How Do the Middle Class and the Poor Grow Apart? An Empirical Test of the Psychological Well-Being Pathway in Middle-Income Countries

2016 ◽  
Vol 28 (5) ◽  
pp. 893-915
Author(s):  
Rick Mourits ◽  
Luuk Van Kempen

Subject Patterns of inequality. Significance Inequality across the world varies significantly, particularly among middle-income countries. Much of this variance is the result of differences in the income shares of the poor and rich since the middle class receives a similar level of income in most cases. Latin America occupies a peculiar position in these comparisons: it is the most unequal region in the world because the wealthy are able to control more income than anywhere else. Impacts Effective measures to tackle inequality would require politically difficult reforms of the income tax system. Pressures to redistribute resources to the poor will squeeze the middle classes in times of muted growth. Elite power will be particularly significant in countries such as Colombia and Brazil, if less so in Argentina and Uruguay.


Author(s):  
Suman Verma

Effective social protection policies are crucial to realizing adolescents’ rights, ensuring their well-being, breaking the cycle of poverty and vulnerability, and helping them realize their full developmental potential. Low- and middle-income countries (LMICs) have extended social security coverage to ensure basic protections—while continuing to develop social protection systems. Social protection for LMIC adolescents in the context of gross violations of their basic rights is examined. Prevalence, consequences of protection rights violations, and the role and impact of social protection programs in ensuring enhanced opportunities for development and well-being among young people are discussed. Results demonstrate direct impacts (e.g., increased income, consumption, goods and services access; greater social inclusion; reduced household stress). LMICs need integrated social protection policy and program expansion if the 2030 Agenda for Sustainable Development is to be realized. With adolescent-centered policies and investments, governments can help adolescents realize their rights to a fulfilling and productive life.


BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e034986 ◽  
Author(s):  
Sara Valdebenito ◽  
Aja Murray ◽  
Claire Hughes ◽  
Adriana Băban ◽  
Asvini D Fernando ◽  
...  

IntroductionViolence against children is a health, human rights and social problem affecting approximately half of the world’s children. Its effects begin at prenatal stages with long-lasting impacts on later health and well-being. The Evidence for Better Lives Study (EBLS) aims to produce high-quality longitudinal data from cities in eight low- and middle-income countries—Ghana, Jamaica, Pakistan, the Philippines, Romania, South Africa, Sri Lanka and Vietnam—to support effective intervention to reduce violence against children. EBLS-Foundational Research (EBLS-FR) tests critical aspects of the planned EBLS, including participant recruitment and retention, data collection and analysis. Alongside epidemiological estimates of levels and predictors of exposure to violence and adversity during pregnancy, we plan to explore mechanisms that may link exposure to violence to mothers’ biological stress markers and subjective well-being.Methods and analysesEBLS-FR is a short longitudinal study with a sample of 1200 pregnant women. Data are collected during the last trimester of pregnancy and 2 to 6 months after birth. The questionnaire for participating women has been translated into nine languages. Measures obtained from mothers will include, among others, mental and physical health, attitudes to corporal punishment, adverse childhood experiences, prenatal intimate partner violence, substance use and social/community support. Hair and dry blood spot samples are collected from the pregnant women to measure stress markers. To explore research participation among fathers, EBLS-FR is recruiting 300 fathers in the Philippines and Sri Lanka.Ethics and disseminationThe study received ethical approvals at all recruiting sites and universities in the project. Results will be disseminated through journal publications, conferences and seminar presentations involving local communities, health services and other stakeholders. Findings from this work will help to adjust the subsequent stages of the EBLS project.


BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e047650
Author(s):  
Wiraporn Pothisiri ◽  
Paolo Miguel Manalang Vicerra

ObjectiveThe COVID-19 situation in Thailand was controlled with various social measures. Much of the information covered in the media and in studies focused on the public health and economic aspects of the pandemic. This study aimed to explore the psychological well-being of older people, which is important especially in an ageing society categorised as low income or middle income due to the limits of economic and healthcare resources.SettingThe impact of COVID-19 on older persons in Thailand, an online survey, taken across nine provinces within the five regions of the country.ParticipantsInformation was collected from 1230 adults aged at least 60 years old.If an older person was illiterate, unable to access the internet or had a disability preventing them from responding to the survey, an intermediary residing in the community conducted the survey interview.Primary and secondary outcome measuresThe analysis focused on the worries of older adults and the factors associated with psychological distress experienced during the pandemic using logistic regression analysis.ResultsThe majority of people aged at least 60 years old experienced psychological distress during COVID-19. Employment loss (OR 1.08, 95% CI 0.78 to 1.38), inadequate income (OR 1.77, 95% CI 1.28 to 2.44) and debt incursion (OR 2.74, 95% CI 1.57 to 4.80) were detrimental to psychological well-being. The negative changes in the perception of their health status (OR 1.92, 95% CI 1.23 to 2.99) and decreased life satisfaction (OR 1.49, 95% CI 0.45 to 1.87) also weighed on older Thais. The protective factors for psychological well-being were residing in rural areas (OR 0.46, 95% CI 0.35 to 0.61) and being married (OR 0.75, 95% CI 0.55 to 1.01).ConclusionObserving the concerns of the older population is important for introducing policies that can alleviate their precarious financial and health statuses.


2021 ◽  
Author(s):  
Charlotte Dieteren ◽  
Igna Bonfrer

Abstract Background The heavy and ever rising burden of non-communicable diseases (NCDs) in low- and middle-income countries (LMICs) warrants interventions to reduce their underlying risk factors, which are often linked to lifestyles. To effectively supplement nationwide policies with targeted interventions, it is important to know how these risk factors are distributed across socioeconomic segments of populations in LMICs. This study quantifies the prevalence and socioeconomic inequalities in lifestyle risk factors in LMICs, to identify policy priorities conducive to the Sustainable Development Goal of a one third reduction in deaths from NCDs by 2030. Methods Data from 1,278,624 adult respondents to Demographic & Health Surveys across 22 LMICs between 2013 and 2018 are used to estimate crude prevalence rates and socioeconomic inequalities in tobacco use, overweight, harmful alcohol use and the clustering of these three in a household. Inequalities are measured by a concentration index and correlated with the percentage of GDP spent on health. We estimate a multilevel model to examine associations of individual characteristics with the different lifestyle risk factors. Results The prevalence of tobacco use among men ranges from 59.6% (Armenia) to 6.6% (Nigeria). The highest level of overweight among women is 83.7% (Egypt) while this is less than 12% in Burundi, Chad and Timor-Leste. 82.5% of women in Burundi report that their partner is “often or sometimes drunk” compared to 1.3% in Gambia. Tobacco use is concentrated among the poor, except for the low share of men smoking in Nigeria. Overweight, however, is concentrated among the better off, especially in Tanzania and Zimbabwe (Erreygers Index (EI) 0.227 and 0.232). Harmful alcohol use is more concentrated among the better off in Nigeria (EI 0.127), while Chad, Rwanda and Togo show an unequal pro-poor distribution (EI respectively − 0.147, -0.210, -0.266). Cambodia exhibits the largest socioeconomic inequality in unhealthy household behaviour (EI -0.253). The multilevel analyses confirm that in LMICs, tobacco and alcohol use are largely concentrated among the poor, while overweight is concentrated among the better-off. The associations between the share of GDP spent on health and the socioeconomical distribution of lifestyle factors are multidirectional. Conclusions This study emphasizes the importance of lifestyle risk factors in LMICs and the socioeconomic variation therein. Given the different socioeconomic patterns in lifestyle risk factors - overweight patters in LMICs differ considerably from those in high income countries- tailored interventions towards specific high-risk populations are warranted to supplement nationwide policies.


2021 ◽  
Vol 235 ◽  
pp. 01019
Author(s):  
Siming Jia

This paper collected panel data of 74 countries from 1990 to 2017, and based on the Chinn-It index to depict the degree of capital account opening. Under the framework of the neoclassical economic growth model, the impact of capital account opening on economic growth was empirically tested by systematic GMM. The results show that: first, taking the overall capital account openness as the explanatory variable, the coefficient of the capital account openness of the whole sample is significantly positive. Further, considering the national differences found that high income countries capital account openness coefficient is significantly positive, but in low and middle-income countries capital account openness coefficient on economic and statistical significance were not significant, indicating that high income countries made open dividends, while in low and middle-income countries and earnings in the capital account liberalization. Finally, it proposes to open the capital account sub-projects step by step, strengthen prudent supervision in the process of further opening the capital account, and improve the regulatory legal system.


2020 ◽  
Author(s):  
Charlotte Dieteren ◽  
Igna Bonfrer

Abstract Background: The heavy and ever rising burden of non-communicable diseases (NCDs) in low- and middle-income countries (LMICs) warrants interventions to reduce unhealthy lifestyles. To effectively target these interventions, it is important to know how unhealthy lifestyles vary with socioeconomic characteristics. This study quantifies prevalence and socioeconomic inequalities in unhealthy lifestyles in LMICs, to identify policy priorities conducive to the Sustainable Development Goal of a one third reduction in deaths from NCDs by 2030.Methods: Data from 1,278,624 adult respondents to Demographic & Health Surveys across 22 LMICs between 2013 and 2018 are used to estimate crude prevalence rates and socioeconomic inequalities in tobacco use, overweight, harmful alcohol use and the clustering of these three in a household. Inequalities are measured by a concentration index and correlated with the percentage of GDP spent on health. We estimate a multilevel model to examine associations of individual characteristics with different unhealthy lifestyles.Results: The prevalence of tobacco use among men ranges from 59.6% (Armenia) to 6.6% (Nigeria). The highest level of overweight among women is 83.7% (Egypt) while this is less than 12% in Burundi, Chad and Timor-Leste. 82.5% of women in Burundi report that their partner is “often or sometimes drunk” compared to 1.3% in Gambia. Tobacco use is concentrated among the poor, except for the low share of men smoking in Nigeria. Overweight, however, is concentrated among the better off, especially in Tanzania and Zimbabwe (Erreygers Index (EI) 0.227 and 0.232). Harmful alcohol use is more concentrated among the better off in Nigeria (EI 0.127), while Chad, Rwanda and Togo show an unequal pro-poor distribution (EI respectively -0.147, -0.210, -0.266). Cambodia exhibits the largest socioeconomic inequality in unhealthy household behaviour (EI -0.253). The multilevel analyses confirm that in LMICs, tobacco and alcohol use are largely concentrated among the poor, while overweight is concentrated among the better-off.Conclusions: This study emphasizes the importance of unhealthy lifestyles in LMICs and the socioeconomic variation therein. Given the different socioeconomic patterns in unhealthy lifestyles - overweight patters in LMICs differ considerably from those in high income countries- tailored interventions towards specific high-risk populations are warranted.


2021 ◽  
pp. 33-46
Author(s):  
Than Sein

The history and development of public health in low- and middle-income countries (LMICs) shows that important breakthroughs in public health interventions have led to great improvements in economic development. Health determines economic productivity and prosperity, and the physical and emotional well- being of the people. The mindset of the population afflicted with a high infant mortality rate usually lacks the secure knowledge of its children’s longevity, witnesses higher fertility rates, and experiences the quality- quantity trade- off in child- rearing. Ever since the health- for- all movement was initiated over three decades ago, health, equity, and social justice remain the main themes of social and health policy. It is essential for all public health professionals to sustain these values, especially those in LMICs and the international community.


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