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.     

Factors Associated with Academic Achievement for Sexual and Gender Minority and Heterosexual Cisgender Students: Implications from a Nationally Representative Study

Research on sexual and gender minority student achievement indicates that such students report lowered achievement relative to other students. Increased victimization and less school belonging, amongst other factors, have been identified as contributing to these inequalities. However, supportive schooling structures and caregiver support may support their achievement. A nationally representative survey of secondary school students was used to identify specific factors that support achievement for sexual minority (n?=?485), gender minority (n?=?298), and heterosexual cisgender (where one’s sex assigned at birth “matches” a binary gender identity, i.e., a male assigned at birth identifies as a boy/man, n?=?7064) students in New Zealand. While reported victimization did not affect achievement for sexual and gender minority students, school belonging, and teacher expectations of success, emerged as significant factors. Differences emerged between sexual minority and gender minority achievement factors, suggesting a range of detailed policy implications and recommendations.

     

Capabilities Theory and the Limits of Liberal Justice: On Nussbaum’s Frontiers of Justice

In Frontiers of Justice, Martha Nussbaum applies the “Capabilities Approach,” which she calls “one species of a human rights approach,” to justice issues that have in her view been inadequately addressed in liberal political theory. These issues include rights of the disabled, rights that transcend national borders, and animal rights issues. She demonstrates the weakness of Rawlsianism, contractualism in general, and much of the Kantian tradition in moral philosophy and shows the need to move beyond the limitations of narrow rationalism, nationalism, and speciesism. Nevertheless, Nussbaum fails to elaborate adequately the grounds for her own capabilities position or to face fundamental theoretical questions about the nature and implications of that position.     

Self-Injurious Thoughts and Behaviors Among Youth in an Underserved Area of the Southern United States: Exploring the Moderating Roles of Gender,Racial/Ethnic Background,and School-Level

Despite the clinical relevance of self-injurious thoughts and behaviors (SITB) among youth, little is known about the subset of youth most at-risk for SITB. This study examined the moderating roles of gender, racial/ethnic background, and school-level (and their interactions) on rates of SITB within a large (N = 2638, 52.2% female), ethnically-diverse sample of middle- and high-school youth in a relatively poor and underserved area of the Southern United States. Extending extant research in this area, findings indicated a significant interaction between gender and race for self-injurious behaviors, with African–American boys reporting higher rates than all other groups. Findings also indicated significant interactions between school-level and both gender and race for self-injurious thoughts. Whereas comparable levels of self-injurious thoughts were reported across middle- and high-schools for girls and African–American youth, the frequency of these thoughts was higher among both boys and White students in high-school (vs. middle-school). Results highlight the need for further research on SITB among diverse youth in underserved areas.     

Spontaneous or Constructed? Neighborhood Governance Reforms in Los Angeles and Shanghai

Can grassroots government succeed on its own without state involvement? By comparing approaches in two metropolitan governments—neighborhood councils in Los Angeles and resident committees in Shanghai—Bin Chen of the City University of New York at Baruch College, Terry L. Cooper of the University of Southern California, and Rong Sun of Shanghai Tongji University underscore the need to understand the interrelationships among the political and administrative structures where these specific reforms are implemented. Their analysis points out that the efficacy of a government-initiated civic engagement program depends on a balanced combination of state involvement and community self-organization.     

Collective Bargaining and The Performance of the Public Schools

Students of American politics rarely study public sector unions and their impacts on government. The literature sees bureaucratic power as rooted in expertise, but largely ignores the fact that bureaucrats often join unions to promote their own interests, and that the power of their unions may affect government and its performance. This article focuses on the public schools, which are among the most numerous government agencies in the country, and investigates whether collective bargaining by teachers—the key bureaucrats—affects the schools' capacity to educate children. Using California data, analysis shows that, in large school districts, restrictive labor contracts have a very negative impact on academic achievement, particularly for minority students. The evidence suggests, then, that public sector unions do indeed have important consequences for American public education. Whether they are consequential in other areas of government remains to be seen, but it is an avenue well worth pursuing.     

Policy adoption in dynamic international environments: Evidence from national AIDS programs

The policy adoption is often seen as a function of internal determinants, external determinants, or a combination of the two. In the years since the start of the HIV/AIDS epidemic nearly every country in the world has adopted of some nature a program to combat the epidemic. This article demonstrates the mixed mechanisms influencing the adoption of AIDS programs, in a quantitative study of 90 countries. Prior studies have claimed that multilateral organizations were vital to global action against the HIV/AIDS epidemic. This study provides empirical evidence showing the actions taken by the multilateral organizations have both helped and hindered efforts to combat the HIV/AIDS epidemic. Copyright © 2009 John Wiley & Sons, Ltd.     

Rational benevolence in small committees

We consider a game in which three committee members must divide up a benefit among themselves. In response to the large literature on sequential procedures in this type of game, we propose an institution that is inspired by auction theory. The (sealed) bids of the players are proposals for a distribution of the benefit and are given simultaneously. If any of the bids is preferred to all others in a pairwise comparison (i.e., a Condorcet winner exists) then this proposal is implemented. If such a bid does not exist then an equal split of the benefit is assumed. An equilibrium of this game is for each player to suggest that one of the opponents should receive the lion’s share of the benefit, even though each player cares only about his own share. We call this phenomenon “rational benevolence”. Although the end that is desired by the players is purely egoistic, the means of achieving it may be perceived as benevolent. Several applications of the game are suggested.     

Designing Public Participation: Managing Problem Settings and Social Equity

Researchers suggest that inequity and disparities in public participation in the policy‐making process will go hand in hand unless public managers and community leaders are attentive to these concerns when they are designing participation opportunities. Previous research has considered how the design of participatory opportunities can address inequity, but it has provided few insights into what is behind design choices. This article provides a theoretical framework that links public managers' and community leaders' perspectives on their own political efficacy and sources of their efficacy, yielding four types of “designers.” The research hypothesizes that these types have different narratives of social equity in participation that affect their design choices. Data from more than 100 public managers and community leaders provide preliminary support for these relationships. Findings suggest that inequitable public participation will persist unless designers consider what is behind their choices, focusing first on understanding the problem setting, or their narrative of equity in public participation.     

Locating Supreme Court Opinions in Doctrine Space

We develop a scaling model to estimate U.S. Supreme Court opinion locations and justice ideal points along a common spatial dimension using data derived from the citations between opinions. Citations from new opinions to precedent opinions usually apply and endorse the doctrine of the precedent opinion; however, sometimes they implicitly or explicitly dispute the precedent opinion. We collect original datasets classifying citations from search and seizure and freedom of religion opinions written between 1953 and 2006 into these different types and develop a model relating the similarity of the doctrine embodied in the citing and cited opinions to the relative probability of these different types of citations. The resulting spatial estimates of opinion location are used to evaluate theories of Supreme Court bargaining and opinion writing. We find empirical support for theoretical models that predict the majority opinion will fall at the ideal point of the median member of the majority coalition. Given the centrality of theories of judicial policymaking to various substantive problems in political science, the method of scaling opinions developed in this article can facilitate a range of future research.