Social policy and health: transition countries in a comparative perspective

T. Ferrarini, O. Sjöberg. Social policy and health: transition countries in a comparative perspective Int J Soc Welfare 2010: ??: ??–??© 2010 The Author(s), Journal compilation © 2010 Blackwell Publishing Ltd and International Journal of Social Welfare. This article analyses the development and design of unemployment insurance and family policy benefits and their links to health outcomes in Estonia, Poland, the Slovak Republic, Slovenia, the Czech Republic and Hungary from the mid‐1990s. Comparing these six transition countries with long‐standing welfare democracies reveals important similarities and differences in policy and health. Unemployment benefit schemes resemble corporatist schemes in important respects, however, with lower coverage and average benefits. Subjective wellbeing is also comparatively low among both employed and unemployed in the transition countries. Several transition countries have mixed family policy strategies that simultaneously support dual‐earner families and traditional gender roles. One clear exception is Slovenia, which has a highly developed dual‐earner support. Family policy generosity is related to lower rates of poverty, infant mortality and child injuries. The article demonstrates the fruitfulness of institutional analyses of the link between social policy and population health in a broader welfare state context.     

Public pension institutions and old‐age mortality in a comparative perspective

Norström T, Palme J. Public pension institutions and old‐age mortality in a comparative perspective Int J Soc Welfare 2010: ??: ??–??© 2010 The Author(s), Journal compilation © 2010 Blackwell Publishing Ltd and International Journal of Social Welfare. The aim of the study was to estimate the impact of changes in pension rights on old‐age mortality. We made a distinction between two dimensions of pension benefits, one of providing basic security (BASIC), and the other of providing income security (INCOME). Analyses were based on data for 18 OECD countries during the post‐war period. The outcome comprised old‐age excess mortality, defined as the ratio of the mortality rate 65+ to the mortality rate in the age group 30–59 years. The latter was regarded as a proxy for unobserved factors potentially related to old‐age mortality as well as pension rights. The pooled cross‐sectional time series data were analysed through fixed effects modelling. The results suggest that BASIC (but not INCOME) has a beneficial impact on old‐age excess mortality, which was statistically significant. We interpret the results in terms of the poverty‐reducing effects of pension entitlements with a basic security orientation.     

One hundred years of money,welfare and death: mortality,economic growth and the development of the welfare state in 17 OECD countries 1900–2000

Kangas O. One hundred years of money, welfare and death: mortality, economic growth and the development of the welfare state in 17 OECD countries 1900–2000 Int J Soc Welfare 2010: ??: ??–??© 2010 The Author(s), Journal compilation © 2010 Blackwell Publishing Ltd and International Journal of Social Welfare. The article focuses on the role played by the welfare state vis‐à‐vis GDP in the increase of life expectancy in 17 OECD countries 1900–2000. The article shows that money matters, war kills and the welfare state is good for health. There is a curvilinear relationship between prosperity and longevity: after a certain level, the marginal utility of an extra dollar levels off. In the longer run, growth is a necessary but not sufficient condition. The welfare state plays its role, too. Bigger is better, be it with regard to social spending or the generosity or coverage of social protection. For the life expectancy of a population to increase, it is better to have broader coverage or universal access to care than to have more generous benefits, which are channelled to a limited circle of citizens. It is better to give adequately to all than lavishly to too few.     

The potential power of social policy programmes: income redistribution,economic resources and health

Lundberg O, Fritzell J, Åberg Yngwe M, Kölegård ML. The potential power of social policy programmes: income redistribution, economic resources and health Int J Soc Welfare 2010: ??: ??–??© 2010 The Author(s), Journal compilation © 2010 Blackwell Publishing Ltd and International Journal of Social Welfare. This Supplement includes a number of articles dealing with the role of social policy schemes for public health across the life course. As a key social determinant of health, poverty and its consequences have historically been at the forefront of the public health discussion. But also in rich countries today, economic resources are likely to be important for health and survival, both on an individual and an aggregate level. This introductory article serves as a background for the more specific analyses that follow. The focus is on why income and income inequality could have an effect on individual and population health. We discuss relationships between the individual and population levels and between income and health, and some of the possible mechanisms involved. We also present arguments for why welfare state institutions may matter.     

The Argentine welfare state: enduring and resisting change

Isuani EA. The Argentine welfare state: enduring and resisting change
Int J Soc Welfare 2010: 19: 104–114 © 2009 The Author(s), Journal compilation © 2009 Blackwell Publishing Ltd and the International Journal of Social Welfare. It is widely accepted that during the 1990s, the Argentine state experienced a general retrenchment. This article shows that, though this may have been true in the economic realm, this retrenchment did not take place in the diverse arenas of social policy. While privatisations and labour market flexibility dismantled the foundations of Keynesianism, the components of the welfare state experienced substantial growth. At the same time, the changes experienced by the welfare state in the past quarter century have not included a transformation of its basic principles, despite the profound changes experienced by Argentine society during this period.     

The potential of asset‐based development strategies for poverty alleviation in Sub‐Saharan Africa

Ssewamala FM, Sperber, ES, Zimmerman JM, Karimli L. The potential of asset‐based development strategies for poverty alleviation in Sub‐Saharan Africa Int J Soc Welfare 2010: 19: 433–443 © 2010 The Author(s), Journal compilation © 2010 Blackwell Publishing Ltd and International Journal of Social Welfare. This article explores the potential of a relatively new approach to social development as a poverty alleviation strategy in Sub‐Saharan Africa (SSA): asset‐based development, an integrated approach to human, social, and economic capital formation. It considers the theoretical framework guiding asset‐based development and the accompanying set of programmatic and policy‐level tools for poverty alleviation in SSA. After considering the recent historical and theoretical contexts of the approach, the authors examine the potential of asset‐based development programs, specifically savings‐led microfinance programs for the poor, to engender development and, more specifically, poverty alleviation in the region. Major challenges and directions for future research are presented.     

Class and gender inequalities in different types of welfare states: the Social Citizenship Indicator Program (SCIP)

Korpi W. Class and gender inequalities in different types of welfare states: the Social Citizenship Indicator Program (SCIP) Int J Soc Welfare 2010: ??: ??–??© 2010 The Author(s), Journal compilation © 2010 Blackwell Publishing Ltd and International Journal of Social Welfare. This article considers the role of legislated welfare state institutions as mediators of effects of political and structural forces on citizens' levels of living of relevance to inequalities in health and mortality. The focus is on institutional structures of welfare state programmes relevant to class inequality, as indicated by income inequalities, and to gender inequality, conceived of as differences in agency. I introduce the Social Citizenship Indicator Program, a database providing quantitative and qualitative information on structures of main social insurance programmes in 18 countries from 1930 to 2000, on about 300,000 data points. It is used to delineate types of distributive institutions of relevance for income inequality. Institutions relevant for gendered agency inequality affect choices by women, especially mothers, between unpaid and paid work. Driving forces behind the emergence of differences in distributive institutions are discussed, and patterns of class and gender inequalities are outlined.     

Societal shifts and changed patterns of poverty

Fritzell J, Ritakallio VM. Societal shifts and changed patterns of poverty Int J Soc Welfare 2010: ??: ??–??© 2010 The Author(s), Journal compilation © 2010 Blackwell Publishing Ltd and International Journal of Social Welfare. This article uses data from the Luxembourg Income Study to analyse cross‐national and cross‐temporal poverty risks in 11 Western countries. We show that poverty risks have tended to increase from the early 1980s to 2000. In line with what we would expect based on the welfare state literature, the Nordic countries tend to have the lowest poverty rates. However, the proportion of the national population with a market income below the poverty threshold has increased in all countries and the cross‐national variation in market income poverty is not apparently related to the type of welfare state regime. We perform a simulation analysis to test whether structural factors, that is, compositional differences in age, family and labour market behaviour, could account for the cross‐national variation found. Our results demonstrate the increasing importance of household labour market attachment for alleviating poverty risks, as well as for explaining the cross‐national variation in these risks.     

Responsible pragmatism in Turkish social policy making in the face of Islamic egalitarianism and neoliberal austerity

Akan T. Responsible pragmatism in Turkish social policy making in the face of Islamic egalitarianism and neoliberal austerity Int J Soc Welfare 2011: 20: 367–380 © 2011 The Author(s), International Journal of Social Welfare © 2011 Blackwell Publishing Ltd and the International Journal of Social Welfare. Founded in August 2001, the Justice and Development Party of Turkey (JDP) has forged a brand new identity, the Conservative Democracy, and initiated challenging politico‐economic reforms since November 2002 when it came to power. Among these reforms, the social policies of the Conservative Democrats have intriguingly yielded mixed blessings of a strategic settlement between equality of outcome and opportunity. This article argues that such a result originated from the commodification by the Conservative Democrats of the Islamic egalitarianism of ‘the Just Order’, the politico‐economic programme to which the JDP's leaders were strictly committed before becoming the Conservative Democrats. Entitling the social policy strategy of JDP as ‘Responsible Pragmatism’, this article concludes that it was an unsustainable but flexible social policy strategy that has gone as far as it can, now, on the eve of the 2011 general elections.     

Do public pensions matter for health and wellbeing among retired persons? Basic and income security pensions across 13 Western European countries

Esser I, Palme J. Do public pensions matter for health and wellbeing among retired persons? Basic and income security pensions across 13 Western European countries Int J Soc Welfare 2010: ??: ??–??© 2010 The Author(s), Journal compilation © 2010 Blackwell Publishing Ltd and International Journal of Social Welfare. Mortality rates suggest that elderly people in the advanced welfare democracies have experienced dramatically improved health over the past decades. This study examined the importance of public pensions for self‐reported health and wellbeing among retired persons in 13 Organisation for Economic Cooperation and Development countries in 2002–2005. New public pension data make it possible to distinguish between two qualities of pension systems: ‘basic security’ for those who have no or a short work history, and ‘income security’ for those with a more extensive contribution record. For enhanced cross‐national comparison, relative measures of ill‐health and wellbeing were constructed to account for cultural bias in responses to survey questions and heterogeneity among countries in the general level of population health. Overall, better health is found in countries with more generous pensions, although the results are gendered; for women's health, high basic security of the pension system appears to be particularly important. Women's wellbeing also tends to be more dependent on the quality of basic security.     

Trends in long‐term sickness absence in Sweden 1992–2008: the role of economic conditions,legislation, demography,work environment and alcohol consumption

Lidwall U, Marklund S. Trends in long‐term sickness absence in Sweden 1992–2008: the role of economic conditions, legislation, demography, work environment and alcohol consumption Int J Soc Welfare 2011: 20: 167©179 © 2010 The Author(s), International Journal of Social Welfare © 2010 Blackwell Publishing Ltd and the International Journal of Social Welfare. In Sweden, absence from work because of illness or injury has fluctuated considerably over time. This study aimed to identify potentially important factors behind variations in long‐term sickness absence. Aggregated data were used to assess factors correlated with the number of ongoing cases of sickness absence lasting more than 59 days. Trends were analysed using statistics from national social insurance records, labour force surveys and other official statistics. Although specific changes in the degree of generosity in the sickness insurance scheme were important in some cases, the results showed no consistent associations for the study period 1992–2008. Men were generally more sensitive to macroeconomic factors than women. Furthermore, compared with earlier findings, workforce composition had less impact on variations in long‐term sickness absence. Notably, public health indicators such as alcohol sales and working conditions were clearly related to long‐term sick leave during the period under investigation.     

Does family still matter? Public and private transfers in emerging welfare state systems in a comparative perspective

Kim JW, Choi YJ. Does family still matter? Public and private transfers in emerging welfare state systems in a comparative perspective Int J Soc Welfare 2011: 20: 353–366 © 2010 The Author(s), International Journal of Social Welfare © 2010 Blackwell Publishing Ltd and the International Journal of Social Welfare. While the role of the family has been a distinctive feature of East Asian welfare systems, rapid social policy development and reforms in South Korea and Taiwan over the last two decades have led to an increase in public welfare. Yet, despite a growing number of studies, little is known about the role of family support – private transfers – and public programmes in the performance of state welfare. This article reports on a comparative analysis of the role of public and private transfers aimed at poverty and inequality reduction in 12 Western and two East Asian states employing the Luxemburg Income Study data set. Results indicate that, in contrast to the West, private transfers that rest primarily on family support remain more important than public transfers in reducing income inequality and poverty in South Korea and Taiwan.     

The interaction effects of scheduling control and work–life balance programs on job satisfaction and mental health

Jang SJ, Park R, Zippay A. The interaction effects of scheduling control and work–life balance programs on job satisfaction and mental health Int J Soc Welfare 2011: 20: 135–143 © 2010 The Author(s), International Journal of Social Welfare © 2010 Blackwell Publishing Ltd and International Journal of Social Welfare. The demands of balancing employment and family responsibilities strain the health and welfare of many employees worldwide, and social welfare policy analysts are increasingly attending to the factors that can alleviate such stress. The present study examined associations between the availability of work–life balance programs, employees' authority to arrange their own work hours, job satisfaction, and mental health among 1,293 employees in 50 companies in South Korea. The study is unique in its use of multilevel analysis in examining individual‐ and company‐level variables. The results add to the evidence regarding the positive relationship between the availability of scheduling control and work–life balance policies on the one hand, and job satisfaction and mental wellbeing, on the other.     

The forgotten half: analysing the politics of welfare services

Jensen C. The forgotten half: analysing the politics of welfare services Int J Soc Welfare 2011: 20: 404–412 © 2010 The Author(s), International Journal of Social Welfare © 2010 Blackwell Publishing Ltd and the International Journal of Social Welfare. This article discusses the welfare state and argues that the service component has been neglected in the mainstream literature. A main reason for the neglect is the lack of theorising on the distinction between the politics of welfare services and the politics of transfers. An analytical framework that may help overcome this problem is presented.     

Social security for China's rural aged: a proposal based on a universal non‐contributory pension

Yang Y, Williamson JB, Shen C. Social security for China's rural aged: a proposal based on a universal non‐contributory pension Int J Soc Welfare 2010: 19: 236–245 © 2009 The Author(s), Journal compilation © 2009 Blackwell Publishing Ltd and the International Journal of Social Welfare. China's relative lack of social security coverage for rural elders exacerbates the already severe rural–urban economic disparity, slows the rate of rural poverty reduction, and raises social justice concerns. Our analysis draws on evidence from a number of sources including interviews with experts on China, Chinese government documents, Chinese newspaper accounts, and other sources from other countries. Based on our analysis of what has been tried in other countries and the current situation in rural China, we offer some suggestions for Chinese policy makers. We suggest that, for rural China, a universal non‐contributory old‐age pension deserves serious consideration, and refer to our proposed model as a Rural Old‐Age Social Pension. It will reduce the level of poverty in rural areas and the degree of income inequality between rural and urban areas while simultaneously promoting social and political stability.     

Welfare residualism: a comparative study of the Basic Livelihood Security systems in China and South Korea

Gao Q, Yoo J, Yang S‐M, Zhai F. Welfare residualism: a comparative study of the Basic Livelihood Security systems in China and South Korea Int J Soc Welfare 2011: 20: 113–124 © 2010 The Author(s), International Journal of Social Welfare © 2010 Blackwell Publishing Ltd and International Journal of Social Welfare. In this article, the Basic Livelihood Security (BLS) systems of China and South Korea are compared. The purpose of BLS is to provide a safety net for poor families, particularly the unemployed and the retired who were hard‐hit by recent economic reforms and crises. A common characteristic of the two systems is residual welfare marked by strict eligibility rules and limited coverage. Both systems are subordinate to the primary goal of economic growth and therefore only compensate for the very disadvantaged left behind by market competition. Neither system is particularly effective in achieving its original antipoverty goals. However, South Korea's provision of self‐support programs to supplement cash transfers has helped individuals to move from welfare to work, and thus has implications for China's BLS system. Both countries need to put more emphasis on equity and social justice in their ongoing reforms and expansions of BLS.     

Fulfilment of basic needs from a subjective point of view in rural Guatemala

Guardiola J, García‐Muñoz T. Fulfilment of basic needs from a subjective point of view in rural Guatemala Int J Soc Welfare 2011: 20: 393–403 © 2010 The Author(s), International Journal of Social Welfare © 2010 Blackwell Publishing Ltd and the International Journal of Social Welfare. The study of subjective wellbeing in developing countries is a relatively new field of research, but interest is increasing among researchers. A few decades ago, techniques such as the basic needs approach were applied in order to understand development. The basic needs framework has recently been used to define and monitor the Millennium Development Goals. However, it is limited when it comes to defining the content of basic needs and determining to what extent they are being satisfied, which leaves this decision to an external authority other than the individual. In this article, we estimated how certain indicators and assets have influenced the perception of basic needs in a rural area of Guatemala using a data set containing 369 interviews with Mayan households. The results allowed us to identify the characteristics or assets that influence the perception of basic needs, leaving the decision as to the Mayan people themselves as to whether their basic needs are being met.     

Who are the lucky ones? Heterogeneity in active labour market policy outcomes

Nordlund M. Who are the lucky ones? Heterogeneity in active labour market policy outcomes Int J Soc Welfare 2011: 20: 144–155 © 2010 The Author(s), International Journal of Social Welfare © 2010 Blackwell Publishing Ltd and International Journal of Social Welfare. This study focuses on how the effects from investments in Active Labour Market Policy programmes (ALMPs) may be differently distributed due to the age and educational level of participants. Outcomes were measured as the chance of labour market inclusion, labour market stability and post‐unemployment incomes. This longitudinal study captures long‐term effects among 50,000 Swedes who entered unemployment in 1993. While the youngest gained most from ALMP‐training, the oldest were best helped by ALMP‐ employment in reducing the risk of labour market exit. The lowest educated gained much from ALMP participation, although the effects were weaker than expected: those with a higher education gained more in terms of labour market stability from ALMP‐training compared with the less educated persons. This result was interpreted in terms of a springboard effect, meaning that ALMP‐training pushes higher educated people into further education in the regular educational arena.     

Childcare: welfare or investment?

Conley A. Childcare: welfare or investment? Int J Soc Welfare 2010: 19: 173–181 © 2009 The Author, Journal compilation © 2009 Blackwell Publishing Ltd and the International Journal of Social Welfare. Childcare (also called day care or preschool) has generally served three purposes: to care for children while parents are employed; to provide early childhood education; and to cater to the needs of poor and disadvantaged children. This article proposes that the welfare approach to childcare be augmented by a social investment approach to enhance human and social capital investments among low income families and communities and to contribute to wider social development goals. The Head Start program in the United States and the Integrated Child Development Scheme in India are used to illustrate this argument.     

Client contribution in negotiations on employability – categories revised?

Eskelinen L, Olesen SP, Caswell D. Client contribution in negotiations on employability – categories revised? Int J Soc Welfare 2010: 19: 330–338 © 2010 The Author(s), Journal compilation © 2010 Blackwell Publishing Ltd and International Journal of Social Welfare. In this article, we explore how the institutional category ‘unemployed’ is specified in everyday practice when implementing an active employment policy. We illustrate the process of categorisation as an aspect of the in situ positioning and self‐representation of the client by examining one social worker–client talk: how the category unemployed is shaped and ‘translated’ when the client negotiates her situation with the social worker. Two types of category revisions are identified. First, the employability of the client, rather than her unemployment situation, is the issue under negotiation. Second, the client introduces new categories that are compatible with the demands of the employment system. She contributes by drawing on discursive resources related to the category of ‘active job seeker’ but does this with an own agenda of looking for a suitable job. The analysis elucidates the client's contribution to institutional practice and discusses constitutive and constituted elements of categorisation.