Public Policy and Inequalities of Choice and Autonomy

Choice by service users has been promoted in social policy across many developed welfare states, often on the grounds that it will incentivize providers to enhance quality and efficiency. But this instrumental motivation for the promotion of choice overlooks the possibility that choice, understood in the deeper sense of autonomy, has intrinsic value, as suggested by egalitarian and capability‐based theories of social justice. This article argues that the narrow motivation of choice policies leads to a focus on services rather than outcomes for individuals and fails to address deep‐seated inequalities in the opportunities people have for real autonomy. We test this concept using newly collected data for the UK. Our empirical findings indicate that disabled people are more likely to experience constrained autonomy in all respects, while being from a low socio‐economic group and/or lacking educational qualifications is a risk factor across several components. We conclude that improving the ‘choice’ agenda for policy requires: (1) adopting a more sophisticated concept of ‘choice’ such as the conceptualization of ‘choice as autonomy’ outlined here; (2) developing a better understanding of existing inequalities in autonomy, such as we begin to explore in our empirical results; and (3) tackling these inequalities through, for example, the removal of obstacles to active decision‐making by providing effective support and advocacy, especially for disabled people, and addressing the major structural barriers – poverty, ill health and geographical inequality – which place significant restrictions on the autonomy of those who are already disadvantaged.     

Social Work in Rural New South Wales School Settings: Addressing Inequalities Beyond the School Gate

Children and young people in rural Australia experience disadvantage compared with metropolitan counterparts, with low educational attainment and disengagement from schooling being linked to poorer health outcomes. Schools are an existing contact point between individuals and health services. However, these health services are often overburdened and have limited scope to address broader social issues and teaching staff are focused on achieving curriculum outcomes. Embedding social workers within schools may provide an avenue for supporting students, yet social workers are rarely present in New South Wales public schools. This paper describes a study to determine teachers’ understanding of the socioeconomic issues faced by school students, and the role of the social work profession in addressing such issues as part of the early stages of establishing a Social Work in Schools (SWiS) project. Eighteen semistructured interviews were undertaken with teachers across four rural Australian schools. Participants identified their awareness of potential risk factors that could lead to educational disengagement, reflected on their own limitations in dealing with these broader health presentations given their teaching focus, and provided insights into their understanding of the potential role of social workers.     

Vestiges of the medical model: a critical exploration of the Ontario Disability Support Program in Ontario,Canada

Although ample literature exists on workfare in Ontario, Canada, research on the social assistance programme for disabled people, the Ontario Disability Support Program (ODSP), is relatively scant. What we do know points to similar shortcomings. We present a critical disability study considering four policy domains to explore how disabled people are identified and accommodated in Ontario. Discussing the principles of universal design, we argue for policy design that meets the needs of as many individuals as possible, while accounting for significant human variability. We conclude that the ODSP, in failing to adopt a rights-based framework, violates the dignity and rights of disabled people.     

Persons with disabilities and the Colombian armed conflict

This article is about the armed conflict in Colombia and the situation for people with disabilities. Decades of internal conflict have created a complex situation which both gives rise to disability but also fails to take account of the many urgent needs of people with disabilities. Despite the ratification by Colombia of the UN Convention on the Rights of Persons with Disabilities, persons with disabilities are still not accorded a voice in the peace agreements. Although there is little known about the extent of disability in Colombia, it is important to understand the history of the Colombian armed conflict to see how it impacts on disability issues. We conclude by highlighting the legal instruments in Colombia which provide opportunities now to redress some of those wrongs.     

Internalized Homonegativity,Confucianism, and Self-Esteem at the Emergence of an LGBTQ Identity in Modern Vietnam

We examine the relationships between internalized homonegativity, Confucianism, and self-esteem among LGBTQ adults who grew up during the Open Door Policy, or ??i M?i, in Vietnam. Participants were identified via activist networks and social media groups. They completed online survey focused on internalized homo/transphobia, self-esteem, and Confucian values. The study revealed that more exposure to Confucian values in early life is related to higher levels of internalized homonegativity. Male-born participants also had a higher level of internalized homonegativity than female-born participants. In general, lower levels of self-esteem were also related to higher levels of internalized homonegativity. We discuss the implications of these findings in light of conflicting values between Confucianism and the economic and social transformation that has occurred under ??i M?i.     

My Assistant and I: disabled children's and adolescents' roles and relationships to their assistants

The purpose of this grounded theory study was to describe how children and adolescents with restricted mobility perceive their assistant with a focus on their roles and relationships with one another. The group investigated consisted of 13 children and adolescents with restricted mobility from northern Sweden, aged from 8 to 19 years. The analysis resulted in five categories: 1, the replaceable assistant; 2, the assistant as mother/father; 3, the professional assistant; 4, the assistant as a friend; and finally 5, my ideal assistant. In each category the child/adolescent was seen in relation to the assistant, i.e. the main story 'My assistant and I' from different perspectives. The findings showed that relation towards/from the assistant were both mutual and non-mutual, and that there were relations that by the children/adolescents were perceived as ambivalent and unequal. The findings are discussed on the basis of the significance of these roles and relations in the children and adolescents' development.     

Multisystemic Therapy for Child Abuse and Neglect: Do Parents Show Improvement in Parental Mental Health Problems and Parental Stress?

Multisystemic Therapy for Child Abuse and Neglect (MST-CAN) is an evidence-based program for families with children who experience maltreatment. This clinical trial is the first evaluation of MST-CAN in a German-speaking area. Parental psychological problems and parental stress have been shown to be risk factors for child abuse and neglect. By the end of treatment, parents reported significantly less psychological distress than before the start of MST-CAN. Six months after treatment, this reduction was still evident. However, parents did not report any significant reduction of parental stress at any of the three time points. MST-CAN is an effective intervention for child maltreatment that not only combats child abuse and neglect but also has the potential to alleviate parental psychological distress.     

Temperature,climate change,and birth weight: evidence from Hungary

Population and Environment - We analyze the impact of in utero temperature exposure on the birth weight and an indicator for low birth weight using administrative data on singleton live births...