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Mobility Regimes and Parental Wealth: The United States, Germany, and Sweden in Comparison
Mobility Regimes and Parental Wealth: The United States, Germany, and Sweden in Comparison
Source: University of Michigan Populations Studies Center
We study the role of parental wealth for children’s educational and occupational outcomes across three types of welfare states and outline a theoretical model that assumes parental wealth to impact offspring’s attainment through two mechanisms, wealth’s purchasing function and its insurance function. We argue that welfare states can limit the purchasing function of wealth, for instance by providing free education and generous social benefits, yet none of the welfare states examined here provides a functional equivalent to the insurance against adverse outcomes afforded by parental wealth. Our empirical evidence of substantial associations between parental wealth and children’s educational success and social mobility in three nations that are marked by large institutional differences is in line with this interpretation and helps us re-examine and extend existing typologies of mobility regimes.
New 2011 Survey of Patients with Complex Care Needs in Eleven Countries Finds That Care Is Often Poorly Coordinated
New 2011 Survey of Patients with Complex Care Needs in Eleven Countries Finds That Care Is Often Poorly Coordinated
Source: Commonwealth Fund
An international survey of adults living with health problems and complex care needs found that patients in the United States are much more likely than those in 10 other high-income countries to forgo needed care because of costs and to struggle with medical debt. In all the countries surveyed, patients who have a medical home reported better coordination of care, fewer medical errors, and greater satisfaction with care than those without one.
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Key Findings
- Sicker adults in the U.S. stood out for having cost and access problems. More than one of four (27%) were unable to pay or encountered serious problems paying medical bills in the past year, compared with between 1 percent and 14 percent of adults in the other countries. In the U.S., 42 percent reported not visiting a doctor, not filling a prescription, or not getting recommended care. This is twice the rate for every other country but Australia, New Zealand, and Germany.
- In the U.S., cost-related access problems and medical bill burdens were concentrated among adults under age 65. Compared with Medicare-aged adults 65 or older, adults under 65 were far more likely to go without care because of the cost or to have problems paying bills.
- Adults with complex care needs who received care from a medical home—an accessible primary care practice that knows their medical history and helps coordinate care—were less likely to report experiencing medical errors, test duplication, and other care coordination failures. They were also more likely to report having arrangements for follow-up care after a hospitalization and more likely to rate their care highly.
- Sicker adults in the U.K. and Switzerland were the most likely to have a medical home: nearly three-quarters were connected to practices that have medical home characteristics, compared with around half in most of the other countries.
New Study: U.S. Ranks Last Among High-Income Nations on Preventable Deaths, Lagging Behind as Others Improve More Rapidly
New Study: U.S. Ranks Last Among High-Income Nations on Preventable Deaths, Lagging Behind as Others Improve More Rapidly
Source: Commonwealth Fund (Health Policy)
The United States placed last among 16 high-income, industrialized nations when it comes to deaths that could potentially have been prevented by timely access to effective health care, according to a Commonwealth Fund–supported study that appeared online in the journal Health Policy this week and will be available in print on October 25th as part of the November issue. According to the study, other nations lowered their preventable death rates an average of 31 percent between 1997–98 and 2006–07, while the U.S. rate declined by only 20 percent, from 120 to 96 per 100,000. At the end of the decade, the preventable mortality rate in the U.S. was almost twice that in France, which had the lowest rate—55 per 100,000.
In “Variations in Amenable Mortality—Trends in 16 High Income Nations,” Ellen Nolte of RAND Europe and Martin McKee of the London School of Hygiene and Tropical Medicine analyzed deaths that occurred before age 75 from causes like treatable cancer, diabetes, childhood infections/respiratory diseases, and complications from surgeries. They found that an average 41 percent drop in death rates from ischemic heart disease was the primary driver of declining preventable deaths, and they estimate that if the U.S. could improve its preventable death rate to match that of the three best-performing countries—France, Australia, and Italy—84,000 fewer people would have died each year by the end of the period studied.
“This study points to substantial opportunity to prevent premature death in the United States. We spend far more than any of the comparison countries—up to twice as much—yet are improving less rapidly,” said Commonwealth Fund Senior Vice President Cathy Schoen. “The good news is we know lower death rates are achievable if we enhance access and ensure high-quality care regardless of where you live. Looking forward, reforms under the Affordable Care Act have the potential to reduce the number of preventable deaths in the U.S. We have the potential to join the leaders among high-income countries.”
+ Variations in Amenable Mortality—Trends in 16 High-Income Nations
On the road: Social aspects of commuting long distances to work
On the road: Social aspects of commuting long distances to work
Source: Umeå University, Faculty of Social Sciences, Department of Social and Economic Geography
With its point of departure of increasing numbers of people being engaged in commuting, the aim of this thesis is to reveal prerequisites for and consequences of long-distance commuting in Sweden for the individual and his or her partner. Special attention has been given to prerequisites for long-distance commuting in sparsely populated areas, and to social consequences related to long-distance commuting in terms of gender differences in commuting patterns, earnings and separation. The thesis is based on four empirical studies, presented in different papers. Two studies draw on individual longitudinal register data on all Swedish long-distance commuters living with a partner. The other two focus on commuting behaviour in sparsely populated areas, one based on individual register data and the other on a survey.
Long-distance commuting (>30 kilometres) has become an increasingly common mobility strategy among Swedish workers and their households. Results from the thesis show that 11 percent of Swedish workers are long-distance commuters and about half of them live in a relationship. Among these couples many are families with children, indicating the importance of social ties in households’ decisions on where to work and live. Most long-distance commuters are men, and it is also likely that long-distance commuters have a high education level and are employed in the private sector. For the majority, long-distance commuting gives higher earnings; however, men benefit economically more than women do. As long-distance commuting reduces available family time, the non-commuting spouse often takes on a larger share of household commitments. The thesis shows that men’s long-distance commuting may therefore serve to reproduce and reinforce traditional gender roles on the labour market and within households. On the other hand, women’s long-distance commuting can lead to more equalitarian relationships on the labour market and within households. For the majority of couples it seems as if long-distance commuting becomes more than a temporary mobility strategy, while for some couples it does not work out very well. Separation rates are found to be higher among long-distance commuters compared to other couples; especially the first years of commuting seem to be the most challenging. It is suggested that coping strategies are important to make the consequences of long-distance commuting easier to handle and adjust to in the daily life puzzle. For those unable to handle these consequences, long-distance commuting is not a sustainable mobility strategy and can even end a relationship.
The extent of long-distance commuting is low in sparsely populated areas, and those who do long-distance commute are mainly men. Most people work and live within the same locality and do not accept longer commuting times than do those in densely populated areas. In this thesis it is argued that facilitating car commuting in the more sparsely populated areas of Sweden can be more economically and socially sustainable, for the individual commuters as well as for society, than encouraging commuting by public transportation.
+ Full Paper (PDF)
Country Specific Information: Sweden
Country Specific Information: Sweden
Source: U.S. Department of State
May 04, 2011
COUNTRY DESCRIPTION: Sweden is a highly developed, stable democracy with a modern economy. Read the Department of State Background Notes on Sweden for additional information.
How health systems make available information on service providers: Experience in seven countries
How health systems make available information on service providers: Experience in seven countries
Source: RAND Corporation
The report reviews and discusses information systems reporting on the quality or performance of providers of healthcare (‘quality information systems’) in seven countries: Denmark, England, Germany, Italy, the Netherlands, Sweden and the United States. Data collection involves a review of the published and grey literature and is complemented by information provided by key informants in the selected countries using a detailed questionnaire. Quality information systems typically address a number of audiences, including patients (or respectively the general public before receiving services and becoming patients), commissioners, purchasers and regulators. We observe that as the policy context for quality reporting in countries varies, so also does the nature and scope of quality information systems within and between countries. Systems often pursue multiple aims and objectives, which typically are (a) to support patient choice (b) to influence provider behaviour to enhance the quality of care (c) to strengthen transparency of the provider-commissioner relationship and the healthcare system as a whole and (d) to hold healthcare providers and commissioners to account for the quality of care they provide and the purchasing decisions they make. We emphasise that the main users of information systems are the providers themselves as the publication of information provides an incentive for improving the quality of care. Finally, based on the evidence reviewed, we identify a number of considerations for the design of successful quality information systems, such as the clear definition of objectives, ensuring users’ accessibility and stakeholder involvement, as well as the need to provide valid, reliable and consistent data.
