Nationwide evidence that education disrupts the intergenerational transmission of disadvantage

2021 ◽  
Vol 118 (31) ◽  
pp. e2103896118
Signe Hald Andersen ◽  
Leah S. Richmond-Rakerd ◽  
Terrie E. Moffitt ◽  
Avshalom Caspi

Despite overall improvements in health and living standards in the Western world, health and social disadvantages persist across generations. Using nationwide administrative databases linked for 2.1 million Danish citizens, we leveraged a three-generation approach to test whether multiple, different health and social disadvantages—poor physical health, poor mental health, social welfare dependency, criminal offending, and Child Protective Services involvement—were transmitted within families and whether education disrupted these statistical associations. Health and social disadvantages concentrated, aggregated, and accumulated within a small, high-need segment of families: Adults who relied disproportionately on multiple, different health and social services tended to have parents who relied disproportionately on multiple, different health and social services and tended to have children who evidenced risk for disadvantage at an early age, through appearance in protective services records. Intra- and intergenerational comparisons were consistent with the possibility that education disrupted this transmission. Within families, siblings who obtained more education were at a reduced risk for later-life disadvantage compared with their cosiblings who obtained less education, despite shared family background. Supporting the education potential of the most vulnerable citizens might mitigate the multigenerational transmission of multiple disadvantages and reduce health and social disparities.

1983 ◽  
Vol 8 (2) ◽  
pp. 16-19
Phillip A. Swain

Human service networks are completely unwieldy and changeable, and analysis of them is no simple task. Nevertheless, the examination of two such systems – in Michigan, U.S.A. and in Victoria, Australia – ought to enable some conclusions to be drawn as to the effectivenesss and implications of two alternative implementations of basically similar policies for the protection of children. Such an examination is here attempted, using for comparison the Child Protection Units operating under the auspice of the Michigan Department of Social Services in Michigan, U.S.A., and those operated by the Children’s Protection Society in Victoria, Australia.

JAMA ◽  
2018 ◽  
Vol 320 (21) ◽  
pp. 2197 ◽  
William H. Shrank ◽  
Donna J. Keyser ◽  
John G. Lovelace

2020 ◽  
Vol 90 (1) ◽  
pp. 48-62 ◽  
Kathryn Maguire-Jack ◽  
Sarah A. Font ◽  
Rebecca Dillard

2009 ◽  
Vol 33 (1) ◽  
pp. 3

THERE IS PLENTY OF ACTIVITY throughout the world focusing on encrypting personal health (and other) information on credit card-sized plastic ?smart? cards. These cards are embedded with a computer chip and could provide easy access to essential health information. As with many new technologies, there is debate about smart cards in health. In July 2004 the Federal Minister for Health and Ageing at that time, the Hon Tony Abbott, announced that ?Australians will have access to a new Medicare smart card as part of the government?s electronic health agenda to improve the quality and accessibility of patient information across the health system?.1 This led to the introduction of the Health and Social Services smart card initiative. The business case for this initiative suggested that this card could replace around 17 government issued ?health? cards, while improving proof of identify arrangements.2 While in opposition, the Labor Party opposed the notion of the smart card, claiming it was an identity card by stealth,3 and at the time of writing, it appears that the health smart card has been put on the backburner while the Government sorts out the priorities. In this issue, Mohd Rosli and his Melbourne colleagues report on a study of patient and staff perceptions about health smart cards (page 136). In this study, 270 emergency department patients and 92 staff completed self-administered questionnaires. The findings among patients and staff generally supported the introduction of smart cards with the majority reporting that the advantages outweighed the disadvantages. The majority of the respondents indicated that the cards should be brought into use, and that they would use one if offered. However, the study did find that a large proportion of staff and patients were not aware of health smart cards at all. A fundamental change in the structure of our relationship with the government had been proposed through the Health and Social Services smart card initiative, and yet the findings of this study suggest that the Australian public was ill prepared to discuss the implications. Where is the information sharing, the discussion and the debate that can help shape our health care system for the future? In our last issue of 2008 we included a call for student papers. I would like to remind all readers of this important initiative, reproduced overleaf, as I believe this is an effective way to begin to encourage the necessary discussion and debate.

1998 ◽  
Vol 16 (5) ◽  
pp. 559-572 ◽  
N T Hanlon ◽  
M W Rosenberg

New public management (NPM) has become the mantra for public sector restructuring in OECD nations. We critically examine NPM in the context of recent public sector restructuring initiatives in the province of Ontario, Canada. Two NPM-inspired reform mechanisms employed by the Ontario government—the benchmarking of hospital-utilization indicators and the offloading of a greater share of patient-care responsibilities to the private sector—are examined as they impact on the economically disadvantaged city of Thunder Bay in the province's remote Northwestern region. We argue that the health reforms pursued by the Ontario government are focused on a one-dimensional notion of efficiency which denies important socioeconomic and health-service-environment dimensions that account for local differences in health-services utilization. Although this type of reform approach achieves short-term cost savings, we question whether the longer term effects on health and social services are efficient and equitable from a systemwide perspective. Ultimately, we question whether NPM will solve the problems inherent in publicly supported health and social services or will generate a new set of problems linked to the belief in the primacy of market mechanisms.

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