Poverty

Access to Care Among Vulnerable Populations Enrolled in Commercial HMOs

Access to Care Among Vulnerable Populations Enrolled in Commercial HMOs
Journal of Health Care for the Poor and Underserved, Volume 14, Number 3, pages 372-385.

Carlson, M. & Blustein, J.
01/01/2003

This cross-sectional study compares self-reported access to care among a representative sample of 13,952 HMO enrollees in New Jersey. Using multivariate logistic regression, this study found that compared with college graduates, those with less than a high school education reported more difficulty obtaining tests or treatment. Compared with whites, Hispanics were more likely to report difficulty seeing their primary care provider, and African Americans reported greater difficulty seeing a specialist and obtaining tests and treatment. Enrollees in poor health were more likely to report problems seeing a specialist and obtaining tests and treatment than enrollees in excellent health. Income was not a consistent predictor of access. Nonfinancial barriers appear to be more influential than financial barriers for predicting access problems in commercial HMOs. More work is needed to identify the source of nonfinancial barriers to care among vulnerable populations.

Changing Children's Trajectories of Development: Two-Year Evidence for the Effectiveness of a School-Based Approach to Violence Prevention

Changing Children's Trajectories of Development: Two-Year Evidence for the Effectiveness of a School-Based Approach to Violence Prevention
National Center for Children in Poverty, New York, NY.

Aber, J.L., Brown, J.L., Gershoff, E.T., Jones, S.M. & Pedersen, S.F.A.
01/01/2003

Awareness of youth violence has increased in recent years, resulting in more interest in programs that can prevent violent and aggressive behavior. Although overall rates of violence among young people have declined since the mid-1990s, rates of some forms of youth aggression, violence, and crime remain high. National data reveal that, each year, about 15 percent of high school students are involved in a physical fight at school and 8 percent are threatened or injured with a weapon. 1 Urban youth are at particular risk for exposure to violence and victimization.

This report describes one of the largest and longest running school-based violence prevention programs in the country-the Resolving Conflict Creatively Program (RCCP)-and discusses the results of a rigorous evaluation conducted by the National Center for Children in Poverty (NCCP) at Columbia University's Mailman School of Public Health. The evaluation provides concrete evidence that early, school-based prevention initiatives such as the RCCP can work and should be included in communities' efforts to prevent violence among children and youth.

 

Child Poverty in the U.S.: An Evidence-Based Conceptual Framework for Programs and Policies

Child Poverty in the U.S.: An Evidence-Based Conceptual Framework for Programs and Policies
In R. M. Lerner, F. Jacobs, & D. Wertlieb (Eds.) Promoting positive child, adolescent, and family development: A handbook of program and policy innovations, (pp. 81-136). Thousand Oaks, California: Sage Publications,

Gershoff, E.T., Aber, J.L. & Raver, C.C.
01/01/2003

Introduce the concrete reality of family finances when living on the line. Describe the great variation in "supports" for low-income families & their children within & across States.

Development and Validation of a Brief Pediatric Screen for Asthma and Allergies Among Children

Development and Validation of a Brief Pediatric Screen for Asthma and Allergies Among Children
Annals of Allergy, Asthma, & Immunology, 90, 500-507.

Wolf, R.L., Berry, C. & Quinn, K.
01/01/2003

Background: Asthma is the most common disease of childhood, but the recognition and detection remain poor, especially among schoolchildren. There has been an increase in the number of instruments available to detect the risk of asthma earlier in children. We have previously validated a simple, self-reported screen, the Brief Pediatric Asthma Screen (BPAS).

Objective: To develop a new screen for asthma and allergies based on the BPAS (BPAS ) with the intent of keeping the screen brief and simple, while including allergy detection.

Methods: Questions from the BPAS were extensively revised, and questions regarding allergic rhinitis were added. A panel of parents of asthmatic children reviewed and critiqued the questions. The final BPAS was distributed in elementary schools, and a cohort of 129 participated in a validation against the gold standard of evaluation by an expert in asthma.

Results: For asthma the best items were wheeze, persistent cough, night cough, and response to change in air temperature. The simplest scoring, any 1 of the 4 items, yielded the best balance of specificity (73.6%) and sensitivity (73.3%). For allergy, using all six items, having any one or any two of the items had sensitivity of 71.4% and specificity of 77.3%.

Conclusions: The BPAS provides a rapid and valid method for the detection of potential allergy and asthma in schoolchildren. Sensitivity and specificity are acceptable for both asthma and allergies.

Effects of Welfare and Anti-Poverty Policies on Adult Economic and Middle-Childhood Outcomes Differ for the Hardest to Employ

Effects of Welfare and Anti-Poverty Policies on Adult Economic and Middle-Childhood Outcomes Differ for the Hardest to Employ
Child Development, Volume 74, pp. 1500-1521,

Yoshikawa, H., Magnuson, K.A., Bos, J.M. & Hsueh, J..
01/01/2003

Data from the Minnesota Family Investment Program and the New Hope demonstration were used to determine whether experimental effects of antipoverty policies differ by parents' risk for nonemployment. Using propensity score analysis, increases in employment and income were largest in the harder-to-employ halves of both samples. However, only children in the moderately hard-to-employ quartiles (50th to 75th percentile) consistently showed improvements in school and behavior outcomes. The very-hardest-to-employ 25% experienced decreases in school engagement, and increases in aggressive behaviors, despite substantial increases in parental employment and income. In this group, increases in maternal depression, reductions in regular family routines, and smaller increases in job stability and center-based child care occurred. These factors may have counteracted the potential benefits of increased income on children.

Is Microfinance an Effective Strategy to Reach the Millenium Development Goals?

Is Microfinance an Effective Strategy to Reach the Millenium Development Goals?
Focus Note No. 24. Washington, DC: Consultative Group to Assist the Poor. July

Morduch, J., Hashemi, S. & Littlefield, E.
01/01/2003

The United Nations' Millennium Development Goals (MDGs) have galvanized the development community with an urgent challenge to improve the welfare of the world's neediest people. This paper reviews the mounting body of evidence showing that the availability of financial services for poor households is a critical contextual factor with strong impact on the achievement of MDGs. Evidence from the millions of microfinance clients around the world demonstrates that access to financial services enables poor people to increase their household incomes, build assets, and reduce their vulnerability to the crises that are so much a part of their daily lives.

New Hope for Families and Children: Five-Year Results of a Program to Reduce Poverty and Reform Welfare

New Hope for Families and Children: Five-Year Results of a Program to Reduce Poverty and Reform Welfare

Huston, A., Miller, C., Richburg-Hayes, L., Duncan, G.J., Eldred, C.A., Weisner, T.S., Lowe, E., McLoyd, V.C., Crosby, D.A., Ripke, M.N. & Redcross, C.
01/01/2003

The principle guiding the New Hope Project — a demonstration program that was implemented in two inner-city areas in Milwaukee from 1994 through 1998 — was that anyone who works full time should not be poor. New Hope offered low-income people who were willing to work full time several benefits, each of which was available for three years: an earnings supplement to raise their income above the poverty level; subsidized health insurance; subsidized child care; and, for people who had difficulty finding full-time work, referral to a wage-paying community service job. The program was designed to increase employment and income as well as use of health insurance and licensed child care, and it was hoped that children would be the ultimate beneficiaries of these changes. A team of researchers at MDRC and the University of Texas at Austin is examining New Hope’s effects in a largescale random assignment study. This interim report from the study focuses on the families and children of the 745 sample members who had at least one child between the ages of 1 and 10 when they entered the study. The new findings draw on administrative records and survey data covering the period up to five years after study entry (Year 5), that is, two years after the program ended. A final report will examine New Hope’s effects after eight years.

Public Attitudes Toward Low-Income Children and Families: How the Belief in a Just World Influences American’s Attitudes Toward Solutions to Poverty

Public Attitudes Toward Low-Income Children and Families: How the Belief in a Just World Influences American’s Attitudes Toward Solutions to Poverty
Communications Research Brief, National Center for Children in Poverty, Columbia University.

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

This report examines the psychological concept of “Belief in a Just World” and how it influences public opinion about low-income mothers and their efforts to become economically self-sufficient. Understanding these attitudes helps organizations like NCCP generate support for policies that assist low-income families.

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

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

Michalopoulos, C., Edin, K., Fink, B., Iandriscina, M., Polit, D., Polyne, J..& Verma, N.
01/01/2003

The 1996 welfare reform law called for 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 to widespread suffering. Whether the reform succeeds or fails 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 the specific ways in which reform unfolded in Philadelphia. The study uses field research, state records, surveys and ethnographic interviews of welfare recipients, 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, the study captures welfare reform in the best of times but focuses on the poorest families and neighborhoods.

What Have We Learned from HUDs Moving to Opportunity Program?

What Have We Learned from HUDs Moving to Opportunity Program?
In John M. Goering and Judith D. Feins, eds., Choosing a Better Life? A Social Experiment in Leaving Poverty Behind: Evaluation of the Moving to Opportunity Program. Washington, DC: Urban Institute Press,

Ellen, I.G. & Turner, M.
01/01/2003

As the centerpiece of policymakers' efforts to "deconcentrate" poverty in urban America, the Moving to Opportunity (MTO) project gave roughly 4,600 volunteer families the chance to move out of public housing projects in deeply impoverished neighborhoods in five cities-Baltimore, Boston, Chicago, Los Angeles, and New York. Researchers wanted to find out to what extent moving out of a poor neighborhood into a better-off area would improve the lives of public housing families. Choosing a Better Life? is the first distillation of years of research on the MTO project, the largest rigorously designed social experiment to investigate the consequences of moving low-income public housing residents to low-poverty neighborhoods. In this book, leading social scientists and policy experts examine the legislative and political foundations of the project, analyze the effects of MTO on lives of the families involved, and explore lessons learned from this important piece of U.S. social policy.

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