As a cultural ideal, hegemonic masculinity positions men as breadwinners in the gender order-a position that systematically benefits men and disadvantages women. Because economic success is key to performing masculinity (Connell 2005), the COVID-19 pandemic and its economic fallout offer an opportunity to evaluate shifting gender dynamics amidst rapid changes in employment and domestic demands for heterosexual couples with children. Closures of schools, daycare facilities, and workplaces around the world shifted more paid and unpaid work into the home, leading journalists and academics to question whether the pandemic would be a catalyst to "un-stall" the gender revolution. Specifically, they wondered if men would take on more domestic work, generating a more equal gender division of household labor (Smith and Johnson 2020). In this essay, we argue that traditional gender roles were reinforced for U.S. parents but were eroded for Australian
During the first few months of the COVID‐19 pandemic, the world witnessed major economic, school, and daycare closures. We sampled respondents in Australia and the US during the height of the first restrictions to understand how the first quarantine structured their emotional strain and financial worry (825 Australians and 835 Americans aged between 18 and 65; May 2–3, 2020; source YouGov). We apply structural equation modeling to demonstrate that the emotional well‐being impacts of COVID‐19 are not only gendered but also vary between childless people and parents. Specifically, we show that compared to Australians, Americans were more impacted by changes in their financial circumstances. Further, while the financial worry and emotional strain impacts were similar between childless people and parents in Australia, significant differences existed between the two groups in the United States. In particular, we identify American mothers as the most disadvantaged group—feeling the most anxious and financially worried about both employment and domestic changes under COVID‐19. Policy wise, we argue that COVID‐19 is exacerbating gender inequality in emotional health. To slow down this trend, more adequate mental health supports are needed, particularly for mothers.
Background The Chinese government’s early handling of COVID-19 has been perceived as aggressive and oppressive. Many of the most radical measures were adopted in Henan province, immediately north of Hubei, the pandemic’s epicentre in China. However, little is known about how rural residents—a group systematically disadvantaged in Chinese society—responded to authorities’ draconian restrictions. Methods To understand the lockdown measures and rural community responses at the grassroots level, face-to-face interviewers were conducted with both village cadres and villagers from two Henan villages in May and June 2020. The interviews were analysed with qualitative content analysis methods, with the coding process guided by the concepts of resilience, vulnerability and adaptability from the literature on disaster risk reduction. Results We found that the lockdown measures were indeed radical and disproportionate relative to the level of risk presented; however, they were largely accepted by villagers. This contradiction can be explained by two key contributing factors: (i) shared interests of individual villagers and the converged goal of government and civil society, and (ii) tacit flexibility in COVID-19 adaption strategies to tackle conflict resulting from goal diversion between citizens and local governments. Conclusions These findings highlight the nuances of ground-level politics. Despite their ‘radical’ nature, the lockdown measures were not implemented as simple top-down coercion. Instead, they involved, importantly, the bottom-up, localised response of villagers, and they were negotiated and adapted according to local circumstances.
Introduction Influenza has been linked to the crowding in emergency departments (ED) across the world. The impact of the Coronavirus Disease 2019 (COVID-19) pandemic on China EDs has been quite different from those during past influenza outbreaks. Our objective was to determine if COVID-19 changed ED visit disease severity during the pandemic. Methods This was a retrospective cross sectional study conducted in Nanjing, China. We captured ED visit data from 28 hospitals. We then compared visit numbers from October 2019 to February 2020 for a month-to-month analysis and every February from 2017 to 2020 for a year-to-year analysis. Inter-group chi-square test and time series trend tests were performed to compare visit numbers. The primary outcome was the proportion of severe disease visits in the EDs. Results Through February 29 th 2020, there were 93 laboratory-confirmed COVID-19 patients in Nanjing, of which 40 cases (43.01%) were first seen in the ED. The total number of ED visits in Nanjing in February 2020, were dramatically decreased ( n = 99,949) in compared to January 2020 ( n = 313,125) and February 2019 ( n = 262,503). Except for poisoning, the severe diseases in EDs all decreased in absolute number, but increased in proportion both in year-to-year and month-to-month analyses. This increase in proportional ED disease severity was greater in higher-level referral hospitals when compared year by year. Conclusion The COVID-19 outbreak has been associated with decreases in ED visits in Nanjing, China, but increases in the proportion of severe ED visits.
Following the COVID-19 outbreak, anti-Asian racism increased around the world, as exhibited through greater instances of abuse and hate crimes. To better understand the scale of anti-Asian racism and the characteristics of people who may be expressing racial prejudice, we sampled respondents in Australia and the United States over 31 August-9 September 2020 (1375 Australians and 1060 Americans aged 18 or above; source YouGov). To address potential social desirability bias, we use both direct and indirect (list experiment) questions to measure anti-Asian sentiment and link these variables to key socioeconomic factors.We find that, instead of being universal among general populations, anti-Asian sentiment is patterned differently across both country contexts and socioeconomic groups. In the United States, the most significant predictor of anti-Asian bias is political affiliation. By contrast, in Australia, anti-Asian bias is closely linked to a wide range of socioeconomic factors including political affiliation, age, gender, employment status and income.
Background: Since the mid-2000s, the Chinese government has increased government health expenditures (GHE) significantly to address widespread complaints about health delivery. This study examines the real per capita provincial GHE over the period [2007][2008][2009][2010][2011][2012][2013] to identify the determinants of provincial GHE during the most recent round of health reforms. Methods: A range of theoretically grounded socioeconomic indicators were collected from the China Statistical Yearbooks and then factored to reduce the number of highly correlated indicators. Maps were drawn to visualise the spatial patterns of key variables and fixed-effects regressions were run to test relationships between the real per capita provincial GHE and various variables. GMM estimators were used to address endogeneity problems. Results: Key determinants of provincial GHE in China include the real per capita budgetary deficits, economy, and industrial structure (two factors composed from an exploratory factor analysis). Increasing 1000 yuan real per capita budgetary deficits was expected to increase the real per capita GHE by 34 yuan. A one-unit increase in the economy was associated with a 249 yuan higher real per capita GHE, while a one-unit increase in the industrial structure was expected to decrease the real per capita GHE by 33 yuan. Conclusions: The findings of this study reveal a worrisome picture: potential inefficiencies of the central government's funding efforts and the overwhelming importance of economic development for GHE.
This study focuses on the role of primary care in China’s response to COVID-19. A retrospective, reflective approach was taken using data available to one of the authors who led the national community response to COVID-19, first in Wuhan and then multiple cities in ten provinces/municipalities across the country. At the peak of the pandemic, primary care providers shoulder various public health responsibilities and work in close partnerships with other key stakeholders in the local communities. Primary care providers keep playing a ‘sentinel’/surveillance role in identifying re-emerging cases after the elimination of community transmissions of COVID-19. Critically, however, the pandemic once again highlights some key limitations of the primary care sector, including the lack of gatekeeping, limited capacity and weak integration between medical care and public health.
Background: In moving toward universal health coverage in China, it is crucial to identify which populations should be prioritized for which interventions rather than blindly increasing welfare packages or capital investments. We identify the characteristics of vulnerable groups from multiple perspectives through estimating catastrophic health expenditure (CHE) and recommend intervention priorities.Methods: Data were from National Health Service Survey conducted in 2003, 2008, and 2013. According to the recommendation of WHO, this study adopted 40% as the CHE threshold. A binary regression was used to identify the determinants of CHE occurrence; a probit model was used to obtain CHE standardized incidence under the characteristics of single and two dimensions in 2013.Results: The total incidence of CHE in 2013 was 13.9%, which shows a general trend of growth from 2003 to 2013. Families in western and central regions and rural areas were more at risk. Factors related to social demography show that households with a female or an unmarried head of household or with a low socioeconomic status were more likely to experience CHE. Households with older adults aged 60 and above had 1,524 times higher likelihood of experiencing CHE. Among the health insurance schemes, the participants covered by the New Rural Cooperative Medical Scheme had the highest risk compared with the participants of all basic health insurance schemes. Households with several members seeking outpatient, inpatient care or with non-communicable diseases were more likely to experience CHE. Households with members not seeing a doctor or hospitalized despite the need for it were more likely to experience CHE. Characteristics such as a household head with characteristics related to low socioeconomic status, having more than two hospitalized family members, ranked high. Meanwhile, the combination of having illiterate household heads and with being covered by other health insurance plans or by none ranked the first place. Cancer notably caused a relatively high medical expenditure among households with CHE.Conclusion: In China, considering the vulnerability of the population across different dimensions is conducive to the alleviation of high CHE. Furthermore, people with multiple vulnerabilities should be prioritized for intervention. Identifying and targeting them to offer help and support will be an effective approach.
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