Recent Policy Research Articles

The expressivist argument for recent policy changes regarding the provision of prenatal testing in Japan

ABSTRACT The Japanese government and medical professionals have negative attitudes toward the provision of prenatal testing and related information due to social concern regarding discrimination against persons with disabilities. However, with the rapid increase in the number of non-invasive prenatal tests, particularly at non-certificated medical facilities, in response to the growing demand from pregnant women, the Japanese government and medical professional associations have enacted radical changes marking an active commitment to the provision of information on these services. While a major justification for these policy changes is to ensure respect for reproductive autonomy and women’s self-determination, they may reinforce the concern regarding discrimination. This article investigated the argument that these new policies may reinforce discrimination and examined three objections to this argument. The results revealed that the recent policy changes, particularly for specific fetal traits, may imply a negative belief about people living with the same traits. Consequently, fundamental institutional changes are necessary.

Skilled Nursing and Home Health Policy: A Primer for the Hospital Clinician

This paper addresses the increasing challenges faced by hospital clinicians in coordinating and recommending postacute care for patients, focusing on issues related to access to the most common postacute services: skilled nursing facilities (SNFs) and home health agencies (HHAs). In coordinating discharges, hospital clinicians have minimal information on care delivery in these settings. This knowledge gap is exacerbated by the disrupted continuum of patient care between acute care hospitals, SNFs, and HHAs. To address these challenges, hospital clinicians must understand how recent federal policies have impacted SNF and HHA care provision. The paper provides an overview of recent Centers for Medicare and Medicaid Services (CMS) policies and programs affecting SNFs and HHAs, including: (1) fee-for-service reimbursement reform (ie, Patient Driven Payment Model [PDPM] and the Patient Driven Groupings Model [PDGM]); (2) bundled payment programs; (3) accountable care organizations; (4) Medicare Advantage plans. Overall, this paper aims to help hospital clinicians stay informed about the evolving landscape of postacute care delivery by providing relevant information on how recent policy changes have impacted patient care.

The war in Ukraine is changing plausible future socioeconomic scenarios leading to an unexplored outlook for biodiversity

AbstractShared socioeconomic pathways are a key tool in predicting biodiversity scenarios and in the subsequent design of environmental policies. Here, we discuss how recent policy changes to global trade routes, agriculture, and energy production in response to the war in Ukraine are impacting socioeconomic scenarios used to set and assess biodiversity targets. We also discuss how the disruption to the global geopolitical landscape provides a window of opportunity for policy reform and the radical societal paradigm shift that is needed to tackle the global biodiversity crisis. We call for the re‐evaluation of biodiversity targets with newly developed scenarios that reflect the changes made to production and consumption patterns. We also recommend establishing national biodiversity working groups to screen proposed policies for their potential risks to the drivers of biodiversity change, since policy decisions made in response to the war that seemingly are far removed from the environment can have lasting impacts on nature.

Unhealthy Food and Beverage Marketing to Children in the Digital Age: Global Research and Policy Challenges and Priorities.

Food and nonalcoholic beverage marketing is implicated in poor diet and obesity in children. The rapid growth and proliferation of digital marketing has resulted in dramatic changes to advertising practices and children's exposure. The constantly evolving and data-driven nature of digital food marketing presents substantial challenges for researchers seeking to quantify the impact on children and for policymakers tasked with designing and implementing restrictive policies. We outline the latest evidence on children's experience of the contemporary digital food marketing ecosystem, conceptual frameworks guiding digital food marketing research, the impact of digital food marketing on dietary outcomes, and the methods used to determine impact, and we consider the key research and policy challenges and priorities for the field. Recent methodological and policy developments represent opportunities to apply novel and innovative solutions to address this complex issue, which could drive meaningful improvements in children's dietary health.

On the tail of two species: The changing place of the peregrine falcon in society

Abstract Wildlife conservation can become contentious when human interests are impinged. For peregrine falcons (Falco peregrinus) in the United Kingdom, their iconic status as a protected species is contested by pigeon racers and falconers restrained by strict wildlife policies. However, even entrenched conservation policies can shift, sparking controversy. This paper seeks to understand the conditions leading to recent conservation policy shifts and conflicts. Through archival research and discourse analysis of falconry and pigeon racers' rhetoric, I review the development of 150 years of UK wildlife legislation and politics surrounding peregrines, situating present‐day conflict within long‐standing tensions between competing interests. In doing so, I demonstrate how contrasting ideologies of the raptors existed simultaneously between groups. Each vied for dominance and influenced policies over time, with the ideologies of ‘winners’ suppressing that of the ‘losers’ to become the norm. This historical approach highlights the key role global events like war played in overpowering the dominance of protective ideologies towards peregrines domestically, allowing peregrine culls and capture to become socially permissible. Conversely, post‐War environmental movements originating in the United States suppressed falconry's extractive relationships with peregrines in the United Kingdom, entrenching ecological priorities as a norm still conventional today. I argue that wildlife protection is contested because cultural extinction of falconry and pigeon racing were imminent, brought on by policymakers' focus on preventing the biological extinction of peregrines. However, recent policy shifts highlight the acceptance of anthropocentric interests within conservation practices. Policy implications: Animals can play multiple roles in society, but the public may not be accustomed to anthropocentric interests overtly displayed within contemporary conservation practices. Policy needs to be more sensitive towards accommodating or communicating human interests, but to also reflect on the social and ecological implications of their own ideologies towards conservation. Read the free Plain Language Summary for this article on the Journal blog.

Mapping and Assessing Urban Agriculture in São Paulo: Tackling Socio-Economic and Environmental Issues through Nature-Based Solutions

Inefficient urban transformations pose multifaceted challenges. In this context, urban agriculture (UA) can address environmental and socio-economic issues. Despite recent UA policies in São Paulo, the lack of data hampers comprehensive evaluations, highlighting the need for robust indicators to enhance environmental sustainability. This article assesses São Paulo’s UA potential using an Ecosystem Services (ES)-based approach, combining ES spatial mapping and a producer survey at 49 UA sites. Results show natural habitats and anthropic areas within urbanised land, especially in the south, with high habitat quality scores. Nine ES were identified: food supply, commercialisation, income generation, waste mediation, lifecycle maintenance, soil formation, leisure/social, well-being, and education. Utilising mixed methods, this study provides innovative insights into ES related to UA in São Paulo, offering valuable input for urban policies and planning.

Industrial and innovation policies in times of crisis: a widening technological divide?

Purpose The purpose of this paper is to analyze the ongoing revival of industrial and innovation policies across developed and developing economies. Design/methodology/approach The paper compare the scale and scope of recent industrial and innovation policy initiatives across developed and developing economies. Also, it analyzes recent data regarding R&D investments and other innovation indicators. Findings There are enormous disparities across economies in their capacity to implement industrial policies, particularly those to support science, technology and innovation. Most developed economies, and a few developing economies, are implementing bold, ambitious and medium-term innovation policies towards bolstering R&D investments, supporting advanced manufacturing and green energies and strengthening technological capabilities. Amid lack of fiscal policy space and vulnerable debt sustainability positions, institutional deficiencies and weak innovation ecosystems, developing economies – particularly in Africa and Latin America – face enormous challenges to implement strategic industrial and innovation policies. Research limitations/implications Under the current economic, financing and institutional conditions, together with subdued global trade and ongoing geopolitical fragmentation, the technological divide and innovation asymmetries across economies will likely widen even further, paving the ground for a “development divergence” in the coming decade. Originality/value The paper analyzes the implications of the current industrial and innovation policy trends across developed and developing countries. Under the current economic, financing and institutional conditions, together with subdued global trade and ongoing geopolitical fragmentation, the technological divide and innovation asymmetries across economies will likely widen even further, paving the ground for a “development divergence” in the coming decade.

Producing accountability with autonomy in Denmark and England: the analytical potential of assemblage theory with critical realism in comparative education

ABSTRACT School autonomy with accountability (SAWA) reforms have developed in diverse forms in Northern Europe. Following processes of decentralization to the municipal and school levels, quality assurance and inspection became key to the test-based accountability agendas of Denmark and England respectively. With an abductive approach, we explore the epistemological potential of a hybrid theoretical framework, which combines assemblage theory with critical realism, to analyze the production stories of these two policy instruments. Drawing on data from an international comparative research project, and more recent policy document analyses, we examine the arrangement of social entities – discourses, instruments, technologies, artefacts, and actors – that led to particular accountability outcomes within these specific educational assemblages. We argue that, despite distinctions in their social entities, the dominant state assemblages of accountability in Denmark and England have been captured by the global SAWA and capitalist assemblages at distinct times. Although school actors are incorporated into, and antagonistic towards, the state assemblages, change is limited due to the resilience of the underlying logic of epistemic governance and the desire to improve educational standards for a global knowledge economy. We conclude briefly with an assessment of the utility of the hybrid framework to the comparison of SAWA.

Impact of health policy changes on population health

Recent health policy changes have had a profound impact on population health, reflecting diverse approaches and outcomes across different regions. The affordable care act (ACA) in the United States expanded healthcare coverage, improving access to preventive services and chronic disease management. Despite these advancements, disparities in health outcomes persist, particularly among minority and low-income populations. In Europe, universal healthcare systems like those in Germany and the Netherlands have achieved near-universal coverage and high public satisfaction. However, socioeconomic inequalities continue to influence health outcomes, necessitating policies that address broader social determinants of health. Low- and middle-income countries (LMICs) have implemented universal health coverage (UHC) initiatives, such as Thailand's UHC scheme and Rwanda's community-based health insurance. These reforms have led to significant improvements in maternal and child health, reduced out-of-pocket expenditures, and increased healthcare utilization among the poor. However, disparities between urban and rural populations remain a challenge, underscoring the need for comprehensive strategies that strengthen healthcare systems and infrastructure. Future directions for health policy improvement include addressing health disparities, integrating technology, and promoting preventive care. Community-based interventions and cultural competency training for healthcare providers can reduce disparities and enhance patient satisfaction. The integration of telemedicine, electronic health records, and health information exchanges can improve care coordination and access to services, although equitable access to digital health tools is essential. Emphasizing preventive care through increased funding, incentivizing providers, and raising public awareness can significantly reduce the burden of chronic diseases. Engaging patients in their healthcare decisions and promoting shared decision-making fosters a collaborative and effective healthcare environment. Policymakers must adopt comprehensive and adaptable strategies to address persistent disparities, integrate technology, and promote preventive care, ultimately leading to more equitable and effective health outcomes for diverse populations.

Land use changes in the Min River basin and their impact on carbon storage

BackgroundThe changes in land use patterns may provide immediate economic advantages, but they also lead to significant disruptions in ecosystem services. These modifications have the potential to adversely impact water supply, air quality, disaster response, carbon storage, and biodiversity. Therefore, these modifications affect the provision of ecosystem services and have a negative effect on human well-being. Hence, it is crucial to investigate how land use changes affect carbon storage to enhance ecosystem services, lessen the consequences of climate change, advance human welfare, and direct effective land management practices. MethodsMin River Basin (MRB) is a significant water reservoir in China, providing valuable ecosystem services. Currently, the MRB is undergoing significant alterations in the land use due to country’s policy changes. Therefore, this study analyzed alterations in land use, dynamics of the alterations, and transfer matrix in MRB. The alterations in these indices were recorded for three time periods, i.e., 2000, 2010, and 2020. Furthermore, the influence of land use changes on carbon storage was investigated by InVEST (Integrated Valuation of Ecosystem Services and Tradeoffs) model. ResultsThe main land use classes in the MRB consisted of forest land, grassland, and arable land, and most of the alterations were recorded among these three classes. The arable land was declined by 163–333 km2, while grassland reduced by 23–233 km2 from 2000 to 2020. Likewise, forest land witnessed a decrease of 34–167 km2 from 2000 to 2020. The dominant land use dynamics consisted of construction land and water areas, whereas the entire land use dynamics exhibit a consistent increasing trend. Moreover, carbon storage witnessed a significant decrease during the study period due to the reduction in forest land, grassland, and arable land. ConclusionThe land use patterns in the MRB have witnessed substantial transformations because of recent policy implementations. Land use changes from forest land, arable land and grassland to other types exerted significant influence on carbon storage. Generally, carbon storage decreased from 2000 to 2020. The decline in carbon storage in the MRB is mostly attributed to urban growth, and construction activities. Therefore, these activities should be carefully monitored to improve carbon storage in the basin.

The Decarbonization Bargain: How the Decarbonizable Sector Shapes Climate Politics

Political scientists conceptualize climate politics as a distributive struggle between emerging green and incumbent fossil coalitions. We argue that, even though this conceptualization is historically accurate, a dichotomous understanding no longer fully explains conflicts over climate policy. Importantly, it misses a group of industries that are central to recent policy progress: the decarbonizable sector. Decarbonizable industries, such as automakers or energy-intensive manufacturers, have long been part of fossil coalitions but can develop new sources of competitiveness through decarbonization. This makes them receptive to a bargain: agreeing to meet climate goals in exchange for policies that support their decarbonization, especially fiscal policies that partially fund or de-risk their business transitions. We establish this argument using an original measurement of the size of the decarbonizable sector and corroborate our findings through case studies of green spending policies in the United States, Germany, and the United Kingdom.

Analysis of Ohio Advanced Practice Registered Nurses' Rate of Prescribing Naltrexone for Patients With Alcohol Use Disorder Since Elimination of the X-Waiver.

Alcohol use disorder (AUD) is common and deadly. Naltrexone is a treatment for AUD. Previous research examined factors that predict Ohio Advanced Practice Registered Nurses' (APRNs) utilization of naltrexone to treat AUD. Inclusion criteria included APRNs' endorsing receipt of the X-waiver, a designation indicating providers' receipt of substance use disorder education. In 2023, the X-waiver was eliminated. The purpose of this study was to replicate the previous research design in respondents without an X-waiver and compare findings. The aims of this study were three-fold: (1) assess whether race, age, practice setting, years in practice, or work experience with an addiction specialist physician predicted prescription of naltrexone for AUD, (2) assess whether the goal of abstinence or reduced alcohol use as desired treatment affected the likelihood of naltrexone prescription for AUD, and (3) compare differences between the answers in the current respondent group without X-waiver and the previous study's X-waivered respondents. All Ohio APRNs were sent surveys. Eighty-eight responses were included in analysis. Descriptive statistics, logistic regression, and chi-square results were reported. Work experience with an addiction specialist physician was negatively associated with prescribing naltrexone for AUD. Respondents from the previous study of X-waivered APRNs were significantly more likely to prescribe naltrexone for reduced alcohol consumption as a treatment outcome than the respondents in this study. The recent policy change eliminating the X-waiver provides important context for research, adding to the substance use disorder literature.

Health, energy security or people's jobs? Understanding cooking transition narratives and energy justice implications in Tanzania

The achievement of Sustainable Development Goal 7 ‘affordable and clean energy for all’ is incomplete with 1.8 billion people worldwide still dependent on biomass for cooking, with detrimental effects on health, well-being and environment. The situation is especially acute in Sub-Saharan Africa. This study explores cooking transition narratives in the Tanzanian context. The recent policy initiative towards clean cooking from the Tanzanian government provides the opportunity to investigate the main actors and perspectives that set the scene for clean cooking, and justice implications. Drawing on interviews with relevant stakeholders and analysis of key strategic documents we find that the current narratives highlight technical, financial and environmental dimensions, but has little emphasis on the end-users. This provides limited understanding of the practices that underpin cooking, and people's ability to transition to clean cooking technologies. In the future, there is a need to consult the end-users to ensure a successful, just and sustainable transition.

The relationship between the lifestyle health index and voter turnout during the 2020 United States presidential election in the context of regional cultures

ObjectivesThere are numerous population health challenges confronting the United States (U.S.), including the unhealthy lifestyle – chronic disease pandemics. However, the impact of unhealthy lifestyle behaviors and the increased prevalence of chronic diseases that result from them affect many facets of life outside of the health domain, and their scope remains under-appreciated. The current analysis contributes to addressing this knowledge gap by comparing the newly developed Lifestyle Health Index (LHI) to U.S. county-level voter turnout rates in the 2020 presidential election. Study designDescriptive, cross-sectional, retrospective analysis. MethodsCounty-level data on the LHI, percent voter turnout, and the American Nations regional cultures model schematic was used in the current analysis. ResultsPearson correlations between county-level LHI scores and sub scores and Democratic, Republican, and overall voter turnout were all statistically significant and of similar strength (r > 0.63, p < 0.001). All counties in the worst performing LHI quartile had a voter turnout <60 %. Higher LHIs were consistently assocaited with lower voter turnout across the regional cultures, although heterogeneity was evident across the American Nations. ConclusionsA large percentage of the U.S. population is afflicted with poor health, and unhealthy lifestyle behaviors are a primary driver. Poor health does not occur in a vacuum and impacts many other facets of an individual's life. The current study further demonstrates the potential detrimental impact of poor health on civic engagement, specifically participation in the electoral process (i.e, citizens' health may influence voter turnout). Health care professionals and institutions in the U.S. should uniformly embrace the recent policy brief by the American College of Physicians on participation in the electoral process for patients receiving care. This paradigm shift has the potential to substantially improve voter turnout during U.S. elections.

COVID Street Cafés: Assessing Policy Windows in Five North American Cities

Problem, research strategy, and findings: Cities experimented with street design to address health and economic impacts of the COVID pandemic between 2020 and 2023. Scholars have suggested that COVID represented a window of opportunity to transform aspects of urban planning, but the degree to which emergency interventions portend longer-term changes requires study. This study focused on street cafés as one of the more significant COVID-era street transformations. Street cafés are allocations of space in the cartway for outdoor dining. They introduce a social use to street space while increasing the complexity of managing street space. To assess the idea that the COVID crisis was a window of opportunity, we conducted a comparative case study of COVID street café programs in five North American cities. We drew on 16 interviews and analysis of policy documents to examine how street café programs were implemented, how they adapted existing policy and institutions, and whether their implementation represented a policy punctuation. Despite common objectives, implementing COVID street café programs played out differently in each case city. Urban form, existing policy, administration of emergency programs, and café design and experimentation all affected outcomes. These COVID-era programs led to one city initiating a new street café program; in two other cities, they accelerated implementation of recent policy initiatives, and the experience in the final two cities was ambiguous. Takeaway for practice: This research highlights the importance of recently adopted street policy in shaping emergency response. Although installation of COVID street cafés was widespread, planners will have to renegotiate emergency actions taken to lessen regulatory, administrative, and financial hurdles to café implementation to sustain viable street café programs in the long run.

Approaching collaboration in primary care differently: Exploring boundaries and boundary objects.

In recent primary care policy, collaboration is often understood as an outcome, such as the delivery of team-based care or an integrated health system. This outcome-based understanding of collaboration in policy has proven challenging to achieve in practice. This article introduces the concepts of constructing boundaries and boundary objects used in other disciplines, to support our understanding of collaboration by observing the collaborative process. Multiple methods, such as semi-structured interviews, discourse analysis, and member-checking, were used to compare primary care collaborations across three distinct time periods during the onset of COVID-19 within Interior British Columbia. Data analysis revealed the changing nature of boundaries and boundary objects, providing insights into the collaborative process. Through the exploration of boundaries and boundary objects, this article provides a way to approach collaboration in practice differently. By better understanding the process of collaboration, this research could potentially improve collaborative outcomes.

Development of a Global Physical Literacy (GloPL) Action Framework: Study protocol for a consensus process.

The holistic concept of physical literacy (PL) has gained growing attention in recent research, policy, and practice. Many important policy documents of the physical activity and educational fields (e.g., Global Action Plan on Physical Activity 2018-2030 by the World Health Organization, UNESCO's Quality Physical Education guidelines for policymakers) have specified PL. However, a clear framework for action is needed, as most initiatives across the world are fragmented, lack a prospective orientation, can benefit from conceptual clarification, and are not linked to effective translation into practice. Therefore, we aim to consensually develop a Global Physical Literacy (GloPL) Action Framework to define goals and principles (asking what is needed) as well as actions and ways (asking how these can be achieved) to move PL forward. We apply a three-stage group Delphi technique involving three representation groups: (a) geographical representatives to achieve global coverage of perspectives; (b) representatives of special thematic interest reflecting prominent gaps of current PL activities; and (c) representatives of societies from the broad field of physical activity and health to facilitate dissemination. The process will begin with an individual pre-Delphi exercise, in which experts generate initial ideas for the framework, followed by a four-eye document analysis to derive themes for the discussion. Subsequently, the experts will meet face-to-face in three online rounds to discuss and prioritize the themes. Interspersed formal voting with pre-defined agreement thresholds (via descriptive statistics) will inform the inclusion of themes within the final framework. A global consensus on goals, principles, actions, and ways for the development of PL has the potential to provide a largely accepted roadmap for future activities in research, policy, and practice. The co-production approach will help disseminate the GloPL Action Framework and benefit work in relevant application fields of physical activity and health worldwide.

National climate legislation and policymaking and energy security: International evidence

With the shift towards low-carbon economies, energy security has emerged as an increasingly vital concern for governments worldwide, particularly in recent years, because of ongoing conflicts and increased volatility in the international energy market. Both laws and policies are essential tools for mitigating climate change challenges; however, its role in energy security remains unexplored. Drawing on climate-related legislative activities in 127 countries from 2000 to 2021, this study examines the short- and long-term impact of climate laws and policies on energy security performance (ESP). The empirical results demonstrate that both recent and longstanding climate laws and policies have enhanced the national ESP on a global scale. Furthermore, we find that laws outperform policies regarding energy security improvement. Additional analyses indicate that the impact of climate laws and policies on ESP is more effective across high- and upper-middle-income countries, and less effective in low-income countries, especially those in Africa. Our findings highlight the significance of climate legislative efforts and provide important implications for global governments in securing their green transition.

Corporate taxation in Spain: analyzing efficiency and revenue potential

This paper offers a comprehensive analysis of Spain’s corporate tax system through the lens of the Laffer curve and Buoyancy index, assessing its efficiency in generating revenue. The study finds that Spain is nearing the Laffer curve’s optimal tax rate, beyond which tax revenue may decrease with rate hikes. The Buoyancy index reveals a fluctuating response of tax revenues to economic shifts, indicating vulnerability in economic downturns. We trace Spain’s corporate tax evolution, examining current structures and recent policy reforms, and explore how corporate taxation influences economic activities and investment. The paper proposes policy recommendations, including reassessing the corporate tax rate, advocating structural reforms for a wider tax base, and policies promoting economic growth. Emphasis is placed on counter-cyclical fiscal policies, regular evaluation of tax incentives, improving tax compliance, and Spain’s role in global tax coordination. This research contributes to fiscal policy discussions, advocating a balanced tax approach for sustainable economic development and guiding policymakers toward resilient fiscal strategies in a dynamic economic environment.

Inequities in the green transition: anti-mining protests in the European periphery

Supposed green technological fixes to the climate crisis necessitate the mining of raw materials such as lithium en masse, spurring the proliferation of mining globally and the associated social and ecological harms. Major economies are engaged in a resource race for critical raw materials that are indispensable inputs for electric vehicles and digital technologies in the green transition and fourth industrial revolution (Kalantzakos, 2020; Kalantzakos et al, 2023). As this race materialises, so too has resistance and contestation on the proposed mining sites. This article engages with the critical literature on ecologically unequal exchanges (Hornborg, 1998; 2014; 2016) and extractivism (Acosta, 2013) to explore protracted civil society resistance to two lithium mining projects in rural and agrarian regions of Serbia and Portugal. The European Union is pursuing a dual agenda of decarbonising personal use transport and resource autonomy in an increasingly shifting geopolitical order; in turn a massive effort for onshoring mining activities is underway in Europe. The author argues that recent policy enactments by the European Union for onshore mining produces ecological and social harms in rural and agrarian areas and is illustrative of an unequal ecological and economic exchange. Agrarian and subsistence livelihoods are affected in pursuit of green technological solutions, highlighting the contradictory character of the green transition under capitalism and ultimately advocates for a degrowth position.