Evidence and equity: Struggles over federal employment equity policy in Canada, 1984–95

Abstract: This article traces debates about federal employment equity policy in Canada in the 1980s and 1990s, focusing specifically on the role of data and statistics in policy‐making. The authors interpret policy‐makers' extensive use of evidence‐based policy instruments in the implementation of employment equity as an attempt to offer a technical solution to the deeply politicized problem of workplace discrimination. By exploring policy debates from the Royal Commission on Equality in Employment (the Abella Commission) (1984) to the passage of the reformed Employment Equity Act in 1995, the authors show how recourse to evidence‐based deliberation failed to contain political conflict, because the meaning and use of statistical data became the object of political struggle among the main policy stakeholders. The article concludes by considering the implications of this case study for the broader comparative debate on the role of evidence‐based methods in policy‐making.     

Perceptions of the health system and public trust in government in low- and middle-income countries: evidence from the World Health Surveys

In low- and middle-income countries, health care systems are an important means by which individuals interact with their government. As such, aspects of health systems in these countries may be associated with public trust in government. Greater trust in government may in turn improve governance and government effectiveness. We identify health system and non-health system factors hypothesized to be associated with trust in government and fit several multilevel regression models to cross-national data from 51,300 respondents in thirty-eight low- and middle-income countries participating in the World Health Surveys. We find that health system performance factors are associated with trust in government while controlling for a range of non-health system covariates. Taken together, higher technical quality of health services, more responsive service delivery, fair treatment, better health outcomes, and financial risk protection accounted for a 13 percentage point increase in the probability of having trust in government. Health system performance and good governance may be more inter-related than previously thought. This finding is particularly important for low-income and fragile states, where health systems and governments tend to be weakest. Future research efforts should focus on determining the causal mechanisms that underlie the observed associations between health system performance and trust in government.     

Exposure to intimate partner violence, peer relations, and risk for internalizing behaviors: a prospective longitudinal study

The present study examines the quality of peer relations as a mediator between exposure to IPV (intimate partner violence) and internalizing behaviors in a sample of 129 preadolescents and adolescents (ages 10-18), who were interviewed via telephone as part of a multigenerational, prospective, longitudinal study. Relational victimization is also examined as a moderator of IPV exposure on internalizing behaviors. Results demonstrate a significant association of exposure to severe IPV and internalizing behaviors. Relational victimization is found to moderate the effects of exposure to severe IPV on internalizing behaviors. The present findings suggest that the effects of exposure to IPV had a particularly important effect on the risk for internalizing problems if the adolescent also experienced relational victimization. Conversely, the receipt of prosocial behaviors buffer against the effects of IPV exposure on internalizing symptoms in teen girls.     

Extra information about treatment is too much for the patient with psychosis

BackgroundCase law across jurisdictions requires ever more complete disclosure of material facts when obtaining consent to treatment.AimsTo determine whether giving extra information impairs the mental capacity to make decisions about treatment.MethodThe MacCAT-T, MacCAT-FP, PANSS and GAF were administered to 88 detained forensic patients with psychosis. Two positive and two negative facts were given about each of two anti-psychotic drugs, and no treatment (twelve items). A choice was elicited. The criterion for incompetence was inability to express a choice. Two extra positive and two extra negative facts about each of the three options were given (twelve extra items) and a choice was again elicited, while repeating the MacCAT-T.ResultsGiving extra information led to a decline in the total score on the MacCAT-T. Twenty one were initially unable to make a choice (24%). After additional information, 33 were incapable (37.5%, Chi-squared p < 0.001). Those initially incapable had the lowest scores on all measures of functional capacity and GAF, with highest scores for symptoms. Those able to choose a treatment option had the highest levels of function and least symptoms. Those who became incapable had intermediate scores.ConclusionsGiving extra information made an extra 15% unable to choose. Clinical judgement must be exercised concerning the amount of information disclosed. Deciding what is material to the individual is arbitrary when so few items of information can be processed. Greater use of guardianship and independent second opinions is recommended.     

Book reviews

Jonathan Michie and John Grieve Smith (eds), Managing the Global Economy, (Oxford University Press, Oxford 1995). 343pp. ISBN 0–19–828968–5 (pb).

Hilary Rose, Love, power and knowledge: towards a feminist transformation of the sciences, (Polity Press, Cambridge 1994). 336pp. ISBN 0–7456–1001–3 (pb).

Daniele Archibugi and David Held (eds), Cosmopolitan Democracy, (Polity Press, Cambridge 1995). 190pp. ISBN 0–7456–1380–2, 0–7456–1381 0 (pb).

Olivier Roy, The Failure of Political Islam, (I B Tauris, London 1994). 224 pp. ISBN 1–85043–880–3.

T. Gallagher, Romania After Ceausescu, (Edinburgh University Press, Edinburgh 1995). 276pp. ISBN 0 7486 0613 0 (pb).

John Gray, Beyond the New Right: Markets, Government and the Common Environment, (Routledge, London and New York 1993). 195pp. ISBN 0–145–09297–3 9, 0–145–10706–7 (pb).

Anthony Giddens, Beyond Left and Right: the Future of Radical Politics, (Polity Press, Cambridge 1994). 276pp. ISBN 0–7456–1438–8, 0–7456–1439–6 (pb).

Nicola Field, Over the Rainbow: Money, Class and Homophobia, (Pluto, London 1995). 193pp. ISBN 0–7453–0825–2.

Red‐Green Study Group, What on earth is to be done? A red‐green dialogue, (Red‐Green Study Group, Manchester 1995). x+69pp. ISBN 0–9525784–0–9.

Darrow Schecter, Radical theories: Paths beyond Marxism and social democracy, (Manchester University Press, Manchester and New York 1994). x+205pp. ISBN 0–7190–4385–9.