Co-Production and Health System Reform – From Re-Imagining To Re-Making

There is growing interest in the application of citizen participation within all areas of public sector service development, where it is increasingly promoted as a significant strand of post-neoliberal policy concerned with re-imagining citizenship and more participatory forms of citizen/consumer engagement. The application of such a perspective within health services, via co-production, has both beneficial, but also problematic implications for the organisation of such services, for professional practice and education. Given the disappointing results in increasing consumer involvement in health services via 'choice' and 'voice' participation strategies, the question of how the more challenging approach of co-production will fare needs to be addressed. The article discusses the possibilities and challenges of system-wide co-production for health. It identifies the discourse and practice contours of co-production, differentiating co-production from other health consumer-led approaches. Finally, it identifies issues critically related to the successful implementation of co-production where additional theorisation and research are required.     

Adolescents’ Educational Outcomes: Racial and Ethnic Variations in Peer Network Importance

Little attention has been paid to the role of peer social capital in the school context, especially as a predictor of adolescents’ academic outcomes. This study uses a nationally representative (N = 13,738, female = 51%), longitudinal sample and multilevel models to examine how peer networks impact educational achievement and attainment. Results reveal that, in addition to those factors typically associated with academic outcomes (e.g., school composition), two individual-level peer network measures, SES and heterogeneity, had significant effects. Although educational attainment was generally worse in low SES schools, for all ethnic groups higher attainment was associated with attending schools with higher concentrations of minority students. At the individual level, however, membership in integrated peer networks was negatively related to high school graduation for Asians, Latinos, and non-Hispanic whites, and to GPA for Asians and Latinos, as only African-American achievement increased in more racially/ethnically heterogeneous peer networks. Our results suggest that co-ethnic and co-racial peer friendship networks should not be viewed as obstacles to the educational accomplishments of today’s youth. In fact, in many cases the opposite was true, as results generally support the ethnic social capital hypothesis while providing little corroboration for oppositional culture theory. Results also suggest that co-racial and co-ethnic ties may mediate the negative effects of school choice, or more specifically of between-school socioeconomic segregation. Consequently, we conclude that school policies aimed at socioeconomic desegregation are likely to beneficially affect the academic outcomes of all race/ethnic groups.

The role of universities in the promotion of worker protection: UCLA labor occupational health and safety program as a model for countries with developing economies

ABSTRACT

Protection of the workers’ health in countries with developing economies is increasingly important because of the adverse effects of globalization, along with changing industrial relations, the rise of precarious work and outsourcing, and the decline in unionization. In this study, I examine whether the institutes created by universities might serve as an interface between workers, academia, and state agencies, and provide assistance for both improving workplace conditions and enforcing occupational health and safety rules. I describe the history of one such effort: The Labor Occupational Safety and Health Program (LOSH) at the University of California, Los Angeles (UCLA). Using a review of written sources along with participatory observation and interviews as methods, I found that the challenges faced by LOSH historically have important parallels in countries with developing economies today. Ultimately, university-based occupational health programs like LOSH need to be followed in other parts of the world and be supported by governments if the mission to reduce workplace injuries and diseases is going to be realized in the United States and in other countries.     

Reproductive health services: “Business-in-a-Box” as a model social innovation

Access to reproductive health services and products in remote and rural communities is a critical area of concern for developing countries. This article considers a pilot intervention in three districts of Pakistan where “Business-in-a-Box” as a model of place-based social innovation is used to improve the socio-economic conditions of women in remote rural settings through socially responsible micro-franchising. It finds that such programmes help build a sense of community, ownership and grassroots capabilities and skills. The article also discusses the impacts of such actions on the individual and community life, and the need to upscale and sustain these initiatives.     

Political Trust,Ideology, and Public Support in the United States for Government Spending on Health Care

The U.S. health-care costs have increased at a rapid rate over the last several decades. How much responsibility the government should bear with the increase in health-care costs is one of the main questions that lack consensus among the American people. Utilizing the 2016 General Social Survey data, this study shows that over two-thirds of Americans want to see more or much more spending on health care by the government. An ordered logit regression model shows that political trust and ideology are significant correlates in predicting attitudes toward government spending on health care. The policy implications of the findings are discussed in the “Conclusion” section.     

A Profile of Violent Offenders in Spanish Prisons

In Europe, it is relatively uncommon to find studies that investigate the criminal profiles of violent offenders, especially infrequent are those that pay special attention to offenders’ mental health/substance use disorders and histories of violence during childhood. The current research explores whether inmates who are incarcerated for violent offenses (n = 536) in Spain are different in terms of the aforementioned factors as compared to inmates incarcerated for non-violent offenses (n = 536). Multivariate logistic regression analysis revealed that violent offenders, as compared to their non-violent counterparts, were more likely to be younger, younger at the time of their first arrest, single, use alcohol, receive treatment in prison for anxiety or schizophrenia, and report physical abuse during childhood.     

Public health as an agent of internal colonialism in interwar Czechoslovakia: shaping the discourse about the nation’s children

Shmidt’s text discusses the specifics of internal colonialism in the discourses and practices of the dominant group (Czechs) concerning Slovaks and Rusyns, ethnic groups from the peripheral, eastern areas of interwar Czechoslovakia. By targeting the reproductive patterns of these groups, seen as undesirable by the authorities, internal colonialism shaped the discourse about children by consistently opposing the normalized childhood inside the nation to the supposedly abnormal child development outside the civilizing process. Shmidt focuses on three interwar projects aimed at introducing new public health practices as an ‘infrastructure of dependence’ with regard to the peripheral groups. Being directly supported by the Rockefeller Foundation, these projects contributed to building the new Czechoslovak nation and securing its international legitimacy.     

On scale work: evidential practices and global health interventions

Abstract

Scalability can be understood as the ability to expand without changing. Yet, expanding an intervention to a global scale, we suggest, is a significant and difficult accomplishment. In this paper we propose to explore the kind of evidential exigencies that this accomplishment involves. To do so, we focus on the field of global health and examine how child immunization against the pneumococcus bacterium has been scaled up in low-income countries. The paper first attends to initial epidemiological scrutiny that revealed the existence of a large-scale public health problem and the possibility of an expandable solution (vaccination). It then describes the set-up of a funding arrangement using overseas aid to purchase vaccine doses manufactured by pharmaceutical companies, before paying attention to various frictions that affect the widespread use of pneumococcal vaccines. In these different moments through which scalability is accomplished, always partially and temporarily, we show that a dual activity can be witnessed, a pivoting between referential work and forward projection. To conclude, we suggest that scalability is more usefully approached as a form of expansion that is always attentive to the possibilities of change.     

Ebola vaccines,evidentiary charisma and the rise of global health emergency research

Abstract

The 2013–2016 West African Ebola outbreak was both a catastrophic public health disaster and a rare research opportunity. This paper analyses how the tensions between the humanitarian imperatives of disease control and the epistemic conventions of bioscientific inquiry played out in the accelerated development, testing and licensure of Ebola vaccines. Beginning with the epidemiological projections of the disease’s spread, the paper develops the notion of evidentiary charisma to capture the power of experimental designs and data packages to marshal public health salience, recruit moral legitimacy and short-circuit scientific contestation. Attention to the charismatic dimensions of Ebola vaccine R&D helps to unpick the simultaneous appeals to exception and convention in the unfolding of a global health crisis, and to trace the normative and technical contours of the emerging paradigm of emergency research.