There are persistent ethnic gaps in uptake of child healthcare services in New Zealand (NZ), despite increasing policy to promote equitable access. We examined ethnic differences in the uptake of ...immunisation and primary healthcare services at different ages and quantified the contribution of relevant explanatory factors, in order to identify potential points of intervention.
We used data from the Growing Up in New Zealand birth cohort study, including children born between 2009 and 2010. Econometric approaches were used to explore underlying mechanisms behind ethnic differences in service uptake. Multivariable regression was used to adjust for mother, child, household, socioeconomic, mobility, and social factors. Decomposition analysis was used to assess the proportion of each ethnic gap that could be explained, as well as the main drivers behind the explained component. These analyses were repeated for four data time-points.
Six thousand eight hundred twenty-two mothers were enrolled during the antenatal survey, and children were followed up at 9-months, 2-years and 4-years. In univariable models, there were ethnic gaps in uptake of immunisation and primary care services. After adjusting for covariates in multivariable models, compared to NZ Europeans, Asian and Pacific children had higher timeliness and completeness of immunisation at all time-points, while indigenous Māori had lower timeliness of first-year vaccines despite high intentions to immunise. Asian and Pacific mothers were less likely to have their first-choice lead maternity caregiver (LMC) than NZ Europeans mothers, and Māori and Asian mothers were less likely to be satisfied with their general practitioner (GP) at 2-years. Healthcare utilisation was strongly influenced by socio-economic, mobility and social factors including ethnic discrimination. In decomposition models comparing Māori to NZ Europeans, the strongest drivers for timely first-year immunisations and GP satisfaction (2-years) were household composition and household income. Gaps between Pacific and NZ Europeans in timely first-year immunisations and choice of maternity carer were largely unexplained by factors included in the models.
Ethnic gaps in uptake of child healthcare services vary by ethnicity, service, and time-point, and are driven by different factors. Addressing healthcare disparities will require interventions tailored to specific ethnic groups, as well as addressing underlying social determinants and structural racism. Gaps that remain unexplained by our models require further investigation.
This study presents new empirical evidence on the role of time trends in low pay persistence. We utilize population-wide tax records to track monthly labour market trajectories of initially low-paid ...workers. By performing age- and qualification-specific regressions, we find that low pay persistence reduces with time. However, the magnitude is highly heterogeneous across workforce characteristics. For a qualified worker in their early 20s, the risk of staying on low-pay declines by, on average, 5-10% points after one year. For a worker in their 50s, persistence remains almost unchanged regardless of their qualification level. We conclude that policy initiatives need to be more nuanced than a simple one-size-fits-all approach by accounting for time trends in low-pay persistence.
This study examines the relationship between state cyberbullying laws (which require schools to enact effective guidelines to address cyberbullying) and the reporting behavior of youth. The analysis ...utilizes nationally representative samples of high-school adolescents from the Youth Risk Behavior Surveys and incorporates state-time variation in the implementation of cyberbullying laws in a difference-in-differences framework. Key results indicate that adoption of a cyberbullying law is related to statistically significant increases in the likelihood that students report experiences of being victimized by electronic bullying as well as various forms physical bullying at school. Further empirical analyses signal that the increase in students' reporting of victimization experiences is likely to be driven by the laws' intended increase in victims' reporting rather than by a potential rise in incidence of cyberbullying (and school violence) in the post-implementation period. The regression estimates are robust to the inclusion of multiple sensitivity checks.
Summary
State‐specific statutes providing legal consequences for perpetrating domestic violence in the presence of a child have been enacted across the United States between 1996 and 2012. This paper ...examines the impact of this child welfare legislation, using a difference‐in‐differences approach. We find a significant drop in domestic violence‐related homicide rates, when considering a wide range of victim–offender relationships. However, this result does not hold for marital homicides, suggesting that for this subpopulation, the risk of reprisal and consequent reduction in reporting may be counterbalancing the hypothesized deterrent impacts of the legislation.
This paper presents the modeling and analysis of a novel priority valve controlled open-loop Cable Reeling Drum (CRD) drive of Load Haul Dump (LHD) vehicle. The LHD vehicle is basically a trackless ...loading machine having wide applications in underground mining operations. The CRD incorporated in the said machine performs the reeling/unreeling operation of the flexible trailing cables that supply electric power to the machine. In this respect, a novel hydraulic circuit is proposed that incorporates a priority valve for the operation of the hydro motor driving the CRD, unlike the existing LHD machines having a separate hydraulic arrangement for the CRD operation. In the present study, the flow through the bypass port of the priority flow divider (PFD) valve is utilized for driving the CRD. In analyzing the proposed hydraulic system, the detailed model is analytically solved in MATLAB/Simulink software, and the simulation results are validated experimentally. The effects of change of the critical parameters on the system's dynamic responses are analyzed using the validated simulation model. The investigations show that till the fluid flow metered to the PFD valve is higher than the priority flow demand, the machine's priority function is not affected by the operation of the CRD. However, with the actuation of the priority operation, the hydro-motor drive speed of the CRD decreases. The model proposed in this study may be considered as a basis for the re-design of the hydraulic arrangement of CRD drive incorporated in an LHD machine for its improved performance.
We investigate whether having a child immunized at a prior schedule genuinely increases the likelihood of vaccinating the child at the subsequent schedule. We use longitudinal data from the Growing ...Up in New Zealand study and apply a dynamic random-effects model that also controls for the initial immunization status. Prior to any covariate-adjusted estimations, our data shows that almost 96% of the children immunized at the previous schedule are also immunized at the subsequent schedule. In comparison, only 29% of children who were not immunized at the prior schedule receive immunization at the next milestone, thereby indicating an unadjusted state dependence in immunization of 67 percentage points (p.p.). Upon controlling for relevant covariates and unobserved heterogeneities, the genuine state dependence in immunization is, on average, estimated to be 20 p.p. Importantly, the magnitude of the state dependence is greater for Māori (by 5 p.p.) and also greater for mothers that report being discouraged from having their child immunized during the antenatal period (by 10 p.p.).
•We examine if child vaccination at a prior schedule increases subsequent vaccinations.•We use data from the Growing Up in NZ birth cohort.•We find sizeable state dependence in immunization, which is larger for Māori.•Effects are larger if a mother is discouraged from vaccinating.
The minimum alcohol purchasing age in New Zealand was lowered from 20 to 18 in December 1999. Focusing on two distinct legislative regimes, we utilize a national‐level census of all criminal ...convictions to examine the impact of unrestricted alcohol purchasing rights on alcohol‐induced criminal behaviour. Our study reveals that overall trends in alcohol‐related convictions are obscured by offenses that can only be prosecuted up to a certain age. After removing confounding influences from additional regulations that hold relevance under one legislative regime but not the other, we do not find a statistically meaningful increase in overall measures of alcohol‐related crimes at the minimum legal alcohol purchasing age. The novel empirical findings from our study extend the geographic focus of the existing international literature on the social costs of gaining unrestricted access to alcohol.
•State-level full parity mental illness laws improve mental health among the college-aged population.•State-level full parity mental illness laws have positive spillover effects on the educational ...performance of college students.•Educational effects of full parity mental illness laws are concentrated among female students.
We examine the effect of the state-level full parity mental illness law implementation on mental illness among college-aged individuals and human capital accumulation in college. We utilize administrative data on completed suicides and grade point average (GPA) and survey data on reported mental illness days and decisions to disenroll from college between 1998 and 2008 in a difference-in-differences (DD) analysis to uncover the causal effects of state-level parity laws. We find that state-level parity law reduces youth suicide rate and propensity to report any poor mental health day, increases college GPA, and does not change the propensity to disenroll from college.
Our analysis presents a case study on the impacts of Health Care Home (HCH) – a large-scale technology-based healthcare innovation in New Zealand’s primary healthcare system. For our analysis, we ...link the registered population of health practices within the Wellington region to administrative hospital admission data for quarterly periods between 2014 and 2017. By employing variation in the timing of HCH implementation across practices (selected via propensity score matching), we estimate differences-in-differences models to investigate the effects of the intervention on multiple patient outcomes. Additionally, we incorporate a number of empirical specifications to test the robustness of estimates. HCH results in a statistically significant reduction in the likelihood of emergency department (ED) presentations by 6–8 %, with no significant impacts on other health outcomes. The impact on ED presentations aligns with the expectation that the HCH intervention would produce downstream effects of a reduced economic burden on public hospital services.
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