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Concept: Working poor

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This article explores the controversial practice of transnational gestational surrogacy and poses a provocative question: Does it have to be exploitative? Various existing models of exploitation are considered and a novel exploitation-evaluation heuristic is introduced to assist in the analysis of the potentially exploitative dimensions/elements of complex health-related practices. On the basis of application of the heuristic, I conclude that transnational gestational surrogacy, as currently practiced in low-income country settings (such as rural, western India), is exploitative of surrogate women. Arising out of consideration of the heuristic’s exploitation conditions, a set of public education and enabled choice, enhanced protections, and empowerment reforms to transnational gestational surrogacy practice is proposed that, if incorporated into a national regulatory framework and actualized within a low income country, could possibly render such practice nonexploitative.

Concepts: Pregnancy, Poverty, Obstetrics, Exploitation, The Practice, Surrogacy, Working poor, Capitalism

10

The creation of economically mixed communities has been proposed as one way to improve the life outcomes of children growing up in poverty. However, whether low-income children benefit from living alongside more affluent neighbors is unknown.

Concepts: Poverty, Antisocial personality disorder, Wealth, Working poor, The Creation of Adam, Tariff, Basic needs

5

Why do the poor make shortsighted choices in decisions that involve delayed payoffs? Foregoing immediate rewards for larger, later rewards requires that decision makers (i) believe future payoffs will occur and (ii) are not forced to take the immediate reward out of financial need. Low-income individuals may be both less likely to believe future payoffs will occur and less able to forego immediate rewards due to higher financial need; they may thus appear to discount the future more heavily. We propose that trust in one’s community-which, unlike generalized trust, we find does not covary with levels of income-can partially offset the effects of low income on myopic decisions. Specifically, we hypothesize that low-income individuals with higher community trust make less myopic intertemporal decisions because they believe their community will buffer, or cushion, against their financial need. In archival data and laboratory studies, we find that higher levels of community trust among low-income individuals lead to less myopic decisions. We also test our predictions with a 2-y community trust intervention in rural Bangladesh involving 121 union councils (the smallest rural administrative and local government unit) and find that residents in treated union councils show higher levels of community trust and make less myopic intertemporal choices than residents in control union councils. We discuss the implications of these results for the design of domestic and global policy interventions to help the poor make decisions that could alleviate poverty.

Concepts: Decision making, Poverty, Prediction, Futurology, Future, World Bank, Cycle of poverty, Working poor

5

OBJECTIVEThis study was designed to examine whether residents living in neighborhoods that are less conducive to walking or other physical activities are more likely to develop diabetes and, if so, whether recent immigrants are particularly susceptible to such effects.METHODSWe conducted a population-based, retrospective cohort study to assess the impact of neighborhood walkability on diabetes incidence among recent immigrants (n = 214,882) relative to long-term residents (n = 1,024,380). Adults aged 30-64 years who were free of diabetes and living in Toronto, Canada, on 31 March 2005 were identified from administrative health databases and followed until 31 March 2010 for the development of diabetes, using a validated algorithm. Neighborhood characteristics, including walkability and income, were derived from the Canadian Census and other sources.RESULTSNeighborhood walkability was a strong predictor of diabetes incidence independent of age and area income, particularly among recent immigrants (lowest [quintile 1 {Q1}] vs. highest [quintile 5 {Q5}] walkability quintile: relative risk [RR] 1.58 [95% CI 1.42-1.75] for men; 1.67 [1.48-1.88] for women) compared with long-term residents (Q1 to Q5) 1.32 [1.26-1.38] for men; 1.24 [1.18-1.31] for women). Coexisting poverty accentuated these effects; diabetes incidence varied threefold between recent immigrants living in low-income/low walkability areas (16.2 per 1,000) and those living in high-income/high walkability areas (5.1 per 1,000).CONCLUSIONSNeighborhood walkability was inversely associated with the development of diabetes in our setting, particularly among recent immigrants living in low-income areas.

Concepts: Cohort study, Epidemiology, Medical statistics, Poverty, Relative risk, Canada, Neighbourhood, Working poor

4

Working poverty has become a major public health concern in recent times, and low-paid, insecure employment has been widely linked to poor psychological wellbeing. The London Living Wage (LLW) campaign aims to ensure employees receive adequate pay. The objective of this study is to investigate whether working for a LLW employer predicted higher levels of psychological wellbeing among low-wage service sector employees.

Concepts: Public health, Poverty, Employment, Gross domestic product, Minimum wage, Working poor, Wage, Basic needs

3

Research suggests that living in fuel poverty and cold homes contributes to poor physical and mental health, and that interventions targeted at those living in poor quality housing may lead to health improvements. However, little is known about the socio-economic intermediaries and processes that contribute to better health. This study examined the relationship between energy efficiency investments to homes in low-income areas and mental and physical health of residents, as well as a number of psychosocial outcomes likely to be part of the complex relationship between energy efficiency measures and health outcomes.

Concepts: Health, Poverty, Economics, Temperature, Working poor, Energy conservation, Basic needs, Fuel poverty

3

To integrate immigrants into their societies, European countries have adopted different types of policies, which may influence health through both material and psychosocial determinants. Recent studies have suggested poorer health outcomes for immigrants living in countries with poorly rated integration policies.

Concepts: Poverty, Europe, Working poor, Basic needs

1

Childhood poverty is hypothesized to increase risk for mental and physical health problems at least in part through dysregulation of the hypothalamic-pituitary-adrenal axis. However, less is known about the specific psychosocial stressors associated with cortisol reactivity and regulation for children living in poverty. The current study investigates negative life events, household chaos, and family conflict in preschool and middle childhood as potential predictors of cortisol regulation in low-income 7-10 year olds (N = 242; M age = 7.9 years). Participants were assessed in preschool and participated in a follow-up assessment in middle childhood, during which diurnal free cortisol and free cortisol reactivity to the Trier Social Stress Test for Children (TSST-C) were assessed. Household chaos during preschool predicted a more blunted diurnal cortisol slope in middle childhood. Greater negative life events during preschool and greater concurrent family conflict were associated with increased free cortisol reactivity in middle childhood.

Concepts: Scientific method, Poverty, Prediction, Futurology, Assessment, Cortisol, Hypothesis, Working poor

1

In a Perspective, Cleusa Ferri and K. S. Jacob discuss the assessment, recognition, and care of people living with dementia in low- and middle-income countries.

Concepts: Fact, Sovereign state, Working poor, Hebron

1

Greater belief in free will is associated with greater empathy towards the working poor, support for social mobility, greater desire for socio-economic equality, and less belief that poor people are fated to live in poverty. We found no sign that belief in free will led to prejudice or discrimination against poor people or undercut justice. These findings from an online survey flatly contradict the claims made by James Miles (2013). Belief in a just world did produce many of the patterns Miles attributed to belief in free will. We also question the reasoning and the strength of the purported evidence in his article, and we recommend that future writers on the topic should cultivate cautious, open-minded consideration of competing views. Miles' article is a useful reminder that to some writers, the topic of free will elicits strong emotional reactions.

Concepts: Psychology, Poverty, Sociology, Philosophy, Emotion, Socioeconomics, William James, Working poor