Socio-economic inequalities in health among older adults in two rural sub-districts in India and Bangladesh: a comparative cross-sectional study

Health inequalities have been observed among older people in many developing countries, particularly among those with least social protection and low socio-economic (SES) status. This study attempted to examine effects of SES on the health of older adults, and related gender differences, in two rural sub-districts - Matlab, Bangladesh and Vadu, India. The study utilised the WHO SAGE-INDEPTH Wave 1, 2007 Matlab, Bangladesh and Vadu, Pune District, India datasets. Both gender and SES indicators were strongly associated with all health indicators of older adults in the Bangladesh site, whereas in India, education and asset quintiles were not consistently associated with self-rated health, quality of life and functional ability score but gender was consistently associated with all health indicators except the quality of life score. The SES-health gradient was noticeably higher amongst older adults in Matlab, Bangladesh than in Vadu, India. Education was also found to be an important predictor of health outcome in both sites.     

Education and perceptions of social status and power among women in Larteh,Ghana

In exploring the status of women in the developing world, most research emphasizes the impact of development indicators, like income or health, on women. This article goes beyond development indicators by discussing women's own perceptions of social status and power in rural Larteh, Ghana. It focuses primarily on the effects of gender and education on perception of social status and power. Section 1 offers a brief overview of the history of Ghana, reflecting the current position of women in the country. Definitions of social status and power within an African context are presented in section 2. Section 3 examines 24 interviews collected in Ghana, which asks respondents to discuss their own social status and power in relation to their community. In general, the results indicate that a woman's perception of increased social status and power is dependent on education and occupation. Other factors affecting perceptions of social status and power are wealth and culturally embedded positions held within the community, including elder, chief, and priestess.     

Patents and medicines: the relationship between TRIPS and the human right to health

The question of access to drugs in developing countries is at present largely influenced by the TRIPS Agreement. TRIPS compliance in the field of health requires substantial changes to existing patent laws in some countries. These changes must be analysed in the context of the spread of epidemics like HIV/AIDS and in relation to other international obligations that states have, for instance, with regard to the human right to health.
Intellectual property rights treaties today have significant impacts on the realization of some human rights like the right to health. This article examines the extent to which TRIPS encompasses flexibility for developing countries to be able to foster better access to medicines. It also examines these issues from the point of view of human rights and considers, in particular, the ways in which the relationship between human rights and intellectual property can be improved in international law.     

Disparities in entrepreneurial activity and attitude across EU countries

The levels and characteristics of entrepreneurship differ widely across EU countries and regions. Taking as reference data provided by the Global Entrepreneurship Monitor on entrepreneurial activity and entrepreneurial attitude, this paper analyses the disparities in entrepreneurship indicators among EU member countries in 2007 and 2013, highlighting the most significant changes that occurred during the Great Recession. Some of the major indices of inequality are calculated (Gini, Theil and Atkinson) and the change in the Gini coefficient between these two years is additively decomposed into mobility and progressivity components. Overall, we find that cross-national inequalities tend to increase in the procyclical aspects of entrepreneurial activity and attitude, while they tend to decrease in the countercyclical aspects. For entrepreneurial activity indicators, we reveal that heterogeneity increases in indicators such as opportunity-driven entrepreneurial activity and total entrepreneurial activity, while necessity-driven entrepreneurial activity becomes more homogeneous across countries. Regarding entrepreneurial attitudes, disparities among countries decrease in all indicators, except in perceived opportunities, for which cross-national inequality grows considerably during the crisis period.     

How Capitalism Was Built. The Transformation of Central and Eastern Europe,Russia, and Central Asia. Anders Åslund

An American political geographer and noted specialist in the electoral geography of the post-Soviet states explores the extent to which underlying social, political, and economic conditions in North African countries experiencing regime change prompted by mass political unrest (Egypt, Tunisia) resemble those prevailing in the five Central Asian states. The author compares the countries' rankings on a number of relevant indicators (e.g., Human Development Index, Corruption Perceptions Index, Freedom House indices of political rights and civil liberties) before undertaking a more qualitative assessment of human rights, institutional control, and external support for current Central Asian regimes. Although Uzbekistan, the most populous state with the most repressive regime in the region, is a focus of attention, the same abuses and challenges are evident, albeit in varying degrees, in other vulnerable post-Soviet countries of Central Asia.     

Health Patterns of the Etruscan Population (6th–3rd Centuries bc) in Northern Italy: The Case of Spina

A sample of 303 skeletons from the Etruscan necropolis of Spina (Ferrara, Italy, 6th–3rd centuries bc ) was examined for paleopathological lesions in order to assess the general health, diseases and quality of life of this Iron Age population. The observed pathologies included porotic hyperostosis, specific and aspecific infections, metabolic and endocrine disorders, tumours and osteoarthritis. A total of 46.7% of adults and 7.7% of subadults showed at least one pathological lesion. Statistical comparisons were made between sexes and adult‐age classes (20–35 years and >35 years) to analyse the prevalence of the lesions. The analysis of porotic hyperostosis and osteoperiostitis allowed to determine the general health status of this group, and the analysis of osteoarthritis allowed to hypothesise a gender division of labour. The results suggest a relatively high‐life expectancy for the time as well as good health and quality of life. The few specific infections and metabolic disorders indicate fairly good nutrition, while the high frequency of porotic hyperostosis can be partly linked to some type of hereditary anaemia. Copyright © 2015 John Wiley & Sons, Ltd.     

中国人口文化素质指数及其空间分异

在构建人口文化素质指数的基础上,结合我国文化教育现状,对我国近十年的人口文化素质指数进行了定量与定性分析。结果表明:我国人口文化素质指数正在快速提高,但整体水平较低;人口文化素质指数的空间差异明显,东部最高,中部次之、西部最低,低于全国平均水平的省域主要位于西部;近2/3的省域发散趋异,收敛趋同的省域不到1/3,向上发散趋异的省域主要位于东、中部,向下发散趋异的省域主要位于西部,空间差异有扩大的趋势;人口文化素质指数与人口城市化水平、经济发展水平分别存在显著的线性关系和对数关系。     

The Measurement of Socio‐economic Gender Inequality Revisited

The measurement of socio‐economic gender inequality has not received much attention from the development literature despite its great relevance and important policy implications. In this article we present two new indices to measure gender inequalities that overcome some of the limitations inherent in the UNDP gender‐related indices and other indices presented in the literature. The proposed new indices are conducive to exploring the extent to which gender gaps favour women and/or men, and to showing the contribution of the different subcomponents to the overall levels of gender inequality. Using UNDP data, our calculations suggest that the levels of gender inequality are mostly explained by differences in the earned‐income subcomponent and that the average difference between women's and men's achievement levels has been reduced by 12 per cent during the period 1995–2005.     

Youth,gender and livelihoods in West Africa: Perspectives from Ghana and the Gambia

In this paper we report on preliminary fieldwork conducted in Ghana and The Gambia on the interrelationships among youth, gender and livelihoods. We examine how policy in developing countries, typically characterised as related to child labour or education, needs to emphasise the linkage across processes that affect young people. We argue that policy will be improved if young people are given voice to express how work, education, social networks, and culturally-bound notions of responsibility are linked and how they perceive the opportunities and constraints on their ‘life chances’.     

城市入境旅游景气指数构建研究——以北京为例

本文基于城市视角编制了旅游景气指数,并从理论上建立了包括先行指数、一致指数、滞后指数的旅游景气指数体系。本文以北京为例,运用月度数据编制了2007年-2012年入境旅游景气先行指数和一致指数,分析了在此期间北京入境旅游市场的波动情况及成因,揭示了先行指数和一致指数之间存在的时滞关系,以期为政府管理机构和旅游企业准确判断城市旅游业的发展并预测未来的动向、制定相关政策提供一定的依据。     

Rural–Urban Migration and Gender Disparities in Child Healthcare in China and India

This article assesses the impact of rural–urban migration on gender disparities in children's access to healthcare in China and India. Much research has shown widespread discrimination against girl children in both countries, including in health investments, contributing to the well‐known problem of Asia's ‘missing’ women. Much less clear is the impact of the massive rural–urban migration now occurring in China and India on discrimination against daughters. Migration is usually thought to have a positive effect on child health, because of improved access to healthcare facilities, but this is not necessarily equally beneficial for both sons and daughters. Based on fourteen months of fieldwork with rural migrant families in Shenzhen (China) and Mumbai (India), this article argues that where migration improves access to healthcare, it may increase rather than decrease the gender gap in treatment of child illness in the short term, as resources are concentrated on the treatment of sons. Furthermore, it is not the case that rural–urban migration necessarily leads to better access to healthcare even for sons: some forms of migration may actually have an overall negative effect on child health outcomes. For these two reasons, development strategies focusing on large‐scale rural–urban migration should not be seen as a short‐term solution to problems of gender inequity in child health.     

The Costs of Exclusion: Gender Job Segregation,Structural Change and the Labour Share of Income

While women's share of employment has risen in many countries over the last two decades, gender job segregation has worsened, with women increasingly excluded from ‘good’ jobs in the industrial sector. In this article, the determinants of gender job segregation are assessed using panel data for a broad set of developing countries covering the period 1991–2015. The effect of gender job segregation on all workers, via the labour share of income, is also analysed. The results identify two major contributors to gender job segregation — the rising capital/labour ratio and the ratio of female/male labour force participation rates — indicative of ‘crowding’ and exclusion as economies move up the industrial ladder. The analysis further indicates that the crowding of women into lower quality jobs has a negative effect on workers as a whole by dampening the labour share of income. Those processes are influenced by global and macroeconomic conditions and policies that have circumscribed the expansion of high‐quality jobs relative to labour supply, intensifying competition for ‘good’ jobs and weakening labour's bargaining power.     

Shaming and Sanitation in Indonesia: A Return to Colonial Public Health Practices?

Adequate sanitation is vital to human health, yet progress on the Millennium Development Goal for sanitation has been slow and the target is likely to be missed by one billion people. Indonesia has the third highest number of people of any country in the world without access to sanitation and, like most developing countries, it is devoting insufficient resources to the issue. In rural areas, rather than providing additional funding, the government — with support of the World Bank — has promoted the Community‐Led Total Sanitation (CLTS) approach, which uses social mobilization to encourage people to construct their own latrines. In Indonesia as elsewhere, CLTS involves more than just education and encouragement; it uses social shaming and punishments. The authors argue that this is not only an inadequate approach but one which echoes coercive, race‐based colonial public health practices. This article thus integrates extant historiography on Indonesian colonial medicine with contemporary scholarly literature and field research on CLTS using case studies of a 1920s hookworm‐eradication programme funded by the Rockefeller Foundation, and the current World Bank Water and Sanitation Programme, both in Java.     

北京居民日常休闲行为的性别差异

休闲的性别差异研究是西方休闲研究的重要研究主题。本文以北京市2007年居民活动日志问卷调查数据作为基础,多角度地分析了居民日常休闲行为中的性别差异。研究发现:男性拥有更多的休闲机会;女性休闲时间显著少于男性,并要花费更多时间在家务和照料活动,同时,女性更乐意将时间用在社交活动,而男性更倾向于将时间用在体育锻炼和上网活动;对于休闲地点的选择,男性和女性居民选择家内和家外休闲差异不大,但对于文化娱乐活动,男性平均出行距离更远,女性更倾向于选择较近的地点;在休闲中,男性倾向于一个人休闲而女性更倾向与家人一起休闲,表明女性更重视休闲活动中的社会关系。     

Towards the construction of place-specific measures of deprivation: a case study from the Vancouver metropolitan area

There have been numerous attempts to measure population health outcomes using socio-economic indicators. Few investigations have utilized a survey-based approach. This article develops a new means for identifying key socio-economic indicators of relative health outcomes within greater Vancouver, British Columbia (BC). The index, referred to as the Vancouver Area Neighbourhood Deprivation Index (VANDIX), was constructed from a survey of provincial Medical Health Officers (MHOs). The MHOs were asked to rank socio-economic indicators selected from the 2001 National Census by their relative influence on health outcomes throughout the province. Response consistency was evaluated with a weighted Kappa test statistic. The VANDIX score was assigned to Census Dissemination Areas and Census Tract administrative geographies. The scores were then compared to a subset of the 2003 Canadian Community Health Survey (CCHS) Cycle 2.1 database on self-assessed health. Outcome scores between the     

Population studies

A number of studies have been published about the population change in New Zealand between 1936 and 1986. During this time an intellectual and demographic revolution also took place simultaneously. From 1961 and 1986 the population increased from 2.4 million to 3.3 million mainly because of Polynesian immigration, and the elderly and females also increased. The Maoris became urban. Mortality stayed stable, but fertility declined to below replacement level in the 1980's. Murray Wilson (1988) analyzed the relationship of fertility and mortality in terms of a post-transitional (developed) society like Australia or the European norm of a 2-children family. In his view the youth culture, television, and female aspirations greatly influenced childrearing. Daniel Noin (1988) examined the current state of geographical research on mortality from a methodological point of view finding wide differences in mortality in Quebec, Brussels, Paris, and London attributable to culture. Mosley and Chen (1984) argued that social, cultural, and economic factors to mortality are mediated by individual, household, and community variables. Jones and Moon (1987) dealt with medical geography in the context of the consumption of health care and disease ecology. Momsen and Townsend (1987) addressed the role of women in developing countries stating that gender is socially created and it examined the worldwide subordination of women. In the 1980's a host of other authors have also touched on the subject of the demography of gender analyzing discrimination against female children, unmarried American women, and single parent families. Yet Fahey (1988) stated that gender was only regarded relevant by Australian geographers as a demographic variable.     

Inequality in Human Resources for Health: Measurement Issues

This article discusses options to allow comparative analysis of inequalities in the distribution of health workers (HWs) across and within countries using a single summary measure of the distribution. Income inequality generally is measured across individuals, but inequalities in the dispersion of HWs must use geographical areas or population groupings as units of analysis. The article first shows how this change of observational unit creates a resolution problem for various inequality indices and then tests how sensitive a simple ratio measure of the distribution of HWs is to changes in resolution. This ratio of inequality is illustrated first with the global distribution of HWs and then with its distributions within Indonesia. The resolution problem is not solved through this new approach, and indicators of inequalities of access to HWs or health services more generally appear not to be comparable across countries. Investigating geographical inequalities over time in one setting is possible but only if the units of analysis remain the same over time.     

旅游发展对云南世居父权制少数民族妇女社会性别观念的影响——基于撒尼、傣和哈尼三民族案例的比较研究

以撒尼、傣和哈尼三个父权制少数民族为研究对象,以曼春满、曼乍与曼嘎俭村、五棵树与月湖村、箐口和大鱼塘村为案例地,通过问卷调查和深度访谈,对发展旅游村寨和未发展旅游村寨妇女的社会性别观念进行横纵向对比分析,探讨旅游发展对云南世居父权制少数民族妇女社会性别观念的影响。研究认为:旅游发展对云南世居少数民族妇女社会性别观念产生了全面而深刻的影响,旅游带来的社会文化的交融,少数民族妇女主体意识和自立能力的增强,不断建构起男女平等的现代社会性别观念。研究将有利于少数民族社区和谐社会的建设,并对男女平等国策的实现有着重要的现实意义。     

Gender disparities in child health care seeking in northern Vietnam

Vietnam recently demonstrated a skewed sex ratio at birth. Little research has examined postnatal impacts of son preference in Vietnam, such as in child health care seeking. Past research in other Asian countries with son preference has found that parents are more likely to take sons to a health facility when they are sick, to do so more promptly, and invest more resources in care, than daughters. Using data from a paediatric hospital emergency department, we analyse gender differences in illnesses, referral patterns, and outcomes among children to understand how gender disparities in paediatric hospital admissions arise. Almost twice as many boys were brought into the facility as girls. Compared to girls, boys were significantly more likely to have bypassed lower-level facilities and entered care at the tertiary facility, controlling for severity of illness and socio-demographic characteristics. This suggests parents provide preferential treatment to boys, potentially leading to excess morbidity among girls who become ill. However, we find no significant differences in delay of care seeking or evidence of provider bias. Ensuring that girls are able to access appropriate, quality care when needed, will improve equity of access to care for all children.