Access to Health Care: Social Determinants of Preventive Cancer Screening Use in Northern British Columbia

The purpose of this study was to examine theextent to which social factors are influentialin determining women's access to cancerscreening services in Prince George, BritishColumbia. Specifically, this study evaluatedthe association of age, income, education, workstatus, disability, marital status, andimmigrant status with previous use of screeningmammography and Pap tests. Data was obtainedfrom the 1994 National Population HealthSurvey, which contains a sample of 416 womenfrom the Prince George area. A series oflogistic regression analyses were used todistinguish ever versus never beenscreened as well as recency of previousscreening. Participation rates in screeningmammography in Prince George are comparativelyhigh; however, no association was found betweensocial factors and previous mammography use.This suggests women in Prince George areparticipating in mammography servicesregardless of social background. Participationrates in Pap test screening in Prince Georgeare high and are similar to provincialaverages; however, while a large percentage ofwomen have been screened, this percentagevaries across social groups. Immigrant women,single women, and women with less education areover represented among women who have never hada Pap test. In addition, older women are lesslikely to obtain a recent Pap test whencompared to younger women. This study suggeststhat certain groups of women in northernBritish Columbia experience low participationin health services, resulting in a higher riskfor poor health and a poor quality of life.     

A Statistical Examination of the Health Utility Index-Mark III as a Summary Measure of Health Status for a General Population Health Survey

The purpose of this study was to examine the abilityof the Health Utility Index-Mark III (HUI-Mark III) toprovide a summary measure of the physical, mental andsocial dimensions of health assessed in the 1994/5National Population Health Survey (NPHS). The sampleconsisted of 838 (402 male, 436 female) randomlyselected residents of Prince George, British Columbia.An exploratory factor analysis was conducted using themeasures of physical, psychological and social healthincluded in the NPHS. The HUI-Mark III scores werethen regressed on to the factors in an attempt todetermine the proportion of variance in factor scoresaccounted for by the HUI-Mark III. The results suggestthat the HUI-Mark III is primarily a measure ofphysical impairment that does not adequately representthe physical, mental and social dimensions of healthas measured in the NPHS.     

Towards Neo-Bismarckian Health Care States? Comparing Health Insurance Reforms in Bismarckian Welfare Systems

Germany, France and the Netherlands all have specific ‘Bismarckian’ health insurance systems, which encounter different and specific problems (and solutions) from those of national health systems. Following a relatively similar trajectory, the three systems have gone through important changes: they now combine universalization through the state and marketization based on regulated competition; they associate more state control (directly or through agencies) and more competition and market mechanisms. Competition between insurers has gained importance in Germany and the Netherlands and the state is reinforcing its controlling capacities in France and Germany. Up to now, continental health insurance systems have remained, however, Bismarckian (they are still mainly financed by social contribution, managed by health insurance funds, they deliver public and private health care, and freedom is still higher than in national health systems), but a new ‘regulatory health care state’ is emerging. Those changes are embedded in the existing institutions since the aim of the reforms is more to change the logic of institutions than to change the institutions themselves. Hence, structural changes occur without revolution in the system.     

Rwanda's Health System and Sickness Insurance Schemes

After the war and the 1994 genocide, Rwanda drew up a national health policy with a view to realigning its health system. The reform, which was designed to remedy the deficiencies of the previous system, focused on community involvement in managing and financing health services. Achieving this objective was never going to be easy, but thanks to a growing number of initiatives 37.8 per cent of the Rwandan population now have some degree of sickness insurance cover. However, the system in general, and more particularly the mutual associations organized around the community, needs to be strengthened.     

The Primary Importance of Corporate Social Responsibility and Ethicality in Corporate Reputation: An Empirical Study

We examine three assumptions commonly held in the corporate reputation literature: (1) reputation ratings of owners and investors are generally representative of all stakeholders; (2) stakeholders will generally provide a higher reputation rating to firms that emphasize corporate social responsibility versus firms that do not; and (3) profitability is the primary criterion of importance to all stakeholders when rating a firm's reputation. Using an exploratory in‐class exercise, our findings suggest that: (1) there are significant differences among stakeholder groups in their reputation ratings; (2) firms that emphasize corporate social responsibility are not rated more highly across all stakeholder groups; and (3) for all stakeholder groups, the ethicality criterion explained more of the variance in firms' reputation ratings than the profitability criterion.     

ON OPTIMIZING MULTI-LEVEL DESIGNS: POWER UNDER BUDGET CONSTRAINTS

This paper derives a procedure for efficiently allocating the number of units in multi‐level designs given prespecified power levels. The derivation of the procedure is based on a constrained optimization problem that maximizes a general form of a ratio of expected mean squares subject to a budget constraint. The procedure makes use of variance component estimates to optimize designs during the budget formulating stages. The method provides more general closed form solutions than other currently available formulae. As such, the proposed procedure allows for the determination of the optimal numbers of units for studies that involve more complex designs. A method is also described for optimizing designs when variance component estimates are not available. Case studies are provided to demonstrate the method.     

Managing Motivation,Organization and Governance

Journal of Management and Governance -     

Are Political Economists Selfish and Indoctrinated? Evidence from a Natural Experiment

Most professional economists believe that economists in general are more selfish than other people and that this increased selfishness is due to economics education. This article offers empirical evidence against this widely held belief. Using a unique data set about giving behavior in connection with two social funds at the University of Zurich, it is shown that economics education does not make people act more selfishly. Rather, this natural experiment suggests that the particular behavior of economists can be explained by a selection effect.     

Reunifying Versus Living Apart Together Across Borders: A Comparative Analysis of sub‐Saharan Migration to Europe

This article studies the process of reunification in Europe among “living apart together across borders” (LATAB) couples of African origin (DR Congo, Ghana, and Senegal). Couple reunion is conceived as a multilevel process, wherein state selection (through immigration policies in destination countries) interacts with self‐selection (at the couple level), under influence of the social context at origin. Based on event history analyses of the MAFE project, empirical results show that LATAB is a majority and durable living arrangement for sub‐Saharan migrants, that the odds if reunifying depend on gender and inter‐generational relationships, and that restrictive contexts at destination do not deter couple reunion.