Regional differences in socio-economic health inequalities in Spain

This paper reports an analysis of income related health inequalities at the AutonomousCommunity level in Spain using the self assessed health measure in the 2001 edition of theEncuesta Nacional de Salud. We use recently developed methods in order to cardinalise andmodel self assessed health within a regression framework, decompose the sources ofinequality and explain the observed differences across regions. We find that the regions with the highest levels of mean health tend to enjoy the lowest degrees of income related health inequality and vice-versa. The main feature characterizing regions where income related health inequality is low is the absence of a positive gradient between income and health. In turn, the regions where income related health inequality is greater are characterized by a strong and significant positive gradient between health and income. These results suggest that policies aimed at eliminating the gradient between health and income can potentially lead to greate r reductions in socio-economic health inequalities than policies aimed at redistributing income.

Self-organized evolution in a socio-economic environment

We propose a general scenario to analyze technological changes in socio-economic environments. We illustrate the ideas with a model that incorporating the main trends is simple enough to extract analytical results and, at the same time, sufficiently complex to display a rich dynamic behavior. Our study shows that there exists a macroscopic observable that is maximized in a regime where the system is critical, in the sense that the distribution of events follow power laws. Computer simulations show that, in addition, the system always self-organizes to achieve the optimal performance in the stationary state.

Estudio sobre los procesos de integración laboral de los inmigrantes. Study of immigrants' labour integration process

El presente trabajo pretende mostrar los resultados de un estudio cuya intención era identificar posibles variables que afectan a los procesos y estrategias de integración laboral de personas procedentes de otros países; las necesidades formativas en relación al colectivo de referencia y ampliar el conocimiento del fenómeno en aras de la intervención psicoeducativa y social. A partir de una metodología de investigación de orientación cualitativa se ha concluido que las diferencias en cuanto a las estrategias de integración y sus logros están más determinadas por los niveles de cualificación en el país de origen que por las propias diferencias culturales. The article shows the results of a study carried out by the authors to identify possible variables that affect the processes and strategies of occupational integration of people coming from other countries, to establish training needs in relation to the reference group and to extend the knowledge of the phenomenon for the sake of the educational and social intervention. Using a qualitative research methodology, it was concluded that the differences in integration strategies and their accomplishments are better explained by the levels of qualification attained in the country of origin than by cultural differences.

Estudio sobre los procesos de integración laboral de los inmigrantes. Study of immigrants' labour integration process

El presente trabajo pretende mostrar los resultados de un estudio cuya intención era identificar posibles variables que afectan a los procesos y estrategias de integración laboral de personas procedentes de otros países; las necesidades formativas en relación al colectivo de referencia y ampliar el conocimiento del fenómeno en aras de la intervención psicoeducativa y social. A partir de una metodología de investigación de orientación cualitativa se ha concluido que las diferencias en cuanto a las estrategias de integración y sus logros están más determinadas por los niveles de cualificación en el país de origen que por las propias diferencias culturales. The article shows the results of a study carried out by the authors to identify possible variables that affect the processes and strategies of occupational integration of people coming from other countries, to establish training needs in relation to the reference group and to extend the knowledge of the phenomenon for the sake of the educational and social intervention. Using a qualitative research methodology, it was concluded that the differences in integration strategies and their accomplishments are better explained by the levels of qualification attained in the country of origin than by cultural differences.

Neighbourhood socio-economic position, late presentation and outcomes in people living with HIV in Switzerland.

OBJECTIVES: Inequalities and inequities in health are an important public health concern. In Switzerland, mortality in the general population varies according to the socio-economic position (SEP) of neighbourhoods. We examined the influence of neighbourhood SEP on presentation and outcomes in HIV-positive individuals in the era of combination antiretroviral therapy (cART). METHODS: The neighbourhood SEP of patients followed in the Swiss HIV Cohort Study (SHCS) 2000-2013 was obtained on the basis of 2000 census data on the 50 nearest households (education and occupation of household head, rent, mean number of persons per room). We used Cox and logistic regression models to examine the probability of late presentation, virologic response to cART, loss to follow-up and death across quintiles of neighbourhood SEP. RESULTS: A total of 4489 SHCS participants were included. Presentation with advanced disease [CD4 cell count <200 cells/μl or AIDS] and with AIDS was less common in neighbourhoods of higher SEP: the age and sex-adjusted odds ratio (OR) comparing the highest with the lowest quintile of SEP was 0.71 [95% confidence interval (95% CI) 0.58-0.87] and 0.59 (95% CI 0.45-0.77), respectively. An undetectable viral load at 6 months of cART was more common in the highest than in the lowest quintile (OR 1.52; 95% CI 1.14-2.04). Loss to follow-up, mortality and causes of death were not associated with neighbourhood SEP. CONCLUSION: Late presentation was more common and virologic response to cART less common in HIV-positive individuals living in neighbourhoods of lower SEP, but in contrast to the general population, there was no clear trend for mortality.

Social inequalities of functioning and perceived health in Switzerland: a representative cross-sectional analysis.

Many people worldwide live with a disability, i.e. limitations in functioning. The prevalence is expected to increase due to demographic change and the growing importance of non-communicable disease and injury. To date, many epidemiological studies have used simple dichotomous measures of disability, even though the WHO's International Classification of Functioning, Disability, and Health (ICF) provides a multi-dimensional framework of functioning. We aimed to examine associations of socio-economic status (SES) and social integration in 3 core domains of functioning (impairment, pain, limitations in activity and participation) and perceived health. We conducted a secondary analysis of representative cross-sectional data of the Swiss Health Survey 2007 including 10,336 female and 8,424 male Swiss residents aged 15 or more. Guided by a theoretical ICF-based model, 4 mixed effects Poisson regressions were fitted in order to explain functioning and perceived health by indicators of SES and social integration. Analyses were stratified by age groups (15-30, 31-54, ≥55 years). In all age groups, SES and social integration were significantly associated with functional and perceived health. Among the functional domains, impairment and pain were closely related, and both were associated with limitations in activity and participation. SES, social integration and functioning were related to perceived health. We found pronounced social inequalities in functioning and perceived health, supporting our theoretical model. Social factors play a significant role in the experience of health, even in a wealthy country such as Switzerland. These findings await confirmation in other, particularly lower resourced settings.

Excess winter deaths caused by cardiovascular diseases are associated with both mild winter temperature and socio-economic inequalities in the U.S.

Mortality from cardiovascular diseases (CVD) exhibits seasonal variation. For example, 30% more deaths occurred in winter compared to summer in a multicountry study [1]. The effect of cold temperature on several CVD risk factors and on seasonal influenza infection may partially underlie this seasonal variation [2] and [3]. However an unexplained paradox has been observed: seasonality in CVD mortality is larger in temperate mid-latitude countries (e.g. Portugal) than in colder northern countries (e.g. Scandinavian countries) [1]. This paradox has also been previously observed in Europe for overall mortality, and it may relate to uneven proportions between countries of people who are unable to adequately protect themselves against cold due to low socio-economic status (SES), e.g. inadequate clothing, housing insulation and heating systems [4] and [5]. We hypothesized that the seasonal variability in CVD mortality is larger in low socio-economic U.S. states experiencing mild winters compared to high socio-economic states experiencing cold winters.

Value of Information Logistics Integration in Digital Business Ecosystem

Digital business ecosystems (DBE) are becoming an increasingly popular concept for modelling and building distributed systems in heterogeneous, decentralized and open environments. Information- and communication technology (ICT) enabled business solutions have created an opportunity for automated business relations and transactions. The deployment of ICT in business-to-business (B2B) integration seeks to improve competitiveness by establishing real-time information and offering better information visibility to business ecosystem actors. The products, components and raw material flows in supply chains are traditionally studied in logistics research. In this study, we expand the research to cover the processes parallel to the service and information flows as information logistics integration. In this thesis, we show how better integration and automation of information flows enhance the speed of processes and, thus, provide cost savings and other benefits for organizations. Investments in DBE are intended to add value through business automation and are key decisions in building up information logistics integration. Business solutions that build on automation are important sources of value in networks that promote and support business relations and transactions. Value is created through improved productivity and effectiveness when new, more efficient collaboration methods are discovered and integrated into DBE. Organizations, business networks and collaborations, even with competitors, form DBE in which information logistics integration has a significant role as a value driver. However, traditional economic and computing theories do not focus on digital business ecosystems as a separate form of organization, and they do not provide conceptual frameworks that can be used to explore digital business ecosystems as value drivers—combined internal management and external coordination mechanisms for information logistics integration are not the current practice of a company’s strategic process. In this thesis, we have developed and tested a framework to explore the digital business ecosystems developed and a coordination model for digital business ecosystem integration; moreover, we have analysed the value of information logistics integration. The research is based on a case study and on mixed methods, in which we use the Delphi method and Internetbased tools for idea generation and development. We conducted many interviews with key experts, which we recoded, transcribed and coded to find success factors. Qualitative analyses were based on a Monte Carlo simulation, which sought cost savings, and Real Option Valuation, which sought an optimal investment program for the ecosystem level. This study provides valuable knowledge regarding information logistics integration by utilizing a suitable business process information model for collaboration. An information model is based on the business process scenarios and on detailed transactions for the mapping and automation of product, service and information flows. The research results illustrate the current cap of understanding information logistics integration in a digital business ecosystem. Based on success factors, we were able to illustrate how specific coordination mechanisms related to network management and orchestration could be designed. We also pointed out the potential of information logistics integration in value creation. With the help of global standardization experts, we utilized the design of the core information model for B2B integration. We built this quantitative analysis by using the Monte Carlo-based simulation model and the Real Option Value model. This research covers relevant new research disciplines, such as information logistics integration and digital business ecosystems, in which the current literature needs to be improved. This research was executed by high-level experts and managers responsible for global business network B2B integration. However, the research was dominated by one industry domain, and therefore a more comprehensive exploration should be undertaken to cover a larger population of business sectors. Based on this research, the new quantitative survey could provide new possibilities to examine information logistics integration in digital business ecosystems. The value activities indicate that further studies should continue, especially with regard to the collaboration issues on integration, focusing on a user-centric approach. We should better understand how real-time information supports customer value creation by imbedding the information into the lifetime value of products and services. The aim of this research was to build competitive advantage through B2B integration to support a real-time economy. For practitioners, this research created several tools and concepts to improve value activities, information logistics integration design and management and orchestration models. Based on the results, the companies were able to better understand the formulation of the digital business ecosystem and the importance of joint efforts in collaboration. However, the challenge of incorporating this new knowledge into strategic processes in a multi-stakeholder environment remains. This challenge has been noted, and new projects have been established in pursuit of a real-time economy.

Coping with globalization: Asian versus Latin American strategies of development, 1980-2010

When compared to Latin America, Asian economies since 1980 have grown faster and have done so with relatively modest inequalities. Why? A comparison of Asia and Latin America underlines the superiority of the nationalist capitalist model of development, which has often been pursued more explicitly in Asia, over that of a dependent capitalist model, which has often been pursued in Latin America. In comparison to Latin America, the Asian model has facilitated higher and less volatile rates of economic growth and a greater political room to pursue social democratic policies. The "tap root" of these alternate pathways is relative autonomy from global constraints: states and economies in Asia have been more nationalist and autonomous than in Latin America.

Germany's socio-economic model and the Euro crisis

Germany's socio-economic model, the "social market economy", was established in West Germany after World War II and extended to the unified Germany in 1990. During a prolonged recession after the adoption of the Euro in 1998, major reforms (Agenda 2010) were introduced which many consider as the key of Germany's recent success. The reforms had mixed results: employment increased but has consisted to a large extent of precarious low-wage jobs. Growth depended on export surpluses based on an internal real devaluation (low unit labour costs) which make Germany vulnerable to global recessions as in 2009. Overall inequality increased substantially.

Au carrefour de l’intégration socio-professionnelle : perspectives et questionnements de personnes vivant avec des problèmes de santé mentale

Ce travail de mémoire porte sur le processus d’insertion sociale et économique des personnes vivant des problèmes de santé mentale. Le travail est devenu un important véhicule d’intégration sociale. En effet, on prétend que la pratique d’un métier serait pour les personnes souffrant de problèmes de santé un outil de rétablissement et de mieux-être, car elle permet de réduire les symptômes et l’incidence des hospitalisations. Le travail permet, également, d’augmenter les interactions sociales et de contribuer activement à la société. Il existe, toutefois, d’autres véhicules d’intégration qui semblent, sous certains angles, apporter les mêmes avantages. Les activités bénévoles améliorent la qualité de vie, favorisent les interactions sociales et donnent, à l’individu, l’occasion de contribuer à sa communauté. Par ailleurs, le retrait social peut être un moyen de s’éloigner des pressions sociales et de s’accorder une pause bénéfique. On soutient que les personnes ayant un problème de santé mentale qui ont une lecture positive de leur situation de marginalité tendent à être moins hospitalisées. S’appuyant sur une démarche qualitative, ce travail de recherche a tenté de cerner les perspectives, les questionnements et les perceptions des personnes ayant un trouble mental à l’égard d’un processus d’intégration socioprofessionnelle, de participation sociale et de retrait social. Des entrevues semi-dirigées ont été menées auprès de onze personnes, et grâce à ces entretiens, un portrait au regard de leurs parcours social et professionnel a pu être brossé. Les entretiens ont permis d’explorer l’impact des problèmes de santé mentale sur leur réalité et sur leur identité, leurs représentations du marché de l’emploi et les motifs qui justifient le choix de s’engager ou de renoncer à un processus d’intégration socioprofessionnelle. Les résultats de cette recherche ont permis d'identifier cinq facteurs qui peuvent influencer la décision des personnes qui sont le rapport à l'environnement social, l'identité, le rapport aux institutions de l'État, les discours de légitimation et les perspectives d'avenir. Les résultats démontrent que l'on ne peut isoler les notions de vulnérabilité, d'autonomie, de bien-être ou de stabilité dans une phase spécifique. La vulnérabilité, l'autonomie, le bien-être et la stabilité sont des états que l’on peut vivre en situation de retrait social, de participation sociale et d’intégration socioprofessionnelle. Selon les circonstances et l’état émotif, ils peuvent être des modes adaptés ou inadaptés.

Assessment of the strategies of organic fruit production and fruit drying in Uganda

Organic agriculture in Uganda is developing at a fast pace and despite this trend Uganda is still unable to produce enough fresh and dry organic fruits mainly pineapple to meet the exporters demand. This current research investigated the strategies of farmers at production level by assessing the pros and cons of fruit growing, organic agriculture and fruit drying in order to understand the underlying causal factor for the low production of organic dry fruits in a major fruit producing district of Uganda. The study was carried out in two separate and distinctive areas; one which only produces and export fresh organic pineapple and the other which exports dried fruits (mainly pineapple and papaya). About 10% of the farmers in the two study areas were surveyed using questionnaires which were further followed by semi-structured interviews and participatory rural appraisals activities with various types of farmers in order to understand the different decisions and strategies of farmers. 82% and 74% of farmers in the two study areas grew fruits as it gave better economic returns and for 77% and 90% respectively in the two study areas, the reasons for growing fruit was the ease of selling compared to other crops. All the farmers were relying on coffee husk for growing organic pineapples. However, 50% of the farmers want to grow pineapples (either organic or conventional) but couldn't afford to buy coffee husk. Fruit drying was mainly a strategy to utilize cheap fruits during harvesting seasons for value addition. 71% and 42% of farmers in the two study areas wanted to dry fruits but it was beyond their economic capacity to buy the driers. Decision of the farmers whether to grow fruits or cereals, organic or conventional agriculture and selling the fruits as fresh or dry were dependent mainly on the economic, knowledge and resource availability of each type of practices. It is concluded that the main barrier for an increase in the production of organic dried fruits is at the processing level, and the limited capacity for investments in drying facilities.

Determinantes socio-económicas de la desnutrición global infantil en la Localidad de Ciudad Bolívar (Bogotá, Colombia) en el año 2011

La desnutrición infantil y la pobreza se encuentran asociadas y estas a su vez con el progreso de los países. Conocer las determinantes sociales y económicas de la niñez que padece de bajo peso es necesario para crear escenarios propicios para el adecuado desarrollo de la primera infancia y de esta manera contribuir con la superación de la pobreza en el marco de sistemas sanitarios equitativos. Se realiza una descripción de las características socio-económicas y un análisis de posibles asociaciones entre estas y el bajo peso infantil de una muestra de infantes de uno de los sectores de mayor vulnerabilidad y pobreza de Bogotá (Colombia). La tasa del bajo peso infantil en la muestra del estudio en más alta a la presentada en Bogotá y Colombia (8.5%, 2.9% y 3.4% respectivamente). Al realizar el análisis de las posibles asociaciones entre el bajo peso y las variables de estudio, se evidencia que las relaciones son débiles entre la primera y las segundas, siendo la condición de desplazamiento la que mayor asociación positiva presenta con la deficiencia nutricional seguido del rango de edad entre los 25 y 36 meses. La situación que presenta mayor independencia con respecto al bajo peso infantil es contar con vivienda propia seguida del sexo. La desnutrición infantil se presenta en niveles importantes en sectores de mayor vulnerabilidad con implicaciones para el adecuado desarrollo de los infantes y para las intenciones de reducción de los índices de pobreza en el país. El fortalecimiento de las políticas públicas que favorezca el desarrollo infantil, la superación de la pobreza y las inequidades en los sistemas de salud deben contemplar acciones integrales dirigidas a los más vulnerables, con la participación de la sociedad civil y los sectores públicos y privados, el compromiso político y económico de los gobiernos y reglas claras que contribuyan a la solución estructural de la pobreza y que promueva el adecuado desarrollo infantil.

Social housing and land use planning in Medellin during the period 2006-2011. Steps towards socio economic and residential segregation

This paper presents an approach to the relationship between land use planning and socioeconomic residential segregation, from the location of social housing in Medellin, Colombia, during the period 2006-2011. The first part introduces the land use regulations regarding the location of social housing, identifying ambiguities in the current spatial plan. Next, we present the intersection of  regulatory information and the location of the projects that were under construction during the  study period, highlighting the need to consider the location as an important characteristic of social housing and residential segregation as a phenomenon that must be recognized and worked on land  use planning in our cities.