Transportation Disadvantage and Neighborhood Sociodemographics: A Composite Indicator Approach to Examining Social Inequalities

Transportation disadvantage refers to the barriers to or limits on the participation in daily socioeconomic and political life due to the reduced physical accessibility to services and opportunities. The transportation disadvantaged groups not only face the problems of social exclusion in location, but also experience greater exposure to a diversity of social and environmental threat. Under this context, identifying the transportation disadvantaged neighborhoods is of great interest for urban planners. This paper examines the transportation disadvantage in association with neighborhood sociodemographics in Shenzhen, China. A set of multidimensional indicators are initially selected to measure the transportation disadvantage (physical conditions, public transport services, education opportunity, employment opportunity, medical care opportunity, food opportunity, and commercial opportunity). Based on these indicators, principal component analysis produces four composite indicators of different types of transportation disadvantage: transportation disadvantage in physical infrastructure and public services, transportation disadvantage in food and education accessibility, transportation disadvantage in medical care accessibility, and transportation disadvantage in commercial and employment accessibility. In space, the transportation disadvantaged neighborhoods are generally located in the outskirts. Transportation disadvantage is more likely to be observed in neighborhoods that are economically, educationally, residentially and occupationally disadvantaged. These findings reveal significant inequalities in transportation opportunity.     

Area Social Deprivation and Public Health: Analyzing the Spatial Non-stationary Associations Using Geographically Weighed Regression

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.     

Neighborhood Characteristics and Older Adults’ Well-Being: The Roles of Sense of Community and Personal Resilience

The ecological model stresses the importance of the neighborhood context to aging successfully. This cross-sectional study aimed to examine the associations between neighborhood characteristics (public space, senior population density, and senior service) and the well-being of older adults, with sense of community as a potential mediator and personal resilience as a potential moderator. The sample consisted of 628 individuals (aged 60–97 years) recruited from 32 neighborhoods in Beijing, China. They completed measures of resilience, sense of community, and well-being. Neighborhood characteristics, including per capita public space, senior population density, and senior services, were obtained from neighborhood committees. We used hierarchical linear modeling to analyze the individual data from participants’ self-reported measures and objective data regarding neighborhoods. The results showed that: (a) public space, senior population density, and senior services were positively associated with the well-being of older adults; (b) sense of community mediated the above associations; (c) the associations between neighborhood characteristics—such as per capita public space, senior services, and well-being—were strengthened by personal resilience. This study highlighted the importance of neighborhoods to older adult’s well-being, including objective characteristics and a subjective sense of community. Besides personal strength, enhancing neighborhood resources is recommended to promote the well-being of elderly people.     

Attaining global health: challenges and opportunities

This issue of the Population Bulletin examines health trends in both developed and developing regions using health measures such as mortality and morbidity and the disability-adjusted life year. It also assesses the challenge of improving health worldwide. The authors proposed the following common denominators in the global challenge to improve health: 1) an individual's health status reflects the interplay of many factors such as the physical environment, political stability, and community structure; 2) direct correlation between the population's level of health and educational levels within that population; 3) prudent use of existing resources may contribute to a healthier public; 4) both public sector and private sector resources are vital for obtaining the best health possible; 5) effective infrastructure for health delivery requires fundamental changes in how governments and health system operate; and 6) policies to promote health are key components of community health efforts.     

Rating Health and Social Indicators for Use with Indigenous Communities: A Tool for Balancing Cultural and Scientific Utility

This study reports on the development and evaluation of a rating tool to assess the scientific utility and cultural appropriateness of community-level indicators for application with Indigenous populations. Indicator criteria proposed by the U.S. Institute of Medicine were culturally adapted through reviewing the literature and consultations with academic and Indigenous stakeholders. Pre-testing and collaborator feedback drove the iterative development of the tool with stakeholder groups in Canada, Aotearoa/New Zealand, and Australia. Pilot testing with 17 raters across countries involved rating the same selection of six health and social indicators using a six-point ordinal scale. The final version of the rating tool includes 16 questions within three criterion domains: importance, soundness, and viability. Academic and community stakeholder review established face and content validity. The indicator rating tool demonstrated good internal consistency and excellent inter-rater reliability for two of three pilot testing groups. Use of this instrument can strengthen collaborative research planning and evaluation with Indigenous communities through selection of relevant and culturally appropriate indicators for application to public health research, prevention programmes, and health and social policy.     

Quality of Life Perceptions and Directions for Urban Regeneration in Hong Kong

Urban regeneration can be an effective tool to promote sustainability and enhance macro-level quality of life if the principles of encouraging participation, building community character, advancing equity, improving environment and enlivening the economy are observed. Through the assessment of various quality of life indicators related to these five basic principles for sustainable urban regeneration by the public, private and community sectors, this paper finds that Hong Kong falls far short of realizing these fundamental principles. There are also considerable discrepancies between the public and non-public (private and NGOs) sectors in terms of evaluating existing quality of life issues and perceiving their relative priorities. The private and community sectors tend to have lower rating of existing situation and consequently a longer priority list. On the contrary, the public sector seems to be more complacent with the existing quality of life situations and has a much shorter priority list. The public sector’s more relaxed attitude coupled with a top-down executive-led polity mean that Hong Kong will probably have a long way to go toward sustainable urban regeneration.     

A multi-level,bipolar view of the urban residential environment: Local community vs. mass societal forces

A multidisciplinary review of the urban literature reveals that theory can be ranged along two bipolar continua—individual vs. aggregate levels of analysis and equilibrium vs. conflict models of behavior. Research employed such bipolar conceptualizations to examine the persistence or deterioration of local community structure in a contemporary urban environment. A two-year ethnographic community study was conducted in Syracuse, New York and Onondaga County. Also examined were program processes of an experimental program designed to enhance neighborhood organization and social networks of 157 families living in ten randomly selected neighborhoods. Data collection methods included participant observation supplemented by archival research and in-depth interviews with community leaders. It was found that both bipolar models were necessary to illuminate processes at work within a city experiencing a sharp decline in population and in economic activity. Three coping strategies employed by city institutions to counter this decline were distinguished, but it was observed that often such strategies led to disruption of residential neighborhoods. We concluded that while local community structure remains in some neighborhoods, conflict between residential and nonresidential interests poses an ever more serious threat.     

Measuring public sector size in the advanced market economy countries: The problem of deflators

A great deal of scholarly attention has been directed to understanding the causes of the growth of the public sector in the developed market economy countries in recent decades. Unfortunately, this literature has been clouded by uncertainty over measurement of the central variable at issue, the relative size of the public sector. Traditionally, public sector size has been measured as the ratio of government expenditures to GDP, with both figures expressed in current national currencies. Recently, however, this standard approach has been criticized by those who argue that figures for government expenditures and GDP should be separately deflated to account for different rates of inflation in the public sector and the economy as a whole. The purpose of this paper is to explore the empirical relationship between same- and different-deflator indicators of public sector size, focusing on social expenditures in 19 developed market economy countries over the period 1960–1981. The analysis finds that same- and different-deflator indicators are generally strongly correlated and that the choice of deflators, while of some importance, is not of overriding significance in assessing four major explanation of public sector growth in the countries examined.     

Subjective Indicators in the Health Sector and Their Usefulness in Policy Making

A considerable literature produced in the field of social sciences focused in the last 20 years on the importance of subjective indicators of wellbeing as an element of great significance in the analysis of public policies and quality of services, in addition to objective indicators. The health sector is characterized by a particular propensity and special consideration of the role of patients and other persons involved in the care process (family, doctors, nurses, etc.), and therefore of subjective elements. Since the end of the 1980s several studies considered the incongruences between health demand and health service supply and introduced in the debate the need to produce better evaluation methodologies, based on the interaction between objective an subjective data. The consequence was that subjective assessment by users and operators is now an integral part of any health service evaluation activity. The paper shows the evolution of scientific approaches to health services assessment, and the nature of subjective indicators mostly utilized in recent Italian experiences. Special attention is dedicated to an interesting attempt to enlarge the evaluation approach, aim of which is to contribute to the assessment of the social impact of administrative actions and public services stimulating the contribution of social parties and independent experts and involving public authorities and policy-makers.     

Quality of Life Perceptions and Directions for Urban Regeneration in Hong Kong

Urban regeneration can be an effective tool to promote sustainability and enhance macro-level quality of life if the principles of encouraging participation, building community character, advancing equity, improving environment and enlivening the economy are observed. Through the assessment of various quality of life indicators related to these five basic principles for sustainable urban regeneration by the public, private and community sectors, this paper finds that Hong Kong falls far short of realizing these fundamental principles. There are also considerable discrepancies between the public and non-public (private and NGOs) sectors in terms of evaluating existing quality of life issues and perceiving their relative priorities. The private and community sectors tend to have lower rating of existing situation and consequently a longer priority list. On the contrary, the public sector seems to be more complacent with the existing quality of life situations and has a much shorter priority list. The public sectors more relaxed attitude coupled with a top-down executive-led polity mean that Hong Kong will probably have a long way to go toward sustainable urban regeneration.     

Barriers to antenatal psychosocial assessment and depression screening in private hospital settings

Problem

The evidence of benefit for antenatal psychosocial assessment and depression screening has been sufficient to lead the implementation of screening in public hospitals in all states of Australia. Details of the implementation of perinatal screening in private obstetric settings is less well known.

CONSTRUCTING A HEALTH AND SOCIAL INDICATOR FRAMEWORK FOR INDIGENOUS COMMUNITY HEALTH RESEARCH

Health and social indicators that capture the distinct historical, social, and cultural contexts of Indigenous communities can play an important role in informing the planning and delivery of community interventions. There is currently considerable interest in cataloguing and vetting meaningful community-level health and social indicators that could be applied to research and health promotion activities in Indigenous communities in Australia, Canada, and New Zealand, inclusive of conventional indicators as well as measures developed specifically for use in or with Indigenous communities. To avoid haphazard selection of indicators, and to assure the comprehensiveness and relevance of any given set of indicators, a framework that can accommodate and conceptually classify indicators representing a full range of domains is required. We report here on the development of a conceptual framework, by which Indigenous community indicators, and more general community-level social indicators, can be sorted, catalogued, and systematically classified within four hierarchical levels. The indicator framework was developed across Canada, Australia and New Zealand in consultation with academic researchers and Indigenous community stakeholders, building from established health and social indicator systems. The Indigenous indicator framework permits Indigenous communities, public health researchers, and funding agencies to compare and select the most appropriate indicators for application in specific contexts from the multitude of existing indicators.     

Putting people into place

Over the past two decades, there has been an explosion of empirical research on neighborhoods and health. However, although the data and approaches owe much to the early contributions of demographers and population scientists, this debt is largely unrecognized. Likewise, challenges posed in the early literature remain largely unanswered. I argue that just as demographers and population scientists were pioneers in the study of neighborhoods and health, they are uniquely poised to lead the field again. Putting people into place means explaining behavior and outcomes in relation to a potentially changing local context. A more dynamic conceptualization is needed that fully incorporates human agency, integrates multiple dimensions of local social and spatial context, develops the necessary longitudinal data, and implements appropriate tools. Diverse approaches with complementary strengths will help surmount the many analytic challenges to studying the dynamics of neighborhoods and health, including agent-based microsimulation models.     

Zones of Difference,Boundaries of Access: Moral Geography and Community Mapping in Abidjan,Côte d’Ivoire

ABSTRACT

In Abidjan, Côte d’Ivoire, 18% of men who have sex with men (MSM) are HIV-positive. Based on ethnographic research conducted among HIV peer educators and activists in Abidjan, I examine their narratives and hand-drawn maps of city space. I draw on a methodological process of map-making to examine research participants’ evaluations of neighborhoods and link these evaluations to debates over national and cultural belonging in Côte d’Ivoire. I suggest a moral geography emerges from the maps and narratives and ask what the bioethical implications of moral geography are in the context of service delivery and activism among sexual minorities.     

Health Outcomes and Volunteering: The Moderating Role of Religiosity

In this paper, we examine whether and what extent public and private forms of religiosity act as moderators of the volunteering and well-being relationship in mid- to later-life. We use data from the second wave of the National Survey of Midlife Development in the United States (n = 1,805). We analyzed the relationships between volunteering and indicators of well-being (self-rated physical and mental health), and tested the moderating effects of public and private religiosity on the volunteering and well-being relationship. Our findings suggest that salubrious effects of volunteering on the self-perceived physical and mental health of middle- aged and older- aged adults varied by their participation in different forms of religiosity. In particular, volunteers who engaged in more public forms of religiosity reported significantly better physical and mental health than non-volunteers who engaged in these forms of religiosity. In other words, individuals who were actively engaged public forms of religious practices and who volunteered, maximized the associated health benefits.     

Slum Residence and Child Health in Developing Countries

Continued population growth and increasing urbanization have led to the formation of large informal urban settlements in many developing countries in recent decades. The high prevalence of poverty, overcrowding, and poor sanitation observed in these settlements—commonly referred to as “slums”—suggests that slum residence constitutes a major health risk for children. In this article, we use data from 191 Demographic and Health Surveys (DHS) across 73 developing countries to investigate this concern empirically. Our results indicate that children in slums have better health outcomes than children living in rural areas yet fare worse than children in better-off neighborhoods of the same urban settlements. A large fraction of the observed health differences appears to be explained by pronounced differences in maternal education, household wealth, and access to health services across residential areas. After we control for these characteristics, children growing up in the slums and better-off neighborhoods of towns show levels of morbidity and mortality that are not statistically different from those of children living in rural areas. Compared with rural children, children living in cities (irrespective of slum or formal residence) fare better with respect to mortality and stunting but not with respect to recent illness episodes.     

Using Child and Family Indicators to Influence Communities and Policy in Los Angeles County

This article presents a case study on the use of social indicators to guide community action and influence policy decisions around children and families in Los Angeles County California. Since the early 1990s, the Children's Planning Council has incorporated strategic use of data in all of its planning and community organizing. The Council has developed a unique set of strategies for using social indicators, in combination with large-scale organizing, to convene stakeholders, change perceptions and influence decison-making. The article describes the Council, the theoretical framework that guides its approach to data, key issues that have guided its information strategies, and the challenges that still lie ahead.     

Gender disparities in completing school education in India: explaining geographical variations

Researchers in demography, the labour market and health have observed that North Indian women face greater discrimination than women in other zones. This study examines whether a similar pattern is replicated with respect to completion of school education. We find that gender disparities are higher in northern states in rural areas. In urban areas, however, eastern states display greater disparities. This is also confirmed if we control for household traits, community characteristics and the regional context. However, when we decompose the differences in probability of completing school education across gender, the contribution of the control variables is found to be insignificant, relative to that of the coefficient effect (which is sometimes put forward as a measure of discrimination) in both rural and urban areas of Eastern India. The divergence in regional pattern of gender disparity from patterns observed for demographic and health indicators shows that gender discrimination is a complex multilayered phenomenon and the interaction between these layers may assume unexpected forms.     

In vitro fertilization and public policy: turning to the consumer

A responsible and comprehensive policy of in vitro fertilization should be preceded by the gathering of empirical information about the application of the procedure in the 138 IVF centers across the country. To date, attention has been directed more to the implications of IVF as a whole than to actual behaviors in the medical community. It is appropriate to survey patients and physicians, examine consent forms, and study guidelines issued by the medical community in order to enhance public knowledge of what has been done voluntarily in the medical community and what remains to be done. Moreover, consumers should be encouraged to speak about their experiences and other groups encouraged to act as advocates for affirmative IVF policy. At present, the interest group spectrum is skewed by physicians' interests groups (speaking for IVF) and other interest groups criticizing the technique. Organized advocates for affirmative IVF policy are less well represented.     

Dynamics of Spanish-Language Neighborhoods in Chicago and Atlanta: 1990–2000

This study examines and compares how the spatial arrangements of Spanish speakers have changed over time in a traditional immigrant gateway, Chicago, and in an emerging immigrant gateway, Atlanta. Using the 1990 and 2000 U.S. Census data, spatial autocorrelation analysis confirms that Spanish-language neighborhoods continue to be in the city and the suburbs of Chicago. Atlanta’s Spanish-language neighborhoods, on the other hand, are mainly located in the suburbs where major growth took place over the decade. However, Spanish-language neighborhoods in both the city and suburbs of Atlanta and Chicago share similar characteristics: higher percentages of residents who are foreign-born and limited English proficient, and households with low levels of income. While the model of spatial assimilation is still relevant to our understanding of residential patterns among contemporary immigrants and their descendants, the interpretation of findings, including those for new destinations such as Atlanta where large-scale immigration occurred after suburbanization, should place less emphasis on the central city/suburb distinction and suburban homogeneity. The growing diversity in language use among residents necessitates the provision of accessible social services and information.