Research question: The current study investigates the income elasticities and socio-economic determinants of direct and indirect sports expenditure categories by means of a log normal hurdle regression. Research methods: The data stem from a representative sample of 3005 Flemish families with school-aged children, gathered through a sports-specific survey. A log normal hurdle regression was used to calculate the determining factors and expenditure elasticities of expenditure on sports participation. Results and findings: The results indicate that income, education and the age of the youngest child are positively related to almost all sports expenditure categories, while the number of family members and degree of urbanisation are significant for only a number of the expenditure categories. The elasticity value of the direct sports expenses is smaller than is the case for indirect sports expenditure. Between the expenditure categories large differences exist, as relatively large elasticities are found for sports holidays, transport and sports food and drinks, as opposed to low values of sports events, sports club membership, entrance fees for sports infrastructure, sports camps, clothing, footwear and equipment. Implications: The fact that income significantly influences all expenditure categories demonstrates that further policy intervention is required to make sports consumption more accessible to lower income groups. Sports enterprises and policymakers need to be aware that negative income shifts have a more profound impact on the indirect expenditure categories, and that certain sports activities (e.g. participation events) are relatively more favoured by low-income groups than is the case for sports club membership
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Despite the many benefits of club-organized sports participation for children, sports participation is lower among children from low-income families than among those from middle- or high-income families. Social safety experienced by parents from low-income families is an important facilitator for parents to request financial support for their children’s sports participation. Therefore, the first aim of this study was to better understand parental social (un)safety in the context of acquiring financial support for children’s sports participation and how to create a safe social environment for low-income parents to request and receive this financial support. The second aim was to describe the co-creation process, which was organized to contribute to social safety solutions. To reach these goals, we applied a participatory action research method in the form of four co-creation sessions with professionals and an expert-by-experience, as well as a group interview with parents from low-income families. The data analysis included a thematic analysis of the qualitative data. The results showed that from the perspective of parents, social safety encompassed various aspects such as understandable information, procedures based on trust, and efficient referral processes. Sport clubs were identified as the primary source of information for parents. Regarding the co-creation process, the study found that stakeholders tended to overestimate parental social safety levels. Although the stakeholders enjoyed and learned from the sessions, differences in prior knowledge and a lack of a shared perspective on the purpose of the sessions made it challenging to collaboratively create solutions. The study’s recommendations include strategies for increasing parental social safety and facilitating more effective co-creation processes. The findings of this study can be used to inform the development of interventions that contribute to a social environment in which parents from low-income families feel safe to request and receive financial support for their children’s sports participation.
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BACKGROUND: Prenatal healthcare is likely to prevent adverse outcomes, but an adequate review of utilization and its determinants is lacking.OBJECTIVE: To review systematically the evidence for the determinants of prenatal healthcare utilization in high-income countries.METHOD: Search of publications in EMBASE, CINAHL and PubMed (1992-2010). Studies that attempted to study determinants of prenatal healthcare utilization in high-income countries were included. Two reviewers independently assessed the eligibility and methodological quality of the studies. Only high-quality studies were included. Data on inadequate use (i.e. late initiation, low-use, inadequate use or non-use) were categorized as individual, contextual and health behaviour-related determinants. Due to the heterogeneity of the studies, a quantitative meta-analysis was not possible.RESULTS: Ultimately eight high-quality studies were included. Low maternal age, low educational level, non-marital status, ethnic minority, planned pattern of prenatal care, hospital type, unplanned place of delivery, uninsured status, high parity, no previous premature birth and late recognition of pregnancy were identified as individual determinants of inadequate use. Contextual determinants included living in distressed neighbourhoods. Living in neighbourhoods with higher rates of unemployment, single parent families, medium-average family incomes, low-educated residents, and women reporting Canadian Aboriginal status were associated with inadequate use or entering care after 6 months. Regarding health behaviour, inadequate use was more likely among women who smoked during pregnancy.CONCLUSION: Evidence for determinants of prenatal care utilization is limited. More studies are needed to ensure adequate prenatal care for pregnant women at risk.
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Although lifetime employment was once commonplace, the situation has changed dramatically over the last century. The group of precarious workers has increased, and with it, the size of the precariat. Although there is a body of research on how precarious workers perceive the effect of their precarity on their social, psychological, and economic well-being, there is no research on the needs of precarious workers. In this article, we report the findings of an exploratory study about precarious worker’s needs. The findings show that the precariat has a diversity of needs, ranging from the need for a higher income to the need for a change in the discourse on self-reliance. Most of the needs are targeted toward the government and are not only related to labor. This is, however, contradictory to the ideology of downsizing the welfare state, in which governments focus on creating more temporary or steppingstone jobs. The needs show that the measures orientated toward the labor market are insufficient because they meet only a marginal part of the needs of the precariat.
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This study investigates patients' access to surgical care for burns in a low- and middle-income setting by studying timeliness, surgical capacity, and affordability. A survey was conducted in a regional referral hospital in Manyara, Tanzania. In total, 67 patients were included. To obtain information on burn victims in need of surgical care, irrespective of time lapsed from the burn injury, both patients with burn wounds and patients with contractures were included. Information provided by patients and/or caregivers was supplemented with data from patient files and interviews with hospital administration and physicians. In the burn wound group, 50% reached a facility within 24 hours after the injury. Referrals from other health facilities to the regional referral hospital were made within 3 weeks for 74% in this group. Of contracture patients, 74% had sought healthcare after the acute burn injury. Of the same group, only 4% had been treated with skin grafts beforehand, and 70% never received surgical care or a referral. Together, both groups indicated that lack of trust, surgical capacity, and referral timeliness were important factors negatively affecting patient access to surgical care. Accounting for hospital fees indicated patients routinely exceeded the catastrophic expenditure threshold. It was determined that healthcare for burn victims is without financial risk protection. We recommend strengthening burn care and reconstructive surgical programs in similar settings, using a more comprehensive health systems approach to identify and address both medical and socioeconomic factors that determine patient mortality and disability.
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Introduction This study aims to explore maternal and perinatal outcomes of migrant women in Iceland. Material and methods This prospective population-based cohort study included women who gave birth to a singleton in Iceland between 1997 and 2018, comprising a total of 92 403 births. Migrant women were defined as women with citizenship other than Icelandic, including refugees and asylum seekers, and categorized into three groups, based on their country of citizenship Human Development Index score. The effect of country of citizenship was estimated. The main outcome measures were onset of labor, augmentation, epidural, perineum support, episiotomy, mode of birth, obstetric anal sphincter injury, postpartum hemorrhage, preterm birth, a 5-minute Apgar <7, neonatal intensive care unit admission and perinatal mortality. Odds ratios (ORs) and 95% confidence intervals (CIs) for maternal and perinatal outcomes were calculated using logistic regression models. Results A total of 8158 migrant women gave birth during the study period: 4401 primiparous and 3757 multiparous. Overall, migrant women had higher adjusted ORs (aORs) for episiotomy (primiparas: aOR 1.43, 95% CI 1.26–1.61; multiparas: 1.39, 95% CI 1.21–1.60) and instrumental births (primiparas: 1.14, 95% CI 1.02–1.27, multiparas: 1.41, 95% CI 1.16–1.72) and lower aORs of induction of labor (primiparas: 0.88, 95% CI 0.79–0.98; multiparas: 0.74, 95% CI 0.66–0.83), compared with Icelandic women. Migrant women from countries with a high Human Development Index score (≥0.900) had similar or better outcomes compared with Icelandic women, whereas migrant women from countries with a lower Human Development Index score than that of Iceland (<0.900) had additionally increased odds of maternal and perinatal complications and interventions, such as emergency cesarean and postpartum hemorrhage. Conclusions Women’s citizenship and country of citizenship Human Development Index scores are significantly associated with a range of maternal and perinatal complications and interventions, such as episiotomy and instrumental birth. The results indicate the need for further exploration of whether Icelandic perinatal healthcare services meet the care needs of migrant women.
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Given the recent economic crisis and the risen poverty rates, sports managers need to get insight in the effect of income and other socio-economic determinants on the household time and money that is spent on sports participation. By means of a Tobit regression, this study analyses the magnitude of the income effect for the thirteen most practiced sports by households in Flanders (the Dutch speaking part of Belgium), which are soccer, swimming, dance, cycling, running, fitness, tennis, horse riding, winter sports, martial arts, volleyball, walking and basketball. The results demonstrate that income has a positive effect on both time and money expenditure on sports participation, although differences are found between the 13 sports activities. For example, the effect of income on time and money expenditure is relatively high for sports activities like running and winter sports, while it is lower for other sports such as fitness, horse riding, walking and swimming. Commercial enterprises can use the results of this study to identify which sports to focus on, and how they will organise their segmentation process. For government, the results demonstrate which barriers prevent people from taking part in specific sports activities, based upon which they should evaluate their policy decisions.
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