Welfare regime and social class variation in poverty and economic vulnerability in Europe: an analysis of EU-SILC

In this paper we address a set of interrelated issues. These comprise increasing concerns about reliance on nationally based income poverty measures in the context of EU enlargement, the relative merits of one-dimensional versus multidimensional approaches to poverty and social exclusion and the continuing relevance of class-based explanations of life chances. When identifying economically vulnerable groups we find that, contrary to the situation with national income poverty measures, levels of vulnerability vary systematically across welfare regimes. The multidimensional profile of the economically vulnerable sharply differentiates them from the remainder of the population. While they are also characterised by distinctively higher levels of multiple deprivation, a substantial majority of the economically vulnerable are not exposed to such deprivation. Unlike the national relative income approach, the focus on economic vulnerability reveals a pattern of class differentiation that is not dominated by the contrast between the self-employed and all others. In contrast to a European-wide relative income approach, it also simultaneously captures the fact that absolute levels of vulnerability are distinctively higher among the lower social classes in the less comprehensive and generous welfare regimes while class relativities are significantly sharper at the other end of the spectrum.

Identifying Economically Vulnerable Groups as the Economic Crisis Emerged

A frequent refrain during recent debates on welfare cuts and tax increases has related to the need to "protect the vulnerable". However, it is far from clear that a consensus exists on which individuals or groups are to be included under this heading with a consequent lack of clarity for the policy implications of pursuing this goal. In this paper, operating with a conception of social exclusion that incorporates notions of dynamics and multidimensionality, we make use of EU-SILC 2008 data for Ireland to clarify the distinction between income poverty and economic vulnerability. We then proceed to consider the relationship between these outcomes and multiple deprivation, financial pressures and perceptions of recent and future economic prospects. Our analysis is then extended to compare patterns of risk for poverty and vulnerability in relation to key socio-economic groups. Finally, we will consider the relationship between poverty and vulnerability and the distribution of welfare dependence. Our analysis suggests that the vulnerable but non-poor group may need to be a key focus of policy attention in the future.

The 'Europeanization' of Reference Groups

In this paper we address the question of the relative importance of within and between country differences in income and material deprivation in the European Union in the context of recent suggestions that insufficient attention has been paid to the latter. In particular, we respond to the argument that the 'state bounded' relative income approach obscures the significance of EU-wide reference groups. Making use of EU-SILC 2004, we have sought to quantify the magnitude of relevant within and between country differences and their relative impact. Overall, our analysis supports the view that the predominant frame of reference is a national one. The limited impact of European reference groups observed in our analysis does not require explanation in terms of the emergence of a European social stratification system. Furthermore, the significance of such comparisons depends not only on the expectations of those affected by European inequalities but on the degree of legitimacy afforded to ensuing demands. While an EU-wide income-threshold can provide information regarding progress of the Union towards greater social cohesion, its usage for this purpose does not require a strong sense of European identity. Given the current status of the European Social Model, it would seem unwise to attribute an undue degree of policy relevance to the relatively modest impact of EU-wide reference groups revealed in our analysis.

Persistent and consistent poverty in the 1994 and 1995 waves of the European Community Household Panel Survey

This paper focuses on the mismatch between income and deprivation measures of poverty. Using the first two waves of the European Community Household Panel Survey, a measure of relative deprivation is constructed and the overlap between the relative income poor and relatively deprived is examined, There is very limited overlap with the lowest relative income threshold. The overlap increases as the income threshold is raised, but it remains true that less than half those below the 60 percent relative income line are among the most deprived. Relative deprivation is shown to be related to the persistence of income poverty, but also to a range of other resource and need factors. Income and deprivation measures each contain information that can profitably be employed to enhance our understanding of poverty and a range of other social phenomena. This is illustrated by the manner in which both income poverty and relative deprivation are associated with self-reported difficulty making ends meet.

Targeting poverty: Lessons from monitoring Ireland's national anti-poverty strategy

In 1997 the Irish government adopted the National Anti-Poverty Strategy (NAPS), a global target for the reduction of poverty which illuminates a range of issues relating to official poverty targets. The Irish target is framed in terms of a relative poverty measure incorporating both relative income and direct measures of deprivation based on data on the extent of poverty from 1994. Since 1994 Ireland has experienced an unprecedented period of economic growth that makes it particularly important to assess whether the target has been achieved, but in doing so we cannot avoid asking some underlying questions about how poverty should be measured and monitored over time. After briefly outlining the nature of the NAPS measure, this article examines trends in poverty in Ireland between 1987 and 1997, Results show that the relative income and deprivation components of the NAPS measure reveal differential trends with increasing relative income poverty, but decreasing deprivation. However, this differential could be due to the fact that the direct measures of deprivation upon which NAPS is based have not been updated to take account of changes in real living standards and increasing expectations. To test whether this is so, we examine the extent to which expectations about living standards and the structure of deprivation have changed over time using confirmatory factor analysis and tests of criterion validity using different definitions of deprivation. Results show that the combined income and deprivation measure, as originally constituted, continues to identify a set of households experiencing generalised deprivation resulting from a lack of resources.

Urban housing and the role of 'underclass' processes: the case of Ireland

Rising levels of urban deprivation and a perception that poverty has become more concentrated in such areas and has taken on a qualitatively different character have provoked a variety of popular and academic responses. The potentially most fruitful set of hypotheses focuses on the unintended of weak labour force attachment and social isolation is perceived to lead to behaviour and orientations that contribute to a vicious circle of deprivation. In examining the value of this conceptual framework in the Irish case we proceed by measuring directly the social-psychological factors which ave hypothesized to mediate the 'underclass' process.

A significantly higher level of poverty is found in urban public-sector tenant households. This finding cannot be accounted for entirely by socio-demographic differences. It is the assessment of this net or residual effect that is crucial to an evaluation of vicious circle explanations. Controlling for the critical social-psychological factors we found that net effect was reduced by less than a quarter and concluded that the remaining effect is more plausibly attributed to the role of selection than to underclass processes. Analysis of the changing relationship between urban public-sector tenancy and poverty provides support for this interpretation.

For the main part the distinctiveness of social housing tenants is a consequence of the disadvantages they stiffer in relation to employment opportunities and living standards. Ultimately it is these problems that policy interventions, whatever the level at which they take place, must address.

Analyzing Intergenerational Influences on Income Poverty & Economic Vulnerability with EU-SILC

The European Union Statistics of Income and Living Conditions
(EU-SILC) 2005 wave includes a special module on inter-generational
transmission of poverty. In addition to the standard data relating to income
and material deprivation, information relating to parental background and
childhood circumstances was collected for all household members aged over
24 and less than 66 at the end of the income reference period. In principle,
the module provides an unprecedented opportunity to apply a welfare regime
perspective to a comparative European analysis of the relationship between
poverty and social exclusion and parental characteristics and childhood
economic circumstances. In this paper, we seek to exploit such potential. In
pursuing this objective, it is necessary to take into account some of the
limitations of the data. We do by restricting our attention to a set of
countries where data issues seem less extreme. Finally, we compare findings
from one dimensional and multidimensional approaches to poverty and social
exclusion in order to provide an assessment of the extent to which our
analysis of welfare regime variation provides a coherent account of the
intergenerational transmission of disadvantage.

Social class, unemployment, and psychological distress

Attempts to explain variation in rates of psychological distress by social class have included reference to social selection, differential exposure to stress, and differential vulnerability arising from inequalities in access to resources. Our analysis draws on data from a national survey of the Republic of Ireland in order to examine these hypotheses. No evidence to support the social selection hypothesis was found. In addressing the issue of differential responsiveness, attention was focused on the interaction between unemployment and social class in their impact on psychological distress. While rather weak support for the hypothesis of differential vulnerability was found among women, our examination of the impact of husband's unemployment provided no evidence leading in this direction. Among men unemployment actually had a stronger impact for men in higher social classes. The major factors leading to social class differences in psychological distress are greater exposure to unemployment and economic deprivation. © 1994 Oxford University Press.

Description and predictors of hospital costs of oesophageal cancer during the first year following diagnosis in Northern Ireland

The cost-effectiveness of novel interventions in the treatment of cancer is well researched; however, relatively little attention is paid to the cost of many aspects of routine care. Oesophageal cancer is the ninth most common cancer in the UK and sixth most common cause of cancer death. It usually presents late and has a poor prognosis. The hospital costs incurred by oesophageal cancer patients diagnosed in Northern Ireland in 2005 (n = 198) were determined by review of medical records. The average cost of hospital care per patient in the 12 months from presentation was £7847. Variations in total hospital costs by age at diagnosis, gender, cancer stage, histological type, mortality at 1 year, co-morbidity count and socio-economic status were analysed using multiple regression analyses. Higher costs were associated with earlier stages of cancer and cancer stage remained a significant predictor of costs after controlling for cancer type, patient age and mortality at 1 year. Thus, although early detection of cancer usually improves survival, this would mean increased costs in the first year. Deprivation achieved borderline significance with those from more deprived areas having lower resource consumption relative to the more affluent. © 2013 John Wiley & Sons Ltd.

The Great Recession and the changing distribution of economic vulnerability by social class:The Irish case

Ireland provides an interesting case study of the distributional consequences of the Great Recession. To explore such effects we develop a measure of economic vulnerability based on a multidimensional risk profile for income poverty, material deprivation and economic stress. In the context of conflicting expectations of trends in social class differentials, we provide a comparison of pre and post-recession periods. Our analysis reveals a doubling of levels of economic vulnerability and a significant change in multidimensional profiles. Income poverty became less closely associated with material deprivation and economic stress and the degree of polarization between vulnerable and non-vulnerable classes was significantly reduced. Economic vulnerability is highly stratified by social class for both pre and post-recession periods. Focusing on absolute change, the main contrast is between the salariat and the non-agricultural self-employed and the remaining classes; providing some support for notions of polarization. In terms of relative change the higher salariat, the non-agricultural self-employed, the semi-unskilled manual and those who never worked gained relative to the remaining classes. This provides support the notion of ‘middle class squeeze’. The changing relationship between social class and household work intensity reflected a similar pattern. The impact of the latter on economic vulnerability declined sharply, while it came to play an increasing role in mediating the impact of membership of the non-agricultural middle classes. Responding to the political pressures likely to be associated with ‘middle class squeeze’ while sustaining the social welfare arrangements that have traditionally protected the economically vulnerable presents formidable challenges in terms of maintaining social cohesion and political legitimacy.

Multidimensional poverty measurement in Europe:An application of the adjusted headcount approach

As awareness of the limitations of relying solely on income to measure poverty has become more widespread, attention has been increasingly focused on multi-dimensional approaches, to the point where the EU has adopted a multidimensional poverty and social exclusion target for 2020. The rationale advanced is that the computation of a multidimensional poverty index is an effective way of communicating in a political environment, and a necessary tool in order to monitor 27 different national situations. By contrast with the rather ad hoc way in which the EU 2020 poverty target has been framed and rationalised, the adjusted head count ratio applied here has a number of desirable axiomatic properties. It constitutes a significant improvement on union and intersection approaches and allows for the decomposition of multidimensional poverty in terms of dimensions of deprivation and socio-economic attributes. Since understanding poverty as multidimensional does not necessarily require constructing a multidimensional poverty index, on the basis of our analysis we provide a more general consideration of the value of developing a multidimensional index of poverty for the European Union.

Physical activity assessment in practice: a mixed methods study of GPPAQ use in primary care

Background: Insufficient physical activity (PA) levels which increase the risk of chronic disease are reported by almost two-thirds of the population. More evidence is needed about how PA promotion can be effectively implemented in general practice (GP), particularly in socio-economically disadvantaged communities. One tool recommended for the assessment of PA in GP and supported by NICE (National Institute for Health and Care Excellence) is The General Practice Physical Activity Questionnaire (GPPAQ) but details of how it may be used and of its acceptability to practitioners and patients are limited. This study aims to examine aspects of GPPAQ administration in non-urgent patient contacts using different primary care electronic recording systems and to explore the views of health professionals regarding its use.

Methods: Four general practices, selected because of their location within socio-economically disadvantaged areas, were invited to administer GPPAQs to patients, aged 35-75 years, attending non-urgent consultations, over two-week periods. They used different methods of administration and different electronic medical record systems (EMIS, Premiere, Vision). Participants’ (general practitioners (GPs), nurses and receptionists) views regarding GPPAQ use were explored via questionnaires and focus groups.

Results: Of 2,154 eligible consultations, 192 (8.9%) completed GPPAQs; of these 83 (43%) were categorised as inactive. All practices were located within areas ranked as being in the tertile of greatest socio-economic deprivation in Northern Ireland. GPs/nurses in two practices invited completion of the GPPAQ, receptionists did so in two. One practice used an electronic template; three used paper copies of the questionnaires. End-of-study questionnaires, completed by 11 GPs, 3 nurses and 2 receptionists and two focus groups, with GPs (n = 8) and nurses (n = 4) indicated that practitioners considered the GPPAQ easy to use but not in every consultation. Its use extended consultation time, particularly for patients with complex problems who could potentially benefit from PA promotion.

Conclusions: GPs and nurses reported that the GPPAQ itself was an easy tool with which to assess PA levels in general practice and feasible to use in a range of electronic record systems but integration within routine practice is constrained by time and complex consultations. Further exploration of ways to facilitate PA promotion into practice is needed.

Characterisation of the active/de-active transition of mitochondrial complex I

Oxidation of NADH in the mitochondrial matrix of aerobic cells is catalysed by mitochondrial complex I. The regulation of this mitochondrial enzyme is not completely understood. An interesting characteristic of complex I from some organisms is the ability to adopt two distinct states: the so-called catalytically active (A) and the de-active, dormant state (D). The A-form in situ can undergo de-activation when the activity of the respiratory chain is limited (i.e. in the absence of oxygen). The mechanisms and driving force behind the A/D transition of the enzyme are currently unknown, but several subunits are most likely involved in the conformational rearrangements: the accessory subunit 39 kDa (NDUFA9) and the mitochondrially encoded subunits, ND3 and ND1. These three subunits are located in the region of the quinone binding site. The A/D transition could represent an intrinsic mechanism which provides a fast response of the mitochondrial respiratory chain to oxygen deprivation. The physiological role of the accumulation of the D-form in anoxia is most probably to protect mitochondria from ROS generation due to the rapid burst of respiration following reoxygenation. The de-activation rate varies in different tissues and can be modulated by the temperature, the presence of free fatty acids and divalent cations, the NAD/NADH ratio in the matrix, the presence of nitric oxide and oxygen availability. Cysteine-39 of the ND3 subunit, exposed in the D-form, is susceptible to covalent modification by nitrosothiols, ROS and RNS. The D-form in situ could react with natural effectors in mitochondria or with pharmacological agents. Therefore the modulation of the re-activation rate of complex I could be a way to ameliorate the ischaemia/reperfusion damage. This article is part of a Special Issue entitled: 18th European Bioenergetic Conference. Guest Editors: Manuela Pereira and Miguel Teixeira.

Exploring lay views on physical activity and their implications for public health policy. A case study from East Belfast

It is now recognised that inactive lifestyles underpin much of the disease burden evident in the richer nations of the world. Indeed, the WHO has identified physical inactivity as a 'global public health problem' and has established minimum physical activity (PA) targets for people at different stages of the life-course. Yet, according to WHO, just under 1/3 of working age adults across the globe meet those targets and it is not at all clear how the disjunction between the recommendations of policy makers and the behaviour of ordinary people might be surmounted. Using an opportunity to examine the impact of an urban regeneration project on community residents in East Belfast (Northern Ireland) this paper examines the views of some 113 people on how to increase rates of PA in an area of multiple deprivation. The results of the analysis suggest that lay people rarely consider PA as a discrete issue, or one that centres on individuals and their motivation, but rather as one component in a complex web of concerns, processes and events that include such things as the actions of neighbours and relatives, material and political environments, vandalism, violence, and the weather. We explore and unravel the nature of those concerns using novel methods of content analysis that generate 'issue webs'. Particular attention is paid to the ways in which lay people conceptualize 'activity' and to the manner in which they point to ways of encouraging activity that are rooted in everyday life rather than in the corpocentric, agent-centred and often sport dominated strategies favoured by local policy makers. Our results support those who argue that interventions to increase rates of PA need to move beyond behavioural approaches that focus on individuals and consider the social, political and material contexts in which 'activity' occurs.

Behavioural outcomes at 3 years of age among late preterm infants admitted to neonatal intensive care: a cohort study

Objective: Examine the behavioural outcomes at age 3 years of late preterm infants (LPIs) who were admitted to neonatal intensive care (NIC) in comparison with LPIs who were not admitted.
Method: This cohort study prospectively recruited 225 children born late preterm (34–36+6 weeks gestation) in 2006 in Northern Ireland, now aged 3 years. Two groups were compared: LPIs who received NIC (study; n=103) and LPIs who did not receive NIC (control; n=122). Parents/guardians completed the Child Behaviour Checklist/1½-5. Descriptive maternal and infant data were also collected.
Results: As expected LPI children admitted to NIC had higher medical risk than the non-admitted comparison group (increased caesarean section, born at earlier gestation, lower birth weight and an episode of resuscitation at birth). LPIs admitted to NIC scored higher on the Child Behaviour Checklist/1½-5 compared with those who were not admitted indicating more behavioural problems; this was statistically significant for the Aggressive Behaviour Subscale (z=−2.36) and the Externalising Problems Scale (z=−2.42). The group difference on the Externalising Problems Scale was no longer significant after controlling for gender, gestational age and deprivation score.
Conclusions: This study provides valuable data on the behaviour at age 3 years of LPIs admitted to NIC compared with LPIs not admitted to NIC. Further research would be beneficial to explore medical and psychosocial explanations for observed differences between groups using large prospective cohort studies.