Life-cycle living standards of intact and disrupted English working families, 1260-1850

We provide a framework for considering the living standards among intact and disrupted working-class families of various sizes in historical England. We estimate family incomes without resort to the usual male day wages and ahistorical assumptions about men’s labour inputs, instead using approximations of their annual earnings. We incorporate women and children’s wages and labour inputs and use a family life-cycle approach which accommodates consumption smoothing through saving. The analysis extends to families with often overlooked but historically common structures: widows with their children, deserted wives, and families which include husbands/fathers but ones unable or unwilling to work. Our framework suggests living standards varied considerably over time and by family structure and dependency ratio. Small and intact families enjoyed high and rising living standards after 1700. Large, broken, and disrupted families depended on child labour and poor relief up until 1830

Beyond the male breadwinner: life-cycle living standards of intact and disrupted English working families, 1260-1850

This article provides a novel framework within which to evaluate real household incomes of predominantly rural working families of various sizes and structures in England in the years 1260–1850. We reject ahistorical assumptions about complete reliance on men's wages and male breadwinning, moving closer to reality by including women and children's contributions to family incomes. Our empirical strategy benefits from recent estimates of men's annual earnings, so avoiding the need to gross up day rates using problematic assumptions about days worked, and from new data on women and children's wages and labour inputs. A family life-cycle approach which accommodates consumption smoothing through saving adds further breadth and realism. Moreover, the analysis embraces two historically common but often overlooked family types alternative to the traditional male-breadwinner model: one where the husband is missing having died or deserted, and one where the husband is present but unwilling or unable to find work. Our framework suggests living standards varied widely by family structure and dependency ratio. Incorporating detailed demographic data available for 1560 onward suggests that small and intact families enjoyed high and rising living standards after 1700, while large or disrupted families depended on child labour and poor relief until c. 1830. A broader perspective on family structures informs understanding of the chronology and nature of poverty and coping strategies

Individual Health Trainers to support health and wellbeing for people under community supervision in the criminal justice system: the STRENGTHEN pilot RCT

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Patient-Reported Measures for Person-Centered Coordinated Care: A Comparative Domain Map and Web-Based Compendium for Supporting Policy Development and Implementation

BACKGROUND: Patient-reported measure (PRM) questionnaires were originally used in research to measure outcomes of intervention studies. They have now evolved into a diverse family of tools measuring a range of constructs including quality of life and experiences of care. Current health and social care policy increasingly advocates their use for embedding the patient voice into service redesign through new models of care such as person-centered coordinated care (P3C). If chosen carefully and used efficiently, these tools can help improve care delivery through a variety of novel ways, including system-level feedback for health care management and commissioning. Support and guidance on how to use these tools would be critical to achieve these goals. OBJECTIVE: The objective of this study was to develop evidence-based guidance and support for the use of P3C-PRMs in health and social care policy through identification of PRMs that can be used to enhance the development of P3C, mapping P3C-PRMs against an existing model of domains of P3C, and integration and organization of the information in a user-friendly Web-based database. METHODS: A pragmatic approach was used for the systematic identification of candidate P3C-PRMs, which aimed at balancing comprehensiveness and feasibility. This utilized a number of resources, including existing compendiums, peer-reviewed and gray literature (using a flexible search strategy), and stakeholder engagement (which included guidance for relevant clinical areas). A subset of those candidate measures (meeting prespecified eligibility criteria) was then mapped against a theoretical model of P3C, facilitating classification of the construct being measured and the subsequent generation of shortlists for generic P3C measures, specific aspects of P3C (eg, communication or decision making), and condition-specific measures (eg, diabetes, cancer) in priority areas, as highlighted by stakeholders. RESULTS: In total, 328 P3C-PRMs were identified, which were used to populate a freely available Web-based database. Of these, 63 P3C-PRMs met the eligibility criteria for shortlisting and were classified according to their measurement constructs and mapped against the theoretical P3C model. We identified tools with the best coverage of P3C, thereby providing evidence of their content validity as outcome measures for new models of care. Transitions and medications were 2 areas currently poorly covered by existing measures. All the information is currently available at a user-friendly web-based portal (p3c.org.uk), which includes all relevant information on each measure, such as the constructs targeted and links to relevant literature, in addition to shortlists according to relevant constructs. CONCLUSIONS: A detailed compendium of P3C-PRMs has been developed using a pragmatic systematic approach supported by stakeholder engagement. Our user-friendly suite of tools is designed to act as a portal to the world of PRMs for P3C, and have utility for a broad audience, including (but not limited to) health care commissioners, managers, and researchers.BACKGROUND: Patient-reported measure (PRM) questionnaires were originally used in research to measure outcomes of intervention studies. They have now evolved into a diverse family of tools measuring a range of constructs including quality of life and experiences of care. Current health and social care policy increasingly advocates their use for embedding the patient voice into service redesign through new models of care such as person-centered coordinated care (P3C). If chosen carefully and used efficiently, these tools can help improve care delivery through a variety of novel ways, including system-level feedback for health care management and commissioning. Support and guidance on how to use these tools would be critical to achieve these goals. OBJECTIVE: The objective of this study was to develop evidence-based guidance and support for the use of P3C-PRMs in health and social care policy through identification of PRMs that can be used to enhance the development of P3C, mapping P3C-PRMs against an existing model of domains of P3C, and integration and organization of the information in a user-friendly Web-based database. METHODS: A pragmatic approach was used for the systematic identification of candidate P3C-PRMs, which aimed at balancing comprehensiveness and feasibility. This utilized a number of resources, including existing compendiums, peer-reviewed and gray literature (using a flexible search strategy), and stakeholder engagement (which included guidance for relevant clinical areas). A subset of those candidate measures (meeting prespecified eligibility criteria) was then mapped against a theoretical model of P3C, facilitating classification of the construct being measured and the subsequent generation of shortlists for generic P3C measures, specific aspects of P3C (eg, communication or decision making), and condition-specific measures (eg, diabetes, cancer) in priority areas, as highlighted by stakeholders. RESULTS: In total, 328 P3C-PRMs were identified, which were used to populate a freely available Web-based database. Of these, 63 P3C-PRMs met the eligibility criteria for shortlisting and were classified according to their measurement constructs and mapped against the theoretical P3C model. We identified tools with the best coverage of P3C, thereby providing evidence of their content validity as outcome measures for new models of care. Transitions and medications were 2 areas currently poorly covered by existing measures. All the information is currently available at a user-friendly web-based portal (p3c.org.uk), which includes all relevant information on each measure, such as the constructs targeted and links to relevant literature, in addition to shortlists according to relevant constructs. CONCLUSIONS: A detailed compendium of P3C-PRMs has been developed using a pragmatic systematic approach supported by stakeholder engagement. Our user-friendly suite of tools is designed to act as a portal to the world of PRMs for P3C, and have utility for a broad audience, including (but not limited to) health care commissioners, managers, and researchers

Women's labour force participation and the transition of the male- breadwinner family, 1790-1865.

A dataset of 1161 household budgets is used to explore married women's labour force participation during the period of industrialization in the UK. The data cast doubt on census enumerations of women's work; occupational designations understate the number of women participating, compared with calculations based on earnings. Participation rates tended to decline, although the path of decline varied among occupations. Controlling for economic variables and household characteristics in a probit regression model confirms the overall downward trend and suggests that ideological and institutional factors were important in restricting women's work. In general, women's experience of industrialization was of increased financial dependence on men

Old questions, new data, and alternative perspectives: families' living standards in the industrial revolution.

We have used the household accounts of 1,350 husband-wife families to investigate trends in male earnings and family incomes. This evidence confirms the material progress suggested by trends in the real wage rates of adult males. But the budget data underscore occupational and regional distinctions, discontinuities in the growth process, and changes over time in the ability of other family members to offset the effects of the business cycle on men's earnings. Overall, family incomes grew less than male earnings

The origins and expansion of the male breadwinner family: The case of nineteenth-century Britain.

The transition from a family economy in which incomes were democratically secured through the best efforts of all family members to one in which men supported dependent wives and children appears as a watershed in many otherwise very different histories of the family. It looms large in both orthodox economic analyses of historical trends in female participation rates and feminist depictions of a symbiotic structural relationship between inherited patriarchal relationships and nascent industrial capitalism. Both camps agree, as Creighton has recently put it, about “the out-lines of [the] development” of the male breadwinner family. Where they disagree is in “the factors responsible for its origins and expansion”. Why did families move away from an asserted “golden age” of egalitarian sourcing of incomes, which involved husbands, wives and children, to dependence on a male breadwinner who aspired to a family wage? Neo-classical economic historians emphasize the supply conditions, concentrating on income effects from men's earnings, family structure variables and alternatives to women's employment in terms of productive activities in the home. In contrast, dual systems theorists emphasize demand conditions in terms of institutional constraints on women's and children's employment exemplified by the exclusionary strategies of chauvinist trade unions, labour legislation which limited the opportunities of women and children, and the legitimation of men's wage demands by references to their need for a family wage. Our view is that systematic empirical investigation of the male breadwinner family has been lacking, even the timescale of its appearance and development remains obscure. Unless we fill in the outlines with more empirical detail we will never discover the reasons for its origins and expansion

"The Exploitation of Little Children": Child Labor and the Family Economy in the Industrial Revolution.

The effects of industrialization on children′s work were investigated using a data set of household budgets. We found that in early industrialization the number of children working, and the number working in factories both increased, while the age at which children started work decreased. This last effect is related to changes in household structure. Older children were gaining independence earlier, leaving younger siblings to augment family incomes. But industrialization had only a transitory effect on children′s work. Participation was in decline after midcentury. However, there are longer-term implications for the sexual division of labor as the effects of labor market changes differed for girls and boys