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Primary Care, Social Inequality, and Stroke Mortality in U.S. States--a Longitudinal Analysis, 1985-1995

Primary Care, Social Inequality, and Stroke Mortality in U.S. States--a Longitudinal Analysis, 1985-1995
Stroke Volume 34 Number 8, pages 1958-64.

Shi, L., Macinko, J., Starfield, B. & Politzer, R.
01/01/2003

BACKGROUND AND PURPOSE: The goal of this study was to test whether primary care reduces the impact of income inequality on stroke mortality. METHODS: This study used pooled time-series cross-sectional analysis of 11 years of state-level data (n=549). Analyses controlled for education levels, unemployment, racial/ethnic composition, and percent urban. Contemporaneous and time-lagged covariates were modeled. RESULTS: Primary care was negatively associated with stroke mortality in models including all covariates (P<0.0001). The impact of income inequality on stroke mortality was reduced in the presence of primary care (P<0.0001) but disappeared with the addition of covariates (P>0.05). CONCLUSIONS: In the absence of social policy that addresses sociodemographic determinants of health, primary care promotion may serve as a palliative strategy for combating stroke mortality and reducing the adverse impact of income inequality on health.

Public Attitudes Toward Low-Income Children and Families: How Employment Barriers and Welfare/Work Status Affect Public Support for Government Assistance

Public Attitudes Toward Low-Income Children and Families: How Employment Barriers and Welfare/Work Status Affect Public Support for Government Assistance
Communications Research Brief, National Center for Children in Poverty, Columbia University,

Lennon, M.C., Applebaum, L.D. & Aber, J.L.
01/01/2003

This report examines how the public responds to specific characteristics of women who face economic struggles. Our subject’s characteristics are randomly varied to include her barriers to employment (such as physical disability, mental illness, living in an area with high unemployment, and trouble with reliable child care) and whether she works or receives welfare.

Reader in Gender, Work and Organization

Reader in Gender, Work and Organization
Blackwell Publishers,

Ely, R., Foldy, E.G. & Scully, M.
01/01/2003

This reader uses an alternative approach to gender at work to provoke new thinking about traditional management topics, such as leadership and negotiation. Presents students with an alternative conceptual approach to gender in the workplace. Connects gender with other dimensions of difference such as race and class for a deeper understanding of diversity in organizations. Illustrates how traditional images of competence and the ideal worker result in narrow ways of thinking about work, limiting both opportunity and organizational effectiveness. Provokes new ways of thinking about leadership, human resource management, negotiation, globalization and organizational change.

Work and Family Policies in the United States: Challenges and Opportunities for Child and Youth Development

Work and Family Policies in the United States: Challenges and Opportunities for Child and Youth Development
National Academy Press. [authorship of chapter in National Academy of Sciences report, and contributions to other chapters]Washington, DC.,

Yoshikawa, H., Gootman, J. & Smolensky, E., (Eds.)
01/01/2003

The World Cities Project: Rationale, Organization, and Design for Comparison of Megacity Health Systems

The World Cities Project: Rationale, Organization, and Design for Comparison of Megacity Health Systems
Journal of Urban Health: Bulletin of the New York Academy of Medicine, vol. 79, no. 4, December

Rodwin, V.G. & Gusmano, M.K.
12/01/2002

This article provides an overview of the World Cities Project (WCP), our rationale for it, our framework for comparative analysis, and an overview of current studies in progress. The WCP uses New York, London, Paris, and Tokyo as a laboratory in which to study urban health, particularly the evolution and current organization of public health infrastructure, as well as the health status and quality of life in these cities. Comparing world cities in wealthier nations is important because of (1) global trends in urbanization, emerging health risks, and population aging; (2) the dominant influence of these cities on “megacities” of developing nations; and (3) the existence of data and scholarship about these world cities, which provides a foundation for comparing their health systems and health. We argue that, in contrast to nation-states, world cities provide opportunities for more refined comparisons and cross-national learning. To provide a framework for WCP, we define an urban core for each city and examine the similarities and differences among them. Our current studies shed light on inequalities in health care use and health status, the importance of neighborhoods in protecting population health, and quality of life in diverse urban communities.

Telecommuting and the Demand for Urban Living: A Preliminary Look at White-Collar Workers

Telecommuting and the Demand for Urban Living: A Preliminary Look at White-Collar Workers
Urban Studies 39(4),

Ellen, I.G. & Hempstead, K.
01/01/2002

With recent advances in communications technology, telecommuting appears to be an increasingly viable option for many workers. For urban researchers, the key question is whether this growing ability to telecommute is altering residential location decisions and leading households to live in smaller, lower-density and more remote locations. Using the Work Schedules supplement from the 1997 Current Population Study, this paper explores this question. Specifically, it examines the prevalence of telecommuting, explores the relationship between telecommuting and the residential choices of white-collar workers and, finally, speculates about future impacts on residential patterns and urban form.

Welfare Reform in Cleveland: Implementation, Effects, and Experiences of Poor Families and Neighborhoods

Welfare Reform in Cleveland: Implementation, Effects, and Experiences of Poor Families and Neighborhoods
MDRC,

Brock, T., Coulton, C., London, A., Polit, D. Richburg-Hayes, L., Scott, E. & Verma, N.
01/01/2002

The 1996 Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) ushered in profound changes in welfare policy, including a five-year time limit on federally funded cash assistance (known as Temporary Assistance for Needy Families, or TANF), stricter work requirements, and greater flexibility for states in designing and managing programs. The law’s supporters hoped that it would spark innovation and reduce welfare use; critics feared that it would lead to cuts in benefits and widespread suffering. Whether PRWORA’s reforms succeed or fail depends largely on what happens in big cities, where poverty and welfare receipt are most concentrated. This report — one of a series from MDRC’s Project on Devolution and Urban Change — examines how welfare reform unfolded in Ohio’s largest city and county: Cleveland, in Cuyahoga County. Ohio’s TANF program features one of the country’s shortest time limits (36 months) and has a strong emphasis on moving welfare recipients into employment. This study uses field research, surveys and interviews of current and former welfare recipients, state and county welfare and employment records, and indicators of social and economic trends to assess TANF’s implementation and effects. Because of the strong economy and ample funding for services in the late 1990s, it captures welfare reform in the best of times, while also focusing on the poorest families and neighborhoods.

A Randomized Trial of Nurse Specialist Home Care for Women with High Risk Pregnancies: Outcomes and Costs

A Randomized Trial of Nurse Specialist Home Care for Women with High Risk Pregnancies: Outcomes and Costs
American Journal of Managed Care, Volume 7, Number 8, August

Brooten, D., Youngblut, J., Brown L., Finkler, S. et. al.
08/01/2001

OBJECTIVE: To examine prenatal, maternal, and infant outcomes and costs through 1 year after delivery using a model of prenatal care for women at high risk of delivering low-birthweight infants in which half of the prenatal care was provided in women’s homes by nurse specialists with master’s degrees. STUDY DESIGN: Randomized clinical trial. PATIENTS AND METHODS: A sample of 173 women (and 194 infants) with high-risk pregnancies (gestational or pregestational diabetes mellitus, chronic hypertension, preterm labor, or high risk of preterm labor) were randomly assigned to the intervention group (85 women and 94 infants) or the control group (88 women and 100 infants). Control women received usual prenatal care. Intervention women received half of their prenatal care in their homes, with teaching, counseling, telephone outreach, daily telephone availability, and a postpartum home visit by nurse specialists with physician backup. RESULTS:For the full sample, mean maternal age was 27 years; 85.5% of women were single mothers, 36.4% had less than a high school education, 93.6% were African American, and 93.6% had public health insurance, with no differences between groups on these variables. The intervention group had lower fetal/infant mortality vs the control group (2 vs 9), 11 fewer preterm infants, more twin pregnancies carried to term (77.7% vs 33.3%), fewer prenatal hospitalizations (41 vs 49), fewer infant rehospitalizations (18 vs 24), and a savings of more than 750 total hospital days and $2,880,000. CONCLUSION: This model of care provides a reasoned solution to improving pregnancy and infant outcomes while reducing healthcare costs.

Job Loss and Employment Behavior of Older Workers

Job Loss and Employment Behavior of Older Workers
Journal of Labor Economics, April

Chan, S. & Stevens, A.H.
04/01/2001

This article uses data from the Health and Retirement Study to examine the employment patterns of workers aged 50 and above who have experienced an involuntary job loss. Hazard models for returning to work and for exiting post-displacement employment are estimated and used to examine work patterns for 10 years following a job loss. Our findings show that a job loss results in large and lasting effects on future employment probabilities. Four years after job losses at age 55, the employment rate of displaced workers remains 20 percentage points below the employment rate of similar nondisplaced workers.

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