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21. U.S. and Global Approaches to Financing Long-Term Care: Understanding the Patchwork

Author:
Celli Horstman, Evan D. Gumas, and Gretchen Jacobson
Publication Date:
02-2023
Content Type:
Policy Brief
Institution:
Commonwealth Fund
Abstract:
Most United States adults age 65 and older will need long-term care toward the end of their lives.1 Long-term care, provided in the home, community, or in institutional settings like a nursing home, includes medical care as well as personal, nonmedical care for people who are unable to perform activities of daily living, like cooking or bathing. Some services also may support social needs for those unable to perform what are known as instrumental activities of daily living, such as shopping or medication management. In 2018, more than 5 million people in the United States used home health care, including adult day care or home health agency services, and nearly 4 million people resided in nursing homes or residential care communities.2 Despite the widespread need for long-term care, the U.S. has no national program to cover the costs of long-term care. While certain states have implemented their own programs, the resulting patchwork of funding has left many Americans with no sustainable way to pay for the services they require. Other developed countries have comprehensive, national long-term care financing systems featuring broad eligibility and high levels of financial support. In this brief, we analyze data from multiple sources on long-term care costs in the U.S., as well as spending data from the Organisation for Economic Co-operation and Development (OECD), to better understand long-term care financing strategies in 12 high-income countries. In addition to these data, we synthesized initiatives to long-term care funding in these 12 countries. (For details, see “How We Conducted This Study.”) Since the U.S. does not have a national funding strategy, we also focused on individual state approaches. International and U.S. state approaches may provide insights to policymakers seeking to advance comprehensive long-term care funding.
Topic:
Health, Health Care Policy, Inequality, and Social Services
Political Geography:
Global Focus

22. Analysis on the Determinants of Labor Share and Its Policy Implications

Author:
Yaein Baek, Minsoo Han, Wongi Kim, and Hyunsuk Kim
Publication Date:
02-2023
Content Type:
Policy Brief
Institution:
Korea Institute for International Economic Policy (KIEP)
Abstract:
There has been a significant decline in the global labor share, leading to numerous studies about the cause of this drop. The labor share is used as one of the main indicators of inequality because a decrease in the labor share can lead to aggravation of income inequality. This is because low-skilled workers can be greatly affected by such a decline in the labor share and the main source of in-come for the low-income class, including the self-employed, is labor income. Among various indicators of inequality, this study analyzes the determinants of the change in labor share. Technological changes such as adoption of robots, advancements in information and communications technology (ICT) and the Fourth Industrial Revolution (4IR) are expected to change the labor market. Hence, this study analyzes the impact of technological changes on labor share and suggests policy responses.
Topic:
Economics, Science and Technology, Labor Issues, and Inequality
Political Geography:
Global Focus

23. An Age of Crises: Prospects for inequality and division

Author:
Roshni Menon
Publication Date:
02-2023
Content Type:
Special Report
Institution:
Center on International Cooperation (CIC)
Abstract:
Inequalities can shape, drive, and amplify crises and at the same time, be the consequence of crises. The double shock of the COVID-19 pandemic followed by the Russian invasion of Ukraine has been accompanied by an uptick in income and social inequalities. Moreover, a world enveloped in a series of crises has become the grim backdrop for many of the current discourses on how to solve salient world problems. The complexity and force of how each individual crisis overlaps and interacts with, and sometimes worsens the impact of other crises—including rising levels of inequality and exclusion—is profound and damaging, requiring careful analysis of both consequences and solutions. For instance, surging inflation rates, which began in 2021, as well as the food and energy crises set off largely by the Russian invasion of Ukraine, have precipitated and worsened the debt crisis in many lower income countries. Combined with the existential threat of climate change and related and prevalent extreme climate events, a perfect and potent storm of events have been set in motion: even if aspects of today’s cost-of-living crisis wane, their ripple effects will continue to reverberate, in some instances setting off political instability and social unrest in parts of the world. The lessons learned from these crises, and their interaction with inequality and exclusion will be critical to better prepare for the future, and to break the deadly spiral of crises and rising inequality. While disasters—both those created by people and generated by nature—have increasingly become a daily reality for many in different parts of the world, policies at the global, regional, and national levels, have yet to catch up with this new reality. Looking across six areas—food and fuel shortages, inflation, debt distress, extreme climate-related events, and political unrest—there are very few countries that escape the reach of at least one crisis. However, more alarmingly, many countries are exposed to multiple and compounding levels of economic, social, and environmental shock; which can intersect with underlying inequalities and vulnerabilities such that a vicious cycle of income inequality, increasing social stratification, and discontent spreads across societies and generations. New research from the Pathfinders team shows that in those countries for which complete data exists across six crises (90 in total), eight countries are at risk for being impacted by all crises at the same time. 72 out of these 90 countries (or 80 percent) are at high or moderate risk of suffering from at least three crises at the same time. If we limit the analysis to five crises (food price shock, inflation, extreme climate events, debt distress, and protests), 10 out of the 134 countries with complete data are at high or moderate risk of suffering from all five crises and 86 countries (65 percent) from at least three crises. This number may even be an underestimate as typically lower income countries have less capacity to collect data and tend to deal with multiple crises arising from debt and cost-of-living issues. In response to these multiple crises (or polycrisis), urgent, integrated, and coordinated policy interventions are needed, including even greater cooperation and commitment at the global level. Without a sharp change of course, a renewed recommitment to multilateralism and bolder action to address root causes, there will be little change for the better. There is an opportunity for committed countries to advocate for sustained and urgent action to respond to the immediate humanitarian needs of a great majority of the world’s population. Policy solutions can be geared towards the shorter and longer terms: The first includes an urgent set of instruments aimed at reducing suffering as soon as possible and a second set focused on achieving longer-term structural transformation to reduce vulnerability and promote sustainability.
Topic:
Inequality, Crisis Management, COVID-19, and Russia-Ukraine War
Political Geography:
Global Focus

24. From Rhetoric to Action: Delivering Inequality & Exclusion

Author:
Center on International Cooperation
Publication Date:
03-2023
Content Type:
Special Report
Institution:
Center on International Cooperation (CIC)
Abstract:
Inequality and exclusion are not destiny. Change is possible. Following three years of research, country visits, expert meetings, and debate, the Pathfinders’ Grand Challenge on Inequality and Exclusion has identified policy priorities for immediate and longer-term actions to tackle inequality and exclusion. The report draws on the lived experiences and desires of people across countries around the world. To understand citizens’ concerns about inequalities, their policy priorities, and their desire for change, we commissioned a public opinion survey in eight countries: Canada, Costa Rica, Mexico, Sierra Leone, South Korea, Sweden, Tunisia, and Uruguay. These opinion surveys show an immense preoccupation with societal divisions and a consensus that more needs to be done to address them. What is working to make progress on equality and inclusion? Countries and local communities that have made sustained progress towards more inclusive and equal societies have generally taken a three-pronged approach: They have delivered visible results that make a material difference in people’s daily lives, in areas such as social protection, housing and wages; they have built solidarity, through for example truth-telling exercises, police and justice reform and community empowerment; and they have secured credibility and sought to avert reversals by fighting corruption, broadening political power, and increasing the public financing needed for policy development.
Topic:
Public Opinion, Inequality, Survey, and Exclusion
Political Geography:
Canada, South Korea, Uruguay, Sierra Leone, Sweden, Mexico, Tunisia, Costa Rica, and Global Focus

25. Top Wealth and Its Historical Origins: An Analysis of Germany’s Largest Privately Held Fortunes in 2019

Author:
Daria Tisch and Emma Ischinsky
Publication Date:
04-2023
Content Type:
Working Paper
Institution:
Max Planck Sciences Po Center on Coping with Instability in Market Societies (MaxPo)
Abstract:
Rising wealth inequality is both a topic in recent policy discussion and in the social sciences. Despite the general interest in wealth concentration, we know only little about the largest privately held fortunes. To help fill this gap we analyze the historical origins of Germany’s 1,032 largest fortunes in 2019. In particular, we identify the share of entrenched fortunes – fortunes which date back to the beginning of the twentieth century – and ask to what extent they differ from more recently established ones. Furthermore, we examine in an exploratory way if entrenched fortunes are connected to fortunes with more recent origins through family lines. We use a journalistic rich list published by the manager magazin in 2019, which we link with both rich lists from 1912/1914 and Wikidata. We find that about eight percent of today’s fortunes can be traced back to fortunes held by the same families in 1913. Regression analyses show that entrenched fortunes rank on average higher on the rich list than the remaining ones. Descriptive network analyses indicate that some of today’s largest fortunes are intertwined through marital lines, hinting at social closure at the top. Our findings indicate that the accumulation and perpetuation of fortunes over many generations is an important feature of top wealth in Germany.
Topic:
Inequality, Family, Elites, Wealth, Inheritance, and Network Analysis
Political Geography:
Europe and Global Focus

26. Starr Forum: Power and Progress: Our Thousand-Year Struggle Over Technology and Prosperity

Author:
Daron Acemoglu and Fotini Christia
Publication Date:
10-2023
Content Type:
Video
Institution:
MIT Center for International Studies
Abstract:
A thousand years of history and contemporary evidence make one thing clear: progress depends on the choices we make about technology. New ways of organizing production and communication can either serve the narrow interests of an elite or become the foundation for widespread prosperity. Today, digital technologies and artificial intelligence threaten jobs and democracy through excessive automation, massive data collection, and intrusive surveillance. Will the next decades bring shared prosperity or a further move in the direction of two-tiered societies? Join us for this important discussion with Daron Acemoglu, the co-author of Power and Progress.
Topic:
Science and Technology, Communications, Inequality, Elites, Prosperity, and Production
Political Geography:
Global Focus

27. Construction productivity and global inequality

Author:
Saumik Paul and Kunal Sen
Publication Date:
11-2023
Content Type:
Working Paper
Institution:
United Nations University
Abstract:
Two well established stylized facts of economic development are a strong correlation between investment and income, and large differences in investment rates across countries. Construction is the largest component of investment. This paper examines the implications of heterogeneity in construction productivity on cross-country income disparity. We estimate the 10:1 spread in construction productivity among 145 countries in 2005 as a factor of 61.7-fold. Based on a general equilibrium model with input–output linkages, we find that the 10:1 spread in income per capita declines by 45 per cent when the construction productivity gap is eliminated. Sectoral characterization of the aggregate effect of a change in construction productivity shows heterogeneous sectoral contributions to income convergence. Electrical equipment, metals, and transport equipment play stronger roles in transforming the effect of a change in construction productivity to the aggregate level in China compared with other countries.
Topic:
Inequality, Investment, Productivity, Construction, and Income
Political Geography:
China and Global Focus

28. Towards caring and safeguarding research practices – A trauma-informed approach to violence-related qualitative research

Author:
Gugu Resha and Amina Mwaikambo
Publication Date:
10-2023
Content Type:
Policy Brief
Institution:
Centre for the Study of Violence and Reconciliation (CSVR)
Abstract:
IIn recent years, there has been a growing recognition of the importance of understanding vicarious trauma among practitioners and researchers of sexual and gender-based violence as well as other forms of violence. Mental health practitioners and organisations working with people affected by violence are framing the provision of resources and tools to prevent vicarious trauma as a crucial ethical and institutional obligation. This comes from the understanding that trauma exposure can affect both the research participants and the researcher and can have lingering effects well beyond the duration of the study in the form of re-experiencing thoughts, feelings and sensations that were experienced during a traumatic event or the re-telling of that event. Among these risks faced by researchers, scholars have included the challenge of blurred boundaries between interviews and therapy during qualitative research, the spillover effects of traumatic experiences and emotional collateral experienced by research staff, and countertransference of trauma which has mostly been described in the context of therapists and clients but also extends to researchers. Research has also shown that plans for researcher safety and well-being are a necessary strategy for building researcher resilience and preventing vicarious trauma. The growing literature on this topic reveals the centrality of this issue to the area on qualitative research, violence and trauma. The work that the Center for the Study of Violence and Reconciliation (CSVR) has done on violence and how it impacts communities over the past few decades has highlighted the importance of support mechanisms and systems to ensure the well-being of the staff who carry out research with participants who have witnessed or experienced violence. Our own reflections from CSVR researchers, fieldworkers, and mental health practitioners have shown the need to establish a rigorous and consistent framework to adequately capacitate staff to understand the risks that come with designing and carrying out research with participants on their experiences of violence. More specifically, these reflections have highlighted the reality of how trauma from these experiences affects research participants in their engagement with researchers, and how the repeated exposure to people recounting their traumatic experiences can inadvertently affect researchers too. These reflections indicate the need for research frameworks that take the effects of trauma into account, to guide researchers in their research design in order to safeguard their own well-being as well as that of their participants during the project. This practice brief consolidates the feedback of researchers, data collectors, and mental health practitioners about the challenges they face in the field and offers practical strategies on how to use a trauma-informed approach in research to provide adequate support, training, and measures to ensure that these adverse effects are limited with appropriate planning and implementation. The objective of this practice brief is to promote a trauma-informed research practice that ensures that research projects: Address research participants in a manner that is sensitive to traumatic experiences of violence and its effects; Avoid re-traumatising participants; Avoid second-hand traumatisation of researchers and data collectors; and, Contain any adverse effects on the researchers and data collectors that may emerge from the context and exposure to people who have witnessed and experienced violence. This brief seeks to improve and consolidate the existing tools within CSVR’s own research methods and operationalise trauma-informed approach into the research design process and distress protocol. Furthermore, this brief seeks to provide guidance for CSVR’s partners, as well as other research and nonprofit organisations, social intervention projects, and practitioners who conduct research in areas such as gender-based violence, conflict, and other forms of violence that may result in traumatic effects on individuals, families, and communities.
Topic:
Inequality, Trauma, Mental Health, Social Cohesion, Qualitative Research, and Safeguarding
Political Geography:
Global Focus

29. Inequality, Current Account Imbalances and Middle Incomes

Author:
Océane Blomme and Jérôme Héricourt
Publication Date:
04-2023
Content Type:
Working Paper
Institution:
Centre d'Etudes Prospectives et d'Informations Internationales (CEPII)
Abstract:
This paper investigates the complex relationship between current account balance and income inequality, putting specific emphasis on the potential sources of non-linearities in the latter. Based on a dataset for 52 developed and developing countries over the period 1990-2019, we first show a one-standard-deviation increase in various income inequality indicators generates a decrease in the ratio of current account over GDP by -0.5 to -0.9 percentage points in developed countries, but no significant impact when the sample is expanded to include emerging and developing countries. We then show those average impacts are distorted along the distribution of economic and financial development variables: for those countries displaying low GDP per capita, low levels of financial deregulation and of capital account openness, additional income inequality actually improves the current account balance. Conversely, the impact of income inequality on current account is all the more negative that financial markets are bigger, more deregulated and more open. In addition, the decrease in the current account balance is 1.2 to 1.4 times more important in countries with higher financial development or more open capital account when the increase in inequality is driven by the income of top earners relative to the middle class rather than by the increase in top earners' incomes at the expense of the lowest percentiles of the distribution. Those results are robust to various robustness checks for endogeneity concerns, possible impact of the Great Financial Crisis, and variable definitions.
Topic:
Inequality, Finance, Middle Class, and Income
Political Geography:
Global Focus

30. The Post-COVID Consensus

Author:
Shahid Yusuf
Publication Date:
10-2023
Content Type:
Policy Brief
Institution:
Center for Global Development (CGD)
Abstract:
Development economics is turning a full circle with a difference. This paper addresses the circling back to the policies in vogue during the 1980s and earlier, including industrial policies, coupled with protectionism; accounts for the regression to earlier certitudes after an extended spell of globalization underpinned by market fundamentalism; and indicates how a transforming global environment has enlarged the policy agenda. There is a new policy consensus in the making, which borrows some elements of the Washington Consensus but goes beyond to encompass a broader policy agenda.
Topic:
Development, Markets, Poverty, Inequality, Economic Development, and COVID-19
Political Geography:
Global Focus