A Nation-Wide Inequality Exploration of Healthcare Services and Medical and Paramedical Professionals at the Region Level in France

Whereas longevity differences between movers and stayers are well‐known, the impact of migration on regional disparities in longevity remains understudied. We estimated the contribution of internal migration to regional life expectancy levels and disparities across the Netherlands, thereby assessing the importance of different age groups. We used mortality and demographic data by internal migrant status, COROP (NUTS‐3) region, age and sex from the Dutch population register, including the native population aged 10+ in 2015–2019. We compared regional disparities in life expectancy at age 10 (e10) for the observed population and hypothetical ‘no‐migration’ population using each individual's place of residence 10 years earlier. We also applied age‐decomposition methods. The range in e10 across the 40 COROP regions was 2.22 years for males and 2.54 years for females. Artificially putting movers back into their region of origin yielded differences in regional e10 of between −0.2 to 0.3 years for males and −0.5 to 0.3 years for females, and – on average – 1.65% (males) and 4.17% (females) reduced regional disparities in population‐weighted standard deviation of e10. The age groups that contributed most to the difference in regional disparities in e10 between the observed and the hypothetical situation were 65+ and 10–29 for males, and 30–64 and 65+ for females. The small impact of internal migration on regional disparities in e10 is likely due to the low proportion of movers. Causal effects (socioeconomic composition, health behaviour prevalence) appear more important in determining regional life expectancy disparities in the Netherlands than selection effects.

This study was undertaken to investigate the pattern of utilization of medical and dental health care services in rural Tanzania. Two hundred adults, 91 men and 109 women aged 20 or over, were interviewed. Nearly all subjects reported using modern dental and medical health care services. Home remedy was the only indigenous method of treatment used for dental problems while for medical problems a traditional healer was the most commonly used indigenous alternative. The use of both indigenous and modern health care services was significantly lower for dental than for medical problems (P < 0.05). It seems that the pattern of utilization of health care services differs for medical and dental problems. This should be taken into account when planning comprehensive health care services for rural African societies.

Bande R., Fernández M. and Montuenga V. M. (2007) Regional disparities in the unemployment rate: the role of the wage-setting mechanism in Spain, 1987–92, Regional Studies 41, –. The aim of this paper is to show how regional unemployment disparities in Spain widen during economic upturns and to provide an explanation of this behaviour. The analysis is based on the study of the wage-setting mechanism that allows an estimation of the responses of wages to both labour productivity and the general situation of the labour market, and an assessment of their impact on the evolution of regional unemployment. The results of this estimation at the regional level with manufacturing data confirm the existence of marked differences between industries and between regions these responses. These differences can be interpreted as a distinctive wage-setting mechanism across industries and regions, which may explain the evolution of unemployment rates within the regional labour markets. Bande R., Fernández M. et Montuenga V. M. (2007) Les écarts régionaux du taux de chômage: le rôle du réajustement des salaires en Espagne de 1987 à 1992, Regional Studies 41, –. Cet article cherche à démontrer comment les écarts régionaux du taux de chômage en Espagne se creusent au moment d'une reprise économique et à en fournir une explication. L'analyse est fondée sur une étude du réajustement des salaires, ce qui permet une estimation de la réponse des salaires à la productivité du travail et à la situation générale sur le marché du travail, et l'évaluation de leur impact sur l'évolution du chômage sur le plan régional. Les résultats de cette estimation faite au niveau régional a partir des données l'industrielles confirment la présence des différences interindustrielles et interrégionales sensibles. On pourrait interpréter ces différences comme un réajustement des salaires caractéristique à travers les industries et les régions, ce qui expliquerait l'évolution des taux de chômage au sein des marchés du travail régionaux. Ecarts des salaires Chômage Données par enquête permanente Espagne Bande R., Fernández M. und Montuenga V. M. (2007) Regionale Ungleichgewichte bei den Arbeitslosenzahlen: die Rolle der Mechanismen zur Lohnfestsetzung in Spanien, 1987–92, Regional Studies 41, –. In diesem Beitrag wird verdeutlicht, wie sich in Spanien regionale Ungleichgewichte im Beschäftigungsniveau während eines Wirtschaftsaufschwungs verstärken, und es wird eine Erklärung für dieses Phänomen geliefert. Die Analyse gründet auf einer Untersuchung des Mechanismus zur Lohnfestsetzung, die es ermöglicht, die Reaktion der Löhne auf die Arbeitsproduktivität und die allgemeine Situation auf dem Arbeitsmarkt abzuschätzen und deren Auswirkung auf die Entwicklung der regionalen Arbeitslosigkeit zu bewerten. Die Ergebnisse dieser Schätzung auf regionaler Ebene mit Produktionsdaten bestätigen die Existenz ausgeprägter Unterschiede hinsichtlich dieser Reaktionen zwischen den verschiedenen Branchen und Regionen. Diese Unterschiede lassen sich als charakteristischer Mechanismus zur Lohnfestsetzung für verschiedene Branchen und Regionen interpretieren, was die Entwicklung der Arbeitslosenzahlen innerhalb der regionalen Arbeitsmärkte erklären könnte. Lohnunterschiede Arbeitslosigkeit Paneldaten Spanien Bande R., Fernández M. y Montuenga V. M. (2007) Desigualdades regionales en la tasa de desempleo: la importancia del mecanismo para determinar salarios en España, 1987–92, Regional Studies 41, –. El objetivo de este artículo es demostrar en qué medida aumentan en España las desigualdades regionales de desempleo cuando ocurre un repunte en la economía y explicar el motivo de este comportamiento. Este análisis se basa en el estudio del mecanismo de la determinación de salarios que permite calcular cómo responden los salarios a la productividad laboral y la situación general del mercado de trabajo, y evaluar el impacto en la evolución del desempleo regional. Los resultados de esta estimación a nivel regional con datos industriales confirman la existencia de marcadas diferencias entre las industrias y las regiones con estas respuestas. Estas diferencias pueden ser interpretadas como un mecanismo distintivo de la determinación de salarios en las industrias y regiones lo que explicaría la evolución de las tasas de desempleo en los mercados laborales a nivel regional. Diferencias de salarios Desempleo Datos del panel España

Development is a multidimensional process that aims to generate significant changes in the betterment of people's lives. However, development does not always able to form regional balance. The phenomenon of disparity always shades the regional development process. As a province with the highest number of regencies and cities, the development of East Java Province is inseparable from the phenomenon of disparity. This study aimed to analyze the performance, regional disparities, and spatial autocorrelation of regional development in East Java Province in 2017. Performance of regional development was measured using TOPSIS analysis. Level of regional disparity was calculated by the Coefficient Variation (CV). Spatial pattern of development performance was explored through analysis of spatial autocorrelation by Moran Index and Local Indicator of Spatial Autocorrelation (LISA). Results of analysis on regional development performance show that Kediri City had the highest performance in East Java Province, meanwhile Tuban Regency had the lowest performance. At the regional level, Pantura (North Coast) and Central Region have higher regional development performance average compared to Pansela (South Coast), Tapal Kuda, and Madura regions. Regional disparity in East Java Province occur between regions and within regions (between regencies/cities). Pantura is the region with the highest regional development performance disparity, meanwhile Madura region is relatively homogenous with low development performance. Result of Moran and LISA analysis interpret that spatial and contiguity aspects effect regional development significantly which tends to form a cluster pattern. Therefore, spatial factors and regional linkage are essential elements in regional development.

Positive Effects of Declining Age-Standardized All-Cause Mortality Rates in China During 2005-2015

Human capital is a major driver of regional growth and provides insight into degrees of regional disparity (Barro &amp; Lee ). Addressing these disparities is crucial to economic stability and cohesion in Turkey; therefore, we investigated the regional distribution of human capital and its evolution between 2008 and 2012. We used district level address‐based population registration system data from 957 districts to analyze regional human capital disparities and report significant results. Specifically, regional disparities in human capital are decreasing in Turkey, but enormous regional district level disparities persist. A disparity exists between the western and eastern regions in human capital at both primary and secondary educational levels. However, this east–west dualism almost disappears with regard to human capital at the tertiary educational level, which is heavily concentrated in Turkey's major cities (Istanbul, Ankara, Izmir, Kocaeli, and Bursa).

The paper is an attempt to review the status of health parameters in the light of demographic attributes of population growth and mortality in Ethiopia. Health infrastructures, health personnel and health services to population ratios have been worked out and compared at regional levels. Twenty-six variables have been used to analyze national and regional situations. Results have been explained in terms of regional development levels, regional disparity, relative disparity and absolute disparity in the case of health services, infrastructures and health personnel to population ratios. In terms of health sector development; Addis Ababa, Amhara and Harari regions have high development (D.I= 0.283-0.74); Dire Dawa, Oromia and Tigray have moderately high development (D.I. = 0.165-0.220); Afar, SNNPR, and Somali regions have a moderately low level of development (D.I. from 0.125 to 0.155); while regions of Gambella and Beneshangul Gumuz reflect a low level of development (D.I. from 0.114 to 0.115) in relation to health facilities and infrastructures. The absolute disparity was extremely high in variables such as Basic Emergency Obstetric Care (BemOC) (1:534) and Comprehensive Emergency Obstetric Care (CemOC) (1:204) and availability of all other health professionals (1: 118.13).Similarly, the relative disparity was very high in cases of the functional health center to population ratio (230.71 %), all other health professionals (133.22%), BEmOC (120.36),CEmOC (116.52% and deaths due to malaria (114.85%). In terms of health sector performance Addis Ababa and Amhara regions present low regional disparities while Gambella and Beneshangul Gumuz regions reflect a very high regional disparity.

In comparison with other South Asian countries, Sri Lanka maintains well-developed health care systems. Nonetheless, limited health care services are provided to mothers and children in the hill country. This research raises a series of questions concerning current challenges for safe motherhood, such as health care services already present, spatial distribution of health care professionals, and health policy in the hill counties of Sri Lanka. The authors argue that to understand the existing infrastructure of health care systems and future challenges to provision of health care services, it is important to depict the spatial location of health care units and to recognize the complexity of interactions between these units and the social, economic, and health environment. Such assessment provides a human geography approach that investigates health care systems in spatial dimensions. This study uses the geographical techniques of Geographic Information Systems and Global Positioning Systems to answer the fundamental questions of “what is where,” “why is it there,” and “why do we care.” The questions underline the importance of spatial methodology in assessment of safe motherhood and the importance of accurate and precise knowledge about the status of maternal health.

The progress of agriculture is precondition for overall development of Indian economy. It pays meaningfully to the export incomes and affects the performance of other divisions of the economy through forward and backward links. The current paper investigates block and regional level disparity in agriculture development in Kongu Uplands on several of agricultural variables. It uses UNDP methodology to standardize various indicators for agricultural achievement in the study area. A composite index has been constructed at the block level and also regional level. The relative variations and changes in ranks of various blocks have been calculated. The agricultural development in the Kongu Upland is moderate with index value of 0.503. The outcomes inspired more determined effort on the side of the policy-makers is wanted if the development policy has to be made truly inclusive. Keywords Agricultural development, Kongu uplands, UNDP, composite index, policy makers

Economic integration in Europe has been accompanied by concerns about the effect of integration on regional disparities in the European Union. This paper investigates the effects of the most recent EU enlargement on convergence among countries and regions in the EU-27. Departing from a new economic geography framework, we focus on integration effects caused by changes in market access, released by a reduction of trade impediments. Special attention is paid to the catching-up process of the new member states (NMSs) and the development of regional disparities within the East European countries. From 1995 to 2004, the EU integration process was marked by an economic catching-up of the NMSs. At the same time, regional within-country disparities in the NMSs have been increasing. Our simulation analysis shows that trade integration has a strong effect on market potentials in East European regions. Comparatively strong changes in market access are supposed to foster the East European catching-up at the national and regional levels. However, accounting for these integration effects does not significantly alter the findings of our convergence analysis.

The article examines the prospects and challenges of digitalizing civil society in Ukraine, with a particular focus on the regional level. It identifies key aspects of implementing digital technologies in civic activities and analyzes their impact on interactions between government authorities, civil organizations, and citizens. Emphasis is placed on regional disparities in access to digital infrastructure and resources, which significantly affect the pace and quality of digital transformations. The analysis highlights the importance of addressing these challenges to ensure equitable and inclusive digital development across the country.International experience from Estonia, Latvia, Sweden, and Denmark is studied to provide valuable insights into effective e-governance practices. Examples include Estonia’s comprehensive e-governance system, Latvia’s initiatives to bridge the digital divide, and the use of open data platforms in Sweden and Denmark to enhance transparency and citizen engagement. These examples demonstrate the potential of digital technologies to strengthen civil society and foster democratic participation.The article also explores practical measures such as the development of digital infrastructure, targeted educational programs to enhance digital literacy, and the implementation of user-friendly online platforms to encourage citizen involvement in decision-making processes. Recommendations are provided for overcoming regional digital disparities, promoting technological accessibility, and creating a cohesive strategy for digital transformation. The findings conclude that integrating successful international practices, combined with tailored solutions that consider Ukraine’s unique regional characteristics, can significantly contribute to the effective digital transformation of civil society. By addressing the challenges of the digital divide, enhancing the capacity for civic engagement, and fostering collaboration between stakeholders, Ukraine can create a robust and inclusive framework for the sustainable development of its civil society in the digital era.

Pakistan’s military, which has directly controlled the country’s affairs for more than half of its post-independence history and which often retained real political power even during periods of democratic rule, has played a significant role in trade liberalisation. Regional disparities have increased since the beginning of major trade liberalisation attempts in the 1980s and at present, regional conflicts and the associated regional disparities are extremely high. The authors critically review the country's post-independence political economy of trade liberalisation, the resulting structural change and the story of regional disparities, identifying possible relations with political regimes. Using a regional computable general equilibrium (CGE) model, the effects of trade liberalisation on regional disparities are quantitatively examined, with an emphasis on the key export industries at a national level and on the relative output and employment growth at a regional level. In the first study to distinguish a possible link between trade liberalisation and regional disparities under dissimilar political regimes, such as autocracy and democracy, Butt and Bandara use Pakistan as a case study to draw broader lessons for other developing countries. This book will be of interest to academics, economists, political analysts and policymakers interested in development economics in general and South Asia in particular.

Inequality of Educational Opportunity in India: Changes Over Time and Across States

Regional disparity is a phenomenon of economic differences between regions (Bakri, et.al 2016). The Bappeda of Banten Province stated that South Tangerang City experienced a relatively high regional disparity level (Noviar, 2021). Triyanto, et.al (2019) stated that land use changes influenced regional disparity. However, this influence has not been identified in South Tangerang City. This study aims to identify the influence of land use change on regional disparity between sub-districts in South Tangerang City in 2015 and 2019. The data collection technique uses secondary data from related agencies with regional disparity, spatial and multiple linear regression statistical analysis techniques. The results of the analysis show that regional disparity consist of low, medium and high levels. Then, land use changes in 2019 are built-up land use change with an area of ​​493.29 ha (84.75%) and non-built-up land use change with an area of ​​88.73 ha (15.25%) out of a total of 582, 02 ha (100%). Furthermore, the influence of built-up land use change (X1) and non-built-up land use change (X2) simultaneously or partially has a significant influence on regional disparity (Y) which is 86%, while the remaining 14% is influenced by other independent not examined variables.

Neonatal mortality remains a significant public health challenge in Ghana, with regional disparities and systemic inequities affecting progress toward achieving Sustainable Development Goal (SDG) 3. Previous studies show about three-fourths of these deaths occur in the early neonatal period (i.e., the first week of life). Despite national efforts to improve neonatal survival, limited data exist on spatial, motorized accessibility, and temporal trends. The aim of the study is to analyze neonatal mortality trends and burden across Ghana from 2019 to 2023, identify regional disparities, high risk regions and districts, and to examine the impact of healthcare accessibility on neonatal outcomes using geospatial and statistical modelling. Using a retrospective analysis of neonatal mortality data from the District Health Information Management System 2 (DHIMS-2), we conducted a cross-sectional descriptive survey assessing early, late, and institutional neonatal mortality rates at national and regional levels. Geospatial mapping and poisson regression models were employed to identify high-risk areas and associated factors. A p-value <0.05 was used to declare statistical significance. Neonatal mortality in Ghana declined significantly between 2019 and 2023: early neonatal deaths decreased by 28.6% (4,645 to 3,317), and late neonatal deaths by 20.9% (912 to 721). Early and late neonatal mortality rates fell by 35.2% (6.51 to 4.22 per 1,000 live births) and 30.3% (1.32 to 0.92 per 1,000), respectively, with institutional neonatal mortality declining by 34.2% (7.79 to 5.13 per 1,000). However, stark regional disparities persisted. Greater Accra (5,626 deaths, 22.4%), Ashanti (4,234 deaths, 16.9%), and Northern (2,512 deaths, 10.0%) bore the highest burdens, while Savannah (259 deaths, 1.0%) and North-East (361 deaths, 1.4%) recorded the lowest. Poisson regression confirmed significant subnational heterogeneity: Oti (IRR=0.24; CI=0.13, 0.45), Western North (IRR=0.28; CI=0.15, 0.50), and North-East (IRR=0.37; CI=0.21, 0.62) exhibited mortality rates substantially lower than Greater Accra's baseline (IRR=1). Conversely, Bono (IRR=0.73; CI=0.48, 1.12) and the Northern Region (IRR=0.74; CI=0.49, 1.13) showed no significant differences. Rural areas faced critical access barriers, with over 60% requiring >60min to reach hospitals, likely exacerbating delays in care. These findings underscore progress in national mortality trends but highlight persistent inequities demanding region-specific interventions. Neonatal mortality in Ghana has declined over time, yet significant regional disparities and access inequities remain. Targeted interventions, such as improving rural healthcare infrastructure, expanding neonatal intensive care units, and strengthening ante/postnatal care, are crucial to address these gaps, and to improve healthcare access and outcomes for newborns. Future research should explore quality-of-care determinants and community-level interventions to improve in neonatal survival. The study highlights the importance of robust surveillance systems for monitoring neonatal health trends and guiding resource allocation.