Inequality and Neighbourhood Effects

2017 ◽  
Author(s):  
Namrata Gulati ◽  
Tridip Ray
Keyword(s):  
Income Inequality ◽  
Health Care Services ◽  
Service Providers ◽  
Market Access ◽  
Consumer Surplus ◽  
Neighbourhood Effects ◽  
Care Services ◽  
The Poor ◽  
Complete Exclusion ◽  
The Rich

The key insight in our research is to recognize inequality–neighbourhood interaction: neighbourhood effects interacting with income inequality may affect poor people’s ability to access basic facilities like health-care services, schooling, and so on. While Gulati and Ray (2016) model this interaction on a monopolist service provider in a neighbourhood structured as a linear city where rich and poor consumers live side by side, in this chapter we extend the analysis to a competitive framework with free entry and exit where the natural neighbourhood structure is a circular city. We find inverted-U shape relationships between income inequality and market access and welfare of the poor: if we compare a cross-section of societies, the poor community as a whole is initially better off living in relatively richer societies, but, beyond a point, the aggregate market access and consumer surplus of the poor starts declining as society becomes richer. We identify the possibility of complete exclusion of the poor from the market: a scenario where the service providers cater only to the rich and the poor have absolutely no market access, and find that it is the higher income gap between rich and poor that exposes the poor to this unfortunate outcome.

Are the Poor Catching Up with the Rich in Utilising Maternal Health Care Services? Evidence from India

2021 ◽  
Vol 23 (3) ◽  
pp. 470-481
Author(s):  
Sohini Paul
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Health Services ◽  
Health Care Services ◽  
National Level ◽  
Maternal Health Care ◽  
Care Services ◽  
The Poor ◽  
Maternal Health Care Services ◽  
The Rich

India launched the National Rural Health Mission (NRHM) in 2005 to improve maternal and child health by providing good quality health services to all, especially deprived sections of society, to reduce inequality in access to health services. With the backdrop of NRHM, we analysed the extent to which the utilisation of maternal health care services (MHCSs) in the three stages of the continuum of care—antenatal care (ANC), care during child delivery and postnatal care (PNC)—–has improved among the poor vis-à-vis the rich in India, and the corresponding narrowing down in inequality in the period 2006–2016. Data from the 3rd round of the National Family Health Survey (NFHS) in 2005–2006, capturing the pre-NRHM period and the 4th round of NFHS 2015–2016, capturing the post-NRHM era ten years after the implementation of the flagship programme, are used for the analysis. We estimated absolute as well as relative measures of inequality, absolute gap and coverage ratio between the poor and rich, slope index of inequality and concentration index. Our findings show that maternal health care coverage increased significantly among the poor for all components of MHCSs. Even so, the extent of utilisation of services remains significantly lower among the poor in 2015–2016 compared to the coverage among the rich in 2005–2006. Although inequality declined at the national level over the decade, it still persists. High equity has been achieved in using skilled birth attendance during child delivery and institutional delivery during 2015–2016, however, inequality continues to be higher for ANC indicators including consumption of iron and folic acid supplements for at least 100 days, receipt of four or more antenatal check-ups and comprehensive health check-ups at least once during antenatal visits and receipt of first check-up in the first trimester.

Health Care Services and EU Competition Law

2020 ◽  
Author(s):  
Okeoghene Odudu
Keyword(s):  
Market Power ◽  
Healthcare Service ◽  
Health Care Services ◽  
Service Providers ◽  
Competition Law ◽  
Healthcare Services ◽  
System Matrix ◽  
Member States ◽  
Eu Member States ◽  
Care Services

This chapter investigates how, within a number of European Union (EU) Member States, competition law has been used to address problems of market power in the healthcare services sector. It summarizes the relevant EU and national competition laws and considers the experience of applying those laws to providers of healthcare services. The chapter is chiefly concerned with healthcare services in England, although examples are drawn for other EU Member States. Examination of the English experience provides a view of the use of competition law to address market power problems in most elements of the health system matrix. The chapter then considers three challenges that emerge from that experience of using competition law to address problems of market power in healthcare service markets. The first challenges the applicability of competition law to healthcare service providers operating in each or every element of the healthcare system matrix. The second, accepting applicability, questions the appropriateness of the substantive rules to healthcare services. The third, a battle of authority and autonomy, considers whether decisions made by healthcare service providers should be subject to external review and the type of review that competition law offers.

The effects of debt restructurings on income inequality in the developing world

2021 ◽  
pp. 135406612110014
Author(s):  
Glen Biglaiser ◽  
Ronald J. McGauvran
Keyword(s):  
Developing Countries ◽  
Panel Data ◽  
Income Inequality ◽  
Income Distribution ◽  
Government Spending ◽  
Tax Reform ◽  
Social Spending ◽  
The Poor ◽  
The Rich ◽  
The Impact

Developing countries, saddled with debts, often prefer investors absorb losses through debt restructurings. By not making full repayments, debtor governments could increase social spending, serving poorer constituents, and, in turn, lowering income inequality. Alternatively, debtor governments could reduce taxes and cut government spending, bolstering the assets of the rich at the expense of the poor. Using panel data for 71 developing countries from 1986 to 2016, we assess the effects of debt restructurings on societal income distribution. Specifically, we study the impact of debt restructurings on social spending, tax reform, and income inequality. We find that countries receiving debt restructurings tend to use their newly acquired economic flexibility to reduce taxes and lower social spending, worsening income inequality. The results are also robust to different model specifications. Our study contributes to the globalization and the poor debate, suggesting the economic harm caused to the less well-off following debt restructurings.

Transnational Diffusion of Health Policy Ideas in Uruguay in the Early Twentieth Century

2021 ◽  
Vol 33 (3) ◽  
pp. 317-343
Author(s):  
CECILIA ROSSEL ◽  
FELIPE MONESTIER
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Public Assistance ◽  
Care Services ◽  
Policy Ideas ◽  
The Poor ◽  
Role Of The State ◽  
Parliamentary Debate ◽  
The Law

AbstractThis article analyzes how policy ideas already adopted in Europe, particularly in France, were taken into consideration for the design of Uruguay’s National Public Assistance (NPA) policy. Established in 1910, the NPA was a pioneering government social policy for the time and for the region.Some have argued that the design of the NPA law followed the secular and republican model instituted in France at the end of the nineteenth century when France established the Assistance Publique, particularly regarding the extent of public assistance to the poor, the role of the state in the provision of health care (as opposed to charity-based provision) and the centralization of health-care services (as opposed to a decentralized health-care system).We analyze how these revolutionary ideas were discussed by the technicians and politicians who participated in the process that culminated in the approval of the law in Uruguay discussed these revolutionary ideas. We explore the factors that motivated the creation of the commission that developed the law. We also review available documentation on the drafting of the bill and the parliamentary debate that culminated in its approval. We find that the design of the NPA included many ideas diffused mainly from France. The French model was not simply emulated, however. Rather, the authors of the NPA thoroughly analyzed and considered the features and main consequences of the Assistance Publique, suggesting that diffusion in this case was more a process of learning than of simple mimicry.

Evaluating models of working at the interface between mental health services and primary care

1997 ◽  
Vol 170 (1) ◽  
pp. 6-11 ◽  
Author(s):  
Linda Gask ◽  
Bonnie Sibbald ◽  
Francis Creed
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Health Services ◽  
Health Care Services ◽  
Service Providers ◽  
Psychiatric Nurses ◽  
Local Health ◽  
Care Services ◽  
Secondary Health Care

BackgroundThis paper examines the feasibility of evaluating innovative models of working at the interface between primary care and secondary mental health services.MethodMethodological problems relevant to evaluation of innovative models of working at the interface are discussed.ResultsAlthough there is some evidence that neurotic disorders can be more cost-effectively treated in primary care, many general practitioners (GPs), and possibly some patients, prefer referral to community mental health teams and community psychiatric nurses, which are provided by the secondary health care services. Since the latter are provided with the intention of improving serious mental illness their involvement in the care of neurotic illness can lead to tensions between GPs, local health authorities and service providers. There is little evidence to suggest that psychiatrists working in health centres using the ‘shifted out-patient’ model have eased this problem. By contrast the ‘consultation-liaison’ (C-L) model has a number of theoretical advantages; referrals to secondary care should be limited to those most in need of this level of expertise and GP management skills should improve, so leading to better quality of care for patients who are not referred.ConclusionStudies comparing the different models of service delivery are required to address the tensions that have arisen following changes in government policy. Further work is also needed to develop the necessary research tools.

scholarly journals China's Post-Socialist Inequality

2012 ◽  
Vol 111 (746) ◽  
pp. 229-234 ◽  
Author(s):  
Martin King Whyte
Keyword(s):  
Income Inequality ◽  
Sharp Increase ◽  
The Poor ◽  
The Rich

The country's sharp increase in income inequality is not the result of the rich getting richer while the poor become poorer.

Reevaluating Funding Mechanisms for UK Primary Care Trusts: A New Model of Secondary Care Usage Incorporating Lifestyle Data

10.1068/c0427 ◽  
2005 ◽  
Vol 23 (3) ◽  
pp. 317-336 ◽  
Author(s):  
Mark Birkin ◽  
Graham Clarke ◽  
Phil Gibson ◽  
Roger Dewhurst ◽  
Jacqui Bobby
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Goodness Of Fit ◽  
Service Providers ◽  
Social Economic ◽  
Explanatory Variables ◽  
Care Services ◽  
Funding Mechanisms ◽  
The City ◽  
Use Of Health Care

This paper is concerned with modelling variations in the use of health-care services between small geographic areas. A range of potential explanatory variables are identified from a review of previous literature, ranging from social, economic, and demographic factors through access to services, and practitioner characteristics, to new measures of behaviour and lifestyle. Real admissions data for the city of Leeds relating to a variety of services over a three-year period are introduced to calibrate a series of utilisation models. It is argued that the strength of the goodness of fit makes these models potentially useful in the evaluation of resource allocation between service providers. By providing better global models of usage it is possible to examine small-area outliers to highlight areas where revealed demand, or usage, is not reflecting need as much as it should. In particular, this paper demonstrates the importance of lifestyle preferences in modelling the utilisation of health-care services.

Income Inequality, Life Satisfaction, and Economic Worries

2016 ◽  
Vol 8 (2) ◽  
pp. 133-141 ◽  
Author(s):  
Bettina Roth ◽  
Elisabeth Hahn ◽  
Frank M. Spinath
Keyword(s):  
Life Satisfaction ◽  
Income Inequality ◽  
Middle Class ◽  
Panel Study ◽  
National Level ◽  
Negative Relationship ◽  
Income Disparity ◽  
Negative Effects ◽  
The Poor ◽  
The Rich

We analyzed the effect of income inequality on Germans’ life satisfaction considering factors explaining the mechanism of this relationship. Based on data from the German Socio-Economic Panel Study for the years 1984 to 2012, we found a negative relationship between national-level income disparity and average life satisfaction, meaning that people felt happier in years with lower inequality. The effect was completely mediated by economic worries, which increased with rising inequality and in turn reduced people’s satisfaction. However, people’s reaction to inequality depended on their income level: Considering the direct effect of inequality, higher income disparity was clearly detrimental only for the poor and the middle class. Moreover, we found a significant mediation through economic worries for the middle class but not for the poor. The rich showed a more complex pattern of interrelations with both, positive and negative effects of inequality when controlling for economic worries.

A Comparative Study of Inequality and Corruption

2005 ◽  
Vol 70 (1) ◽  
pp. 136-157 ◽  
Author(s):  
You Jong-sung ◽  
Sanjeev Khagram
Keyword(s):  
Income Inequality ◽  
Instrumental Variables ◽  
Significant Interaction ◽  
Explanatory Power ◽  
Significant Interaction Effect ◽  
The Poor ◽  
The World ◽  
Corruption Index ◽  
The Rich ◽  
Control Of Corruption

This article argues that income inequality increases the level of corruption through material and normative mechanisms. The wealthy have both greater motivation and more opportunity to engage in corruption, whereas the poor are more vulnerable to extortion and less able to monitor and hold the rich and powerful accountable as inequality increases. Inequality also adversely affects social norms about corruption and people's beliefs about the legitimacy of rules and institutions, thereby making it easier for them to tolerate corruption as acceptable behavior. This comparative analysis of 129 countries using two-stage least squares methods with a variety of instrumental variables supports the authors' hypotheses using different measures of corruption (the World Bank's Control of Corruption Index and the Transparency International's Corruption Perceptions Index). The explanatory power of inequality is at least as important as conventionally accepted causes of corruption such as economic development. The authors also found a significant interaction effect between inequality and democracy, as well as evidence that inequality affects norms and perceptions about corruption using the World Values Surveys data. Because corruption also contributes to income inequality, societies often fall into vicious circles of inequality and corruption.

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