Suchergebnisse

This article explores the motivations for unregulated child care use within Canada. Using focus group data from 109 mothers, we analyze unregulated child care use within a policy context in which regulated child care is only available for 20% of preschool children. The key drivers for unregulated care were framed by participants as benefits: trust in a known caregiver with similar values, offered in a home-like environment. Importantly, one driver that was not seen as beneficial was the lack of affordable and accessible, regulated child care. Sometimes used as a last resort amid regulated child care shortages, unregulated care became the driver of how mothers organized their time. Within the constraints of a limited regulatory child care environment, we argue that Mathieu's (2016) concept of demotherization is beyond the grasp of the majority of Canadian mothers.

"Our global reliance on private automobiles as the primary means for transporting individuals is likely to become of increasing political importance over the next ten to twenty years. While the individual benefits of car-based travel continues to be recognized, the wider environmental and social cost of automobiles is also significant and the need for political intervention to control some of their worst effects is increasingly accepted within policy circles internationally. It is within this wider context that 'Auto Motives' is set. It critically evaluates the evidence for better understanding 'what drives us to drive'. Uniquely, it draws together and explains the diverse theoretical literatures that pertain to people's auto motives and considers these theories in light of empirical research of what actually informs our automobile decisions and behaviours. With contributions from leading academic experts from around the world, its core arguments and narratives are presented in such a way as to offer widespread appeal to a wide ranging audience"--Provided by publisher

Contents -- Preface -- Chapter 1 -- Medicare: Potential Uses of Electronically Readable Cards for Beneficiaries and Providers* -- Why GAO Did This Study -- What GAO Found -- Abbreviations -- Background -- Key Proposed Uses for Electronically Readable Cards -- Medicare Program Integrity -- Identity Authentication -- Smart Cards Can Provide More Rigorous Authentication, but All Cards Could Electronically Convey Beneficiary Identity and Insurance Information -- The Use of Electronically Readable Cards Would Provide Limited Benefits for Reducing Fraud, but Could Aid Administrative Processes

Using data from a 1996/1997 survey of undocumented Latino immigrants in four sites, we examine reasons for coming to the United States, use of health care services, and participation in government programs. We find that undocumented Latinos come to this country primarily for jobs. Their ambulatory health care use is low compared with that of all Latinos and all persons nationally, and their rates of hospitalization are comparable except for hospitalization for childbirth. Almost half of married undocumented Latinos have a child who is a U.S. citizen. Excluding undocumented immigrants from receiving government-funded health care services is unlikely to reduce the level of immigration and likely to affect the well-being of children who are U.S. citizens living in immigrant households.

Using data from a 1996/1997 survey of undocumented Latino immigrants in four sites, we examine reasons for coming to the United States, use of health care services, and participation in government programs. We find that undocumented Latinos come to this country primarily for jobs. Their ambulatory health care use is low compared with that of all Latinos and all persons nationally, and their rates of hospitalization are comparable except for hospitalization for childbirth. Almost half of married undocumented Latinos have a child who is a U.S. citizen. Excluding undocumented immigrants from receiving government-funded health care services is unlikely to reduce the level of immigration and likely to affect the well-being of children who are U.S. citizens living in immigrant households.

Many countries are today facing substantial environmental and societal costs of private car use such as congestion, noise, and air pollution. Transport authorities therefore implement various policy measures that aim to modify or reduce private car use. These are generally referred to as Travel Demand Management (TDM) measures. In this research report we propose a classification of the various TDM-measures, encompassing the specific characteristics of each, how the various measures may be distinguished from each other and to what extent they may interact, as well as how effective they are in modifying or reducing private car use. A theoretical framework is proposed next, to account for how the TDM measures impact on car users' change in travel behaviour. The theoretical framework posits that, if a change goal is set, it is followed by forming plans to attain the set goal (e.g., to change from using the car to using alternative modes). A principle of cost-minimization is proposed that describes how car users incrementally implement plans to achieve their set goals. A review of voluntary travel-behavior change (VTBC) programs shows that in general the VTBC-related TDM measures are effective. Yet, it is still unclear whether these positive effects are long-term. Furthermore, the positive effects are apparently only observed for motivated (and self-selected) participants and not even necessarily for all of them unless some facilitating conditions are fulfilled. However, the VTBC measures meet with higher public acceptance, are politically feasible, and cost-effective. It is argued that more research is needed to answer the questions of when and why VTBC measures work, wherein also a closer investigation into which individual and situational factors it is that generates the positive effect.

Objective
Racial disparities in health outcomes are a persistent threat in gentrifying neighborhoods. A contributor to health outcomes is health services utilization, the extent to which people receive care from a medical professional. There are documented racial disparities in health services utilization in the general population. We aim to determine whether racial disparities in health services utilization exist in gentrifying neighborhoods.


Methods
We used data from the American Community Survey to identify gentrifying neighborhoods across the United States from 2006 to 2017. We collected data on three measures of healthcare services utilization (office-based physician visits, office-based nonphysician visits, and having a usual source of care) for 247 Black and 689 White non-Hispanic respondents of the 2014 Medical Expenditure Panel Survey living in gentrifying neighborhoods. We used modified Poisson models to determine whether there is a difference in the prevalence of health services utilization by race among residents of gentrifying neighborhoods.


Results
After adjusting for age, gender, education, income, employment, insurance, marital status, region, and self-rated health, Black residents of gentrifying neighborhoods demonstrated a similar prevalence of having an office-based physician visit, a lower prevalence of having an office-based nonphysician visit (prevalence ratio: 0.74; 95% confidence interval, 0.60 to 0.91), and a lower prevalence of having a usual source of care (prevalence ratio: 0.87; 95% confidence interval, 0.77 to 0.98) than White residents.


Conclusions
The existence of racial disparities in health services utilization in US gentrifying neighborhoods demonstrates a need for policy-relevant solutions to create a more equitable distribution of health resources.

Successful promotion of alternative transport modes needs to be underpinned by better understandings of a seemingly cemented collective preference for private car use. This paper contributes to these understandings and proposes that automobility's dominance can be explained by a series of benefits intimately linked to the car. These benefits extend beyond those associated with utilitarian factors such as saving time. The concept of ontological security is used to propose that attachments to the private car are underpinned by an innate desire for predictability, autonomy and acceptance in modern lives increasingly characterised by insecurity. Empirical evidence on the journey to work in Australia's largest city, Sydney, is applied to examine the way mobility is practised and inform the paper's central proposition.

In June 2019, the government of the Flemish Region (Belgium) launched the "mobility score," a standardized built environment indicator that informs citizens in Flanders about the walking or cycling accessibility from their dwelling to a range of basic amenities and public transport stops. The development of the mobility score was developed to be a tool to raise awareness of the environmental impact of travel. Against this backdrop, this paper assesses the extent to which the mobility score can predict car use and aims to contribute to the line of research that studies travel patterns in relation to accessibility, spatial context, and travel mode choice. Based on the data from the Flemish Travel Behavior Survey, we analyze the effect of the interaction between the built environment, frequency of car use and vehicle kilometers traveled. Our findings illustrate that frequent and intensive car use is not an exclusive feature of suburban and rural residents in Flanders, or of those who travel long distances. The outcomes show that the mobility score can predict the frequency of car travel but only in the inner city. As for other areas, travel behavior shows little variance among respondents. The presence of a company car in a household is a much stronger predictor of vehicle kilometers traveled than any other variable, including the built environment. Travel behavior turns toward car use once a household acquires a car, almost regardless of the type of neighborhoods where respondents live. In Flanders, policy has so far been directed more toward curbing car use than discouraging car ownership. Our findings suggest that it could be more effective to aim for the latter, as this prevents the development of a cycle of car-oriented behavior in the first place.