Vulnerable Populations

What Does Government Spend on Children? Evidence from Five Cities

What Does Government Spend on Children? Evidence from Five Cities
Brookings Institute, Center on Urban and Metropolitan Policy, March,

Brecher, C., Searcy, C., Silver, D. & Weitzman, B.C.
03/01/2004

This paper examines public spending on children between 1997 and 2000 in five localities: Baltimore, Detroit, Oakland, Philadelphia, and Richmond. These cities participate in the Urban Health Initiative (UHI), a ten-year Robert Wood Johnson Foundation program aimed at improving health and safety for young people in these cities. The Center for Health and Public Service Research at New York University is evaluating the program. The evaluation seeks to determine whether collaborative efforts of interested organizations can develop and implement plans to change service delivery systems for children, and whether such changes result in better outcomes for children. A group of ten additional cities serves as a comparative benchmark.

Academic Achievement Among Formerly Homeless Adolescents and Their Continuously Housed Peers

Academic Achievement Among Formerly Homeless Adolescents and Their Continuously Housed Peers
Journal of School Psychology, Vol. 42, No. 3, pp. 179-199.

Rafferty, Y., Shinn, M. & Weitzman, B.
01/01/2004

This study examined the school experiences and academic achievement of 46 adolescents in families who experienced homelessness and 87 permanently housed adolescents whose families received public assistance. Measures taken after the homeless students were rehoused showed that both groups valued school highly and were similar in cognitive abilities assessed with the similarities subtest of the Wechsler Intelligence Scale for Children—Revised (WISC-R). Formerly homeless students had more school mobility, more grade retention, and worse school experiences by mother report and lower plans for post secondary education by self-report. Both groups scored poorly on standardized tests of academic achievement. Homelessness was associated with further declines in achievement during the period of maximal residential disruption, but did not have effects 5 years later.

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.

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