During the process of post-war Fordist suburban expansion, the American and Canadian city was expanded and built around the automobile as the dominant mode of transportation. This caused an inversion of the pattern of centrality and access in cities, and auto-accessible suburbs became the place of wealth and privilege, away from the city centre. There is reason to believe that these patterns are changing in this century. A re-investment in downtowns along with a loss of middle-class manufacturing jobs and income is resulting in changing suburban socioeconomic geographies. If auto-oriented suburbs are becoming the new location of affordability and decline, this would result in an unprecedented situation: car-dependent social peripheralization. This dissertation tests this possibility. Using statistics and spatial analysis, it presents public data on socioeconomics, urban form and public transit to try and understand the current geographies of housing affordability in relation to transit access in twenty large metropolitan regions. This research is concerned with how the spatial polarization of housing affordability to suburban areas impacts access to public transit for lower-income households. In a comparative survey of twenty North American cities, I demonstrate that the lowest-cost home ownership is often found outside of the zone served by frequent transit networks, while the lowest-cost rental housing is fragmented across both transit networks and outside them. Half of the cities studied did not have enough frequent transit lines to offer an accessible network at all. The results show that in cities with transit systems that offer metropolitan-scale access, there is commonly a misalignment between affordable home ownership opportunities and frequent transit networks. When incomes and other socioeconomic and built-in environment variables are taken into account, the cost of owner-occupied housing is higher in transit-accessible areas. This is problematic from the perspectives of social justice and economic efficiency: cities will not offer fair access to opportunity if large segments of the population are priced out. The issue of isolated suburbanisms calls for adding social utility to the criteria for transit extension, as well as for innovative land use policy to encourage affordable transit-oriented intensification in these areas. While this analysis offers a snapshot of current conditions, further quantitative and qualitative research would add to our understanding of these issues. This research suggests, at a comparative metropolitan scale in the North American context, that affordable home ownership is now often connected to automobile dependency and separated from access to alternative, less expensive mobilities. This lack of affordable access is a concern for social and environmental justice, for economic mobility and for personal and community agency.

Mixed-use development is one of the canonical elements of modern urban planning theory and practice. The principles of this approach to development are applied throughout the world and have seen a resurgence in the last several decades as part of the rise of populist movements such as smart growth and new urbanism. At the same time, cities across the industrialized world have been reshaped within the broader context of fundamental restructuring in the labour market over the past several decades. The urban core of the post-industrial city has increasingly become the site of residential development amongst various complementary land uses, marketed to an upwardly mobile professional class. Who benefits from this kind of mixed-use development in the housing market? Despite its popularity, mixed-use development is not often examined with regard to the affordability of housing. This study explores the affordability of housing in areas zoned as mixed-use in the old City of Toronto in relation to shifts in the occupational structure of the city’s workforce between 1991 and 2006. Using census data and spatial analysis methods, the cartographic and analytical outputs of this study demonstrate two major findings: first, that housing in mixed-use areas was more expensive than the rest of the city over the study period; and second, that socioeconomic polarization between classes of occupations is not only evident in mixed-use areas, but in some ways more pronounced than in the rest of the city. Based on these findings, the study concludes with a realistic assessment of why and how academics, practitioners and policymakers active in urban planning should step up efforts to couple the revitalization of Toronto’s urban core with gains to the affordability of housing.

Thesis (M.G.S.)--Miami University, Dept. of Sociology and Gerontology, 2008. / Title from first page of PDF document. Includes bibliographical references (p. 44-47).

Magister Public Health - MPH / The aim of the study was to explore the challenges to uptake of cervical cancer screening among women accessing maternal and child health services at Nsambya Hospital in Kampala, Uganda.

Alors qu’il semble acquis par la plupart des acteurs de la construction et du logement que l’évolution de la réglementation a joué un rôle non négligeable dans la hausse des prix des logements neufs au cours des années 2000 en France, cette thèse se propose d’interroger le lien entre accroissement des prix, renforcement normatif et accessibilité économique des logements neufs pour les ménages modestes. Autrement dit, ces logements à haute valeur réglementaire sont-ils devenus trop chers pour accueillir les plus modestes d’entre nous ? Dans une démarche plus empirique que théorique, notre recherche consiste en la construction d’un faisceau d’indices permettant d’éclairer cette question à partir d’exploitations statistiques, de monographies et d’entretiens avec les acteurs de la construction.Nous nous attachons à étudier les mécanismes de fixation des prix des logements neufs à la vente et à la location, leur évolution brute et en lien avec les revenus des ménages, ainsi que la comparaison avec le prix des logements anciens. Après avoir retracé l’évolution de la réglementation dans le logement, un recensement des surcoûts évalués dans la littérature fait le jour sur la faiblesse des arguments appuyant la thèse d’une hausse des prix induite par le renforcement réglementaire au cours des années 2000. C’est pourquoi nous tentons de mesurer scientifiquement l’impact de la réglementation sur les prix de revient et les prix de vente des logements en faisant notamment appel à la modélisation hédonique et à des monographies. Bien que, finalement, la réglementation ne semble pas avoir été l’un des déterminants majeurs de l’accroissement des prix des logements neufs, la question de leur accessibilité économique continue à se poser. L’étude du peuplement des logements neufs, de son évolution et du cas particulier de la représentation des ménages modestes au sein de ce parc éclaire cette question / While it appears to be common knowledge that regulatory developments in the construction sector contributed to increase prices for new housing in the 2000s in France, this thesis questions the seemingly causal link between construction regulation and housing prices, and explores its impact for low-income households. Using a more empirical than theoretical methodology, our research consists of building a body of evidence to clarify this question on the basis of statistical evaluation, monographs and interviews with stakeholders in the construction sector.In this perspective we intend to determine the pricing mechanism for new housing, whether for rent or for sale, and explore the price development against households incomes and compare their value with old housing. After setting out the successive evolutions of housing regulation, our literature review, which in particular highlights evaluated additional costs, proves that increase in housing prices is not directly related to regulation. Our research will try to scientifically measure the impact of these new regulations on prediction and purchase prices through the use of hedonic regressions. Although we argue regulation has not been one of the principal determinants of the price increases of new housing, factors affecting their affordability remains an open question. We propose to study the evolution of the new housing population, with particular attention to the low income households

Preventative care services allow patients to be fully equipped with the knowledge, tools, and other resources to help them discover and treat many diseases and illnesses so that the burden of costs will not fall on patients and their families. Since the passage of the Affordable Care of Act (ACA) by President Barack Obama, the requirement for health insurance coverage has not translated to utilization of preventative care services. The purpose of this study is to determine the motivation for African Americans who have insurance coverage and access to care who are not taking advantage of opportunities for screenings and health education. The health belief model was used to determine how belief and modifying factors influence health decisions. The quantitative study required use of a secondary dataset to determine utilization of preventative care services, insurance affordability, future access to care and understanding of the health care law. The study included testing the statistical significance of these factors among African Americans, White Americans, and Hispanic Americans who participated in the Healthy Americas Survey. Using the program SPSS to process data analyzation and organize output, results reveal that African American participants are concerned about the future ability to access and afford care. With a history of distrust amongst African Americans and the health industry, social implications are for administrators and providers to bridge the gap by offering health education to those in their immediate communities and requesting and implementing feedback from those same individuals.

Philosophiae Doctor - PhD / Introduction: Untreated caries of the permanent dentition is the most prevalent condition worldwide. Ongoing globalisation and the heightened exposure to a refined, westernised diet against a backdrop of deficient health services and inadequate implementation of preventive public health measures, means that dental caries remains pervasive, especially in emerging economies. In South Africa, an estimated 90% of caries remains untreated, disproportionately affecting the poor and detrimentally impacting on the economy. The use of an effective fluoridated toothpaste is regarded as the best clinical practice available today in caries management. Aim: The aim of the present study was to evaluate the availability, pricing and affordability of fluoridated toothpastes marketed to South African households and to identify mechanisms to improve financial access among low-income households. Methods: A cross-sectional survey of fluoridated toothpastes, retail price and unit weight/volume was undertaken. Following calculation of a median reference price for each paste, affordability relative to household income brackets was assessed using a modification of the WHO/HAI’s essential medicines pricing protocol. Affordability was expressed in terms of the number of days of disposable household income required to purchase the annual, household therapeutic dosage of a fluoridated toothpaste. Results: Despite the wide availability (n=142) of fluoridated toothpastes, of those assessed for affordability (n=130), none and 49% were affordable to households located in the first and second lowest income brackets, collectively termed low-income earners. Accessibility (±96%) increased sharply for low emerging middle income households and upwards. In general, as household income declined, the proportion of daily, disposable income required to purchase the annual, household therapeutic dosage increased. Households located in the lowest income bracket spent 104.3% of daily income on the annual dosage of the lowest priced toothpaste in contrast to 0.23% spent by the wealthiest households. Horizontal disparity in terms of affordability between household income brackets differed significantly (p<0.00001). Conclusion: Stark inequity in affordability of fluoridated toothpastes exists between low income and affluent households with dire implications in terms of oral health and economic hardship suffered by the poor. To redress this social injustice, a number of price regulatory policies and funding mechanisms are suggested to stimulate dialogue and urge all relevant entities (clinical, legal, industrial, and governmental) to take action urgently.

With the change in political and economic situations, increased urbanization and the growing population in China leads to extended housing needs, which results in various problems for the real estate market, such as the pronounced rise of housing price and unreasonable housing supply system. At present, the major issue that the government is facing with is how to improve the housing availability and provide space to the urban residents to solve the problem that many urban residents are unable to afford housing. In order to fully understand the housing market in Beijing city, this paper adopted quantitative methods of Housing Price to Income Ratio, Residual Income, and the Housing Affordability Index to examine the housing affordability of Beijing urban residents from 2004 to 2013, based upon the data collected from Beijing Statistic Yearbook mostly. The analysis revealed that there is a declining trend of housing affordability in Beijing and the gap between residential housing prices and urban households’ incomes and the difference between the poor and the rich is obvious.

Housing affordability is the relationship between households’ income and housing expenditure. The public are very concerned about the high price of residential housing in Beijing, which is considered go beyond the income of average citizens. In order to fully understand the China’s real estate market, the paper first analyses the land policy, housing reform and housing finance, etc. Then this paper examine to what the extent the high housing price had led to low levels of housing affordability from 2000 until 2009 among Beijing urban households. The ratio analysis has been conducted to measure housing affordability. Meanwhile, we compute the housing-induced poverty, find maximum affordable housing prices for all the income classes, and suggest the housing assistance that should be provided to urban households in Beijing. Approximately, only 20% Beijing urban residents have purchase affordability for a standardized new residential housing, no matter which approach is used, strong statistical evidences reveal that there is an incessant large gap between residential housing prices and urban residents’ incomes in Beijing.

Includes bibliographical references / This dissertation intends to shed light on open-membership medical scheme benefit design in South Africa. This will be done by analysing the benefit design of 118 benefit options, so as to provide an overview of the structure and nature of the benefit offerings available in the market in 2014. In addition, affordability of these benefit options was analysed in order to identify whether or not there exist connections between the benefits on offer and the price of cover. This paper will argue that at present, the large number of benefit options available in the market, the lack of standardisation between benefit options, together with the mosaic of confusing terminology employed in scheme brochures, creates a highly complex environment that hampers consumer decision making. However, this implicit complexity was found to be necessary owing to the incomplete regulatory environment surrounding medical schemes. The findings of this investigation show that benefit design requires significant attention in order to facilitate equitable access to cover in South Africa.