Self-rated health and barriers to healthcare in Ukraine: The pivotal role of gender and its intersections

The ongoing health crisis in the Ukraine has persisted for 48 years with a clear division of gender-based outcomes as seen in the decline of male life expectancy and stagnation of female longevity. The purpose of this paper is to investigate differences in self-rated health and system barriers to health care applicable to gender and its intersections because of the differing negative health outcomes for men and women. Intersectionality theory provides an analytic framework for interpreting our results. Utilizing a nationwide sample of the Ukrainian population (N = 1908), we found that low socioeconomic status (SES) women rate their health worse than men generally and any other socioeconomic group. Yet women also face the greatest barriers to health care until older ages when the ailments of men cause them to likewise face the obstacles. In reviewing the barrier to health care scale, one barrier—that of health care services being too expensive—dominated the responses with some 52.5 percent of the sample reporting it. Consequently, the greatest problem in Ukraine with respect to health reform reported by the population is the out-of-pocket costs for care in a system that is officially free. These costs, constituting some 40 percent of all national health expenditures, affect women and the aged the most.     

Federal Aid to Local Governments in the West: An Irony of the Reagan Revolution

Despite the fact that the Reagan election was viewed as a power shift toward the West, the decade of the 1980s produced cruel disappointment. The region was generally left out of the economic recmery of the nation because of the bust in the agricultural and mineral industries. These state and local gmernments which sufferfrom high costs and low resources were particularly dependent on the national gmernment at the very time when the Reagan Administration was cutting federal aid and transferring power to the states. Unlike Nixon's New Federalism which helped the state and local governments of the West, Reagan's policies caused their relative position in federal aid flows to deteriorate. Although the Reagan revolution in cutting domestic programs was viewed as the embodiment of western rugged individualism, the region lost in terms of federal aid to small rural local governments.