Poverty

Who Is Accountable for Racial Equity in Health Care?

Who Is Accountable for Racial Equity in Health Care?
Journal of the American Medical Association. Vol. 299 No.7, February 20: 814-816.

Blustein, J.
02/20/2008

Racial disparities are a ubiquitous feature of the US medical landscape, with health care delivery substantially segregated by race/ethnicity. Recent evidence from hospitals,1-3 nursing homes,4-5 and physicians' offices6 suggests that those caring for minority patients do not perform as well as those who care for nonminority patients, on average. This evidence is troubling but hardly surprising because the limited resources of those who care for the poor have helped to create and sustain racial disparities. As the United States enters an era of accountability in health care, it is time to consider these familiar circumstances from a new perspective.

IESP Brief: Public Funding for After-School Programs 1998-2008

IESP Brief: Public Funding for After-School Programs 1998-2008

Weinstein, M., Calabrese, T.
01/01/2008

The authors of this policy brief document that in the decade since the Open Society Institute awarded a challenge grant to TASC to encourage the creation of sustainable public funding streams for after-school programs, every level of government has dramatically increased public funding for comprehensive after-school programs in New York City.
The authors note that the City of New York has contributed an increasingly larger share of public support since the city launched its Out-of-School Time Initiative to provide kids with academic, cultural and recreational activities after school and during summers. The authors estimate that eight times more kids in kindergarten through high school attend after-school programs today than in 1998. "Over the past ten years in New York City," they conclude, "public support for after-school programs has become one of the foundations of service for children and youth."

Reversal of Fortunes: Low Income Neighborhoods in the 1990s

Reversal of Fortunes: Low Income Neighborhoods in the 1990s
Urban Studies, 45: 845-869.

O'Regan, K. & Ellen, I.G.
01/01/2008

This paper offers new empirical evidence about the prospects of lower-income, US urban neighbourhoods during the 1990s. Using the Neighborhood Change Database, which offers a balanced panel of census tracts with consistent boundaries from 1970 to 2000 for all metropolitan areas in the US, evidence is found of a significant shift in the fortunes of lower-income, urban neighbourhoods during the 1990s. There was a notable increase in the 1990s in the proportion of lower-income and poor neighbourhoods experiencing a gain in economic status. Secondly, in terms of geographical patterns, it is found that this upgrading occurred throughout the country, not just in selected regions or cities. Finally, it is found that the determinants of changes in lower-income, urban neighbourhoods shifted during the 1990s. In contrast to earlier decades, both the share of Blacks and the poverty rate were positively related to subsequent economic gain in these neighbourhoods during the 1990s.

The Intergenerational Transmission of Context

The Intergenerational Transmission of Context
American Journal of Sociology, Jan 2008, Vol. 113 Issue 4, p931-969, 39p.

Sharkey, P.
01/01/2008

This article draws on the extensive literature on economic and social mobility in America to examine intergenerational contextual mobility, defined as the degree to which inequalities in neighborhood environments persist across generations. PSID data are analyzed to reveal remarkable continuity in neighborhood economic status from one generation to the next. The primary consequence of persistent neighborhood stratification is that the racial inequality in America's neighborhoods that existed a generation ago has been transmitted, for the most part unchanged, to the current generation. More than 70% of black children who grow up in the poorest quarter of American neighborhoods remain in the poorest quarter of neighborhoods as adults, compared to 40% of whites. The results suggest that racial inequality in neighborhood economic status is substantially underestimated with short-term measures of neighborhood income or poverty and, second, that the steps taken to end racial discrimination in the housing and lending markets have not enabled black Americans to advance out of America's poorest neighborhoods.

Disappearing acts: The social networks of formerly homeless individuals with co-occurring disorders

Disappearing acts: The social networks of formerly homeless individuals with co-occurring disorders
Social Science & Medicine, 65, 2031-2042.

Hawkins, R. L. & Abrams, C.
11/01/2007

Studies of the social lives of men and women living with co-occurring disorders (substance abuse and serious mental illness) suggest that social networks critically influence recovery. In this paper, we examine some of the reasons that the social networks of individuals with co-occurring disorders are small, and the impact of small networks for this population. Using a social capital framework with cross-case analysis, we analyze 72 in-depth qualitative interviews with 39 formerly homeless mentally ill men and women who were substance abusers. All were participants in the New York Services Study (HYSS), a federally funded study of mentally ill adults in New York City. The patterns suggest that networks shrunk because 1) social network members died prematurely, 2) study participants withdrew or pushed others away, and 3) friends and family members faced so many obstacles of their own that they could not provide resources for the study participants. We suggest that as networks diminished, some participants responded by attempting to rebuild their networks, even if the networks provided negative social capital, and others isolated themselves socially to escape the pressures and disappointments of interaction.

From districts to schools: The distribution of resources across schools in big city school districts

From districts to schools: The distribution of resources across schools in big city school districts
Economics of Education Review Oct 2007, Vol. 26 Issue 5, p532-545, 14p

Rubenstein, R. & Schwartz, A.E., Stiefel, L., Bel Hadj Amor, H.
10/01/2007

While the distribution of resources across school districts is well studied, relatively little attention has been paid to how resources are allocated to individual schools inside those districts. This paper explores the determinants of resource allocation across schools in large districts based on factors that reflect differential school costs or factors that may, in practice, be related to the distribution of resources. Using detailed data on school resources and student and school characteristics in New York City, Cleveland and Columbus, Ohio, we find that schools with higher percentages of poor pupils often receive more money and have more teachers per pupil, but the teachers tend to be less educated and less well paid, with a particularly consistent pattern in New York City schools. We conclude with implications for policy and further research.

Toward a Mandatory Working Policy for Men

Toward a Mandatory Working Policy for Men
The Future of Children, Vol. 17, no. 2

Mead, L.
09/01/2007

Lawrence Mead addresses the problem of nonwork among low-income men, particularly low-income black men, and its implications for families and children. The poor work effort, he says, appears to be caused partly by falling wages and other opportunity constraints but principally by an oppositional culture and a breakdown of work discipline. Mead argues that if government policies are to increase work among poor men, they must not merely improve wages and skills but enforce work in available jobs. Using the same "help with hassle" approach that welfare reform has used successfully to increase work among poor mothers, policymakers should adapt the child support enforcement and criminal justice systems so that both actively help their clients find employment and then back up that help with a requirement that they work. Men with unpaid child support judgments and parolees leaving prison would be told to get a job or pay up, as they are now. But if they did not, they would be remanded to a required work program where their efforts to work would be closely supervised. They would have to participate and get a private job and have their subsequent employment verified. Failing that, they would be assigned to work crews, where again compliance would be verified. Men who failed to participate and work steadily would--unless there were good cause--be sent back to the child support or parole authorities to be imprisoned. But men who complied would be freed from the work program after a year or two. They would then revert to the looser supervision practiced by the regular child support and parole systems. If their employment record deteriorated, they could again be remanded to the work program. Mead estimates that such a program would involve as many as 1.5 million men who are already in the child support and criminal justice systems and would cost $2.4 billion to $4.8 billion a year. It is premature, says Mead, for such a program to be mandated nationwide. Rather, the best role for national policy at this point is to establish and evaluate promising model programs to see which work best.

Financial Performance and Outreach: A Global Analysis of Leading Microbanks

Financial Performance and Outreach: A Global Analysis of Leading Microbanks
Economic Journal, February 2007, Vol. 117, Issue 517, pp. F107-F133

Morduch, J., Cull, R. & Demirguc-Kunt, A.
02/01/2007

Microfinance promises to reduce poverty by employing profit-making banking practices in low-income communities. Many microfinance institutions have secured high loan repayment rates but, so far, relatively few earn profits. We examine why this promise remains unmet. We explore patterns of profitability, loan repayment, and cost reduction with unusually high-quality data on 124 institutions in 49 countries. The evidence shows the possibility of earning profits while serving the poor, but a trade-off emerges between profitability and serving the poorest. Raising fees to very high levels does not ensure greater profitability and the benefits of cost-cutting diminish when serving better-off customers.

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