Territorial Inequalities Research Articles

Public Policies on Sport in the Perspective of Reducing Inequalities at Local Level: Recent Legislation in Italy

The paper examines how public policies on sports can serve as a factor for reducing territorial inequalities and fostering local development. By analyzing recent legislative interventions in Italy, including the National Recovery and Resilience Plan and other sports-related initiatives, the paper explores the evolving role of sports in addressing social and territorial disparities. It emphasizes how public policies related to sports not only enhance territorial attractiveness but also contribute to social cohesion and urban regeneration, particularly in marginalized areas. These policies align with the recent reform of the Italian Constitution, recognizing sports as a tool for promoting sustainable development and reducing inequalities at the local level.

Territorial Inequalities and (de)Concentration of Public Investment in Science: A Study on CONICET (Argentina) and the Tensions Between Academic Excellence and Equity

Territorial Inequalities and (de)Concentration of Public Investment in Science: A Study on CONICET (Argentina) and the Tensions Between Academic Excellence and Equity

Territorial health inequalities in breast cancer mortality across France from 1968 to 2017

Abstract Background Territorial health inequalities are of growing concern in countries with universal health systems. From 2003, three successive national cancer plans were launched in France, aiming to improve prevention and treatment. Regions in France are responsible for strategic and financial management of healthcare within their boundaries, which, until 2016, included up to 8 departments. In this study, we analyze the evolution of between and within-region territorial inequalities in breast cancer mortality over 50 years. Methods We used direct and indirect standardization to analyze trends in breast cancer mortality for women aged 25 to 74 years between 1968 and 2017 in each department of metropolitan France. We analyzed the evolution of relative inequalities over time using standard errors of age-adjusted rates. We used multilevel Poisson regression to estimate how much the regional level contributed to territorial variation. Results Over the period 1968 to 1992, breast cancer standardized mortality ratios (SMRs) increased (+16%) while relative territorial inequalities decreased (-21%). After 1997, SMRs decreased (-23%) but territorial inequalities remained unchanged. In 18 out of 22 regions, inequalities were lower at the end than at the start of the study period. Period proved to be the most important determinant of variation in mortality. However, multilevel models also suggested that the regional level explained most of the remaining variation in each period (from 50% to over 80%). Conclusions Over the study period in most French regions, breast cancer mortality has decreased, and so have relative inequalities. Nevertheless, there is evidence that regions have performed differently. The proportion of variation explained by the regional level suggests the continued relevance of the health system on breast cancer mortality. Key messages • Territorial inequality in breast cancer mortality has decreased in France over the 1968-2017 period. • In most regions, disparities between departments have decreased.

Health-promoting school. Mediation effects on health behaviors and the socio-economic level of pupils

Abstract Pupils health indicators and behaviors are marked by social and territorial inequalities which develop early (DREES, 2015, 2019). In order to combat these inequalities and improve the health behaviors and well-being of pupils, the “health-promoting school” approach is recognized as convincing. It is endorsed by the World Health Organization (Langford, 2015; WHO, 2021). The health policy currently implemented in French schools is convergent (MEN, 2018, 2021). In order to disseminate this policy, since 2019, the Alliance project has been implemented in 101 French schools (9 - 12 years old) and 97 municipalities in the AURA region. Each school and community are trained and supported to promote the development of professional practices and a health promotion project to improve the health behaviors of pupils. The question arises as to the extent to which the development of health-promoting teaching projects and practices participating in the strengthening of health protective factors - life skills and health literacy - of pupils would have a mediating effect from the point of view of socio-economic level and health behaviors of pupils? Each year, data are collected from pupils by questionnaire, mesuring their well-being, health habits, psychosocial competencies and their families’ socio-economic level. 11500 questionnaires collected during 3 years have been analyzed. Descriptive and bivariate analysis indicate sevreral improvements between years in their health habits like for example daily physical activities (6% for T0 and 16% for T2) or daily consumption of sweets (17% for T0 and 13% for T2). They confirm negative influence of risk factors as low socio-economic level on health habits. But mediation analysis show that psychosocial competencies, especially emotionnal and social competencies, mediate significatively this influence (mediation effect range from 5% to 21%). Key messages • The health indicators and behaviors of young people are marked very early on by social and territorial health inequalities. • Health-promoting school approach and particularly – life skills and health literacy – would have a mediation effect on health behaviors and the socio-economic level of students.

A postcode lottery in education? Explaining regional inequality in multilevel systems

AbstractInequality is a challenge for societies around the globe. In addition to its socio‐economic and political dimensions, inequality also has a territorial dimension. Focusing on educational inequality across regions, this article explores factors that shape regional differences in student enrolment and educational attainment in 14 OECD countries. The findings of the article suggest that a strong level of regional authority over education increases regional inequality in education. Further factors are regional differences in education expenditures and variation in the population size of regions. Low regional inequality in education seems to be explained by a low degree of regional authority or low differences in education spending. By examining regional inequality in education, the article enhances our understanding of the way multilevel governance influences the quality of life within regions. In particular, it highlights the impact of decentralization on territorial inequality.

Priorities and challenges in social and healthcare policies for older people living in the Mediterranean basin: A Delphi panel study

BackgroundRecently, the countries in the Mediterranean basin (which share cultural ties) have been showing a common trend of declining social support for the elderly, with deficiencies in social care models for this demographic. Thus, this Delphi panel study analyzed the gaps in social and integrated care among the participating countries in a European research project.MethodsThis three-round Delphi panel study focused on the European countries of Greece and Spain and the non-European countries of Egypt, Lebanon, and Tunisia. In this project, experts were identified according to their level of expertise in the subject matter, their gender, and their membership in different social groups. Subsequently, they were asked to identify the current situation of social care, set future goals, and locate the gaps regarding the social and healthcare models for older people in the participating countries. The median score (Mdn) and interquartile range (IQR) were calculated to assess the degree of consensus on the different priorities.ResultsAmong the participating countries, there was a lack of state agreements to maintain social care models, a lack of coordination between public and private institutions to provide social care services, territorial inequalities in terms of access and coverage of rights, and job insecurity for professionals. The desired situation was to integrate social and healthcare services with a person-centered social care model, thus promoting autonomy and empowering users and families in participation and decision-making.ConclusionsThis Delphi study reveals significant disparities in social and healthcare policies for older adults across Mediterranean countries, highlighting shared challenges and specific national needs. European nations like Greece and Spain face fragmented systems, while non-European countries such as Lebanon, Egypt, and Tunisia lack specialized geriatric services and social security. All countries urgently need better professional training, social and economic empowerment of older adults, and integrated national strategies. These findings offer key insights for policymakers to develop equitable, sustainable solutions for aging populations.

Political discontent in Spain, diagnosis and solutions

The starting point is the presence of a widespread feeling of political confrontation and division among Spanish citizens. This is compounded by dissatisfaction with and distrust in a system that is perceived by many as elitist and out of touch with real needs. Several factors related to this perception of politics are explained and quantified. On the one hand, there are economic elements, such as the stagnation of GDP per capita, the persistence of a relatively high at-risk-of-poverty rate, and the rates of material deprivation. And in all these elements, a significant territorial inequality can be observed. There are significant differences between Spain, France and Germany over the period considered. On the other hand, political factors determine much of the public debate in Spain: Historical memory and the Spanish Civil War, as well as the terrorism of ETA and other terrorist groups. The emergence of new parties is analyzed, especially VOX. Finally, the enormous difficulty of finding a territorial structure of political power that would bring together the consensus of most political forces. It is necessary to find formulas for fiscal federalism that will make it possible to move away from the current decentralization of spending without the Autonomous Communities having their own tax capacity. This study concludes by pointing out the relevance of all these problems and the need to find solutions through democratic debate and deliberation with agreements.

Bulgaria’s regional policy: Analysing paradigm shifts and dynamics of territorial inequalities

Abstract Domestic regional policies are increasingly expected to tackle significant spatial disparities, promote territorial justice, and ensure equal opportunities, thereby supporting various aspects of sustainability. This article focuses on the case of Bulgaria, serving a dual purpose: it outlines the emergence and evolution of contemporary regional policy in the country and measures the extent and dynamics of socio-economic inequalities at different territorial levels. The conceptualization of a comprehensive regional policy framework following the socialist era was largely driven by top-down Europeanization impulses, which catalysed political debates on the transformed roles of the regions and the necessity for effective decentralisation. However, despite years of domestic regional policy implementation, socio-economic inequalities in Bulgaria remain substantial, with certain peripheral regions notably trailing behind. The comprehensive assessments conducted in this study include primarily descriptive statistics, regression and correlation analyses, time series analyses, and classification/categorization of territorial units. They indicate significant spatial heterogeneity and the prevalence of pronounced ‘centre-periphery’ patterns, which pose a serious threat to the long-term sustainable development of the country.

Tourist Walking Trails in Italy and Argentina: Navigating Political Recognition and Socio-Territorial Innovation

Tourism is often considered the world’s biggest industry, as it contributes approximately 10% of the global GDP. Despite this economic impact, tourism also includes important critical issues like territorial inequalities, diminishment of local engagement, and has high environmental and cultural impacts. This study investigates the rise of “walking trail tourism”, a niche sector where the respect for local communities and the environmental sustainability are particularly important. The focus is on Italy and Argentina: two countries with very different political, tourism, and biophysical backgrounds, but with the common recent development of walking trails and forms of social innovation. This study explores three main questions: the trends in walking trail tourism, the role of these trails in fostering local social innovation, and the influence of national policies in this domain. The study combines historical-statistical analysis, political–legislative review, and interviews with experts in order to assess all these aspects. Findings reveal significant social innovation trends within walking trail tourism but also challenges in territorial coordination and the establishment of national governance. Italy and Argentina are both characterized by an opposite situation regarding walking trails: there are several local initiatives but a lack of national guidelines in the former, and some good national policies but few bottom-up initiatives in the latter.

The Location of Home Support Services for Older Adults in the Aveiro Region of Portugal

ABSTRACT Home and community-based services are key to an aging society and the aging in place strategies that are preferred by older adults as well as policymakers. But the provision of these kinds of services is often inadequate in territorial terms, raising the question of how to increase their reach and efficiency. This article analyzes the spatial coverage of home support services in the Aveiro Region of Portugal, considering the distribution of their target population and identifying network configurations which would provide these services more efficiently, through a location analysis that minimizes the distance to potential users of these services. This approach showed that, in the Aveiro Region, the spatial coverage of these services is highly uneven and insufficient, considering that the population with difficulties in performing daily tasks exceeds the population benefiting from these services and that the level of coverage differs greatly between territories. It also showed that significant efficiency and equity gains are possible by optimizing the service providers’ location at the supra-municipal scale, decreasing the distances to be covered and reducing territorial inequalities.

Informal settlements in Colombia: A look at the city of Tunja (2010-2022)

This paper presents a comprehensive analysis of informal settlements in Tunja, Colombia, from 2010 to 2022. It examines the historical, social, and economic factors that contribute to these settlements, using various data sources, including development and territorial planning plans, the Agustín Codazzi Geographic Institute, and local government records. The study highlights significant inequalities in access to public services between urban and rural areas, exacerbated by environmental hazards from nearby mines, landfills, and sewage treatment plants. The research employs a descriptive and explanatory approach, detailing the historical context and theoretical frameworks related to agglomeration economics, territorial inequality, and urbanization processes. A historical-deductive method ensures logical consistency in the analysis of data from 2010 to 2022. The study also utilizes georeferencing techniques to present spatial data on service coverage and demographic characteristics, differentiating urban and rural disparities. Findings show that informal settlements in Tunja are predominantly located on the periphery of the city, with significant disparities in service coverage. While urban areas have over 90% coverage of basic services, rural areas lack adequate infrastructure, particularly sewage, gas, and internet services. The study identifies specific settlements, such as Runta and Pirgua, details their access to services and highlights environmental and structural issues.

Transformations in the sanitation sector in the State of Rio de Janeiro: neoliberalism and regulatory changes

This article analyzes the reconfiguration of water supply services provided to municipalities across the State of Rio de Janeiro. It seeks to examines how advancements in the neoliberalization of Brazil's basic sanitation sector have contributed to a fragmentation in the provision of services and to the emergence of uneven geographies on a regional scale. This will be conducted through the lens of policy experimentation, particularly after the approval of Law 14.026/2020. The study is based on an approach concerning the commodification of public services within the context of neoliberalism, marked by a complex reformulation of regulatory mechanisms. The methodology combines an analysis of secondary data, documentary research, and thematic mapping. The results reveal that the management of sanitation services is increasingly guided by market logic, with the experimentation of controversial regulatory mechanisms that have exacerbated fragmentation and deepened territorial inequality.

Suivi de la prise en charge scolaire et médicosociale des enfants inclus dans le registre des handicaps de l’enfant de Guyane : entre théorie et réalité

IntroductionIn France, to benefit from appropriate medical, social and educational care, children with autism spectrum disorders must obtain a referral from the Maison Départementale des Personnes Handicapées (MDPH), and these notifications must then be implemented. In French Guiana, social and territorial inequalities in health are omnipresent. However, there are no data on the care of adolescents with Autism Spectrum Disorder in French Guiana. Aim and methodologyThe aim of the project was to explore the educational and medico-social pathways of children included in Guiana's autism spectrum disorder register since 2016 (who were living in Guiana in 2016 and whose ASD had been diagnosed before their 8th birthday) by means of a telephone interview and data collection at the MDPH. We included 52 young people aged 11 to 18, including 40 families contacted by telephone. The results obtained through the variables collected show that, despite a diagnosis made before the age of 8, only 29 young people (out of 47 completed) benefit from medical, social and educational care that coincides with the recommendations of the current Commission des droits et de l’autonomie des personnes handicapées (CDAPH). ResultsOf the 52 young people monitored, at least nine – or 17.3% – were not receiving any form of education. Thirty one young people were receiving medical, social, health and/or educational care at the time of the survey, compared with 16 who were not receiving any, mainly because they had been on a waiting list for an average of five years. In addition, 34% said they were not satisfied with the overall care their child received, mainly because of staff shortages. ConclusionIn conclusion, in French Guiana, there is a significant gap between what is recommended to parents for their teenage child's care and what is actually possible.

Revisiting wildfire resilience from a territorial perspective: insights from Mediterranean Spain

Wildfires are increasingly recognized as a complex socioecological phenomenon, yet their linkages with territorial development are not clearly spelled out. This article seeks to unveil the sociopolitical and sociospatial ramifications of wildfires by framing them as a territorial issue, and understanding fire-prone territories as dynamic entities that emerge in essentially political processes, defined by socioecological relations that unfold across different spatial and temporal scales. Against this backdrop, building resilience is considered a territorially embedded and continuous process, driven by mechanisms operating “behind the flames.” By operationalizing this framework in the region of Valencia (Spain), it is shown how social innovation can help overcome lock-ins and enhance resilience. This research showcases the importance of building a trusting, collaborative culture across sectors and actors, and brings to the forefront the importance of considering rural–urban relationships for reducing territorial inequalities and building more resilient futures in Mediterranean, fire-prone territories.

Measuring food insecurity: Food Affordability Index as a measure of territorial inequalities

The devastating economic and social impact of COVID-19 and the war in Ukraine has exacerbated poverty and food insecurity, making it harder for people to access food. Based on a multidimensional understanding of food insecurity, this study focuses on one of the most challenging dimensions for affluent societies, namely, the economic access to food. Therefore, the research aims to develop an innovative Food Affordability Index (FIA) that captures the inter-territorial inequalities and critical problems created by the economic disruptions in the local food system that prevent people from eating healthy. The index is based on a survey of the prices of products suitable for healthy eating in thirty shops in Rome, Italy. A distinction was made both by the type of distribution channel (e.g. discount and supermarket) and by the area in which the survey was conducted, i.e., the 15 municipalities of Rome. This study sheds light on the problem of food insecurity and highlights areas where households are far from an ideal healthy diet. Understanding the spatial distribution of economic inequalities in access to healthy food seems crucial for the implementation of targeted policies and programmes to address this problem, which is increasingly structural in affluent societies.

The Dynamics of Regional Inequalities in Romania. Comparative Analysis between the major Crises – Financial and Sanitary

In Romania, the issue of economic inequalities and regional convergence is one of the current important topics on which the attention of economic specialists and the decision-making factors is focused. In the actual context, the regional policy in Romania is implemented at regional level, the regions being formed by counties that have voluntarily associated on the basis of a convention signed by the representatives of the County Councils, respectively of the General Council of Bucharest. After the year 2000, the development regions faced two major crises: the global financial crisis (2008-2009) and the one caused by the COVID-19 pandemic (2020-2021). Both crises have caused important effects at regional level and both have been supported by a number of territorial strategies and policies, to which there was added the cohesion and regional development policy financed by the EU Structural Funds. The paper is based on the analysis of the differences between the regions of Romania, in the period 2008-2022, during the COVID-19 pandemic, by highlighting the differences between the dynamics of certain indicators, of the analysis of the GINI coefficients for measuring inequalities, trying to answer the question which of the two crises, financial or health, affected the level of territorial inequalities more and what was the evolution of the regions of Romania in these two sub-periods. Regarding the financial crisis versus the pandemic one, in the majority of the indicators, it was shown that the values of the Gini coefficients in the 2020-2022 were higher than the ones in 2008-2010 and also after the COVID-19 crisis the tendency of increased disparities was maintained. The only domains that were least affected by the pandemic were demography (rural population), transportation infrastructure and economic potential (companies with 10-49 employees).

The Effect of Information About Local Demand for Redistribution on Support for Territorial Transfers Among Affluent Groups

Many multitier polities have some scheme of territorial-based redistribution, which plays a crucial role in mitigating territorial inequality. This article looks at the public opinion on inter-regional transfers and argues that: (1) perceptions of aggregate electoral support for interpersonal redistribution in the region affect support for inter-regional redistribution independently of perceptions about the region’s economic conditions and (2) perceptions of high electoral support for interpersonal redistribution among the region’s affluent can lead them to favor territorial transfers, because these transfers may work as a mechanism for local redistribution cost displacement. We test our argument using a survey experiment in which we provide information about regional economic conditions and aggregate demand for interpersonal redistribution. Our contribution highlights that the aggregate demand for interpersonal redistribution within regions is not necessarily endogenous to regions material conditions, and that the perception of this aggregate demand by the affluent affects their inter-regional redistributive preferences.

TEMPORARY REMOVAL: Mortalité maternelle en France, 2016–2018, fréquence, causes et profil des femmes

Objective: To describe, for the 2016-2018 period, the frequency, causes and risk factors of maternal deaths in France.Method: Data from the National Confidential Enquiry into Maternal Deaths for 2016-2018Results: For 2016-2018, 272 maternal deaths occurred in France, i.e a maternal mortality ratio of 11,8 per 100,000 live births (95% CI 10,4-13,3), and 8.5 (IC 95 % 7,4-9,8) for maternal mortality up to 42 days. Compared to women aged 20-24, the risk of maternal death is multiplied by 2.6 for women aged 35-39, by 5 for women aged 40 and over. Obese women are twice as frequent among maternal deaths (26%) than in the general population of parturients (11%). There are territorial disparities -the maternal mortality ratio in the French overseas departments is 2 times higher than in metropolitan France (significant difference but smaller than in 2013-2015)-, and social disparities -the mortality of migrant women remains higher than that of women born in France, particularly for women born in sub-Saharan Africa whose risk is 3 times higher than that native women. One in three women who died (34%) had socio-economic vulnerability versus 22% in the overall population of parturients.Among causes of maternal deaths, the predominant role of psychiatric conditions (mostly suicides) is confirmed for the period 2016-2018, leading cause of maternal mortality considered up to 1 year (17%), MMR of 1.9 /100,000 NV. i.e. approximately one death from psychiatric causes every 3 weeks. Cardiovascular diseases are the second leading cause of maternal mortality up to one year (14%) and the leading cause up to 42 days (16%), with 1.3 deaths per 100,000 NV. Amniotic embolism ranks as the third cause (8%) (2nd cause, 11%, for MM limited to 42 days), i.e. MMR of 0.9 per 100,000 NV. After a regular decline over the last decade, maternal mortality from obstetric hemorrhage is at a stable level compared to the previous triennium 2013-2015, MMR of 0.9/100,000 NV, i.e 5th cause of MM up to one year (7%) and 4th cause of MM up to 42 days.Conclusion: The overall national maternal mortality ratio does not show a downward trend, even with constant surveillance method. Territorial inequalities persist but change in their magnitude and in the regions concerned. The profile of the causes of maternal mortality up to one year of the pregnancy end shows the leading role of suicides and cardiovascular diseases, which illustrates that the health of pregnant women or those who have recently given birth is not limited to the obstetric domain, and highlights the importance of multidisciplinarity in the management and organization of care for women in this period

EKONOMSKA KRIZA I KONVERGENCIJA REGIONALNIH DISPARITETA

Overall regional disproportions in the Republic of Serbia are directly dependent on the degree of economic development of certain areas on its territory. Territorial inequality in the availability and quality of all factors of economic development, as an endogenous variable of certain regions, causes migration, i.e. human migration, as well as the allocation of every other form of capital to places of optimal use, deepening regional differences in economic development. The consequence of such developments on the regional development of the Republic of Serbia in the long term is divergence, that is, an increase in regional differences. In the short and medium term, more developed regions are in a far better position than less developed ones to take advantage of the opportunities generated by economic growth. However, in the conditions of the economic crisis, when developed national economies and regions "slow down", they feel the drop in demand faster and more strongly, and they fall back faster compared to less developed regions. This phenomenon is the main reason for the convergence of regional disparities. Key words: regional differences, the economic crisis, the level of economic development, convergence.

Health care itineraries for women in situations of abortion: methodological aspects of a qualitative study for Birth in Brazil II survey.

In recent decades, several academic studies on abortion have been produced in Brazil, with different designs, objectives, and methodologies. However, due to the diversity of situations in which Brazilian women experience abortion, the complexity of this topic, and its modulations in different political and sociocultural contexts, it still challenges academicians and the fields of health and reproductive rights. In this article, we present methodological aspects of a qualitative study on health care itineraries of women in situations of abortion, a component of the Birth in Brazil II survey, whose objective is to discuss the effects of gender; race/ethnicity; social class; generational, regional, and territorial inequalities on care itineraries. We discuss the study design development, the construction of the theoretical framework and specific analytical axes, the development of interview instrument, definition of participant selection criteria, strategies to contact participants and conduct the interviews, management of field work and materials produced, analytical procedures, and ethical issues. In total, 120 narrative interviews were conducted in order to include a diversity of women and obtain detailed results from the quantitative analysis under Birth in Brazil II survey. The context of criminalization of abortion has an impact on the production of knowledge on this subject, creating challenges such as difficult access to women, women's anonymity, privacy and data confidentiality, creation of objective and subjective conditions so that they can narrate their experiences in depth. With this article, we seek to contribute to the debate about these challenges in abortion research in Brazil.