theory of how they change. In this paper, we pursue answers to these questions through empirical analysis of the Life in Transition survey (LiTs), vignettes, and a focused synthesis of the literature.

We contend that paying attention to the processes that result in exclusion can lead to more effective inclusion than policies that merely address outcomes such as group differences in health, poverty, housing, education, or labor force participation. Narrowly addressing only outcome differentials ignores the broader underlying values that result in exclusion in the first place. For example, policies aiming for a leveling of the economic playing field and widening opportunities for minority groups can easily be undermined if they do not tackle the discriminatory beliefs and practices of the broader society and, especially, of the staff in agencies that are responsible for implementing the policies.

Maria’s story, told below, illustrates many of the points made in the remainder of the paper: exclusion is often the result of prejudiced attitudes and discriminatory behaviors between an individual from one social group, toward another from a different group. However, the values that underlie these attitudes and behaviors are not limited to direct interactions between individuals, but are also embedded within institutions. What might appear to be technical decisions about, for example, provision of health care is actually informed by value-driven notions of who is deserving of treatment, the relationships between indigenous and other people, and culture-specific ideas about what kind of health care is acceptable and desirable. Moreover, even where the formal values of institutions are inclusive, the actions by staff may still be discriminatory and result in exclusion.

Maria’s story illustrates the way in which multiple identities often intersect and amplify exclusion: As an indigenous women living in a remote and underdeveloped area, she is particularly vulnerable to exclusion. Furthermore, Maria’s story also illustrates how different exclusionary processes and outcomes reinforce each other. Maria is an illiterate woman who is unable to understand the Spanish language spoken by healthcare providers and who has a husband who precludes her from making her own decisions about family planning. These are all processes and outcomes of exclusion that ultimately contributed to Maria’s death and her family’s subsequent hardships. Poverty, as this story illustrates, is simply one among many other factors in a complex and mutually reinforcing web of social exclusion.

The remainder of this paper is structured as follows. Section 2 uses data from the LiTs and the World Value Survey (WVS) to illustrate the high prevalence of negative attitudes toward defined groups. Section 3 presents a statistical analysis of negative attitudes. Section 4 explores the origins of values, attitudes and behavior that we discuss in the statistical analysis and how they can underpin social exclusion. Section 5 explores interactions between norms and formal and informal institutions, while section 6 discusses opportunities for development approaches to tackle the norms and behaviors that underpin social exclusion. Section 7 summarizes and draws out conclusions.

# **_CASE: Maria’s Story_**<sup>**2**</sup>

> 2 Maria’s story is adapted and consolidated from Alicia Ely Yamin’s work on maternal mortality, detailing the stories of several indigenous women who died of child birth complications in the _Altiplano_ , Peru.

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