Gender differences in health and health care utilisation in various ethnic groups in the Netherlands: a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>To determine gender differences in health and health care utilisation within and between various ethnic groups in the Netherlands.</p> <p>Methods</p> <p>Data from the second Dutch National Survey of General Practice (2000–2002) were used. A total of 7,789 persons from the indigenous population and 1,512 persons from the four largest migrant groups in the Netherlands – Morocco, Netherlands Antilles, Turkey and Surinam – aged 18 years and older were interviewed. Self-reported health outcomes studied were general health status and the presence of acute (past 14 days) and chronic conditions (past 12 months). And self-reported utilisation of the following health care services was analysed: having contacted a general practitioner (past 2 months), a medical specialist, physiotherapist or ambulatory mental health service (past 12 months), hospitalisation (past 12 months) and use of medication (past 14 days). Gender differences in these outcomes were examined within and between the ethnic groups, using logistic regression analyses.</p> <p>Results</p> <p>In general, women showed poorer health than men; the largest differences were found for the Turkish respondents, followed by Moroccans, and Surinamese. Furthermore, women from Morocco and the Netherlands Antilles more often contacted a general practitioner than men from these countries. Women from Turkey were more hospitalised than Turkish men. Women from Morocco more often contacted ambulatory mental health care than men from this country, and women with an indigenous background more often used over the counter medication than men with an indigenous background.</p> <p>Conclusion</p> <p>In general the self-reported health of women is worse compared to that of men, although the size of the gender differences may vary according to the particular health outcome and among the ethnic groups. This information might be helpful to develop policy to improve the health status of specific groups according to gender and ethnicity. In addition, in some ethnic groups, and for some types of health care services, the use by women is higher compared to that by men. More research is needed to explain these differences.</p

The Future of the British Nuclear Deterrent: An Assessment of Decision Factors; Strategic Insights, v. 6, issue 1 (January 2007)

This article appeared in Strategic Insights, v.6, issue 1 (January 2007)Approved for public release; distribution is unlimited

Influencing Clients in Counterinsurgency:U.S. Involvement in El Salvador’s Civil War, 1979–92

After a decade and a half of counterinsurgency operations in Iraq and Afghanistan, U.S. policymakers want to change their approach to COIN by providing aid and advice to local governments rather than directly intervening with U.S. forces. Both this strategy and U.S. counterinsurgency doctrine in general, however, do not acknowledge the difficulty of convincing clients to follow U.S. COIN prescriptions. The historical record suggests that, despite a shared aim of defeating an insurgency, the United States and its local partners have had significantly different goals, priorities, and interests with respect to the conduct of their counterinsurgency campaigns. Consequently, a key focus of attention in any future counterinsurgency assistance effort should be on shaping the client state's strategy and behavior. Although it is tempting to think that providing significant amounts of aid will generate the leverage necessary to affect a client's behavior and policies, the U.S. experience in assisting the government of El Salvador in that country's twelve-year civil war demonstrates that influence is more likely to flow from tight conditions on aid than from boundless generosity. </jats:p

The lesser of two evils? : U.S. indirect intervention in counterinsurgency, 1946-1991

This book is a comparative study of U.S. efforts to assist allied nations in counterinsurgency through indirect intervention, with a specific focus on how external aid can induce political, economic and military reform as part of a broader counterinsurgency strategy. A critical error lies at the heart of the U.S. Counterinsurgency manual, FM 3-24, and much of the literature it draws on: the erroneous assumption that it will be comparatively easy for a patron state to shape the counterinsurgency strategies of the client government it is supporting because the priorities, goals and interests of the two parties will be closely aligned. In fact, history demonstrates that is rarely the case. Critical counterinsurgency scholars, such as Douglas Blaufarb, Michael Shafer, William adorn and Benjamin Schwartz, have argued that given the divergent preferences of the U.S. and the local government it is assisting and the relative lack of leverage provided by foreign aid, external assistance will reduce the local government's incentives to address root causes of discontent and encourage counterinsurgency strategies based solely on repression-contravening American counterinsurgency doctrine and preferences. Although this represents an important critique of U.S. counterinsurgency thinking that has been ignored in the contemporary discourse, it is incomplete. This study revises the arguments of these critical scholars about the ability to gain leverage via aid by examining their principal case studies, the Hukbalahap Rebellion in the Philippines (1946-1953), Vietnam during the rule of Ngo Dinh Diem (1955-1963) and the Salvadorian Civil War (1979-1991) in considerably greater detail than the original scholars did-drawing on tens of thousands of pages of primary materials from nineteen different archives in three countries. In doing so, this work makes several unique contributions. First, the book demonstrates that while the warnings of the critical COIN scholars are cogent, they failed to detect the use of varying aid strategies by the United States during the course of its interventions. In fact, the particular choice of aid strategy directly affected the generation of inter-alliance leverage, with inducement-the unilateral provision of incentives and other positive sanctions-and conditionality-the strict tying of specific aid to specific reforms-resulting in significantly different levels of client compliance with the patron's preferred policies. Second, it employs agency theory to examine the patterns of patron-client dynamics during indirect interventions in a theoretically rigorous and structured manner that indicates the key agency problem is about adverse selection, not moral hazard, as some critical scholars have suggested. Finally, the study identifies and corrects several important errors of causality in the case studies employed by the critical counterinsurgency scholars. In addition to expanding the understanding of the role of allies and external support in counterinsurgency, two areas which are under-theorized in the academic literature on the subject, the issues explored in this study have relevance for contemporary policy challenges in Afghanistan and Pakistan.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

The Forgotten Front:Patron-Client Relationships in Counterinsurgency

After a decade and a half of war in Iraq and Afghanistan, US policymakers are seeking to provide aid and advice to local governments&amp;apos; counterinsurgency campaigns rather than directly intervening with US forces. This strategy, and US counterinsurgency doctrine in general, fail to recognize that despite a shared aim of defeating an insurgency, the US and its local partner frequently have differing priorities with respect to the conduct of counterinsurgency operations. Without some degree of reform or policy change on the part of the insurgency-plagued government, American support will have a limited impact. Using three detailed case studies - the Hukbalahap Rebellion in the Philippines, Vietnam during the rule of Ngo Dinh Diem, and the Salvadorian Civil War - Ladwig demonstrates that providing significant amounts of aid will not generate sufficient leverage to affect a client&amp;apos;s behaviour and policies. Instead, he argues that influence flows from pressure and tight conditions on aid rather than from boundless generosity.</jats:p

Replication Data for: “Executive Particularism and Ministerial Selection in India,” Legislative Studies Quarterly

Replication Data for: Walter C. Ladwig III, “Executive Particularism and Ministerial Selection in India,” Legislative Studies Quarterly, forthcoming