Outcomes for children's health and well‐being

Health outcomes are implicit in the government's major policies on reducing poverty, unemployment and social exclusion, and in environmental regeneration, as well as in explicitly targeted policies for modernising the National Health Service. The impact of policies in childhood are regarded as a key feature in determining socioeconomic outcomes in many domains, among which mental health plays a particularly important part. But although early intervention is recognised as crucial in the achievement of socioeconomic and health policy aims, outcomes in children and for children have only recently received full recognition. This article outlines the impact that government policies may have on health outcomes for children. However, the assessment of changes in health status is difficult and mostly relies on proxy measures. The evidence that any changes can be related to policy is extremely limited and mostly based on small‐scale and locally specific projects. What can be learnt from these and from collective analysis of linked projects, such as those funded through the CAMHS Innovation Grant, is discussed. Because of the attention paid by the government to evidence‐based policy, outcomes in all domains will become known before long for major national children's policy initiatives such as the Sure Start programme, highlighting the crucial and continuing need for evaluation of the ways in which policies are implemented. Copyright © 2003 John Wiley & Sons, Ltd.     

The Migration–Development Nexus: Evidence and Policy Options

Migration and development are linked in many ways – through the livelihood and survival strategies of individuals, households, and communities; through large and often well–targeted remittances; through investments and advocacy by migrants, refugees, diasporas and their transnational communities; and through international mobility associated with global integration, inequality, and insecurity. Until now, migration and development have constituted separate policy fields. Differing policy approaches that hinder national coordination and international cooperation mark these fields. For migration authorities, the control of migration flows to the European Union and other OECD countries are a high priority issue, as is the integration of migrants into the labour market and wider society. On the other hand, development agencies may fear that the development policy objectives are jeopardized if migration is taken into consideration. Can long–term goals of global poverty reduction be achieved if short–term migration policy interests are to be met? Can partnership with developing countries be real if preventing further migration is the principal European migration policy goal? While there may be good reasons to keep some policies separate, conflicting policies are costly and counter–productive. More importantly, there is unused potential in mutually supportive policies, that is, the constructive use of activities and interventions that are common to both fields and which may have positive effects on poverty reduction, development, prevention of violent conflicts, and international mobility. This paper focuses on positive dimensions and possibilities in the migration–development nexus. It highlights the links between migration, development, and conflict from the premise that to align policies on migration and development, migrant and refugee diasporas must be acknowledged as a development resource.     

Family Policy and Complex Contemporary Families: A Decade in Review and Implications for the Next Decade of Research and Policy Practice

Prior Journal of Marriage and Family decade-in-review articles have grappled with the definition and role of family policy for research and policy practice while emphasizing its value to both. In this article, we begin with a broad conceptualization of family policy that encompasses actions intended to achieve explicitly stated goals for families (explicit policies) and those that affect families without an explicitly stated goal for doing so (implicit policies), which we believe provides a solid framework for guiding and understanding both research and practice in the field. Second, we review major U.S. policy initiatives in the past decade and their documented and potential effects on families. Third, we describe several key aspects by which contemporary families have become more diverse and complex. Fourth, we discuss the implications of ongoing family complexity for public policies. We conclude with a discussion about future research and policy development in the context of contemporary family complexity.     

Influencing alcohol control policies and practices at community festivals

The goal of this study was to assess the feasibility and effectiveness of two interventions aimed at reducing alcohol-related risks at community festivals--a training program for festival planners and a community organizing campaign. We randomly selected four festivals for each intervention and had 24 comparison festivals. Our assessment included process evaluation to track and evaluate types of alcohol policies resulting from each of the interventions, pre and post telephone surveys of key festival planners and law enforcement agencies, and pre and post pseudo-underage and pseudo-intoxicated purchase attempts. Analyses showed that both interventions were feasible and were successful in influencing adoption of written policies and improving alcohol-related practices. However, neither intervention appeared to decrease propensity for illegal alcohol sales at these events, likely due, in part, to the short time frame of the interventions. Future research should assess effects of the interventions on alcohol-related problems and effects of enforcement interventions.     

Efficacy of interventions targeting alcohol,drug and smoking behaviors in university and college students: A review of randomized controlled trials

Objective: To evaluate the effectiveness of interventions targeting alcohol consumption, drug use and smoking for college/university students.Participants: College/University students.Methods: Studies were eligible if: (1)included students attending universities/colleges; (2)implemented in a university/college setting; (3)aimed to improve at least one of the following behaviors: alcohol and/or drug use and/or smoking; (4)were RCTs. The effect of the interventions on behaviors was determined by the percentage of studies that reported an effect. Due to the heterogeneity of outcomes meta-analysis was not conducted.Results: 88 studies met criteria. University-based interventions were effective for reducing alcohol-related outcomes (drinking patterns, BAC, consequences, problem drinking). Inconsistent findings for drug and smoking were observed.Conclusions: University-based interventions have the potential to improve health for students. While there is a breadth of research examining the efficacy of interventions to reduce alcohol consumption, further research is needed to determine the best approach for addressing smoking and drug use among students.     

Policy sources of worker dissatisfactions: the case of human services in aging

This article explores job dissatisfaction experienced by service providers in the field of aging and the policy sources of such dissatisfactions. Workers interviewed identified four major areas of complaint about their jobs: lack of resources, agency problems, mandates and regulations, and client characteristics. Such problems, it is argued, are associated with specific characteristics of policies under which the respondents work. These characteristics include the symbolic nature of legislation, policy ambiguity, universal entitlement, and calculated fragmentation. Whether or not policy changes should be made to alleviate worker dissatisfactions is discussed in the concluding section of the article.     

Places for Place‐Based Policy

Place‐based policy is both ubiquitous and widely criticised. The conventional economic case against place‐targeted interventions is strong, relegating its application to a narrow range of cases of immobile labour resources, market imperfections and/or other externalities. However, both internationally and domestically, equity considerations lead to policies and programmes for disadvantaged regions and their populations. Budget constraints and accountability suggest a selection or ‘triage’ process targeting places with the highest returns in contributing to social welfare. Furthermore, the challenges facing rural areas may be fundamentally different in developed from developing countries. This article proposes a framework for assessing places appropriate for place‐based policies, using the examples of Canada, Chile and Peru.     

Recommendations for International Gambling Harm-Minimisation Guidelines: Comparison with Effective Public Health Policy

Problem gambling represents a significant public health problem, however, research on effective gambling harm-minimisation measures lags behind other fields, including other addictive disorders. In recognition of the need for consistency between international jurisdictions and the importance of basing policy on empirical evidence, international conventions exist for policy on alcohol, tobacco, and illegal substances. This paper examines the evidence of best practice policies to provide recommendations for international guidelines for harm-minimisation policy for gambling, including specific consideration of the specific requirements for policies on Internet gambling. Evidence indicates that many of the public health policies implemented for addictive substances can be adapted to address gambling-related harms. Specifically, a minimum legal age of at least 18 for gambling participation, licensing of gambling venues and activities with responsible gambling and consumer protection strategies mandated, and brief interventions should be available for those at-risk for and experiencing gambling-related problems. However, there is mixed evidence on the effectiveness of limits on opening hours and gambling venue density and increased taxation to minimise harms. Given increases in trade globalisation and particularly the global nature of Internet gambling, it is recommended that jurisdictions take actions to harmonise gambling public health policies.     

Industrial Policy Capture in Taiwan and South Korea

Whatever the theoretical merits of an industrial policy, in practice state incentives in support of infant industry are difficult to withdraw once they have been granted. Infant maturation is thereby delayed, resulting in ‘policy capture’ which confers rents on the assisted firms at the expense of consumers and/or taxpayers. The process is well-documented in poorly managed economies pursuing autarkic industrial policies (Auty, 1994a). This article examines evidence of policy capture in well-managed economies pursuing competitive industrial policies. Examples are drawn from the heavy (and chemical) industry drives of South Korea (hereafter Korea) and Taiwan, but the research is first set in the context of the industrial policy debate.     

Parental Protest,Public Opinion,and War Termination: Israel's ‘Four Mothers’ Movement

Peace movements that challenge national security policies typically remain politically marginal. However, the unusual cases that evince causal linkages among grass-roots activism, public opinion shifts, and a government's decision to change policy suggest hypotheses about the sorts of organizational characteristics and political conditions that can increase movements' prospects for influence. This article considers the case of Israel's Four Mothers – Leaving Lebanon in Peace that in the late 1990s successfully sought to end Israel's war in southern Lebanon. The article adopts a political-mediation model of peace movement outcomes that draws on Giugni's (2004) model of movements' policy impact. It finds support for the idea that when grass-roots activists and their elite supporters among politicians and the media act jointly, they can exert influence on policy outcomes. Anti-war movements led by soldiers' family members may have particularly abilities to shift public opinion against the war so as to create political incentives for office-seekers to end it.     

European Youth Gang Policy in Comparative Context

The past decade has seen increased reports of street gangs across a range of contexts. In Europe, anxieties over street‐based youth has led to the development of gang‐specific policies across a range of jurisdictions, most notably the UK. Following a similar pattern of policy mobility in criminal justice, many of these policies have origins in the US system. In this review of international gang policy developments, we critically examine a number of these policies in a comparative context ‐ including gang policing units and intelligence databases ‐ and interrogate their efficacy. Drawing on cogent examples from the UK, we argue for caution in adopting US gang intervention tactics due to the lack of empirical evidence relating to their applicability or efficacy, and the corresponding potential for discrimination toward the most marginalised and socially excluded children and young people in society.     

Health care for an immigrant nation: Policy and practice in Australia

Australia is one of the most multicultural nations on earth. Over 100 different languages are spoken by Australians in the normal course of their lives. 20% of its population was born in another country and 24% of Australians have one or both parents born overseas. It is within this socio‐demographic context that Australia has developed its social and institutional policies of multicultur‐alism provided the intellectual capital and impetus for the creation of a Migrant Health Policy. The latter, in turn, is responsible for the operational policies about language, culture, information marketing and agency operations, which govern the nature and extent of health care services to the community. This paper provides a historical view of the role of immigration in Australia's development, explains the policy creation process, its antecedents and its service outcomes, and concludes with a summary of the major challenges which confront the health care system in its quest to provide equitable, relevant and responsive services to a multilingual and multicultural community.     

BUILDING THE EVIDENCE BASE FROM LONGITUDINAL DATA

Survey data from cross-sectional snapshots give an incomplete picture of the social fabric. Without longitudinal information, planners, practitioners, social scientists and policy makers would be in the dark about dynamics, durations and pathways of human development. Longitudinal data collected in birth cohort studies give a better guide to long-term processes and outcomes and are more informative about the causal relations that are the drivers of disadvantage or success. The content and structure of Britain's Birth Cohort Studies are described to illustrate the challenges of creating and studying longitudinal evidence. Examples of findings and policies based on these prospective longitudinal studies are given, along with a discussion of the practical decisions that have to be confronted in undertaking them.     

Global Convergence: Aging and Long-Term Care Policy Challenges in the Developing World

Aging around the world poses a global challenge in eldercare. This challenge is particularly felt in low- and middle-income countries (LMICs), where population aging outpaces the development of aged care policies and services. This Perspective highlights the phenomenon of global convergence in several unsettling trends and challenges shared across LMICs. These include the weakening of informal family care systems for the elderly, growing need for formal long-term care of the frail and disabled who can no longer be adequately supported by family members, and mounting pressures for policy responses to tackle these societal challenges. It is argued that policymakers should take a proactive stance. That is, when family care for the elderly falls short and family caregivers are increasingly under strain, the government should step in and step up support to fill in the gap by developing appropriate policies and a continuum of long-term care services that are accessible and affordable for the majority of older people in need. Three general principles are then suggested with regard to long-term care provision, financing, and quality assurance, which transcend national borders and can be used to guide long-term care policymaking across LMICs.     

Alcohol and Sexual Health Behavior: “What We Know and How We Know It”

Alcohol, despite salutary associations with sexuality, has been implicated in sexual health problems. This review examines the relationship between alcohol and outcomes related to sexual health. Methodological considerations limiting causal assertions permissible with nonexperimental data are discussed, as are advantages of experimental methods. Findings from laboratory experiments are reviewed evaluating causal effects of acute alcohol intoxication on a variety of outcomes, including sexual arousal, sexual desire, orgasm, and sexual risk behaviors related to sexually transmitted infections (STIs) and human immunodeficiency virus (HIV). Several variables exerting mediating and moderating influences are identified. It is concluded that acute alcohol intoxication is capable of exerting a causal impact on multiple constituent components of sexual responding related to sexual health. Both alcohol expectancy and alcohol myopia theories have been supported as explanations for these causal effects. Furthermore, for sexual risk behavior, noteworthy recent developments include research highlighting the importance of women’s sexual victimization history and men’s condom use resistance. Limitations and implications associated with this body of research are also discussed.     

Influencing Mobility Outside Transport Policy

Because levels of mobility and car ownership have risen substantially over recent decades (and the increase seems likely to continue), mobility management is becoming more and more important. Transport policy clearly has a direct impact on mobility and can be used to influence the supply and demand for transport. However, transport policy is not the only way to influence mobility. Other areas of policy making (such as energy or waste policies, for example) are also important determinants of mobility, although the influence of these 'non-transport policies' on mobility is often overlooked when identifying policies for mobility management. In this paper, we show that certain non-transport policies might increase mobility whilst others might reduce it. For example, macro-economic policy and land-use planning might act to reduce travel, whilst EU enlargement and cross-border trade agreements might act in the opposite direction and increase travel. Non-transport policies may also indirectly affect mobility. For example, research and development policy can stimulate the introduction of new technology, which in turn can have implications for the introduction of new transport policy options (such as electronic road pricing) and consequently mobility levels. We present a framework with examples to conceptualize the links (both direct and indirect) between transport policies, non-transport policies, social and economic trends, innovation and technology, and mobility. We then identify some of the potential impacts of non-transport policies on mobility in more qualitative terms, including a review of the role of land-use planning, ICT (information, communications and technology) and macro-economic policies in influencing mobility. We conclude that thinking must change about solutions to transport problems. Transport policies alone may not be enough to manage mobility effectively. The achievement of sustainable transport requires transport demand to be reduced at source by combining complementary transport policies and non-transport policies, including technology. We also suggest that new methods of analysis are required to reflect the true complexity of change in travel that is now taking place. This complexity has arisen from a combination of factors, including non-transport policies, and the range of responses from individuals and firms to this new flexibility needs to be understood.     

Change and Continuity in Australian International Migration Policy

Almost half Australia's population are an immigrant or the child of an immigrant. This paper traces changes in Australia's immigration policy over the postwar period and relates them to changing global and national developments. While Australian postwar immigration policy changes are similar in many ways to those in other “traditional” migration countries there are a number of distinctive elements. The effectiveness of those policies in achieving government goals is assessed and it is concluded that most objectives of policy have been successfully achieved. Nevertheless there are a number of challenges which Australian policy makers face over the next decade.     

Stroke in Developing Countries: Epidemiology,Impact and Policy Implications

The burden of stroke and other non‐communicable diseases has risen sharply in developing countries in recent years. This article provides a detailed review of this trend and its underlying causes, and discusses the social and economic effects of stroke and the scope for interventions to reduce incidence and mitigate impacts. It demonstrates that policy‐makers have been slow to recognise the growing scale of the challenge, and argues for large‐scale public health campaigns focused on primary and secondary prevention.     

A Comparison of Spanish and American Housing Policy Frameworks Addressing Housing for the Elderly

Abstract

Housing policies in Spain and die United States have important similarities and dissimilarities mat affect housing for the elderly. Spain, even more so than me United States, promotes homeownership. Bom countries face significant challenges in addressing the housing needs of the elderly, particularly those challenges associated wim aging in place. The paper reviews me broader housing policy frameworks in bom countries in order to understand me context for elderly housing policy. The paper identifies lessons from the American experience mat can expand housing policies in Spain.     

Policy advocacy for women's unpaid care work: comparing approaches and strategies in Nepal and Nigeria

This article focuses on policy advocacy programmes in Nepal and Nigeria, instigated by ActionAid International with local women's rights organisations and non-government organisations, and supported by the Institute of Development Studies, UK. These programmes aimed to challenge women's unequal responsibility for care work and to influence policymakers to understand the importance of providing services to support them. One of the main components of these programmes was child care, a responsibility which most women experience 24/7 for at least two decades of their lives, and which profoundly shapes their lives and opportunities. We examine the processes through which each of the country teams have engaged with public policies on this issue, focusing on the similarities and differences in each context. Although the programme of activities has been implemented in much the same way in both countries, and each chose to focus on early child-care provision as the main policy demand, the partnerships and policy processes chosen differ greatly. Specifically, we distinguish between ‘critical engagement’ (in the case of Nepal), as compared to ‘constructive engagement’ (in the case of Nigeria). The article ends with some reflections on the challenges facing the teams during their work, and the implications and lessons that can be drawn from these two case studies.