Rich doctors and poor patients: Market failure and health care systems in developing countries

This article argues that, in developing countries, health care systems (HCS) have been facing the problem of market failure, implying that the fair rules of market principles do not apply and patients often become losers. Explaining the theoretical issues involved, the article examines various causes of market failures in HCS, including: rent-seeking activities by doctors, asymmetric information between doctors and patients, between patients and insurance companies, and the oligopolistic behaviour of health care practitioners. The policy implications of the study suggest that, in many cases, government intervention is essential to eliminate market failures in the HCS in developing countries.     

The EU and Russia's conflicting regime preferences in Ukraine: assessing regime promotion strategies in the scope of the Ukraine crisis

This paper evaluates the competitiveness of the European Union (EU) and Russia's regime preferences in their foreign policies towards Ukraine in the scope of the on-going Ukraine crisis. It is argued that the underpinning geopolitical environment Ukraine currently resides in, wedged between two much larger powers (the EU and Russia), renders it a vulnerable target state for regime promotion from both sides. Indeed, since the 2004 Orange revolution in Ukraine, both the EU and Russia have had discernible regime promotion strategies in their foreign policies. The EU's regime promotion has focussed on facilitating democracy in Ukraine, along with more material interests (trade and strategic aims) while Russia has reacted with increasingly zero-sum policies which pursue its preference for having a loyal and Russian-facing regime in Ukraine. Ultimately, the increasing competitiveness of the EU and Russia has been a key factor in the onset of the Ukraine crisis, which offers important insight into the relationship between large powers and the smaller third states which lie in their overlapping spheres of influence.     

Age Differences Among Homeless Individuals: Adolescence Through Adulthood

The present study examines differences between homeless adolescents, young adults, and older adults served by homeless shelters or food programs to inform service provision. Four homeless studies using the same sampling and measurement methods were pooled to permit comparisons across age groups. Results showed that homeless adolescents demonstrated greater resilience than younger and older adults. Adolescents reported the shortest duration of homelessness, lowest number of life stressors, fewest physical symptoms, largest social networks, and fewest clinically significant mental health problems. Adolescents also received fewer alcohol and drug abuse diagnoses than younger and older adults. Younger adults reported less time homeless and fewer physical symptoms than older adults, but more life stressors. Younger adults also endorsed higher levels of hostile and paranoid psychological symptoms. Implications for service provision and policy are discussed.     

Post-Hospital Medical Respite Care and Hospital Readmission of Homeless Persons

Medical respite programs offer medical, nursing, and other care as well as accommodation for homeless persons discharged from acute hospital stays. They represent a community-based adaptation of urban health systems to the specific needs of homeless persons. This article examines whether post-hospital discharge to a homeless medical respite program was associated with a reduced chance of 90-day readmission compared to other disposition options. Adjusting for imbalances in patient characteristics using propensity scores, respite patients were the only group that was significantly less likely to be readmitted within 90 days compared to those released to Own Care. Respite programs merit attention as a potentially efficacious service for homeless persons leaving the hospital.     

Investigating the Roles of Neighborhood Environments and Housing-Based Social Support in the Relocation of Persons Made Homeless by Hurricane Katrina

This study examined whether social support tied to relocation efforts and neighborhood social climate may mediate the effects of stressful life events on mental health outcomes following Hurricane Katrina. Participants were 108 adult persons made homeless by Hurricane Katrina and evacuated to Columbia, South Carolina. Civic leaders developed an intervention model that emphasized (a) a one-stop point of entry, (b) living in hotels and apartments rather than shelters, and (c) matching hotels with volunteer “hosts” to assist in relocation efforts. Results revealed that perceived neighborhood factors and satisfaction with host relationship were related to several mental health outcomes. Neighborhood social climate partially mediated several mental health outcomes. Implications of this intervention model and the utility of social ecological perspectives on homelessness interventions are discussed.     

Community-Partnered Needs Assessment: A Strategy to Teach College Students About Health Disparities

Partnering with communities to provide service-learning opportunities for undergraduates can be an effective strategy to teach college students about health disparities. In the current study, undergraduates partnered with a public K–8 school to conduct a participatory needs assessment. College students worked directly with teachers, parents, public school students, and key stakeholders to identify and prioritize health needs, and they awarded the partnership school a grant to address physical activity and bullying. Undergraduates rated the class highly favorably and reported a deeper understanding of health disparities resulting from the service-learning activity. Health disparities research is increasingly becoming a national priority and service learning can attract future talent by providing undergraduates with the opportunity to engage in the material in a meaningful way with clear community benefit.     

Parenting education: Primary prevention in a rural community

SUMMARY

The present paper describes the educational background and current role of a community psychologist conducting tobacco control studies at a research institute affiliated with a university medical school. This includes how the author originally became interested in community psychology as an undergraduate, chose a graduate training program and postdoctoral fellowship, and how this training was instrumental in obtaining the current position.     

A Response to the Critiques of Tobacco Sales and Tobacco Possession Laws

SUMMARY

Several researchers within the anti-smoking community have recently claimed that youth access tobacco programs are ineffective and drain limited resources. They make these claims because they feel that youth access programs do not affect teen smoking prevalence. Others have argued that anti-smoking interventions should not fine minors for possession of tobacco. In this last article, we provide a response to these arguments.     

Welfare Reform and Women's Health

SUMMARY

The WCHPC studied the extent of collaboration between state women's health officials and TANF officials with respect to programs that affect the health and well-being of poor women. The kinds and extent of monitoring activities designed to gather information on the health status of this population were also examined. Great unevenness across states was revealed for both collaboration and monitoring. State-level interest in improving both was assessed, barriers to improvement were identified, and recommendations for steps forward were solicited.