Poor people on the move: county-to-county migration and the spatial concentration of poverty

The Right to Not Catch Up—Transitioning European Territorial Cohesion towards Spatial Justice for Sustainability

Recent EU environmental and spatial policies notably strive towards the development paradigm of green growth and economic competitiveness. However, operationalizing spatial policies through growth-driven GDP logics promotes an unequal race towards narrowly defined developmental ‘success’, while perpetuating social, economic and environmental inequalities. Meanwhile, the EU’s territorial cohesion approach has remained a conceptual ‘black box’, its apparent inadequacy for notably mitigating territorial disparities leading to renewed questions about territorial policy’s relevance, delivery and evaluation. In this paper, we add to calls for redesigning territorial cohesion by proposing a turn towards spatial justice for territorial sustainability. Pointing out the need to refocus on regional capabilities and alternative development trajectories, we argue that the ‘right to not catch up’ enables a more locally meaningful and globally sustainable development. Drawing from regional statistics, policy analyses and an empirical case study of three European Territorial Cooperation programs in the heterogeneous Austrian-Czech-Slovak-Hungarian border region, we illustrate how current EU spatial policy approaches evolve in regional practice and why current policy aims fall short for sustainable transformations. Through interrogating development discourses and their alternatives, we contribute to emerging new perspectives on sustainable territorial development at the European as well as at regional levels.

LINKING RACIAL COMPOSITION, BLACK-WHITE INEQUALITY, AND REGIONAL DIFFERENCE: THE ROLE OF MIGRATION

The percent black-inequality relationship and the unique position of the South have been cornerstones of research on US racial inequality. Using an innovative methodological approach, I address how migration contributes to our understanding of the percent black-inequality relationship. I find that the educationally selective migration of blacks and whites significantly contributes to the percent black-inequality relationship via compositional changes. However, any explanatory power is limited to the non-South. Migration plays a role in understanding this relationship, yet processes related to black population concentration still generate black disadvantage anew, particularly within the South.

(Un)natural disaster: vulnerability, long-distance displacement, and the extended geography of neighborhood distress and attainment after Katrina

After Hurricane Katrina, socioeconomically vulnerable populations were slow to return to their poor and segregated pre-disaster neighborhoods. Yet, very little is known about the quality of their post-disaster neighborhoods. While vulnerable groups rarely escape neighborhood poverty, some Katrina evacuees showed signs of neighborhood improvement. The current study investigates this puzzle and the significance of long-distance moves for neighborhood change among participants in the Resilience in the Survivors of Katrina Project. Seven hundred low-income, mostly minority mothers in community college in New Orleans before Katrina were tracked across the country a year and a half later. The findings show that respondents' immediate and extended neighborhoods and metropolitan areas after Katrina were less disadvantaged, less organizationally isolated, and more racially and ethnically diverse compared to their pre-hurricane environments, and to the environments of those staying or returning home. Counterfactual analyses showed that more than within-neighborhood changes over time, between-neighborhood mobility and long-distance migration decreased respondents' exposures to distress in their neighborhood, extended geographic area, and metropolitan area.

Rural patients' knowledge about heart failure

BACKGROUND

Heart failure (HF) is a potentially disabling condition requiring significant patient knowledge to manage the requirements of self-care. The need for self-care is important for all patients but particularly for those living in rural areas that are geographically remote from healthcare services.

OBJECTIVE

The aim of this study was to identify the level of knowledge of rural patients with HF and the clinical and demographic characteristics associated with low levels of HF knowledge.

METHODS

Baseline data from 612 patients with HF enrolled in the Rural Education to Improve Outcomes in Heart Failure trial were analyzed using the Heart Failure Knowledge Scale, the Short Test of Functional Health Literacy in Adults, and the anxiety subscale of the Brief Symptom Inventory. Multiple linear regression was used to explore the contribution of sociodemographic and clinical variables to levels of HF knowledge.

RESULTS

The mean (SD) age was 66 (13) years; 59% were men, and 50.5% had an ejection fraction of less than 40%. The mean (SD) percent correct on the Heart Failure Knowledge Scale was 69.5% (13%; range, 25%-100%), with the most frequent incorrect items related to symptoms of HF and the need for daily weights. The men and the older patients scored significantly lower in HF knowledge than did the women and the younger patients (P = 0.002 and 0.011, respectively). The patients with preserved systolic function also scored significantly lower than those with systolic HF (P = 0.030).

CONCLUSIONS

Patients who are at risk for poor self-care because of low levels of HF knowledge can be identified. Older patients, men, and, patients with HF with preserved systolic function may require special educational strategies to gain the knowledge required for effective self-care.

Spatial Variation in the Relationship between Hispanic Concentration and County Poverty: A Migration Perspective

Racial/ethnic minority concentration is generally positively related to county poverty. Yet, spatial variation in this relationship may call into question the meaning attached to racial/ethnic concentration. We argue that racial/ethnic concentration reflects more than just the concentration of individuals from a disadvantaged group. In addition, we extend previous work by taking a migration perspective to explain spatial non-stationarity in racial/ethnic concentration’s relationship with county poverty. Factors related to the migration process, including migrant selectivity and spatial differentiation in place characteristics, could alter the relationship between a minority group’s concentration and poverty. We employ spatially informed methods and 2006–2010 American Community Survey data to examine the relationship between Hispanic concentration and county poverty. The GWR results indicate significant spatial variation in the percent Hispanic-county poverty relationship. Hispanic migration regimes capture some of the observed relationship non-stationarity, suggesting migration-related processes partially drive Hispanic-county poverty relationship non-stationarity. However, we discuss other explanations that should be considered in future research. This work advances research on spatial inequality by examining the social implications of migration and by investigating the role of place in shaping the meaning of minority concentration.

[Internal migration in Spain in the 20th century: a new focus for the study of social inequalities in health]

OBJECTIVE

Catalonia and the Basque Country received substantial immigration quotas from the rest of Spain during the twentieth century. This study aimed to analyze inequalities in health by birthplace (the population born in the same region or other autonomous regions) in these two geographical areas.

METHODS

We conducted a cross-sectional study in the non-institutionalized population aged 50 to 79 years, with data from the health surveys of Catalonia 2006 (n=5,483) and the Basque Country 2007 (n=3,424). We used log-binomial models to estimate the prevalence ratios (PR) of poor self-rated health by birthplace, stratified by sex and social class, and successively adjusted for age, social class and educational attainment.

RESULTS

Immigrants from other autonomous regions had poorer self-rated health than the native-born population, both in the Basque Country (age-adjusted PR in men 1.30, 95% CI 1.11-1.54; women 1.42, 95% CI 1.25-1.62,) and in Catalonia (PR in men 1.41, 95% CI 1.26-1.62; PR in women 1.25, 95% CI 1.16-1.35). PRs were reduced but remained significant after adjustment for social class and educational attainment and stratification by manual or non-manual social class.

CONCLUSIONS

In both communities there are health inequalities that are detrimental to the immigrant population from the rest of Spain, which constitutes approximately half of the population in the studied age cohorts. Future studies should explore the persistence of these inequalities in other health indicators and their reproduction in second generations, and identify entry points for preventive policies.

Rural/urban differences in self-rated health: examining the roles of county size and metropolitan adjacency

This research explored the roles of 'rurality' - nonmetropolitan county population size and adjacency to metropolitan areas - on self-rated health among a nationally representative sample of US adults. Using seven years of pooled individual level data from the Behavioral Risk Factor Surveillance System and county-level data from the County Characteristics survey, we found that residents of remote rural counties have the greatest odds of reporting bad health and that the significant differences in self-rated health between metropolitan residents and residents of rural areas can be entirely explained by rural structural disadvantage, including higher rates of unemployment and population loss and lower levels of educational attainment.