Cost-benefit analysis—a critique

This paper surveys some of the main criticisms of cost-benefit analysis (CBA) that have emerged over the years. It is noted in passing that views on what type of technique CBA really is, or should be, have differed and continue to differ depending on the set of value judgements used. We emphasise that the more recent suggested extensions to or modifications of CBA have sought to make the technique more comprehensive (i.e. to include distributional, environmental quality and other objectives as well as economic efficiency) at the inevitable cost of a loss of precision. The underlying principles of CBA are examined and the problems of multiple objective planning highlighted. Valuation problems are analysed, in particular with regard to amenity and environmental effects. Finally, the issues of uncertainty, irreversibility and intergenerational equity are raised briefly to indicate the complexity of the decision-making task when large-scale technologically advanced projects have to be appraised. In conclusion it is argued that CBA presented in a disaggregated format, as a comprehensive method for the ordering of information and a testing procedure for a range of valuations can perform a useful role in the decision-making process. The term ‘policy analysis’ is probably a better one for this broader view of the use of CBA. Ultimately we seem to be searching for a synthesis of the participatory and the traditional (technocratic) style of decision-making though we have a long and difficult course to chart before we even approach such a goal.     

Comparing sexual behavioral patterns between two bathhouses: implications for HIV prevention intervention policy

There is a glaring lack of data to inform culturally appropriate HIV prevention interventions targeting environments such as bathhouses where men who have sex with men (MSM) practice sexual risk behaviors. This study compares sexual behavioral patterns across two bathhouse sites in order to identify important themes to address when tailoring HIV prevention interventions to bathhouse environments. We analyzed semi-structured interviews with workers and patrons at two bathhouses to explore similarities and differences. A coding scheme was established and data were organized according to conceptual themes. We found that differences between the two sites emerged in six key areas: bathhouse clientele, attraction to particular sites, sexual practices and condom use, communication about sex and HIV status, bathhouse rules, and substance use. Implications for HIV prevention intervention policy are discussed.     

Marital Conflict Trajectories and Associations With Children's Disruptive Behavior

We seek to identify heterogeneous trajectories of marital conflict during the early childhood period, identify predictors associated with these trajectories, and examine associations between trajectory group membership and children's disruptive behavior. Participants were 469 families examined 4 times when the children were 2 to 54 months of age. Maternal reports of marital conflict, adverse childhood experiences, depressive symptoms, and sociodemographic characteristics were collected, and averaged maternal and paternal reports of child disruptive problems were used. Using growth mixture modeling, 3 trajectories of marital conflict were identified: high increasing (21.8%), high decreasing (7%), and low stable (71.2%). Maternal adverse childhood experiences predicted increased risk of belonging in the high‐increasing group, whereas depressive symptoms predicted increased risk of belonging in the high‐decreasing group. Importantly, children of mothers in the high‐increasing group exhibited higher levels of disruptive behavior at 54 months when compared with children of mothers in the high‐decreasing and low‐stable groups.     

“We have a lot of goodwill, but we still need to eat…”: Valuing Women’s Long Term Voluntarism in Community Development in Lima

This paper focuses on recognizing the contribution made to development by grassroots women working on a voluntary basis in long term development projects. Using the example of healthcare, the paper problematizes the widespread move towards an increased reliance on voluntary and third sector provision. Drawing on literature around women’s community activism, the research considers the extent to which women carrying out health promotion work in Peru have taken on this role as more than “just voluntary work,” highlighting their long term commitment during more than a decade of health promotion activities. The paper develops debates around the professionalization of voluntary work, particularly considering the issue of economic remuneration for health promoters, and emphasizing the gendered nature of their voluntarism; concluding by questioning the sustainability of poor women’s long term, and largely unpaid, involvement as the linchpins of community development projects.

Exposure to Environmental Tobacco Smoke in the Workplace and the Impact of Away-From-Work Exposure

Concentrating on exposure in workplaces where smoking occurs, we examined environmental tobacco smoke (ETS)-related concentration data from the 16-City Study.^(1,2) This study involved a large population of nonsmokers, used personal monitors, and encompassed a wide selection of ETS-related constituents. This first article in a series of three describes the 16-City Study, considers the impact of demographic variables, and concludes that these variables did not explain differences in exposure to ETS. We compared 16-City Study concentrations obtained in the workplace to previously reported workplace concentrations and determined that data from this study were representative of current ETS exposure in nonmanufacturing workplaces where smoking occurs. Considering factors other than demographic factors, we found that, not surprisingly, the number of cigarettes observed in the workplace had an impact on exposure concentrations. Finally, we compared people from homes where smoking occurs with people from nonsmoking homes and found that people from smoking homes observed more smoking in the workplace and experienced higher concentrations of ETS-related compounds in the workplace, even when they observed the same number of cigarettes being smoked in the workplace. In two subsequent articles in this series, we discuss relationships between various ETS markers and provide estimates of distributions of doses to nonsmoking workers employed in workplaces where smoking occurs.     

Work and Family in the 1990s

This review highlights four themes emerging from the work and family literature of the 1990s. The first theme evolves from the historical legacy of the maternal employment literature with its focus on children's well‐being. The second theme, work socialization, is based on the premise that occupational conditions, such as autonomy and complexity, shape the values of workers who in turn generalize these lessons off the job. Research on work stress, the third theme, explores how experiences of short‐ and long‐term stress at work make their mark on workers' behavior and well‐being off the job. Finally, the multiple roles literature focuses on how individuals balance roles, such as parent, spouse, and worker, and the consequences for health and family relationships. In addition to these four major themes, advances in work and family policy initiatives over the past decade are discussed. Suggestions for future research focus on addressing issues of causality, attending to the complexity of social contexts, linking research to policy, and developing interdisciplinary theories and research designs.