methodology made up of four steps, where the Gini index has been considered, it results that HSR increases inequity in four European countries. [ABSTRACT FROM AUTHOR]

Background Global obesity estimates show a steadily increasing pattern across socioeconomic and geographical divides, especially among women. Our analysis tracked and described obesity trends across multiple equity dimensions among women of reproductive age (15–49 y) in 11 sub-Saharan African (SSA) countries during 1994–2015. Methods This study consisted of a cross-sectional series analysis using nationally representative demographic and health surveys (DHS) data. The countries included were Cameroon, Comoros, Congo, Cote d'Ivoire, Ghana, Kenya, Lesotho, Nigeria, Senegal, Zambia and Zimbabwe. The data reported are from a reanalysis conducted using the WHO Health Equity Assessment Toolkit that assesses inter- and intra-country health inequalities across socioeconomic and geographical dimensions. We generated equiplots to display intra- and inter-country equity gaps. Results There was an increasing trend in obesity among women of reproductive age across all 11 SSA countries. Obesity increased unequally across wealth categories, place of residence and educational measures of inequality. The wealthiest, most educated and urban dwellers in most countries had a higher prevalence of obesity. However, in Comoros, obesity did not increase consistently with increasing wealth or education compared with other countries. The most educated and wealthiest women in Comoros had lower obesity rates compared with their less wealthy and less well-educated counterparts. Conclusion A window of opportunity is presented to governments to act structurally and at policy level to reduce obesity generally and prevent a greater burden on disadvantaged subpopulation groups in sub-Saharan Africa. [ABSTRACT FROM AUTHOR]

Despite efforts taken by the Government of India, mothers and newborns are excluded from the maternal and child health services, especially those in poorer and weaker sections of the society. Hence, we have utilized the most recent National Family Health Survey (NFHS-4) data to assess the socio-economic inequities in antenatal care (ANC), intranatal care and postnatal care (PNC) coverage for mothers and newborns in India. We have analysed the NFHS-4 data gathered from the Demographic Health Survey programme. Stratification and clustering in the sample design were accounted for using 'svyset' command. Point estimates were reported as proportions with 95% confidence interval. The concentration curve and index were used to represent the socio-economic inequities. Theil index was computed to report inequities across geographical regions and place of residence. In total, 190 797 women who had at least one live birth in the preceding 5 years were included. About 52.1% of women had at least four ANC visits and 81.4% had institutional delivery. About 25.2% and 27.1% of the newborn received PNC within 24 and 48 h of delivery. The proportion of women who received PNC within 24 and 48 h after the delivery was 63.4% and 65.2%, respectively. Maximum inequity was observed for ANC (concentration index-0.195) followed by receipt of PNC by mothers within 24 and 48 h (concentration index-0.106 and 0.103). Women from the rural areas had a disproportionately high proportion of home deliveries (Theil index-3813.6). The findings from this study inform the policymakers and planners about the socio-economic inequity existing across various maternal and child health indicators. This will help them in making informed decisions and strengthen the maternal and child health programme in our country. [ABSTRACT FROM AUTHOR]

• Propose a methodological framework for assessing the equity performance of bike sharing systems. • Model Individual accessibility to activity locations using bike-sharing as the mode of transportation. • Analyze equity performance from the perspective of both horizontal and vertical equity through a series of equity measures. • Carry out a case study with real data from the Coast Bike Share system in southern Tampa. The rising adoption of bike-sharing systems brings significant benefits to individuals and society as a whole. However, whether these benefits are distributed throughout society in a fair manner is still an open question. This study presents a methodological framework for assessing the equity performance of bike-sharing systems, with Coast Bike Share system in southern Tampa as a case study. The framework integrates three different datasets: bike-sharing infrastructure, individual travel itineraries and individual sociodemographic attribute data. With these datasets, we model individual accessibility to activity locations using bike-sharing as the mode of transportation by analyzing the "walking-cycling-walking" process of a bike-sharing trip and the trip-chaining behavior in individuals' travel itineraries. Further, a series of equity measures are used to analyze equity performance from the perspective of both horizontal and vertical equity. To assess horizontal equity, we apply the Lorenz curve, Gini index and mapped geographic differences. For vertical equity, we compare descriptive statistics by group, perform analysis of variance, and calculate the subgroup inequality index using disaggregated data. Results reveal that accessibility to bike-sharing is not evenly distributed among individuals in the population, within the geographic space, and among different sociodemographic groups of southern Tampa. Further, our results also highlight the need to incorporate high-resolution disaggregated data and tour-based analysis to address the equity performance of bike-sharing systems. [ABSTRACT FROM AUTHOR]

This paper reports the results of a scientific survey of the equity valuation practices of CFA Institute members with equity analysis job responsibilities. Using an instrument designed to minimize biases in prior valuation surveys and sampling a larger group than in previous studies (13,500 investment professionals, resulting in 1,980 valid completed questionnaires), this paper documents professional practices in the selection of equity valuation approaches, including specific model variations and key input preferences. Important differences in practice were observed across geographies and employer firm types. [ABSTRACT FROM AUTHOR]

Abstract A basic question for the assessment of the fairness of a project financing formula on successive generations is to determine what is the most appropriate method to group the affected individuals over the years. The generational approach in the "Intergenerational Redistributive Effects Model" (IREM) deals with it through the ad-hoc concept of overlapping annual generations. This concept requires establishing the number of years (or timespan) included in the generation and how to incorporate in it those individuals living in years that are not the central one. To do so in a way that reflects the sensitivity of society to the effects of a major transport infrastructure project, specific surveys with a novel approach were designed. The outputs from the survey carried out in Catalonia show evidence suggesting that discount functions should tend to decline at a higher rate in the short term than in the long term. Thus, future impacts of transport investments, both future socio-economic net benefits and financial burdens, should be considered less important than immediate (present) outcomes in the decision-making process. Further, there are reasons to consider that discounting is not neutral to reflect the social interest of large-scale transport projects for the successive generations involved. [ABSTRACT FROM AUTHOR]

In rapidly-growing metropolitan regions, it is crucial that transportation-related policies and infrastructure are designed to ensure that everyone can participate equitably in economic, social, and civil opportunities. Ridehailing services are touted to improve mobility options, but there is scant research that incorporates this mode within an accessibility framework. This paper employs a generalized cost measure in a multi-modal accessibility framework, namely Access Profile Analysis, to assess the role of ridehailing in providing job access to historically under-resourced parts of Toronto, Canada, referred to by the city as Neighborhood Improvement Areas (NIAs). Ridehailing is analyzed both as a mode of commute and as a feeder to the transit network (a first-mile solution). The results indicate that there are two main determinants of the extent to which ridehailing provides additional accessibility over transit: the transit level of service at the origin zone and the zone's proximity to employment opportunities. The ridehailing mode is shown to increase accessibility especially to closer destinations (jobs), with the highest improvement seen in the city's inner suburbs. On the other hand, integrating ridehailing with public transit does little to improve access to jobs. Compared to the rest of the city, NIAs experience a higher accessibility improvement from ridehailing alone, but not from its integration with transit. Nonetheless, job accessibility remains lower in NIAs than in other areas – even after the introduction of ridehailing. [ABSTRACT FROM AUTHOR]

An economic analysis identifies, measures, and compares the costs and benefits of alternative interventions, with the objective of supporting decisions concerning the best use of limited resources. The cost benefit analysis (CBA) has played a significant role within the entire decision-making process, and is the principal assessment methodology. In recent years, equity issues in relation to transportation planning have become a hot topic at an international level. In this paper, the objective was to integrate equity within the evaluation of transport projects, specifically high speed rail projects. Here, consumer surplus is conceived as a monetized measure of both direct and indirect benefits for all zones, and for all socioeconomic categories served and not served by HSR, respectively. The added value of this paper is in rethinking these two shares in the computation of the total net present value as equity measures of the project itself. Specifically, the distribution of the HSR benefits among the different groups or zones in a given study area can be computed, and a comparison of the values for each zone of the study area and for each category makes it possible to assess the effects of equity between zones/categories. [ABSTRACT FROM AUTHOR]

Bike share systems are a standard feature of the urban mobility ecosystem but they have received criticism for serving a narrow demographic band of residents and visitors while underrepresenting others. This analysis employed Chi-square and multivariate linear regression analyses to understand effect sizes associated with how various demographic groups in Baltimore, MD perceive barriers to utilizing the city's new Baltimore Bike Share (BBS) system. The analysis revealed that people of color, Hispanics, the less-educated, females, low income earners, and the unemployed are underrepresented in system membership. Regression analysis of non-user survey data suggested that nonwhite individuals are associated with a moderate increase in perceiving BBS to be challenging when riding with children or cargo. Being female is associated with concerns about system use, the ability to ride comfortably, maintaining personal hygiene, being a victim of crime or harassment, and an overall lack of interest in biking in Baltimore. Identifying as having low income or less education was not observed to be associated with any of the barrier conditions examined in this study. These findings can be leveraged to develop programs and policies to improve participation rates within underrepresented groups and enhance system equity. [ABSTRACT FROM AUTHOR]

Background: Some falls prevention interventions for the older population appear cost-effective, but there is uncertainty about others. Therefore, we aimed to model three types of exercise programme each running for 25 years among 65+ year olds: (i) a peer-led group-based one; (ii) a home-based one and (iii) a commercial one., Methods: An established Markov model for studying falls prevention in New Zealand (NZ) was adapted to estimate incremental cost-effectiveness ratios (ICERs) in cost per quality-adjusted life-years (QALYs) gained. Detailed NZ experimental, epidemiological and cost data were used for the base year 2011. A health system perspective was taken and a discount rate of 3% applied. Intervention effectiveness estimates came from a Cochrane Review., Results: The intervention generating the greatest health gain and costing the least was the home-based exercise programme intervention. Lifetime health gains were estimated at 47 100 QALYs (95%uncertainty interval (UI) 22 300 to 74 400). Cost-effectiveness was high (ICER: US$4640 per QALY gained; (95% UI US$996 to 10 500)), and probably more so than a home safety assessment and modification intervention using the same basic model (ICER: US$6060). The peer-led group-based exercise programme was estimated to generate 42 000 QALYs with an ICER of US$9490. The commercially provided group programme was more expensive and less cost-effective (ICER: US$34 500). Further analyses by sex, age group and ethnicity (Indigenous Māori and non-Māori) for the peer-led group-intervention showed similar health gains and cost-effectiveness., Conclusions: Implementing any of these three types of exercise programme for falls prevention in older people could produce considerable health gain, but with the home-based version being likely to be the most cost-effective., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2019. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)