Spending Priorities Research Articles

Data-Driven Insights on the Effects of COVID-19 on Public Interest in Medical Aesthetics: Part II (Active Analysis).

BackgroundThe COVID-19 pandemic significantly affected financial and psychosocial factors that influence plastic surgery demand.ObjectivesThe authors sought to actively assess public interest changes and the reasons underlying these shifts.MethodsUsing Amazons’ Mechanical Turk, we crowdsourced public opinions regarding aesthetic interventions from April 30 to May 3, 2020. The survey assessed prior experience with and interest in 6 aesthetic interventions before and during the pandemic and reasons for changing interest. United States residents aged 18 years and over who passed the attention check were included.ResultsWe included 704 of 838 total responses. One-half of respondents were female; the median age group was 25 to 34 years. During the pandemic, 21% of respondents had increased and 33% decreased interest in at least one intervention. Non-invasive procedures (7.3%), facial aesthetic surgery (6.6%), and medical-grade skincare (5.9%) elicited the greatest interest increase. Seeing themselves in the mirror more often (43.2%), desire to look better after the crisis (41.8%), and increased time on social media (40.4%) were the top reasons for increased interest. The most common reasons for decreased interest were changing spending priorities (58%), focusing on other health aspects (49.8%), and worrying about infection in medical facilities (46.3%). Almost one-half of respondents considered virtual consultations for interventions of increased interest.ConclusionsThe COVID-19 pandemic significantly affected interest in medical aesthetics. Offering telemedicine and discussing detailed COVID-19 infection control policies with patients will be critical to address patient needs and concerns. These findings can be used to improve patient outreach, advertisement, and counseling as practices focus on reopening.

ANALISIS PEMAHAMAN KEWANGAN DALAM KALANGAN MAHASISWA AKADEMI PENGAJIAN ISLAM UNIVERSITI MALAYA

With many university students receiving formal financial education, more individual have become significant understanding on their own money management. As a result, they able to successfully manage their own tuition fees, cost of living and entertainment without their parents’ guidance. This paper explored financial understanding of undergraduates at Academy of Islamic Studies University of Malaya (APIUM). Specifically, this paper investigated their demographic profiles and its relationship with their understanding on zakāh, takaful and free-interest loans offered by Islamic financial institutions. In addition, this paper also investigated on their spending behaviour. Characteristics such as field of study, source of education funds, education financing and their spending priority were examined to determine the main drivers behind the receiving of zakāh, subscribing monthly takaful, engaging in interest-based loans as well as their spending behavior. We assumed that financial literacy defined by OECD has become our underlying framework for this paper. Findings indicated that undergraduates with full sponsored by their family have different view about receiving zakāh funds, subscribing takaful, engaging in free-interest loan, and spending on entertainment cost. It is expected that this study would be expanded to more undergraduates who come from rich family backgrounds. It is expected that this study may help university to develop appropriate program of financial education suitable for undergraduates of various demographic profiles including those who come from rich family.

ANALISIS PEMAHAMAN KEWANGAN DALAM KALANGAN MAHASISWA AKADEMI PENGAJIAN ISLAM UNIVERSITI MALAYA: Financial Understanding Analysis among Academy of Islamic Studies’ Undergraduates in University of Malaya

With many university students receiving formal financial education, more individual have become significant understanding on their own money management. As a result, they able to successfully manage their own tuition fees, cost of living and entertainment without their parents’ guidance. This paper explored financial understanding of undergraduates at Academy of Islamic Studies University of Malaya (APIUM). Specifically, this paper investigated their demographic profiles and its relationship with their understanding on zakāh, takaful and free-interest loans offered by Islamic financial institutions. In addition, this paper also investigated on their spending behaviour. Characteristics such as field of study, source of education funds, education financing and their spending priority were examined to determine the main drivers behind the receiving of zakāh, subscribing monthly takaful, engaging in interest-based loans as well as their spending behavior. We assumed that financial literacy defined by OECD has become our underlying framework for this paper. Findings indicated that undergraduates with full sponsored by their family have different view about receiving zakāh funds, subscribing takaful, engaging in free-interest loan, and spending on entertainment cost. It is expected that this study would be expanded to more undergraduates who come from rich family backgrounds. It is expected that this study may help university to develop appropriate program of financial education suitable for undergraduates of various demographic profiles including those who come from rich family.

Women's experiences with mixed use of wood and gas cookstoves and fuels in rural Lambayeque, Peru

Introduction: Despite program efforts to encourage use of clean cookstoves and fuels to mitigate climate change, many communities continue to use wood-fueled open fires. Objectives: Describe experiences of participants with mixed use of cooking and fuel technologies (e.g. open fires and chimney stoves using wood and liquefied petroleum gas (LPG) stoves) in rural Lambayeque, Peru in 2018. Material and methods: Fifteen participants were interviewed using a qualitative exploratory research design. Data was collected through semi-structured interviews and analyzed using thematic content analysis. Results: Four categories emerged: decisions about acquiring cooking fuels are primarily based on cost; plastic trash is used to light wood-burning stoves; decisions to use gas over wood are based on quick food cooking time; and benefits and health problems are recognized, but mixed use of fuels persist. Conclusion: Use of both traditional wood cookstoves and plastic trash to ignite fires were used frequently because both are free or cheap. The environmental impact of cutting down trees isn't considered important, but interviewees did notice detriments to their wellbeing. Although gas stoves are used and benefits were mentioned, use of traditional stoves persists. We recommend that policy makers in Peru begin to address barriers to full adoption of new clean cooking technologies and consider governmental subsidies to meet families' spending priorities.

Aligning US Spending Priorities Using the Health Impact Pyramid Lens.

Thomas Frieden's "health impact pyramid" presents a hierarchy in which the wide base of the pyramid of socioeconomic factors at a population level has more impact on the health of the public than do individually focused interventions at the pyramid's top.From this pyramid perspective, the US spending priorities are misaligned, as expenses targeted at public health and socioeconomic factors are far outstripped by spending on individual health care services at the top of the pyramid. The nation's ongoing debate on health care reform continues to focus on access to individual health care services, despite evidence demonstrating the health impacts of population-level efforts at the base of the pyramid and the synergistic health impacts of health and social service collaboration.We examine the need for improved systems alignment through the lens of the health impact pyramid. We catalog the types of misalignments and their social, political, and systems genesis. We identify promising opportunities to realign US health spending toward the socioeconomic factor base of the health impact pyramid and emphasize the need to integrate and align public health, social services, and medical care in the United States.

Gender Sensitive Budgeting and The Place of Women in the Budget in Turkey

Bütçe, devletlerin kamu gelirlerini ne şekilde harcadıklarını ve harcama önceliklerinin ne olduğunu gösteren, bununla beraber ülkenin yönetim anlayışı, gelişmişlik düzeyi, gelir dağılımı gibi konularda önemli ipucu niteliğinde bilgiler içeren bir belgedir. Gerçekleşmesi öngörülen gelir ve gider tahminlerini içeren bir cetvel niteliğindeki bütçenin, en önemli işlevlerinden biri de çağdaş işlevleridir. Diğer bir ifade ile bölgelerarası, şehirlerarası ve vatandaşlar arası gelirin yeniden dağılımını sağlayarak fırsat eşitliği yaratmaktır. Kadın ve erkek arasında fırsat eşitliğinin çokça konuşulduğu son yıllarda cinsiyete duyarlı bütçeleme yaklaşımı da güncelliğini koruyarak yeni uygulamalar ile gelişmiş ekonomi politikalarında yerini bulmaktadır. Türkiye’de de son yıllarda bu doğrultuda uygulamaya konulan birçok düzenleme mevcuttur. Bu çerçevede ülkemizde, “Kadın Statü Genel Müdürlüğü”, “Kadın Erkek Fırsat Eşitliği Komisyonu” gibi kuruluşlar kurulmuş olup bu kurumlar tarafından araştırmalar yapılarak önemli stratejik eylem planları hazırlanmaktadır. Diğer taraftan cinsiyet eşitsizliğinin azaltılması konusunda, kadınlara yönelik girişimcilik destekleri, yerel yönetimler tarafından uygulanan sosyal ve sportif faaliyetler günümüzde olumlu gelişmeler olarak karşımıza çıkmaktadır. Ancak bu uygulamaların ve kadına fırsat eşitliği yaratmaya yönelik kamu harcamalarının yeterli düzeyde olmadığı söylenebilir.

Greening the Post-pandemic Recovery in the G20

Rebuilding G20 economies after the COVID-19 pandemic requires rethinking what type of economy we need and want in the future. Simply reviving the existing ‘brown’ economy will exacerbate irreversible climate change and other environmental risks. For G20 economies, investing in a workable and affordable green transition is essential. A good place to start is learning what worked and what did not from previous efforts to green the economic recovery during the 2008–2009 Great Recession, examining the cases of the United States and South Korea. Policies for a sustained economic recovery amount to much more than just short-term fiscal stimulus. Transitioning from fossil fuels to a sustainable low-carbon economy will require long-term commitments (5–10 years) of public spending and pricing reforms. The priorities for public spending include support for private sector green innovation and infrastructure, development of smart grids, transport systems, charging station networks, and sustainable cities. Pricing carbon and pollution, and removing fossil-fuel subsidies, can accelerate the transition, raise revenues for the necessary public investments, and lower the overall cost of the green transition.

Meanings and attitudes regarding education and household spending priorities of the new middle-class families in Brazil

This study investigates how meanings ascribed to education influence lower-income parents on investing (or not) in their children’s education, and how this in turn influences family expenditures and consumption priorities. Based on 62 ethnographic interviews with individuals who had ascended from poverty to the lower fractions of the Brazilian urban middle-class, we examine differences within a relatively homogeneous fraction in terms of social status and income. Three distinct groups emerged: (1) parents who live in the favelas (slums) and see school as an agent to keep children away from deviant behaviours, (2) parents who live in the favelas and invest in education as an enabler of upwards social mobility, and (3) parents from less affluent suburbs who pay for private education to keep their children from interacting with bad influences outside the territory. Even in socially segregated territories, meanings were shaped less by parents’ amount and composition of cultural and economic capitals, and more by their own experiences with the educational system and access to positive role models (or lack thereof). It appears that the meanings attached to education end up defining family expenditures, family budget and important consumption trade-offs. In addition, our findings reveal a subtle, fine-grained mechanism of distinction based on school choice among the class fraction’s members. We draw on Wilson’s social isolation theory to show how parents of similar economic and cultural capital, and who were socialized in a similar cultural milieu, ascribe different meanings to education, and the resulting differences in household consumption patterns. We thus offer insights on the different reproduction mechanisms at play within an economically disadvantaged social fraction that had moved from poverty to the lower urban middle-class in Brazil.

Will Covid‐19 change attitudes towards the welfare state?

Britain’s welfare state has suddenly been presented with a new challenge – to keep the country afloat during the Covid‐19 pandemic. The most immediate pressure is on the health service, whose ability to cope with the numbers needing hospital care is now imposing a constraint on the country’s economic activity. But, after successive years of reining back the scale of welfare provision to those of working age, the government is now also providing – via the social security system – increased levels of support to those who have lost their incomes, as well as subsidising on an unprecedented scale the salaries of those in work.

Assessing Healthcare Capacity in India

We assess India’s healthcare capacity by comparing several countrywide and state-level metrics: per capita spending on healthcare, healthcare spending priority in budgets, hospital bed capacity, and capacity in terms of doctors, nurses, and total healthcare personnel. We find that, overall, India has very fragile healthcare infrastructure for dealing with the COVID-19 outbreak. We make three recommendations: (1) India’s private-sector healthcare system has more capacity than government facilities, so the Indian government will need to rely on and incentivize the private sector by increasing funding and removing bottlenecks. (2) Healthcare capacity varies across states, and the union government should identify and assist at-risk states. (3) Compared to rural areas, urban areas are very poorly served by the state hospitals, creating an urgent need for state governments to identify and assist at-risk, high-density urban areas. In the absence of a vaccine, the lockdown may have to continue longer with measures such as a universal basic income implemented for the poor, allowing India to swiftly build up its healthcare infrastructure.

Discretionary spending priorities of unemployed, job-seeking adults who smoke cigarettes

ObjectiveTobacco use is detrimental to physical and financial wellbeing. Smoking is associated with unemployment and a harder time finding re-employment. The current study examined job-seekers’ prioritization of smoking over other discretionary items. MethodsAdult, unemployed job-seekers smoking daily ranked items from 1 (highest) to 13 (lowest) for prioritization of their discretionary spending. The online survey randomly ordered the presentation of items. The Heaviness of Smoking Index (HSI, time to first cigarette and cigarettes per day) assessed severity of nicotine addiction. ResultsThe sample (N = 290) was 70% men, 42% African American and 30% non-Hispanic Caucasian, with mean age of 43 (SD = 11), smoking an average of 12 cigarettes per day (SD = 6), and 67% smoking within 30 min of waking. Overall, cigarettes (M = 4.7, SD = 3.1) ranked second in importance behind only food (M = 2.5, SD = 2.7); 45% of the sample ranked tobacco in their top 3 spending priorities, and 26% ranked cigarettes as a higher priority than food. Cellular charges, transportation, grooming, and clothing ranked third through sixth, respectively. Higher HSI scores significantly correlated with greater prioritization of cigarettes (r = −0.25), and lower prioritization of food (r = 0.16) and transportation (r = 0.13), p’s < 0.05. ConclusionsFindings indicate cigarettes were highly prioritized, second only to food among job-seekers who smoke. Cigarettes were prioritized over job-seeking resources and health care, particularly among those who were more heavily addicted. Tobacco addiction can preempt basic life needs and reduce resources for finding re-employment.

Guns and Butter in China: How Chinese Citizens Respond to Military Spending

AbstractMilitaries are sustained by public money that is diverted away from other domestic ends. How the public react to the “guns-versus-butter” trade-off is thus an important question in understanding the microfoundations of Chinese military power. However, there are few studies on public attitudes towards military spending in China, whose rising power has been a grave concern to many policymakers around the world. We fielded a national online survey to investigate the nature of public support for military spending in China. We find that Chinese citizens support military spending in the abstract, but their support diminishes when considered alongside other domestic spending priorities. We also find that public support for military spending coexists surprisingly with anti-war sentiments and a significant strain of isolationism. In addition, while the conventional wisdom suggests that nationalism moves a state towards bellicosity and war, we find that Chinese citizens with a stronger sense of national pride report stronger anti-war sentiments than other citizens.

How Would Low-Income Communities Prioritize Medicaid Spending?

Medicaid plays a critical role in low-income, minority, and medically underserved communities, particularly in states that have expanded Medicaid under the Affordable Care Act. Yet, the voices of underresourced communities are often unheard in decisions about how to allocate Medicaid's scarce resources, and traditional methods of public engagement are poorly suited to gathering such input. We argue that deliberative public engagement can be a useful tool for involving communities in setting Medicaid priorities. We engaged 209 residents of low-income, medically underserved Michigan communities in discussions about Medicaid spending priorities using an exercise in informed deliberation: CHAT (CHoosing All Together). Participants learned about Medicaid, deliberated in small groups, and set priorities both individually and collectively. Participants prioritized broad eligibility consistent with the ACA expansion, accepted some cost sharing, and prioritized spending in areas-including mental health-that are historically underfunded. Participants allocated less funding beyond benefit coverage, such as spending on healthy communities. Participants perceived the deliberative process as fair and informative, and they supported using it in the policy-making process. The choices of participants from low-income, medically underserved communities reflect a unique set of priorities and suggest that engaging low-income communities more deeply in Medicaid policy making might result in different prioritization decisions.

Self-Rated and Social Determinants of Health Spending Attitudes in the United States

Objectives: To identify how self-rated health and social determinants of health are associated with people’s health attitudes towards government spending on improving national health in the US. Methods: We used data from eight biennial nationally representative General Social Surveys from 2004 to 2018 (n = 21116) to assess the determinants of health spending attitudes among US adults through a multivariate logistic regression model. Results: More than three quarters of adults responded that government health spending was ‘too little’ for improving and protecting American health. However, we found that those with ‘fair’ self-rated health were more likely to respond ‘too little’ or negative about health spending after adjusting for socioeconomic and sociodemographic factors and current political regimes. Conclusions: The perception of government health spending is high among US adults, and their self-rated health along with social determinants cannot fully explain this relationship. Examining self-rated health in the context of other sociopolitical factors is critical for understanding negative health spending attitudes and to restructure health spending priorities in the US.

Eco-Social Divides in Europe: Public Attitudes towards Welfare and Climate Change Policies

In the face of accelerating global warming and attendant natural disasters, it is clear that governments all over the world eventually have to take measures to mitigate the most adverse consequences of climate change. However, the costs of these measures are likely to force governments to reconsider some of their tax and spending priorities, of which social spending is the largest expenditure item in developed welfare states. Unless carried out in a way that is considered as fair by most citizens, such trade-off is likely to add a new, ecological dimension to the existing social cleavages in people’s preferences for public provision. Whether or not the possible tensions between the two sets of policies have already resulted in the emergence of a new, eco-social divide in Europe is an open question. In this paper, we hypothesise that there are four distinct attitude groups in relation to welfare and climate change policies, and that the probability of belonging to any of these groups is influenced by individuals’ socioeconomic and ideological characteristics, as well as the country context in which they live. We test our hypotheses using data from the eighth round of the European Social Survey conducted in 2016/17 in multinomial regression models. Results suggest that across Europe people are considerably divided in their support of public welfare and climate policies, but that support for both dimensions is highest in the Nordic countries. At the micro level, we find political ideology and trust in public institutions to be the most important drivers of a newly emerging eco-social divide.

NGOs Activities and Local Government Spending in Upper West region of Ghana: Are they Complements or Substitutes?

There is an increasing interest in the relationship between non-governmental organisations (NGOs) and local governments in terms of social spending in developing countries. However, the current literature on NGOs and social spending, especially for those pertaining to developing countries and Ghana in particular, does not examine the extent to which NGOs’ presence shapes local authorities’ spending on the provision of basic social amenities. This study examines NGOs’ presence on constituents’ opinion about local government social spending. Using the probit regression estimation approach, this study found that services provided by NGOs might be allowing local government authorities to change their spending patterns and priorities. Thus, the presence of NGOs tends to crowd-out social spending in the Upper West region. To the extent that proliferation of NGOs lowers social spending, local government authorities might also be taking advantage of NGOs operations to neglect their constitutionally mandated responsibility of providing basic social amenities in their communities of practice. This article discusses key implications for policy.

Public Preferences for Government Spending Priorities: Survey Evidence from Germany

Abstract Employing data from a representative survey conducted in Germany, this paper examines public preferences for the size and composition of government expenditure. We focus on public attitudes towards taxes, public debt incurrence and public spending in six different policy areas. Our findings suggest, first, that individual preferences for the use of additional tax money can be categorised as either capital-oriented expenditure or public debt reduction. Second, we find that fiscal preferences differ along various dimensions. Specifically, personal economic well-being, economic literacy, confidence in politicians, political ideology and time preference are significantly related to individual attitudes towards public spending, taxes and debt. The magnitude of the effects is particularly large for time preference, economic knowledge and party preference. Third, public preferences for public spending priorities are only marginally affected when considering a public budget constraint.

‘It’s not like I ever use the money for me to go out and live the café lifestyle’: Pacific mothers talk about child support money

ABSTRACT Much of the sociological literature on how child support is allocated and used engages with normative white Western understandings of family structure, the organization of gender relations, and the distribution and management of financial resources within that structure. There has been an absence of an examination of how mothers and fathers from ethnic minority communities navigate and negotiate uses of child support money. Drawing on interviews with nine Pacific mothers in receipt of or eligible to receive child support, this paper considers the differences between white Western and Pacific practices of money transfer within families, as well as discursive constructions of child support, to explore how Pacific mothers reconcile Pacific understandings of money with how they construct, allocate and use child support, and the extent to which this money is understood and treated as ‘special money’ (Zelizer, V. A. (1989). The social meaning of money: “Special monies”. American Journal of Sociology, 95(2), 342–377.). The mothers’ discussions of child support money emphasize child-centred spending priorities in ways that challenge practices associated the flow of money in Pacific families, but reaffirm their identities as ‘good’ mothers. This paper concludes by arguing that discursive constructions of child support operate in ways that constrain how the mothers in this study allocated and used child support money.

New memo offers first glimpse of how Trump’s science adviser would like to shape spending priorities

New memo offers first glimpse of how Trump’s science adviser would like to shape spending priorities

Into the Machine: Economic Tools, Sovereignty, and Joy in a Global Health Institution.

Since the early 1990s, the World Bank and Inter-American Development Bank have led efforts advocating the use of economic tools in setting priorities for health spending in poor countries. But while these powerful global health institutions present economic management as the key to improving health, they often fail to implement even their own policies requiring the use of economic tools for health project planning. In these institutions, economic tools operate beyond application for decision-making, becoming simultaneously a site of tensions regarding sovereignty and sites of enjoyment for economists at development bank headquarters. This article traces the ways that economic tools are both deployed and left aside across development bank networks, and in the process are productive of both affect and power. Attention to frictions in the use of economic tools ought to help motivate more just global health governance, taking into account political considerations that are built into expert practice.