1993 health guide. Top 10 health stories to watch

A sea change seems likely in the way health care is delivered. In medicine, public health and nutrition, here's what else the year will bring.     

The economics of the women's movement

In recent years, the political process has seemed to become increasingly favorable to issues involving women, as shown by the relatively large number of states which have passed the Equal Rights Amendment. The economic theory of politics would imply that this result would occur if the interests of women in removing labor force sex discrimination had increased. We argue that most sex descrimination in hiring and pay of women is in the form of statistical discrimination where sex is used as a proxy for labor force attachment. If this is so, then, on net, sex discrimination in employment practices would pay in the sense that the gainers from such behavior would gain more than the losers would lose. Married women would share in such gains since they would be compensated for their lower earnings by the higher earnings of their husbands. Single women, however, would receive no such compensation. We therefore hypothesize that the recent increase in legislation benefitting women is related to marriage rates, not to female labor force participation. Using votes in the state legislatures on the ERA as a measure of success by state of the women's movement, we find that our results do hold — number of single women is significant in explaining such voting but female labor force participation is not significant.     

The state of nature and the evolution of political preferences

Analysis of governmental institutions often proceeds from ahypothetical 'state of nature', according to which humans areanalyzed as if they once existed as solitary individuals withno rules. Humans have never existed as humans in such an environmentbut have always been a group-living species. Rules have evolvedwith humans and were never 'created' de novo. Evolved ruleshave implications for contemporary governance. Human groupshave always been in conflict, and rules distinguish betweengroup members and outsiders. These rules have proved remarkablyflexible. Some rules regulate private conduct of group members.Although the desirability of these rules today is unclear, Iargue that a libertarian regime would have been unstable, whichmay explain why there are few persons with tastes for libertariangovernments. This analysis further explains why utility functionscontain elements of envy. Rules of property, contract, and hierarchyare well developed and universal among humans.     

Altruism and Self Interest in Medical Decision Making

We seem to prefer that medicine and medical care be provided through altruistic motives. Even the pharmaceutical industry justifies its behavior in terms of altruistic purposes. But economists have known since Adam Smith that self-interested behavior can create large and growing social benefits. This is true for medical care as well as for other goods. First, I consider specifically the case of pharmaceutical promotion, both to physicians and to consumers. I argue that such promotion is highly beneficial to patients and leads to health improvements. I consider some criticisms of promotion, and show that they are misguided. I then provide some evolutionary explanations for our erroneous beliefs about medical care.     

The Consequences of Prisoners’ Micro‐Resistance

For more than twenty years, scholars have called for greater attention to the consequences of micro‐resistance to legality. Using archival data from Philadelphia's Eastern State Penitentiary (1829–1875), I examine the consequences of noncompliant prisoner behavior. I find that prisoners’ noncompliance often entailed substantial costs to prisoners, particularly in comparison to the substantial benefits of complying with the prison regime. Despite its cost to prisoners, noncompliance did not have a single set of uniformly negative consequences for the prison regime. In fact, some forms of noncompliance may have actually protected the prison's reputation. Prison administrators, external allies, and critics used episodes of noncompliance for their own goals and to reinforce their preexisting claims about the propriety of competing prison designs, yielding this variable significance of noncompliance. As this study illustrates, connecting prisoner misconduct to power dynamics in the broader field produces a fuller understanding of micro‐resistance's consequences.     

Advancing a Conceptual and Empirical Model of School Climate for School Staff in California

ABSTRACT

School climate is increasingly intertwined with efforts to create safe schools and improve social-emotional learning and academic outcomes. While current definitions of school climate implicate the decisions and actions of school staff members, the majority of school climate research focuses on the perspectives of students. This study presents an adapted model of school climate that focuses on the experiences of school staff members, and is one of the first empirical studies to explore a statewide data set of responses from staff members in California public schools. Results suggest that there are meaningful differences in the experiences of school climate for different staff members and that these differences should guide the assessments of school climate and changes to policies and procedures that may influence climate.