World population trends in 1960-70

The rapid rise in world population for the 4 periods 1950-1955, 1955 -1960, 1960-1965, and 1965-1970 is mainly due to a decline in the crude death rate from 24/1000 in 1950-1955 to 16.1/1000 in 1965-1970. 1950 was a turning-point in mortality rates because for the first time public health measures became widely available in less developed regions. These less developed regions contained 63.4% of the world population in 1930, 65.5% in 1950, and 70.0% in 1970. World population increased by 22% in 1960-1970, compared to 20% in 1950-1960, which was twice as much as the 20% registered for the 20 years 1930-1950. Developed regions contributed a 14% increase between 1950-1960 and 12% between 1960-1970; in less developed regions the increases were 23% and 27% respectively. Demographic conferences have begun to neglect mortality, but this is still a vital part of total population growth. Evidence is that the mortality decline in less developed countries is beginning to level off so that previous population projections may not be reached. What decline has been seen in crude birth rates in less developed countries is largely attributable to declines in East Asia, notably in the People's Republic of China, Republic of Korea, and other Chinese or Chinese culture-related populations, as well as some of the smaller Latin American countries and some small islands off Africa. Such demographic giants as India, Indonesia, Pakistan, and sub-Saharan Africa have shown little change. In areas with high fertility there are more mothers under age 20 and more births to women over age 35 while in low-fertility areas births are concentrated in the 20-35 year groups. An interesting example is Japan which has 50% of its births to mothers 25-29 years of age. Less developed countries have a larger proportion o f the population under age 14 while developed countries which have had lower fertility for a number of years have larger numbers in the older age groups. In less developed areas the greatest burdens are associated with child-rearing while welfare for the aged is the great concern in the more developed areas of the world. The great trend toward urbanization in all parts of the world means that the population problems commanding greatest attention are those associated with large and fast-growing cities.     

GENDER,MORTALITY, AND CORPOREAL INEQUALITY

Most previous empirical analyses of gender inequality have focused on modern economic indicators such as income. The advancement of theory on gender stratification requires detailed analysis of indicators with greater endurance and prevalence in world-historical terms. Sex mortality differentials are presented as cross-cultural indicators of corporeal gender inequality, defined as differential access to basic bodily resources for life and health. Indeed, mortality differentials represent a more fundamental form of gender inequality, in that women first must be alive before they may be denied access to other resources such as equal pay. Analysis of United Nations and World Bank data on developed and developing countries evidence the importance of ecological, economic, and familial explanations in determining corporeal gender inequality. Women's familial roles are found to be more important for gender inequalities in death at younger ages, and women's economic roles are more important for death at older ages. Implications of the results for mortality decline and gender stratification theory are discussed.     

How Can Low‐income Countries Gain from a Framework Agreement on Climate Change? An Analysis with Integrated Assessment Modelling

By using the integrated assessment model RICE this article carries out a scenario analysis with different assumptions about international negotiations on climate change, in particular hypothesising about reduction in targets for greenhouse gas emissions, technology transfers and financial transfer programmes. It finds that, in terms of growth, developing countries and in particular sub‐Saharan Africa will benefit from agreements that reduce the level of pollution and promote technological diffusion. Moreover, when developed countries are subject to emissions limits and poor regions have no such commitments, financial transfers from rich to developing countries for adaptation and mitigation enhance pro‐poor growth and help the effectiveness of poor countries in reducing emissions.     

Aging,Health, and Social Policy:

Seven major turning points in the evolution of U.S. aging policy are identified and reviewed: (1) the Social Security Act (2) the Great Society (3) the federalization of Old Age Assistance (4) the enactment of comprehensive social services (5) Social Security improvements (6) New Federalism, and (7) medical cost-containment policies under Medicare and Medicaid. In the 1980s, significant and growing problems of uninsurance and underinsurance for health care have re-emerged. Simultaneously, state Medicaid programs are characterized by their increasing variation and inequities, while there has been a decline in access for the poor. The future of aging policy will be decided in the context of four socio-demographic realities: (1) population aging (2) trends in mortality and morbidity (3) the relationship between income and health, and (4) aging as a woman's issue. The article concludes with a call for a recommitment to the public interest and to public solutions which affirm that health care is an inalienable right.     

The multinational transfer of competency-based foster parent assessment, selection, and training: a nine-country case study.

The UN Convention on the Rights of the Child mandates (Articles 19 and 20) that alternative care be available to protect children from maltreatment by parents and caregivers. Increasingly, countries around the world have recognized the benefits to child well-being of family-based care as an alternative to institutional care. The special if not extraordinary needs of children separated from parents because of abuse, neglect, and maltreatment and placed with foster families requires a commensurate effort to develop foster families who have special if not extraordinary skills. Methods that are effective and replicable across countries offer significant advantages, reducing investments in policies and practices that otherwise would have to be developed independently, country by country. This case study describes the factors that contributed to the transfer of knowledge in the assessment, selection, and training of foster parents and the impact to date.     

Mortality rates as indicators of cross-cultural development: regional variations in the Third World

"While infant mortality and the under 5 mortality rates are widely used as measures of development, the death rate among 1-4 year olds may be a more effective measure of socioenvironmental conditions affecting mortality, since this age group is less influenced by genetic and biological factors than infants. This article looks at the relationship between infant, under 5, and 1-4 mortality rates and level of development, immunization, information, access to drinking water and health services, and literacy rates among mothers for 78 less developed countries. The evidence suggests that socioenvironmental variables have greater degrees of correlation with age group 1-4 mortality than infant or under 5 mortality, pointing to the importance of this measure in cross-cultural research."     

Residence and Income Inequality: Effects on Mortality Among U.S. Counties

Abstract Despite lower average incomes, greater percentages living in poverty, lower levels of health insurance, less preventive health care, and poorer health status, nonmetropolitan residents have been found to experience lower mortality than their metropolitan counterparts. Several pathways through which residence influences mortality have been proposed. The objective of this study is to examine the effects of income inequality on residential differentials in mortality. Using data from the Compressed Mortality File for counties in the coterminous United States for 1990, we estimate weighted least squares models of total mortality for 3,067 counties, and separately for metropolitan and nonmetropolitan counties. Mortality is lower in nonmetropolitan counties than in metropolitan counties, once rates are standardized for age, sex, and race. Moreover, income inequality exerts stronger effects in nonmetro counties, an effect that persists when per capita income, median household size, and racial composition are controlled. The percentage of the population that is black exerts an independent effect on mortality in both metro and non‐metro counties.     

The international migration of nurses in long-term care

This article describes five major factors that are affecting patterns of international migration among nurses who work in long-term care settings: DEMOGRAPHIC DRIVERS: The aging of the populations in developed countries and the low to negative growth in the working-age population will increase the demand for international workers to provide long-term care services. GENDER AND RACE: A dual labor market of long-term care workers, increasingly made up of women of color, is becoming internationalized by the employment of migrating nurses from developing countries. CREDENTIALING: The process of credentialing skilled workers creates barriers to entry for migrating nurses and leads to "decredentialing" where registered nurses work as licensed practical nurses or aides. COLONIAL HISTORY AND GEOGRAPHY: The colonial histories of many European countries and the United States have increased migration from former colonies in developing countries to former colonial powers. WORKER RECRUITMENT: Efforts to limit the recruitment of health care workers from some developing countries have had little effect on migration, in part because much of the recruitment comes through informal channels of family and friends.     

Einkommen, Gesundheit und Mortalität in Deutschland, Grossbritannien und den USA

The paper examines the effect of income on mortality with respect to different health statuses and institutional characteristics of the health care system in the USA, Great Britain and West Germany. It is hypothesized that the nature of the theoretical contribution of income in explaining mortality risks changes on whether good or poor health is considered. Taking into account that the health care systems of the countries in question vary by their degree of household out-of-pocket expenditure, we expect an association between income and mortality that differs by country. The analysis is based on the German Socio-economic Panel (GSOEP), the British Household Panel Study (BHPS), and the Panel Study of Income Dynamics (PSID). The effect of income on mortality is found to be weakest when medical services are sought in the presence of poor health within the framework of a national health insurance that renders free primary health care (Great Britain, Germany). The effect is strongest when the provision of primary health care depends strongly on private expenditures (USA).     

The Transnational Tilt of the Treadmill and the Role of Trade Openness on Carbon Emissions: A Comparative International Study, 1965–2010

There are various schools of thought regarding the relationship between the environment and economy. Ecological modernization argues that the harmful effects of economic growth and development on the environment decline through time, whereas the treadmill of production and ecologically unequal exchange postulate different perspectives. This study relies on World Bank and World Resources Institute data for the period of 1965–2010. Time‐series cross‐sectional Prais‐Winsten (PW) regression models with panel‐corrected standard errors (PCSE) are employed to examine whether economic growth and trade openness intensified or decoupled in relation to three measures of carbon dioxide (CO₂₎ emissions during this period. The findings of this study indicate that there has been a “tilt” in the treadmill of production—that is, the most environmentally degrading production processes have moved to less developed countries. Furthermore, integration into the world economy has been associated with an intensification in CO₂ emissions for less developed countries. Surprisingly, however, this phenomenon does not seem to be driven by exports sent to high‐income nations, suggesting that there are mechanisms embodied within the global organization of production that require further exploration.     

Changing Meanings, Changing Institutions: An Institutional Analysis of Patent Legislation

Conceptions of patents have changed significantly over the past two centuries, reflecting broad changes in state structures and the international system. In the late eighteenth century, the creation of democratic states such as the United States and France encouraged the conceptualization of patents as an economic and political right belonging to an individual, rather than to a corporate body such as a guild. A second conception of patents arose in the nineteenth century in which patents become a state-based mechanism for motivating economic growth. In the late twentieth century, patents have become conceptualized as an essential part of the economic infrastructure of a state, for both industrialized and less developed countries. This conceptualization has allowed international development organizations to become central in the diffusion of patent legislation to less developed countries. These changes in conceptions about patents did not always occur smoothly, however. Major controversies over the role and usefulness of patents occurred in each century, implying that the diffusion of patent legislation was by no means inevitable. This paper illustrates these arguments with a historical discussion of patents and a statistical analysis that models the adoption of patent legislation for all countries from 1790–1984.     

Health care,social care or both? A qualitative explorative study of different focuses in long-term care of older people in France,Portugal and Sweden

Challenges with an ageing population are increasingly becoming a reality in the Western world. Since cognitive impairment increases with age, we can expect an increasing number of older people in need of care. The aim of this article is to describe, analyse and compare different focuses on care of older people with dementia, using examples from France, Portugal and Sweden. The questions are principally focused on the participants’ view about their tasks, the organisation of work, the professional role and cooperation with other professions. Everyday care was studied through observations and participant observations and the staff's opinion was explored by means of interviews. Twenty-two care settings for older people were included. The findings showed that France provided mainly ‘health care’, Sweden ‘social care’ and Portugal an integrated ‘health care and social care’. In a comparative perspective the Portuguese general care of older people, which focuses on integration of health care, social care and social work, also seems to provide care for older people suffering from dementia which best corresponds to the previously developed group living model.     

Educational Gradients in Parents' Child‐Care Time Across Countries, 1965–2012

Parental time with children leads to posive child outcomes. Some studies have reported a posive educational gradient: More educated parents devote more time to children than other parents. Furthermore, some research finds that parental child care increased over time. Less certain is whether more educated parents increased their time more than less educated ones did, whether parenting trends for mothers and fathers are the same, and whether observed patterns characterize all Western countries or only some. Hypotheses inspired by theories of social diffusion, class differentiation, and ideologies of child rearing are tested with time‐use data for 11 Western countries between 1965 and 2012. For both mothers and fathers, results indicated a widespread educational gradient and an increase in child‐care time. In a number of countries, the posive educational gradient increased; nowhere was it dished. Thus, the advantages of intensive parenting continued to accrue to the well‐educated elite.     

Is caring for older parents detrimental to women’s mental health? The role of the European North–South gradient

In the last decades, both the lengthening of life expectancy and an accentuated decline in birth rates have reduced the consistency of the younger generational cohorts. Due to an ageing population, the burden of caregiving is expected to intensify in the next quarter of the century in Europe, especially for mature women. This paper investigates the impact of the provision of constant care for older parents on the mental health of adult daughters, between the ages of 50 and 75, living in different European countries. Data is drawn from the Survey of Health, Ageing and Retirement in Europe. Information on mental health status is provided by Euro-D depression scale, a measure of depression standardized across European countries. We focus on differences in the effects according to the North–South gradient: we test whether the relationship between informal caregiving and mental health differs across European macro-regions. Our results, robust under different specifications of the propensity score model, reveal a clear North–South gradient: the provision of informal care has a negative and significant impact on daughters’ mental health in the Mediterranean countries only, where the amount of resources allocated to the Long Term Care is minimal and the local system of health and social services for the elderly lacks the necessary structures to meet the increasing demand for eldercare.     

Medical care, living conditions, and children's well-being

We examine the effect of medical care and living conditions on children's physical and psychological well-being. We develop a causal model in which living conditions (including the socioeconomic status of the family and the social-psychological aspects of family functioning) may affect well-being both directly, and indirectly through medical care. We find that families in the higher social classes and families that function well tend to go to large prepaid groups where they receive good medical care. High quality technical care of illness, in turn, improves physical health. The quality of psychotherapeutic care, on the other hand, has no effect on psychological well-being. For this aspect of health, the effect of living conditions is largely direct, rather than indirect by way of medical care. Families characterized by high levels of functioning have children who are psychologically healthy. In addition, physical health affects psychological well-being, but not vice versa.     

Inequitable Access to Health Services for Older Adults with Diabetes: Potential Solutions on a State Level

Diabetes is a serious global public health challenge. The cost for health services for diabetes care has increased 41% over the past 5 years. Despite escalating health expenditure, the United States continues to have higher rates of diabetes than many other developed countries. There is a need for health care reform in the United States not only in reducing health care costs but also in improving the quality of preventative care. This study presents the testing of a multilevel model investigating variables on the individual and state levels to develop a better understanding of the most important contextual pathways that can lead to providing older adults (50+) with type 2 diabetes with the recommended preventative quality care they require. The model was tested using a three-level repeated cross-sectional design with data from various existing data sources, using a national sample of 181,870 individuals aged 50 years and older. Results showed that differences in state health care systems contributed to inequitable access. Specifically, in a state where there was a higher percentage of adults 65 and older coupled with a shortage of health care professionals, the likelihood of receiving the recommended preventative quality care decreased. Also, older adults living in states with a higher percentage of people with diagnosed diabetes but with a lower-than-average annual per capita health care expenditure fared worse in receiving quality preventative care. Last, older adults in wealthy states with higher percentages of uninsured people had the lowest odds of receiving quality preventative care. Health care reform, similar to what is currently promoted by the Patient Protection and Affordable Care Act of 2010, is recommended to improve the performance of all health care systems in all states.     

Of Skilled Migration,Brain Drains and Policy Responses*

Developed countries are increasingly trying to attract skilled migrants, rarely giving any consideration to the impact that this migration might have on countries of origin. The debate on the “brain drain” is not new but it has taken on greater urgency in the context of a globalizing economy and ageing societies and this article reviews the evidence over time and space. It examines opposing interpretations of the impact of the skilled from countries of origin and goes on to examine the particular case of the migration of health professionals. Health workers are seen to be key to achieving basic welfare objectives in any country and their loss may be critical to countries of origin. Hence, the movement of health professionals may be central to any understanding of a brain drain. However, the case for a brain drain, even in this sector, is not straightforward. Specific country and place of origin of the skilled, place of training, appropriateness of training, fit of skills to needs, and the role of return and inmigration of health professionals all need to be taken into consideration. The article examines the case for a two‐tiered health training system, one for global markets and the other for local markets. Retention and return of the skilled are examined through the potential for outsourcing in both education and health care. The article concludes with an examination of policy approaches towards skilled migration and offers pointers towards a more balanced and integrated approach by placing the emphasis on development rather than control of migrants.     

Public health research – multidisciplinary,high-benefit,undervalued

The major health problems faced by policy-makers and practitioners at national and local levels require public health approaches. However, public health research is the “poor relative” of biomedical research: it is worthy, but not rich. In the European Commission's health research programme, biomedicine gets 90% of the funding, whereas public health research gets less than 10%. This pattern is repeated nationally in most countries, reflecting public policies to support industries – pharmaceuticals, biotechnology, medical devices – where profits are to be made, rather than not-for-profit, public health research. SPHERE, a study coordinated through the European Public Health Association, conducted bibliometric analyses across public health research themes and mapped the European and national structures and priorities for research. Whilst most European countries have national strategies (and some programmes) for public health, few have public health research strategies and the coordination of public health research is weak. Three further studies are being undertaken. In STEPS, the contribution of civil society organizations in the new EU member states to public health research will be discussed at national workshops with the ministries of health, the science/research councils and the national public health associations. In PHIRE, thematic Sections and the national member associations together evaluate the impact of European-funded health projects within member states. In FAHRE, the specific theme of food and health will be addressed, bridging industry and non-profit research sectors. Arguments for public health research can be made through lobbying at European level, but researchers and practitioners also need to influence the development of public health research within individual countries – leading to a European Public Health Research Area.     

Transfer Pricing in Transition Economies: Evidence from Ukraine

Faced with possibilities and challenges of doing business under different regulatory regimes, transnational corporations have developed a number of transfer mechanisms to take advantage of profit maximization opportunities. Transfer pricing is a transfer mechanism widely used by transnational corporations. Implications of transfer pricing for profitability and the need for transfer pricing regulation are well understood by national governments, which is reflected in the fact that more than 60 governments have introduced some form of transfer pricing controls. Transfer pricing is a challenging issue for transition economies as their transfer pricing regulatory systems are less mature than those of developed countries. The authors have initiated an empirical study on transfer pricing strategies in the Ukrainian market. In addition, the national regulatory regime for transfer pricing was evaluated compared to international best practices. This article is an attempt to draw attention of the research community and Ukrainian policy-makers to transfer pricing issues in Ukraine.      

The Role of Information and Communication Technologies in Addressing Safe Motherhood in South Asia

ABSTRACT

As it is recently recognized in academic and policy circles, limited access to information and limited knowledge are among key factors contributing to worldwide poverty, especially in low developed countries. Consequently, access to “knowledge” has become an integral part of discussions about global development, improvement of societal well-being, and empowerment of women. This article addresses the problem of the limited spread of information about maternal health and available maternal care services across impoverished South Asian countries. Lack of knowledge greatly contributes to underutilization of medical services and available maternal care that leads to high rates of maternal and infant mortality and pregnancy-related complications which, with proper medical care, could be avoided.