In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.
Throughout the twentieth century, much of the population in Latin America lacked access to social protection. Since the 1990s, however, social policy for millions of outsiders - rural, informal, and unemployed workers and dependents - has been expanded dramatically. Social Policy Expansion in Latin America shows that the critical factors driving expansion are electoral competition for the vote of outsiders and social mobilization for policy change. The balance of partisan power and the involvement of social movements in policy design explain cross-national variation in policy models, in terms of benefit levels, coverage, and civil society participation in implementation. The book draws on in-depth case studies of policy making in Argentina, Brazil, Chile, and Mexico over several administrations and across three policy areas: health care, pensions, and income support. Secondary case studies illustrate how the theory applies to other developing countries.
Social policies can transform the lives of the poor and marginalized, yet inequitable implementation often limits their access. Uneven Social Policies shifts the focus of welfare state analysis away from policy design and toward policy implementation. By examining variation in political motivations, state capacity, and policy legacies, it explains why some policies are implemented more effectively than others, why some deliver votes to incumbent governments while others do not, and why regionally elected executives block the implementation of some but not all national policies. Niedzwiecki explores this variation across provinces and municipalities by combining case studies with statistical analysis of conditional cash transfers and health policies in two decentralized countries, Argentina and Brazil. The analysis draws on original data gathered during fifteen months of field research that included more than 230 interviews with politicians and 140 with policy recipients.
The United States is among the wealthiest nations in the world, but it is far from the healthiest. Although life expectancy and survival rates in the United States have improved dramatically over the past century, Americans live shorter lives and experience more injuries and illnesses than people in other high-income countries. The U.S. health disadvantage cannot be attributed solely to the adverse health status of racial or ethnic minorities or poor people: even highly advantaged Americans are in worse health than their counterparts in other, "peer" countries. In light of the new and growing evidence about the U.S. health disadvantage, the National Institutes of Health asked the National Research Council (NRC) and the Institute of Medicine (IOM) to convene a panel of experts to study the issue. The Panel on Understanding Cross-National Health Differences Among High-Income Countries examined whether the U.S. health disadvantage exists across the life span, considered potential explanations, and assessed the larger implications of the findings. U.S. Health in International Perspective presents detailed evidence on the issue, explores the possible explanations for the shorter and less healthy lives of Americans than those of people in comparable countries, and recommends actions by both government and nongovernment agencies and organizations to address the U.S. health disadvantage.
Essays on speculative/science fiction explore the futures that feed our most cherished fantasies and terrifying nightmares, while helping diverse communities devise new survival strategies for a tough millennium. The explosion in speculative/science fiction (SF) across different media from the late twentieth century to the present has compelled those in the field of SF studies to rethink the community’s identity, orientation, and stakes. In this edited collection, more than forty writers, critics, game designers, scholars, and activists explore core SF texts, with an eye toward a future in which corporations dominate both the means of production and the means of distribution and governments rely on powerful surveillance and carceral technologies. The essays, international in scope, demonstrate the diversity of SF through a balance of popular mass-market novels, comics, films, games, TV shows, creepypastas, and more niche works. SF works explored range from Riot Baby by Tochi Onyebuchi, 2084: The End of the World by Boualem Sansal, Terra Nullius by Claire Coleman, Watchmen and X-Men comics, and the Marvel film Captain America: The Winter Soldier, to the MaddAddam trilogy by Margaret Atwood, The Dispossessed by Ursula K. Le Guin, The Wandering Earth by Liu Cixin, and the Wormwood trilogy by Tade Thompson. In an era in which ecological disaster and global pandemics regularly expose and intensify deep political-economic inequalities, what futures has SF anticipated? What survival strategies has it provided us? Can it help us to deal with, and grow beyond, the inequalities and injustices of our times? Unlike other books of speculative/science fiction criticism, Uneven Futures uses a think piece format to make its critical insights engaging to a wide audience. The essays inspire visions of better possible futures—drawing on feminist, queer, and global speculative engagements with Indigenous, Latinx, and Afro- and African futurisms—while imparting important lessons for political organizing in the present. Contributors: Ben Abraham, Emmet Asher-Perrin, Brent Ryan Bellamy, Gerry Canavan, Andrew Ferguson, Fabio Fernandes, Dexter Gabriel, M. Elizabeth Ginway, Sean Guynes, Ouissal Harize, David M. Higgins, Veronica Hollinger, Allanah Hunt, Nicola Hunte, Nathaniel Isaacson, Ayana Jamieson, Darshana Jayemanne, Gwyneth Jones, Brendan Keogh, Sami Ahmad Khan, Cameron Kunzelman, Bryan Kamaoli Kuwada, Isiah Lavender III, Caryn Lesuma, Karen Lord, Sarah Marrs, Farah Mendlesohn, Cathryn Merla-Watson, Hugh Charles O’Connell, B. Pladek, John Rieder, Lysa Rivera, Kim Stanley Robinson, Steven Shaviro, Rebekah Sheldon, Alison Sperling, Alfredo Suppia, Bogi Takács, Taryne Jade Taylor, Sherryl Vint, Kirin Wachter-Grene, Ida Yoshinaga.
Why do some middle-income countries diversify their economies but fail to upgrade – to produce world-class products based on local inputs and technological capacities? Why have the 'little tigers' of Southeast Asia, such as Thailand, continued to lag behind the Newly Industrializing Countries of East Asia? Richard Doner goes beyond 'political will' by emphasizing institutional capacities and political pressures: development challenges vary; upgrading poses tough challenges that require robust institutional capacities. Such strengths are political in origin. They reflect pressures, such as security threats and resource constraints, which motivate political leaders to focus on efficiency more than clientelist payoffs. Such pressures help to explain the political institutions – 'veto players' – through which leaders operate. Doner assesses this argument by analyzing Thai development historically, in three sectors (sugar, textiles, and autos) and in comparison with both weaker and stronger competitors (Philippines, Indonesia, Taiwan, Brazil, and South Korea).
This comprehensive book uses a rich array of case studies from cities in Asia, Latin America, Africa, Southern Europe, and beyond to highlight the intensifying global struggle over urban space and underline gentrification as a growing and important battleground in the contemporary world.
Perceptions of eroding living standards, low levels of life satisfaction, and pessimism about prospects for economic mobility are widespread in the Middle East and North Africa region today. Conventional measures of economic well-being offer little explanation for these trends; in most countries in the region, extreme poverty is low and declining and economic inequality is lower than in other parts of the world. "Uneven Odds, Unequal Outcomes: Inequality of Opportunity in the Middle East and North Africa" investigates possible reasons for this disconnect, focusing on the role played by inadequate and unequal access to opportunities leading to economic mobility. The inability of most countries in the region to meet the economic aspirations of citizens is closely linked to persistent weaknesses in the labor markets where the pace of job creation has been chronically below levels required to absorb the growing and increasingly better educated population. Opportunities and life paths can diverge early in life if access to basic services in health, education, and infrastructure are unequally distributed among children in their formative years, and this book documents sharp disparities in the quality of services available to children of varying birth circumstances in the region. Although the most intense debates in development coalesce around inequality of income or wealth, the notion of inequality of opportunity has an intuitive appeal that can bridge ideological differences. By drawing attention to the notion of equality of opportunity to create a level playing field for all sections of society, "Uneven Odds, Unequal Outcomes: Inequality of Opportunity in the Middle East and North Africa" highlights the need to critically examine the social contract and governance structures that guide the delivery of services and are instrumental for implementing necessary reforms to make labor markets more dynamic and equitable. --
Racial and ethnic disparities in health care are known to reflect access to care and other issues that arise from differing socioeconomic conditions. There is, however, increasing evidence that even after such differences are accounted for, race and ethnicity remain significant predictors of the quality of health care received. In Unequal Treatment, a panel of experts documents this evidence and explores how persons of color experience the health care environment. The book examines how disparities in treatment may arise in health care systems and looks at aspects of the clinical encounter that may contribute to such disparities. Patients' and providers' attitudes, expectations, and behavior are analyzed. How to intervene? Unequal Treatment offers recommendations for improvements in medical care financing, allocation of care, availability of language translation, community-based care, and other arenas. The committee highlights the potential of cross-cultural education to improve provider-patient communication and offers a detailed look at how to integrate cross-cultural learning within the health professions. The book concludes with recommendations for data collection and research initiatives. Unequal Treatment will be vitally important to health care policymakers, administrators, providers, educators, and students as well as advocates for people of color.