Sharp Disparities Research Articles

Broken Ladders? Labour Market Inequality in Indonesia and India

This paper examines labour market inequality in Indonesia and India, using a common conceptual approach that draws on a job ladder framework. In the framework, I differentiate between self-employment and wage-informal employment and between formal, upper-tier informal and lower-tier informal employment. I find that Indonesia and India both have job ladders that are narrow at the top and broad at the bottom, with the share of workers in lower-tier informal jobs significantly exceeding the share of workers in upper informal and formal employment. However, more people are in formal wage-employment in Indonesia than in India. Unlike in Indonesia, where the share of wage-employment in total employment increased from 2001 to 2020, the corresponding share in India was relatively constant from 1988 to 2022. Sharp disparities are evident in the earnings of workers in different tiers of the labour market in Indonesia and India, and evidence of convergence in earnings is limited between lower-tier informal workers and formal workers, at least in Indonesia. I also find that females and less-educated workers occupy the lower tiers of the labour markets in the two countries.

To fee or not to fee: Requester attitudes toward freedom of information charges

This study seeks to establish a foundation for how FOI fees are received by public record requesters, and how fees influence behavior across demographics and requester types. A survey of 330 public records requesters in the United States revealed sharp disparities in how requesters perceive fees. Private citizens, journalists, academics, and nonprofit requesters were more likely to identify excessive fees as a serious impediment, whereas commercial requesters and lawyers did not. The study also found differences in how fees are experienced at the federal, state, and local levels. Findings suggest that fees are particularly problematic for certain requester types, notably average citizens and those seeking records in the public interest, and that fees may therefore obstruct the public's ability to become informed and better self-govern. Based on democratic theory, this U.S.-based study provides caution and insights for governments throughout the world against imposing barriers that might obstruct civic participation.

Land, Private Property, and the Universal Destination of Goods: A Catholic Perspective on Economic Inequality in Latin America

Abstract Latin America is plagued by extreme wealth inequality, much of which results from sharp disparities in land ownership. In addition to limiting access of basic goods to millions of Latin Americans, concentrations in land ownership harm the common good. Extreme disparities correlate to sluggish economic growth, inefficient agricultural practices, weakened public institutions, income disparities, and sharp increases in environmental degradation. A related concern is the destruction of indigenous peoples’ land in the Amazon and denial of access to land that is rightfully theirs. This paper examines how resources from Catholic Social Teaching help us reflect critically upon and respond to these injustices. It analyzes in particular how Pope Francis and the Amazonian bishops apply the tradition in markedly new ways, ways that are shaped by and directed to this diverse, abundant and unique socio-geographical region. Attention is paid not only to what Catholic Social Teaching can bring to local justice issues, but also lessons indigenous peoples can teach the broader Church.

Disparities in Loss from COVID-19: Comparing across and among First- and Second-Generation Latinx and Asian Adults

The coronavirus disease 2019 (COVID-19) pandemic has resulted in more than 900,000 deaths in the United States, disproportionately affecting racial and ethnic minorities. The pandemic is likely leading to disparate experiences of loss, though little research to date has examined disparities in experiences of loss from COVID-19. Drawing on a nationally representative survey of 6,000 first- and second-generation Latinx and Asian adults carried out in April and May 2021, this study reveals sharp disparities between and within ethnoracial groups in the United States in the experience of losing household members or close family and friends to COVID-19. Latinx adults were 1.65 times more likely than Asian adults to experience the loss of a loved one from COVID-19 (38 percent vs. 23 percent). First- and second-generation Indian Americans experienced disproportionately high rates of loss relative to other Asian Americans (33 percent). Looking both across and within ethnoracial categories is critical for understanding how the pandemic has compounded preexisting disadvantage.

Angela Merkel’s Record on Immigration and Gender

ABSTRACT Angela Merkel served as Chancellor at a time when German society was quickly diversifying due to immigration. Her policy choices now shape the life chances of millions of immigrants and their descendants. These choices also set the terms on which Germans will decide which divisions and which forms of solidarity will characterise the society in the years to come. Merkel was more willing to accept the reality of immigration than earlier CDU leaders. And yet I argue that, faced with rapid societal change, the Merkel governments generally avoided deep reforms of existing institutions, even those that yield sharp disparities by immigration status and gender. I find that, although Merkel focused on economic integration and female labour force participation, immigrant-origin residents have made only slow progress in these areas, though educational disparities have narrowed. Additionally, millions of long-term residents still lack German citizenship and the right to vote, so that their voices are muted in debates over what it means to be German. Meanwhile support for anti-immigrant extremists has surged. I conclude that it is an open question whether Merkel’s conservative approach will provide a stable basis for the economic, social, and political consolidation of a more diverse Germany.

The Construction of Value in Science Research Articles: A Quantitative Study of Topoi Used in Introductions

Scholars in the field of writing and rhetorical studies have long been interested in professional writing and the ways in which experts frame their research for disciplinary audiences. Three decades ago, rhetoricians incorporated stasis theory into their work as a way to explore the nature of argument and persuasion in scientific discourse. However, what is missing in these general arguments based on stasis are the particular arguments in science texts aimed at persuasion. Specifically, this article analyzes arguments from the stasis of value in introductions of science research articles. This work is grounded in the Classical topoi, or topics, cataloging types of arguments and identifying seven topoi. I analyzed 60 introductions from articles in three different science journals, totaling the number of value arguments and arguments comprising the topoi. Findings yielded different proportions in types of arguments, sharp disparities among the journals, and widespread use of value arguments. The broader issue at work in this article is how scientists make a case for the importance of their research and how these findings might inform writing and argumentation in the sciences.

Exposure to COVID-19: is there a disproportionate burden on low-paid jobs in France?

Although a majority of COVID-19 victims are among the elderly, workers holding low-paid jobs in the essential service sectors and those who are more likely to trade their health for economic reasons may be particularly exposed. Our aim is to gather existing data suggesting a disproportionate burden of the epidemic on the lower income categories.We focus on the situation of France, which has been hard hit. Workers highly exposed to the risk of COVID-19 infection are those who routinely have close face-to-face contacts with the public/colleagues, and/or exposure to infectious agents. Prior knowledge on usual working conditions can help us highlight at-risk occupations and related risks outside the work environment during the epidemic. We analysed national data on working conditions (CT2013), exposure to occupational hazards (SUMER2017) and a flash survey conducted during the lockdown.Before the lockdown (mid-March 2020), at least 8.8 million of workers were highly exposed to Covid-19 in France. There were however sharp disparities across occupational groups. As high as 41% of the bottom quarter of earners belonged to the highly exposed group, as opposed to 12% of the top quarter of earners. Apart from health care workers and first responders, other frontline workers with low-pay such as cleaners, personal aids and cashiers are among the most exposed. The situation has yet changed during the lockdown, with teleworking, reduced hours/layoffs, and type and timing of protective measures taken by employers. Lower salary workers have been highly exposed to the risk of COVID-19 infection. They may carry a heavy health burden related to the current crisis, especially when not sufficiently protected. Their occupational risks are further compounded by their transportation and housing conditions, along with comorbidities and access to healthcare. This lays ground to greater spread and severity of the disease among working-age and older working-class adults.

Assessing inequalities and regional disparities in child nutrition outcomes in India using MANUSH \u2013 a more sensitive yardstick

BackgroundIndia is strongly committed to reducing the burden of child malnutrition, which has remained a persistent concern. Findings from recent surveys indicate co-existence of child undernutrition, micronutrient deficiency and overweight/obesity, i.e. the triple burden of malnutrition among children below 5 years. While considerable efforts are being made to address this challenge, and several composite indices are being explored to inform policy actions, the methodology used for creating such indices, i.e., linear averaging, has its limitations. Briefly put, it could mask the uneven improvement across different indicators by discounting the ‘lagging’ indicators, and hence not incentivising a balanced improvement. Signifying negative implications on policy discourse for improved nutrition. To address this gap, we attempt to develop a composite index for estimating the triple burden of malnutrition in India, using a more sensitive measure, MANUSH.MethodologyData from publicly available nation-wide surveys - National Family Health Survey (NFHS) and Comprehensive National Nutrition Survey (CNNS), was used for this study. First, we addressed the robustness of MANUSH method of composite indexing over conventional aggregation methods. Second, using MANUSH scores, we assessed the triple burden of malnutrition at the subnational level over different periods NHFS- 3(2005–06), NFHS-4 (2015–16) and CNNS (2106–18). Using mapping and spatial analysis tools, we assessed neighbourhood dependency and formation of clusters, within and across states.ResultMANUSH method scores over other aggregation measures that use linear aggregation or geometric mean. It does so by fulfilling additional conditions of Shortfall and Hiatus Sensitivity, implicitly penalising cases where the improvement in worst-off dimension is lesser than the improvement in best-off dimension, or where, even with an overall improvement in the composite index, the gap between different dimensions does not reduce. MANUSH scores helped in revealing the gaps in the improvement of nutrition outcomes among different indicators and, the rising inequalities within and across states and districts in India. Significant clusters (p < 0.05) of high burden and low burden districts were found, revealing geographical heterogeneities and sharp regional disparities. A MANUSH based index is useful in context-specific planning and prioritising different interventions, an approach advocated by the newly launched National Nutrition Mission in India.ConclusionMANUSH based index emphasises balanced development in nutritional outcomes and is hence relevant for diverse and unevenly developing economy like India.

A targeted approach to payments for ecosystem services

Payment for ecosystem services (PES) is championed as a promising approach for advancing environmental conservation. As part of an ongoing project of refashioning PES intellectually and practically, we introduce a targeted approach to application of the logic of PES. We identify specific circumstances in which PES has potential to be ecologically effective and socially progressive. Specifically, we identify probability for success to increase where there are sharp disparities in the economic and ecological status of ecosystem service providers and beneficiaries. In identifying wealth and ecological disparities as important elements of PES design, we do not naturalize economic stratification in any way. Our aim is to highlight significant limits on the scope of PES and to advance a pragmatic, integrated approach to incentive-based environmental management. These insights can help policy makers and environmental management professionals to advance a more modest, targeted and practical approach to PES.

Manajemen Ekonomi Outopilot: Kegagalan Negara Mencari Identitas?

Political democracy should be equivalent to the economic development of the quality of democracy, economic democracy if not upright, even the owner of the ruling power and money, which is parallel to force global corporatocracy. Consequently, the economic oligarchy preservation reinforces control of production and distribution from upstream to downstream and power monopoly of the market. The implication, increasingly sharp economic disparities, exclusive owner of the money and power become fertile, and the end could jeopardize the harmony of the national economy. The loss of national economic identity that makes people feel lost the “pilot of the state”. What happens then is the autopilot state. Viewing unclear direction of the economy, the national economy should clarify the true figure.

Melanoma prognosis in Europe: far from equal

Comprehensive, population-based analysis of melanoma survival throughout Europe is hindered by the uneven coverage and quality of European cancer registries, and by logistical and financial shortcomings. Mortality-to-incidence ratios (MIRs) have been used as a proxy for estimating survival for multiple cancers and to model melanoma prognosis, higher MIR values reflecting poorer prognosis. Updated and improved pan-European estimates of mortality and incidence rates for melanoma have become available through the International Agency for Research of Cancer project Globocan 2008, showing marked differences among European countries. To analyse MIRs for melanoma across Europe and their relationship with national health expenditures, aiming to identify countries and regions with disproportionately poor prognosis. Estimated age-standardized rates of melanoma incidence and mortality provided by Globocan 2008 were used to calculate the MIR for each European country and region. Total health expenditures per capita in European countries for 2008 were provided by the World Health Organization/Global Health Observatory. The potential correlation between MIR and total health expenditure per capita was analysed through Pearson's correlation. Mortality-to-incidence ratios for melanoma ranged between 0·09 in Switzerland and 0·44 in Latvia. The regional average MIR was the highest in Central and Eastern Europe at 0·35; the lowest was in Western Europe, at 0·13. We found a strong inverse correlation between the individual nation's total health expenditure per capita and the calculated melanoma MIR (r = -0·76, P < 0·05). While further improvement of melanoma registration is necessary, our findings reveal sharp disparities in the prognosis of melanoma across the Continent, correlated with significant differences in health care expenditures.

Note from the Editor

Note from the Editor Virginia M. Brennan, PhD, MA Increasingly over the past decade and a half, public health scholars and practitioners have endeavored to involve communities in the planning and execution of programs and research conducted in those communities. Many of the people who read and write for JHCPU work these fields every day. In Part 1 of the present issue (Working with Communities), we venture into some particular communities, guided by people who work there. We learn about a Tennessee program for low-income women’s prenatal care started by students and faculty at Meharry Medical College and Vanderbilt University over forty years ago that continues to this day (Elkins et al.) and about the efforts of Golden Valley Health Centers in California to formally assess the linguistic proficiency of bilingual staff members who serve as interpreters (Nunez de Jaimes et al.). The research section of Part 1 opens with a paper about an interactive mobile tablet application for assessing risk of early childhood caries, called MySmile Buddy (Chinn et al.). A collaborative group of professionals developed and implemented MySmile Buddy; the authors got good results when they tested its utility for community health workers and its acceptability to low-income mothers in New York City. An intervention in Philadelphia is designed to improve the lives and trajectory of victims of interpersonal violence seen in city hospitals (Corbin et al.) Researchers assessed the frequency of post-traumatic stress disorder and a history of adverse childhood experiences among participants, finding them extremely widespread. This information will enable practitioners to tailor their violence-prevention initiatives to fit people with such profiles. Next, we learn from Ahlers-Schmidt et al. what their Spanish-speaking participants in Kansas reported finding most useful in health-related text messages, a form of communication that this community favors (perhaps due to limited access to e-mail). More than English-speakers, the respondents in this study wanted explanations of why certain vaccines were important, and shorthand definitions of medical terms, as well as reminders of appointments and related practicalities. The paper by Jiminez and colleagues on how parental health literacy affects early intervention with at-risk children in hospitals affiliated with the University of Pennsylvania, is related. Gower and colleagues looked into why nearly half the low-income individuals referred for eye exam follow-ups over the course of two years failed to return, finding that transportation and inadequate reminders continue to impede care. This research took place at Physician’s Free Clinic (a specialty clinic) in Columbus, Ohio. Klein et al.’s research also took place in clinic settings in Ohio: these authors report on the successful implementation of a medical-legal partnership that connects families in need to legal aid through pediatrician visits. The three long research papers in the Working with Communities section cover a broad spectrum: The first (Kiesler et al.) is an exploration of the social determinants of health of people working on the backstretch at horse-racing tracks, an old venue where the changing populations of the most needy workers in the U.S. have long put their bodies on the line in tough conditions for very little pay. Today, its denizens tend [End Page x] to be Latino. The Photovoice method is an especially inviting way for community members to work with professional researchers and we see it employed to good effect here. Next, we turn to a different perspective on health inequities: Close and colleagues held focus groups with African American participants in Florida exploring how aware people were of the sharp disparities in infant mortality between African Americans and Whites—in some counties in Florida, Black infant mortality is four times as high as White infant mortality—and discussing people’s ideas about the reasons for these disparities. Here, then, the tangible outcomes are in education, expression, and activation of community members on a critical public health problem. The Working with Communities section concludes with Martin, Howell, et al. on recruiting Latinas into a randomized control trial. The specter of cancer loomed over the Industrial Age and continues to loom over us in the Information Age. Part 2 of this issue (Cancer) contributes...

Civic Disparities: Exploring Students' Perceptions of Citizenship within Singapore's Academic Tracks

Drawing on individual interviews with 62 students from three secondary schools, the authors of this study investigate how Singapore students from different educational tracks understand their role as citizens in a democracy. In contrast to most countries, the constitutionally democratic state of Singapore explicitly assigns separate citizenship roles to students from different education tracks. Premised on the principle of meritocracy, the Singapore state has also developed separate citizenship education programs incorporating different values, skills, and knowledge for students from the academic and vocational tracks. The study illustrates sharp disparities in how citizenship and democracy is conceptualized by students from the different education tracks. The differences in civic efficacy, learning outcomes, knowledge, and skills also closely parallel the different goals of the social studies and citizenship education programs for students from the academic and vocational tracks.

Regional Variations of Social Sector Development: District Level Study of West Bengal State

The study makes an attempt to examine the inter-district disparities in social sector and their impact on social development through cross-sectional data and inter-temporal analysis of 18 districts in West Bengal. Social sector development is directly related to broader enhancement of human well-being and quality of life. This includes not only an adequate level of consumption of food and other consumer goods but also access to basic social services, especially education, health, drinking water facilities and basic sanitation. The study reveals that two dimensions come out to be meaningful, namely, quantitative and qualitative dimensional development. The study finds that there are sharp disparities among the districts in the State of West Bengal.

Environmental justice and the health of children.

Environmental injustice is the inequitable and disproportionately heavy exposure of poor, minority, and disenfranchised populations to toxic chemicals and other environmental hazards. Environmental injustice contributes to disparities in health status across populations of differing ethnicity, race, and socioeconomic status. Infants and children, because of their unique biological vulnerabilities and age-related patterns of exposure, are especially vulnerable to the health impacts of environmental injustice. These impacts are illustrated by sharp disparities across children of different racial and ethnic backgrounds in the prevalence of 3 common diseases caused in part by environmental factors: asthma, lead poisoning, and obesity. Documentation of linkages between health disparities and environmental injustice is an important step toward achieving environmental justice.

Participatory measurements of sustainable urban development and quality of life in post-socialist Zadar, Croatia

Over the last two decades, there has been an intensive discourse and research about measuring sustainable urban development. Many cities, regions and countries have decided to introduce indicators for monitoring and measuring the progress towards sustainability. Today there is a wide spread perception that information on the environment in general, and urban environment in particular, is the determinant of effective rational decisions and allocation of resources. Such information would enable planners and decision makers to formulate redistributive policies and programmes to address some of the disparities that exist in a post-socialist city. Cities of the post-socialist world characterized by sharp disparities, socio-economic contrasts and environmental degradation provide an excellent laboratory for tracing information on the quality of urban life. The current situation in the emerging Croatian coastal city of Zadar reflects the diversity of the post-socialist urban change in a very fragile Mediterranean landscape. This paper takes a critical look at sustainable development and its measurements. It describes the participatory approach through which different local communities in Zadar were evaluating quality of life based on basic pillars of sustainable development. The identification and collection of their opinions provide valuable data base and community input into urban governance and development planning decision making.

Écarts entre le référentiel et la pratique dans le diabète de type 2: Les préjugés des médecins et des patients sont un obstacle à une éducation efficace des patients

Health insurance data show that general practitioners (GPs) do not strictly apply clinical practice guidelines for the management of patients with type 2 diabetes.The Health insurance fund of the Centre region assessed doctors' practices in diabetes management and found sharp disparities. Our study sought to explain these differences by questioning (through interviews and questionnaires) a cross-section of GPs and patients with diabetes.Interviews and questionnaires show that doctors are well aware of the recommendations for follow-up and generally agree with them. Their systematic application, however, runs up against the concrete conditions of daily practice, especially in terms of diabetes education.GPs see the management of patients with diabetes as a combination of their own skills (decisions and advice) and of responsible patient behavior. Our results, however, suggest that GPs fail to counsel their patients properly because they cannot communicate to their patients the importance of diet and physical activity. Optimum management requires that doctors develop a cooperative relation with other health professionals and improve the patient-doctor relation to promote patients' understanding of the principles of their treatment and help them to accept responsibility for managing their disease.

“There's Still Not Justice”: Youth Civic Identity Development amid Distinct School and Community Contexts

Qualitative research describing and theorizing about the emerging civic identities of diverse youth is scarce. This study provides a textured view of how civic identity is constructed and negotiated by racially and socioeconomically diverse adolescents, based on interviews and in-class discussions conducted with students in four public secondary schools. Youth living in distinct contexts come to school-based civic education with varied understandings—shaped by disparate daily experiences—of what it means to be an American citizen and a participant in the civic life of a democracy. This investigator's examination of diverse adolescents’ discussions of their in-school and out-of-school civic experiences suggests a “typology” of civic identity that runs counter to prevalent views of the civic engagement of urban, minority youth. The study illustrates sharp disparities in daily civic experiences of youth from diverse racial and socioeconomic backgrounds, and suggests that schools can either hinder or encourage development of engaged, action-oriented civic identities among students from various contexts.

Social and School Differentiation in Urban Space: Inequalities and Local Configurations

The distribution of school provision in the greater Paris metropolitan area, including the availability of certain courses and study programs, is strongly correlated with the social profiles of the different localities and corresponds to sharp disparities. The highly diversified, attractive school options in localities whose residents are highly privileged in socioeconomic and occupational terms stand in contrast to the less diversified educational resources, including fewer course and study-program options, and reduced private school presence in more markedly working-class municipalities. Different approaches to school choice are strongly linked to parents' socioeconomic status but do not amount merely to practices for avoiding stigmatized middle schools in working-class localities. Those approaches make sense when considered in relation to what may be tightly circumscribed social and school environments and differentiated social positions and demands. The results presented here call into question the effectiveness of school-districting rules in France aimed at regulating the social profile of middle schools. As in London, Amsterdam, and Madrid, school dynamics and urban space in the outskirts of Paris are closely intertwined and increasingly interact in producing segregation.

The Building Resiliency and Vocational Excellence (BRAVE) Program: A Violence-Prevention and Role Model Program for Young, African American Males

There are sharp disparities between non-Hispanic Whites and African Americans in mortality and years of potential life lost for numerous health-related conditions, including HIV/AIDS. The Building Resiliency and Vocational Excellence (BRAVE) Program is an intervention using Resiliency Networking designed for use with African American young men to help offset these disparities. Resiliency Networking incorporates coaching, career planning, and re-definition of gender roles to help young men develop a sense of purpose and future and to manage their lifestyles effectively. In addition to fostering a strong link with an older mentor, the program fosters healthy peer-to-peer relationships. The paper reports on preliminary use of the intervention and recommends future applications.