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Rectifying the imbalance of theorisation of education expansion focusing on its benefits, this study examines the relationship between education expansion and income inequality by turning our attention to its risky aspects. We investigate how expanding education might not effectively mitigate income inequality, because it brings about costly and risky competition for the positional value of education. We consider welfare regimes as relevant institutional factors associated with educational positionality based on the similarities between two environmental conditions that make education positional and two underlying dimensions of welfare regimes (de-stratification and commodification). We analysed higher education cases in twenty-four to twenty-five developed countries from 2000 to 2020. Our results show that higher education expansion initially reduced income inequality, but the reducing effect was attenuated, and eventually, it increased income inequality when higher education was positional, corresponding to the countries with a liberal regime and two East Asian countries such as Japan and Korea.
Australia’s education system is one of the most developed globally and also one of the most privatised. Despite the substantial expenditure by state governments and the federal government, it is profoundly unequal with respect to access, funding, resources, and results from early childhood education to university. The inequality has class and spatial features, and Indigenous Australians are at the bottom of the rung. Drawing on Bourdieu’s concepts of cultural, social, and economic capital, I show that the education system, whilst certainly allowing for some mobility, facilitates the reproduction of the existing class structure. Children from low-income households are more likely to not attend childcare, to attend a school that lacks resources and where going on to university is viewed as exceptional rather than the rule. In contrast, the economic capital of wealthier households allows them to access childcare and elite private schools. The cultural and social capital of these schools reproduces a born to rule ethos, and progression to an elite university is an assumed path.
This article examines the COVID-era shift in the disability politics of sensory-theatre artists in the United Kingdom who create work for neurodiverse young audiences, arguing that the pandemic pushed them toward a more expansive and overtly political understanding of disability. I examine the work of three companies – Oily Cart (London), Frozen Light (Norwich) and Spectra (Birmingham) – who adjusted their practices to embrace their audiences’ shifting access needs, including those in caregiving roles. These changes move sensory theatre into a more politicized realm, echoing calls from crip studies scholars and disability justice activists to reimagine disability as a relational category from which solidarity can arise that does not hinge entirely on medical diagnosis. These artists’ renewed commitments to relational access provide lessons for performing artists and audiences navigating how to care for one another through the massive death and disablement of the ongoing pandemic.
This article introduces a model that harnesses praxis as a powerful tool for critique, knowledge, and action within the realm of public archaeology. The adopted framework focuses on persistence as a middle-range methodology that bridges the material past to activist and collaborative-based projects. Recent research at Mission La Purísima Concepción in Lompoc, California, shows the effectiveness of this model and its real-world application. Visitors to California missions encounter the pervasive “Mission Myth”—a narrative that systematically overlooks and marginalizes Indigenous presence while perpetuating ideas of White hegemony and Eurocentrism. Archaeological excavations in the Native rancheria and collaboration with members of the Chumash community help resist notions of Indigenous erasure. By activating notions of persistence through public archaeology, this study contributes to dismantling entrenched terminal narratives, paving the way for a more accurate representation of the past and fostering a more inclusive archaeological practice.
This article focuses on the ancestral human remains of Indigenous peoples that were taken by European invaders during the colonial era. It begins by considering the notion of human remains. It then describes the two types of heritage that result from the removal of human remains: the tangible heritage made of the remains exhibited or stored in the museums or universities of former colonial States, and the intangible heritage made of the collective memories of the surviving communities and their descendants about the removal (and the absence) of the stolen remains. The article next examines the role of national and international laws with respect to the restitution of human remains by exploring the concept of transitional justice. This article argues that transitional justice can facilitate the meaningful repatriation of ancestral human remains and hence the healing of past injustice.
This study explores the impact of power dynamics – represented by linguistic privilege, learning environment, and identity formation – on translingual practices in Chinese as a Second Language (CSL) writing education. It focuses on a specific case involving Chinese language learners at a Sino-US joint-venture university in China to elucidate these dynamics in a real-life context. The findings revealed how societal expectations, internalized power dynamics, and prevailing language ideologies nurtured perceptions of a diminished Chinese identity and influenced students' language preferences and engagement in CSL writing. The article argues that the decolonization of writing education necessitates critical awareness of power dynamics and the challenges they pose to monolingual ideologies. It also proposes pedagogical strategies to incorporate power dynamics into translingual practices by emphasizing the need to embrace language diversity and fluidity, facilitate translingual identity formation, and employ reflective practices. By raising awareness of power dynamics in translingual practices, educators can empower students to confront the linguistic status quo, promote linguistic justice, and cultivate a more equitable CSL writing education.
Scholars of the past frame the ‘origins’ or evolution of inequality, usually using archaeological or anthropological evidence as a basis for their arguments, as an intentional, inevitable, important step towards the development of states, implicitly framed as the pinnacle of human political and economic achievement. Anarchist archaeologies reject the idea of hierarchy as a positive or inevitable evolutionary outcome underlying the path to civilization. We argue instead for a radical reorientation towards archaeologies of equality. We propose a prefigurative archaeology that celebrates the myriad ways that human beings have actively undermined and resisted hierarchical social arrangements. We aim to reorient archaeology's focus towards societies that purposefully prevented or constrained the emergence of inequality. To demonstrate the potential of archaeologies of equality we present case examples from Oceania, Britain, West Asia and the American Southwest. Highlighting the accomplishments of societies of equals in the past demonstrates the contingency and problematic nature of present forms of inequality. It allows us to explore a different set of pasts and thus enact different presents as we imagine different futures.
Drawing on data generated from a two-year ethnographic observation with a group of multiethnic Black women, this investigation delves into the ways they employ discursive and linguistic strategies, namely solidarity through difference and distinction, solidarity through denaturalizing difference, and solidarity through shared struggles and learning in deictically anchored interactions. The study presents a moment-by-moment analysis of culturally and socially situated conversations. These conversations allow us to see how the social actors enact different stance-taking and scaling practices to construct meanings about race that intersect with gender/transnational identities. Discursive practices show that when we closely attend to race, transnationalism, and gender, specifically considering the particularity of Black womanhood, new and more complex ways of understanding transnational identity formation emerge. Participants’ constructions indicate that women co-construct a unique brand of Black feminist solidarity that is not based on similarity but meaningfully created through differentiation and distinction. (Black immigrant women, solidarity, stance-taking, scaling and deixis difference, African diaspora, intersectionality)*
The complex regulatory framework governing the U.S. health care system can be an obstacle to programming that address health-related social needs. In particular, health care fraud and abuse law is a pernicious barrier as health care organizations may minimize or forego programming altogether out of real and perceived concern for compliance. And because health care organizations have varying resources to navigate and resolve compliance concerns, as well as different levels of risk tolerance, fears related to the legal landscape may further entrench inequities in access to meaningful programs that improve health outcomes. This article uses food and nutrition programming as a case study to explore the complexities presented by this area of law and to highlight pathways forward.
Common mental health problems (particularly depression and anxiety) are common among adolescents during the perinatal period. Previous research has identified the distinctive needs of this group and called for contextually appropriate psychosocial interventions. The current study conducted in Malawi aimed to explore risk and protective factors for common mental health problems, and barriers to accessing mental health care, among perinatal adolescents, to develop a contextually relevant intervention for preventing and treating perinatal depression and anxiety. An exploratory qualitative study was conducted in antenatal and postnatal clinics in Zomba district, Malawi in January–March 2022. In-depth individual interviews were completed with perinatal adolescents aged ≤19 (n = 14); their family members (n = 4); and healthcare workers (n = 8). Interview data were subjected to thematic framework analysis. Data were organised around two themes: “psychosocial risk and protective factors” (potential causes of common mental health problems among adolescents); and “health care services” (maternal and mental health services available, and adolescents’ experiences of using these services). Interventions need to go beyond targeting symptoms of depression and anxiety to addressing the wider contextual risk factors and barriers to care at the different socioecological levels.
Most family violence research has been conducted in high-income countries, although family violence rates are higher in low- and middle-income countries (LMICs), and outcomes more severe. Given the strong associations of family violence with substance use and mental illness, the aim of this systematic review was to examine interventions that targeted familial violence and at least one other condition of substance use or mental illness to determine effective treatments in LMICs. We conducted a systematic review of interventions that addressed family violence and mental illness or substance use. A committee of three researchers independently screened titles and abstracts and conducted full-text eligibility assessments. Two researchers conducted a risk of bias assessment. Data were extracted using a structured spreadsheet and narratively synthesized. Our search identified 29 articles produced from 19 studies conducted in 13 LMICs. Most (n = 15) studies randomized to study condition. Lack of blinding was the most common threat. The external validity of studies was generally poor. Fourteen studies had a primary intervention target of family violence, mental health, substance use, economic improvement, or HIV. None of the studies showed improvements in all intervention areas. Child maltreatment was less likely to be addressed than intimate partner violence (IPV). Targeted interventions for substance and mental health mostly improved primary outcomes, although they were less effective in reducing IPV. Evidence-based treatments must be rigorously evaluated before innovations in implementation can occur. Interventions overwhelmingly addressed IPV victimization and should consider how to work with couples and include men and children.
Inclusion and diversity in precision oncology are essential in reducing cancer disparities among racial and ethnic groups. However, present studies have favored the recruitment and participation of Whites, with limited applicability of their results to minority groups. Many reasons for their underrepresentation are downstream manifestations of structural racism. Therefore, this scoping review provides a precise mapping of recruitment and participation barriers for minorities in precision oncology that are associated with structural racism, including a critical appraisal of how disciplinary norms, paradigms, and tools used therein could inadvertently contribute to unforeseen inclusion and diversity challenges. Empirical and theoretical publications from Web of Science and PubMed were searched and analyzed to identify recruitment and participation barriers for minorities in precision oncology. In addition, using the public health critical race praxis (PHCRP) as guiding analytical framework, empirical studies were analyzed to identify unforeseen barriers resulting from simplification processes, assumptions, norms, paradigms, and tools used during the research process. One-hundred thirty-five barriers to recruitment and participation were identified or reported in included publications. They were subsequently categorized as being a manifestation of one of the following forms of racism, namely internalized, interpersonal, institutional, and structural racism. The PCHRP analysis revealed four additional factors to be considered in precision oncology studies in ensuring appropriate representation of their study populations. Future interventions aimed at reducing health disparities should focus predominantly on barriers associated with structural and institutional racism, which should then have ripple effects on other forms of racism. Importantly, the four factors identified through the PHCRP framework could further explain the lower participation rates of minorities in precision oncology and related activities. Therefore, they should be given due consideration by all stakeholders involved in the precision oncology ecosystem, from researchers and healthcare professionals to policy-makers, research ethics committees, and funders.
One of the Sustainable Development Goals, number 10, is about reducing inequality within and between countries. This paper argues that the existing structure of the (international) financial system is, for various reasons, one of the determinants of (growing) inequality. This should receive more attention.
Public mental health involves a population approach to mental health, and includes treatment of mental disorder, prevention of associated impacts, prevention of mental disorder and promotion of mental well-being, including for those people recovering from mental disorder. Such interventions can result in a broad range of impacts and associated economic savings even in the short term. However, even in high-income countries only a minority of people with mental disorder receive any treatment, while provision is far less in low- and middle-income countries. Coverage of interventions to prevent mental disorder and promote mental well-being is far less even in high-income countries, despite such interventions being required for sustainable reduction in the burden of mental disorder. This implementation gap results in a broad set of impacts and associated economic costs. Mental health needs assessments represent an important framework and mechanism to address this implementation gap – in low- and middle-income as well as high-income countries. Training and support to perform mental health needs assessments is important, as is the use of information derived from such assessments to more effectively advocate for the required level of resources to address the implementation gap. Such a public health approach to mental health represents an opportunity for psychiatrists to advocate more effectively for resources at both the local and national level. This can improve the coverage and outcomes of a range of public mental health interventions that result in broad impacts and associated economic savings, which can be estimated.
We use a reliable, intuitive and simple set of indicators to capture three dimensions of access – availability, affordability and acceptability. Data are from South Africa’s 2009 and 2010 General Household Surveys (n=190,164). Affordability constraints were faced by 23% and are more concentrated amongst the poorest. However, 73% of affordability constraints are due to travel costs which are aligned with findings of the availability constraints dimension. Availability constraints, involving distances and transport costs, particularly in underdeveloped rural areas, and inconvenient opening times, were faced by 27%. Acceptability constraints were noted by only 10%. We approximate acceptability with an indicator measuring the share of community members bypassing the closest health care facility, as we argue that reported health care provider choice is more reliable than stated preferences. However, the indicator assumes a choice of available and affordable providers, which may often not be an accurate assumption in rural areas. We recommend further work on the measurement of acceptability in household surveys, especially considering this dimension’s importance for health reform.
This article analyses the human rights implications of impact investing, which aims to create positive social and environmental impacts in addition to financial returns. Reflecting growing awareness of the capacity of the global capital markets to advance sustainable development, companies and institutional investors are seeking new financial instruments and strategies. This article focuses on social bonds, a prominent and illuminating example of this phenomenon. Social bonds are debt securities sold to investors whose proceeds are used to finance projects with a defined social benefit such as affordable housing, education, food security, and access to healthcare. To analyse social bonds in the context of human rights, this article proposes a framework for evaluating human rights factors in impact investing and applies it to the social bond market. It finds that current standards and practices do not adequately account for the human rights implications of social bonds. In light of these observations, this article suggests reforms to the social bond market that enhance investor assessment, external assurance, and impact-maximizing leverage.
This article provides new evidence on the relationship between benefit conditionality and mental health. Using data on Temporary Assistance for Needy Families policies (TANF) – the main form of poverty relief in the United States – it explores whether the mental health of low-educated single mothers varies according to the stringency of conditionality requirements attached to receipt of benefit. Specifically, the article combines state-level data on sanctioning practices, work requirements and welfare-to-work spending with health data from the Behavioral Risk Factor Surveillance System and evaluates the impact of conditionality on mental health over a fifteen-year period (2000 to 2015). It finds that states that have harsher sanctions, stricter job search requirements and higher expenditure on welfare-to-work policies, have worse mental health among low-educated single mothers. There is also evidence that between-wave increases in the stringency of conditionality requirements are associated with deteriorations in mental health among the recipient population. It is suggested that these findings may reflect an overall effect of ‘intensive conditionality’, rather than of the individual variables per se. The article ends by considering the wider implications for policy and research.
Evidence-based practice (EBP), which is commonly implemented in high-income countries (HICs), integrates the best research evidence, clinical expertise and patient preferences in the planning and provision of healthcare for both physical and mental health conditions. Although the same principles of EBP apply in low- and middle-income countries (LMICs), research into and implementation of such interventions in these countries remains significantly behind compared with HICs. This article presents a brief overview of the global mental health agenda and initiatives aiming to address this pressing gap through the promotion of research and scaling up services, identification of barriers to developing and implementing EBP in LMICs, and possible solutions to overcome them.
Africa may be heading for an era of genomics medicine. There are also expectations that genomics may play a role in reducing global health inequities. However, the near lack of genomics studies on African populations has led to concerns that genomics may widen, rather than close, the global health inequity gap. To prevent a possible genomics divide, the genomics ‘revolution’ has been extended to Africa. This is motivated, in part, by Africa's rich genetic diversity and high disease burden. What remains unclear, however, are the prospects of using genomics technology for healthcare in Africa. In this qualitative study, we explored the views of 17 genomics researchers in Africa on the prospects and challenges of genomics medicine in Africa. Interviewees were researchers in Africa who were involved in genomics research projects in Africa. Analysis of in-depth interviews suggest that genomics medicine may have an impact on disease surveillance, diagnosis, treatment and prevention. However, Africa's capacity for genomics medicine, current research priorities in genomics and the translation of research findings will be key defining factors impacting on the ability of genomics medicine to improve healthcare in Africa.