Search

Under neoliberal social provision, debt has become a primary tool for US households to pursue economic mobility and manage risk. Borrowing supports financial and non‐financial investments that, in theory, should lead to lifetime income and asset gains from which debt can be repaid. Many scholars argue, however, that reliance on credit as a welfare tool significantly increases inequality, particularly along racial lines. In this paper, I examine this process of debt‐financed asset accumulation by analyzing racial disparities in the relationship between household debt and assets. Using Survey of Consumer Finances data, I examine disparities in assets held at given debt levels across Black and White households. Results indicate that at equal debt levels, Black households' assets are between 30% and 80% lower than those of comparable White households. This suggests that White households benefit considerably more from social policies that center borrowing as a mechanism of social provision. This likely contributes to the persistence of the racial wealth gap. Racial disparities in access to credit, to homeownership, and to non‐market financial transfers like inheritances partly explain White households' higher returns, but racial gaps remain even when accounting for these factors. [ABSTRACT FROM AUTHOR]

In this paper, factors associated with poverty among refugees were explored using a nationally representative sample in the United States. Relying on the social exclusion theory,) a refugee integration framework was selected as a conceptual framework of the study. Poverty was calculated based on households' income (income poverty) and deprivation in three domains of education, health, and housing (multidimensional poverty). Multivariate models of the study identified limited English language proficiency as the strongest predictor of both income and multidimensional poverty among refugees. The findings call for more attention to English language training among refugees in the United States. [ABSTRACT FROM AUTHOR]

Purpose: Nonfamily farms are responsible for a disproportionate amount of US agriculture production. The importance of these operations to the volume of agriculture production in the United States has led researchers and policymakers to understand nonfamily farms as large commercial operations. This paper examines whether the distinction between family and nonfamily helps explain the financial outcomes of farm operations and households. Design/methodology/approach: We test for differences in financial outcomes of the household and operations of family and nonfamily farms using an Oaxaca-Blinder decomposition. We compare these results to a decomposition of other possible typologies. Findings: We present evidence that nonfamily farms are a heterogeneous group with a majority of small operations that are dominated by a small number of large operations. We discover that differences associated with the family-nonfamily distinction are largely explained by observable farm and operator characteristics that arise mechanically from the definition. However, we find suggestive evidence that family-nonfamily classification captures differences in economic behavior that lead to higher profitability measures to nonfamily farms. We find little evidence of any inherent structural differences between family and nonfamily farms that helps explain financial outcomes related to leverage or household finances. Practical implications: We conclude that including nonfamily farms in official statistics of farm households may provide a more comprehensive overview of the farm sector, as our results suggest that family and nonfamily farms do not have innate differences that help explain many of their financial outcomes. Originality/value: We incorporate previously unused data on nonfamily farm households and test the difference in mean financial outcomes between family and nonfamily farms. [ABSTRACT FROM AUTHOR]

During the early months of the COVID-19 pandemic, 12 states banned or restricted abortion access under elective-procedure restrictions. The rationale was preserving hospital capacity and personal protective equipment (PPE); however, abortions commonly take place in clinics and use less PPE than childbirth. This paper investigates the discursive construction of abortions, the people who get them, and the fetuses in this legislation. The authors analyzed 13 antiabortion documents using an iterative process of thematic coding and memo writing. Twenty-three percent of the legislation listed abortion as banned, whereas the remaining laws implied abortion within the terms "elective" or "nonessential." Legislation used common antiabortion tactics, such as the trivialization of abortion, risk discourses, and constructions of motherhood and fetal personhood. Discourses delegitimized abortion providers and used quasi-medical justifications for banning abortion. Finally, legislation constructed abortion clinics as sites of contagion and waste and consequently as risks to public health. The results highlight the vulnerability of abortion and the connection between abortion policy and other conservative policies, and they gesture toward a strategic attempt to ban abortion federally. These findings have several implications for a post-Roe United States and for stakeholders wishing to increase abortion access. [ABSTRACT FROM AUTHOR]

Self-rated health (SRH) is a salient outcome for cancer survivors. Although depression is a well-studied correlate with SRH, few studies have focused on the role of cancer survivors' age on the association between depression and SRH. This study evaluates demographic and psychosocial factors associated with cancer survivors' SRH. We also assess the moderating role of age to the association between depression and SRH. This paper analyzed 2,470 U.S. cancer survivors from the 2019 National Health Interview Survey. Two ordered logistic regression models with complex survey weights were used for analyses. Missing data was addressed using multiple imputations by chained equations. Being female, higher education and higher income were positively associated with better SRH. While the relationship between higher education and higher income was consistent with previous findings, the positive association between being female and SRH was different from previous studies. Age significantly moderated the association between depression and SRH, evidenced by results of the joint tests of all interaction term coefficients being statistically significant, F(2, 544.6) = 5.13, p < 0.01. The findings of the study highlighted the significance of screening for social determinants of health and health disparity when supporting cancer survivors. Additionally, findings of this study emphasized the significance of adopting an age-specific approach when evaluating and addressing depression across different age groups of cancer survivors. [ABSTRACT FROM AUTHOR]

The prolonged COVID-19 pandemic has tied up significant medical resources, and its management poses a challenge for the public health care decision making. Accurate predictions of the hospitalizations are crucial for the decision makers to make informed decision for the medical resource allocation. This paper proposes a method named County Augmented Transformer (CAT). To generate accurate predictions of four-week-ahead COVID-19 related hospitalizations for every states in the United States. Inspired by the modern deep learning techniques, our method is based on a self-attention model (known as the transformer model) that is actively used in Natural Language Processing. Our transformer based model can capture both short-term and long-term dependencies within the time series while enjoying computational efficiency. Our model is a data based approach that utilizes the publicly available information including the COVID-19 related number of confirmed cases, deaths, hospitalizations data, and the household median income data. Our numerical experiments demonstrate the strength and the usability of our model as a potential tool for assisting the medical resources allocation. [ABSTRACT FROM AUTHOR]

To describe the quality of food and physical activity (PA) environments by World Bank Income level in jurisdictions from the Children's Healthy Living Program. Baseline cross-sectional community data were analyzed from 11 jurisdictions categorized by World Bank Income levels to describe exposure to different food and PA outlets. The Children's Healthy Living Program was a multilevel, multijurisdictional prevalence study and community intervention trial that reduced child obesity in the US-Affiliated Pacific region. US-Affiliated Pacific region. Food (n = 426) and PA (n = 552) Outlets. Physical activity and food scores that reflect the quality of the outlets that support being physically active and healthy eating options, respectively. Descriptive statistics are presented as means ± SD or percentages. High-income-income level jurisdictions had higher food and PA scores than middle-income level jurisdictions. The US-Affiliated Pacific region has limited quality food and PA outlets in underserved communities at risk for obesity. The findings in this paper can be used to develop tools and design interventions to improve the food and PA environment to increase a healthier, active lifestyle. [ABSTRACT FROM AUTHOR]

This paper first explores spatial distributions and patterns of COVID-19 case rates (cases/100,000 people) and mortality rates (deaths/100,000 people) and their disparities between urban and rural counties in the contiguous US. A county-level social vulnerability index was created using principal component analysis. Social vulnerability components were regressed against both county case and mortality rates. Results suggest that hotspots of case and mortality rates are clustered in Midwest and Upper-Midwest US. We found substantial disparities in case and mortality rates between urban and rural counties. County social vulnerability was positively correlated with both case and mortality rates suggesting counties with higher social vulnerability had higher case and mortality rates. Relationships between social vulnerability components and case and mortality rates vary across the conterminous US. Additionally, counties with increased racial and ethnic minorities, higher percentages of minors, and lower median household income are associated with higher COVID-19 case and mortality rates. [ABSTRACT FROM AUTHOR]

In recent decades, data-driven approaches have been developed to analyze demographic and economic surveys on a large scale. Despite advances in multivariate techniques and learning methods, in practice the analysis and interpretations are often focused on a small portion of available data and limited to a single perspective. This paper aims to utilize a selected array of multivariate statistical learning methods in the analysis of income and expenditure patterns of households in the United States using the Public-Use Microdata from the Bureau of Labor Statistics Consumer Expenditure Survey (CE). The objective is to propose an effective data pipeline that provides visualizations and comprehensive interpretations for applications in governmental regulations and economic research, using thirty-five original survey variables covering the categories of demographics, income and expenditure. Details on feature extraction not only showcase CE as a unique publicly-shared big data resource with high potential for in-depth analysis, but also assist interested researchers with pre-processing. Challenges from missing values and categorical variables are treated in the exploratory analysis, while statistical learning methods are comprehensively employed to address multiple economic perspectives. Principal component analysis suggests that after-tax income, wage/salary income, and the quarterly expenditure in food, housing and overall as the five most important of the selected variables, while cluster analysis identifies and visualizes the implicit structure between variables. Based on this, canonical correlation analysis reveals high correlation between two selected groups of variables, one of income and the other of expenditure. [ABSTRACT FROM AUTHOR]

Accelerated resolution therapy (ART) is a psychotherapy for the treatment of prolonged grief disorder (PGD) defined as severe, enduring longing for the lost person. Currently, ART lacks examination of intrapersonal processes, like expectancy, as behavioural mechanisms for action. Therefore, the purpose of this paper was to present the findings on participants' treatment expectations of ART for PGD and then discuss potential hypotheses for future testing. This study was a primary qualitative descriptive analysis of prospectively collected interview data (collected 2017–2019) accrued as part of a randomised, wait‐list controlled clinical trial in bereaved hospice family caregivers in the United States. The sample included 29 former informal caregivers who were at least 1‐year post death of their care recipient. They were primarily female, older (67.4 ± 7.1 years), and a little over half (n = 18) had been married to their care recipient. Thematic analysis resulted in three distinct themes with six sub‐themes: The role of knowledge in expectations (sub‐themes uncertainty, prior knowledge); The role of personality in expectations (sub‐themes openness, positive affect); and Expecting a process (sub‐themes cognitive processes, affective processes) which described the interaction of person and process in shaping expectations of our intervention. An across theme analysis of the specificity of the participants' expectations uncovered that knowledge and personality inform expectations of ART and that individuals who verbalise a process for recovery tend to be very specific in their expectations. Three hypotheses for testing are put forward and implications for practice, research and policy discussed. [ABSTRACT FROM AUTHOR]

The article presents abstracts on the U.S. economic research which includes the implications of countervailing effects of market power and relationships in small business lending, examination on the welfare-maximizing monetary policy in micro-founded general equilibrium model of the economy and the theory of interpersonal income comparison using individual-level data on suicide deaths.

'Medical iatrogenesis' was first defined by Illich as injuries 'done to patients by ineffective, unsafe, and erroneous treatments'. Following Lokumage's original usage of the term, this paper explores 'obstetric iatrogenesis' along a spectrum ranging from unintentional harm (UH) to overt disrespect, violence, and abuse (DVA), employing the acronym 'UHDVA' for this spectrum. This paper draws attention to the systemic maltreatment rooted in the technocratic model of birth, which includes UH normalized forms of mistreatment that childbearers and providers may not recognize as abusive. Equally, this paper assesses how obstetric iatrogenesis disproportionately impacts Black, Indigenous, and People of Color (BIPOC), contributing to worse perinatal outcomes for BIPOC childbearers. Much of the work on 'obstetric violence' that documents the most detrimental end of the UHDVA spectrum has focused on low-to-middle income countries in Latin America and the Caribbean. Based on a dataset of 62 interviews and on our personal observations, this paper shows that significant UHDVA also occurs in the high-income U.S., provide concrete examples, and suggest humanistic solutions. [ABSTRACT FROM AUTHOR]

Objectives Previous research in the United States suggests contextual income mobility may play a role in explaining the disparities between life expectancy in the United States and peer countries. This article aims to extend previous research by estimating the consequences of average individual exposure to mobility regimes during childhood and adolescence on adult health. Methods This study draws its data from two longitudinal datasets that track the county of residence of respondents during childhood and adolescence, the Panel Study of Income Dynamics and the National Longitudinal Survey of Youth 1997. We implement marginal structural models to assess the association of the average exposure to county income mobility on five health outcomes and behaviors. Results The results are only partially consistent with a systematic association between exposure to income mobility and health outcomes. Evidence obtained from the National Longitudinal Survey of Youth suggests less income mobility might increase the probability of smoking by age 30. Discussion The paper provides a precise assessment of the hypothesis that childhood exposure to income mobility regimes may influence health status through behavior later in life and contribute to longevity gaps. Only partial evidence on smoking suggests an association between income mobility and health, so we discuss potential reasons for the disparities in results with previous research. [ABSTRACT FROM AUTHOR]

The integration of medical schools and clinical partners is effectively established through the formation of academic medical centers (AMCs). The tripartite mission of AMCs emphasizes the importance of providing critical clinical services, medical innovation through research, and the education of future health care leaders. Although AMCs represent only 5% of all hospitals, they contribute substantially to serving disadvantaged populations of patients, including an estimated 37% of all charity care and 26% of all Medicaid hospitalizations. Currently, most AMCs use a business model centered upon revenue generated from hospital services and/or practice plans. In the last decade, mounting financial demands have placed significant pressure on AMC finances because of the rising costs associated with complex clinical care and operating diverse graduate medical education programs. A shift toward population health-centric health care management strategies will profoundly influence the predominant forms of health care delivery in the United States in the foreseeable future. Health systems are increasingly pursuing new strategies to manage financial risk, such as forming Accountable Care Organizations and provider-sponsored plans to provide value-based care. Refocusing research and operational capacity toward population health management fosters collaboration and enables reintegration with hospital and clinical partners across care networks, and can potentially create new revenue streams for AMCs. Despite the benefits of population health integration, current literature lacks a blueprint to guide AMCs in the transformation toward sustainable population health management models. The purpose of this paper is to propose a modern conceptual framework that can be operationalized by AMCs in order to achieve a sustainable future. [ABSTRACT FROM AUTHOR]

Easterlin's relative income hypothesis refers to the current income of young adults compared to the level of material aspirations acquired during childhood. The hypothesis implies that young individuals are expected to reduce fertility if their material aspirations grow at a higher rate than their incomes. This paper examines whether the same hypothesis holds true for marriage. A higher (lower) level of income combined with a lower (higher) level of material aspirations would increase (decrease) relative income and consequently could affect marriage rates. Thus, relative income might be one explanation for the "marriage paradox" which indicates that young adults in the United States retreat from marriage despite perceiving it as a milestone of their lives. One might also expect relative income to be a better predictor of marriage than absolute income. This is because, according to the Easterlin hypothesis, the behaviour of young adults reflects not only their response to changes in external conditions (e.g. absolute income), but also to past events they have experienced. We employ panel dynamic methods and causality tests for the United States that span the period from 1981 to 2016. Empirical analysis supports the relative income hypothesis. Causality tests indicate that the relationship runs mostly from relative income to marriage rather than the other way round. Relative income emerges as a stronger predictor than absolute income in all of the methods employed. [ABSTRACT FROM AUTHOR]

Objectives: Community health worker (CHW) programs are a promising strategy to improve maternal and child health outcomes, particularly among low-resource women. Yet, little is known about which aspects of CHW-client relationships are most salient for promoting positive change. This paper examines features of the CHW-client relationship that perinatal women with chronic conditions reported as being beneficial for their experience of prenatal care and pregnancy. Methods: Focus groups and interviews were conducted with 18 CHWs and 39 clients from three Merck for Mothers-funded programs in the Eastern United States. Data were analyzed using a grounded theory-informed thematic approach. Results: CHWs built trust-based relationships through emotional attendance, authenticity, and prioritization of clients' needs. They provided instrumental, informational, and emotional support that clients reported facilitated greater engagement with the healthcare system, improved health behaviors, and reduced stress. CHWs and clients alike viewed their relationships as having long-lasting impacts, made possible by the trust-based bond between them. Discussion: Strong, trusting relationships with CHWs may be one avenue through which to improve maternal and infant health for vulnerable perinatal women. Community health care programs should promote trust-building as an explicit program goal. Trust-based CHW-client relationships may serve as an exemplar for transforming traditional care relationships between providers and clients, leading to greater client engagement in care and improved health. [ABSTRACT FROM AUTHOR]

Black/African Americans have the most severe and disproportionate burden of HIV of all racial/ethnic groups in the United States. Oppression operates at four interrelated levels (i.e., socio-structural (macro), institutional (exo), community/family (meso), and inter- and intrapersonal (micro)) that perpetuate the HIV epidemic in Black/African American communities. Oppressive (e.g., racist and sexist) cultural scripts transferred to individuals through community, family and interpersonal relationships may play a role in HIV/STI risk. However, socio-behavioral health interventions or behavioral risk reduction interventions have traditionally focused solely on individual-level health risk behaviors allowing invisible, inequitable socio-structural factors to continue unchallenged. A new intervention, Black Men and Women: Empowering Self, Relationships and Community, was sculpted from two existing interventions Community Wise and Men of African American Legacy Empowering Self (MAALES) to develop awareness of oppressive cultural scripts operating on interpersonal and intrapersonal levels and to take action against these oppressive messages to reclaim identity, restore relationships, and build community. This paper summarizes the theory and selected sociodramatic components of the intervention that promote healing in action to reduce HIV/STI risk among heterosexually identified, low-income African American men and women with multiple sex partners. Lessons learned in theory, research and practice are also discussed. [ABSTRACT FROM AUTHOR]

Homeschooling has witnessed an upsurge in the United States since the movement for school choice gained momentum in the 1990s. Most research on homeschooling has been on non-representative samples of median-income white Americans, making it difficult for policymakers to accept its reliability. In addition, homeschoolers now include other ethnic groups and families with low socio-economic status, who existing research has largely ignored. We also know little about the families' perceptions of barriers to homeschooling. In this paper, we address these gaps in homeschooling research by analyzing a state-representative sample of homeschooling families in Georgia belonging to a fragile community (e.g., household income $40,000 or less, disproportionately African American, children ages 2–18) recruited to the panel through randomized double-blind methods. Cross-sectional findings suggest that demographic variables do not explain much of the variation in homeschooling. Four perceived barriers stand out as significant negative predictors of both outcomes (i.e., now homeschooling and desire to homeschool). These barriers are parents not understanding homeschool laws, having various concerns about their children (e.g., concern social services agency may bother them if they homeschool), apprehensions about the socialization of their children, and unease about their own knowledge to homeschool. Findings suggest that policymakers should differentiate between the barriers to homeschooling faced by fragile families that do not already homeschool their children versus those that currently homeschool. [ABSTRACT FROM AUTHOR]

New research reveals spatial variation in a number of subjective measures like happiness and well-being. Yet, scholars remain divided over the geographic scale and attributes that matter. This paper examines how "geographic context"—one's relative income position and the level of income inequality—is associated with individual financial well-being (FWB) at various geographic scales in the U.S. Drawing on data from the 1995 Midlife in the United States survey and the 1990 Census, I identify four major findings: (1) the geographic context is more likely to influence FWB as household income increases, as low-income individuals tend to report poorer FWB regardless of where they live; (2) high-income individuals tend to report greater FWB as their relative income position rises; (3) differences in FWB across income rankings are more pronounced as income inequality increases; and (4) geographic context has the greatest effect on FWB when measured at the extralocal level (labor market area), followed by the context at the local level (Census tract). These findings provide new insight into the salient attributes, as well as scale, of the geographic context that may help shape individual financial well-being. [ABSTRACT FROM AUTHOR]

Relying on two unique data-sets on Chinese older immigrants (N = 3,157) and younger immigrants with ageing parents (N = 469) in Chicago, this study compared the level of filial expectation among the two groups and examined the predictors and mental health implications of having high filial expectation among each group. Results of t-tests, logistic regression and negative binominal analyses showed that, regardless of socio-demographic variables, acculturation, physical health and family relations, Chinese adult children had higher filial expectations on themselves than older immigrants' filial expectation on the younger generation. Chinese older immigrants who had less education, lower levels of acculturation, poorer health and closer relationships with children reported higher filial expectation. In the cohort of younger immigrants, high filial expectation was associated with lower income, better health and closer relations with their parents. In addition, having high filial expectation was associated with lower levels of depression and anxiety among the older immigrants, but not among the younger cohort. The results indicated that, whereas Chinese older immigrants seemed to adapt their filial expectation in the new society, the younger cohort still strongly adhere to this traditional family norm. Maintaining strong filial expectation might be a protective factor for older immigrants' mental health. Practice and policy implications of these findings are discussed in the paper. [ABSTRACT FROM AUTHOR]

How do economic conditions – income and the generosity of social insurance–affect religious behavior? This paper provides novel evidence for the United States using variation in Earned Income Tax Credit benefits across states, over time, and by number of children. In the raw data, income and religiosity have a trivial relationship. In contrast, the instrumental variables strategy shows that increases in income from the EITC are found to sizably reduce religious attendance among low-income individuals. Among individuals who attend, the results indicate that an additional $1000 in annual income is associated with a decrease of roughly 1 service per year (as compared to an average of 16 services per year). The effect arises mainly along the intensive margin, decreasing devout behavior and increasing more marginal attendance, but having little impact on whether an individual participates at all or on beliefs. There are also minimal effects on the occurrence and amount of contributions to religious organizations. The results extend our understanding of the determinants of religiosity, the relationship between governmental income support and religious behavior, and the social effects of the Earned Income Tax Credit. [ABSTRACT FROM AUTHOR]

The “income inequality hypothesis” holds that rising income inequality affects the distribution of a wide range of social and economic outcomes. Although it is often alleged that rising income inequality will increase the advantages of the well-off in the competition for college, some researchers have provided descriptive evidence at odds with the income inequality hypothesis. In this paper, we track long-term trends in family income inequalities in college enrollment and completion (“collegiate inequalities”) using all available nationally representative datasets for cohorts born between 1908 and 1995. We show that the trends in collegiate inequalities moved in lockstep with the trend in income inequality over the past century. There is one exception to this general finding: For cohorts at risk for serving in the Vietnam War, collegiate inequalities were high, while income inequality was low. During this period, inequality in college enrollment and completion was significantly higher for men than for women, suggesting a bona fide “Vietnam War” effect. Aside from this singular confounding event, a century of evidence establishes a strong association between income and collegiate inequality, providing support for the view that rising income inequality is fundamentally changing the distribution of life chances. [ABSTRACT FROM AUTHOR]

Immediately following the attacks of 9/11 in New York, mainstream media outlets echoed the notion of Muslims as strangers who are unable to assimilate into American culture. The purported difficulty in the assimilation of Muslims in America was linked with their religious affiliation, an indelible marker of their ideology, and one that supersedes any national identity. Given the paucity of research on the assimilation of Muslims in America, this paper sought to explore if-and-how this group is assimilating into American culture. Utilizing a mixed-method design, we conducted focus groups, followed by a multi-state survey. Using segmented assimilation theory, we found evidence that Muslims with higher educational attainment and household incomes are well-assimilated. We also found that respondents who identify themselves strongly as Muslim are less likely to assimilate, preferring instead to maintain close in-group ties. We discuss the implications of these findings in greater detail. [ABSTRACT FROM AUTHOR]

Foreign-trade zones (FTZs) are restricted-access sites where domestic and foreign goods are stored, manufactured, or assembled. Products foreign bound from an FTZ do not pay duties, tariffs, or ad valorem state taxes, yet are considered domestic goods. These zones are outside of US Customs and Borders Protection (CBP) jurisdiction and are considered foreign territory. FTZs are intended to promote economic development, provide a competitive advantage to US firms, and improve access to foreign markets for US manufacturing firms. However, while these zones can positively impact local economies, they may attract investment away from underserved regions, thereby exacerbating spatial inequality. This paper analyzes the spatial relationship between the number of FTZs, median household income, unemployment rates, income growth rates, and the number of manufacturing firms by county in the Southeastern United States. Results from this study find that counties with FTZs in the Southeast have significantly higher economic output than counties without access to FTZs. [ABSTRACT FROM AUTHOR]

The peculiar operation of the 1798 federal direct tax has led scholars to question whether tax officials reported the land valuations from their districts faithfully. Peter Lindert and Jeffrey Williamson argue that southern tax assessors systemically under reported the value of southern real estate, and they adjust their income estimates to account for the likelihood of corruption. This paper affirms the reliability of the tax returns by demonstrating that population density, rather than corruption or lax enforcement, can explain nearly all of the variation between the assessment districts. Accepting the tax valuations as accurate would lower Lindert and Williamson's income estimates, imply slower growth rate between 1774 and 1800, and suggest a higher growth rate between 1800 and 1850. [ABSTRACT FROM AUTHOR]

Evolutionary theory predicts that social status and fertility will be positively related. It also predicts that the relationship between status and fertility will differ for men and women. This is particularly likely in modern societies given evidence that females face greater trade-offs between status and resource acquisition and fertility than males. This paper tests these hypotheses using newly released data from the 2014 wave of the Survey of Income and Program Participation by the US Census, which has the first complete measures of fertility and number of childbearing partners for a large, representative, national probability sample of men and women and also contains comprehensive measures of economic status as measured by personal and family resources, including income from all sources and all assets. Multivariate analyses show that personal income is positively associated with total fertility and number of childbearing unions for men only. For men, personal net worth is positively associated with number of childbearing unions; it is also positively associated with fertility for married men with a spouse present. These findings support evolutionary predictions of a positive relationship between status, access to mates, and reproductive success for males. Whereas personal income and personal net worth are negatively associated with total fertility and number of childbearing unions for women, family income (net of personal income) is positively associated with total fertility for women. For married men living with a spouse, family income (net of personal income) is negatively associated with total fertility. These findings are consistent with evolutionary theory given the existence of greater trade-offs between production and reproduction for women in an advanced industrial society. For women and men, family net worth (net of personal net worth) is negatively associated with number of childbearing unions and fertility. Implications are discussed. [ABSTRACT FROM AUTHOR]

Graduation model is an approach to social development that focuses on asset creation and sustained development. This model has widely accepted as an innovative strategy to address the issues of extreme poverty and deprivation. The present paper is the manifestation of a major intervention program implemented in the three States of India namely Assam, Bihar and West Bengal. The intervention package aimed to alleviate the extreme poverty, creation of assets and enhancement of other social development indicators. The participating households were chosen from the identified backward localities of the above mentioned States. The total number of households participated in the study were 750. The structured intervention program was delivered for 2 years. The various dimensions of poverty alleviation, self-sufficiency, asset creation and social development were addressed in the intervention program. Both quantitative and qualitative techniques were adopted for analyzing the pre and post-intervention phases. The result of the study indicates positive signs of graduation from poverty and deprivation. Significant improvements were evident in the household and income generating assets. The intervention yielded positive results in bringing changes in the habits of saving and attitudes towards the access to public facilities. [ABSTRACT FROM AUTHOR]

Abstract Smoking in the United States follows a clear socioeconomic gradient: low-income Americans smoke more and quit less than those with more education and income. Evidence-based interventions like tobacco quitlines are designed to make effective cessation services available on a population basis to all smokers. However, these interventions do not address many of the unique challenges faced by low-income smokers, including unmet basic needs like food, housing, personal safety and money for necessities that often supersede health needs. Research is needed to maximize the use and effectiveness of tobacco quitlines in low-income populations. This paper details the rationale, design and methods for a 2 × 2 randomized controlled trial currently underway comparing the effects of Standard and Specialized Tobacco Quitlines with and without Basic Needs Navigation on intervention engagement and smoking cessation among low-income smokers. Smokers are recruited from United Way 2-1-1 in Missouri and all participants receive tobacco quitline services from Optum. Quitline and navigation services are provided for 3 months. Participants complete telephone surveys at baseline, 3- and 6-month follow up. The primary study outcome is self-reported 7-day point prevalence abstinence at 6-month follow up. Embedding the study in practice agencies will accelerate dissemination and scalability should our findings demonstrate intervention effectiveness. [ABSTRACT FROM AUTHOR]

Purpose: Motivated by the news media and a lack of comprehensive research on the USA, the purpose of this paper is to examine the relationship between changes in road fatalities and gasoline prices, per capita disposable personal income, alcohol consumption per adult, blood alcohol concentration (BAC) limits and gender. Design/methodology/approach: This study employs both static and dynamic panel data models, making use of annual data over the 2000–2013 period collected from the 50 states of the USA and the consistent system GMM estimators of the parameters, to estimate the impact of these variables on fatalities per 100,000 persons and per 100,000 vehicles. Findings: The results highlight the importance of gasoline prices in determining the level of road fatalities, underscoring that a 10 percent decrease in gasoline prices leads to a 248 increase in the total number of road fatalities, but with many more injuries. Increases in the female-to-total driver ratio have a greater significant positive impact on road fatalities where a 10 percent increase in this ratio increases road fatalities by 1,008 deaths. Increases in registered vehicles per capita also increase the number of fatalities. Other variables such as alcohol consumption per adult and BAC limits are not as important. Policy implications are also provided. Research limitations/implications: The results of this study highlight the importance of gasoline prices in determining the number of road fatalities. This factor can be an effective policy measure by which policymakers can offset increases in fatalities due to further drastic declines in future gasoline prices. But the effects of the gasoline prices in determining the number of road fatalities are not as strong as the media would lead us to believe. The media ignores the impact of other factors on fatalities, which results in an overestimation of the impact of gasoline prices. Originality/value: This study uses the panel data of 50 US states and the dynamic panel data model. In addition to gasoline price effects on the road fatalities, this study also considers other factors such as gender, gasoline taxes, per capita disposable personal income, per capita alcohol consumption, BAC limits and number of registered vehicles. [ABSTRACT FROM AUTHOR]

Background and Objectives Reverse mortgages are loans that allow older homeowners to borrow from their home equity with no repayment due until the borrower dies or moves out of the home. We currently know very little about how homeowners evaluate and experience reverse mortgages as solutions to their financial and housing needs in later life. Furthermore, despite an increasingly diverse population of reverse mortgage borrowers, we know little about how social inequalities may contribute to reverse mortgage decisions and their outcomes. In this paper, we examine reverse mortgage decision-making and experiences in a racially and economically diverse sample of older US homeowners. Research Design and Methods We conducted 44 in-depth interviews with older homeowners who were considering or who had obtained a reverse mortgage loan. We inductively and iteratively developed a thematic coding scheme that was applied to all interview transcripts. Results Our analysis produced a dichotomous schema of reverse mortgage decision making that was shaped by social and economic opportunities and constraints. For some participants, reverse mortgages represented strategic tools used to maximize home equity and its benefits. For others, it was an option of last resort to which participants turned when faced with the imminent loss of their home. Discussion and Implications Focusing on reverse mortgages, our analysis suggests way that social inequalities may be reproduced through financial decisions and the unequal landscapes of opportunity in which they are made. [ABSTRACT FROM AUTHOR]

Stratification and inequality are among the most central concepts in sociology, and although related, they are fundamentally distinct: inequality refers to the extent to which resources are distributed unevenly across individuals or between population subgroups, whereas stratification refers to the extent to which population subgroups occupy distinct hierarchical layers within an overall resource distribution. Despite the centrality of stratification in theories of class structure, prior empirical studies have focused exclusively on measures of inequality, which do not accurately capture the degree of class stratification and suffer from a variety of methodological limitations. In this paper, we employ a novel rank-based index of stratification to measure the degree to which occupational classes inhabit distinct, non-overlapping, and hierarchically arranged layers in the distribution of personal market income. The stratification index is nonparametric, both scale and translation invariant, and independent of the level of inequality. Based on this index, our results show that the US income distribution is highly stratified by occupational class and that the degree of class stratification increased substantially from 1980 to 2016. Moreover, we find that this trend is almost entirely due to growing stratification among aggregate occupational classes rather than among the disaggregate occupations nested within them. Finally, a set of counterfactual analyses indicate that the rise of occupational class stratification is driven by increases in the income returns to education, deunionization, and deindustrialization, although the relative importance of these factors varies by gender. [ABSTRACT FROM AUTHOR]

Racial stratification in immigrant earnings has been widely influential in theories of immigrant socioeconomic assimilation, but discussions of how racial stratification might differ by gender are underdeveloped. Segmented assimilation theory attempts to explain the underlying mechanisms that cause racial disparities, but it fails to incorporate gendered dynamics like occupational sex segregation and the feminization of particular labour flows. In this paper, we address that gap. Using data from the 1990 decennial census and the American Community Survey in 2009-11, we compare the earnings of black and white African migrants to US-born blacks and whites separately by gender. Our findings indicate that black African migrant women experience no racial disadvantage in their earnings, but black African migrant men do. Our results highlight the importance of examining racial differences in immigrant earnings interacting with gender. [ABSTRACT FROM AUTHOR]

Objectives The Advisory Committee on Immunization Practices (ACIP) and the American College of Obstetricians and Gynecologists (ACOG) recommend that pregnant women receive the Tdap vaccine during every pregnancy. The objectives of this paper are to evaluate disparities in Tdap vaccination among pregnant women in the U.S., and to assess whether race/ethnicity and other characteristics are associated with factors that inform pregnant women's decisions about Tdap vaccination. Methods We conducted a nationwide cross-sectional web-based survey of pregnant women in the U.S. during June-July 2014. The primary outcome was self-reported vaccination status with Tdap during pregnancy, categorized as vaccinated, unvaccinated with intent to be vaccinated during the current pregnancy, and unvaccinated with no intent to be vaccinated during the current pregnancy. Secondary outcomes included factors that influenced women's decisions about vaccination and information needs. We used multivariable logistic regression models to estimate odds ratios for associations between race/ethnicity and the outcomes. Results Among pregnant women who completed the survey, 41% (95% CI 36-45%) reported that they had received Tdap during the current pregnancy. Among those women in the third trimester at the time of survey, 52% (95% CI 43-60%) had received Tdap during the current pregnancy. Hispanic women had higher Tdap vaccination than white women and black women (53%, p < 0.05, compared with 38 and 36%, respectively). In logistic regression models adjusting for maternal age, geographic region, education, and income, Hispanic women were more likely to have been vaccinated with Tdap compared with white women (aOR 2.29, 95% CI 1.20-4.37). Higher income and residing in the western U.S. were also independently associated with Tdap vaccination during pregnancy. Twenty-six percent of surveyed women had not been vaccinated with Tdap yet but intended to receive the vaccine during the current pregnancy; this proportion did not differ significantly by race/ethnicity. The most common factor that influenced women to get vaccinated was a health care provider (HCP) recommendation. The most common reason for not getting vaccinated was a concern about safety of the vaccine. Conclusions This study found that some disparities exist in Tdap vaccination among pregnant women in the U.S., and HCPs have an important role in providing information and recommendations about the maternal Tdap recommendation to pregnant women so they can make informed vaccination decisions. [ABSTRACT FROM AUTHOR]

Abstract Our paper explores how legal status stratification shapes the health and health care of low-income patients with chronic illnesses in the U.S. healthcare safety net. Drawing on data from over two years of ethnographic fieldwork at urban safety-net clinics, we examine efforts by Complex Care Management (CCM) teams to stabilize patients with uncontrolled chronic illnesses through primary care-integrated support. We show that stratified citizenship and geographic variability correspond to different possibilities for health care. We suggest an approach to immigration as a structural determinant of health that accounts for the complex, stratified, and changing nature of citizenship status. We also highlight how geographical differences and interactions among local, state, and federal policies support the notion that citizenship is stratified across multiple tiers with distinctive possibilities and constraints for health. While county-based health plans at each of the study sites include residents with varying legal status, lack of formal legal status remains a substantial obstacle to care. Many immigrants are unable to take full advantage of primary and specialty care, resulting in unnecessary morbidity and mortality. In some cases, patients have returned to their country of origin to die. While CCM teams provide an impressive level of support to assist immigrant patients in navigating healthcare and immigration bureaucracies, legal and geographic stratification limit their ability to address broader aspects of these patients' social context. Highlights • Immigration status shapes the health of chronically ill U.S. safety net patients. • Local, state, and federal policies differentially stratify legal status and health. • Ethnography illustrates health impacts of stratified legal status. • Complex care management patients lacking legal status face obstacles to care. • Legal and geographic stratification impede immigrant CCM patients' health. [ABSTRACT FROM AUTHOR]

Purpose: Cancer survivors undergo lifelong surveillance regimens that involve repeated diagnostic medical imaging. As many of these diagnostic tests use ionizing radiation, which may modestly increase cancer risks, they may present a source of worry for survivors. The aims of this paper are to describe cancer survivors’ level of worry about medical imaging radiation (MIR) and to identify patterns of MIR worry across subgroups defined by cancer type, other medical and demographic factors, and physician trust.Method: This cross-sectional study used the 2012-2013 Health Information National Trends Survey of US adults conducted by the National Cancer Institute. The analysis focused on the 452 respondents identifying as cancer survivors. Weighted logistic regression analysis was used to evaluate factors associated with higher MIR worry (reporting “some” or “a lot” of MIR worry).Results: Nearly half (42%) of the sample reported higher worry about MIR. Unadjusted and adjusted logistic regressions indicated higher rates of MIR worry among those with lower incomes, those who self-reported poorer health, and those who completed cancer treatment within the past 10 years. Receipt of radiation treatment was associated with higher MIR worry in unadjusted analysis.Conclusion: Worries about MIR are relatively common among cancer survivors. An accurate assessment of the rates and patterns of worry could aid efforts to improve these individuals’ survivorship care and education. [ABSTRACT FROM AUTHOR]

Business geographers devote considerable effort to develop models of space to answer complex spatial questions. Unfortunately, little thought is given to the accuracy of the input data in these models. This paper examines the accuracy of tract-level population and income data reported for the second quarter of 2015 from five spatial-demographic data vendors commonly used in the corporate location-decision process (Experian, Synergos/PopStats, ScanUS, ESRI and EASI). Data are compiled for 80 Census tracts in the 40 fastest growing US metropolitan areas. Little agreement between data vendors was found – mean absolute percent errors (MAPE) for 2015 population and income estimates were 8.97% and 11.98% respectively. Error rates increase substantially in urban tracts, low income tracts, and high-density tracts. These accuracy biases are likely to contribute to the under provision of retail in urban settings. Strategies for minimizing the impact of this error and for improving commercial demographic data quality are also discussed. [ABSTRACT FROM AUTHOR]

In this paper we examine how internal migration redistributes earned income across U. S. states between 1995 and 2010. We examine interregional income flows by first describing the movement of earned income between U. S. states. Second, we examine the effect of income migration on spatial patterns of income inequality. The question we ask is, 'does migration increase or decrease convergence income across U. S. States?' A primary contribution of this paper is that instead of using only 1 year of income migration data to explore these issues, we use yearly data from the first year the Internal Revenue Service (IRS) data started including income (1995/1996) up to the most current data available (2009/2010). Results indicate that income convergence/divergence across states varies by whether or not there is general economic expansion or contraction. Nevertheless, some high-amenity states continually attract high-income households. [ABSTRACT FROM AUTHOR]

In this paper, we present novel evidence of the extent to which intergenerational mobility is generalized or specific across domains of human and health capital. That is, do children who experience greater mobility in one domain (e.g., income) also experience mobility in other domains (education, health status, health behaviors, crime). Using rich data in Add Health, we find evidence against generalized mobility—families that are more mobile in one domain are not more mobile in others. We then ask a place-based version of this question, motivated by Chetty et al. (2014)'s work showing high levels of geographically-based income mobility in the US. The school-based sampling combined with parent-child links across many outcome domains of the Add Health allows us to use a common dataset between the two analyses. Like our individual-based results, we find limited evidence of generalized mobility by place—indeed, most estimates suggest close-to-zero correlations between many of the ten domains we explore. • Theoretically, intergenerational mobility could be generalized or specific. • Empirically, we find more evidence of specific mobility. • People and places with high income mobility may not have high health mobility. [ABSTRACT FROM AUTHOR]

• Stably nonemployment is most strongly associated with low income and poverty but not material hardship. • Unstably employed households, particularly those that experience only job losses are more likely to have material hardship than consistently employed households. • The safety net as a whole appears to be more effective for nonworking households than for unstably working households. • In-kind transfers appear more important for unstably employed households, particularly those that are single-adult headed households facing job losses. • Cash transfers effectively buffer against the negative impact of stably nonemployment. Labor market structures and job characteristics have changed in the United States over the last few decades – often making work more unpredictable. Employment instability, or job churning, may have distinct consequences for households' economic well-being. Meanwhile, American social policies have shifted from cash-based benefits toward in-kind and work-conditioned programs. Yet, we know little about how social programs buffer the financial hardships imposed by economic shocks due to job churning. This paper harnesses novel data collected at 3-month intervals to study the associations between household members' employment trajectories and (1) household income packages, (2) poverty status, and (3) material hardships, paying particular attention to whether government benefit receipt buffers against the adverse financial consequences of unstable employment. We find that consistent unemployment is most strongly associated with low income and poverty but not material hardship. Unstably employed households, particularly those that are single-adult headed households and experienced only job losses are significantly more likely to experience material hardship than consistently employed households. Our results also suggest that cash transfers effectively buffer against the negative impact of persistent unemployment, while in-kind transfers appear more important for unstably employed households, particularly those that are single-adult headed households. Together, these results highlight the roles and extent of impacts of cash, in-kind benefits, and the tax system, which can inform future policy recommendations in an age of high levels of economic insecurity. [ABSTRACT FROM AUTHOR]

The Great Recession forced many people around to cut back on consumption and is one reason that drives the rise of right-wing forces. One response to the downturn has been a call for a return to high-level growth and consumption of goods. By contrast, this paper argues in favor of an alternative conception of the good life. To defend this thesis, it first surveys the social science literature regarding the relationship between income and happiness, noting that the growth of the former does not necessarily translate to improvements in the latter. Next, it provides a number of explanations of why greater income and consumption often do not yield greater happiness. The paper then goes on to discuss historical and theoretical alternatives to consumerism-driven life and society. Finally, it discusses how happiness can best be found in socializing with others, participating in the community, and engaging in spiritual and intellectual pursuits. The paper, thus, concludes that human contentment and flourishing is perhaps best found outside of the high-growth, high-consumption paradigm. Moreover, it finds that such a new normal is not only protective of the environment, but also enhances social justice. [ABSTRACT FROM AUTHOR]