Insurers : too many, too few, or"just right"? initial observations on a cross-country dataset of concentration and competition measures

In many markets, industry and policymakers agree that there may be too many insurers. In others, the consensus is that there could be benefit from more competition. But this broad consensus is often supported by evidence that is more qualitative, anecdotal, or judgmental despite being unanimous.What is less clear, however, is how far consolidation or liberalization will go, how fast, and when it will end. This paper presents some initial observations from a cross-country data set and proposes that individual country results can be interpreted against this data set to inform expectations regarding trends in competition, concentration and consolidation, to inform analysis of the sector, for individual firm strategic planning and wider market risk assessments. A"natural level"for measures is suggested as a starting hypothesis. Further consideration is then made of the role of absolute market size, stage of market development, and differentials between life and non life segments. Analysis of the natural level, adjusted for market conditions, can then be used to develop preliminary views on current and expected market dynamics, strategic planning, and to inform policy, regulatory and supervisory priorities.Debt Markets,Markets and Market Access,Emerging Markets,Microfinance,Insurance&Risk Mitigation

A systematic review of grandparents’ influence on grandchildren’s cancer risk factors

Many lifestyle patterns are established when children are young. Research has focused on the potential role of parents as a risk factor for non communicable disease in children, but there is limited investigation of the role of other caregivers, such as grandparents. The aim of this review was to identify and synthesise evidence for any influence grandparents’ care practices may have on their grandchildren’s long term cancer risk factors. A systematic review was carried out with searches across four databases (MEDLINE, Embase, Web of Science, PsycINFO) as well as searches of reference lists and citing articles, and Google Scholar. Search terms were based on six areas of risk that family care could potentially influence–weight, diet, physical activity, tobacco, alcohol and sun exposure. All study designs were included, as were studies that provided an indication of the interaction of grandparents with their grandchildren. Studies were excluded if grandparents were primary caregivers and if children had serious health conditions. Study quality was assessed using National Institute for Health and Care Excellence checklists. Grandparent impact was categorised as beneficial, adverse, mixed or as having no impact. Due to study heterogeneity a meta-analysis was not possible. Qualitative studies underwent a thematic synthesis of their results. Results from all included studies indicated that there was a sufficient evidence base for weight, diet, physical activity and tobacco studies to draw conclusions about grandparents’ influence. One study examined alcohol and no studies examined sun exposure. Evidence indicated that, overall, grandparents had an adverse impact on their grandchildren’s cancer risk factors. The theoretical work in the included studies was limited. Theoretically underpinned interventions designed to reduce these risk factors must consider grandparents’ role, as well as parents’, and be evaluated robustly to inform the evidence base further

SEEING GREEN: GENDERED RELATIONSHIP EXPECTATIONS AND SEXUAL RISK AMONG ECONOMICALLY UNDERSERVED ADOLESCENTS IN BRADDOCK, PENNSYLVANIA

This dissertation examines adolescent sexual health disparities from the perspective of economically underserved youth considered “at risk” living in the Mon Valley of southwestern Pennsylvania. Adolescent discussions of relationship and sexual risk highlight social relations and contexts in contrast to discrete behaviors and outcomes. While adolescents are aware of the possibility for contracting a sexually transmitted disease or pregnancy from engaging in sex, these risks are negated or mitigated in relation to other risks that threaten self esteem, group belonging, and a moderate sense of security. In addition, variation by age and gender contribute to complex constructions of romantic relationship expectations that inform the context for sexual risk taking beliefs and behaviors. Adolescent risk taking is social, symbolic, and subjective and not solely reducible to individualistic domains of knowledge or adoption of preventative measures. Therefore, this qualitative study examines the ways in which poverty structures the social meanings of risks. This study is based on 18 months of ethnographic research including in-depth interviews, creative arts-based data collection sessions, participant observation, and on-going dialogue with community stakeholders. In addition, this qualitative research provided an opportunity to explore, investigate and document gender and age differences: there were two adolescent age cohorts each including male and female participants. Older adolescents detailed the scope and content of romantic relationships and perceptions of sexual risk while younger adolescents detailed relationship dynamics. The qualitative approach broadens the scope of inquiry from acts (e.g. use of protection) or outcomes (e.g. STDs, teenage pregnancy) to include social and power dynamics influencing gendered expectations in relationships. Additionally, this dissertation explores relationship expectations among younger adolescents who are traditionally absent from research on sexual health. Furthermore, discussions of sexual risk need to be contextualized to incorporate larger social and cultural constructions of what is considered “risk” as well as the potential benefits incurred by risk taking. Policy suggestions would include an explicit recognition of the role of poverty in adolescent sexual health disparities (and health disparities more broadly), and a first step would be to track adolescent sexual health information by socioeconomic status in addition to geographic location and race/ethnicity