Impact of average household income and damage exposure on post-earthquake distress and functioning: A community study following the February 2011 Christchurch earthquake.

Post-traumatic stress, depression and anxiety symptoms are common outcomes following earthquakes, and may persist for months and years. This study systematically examined the impact of neighbourhood damage exposure and average household income on psychological distress and functioning in 600 residents of Christchurch, New Zealand, 4–6 months after the fatal February, 2011 earthquake. Participants were from highly affected and relatively unaffected suburbs in low, medium and high average household income areas. The assessment battery included the Acute Stress Disorder Scale, the depression module of the Patient Health Questionnaire (PHQ-9), and the Generalized Anxiety Disorder Scale (GAD-7), along with single item measures of substance use, earthquake damage and impact, and disruptions in daily life and relationship functioning. Controlling for age, gender and social isolation, participants from low income areas were more likely to meet diagnostic cut-offs for depression and anxiety, and have more severe anxiety symptoms. Higher probabilities of acute stress, depression and anxiety diagnoses were evident in affected versus unaffected areas, and those in affected areas had more severe acute stress, depression and anxiety symptoms. An interaction between income and earthquake effect was found for depression, with those from the low and medium income affected suburbs more depressed. Those from low income areas were more likely, post-earthquake, to start psychiatric medication and increase smoking. There was a uniform increase in alcohol use across participants. Those from the low income affected suburb had greater general and relationship disruption post-quake. Average household income and damage exposure made unique contributions to earthquake-related distress and dysfunction.

Willingness to pay for potential enhancements to a low-cost cataract surgical package in rural southern China.

PURPOSE: To assess determinants of patients' willingness to pay (WTP) for potential components of a multi-tiered cataract surgical package offered by a non-governmental organization (NGO) in rural China. DESIGN: Cross-sectional study. METHODS: Demographic and clinical data were collected from 505 patients presenting for cataract screening or surgery in Yangjiang, China. Willingness to pay for potential enhancements to the current surgery package was assessed using a bidding format with random payment cards. RESULTS: Among 426 subjects (84.4%) completing interviews, the mean age was 73.9 ± 7.3 years, 67.6% were women and 73% (n = 310) would pay for at least one offering, with 33-38% WTP for each item. Among those who would pay, the mean WTP for food was US$1.68 ± 0.13, transportation US$3.24 ± 0.25, senior surgeon US$50.0 ± 3.36 and US$89.4 ± 4.19 for an imported intra-ocular lens (IOL). The estimated total recovery from these enhancements under various assumptions would be US$20-50 (compared to the current programme price of US$65). In multivariate models, WTP for the senior surgeon increased with knowledge of a person previously operated for cataract (OR = 2.13, 95% CI 1.42-3.18, p < 0.001). Willingness to pay for the imported IOL increased with knowledge of a previously operated person (OR = 1.85, 95% CI 1.24-2.75, p < 0.01) and decreased with age >75 years (OR = 0.61, 0.40-0.93, p < 0.05). CONCLUSIONS: Opportunities exist to increase cataract programme revenues through multi-tiered offerings in this setting, allowing greater subsidization of low-income patients. Personal familiarity with cataract surgery is important in determining WTP. © 2011 The Authors. Acta Ophthalmologica © 2011 Acta Ophthalmologica Scandinavica Foundation.

The role of molecular, clinical and socioeconomic factors in the long-term survival of axillary node negative breast cancer patients

The overall objective of this study was to investigate factors associated with long-term survival in axillary node negative (ANN) breast cancer patients. Clinical and biological factors included stage, histopathologic grade, p53 mutation, Her-2/neu amplification, estrogen receptor status (ER), progesterone receptor status (PR) and vascular invasion. Census derived socioeconomic (SES) indicators included median individual and household income, proportions of university educated individuals, housing type, "incidence" of low income and an indicator of living in an affluent neighbourhood. The effects of these measures on breast cancer-specific survival and competing cause survival were investigated. A cohort study examining survival among axillary node negative (ANN) breast cancer patients in the greater Toronto area commenced in 1 989. Patients were followed up until death, lost-to-follow up or study termination in 2004. Data were collected from several sources measuring patient demographics, clinical factors, treatment, recurrence of disease and survival. Census level SES data were collected using census geo-coding of patient addresses' at the time of diagnosis. Additional survival data were acquired from the Ontario Cancer Registry to enhance and extend the observation period of the study. Survival patterns were examined using KaplanMeier and life table procedures. Associations were examined using log-rank and Wilcoxon tests of univariate significance. Multivariate survival analyses were perfonned using Cox proportional hazards models. Analyses were stratified into less than and greater than 5 year survival periods to observe whether known markers of short-tenn survival were also associated with reductions in long-tenn survival among breast cancer patients. The 15 year survival probabilities in this cohort were: for breast cancerspecific survival 0.88, competing causes survival 0.89 and for overall survival 0.78. Estrogen receptor (ER) and progesterone receptor (PR) status (Hazard Ratio (HR) ERIPR- versus ER+/PR+, 8.15,95% CI, 4.74, 14.00), p53 mutation (HR, 3.88, 95% CI, 2.00, 7.53) and Her-2 amplification (HR, 2.66, 95% CI, 1.36, 5.19) were associated with significant reductions in short-tenn breast cancer-specific survival «5 years following diagnosis), however, not with long-term survival in univariate analyses. Stage, histopathologic grade and ERiPR status were the clinicallbiologieal factors that were associated with short-term breast cancer specific survival in multivariate results. Living in an affluent neighbourhood (top quintile of median household income compared to the rest of the population) was associated with the largest significant increase in long-tenn breast cancer-specific survival after adjustment for stage, histopathologic grade and treatment (HR, 0.36, 95% CI, 0.12, 0.89).

"Welcome to my life" : the experiences of single mothers who are the recipients of multiple state provided benefits

Abstract This research takes the lens of social reproduction as a starting point for an examination of the effects of recent social welfare reforms on the lives o.fsingle mothers. As the cumulative effects o.f diminishing state provided benefits take hold, tensions are heightened as single mothers internalize the insecurity of earning an income in 11 capitalist labour market, while trying to carry out all that is involved in social reproduction with inadequate means of survival. Through interviewing single mothers who are the recipients of mUltiple state provided benefits (social assistance, student loans, subsidized housing and subsidized childcare), this thesis illuminates the cOl1linued regulation of women in an effort to assure that social reproduction is occurring at the lowest cost possible. State provided benefits are set lip in such a way that it is near impossible for single mothers to make ends meet without entering the labour force or entering into co-residential relationships. This push towards the labour force and/or marriage via punitive welfare policies illuminates the devaluation of the labour that is done at home. Through interviewing 5 single mothers, I will demonstrate the extensive labour that goes into maintaining their households. In addition .J case managers are interviewed. The employees of social assistance, subsidized hOllsing, subsidized childcare and student loans, have much agency in deeming who is worthy of receiving benefits. The employees of these agencies have the ability to make these women's lives easier or more complicated by how the workers interpret the policy regulations. Social policies are of paramount importance in the quest for women's equality and thus have consequences for how women's daily lives are organized. The rules and regulations that govern the individual policies are complex and bureaucratic and have implications for the ways in which women must organize their lives in order to survive. The shifts in social policy have been guided by neo-liberal assumptions with a focus on individual responsibility and a market-modeled welfare state. The caring work that is involved in raising children to be productive in a capitalist society is ignored or devalued in current policies. The emphasis in each polic.:v is on getting women who receive benefits into the paid work force, with little facilitation or investment into the caring work these women do on a daily basis that in turn supports capitalism. Policies, such as social assistance, subsidized housing, subsidized childcare and student loans, are set up in such a way that ignores the reality of women's day-to-day lives and devalues the necessary work done at home. It takes an abundance of labour and strategizing for women to seek out necessary means of survival, labour that is amplified when a woman is dealing with mUltiple slate provided benefits.

The impact of social welfare reform and workfare on lone-parent female headed households in the Niagara Region

This thesis explores the impact of recent social welfare reforms on the lives of social assistance recipients. The focus is on single mothers who are dependent on social assistance in a small city in southern Ontario. This detailed examination is complemented with existing case studies in Canada, the United States and New Zealand, as well as aggregate data on poverty in Canada. Participants for the research study were recruited by flyer distribution and referral. Following recruitment, selected participants were scheduled for a tape- recorded interview. The final sample population consists of eight single mothers on social assistance and/or workfare participants. This information is supplemented with interviews from two Ontario Works caseworkers and two Women's Advocates from a local crisis housing organization. This research project is guided by a socialist feminist framework. Evidence from interview participants suggest that single mothers continue to struggle in terms of meeting basic needs, such as food, clothing and medications. Housing for low-income families is a concern expressed by the participants as well as by Women's Advocates who operate within the region. In addition, subsidized housing continues to be problematic in terms of both safety and availability. Recent social welfare refonns (reductions in welfare income and introduction of workfare features) have intensified the economic and social marginalization of these women. Participants, for example, voice concerns about valuing self-evaluation in their Ontario Works and workfare activities. Considerable evidence from interview participants suggest that single mothers remain economically marginalized.

Les sources d'incohérences des initiatives de financement du logement social au Nicaragua

Le Nicaragua connaît un déficit en logement très préoccupant. Celui-ci est du en grande partie à l’incapacité du secteur financier à satisfaire la demande des familles à faible revenu. De nombreuses initiatives ont été mises en place par des organismes provenant des trois sphères sociétales pour pallier ce problème. Certains l’ont fait avec succès d’autres sans. Aujourd’hui bien que ces initiatives aient comme objectif de répondre au problème existant, le déficit continu de se creuser. Ce mémoire propose une analyse des causes du problème afin de comprendre pourquoi les initiatives mises en place ne fonctionnent pas comme elles le devraient. Il met en avant le manque de coordination qui existe enter les acteurs et démontre que l’ensemble du secteur fonctionne selon une organisation « en silo » révélatrice d’un manque de cohérence des politiques de financement du logement. Enfin il analyse les origines possibles d’une telle organisation et des incohérences politiques qui l’ont amenée. Par cette analyse, il tente de déterminer la part de responsabilité relative imputable à l’État nicaraguayen et à l’Aide Publique au Développement qui est la principale source de fonds de tous ces programmes.

Étude exploratoire du soutien social dans le processus menant à l'hébergement des aînés en perte d'autonomie

Contexte : Au Québec, la très grande majorité des personnes âgées vivent dans un logement conventionnel. Pour celles qui sont en plus grande perte d’autonomie et qui ont besoin d’un environnement adapté à leurs besoins, soit environ 12 % de la population âgée de 65 ans ou plus en 2006, les options sont relativement limitées. Au 1er rang, on retrouve les résidences privées, pour ceux et celles qui en ont les moyens. Pour les autres, il y a les centres de soins de longue durée publics ou privés. Viennent ensuite les organismes sans but lucratif qui opèrent des projets résidentiels pour aînés, les communautés religieuses qui accueillent des personnes âgées dans leurs résidences, les ressources intermédiaires, les ressources de type familial, les habitations à loyer modique pour personnes âgées et les coopératives d’habitation. Les ressources alternatives du type projets novateurs arrivent en dernière position, ce qui explique que l’on en sait encore très peu sur la transition vers ce type d’hébergement. Problème et objet de recherche : La transition vers un milieu de vie substitut est un processus qui peut être potentiellement stressant dans la vie d’une personne âgée. Son réseau de soutien peut être appelé à jouer un rôle important pour l’aider à vivre cette transition avec plus de facilité. Si la littérature sur le soutien social est abondante, elle est plus limitée en ce qui concerne la relation entre le soutien social et la transition en milieu d’hébergement. La plupart des travaux recensés étudient les conséquences de l’hébergement durant les mois qui suivent le relogement. Quelques études analysent le processus décisionnel mais rares sont celles qui s’intéressent à toutes les étapes du processus qui précèdent le relogement. La plupart des recherches analysent surtout le point de vue des aidants et parfois celui des professionnels. Celui des personnes âgées est moins connu. But et objectifs : Le but de cette étude consiste à mieux comprendre comment opèrent les différentes formes de soutien social auprès des personnes âgées durant les diverses étapes du processus de transition en milieu d’hébergement. Plus précisément, elle vise à mieux comprendre comment ces personnes perçoivent les différents types de soutien apporté par leur réseau de soutien durant la transition, la signification que prend pour elles l’aide reçue, les besoins auxquels répond le soutien reçu et pourquoi elles apprécient ou non le soutien reçu. Cadre conceptuel : Cette recherche de type exploratoire et rétrospective se situe dans une approche des parcours de vie. La transition en milieu d’hébergement est étudiée comme un processus faisant partie de la trajectoire résidentielle de la personne. On privilégie une approche interactionnelle et constructiviste du soutien social qui accorde une attention plus grande aux interprétations subjectives des personnes faisant partie des réseaux de soutien. Méthodologie : On a interviewé huit (8) résidents (6 femmes et 2 hommes) de 64 ans ou plus, vivant dans un milieu d’hébergement alternatif de type projet novateur : les Habitations St-Christophe, une ressource alternative située dans la ville de Laval au Québec. Les perceptions des sujets du soutien social reçu durant la transition sont analysées à l’aide de la théorisation ancrée, la plus appropriée pour comprendre de l’intérieur le point de vue des participants. Résultats : L’analyse des perceptions des résidents interviewés du processus qui les a conduits aux Habitations St-Christophe a permis de mieux comprendre l’influence de leurs trajectoires résidentielles, les transitions ayant mené à leur hébergement, leurs perceptions du processus décisionnel et du rôle joué par des tiers dans les décisions prises, ainsi que les motifs de ces décisions, de même que le rôle joué par le soutien social durant la transition. Trois modèles de réseaux ont été identifiés, en tenant compte de la fréquence des contacts, de l’intensité des liens et de la disponibilité du soutien. Les formes les plus importantes de soutien reçu ont été identifiées à partir des perceptions des sujets de l’aide émotionnelle, instrumentale et cognitive fournie pendant la transition et de leur appréciation du soutien reçu. L’analyse a permis d’identifier deux modèles de transition (transition réfléchie, préparée et anticipée versus transition précipitée) et deux modèles de soutien (soutien valorisé versus soutien peu valorisé). Conclusions : Outre les éléments de convergence et les points de divergence observés entre nos résultats et la littérature, un certain nombre d’enseignements ont été retenus au niveau de l’intervention. Ceux-ci concernent les conditions gagnantes à mettre en place par les gestionnaires des services publics, certains principes à respecter dans les interventions, les mesures à prendre pour améliorer les interventions des professionnels et les interventions à mettre en place à l’intention des personnes âgées et de leurs proches aidants.

Poverty targeting and income impact of subsidised credit on accessed households in the Northern Mountainous Region of Vietnam

This paper uses the data of 1338 rural households in the Northern Mountainous Region of Vietnam to examine the extent to which subsidised credit targets the poor and its impacts. Principal Component Analysis and Propensity Score Matching were used to evaluate the depth of outreach and the income impact of credit. To address the problem of model uncertainty, the approach of Bayesian Model Average applied to the probit model was used. Results showed that subsidised credit successfully targeted the poor households with 24.10% and 69.20% of clients falling into the poorest group and the three bottom groups respectively. Moreover, those who received subsidised credit make up 83% of ethnic minority households. These results indicate that governmental subsidies are necessary to reach the poor and low income households, who need capital but are normally bypassed by commercial banks. Analyses also showed that ethnicity and age of household heads, number of helpers, savings, as well as how affected households are by shocks were all factors that further explained the probability at which subsidised credit has been assessed. Furthermore, recipients obtained a 2.61% higher total income and a 5.93% higher farm income compared to non-recipients. However, these small magnitudes of effects are statistically insignificant at a 5% level. Although the subsidised credit is insufficient to significantly improve the income of the poor households, it possibly prevents these households of becoming even poorer.

La movilidad residencial de los hogares con bajos ingresos y jefatura femenina en el área

En este artículo se analizan algunos aspectos de la movilidad residencial de los hogares con bajos ingresos y jefatura femenina en el área metropolitana de Bogotá. Para ello, se examinan los datos producidos por la encuesta de movilidad 2009 y una serie de entrevistas realizadas en el Proyecto “Metrópolis de América Latina en la globalización: reconfiguraciones territoriales, movilidad espacial, acción pública”, Metal. Se presenta un contexto a partir de algunos indicadores censales y, en seguida, algunos resultados de la encuesta: en primer lugar, características de las jefas de hogar como edad, estado conyugal, ocupación, grado educativo; posteriormente, sobre las zonas donde residen, en particular, su localización en el área metropolitana y la morfología del barrio. Por último, aspectos como la tenencia, el tipo de vivienda, la localización de las redes familiares y el ciclo vital del hogar.

Factores asociados a deficiencia de zinc en niños colombianos entre 1 y 4 años de edad

Introducción: Las deficiencias de micronutrientes continúan siendo un problema de salud pública en la población infantil, dentro de las ellas se ha encontrado a la deficiencia de zinc causa importante de morbi-mortalidad en los países en desarrollo, la nutrición adecuada de zinc es esencial para un crecimiento adecuado, inmunocompetencia y desarrollo neuroconductual; se dispone de información insuficiente sobre el estado de zinc en la población preescolar lo cual dificulta la expansión de las intervenciones para el control de su deficiencia. Colombia presenta una deficiencia de este micronutriente, considerándose a nivel mundial como un problema de salud pública moderado a severo. Una evaluación sobre la prevalencia y factores determinantes asociados puede proporcionar datos sobre el riesgo de deficiencia de zinc en una población, considerando factores demográficos, sociales y nutricionales que podrían predisponer a la población preescolar colombiana a sufrir este déficit. Metodología: Estudio observacional de corte transversal que incluyó 4275 niños entre 1 y 4 años, utilizando datos de la Encuesta Nacional de Situación Nutricional (ENSIN-2010). Se realizaron análisis bivariados y multivariados para determinar factores asociados positiva y negativamente con deficiencia de zinc. Resultados: El 49,1% de los niños encuestados cursaban con deficiencia de zinc. Los factores de riesgo asociados a deficiencia de zinc encontrados fueron menor edad, peso y talla bajos, vivir en región Atlántica, región Central, Territorios Nacionales, vivienda en área de población dispersa, pertenencia a etnia afrocolombiana, pertenencia a etnia indígena, estar afiliado a régimen subsidiado, no estar afiliado a ningún régimen de salud, madre sin educación, no asistencia a programa de alimentación dirigido y el grado severo de inseguridad Conclusiones: El déficit de zinc en los niños entre 1 y 4 años de edad es multifactorial, siendo un reflejo probable de la situación de inequidad de la población colombiana, en especial, la más pobre y vulnerable. Palabras clave: Zinc, Deficiencia de zinc, factores asociados, niños entre 1 y 4 años, Colombia

The politics of in-work benefits: The case of the ‘active income of solidarity’ in France

In-work benefits have been introduced in a number of Bismarckian welfare regimes in a context of austerity despite being targeted at politically weak constituents and representing a deviation from prevailing welfare institutions. This article addresses this puzzle by looking at the introduction in 2008 of an in-work benefit scheme in France, the Active Income of Solidarity. The analysis reveals that this reform was the result of a cross-cutting alliance between the conservative party and employers, as well as parts of the socialist party and the union movement. The alliance was possible thanks to actors’ multiple interpretations of the reform. The reform was difficult to oppose given its support by experts and public opinion and because it entailed an increase in revenues for low-income workers.

Intersections of Jane Jacobs’ conditions for diversity and low-carbon urban systems: a look at four global cities

Countless cities are rapidly developing across the globe, pressing the need for clear urban planning and design recommendations geared towards sustainability. This article examines the intersections of Jane Jacobs’ four conditions for diversity with low-carbon and low-energy use urban systems in four cities around the world: Lyon (France), Chicago (United-States), Kolkata (India), and Singapore (Singapore). After reviewing Jacobs’ four conditions for diversity, we introduce the four cities and describe their historical development context. We then present a framework to study the cities along three dimensions: population and density, infrastructure development/use, and climate and landscape. These cities differ in many respects and their analysis is instructive for many other cities around the globe. Jacobs’ conditions are present in all of them, manifested in different ways and to varying degrees. Overall we find that the adoption of Jacobs' conditions seems to align well with concepts of low-carbon urban systems, with their focus on walkability, transit-oriented design, and more efficient land use (i.e., smaller unit sizes). Transportation sector emissions seems to demonstrate a stronger influence from the presence of Jacobs' conditions, while the link was less pronounced in the building sector. Kolkata, a low-income, developing world city, seems to possess many of Jacobs' conditions, while exhibiting low per capita emissions - maintaining both of these during its economic expansion will take careful consideration. Greenhouse gas mitigation, however, is inherently an in situ problem and the first task must therefore be to gain local knowledge of an area before developing strategies to lower its carbon footprint.

Coordination, inclusiveness and wage inequality between median and bottom income workers

What explains cross-national variation in wage inequality? Research in comparative political economy stresses the importance of the welfare state and wage coordination in reducing not only disposable income inequality but also gross earnings inequality. However, the cross-national variation in gross earnings inequality between median and low income workers is at odds with this conventional wisdom: the German coordinated market economy is now more unequal in this type of inequality than the UK, a liberal market economy. To solve this puzzle, I argue that non-inclusive coordination benefits median but not bottom income workers and is as a result associated with higher – rather than lower - wage inequality. I find support for this argument using a large N quantitative analysis of wage inequality in a panel of Western European countries. Results are robust to the inclusion of numerous controls, country fixed effects, and also hold with a sample of OECD countries. Taken together these findings force us to reconsider the relationship between coordination and wage inequality at the bottom of the income distribution.

A incorporação de gênero nos programas habitacionais: equívocos e conceitos

The integration of gender into Public Policies is understood as the recognition of the fact that the population is not homogeneous, but marked by differences. If the intention of Public Policies is to attend the different needs of the population and not to discriminate against any group, these differences have to be apprehended. Depending on how the issues of gender are integrated into policies, there is a danger of them being reduced to a blueprint list that has to be fulfiled which could transform their elaboration into a technical activity distancing it from the needs of the target group. This research intends to discuss the assumption behind low-income women which could jeopardize the elaboration of housing programmes with a gender perspective, and also discuss the concepts which have to be considered in the elaboration of those programmes.

O jogo das interligadas: uma política pública em avaliação: a lei no. 10.209/86 do município de São Paulo: 1986-1993

Trata dos problemas de operacionalização da Lei Municipal n. 10.209 de 09 de dezembro de 1986, de seu aperfeiçoamento de 1988 a 1993 e dos resultados obtidos em habitações de interesse social doadas a Prefeitura pelos empreendedores imobiliários, em contrapartida a exceções à legislação de uso e ocupação do solo do Município de São Paulo.