Virus interruptus: An Arendtian exploration of political world‐building in pandemic times

Building upon a series of blog posts and conversations, two feminist scholars explore how political community, trust, responsibility and solidarity are affected by the COVID‐19 pandemic. We explore the ways in which we can engage in political world‐building during pandemic times through the work of Hannah Arendt. Following Arendt’s notion of the world as the space for human togetherness, we ask: how can we respond to COVID‐19’s interruptions to the familiarity of daily life and our relationship to public space? By extending relational accounts of public health and organizational ethics, we critique a narrow view of solidarity that focuses on individual compliance with public health directives. Instead, we argue that solidarity involves addressing structural inequities, both within public health and our wider community. Finally, we suggest possibilities for political world‐building by considering how new forms of human togetherness might emerge as we forge a collective ‘new normal’.     

Hospital Community Benefit in Rural Appalachia: One More Gap*

Non‐profit hospitals are important anchors in Appalachian communities, in part because of the concentration of health care dollars within these institutions. Community benefit efforts of these hospitals, therefore, have the potential to fill gaps in public health and social service provision in underserved areas with documented health disparities and access barriers. To date, however, we do not fully understand how community benefit practices vary by hospital setting. Employing hierarchical linear modeling using a multilevel mixed‐effects approach, this study analyzes data from the years 2010 to 2016 to assess community benefit practices and spending between hospitals in Appalachia and non‐Appalachian counties. Findings indicate that hospitals within Appalachian counties, and rural hospitals in this region, in particular, spent less on community benefit than hospitals, not in this region. Given the potential for community benefit to impact health outcomes and access to care, this disparity is important to state and local public health efforts and suggests the need for additional support for hospitals to engage their communities around critical health needs.     

Organisationsentwicklung durch Gesundheitsförderung,dargestellt am Beispiel Krankenhaus

The public interest in the health status of the individual has increased steadily over the last decades. Organisations — as goal oriented groups of individuals-need health promotion too. The article shows, using hospitals as an example, that this can be an important task for corporate social work. In addition to fundamental reflections on the health damaging impact of hospitals on their staff this article describes as well concrete and practical measures of how health promotion can be achieved in companies.     

Regulatory fit effects on perceived fiscal exchange and tax compliance

Paying taxes can be considered a contribution to the welfare of a society. But even though tax payments are redistributed to citizens in the form of public goods and services, taxpayers often do not perceive many benefits from paying taxes. Information campaigns about the use of taxes for financing public goods and services could increase taxpayers’ understanding of the importance of taxes, strengthen their perception of fiscal exchange and consequently also increase tax compliance. Two studies examined how fit between framing of information and taxpayers’ regulatory focus affects perceived fiscal exchange and tax compliance. Taxpayers should perceive the exchange between tax payments and provision of public goods and services as higher if information framing suits their regulatory focus. Study 1 supported this hypothesis for induced regulatory focus. Study 2 replicated the findings for chronic regulatory focus and further demonstrated that regulatory fit also affects tax compliance. The results provide further evidence for findings from previous studies concerning regulatory fit effects on tax attitudes and extend these findings to a context with low tax morale.     

Breast‐Feeding Advocacy,Risk Society and Health Moralism: A Decade’s Scholarship

This article reviews research published this century that engages critically with the mantra ‘Breast is Best’ and the associated expansion of official breast‐feeding promotion programmes. In recent years there has been a marked increase in the number of such studies published. They mostly explore experience in English speaking, industrialised countries (the US, Canada, New Zealand, Australia and Great Britain) which are in some social and cultural respects dissimilar, yet where very similar developments and problems are detected in regards to breast‐feeding promotion. We highlight how this exploration of breast‐feeding promotion internationally has developed understanding of wider sociological themes. This scholarship, we suggest, has provided a powerful illustration of the relation between risk society (more particularly a heightened consciousness of risk) and the evolution of a code of conduct that regulates behaviour, that has been termed ‘health moralizm’. The article covers three themes: ‘Science, risk society, authority and choice’; ‘Public health policy and infant feeding’; and ‘Moralization and women’s identity work’. We conclude that the research discussed shows how the sociological imagination continues to shed light on the relation between private troubles and public issues. We also suggest one conclusion that can be drawn from this research is that official discourse and everyday maternal experience appear increasingly distant from each other.     

Healthcare Reforms and the Creation of Ex‐/Included Categories of Patients — “Irregular Migrants” and the “Undesirable” in the French Healthcare System

This article reconstructs the socio‐historical processes that have led to the formal inclusion and marginalization of “irregular migrants” in the French public health insurance system and the parallel legal production of exclusion of a share of this group. It interrogates the binary inclusion/exclusion in the field of healthcare linking it to the logic of sovereignty and governmentality in a stratified society. It shows how these processes have led to unequal health practices and increased obstacles to accessing health insurance and healthcare providers, and, consequently, has resulted in the exclusion of a share of this group from the regular healthcare system. These two levels of discrimination are illustrated using empirical research on departments in French public hospitals that have been designed to enable access to care for individuals without insurance (Permanence d'accès aux soins de santé, or PASS: health care access units).     

Infant regulation during the pandemic: Associations with maternal response to the COVID-19 pandemic,well-being,and socio-emotional investment

In the transition to parenthood, the COVID-19 pandemic poses an additional strain on parental well-being. Confirmed infections or having to quarantine, as well as public health measures negatively affect parents and infants. Contrary to previous studies mainly focusing on the well-being of school-aged children and their parents during lockdown periods, the present study investigated how mothers of infants respond to the COVID-19 pandemic and whether this is related to maternal well-being, maternal socio-emotional investment, and infant regulation. Between April and June 2021, 206 mothers of infants (M_age = 7.14 months, SD_age = 3.75 months) reported on COVID-19 infections, their response to the COVID-19 pandemic, their well-being, socio-emotional investment, and their infant’s regulation. Exploratory factor analyses yielded five dimensions of maternal response to the COVID-19 pandemic: social distancing, worrying about the child, birth anxiety, distancing from the child, and information on COVID-19-related parenting behavior and support. These dimensions were related to mother-reported infant regulatory problems. Path analyses revealed paths via reduced maternal well-being and maternal socio-emotional investment. Maternal perceptions of infant regulatory problems are related to how the mothers respond to the COVID-19 pandemic. Better information about COVID-19-related parenting behavior and support might buffer against these effects.     

Performance evaluations of for‐profit and nonprofit U.S. hospitals since 1980

This synthesis of studies examines whether the published literature shows an evidence‐based consensus on performance differences between private for‐profit and nonprofit hospitals in the United States since 1980. The author systematically and comprehensively surveyed peer‐reviewed publications to clarify this question. The author's second objective was to learn what proportion of all research assessing for‐profit and nonprofit health care providers is devoted to hospitals compared to all other providers. The third goal was to discover how any trends in observed performance differences among hospitals compare with trends among other provider types. Computerized bibliographic searches of all relevant databases yielded seventy‐five studies (ninety‐three assessments) that compared the performance of for‐profit and nonprofit hospitals on four performance criteria: access, quality, cost or efficiency, and amount of charity care. The author coded findings on performance in one of three ways: for‐profit superiority, nonprofit superiority, or inconclusive. Most studies (60 percent) reported that nonprofit hospitals have better relative performance than for‐profit hospitals, clear evidence of their organizational effectiveness. Thirty‐one percent were inconclusive, and 8 percent reported that for‐profits were better.     

Using regulatory fit theory to examine how the communication context of compliance-gaining interactions influences compliance

Compliance-gaining research focuses mainly on how message variations differentially affect compliance; however, few studies have examined how framing the compliance-gaining goal (i.e., promotion/prevention) and providing a means to achieve the goal function concurrently to influence compliance. The current study uses regulatory fit theory to examine how a fit between goals and means of compliance-gaining messages affects compliance. A field experiment was conducted in which subjects were presented with a compliance-gaining request in which goals and means were varied. Results indicated that compliance rates and donation amounts were higher under conditions of fit between the regulatory orientation of goals and means rather than non-fit. Findings are discussed in light of their implications for compliance-gaining research and regulatory fit theory.     

Working‐class mothers’ school involvement: a class‐specific maternal ideal?

Recent ideological shifts, along with budgeting constraints, have made parental involvement in the schooling process necessary. Such expectations have increased the toll on working‐class mothers, who now have to assume responsibility in three time‐consuming areas: child care at home, school involvement and labour market participation. In analysing how mothers deal with this threefold expectation, research has focused on class‐specific maternal ideals and practices, but rarely directed systematic attention to how these concurrent expectations shape the maternal ideals they embrace. Moreover, few studies have examined how mothers’ maternal ideals shape their employment interruptions. The current paper considers how working‐class mothers rationalize the maternal ideals they embrace with regard to school involvement and examines how they negotiate them vis‐à‐vis other possible maternal ideals. Interviews of 48 Israeli low‐income mothers reveal that educational success is consensually perceived as critical for maximizing life chances and that this understanding evolved from the gradual realization that school involvement through extensive mothering – where women rely on others to meet their children's schooling needs – must be replaced by school involvement through intensive mothering – namely, personal presence‐based nurturing. We draw some implications relevant to the debate over class‐based maternal ideals.     

Changing perspectives on the child at risk at the end of the nineteenth century. The Belgian Maritime Hospital Roger de Grimberghe (1884–1914) as a space of inclusion and exclusion

In this historical‐geographical approach to the Belgian Maritime Hospital Roger de Grimberghe space is introduced as a conceptual tool to deconstruct the notion of the child at risk. The starting point for the creation of the maritime hospitals lay in the immediate relationship between the idea of improving children’s welfare with healthy sea air and concern about declining public health at the end of the nineteenth century, together with a need for the moral reclamation of the nation. Within this context particular attention focused on ‘the child at risk’, the ‘abnormal child’ and the ‘mentally retarded child’. This research shows how the maritime hospital can be considered a battlefield on which two different discursive practices about children at risk (the political and the medical) clashed. Both practices and perspectives are characterized by mechanisms of inclusion and exclusion.     

Child health in Peru: importance of regional variation and community effects on children's height and weight

In developing countries, height and weight are good indicators of children's health and nutritional status. Maternal education has been accepted as one of the most important influences on child health. Using the 2000 Demographic and Health Survey of Peru, however, I find that the effect of maternal education varies as a function of region. In the most prosperous urban region, maternal education is less important for child health than in poor rural areas, and a higher level of education has a greater effect in rural areas. Multilevel analysis shows that a significant part of the observed correlation between maternal education and child health is moderated by regional differences and community characteristics. The finding suggests that Peruvian public policy should emphasize resource redistribution as well as women's education, and that investment in maternal education should be considered within regional contexts to enhance child health in rural areas.     

The strategic leadership of complex practice: opportunities and challenges

This paper addresses the issue of how strategic‐level partnerships, such as Local Safeguarding Children Boards, know about and learn from practice. The death of Baby Peter in Haringey exposed the dangers of reliance on numerical performance data alone to inform leaders about the true state of practice. The drivers for, and impact of, regulatory, media and political pressures on front‐line practice and partnership behaviour are discussed with reference to the rise of organisational risk management and ‘rule‐based’ responses (Munro, 2009 ). These are exacerbated by an overload of negative data about child protection systems which results in contagious ‘attention cascades’ which lead to over‐simplification of complex issues and the rush to quick‐fix solutions. This results in compliance‐based responses designed to avoid ‘blame’, based on individualistic analyses of complex situations. Under these conditions, ‘learning’, such as from serious case reviews, can become regressive (how to avoid future culpability) rather than progressive (how to improve knowledge skills and practice). It is argued that understanding and improving practice require strategic partnerships to have engaged with front‐line staff in order to access practice narratives as well as performance numbers, and to achieve an accurate and systemic analysis of the state of practice and how it can be improved. This calls for collective forms of knowing and reflecting and the paper concludes by describing examples. Copyright © 2010 John Wiley & Sons, Ltd.     

Public Sector Reform and Women's Work in Poland: ‘Working for Juice,Coffee and Cheap Cosmetics!’

The debate on the transformation of work in east central Europe has concentrated on the restructuring of employment in manufacturing to the detriment of any discussion of the transformation of work in the service and public sectors, where the majority of women are employed. Moreover, while it is frequently recognized that women have been hit hard by job loss and unemployment, less attention has been paid the changing experiences of women in work. This article looks at the profound impact of market‐driven reforms in the Polish health and education sectors implemented in the late 1990s, and considers their implications for women and their work. It reports on interviews with a cross‐section of women workers in schools and hospitals and with trade union leaders at both the national and branch level. The impacts of the reforms and the experiences of women workers are discussed through the themes of changing employment levels, the restructuring of working conditions, job security, wages, training, and the double burden of balancing domestic and work lives. The general findings are that although the impact has been highly uneven between workplaces and regions, in general women have experienced an intensification of work and deteriorating working conditions. Their personal lives are not only more stressful due to the pressure at work, but also the double burden of paid and domestic work has increased due to the marketization of public provision. In both sectors, the response to reform has been widespread and militant industrial action, which has gained considerable political attention. We therefore also focus on how women have contested change, both passively and actively, through trade unionism and other political practice.     

Amplifying accountability by benchmarking results at district and national levels

This multi‐level ethnography of the Zambian health system illustrates the importance of top‐down accountability, and how it has emerged in a historically neglected sector. Maternal healthcare indicators are prioritized when they are benchmarked, at district and national levels. The realization that Zambia was lagging behind African countries in making progress towards Millennium Development Goal (MDG) 5 (to reduce the maternal mortality ratio by three quarters) appears to have evoked reputational concerns and revealed inspirational possibilities. Growing prioritization also stems from a change in incentives, with some partner funding being conditional on the proportion of deliveries attended by skilled health personnel.     

The World Bank,Organized Hypocrisy,and Women's Health: A Cross‐National Analysis of Maternal Mortality in Sub‐Saharan Africa

The theory of organized hypocrisy asserts that an organization depends upon its external environment for both financial support and conferred legitimacy, which can lead to conflicting policy agendas. We apply the theory of organized hypocrisy to World Bank structural adjustment and investment lending for reproductive health, hypothesizing these two lending policies should have differential effects on maternal mortality. We estimate a two‐way fixed effects regression model with robust standard errors clustered by country to examine the effect of World Bank reproductive health lending on maternal mortality within sub‐Saharan African nations over the period 1990–2010. We find that in every model the coefficients for World Bank structural adjustment lending in the health sector are positive and significant while the coefficients for World Bank investment lending in the reproductive health sector are negative and significant. The findings lend support to the theory that the World Bank is pursuing contradictory agendas, embodied by its lending policies, which can have differential effects on maternal mortality.     

Health Consequences of Laws and Public Policies That Target,or Protect,Marginalized Populations

Laws and public policies that are seemingly unrelated to health, nevertheless, can have health consequences in populations that are targeted, or protected, by that legislation. In this paper, I first review research showing that systems of oppression, such as racism and sexism, can cause negative health outcomes. I next discuss mechanisms underlying the relationship between such systems of oppression and negative health effects. Last, I review research showing that laws and public policies can be seen as components of systems of oppression and, as such, are linked to health outcomes. Some policies and laws I include in my review are anti‐same‐sex marriage bills, punitive immigration laws, stop and frisk policies, and state‐level voter disenfranchisement policies. The link between health outcomes and laws and public policies has implications for the current political climate.     

Expectant Mothers and Absent Fathers: Paid Maternity Leave in Australia

In this article we explore how the reluctance to introduce a national paid maternity leave scheme in Australia reflects gendered norms and constructions of parenthood and work. We report on the findings of a study of selected media texts that show how the public discourse that surrounded proposals to introduce such a scheme exhibited deep‐seated resistance to women who combine motherhood with continued attachment to the paid workforce. Using a multi‐modal approach to discourse analysis, we show how gender and maternity are constructed using cultural and historical discursive resources that reinforce a conservative national identity. By focusing on what is both absent and present in the media texts we show how ‘actual fathers’ are rendered invisible and the space filled by the government as ‘symbolic fathers’ impregnating a production line of maternal citizens.     

Collisions Between Institutional and Populist Risk Imaginaries: The “Dark Side” of Negative Asymmetric Thinking

Expert knowledge informs the construction of public problems from gun violence to disease epidemics to climate change, and institutional actors draw on this knowledge to implement public policy to mitigate or repair the related harms. The expanding role of experts and institutions in managing risks has come at a time of declining public trust in institutions and a legitimacy crisis around expert knowledge. What happens when these tendencies collide? Previous scholarship has examined how disaster arises through failures of foresight, and how cultural‐cognitive biases can prevent actors from seeing disasters coming. Less is known about the mobilization of resistance against risk management policies. This theoretical essay examines a particular category of that resistance: conspiracist discourse that frames risk as emanating primarily from perceived secret agendas of institutions and experts that explicitly claim to be acting in the public interest. This essay argues that conspiracy thinking can be best understood as rooted in a “populist risk imaginary,” which is rooted in negative asymmetry, a cultural‐cognitive bias that foregrounds the possibility of worst‐case outcomes. Conspiracy discourse can be understood as the “dark side” of negative asymmetry, which is otherwise used by service‐oriented professionals to sharpen their foresight in preempting future dangers.     

Women's Status,Fertility Decline,and Women's Health in Developing Countries: Direct and Indirect Influences of Social Status on Health

Abstract In the present three‐wave study of 72 developing countries, we use growth curves to examine how changes in fertility and level of fertility mediate the effect of women's social status on women's health as measured by infant mortality, maternal mortality, and female life expectancy. We find that level of female education, average age at marriage, and the percentage of married women using contraceptives influence attained level of fertility, with controls for economic growth and dependency status. Change in fertility, however, is predicted only by average age at marriage and by level of education. Change in fertility, in turn, predicts improvement in all three women's health indicators, while the level of fertility predicts improvement in maternal mortality and infant mortality. In addition to the mediating effects of fertility, both age at marriage and education contribute directly to reduced level of infant mortality; level of primary education contributes directly to reduced levels of maternal mortality; and use of contraceptives contributes directly to improvement in female life expectancy. These findings provide strong evidence that women's social status makes direct contributions to women's health which cannot be attributed to economic growth, dependency status, and/or the mediating effects of level and change in fertility. The policy implication for developing countries is that greater gains can be made in women's health, particularly maternal health, by improving women's social status, especially in rural areas.