"Dislocation", shelter,and crisis: Afghanistan's refugees and notions of home

Millions of people have become refugees or been displaced within Afghanistan during 17 years of war within the country. Conversations with women in a camp for the displaced reveal what it means for women to lose their homes, especially in the context of ongoing instability and conflict. Sections discuss homelessness in Kabul, linking psycho-social and practical needs, coping with dislocation, stability and land ownership, mobility and security, family breakdown, temporary and permanent settlements, and meeting needs versus creating dependency. The author concludes that among people displaced from their homes for so many years, their physical and spiritual homes nonetheless remain inseparable from their lives. It is important to maintain the individual notion of home if life is to be worth living and hope retained. Relief agencies must help in an appropriate manner and to an appropriate extent. Oxfam has been working beyond the refugee camps, in a return to the city of Kabul, since July 1995. When this article was written, the NGO was involved in a joint venture to restore the piped water supply which, like the electricity supply, was looted and damaged. It also plans to distribute plastic sheeting for use as roofs and floor covering during the winter. Oxfam currently plans discreet activities rather than an integrated approach.     

Health care futures. Part 2: The future of physician executives? Panel discussion

What is the future of health care in America? This is Part 2 of The Physician Executive panel discussion that explores the future of health care in America. To narrow this ambitious focus somewhat, the future is defined as five to 10 years hence. In Part 1, which was published in the May/June issue, Russell C. Coile, Jr., Barbara LeTourneau, MD, MBA, FACPE, James Reinertsen, MD, Uwe Reinhardt, PhD, Marshall Ruffin, MD, MPH, MBA, FACPE, and David Vogel, MS, shared their opinions about what the future holds in managed care, information technology, and biotechnology. In Part 2, Susan Cejka, Barbara LeTourneau, MD, MBA, FACPE, John Henry Pfifferling, PhD, Uwe Reinhardt, PhD, and James Todd, MD, share their views on the future of medical education and physician executives.     

Ability, disability, and the oldest old

A measure of range of ability is used to profile the 85-years-old-and-older (oldest old) population, including the highly disabled institutional population. This new measure uses two new questions available in the 1990 Decennial Census concerning a self-care limitation and a mobility limitation as well as the usual question concerning a work limitation. In addition to examining the extent of disability among the oldest old, the article examines the extent of care potentially available in the household as well as the economic characteristics of this age group. It is also profiled in terms of relevant personal characteristics, including age, gender, marital status, race, ethnicity, rural residence, education, and employment. A key question addressed is the need for help or care among the oldest old and how various long-term care proposals would meet such needs. A careful analysis of this unique and growing population is necessary to both allay fears of the cost of care or help as well as to dispel stereotypes of this age group as frail and dependent, and in need of institutional care.     

Implementation and process evaluation of a student "school-as-community" group. A component of a school-based drug abuse prevention program

Little documentation exists regarding the functioning of formalized adolescent groups as drug abuse prevention agents. Two studies are described that were conducted at high schools whose students are at high risk for drug abuse. Twenty-one schools were randomly assigned to one of three conditions: (a) standard care, (b) classroom drug abuse education only, or (c) classroom plus school-as-community. Results of the first study indicated that the school-as-community component--which involved weekly meetings and periodic events at seven schools--was implemented as planned, drug abused focused, and perceived as productive in discouraging drug abuse. In the second study, staff in the classroom plus school-as-community condition self-reported involvement in the greatest number of community activities across the school year, compared with staff from the other two conditions. These two studies support the feasibility of formalized groups of high-risk youth to promote drug-free events.     

Comparing measures of poverty and relative deprivation: an example for Belgium

This paper presents three different poverty standards. A first approach takes the disposable income as an indicator of poverty. A second approach uses the Leyden approach. Finally an aggregate index of deprivation, based on the observation of consumption events, is constructed through a particular econometric procedure proposed by Desai and Shah (1988). These alternative measures are then compared on a sample composed of 6380 Belgian households. Such an analysis can be expected to provide some further insight into the problem of measuring poverty, which has been the subject of a recent controversial debate.We thank the participants of the Second Annual Meeting of the European Society for Population Economics, June 23–25, 1988, Mannheim (FRG), L. Gevers, J. Lindsey, P. Pestieau, B. Sak, K. Van den Bosch and two anonymous referees for their comments and suggestions.     

The social implications of population displacement and resettlement: an overview with a focus on the Arab Middle East

"Recent decades have witnessed a global increase in the collective displacement of populations as a result of natural disasters, wars and development projects. The social implications of displacement, and its corollary process of resettlement, are explored in this article, with a focus on the Arab world....[The author suggests that] an approach which emphasizes the relation between the causes and consequences of displacement, examines cases in their historical contexts, and selects the appropriate unit of analysis is essential in developing an adequate framework of analysis."     

Residential segregation in Australian cities: a literature review

"In this review of literature dealing with the postwar immigrant experience in urban Australia, some of the key interpretations of residential segregation are assessed. The article focuses on studies which have examined ethnic clusters formed by southern Europeans in Sydney and Melbourne and more recently by Indochinese refugees. Much of the analysis to date has been based on measuring static residential patterns rather than social interaction, and the need to question the significance of ethnic concentrations which sometimes characterize the early stages of immigrant adaptation is suggested."     

The health care Titanic: women and children first?

The plight of people who lack access to health care has captured national attention and led to a number of proposals to remedy the problem. The authors look at three types of proposals being advanced--"pro-competition" plans, "pay-or-play" plans, and a national health care system--and find that they fail to address adequately the pressing needs of two groups of the poor: women of childbearing age and elderly women.     

Reformulating the development theory of welfare

Industrialization, technological change and overall economic development are often cited as important factors in the development of welfare states. This article examines the importance of cycles in economic activity and cycles in technological innovation to enhancing our understanding of welfare. The history of technological change in health-care services is used to illustrate the argument.     

Estimates of fertility in Bangladesh

The attempt is made to estimate fertility levels in Bangladesh on the basis of data collected during the 1974 Census. In the 1st section attention is directed to providing an overall picture of the demographic situation in the country. Comparisons between the 1961 and 1974 data demonstrates that the 1974 Census data provide consistent results. Factors such as the degree of urbanization, literacy and economic participation rates--considered as indicators of development--all seem to show little progress during the intercensal period. The use of child/women ratios (CWRs) provides plausible evidence of the likelihood of a fertility decline. A decline in CWR values is small for "all areas" but a marked decline can be noted for "urban areas." The recorded mean number of children is less in 1974 than in 1961 for women under age 35 whereas for the older groups the 1974 Census shows higher mean numbers. The Bangladesh Fertility Survey (BFS) data result for the total fertility rate of 6.58 is very close to that estimated for the 1974 Census--6.59. The reverse survival method also indicates that birthrates have been lower during the 1969-1974 period.