Inequality

Black–White Differences in Avoidable Mortality in the USA, 1980–2005

Black–White Differences in Avoidable Mortality in the USA, 1980–2005
Journal of Epidemiology and Community Health, Vol. 63 no. 9, pp. 715-721. 10.1136/jech.2008.081141

Macinko, J., and I.T. Elo
09/01/2009

Background: Avoidable Mortality (AM) describes causes of death that should not occur in the presence of highquality and timely medical treatment and from causes that can be influenced at least in part by public policy/ behaviour. This study analyses black–white disparities in AM.

Methods: Mortality under age 65 was analysed from: (1) conditions amenable to medical care; (2) those sensitive to public policy and/or behaviour change; (3) ischaemic heart disease; (4) HIV/AIDS; and (5) the remaining causes of death. Age-standardised death rates (ASDRs) were constructed for each race and sex group using vital statistics and census data from 1980–2005. Absolute rate differences and the proportionate contribution of each cause of death group to all-cause black–white mortality disparities are calculated based on the ASDRs. Negative binomial regression was used to model relative risks of death.

Results: In 2005, medical care amenable mortality was the largest source of absolute black–white mortality disparity, contributing 30% of the black–white difference in all-cause mortality among men and 42% among women; mortality subject to policy/behaviour interventions contributed 20% of the black–white difference for men and 4% for women. Although absolute black–white differences for most conditions diminished over time, relative disparities as measured by rate ratios showed little change, except for HIV/AIDS for which relative risks increased substantially for black men and women.

Conclusions: There is considerable potential for narrowing of the black–white difference in AM, especially from causes amenable to medical care and (for men) policy/behaviour interventions.

Portfolios of the Poor: How the World's Poor Live on $2 a Day

Portfolios of the Poor: How the World's Poor Live on $2 a Day
Princeton, NJ: Princeton University Press. May 2009

Collins, D., Morduch, J., Rutherford, S. & Ruthven, O.
05/01/2009

About forty percent of the world's people live on incomes of two dollars a day or less. If you've never had to survive on an income so small, it is hard to imagine. How would you put food on the table, afford a home, and educate your children? How would you handle emergencies and old age? Every day, more than a billion people around the world must answer these questions. Portfolios of the Poor is the first book to explain systematically how the poor find solutions.

The authors report on the yearlong "financial diaries" of villagers and slum dwellers in Bangladesh, India, and South Africa--records that track penny by penny how specific households manage their money. The stories of these families are often surprising and inspiring. Most poor households do not live hand to mouth, spending what they earn in a desperate bid to keep afloat. Instead, they employ financial tools, many linked to informal networks and family ties. They push money into savings for reserves, squeeze money out of creditors whenever possible, run sophisticated savings clubs, and use microfinancing wherever available. Their experiences reveal new methods to fight poverty and ways to envision the next generation of banks for the "bottom billion."

Race, Gender and the Recession: Job Creation and Employment

Race, Gender and the Recession: Job Creation and Employment

C. Nicole Mason, Ph.D
05/01/2009

This report focuses on the effect of the recession and the American Recovery and Reinvestment Act (ARRA) on economically marginalized communities. The Network highlights four key areas of impact for women of color and their families: job creation and employment, housing and social services, education, and tax cuts to individuals.

The Impact of Primary Healthcare on Population Health in Low‐ and Middle‐Income Countries

The Impact of Primary Healthcare on Population Health in Low‐ and Middle‐Income Countries
Journal of Ambulatory Care Management, Vo. 32 no. 2, pp. 150-171. 10.1097/JAC.0b013e3181994221

Macinko, J., B. Starfield, and T. Erinosho
04/01/2009

This article assesses 36 peer-reviewed studies of the impact of primary healthcare (PHC) on health outcomes in low- and middle-income countries. Studies were abstracted and assessed according to where they took place, the research design used, target population, primary care measures, and overall conclusions. Results indicate that the bulk of evidence for PHC effectiveness is focused on infant and child health, but there is also evidence of the positive role PHC has on population health over time. Although the peer-reviewed literature is lacking in rigorous experimental studies, a small number of relatively well-designed observational studies and the consistency of findings generally support the contention that an integrated approach to primary care can improve health. A few large-scale experiences also help identify elements of good practice. The review concludes with several recommendations for future studies, including a focus on better conceptualizing and measuring PHC, further investigation into the advantages of comprehensive over selective PHC, need for experimental or quasi-experimental research designs that allow testing of the independent effect of primary care on outcomes over time, and a more detailed conceptual framework guiding overall evaluation design that places limits on the parameters under consideration and describes relationships among different levels and types of data likely to be collected in the evaluation process.

Microfinance Meets the Market

Microfinance Meets the Market
February Journal of Economic Perspectives 23(1), Winter:  167-192.

Morduch, J., Cull, R. & Demirguc-Kunt, A.
02/01/2009

In this paper, we examine the economic logic behind microfinance institutions and consider the movement from socially oriented nonprofit microfinance institutions to for-profit microfinance. Drawing on a large dataset that includes most of the world's leading microfinance institutions, we explore eight questions about the microfinance "industry": Who are the lenders? How widespread is profitability? Are loans in fact repaid at the high rates advertised? Who are the customers? Why are interest rates so high? Are profits high enough to attract profit-maximizing investors? How important are subsidies? The evidence suggests that investors seeking pure profits would have little interest in most of the institutions we see that are now serving poorer customers. We will suggest that the future of microfinance is unlikely to follow a single path. The recent clash between supporters of profit-driven Banco Compartamos and of the Grameen Bank with its "social business" model offers us a false choice. Commercial investment is necessary to fund the continued expansion of microfinance, but institutions with strong social missions, many taking advantage of subsidies, remain best placed to reach and serve the poorest customers, and some are doing so at a massive scale. The market is a powerful force, but it cannot fill all gaps.

A critical Review of Race and Ethnicity in the Leadership Literature: Surfacing Context, Power and the Collective Dimensions of Leadership.

A critical Review of Race and Ethnicity in the Leadership Literature: Surfacing Context, Power and the Collective Dimensions of Leadership.
The Leadership Quarterly, 20  

Ospina, S. and E. G. Foldy
01/01/2009


Leadership studies focusing on race–ethnicity provide particularly rich contexts to illuminate the human condition as it pertains to leadership. Yet insights about the leadership experience of people of color from context-rich research within education, communications and black studies remain marginal in the field. Our framework integrates these, categorizing reviewed studies according to the effects of race–ethnicity on perceptions of leadership, the effects of race–ethnicity on leadership enactments, and actors' approach to the social reality of race–ethnicity. The review reveals a gradual convergence of theories of leadership and theories of race–ethnicity as their relational dimensions are increasingly emphasized. A shift in the conceptualization of race–ethnicity in relation to leadership is reported, from a constraint to a personal resource to a simultaneous consideration of its constraining and liberating capacity. Concurrent shifts in the treatment of context, power, agency versus structure and causality are also explored, as are fertile areas for future research.

Making Ends Meet: Women and Poverty in New York City

Making Ends Meet: Women and Poverty in New York City

Mason, C.N. & Salas, D.
01/01/2009

 In March 2009, The Network in collaboration with the New York Women's Foundation will release a new report on women living in poverty in New York City.  The dynamic study will include qualitative data as well as narratives from women about the impact of poverty on communities and families.  The report will help inform funding priorities for the Foundation.

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