Socioeconomic inequality profiles in physical and developmental health from 0-7 years : Australian National Study

Background: Early and persistent exposure to socioeconomic disadvantage impairs children’s health and wellbeing. However, it is unclear at what age health inequalities emerge or whether these relationships vary across ages and outcomes. We address these issues using cross-sectional Australian population data on the physical and developmental health of children at ages 0-1, 2-3, 4-5 and 6-7 years. Methods: 10 physical and developmental health outcomes were assessed in 2004 and 2006 for two cohorts each comprising around 5000 children. Socioeconomic position was measured as a composite of parental education, occupation and household income. Results: Lower socioeconomic position was associated with increased odds for poor outcomes. For physical health outcomes and socio-emotional competence, associations were similar across age groups and were consistent with either threshold effects (for poor general health, special healthcare needs and socio-emotional competence) or gradient effects (for illness with wheeze, sleep problems and injury). For socio-emotional difficulties, communication, vocabulary and emergent literacy, stronger socioeconomic associations were observed. The patterns were linear or accelerated and varied across ages. Conclusions: From very early childhood, social disadvantage was associated with poorer outcomes across most measures of physical and developmental health and showed no evidence of either strengthening or attenuating at older compared to younger ages. Findings confirm the importance of early childhood as a key focus for health promotion and prevention efforts.

'I am smart and I am not joking': Aiming high in the middle years of schooling

In this paper, we draw on accounts from students to inform a Middle Schooling movement that has been variously described as "arrested", "unfinished" and "exhausted". We propose that if the Middle Schooling movement is to understand the changing worlds of students and develop new approaches in the middle years of schooling, then it is important to draw on the insights that individual students can provide by conducting research with "students-as-informants". The early adolescent informants to this paper report high hopes for their futures (despite their lower socio-economic surroundings), which reinforces the importance of supporting successful learner identities and highlights the role of schooling in the decline of adolescent student aspirations. However, their insights did not stop at the individual learner, with students also identifying cultural and structural constraints to reform. As such, we argue that students may be both an important resource for inquiry into individual school reform and for the Middle Schooling movement internationally.

Making space and place for knowledge production : socio-spatial development of knowledge community precincts

In the knowledge era the importance of making space and place for knowledge production is clearly understood worldwide by many city administrations that are keen on restructuring their cities as highly competitive and creative places. Consequently, knowledge-based urban development and socio-spatial development of knowledge community precincts have taken their places among the emerging agendas of the urban planning and development practice. This chapter explores these emerging issues and scrutinizes the development of knowledge community precincts that have important economic, social and cultural dimensions on the formation of competitive and creative urban regions. The chapter also sheds light on the new challenges for planning discipline, and discusses the need for and some specifics of a new planning paradigm suitable for dealing with 21st Century’s socio-economic development and urbanization problems.

Sustainable transportation development : a framework to determine transportation disadvantaged

Urban sprawl combined with low density development causes unsustainable development patterns including accessibility and mobility problems, especially for those who do not have the capacity to own a vehicle or access to quality public transport services. Sustainable transportation development is crucial in order to solve transport disadvantage problems in urban settlements. People who are affected by these problems are referred to as ‘transportation disadvantaged’. Transportation disadvantage is a multi-dimensional problem that combines socio-economics, transportation and spatial characteristics or dimensions. However, a substantial number of transportation disadvantage studies so far only focus on the socio-economic and transportation dimensions, while the latter dimension of transportation disadvantage has been neglected. This chapter investigates the spatial dimension of transportation disadvantage by comparing the travel capabilities of residents and their accessibility levels with land use characteristics. The analysis of the study identifies significant land use characteristics with travel inability, and is useful for identifying the transportation disadvantaged population.

Bayesian spatiotemporal analysis of socio-ecologic drivers of Ross River Virus transmission in Queensland, Australia

This study aims to examine the impact of socio-ecologic factors on the transmission of Ross River virus (RRV) infection and to identify areas prone to social and ecologic-driven epidemics in Queensland, Australia. We used a Bayesian spatiotemporal conditional autoregressive model to quantify the relationship between monthly variation of RRV incidence and socio-ecologic factors and to determine spatiotemporal patterns. Our results show that the average increase in monthly RRV incidence was 2.4% (95% credible interval (CrI): 0.1–4.5%) and 2.0% (95% CrI: 1.6–2.3%) for a 1°C increase in monthly average maximum temperature and a 10 mm increase in monthly average rainfall, respectively. A significant spatiotemporal variation and interactive effect between temperature and rainfall on RRV incidence were found. No association between Socio-economic Index for Areas (SEIFA) and RRV was observed. The transmission of RRV in Queensland, Australia appeared to be primarily driven by ecologic variables rather than social factors.

Developing a motorcycle and scooter safety compendium for the Asia-Pacific Economic Cooperation (APEC)

Motorcycle and scooter crashes are significant contributors to road trauma in many low, medium and high income countries. The APEC Transportation Working Group has commissioned CARRS-Q to develop a compendium of best practice measures that can be used to reduce crashes, post-crash trauma and associated socio-economic costs. The compendium will be informed by findings from a literature review and an expert survey. The literature review examined motorcycle and scooter safety usage and fatalities along with socio-cultural factors which might influence safety in each economy. A discussion is provided regarding the processes involved in the expert survey and how this might be integrated with the findings from the literature review. The implications for developing the compendium are discussed as is the next step of a workshop to further disseminate findings. This will enable the identification of important motorcycle safety issues in APEC economies and implications for implementation of countermeasures.

An economic evaluation of the Safe Motherhood programme in Guangxi, China

Maternal and infant mortality is a global health issue with a significant social and economic impact. Each year, over half a million women worldwide die due to complications related to pregnancy or childbirth, four million infants die in the first 28 days of life, and eight million infants die in the first year. Ninety-nine percent of maternal and infant deaths are in developing countries. Reducing maternal and infant mortality is among the key international development goals. In China, the national maternal mortality ratio and infant mortality rate were reduced greatly in the past two decades, yet a large discrepancy remains between urban and rural areas. To address this problem, a large-scale Safe Motherhood Programme was initiated in 2000. The programme was implemented in Guangxi in 2003. Interventions in the programme included both demand-side and supply side-interventions focusing on increasing health service use and improving birth outcomes. Little is known about the effects and economic outcomes of the Safe Motherhood Programme in Guangxi, although it has been implemented for seven years. The aim of this research is to estimate the effectiveness and cost-effectiveness of the interventions in the Safe Motherhood Programme in Guangxi, China. The objectives of this research include: 1. To evaluate whether the changes of health service use and birth outcomes are associated with the interventions in the Safe Motherhood Programme. 2. To estimate the cost-effectiveness of the interventions in the Safe Motherhood Programme and quantify the uncertainty surrounding the decision. 3. To assess the expected value of perfect information associated with both the whole decision and individual parameters, and interpret the findings to inform priority setting in further research and policy making in this area. A quasi-experimental study design was used in this research to assess the effectiveness of the programme in increasing health service use and improving birth outcomes. The study subjects were 51 intervention counties and 30 control counties. Data on the health service use, birth outcomes and socio-economic factors from 2001 to 2007 were collected from the programme database and statistical yearbooks. Based on the profile plots of the data, general linear mixed models were used to evaluate the effectiveness of the programme while controlling for the effects of baseline levels of the response variables, change of socio-economic factors over time and correlations among repeated measurements from the same county. Redundant multicollinear variables were deleted from the mixed model using the results of the multicollinearity diagnoses. For each response variable, the best covariance structure was selected from 15 alternatives according to the fit statistics including Akaike information criterion, Finite-population corrected Akaike information criterion, and Schwarz.s Bayesian information criterion. Residual diagnostics were used to validate the model assumptions. Statistical inferences were made to show the effect of the programme on health service use and birth outcomes. A decision analytic model was developed to evaluate the cost-effectiveness of the programme, quantify the decision uncertainty, and estimate the expected value of perfect information associated with the decision. The model was used to describe the transitions between health states for women and infants and reflect the change of both costs and health benefits associated with implementing the programme. Result gained from the mixed models and other relevant evidence identified were synthesised appropriately to inform the input parameters of the model. Incremental cost-effectiveness ratios of the programme were calculated for the two groups of intervention counties over time. Uncertainty surrounding the parameters was dealt with using probabilistic sensitivity analysis, and uncertainty relating to model assumptions was handled using scenario analysis. Finally the expected value of perfect information for both the whole model and individual parameters in the model were estimated to inform priority setting in further research in this area.The annual change rates of the antenatal care rate and the institutionalised delivery rate were improved significantly in the intervention counties after the programme was implemented. Significant improvements were also found in the annual change rates of the maternal mortality ratio, the infant mortality rate, the incidence rate of neonatal tetanus and the mortality rate of neonatal tetanus in the intervention counties after the implementation of the programme. The annual change rate of the neonatal mortality rate was also improved, although the improvement was only close to statistical significance. The influences of the socio-economic factors on the health service use indicators and birth outcomes were identified. The rural income per capita had a significant positive impact on the health service use indicators, and a significant negative impact on the birth outcomes. The number of beds in healthcare institutions per 1,000 population and the number of rural telephone subscribers per 1,000 were found to be positively significantly related to the institutionalised delivery rate. The length of highway per square kilometre negatively influenced the maternal mortality ratio. The percentage of employed persons in the primary industry had a significant negative impact on the institutionalised delivery rate, and a significant positive impact on the infant mortality rate and neonatal mortality rate. The incremental costs of implementing the programme over the existing practice were US $11.1 million from the societal perspective, and US $13.8 million from the perspective of the Ministry of Health. Overall, 28,711 life years were generated by the programme, producing an overall incremental cost-effectiveness ratio of US $386 from the societal perspective, and US $480 from the perspective of the Ministry of Health, both of which were below the threshold willingness-to-pay ratio of US $675. The expected net monetary benefit generated by the programme was US $8.3 million from the societal perspective, and US $5.5 million from the perspective of the Ministry of Health. The overall probability that the programme was cost-effective was 0.93 and 0.89 from the two perspectives, respectively. The incremental cost-effectiveness ratio of the programme was insensitive to the different estimates of the three parameters relating to the model assumptions. Further research could be conducted to reduce the uncertainty surrounding the decision, in which the upper limit of investment was US $0.6 million from the societal perspective, and US $1.3 million from the perspective of the Ministry of Health. It is also worthwhile to get a more precise estimate of the improvement of infant mortality rate. The population expected value of perfect information for individual parameters associated with this parameter was US $0.99 million from the societal perspective, and US $1.14 million from the perspective of the Ministry of Health. The findings from this study have shown that the interventions in the Safe Motherhood Programme were both effective and cost-effective in increasing health service use and improving birth outcomes in rural areas of Guangxi, China. Therefore, the programme represents a good public health investment and should be adopted and further expanded to an even broader area if possible. This research provides economic evidence to inform efficient decision making in improving maternal and infant health in developing countries.

Competitive advantages as a foundation for social advantage: The role of social enterprise in regional development

The belief that regions play a role in determining national economic development and that advantages are found at the local and regional level has been the focus of economic geography and development studies over the last 10 years. However, this issue has historically been dominated by economic perspectives, industrial firms, and public bodies. In recent years the social economy is starting to receive greater attention in creating regional advantage as well as ameliorating regional disadvantage. The social economy includes the impact of the third sector such as social enterprises. This paper proposes that understanding the role and function of social enterprise will enable a more nuanced understanding of the socio-economic aspects of regional development. Drawing upon Oliver’s (1997) framework for sustainable competitive advantage it is argued that this established management framework provides a valuable foundation for examining the organisational resources that social enterprise need to operate effectively, as well as the socio-economic resources they produce for regional communities.

Genesis and role of standards : theoretical foundations and socio-economical model for the construction and use of standards

A key issue in the economic development and performance of organizations is the existence of standards. Their definition and control are sources of power and it is important to understand their concept, as it gives standards their direction and their legitimacy, and to explore how they are represented and applied. The difficulties posed by classical micro-economics in establishing a theory of standardization that is compatible with its fundamental axiomatic are acknowledged. We propose to reconsider the problem by taking the opposite perspective in questioning its theoretical base and by reformulating assumptions about the independent and autonomous decisions taken by actors. The Theory of Conventions will offer us a theoretical framework and tools enabling us to understand the systemic dimension and dynamic structure of standards. These will be seen as a special case of conventions. This work aims to provide a sound basis and promote a better consciousness in the development of global project management standards. It aims also to emphasize that social construction is not a matter of copyright but a matter of open minds, collective cognitive process and freedom for the common wealth.

Sustainable transportation development : a framework to determine transportation disadvantaged

Urban sprawl combined with low density development causes unsustainable development patterns including accessibility and mobility problems, especially for those who do not have the capacity to own a vehicle or access to quality public transport services. Sustainable transportation development is crucial in order to solve transport disadvantage problems in urban settlements. People who are affected by these problems are referred to as ‘transportation disadvantaged’. Transportation disadvantage is a multi-dimensional problem that combines socio-economics, transportation and spatial characteristics or dimensions. However, a substantial number of transportation disadvantage studies so far only focus on the socio-economic and transportation dimensions, while the latter dimension of transportation disadvantage has been neglected. This chapter investigates the spatial dimension of transportation disadvantage by comparing the travel capabilities of residents and their accessibility levels with land use characteristics. The analysis of the study identifies significant land use characteristics with travel inability, and is useful for identifying the transportation disadvantaged population.

Did socio-ecological factors drive the spatiotemporal patterns of pandemic influenza A (H1N1)?

BACKGROUND Pandemic influenza A (H1N1) has a significant public health impact. This study aimed to examine the effect of socio-ecological factors on the transmission of H1N1 in Brisbane, Australia. METHODOLOGY We obtained data from Queensland Health on numbers of laboratory-confirmed daily H1N1 in Brisbane by statistical local areas (SLA) in 2009. Data on weather and socio-economic index were obtained from the Australian Bureau of Meteorology and the Australian Bureau of Statistics, respectively. A Bayesian spatial conditional autoregressive (CAR) model was used to quantify the relationship between variation of H1N1 and independent factors and to determine its spatiotemporal patterns. RESULTS Our results show that average increase in weekly H1N1 cases were 45.04% (95% credible interval (CrI): 42.63-47.43%) and 23.20% (95% CrI: 16.10-32.67%), for a 1 °C decrease in average weekly maximum temperature at a lag of one week and a 10mm decrease in average weekly rainfall at a lag of one week, respectively. An interactive effect between temperature and rainfall on H1N1 incidence was found (changes: 0.71%; 95% CrI: 0.48-0.98%). The auto-regression term was significantly associated with H1N1 transmission (changes: 2.5%; 95% CrI: 1.39-3.72). No significant association between socio-economic indexes for areas (SEIFA) and H1N1 was observed at SLA level. CONCLUSIONS Our results demonstrate that average weekly temperature at lag of one week and rainfall at lag of one week were substantially associated with H1N1 incidence at a SLA level. The ecological factors seemed to have played an important role in H1N1 transmission cycles in Brisbane, Australia.

Practices of alternative schools in Queensland in supporting Aboriginal and Torres Strait Islander young people to remain engaged in education

Alternative schools are an emerging model of education offered to young people who have been disenfranchised from conventional schooling opportunities. The body of literature on alternative schools in Australia has not identified how many Indigenous young people are engaged with alternative schools and how alternative schools are supporting Indigenous young people to remain engaged in education. It is well documented that Aboriginal and Torres Strait Islander people experience significant disadvantage including poorer educational outcomes than their non-Indigenous peers. This study seeks to contribute to improving educational outcomes for Aboriginal and Torres Strait Islander young people through exploring Aboriginal and Torres Strait Islander interactions with alternative schools in Queensland and investigating the practices of alternative school leaders in terms of how they are supporting Indigenous young people to remain engaged in education. Critical race theory informed the development of this study. An Aboriginal researcher sought to shift the focus of this study away from Indigenous young people to Principals; to explore their perspective of their own knowledge and practices in supporting Aboriginal and Torres Strait Islander young people at their school. Using survey methodology, a web-based questionnaire was developed to survey Principals’ providing data on alternative schools in Queensland including the demographics of the alternative school; self-reported knowledge of Indigenous cultures and communities and practices that support Aboriginal and Torres Strait Islander young people at their alternative school. There are nine key findings that emerged through the analysis of this study: key finding one is the high percentage of Aboriginal and Torres Strait Islander young people enrolled in schools surveyed; key finding two is there is a high percentage of Aboriginal and Torres Strait Islander staff employed in the schools; key finding three is the majority of the schools are located in low socio-economic areas; key finding four is the strong willingness of Principals’ in this study to engage in self-directed learning in relation to Aboriginal and Torres Strait Islander cultures; key finding five is the limited demonstration of understandings of Aboriginal and Torres Strait Islander cultures and communities; key finding six is the most prevalent practice of Principals’ in this study is the celebration of cultural events and cultural activities; key finding seven is the limited Principal engagement with Aboriginal and Torres Strait Islander young people, their families and the local community; key finding eight is the practice of alternative schools provides limited support and nurturing of Aboriginal and Torres Strait Islander young person’s cultural identity and key finding nine is that Principals’ are relying heavily on informal discussions with staff to know what their staff’s knowledge and skills are in relation to supporting Aboriginal and Torres Strait Islander young people. There are multiple implications that have arisen from this study. The data demonstrated high numbers of Aboriginal and Torre Strait Islander students and staff. The data also revealed that Principal’s demonstration of knowledge in relation to Indigenous cultures and communities was limited, as well as limited Principal engagement with Indigenous young peoples, families and communities. Therefore a major practical implication of this study is the urgent need for quality cultural learning opportunities for leaders of alternative schools to improve practices. Additionally, the implications of this study support an urgent need for further research on the role alternative schools are playing in supporting Indigenous young people to remain engaged in education.

The activation, appropriation and practices of student-equity policy in Australian higher education

Current national reforms in Australian higher education have prioritised efforts to reduce educational disadvantage within a vernacular expression of neoliberal education policy. Student-equity policy in universities is enmeshed in a set of competitive student recruitment relations. This raises practice-based tensions as universities strive to meet specific institutional targets for low-socio-economic status (SES) and Indigenous student participation, whilst broadening participation more generally within the sector. This paper seeks empirically to trace the activation and appropriation of federal policy through two sites of higher education policy practices: a state government-sponsored equity practitioner body and two differently positioned universities, Dawson and McIllwraith, as they engage with low-SES schools. Working together Dorothy Smith’s insights into the textually mediated activation of local practices, Levinson and colleagues’ concept of the local appropriation of authorised policy, and Bourdieu’s notion of the contested field, we demonstrate that the generation of state level and institutionally specific policies for student-equity practices not only articulates to federal policy, but also appropriates the ruling relations of mandated policy. Further, the scope of these creative local appropriations is organised within a hierarchical academic field through which particular institutional imperatives, as well as the needs of low-SES students, are negotiated. The analysis demonstrates the vernacularisation of policy in the national rearticulation of global discourses, in appropriation at the level of the state body and in the practices of equity workers.

Economic evaluation of adolescent reproductive health education interventions in Chilinh, Vietnam

This research was an economic analysis of two novel health education interventions compared to existing practice for reproductive health among young people in northern Vietnam. The research showed that implementing an educational intervention including school-based and health facility-based components was cost effective for males and females. The findings will assist decision makers in efficient allocation of scarce resources for adolescent health promotion in Vietnam and similar socio-economic contexts in Asia.

Digital literacies: Understanding the literate practices of refugee kids in an Afterschool Media Club

Since the 2000s, teachers in an increasing number of Australian schools have been learning how to support students with refugee backgrounds. For some of these students, entry into the Australian school system is not easy. English literacy is integral to some of the challenges confronting the students. In response, educators have been developing and researching ways of engaging with the students’ language and literacy learning. Much of the focus has been on traditional print-based school literacies. In contrast, I look here at student engagement in digital literacies in an after-school media club. Several concepts from the theory of French sociologist, Pierre Bourdieu are useful for understanding the position of students of refugee background in the Australian school system. Like other conflict theories, Bourdieusian theory has sometimes been criticised as ‘pessimistic’, that is, for suggesting that schools necessarily reproduce social disadvantage. However, others have used Bourdieusian theory to analyse and critique the reproductive work of schooling for groups of students who experience educational disadvantage. I align myself with this latter tradition. Specifically, I use Bourdieu’s triad of concepts to explain aspects of the literacy education experiences of some young people of refugee background: field, capital and habitus. In particular, I look at questions of the legitimation of students’ competences as capital in literate fields within and beyond the school context. Data are drawn from an Australian Research Council-funded project, Digital Learning and Print Literacy: A design experiment for the reform of low socio-economic, culturally diverse schools (2009-14). The data analysed in this chapter include interviews and observations relating to the participation of two Congolese girls in an after school media club. Implications are drawn for teachers of literacy in culturally and linguistically diverse contexts. Consideration is made of early childhood, primary and secondary settings.