Adverse birth outcomes like preterm birth and infant mortality are unevenly distributed across socio-economic groups. Risks are usually lowest in groups with high socio-economic status and increase with decreasing status. The general aim of this thesis was to contribute to the understanding of the relation between socio-economic status and birth outcomes, focussing on maternal education and class, studying a range of birth outcomes. More specific aims were to investigate the relation between maternal education and infant health, to study the combined influence of maternal childhood and adult social class on inequalities in infant health and to explore the contribution of maternal working conditions to class inequalities in birth outcomes. The studies are population based, focussing on singletons births 1973-1990. During the period under study, educational differences in birth outcomes increased, especially between those with the lowest and highest education. The low birth weight paradox emerged, suggesting that the distribution of determinants for low birthweight infants differs for these groups. Further, an independent association was found between maternal childhood social class and low birthweight and neonatal mortality, but not for postneonatal mortality. Since this was found for the two outcomes closest to birth, this indicates that the association is mediated through the maternal body. Finally, there is a contribution of maternal working conditions to class inequalities in birth outcome. Lower job control, higher job hazards and higher physical demands were all to some degree related to increased risk of the following adverse birth outcomes: infant mortality, low birthweight, very low birthweight, foetal growth, preterm birth, very and extremely preterm birth. Working conditions demonstrated disparate associations with the birth outcomes, indicating a high complexity in these relationships.

The ongoing development of the new post-apartheid South Africa is still dealing with its own cruel history. A socio-economic structure based on race has been built up over years of colonialization and apartheid where the black people of South Africa have been excluded from being South African citizens. The first democratic election in 1994 contributed to the “freedom in their life-time” that youth from the uprisings in Soweto urged for. But today, fourteen years after the relaxation of the apartheid the same socio-economic structures based on race are still visible, not as strict as then but still exceptionally obvious. Especially if you compare townships, like Khayelitsha in the outskirts of Cape Town, with it’s metropolitan area. Khayelitsha is predominantly black area and is also one of the poorest communities in Cape Town. This thesis looks at one of the first generations in the ambivalence of the new post-apartheid South Africa, twelve years after the fall of apartheid. We have completed 14 qualitative interviews with adolescents in the age between 18-to-21, living in the socio-economic margin, in the township of Khayelitsha. We have examined their relations to the civil society and their participation within it. In addition also their future aspirations and how they will maintain them.

The aim of this study is to examine socio-economic transformation and gender relations in Lao PDR after the adoption of economic liberalization by the Lao government in the late 1980s. Against a background of general socio-economic transformation in Laos the main focus of the study is on the local level, with emphasis on how people in their everyday lives have engaged with and handled the changes. The application of economic liberalization shaped new conditions for people in local communities, and various livelihoods strategies were adopted under the new circumstances. The study examines gender relations, livelihoods and actors of change in two different contexts of globalization. The first context is the case of foreign direct investment in the Sepone mine, the largest gold-copper mine in the country located in Vilabury district, Savannakhet province. Five villages located close to the mine and directly affected by the operation were chosen as research site. The second case is the context of international tourism development in the small town of Vang Vieng, situated halfway between Vientiane Capital and the world heritage town of Luangprabang. The purpose with the two case studies is to examine how changes take place in different places of the same country under the same political direction and development policy. The study is inspired by theories of space and place and the view that phenomena are place-based and different places are constituted by different socio-spatial relations. The findings show that profound changes took place both in the economic and social-cultural spheres, including in gender relations. The two contexts experienced different processes of changes: in the context of Vilabury district, the transformation was produced through top-down development and created a dependency pattern where new social inequalities and social stratification emerged through unequal access to the new resources of the villagers. In the context of Vang Vieng and the expansion of international tourism, the development process proceeded more through a bottom-up pattern; the villagers perceived they were important actors of development, had more equal access to resources and could define livelihood strategies by themselves.

Enhancing primary care is key to the Canadian health care reform. Considered as an indicator of primary care access and quality, hospitalisations for ambulatory care sensitive (ACS) conditions are commonly reported by Canadian organisations as sentinel events signaling problems with the delivery of primary care. However, the literature calls for further research to identify what lies behind ACS hospitalisation rates in regions with a predominantly urban population benefiting from universal access to health care. A theoretical model was built and, using an ecological design, multiple regressions were implemented to identify which neighbourhood characteristics explained the socio-economic gradient in ACS hospitalisation rates observed in Ottawa. Among these neighbourhoods, healthy behaviour and - to a certain extent - health status were significantly associated with ACS hospitalisation rates. Evidence of an association with primary care accessibility was also signaled for the more rural neighbourhoods. Smoking prevention and cessation campaigns may be the most relevant health care strategies to push forward by policy makers hoping to prevent ACS hospitalisations in Ottawa. From a health care equity perspective, targeting these campaigns to neighbourhoods of low socio-economic status may contribute to closing the gap in ACS hospitalisations described in this current study. Reducing the socio-economic inequalities of neighbourhoods would also contribute to health equity.

Tuberculosis (TB) is a two-stage disease, acquisition of infection and progression to disease. A complex interaction exists between the individual and their environment that determines who acquires infection and who progresses to disease. According to TB literature, 10% of individuals with infection will develop TB disease (1;2). Tuberculosis has been described a disease of poverty, but other factors may be important. The contribution of both individual measures, such as ethnic origin, gender and age and area-level measures, or socio-economic factors, to this two-stage process is not well understood. Understanding tuberculosis epidemiology and identifying those at risk for developing TB is important for effectively controlling the disease. The objective of this study was to determine the individual (age, gender, ethnic origin, geographic location) and area-level measures (income, home ownership, housing density, education, and employment) that contribute to the progression from tuberculosis infection to disease. Data from all Canadian-born Caucasians, Status Indians, and non-Status Indians and Metis, with an initial positive tuberculin skin test (TST) documented in the Saskatchewan TB Control database from January 1, 1986 to January 31, 2002 was analyzed. Exclusion criteria included any previous BCG vaccination, treatment for latent TB infection, or missing data. Individual data was obtained from the TB Control database. Area-level measures were obtained by matching individual postal codes with Canada census data to obtain information from enumeration areas. Outcome was time to TB disease at > 1 month following a documented positive tuberculin skin test. Analysis was completed using Cox regression proportional hazards model. 7588 individuals with a positive tuberculin skin test were included in the study and of these 338 (4.5%) developed TB disease. Thirty-four out of 4140 (0.8%) of Caucasians, 183 out of 2649 (6.9%) of Status Indians and 121 out of 799 (15.1%) non-Status Indians and Metis developed TB. The rate of progression to TB was 5.6/1000 person years for the entire study population. The incidence for Caucasians was 0.9/1000 person years, 7.7/1000 person years for Status Indians and 16.0/1000 person years for non-Status Indians and Metis. In the Cox regression model, including individual and area-level measures, the risk factors association with the progression to TB was age and ethnic origin (< 19 years of age HR 3.7, 95% CI 2.8 - 4.8 compared to > 19 years and ethnic origin HR 5.1, 95% CI 3.0 - 8.6 for Status Indians and HR 7.4, 95% CI 4.1-13.3 for non-Status Indians and Metis both compared to Caucasians). No socio-economic factor was consistently associated with progression to disease. We have found that age and ethnic origin are associated with an increased risk of TB infection progressing to disease. The differences in TB rates between Saskatchewan Caucasians and Status Indians, non-Status Indians and Metis can be explained by Grigg's natural history curve of TB epidemiology within a population (3). The Aboriginal population of Saskatchewan is much earlier in its epidemic resulting in higher disease rates compared to the Caucasian population. Identifying those at risk of developing TB and understanding the determinants of TB epidemiology are important for establishing successful TB control programs.

The physical redevelopment of Canadian downtown cores has been seen as a primary issue in economically and socially revitalizing urban areas. In the case of Saskatoon, Saskatchewan, the Citys South Downtown area is in need of such rejuvenation. In 2004 redevelopment plans for the area are underway; Saskatoon has set out a proposal to redevelop both its riverfront area and adjacent South Downtown. In order to accomplish the goal of a revitalized South Downtown, the authors of a successful redevelopment proposal must first identify a suitable user population for the area, namely the population of Saskatoon in its entirety, including the Citys disadvantaged central neighbourhood residents. The purpose of this thesis is to define the socio-economic traits of this potential user population for Saskatoons South Downtown in order to recommend facilities and services that should be included in the redevelopment effort. Census data for the fifty-one census tracts that comprise the census metropolitan area of Saskatoon are used to define the social and economic characteristics of this user population. After reviewing the populations socio-economic situations, as well as the social and business organizations that are currently located in the area, recommendations regarding appropriate, requisite facilities and services can be ascertained. These recommendations could then be implemented in the undertakings currently transpiring in Saskatoons South Downtown. Along with defining the socio-economic character of the user population, this study also examines past redevelopment proposals for Saskatoons South Downtown area in an attempt to understand the historical context of the area. The three main past plans for the South Downtown area include: The Meewasin Valley Project (also known as Moriyamas 100 Year Plan), the Mayors Task Force Report, and Princeton Developments South Downtown Master Plan. All of these failed attempts share many common design traits, culminating in the general goal to develop the area into a commercial, residential and recreational area that would cater to the upper-class residents of the city as well as higher-income tourists and visitors to the area. While it must not be assumed that plans which exclude lower-income populations are inherently wrong and destined to be unsuccessful, by targeting such an exclusive population as the primary users of a South Downtown redevelopment, the authors of the previous plans had inadvertently sought to develop an elite district of Saskatoon, financially inaccessible to a vast majority of the citys population. Defining the socio-economic traits of a user population that is comprised of all Saskatonians, and implementing facilities and services that cater to them, would result in an area that is not discriminating; all peoples regardless of life situation or neighbourhood of residence would be able to enjoy an interesting and revitalized South Downtown area of Saskatoon, Saskatchewan.

No description available.

This study investigates the relocation behaviours of out-movers of deprived areas in the region of Stockholm, Sweden. The research is motivated by the concerns raised by deprived and segregated neighbourhoods in relation to a social fragmentation and an unsuccessful socio-economic inclusion of all citizens. Some researches affirm that the out-movers of deprived neighbourhoods tend to be more integrated than the stayers or the individual moving in such neighbourhoods. And if some studies are concerned about their prospective, they have been restricted to their destinations’ socio-economic features and dismissed any spatial approach.This study aims to analyse flows’ direction and features as well as the areas of destination such as to identify processes of selective migration and how socio-spatial disparities are (re)produced. A specific attention is given to counter-urban movements and their possible correlation to “preservation” objectives: The possible migration of lower classes toward peripheries in order to access a better living environment and avoid a forced economic selective migration toward the urban most deprived neighbourhoods.Descriptive and inferential statistics with binary logistic regressions enabled to put into exergue the selective migration among movers, between the counter-urban and the others but also among counter-urban. If most movers remain in the urban core and in an almost deprived area, a substantial proportion seeks to combine to a move “up” the social ladder (a better suited neighbourhood), a “downward” migration on the urban hierarchy (a move toward the peripheries). And the regression confirms that among this population, a segment is statically significantly disadvantaged and remains in rental after the move.Scholars should consider such evidences by including a spatial dimension to their studies on segregation, neighbourhood sorting processes and selective migration. And most importantly, the results of this study invite them to reassess the traditional life-style and life-cycle explanations of counter-urbanisation in favour of an economic driven migration.

The purpose of this research was to investigate how sustainable agriculture is being conceptualized and implemented in Saskatchewan. Zero tillage, organic farming, and the discourses surrounding them were examined as theoretical and practical responses to sustainable agriculture. Characteristics of 33 organic and 33 zero tillage farming systems located throughout the soil climatic zones of southern Saskatchewan were compared, as well as farmers' perceptions of sustainable agriculture and factors influencing their management decisions. The analysis was extended beyond the local level by examining the links between major socio-political forces shaping agriculture and farmers' perceptions and choices. Central to this analysis is an examination of the role of informal and formal knowledge systems in the development of sustainable agriculture, and how relations of power affect the knowledge that is being produced and ultimately the direction of change in agriculture. Interdisciplinary and exploratory approaches were used to identify and examine a range of emergent issues. The data gathered was analyzed both quantitatively and qualitatively. This study revealed commonalities between zero tillage and organic farmers' basic views on sustainable agriculture, and important differences in the ways these two groups of farmers translated these ideas into practice. Most farmers defined sustainability at the farm-level, focusing on land stewardship and the preservation of the family farm. Farmers adopted zero tillage because of specific environmental, economic and labour advantages, whereas organic farming was adopted for a combination of environmental, health, economic, philosophical/spiritual and labour factors. In general, zero tillage and organic farming systems differed in size, in production and management operations, in land tenure, and in the use of purchased inputs and labour. Zero tillage farms tended to be large, capital-intensive, specialized cropping operations, with a significant proportion of rented land and non-family hired labour. Organic farms were moderate-sized, diversified crop and livestock operations that substituted biological and cultural practices for purchased (agrochemical) inputs, had a high degree of ownership, and relied more upon labour exchange. These characteristics create distinct environmental, economic and social advantages and disadvantages. Zero tillage, compatible with the dominant agricultural paradigm and the industrial model, continues to be promoted by agricultural institutions and agribusiness as the best solution to farm-level sustainability. Interest in organic agriculture and the alternative agricultural paradigm is increasing, however, due to the current crisis in the farm economy and changes in consumers' perceptions and choices.

Tuberculosis (TB) is a two-stage disease, acquisition of infection and progression to disease. A complex interaction exists between the individual and their environment that determines who acquires infection and who progresses to disease. According to TB literature, 10% of individuals with infection will develop TB disease (1;2). Tuberculosis has been described a disease of poverty, but other factors may be important. The contribution of both individual measures, such as ethnic origin, gender and age and area-level measures, or socio-economic factors, to this two-stage process is not well understood. Understanding tuberculosis epidemiology and identifying those at risk for developing TB is important for effectively controlling the disease. The objective of this study was to determine the individual (age, gender, ethnic origin, geographic location) and area-level measures (income, home ownership, housing density, education, and employment) that contribute to the progression from tuberculosis infection to disease. Data from all Canadian-born Caucasians, Status Indians, and non-Status Indians and Metis, with an initial positive tuberculin skin test (TST) documented in the Saskatchewan TB Control database from January 1, 1986 to January 31, 2002 was analyzed. Exclusion criteria included any previous BCG vaccination, treatment for latent TB infection, or missing data. Individual data was obtained from the TB Control database. Area-level measures were obtained by matching individual postal codes with Canada census data to obtain information from enumeration areas. Outcome was time to TB disease at > 1 month following a documented positive tuberculin skin test. Analysis was completed using Cox regression proportional hazards model. 7588 individuals with a positive tuberculin skin test were included in the study and of these 338 (4.5%) developed TB disease. Thirty-four out of 4140 (0.8%) of Caucasians, 183 out of 2649 (6.9%) of Status Indians and 121 out of 799 (15.1%) non-Status Indians and Metis developed TB. The rate of progression to TB was 5.6/1000 person years for the entire study population. The incidence for Caucasians was 0.9/1000 person years, 7.7/1000 person years for Status Indians and 16.0/1000 person years for non-Status Indians and Metis. In the Cox regression model, including individual and area-level measures, the risk factors association with the progression to TB was age and ethnic origin (< 19 years of age HR 3.7, 95% CI 2.8 - 4.8 compared to > 19 years and ethnic origin HR 5.1, 95% CI 3.0 - 8.6 for Status Indians and HR 7.4, 95% CI 4.1-13.3 for non-Status Indians and Metis both compared to Caucasians). No socio-economic factor was consistently associated with progression to disease. We have found that age and ethnic origin are associated with an increased risk of TB infection progressing to disease. The differences in TB rates between Saskatchewan Caucasians and Status Indians, non-Status Indians and Metis can be explained by Grigg's natural history curve of TB epidemiology within a population (3). The Aboriginal population of Saskatchewan is much earlier in its epidemic resulting in higher disease rates compared to the Caucasian population. Identifying those at risk of developing TB and understanding the determinants of TB epidemiology are important for establishing successful TB control programs.