Inequality

The Impact of Microcredit on the Poor in Bangladesh: Revisiting the Evidence

The Impact of Microcredit on the Poor in Bangladesh: Revisiting the Evidence
Journal of Development Studies 50 (4), April 2014: 583-604.

David Roodman and Jonathan Morduch
04/01/2014

We replicate and reanalyse the most influential study of microcredit impacts (Pitt and Khandker, 1998). That study was celebrated for showing that microcredit reduces poverty, a much hoped-for possibility (though one not confirmed by recent randomized controlled trials). We show that the original results on poverty reduction disappear after dropping outliers, or when using a robust linear estimator. Using a new program for estimation of mixed process maximum likelihood models, we show how assumptions critical for the original analysis, such as error normality, are contradicted by the data. We conclude that questions about impact cannot be answered in these data.

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.

The Foreclosure Crisis and Community Development: Exploring the Foreclosed Stock in Hard-Hit Neighborhoods

The Foreclosure Crisis and Community Development: Exploring the Foreclosed Stock in Hard-Hit Neighborhoods
Housing Studies, forthcoming

Ingrid Gould Ellen, Josiah Madar, and Max Weselcouch
03/06/2014

As the foreclosure crisis continues, many communities are faced with a glut of properties that have completed the foreclosure process and are now owned by banks or other mortgage lenders. These properties, referred to as “real estate owned (REO),” often sit vacant for extended periods and, recent studies suggest, depress neighboring property values. They also impose significant costs on local governments, which must try to address the risk of crime, fire, and blight that vacant buildings pose. In addition, many worry that REO properties sold to unscrupulous short-term investors hasten neighborhood decline.

In this article we shed new light on the “REO problem” by studying the stock of REO properties at the neighborhood level in three urban areas: Fulton County, Georgia (which includes Atlanta), Miami-Dade County, Florida, and New York City. Using a combination of longitudinal administrative data sets on foreclosure filings, auction sales, and property transactions provided by local government sources, we identify every property transfer into REO ownership in recent years and all subsequent transfers of these properties. To explore the ongoing neighborhood and community development challenges, we divide census tracts into four groups based on their concentrations of REO properties as of the end of 2011. We then compare these neighborhood types across several dimensions. Because we use a uniform methodology for all three areas, we are also able to compare neighborhood groups across jurisdictions with the metrics we calculate.

We find several neighborhoods in Fulton County and Miami-Dade County with extremely high concentrations of REO properties as of the end of 2011, including some tracts with more than 100 REO properties. In New York City, however, REO concentrations are generally much lower, and no census tract had more than 12 REO properties. In all three jurisdictions, the neighborhoods with relatively high concentrations of REO properties are generally not the most distressed areas of their regions in terms of poverty and unemployment, but are still high-poverty and potentially vulnerable. Moreover, they are disproportionately black, highlighting the uneven impact the foreclosure crisis may be having on communities. Importantly, we find that that the number of REO properties in the hardest-hit neighborhoods of each area was declining as of the end of 2012 (or 2011, our latest year of data in Miami-Dade County), generally in line with the countywide or citywide trend in REO inventories, and that investors did not account for an appreciably higher proportion of purchasers of REO properties in the hardest-hit neighborhoods. Furthermore, few of the properties that were purchased by investors appear to have been “flipped” within a short period. On the other hand, we also find that those REO properties that remained in these cities as of the end of 2012 or 2011 (including those in hard-hit neighborhoods) had been in REO for a longer duration than was typical one year earlier, so the composition of the REO stock may shifting towards more problematic properties. Additionally, in Fulton County’s hardest-hit tracts REO properties made up about 40 percent of all sales in 2012, so were likely still exerting significant downward pressure on housing prices. Finally while the National Stabilization Program (NSP) may be improving neighborhoods in other ways, we find that only a negligible share of the REO sales in the hardest-hit tracts of Fulton and Miami-Dade Counties in 2010 and 2011 were to non-profit entities and developers using NSP funds.

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.

The Contribution of Health Care and Other Interventions to Black-White Disparities in Life Expectancy, 1980-2007

The Contribution of Health Care and Other Interventions to Black-White Disparities in Life Expectancy, 1980-2007
Population Research and Policy Review, Vol. 33, no. 1 (Feb 2014), pp. 97-126. doi: 10.1007/s11113-013-9309-2

Elo, I.T., H. Beltran-Sanchez, and J. Macinko
02/01/2014

Black–white mortality disparities remain sizable in the United States. In this study, we use the concept of avoidable/amenable mortality to estimate cause-of-death contributions to the difference in life expectancy between whites and blacks by gender in the United States in 1980, 1993, and 2007. We begin with a review of the concept of “avoidable mortality” and results of prior studies using this cause-of-death classification. We then present the results of our empirical analyses. We classified causes of death as amenable to medical care, sensitive to public health policies and health behaviors, ischemic heart disease, suicide, HIV/AIDS, and all other causes combined. We used vital statistics data on deaths and Census Bureau population estimates and standard demographic decomposition techniques. In 2007, causes of death amenable to medical care continued to account for close to 2 years of the racial difference in life expectancy among men (2.08) and women (1.85). Causes amenable to public health interventions made a larger contribution to the racial difference in life expectancy among men (1.17 years) than women (0.08 years). The contribution of HIV/AIDS substantially widened the racial difference among both men (1.08 years) and women (0.42 years) in 1993, but its contribution declined over time. Despite progress observed over the time period studied, a substantial portion of black–white disparities in mortality could be reduced given more equitable access to medical care and health interventions.

Spatial Segmentation and the Black Middle Class

Spatial Segmentation and the Black Middle Class
American Journal of Sociology, Vol. 119 no. 4, pp. 903-54. The University of Chicago

Sharkey, P.
01/01/2014

Ethnographic studies of the black middle class focus attention on the ways in which residential environments condition the experiences of different segments of the black class structure. This study places these arguments in a larger demographic context by providing a national analysis of neighborhood inequality and spatial inequality of different racial and ethnic groups in urban America. The findings show that there has been no change over time in the degree to which majority-black neighborhoods are surrounded by spatial disadvantage. Predominantly black neighborhoods, regardless of socioeconomic composition, continue to be spatially linked with areas of severe disadvantage. However, there has been substantial change in the degree to which middle- and upper-income African-American households have separated themselves from highly disadvantaged neighborhoods. These changes are driven primarily by the growing segment of middle- and upper-income African-Americans living in neighborhoods in which they are not the majority group, both in central cities and in suburbs.

Is Micro Too Small? Microcredit vs. SME Finance

Is Micro Too Small? Microcredit vs. SME Finance
World Development 43: 288-297. 2013.

Bauchet, Jonathan and Jonathan Morduch
12/15/2013

Microcredit and SME finance are often pitched as alternative strategies to create employment opportunities in low-income communities. So far, though, little is known about how employment patterns compare. We integrate evidence from three surveys to show that, compared to Bangladeshi microcredit customers, typical SME employees in Bangladesh have more education and professional skills, and live in households that are notably less poor. SME jobs also require long work weeks, clashing with family responsibilities. The evidence from Bangladesh rejects the idea that SME finance more efficiently creates jobs for the population currently served by microcredit.

Hospitalization for ambulatory-care sensitive conditions (ACSC) in Île-de-France: A view from across the Atlantic

Hospitalization for ambulatory-care sensitive conditions (ACSC) in Île-de-France: A view from across the Atlantic
Revue française des affaires sociales; 3(3): 108-125.

Rodwin, VG., Gusmano, MK., and Weisz, D.
12/03/2013

This article presents an indicator used in the United States and other OECD nations (hospitalizations for ambulatory-care sensitive conditions – ACSC) to assess access to primary care services and their capacity to handle a set of medical conditions before they require acute hospital treatment. Based on a study of Ile de France, which relies on residence-based hospital discharge data on patient diagnoses and treatments, the indicator identifies areas where hospitalizations for ACSC appear particularly high. Such hospital stays are considered potentially avoidable. Based on data from the Programme de m.dicalisation des syst.mes d’information (PMSI), disparities are measured. We rely on logistic regression analysis to identify a range of individual factors and neighborhood-level factors that explain these disparities. Access to primary care appears to be worse among residents in areas with average household income in the lowest quartile and among those hospitalized in public hospitals. This raises an important question for the future of health policy. Should areas with higher hospital discharge rates of ACSC be understood as having populations with poor health-seeking behaviors or health care systems not well enough organized to target higher-risk populations?

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