Low health-related quality of life in school-aged children in Tonga, a lower-middle income country in the South Pacific

Background:
Ensuring a good life for all parts of the population, including children, is high on the public health agenda in most countries around the world. Information about children’s perception of their health-related quality of life (HRQoL) and its socio-demographic distribution is, however, limited and almost exclusively reliant on data from Western higher income countries.

Objectives:
To investigate HRQoL in schoolchildren in Tonga, a lower income South Pacific Island country, and to compare this to HRQoL of children in other countries, including Tongan children living in New Zealand, a high-income country in the same region.

Design:
A cross-sectional study from Tonga addressing all secondary schoolchildren (11–18 years old) on the outer island of Vava’u and in three districts of the main island of Tongatapu (2,164 participants). A comparison group drawn from the literature comprised children in 18 higher income and one lower income country (Fiji). A specific New Zealand comparison group involved all children of Tongan descendent at six South Auckland secondary schools (830 participants). HRQoL was assessed by the self-report Pediatric Quality of Life Inventory 4.0.

Results:
HRQoL in Tonga was overall similar in girls and boys, but somewhat lower in children below 15 years of age. The children in Tonga experienced lower HRQoL than the children in all of the 19 comparison countries, with a large difference between children in Tonga and the higher income countries (Cohen’s d 1.0) and a small difference between Tonga and the lower income country Fiji (Cohen’s d 0.3). The children in Tonga also experienced lower HRQoL than Tongan children living in New Zealand (Cohen’s d 0.6).

Conclusion:
The results reveal worrisome low HRQoL in children in Tonga and point towards a potential general pattern of low HRQoL in children living in lower income countries, or, alternatively, in the South Pacific Island countries.

Geo-identity, urban school choice and education campaigns for public schools

Educational campaigning has received little attention in the literature. This study investigates long-term and organised urban campaigns that are collectively lobbying the Victorian State Government in Australia, for a new public high school to be constructed in their suburb. A public high school is also known as a state school, government school, or an ordinary comprehensive school. It receives the majority of its funding from the State and Federal Australian Government, and is generally regarded as ‘free’ education, in comparison to a private school. Whilst the campaigners frame their requests as for a ‘public school’, their primary appeal is for a local school in their community. This study questions how collective campaigning for a locale-specific public school is influenced by geography, class and identity. In order to explore these campaigns, I draw on formative studies of middle-class school choice from an Australian and United Kingdom perspective (Campbell, Proctor, & Sherington, 2009; Reay, Crozier, & James, 2011). To think about the role of geography and space in these processes of choice, I look to apply Harvey’s (1973) theory of absolute, relational and relative space. I use Bourdieu (1999b) as a sociological lens that is attentive to “site effects” and it is through this lens that I think about class as a “collection of properties” (Bourdieu, 1984, p. 106), actualised via mechanisms of identity and representation (Hall, 1996; Rose, 1996a, 1996b). This study redresses three distinct gaps in the literature: first, I focus attention on a contemporary middle-class choice strategy—that is, collective campaigning for a public school. Research within this field is significantly under-developed, despite this choice strategy being on the rise. Second, previous research argues that certain middle-class choosers regard the local public school as “inferior” in some way (Reay, et al., 2011, p. 111), merely acting as a “safety net” (Campbell, et al., 2009, p. 5) and connected to the working-class chooser (Reay & Ball, 1997). The campaigners are characteristic of the middle-class school chooser, but they are purposefully and strategically seeking out the local public school. Therefore, this study looks to build on work by Reay, et al. (2011) in thinking about “against-the-grain school choice”, specifically within the Australian context. Third, this study uses visual and graphic methods in order to examine the influence of geography in the education market (Taylor, 2001). I see the visualisation of space and schooling that I offer in this dissertation as a key theoretical contribution of this study. I draw on a number of data sets, both qualitative and quantitative, to explore the research questions. I interviewed campaigners and attended campaign meetings as participant observer; I collected statistical data from fifteen different suburbs and schools, and conducted comparative analyses of each. These analyses are displayed by using visual graphs. This study uses maps created by a professional graphic designer and photographs by a professional photographer; I draw on publications by the campaigners themselves, such as surveys, reports and social media; but also, interviews with campaigners that are published in local or state newspapers. The multiple data sets enable an immersive and rich graphic ethnography. This study contributes by building on understandings of how particular sociological cohorts of choosers are engaging with, and choosing, the urban public school in Australia. It is relevant for policy making, in that it comes at a time of increasing privatisation and a move toward independent public schools. This study identifies cohorts of choosers that are employing individual and collective political strategies to obtain a specific school, and it identifies this cohort via explicit class-based characteristics and their school choice behaviours. I look to use fresh theoretical and methodological approaches that emphasise space and geography, theorising geo-identity and the pseudo-private school

Politics, religion and morals: the symbolism of public schooling for the urban middle-class identity

Research points to sections of the middle-class repopulating the ‘ordinary’ urban public school and whilst there are key differences in how they are navigating public school choices, from ‘seeking a critical mass’ (Posey-Maddox, Kimelberg, and Cucchiara 2014) to resisting traditional methods of choice and going ‘against-the-grain’ (Reay, Crozier, and James 2013), or collectively campaigning for a brand new public school, the urban middle-class are developing contemporary methods to challenge the existing ways of thinking about middle-class choice. Drawing on this literature, this paper explores the symbolism of public schooling for relatively affluent choosers in the city of Melbourne, Australia. The positioning of public schooling as essentially secular and liberal indicates how the public school is valorised within the contemporary market place. Within a market that tends to under-sell the public school, the perceived lack of organized religion and progressivism may be the unique selling point for the cosmopolitan, globalized consumer.

Middle-class school choice in urban spaces: the economics of public schooling and globalized education reform

Middle-class School Choice in Urban Spaces examines government-funded public schools from a range of perspectives and scholarship in order to examine the historical, political and economic conditions of public schooling within a globalized, post-welfare context. In this book, Rowe argues that post-welfare policy conditions are detrimental to government-funded public schools, as they engender consistent pressure in rearticulating the public school in alignment with the market, produce tensions in serving the more historical conceptualizations of public schooling, and are preoccupied by contemporary profit-driven concerns.Chapters focus on public schooling from different global perspectives, with examples from Chile and the US, to examine how various social movements encapsulate ideologies around public schooling. Rowe also draws upon a rich, five-year ethnographic study of campaigns lobbying the Victorian State Government in Australia for a brand-new, local-specific public school. Critical attention is paid to the public school as a means to achieve empowerment and overcome discrimination, and both a local and global lens are used to identify how parents choose the public school, the values they attach to it, and the strategies they use to obtain it. Also considered, however, are how quality gaps, distances and differences between public schools threaten to undermine the democracy of education as a means for individuals to be socially mobile and escape poverty.This book makes an important contribution to our understanding of global social movements and activism around public education. As such, it will be of key interest to researchers, academics and postgraduate students in the field of education, specifically those working on school choice, class and identity, as well as educational geography.

Shopping for schools or shopping for peers : public schools and catchment area segregation

Market theory positions the consumer as a rational choice actor, making informed schooling choices on the basis of ‘hard’ evidence of relative school effectiveness. Yet there are concerns that parents simply choose schools based on socio-demographic characteristics, thus leading to greater social segregation and undercutting the potential of choice to drive quality improvements. In this paper we explore segregation by examining catchment areas for a range of public high schools in a specific middle-class urban area. We focus on socio-demographic characteristics, including levels of income, country of birth and religion affiliation, in order to explore residential segregation according to public high school catchment areas. Our data suggests distinct residential segregation between catchment areas for each public school within our dataset, particularly for the schools deemed to be popular and rejected, that may pose risks for broader equity concerns. We argue that, in contrast to market theory, even more affluent and active choosers are not equipped with information on the programmatic quality of their different school options, but instead may be relying on socio-demographic characteristics of schools—through surrogate information about the urban spaces that the schools occupy—in order to choose peer groups, if not programs, for their children.