Vulnerable Populations

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.

High Stakes in the Classroom, High Stakes on the Street: The Effects of Community Violence on Students’ Standardized Test Performance

High Stakes in the Classroom, High Stakes on the Street: The Effects of Community Violence on Students’ Standardized Test Performance
Sociological Science, forthcoming

Ingrid Gould Ellen, Amy Ellen Schwartz, Patrick Sharkey, and Johanna Lacoe
03/06/2014

This paper examines the effect of exposure to violent crime on students’ standardized test performance among a sample of students in New York City public schools. To identify the effect of exposure to community violence on children’s test scores, we compare students exposed to an incident of violent crime on their own blockface in the week prior to the exam to students exposed in the week after the exam. The results show that such exposure to violent crime reduces performance on English Language Arts assessments, and no effect on Math scores. The effect of exposure to violent crime is most pronounced among African Americans, and reduces the passing rates of black students by approximately 3 percentage points.

Dispelling An Urban Legend: Frequent Emergency Department Users Have Substantial Burden Of Disease

Dispelling An Urban Legend: Frequent Emergency Department Users Have Substantial Burden Of Disease
Health Affairs, 32, no.12 (2013):2099-2108

Billings, John and Maria C. Raven
12/01/2013

Urban legend has often characterized frequent emergency department (ED) patients as mentally ill substance users who are a costly drain on the health care system and who contribute to ED overcrowding because of unnecessary visits for conditions that could be treated more efficiently elsewhere. This study of Medicaid ED users in New York City shows that behavioral health conditions are responsible for a small share of ED visits by frequent users, and that ED use accounts for a small portion of these patients’ total Medicaid costs. Frequent ED users have a substantial burden of disease, and they have high rates of primary and specialty care use. They also have linkages to outpatient care that are comparable to those of other ED patients. It is possible to use predictive modeling to identify who will become a repeat ED user and thus to help target interventions. However, policy makers should view reducing frequent ED use as only one element of more-comprehensive intervention strategies for frequent health system users.

Banks and Microbanks

Banks and Microbanks
Journal of Financial Services Research

Robert Cull, Asli Demirgüç-Kunt, and Jonathan Morduch
09/16/2013

We combine two datasets to examine whether the presence of banks affects the profitability and outreach of microfinance institutions.We find evidence that competition matters. Greater bank penetration in the overall economy is associated with microbanks pushing toward poorer markets, as reflected in smaller average loans sizes and greater outreach to women. The evidence is particularly strong for microbanks relying on commercial-funding and using traditional bilateral lending contracts (rather than group lending methods favored by microfinance NGOs). We consider plausible alternative explanations for the correlations, including relationships that run through the nature of the regulatory environment and the structure of the banking environment, but we fail to find strong support for these alternative hypotheses.

Urinary phthalates and increased insulin resistance in adolescents

Urinary phthalates and increased insulin resistance in adolescents
Pediatrics. 2013 Sep;132(3):e646-55. doi: 10.1542/peds.2012-4022. Epub 2013 Aug 19.

Trasande L, Spanier AJ, Sathyanarayana S, Attina TM, Blustein J.
09/12/2013

BACKGROUND: Di-2-ethylhexylphthalate (DEHP) is an environmental chemical commonly found in processed foods. Phthalate exposures, in particular to DEHP, have been associated with insulin resistance in adults, but have not been studied in adolescents.

METHODS:

Using cross-sectional data from 766 fasting 12- to 19-year-olds in the 2003-2008 NHANES, we examined associations of phthalate metabolites with continuous and categorical measures of homeostatic model assessment of insulin resistance (HOMA-IR).

RESULTS:

Controlling for demographic and behavioral factors, diet, continuous age, BMI category, and urinary creatinine, for each log (roughly threefold) increase in DEHP metabolites, a 0.27 increase (95% confidence interval 0.14-0.40; P < .001) in HOMA-IR was identified. Compared with the first tertile of DEHP metabolite in the study population (14.5% insulin resistant), the third tertile had 21.6% prevalence (95% confidence interval 17.2%-26.0%; P = .02). Associations persisted despite controlling for bisphenol A, another endocrine-disrupting chemical commonly found in foods, and HOMA-IR and insulin resistance were not significantly associated with metabolites of lower molecular weight phthalates commonly found in cosmetics and other personal care products.

CONCLUSIONS:

Urinary DEHP concentrations were associated with increased insulin resistance in this cross-sectional study of adolescents. This study cannot rule out the possibility that insulin-resistant children ingest food with higher phthalate content, or that insulin-resistant children excrete more DEHP.

Scientific Publications on Firearms in Youth Before and After Congressional Action Prohibiting Federal Research Funding

Scientific Publications on Firearms in Youth Before and After Congressional Action Prohibiting Federal Research Funding
Journal of the American Medical Association [JAMA];310(5): 532-533.

Ladapo, Joseph, Benjamin Rodwin, Andrew M. Ryan, Leonardo Trasande, Jan Blustein
09/04/2013

In January 1996, Congress passed an appropriations bill amendment prohibiting the US Centers for Disease Control and Prevention (CDC) from using “funds made available for injury prevention … to advocate or promote gun control.” This provision was triggered by evidence linking gun ownership to health harms, created uncertainty among CDC officials and researchers about what could be studied, and led to significant declines in funding. We evaluated the change in the number of publications on firearms in youth compared with research on other leading causes of death before and after the Congressional action. We focused on children and adolescents because they disproportionately experience gun violence and injury.

Financing Medicaid: Federalism and the Growth of America's Health Care Safety Net

Financing Medicaid: Federalism and the Growth of America's Health Care Safety Net
University of Michigan Press

Shanna Rose
08/29/2013

Medicaid has evolved over the past five decades from a tiny “welfare medicine” program into the single largest health insurance program in the United States. Contrary to the conventional wisdom that programs for the poor are vulnerable to instability and retrenchment because they lack a powerful constituency, This book finds that, as a result of its unique institutional structure, Medicaid does, in fact, have an organized, influential interest group: the nation’s governors. Although governors routinely criticize Medicaid for its mounting cost to the states, they have found it difficult to resist the powerful expansionary incentives created by the program’s open-ended federal matching grants. Throughout the program’s history, state leaders have used a variety of methods ranging from lobbying and negotiation to creative financing mechanisms and waivers to maximize federal aid, thereby fueling Medicaid’s growth. And, perceiving federal retrenchment efforts as a threat to their states’ financial interests, the governors have repeatedly worked together in bipartisan fashion to defend the program against cutbacks. Indeed, Rose argues, Medicaid has been a driving force behind the mobilization of the intergovernmental lobby, and specifically the National Governors Association—one of the most powerful interest groups in Washington. Financing Medicaid intertwines theory, historical narrative, and case studies, drawing on a variety of sources including archival materials from gubernatorial and presidential libraries and the National Governors Association.

Building Job Quality from the Inside-Out: Immigrants, Skill, and Jobs in the Construction Industry

Building Job Quality from the Inside-Out: Immigrants, Skill, and Jobs in the Construction Industry
Industrial Labor Relations Review. 66(4): 785-807.

Iskander, N. and N. Lowe
07/01/2013

Using an ethnographic case study of Mexican immigrant construction workers in two U.S. cities and in Mexico, the authors illustrate the contribution of immigrant skill as a resource for changing workplace practices. As a complement to explanations that situate the protection of job quality and the defense of skill to external institutions, the authors show that immigrants use collective learning practices to improve job quality from inside the work environment—that is to say from the inside-out. The authors also find that immigrants use collective skill-building practices to negotiate for improvements to their jobs; however, their ability to do so depends on the institutions that organize production locally. Particular attention is given to the quality of those industry institutions, noting that where they are more malleable, immigrant workers gain more latitude to alter their working conditions and their prospects for advancement.

Not Just for Poor Kids: The Impact of Universal Free School Breakfast on Meal Participation and Student Outcomes

Not Just for Poor Kids: The Impact of Universal Free School Breakfast on Meal Participation and Student Outcomes
Economics of Education Review, 36: 88-107

Leos-Urbel, J., Schwartz, A. E., Weinstein, M., & Corcoran, S.
06/18/2013

This paper examines the impact of the implementation of a universal free school breakfast policy on meals program participation, attendance, and academic achievement. In 2003, New York City made school breakfast free for all students regardless of income, while increasing the price of lunch for those ineligible for meal subsidies. Using a difference-indifference estimation strategy, we derive plausibly causal estimates of the policy’s impact by exploiting within and between group variation in school meal pricing before and after the policy change. Our estimates suggest that the policy resulted in small increases in breakfast participation both for students who experienced a decrease in the price of breakfast and for free-lunch eligible students who experienced no price change. The latter suggests that universal provision may alter behavior through mechanisms other than price, highlighting the potential merits of universal provision over targeted services. We find limited evidence of policy impacts on academic outcomes.

Race/Ethnicity-Specific Associations of Urinary Phthalates with Childhood Body Mass in a Nationally Representative Sample

Race/Ethnicity-Specific Associations of Urinary Phthalates with Childhood Body Mass in a Nationally Representative Sample
Environmental Health Perspectives. 121:501-506.

Trasande, Leonardo, Teresa M Attina, S Sathyanarayana, Adam J Spanier, Jan Blustein.
04/01/2013

Background: Phthalates have antiandrogenic effects and may disrupt lipid and carbohydrate metabolism. Racial/ethnic subpopulations have been documented to have varying urinary phthalate concentrations and prevalences of childhood obesity.

Objective: We examined associations between urinary phthalate metabolites and body mass outcomes in a nationally representative sample of U.S. children and adolescents.

Methods: We performed stratified and whole-sample cross-sectional analyses of 2,884 children 6–19 years of age who participated in the 2003–2008 National Health and Nutrition Examination Survey. Multivariable linear and logistic analyses of body mass index z-score, overweight, and obesity were performed against molar concentrations of low-molecular-weight (LMW), high-molecular-weight (HMW), and di-2-ethylhexylphthalate (DEHP) metabolites, controlling for sex, television watching, caregiver education, caloric intake, poverty–income ratio, race/ethnicity, serum cotinine, and age group. We used sensitivity analysis to examine robustness of results to removing sample weighting, normalizing phthalate concentrations for molecular weight, and examining different dietary intake covariates.

Results: In stratified, multivariable models, each log unit (roughly 3-fold) increase in LMW metabolites was associated with 21% and 22% increases in odds (95% CI: 1.05–1.39 and 1.07–1.39, respectively) of overweight and obesity, and a 0.090-SD unit increase in BMI z-score (95% CI: 0.003–0.18), among non-Hispanic blacks. Significant associations were not identified in any other racial/ethnic subgroup or in the study sample as a whole after controlling for potential confounders, associations were not significant for HMW or DEHP metabolites, and results did not change substantially with sensitivity analysis.

Conclusions: We identified a race/ethnicity–specific association of phthalates with childhood obesity in a nationally representative sample. Further study is needed to corroborate the association and evaluate genetic/epigenomic predisposition and/or increased phthalate exposure as possible explanations for differences among racial/ethnic subgroups.

Pages

Subscribe to Vulnerable Populations