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Author: Ron Martin Publisher: Routledge ISBN: 1000592901 Category : Business & Economics Languages : en Pages : 140
Book Description
EXECUTIVE SUMMARY AND KEY RECOMMENDATIONS The nature of the problem: • Geographical inequalities in the UK are a longstanding and persistent problem rooted in deepseated and cumulative processes of local and regional divergence with antecedents in the inter-war years and accelerating since the early 1980s. • This spatial divergence has been generated by the inability of some places to adapt to the emergence of the post-industrial service and knowledge-based economy whose geographies are very different from those of past heavy industries. As a consequence, the "left behind" problem has become spatially and systemically entrenched. • Challenging ideas of market-led adjustment, there is little evidence that real cost advantages in Northern areas are correcting and offsetting the geographically differentiated development of skilled labour and human capital and the quality of residential and business environments. • A variety of different types of "left behind place" exist at different scales, and these types combine common problems with distinctive economic trajectories and varied causes. These different types will need policies that are sensitive and adaptive to their specific problems and potentialities. • Contemporary economic development is marked by agglomeration in high-skilled and knowledge-intensive activities. Research-based concentrations of high-skilled activity in the UK have been limited and concentrated heavily in parts of London and cities in the Golden Triangle, especially Oxford and Cambridge. Even in London, the benefits have been unevenly spread between boroughs. • Existing analyses of the predicaments of left behind places present a stark division between rapid growth in "winning" high-skilled cities and relative decline in "losing" areas. This view is problematic because it oversimplifies the experience in the UK and other countries. A false binary distinction is presented to policymakers which offers only the possibility of growth in larger cities and derived spillovers and other compensations elsewhere. • Yet, the post-industrial economy involves strong dispersal of activity and growth to smaller cities, towns and rural areas. However, this process has been highly selective between local areas and needs to be better understood. The institutional and policy response: • Past policies in the UK have lacked recognition of the scale and importance of the left behind problem and committed insufficient resources to its resolution. The objective of achieving a less geographically unequal economy has not been incorporated into mainstream policymaking. When compared with other countries, the UK has taken an overcentralized, "top-down" approach to policy formulation and implementation, often applying "one size fits all" policy measures to different geographical situations. • Political cycles have underpinned a disruptive churn of institutions and policies. In contrast with other Organisation for Economic Co-operation and Development (OECD) countries, particularly in Europe, there has been limited long-term strategy and continuity, and inadequate development of local policymaking capacity and capabilities, especially for research, analysis, monitoring and evaluation. • Past policies have been underfunded, inconsistent, and inadequately tailored and adapted to the needs of different local economies. We estimate that, on average over the period 1961–2020, the UK government invested on average £2.9 billion per annum in direct spatial policy (2020 prices), equivalent to around 0.15% of gross national income (GNI) per annum over the period. European Union Structural and Cohesion Policy support has added around 0.12% GNI (2020 prices) per annum to this over the period from the late 1970s. • These broad estimates suggest that discretionary expenditure in the UK on urban and regional policy when both domestic and European Union spatial policy was in operation was equivalent to 0.27% per annum of UK GNI (2020 prices). This is dwarfed by mainstream spending programmes (by comparison, the UK committed £14.5 billion (0.7% of GNI) to international aid in 2019). The level of resources devoted to spatial policy has been modest given the entrenched and cumulative nature of the problem. • Policies for "levelling up" need clearly to distinguish different types of left behind places and devise a set of place-sensitive and targeted policies for these types of "clubs" of left behind areas. This shift will need a radical expansion of "place-based" policymaking in the UK which allows national and local actors to collaborate on the design of appropriate targeted programmes. • A key priority for "levelling up" is revitalizing Northern cities and boosting their contribution to the national economy. Underperformance in these urban centres has been a major contributor to persistent geographical inequality in the UK. • Addressing the UK’s geographical economic inequalities and the plight of left behind places requires substantially more decentralization of power and resources to place-based agencies. This would enable the current UK government’s "levelling up" agenda to capitalize on the many advantages of more "place-based" policymaking to diagnose problems, build on local capabilities, strengthen resilience and adapt to local changes in circumstances. • Crucially, place-based efforts need to be coordinated and aligned with place-sensitive national policies. The key challenge of a levelling up mission is to integrate "place-based" policies with greater place sensitivity in national policies and in regulation and mainstream economic spending. • It is important to develop policies that spread the benefits from agglomeration and ensure that the income effects and innovations produced by high-skill concentrations diffuse to the wider cityregional economies and their firms (especially small and medium-sized enterprises) and workers. There is a clear need for more policy thinking on how this can be achieved. • Policy for levelling-up needs to align and coordinate with the other national missions for net zero carbon and post-pandemic recovery. This suggests that a strong "place-making" agenda focused on quality of life, infrastructure and housing in many left behind places is important for post-industrial and service growth. • Genuine place-making is a long-term process involving public, private and civic participation which allows local responses to those economic, environmental, and social constraints and problems that most strongly reduce the quality of life in local areas. A truly "total place" approach is required. The quality of infrastructure, housing stock and public services is crucial for the quality of place as well as the ability to secure and attract more dispersed forms of growth. There is little hope of delivering "place-making" if public sector austerity is once again allowed to cut back public services more severely in poorer and more deprived areas. The way forward: • The scale and nature of the UK’s contemporary "left behind places" problem are such that only a transformative shift in policy model and a resource commitment of historic proportions are likely to achieve the "levelling up" ambition that is central to the current government’s political ambitions. KEY RECOMMENDATIONS In summary, our recommendations are that the UK government should: • Grasp the transformative moment for local, regional and urban development policy as the UK adjusts to a post-Covid-19 world and seeks a net zero carbon future. • Establish a clear and binding national mission for "levelling up". • Realize the potential of place in policymaking. • Decentralize and devolve towards a multilevel federal polity. • Strengthen subnational funding and financing and adopt new financing models involving the public, private sector and civic sectors to generate the resources required. • Embed geography in the national state and in national policy machinery. • Improve subnational strategic research, intelligence, monitoring and evaluation capacity. A failure to learn from the lessons of the last 70 years of spatial policy risks the UK becoming an ever more divided nation, with all the associated economic, social and political costs, risks and challenges that this presents.
Author: Ron Martin Publisher: Routledge ISBN: 1000592901 Category : Business & Economics Languages : en Pages : 140
Book Description
EXECUTIVE SUMMARY AND KEY RECOMMENDATIONS The nature of the problem: • Geographical inequalities in the UK are a longstanding and persistent problem rooted in deepseated and cumulative processes of local and regional divergence with antecedents in the inter-war years and accelerating since the early 1980s. • This spatial divergence has been generated by the inability of some places to adapt to the emergence of the post-industrial service and knowledge-based economy whose geographies are very different from those of past heavy industries. As a consequence, the "left behind" problem has become spatially and systemically entrenched. • Challenging ideas of market-led adjustment, there is little evidence that real cost advantages in Northern areas are correcting and offsetting the geographically differentiated development of skilled labour and human capital and the quality of residential and business environments. • A variety of different types of "left behind place" exist at different scales, and these types combine common problems with distinctive economic trajectories and varied causes. These different types will need policies that are sensitive and adaptive to their specific problems and potentialities. • Contemporary economic development is marked by agglomeration in high-skilled and knowledge-intensive activities. Research-based concentrations of high-skilled activity in the UK have been limited and concentrated heavily in parts of London and cities in the Golden Triangle, especially Oxford and Cambridge. Even in London, the benefits have been unevenly spread between boroughs. • Existing analyses of the predicaments of left behind places present a stark division between rapid growth in "winning" high-skilled cities and relative decline in "losing" areas. This view is problematic because it oversimplifies the experience in the UK and other countries. A false binary distinction is presented to policymakers which offers only the possibility of growth in larger cities and derived spillovers and other compensations elsewhere. • Yet, the post-industrial economy involves strong dispersal of activity and growth to smaller cities, towns and rural areas. However, this process has been highly selective between local areas and needs to be better understood. The institutional and policy response: • Past policies in the UK have lacked recognition of the scale and importance of the left behind problem and committed insufficient resources to its resolution. The objective of achieving a less geographically unequal economy has not been incorporated into mainstream policymaking. When compared with other countries, the UK has taken an overcentralized, "top-down" approach to policy formulation and implementation, often applying "one size fits all" policy measures to different geographical situations. • Political cycles have underpinned a disruptive churn of institutions and policies. In contrast with other Organisation for Economic Co-operation and Development (OECD) countries, particularly in Europe, there has been limited long-term strategy and continuity, and inadequate development of local policymaking capacity and capabilities, especially for research, analysis, monitoring and evaluation. • Past policies have been underfunded, inconsistent, and inadequately tailored and adapted to the needs of different local economies. We estimate that, on average over the period 1961–2020, the UK government invested on average £2.9 billion per annum in direct spatial policy (2020 prices), equivalent to around 0.15% of gross national income (GNI) per annum over the period. European Union Structural and Cohesion Policy support has added around 0.12% GNI (2020 prices) per annum to this over the period from the late 1970s. • These broad estimates suggest that discretionary expenditure in the UK on urban and regional policy when both domestic and European Union spatial policy was in operation was equivalent to 0.27% per annum of UK GNI (2020 prices). This is dwarfed by mainstream spending programmes (by comparison, the UK committed £14.5 billion (0.7% of GNI) to international aid in 2019). The level of resources devoted to spatial policy has been modest given the entrenched and cumulative nature of the problem. • Policies for "levelling up" need clearly to distinguish different types of left behind places and devise a set of place-sensitive and targeted policies for these types of "clubs" of left behind areas. This shift will need a radical expansion of "place-based" policymaking in the UK which allows national and local actors to collaborate on the design of appropriate targeted programmes. • A key priority for "levelling up" is revitalizing Northern cities and boosting their contribution to the national economy. Underperformance in these urban centres has been a major contributor to persistent geographical inequality in the UK. • Addressing the UK’s geographical economic inequalities and the plight of left behind places requires substantially more decentralization of power and resources to place-based agencies. This would enable the current UK government’s "levelling up" agenda to capitalize on the many advantages of more "place-based" policymaking to diagnose problems, build on local capabilities, strengthen resilience and adapt to local changes in circumstances. • Crucially, place-based efforts need to be coordinated and aligned with place-sensitive national policies. The key challenge of a levelling up mission is to integrate "place-based" policies with greater place sensitivity in national policies and in regulation and mainstream economic spending. • It is important to develop policies that spread the benefits from agglomeration and ensure that the income effects and innovations produced by high-skill concentrations diffuse to the wider cityregional economies and their firms (especially small and medium-sized enterprises) and workers. There is a clear need for more policy thinking on how this can be achieved. • Policy for levelling-up needs to align and coordinate with the other national missions for net zero carbon and post-pandemic recovery. This suggests that a strong "place-making" agenda focused on quality of life, infrastructure and housing in many left behind places is important for post-industrial and service growth. • Genuine place-making is a long-term process involving public, private and civic participation which allows local responses to those economic, environmental, and social constraints and problems that most strongly reduce the quality of life in local areas. A truly "total place" approach is required. The quality of infrastructure, housing stock and public services is crucial for the quality of place as well as the ability to secure and attract more dispersed forms of growth. There is little hope of delivering "place-making" if public sector austerity is once again allowed to cut back public services more severely in poorer and more deprived areas. The way forward: • The scale and nature of the UK’s contemporary "left behind places" problem are such that only a transformative shift in policy model and a resource commitment of historic proportions are likely to achieve the "levelling up" ambition that is central to the current government’s political ambitions. KEY RECOMMENDATIONS In summary, our recommendations are that the UK government should: • Grasp the transformative moment for local, regional and urban development policy as the UK adjusts to a post-Covid-19 world and seeks a net zero carbon future. • Establish a clear and binding national mission for "levelling up". • Realize the potential of place in policymaking. • Decentralize and devolve towards a multilevel federal polity. • Strengthen subnational funding and financing and adopt new financing models involving the public, private sector and civic sectors to generate the resources required. • Embed geography in the national state and in national policy machinery. • Improve subnational strategic research, intelligence, monitoring and evaluation capacity. A failure to learn from the lessons of the last 70 years of spatial policy risks the UK becoming an ever more divided nation, with all the associated economic, social and political costs, risks and challenges that this presents.
Author: Centers of Disease Control Publisher: World Health Organization ISBN: 9289052651 Category : Law Languages : en Pages : 92
Book Description
Evidence indicates that actions within four main themes (early child development fair employment and decent work social protection and the living environment) are likely to have the greatest impact on the social determinants of health and health inequities. A systematic search and analysis of recommendations and policy guidelines from intergovernmental organizations and international bodies identified practical policy options for action on social determinants within these four themes. Policy options focused on early childhood education and care; child poverty; investment strategies for an inclusive economy; active labour market programmes; working conditions; social cash transfers; affordable housing; and planning and regulatory mechanisms to improve air quality and mitigate climate change. Applying combinations of these policy options alongside effective governance for health equity should enable WHO European Region Member States to reduce health inequities and synergize efforts to achieve the United Nations Sustainable Development Goals.
Author: OECD Publisher: OECD Publishing ISBN: 9264805907 Category : Languages : en Pages : 447
Book Description
This volume, developed by the Observatory together with OECD, provides an overall conceptual framework for understanding and applying strategies aimed at improving quality of care. Crucially, it summarizes available evidence on different quality strategies and provides recommendations for their implementation. This book is intended to help policy-makers to understand concepts of quality and to support them to evaluate single strategies and combinations of strategies.
Author: National Academies of Sciences, Engineering, and Medicine Publisher: National Academies Press ISBN: 0309452961 Category : Medical Languages : en Pages : 583
Book Description
In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.
Author: Institute of Medicine Publisher: National Academies Press ISBN: 0309068371 Category : Medical Languages : en Pages : 312
Book Description
Experts estimate that as many as 98,000 people die in any given year from medical errors that occur in hospitals. That's more than die from motor vehicle accidents, breast cancer, or AIDSâ€"three causes that receive far more public attention. Indeed, more people die annually from medication errors than from workplace injuries. Add the financial cost to the human tragedy, and medical error easily rises to the top ranks of urgent, widespread public problems. To Err Is Human breaks the silence that has surrounded medical errors and their consequenceâ€"but not by pointing fingers at caring health care professionals who make honest mistakes. After all, to err is human. Instead, this book sets forth a national agendaâ€"with state and local implicationsâ€"for reducing medical errors and improving patient safety through the design of a safer health system. This volume reveals the often startling statistics of medical error and the disparity between the incidence of error and public perception of it, given many patients' expectations that the medical profession always performs perfectly. A careful examination is made of how the surrounding forces of legislation, regulation, and market activity influence the quality of care provided by health care organizations and then looks at their handling of medical mistakes. Using a detailed case study, the book reviews the current understanding of why these mistakes happen. A key theme is that legitimate liability concerns discourage reporting of errorsâ€"which begs the question, "How can we learn from our mistakes?" Balancing regulatory versus market-based initiatives and public versus private efforts, the Institute of Medicine presents wide-ranging recommendations for improving patient safety, in the areas of leadership, improved data collection and analysis, and development of effective systems at the level of direct patient care. To Err Is Human asserts that the problem is not bad people in health careâ€"it is that good people are working in bad systems that need to be made safer. Comprehensive and straightforward, this book offers a clear prescription for raising the level of patient safety in American health care. It also explains how patients themselves can influence the quality of care that they receive once they check into the hospital. This book will be vitally important to federal, state, and local health policy makers and regulators, health professional licensing officials, hospital administrators, medical educators and students, health caregivers, health journalists, patient advocatesâ€"as well as patients themselves. First in a series of publications from the Quality of Health Care in America, a project initiated by the Institute of Medicine
Author: Paul J. Gertler Publisher: World Bank Publications ISBN: 1464807809 Category : Business & Economics Languages : en Pages : 444
Book Description
The second edition of the Impact Evaluation in Practice handbook is a comprehensive and accessible introduction to impact evaluation for policy makers and development practitioners. First published in 2011, it has been used widely across the development and academic communities. The book incorporates real-world examples to present practical guidelines for designing and implementing impact evaluations. Readers will gain an understanding of impact evaluations and the best ways to use them to design evidence-based policies and programs. The updated version covers the newest techniques for evaluating programs and includes state-of-the-art implementation advice, as well as an expanded set of examples and case studies that draw on recent development challenges. It also includes new material on research ethics and partnerships to conduct impact evaluation. The handbook is divided into four sections: Part One discusses what to evaluate and why; Part Two presents the main impact evaluation methods; Part Three addresses how to manage impact evaluations; Part Four reviews impact evaluation sampling and data collection. Case studies illustrate different applications of impact evaluations. The book links to complementary instructional material available online, including an applied case as well as questions and answers. The updated second edition will be a valuable resource for the international development community, universities, and policy makers looking to build better evidence around what works in development.
Author: Ron Martin
Author: Ron Martin
Author: Tri-State Regional Planning Commission
Author: Max G. Manwaring
Author: Appalachian Regional Commission. Education Advisory Committee
Author: Centers of Disease Control
Author: OECD
Author: CAITLIN. FINLAYSON
Author: National Academies of Sciences, Engineering, and Medicine
Author: Institute of Medicine
Author: Paul J. Gertler