Vulnerable Populations

Dept. of Building, Winning the West

Dept. of Building, Winning the West
The New Yorker, July 5,

Whitagker, C. & Finnegan, W.
01/01/2004

Both sides have started punching harder lately in the brawl over whether or not to build a seventy-five-thousand-seat football stadium over the Hudson rail yards on Manhattan’s far West Side. The New York Jets, who would own the place, will be taking computers from the mouths of needy schoolchildren if the state and the city are forced to provide the six hundred million dollars that would be their part of the deal—or, at least, that’s what the television ads paid for by the Dolan family, the owners of Madison Square Garden, say. Nonsense, say the Jets and their supporters, who include Mayor Bloomberg, Governor Pataki, and the construction unions. The stadium will be such a financial success that it will end up giving computers to needy schoolchildren. Opponents say that the stadium will sink New York City’s bid to host the 2012 Olympics (the International Olympic Committee does not like controversy). No, say the stadium’s backers, it is the centerpiece of the city’s Olympic hopes.

Social Networks and Homelessness Among Women Heads of Household

Social Networks and Homelessness Among Women Heads of Household
American Journal of Community Psychology , 33:1-2, pp. 7-20.

Toohey, Siobhan, M., Shinn, M. & Weitzman, B.C.
01/01/2004

To examine possible bidirectional relationships between homelessness and deficient social networks, we compared the networks of 251 mothers before, and approximately 5 years after, their families entered shelters with networks of 291 consistently housed poor mothers. At Time 1, more women on the verge of homelessness than housed women reported that they had mothers, grandmothers, friends, and relatives but fewer believed these network members were housing resources. At Time 2, after homeless women were rehoused, these network differences between consistently housed and formerly homeless women had largely disappeared. Contrary to prior research findings, formerly homeless mothers did not report smaller networks, more children or fewer partners. However, formerly homeless women did report fewer positive functions. Because of city policies, homeless mothers were frequently rehoused far from network members.

What Matters to Low-Income Patients in Ambulatory Care Facilities?

What Matters to Low-Income Patients in Ambulatory Care Facilities?
Medical Care Research and Review. Sep 2004; 61: 352 - 375.

Delia, D., Hall, A. & Billings, J.
01/01/2004

Poor, uninsured, and minority patients depend disproportionately on hospital outpatient departments (OPDs) and freestanding health centers for ambulatory care. These providers confront significant challenges, including limited resources, greater demand for services, and the need to improve quality and patient satisfaction. The authors use a survey of patients in OPDs and health centers in New York City to determine which aspects of the ambulatory care visit have the greatest influence on patients’ overall site evaluation. The personal interaction between patients and physicians, provider continuity, and the general cleanliness/appearance of the facility stand out as high priorities. Access to services and interactions with other facility staff are of significant, although lesser, importance. These findings suggest ways to restructure the delivery of care so that it is more responsive to the concerns of low-income patients.

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.

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.

Mother-Child Separations Among Homeless and Housed Families Receiving Public Assistance in New York City

Mother-Child Separations Among Homeless and Housed Families Receiving Public Assistance in New York City
American Journal of Community Psychology 30:5, pp. 711-730.

Cowal, K., Shinn, M., Weitzman, B.C., Stojanovic, D. & Labay, L.
01/01/2002

We examined the incidence, characteristics, and predictors of separations of children from mothers in 543 poor families receiving public assistance, 251 of whom had experienced homelessness during the previous 5 years. Forty-four percent of the homeless mothers and 8% of housed mothers were separated from one or more children. A total of 249 children were separated from 110 homeless families and 34 children from 23 housed families. Children were placed with relatives and in foster care but were rarely returned to their mothers. Maternal drug dependence, domestic violence, and institutionalization predicted separations, but homelessness was the most important predictor, equivalent in size to 1.9 other risk factors. We infer that policies regarding child welfare and substance abuse treatment should be changed to reduce unnecessary placements. Studies of homeless children who remain with families may be biased if separated children are excluded.

Variation in Teenage Mothers’ Experiences of Child Care and Other Components of Welfare Reform: Selection Processes and Developmental Consequences

Variation in Teenage Mothers’ Experiences of Child Care and Other Components of Welfare Reform: Selection Processes and Developmental Consequences
Child Development, Volume 72, pp. 299-317,

Yoshikawa, H., Rosman, E.A. & Hsueh, J..
01/01/2001

Developmental evaluations of the current wave of welfare reform programs present challenges with regard to (1) assessing child outcomes; (2) accounting for heterogeneity among low-income families in both baseline characteristics and involvement in self-sufficiency activities and supports, and (3) development of alternatives to experimental approaches to causal inference. This study (N = 1,079) addresses these challenges by examining effects on 4- to 6-year-old children of different patterns of child care, self-sufficiency activities, and other service utilization indicators among experimental-group mothers in a 16-site welfare reform program. Outcomes in areas of cognitive ability and behavior problems were investigated. The study identified seven subgroups of participants engaging in different patterns of service utilization and activity involvement. A two-stage simultaneous equation methodology was used to account for selection, and effects on child cognitive ability of participation in specific patterns of services and activities were found. For example, children of mothers characterized by high levels of involvement in center-based child care, education, and job training showed higher levels of cognitive ability than children of mothers in groups characterized by high involvement in center-based care and education, or center-based care and job training. In addition, children of mothers in groups with high levels of involvement in any of these activities showed higher levels of cognitive ability than those with low levels of involvement. The bulk of selection effects occurred through site-level differences, rather than family-level socio-economic status or maternal depression indicators. Implications for welfare reform program and policy concerns are discussed.

How Do Urban Communities Affect Youth? Using Social Science Research to Inform the Design and Evaluation of Comprehensive Community Initiatives

How Do Urban Communities Affect Youth? Using Social Science Research to Inform the Design and Evaluation of Comprehensive Community Initiatives
In J.P. Connell, A. Kubisch, L. Schorr, & C. Weiss (Eds.) New Approaches to Evaluating Comprehensive Community Initiatives: Concepts, Methods and Contexts, (pp. 93-125). Roundtable on Comprehensive Community Initiatives for Children and Families, The Aspen Institute.

Connell, J.P., Aber, J.L. & Walker, G.
01/01/1995

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