Aboriginal citizen, discredited medical subject: Paradoxical constructions of Aboriginal women's subjectivity in Canadian health care policies

In this paper, we explore paradoxes and contradictions in Canadian health policy discourses that define Aboriginal women as empowered citizens on the one hand and as discredited medical subjects on the other. Drawing on critical discourse theory, we analyze health policy discourses within the contexts of related political and public discourses about Aboriginal peoples in Canada. We describe a double-speak: a paradox between the constructions of Aboriginal women as citizens in dialogue with government in health policy “reforms,” and their construction as discredited medical subjects who lack legitimacy in health care services. Intertwined with explicit resistance to Aboriginal entitlements, deconstruction of health policy discourses within this political context is central to understanding how Aboriginal women continue to be discredited through processes of marginalization.     

Political careers in multi-level systems: Regional chief executives in Italy, 1970–2015

This article focuses on Italian regional chief executives and aims to investigate if and how the Italian regionalization process has affected regional chief executives’ career trajectories. Our analysis is based on an original dataset on political careers of regional heads of government in Italy from 1970 to 2015. After presenting our two research expectations, we find that the direct election of regional presidents and the decentralization process have gone hand in hand with the selection of more regional political outsiders and visible politicians as well as with a higher integration between institutional levels in terms of career paths     

乡村混混与村落、市场和国家的互动——深化理解乡村社会性质和乡村治理基础的新视阈

乡村混混与村落、市场和国家的交互作用,以及由此带来的一系列政治社会现象,构成我们深化理解乡村社会性质和乡村治理基础的新视阈。一方面,乡村性质决定了混混群体在与村落、市场和国家三者的互动中,表现出不同的群体特征、行为逻辑和生命轨迹。另一方面,乡村混混等农村灰色势力又构成了乡村治理的非正式的基础,影响乡村治理的诸多层面,从而构成了乡村治理的非正式的基础。     

Political Sociology of International Interventions: Peacebuilders and the Ground

ABSTRACT

This special issue, instead of questioning what effect peacebuilding interventions have on post-conflict societies, analyses what the ground of intervention does to peacebuilders. It demonstrates that everyday interactions on the ground shape the interveners and even the scope of their missions. We delineate how a political sociology approach might break away from binaries (‘internationals/locals’) and, instead, illuminate processes (of internationalization and localization). We intend to offer a political sociology of the ‘intervention encounter’, that is, to scrutinize the everyday interactions among peacebuilders and between peacebuilders and domestic actors, and to investigate effects of the ground on peacebuilding organizations, doctrines and decision-making processes, as well as on peacebuilders’ trajectories, positions, professional practices and representations. In fine, we explore how peacebuilders’ relations to the ground structure the socio-professional field of peacebuilding.     

On the durability and the decomposition of citizenship: the social logics of forced return migration in Cape Verde

This article explores the impact of deportation, a state practice increasingly applied by European and North American governments, on notions of sociality in transnational social fields. In particular, it concentrates on the dynamics between formal citizenship on the one hand and the moral economies of belonging and membership on the other. Drawing on anthropological fieldwork in Cape Verde, where deportation is producing a new social minority, this article examines the confluence of social and formal legal practices of exercising membership in transnational fields. After summarising the constitutive features of Cape Verdean transnational social formation, the trajectories and perspectives of deportees are highlighted in relation to their family networks, as well as in their encounters with the wider society and state structures. It is argued that understandings of social inclusion and perceptions of membership are embedded in moral discourses on ‘law’ and ‘justice’ as they circulate within transnational social fields. In the context of forced return migration, citizenship emerges as an arena for claiming legitimacy and integration and likewise becomes a key mode of the formulation of conditionalities for integration and social exclusion.     

Political involvement among Toung women: a qualitative analysis

The depoliticization and non‐participation of young people in city life is often a topic of discussion. Given this context, how and why do young people then become activist? This is the main question addressed by a sociological research project on the way young women in Quebec practise political involvement and on the meaning that involvement has for them. The question of why young women get involved has to do with their biographical history, their life trajectories, and the influence of family and friends. How they get involved has to do with what involvement and activism mean to them. One of the principal findings is that the young female activists who participated in this study all have an active conception of citizenship that is not restricted to political involvement. Some of our respondents said that involvement is a way of being, a lifestyle that requires them to act consistently in all aspects of daily life and thus implies living in accordance with one's ideals. In other words, the involvement practised and conceptualized by these young activists corresponds to what can be called a ‘search for ethical consistency’, which aims ‘to give meaning to the values we hold as individuals and as a collectivity’.     

Institutional Change and Embeddedness: Caste and Gender in Financial Cooperatives in Rural India

ABSTRACT

This article examines the interaction between institutional change and caste and gender embeddedness. It develops a framework for understanding how this interaction takes place. The article presents data on the results of an effort by a non-profit development organization, the Cooperative Development Foundation (CDF), to promote women's cooperatives, grounded in the ideas of mutual self-help and equitable access to services, in rural Andhra Pradesh in India. Using a simple theoretical framework that highlights the multi-level nature of institutional change, and the potential for interactions with embeddedness at one level to affect interactions at other levels, the article presents data showing how particular institutional rules of the cooperatives interacted with caste and gender to shape the overall governance and service delivery practices of these new organizations. In particular, after failed attempts to integrate existing, male-dominated cooperatives with women, the CDF created gender-segregated cooperatives. Data from the women's cooperatives show the creation of mixed-caste organizations, with boards of directors that were fairly representative of their membership, but with presidents that were more likely to be from the higher-castes. Access to financial services shows little caste bias, though lending is through caste-based peer groups. The data suggest that the interaction of embeddedness and institutional change is a process contingent on: a) the strategy taken by the development organization towards embeddedness; b) the nature of the institutional change itself relative to the existing social structure; and c) the effects the interactions between institutional change and embeddedness at different levels have on each other.     

Development and evaluation of a survey-based type of benefit classification for the Social Security program

This attempt to classify Social Security beneficiaries by type of benefit using the new Survey of Income and Program Participation (SIPP) has yielded promising results. Evaluations of the classification algorithm based on comparison of the estimated number of beneficiaries in each of the several categories to independent estimates of the number of beneficiaries indicate that in most instances a high percentage of each category has been identified. For the most part, age and monthly benefit amount size distributions seem reasonable. Furthermore, very few persons in the sample who were identified as Social Security beneficiaries could not be assigned to one or another of the benefit groups. The classification procedure also represents a marked improvement over earlier efforts to classify type of beneficiary that relied on data from the March Supplement to the Current Population Survey (CPS). Most importantly, the benefit classification scheme based on SIPP data appears to provide reasonably reliable distinctions between retired-worker and widow benefits for widowed women and permits the identification of retired-worker benefits for those women dually entitled to retired-worker and spouse benefits. In addition, the distinction between disabled- and retired-worker benefits for recipients aged 62-64 appears to be reasonably reliable, and for women under age 65, the classification procedure distinguishes between disabled-worker benefits on the one hand and widow and widowed mother benefits on the other. Finally, SIPP procedures for identifying minor child beneficiaries yield markedly better estimates than those available from the Current Population Survey. These improvements in the SIPP context are due entirely to the presence of information not collected in the CPS. The enhancement of the SIPP data set in turn resulted directly from an assessment of earlier work carried out by Projector and Bretz in the CPS context and on extensive research into the nature of Social Security reporting errors in the CPS. The superiority of the SIPP data set is linked principally to the presence of three pieces of information: the Medicare BIC, the direct question on reasons for benefit receipt asked of persons under age 65, and the direct measurement of recipiency and amount of benefits for minor children. Other items of some import include self-reported work disability, retirement status (ever retired from a job), previous marital status for currently married women, age first prevented from working due to a health condition, and Supplemental Security Income misreporting items.(ABSTRACT TRUNCATED AT 400 WORDS)     

Interactive governance and implementation effectiveness in India's National Health Insurance Program

Many public sector programs, such as those directed at public health, are often multiagency tasks where structural incongruity in the program design is liable to emerge over time from changing operational requirements. Yet, successful implementation remains possible because of the interactions and relationships between implementation parties that encourage cooperation and collaboration despite incongruence in the program design. We examine how the dynamics of these interparty relationships influence implementation success in a comparative study of India's National Health Insurance Scheme. We find that implementation parties exhibiting support and complementarity in their interactions created a virtuous cycle of continually encouraging better performance and vice versa. Thus, our findings exhibit a distinct functionary role of interparty interactions and relationships for eliciting effective implementation and governance. The analysis also showcases the need for policy makers and policy designers to be cognizant of the inadvertent introduction of structural inconsistencies and veto points into program designs and their potential influence on implementation outcomes.     

How policy variables influence the timing of applications for Social Security Disability Insurance

This article analyzes the impact of policy variables--employer accommodations, state Social Security Disability Insurance (DI) allowance rates, and DI benefits--on the timing of an application for DI benefits by workers with a work-limiting health condition starting when their health condition first begins to bother them. The analysis uses a rich mixture of personal and employer characteristics from the Health and Retirement Study linked to Social Security administrative records. We find that most workers do not apply immediately for DI benefits when they are first bothered by a health condition. On the contrary, the median working-age man with a work-limiting condition waits 7 years after that time before applying, and the median working-age woman waits 8 years. Although the risk of applying for benefits is greatest in the year following onset, only 16 percent of men and 13 percent of women in our sample apply within the first year, and the risk of application falls thereafter. That finding suggests that institutional factors, in addition to health factors, may play a role in the timing of DI applications. Using kernel density estimates of the distribution of application and nonapplication ordered by state allowance rates (the rate of acceptance per DI determination in each state), we find that both men and women who live in states with high allowance rates are disproportionately more likely to apply for benefits in the first year after their condition begins to bother them than are those in states with low allowance rates. Using life-table analysis, we also find that men and women who are accommodated by their employers are significantly less likely to apply for DI benefits in each of the first few years after their condition begins to bother them than are those who are not accommodated. On the basis of this evidence, we include these policy variables in a model of the timing of DI application that controls for other socioeconomic variables as well as health. Using a hazard model, we find that workers who live in states with higher allowance rates apply for DI benefits significantly sooner than those living in states with lower allowance rates following the onset of a work-limiting health condition. Workers who are accommodated following the onset of a work-limiting health condition, however, are significantly slower to apply for DI benefits. Using the mean values of all explanatory variables, we estimate the relative importance of changes in these policy variables on the speed with which workers apply for benefits after onset. We find that the mean time until application for men is 10.22 years. Universal accommodations following onset would delay application by 4.36 years. In contrast, a 20 percent decrease in state allowance rates would delay application by only 0.88 years. For working-age women, the average expected time until application once a condition begins to bother them is 10.58 years. Universal accommodations would delay that by 3.76 years, and a 20 percent decrease in allowance rates would delay it by 1.47 years. A complication in this analysis is that the policy variables are to some degree endogenous. Accommodation is probably offered more often to workers who want to continue working. Allowance rates are chosen by states on the basis of federal policy and local choices and probably in part on the health condition of workers in the state. Therefore, our estimates are upper bounds of these policy effects. Still, we believe we provide evidence that the social environment faced by workers with work-limiting health conditions can significantly influence their decision to apply for DI benefits, holding their specific health conditions constant.     

Gender,actors, and institutions at the local level: Explaining variation in policies to address violence against women and girls

Research on gender equality policy has generally focused on actors and institutions at the national and international levels. This article considers the role of local‐level actors and institutions in explaining different policy responses to violence against women and girls (VAWG). The literature on gender policy trajectories identifies the particular importance of executive actors in influencing “status policies” like VAWG. Quantitative data are analyzed to show how local Police and Crime Commissioners in England and Wales have responded to demands for policy action. The focus is on the interaction between the 41 elected commissioners and the new institutional arrangements for police governance introduced in 2012. The article shows that variation in policy outcomes is related (a) to the gender of executive actors and (b) to the way in which actors interpret elements of the institutional framework, regardless of their own gender.     

Double-Speak: The European Union and Gender Parity

Ideas about pursuing a more equal balance between men and women in decision-making bodies and ‘parity democracy’ have been promoted by both the Council of Europe and the institutions of the European Union for nearly 20 years. In the early 1990s, the institutions of the EU played an important role in providing a platform for discussion and debate and thus brought these notions into mainstream political discourse in some of the member states. In response, during the late 1990s and early 2000s, several member states implemented policy to encourage more balanced participation for men and women in national and sub-national decision-making bodies. However, despite its own policy statements to the contrary, the EU decision-making bodies themselves remain male-dominated. This article asks how the EU on the one hand provided an impetus for some of the member states to take action to increase gender balance in decision-making while, on the other hand, its own institutions have remained largely unchanged.     

Health Care Reform in Britain and Germany: Recasting the Political Bargain with the Medical Profession

Health care systems in the postwar period have been governed by political bargains between the state and the medical profession that have delinzated their respective powers and jurisdictions. Recent health care cost containment reforms in Britain and Germany are altering these bargains, and thereby challenge the prerogatives and autonomy of the medical profession in health policy formulation and in administration of the health care systems. But these challenges to doctors' power and autonomy vary between the two countries. Britain's 1989 “internal market” reforms attack the corporatist bargain with physicians by introducing market mechanisms into the National Health Service and, at the same time, strengthening central state control of the health care system. In Germany, on the other hand, the government's 1992 reforms only partially breached the corporatist bargain with doctors in order to strengthen rather than destroy this governance arrangement. The government has tried to curb what it views as excessive power of doctors while still allowing them a significant degree of corporatist self-governance. The reform efforts in both countries highlight some of the problems with different governance arrangements in health care systems and, more specifically, the difficulties associated with a market in health care.     

How Does Islamist Local Governance Affect the Lives of Women?

How do women fare under rule by Islamists? Whereas some scholarly work suggests that Islamists are effective at providing the type of social services that benefit women most, other studies contend that Islamic groups support “pro‐male” policies and cultural interventions that disadvantage the well‐being of women. In order to adjudicate between these views, I compare two neighborhoods in Greater Cairo that are similar on a number of dimensions but in one, a militant Islamist group came to dominate local politics, whereas in the other, strongmen ruled the streets in the absence of a strong state presence. Using an original data set of retrospective health histories for women in each neighborhood, I find that women subject to governance by the Islamic group enjoyed better outcomes related to reproductive health than a statistically matched set of women in the comparable neighborhood while being no more likely to marry early or drop out of school.     

Attitude Responsiveness and Partisan Bias: Direct Experience with the Affordable Care Act

This study evaluates the competing influences of motivated reasoning and personal experience on policy preferences toward the Affordable Care Act. Using cross-sectional and panel survey data, the findings reveal that healthcare attitudes are responsive to information that individuals receive through personal experience. Individuals who experienced a positive change in their insurance situation are found to express more positive views toward the health reform law, while individuals who lost their insurance or experienced an otherwise negative personal impact on their insurance situations express more negative views. The results point to personal experience as a source of information that can influence individuals’ preferences. However, although attitudes are responsive to the quality of one’s personal interactions with the healthcare system, the results also suggest that partisan bias is still at work. Republicans are more likely to blame the health reform law for negative changes in their health insurance situations, while Democrats are more likely to credit the law for positive changes in their situations. These motivated attributions for their personal situations temper how responsive partisans’ attitudes are to information acquired through personal experience.     

THE PERFORMANCE OF NATIONAL HEALTH CARE SYSTEMS: A "GOOD NEWS, BAD NEWS" FINDING FOR REFORM POSSIBILITIES

This paper seeks to contribute to an understanding of how macro health systems work by comparing three possible sets of influences on national health care outcomes: 1) health care facilities and their presumed link to national affluence, 2) social characteristics which are assumed to promote healthy behavior, and 3) political variables in the form of welfare state development. Our findings bear both optimistic and pessimistic connotations. On the one hand, the somewhat limited importance of the first set of factors shows that good health in a country is not simply the function of high spending levels. However, the surprisingly strong role of “social development” in determining health care outcomes that emerges implies that much more than the direct provision of health care must be manipulated to ensure optimal health for a nation's population.     

Driving Development from Below: The Advantages and Limitations of Vernacular Politics in the Bolivian Altiplano

Anthropologists studying the Andean community politics have increasingly emphasised the role of pragmatic, informal ‘vernacular’ political strategies in achieving material and political empowerment of the poor. However, while the concept of vernacular politics marks an advancement over binary and often polarised discussions of the role of local communities in development processes, studies have not fully explored the full range of implications of vernacular strategies on development processes. While researchers have demonstrated the substantial agency that local community actors have to influence development processes, the extent to which this influence effectively resists or reinforces the logic of public policy implementation has not been studied. This article explores the techniques used by rural communities in their interactions with public institutions in rural Bolivia. It shows that community organisations' vernacular political strategies have mixed outcomes: on the one hand, they allow the rural poor to assert their own agendas vis‐à‐vis the state so that they can benefit from public spending, while on the other hand, their tactics have the potential to entrench the influence of local power brokers and perpetuate inefficient uses of public funds. Copyright © 2016 John Wiley & Sons, Ltd.     

Physically demanding occupations, health, and work after retirement: findings from the New Beneficiary Survey

This article uses data on a recent cohort of Social Security retired-worker beneficiaries to examine the predictors of work after initial receipt of benefits. It focuses on two factors: an analysis of the effects of ill health and of employment in a physically demanding occupation in the year preceding receipt of benefits. Based on responses received during the Social Security Administration's New Beneficiary Survey, the employment of men in a physically demanding occupation is associated with a lower probability of work in retirement; the existence of a work-limiting health condition also lowers their probability of work. Full-time, full-year workers in 1979 who had changed jobs in the years just preceding the receipt of Social Security benefits were more likely to work after they became beneficiaries. It may be that workers anticipate constraints on their ability to continue working on a job and reduce the effect of those constraints through earlier job changes. The finding that the work effort of women beneficiaries is not affected by previous employment in occupations identified as physically demanding may signify the failure of customary physical demand indices to measure stress on those jobs in which women are most likely to be employed.     

One of the Boys? Gender Similarities and Differences in Human Capital among Senior Civil Servants in Denmark

Studies have shown how women are underrepresented in senior executive positions in public and private organizations. Equal representation matters both for reasons of performance and legitimacy, and, to understand the mechanisms behind the glass ceiling, we explore if the women making it to the top of the Danish civil service differ from the men who do so. We want to understand if senior executive positions require something different of women than men. Using a dataset consisting of the entire career trajectory of all senior civil servants in Denmark, we find that, on numerous human capital dimensions, the women and men making it to the top are quite similar, for example, in terms of tenure and educational level. However, we find on the one hand that men are more often employed in the most prestigious departments and, at the same time, it seems that men with a profile deviating from the norm are more likely to make it to the top than women. This may indicate that the most prestigious positions – also in terms of early-career positions – are less accessible to women, and that women are less willing to apply for jobs outside their usual domain, or that those responsible for recruitment are less willing to take a chance on a woman with a slightly unorthodox profile. Hence, our study indicates that greater interest should be paid to the dynamics keeping women at lower levels of the hierarchy and possibly to encourage them to apply for top positions.