Questions about Social Determinants of Well-being/Health/Child-caring: Research on Capability and Equity
When one is likely to be spoiled as a result of her/his being least successful in life, it tends to be considered that her/his physical or mental disorder is its cause. Of course, this kind of medical/psychological factor is important. However, our daily life is also led with the influence of social aspects including social security, labor, tax, human relationship and child-raising. The concept of social determinants, which focuses on the background of the medical/psychological factors, becomes to have a significant role not only in academia but in actual efforts.
Referring to various discussions concerning social determinants, I seek the following two normative questions that correlate to each other. The first question is what kind of idea is preferable in order to understand social determinants of well-being/health/child-caring. The second question is what the ideals for designing institutions and making policies to assist people having a tough time should be.
Concerning the first question, I perform research based on capability proposed by Prof. Amartya Sen who is an economist. Capability is the concept that expresses the width of the way of living that people would like to realize. It is intended to create a better scale for assessing well-being by focusing on the substantive richness of people's lives, not on satisfaction and money. Capability consists of multiple scales. For example, human development index, which is created by the United Nations Development Programme, is just one capability approach which is calculated based on the basic elements of gross national income per-capita, enrollment ratio and average life expectancy. In 2014 Japan's human development index ranked twentieth among 188 countries/regions. Although its value is less than the average value of the highest group, it is more than the average value of the Organization for Economic Cooperation and Development members. However, the purpose of human development index is to make a comparison among countries/regions and it is just one way of measuring capability. It is necessary to take the condition of the society people live in and the purpose of capability into account in order to choose suitable items/indexes of capability. Now health issues and life difficulty of single parent households are reported in Japan. Based on such current condition, I investigate capability in specific areas of policies both to remedy health inequalities and to support child-caring among single-female-parent households in Japan.
The second question is studied in discussions over justice, equality, needs and rights. Referring to such research achievements concerning normative theories, I tackle the second question based on equity. Generally, equity means the nature regarding judgement that takes the balance of each individual's state, her/his shares, her/his burdens. I have examined equity which should be referred to in Japanese public assistance system. In addition, I scrutinize health equity which is discussed in the areas of public health/health economics and utilized in practices of such organizations as World Health Organization.
Since capability itself is just a measurement about well-being and health, it does not tell us what we should do as institutional design and policy making. On the other hand, unless we establish the ground which becomes basis for judgement concerning equity, it is difficult to realize the ideal of equity. Thus, my research discusses norms over social determinants of well-being/health/child-caring by pursuing the questions of capability and equity at the same time. By taking advantage of these research achievements, I aim for establishing the foundation of institutional design and policy making to realize decent living.