A comprehensive population health index based on mortality and disability data

Two versions of a new population health index based on the mortality and disability experiences of nations or communities are proposed for comparing their overal health status. One version is the ratio of the mean mortality rate of selected population groups to the mean disability free rate of survivors. The other version is a composite of these variables, transformed to stabilize their variances, that are so weighted as to maximize the probability of correctly differentiating ‘healthy’ and ‘unhealthy’ nations. Problems with application of the index are briefly discussed.     

First Order Dominance Techniques and Multidimensional Poverty Indices: An Empirical Comparison of Different Approaches

In this empirically driven paper we compare the performance of two techniques in the literature of poverty measurement with ordinal data: multidimensional poverty indices and first order dominance techniques (FOD). Combining multiple scenario simulated data with observed data from 48 Demographic and Health Surveys around the developing world, our empirical findings suggest that the FOD approach can be implemented as a useful robustness check for ordinal poverty indices like the multidimensional poverty index (MPI; the United Nations Development Program’s flagship poverty indicator) to distinguish between those country comparisons that are sensitive to alternative specifications of basic measurement assumptions and those which are not. To the extent that the FOD approach is able to uncover the socio-economic gradient that exists between countries, it can be proposed as a viable complement to the MPI with the advantage of not having to rely on many of the normatively binding assumptions that underpin the construction of the index.     

Rating the Rich: An Ordinal Classification to Determine Which Rich Countries are Helping Poorer Ones the Most

When talking about poverty, a lot of energy is expended by academics and sociologists in the identification and classification of the poor. Less attention is paid to classifying the rich. The Center for Global Development created the Commitment to Development Index in 2003, which ranks countries according to their contribution to the reduction of poverty in developing countries. Since its first report, “Ranking the rich, the Index has been quite successful. However, it has also been subject to multiple criticisms. This paper proposes the use of an ordinal classification to rate, not rank, the performance of rich countries. An ordinal classification, where an ordinal scale labels the examples, can help discovering the level of each country’s commitment to development, automatically and independently from others’ performances. It could stimulate both advocacy from civil society and the determination of more coherent public policies in rich countries for poorer ones.The methodology used is Artificial Neural Networks, a common machine learning tool for successfully solving classification problems. Experiments yield robust results, showing better outcomes than other alternative ordinal classifiers, opening the possibility of developing a classification technique which could overcome the limitations of the current ranking technique.     

A further note on the relation between economic development and fertility

The relationship between economic development and fertility has been examined by several scholars. In particular Heer, using data from 41 nations (24 developing and 17 developed) tested three hypotheses. His objective was to reconcile the two prevailing views in this context, namely, that economic development on one hand promotes and on the-other inhibits fertility. However, when we reran Heer’s data separately for the two groups of countries in his list, the pattern of relationships between the variables that he used changed significantly. On this basis, we restricted this study to a further examination of his three hypotheses using data from developing nations only but for two points in time. The evidence from this study seems to support two of the hypotheses in Heer’s study. In other words, whether the analysis of this relationship is restricted to developing nations or includes both developed and developing nations, it remains true that increased economic development implies a decreased illiteracy and a decreased IMR; a decreased illiteracy and IMR are optimal conditions of low fertility. Nonetheless, the data examined here do not seem to resolve the question of whether increased economic development implies a decreased fertility. Accordingly, continued testing of the hypothesis at further points in time with more accurate data is in order.     

Development and Governance in the Ex-Soviet Union: An Empirical Inquiry

The widespread adoption of the concept of wellbeing in the social sciences literature has allowed researchers to move beyond a narrow economic focus on income and consumption as the primary measure of inequality and poverty. Although statistical measurement and analyses of wellbeing have become increasingly feasible due to the availability of rich datasets, the empirical literature on wellbeing remains deficient in a number of ways. In this paper we argue that it is necessary that empirical studies of wellbeing encompass multiple. Applying Sen’s capability approach as our theoretical model we subsequently develop a modelling framework that applies the polychoric principal component analysis (PCA) method for the calculation of objective wellbeing and wellbeing inequality using household asset, education, health and housing dimensions. Findings from our case study of Vietnam challenge previous single dimensional analyses and reveal a number of layers to our understanding of wellbeing inequality in Vietnam. We argue that our use of polychoric PCA is especially suited to the analysis of wellbeing by explicitly incorporating the analysis of both cardinal and ordinal variables and overcoming deficiencies established in the literature relating to the use of standard PCA.

     

A value based index for measuring national quality of life

A new index of the quality of life (QOL) of nations was created. The measured variables are selected based on a universal set of human values derived from the work of Schwartz (1994). The Basic QOL Index, designed primarily to discriminate between developing countries, includes seven variables: purchasing power, homicide rate, fulfillment of basic physical needs, suicide rate, literacy rate, gross human rights violations, and deforestation. The Advanced QOL Index, designed primarily to assess QOL in highly industrialized nations, includes seven variables: physicians per capita, savings rate, per capita income, subjective well-being, percent attending college, income equality, and environmental treaties signed. Combining the two indices produced a reliable measure of QOL that systematically covers diverse human values. The nations scoring highest on the Combined QOL Index were Canada, Switzerland, Netherlands, U.S.A., and Norway, and those scoring lowest were Ethiopia and Rwanda.     

Implicit Social Scaling from an Institutional Perspective

The methodological question concerns constructing a cardinal social index, in order to assess performances of social agents, taking into account implicit political judgments. Based on the formal structure of a Choquet’s expected utility, index construction demands quantification of levels of a meaningful ordinal indicator of overall performance. Contrasting common praxis of using equidistant interval scale, level increments are formally interpreted as variations of social utility. The social scaling is implicitly designed over an evaluative-framework, which is depicted using specifications from the policy-maker. In this setting, criteria of policy are assumed, then intentions, requirements and priorities, perhaps of antagonistic stakeholders, represented. Then, linear programming is used to search for admissible solutions which would provide a coherent index. Interactive scaling is also delineated in order to elicit an institutional index, which is acknowledged by different social actors.     

Indicators of contraceptive policy for nations at three levels of development

The study is concerned with examining variations in contraceptive policies among 74 nations of the world. Employing quantitative data collected by the United Nations, the national policies for three types of contraceptive devices (birth control pills, condoms and IUDs) were examined for nations at three levels of development. The policies for the three items were found to be highly intercorrelated. Given this fact, a restrictiveness index related to the commercial sale of the three types of contraceptive was constructed. A set of independent variables was then related to this restrictive index employing multivariate analysis. The results differed appreciably for the developed and non-developed nations. For the developed nations restrictiveness was significantly related to the fertility rate and the number of physicians in the society, whereas for the developing nations it was significantly related to the infant mortality rate in the society.     

Towards a conceptualisation of woman centred care — A global review of professional standards

BackgroundWoman centred care is purported to underpin Midwifery philosophy. However, the evidence and focus of this concept within midwifery professional standards has yet to be verified. Further to this, woman centred care is, at this time, mostly depicted as a way of assisting, supporting and interacting with a woman and her family. It is however, without a substantive universally accepted definition.ObjectiveThis study aimed to review midwifery standards documents. An organised and targeted methodology was conducted to identify the approaches to woman centred care that currently underpin midwifery governance.MethodsA comprehensive and specific search for ‘woman centred care’ was conducted across a global collection of midwifery standards. A professional document was included if it represented either or all of the underpinnings of midwifery education, contained statements related to standards of practice, overall governance or any equivalence. Individual documents were initially searched for the words ‘woman centred care’, followed by ‘women centred care’, ‘patient/person centred care’ and ‘client centred care’.FindingsAn extensive review of 142 documents was undertaken. These included: thirty independent nations, thirty represented by the European Midwives Association and a further twenty-one identified through the International Confederation of Midwives (ICM). The World Health Organisation (WHO), yielded midwifery information from a further sixty-one nations. The phrase ‘woman centred care’ was located within 3.5% of the documents reviewed. Overall, five examples were found that directly referred to the actual phrase ‘woman centred care’ and one to the use of ‘person centred care’. Therefore, it was established, that at the time of this review, there was limited formal depiction of the concept of woman centred care.     

A Weighted Multidimensional Index of Child Well-Being Which Incorporates Children’s Individual Perceptions

It has been a decade since a landmark piece of work on child well-being measurement based on a summary index was developed in the United States, the Index of Child and Youth Well-Being. Several research studies, both in the U.S. and Europe, followed on from this work. Despite these studies’ valuable contribution, scope exists for further improvements at the methodological level. In the present paper we draw the methodological basis for a new, micro-based summary child well-being index in which children’s views on their own well-being assume a central role and distinct weights (based on the children’s perceptions) to each component that is included in the index are used. Based on 914 pairs of responses of Portuguese children and their carers, the newly proposed index was tested vis-à-vis other methodologies. The econometric estimations show that the significance of all potential well-being determinants (e.g., age, school cycle, mother’s and father’s level of education) remains the same across the distinct methods of calculation of child well-being indexes. However, the consideration of subjective components (degrees of importance and weights) allowed to evidence that the most relevant determinants of child well-being are the set of variables related to the child’s parents, namely education and professional status. In particular, when compared to their counterparts, children whose fathers have higher education degrees reveal an increased overall well-being by around 25 %, whereas children whose fathers are unemployed present a decreased well-being by around 11 %.     

A Regional Development Index for Portugal

In a report from 2008 the Organization for Economic Cooperation and Development came to the conclusion that Portugal is a country still very much marked by regional asymmetries and in need of better regional governance mechanisms and policies. We propose a regional development index for Portugal at the NUTS III level, based on the methodology of the human development index (HDI) from the United Nations Development Programme, which will be helpful to assess the evolution of the asymmetries between regions and evaluate the need for regional policy. Results show us a country that has most of the highest ranked NUTS III regions positioned along the coastline, although some interior NUTS III regions improved their relative positions in the ranking between 2004 and 2009. In addition to the three traditional dimensions of the HDI—income, education, and health—we include two more, given their increasing importance in the literature that criticizes the HDI and suggests the inclusion of new variables—governance and environment. Results show some considerable differences when we add the environment dimension: the interior regions improve their relative positions in the ranking, but in terms of governance they change little. Results also show that there is still the need for regional policy, although the dispersion in the ranking between the best and worst positioned NUTS III regions has decreased in all dimensions except education.     

The Europe 2020 Index

This paper presents a new index to quantify, measure and monitor the progress towards the objectives of the Europe 2020 strategy. This index is based on a set of relevant, accepted, credible, easy to monitor and robust indicators presented by the European Commission at the time the strategy was launched. The internal analysis of the index shows that the Smart and the Inclusive growth dimensions of the strategy are strictly correlated and that the trade-offs between each of these two dimensions and the Sustainable one exist but are decreasing, suggesting that a change towards more sustainable models of development is occurring in Europe. The external analysis of the index shows that it can be a valid measure to assess the overall competitiveness of countries and that the most critical factors for this strategy to be successful are good governance and social capital.     

The Resource-Infrastructure-Environment Index for Measuring Progress: An Application to Australia, Mexico and the US

The resource-infrastructure-environment (RIE) index was proposed as an alternative measure of progress which was then employed to: (1) compare the aggregate (single summary) index findings between Australia (mid-industrialised nation), Mexico (emerging economy), and the US (highly industrialised nation); and (2) compare the RIE index against the gross domestic product (GDP), human development index (HDI) and genuine savings (GS) measure. This paper builds on the previous work by assessing the seven themes and 21 dimensions which comprise the RIE index for the three aforementioned nations, as well as the associated policy implications. The results identified Australia’s strength in the human resource and infrastructure themes. For Mexico, strong contributions came from the natural and generated resource themes as well as the physical environment theme, while the US performed strongly in the infrastructure themes. The comparative results of the US and Mexico illustrated that it is possible to achieve high levels of progress without an excessive reliance on high levels of production and income.     

Away from Dissatisfaction,Closer to Well-Being: A Multidimensional Synthetic Measure

As part of the international debate on methods for measuring the social progress of a population, there has been increasing interest in individual subjective opinions about different aspects of quality of life (elementary indicators). In the literature, many methods have been introduced for producing measures of subjective well-being based on these opinions. Some of these methods aim to construct synthetic measures that allow us to consider all the aspects simultaneously. This topic often requires subjective methodological choices and/or distributional assumptions and, when the opinions are encoded by means of categorical ordinal values, the eventual quantification of the original variables. Here, starting from the Istat multipurpose survey on households’—aspects of daily life, we propose an original method for constructing a global satisfaction index. We introduce a variable based on the joint distribution of all the elementary indicators that is able to express the individual degree of global satisfaction. This approach allows us to maintain the original ordinal data scale and to avoid any aggregation formula. By comparing the observed distribution of the new variable and the theoretical one, which refers to the situation of overall dissatisfaction (all individuals are dissatisfied for every aspect), we propose three indices of global satisfaction. We also implemented two simulation studies that confirms both the efficacy and robustness of our method. We then applied it to measure the global satisfaction degree of the Italian population, using Istat multipurpose survey data for the year 2013.     

农村计划生育与农民生活满意度研究

基于6个省1586户农户的问卷调查数据,运用次序Logit模型,探讨农村计划生育、农村卫生事业、区域环境特征、农民个人特征、家庭特征对农民生活满意度的影响。结果表明,农村计划生育的两个因素中只有是否享受奖扶政策对农民生活满意度有显著影响,是否受过超生惩罚对农民生活满意度没有显著影响,农村卫生事业的两个因素,参加新型合作医疗制度以后看病是否改善和医疗支出负担对农民生活满意度都有显著的影响。根据分析结果提出以下政策建议:在今后的农村公共事业发展中,政府应渐进增加农村公共事业支出比重,进一步完善利益导向政策体系,适当提高奖励扶助标准,加大对农村超生家庭的处罚力度,使惩罚标准与收入及财产相对应。     

Happy life-expectancy

One of the aims of social indicator research is to develop a comprehensive measure of quality-of-life in nations that is analogous to GNP in economic indicator research. For that purpose, several multi dimensional indexes have been proposed. In addition to economic performance, these also acknowledge the nation's success in matters like schooling and social equality. The most current indicator of this type is the ‘Human Development Index’. In this approach QOL is measured by input; the degree to which society provides conditions deemed beneficial (‘presumed’ QOL). The basic problem is that one never knows to what extent the cherished provisions are really good for people. An alternative is measuring QOL in nations by output, and consider how well people actually flourish in the country. This ‘apparent’ QOL can be measured by the degree to which citizens live long and happily. This conception is operationalized by combining registration based estimates of length-of-life, with survey data on subjective appreciation-of-life. Life-expectancy in years is multiplied by average happiness on a 0–1 scale. The product is named ‘Happy Life-Expectancy’ (HLE), and can be interpreted as the number of years the average citizen in a country lives happily at a certain time. HLE was assessed in 48 nations in the early 1990's. It appears to be highest in North-West European nations (about 60) and lowest in Africa (below 35). HLE scores are systematically higher in nations that are most affluent, free, educated, and tolerant. Together, these country-characteristics explain 70% of the statistical variance in HLE. Yet HLE is not significantly related to unemployment, state welfare and income equality, nor to religiousness and trust in institutions. HLE does not differ either with military dominance and population pressure. The conclusion is that HLE qualifies as the envisioned comprehensive social indicator. It has both clear substantive meaning (happy life-years) and theoretical significance (ultimate output measure). HLE differentiates well. Its correlations fit most assumptions about required input, but also challenge some. The indicator is likely to have political appeal.     

A New Proposal to Gauge Intergenerational Mobility: Educational Mobility in Europe as a Case Study

This paper is aimed at presenting a new intergenerational mobility index that (a) combines the intergenerational elasticity and the R-squared of the intergenerational regression and (b) enables the expression of the total degree of mobility as the weighted sum of mobility with respect to both parents. As a case study, we apply our proposal to investigate the intergenerational mobility of education in several European countries and its changes across birth cohorts. The results derived from the proposed index indicate that Nordic countries display higher levels of educational mobility than Southern countries, whereas continental countries are in an intermediate position. Moreover, it appears that the degree of mobility increases over time only in those countries with low initial levels and remains stable for the most mobile countries. Finally, for most of the countries the proposed methodology can prove that the degree of educational mobility with respect to each parent tends to converge to the same level over the course of time.     

A global review of the inferred meaning of woman centred care within midwifery professional standards

BackgroundAs an integral and guiding approach, woman centred care is well-grounded as the cornerstone of midwifery training and practice. A previous global review established that the concept, even though acknowledged as pivotal, has limited attention within the professional standards documents that underpin the discipline [1]. Whilst not detracting from the overall importance of woman centred care, it is further suggested that a broader meaning is generally being implied.ObjectiveWhether other related inferences and meanings of the actual term ‘woman centred care’ are also being utilised, has not yet been established. Therefore, this review of professional documents sought to investigate the occurrence of further depictions of the concept.MethodsWith an implied and inferred meaning of ‘woman centred care’ as the focus, a review and synthesis of narrative from a global sample of midwifery professional standards was conducted. The principles of meta-ethnography were utilised to develop a qualitative approach. Rather than the actual words ‘woman centred care’ further phrases implying or inferring the concept were sought. ‘A priori’ phrases were developed and narrative and examples were synthesised for each.FindingsStandards and governance documents were located from within Australia, the United Kingdom and New Zealand and a further 139 nations. Overall, the seven phrases, each considered as an inference to woman centred care, were all substantiated. As a proportion of all documents, these were collated with the outcomes being a woman’s right to choice (89%), being culturally sensitive (80.5%), a woman’s voice and right to be heard (78%), the woman as an individual (68%), universal human rights (40%), being holistic (39%) and being self-determined (17.5%).ConclusionThe outcomes of this review demonstrate that woman centred care may be a multidimensional concept. There were occurrences of all seven phrases across a broad scope of global professional midwifery documents, and each can be shown through its meaning to contribute something to an understanding of woman centred care. The creation of a universal meaning is recommended.     

Apparent Quality-of-Life in Nations: How Long and Happy People Live

Quality-of-life in nations can be measured by how long and happy people live. This is assessed by combining data on life expectancy drawn from civil registration with survey data on subjective enjoyment of life as a whole. This measure of ‘apparent’ quality-of-life is a good alternative to current indexes of ‘assumed’ quality-of-life such as the Human Development Index. Data are available for 67 nations in the 1990s. The number of Happy-Life-Years varies considerably across nations. Switzerland is at the top with 63.0 years and Moldavia at the bottom with 20.5 years. China is in the middle with an average of 46.7. Happy lifetime has risen considerably in advanced nations over the last decade.People live longer and happier in nations characterised by economic affluence, freedom and justice. Together these three societal qualities explain 66% of the cross-national variance in Happy-Life-Years. Income equality and generous social security do not appear to be required for a long and happy life.