ECLAC thinking in the CEPAL Review (1976-2008)

Includes bibliography

Population, ageing and development

Includes bibliography

Cause-specific mortality and income inequality in Sao Paulo, Brazil

OBJECTIVE: To analyze cause-specifi c mortality rates according to the relative income hypothesis. METHODS: All 96 administrative areas of the city of Sao Paulo, southeastern Brazil, were divided into two groups based on the Gini coefficient of income inequality: high (>= 0.25) and low (<0.25). The propensity score matching method was applied to control for confounders associated with socioeconomic differences among areas. RESULTS: The difference between high and low income inequality areas was statistically significant for homicide (8.57 per 10,000; 95% CI: 2.60; 14.53); ischemic heart disease (5.47 per 10,000 [95% CI 0.76; 10.17]); HIV/AIDS (3.58 per 10,000 [95% CI 0.58; 6.57]); and respiratory diseases (3.56 per 10,000 [95% CI 0.18; 6.94]). The ten most common causes of death accounted for 72.30% of the mortality difference. Infant mortality also had signifi cantly higher age-adjusted rates in high inequality areas (2.80 per 10,000 [95% CI 0.86; 4.74]), as well as among males (27.37 per 10,000 [95% CI 6.19; 48.55]) and females (15.07 per 10,000 [95% CI 3.65; 26.48]). CONCLUSIONS: The study results support the relative income hypothesis. After propensity score matching cause-specifi c mortality rates was higher in more unequal areas. Studies on income inequality in smaller areas should take proper accounting of heterogeneity of social and demographic characteristics.

Cause-specific mortality and income inequality in São Paulo, Brazil

OBJECTIVE: To analyze cause-specific mortality rates according to the relative income hypothesis. METHODS: All 96 administrative areas of the city of São Paulo, southeastern Brazil, were divided into two groups based on the Gini coefficient of income inequality: high (>0.25) and low (<0.25). The propensity score matching method was applied to control for confounders associated with socioeconomic differences among areas. RESULTS: The difference between high and low income inequality areas was statistically significant for homicide (8.57 per 10,000; 95%CI: 2.60;14.53); ischemic heart disease (5.47 per 10,000 [95%CI 0.76;10.17]); HIV/AIDS (3.58 per 10,000 [95%CI 0.58;6.57]); and respiratory diseases (3.56 per 10,000 [95%CI 0.18;6.94]). The ten most common causes of death accounted for 72.30% of the mortality difference. Infant mortality also had significantly higher age-adjusted rates in high inequality areas (2.80 per 10,000 [95%CI 0.86;4.74]), as well as among males (27.37 per 10,000 [95%CI 6.19;48.55]) and females (15.07 per 10,000 [95%CI 3.65;26.48]). CONCLUSIONS: The study results support the relative income hypothesis. After propensity score matching cause-specific mortality rates was higher in more unequal areas. Studies on income inequality in smaller areas should take proper accounting of heterogeneity of social and demographic characteristics.

Valores sociais: com a palavra a juventude

OBJETIVO: Identificar os diferentes posicionamentos de jovens estudantes em relação às expressões sobre valores sociais contemporâneos. MÉTODOS: Estudo descritivo de abordagem quantitativa, utilizou-se uma planilha para assinalar os posicionamentos de 229 estudantes de 15 a 19 anos, participantes de 29 grupos focais realizados em dez escolas de quatro regiões desiguais do município de Santo André, (SP). Os jovens posicionaram-se quanto à concordância - dúvida ou desacordo - sobre um conjunto de expressões valorativas sorteadas e discutidas nos grupos. Estas posições foram analisadas de acordo com suas frequências. RESULTADOS: Por um lado, indicam certo grau de uniformidade de pontos de vista, como consequência da experiência geracional de assimilação dos valores disseminados na sociedade; evidenciam, por outro lado, heterogeneidades que expõem contradições inerentes aos diferentes contextos sociais que cercam esses jovens. CONCLUSÃO: Identificou-se valores que diferem entre jovens pertencentes a distintos grupos sociais enquanto que outros não. Houve mais heterogeneidade do que homogeneidade nas opiniões sobre expressões valorativas utilizadas.

Urban food planning, city logistics and sustainability: the role of the wholesale produce market. The cases of Parma and Bologna food hubs.

At global level, the population is increasingly concentrating in the cities. In Europe, around 75% of the population lives in urban areas and, according to the European Environmental Agency (2010), urban population is foreseen to increase up to 80 % by 2020. At the same time, the quality of life in the cities is declining and urban pollution keeps increasing in terms of carbon dioxide (CO2) emissions, waste, noise, and lack of greenery. Many of European cities struggle to cope with social, economic and environmental problems resulting from pressures such as overcrowding or decline, social inequity, health problems related to food security and pollution. Nowadays local authorities try to solve these problems related to the environmental sustainability through various urban logistics measures, which directly and indirectly affect the urban food supply system, thus an integrated approach including freight transport and food provisioning policies issues is needed. This research centres on the urban food transport system and its impact on the city environmental sustainability. The main question that drives the research analysis is "How the urban food distribution system affects the ecological sustainability in modern cities?" The research analyses the city logistics project for food transport implemented in Parma, Italy, by the wholesale produce market. The case study investigates the renewed role of the wholesale market in the urban food supply chain as commercial and logistic operator, referring to the concept of food hub. Then, a preliminary analysis on the urban food transport for the city of Bologna is presented. The research aims at suggesting a methodological framework to estimate the urban food demand, the urban food supply and to assess the urban food transport performance, in order to identify external costs indicators that help policymakers in evaluating the environmental sustainability of different logistics measures

Diseño y análisis comparativo de un inventario de indicadores de mortalidad evitable adaptado a las condiciones sanitarias de Colombia

Objetivos. Elaborar un inventario de indicadores de mortalidad evitable (INIME) que permita analizar las fallas en el control de los riesgos de mortalidad predominantes en Colombia y comparar los resultados de su aplicación con los obtenidos mediante dos enfoques ampliamente utilizados. Métodos. Se revisaron los registros oficiales de mortalidad de Colombia de 1985 a 2001; las causas básicas de muerte se clasificaron según la CIE-9. Se seleccionaron los indicadores de mortalidad evitable (ME) mediante un algoritmo que combinó las listas de Holland y de Taucher, la definición de Rutstein y colaboradores y el principio de Uemura. Se compararon las proporciones de muertes evitables resultantes de aplicar el INIME y las dos listas de ME a una base de datos con los registros oficiales de defunciones de Colombia de 1993 a 1996. Resultados. De las 680 617 defunciones registradas en el período de estudio, se clasificaron como evitables 18,2% según la lista de Holland y 51,3% según la lista de Taucher. La ME según el INIME ascendió a 76,7%. Este patrón se mantuvo relativamente estable entre 1993 y 1996. Las diferencias observadas en la proporción de muertes evitables según el INIME y las dos listas de ME se relacionaron con el perfil epidemiológico local y el enfoque conceptual de cada lista. Conclusiones. Las diferencias entre el INIME y las listas de ME de Holland y de Taucher muestran las consecuencias de usar una u otra clasificación en el contexto colombiano. El INIME puede constituir un recurso valioso para fundamentar y evaluar políticas sanitarias, pero debe ajustarse a la situación específica en que se aplique.

Armed Groups and Violence in Paraguay

Armed violence in Paraguay is not a recent phenomenon. During the second half of the XX Century, Paraguay saw the rise of a larger number of underground, revolutionary movements that sought the overthrow of the Alfredo Stroessner’s (1954-1989) government. From among those movements emerged the Partido Patria Libre (or, Free Fatherland, also known for its acronym PPL), made up of a two branches: one legal and the other one, operational. The latter was based on people’s power, as represented by “Ejército del Pueblo Paraguayo” (or, the Paraguayan People’s Army, with acronym EPP). After EPP broke with PPL in March 2008, this Marxist-oriented revolutionary project, which was apparently oriented to put an end to the social, political and economic inequalities in Paraguay, began to carry out markedly criminal activities, which included bank robberies, kidnappings, assassinations, terrorist attacks and armed confrontations. Its strategies and modus operandi utilized by the Armed Revolutionary Forces of Colombia (FARC). Paraguay features a farm sector in a state of crisis, in which cattle-ranchers, peasants and agro-exporting companies live in a constant strife. The Paraguayan Departments that are the most affected by this situation are Concepciόn, San Pedro, Canindeyú y Caazapá, which also suffer from a weak government presence. This deficiency has made these departments ripe for drug-trafficking activity by Brazilian groups such as Primer Comando Capital (i.e., First Capital command), also PCC and Comando Vermelho, (i.e., The Red Command). That is why many peasants, now recruited by EPP, have joined the drug-trafficking business and that, not only as marihuana growers but as “campanas” (i.e., early warning sentinels) for the organization. This helps shape their attitudes for their future involvement in all areas of drug-trafficking. Paraguayan society is the result of social inequity and inequality, such as those resulting from a lack of opportunity. Although Paraguay has successfully recovered from the last world economic crisis, economic growth, by itself, does not ensure an improvement in the quality of life. As long as such economic and social gaps persist and the government fails to enact the policies that would result in a more just society and toward EPP neutralization or containment, the latter is bound to grow stronger. In this context, the situation in Paraguay calls for more research into the EPP phenomenon. It would also seem necessary for Paraguay to promote an open national debate that includes all sectors of society in order to raise consciousness and to induce society to take actual steps to eliminate the EPP, as well as any other group that might arise in the immediate future. EPP has strong connections with the Frente Patriόtico Manuel Rodríguez in Chile and other armed groups and peasant movements in other countries of this region. Although most governments in the region are aware that the armed struggle is not a solution to current problems, it might be worth it to hold a regional debate about armed or insurgent groups in Latin American to seek common strategies and cooperation on dealing with them since the expansion of these armed groups is a problem for all.

Teaching Empowerment Through Sport: An Analysis of Fast and Female

This project is about Fast and Female, a community-based girls’ sport organization, that focuses on empowering girls through sport. In this thesis I produce a discourse analysis from interviews with six expert sportswomen and a textual analysis of the organization’s online content – including its social media pages. I ground my analysis in poststructural theory as explained by Chris Weedon (1997) and in literature that helps contextualize and better define empowerment (Collins, 2000; Cruikshank, 1999; Hains, 2012; Sharma, 2008; Simon, 1994) and neoliberalism (Silk & Andrews, 2012). My analysis in this project suggests that Fast and Female develops a community through online and in-person interaction. This community is focused on girls’ sport and empowerment, but, as the organization is situated in a neoliberal context, organizers must take extra consideration in order for the organization to develop a girls’ sport culture that is truly representative of the desires and needs of the participants rather than implicit neoliberal values. It is important to note that Fast and Female does not identify as a feminist organization. Through this thesis I argue that Fast and Female teaches girls that sport is empowering – but, while the organization draws on “empowerment,” a term often used by feminists, it promotes a notion of empowerment that teaches female athletes how to exist within current mainstream and sporting cultures, rather than encouraging them to be empowered female citizens who learn to question and challenge social inequity. I conclude my thesis with suggestions for Fast and Female to encourage empowerment in spite of the current neoliberal situation. I also offer a goal-setting workbook that I developed to encourage girls to set goals while thinking about their communities rather than just themselves.

Of Marx and Makers: an Historical Perspective on Generative Justice

In Marxist frameworks “distributive justice” depends on extracting value through a centralized state. Many new social movements—peer to peer economy, maker activism, community agriculture, queer ecology, etc.—take the opposite approach, keeping value in its unalienated form and allowing it to freely circulate from the bottom up. Unlike Marxism, there is no general theory for bottom-up, unalienated value circulation. This paper examines the concept of “generative justice” through an historical contrast between Marx’s writings and the indigenous cultures that he drew upon. Marx erroneously concluded that while indigenous cultures had unalienated forms of production, only centralized value extraction could allow the productivity needed for a high quality of life. To the contrary, indigenous cultures now provide a robust model for the “gift economy” that underpins open source technological production, agroecology, and restorative approaches to civil rights. Expanding Marx’s concept of unalienated labor value to include unalienated ecological (nonhuman) value, as well as the domain of freedom in speech, sexual orientation, spirituality and other forms of “expressive” value, we arrive at an historically informed perspective for generative justice. 

Diversity and equity: dealing with biological and social differences

In the context of the design of working hours inequities in health associated with biological, psychological, social, and socioeconomic diversities can be observed. The paper first tries to set up a frame of reference for a discussion of this topic, relating to the Universal Declaration of Human Rights and some recent discussions on equity in health and then goes into some factors that produce inequities in health in the context of the design of working hours, dealing with sex or gender, age and job age, personality traits, marital status, social support, diversities in values, and socio-economic differences; the discussion deals with approaches on how to deal with these differences and inequities.

Elicited beliefs and social information in modified dictator games: What do dictators believe other dictators do?

We use subjects actions in modified dictator games to perform a within-subject classification ofindividuals into four different types of interdependent preferences: Selfish, Social Welfaremaximizers, Inequity Averse and Competitive. We elicit beliefs about other subjects actions inthe same modified dictator games to test how much of the existent heterogeneity in others actions is known by subjects. We find that subjects with different interdependent preferences infact have different beliefs about others actions. In particular, Selfish individuals cannotconceive others being non-Selfish while Social Welfare maximizers are closest to the actualdistribution of others actions. We finally provide subjects with information on other subjects actions and re-classify individuals according to their (new) actions in the same modified dictatorgames. We find that social information does not affect Selfish individuals, but that individualswith interdependent preferences are more likely to change their behavior and tend to behavemore selfishly.

Pregnant Adolescents in Vietnam : Social context and health care needs

Background: The number of childbearing adolescents in Vietnam is relatively low but they are more prone to experience adverse outcome than adult women. Reports of increasing rates of abortion and prevalence of STIs including HIV among youth indicate a need to improve services and counselling for these groups. Midwives are key persons in the promotion of young people’s sexual and reproductive health in Vietnam. Aim: The overall aim of this thesis is to describe the prevalence and outcome of adolescent pregnancies in Vietnam (I), to explore the social context and health care seeking behavior of pregnant adolescents (II), as well as to explore the perspectives of health care providers and midwifery students regarding adolescent sexuality and reproductive health service needs (III, IV). Methods: The studies were conducted from 2002 to 2005, combining qualitative and quantitative research methods. A population based prospective survey was used to estimate rates and outcomes of adolescent pregnancies (I). Pregnant and newly delivered adolescents’ experiences of childbearing and their encounters with health care providers were studied using qualitative interviews (II). Health care providers’ perspective on adolescent sexual and reproductive health (ASRH) and views on how to improve the quality of abortion care was explored in focus group discussions (FGD). The values and attitudes of midwifery students about ASRH were investigated using questionnaires and interviews (IV). Descriptive statistics was used to analyse quantitative data (I, IV) and content analysis were applied for qualitative data (II, III, and IV). Findings: Adolescent birth rate was similar to previously reported in Vietnam but lower when compared to other Asian countries. The incidence of stillborn among adolescents was higher than for women in higher reproductive ages. The proportion of preterm deliveries was 20 % of all births, higher than previous findings from Vietnam. About 2 % of the deliveries were home deliveries, more common among women with low education, belonging to ethnic minority and/or living in mountainous areas (I). Ambivalence facing motherhood, pride and happiness but also worries and lack of self-confidence emerged as themes from the interviews; and experience of ‘being in the hands of others’ in a positive, caring sense but also in a sense of subordination in relation to husband, family and health care providers (II). Health care providers at abortion clinics and midwifery students generally disapproved of pre-marital sex, but had a pragmatic view on the need for contraceptive services and counselling to reduce the burden of unwanted pregnancies and abortions for young women. Providers and midwifery students expressed a need for training on ASRH issues (III, IV). Conclusion: Cultural norms and gender inequity make pregnant adolescent women in Vietnam vulnerable to sexual and reproductive health risks. Health care providers experience ethical dilemmas while counselling unmarried adolescents who come for abortion and this has a negative impact on the quality of care. Integrated ASRH in education and training programmes for health care providers, including midwives, as well as continued in-service training on these issues are suggested to improve reproductive health care services in Vietnam.

Associação entre as narrativas em saúde bucal e condições socioeconômico-culturais: a dentição como reflexo da desigualdade social

This anthropological study investigates the lived-experience of oral diseases in the context of poverty in Northeast Brazil. During six months in 2004???, ethnographic interviews, narratives and participant-observation with 31 residents of the low-income community, Dendê, located in Fortaleza, Ceará were conducted and analyzed utilizing a hermeneutic-dialetic method. It is revealed that precarious life conditions make prioritizing caretaking a difficult task. Despite suffering tooth pain, seeking a dentist's care is perceived as "a luxury" not a citzens' right. Difficulties in accessing services and poor quality restorations, favor tooth extractions as the most effective intervention. The deterioration of one's oral health is lamented by community members who seek help from popular clinics, politicians and traditional healers. The experience of dental disease differs according to social class, leaves oral scars of inequity, harms self-esteem and inhibits social inclusion. In this context, "treating" the Teeth of Inequity demands that we deepen our comprehension of the social determinants of health, reduce injustice in the access to quality care, remove demoralizing stigmas and empower the community to confront structural forces which affect its life

Social Panorama of Latin America 2006

Includes bibliography