Inequality

Credit is Not a Right [REVISED]

Credit is Not a Right [REVISED]
Forthcoming in volume edited by Tom Sorell and Luis Cabrera: Microfinance, Rights, and Global Justice. Cambridge University Press.

Gershman, John and Jonathan Morduch
09/15/2014

Muhammad Yunus, the microcredit pioneer, has proposed that access to credit should be a human right. We approach the question by drawing on fieldwork and empirical scholarship in political science and economics. Evidence shows that access to credit may be powerful for some people some of the time, but it is not powerful for everyone all of the time, and in some cases it can do damage. Yunus’s claim for the power of credit access has yet to be widely verified, and most rigorous studies find microcredit impacts that fall far short of the kinds of empirical assertions on which his proposal rests. We discuss ways that expanding the domain of rights can diminish the power of existing rights, and we argue for a right to non-discrimination in credit access, rather than a right to credit access itself.

 

Application of global positioning system methods for the study of obesity and hypertension risk among low-income housing residents in New York City: a spatial feasibility study

Application of global positioning system methods for the study of obesity and hypertension risk among low-income housing residents in New York City: a spatial feasibility study
Geospatial Health, Vol. 9, no. 1, pp. 57-70. DOI: http://dx.doi.org/10.4081/gh.2014.6

Duncan, D.T., S.D. Regan, D. Shelley, K. Day, R.R. Ruff, M. Al-Bayan, and B. Elbel
09/01/2014

The purpose of this study was to evaluate the feasibility of using global positioning system (GPS) methods to understand the spatial context of obesity and hypertension risk among a sample of low-income housing residents in New York City (n = 120). GPS feasibility among participants was measured with a pre- and post-survey as well as adherence to a protocol which included returning the GPS device as well as objective data analysed from the GPS devices. We also conducted qualitative interviews with 21 of the participants. Most of the sample was overweight (26.7%) or obese (40.0%). Almost one-third (30.8%) was pre-hypertensive and 39.2% was hypertensive. Participants reported high ratings of GPS acceptability, ease of use and low levels of wear-related concerns in addition to few concerns related to safety, loss or appearance, which were maintained after the baseline GPS feasibility data collection. Results show that GPS feasibility increased over time. The overall GPS return rate was 95.6%. Out of the total of 114 participants with GPS, 112 (98.2%) delivered at least one hour of GPS data for one day and 84 (73.7%) delivered at least one hour on 7 or more days. The qualitative interviews indicated that overall, participants enjoyed wearing the GPS devices, that they were easy to use and charge and that they generally forgot about the GPS device when wearing it daily. Findings demonstrate that GPS devices may be used in spatial epidemiology research in low-income and potentially other key vulnerable populations to understand geospatial determinants of obesity, hypertension and other diseases that these populations disproportionately experience.

Profile of Rent-Stabilized Units and Tenants in New York City

Profile of Rent-Stabilized Units and Tenants in New York City
Furman Center for Real Estate and Urban Policy. June 2014 Fact Brief.

NYU Furman Center
06/17/2014

Rent Stabilization is a New York State law that restricts how much rents in certain residential housing units can increase annually. The law generally applies to buildings constructed prior to 1974 that have six or more units, or to buildings that opt into the program in exchange for certain public subsidies. Rent Stabilization protects tenants from sharp increases in rents and protects their right to renew their leases.

In 2011, rent stabilized units comprised nearly one million units of housing in New York City—roughly 45 percent the city’s rental housing stock. Stabilized units house many low-income residents across New York City; roughly 66 percent of tenants living in rent-stabilized units were considered low-income in 2011.

This Fact Brief is an update to the NYU Furman Center’s April 2012 publication, Rent Stabilization in New York City. The data in this brief remain the most recent available from the New York City Housing and Vacancy Survey. Data from the 2014 Housing and Vacancy Survey are expected to released next year.

The global cancer divide: relationships between national healthcare resources and cancer outcomes in high-income vs. middle- and low-income countries

The global cancer divide: relationships between national healthcare resources and cancer outcomes in high-income vs. middle- and low-income countries
Journal of Epidemiology & Global Health, Vol 4, no. 2, pp. 115-124. DOI: 10.1016/j.jegh.2013.10.004

Batouli, A., P. Jahanshahi, C.P. Gross, D.V. Makarov, and J.B.Yu
06/01/2014

Background: Cancer continues to rise as a contributor to premature death in the developing world. Despite this, little is known about whether cancer outcomes are related to a country’s income level, and what aspects of national healthcare systems are associated with improved cancer outcomes.

Methods: The most recent estimates of cancer incidence and mortality were used to calculate mortality-to-incidence ratio (MIR) for the 85 countries with reliable data. Countries were categorized according to high-income (Gross Domestic Product (GDP) > $15,000) or middle/low-income (GDP < $15,000), and a multivariate linear regression model was used to determine the association between healthcare system indicators and cancer MIR. Indicators study included per capita GDP, overall total healthcare expenditure (THE), THE as a proportion of GDP, total external beam radiotherapy devices (TEBD) per capita, physician density, and the year 2000 WHO healthcare system rankings.

Results: Cancer MIR in high-income countries (0.47) was significantly lower than that of middle/low-income countries (0.64), with a p < 0.001. In high-income countries, GDP, health expenditure and TEBD showed significant inverse correlations with overall cancer MIR. A $3040 increase in GDP (p = 0.004), a $379 increase in THE (p < 0.001), or an increase of 0.59 TEBD per 100,000 population (p = 0.027) were all associated with a 0.01 decrease in cancer MIR. In middle/low-income countries, only WHO scores correlated with decreased cancer MIR (p = 0.022); 12 specific cancer types also showed similar significant correlations (p < 0.05) as overall cancer MIR.

Conclusions: The analysis of this study suggested that cancer MIR is greater in middle/low-income countries. Furthermore, the WHO healthcare score was associated with improved cancer outcomes in middle/low-income countries while absolute levels of financial resources and infrastructure played a more important role in high-income countries.

Where, When, Why, and For Whom Do Residential Contexts Matter? Moving Away from the Dichotomous Understanding of Neighborhood Effects

Where, When, Why, and For Whom Do Residential Contexts Matter? Moving Away from the Dichotomous Understanding of Neighborhood Effects
Annual Review of Sociology. 2014. 40:559–79. 10.1146/annurev-soc-071913-043350

Sharkey, P., and J. Faber
05/05/2014

The literature on neighborhood effect frequently is evaluated or interpreted in relation to the question, "Do neighborhoods matter?" We argue that this question has had a disproportionate influence on the field and does not align with the complexity of theoretical models of neighborhood effects or empirical findings that have arisen from the literature. In this article, we focus on empirical work that considers how different dimensions of individuals' residential contexts become salient in their lives, how contexts influence individuals' lives over different timeframes, how individuals are affected by social processes operating at different scales, and how residential contexts influence the lives of individuals in heterogeneous ways. In other words, we review research that examines where, when, why, and for whom do residential contexts matter. Using the large literature on neighborhoods and educational and cognitive outcomes as an example, the research we review suggests that any attempt to reduce the literature to a single answer about whether neighborhoods matter is misguided. We call for a more flexible study of context effects in which theory, measurement, and methods are more closely aligned with the specific mechanisms and social processes under study.

Unlocking the Right to Build: Designing a More Flexible System for Transferring Development Rights

Unlocking the Right to Build: Designing a More Flexible System for Transferring Development Rights
Furman Center Policy Brief; March 2014

Vicki Been, John Infranca, Josiah Madar, Jessica Yager
03/19/2014

A new report by the NYU Furman Center details the untapped potential for NYC’s transferable air rights program, a critical tool for high-density housing development in New York City. Using case study examples, the report outlines limitations to the city’s current TDR policies and suggests a policy approach that could unlock millions of square feet of unused air rights to help produce more affordable housing.

Do Housing Choice Voucher Holders Live Near Good Schools

Do Housing Choice Voucher Holders Live Near Good Schools
Journal of Housing Economics 23(1), 2014: 28-40. http://dx.doi.org/10.1016/j.jhe.2013.11.005

Ingrid Gould Ellen, Amy Ellen Schwartz, and Keren Horn
03/06/2014

The Housing Choice Voucher program was created, in part, to help low income households reach a broader range of neighborhoods and schools. Rather than concentrating low income households in designated developments, vouchers allow families to choose their housing units and neighborhoods. In this project we explore whether low income households use the flexibility provided by vouchers to reach neighborhoods with high performing schools. Unlike previous experimental work, which has focused on a small sample of voucher holders constrained to live in low-poverty neighborhoods, we look at the voucher population as a whole and explore the broad range of neighborhoods in which they live. Relying on internal data from HUD on the location of assisted households, we link each voucher holder in the country to the closest elementary school within their school district. We compare the characteristics of the schools that voucher holders are likely to attend to the characteristics of those accessible to other households receiving place based housing subsidies, other similar unsubsidized households and fair market rent units within the same state and metropolitan area. These comparisons provide us with a portrait of the schools that children might have attended absent HUD assistance. In comparison to other poor households in the same metropolitan areas, we find that the schools near voucher holders have lower performing students than the schools near other poor households without a housing subsidy. We probe this surprising finding by exploring whether differences between the demographic characteristics of voucher holders and other poor households explain the differences in the characteristics of nearby schools, and whether school characteristics vary with length of time in the voucher program. We also examine variation across metropolitan areas in the relative quality of schools near to voucher holders and whether this variation is explained by economic, socio-demographic or policy differences across cities.

Electronic Health Record Use, Intensity of Hospital Care, and Patient Outcomes

Electronic Health Record Use, Intensity of Hospital Care, and Patient Outcomes
American Journal of Medicine, Vol. 127, no. 3, pp. 123-130. DOI: 10.1016/j.amjmed.2013.11.010

Blecker, S., K. Goldfeld, N. Park, D. Shine, J.S. Austrian, R. Scott Braithwaite, M.J. Radford, and M.N. Gourevitch
03/01/2014

Objective: Previous studies have suggested that weekend hospital care is inferior to weekday care and that this difference may be related to diminished care intensity. The purpose of this study was to determine whether a metric for measuring intensity of hospital care based on use of the electronic health record was associated with patient-level outcomes.

Methods: We performed a cohort study of hospitalizations at an academic medical center. Intensity of care was defined as the hourly number of provider accessions of the electronic health record, termed “electronic health record interactions.” Hospitalizations were categorized on the basis of the mean difference in electronic health record interactions between the first Friday and the first Saturday of hospitalization. We used regression models to determine the association of these categories with patient outcomes after adjusting for covariates.

Results: Electronic health record interactions decreased from Friday to Saturday in 77% of the 9051 hospitalizations included in the study. Compared with hospitalizations with no change in Friday to Saturday electronic health record interactions, the relative lengths of stay for hospitalizations with a small, moderate, and large decrease in electronic health record interactions were 1.05 (95% confidence interval [CI], 1.00-1.10), 1.11 (95% CI, 1.05-1.17), and 1.25 (95% CI, 1.15-1.35), respectively. Although a large decrease in electronic health record interactions was associated with in-hospital mortality, these findings were not significant after risk adjustment (odds ratio 1.74, 95% CI, 0.93-3.25).

Conclusions: Intensity of inpatient care, measured by electronic health record interactions, significantly diminished from Friday to Saturday, and this decrease was associated with length of stay. Hospitals should consider monitoring and correcting temporal fluctuations in care intensity.

My Brother's Keeper? The Association between Having Siblings in Poor Health and Wealth Accumulation

My Brother's Keeper? The Association between Having Siblings in Poor Health and Wealth Accumulation
Journal of Family Issues, February, Volume 35(3), pp.358-383.

Heflin, C. and N. Chiteji
02/01/2014

When confronted with the economic costs of addressing a serious health problem, many American households do not possess the ability to deal with the crises on their own and may turn to family members for help. Using longitudinal data from the Panel Study of Income Dynamics, we examine if the level of wealth held by individuals is related to the health problems of their siblings. We find evidence that having a sibling who has experienced a health problem decreases the amount of wealth that some families have. The research has implications for the existing literatures on altruism and kin networks, as it sheds some light on the nature of altruism that prevails in U.S. families and on how kinship networks matter. Because of its focus on the consequences of health problems, the research also has implications for public policy discussions about the health care system and social insurance more generally.

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