Uneven Social Policies

Social policies can transform the lives of the poor, yet subnational politics and state capacity often inhibit their success.

In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.

This report examines the links between inequality and other major global trends (or megatrends), with a focus on technological change, climate change, urbanization and international migration. The analysis pays particular attention to poverty and labour market trends, as they mediate the distributional impacts of the major trends selected. It also provides policy recommendations to manage these megatrends in an equitable manner and considers the policy implications, so as to reduce inequalities and support their implementation.

This book provides a novel explanation of widespread social policy expansion in Latin America beginning in the 1990s.

The United States is among the wealthiest nations in the world, but it is far from the healthiest. Although life expectancy and survival rates in the United States have improved dramatically over the past century, Americans live shorter lives and experience more injuries and illnesses than people in other high-income countries. The U.S. health disadvantage cannot be attributed solely to the adverse health status of racial or ethnic minorities or poor people: even highly advantaged Americans are in worse health than their counterparts in other, "peer" countries. In light of the new and growing evidence about the U.S. health disadvantage, the National Institutes of Health asked the National Research Council (NRC) and the Institute of Medicine (IOM) to convene a panel of experts to study the issue. The Panel on Understanding Cross-National Health Differences Among High-Income Countries examined whether the U.S. health disadvantage exists across the life span, considered potential explanations, and assessed the larger implications of the findings. U.S. Health in International Perspective presents detailed evidence on the issue, explores the possible explanations for the shorter and less healthy lives of Americans than those of people in comparable countries, and recommends actions by both government and nongovernment agencies and organizations to address the U.S. health disadvantage.

Relationships between social policy and human development are the subject of much research and theorizing. The literature in this area, however, examines these issues strictly within national contexts. What influence will international agendas such as NAFTA, the World Summit for Social Development, and Habitat II have? Transnational Social Policies specifically addresses the worldwide trend for national policies on human and social development to be increasingly influenced by agendas that are international, or "transnational," in nature. In doing so, the book examines the underlying international developmental, ethical, economic, and political issues shaping national policies in health, education, and employment in the developing world. This book's focus on the "transnational" character of the social policy debate makes it a truly unique and original contribution to the literature. It will appeal to the academic community, worldwide, in international development, public policy and administration, and social work; policymakers, researchers, and practitioners in the field of public (social) policy; and the international community of individuals and organizations working in international social development.

Medicaid is the single largest public health insurer in the United States, covering upwards of 70 million Americans. Crucially, Medicaid is also an intergovernmental program that yokes poverty to federalism: the federal government determines its broad contours, while states have tremendous discretion over how Medicaid is designed and implemented. Where some locales are generous and open handed, others are tight-fisted and punitive. In Fragmented Democracy, Jamila Michener demonstrates the consequences of such disparities for democratic citizenship. Unpacking how federalism transforms Medicaid beneficiaries' interpretations of government and structures their participation in politics, the book examines American democracy from the vantage point(s) of those who are living in or near poverty, (disproportionately) Black or Latino, and reliant on a federated government for vital resources.

Perceptions of eroding living standards and low life satisfaction are widespread in the Middle East and North Africa region today, along with pessimism about prospects for economic mobility. Conventional measures of economic well-being offer little in the way of explanation †“ in most countries in the region, extreme poverty is low and declining and economic inequality is lower than in other parts of the world. This book investigates possible reasons for this disconnect, focusing on the role played by inadequate and unequal access to opportunities to realize one’s aspirations for economic mobility. The inability of most countries in the region to meet the aspirations of citizens is closely linked to persistent weaknesses in the labor markets where the pace of job creation has been chronically below levels required to absorb the growing and increasingly better educated population. A high degree of segmentation in the labor markets also puts the youth and women in the region at a particular disadvantage. While labor markets are critical for mobility, opportunities and life paths can diverge even earlier in life if access to basic services in health, education and infrastructure are unequally distributed among children in their formative years. This book documents sharp disparities in the quality of services available to children of varying birth circumstances in the region. Although the most intense debates in development coalesce around inequality of income or wealth, the notion of inequality of opportunity has an intuitive appeal that can bridge ideological differences. By drawing attention to the notion of equality of opportunity to create a level playing field for all sections of society, the book highlights the need to critically examine the social contract and governance structures that guide the delivery of services and are instrumental for implementing necessary reforms to make labor markets more dynamic and equitable.