Racial and Ethnic Disparities in Health Insurance Coverage: Dynamics of Gaining and Losing Coverage Over the Life-Course

Health insurance coverage varies substantially between racial and ethnic groups in the United States. Compared to non-Hispanic whites, African Americans and people of Hispanic origin had persistently lower insurance coverage rates at all ages. This article describes age- and group-specific dynamics of insurance gain and loss that contribute to inequalities found in traditional cross-sectional studies. It uses the longitudinal 2008 Panel of the Survey of Income and Program Participation (N = 114,345) to describe age-specific patterns of disparity prior to the Affordable Care Act (ACA). A formal decomposition on increment–decrement life tables of insurance gain and loss shows that coverage disparities are predominately driven by minority groups’ greater propensity to lose the insurance that they already have. Uninsured African Americans were faster to gain insurance compared to non-Hispanic whites, but their high rates of insurance loss more than negated this advantage. Disparities from greater rates of loss among minority groups emerge rapidly at the end of childhood and persist throughout adulthood. This is especially true for African Americans and Hispanics, and their relative disadvantages again heighten in their 40s and 50s.     

Life Course Changes in Smoking by Gender and Education: A Cohort Comparison Across France and the United States

Widening of educational disparities and a narrowing female advantage in mortality stem in good part from disparities in smoking. The changes in smoking and mortality disparities across cohorts and countries have been explained by an epidemic model of cigarette use but are also related to life course changes. To better describe and understand changing disparities over the life course, we compare age patterns of smoking in three cohorts and two nations (France and the US) using smoking history measures from the 2010 French health barometer (N = 20,940) and the 2010 US National Health Interview Survey Sample Adult File (N = 20,444). The results demonstrate statistically significant widening of gender and educational differences from adolescence to early and middle adulthood, thus accentuating the disparities already emerging during adolescence. In addition, the widening disparities over the life course have been changing across cohorts: age differences in educational disparities have grown in recent cohorts (especially in France), while age differences in gender disparities have narrowed. The findings highlight the multiple sources of inequality in smoking and health in high-income nations.     

Childbearing Behavior Before and After the 1994 Population Policies in Ghana

Due to the high population growth rate in the mid-20th century, the government of Ghana introduced population policies to reduce the growth rate. Encouraging girls’ education and increasing contraceptive use were the two main policy measures to reduce population growth. In order to get a clear picture of the childbearing dynamics of Ghanaian women in response to the population policy of 1994, we analyzed individual reproductive histories from 1969 to 2003 using 2003 Ghana Demographic Health survey data to disentangle patterns by parity, calendar period, and educational groups. Exponential hazard regression models were used to estimate the relative risk of births. We find some evidence of a critical juncture in fertility trends, particularly for the fifth child. In addition, higher parity transition rates continuously declined for women with secondary or higher education and these educational levels were achieved by a higher share of the population after the policy was implemented. The 1994 population policy was successful if only by virtue of the increasing number of women with secondary or higher education. Belonging to this group is not only associated with lower fertility, but this suppressing effect strengthened in the years following the policy implementation. We also suspect that the increasing similarity between women with no education and with primary education reflects the diffusion of contraceptive knowledge and norms related to childbearing. The educational reform and contraceptive initiatives did result in increased education and contraceptive awareness and are therefore beneficial programs.     

Does Tourism Consumption Behaviour Mirror Differences in Living Standards?

Based on the theoretical foundation of well-being measurement, the study explores differences in living standards by analysing the distribution of tourism expenditure. A mixture of regression models is used to explore the heterogeneity in tourism consumption by identifying groups of families with similar tourism consumption behaviour as a function of certain socio-demographic and economic factors. The empirical analysis, performed on Italian expenditure data, suggests that there are three different patterns of consumption behaviour conditional to the socio-demographic and economic covariates in the tourism market and that differences in tourism consumption between groups of households mirror inequalities in living standards.     

Longitudinal Factor Analysis of Public Expenditure Composition and Human Development in Brazil After the 1988 Constitution

The way public policies are managed in Brazil has changed since the 1988 Federal Constitution. This study aimed to identify how changes in the structure of public expenditure composition at Brazilian federal states influenced local human development in these states. The states’ public expenditures were categorized according to their nature as spending indices whereas human development was measured through a human development index (HD). To verify the relationships between these variables, an accounting-social theoretical model was created and estimated through latent growth modeling (LGM). The LGM measurement period comprised five administration cycles of the Brazilian states (1988–2011). Variables were measured on data of the second year of state government term; their mean initial values and growth rates were recorded. Results show that, influenced by policies of centralized regulation promoted by the federal government, only the social spending growth rates had statistically significant effect on the human development growth rate, although not considered of great magnitude. Among mean initial values, the most significant was that of minimum spending (SIm), which denotes the direct impact of the Fiscal Accountability Law [Lei de Responsabilidade Fiscal, in Portuguese] on human development improvements. The mean initial value of economic spending also showed a positive and significant effect on HD growth rate.     

Regional Differences in the Gender Wage Gap in Spain

This study examines regional differences in the gender wage gap in Spain using matched employer–employee microdata, two different econometric decomposition methods and panel data techniques. Our findings suggest that Spain shows a significant regional heterogeneity in the size of the raw gap, roughly comparable to cross-country differences observed in the European context. The results from the decomposition analysis show that although the bulk of the gender wage gap in Spanish regions is due to differences in the endowments of productive characteristics between males and females there is still a substantial part of the gap that remains unexplained. The analysis of the causes behind the variation of both, the raw and the unexplained gender wage gap by region highlights that several economic, institutional and demographic elements identified in previous studies analysing international differences in the gender wage gap are also relevant to explain regional differences in the gender wage gap in Spain.     

Welfare State Development,Individual Deprivations and Income Inequality: A Cross-Country Analysis in Latin America and the Caribbean

Several scholars have confirmed the role that the welfare state (WS) plays in reducing poverty, promoting equality and ensuring the common wellbeing. One of the limitations of the scholarship has been the conceptualization and operationalization of the WS and poverty as one-dimensional variables. The purpose of this paper is to examine the relationship between welfare state development, single-dimensions deprivations and income inequality in Latin America and the Caribbean, before and after controlling for demographic and cyclical factors. The WS is operationalized as a one-dimensional variable, but also taking into account its multidimensional nature. Three individual deprivations suffered by people on poverty and two income inequality indicators are used as dependent variables. Three pooled time-series cross-section regression analyses with panel-corrected standard errors models were carried out on 18 countries in the region around 2000, 2005 and 2010. This paper shows that the development of social-welfare programs and institutions seems to be an effective way of tackling individual deprivations suffered by people on poverty in the region. On the other hand, the WS development didn’t appear to be effective to reduce income inequality. The outcomes of welfare institutions appear to be the pivotal dimension to reduce income inequality and income deprivations in the region.     

The Comparative Inclusive Human Development of Globalisation in Africa

This study examines the impact of globalisation on inclusive human development in 51 African countries for the period 1996–2011 with particular emphasis on income levels (low income vs. middle income), legal origins (English common law vs. French civil law), resource wealth (oil-rich vs. oil-poor), landlockedness (landlocked vs. unlandlocked), religious domination (Christianity vs. Islam) and political stability (stable vs. unstable). The empirical evidence is based on instrumental variable panel Fixed effects and Tobit regressions in order to control for the unobserved heterogeneity and limited range in the dependent variable. Political, economic, social and general globalisation variables are used. Six main hypotheses are investigated. The findings broadly show that middle income, English common law, oil-poor, unlandlocked, Christian-oriented and politically-stable countries are associated with comparatively higher levels of globalisation-driven inclusive human development. Puzzling findings are elucidated and policy implications discussed.     

Work–Family Conflict and Well-Being Across Europe: The Role of Gender Context

This study analysed whether gender context is important to differences in the relationship between work–family conflict (WFC) and well-being across Europe. We hypothesised that in countries that support equality in work life and where norms support women’s employment, the relationship between WFC and low well-being is weaker than in countries with less support for gender equality. Cohabiting men and women aged 18–65 years from 25 European countries were selected from the European Social Survey. A multilevel analysis was conducted to investigate the relationship between well-being and WFC, and two measurements were used to represent gender context: gender equality in work life and norms regarding women’s employment. Contrary to the hypothesis, the results showed that the negative relationship was stronger in countries with high levels of gender equality in work life and support for women’s employment than in countries with a relatively low level of gender equality in work life and support for traditional gender relations. The context in which gender is constructed may be important when studying the relationship between WFC and well-being. In addition, emphasis should be placed on policies that equalise both the labour market and the work performed at home.     

Revolution Impact on Drinking Water Consumption: Real Case of Tunisia

Water is considered a major social and political issue. This article stands out by its quantification of the impact of socio-political disturbances on social behavior regarding the consumption of drinking water. It also allows the monitoring of fluctuation of the economic pattern through the main economic sectors during these disturbances by the study of a revolution impact—case of the revolution in Tunisia in January 2011, on the spatial, temporal and sectorial variation of the drinking water consumption. Six water users covering the whole consumption are considered in this study: connected and non connected household users, tourism, industries, collective and various other users. Among the results, in this coastal country, the relation between drinking water consumption by tourism, the touristic activities and the national economy are clearly established. All these components are similarly affected by the socio political disturbances but longer lasting fallouts hit only the most vulnerable regions of the country. Industrial activities that used drinking water seemed to be affected only when the socio political disturbance is at its paroxysm due to strikes, sit-ins of unemployed people, job seekers protests and companies closure. The revolution impacts such as weakening of the State’s authority when facing inappropriate and illegitimate social desires, anarchy, people displacement and refugees are the major causes of non-connected household drinking water waste or over-consumption (up to 89 %) and an alarming increase of the induced breakages (+445 % in 2012 compared to 2010).