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There has been a significant amount of work done on the private funding of nonprofits. Yet, despite the enormous size of the nonprofit sector as a whole, the importance of private donations to the sector, and the significance of the sector to public finances, there has been very little empirical research done on the capital structure of nonprofit organizations, and none has examined the potential effects of borrowing on individual contributions. Debt might affect donations because programmatic expansion might “crowd-in” additional donors, the use of debt might “crowd-out” current donors since expansion is undertaken at the behest of the organization (and not due to donor demand for increased output), donors might have a preference for funding current output rather than past output, or because of concerns that the nonprofit will be unable to maintain future programmatic output. These potential effects of debt on giving by individuals have not been the focus of research to date. The primary data for this paper come from the “The National Center on Charitable Statistics (NCCS)-GuideStar National Nonprofit Research Database” that covers fiscal years 1998 through 2003. The digitized data cover all public charities required to file the Form 990. The final sample contains 460,577 observations for 105,273 nonprofit entities. The results for the full sample support a “crowding-out” effect. The analysis is repeated on a subsample of nonprofits more dependent upon donations, following Tinkelman and Mankaney (2007). The restricted sample contains 121,507 observations for 36,595 nonprofit organizations. The results for the subsample are more ambiguous: secured debt has little or no effect, while unsecured debt has a positive effect. The empirical analysis is then expanded to test whether nonprofits with higher than average debt levels have different results than nonprofits with below average debt levels. The results suggest that donors do remove future donations when a nonprofit is more highly leveraged compared to similar organizations.
Nonprofits may fear that the use of debt signals mismanagement or bad governance, worrying that donors will punish the organization by removing future donations. The results presented here suggest a more complicated relationship between nonprofit leverage and donations from individuals than this simple calculus. On the one hand, increases in secured debt ratios (from mortgages and bonds) seems to reduce future contributions, possibly because donors are wary of government or lender intervention in the nonprofit’s management, or possibly because of the lack of flexibility inherent in repaying such rigid debt. On the other hand, unsecured debt, while more expensive, seems to crowd-in donations, even at increasingly higher levels when compared to similar organizations. There are at least two important conclusions from this analysis. First, during times of fiscal stress, nonprofits are often tempted to use restricted funds in ways inconsistent with donor intent simply to ensure organizational survival. Rather than violate the trust of certain donors, the results here suggest that nonprofits would be better off utilizing unsecured (possibly short-term) borrowing to smooth out cash flow needs. This option, however, assumes that nonprofits have access to some type of borrowing which is not true for many organizations. A second conclusion one might draw, therefore, is that policy considerations should be made to expand access to debt for nonprofits. The results here suggest that certain types of unsecured debt might in fact draw in additional resources, allowing nonprofits to leverage these borrowings for additional resources. By encouraging this type of policy option, nonprofits would not only gain access to increased revenue sources, but might be able to maintain programmatic output during times of fiscal stress.

In LGBT Youth in America’s Schools, Jason Cianciotto
and Sean Cahill, experts on lesbian, gay, bisexual,
and transgender public policy advocacy, combine an
accessible review of social science research with analyses
of school practices and local, state, and federal
laws that affect LGBT students. In addition, portraits
of LGBT youth and their experiences with discrimination
at school bring human faces to the issues the
authors discuss.

This is an essential guide for teachers, school administrators,
guidance counselors, and social workers interacting
with students on a daily basis; school board
members and officials determining school policy;
nonprofit advocates and providers of social services
to youth; and academic scholars, graduate students,
and researchers training the next generation of
school administrators and informing future policy and
practice.

Evidence on the relationship between political contributions and legislators’ voting behavior is marred by concerns about endogeneity in the estimation process. Using a legislator’s offspring sex mix as a truly exogenous variable, we employ an instrumental variable estimation procedure to predict the effect of voting behavior on political contributions. Following previous research, we find that a legislator’s proportion daughters has a significant effect on voting behavior for women’s issues, as measured by score in the “Congressional Record on Choice” issued by NARAL Pro-Choice America. In the second stage, we make a unique contribution by demonstrating a significant impact of exogenous voting behavior on PAC contributions, lending further credibility to the hypothesis that Political Action Committees respond to legislators’ voting patterns by “rewarding” political candidates that vote in line with the positions of the PAC, rather than affecting those same votes – at least in this high-profile policy domain.

While less well known to the average American than other federal affordable housing programs such as public housing, the Low-Income Housing Tax Credit Program (LIHTC) is the largest federal program for the production and preservation of affordable housing. Over the past 25 years it has financed the new construction or rehabilitation of more than 2.2 million affordable units, which represents more than enough units to house the population of Colorado. It also, in 2010, accounted for half of all multifamily housing production. Despite its importance, policymakers know little about the tenants the LIHTC program serves, or about the program’s effects on individuals and communities.

Hurricane Sandy demonstrated the strengths and limits of the transportation
infrastructure in New York City and the surrounding region. As a result of the
timely and thorough preparations by New York City and the MTA, along with
the actions of city residents and emergency workers to evacuate and adapt, the
storm wrought far fewer casualties than might have occurred otherwise.

This report evaluates storm preparation and response by New York City and the MTA, discusses New Yorkers' ingenuity in work continuity, and recommends infrastructure and policy improvements.

I n the fall of 2011, the Women of Color Policy Network at New York University's Robert F. Wagner Graduate School of Public Service conducted a survey of over 300 passenger service workers at the region's three major airports: LaGuardia, Kennedy International and Newark Liberty International.
Only workers contracted by the airlines were surveyed. This report focuses on the impact of the low-bid
contracting system on passenger service workers at the airports. It also proposes ways forward and concrete recommendations to raise job quality and performance standards for companies contracted directly with airlines.

We cannot understand Manhattan in the 21st century by relying on conventional measures of urban activity. Simply put, Manhattan consists of much more than its residential population and daily workforce. This island, measuring just 22.96 square miles, serves approximately 4 million people on a typical weekday, 2.9 million on a weekend day, and a weekday night population of 2.05 million. Manhattan, with a residential population of 1.6 million more than doubles its daytime population as a result of the complex network of tunnels, bridges, railroad lines, subways, commuter rail, ferry systems, bicycle lanes, and pedestrian walkways that link Manhattan to the surrounding counties, cities and towns.

This transportation infrastructure, largely built during the twentieth century, is operated by the City of New York, Metropolitan Transportation Authority, and Port Authority of New York & New Jersey. The infrastructure network generates a constant flow of people who are responsible for Manhattan's emergence as a world capital for finance, media, fashion, and the arts.

The residential population count does not include the 1.6 million commuters who enter Manhattan every weekday, or the hundreds of thousands of visitors who use Manhattan's tourist attractions, hospitals, universities, and nightclubs. This report analyzes the volume of people flowing in and out of Manhattan during a 24-hour period; we provide an upper estimate of the actual number of people in Manhattan during a typical work day.

"These 10 articles from leading scholars address federal government activism in such areas as health, education, transportation, and the arts. In some areas, federal involvement has been direct; for example, while school public systems are governed locally, Washington provides about 10% of k–12 funding. Similarly, antipoverty programs, such as the New Deal’s Social Security Act and Aid for Dependent Children, have played a major role in reducing the poverty rate from around 40% in 1900 to 11.2% in 1974. At other times, Washington has exerted influence more subtly, through regulations and research. Examples include the 1933 Glass-Steagall Act, which mandated the separation of investment and commercial banking and the WWII-era research that yielded compounds to prevent and cure malaria, syphilis, and tuberculosis. Further, as public policy scholar Paul C. Light points out in a fascinating concluding piece, more than two-thirds of leading governmental initiatives have been supported by both Democratic and Republican administrations. However, Light adds, the massive tax cut in 2001 “continue[s] to constrain federal investment in problem solving.” The scholars brought together by Ohio State historian Conn (History’s Shadow) persuasively demonstrate how the growth of “big government” throughout the 20th century has benefited ordinary Americans so comprehensively and unobtrusively that they have often taken it for granted."

Publishers Weekly

http://www.publishersweekly.com/978-0-19-985855-2

Health care policymakers have cited transportation
barriers as key obstacles to providing health care to
low-income suburbanites, particularly because suburbs have
become home to a growing number of recent immigrants
who are less likely to own cars than their neighbors. In a
suburb of New York City,we conducted a pilot survey of low
income, largely immigrant clients in four public clinics, to
find out how much transportation difficulties limit their
access to primary care. Clients were receptive to the opportunity
to participate in the survey (response rate = 94%).
Nearly one-quarter reported having transportation problems
that had caused them to miss or reschedule a clinic
appointment in the past. Difficulties included limited and
unreliable local bus service, and a tenuous connection to a
car. Our pilot work suggests that this population is willing to
participate in a survey on this topic. Further, since even
among those attending clinic there was significant evidence
of past transportation problems, it suggests that a populationbased
survey would yield information about substantial
transportation barriers to health care.

Effective means of transport are critical under both normal and extreme conditions, but modern transport systems are subject to many diverse demands. This path-breaking book uniquely draws together the typically conflicting arenas of transport, the environment and security, and provides collective solutions to their respective issues and challenges.

From a primarily urban perspective, the author illustrates that the fields of transportation, environment (with an emphasis on climate change) and security (for both natural hazards and terrorism) and their interconnections remain robust areas for policy and planning. Synthesizing existing data, new analyses, and a rich set of case studies, the book uses transportation networks as a framework to explore transportation in conjunction with environment, security, and interdependencies with other infrastructure sectors. The US rail transit system, ecological corridors, cyber security, planning mechanisms and the effectiveness of technologies are among the topics explored in detail. Case studies of severe and potential impacts of natural hazards, accidents, and security breaches on transportation are presented. These cases support the analyses of the forces on transportation, land use and patterns of population change that connect, disconnect and reconnect people from their environment and security.

The book will prove a fascinating and insightful read for academics, students, and practitioners across a wide range of fields including: transport, environmental economics, environmental management, urban planning, public policy, and terrorism and security.

Public officials have recently sought increased regulation of financial disclosures from not-for-profit organizations as a means of improving accountability with the public. One objective of this study is to examine whether not-for-profit entities already subject to audit requirements submit financial reports in compliance with GAAP. Further, since the majority of not-for-profit organizations are not subject to public audit mandates, this study also ascertains whether other market actors such as donors monitor and demand accrual-based financial information. The empirical analyses indicate that not-for-profit organizations subject to public audit mandates are largely in compliance with GAAP, although a significant minority of organizations subject to state requirements is not; further analyses suggest that external oversight significantly influence the use of accrual reporting. Models are also tested on a subsample of not-for-profits that switched from cash to accrual reporting, with the results suggesting that increasing public and market oversight have a significant effect on the decision to switch methods. The overall results suggest that public and market actors demand accrual-based financial reporting from not-for-profit organizations.

Lake Chapala is a major source of water for crop irrigation and subsistence fishing for a population of 300,000 people in central Mexico. Economic activities have created increasing pollution and pressure on the whole watershed resources. Previous reports of mercury concentrations detected in fish caught in Lake Chapala have raised concerns about health risks to local families who rely on fish for both their livelihood and traditional diet. Our own data has indicated that 27% of women of childbearing age have elevated hair mercury levels, and multivariable analysis indicated that frequent consumption of carp (i.e., once a week or more) was associated with significantly higher hair mercury concentrations. In this paper we describe a range of environmental health research projects. Our main priorities are to build the necessary capacities to identify sources of water pollution, enhance early detection of environmental hazardous exposures, and deliver feasible health protection measures targeting children and pregnant women. Our projects are led by the Children's Environmental Health Specialty Unit nested in the University of Guadalajara, in collaboration with the Department of Environmental Health of Harvard School of Public Health and Department of Pediatrics of the New York School of Medicine. Our partnership focuses on translation of knowledge, building capacity, advocacy and accountability. Communication will be enhanced among women's advocacy coalitions and the Ministries of Environment and Health. We see this initiative as an important pilot program with potential to be strengthened and replicated regionally and internationally.

The Rockefeller Foundation’s Bellagio Center, nestled in the foothills of the
Alps, has a storied past. It was here that the Green Revolution and the Global Aids Vaccine initiatives were conceptualised. In June this year, the Center opened its doors to 20 representatives from policy schools around the world over four days – including Dean Kishore Mahbubani, Professor Kanti Bajpai and myself from the LKY School – to discuss the ‘future of global public policy education’. Delegates grappled with the question: does our increasingly globalised world demand a fundamentally new kind of public policy education?

While the growth of urbanization, worldwide, has improved the lives of migrants from the hinterland, it also raises health risks related to population density, concentrated poverty and the transmission of infectious disease. Will megacity regions evolve into socially infected breeding grounds for the rapid transmission of disease, or can they become critical spatial entities for the protection and promotion of population health? We address this question for the Pearl River Delta Region (PRD) based on recent data from Chinese sources, and on the experience of how New York, Greater London, Tokyo and Paris have grappled with the challenges of protecting population health and providing their populations with access to health care services. In some respects, there are some important lessons from comparative experience for PRD, notably the importance of covering the entire population for health care services and targeting special programs for those at highest risk for disease. In other respects, PRD's growth rate and sheer scale make it a unique megacity region that already faces new challenges and will require new solutions.

This paper investigates the impact of schematic transit maps on passengers' travel decisions. It does two things: First, it proposes an analysis framework that defines four types of information delivered from a transit map: distortion, restoration, codification, and cognition. It then considers the potential impact of this information on three types of travel decisions: location, mode, and path choices.1 Second, it conducts an empirical analysis to explore the impact of the famous London tube map on passengers' path choice in the London Underground (LUL). Using data collected by LUL from 1998 to 2005, the paper develops a path choice model and compares the influence between the distorted tube map (map distance) and reality (travel time) on passengers' path choice behavior. Results show that the elasticity of the map distance is twice that of the travel time, which suggests that passengers often trust the tube map more than their own travel experience on deciding the ‘‘best'' travel path. This is true even for the most experienced passengers using the system. The codification of transfer connections on the tube map, either as a simple dot or as an extended link, could affect passengers' transfer decisions. The implications to transit operation and planning, such as trip assignments, overcrowding mitigation, and the deployment of Advanced Transit Information System (ATIS), are also discussed.

Few studies have adequately assessed the cost of transfers in public transport systems, or provided useful guidance on transfer improvements, such as where to invest (which facility), how to invest (which aspect), and how much to invest (quantitative justification of the investment). This paper proposes a new method based on path choice,3 taking into account both the operator's service supply and the customers' subjective perceptions to assess transfer cost and to identify ways to reduce it. This method evaluates different transfer components (e.g., transfer walking, waiting, and penalty) with distinct policy solutions and differentiates between transfer stations and movements.

The method is applied to one of the largest and most complex public transport systems in the world, the London Underground (LUL), with a focus on 17 major transfer stations and 303 transfer movements. This study confirms that transfers pose a significant cost to LUL, and that cost is distributed unevenly across stations and across platforms at a station.

Transfer stations are perceived very differently by passengers in terms of their overall cost and composition. The case study suggests that a better understanding of transfer behavior and improvements to the transfer experience could significantly benefit public transport systems.

Congestion pricing and land use planning have been proposed as two promising strategies to reduce the externalities associated with driving, including traffic congestion, air pollution, and greenhouse gas emissions. However, they are often viewed by their proponents as substitutive instead of complementary to each other. Using data from a pilot mileage fee program run in Portland, OR, we explored whether congestion pricing and land use planning were mutually supportive in terms of vehicle miles traveled (VMT) reduction. We examined whether effective land use planning could reinforce the benefit of congestion pricing, and whether congestion pricing could strengthen the role of land use planning in encouraging travelers to reduce driving.

VMT data were collected over 10 months from 130 households, which were divided into two groups: those who paid a mileage charge with rates that varied by congestion level (i.e., congestion pricing) and those who paid a mileage charge with a flat structure. Using regression models to compare the two groups, we tested the effect of congestion pricing on VMT reduction across different land use patterns, and the effect of land use on VMT reduction with and without congestion pricing. With congestion pricing, the VMT reduction is greater in traditional (dense and mixed-use) neighborhoods than in suburban (single use, low-density) neighborhoods, probably because of the availability of travel alternatives in the former. Under the same land use pattern, land use attributes explain more variance of household VMT when congestion pricing is implemented, suggesting that this form of mileage fee could make land use planning a more effective mechanism to reduce VMT. In summary, land use planning and congestion pricing appear to be mutually supportive.

For policymakers considering mileage pricing, land use planning affects not only the economic viability but also the political feasibility of a pricing scheme. For urban planners, congestion pricing provides both opportunities and challenges to crafting land use policies that will reduce VMT. For example, a pricing zone that overlaps with dense, mixed-use and transit-accessible development, can reinforce the benefits of these development patterns and encourage greater behavioral changes.

Public administration scholars answer the question: What might Alexander Hamilton, John Jay and James Madison, who between October 1787 and August 1788 penned the Federalist Papers promoting ratification of the U.S. Constitution, add now to the pamphlets, in view of changes in the administration of our government over the past two and a quarter centuries? Are these foundational essays still relevant? How might key pamphlets be updated to reflect new realities?

On October 1, 2011, the maximum loan size eligible for Federal Housing Administration (FHA) insurance or a guarantee from Fannie Mae or Freddie Mac (known as "Government-Sponsored Enterprises" or "GSEs") dropped in dozens of metropolitan areas around the country. When this change took effect, a segment of the mortgage market in each of these areas instantly lost some or all federal backing. If enough borrowers seeking loans in this segment are unable to find financing, the result will be further downward pressure on the corresponding segment of the housing market. In this report, we use recent mortgage origination data to explore some of the possible implications of this policy change for the housing market and the U.S. mortgage finance system.

This report demonstrates that New York City has successfully achieved almost all of the key elements in the NYC2012 Olympic Plan, despite the fact that it was not chosen to host the 2012 Games. For New York City, planning for the 2012 Olympics provided the framework to shape the future of the city, through new mass transit, rezoning, and investment in parks, recreational facilities, and housing throughout the city. Long neglected and underused industrial areas have been transformed as a result of the NYC2012 Plan, including the far west side of Manhattan, which will soon be linked to the rest of the city through an extension of the #7 subway line. This report describes how many projects, long the subject of public discussion and civic debate, were able to be carried out as a result of the NYC2012 Olympic Plan.

This study examines the role of mobile communications in urban transportation systems and analyzes American metropolitan regions best positioned to capitalize on the growth of mobile technologies. This paper identifies three critical factors—data accessibility, mobile network strength, and mobile tech user/developer demographics—and uses data from several public resources in an analysis of major Metropolitan Statistical Areas (MSAs). The authors explore trends and public policy implications for furthering the use of mobile communications in the transportation systems of metropolitan regions.

The rankings revealed that metropolitan regions each have areas of strength and weakness. In fact, no MSA ranked in the top five for each category, suggesting that though several cities were very strong (top five) in two categories (San Jose, San Francisco, Washington DC, San Diego), every MSA has substantial room for improvement.

This paper examines the impact of institutional change on patient care. Using panel data on obstetric deliveries from the state of California in the United States between 1983 and 2001, it develops and tests hypotheses predicting impacts of three features of institutional change-managed care insurance, changing professional controls and public attention to cost-control practices-on cesarean use and geographic variation in cesarean deliveries. It finds that managed care insurance promotes the diffusion of cost-effective patient care practices, reducing cesarean use and increasing variation. I found that over time, managed care patients experience continued lower use and reduced geographic variation as new practices become established. The combined effects of changing professional controls-the growing importance of clinical guidelines-and public attention to cost-control practices also diffuses cost-effective practices, increasing variation and decreasing cesarean use. Cesarean use increases and geographic variation declines in a period of managed care retreat in the late 1990s. The analysis extends prior research by documenting the impact of institutional change on health services use and variation and by suggesting that geographic variation is caused, in part, by the diffusion of new patient care practices

In groups people can accomplish what they cannot do alone.  Now new visual and social technologies are making it possible for people to make decisions and solve complex problems collectively. These technologies  are enabling groups not only to  create community but also to
wield power and create rules to  govern their own affairs. Electronic democracy theorists have either focused on the individual and the state, disregarding the collaborative nature of public life,
or they remain wedded to out-dated and unrealistic conceptions of deliberation. This Article makes two central claims.  First, technology will enable more effective forms of collective action. This is
particularly so of the emerging tools for “collective visualization” which will profoundly reshape the ability of people to make decisions, own and dispose of assets, organize, protest, deliberate,
dissent and resolve disputes together.  From this argument derives a second, normative claim.  We should explore ways to structure the law to defer political and legal decisionmaking downward to
decentralized group-based decisionmaking. This argument about  groups expands upon previous theories of law that recognize a center of power independent of central government: namely, the
corporation.  If we take seriously the potential impact of technology on collective action, we ought to think about what it means to give groups body as well as soul – to “incorporate” them. The
Article rejects the anti-group arguments of Sunstein, Posner and Netanel and argues for the potential to realize legitimate self-governance at a “lower” and more democratic level.  The law has a central role to play in empowering active citizens to take part in this new form of democracy.

The purpose of this effort has been to foster a dialogue among peers at transportation and planning agencies about their experiences with promoting public transit and, in particular, the challenges they face related to bus rapid transit (BRT) projects, as well as the solutions that they have developed in response. Agencies from dozens of large cities around the United States participated at three (3) peer-to-peer exchanges in New York City, Los Angeles, and Cleveland. The facilitated discussions were structure to address the unique barriers to BRT implementation on the streets of dense and/or highly congested large urban centers. Three major themes were the focus of the workshops: Network, Route and Street Design, Traffic Operations, and BRT as a Driver of Economic Development; Building Political, Interagency and Stakeholder Support. The results of the workshops make clear that better public transportation in general and BRT in particular can be cost-effective and useful tools for improving transportation, the environment and for restoring the livability of America‘s large cities.

The present study examines the model of freight consolidation platforms, and urban distribution centers (UDCs) in particular, as a means to solve the last mile problem of urban freight while reducing vehicle miles traveled and associated environmental impacts. This paper attempts to identify the key characteristics that make UDCs successful and discuss under what contextual settings (e.g., institutional, policy) they work best. After an extensive review of UDC cases already implemented in other countries, the study examined three UDCs cases with potential applicability to the New York metropolitan region, discussing models and relevant features and elements that may be transferred to the New York context.

Economic analyses are increasingly appearing in the children's environmental-health literature. In this review, an illustrative selection of articles that represent cost analyses, cost-effectiveness analyses, and cost-benefit analyses is analyzed for the relative merits of each approach. Cost analyses remain the dominant approach due to lack of available data. Cost-effectiveness and cost-benefit analyses in this area face challenges presented by estimation of costs of environmental interventions, whose costs are likely to decrease with further technological innovation. Benefits are also more difficult to quantify economically and can only be partially alleviated through willingness-to-pay approaches. Nevertheless, economic analyses in children's environmental health are highly informative and important informants to public-health and policy practice. Further attention and training in their appropriate use are needed.

Substance use (SU) disorders adversely impact health status and contribute to inappropriate health services use. This qualitative study sought to determine SU-related factors contributing to repeated hospitalizations and to identify opportunities for preventive interventions. Fifty Medicaid-insured inpatients identified by a validated statistical algorithm as being at high-risk for frequent hospitalizations were interviewed at an urban public hospital. Patient drug/alcohol history, experiences with medical, psychiatric and addiction treatment, and social factors contributing to readmission were evaluated. Three themes related to SU and frequent hospitalizations emerged: (a) barriers during hospitalization to planning long-term treatment and follow-up, (b) use of the hospital as a temporary solution to housing/family problems, and (c) unsuccessful SU aftercare following discharge. These data indicate that homelessness, brief lengths of stay complicating discharge planning, patient ambivalence regarding long-term treatment, and inadequate detox-to-rehab transfer resources compromise substance-using patients' likelihood of avoiding repeat hospitalization. Intervention targets included supportive housing, detox-to-rehab transportation, and postdischarge patient support.

This article uses the Advocacy Coalition Framework to identify the stakeholders and their coalitions in the arena of after-school policy, which drew much new attention beginning in the early 1990s in many American cities. Using evidence from case studies in five cities, we show how the framework can be extended beyond stakeholder analysis to include identification of core and secondary value conflicts and of opportunities for policy analysis to help strengthen coalitions and pressures for change. Coalitions in each of the cities differ over core values relating to the purposes of after-school programs (academics versus “fun”), but policy analysts can promote common goals by developing options to deal with the secondary conflicts over the relative importance of facilities versus program content, the modes of collaboration between public schools and community based organizations, and the incentives for public school teachers to engage in staffing after-school programs.

The High Line, Brooklyn Navy Yards, Pier 40 and Myrtle Avenue Station, are examples of projects that are reinventing how we think about the use of infrastructure spaces in New York City. What are the characteristics that define such projects and how is that they have been successful? This paper attempts to provide answers to this question by reviewing four case studies of repurposed transportation infrastructures, drawing out their commonalities and discussing their policy implications. 

This introductory guide calls on all of us—from the small grassroots organization to the mighty foundation to legislators—to shift our frame and the way we think about social and policy change. It is a starting point and a tool to begin the conversation of how we turn this important corner without losing individuals, groups and communities along the way.

We argue in this paper that neighborhoods are highly relevant for the types of issues at the heart of regional science. First, residential and economic activity takes place in particular locations, and particular neighborhoods. Many attributes of those neighborhood environments matter for this activity, from the physical amenities, to the quality of the public and private services received. Second, those neighborhoods vary in their placement in the larger region and this broader arrangement of neighborhoods is particularly important for location choices, commuting behavior and travel patterns. Third, sorting across these neighborhoods by race and income may well matter for educational and labor market outcomes, important components of a region's overall economic activity. For each of these areas we suggest a series of unanswered questions that would benefit from more attention. Focused on neighborhood characteristics themselves, there are important gaps in our understanding of how neighborhoods change - the causes and the consequences. In terms of the overall pattern of neighborhoods and resulting commuting patterns, this connects directly to current concerns about environmental sustainability and there is much need for research relevant to policy makers. And in terms of segregation and sorting across neighborhoods, work is needed on better spatial measures. In addition, housing market causes and consequences for local economic activity are under researched. We expand on each of these, finishing with some suggestions on how newly available data, with improved spatial identifiers, may enable regional scientists to answer some of these research questions.

In the United States, public housing developments are predominantly located in neighborhoods with low median incomes, high rates of poverty and disproportionately high concentrations of minorities. While research consistently shows that public housing developments are located in economically and socially disadvantaged neighborhoods, we know little about the characteristics of the schools serving students in these neighborhoods.

In this paper, the authors examine the characteristics of elementary and middle schools attended by students living in public housing developments in New York City. Using the proportion of public housing students attending each elementary and middle school as their weight, they calculate the weighted average of school characteristics to describe the typical school attended by students living in public housing. They then compare these characteristics to those of the typical school attended by other students throughout the city in an effort to assess whether public schools systematically disadvantage students in public housing in New York City. 

Their  results are decidedly mixed. On one hand, they find no large differences between the resources of the schools attended by students living in public housing and the schools attended by their peers living elsewhere in the city; on the other hand, they find significant differences in student characteristics and outcomes. The typical school attended by public housing students has higher poverty rates and lower average performance on standardized exams than the schools attended by others. These school differences, however, fail to fully explain the performance disparities: they find that students living in public housing score lower, on average, on standardized tests than their schoolmates living elsewhere -- even though they attend the same school. These results point to a need for more nuanced analyses of policies and practices in schools, as well as the outside-of-school factors that shape educational success, to identify and address the needs of students in public housing.

This paper investigates the causal effect of pedestrian environments on walking behavior and focuses on the issue of research design. The paper differentiates between two types of research designs:treatment-based and traveler-based. The first approach emphasizes the variation of the treatment (pedestrian environments), and generally compares distinct neighborhoods, such as urban vs. suburban or transit-oriented vs. auto-dependent. The second approach emphasizes the homogeneity of subject (pedestrians), and aims at the same pedestrian under different environments normally due to home relocation, or the improvement of pedestrian environments.

This paper presents a third method, following a traveler-based research design while providing the pedestrian multiple walking paths with different pedestrian environments.

New York. London. Paris. Although these cities have similar sociodemographic characteristics, including income inequalities and ethic diversity, they have vastly different health systems and services. This book compares the three and considers lessons that can be applied to current and future debates about urban health care.

Highlighting the importance of a national policy for city health systems, the authors use well-established indicators and comparable data sources to shed light on urban health policy and practice. Their detailed comparison of the three city health systems and the national policy regimes in which they function provides information about access to health care in the developed world's largest cities.

The authors first review the current literature on comparative analysis of health systems and offer a brief overview of the public health infrastructure in each city. Later chapters illustrate how timely and appropriate disease prevention, primary care, and specialty health care services can help cities control such problems as premature mortality and heart disease.

In providing empirical comparisons of access to care in these three health systems, the authors refute inaccurate claims about health care outside of the United States.

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Both formal rules and informal norms guide government operations; formal rules often function through informal norms. Balanced budget requirements (BBRs) are formal rules, but they are implemented via the intermediary of informal norms—interpretation of BBRs by state officials. This article examines the fiscal implications of informal norms that govern budgetary balance. We propose that informal norms have substantive implications in policy making and implementation. To test the proposition, we obtain state self-reported, time-varying data on balanced budget provisions as observations of informal norms, compare them against formal, codified balanced budget requirements from recent research to identify gaps between rules and norms, and decompose the gaps using two categories—“interpretations” and “reverse interpretations” of formal balanced budget requirements. We then conduct probit estimation to obtain the effects of informal norms as well as the interpretations and reverse interpretations on two measures of budgetary balance. Results show that informal norms do affect outcomes of government financial operations; the two-step decomposition of the gaps between formal rules and informal norms provides further information on the locus of these effects. The article identifies the interpretation of formal rules as a new research area, thus contributing to the budgetary institutions and policy implementation literatures.

Context: The continuing rise in obesity rates across the United States has proved impervious to clinical treatment or public health exhortation, necessitating policy responses. Nearly a decade's worth of political debates may be hardening into an obesity issue regime, comprising established sets of cognitive frames, stakeholders, and policy options.

Methods: This article is a survey of reports on recently published studies.

Findings: Much of the political discussion regarding obesity is centered on two "frames," personal-responsibility and environmental, yielding very different sets of policy responses. While policy efforts at the federal level have resulted in little action to date, state and/or local solutions such as calorie menu labeling and the expansion of regulations to reduce unhealthy foods at school may have more impact.

Conclusions: Obesity politics is evolving toward a relatively stable state of equilibrium, which could make comprehensive reforms to limit rising obesity rates less feasible. Therefore, to achieve meaningful change, rapid-response research identifying a set of promising reforms, combined with concerted lobbying action, will be necessary.

Obesity burst onto the U.S. national policy agenda in 2000/2001, initially fuelled by a widely disseminated set of maps by the Centers for Disease Control and Prevention (CDC) depicting sharply rising obesity rates nationwide, followed by the surgeon general's warning that obesity had become a "new national epidemic" (Mokdad et al. 2003; Oliver 2006; Satcher 2001). A snapshot of responses since then would include alarmed reactions from medical, media, and policy actors alike. The health establishment has rushed to devise medical treatments, from surgical to pharmaceutical, for obesity and its manifold health effects. Surging media attention to obesity and overweight features reports ranging from dire health alarms ("the current generation may be the first to live shorter lives than their parents-and obesity is to blame"; Belluck 2005, p. A1; see also Daniels 2006; Olshansky et al. 2005) to economic warnings (over $120 billion lost annually to obesity-related illnesses; see e.g., Bhattacharya and Sood 2006) to "lifestyle" stories of coffins, airplane seats, and hospital beds all made larger to suit the "supersizing of America" (St. John 2003, p. A13). Public officials at all levels have decried the "epidemic," although statutory reforms have been concentrated in a few energetic local and state polities; the federal government has been noticeably slow to act. All the while obesity rates continue to rise, with thirty-seven states reporting significant year-to-year increases from 2007 to 2008, with none reporting a decrease (TFAH 2008).

This article explores obesity politics as it has evolved in recent years. First I discuss the sustained struggles over framing the topic now that public agendas have begun to solidify into an "issue regime" around obesity. Then I examine popular local and state policy options and review approaches that could have an impact on soaring obesity rates, along with an assessment of the likelihood of their widespread adoption. While promising policy approaches exist, the opportunity to take action may be closing fast. On most public health issues, policymaking features a bustle of activity followed by a period of quiescence as a regime coalesces-even when the underlying problems continue to mount. Antiobesity advocates who face declining interest from lawmakers will therefore need to devise creative ways to sustain a focus on this topic.

Understanding the complex factors contributing to the growing childhood obesity epidemic is vital not only for the improved health of the world's future generations, but for the healthcare system. The impact of childhood obesity reaches beyond the individual family and into the public arenas of social systems and government policy and programs. Global Perspectives on Childhood Obesity explores these with an approach that considers the current state of childhood obesity around the world as well as future projections, the most highly cited factors contributing to childhood obesity, what it means for the future both for children and society, and suggestions for steps to address and potentially prevent childhood obesity.

High-speed rail lines have been built and proposed in numerous countries throughout the world. The advantages of such lines are a higher quality of service than competing modes (air, bus, auto, conventional rail), potentially faster point-to-point times depending on specifiÂc locations, faster
loading and unloading times, higher safety than some modes, and lower labor costs. The disadvantage primarily lies in higher fixed costs, potentially higher energy costs than some competing modes, and higher noise externalities. Whether the net benefiÂts outweigh the net costs is an empirical question that awaits determination based on location specifiÂc factors, project costs, local demand, and network effects (depending on what else in the network exists). The optimal network design problem is hard (in the mathematical sense of hard, meaning optimal solutions are hard to fiÂnd because of the combinatorics of the possible different network configurations), so heuristics and human judgment are used to design networks.

This paper seeks to make sense of the Rockaway and Yonkers ferry service’s suspension, and draw lessons for those seeking to expand ferry service in New York City in the future. New ferry service has captured the attention of citizens, elected officials and many in the civic community, but a workable network of ferry service has so far eluded New York. Why has a network of publicly funded ferry service failed to take root in New York City? Also, What would a model to fund a ferry route over the long term look like?

On February 12th, 2008, Christine Quinn, Speaker of the New York City Council, took to the dais at the City Council Chambers to deliver the State of the City Address.  Towards the 17th page of an 18 page address, the Speaker’s remarks turned to public transit and the Mayor’s recently released PlaNYC initiatives.  While transit is generally a hot topic in New York, Mayor Bloomberg had made transportation a centerpiece of his second term and was spending the winter in a campaign to convince the State Legislature to approve a congestion pricing scheme in Manhattan to finance transportation capital projects. 

“It’s only natural to look at our natural highways, our water ways... to move New Yorkers efficiently and sustainably.” Said Speaker Quinn,  “That’s why we are proposing and the Mayor has agreed to begin developing a comprehensive five borough, year-round New York City Ferry System.”   The Speaker explained that the idea for ferry service originated through a series of public hearings she held with her colleagues in the Council:

 “Soon after, we began exploring the concept of a pilot ferry service for the Rockaways…got a commitment from the Mayor to fund it…and that service should be up and running by this summer.


Two years and twelve days later, the rhetoric of the State of the City speech came crashing to an anti-climactic end, as a report in the Daily News announced the cancellation of the Rockaways service.  The ferry would cease operations at the end of March.  

Plans for a five borough Ferry System have not materialized, except for an East River ferry serving developments along the Queens/Brooklyn waterfront, currently with two sailings during the AM and PM peak hours is expected to offer more frequent service next year  The Rockaway route had not met ridership projections and was recovering only 15-30% of its operational costs from revenues collected at the farebox.   The failure of the Rockaway ferry service, combined with the cancellation of another newly opened ferry service between Yonkers and Lower Manhattan in 2009 has dashed the hopes of some who wished to exploit New York’s water resources to improve commuting options via ferries.  This has led to questions about the feasibility of expanding ferry service in New York City more broadly. 

As large sections of the New York City waterfront are reclaimed from decades of industrial land use, idyllic waterfront parks have been developed next to gleaming residential towers.  It seems only natural that ferries will soon serve a role in transporting residents and visitors to these new neighborhoods throughout the City.  However, recent experiences illustrate the many obstacles facing expanded ferry services in New York City 

We explore attention to Clinton's health care reform proposal, ongoing debates, and its political demise to develop theory that explains how events create opportunities for cognitive realignment and transformation in institutional logics. Our case analysis illustrates how a bottom-up process of environmental sensemaking led to the emergence and adoption of a logic of managed care, which provided new organizing principles in the hospitals' organizational field. In addition to theorization, highlighted by prior research, we propose a second mechanism of environmental sensemaking: representation of change through exemplars and environmental features. The interplay between theorization, representation, and ongoing event attention can lead to change in institutional logics over an event's life course. We found that the managed care logic did not emerge in a fully formed fashion, but that actors theorized individual dimensions of the logic consistent with changing representations of hospitals' relationships with other actors in the field. As the event unfolded, the individual dimensions came to be theorized as part of an overall managed care logic. The label "managed care," previously understood as a specific organizational form, took on a new meaning to symbolize the organizing principles for hospitals' relationships with a variety of institutional actors as alternative models not congruent with the changing organizational field were abandoned.

We argue in this paper that neighborhoods are highly relevant for the types of issues at the heart of regional science. First, residential and economic activity takes place in particular locations, and particular neighborhoods. Many attributes of those neighborhood environments matter for this activity, from the physical amenities, to the quality of the public and private services received. Second, those neighborhoods vary in their placement in the larger region and this broader arrangement of neighborhoods is particularly important for location choices, commuting behavior and travel patterns. Third, sorting across these neighborhoods by race and income may well matter for educational and labor market outcomes, important components of a region's overall economic activity. For each of these areas we suggest a series of unanswered questions that would benefit from more attention. Focused on neighborhood characteristics themselves, there are important gaps in our understanding of how neighborhoods change - the causes and the consequences. In terms of the overall pattern of neighborhoods and resulting commuting patterns, this connects directly to current concerns about environmental sustainability and there is much need for research relevant to policy makers. And in terms of segregation and sorting across neighborhoods, work is needed on better spatial measures. In addition, housing market causes and consequences for local economic activity are under researched. We expand on each of these, finishing with some suggestions on how newly available data, with improved spatial identifiers, may enable regional scientists to answer some of these research questions.

The American Recovery and Reinvestment Act of 2009 has opened a window for implementing high-speed passenger rail operations in the U.S.  Because North America had never pursued high-speed rail as a national transportation priority, the planning framework for designing such services and linking them to the national transportation system was never created. An intermodal integration strategy will thus have to be developed in parallel with the designs for new high-speed train services, if these projects are to achieve their potential. Connecting these new high-speed passenger rail routes to airport, highway, and transit infrastructure and integrating train operations with aviation, transit and vehicular travel will facilitate future use of high-speed trains and enable high-speed rail supportive land uses to evolve. But designing tomorrow’s high-speed rail to fit into today’s air and surface transportation network would yield suboptimal results. A successful intermodal integration plan for high-speed rail will need to anticipate evolution in air and surface transportation modes that will adapt to the energy and climate challenges shaping future mobility.
 

Health care policymakers have cited transportation barriers as key obstacles to providing health care to low-income suburbanites, particularly because suburbs have become home to a growing number of recent immigrants who are less likely to own cars than their neighbors. In a suburb of New York City, we conducted a pilot survey of low income, largely immigrant clients in four public clinics, to find out how much transportation difficulties limit their access to primary care. Clients were receptive to the opportunity to participate in the survey (response rate = 94%). Nearly one-quarter reported having transportation problems that had caused them to miss or reschedule a clinic appointment in the past. Difficulties included limited and unreliable local bus service, and a tenuous connection to a car. Our pilot work suggests that this population is willing to participate in a survey on this topic. Further, since even among those attending clinic there was significant evidence of past transportation problems, it suggests that a population based survey would yield information about substantial transportation barriers to health care.

In 2005, immigrants exceeded 12% of the US population, with the highest concentrations in large metropolitan areas. While considerable research has focused on how immigrants affect local wages and housing prices, less research has asked how immigrants fare in US urban public schools. Previous studies find that foreign-born students outperform native-born students in their elementary and middle school years, but urban policymakers and practitioners continue to raise concerns about educational outcomes of immigrants arriving in their high school years.

The authors use data on a large cohort of New York City (NYC) public high school students to examine how the performance of students who immigrate during high school (teen immigrants) differs from that of students who immigrate during middle school (tween immigrants) or elementary school (child immigrants), relative to otherwise similar native-born students. Contrary to prior studies, their difference-in-difference estimates suggest that, ceteris paribus, teen immigrants do well compared to native-born migrants, and that the foreign-born advantage is relatively large among the teen (im)migrants. That said, their findings provide cause for concern about the performance of limited English proficient students, blacks and Hispanics and, importantly, teen migrants. In particular, switching school districts in the high school years - that is, student mobility across school districts - may be more detrimental than immigration per se. Results are robust to alternative specifications and cohorts, including a cohort of Miami students.

Victor Rodwin, professor of health policy and management at NYU Wagner, and his colleague Didier Tabuteau, counselor of state and professor of health policy at the Institut d'Etudes Politiques and the University of Paris Descartes, have published a new book (published by Editions Jacob Duvernet) in which they challenge the conventional wisdom that the French health care system is a government-managed, public and collective enterprise and the American system a private, market-oriented and individualist system. Based on six months of debates in Paris while Professor Rodwin held the Fulbright-Toqueville Chair (spring semester, 2010), this book compares public health, health insurance, the power of physicians, health care reform, and the silent revolution that is transforming health care organization in both France and the United States.

Modern methods of fare collection have turned ticketing contracts into complicated information technology projects without necessary bringing all the disciplines of such systems. The high cost of updating or maintaining front line systems makes it very challenging to keep up with the rapid obsolescence cycles that the IT industry considers normal. It is challenging enough to build a system that offers some prospect of working. Wrapping these systems in long term, inflexible contracts with lenders and contractors opposed to making changes presents further challenges. London's experience with such a contract over the last decade offers some lessons for any transit system about to use a public private partnership (PPP) to build a ticketing system.

This policy brief critically assesses the effectiveness of Temporary Assistance to Needy Families (TANF) policies and offers recommendations for strengthening the program's ability to provide an essential safety net for women of color and their families.

New York City is testing a policy of ‘Conditional Cash Transfers’, pioneered in Latin America and designed to address both the reduction of income poverty and investment in children's human capital development. Lawrence Aber examines the welfare policy lessons the NYC experiment might contain for other industrialised countries

This article uses the Advocacy Coalition Framework to identify the stakeholders and their coalitions in the arena of after-school policy, which drew much new attention beginning in the early 1990s in many American cities. Using evidence from case studies in five cities, we show how the framework can be extended beyond stakeholder analysis to include identification of core and secondary value conflicts and of opportunities for policy analysis to help strengthen coalitions and pressures for change. Coalitions in each of the cities differ over core values relating to the purposes of after-school programs (academics versus "fun"), but policy analysts can promote common goals by developing options to deal with the secondary conflicts over the relative importance of facilities versus program content, the modes of collaboration between public schools and community based organizations, and the incentives for public school teachers to engage in staffing after-school programs.

Budgeting is the core financial task in subnational governments. Although limited research has outlined the relationship between the annual operating budget and public pension funds, the existing literature has not considered the manner in which financial resources are measured within government budgets, how this measurement of resources might affect public budget decisions, and how the interaction of the budget with the actuarial model can lead public budget managers to engage in financially damaging transactions such as pension obligation bonds. This paper fills this void, and argues that the short-term nature of public budgeting coupled with the actuarial model's use of expected investment returns rather than a market discount rate for pension liability measurement causes governments to shift risk to future generations. This paper also recommends that a blended discount rate for pension liabilities be considered more appropriate when governments fund their annual pension expenditures using debt rather than equity (such as tax revenues).

Patients with frequent hospitalizations generate a disproportionate share of hospital visits and costs. Accurate determination of patients who might benefit from interventions is challenging: most patients with frequent admissions in 1 year would not continue to have them in the next. Our objective was to employ a validated regression algorithm to case-find Medicaid patients at high-risk for hospitalization in the next 12 months and identify intervention-amenable characteristics to reduce hospitalization risk. We obtained encounter data for 36,457 Medicaid patients with any visit to an urban public hospital from 2001 to 2006 and generated an algorithm-based score for hospitalization risk in the subsequent 12 months for each patient (0 = lowest, 100 = highest). To determine medical and social contributors to the current admission, we conducted in-depth interviews with high-risk hospitalized patients (scores >50) and analyzed associated Medicaid claims data. An algorithm-based risk score >50 was attained in 2,618 (7.2%) patients. The algorithm’s positive predictive value was equal to 0.67. During the study period, 139 high-risk patients were admitted: 60 met inclusion criteria and 50 were interviewed. Fifty-six percent cited the Emergency Department as their usual source of care or had none. Sixty-eight percent had >1 chronic medical conditions, and 42% were admitted for conditions related to substance use. Sixty percent were homeless or precariously housed. Mean Medicaid expenditures for the interviewed patients were $39,188 and $84,040 per patient for the years immediately prior to and following study participation, respectively. Findings including high rates of substance use, homelessness, social isolation, and lack of a medical home will inform the design of interventions to improve community-based care and reduce hospitalizations and associated costs.

The timing of this volume could not be more opportune. It is based on a 2007 conference to honor the work of Karl "Chip" Case, who is renowned for his scientific contributions to the economics of housing and public policy. The chapters analyze risk in the housing market, the regulation of housing markets by government, and other issues in U.S. housing policy. Chapters investigate derivative markets; the role that home equity insurance can play in reducing risk; the role that the regulation of government-sponsored enterprises has played in extending credit to home purchasers in low-income neighborhoods; and the growth in the market for subprime mortgages. The impact of local zoning regulations on housing prices and new construction is also considered. This is a must read during a time of restructuring our nation’s system of housing finance.

The continuing rise in obesity rates across the United States has proved impervious to clinical treatment or public health exhortation, necessitating policy responses. Nearly a decade’s worth of political debates may be hardening into an obesity issue regime, comprising established sets of cognitive frames, stakeholders, and policy options.

Six experiments investigate the hypothesis that social targets who display a greater action orientation are perceived as having more power (i.e., more control, less dependence, and more influence) than less action-oriented targets. I find evidence that this inference pattern is based on the pervasive belief that individuals with more power experience less constraint and have a greater capacity to act according to their own volition. Observers infer that targets have more power and influence when they exhibit more implementation than deliberation in the process of making decisions in their personal lives (Study 1a), in a public policy context (Study 1b), and in small groups (Study 2). In an organizational context, observers infer that a target who votes for a policy to change from the status quo has more power than a target who votes not to change from the status quo (Study 3). People also infer greater intra-organizational power and higher hierarchical rank in targets who take physical action toward a personal goal than in those who do not (Studies 4–5).

Wiki Government shows how to bring innovation to government. In explaining how to enhance political institutions with the power of networks, it offers a fundamental rethinking of democracy in the digital age. Collaborative democracy-government of the people, by the people, for the people-is an old dream. Today, Wiki Government shows how technology can make that dream a reality. In this thought-provoking book, Beth Simone Noveck illustrates how collaborative democracy strengthens public decisionmaking by connecting the power of the many to the work of the few. Equally important, she provides a step-by-step demonstration of how collaborative democracy can be designed, opening policymaking to greater participation. "Wiki Government" tells the story behind one of the most dramatic public sector innovations in recent years - inviting the public to participate in the patent examination process. Patent examiners usually work in secret, cut off from essential information and racing against the clock to master arcane technical claims. The Peer-to-Patent project radically transformed this process by allowing anyone with Internet access to collaborate with the agency in reviewing patent applications. "Wiki Government" describes how a far-flung team of technologists, lawyers, and policymakers pried open a tradition-bound agency's doors. Noveck explains how she brought both fiercely competitive companies and risk-averse bureaucrats on board. She discusses the design challenges the team faced in creating software to distill online collaboration into useful expertise, not just rants or raves. And she explains how law, policy, and technology can be revamped to help government work in more open and participatory ways in a wide range of policy arenas, including education and the environment.

The U.S. health care system faces well-known problems: 47 million people without health insurance, rapidly rising costs that consume 16 percent of the country'e economic output, and widely uneven quality of care. Even many people with coverage are experiencing serious problems paying for the rapidly rising costs of health care and insurance.

This book--a joint product of the National Academy of Public Administration and the National Academy of Social Insurance--undertakes a sweeping analysis of the management and administrative issues that arise in expanding health care coverage. The book identifies the core administrative functions that need to be performed in assuring access to health coverage, describes how these functions are performed at present and under proposed alternatives, draws lessons from experience in the U.S. and abroad, and assesses suggested administrative approaches designed to facilitate the improvement and expansion of health care coverage.

Adequate health care is one of today's most crucial domestic policy concerns. Expanding Access to Health Care is designed to bring together in one place some of the best thinking on the subject, not as an exercise in advocacy, but rather to lay out the issues in a balanced way so that policymakers, researchers, and citizens can better understand the complex details of health care reform.

In March 2009, the RAND Frederick S. Pardee Center for Longer Range Global Policy and the Future Human Condition hosted a workshop called “Shaping Tomorrow Today: Near-Term Steps Towards Long-Term Goals.” The workshop gave policymakers and analysts an opportunity to explore new methods and tools that can help improve long-term decisionmaking. The intent was to conduct this exploration collaboratively, drawing from many countries a mixed group of tool builders, analysts, planners, decisionmakers and interested lay observers. Their task was to consider how analysts and policymakers can determine when it is important to make long-term (as opposed to short-term) decisions, how to make better long-term decisions, and how best to support policymakers in thinking long term, using as case studies the areas of education, international policy, and climate change. These conference proceedings summarize the main discussions and presentations that took place during the two days of the workshop and include the papers written for workshop participants. They will be of interest to anyone engaged in the study and practice of thinking and acting meaningfully over the long term, with particular reference to problems faced by planners and policymakers in public institutions of governance.

Reorganizing primary school grade spans is a tractable and relatively inexpensive school reform. However, assessing the effects of reorganization requires also examining other organizational changes that may accompany grade span reforms. Using data on New York City public schools from 1996 to 2002 and exploiting within-school variations, we examine relationships among grade span, spending, and size. We find that school grade span is associated with differences in school size, class size, and grade size, though generally not with spending and other resources. In addition, we find class size and grade size differences in the same grade level at schools with different configurations, suggesting that school grade span affects not only school size but also class size and grade size. We find few relationships, though, between grade span and school-level performance, pointing to the need to augment these analyses with pupil-level data. We conclude with implications for research and practice.

Many policy problems require governmental leaders to forge vast networks beyond their own hierarchical institutions. This essay explores the challenges of implementation in a networked institutional setting and incentives to induce coordination between agencies and promote quality implementation. It describes the national evaluation of the Assuring Better Child Health and Development program, a state-based program intended to increase and enhance the delivery of child development services for low-income children through the health care sector, using Medicaid as its primary vehicle. Using qualitative evaluation methods, the authors found that all states implemented programs that addressed their stated goals and made changes in Medicaid policies, regulations, or reimbursement mechanisms. The program catalyzed interagency cooperation and coordination. The authors conclude that even a modest level of external support and technical assistance can stimulate significant programmatic change and interorganizational linkages within public agencies to enhance provision of child development services.

Building on decades of authoritative scholarship, this completely updated text continues to offer accessible, carefully crafted, and straightforward coverage of the foundations of American politics, as well consistent focus on the achievements of a government by the people

In an increasingly cynical world, GBTP emphasizes that politics matters and encourages, motivates, and even inspires students–with accounts of individual and collective acts of courageousness, intellect, and integrity in the political arena–to be effective and informed citizens.  

With each chapter now framed by nationally-selected learning objectives and chapter mastery self-tests, several compelling new features, and an all new contemporary design, this thoroughly updated Twenty-Third Edition continues in the book’s long tradition for excellence.  As we enter this very complex political era, there is no more reliable or more relevant text to help you advance your students from being simple onlookers to knowledgeable participants in the American political experience.

Segregation: The Rising Costs for America documents how discriminatory practices in the housing markets through most of the past century, and that continue today, have produced extreme levels of residential segregation that result in significant disparities in access to good jobs, quality education, homeownership attainment and asset accumulation between minority and non-minority households.The book also demonstrates how problems facing minority communities are increasingly important to the nations long-term economic vitality and global competitiveness as a whole. Solutions to the challenges facing the nation in creating a more equitable society are not beyond our ability to design or implement, and it is in the interest of all Americans to support programs aimed at creating a more just society.The book is uniquely valuable to students in the social sciences and public policy, as well as to policy makers, and city planners.

High school reform is currently at the top of the education policy making agenda after years of stagnant achievement and persistent racial and income test score gaps. Although a number of reforms offer some promise of improving U.S. high schools, small schools have emerged as the favored reform model, especially in urban areas, garnering substantial financial investments from both the private and public sectors. In the decade following 1993, the number of high schools in New York City nearly doubled, as new "small" schools opened and large high schools were reorganized into smaller learning communities. The promise of small schools to improve academic engagement, school culture, and, ultimately, student performance has drawn many supporters. However, educators, policy makers, and researchers have raised concerns about the unintended consequences of these new small schools and the possibility that students "left behind" in large, established high schools are incurring negative impacts.

High school reform is currently at the top of the education policy making agenda after years of stagnant achievement and persistent racial and income test score gaps. Although a number of reforms offer some promise of improving U.S. high schools, small schools have emerged as the favored reform model, especially in urban areas, garnering substantial financial investments from both the private and public sectors. In the decade following 1993, the number of high schools in New York City nearly doubled, as new "small" schools opened and large high schools were reorganized into smaller learning communities. The promise of small schools to improve academic engagement, school culture, and, ultimately, student performance has drawn many supporters. However, educators, policy makers, and researchers have raised concerns about the unintended consequences of these new small schools and the possibility that students "left behind" in large, established high schools are incurring negative impacts.

Using 10 years (1993-2003) of data on New York City high schools, we examine the potential systemic effects of small schools that have been identified by critics and researchers.

Research on childhood obesity has primarily been conducted by experts in nutrition, psychology, and medicine. Only recently have public policy scholars devoted serious work to this burgeoning public health crisis. Here the authors advance that research by surveying national experts in health/nutrition and health policy on the public health impact and the political feasibility of fifty-one federal policy options for addressing childhood obesity. Policies that were viewed as politically infeasible but having a great impact on childhood obesity emphasized outright bans on certain activities. In contrast, education and information dissemination policies were viewed as having the potential to receive a favorable hearing from national policy makers but little potential public health impact. Both nutrition and policy experts believed that increasing funding for research would be beneficial and politically feasible. A central need for the field is to develop the means to make high-impact policies more politically feasible.

Der Aufruf des Surgeon Generals 2 beginnt dramatisch: „Übergewicht und Adipositas haben epidemische Ausmaße erreicht...." (Satcher zit. nach Mokdad 2001). Wissenschaftler, Regierungssprecher, Medienexperten, Journalisten und Lobbygruppen stimmen zunehmend lauter in diesen alarmistischen Chor ein. Im Gegensatz aber zu vielen anderen Public-Health-Problemen ist Adipositas zu großen Teilen individuellen Verhaltensweisen wie Essen und Trinken geschuldet. In den Vereinigten Staaten mit ihrer starken Kultur des Individualismus wird Privates oft als Tabuzone für staatliche Interventionen betrachtet: „Die Regierung sollte sich aus den persönlichen Entscheidungen, die ich treffe, heraushalten", schreibt der Washingtoner Universitätsprofessor Robert Rüssel, „meine bzw. deine Essgewohnheiten rechtfertigen nicht, dass mir die Regierung in den Kochtopf guckt" (zit. nach St. Louis Dispatch: 21.03.2002).

How do we understand and also assess the health care of America? Where is health care provided? What are the characteristics of those institutions which provide it? Over the short term, how are changes in health care provisions affecting the health of the population, the cost of care, and access to care? Health Care Delivery in the United States, 8 th Edition discusses these and other core issues in the field. Under the editorship of Dr. Kovner and with the addition of Dr. James Knickman, Senior VP of Evaluation, Robert Wood Johnson Foundation, leading thinkers and practitioners in the field examine how medical knowledge creates new healthcare services. Emerging and recurrent issues from wide perspectives of health policy and public health are also discussed. With an easy to understand format and a focus on the major core challenges of the delivery of health care, this is the textbook of choice for course work in health care, the handbook for administrators and policy makers, and the standard for in-service training programs.

The past two years have been unsettled at best for Congress. Public approval toward Congress remains low, legislative debates have been contentious, polarization remains high, and Congress has a mixed record in dealing with major long-term issues such as Social Security and Medicare. The State Children's Health Insurance program has been delayed awaiting a compromise that might expand coverage, immigration reform has been waylaid by the intensity of opposition across the party lines, energy reform was diluted by ongoing disputes about how to reduce the nation's dependence on foreign oil, and the war in Iraq continues to dictate the pace of major legislative debates.

Developing community capacity to improve health is a cornerstone of community-based public health. The concept of community capacity reflects numerous facets and dimensions of community life and can have different meanings in different contexts. This paper explores how members of one community identify and interpret key aspects of their community's capacity to limit the availability and use of tobacco products. Particular attention is given to examining the interrelationship between various dimensions of community capacity in order to better understand the processes by which communities are able to mobilize for social change. The study is based on qualitative analysis of 19 in-depth interviews with key informants representing a variety of community sectors in Harlem, New York City. Findings indicate that the community is viewed as rich in human and social resources. A strong sense of community identity and connectedness underlies this reserve and serves as a catalyst for action.

The urgency of reducing poverty in the developing world has been the subject of a public campaign by such unlikely policy experts as George Clooney, Alicia Keyes, Elton John, Angelina Jolie, and Bono. And yet accompanying the call for more foreign aid is an almost universal discontent with the effectiveness of the existing aid system. In Reinventing Foreign Aid, development expert William Easterly has gathered top scholars in the field to discuss how to improve foreign aid. These authors, Easterly points out, are not claiming that their ideas will (to invoke a current slogan) Make Poverty History. Rather, they take on specific problems and propose some hard-headed solutions.

The South Bronx, New York, has one of the highest asthma rates among school-age children in the United States. Since children spend significant parts of their day at school, an understanding of where schools are located in relation to environmental health hazards that can potentially affect asthma can provide important information for making
decisions related to urban land-use planning and environmental policy. GIS provides communities with an important tool for leveraging data for policymaking efforts and improving policy makers' understanding of how different land uses might affect public health.

In this essay, we explore how the Environmental Protection Agency (EPA) might use technology to improve the agency's level of scientific expertise and to obtain useful information sooner to inform EPA policymaking. By creating a self-reinforcing collaboration between government and networked publics, new web-based tools could help produce change within government and without - namely governmental decisions informed by better data obtained through citizen participation and civic action coordinated with governmental priorities. The agency has the opportunity to help break the logjam of environmental policymaking by developing transparent and participatory mechanisms for expert citizen participation. The key insight is not to throw open the floodgates to undifferentiated public input, but to design group-based processes that enable online communities to collaborate on finding and vetting information for agencies.

General editor Haider-Markel (U. of Kansas) presents a two-volume encyclopedia intended to serve as a first-stop reference on state politics in the United States, which also includes some coverage of US overseas territories and Puerto Rico. The encyclopedia opens with four broad topical essays on the evolution and impact of state constitutions, the impact of direct democracy (voter initiatives and the like), cooperation between the states, and states as policy testing grounds. It then presents individual state profiles, about ten pages each, that are uniformly structured to allow comparison of state history, the political environment, elections and voting behavior, the legislative branch, the executive branch, the judicial branch, intergovernmental relations, state-tribal relations (where applicable), and long-term issues and policy trends. The state entries also include bibliographies; charts showing partisan distribution of presidential elections from 1988 to 2004; and data tables on political history, political environment, elections and voting behavior, the legislative branch, the executive branch, and the judicial branch. Also included are some 175 A-to-Z topical entries discussing general concepts related to governmental functions and procedures, government structures and bodies, political theory, and political behavior. Examples of specific topics would include gerrymandering, impeachment, public health, auditor, bicameralism, legislative leadership, common law, judicial review, and social welfare. Finally, statistical data on populations, economics, finance, the environment, government spending, voting, and campaign fundraising is presented for all 50 states, followed by a comprehensive index.

Psychologists discuss the influence of social policy on children's development, and the insights and skills that developmental psychologists bring to policy and its process. Among their topics are the role of strategic communications in policy advocacy, from visions to systems of universal pre-kindergarten, new directions in prevention and intervention for teen pregnancy and parenthood, and using the Web to disseminate research and affect public policy.

We find that estimates of the prevalence of teenage smoking and drinking in “urban,” “suburban,” and “rural” areas vary with different definitions of these types of geographic units. Given the salience of youth risk behavior to the public debate, we urge researchers to purposefully choose their definitions of geographic areas and to be explicit about those choices.

There is little doubt that globalization, however defined, has hit the field of
professional policy education in the twenty years since APPAM’s Hiltonhead conference on the future of policy education first took stock of a largely American landscape. Despite the title of this session, the relevant development is not merely the accretion of public policy schools and programs around the world. It is the recognition of international dimensions of the policy education enterprise that, if taken seriously (and participants in this discussion argued that it must), promises to change the way we conduct business on multiple levels. This report of the lively discussion generated in the wake of Iris Geva-May and her coauthors’ stimulating conference paper1 explores why and how.

Attempts to ‘regulate’ civil service personnel- to hold bureaucrats accountable, whether to politicians, the people, professional standards or the rule of law- are as old as the politician-bureaucrat relationship itself. Politicians and citizens throughout Southeast Asia are calling for greater bureaucratic accountability in a variety of country settings: one-party states and emerging democracies, and in countries with capable as well as rudimentary bureaucracies. This paper presents an analytical framework that unpacks the idioms used in common accountability reforms applied in Southeast Asian countries into four categories – ‘rules’, ‘watchdogs’, ‘culture’ and ‘re-engineering’ – and relates reform selection and implementation to country governance characteristics. The framework is used to identify  reform opportunities, constraints and likely trajectories in the diverse Southeast Asian context.

Developing countries that were early, enthusiastic adopters of Primary Health Care often developed an extensive – but eventually dilapidated and under-utilized – network of public clinics at the grassroots. As paradigms and investment patterns of health sector reform have shifted, the question of what role these public clinics can meaningfully play, and how best to revitalize them, has become important in a number of countries. This paper evaluates the strategy taken by, and outcomes of, a major attempt in Vietnam to revitalize the grassroots infrastructure of primary health care against the backdrop of the country’s economic transition. The project’s substantial supply-side investments in infrastructure led to marginal increases in utilization and the quality of preventive health services  provided by the centers. But because the project failed to take adequate stock of broader, public sector-wide trends and reforms over the transition, the investments had little impact on the incentives, accountability patterns and capacities of clinic staff and the local authorities. Such institutional factors are heavily implicated, in Vietnam as elsewhere, in the substantial and often increasing disparities in service access and quality that continue to afflict transitional health sectors.

The study of the health workforce has gained in prominence in recent years, as the dynamic interconnections between human resource issues and health system effectiveness have come into sharper focus. This paper reviews lessons relating to strategic management challenges emerging from the growing literature in this area. Workforce issues are strategic: they affect overall system performance as well as the feasibility and sustainability of health reforms. Viewing workforce issues strategically forces health authorities to confront the yawning gaps between policy and implementation in many developing countries.

Lessons emerge in four areas. Once concerns imbalances in workforce structure, whether from a functional specialization, geographical or facility lens. These imbalances pose a strategic challenge in that authorities must attempt to steer workforce distribution over time using a limited range of policy tools. A second group of lessons concerns the difficulties of central-level steering of the health workforce, often critically weak due to the lack of proper information systems and the complexities of public sector decentralization and service commercialization trends affecting the grassroots. A third cluster examines worker capacity and motivation, often shaped in developing countries as much by the informal norms and incentives as by formal attempts to support workers or to hold them accountable. Finally, a range of reforms centering on service contracting and improvements to human resource management are emerging. Since these have as a necessary (but not sufficient) condition some flexibility in personnel practices, recent trends towards the sharing of such functions with local authorities are promising. The paper identifies a number of current lines of productive research, focusing on the relationship between health policy reforms and the local institutional environments in which the workforce, both public and private, is deployed.

We sought to determine whether low acculturation among Mexican American caregivers protects their children against asthma. Methods. Data were obtained from an observational study of urban pediatric asthma. Dependent variables were children's diagnosed asthma and total (diagnosed plus possible) asthma. Regression models were controlled for caregivers' level of acculturation, education, marital status, depression, life stress, and social support and children's insurance. Results. Caregivers' level of acculturation was associated with children's diagnosed asthma (P=.025) and total asthma (P=.078) in bivariate analyses. In multivariate models, protective effects of caregivers' level of acculturation were mediated by the other covariates. Independent predictors of increased diagnosed asthma included caregivers' life stress (odds ratio [OR]= 1.12, P=.005) and children's insurance, both public (OR=4.71, P=.009) and private (OR = 2.87, P=.071). Only caregiver's life stress predicted increased total asthma (OR = 1.21, P=.001). Conclusions. The protective effect of caregivers' level of acculturation on diagnosed and total asthma for Mexican American children was mediated by social factors, especially caregivers' life stress. Among acculturation measures, foreign birth was more predictive of disease status than was language use or years in country. Increased acculturation among immigrant groups does not appear to lead to greater asthma risk.

This paper examines complex models of the associations between family income, material hardship, parenting, and school readiness among White, Black, and Hispanic 6-year-olds, using the Early Childhood Longitudinal Study-Kindergarten Cohort (ECLS-K). It is critical to test the universality of such complex models, particularly given their implications for intervention, prevention, and public policy. Therefore this study asks: Do measures and models of low income and early school readiness indicators fit differently or similarly for White, Black, and Hispanic children? Measurement equivalence of material hardship, parent stress, parenting behaviors, child cognitive skills, and child social competence is first tested. Model equivalence is then tested by examining whether category membership in a race/ethnic group moderates associations between predictors and young children's school readiness.

This study examines whether rules, particular participants, and executive politics in state tax revenue estimation exert measurable influences on forecast error. Fixed-effects estimation using data from states’ respective fiscal years 1994 to 2003 indicates that all impact state tax revenue forecast accuracy in varying ways, and results suggest that policy can be crafted to effectively mitigate forecast error. Further examination of the quality of participation in tax revenue forecasting as well as the mechanisms of political involvement in this arena is suggested.

We examine the size and distribution of the gap in test scores across races within New York City public schools and the factors that explain these gaps. While gaps are partially explained by differences in student characteristics, such as poverty, differences in schools attended are also important. At the same time, substantial within-school gaps remain and are only partly explained by differences in academic preparation across students from different race groups. Controlling for differences in classrooms attended explains little of the remaining gap, suggesting little role for within-school inequities in resources. There is some evidence that school characteristics matter. Race gaps are negatively correlated with school size-implying small schools may be helpful. In addition, the trade-off between the size and experience of the teaching staff in urban schools may carry unintended consequences for within-school race gaps. © 2006 by the Association for Public Policy Analysis and Management.

We examine the size and distribution of the gap in test scores across races within New York City public schools and the factors that explain these gaps. While gaps are partially explained by differences in student characteristics, such as poverty, differences in schools attended are also important. At the same time, substantial within-school gaps remain and are only partly explained by differences in academic preparation across students from different race groups. Controlling for differences in classrooms attended explains little of the remaining gap, suggesting little role for within-school inequities in resources. There is some evidence that school characteristics matter. Race gaps are negatively correlated with school size - implying small schools may be helpful. In addition, the trade-off between the size and experience of the teaching staff in urban schools may carry unintended consequences for within-school race gaps.

Background: Access to timely and effective medical services can reduce rates of premature mortality attributed to certain conditions. We investigate rates of total and avoidable mortality (AM) and the percentage of avoidable deaths in France, England and Wales and the United States, three wealthy nations with different health systems, and in the urban cores of their world cities, Paris, Inner London and Manhattan. We examine the association between AM and an income-related variable among neighbourhoods of the three cities. Methods: We obtained mortality data from vital statistics sources for each geographic area. For two time-periods, 1988–90 and 1998–2000, we assess the correlation between area of residence and age- and gender-adjusted total and AM rates. In our comparison of world cities, regression models are employed to analyse the association of a neighbourhood income-related variable with AM. Results: France has the lowest mortality rates. The US exhibits higher total, but similar AM rates compared to England and Wales. Rates of AM are lowest in Paris and highest in London. Avoidable mortality rates are higher in poor neighbourhoods of all three cities; only in Manhattan is there a correlation between the percentage of deaths that are avoidable and an income related variable. Conclusions: Beyond the well-known association of income and mortality, persistent disparities in AM exist, particularly in Manhattan and Inner London. These disparities are disturbing and should receive greater attention from policy makers.

Released in partnership with the Human Rights Project of the Urban Justice Center, this shadow report highlights the persistent discrimination experienced by people of color and immigrants in NYC and brings attention to the failure of the City to meet its full obligations under CERD.

In the political context of the reauthorization of federal welfare reform legislation, a nationally representative sample of 1,570 adults in the United States completed a survey examining the factors that affect attitudes and policy preferences with regard to aid for low-income individuals and families in the United States. This study utilized an innovative survey technique, the factorial survey methodology (Rossi & Nock, 1982), which allows for the simultaneous experimental manipulation of a large number of factors through the use of a vignette. This research demonstrates how the portrayal of difficulties faced by people in need and the ways in which they attempt to overcome these difficulties affect support for policies designed to aid low-income individuals and families. In addition, this study of public attitudes considers the role that psychological orientations of the evaluators play in judgments of families in need. In this case, we examined how the evaluators' belief that the world is a just place influences their evaluations of deservingness. Consistent with our expectations, we found that the more efforts the vignette subject engaged in improving her situation, the less deserving of government benefits she was judged to be by respondents with a strong belief in a just world. The reverse was found among respondents with a weaker belief: more efforts were associated with greater judgments of deservingness.

We find that estimates of the prevalence of teenage smoking and drinking in "urban," "suburban," and "rural" areas vary with different definitions of these types of geographic units. Given the salience of youth risk behavior to the public debate, we urge researchers to purposefully choose their definitions of geographic areas and to be explicit about those choices.

Public authorities play a major role in delivering public services. They supplement direct government agencies in three ways:

• Provide a business-like organizational structure for public services that are financed primarily by user fees and whose capital investments are self-financed through bonds supported by user fees.
• Provide a stewardship for major capital assets and make long-run investment decisions with some isolation from pressures of the electoral cycle.
• Provide a mechanism for taking advantage of federal tax benefits for economic development and other purposes that otherwise would be treated as private activities.

Authorities are intended to strike a balance between political accountability and political independence. Unlike heads of direct government agencies, governing boards of authorities are expected to be more independent of those who appoint them, to make difficult and unpopular decisions outside the arena of elected politics, and to be accountable to the public indirectly through reporting, transparency in decision-making and long-run performance. New York State makes extensive use of public authorities.

Bronx Health REACH, a coalition of community- and faith-based groups, health care providers, and an academic institution, recently examined the causes of racial and ethnic health disparities in the southwest Bronx and identified separate systems of care for uninsured and publicly insured patients, who are predominantly people of color, and those with private insurance. We found evidence that patients are sorted into segregated pathways of care, a system of medical apartheid in which differential care contributes to disparities in health care and health outcomes.

Decentralization occupies an important space in debates over public-sector reform in doi moi Vietnam. This paper assesses the changing distribution of roles, responsibilities and resources across levels of government over the past decade. Vietnam is incrementally transfering greater administrative and fiscal responsibilities to the provincial level. In addition, the Communist Party is attempting to prevent local corruption through a much touted “grassroots democratization” initiative. Yet such moves towards decentralization, however cautious, are  problematic in terms of their bureacratic politics and potential impacts on poverty. Incentives for bureacratic actors and local leaders to transfer meaningful control downwards are weak or non-existent within the  current governance structure, which centralizes political power and emphasizes hierarchical, sectoral controls over decision-making and resources. And decentralization trends are exacerbating the weak administrative and fiscal capacities of poorer provinces, threatening to reinforce rather than reduce Vietnam’s widening regional and rural-urban disparities. A more proactice role for the center in redistributing resources, providing technical support and establishing a facilitative policy framework will be crucial if decentralization is to contribute towards improved socioeconomic outcomes in Vietnam’s poorest regions.

New York State, because of its great diversity, has more extensive social and political conflict than most states. Governing New York State: Fifth Edition provides expert assessment of how these conflicts are organized and represented, and how the political process and political institutions work to seek to resolve them. This newly updated fifth edition contains significantly revised material and covers more topics than the prior edition.

The contributors examine conflicts between New York City and the rest of the state, and between federal, state, and local governments. The role of major political parties in organizing and representing broad coalitions of different groups is reviewed, along with the role of third parties, interest groups, and the media. Political institutions that shape the political process-the governor, the legislature, the courts, and the public authorities-are discussed, along with how these institutions affect the representation of responsiveness of various groups. Finally, Governing New York State investigates the major policy areas of the state: the economy, taxes, local education, higher education, health care, welfare, transportation, and the environment.

Objective: To use publicly available secondary data to assess the impact of Brazil's Family Health Program on state level infant mortality rates (IMR) during the 1990s.

Design: Longitudinal ecological analysis using panel data from secondary sources. Analyses controlled for state level measures of access to clean water and sanitation, average income, women's literacy and fertility, physicians and nurses per 10 000 population, and hospital beds per 1000 population. Additional analyses controlled for immunisation coverage and tested interactions between Family Health Program and proportionate mortality from diarrhoea and acute respiratory infections.

Setting: 13 years (1990-2002) of data from 27 Brazilian states.

Main results: From 1990 to 2002 IMR declined from 49.7 to 28.9 per 1000 live births. During the same period average Family Health Program coverage increased from 0% to 36%. A 10% increase in Family Health Program coverage was associated with a 4.5% decrease in IMR, controlling for all other health determinants (p<0.01). Access to clean water and hospital beds per 1000 were negatively associated with IMR, while female illiteracy, fertility rates, and mean income were positively associated with IMR. Examination of interactions between Family Health Program coverage and diarrhoea deaths suggests the programme may reduce IMR at least partly through reductions in diarrhoea deaths. Interactions with deaths from acute respiratory infections were ambiguous.

Conclusions: The Family Health Program is associated with reduced IMR, suggesting it is an important, although not unique, contributor to declining infant mortality in Brazil. Existing secondary datasets provide an important tool for evaluation of the effectiveness of health services in Brazil.

The patent system is broken. The Constitution intended for patents to foster innovation and the promotion of progress in the useful arts. Instead, the Patent Office creates uncertainty and monopoly. Underpaid and overwhelmed examiners struggle under the burden of 350,000 applications per year and a mounting backlog of 600,000. Increasingly patents are approved for unmerited inventions. What if we could make it easier to ensure that only the most worthwhile inventions got twenty years of monopoly rights? What if we could offer a
way to protect the inventor’s investment while still safeguarding the marketplace of ideas from bad inventions? What if we could make informed decisions about scientifically complex
problems before the fact, rather than trying to reform the system ex post? What if we could harness collective intelligence to replace bureaucracy?
This Article argues that we should reform the patent system by re-designing the institution of patent examination. Our existing legal mechanisms for awarding the patent monopoly are
constructed around the outdated assumption that only expert bureaucrats can produce dispassionate decisions in the public interest. Building upon what we have learned from online and off-line systems of collaboration, we can now use the tools available to combine the
wisdom of expert scientific communities of practice with the legal determinations of a trained Patent Office staff.

The patent system is broken. The Constitution intended for patents to foster innovation and
the promotion of progress in the useful arts. Instead, the Patent Office creates uncertainty
and monopoly. Underpaid and overwhelmed examiners struggle under the burden of
350,000 applications per year and a mounting backlog of 600,000. Increasingly patents are
approved for unmerited inventions. What if we could make it easier to ensure that only the
most worthwhile inventions got twenty years of monopoly rights? What if we could offer a
way to protect the inventor’s investment while still safeguarding the marketplace of ideas
from bad inventions? What if we could make informed decisions about scientifically complex
problems before the fact, rather than trying to reform the system ex post? What if we could
harness collective intelligence to replace bureaucracy?
This Article argues that we should reform the patent system by re-designing the institution
of patent examination. Our existing legal mechanisms for awarding the patent monopoly are
constructed around the outdated assumption that only expert bureaucrats can produce
dispassionate decisions in the public interest. Building upon what we have learned from online and off-line systems of collaboration, we can now use the tools available to combine the
wisdom of expert scientific communities of practice with the legal determinations of a
trained Patent Office staff.

We examined racial and ethnic disparities in the total potential burden of asthma in low-income, racially/ethnically heterogeneous Chicago schools, Methods. We used the Brief Pediatric Asthma Screen Plus (BPAS+) and the Spanish BPAS+, validated, caregiver-completed respiratory questionnaires, to identify asthma and possible asthma among students in 14 racially/ethnically diverse public elementary schools. Results. Among 11 490 children, we demonstrated a high lifetime prevalence (12.2%) as well as racial and ethnic disparities in diagnosed asthma, but no disparities in prevalences of possible undiagnosed asthma. Possible asthma cases boost the total potential burden of asthma to more than 1 in 3 non-Hispanic Black and Puerto Rican children. Conclusions. There are significant racial and ethnic disparities in diagnosed asthma among inner-city schoolchildren in Chicago. However, possible undiagnosed asthma appears to have similar prevalences across racial/ethnic groups and contributes to a high total potential asthma burden in each group studied. A better understanding of underdiagnosis is needed to address gaps in asthma care and intervention for low-income communities.

In France, American nostrums of unleashing market forces under the banner of "consumer-directed health care," and selective contracting by private health insurers, have gained little ground. That should not, however, lead one to conclude that the French health care system is irrelevant to the United States. The organization and financing of health care, in France, resembles, in many respects, that of the United States - more so, in fact, than do Britain's National Health Service or Canadian and German national health insurance (NHI). The French reliance on a public-private mix that includes a significant proprietary hospital sector, private fee-for-service medical practice, and enormous patient choice among a pluralistic organization of health care providers makes French NHI a model for what Senator Ted Kennedy and Congressman Pete Stark have called "Medicare for all."

Public schools across the United States are educating an increasing number and diversity of immigrant students. Unfortunately, little is known about their performance relative to native-born students and the extent to which the "nativity gap" might be explained by school and demographic characteristics. This article takes a step toward filling that void using data from New York City where 17 percent of elementary and middle school students are immigrants. We explore disparities in performance between foreign-born and native-born students on reading and math tests in three ways�using levels (unadjusted scores), "value-added" scores (adjusted for prior performance), and an education production function. While unadjusted levels and value-added measures often indicate superior performance among immigrants, disparities are substantially explained by student and school characteristics. Further, while the nativity gap differs for students from different world regions, disparities are considerably diminished in fully specified models. We conclude with implications for urban schools in the United States.

Objective. Recent national survey data indicate an overall asthma prevalence of 12.2% for children who are younger than 18 years. Previous research in clinical samples of children with asthma suggests that their mothers are at greater risk for symptoms of depression. We describe the relationship between maternal symptoms of depression and having a child with asthma in a community-based sample.

Methods. After a school-based ascertainment of asthma and asthma symptoms in 15 low-income, racially/ethnically diverse public elementary schools, 1149 eligible mothers agreed to participate in a longitudinal study. Mothers either had a child with previously diagnosed asthma or a child with symptoms consistent with possible asthma or were in the randomly selected comparison group in which no child in the household had asthma. During the first interview, mothers responded to questions about their own life stressors, supports and mental health, and their children's health.

Results. In bivariate analyses of a community-based sample of children who share low-income neighborhoods, mothers of children with diagnosed or with possible undiagnosed asthma had more symptoms of depression than did mothers of children who have no asthma. Mothers of children with diagnosed or with possible undiagnosed asthma also experienced more life stressors than did mothers of children without asthma. Using nested linear regression, we estimated a model of maternal symptoms of depression. Most of the variation in Center for Epidemiologic Studies-Depression score was accounted for by life stressors and social support. There were no independent effects of either asthma status or asthma status-specific child health status on maternal symptoms of depression.

Conclusion. Children who are under care for chronic conditions such as asthma live and manage their illness outside the clinical setting. Their social context matters, and maternal mental health is related to their children's physical health. Although having a child with asthma may be "just" another stressor in the mother's social context, complex treatment plans must be followed despite the many other pressures of neighborhood and family lives.

In a critical examination of some of the most topical and challenging issues confronting the public sector in developing counties in an era of globalization, the contributors to this book examine the potential and limits of managerial, fiscal and decentralization reforms, and highlight cases where selective use of some of the new management reforms has delivered positive results. A common thread that runs through the book is the challenges of capacity to improve public services. Looking beyond the past and the present into the future, the book provides lessons from the experience of implementing public sector reforms in developing countries.

Although decentralization and reactions against it have become increasingly important policy trends in developing countries, the study of this nearly ubiquitous phenomenon has been largely fractured across academic disciplines, geographic regions, and the academic-practitioner divide. The contributors to this edited volume begin to cross some of these constraining, artificial boundaries. Considering decentralization from an interdisciplinary, historical, and comparative perspective, they collectively explore why it has evolved in particular ways and with varied outcomes.

In addition to taking an atypically comparative perspective, the volume highlights the importance of an historical analysis of decentralization and links this to institutional and public policy outcomes. Placing decentralization in this context illustrates why it has taken dissimilar shapes and produced varying results over time in different countries. This in turn helps to clarify the types of institutions and conditions required for the development and survival of decentralization, paving the way for more creative thinking and informed policymaking. The countries covered include: Cambodia, China, India, Indonesia, Vietnam, Bolivia, Argentina, Mexico, Peru and Brazil.

Students and scholars of economics, political science and development will find the policy and theoretical discussions enlightening. The volume will also prove useful to policymakers and development institutions confronting issues of decentralization.

Philanthropies and government agencies interested in children’s issues are encouraging localities to improve the process of collecting, linking, and sharing microdata and aggregated summary statistics. An implicit assumption of these efforts is that outcomes will improve as a result of the new approaches. However, there has been little systematic study of these efforts. In this article, we examine efforts to improve data practice in 15 distressed American cities. Interviews conducted in these cities revealed variation in the types of information collected, dissemination, and intended audiences. We identify significant challenges to these efforts, including adequate resources, turf battles, technical problems, access to information sources, inconsistent leadership, and absence of political will. We find that little is known about the impact of these initiatives on decision making. Assumptions that improved data practice will lead to improved policy making have not yet been realized in these cities.

Federal social program evaluation has blossomed over the past quarter century. Despite this growth, there has been little accompanying public debate on research ethics. This essay explores the origins and the implications of this relative silence on ethical matters. It reviews the federal regulations that generally govern research ethics, and recounts the history whereby the evaluation of federal programs was specifically exempted from the purview of those regulations. Through a discussion of a recent evaluation that raised ethical concerns, the essay poses - but does not answer - three questions: (1) Are there good reasons to hold federal social program evaluations to different standards than those that apply to other research?; (2) If so, what ethical standards should be used to access such evaluations?; and (3) Should a formal mechanism be developed to ensure that federal social program evaluations are conducted ethically?

This report presents recommendations for redesigning the retirement benefits - health insurance and pension payments - for employees of the City of New York and State of New York. It includes a description of current benefits and a comparison to benefits provided by other large private and public employers.

How do we understand and also assess the health care of America? Where is health care provided? What are the characteristics of those institutions which provide it? Over the short term, how are changes in health care provisions affecting the health of the population, the cost of care, and access to care? Health Care Delivery in the United States, 8 th Edition discusses these and other core issues in the field. Under the editorship of Dr. Kovner and with the addition of Dr. James Knickman, Senior VP of Evaluation, Robert Wood Johnson Foundation, leading thinkers and practitioners in the field examine how medical knowledge creates new healthcare services. Emerging and recurrent issues from wide perspectives of health policy and public health are also discussed. With an easy to understand format and a focus on the major core challenges of the delivery of health care, this is the textbook of choice for course work in health care, the handbook for administrators and policy makers, and the standard for in-service training programs.

This is one of the only books available that addresses financial and managerial accounting within the framework of the three major areas of the public sector. Clear and comprehensive, Finkler's unique and accessible text provides the fundamentals of financial management for those who lack a financial background so that readers can access and apply financial information more effectively. Details the many aspects of strategic and budgetary planning. Outlines the processes involved in implementing and controlling results. Features aspects of accounting unique for Health Care, not-for-profit organizations and state and local governments. Explains balance sheets, operating and cash flow statements. Provides basic foundation for financial analysis. For managers and policy-makers in public service organizations who want to make more efficient use of their organization's financial information.

Health services research is, by nature, multidisciplinary, for it draws on the methods,concepts and theories of social sciences, which are relevant to the study of how the organization and financing of health services can improve the delivery of health care services (Gray, et al., 2003). While medicine and public health, too, are multidisciplinary enterprises drawing on such disciplines as molecular biology, physiology, anatomy, genetics, epidemiology and more, health services research departs from these disciplines in focusing not on the nature of disease and health but rather on the financing and organization of health systems.

So it is with urban health services research albeit that this field is more narrowly focused on health services in cities. The city focus has resulted in a large body of research on vulnerable groups, barriers to service access, public health clinics and community health centers. Likewise, it has led to important investigations of safetynet institutions, e.g. public hospitals and health centers, which serve a disproportionate share of uninsured and low-income patients. In addition, urban health services research has focused on a host of specific services associated with subpopulations suffering from TB, HIV/AIDS, drug addiction and other social pathologies that are typically associated with the "inner city."

How do we understand and also assess the health care of America? Where is health care provided? What are the characteristics of those institutions which provide it? Over the short term, how are changes in health care provisions affecting the health of the population, the cost of care, and access to care?

Health Care Delivery in the United States, 8th Edition discusses these and other core issues in the field. Under the editorship of Dr. Kovner and with the addition of Dr. James Knickman, Senior VP of Evaluation, Robert Wood Johnson Foundation, leading thinkers and practitioners in the field examine how medical knowledge creates new healthcare services. Emerging and recurrent issues from wide perspectives of health policy and public health are also discussed.

Whatever his legacy as an architect of the war in Iraq, Defense Secretary Donald Rumsfeld has already earned a place in American bureaucratic history as one of its most ambitious organizational reformers. Rumsfeld is determined to complete a top to bottom overhaul of his department before he leaves office. Rumsfeld may be one of history's most ambitious reformers, but his actual impact is far from assured. He still faces intense resistance from the armed services, especially the Army, which has the most to lose in the movement to a much lighter military. And many of his proposals are either still under consideration in Congress or only in the early stages of implementation in the department. This is very much Rumsfeld's revolution to win or lose it is highly dependent upon his congressional support, which has ebbed and flowed with the fortunes of war, on the urgency of the war on terrorism, which continues to fade with memories of September 11, and on his relationship with the armed services, which has been shaken by the controversy surrounding the equipping of U.S. troops in Iraq. It also depends on his public reputation, which has dropped in the wake of the prison abuse scandals at Abu Ghraib and Guantanamo Bay. In October 2001, for example, the Harris Poll reported that 78 percent of Americans rated Rumsfeld's job performance as excellent or pretty good; by June 2005, the percentage had fallen to just 42 percent.

The plight of urban schools and their failure to adequately and efficiently educate their students has occupied the national discussion about public schools in America over the last quarter century. While there is little doubt that failing schools exist in rural and suburban locations, the image of city school systems as under-financed, inefficient, inequitable and burdened by students with overwhelming needs is particularly well entrenched in the modern American psyche. As the largest school district in the country, New York City attracts particular attention to its problems. To some extent, this image reflects realities. New York City school children, like many urban students around the country, are more likely to be poor, non-white and immigrants, with limited English skills, and greater instability in their schooling, and the new waves of immigrants from around the world bring students with a formidable array of backgrounds, language skills, and special needs. The resulting changes in the student body pose particular challenges for schools. At the same time, despite a decade of school finance litigation and reform, New York continues to have trouble affording the class sizes, highly qualified teachers and other resources that suburban neighbors enjoy. Finally, there is evidence of continuing segregation and disparities in performance between students of different races and ethnicities.

Contains papers by state education dept. policymakers, analysts, & data providers on emerging issues in school finance. Includes: estimates of disparities & analysis of the causes of expenditures in public school districts; race, poverty & the student curriculum; court-ordered school finance equalization; resource allocation to schools under conditions of radical decentralization; building equity & effectiveness into school-based funding models; alternative options for deflating education expenditures over time; productivity collapse in schools; & evaluating the effect of teacher degree level on educational performance.

We tested the association between the availability of primary care and income inequality on several categories of mortality in US counties. Methods. We used cross-sectional analysis of data from counties (n=3081) in 1990, including analysis of variance and multivariate ordinary least squares regression. Independent variables included primary care resources, income inequality, and sociodemographics. Results. Counties with higher availability of primary care resources experienced between 2% and 3% lower mortality than counties with less primary care. Counties with high income inequality experienced between 11% and 13% higher mortality than counties with less inequality. Conclusions. Primary care resources may partially moderate the effects of income inequality on health outcomes at the county level.

To assess the cost-effectiveness of Intervention for HIV-Seropositive injection drug users-Research and Evaluation (INSPIRE), designed to reduce risky sexual and needle-sharing behaviors in research sites in four US cities (2001-2003). Methods: We collected data on program and participant costs. We used a mathematical model to estimate the number of sex partners of injection drug users expected to become infected with human immunodeficiency virus (HIV) (with and without intervention), cost of treatment for sex partners who became infected, and the effect of infection on partners' quality-adjusted life expectancy. We determined the minimum effect that INSPIRE must have on condom use among participants for the intervention to be cost-saving (intervention cost less than savings from averted HIV infections) or cost-effective (net cost per quality-adjusted life year saved less than $50,000). Results: The intervention cost was $870 per participant. It would be cost-saving if it led to 53 percent reduction in the proportion of participants who had any unprotected sex in 1 year and cost-effective with 17 percent reduction. If behavior change lasted 3 months, the cost-effectiveness threshold was 66 percent; if 3 years, the threshold was 6 percent. Conclusions: Although cost-saving thresholds may not be achievable by the intervention, we anticipate that cost-effectiveness thresholds will be attained.

Objectives. We evaluated the effectiveness of an intervention designed to increase preventive health care seeking among adolescents.

Methods. Adolescents and young adults aged 12 to 21 years, recruited from community-based organizations in 2 different communities, were randomized into either a 3-session intervention or a control condition. We estimated outcomes from 3-month follow-up data using logistic and ordinary least squares regression.

Results. Female intervention participants were significantly more likely than female control participants to have scheduled a health care appointment (odds ratio [OR]=3.04), undergone a checkup (OR=2.87), and discussed with friends or family members the importance of undergoing a checkup (OR=4.5). There were no differences between male intervention and male control participants in terms of outcomes.

Conclusions. This theory-driven, community-based group intervention significantly increased preventive health care seeking among female adolescents. Further research is needed, however, to identify interventions that will produce successful outcomes among male adolescents.

Like many schools of public policy and management, New York University's Wagner School offers a capstone course in which teams of MPA students provide consultation to client organizations, This year, as the they began to assign students to teams, some members of the faculty sounded an alarm. Several of the projects might involve interviewing service recipients about sensitive issues. Other projects would give teams access to confidential information. Faculty members experience with their university human subjects review board knew that such projects, where they to be undertaken in a research context, would require lengthy and cumbersome review. Did the capstone projects need to go through the human subjects review process? If the answer was yes, the program would come to a grinding halt, given the open-endness of a capstone assignments and the bureaucratic nature of the committee application and approval process.

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.

The Resolving Conflict Creatively Program (RCCP) is one of the oldest and largest school-based conflict resolution programs in the United States. Beginning in 1994, we planned and implemented a rigorous scientific evaluation of the RCCP, involving over 350 teachers and 11,000 children from 15 public elementary schools in New York City. In this chapter, we describe the RCCP, explain the rationale for and design of the study, summarize the major results related to the program's impact on children's trajectories of social and emotional learning (SEL) and academic achievement, and discuss the implications of these findings for research, practice, and policy.

An invisible network of digital technology systems underlies the highly visible networks of roads, waterways, satellites, and power-lines. Increasingly, these systems are becoming the "infrastructure's infrastructure," providing a crucial array of data on network demand, performance, reliability, and security. "Digital Infrastructures" presents an interdisciplinary analysis of the technological systems that envelop these networks. The book balances analyses of specific civil and environmental infrastructures with broader policy and management issues, including the challenges of using IT to manage these critical systems under crises conditions. "Digital Infrastructures" addresses not only the technological dimension but, importantly, how social, organizational and environmental forces affect how IT can be used to manage water, power, transport and telecommunication systems. The book is organized four sections. First, fundamental themes of policy, management, and technology are presented to frame the domain of digital infrastructures. Second, the way in which information technologies are applied in specific infrastructure sectors provides an in-depth assessment of what the advantages and disadvantages have been over time. Third, cross-cutting themes of economics, earth systems engineering, and international sustainability show how various systems perspectives approach some of the barriers to integrating information technology and infrastructure. Finally, the concluding section looks at some of the new directions and challenges being posed by issues such as security. "Digital Infrastructures" is the first integrated treatment of how IT technology is fundamentally affecting how critical infrastructures are managed. It is geared to provide the new infrastructure professional with state of the art concepts, methods, and examples for use in creating public policies, strategic plans, and new systems. It will be an essential book for upper level undergraduate and graduate courses in infrastructure management, critical infrastructure, environmental systems management, and management of IT systems.

Educational reform over the past two decades has focused primarily on schools as the critical units of change, often ignoring the role of districts and their effect on schools' performance. Although national reform efforts such as the recently reauthorized Elementary and Secondary Education Act (the No Child Left Behind Act), are directed primarily at schools, local school districts are responsible for a number of functions critical to schooling effectiveness (e.g., hiring, collective bargaining, curriculum development, assessment, fiscal operations, and ancillary functions). Refocusing attention on districts and their effect on schools, this study found differences between high-and low performing community school districts, or administrative subunits, within the NewYork City school system in terms of educational goals, instructional focus, leadership development, teacher recruitment and retention, and professional development.

The Balanced Budget Act of 1997 established federal grants to the states to create the State Children's Health Insurance Program (SCHIP). This presented the states with a number of implementation choices concerning administrative models for the new programs, as well as choices about eligibility standards, enrollment simplification, crowd-out, and cost sharing requirements. At the same time, the states were also implementing welfare reform. We describe the most important of these implementation choices, and using data from the Current Population Survey, we estimate the impacts of state policy on enrollment in this multiprogram environment. The results indicate that SCHIP programs that are administered as Medicaid expansions are more successful than either separate SCHIP plans or combination programs in enrolling children. States that remove asset tests and implement presumptive eligibility and self-declaration of income have higher enrollment levels. Continuous eligibility and adoption of mail-in applications have no effect on overall enrollment. Waiting periods and premiums reduce enrollment. Stringent welfare reform reduces children's enrollment, despite federal policy that was intended to protect children from the consequences of welfare reform. The negative impacts of a number of these policy reforms substantially reduce enrollment, potentially offsetting the more favorable impacts of other policy choices. We estimate that if all states adopted the policy options that facilitate program use, enrollment for children with family incomes less than 200 percent of the poverty line could be raised from the current rate of 42 percent to 58 percent.

Bush continues a trend toward smaller agendas begun in the wake of the 1981 tax cuts, which sharply constrained the amount of federal funding for large scale, new programs. He also continues a trend among Republican presidents toward a �less-is-more� philosophy of domestic policy. His agenda is half as large as Richard Nixon's first-term agenda in 1969-72, a third smaller than Ronald Reagan's first-term agenda in 1981-84, and a quarter smaller than his father's first-term agenda in 1989-92. Although less ambitious than his predecessors, Bush's limited number of large-scale, new proposals have been undeniably bold. His tax cuts, education reform, social security revisions, prescription drug coverage, and homeland security reorganization are easily classified as large-scale, new proposals, and match up with the large-scale, new proposals of the past such as civil rights, voting rights, and Medicare under presidents John F. Kennedy and Lyndon Johnson, environmental protection, revenue sharing, and national health insurance under Richard M. Nixon, energy and social security reform under Jimmy Carter, tax cuts under Ronald Reagan, budget reform under George H. W. Bush, and national health care, Americorps, and welfare reform under Bill Clinton. However, what sets George W. Bush apart is the relatively shallow depth of his agenda. Whereas Kennedy and Johnson pursued 54 large-scale, new proposals in their two first terms, and Nixon another 18, Bush has pursued just five in his. Simply put, George W. Bush has placed all of his domestic policy proposals in a very small basket. Half of his agenda consists of small-scale, conventional proposals, including expanded drug treatment, pension reform, and an energy package that pales in comparison to the energy bills of previous administrations.

Background: Retesting 3 to 4 months after treatment for those infected with chlamydia and/or gonorrhea has been recommended.

Goal: We compared various methods of encouraging return for retesting 3 months after treatment for chlamydia or gonorrhea.

Study: In study 1, participants were randomly assigned to: 1) brief recommendation to return, 2) intervention 1 plus $20 incentive paid at return visit, or 3) intervention 1 plus motivational counseling at the first visit and a phone reminder at 3 months. In study 2, participants at 1 clinic were randomly assigned to 4) intervention 1, 5) intervention 1 plus phone reminder, or 6) intervention 1 plus motivational counseling but no telephone reminder.

Results: Using multiple logistic regression, the odds ratios for interventions 2 and 3, respectively, compared with intervention 1 were 1.2 (95% confidence interval [CI], 0.6-2.5) and 2.6 (95% CI, 1.3-5.0). The odds ratios for interventions 5 and 6 compared with intervention 4 were 18.1 (95% CI, 1.7-193.5) and 4.6 (95% CI, 0.4-58.0).

Conclusions: A monetary incentive did not increase return rates compared with a brief recommendation. A reminder phone call seemed to be the most effective method to increase return.

An invisible network of digital technology systems underlies the highly visible networks of roads, waterways, satellites, and power-lines. Increasingly, these systems are becoming the "infrastructure's infrastructure," providing a crucial array of data on network demand, performance, reliability, and security. Digital Infrastructures presents an interdisciplinary analysis of the technological systems that envelop these networks. The book balances analyses of specific civil and environmental infrastructures with broader policy and management issues, including the challenges of using IT to manage these critical systems under crises conditions.

Digital Infrastructures addresses not only the technological dimension but, importantly, how social, organizational and environmental forces affect how IT can be used to manage water, power, transport and telecommunication systems. The book is organized four sections. First, fundamental themes of policy, management, and technology are presented to frame the domain of digital infrastructures. Second, the way in which information technologies are applied in specific infrastructure sectors provides an in-depth assessment of what the advantages and disadvantages have been over time. Third, cross-cutting themes of economics, earth systems engineering, and international sustainability show how various systems perspectives approach some of the barriers to integrating information technology and infrastructure. Finally, the concluding section looks at some of the new directions and challenges being posed by issues such as security.

Digital Infrastructures is the first integrated treatment of how IT technology is fundamentally affecting how critical infrastructures are managed. It is geared to provide the new infrastructure professional with state of the art concepts, methods, and examples for use in creating public policies, strategic plans, and new systems. It will be an essential book for upper level undergraduate and graduate courses in infrastructure management, critical infrastructure, environmental systems management, and management of IT systems.

In many urban areas in the United States, immigrant children and the children of immigrants are transforming local schools. Immigrant children face - and pose - significant challenges to these schools, challenges that are in many ways greater than those of earlier waves of immigrants. There is, however, relatively little existing research investigating the ways urban public school systems treat and are influenced by the increasing numbers of immigrant children. Using an extraordinarily rich, student-level panel data set covering all 850 of New York City's elementary and middle schools for 5 years, linked to institutional information on the schools themselves, we study the experience of one large urban school system. Given the extraordinary size and diversity of the immigrant population in New York City, we can consider separately subgroups of immigrants whose experiences in and impacts on urban schools systems are likely to differ greatly. This is particularly important for drawing lessons for other urban areas that face flows of immigrants from specific countries of origin.

Our project contains a cross-sectional and a time series component. To start, we examine the characteristics of the schools and districts attended by New York City's immigrant children, including the extent to which the teachers and resources of different groups of immigrant children differ from each other and from the typical native-born student. We examine the degree to which they are segregated within the city's districts and schools - and investigate the extent to which segregation differs between elementary and middle schools. This is particularly interesting because of the strong link between elementary school choice and residential location and the weaker link (and greater degree of choice) at the middle school level.

We will also focus on the "receiving" schools from the perspective of the native-born students, particularly minority and poorer students. While the presence of recent immigrants brings some supplemental federal funding, and additional resources are typically directed at students with Limited English Proficiency, the net resource impact on the schools and their students is poorly understood.

In the second component of our project (exploiting the time-series nature of our data) we will examine changes in school composition over time. Do specific characteristics drive patterns of change? At the school level, we will assess whether and how the presence of native-born students changes in response to changes in the share of students who are immigrants, children of immigrants, and those with limited English proficiency. By tracking the movement of children from one school to another, we can investigate the characteristics of the origin and destination schools (such as population composition and school resources) that appear to affect mobility and identify groups most sensitive to these factors. Are urban school districts in high immigrant areas likely to suffer from more middle-class flight? To what extent does the response depend upon the socioeconomic characteristics of the immigrants - their race, ethnicity, language proficiency, and/or country of origin? This second piece moves beyond a cross-sectional assessment of the resource allocations and impacts associated with immigration, to suggest how these impacts will change over time for other urban districts receiving immigrant children and, perhaps, the issues and problems that policymakers to consider in formulation policy responses.

Indonesia is currently facing some severe challenges, both in political affairs and in economic management. One of these challenges is the recently enacted decentralization program, now well underway, which promises to have some wide-ranging consequences. This edited volume presents original papers, written by a select group of widely recognized and distinguished scholars, that take a hard, objective look at the many effects of decentralization on economic and political issues in Indonesia. There are many questions about this program: how will it be implemented, is there capacity at the local level to implement its reforms, is there sufficient local political accountability to make it work, and how will the decentralization affect the broader program of economic growth and stabilization? Topics covered include: the historical and political dimensions of decentralization, its macroeconomic effects, its effects on poverty alleviation, the assignment of expenditure and revenue functions across levels of government, the design of transfers, the role of natural resource taxation and the effects of local government borrowing. An authoritative, comprehensive collection, Reforming Intergovernmental Fiscal Relations and the Rebuilding of Indonesia will be of interest to economists and policy makers as well as students of public finance, development, and Asian economics.

An invisible network of digital technology systems underlies the highly visible networks of roads, waterways, satellites, and power-lines. Increasingly, these systems are becoming the ''infrastructure's infrastructure'' providing a crucial array of data on network demand, performance, reliability, and security. Digital Infrastructures presents an interdisciplinary analysis of the technological systems that envelop these networks. The book balances analyses of specific civil and environmental infrastructures with broader policy and management issues, including the challenges of using IT to manage these critical systems under crises conditions.

Digital Infrastructures addresses not only the technological dimension but, importantly, how social, organizational and environmental forces affect how IT can be used to manage water, power, transport and telecommunication systems. The book is organized four sections. First, fundamental themes of policy, management, and technology are presented to frame the domain of digital infrastructures. Second, the way in which information technologies are applied in specific infrastructure sectors provides an in-depth assessment of what the advantages and disadvantages have been over time. Third, cross-cutting themes of economics, earth systems engineering, and international sustainability show how various systems perspectives approach some of the barriers to integrating information technology and infrastructure. Finally, the concluding section looks at some of the new directions and challenges being posed by issues such as security.

Digital Infrastructures is the first integrated treatment of how IT technology is fundamentally affecting how critical infrastructures are managed. It is geared to provide the new infrastructure professional with state of the art concepts, methods, and examples for use in creating public policies, strategic plans, and new systems. It will be an essential book for upper level undergraduate and graduate courses in infrastructure management, critical infrastructure, environmental systems management, and management of IT systems.

An invisible network of digital technology systems underlies the highly visible networks of roads, waterways, satellites, and power-lines. Increasingly, these systems are becoming the "infrastructure's infrastructure," providing a crucial array of data on network demand, performance, reliability, and security. "Digital Infrastructures" presents an interdisciplinary analysis of the technological systems that envelop these networks. The book balances analyses of specific civil and environmental infrastructures with broader policy and management issues, including the challenges of using IT to manage these critical systems under crises conditions. "Digital Infrastructures" addresses not only the technological dimension but, importantly, how social, organizational and environmental forces affect how IT can be used to manage water, power, transport and telecommunication systems. The book is organized four sections. First, fundamental themes of policy, management, and technology are presented to frame the domain of digital infrastructures. Second, the way in which information technologies are applied in specific infrastructure sectors provides an in-depth assessment of what the advantages and disadvantages have been over time. Third, cross-cutting themes of economics, earth systems engineering, and international sustainability show how various systems perspectives approach some of the barriers to integrating information technology and infrastructure. Finally, the concluding section looks at some of the new directions and challenges being posed by issues such as security. "Digital Infrastructures" is the first integrated treatment of how IT technology is fundamentally affecting how critical infrastructures are managed. It is geared to provide the new infrastructure professional with state of the art concepts, methods, and examples for use in creating public policies, strategic plans, and new systems. It will be an essential book for upper level undergraduate and graduate courses in infrastructure management, critical infrastructure, environmental systems management, and management of IT systems.

An invisible network of digital technology systems underlies the highly visible networks of roads, waterways, satellites, and power-lines. Increasingly, these systems are becoming the "infrastructure's infrastructure," providing a crucial array of data on network demand, performance, reliability, and security. "Digital Infrastructures" presents an interdisciplinary analysis of the technological systems that envelop these networks. The book balances analyses of specific civil and environmental infrastructures with broader policy and management issues, including the challenges of using IT to manage these critical systems under crises conditions. "Digital Infrastructures" addresses not only the technological dimension but, importantly, how social, organizational and environmental forces affect how IT can be used to manage water, power, transport and telecommunication systems. The book is organized four sections. First, fundamental themes of policy, management, and technology are presented to frame the domain of digital infrastructures. Second, the way in which information technologies are applied in specific infrastructure sectors provides an in-depth assessment of what the advantages and disadvantages have been over time. Third, cross-cutting themes of economics, earth systems engineering, and international sustainability show how various systems perspectives approach some of the barriers to integrating information technology and infrastructure. Finally, the concluding section looks at some of the new directions and challenges being posed by issues such as security. "Digital Infrastructures" is the first integrated treatment of how IT technology is fundamentally affecting how critical infrastructures are managed. It is geared to provide the new infrastructure professional with state of the art concepts, methods, and examples for use in creating public policies, strategic plans, and new systems. It will be an essential book for upper level undergraduate and graduate courses in infrastructure management, critical infrastructure, environmental systems management, and management of IT systems.

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.

Objective
To assess the contribution of primary care systems to a variety of health outcomes in 18 wealthy Organization for Economic Cooperation and Development (OECD) countries over three decades.

Data Sources/Study Setting
Data were primarily derived from OECD Health Data 2001 and from published literature. The unit of analysis is each of 18 wealthy OECD countries from 1970 to 1998 (total n=504).

Study Design
Pooled, cross-sectional, time-series analysis of secondary data using fixed effects regression.

Data Collection/Extraction Methods
Secondary analysis of public-use datasets. Primary care system characteristics were assessed using a common set of indicators derived from secondary datasets, published literature, technical documents, and consultation with in-country experts.

Principal Findings
The strength of a country's primary care system was negatively associated with (a) all-cause mortality, (b) all-cause premature mortality, and (c) cause-specific premature mortality from asthma and bronchitis, emphysema and pneumonia, cardiovascular disease, and heart disease (p<0.05 in fixed effects, multivariate regression analyses). This relationship was significant, albeit reduced in magnitude, even while controlling for macro-level (GDP per capita, total physicians per one thousand population, percent of elderly) and micro-level (average number of ambulatory care visits, per capita income, alcohol and tobacco consumption) determinants of population health.

Conclusions
(1) Strong primary care system and practice characteristics such as geographic regulation, longitudinality, coordination, and community orientation were associated with improved population health. (2) Despite health reform efforts, few OECD countries have improved essential features of their primary care systems as assessed by the scale used here. (3) The proposed scale can also be used to monitor health reform efforts intended to improve primary care.

Public agencies have the mandate to consider the plurality of values, concerns and voices of the larger population in their work, as well as to include a wide variety of citizens in their workforce. When diversity is pursued as an organizational objective, more efficient management and the democratic values of responsiveness and representation in public administration are both said to be better achieved.

Decentralisation is a complex and often somewhat elusive phenomenon. Many countries around the world have been attempting- for several reasons and with varying degrees of intention and success-to create or strengthen sub-national governments in recent years. Africa is no exception to either the decentralisation trend or the reality of its complexity and diversity. Drawing selectively on the large academic and practitioner literature on decentralisation and the articles in this volume, this article briefly outlines a number of typical prominent goals of decentralisation. It then reviews some key dimensions of decentralisation-fiscal, institutional and political. These are too frequently treated separately by policy analysts and policy makers although they are inherently linked. Next, a few popular myths and misconceptions about decentralisation are explored. Finally, a number of common outstanding challenges for improving decentralisation and local government reform efforts in Africa are considered.

Beth Weitzman and Diana Silver from New York University's Center for Health and Public Service Research offer their experience integrating a comparison group design into a theory of change approach.

A population-based Pneumocystis carinii pneumonia (PCP) Index was developed in New York City to identify geographic areas and subpopulations at increased risk for PCP. Methods. A zip code-level PCP Index was created from AIDS surveillance and hospital discharge records and defined as (number of PCP-related hospitalizations)/(number of persons living with AIDS). Results. In 1997, there were 2262 hospitalizations for PCP among 39 740 persons living with AIDS in New York City (PCP Index = .05691). PCP Index values varied widely across neighborhoods with high AIDS prevalence (West Village = .02532 vs Central Harlem = .08696). Some neighborhoods with moderate AIDS prevalence had strikingly high rates (Staten Island = .14035; northern Manhattan = .08756). Conclusions. The PCP Index highlights communities in particular need of public health interventions to improve HIV-related service delivery.

This book takes the conversation between bioethics and health policy to a new level. Moving beyond principles and normative frameworks, bioethicists writing in the volume consider the actual policy problems faced by health care systems, while policy-makers reflect on the moral values inherent in both the process and content of health policy. The result is a vigorous dialogue with some of the nation's leading experts at the interface of ethics and health policy. the book provides a history of the values implicit in U.S. health policy, a discussion of the federal and state roles in policymaking, an ethical examination of the social goals expressed through various policies, an analysis of the role of public opinion in the creation of health policy, and an exploration of the value of the private sector in health policy. In addition, the authors examine some of the major ethical controversies in health policy, such as the challenge of balancing ethical concerns with economic realities, the need to allocate scarce health resources, the call for heightened accountability, and the impact of various policies on vulnerable populations. The book concludes with an examination of the ethical issues in health services research, including the threats to privacy that arise in such research. To a greater extent than any previous volume, it establishes a strong connection between the disciplines of medical ethics and health policy.

Discusses the challenges posed by incorporating Statement No. 34 of the U.S. Governmental Accounting Standards Board, Basic Financial Statements-and Management's Discussion and Analysis-for State and Local Governments (GASB 34) in the core curriculum of a school. Generally accepted accounting principles and GASB 34; Pedagogical issues in GASB 34; Dynamism in learning governmental accounting.

Sound budget policy requires a clear understanding of the nature of fiscal problems and creative thinking in the design of solutions. The recent public debate about how to close
New York City's unprecedented budget gap falls short on both counts. The Citizens Budget Commission - a nonprofit, nonpartisan civic organization - has prepared this document to clear up a series of common misunderstandings that hinder the debate and to focus attention on the potential for significant savings by delivering City services more efficiently. The first part of the document identifies ten "myths" about the budget and provides the facts that dispel them. The second part presents five ideas that together
would save the City more than $1 billion annually. The ideas are based on research conducted by the Commission's staff and presented in greater detail in separate reports published by the Commission.

The American Cancer Society puts it bluntly: "We're fat and it's killing us." Obesity is rising at epidemic rates and, according to a first-ever Surgeon General's report on obesity (issued in 2001), it may soon surpass tobacco as the chief cause of preventable death in the United States. Obesity has been directly linked to heart disease, diabetes, stroke, infertility, and cancer. Each year, obesity costs the nation an estimated $120 billion in medical care and takes some 280,000 lives. Body weight is rising fastest among young Americans-the most dramatic stories feature heart attacks among obese six year-olds.

Public confidence in charitable organizations such as the Red Cross and United Way is essential to a high performing nonprofit or charitable sector. Indeed, confidence affects almost everything that matters to the future of the sector, especially the public's willingness to contribute money and volunteer time. Given its importance as a harbinger, even small declines in confidence should raise alarms across the sector. Complacency does little harm when confidence is high or rising, but may undermine the call for aggressive action
during periods when confidence is low or falling. Unfortunately, according to new research by the Brookings Institution's Center for Public Service, the recent decline in confidence is uncomfortably large, particularly when juxtaposed with other research that has given the sector the benefit of the doubt through question wording or generous analysis.

It is no longer clear that the federal government work force can pass the following five tests of a healthy public service, which are that it should be:
-Motivated by the public good, not security or a stable paycheck.
-Recruited from the top of the labor market, not the bottom.
-Given the tools to do its job well.
-Rewarded for a job well done, not just showing up day after day.
-Trusted by the people and leaders it serves.

The use of private money to support public schools in New York City captured the attention of the public in 1997, as parents in a Greenwich Village elementary school tried to raise private salary funds to prevent one of their teachers from being reassigned. While some heralded the parents for their commitment to their children's education and their willingness to fight to improve their public school, others lamented the action, citing concerns for funding equity between more affluent schools and economically disadvantaged schools. In the end, the Chancellor decided to maintain the teacher in question, but not to accept the privately-raised revenues out of a concern for setting a precedent for allowing parents to fund "core functions" rather than "enrichment" programs. Clearly, this concern stemmed, at least in part, from an underlying worry that allowing schools to seek and accept privately-raised revenues would pose a threat to the equity of schooling in New York City. Would accepting privately-raised money lead schools serving higher income students to have better funding (or better teachers, smaller classes, for example) than those serving lower income students? At the same time, privately-raised resources may also present efficiency concerns. Would curricula or programmatic offerings be chosen based upon the availability of outside funding, rather than the particular needs of the students? This paper explores both the equity and efficiency issues surrounding the use of privately-raised revenues to support public schools, and provides some evidence on the distribution of privately-raised support across public schools in New York City.

This study assessed the effectiveness of a sexually transmitted disease (STD)/HIV behavior change intervention in increasing women's use of the female condom. Methods. A total of 604 women at high risk for STDs and HIV in New York City, Baltimore, Md, and Seattle, Wash, enrolled in a randomized controlled trial of a small-group, skills-training intervention that included information and skills training in the use of the female condom. Results. In a logistic regression, the strongest predictors of use were exposure to the intervention (odds ratio [OR] = 5.5; 95% confidence interval [CI] = 2.8,10.7), intention to use the female condom in the future (OR = 4.5; 95% CI = 2.4, 8.5), having asked a partner to use a condom in the past 30 days (OR = 2.3; 95% CI = 1.3, 3.9), and confidence in asking a partner to use a condom (OR = 1.9; 95% CI = 1.1, 3.5). Conclusions. Clinicians counseling women in the use of the female condom need to provide information, demonstrate its correct use with their clients, and provide an opportunity for their clients to practice skills themselves.

The quality of the environment in communities with large minority populations has been a growing concern particularly with respect to public health given the potential for greater
exposure among minorities and the lower availability of health services to address such exposures. A public health and environmental policy analysis is being conducted by the Institute for Civil Infrastructure Systems (ICIS) at New York University's Wagner Graduate School of Public Service (NYU-Wagner) to address some of these issues in the South Bronx. The Wagner School study is part of a larger project funded by the U.S. EPA about environmental issues in the
South Bronx, NY that aims to provide relationships among air quality, transportation, waste transfer activity, and demographic characteristics in the South Bronx.

How do we understand and also assess the health care of America? Where is health care provided? What are the characteristics of those institutions which provide it? Over the short term, how are changes in health care provisions affecting the health of the population, the cost of care, and access to care? Health Care Delivery in the United States, 8 th Edition discusses these and other core issues in the field. Under the editorship of Dr. Kovner and with the addition of Dr. James Knickman, Senior VP of Evaluation, Robert Wood Johnson Foundation, leading thinkers and practitioners in the field examine how medical knowledge creates new healthcare services. Emerging and recurrent issues from wide perspectives of health policy and public health are also discussed. With an easy to understand format and a focus on the major core challenges of the delivery of health care, this is the textbook of choice for course work in health care, the handbook for administrators and policy makers, and the standard for in-service training programs.

This report recommends a comprehensive reassessment of federal health policies, programs, and processes, including federal-state roles and relationships, and some immediate actions to promote and protect the nation's health and to provide leadership in world health. The report concentrates on the challenges facing the secretary of the U.S. Department of Health and Human Services (DHHS) as the head of the lead health agency in the federal government. The federal government is responsible for five main functions related to health policy: financing; public health protection; collecting and disseminating information about U.S. health and health care delivery systems; capacity building for population health; and direct management of services.

Unlike the current categorical, or highly specialized, approach leading to policies and programs addressing the needs of a specific population, illness, or organizational constituency, a new, comprehensive approach to policy for the 21st century should promote coordinated efforts across programs in order to achieve three goals:

* create conditions that lead to longer, healthier lives for all Americans;
* eliminate health disparities;
* protect communities from avoidable health hazards and help them to address their own health problems.

What does it mean to be poor in America at the dawn of the 21 st century? For that matter, what does it mean to be rich? And how are the two related to each other? These apparently simple questions present enormous theoretical and empirical challenges to any student or social scientist. Wealth and Poverty in America is a collection of over 20 important essays on the complex relationship between the rich and poor in the United States. The authors include classical and contemporary thinkers on a wide variety of topics such as economic systems, the lifestyles of the rich and poor, and public policy. An editorial introduction and suggestions for further reading make this a useful and valuable source of information and analysis on the realities of the American rich and American poor.

One of the few books that addresses financial and managerial accounting within the three major areas of the public sector � government, health, and not-for-profit�the Second Edition provides the fundamentals of financial management for those pursuing careers within these fields. With a unique presentation that explains the rules specific to the public sector, this book outlines the framework for readers to access and apply financial information more effectively. Employing an engaging and user-friendly approach, this book clearly defines essential vocabulary, concepts, methods, and basic tools of financial management and financial analysis that are imperative to achieving success in the field. This book is intended for financial managers and general managers who are required to obtain, understand, and use accounting information to improve the financial results of their organizations, specifically within the areas of government or public policy and management, not-for-profit management, and health policy and management.

The property tax is considered a most unpopular tax, among both scholars and taxpayers. Yet, recent research and analysis has proposed at least a partial rehabilitation of this tax and its role in the arena of local public finance. Based on a conference sponsored by the Lincoln Institute in January 2000, this book presents a systematic and comprehensive review of the economics of local property taxation and examines its policy implications. The ten papers and paired commentaries are written in a nontechnical form to make the findings available to a broad audience of policy makers and other noneconomists.

Compares rural development projects funded by the World Bank in the Philippines and Mexico. Impact of the World Bank on social capital; Indicators of institutional preconditions for informed public participation; Ethnic and gender dimensions of social capital.

A letter to the editor and a response to the letter by Nancy L. Van Devanter about the shortage of public health professionals and the need to support efforts to enhance public health training are presented.

Focuses on the problems of the United States government in competing for public service workforce and the changes in the federal public service. Two features of the federal government's problem in recruiting talents for public service; Characteristics of public service measured by students at top schools of public policy and administration; Ways for the government to regain its edge in recruiting public service employees.

Approximately 3.1 million State residents (one of every six New Yorkers) have no health insurance. This report describes the uninsured population in New York State and the public programs that currently finance medical care for the uninsured. It also identifies the inadequacies of these programs and makes recommendations for reform.

The New Americans sheds light on one of the most controversial issues of the decade. This book identifies the economic gains and losses from immigration -- for the nation, states, and local areas -- and provides a foundation for public discussion and policymaking. Three key questions are explored: -- What is the influence of immigration on the overall economy, especially national and regional labor markets?-- What are the overall effects of immigration on federal, state, and local government budgets?-- What effects will immigration have on the future size and makeup of the nation's population over the next 50 years?The New Americans examines what immigrants gain by coming to the United States and what they contribute to the country, the skills of immigrants and those of native-born Americans, the experiences of immigrant women and other groups, and much more. It offers examples of how to measure the impact of immigration on government revenues and expenditures -- estimating one year's fiscal impact in California, New Jersey, and the United States and projecting the long-run fiscal effects on government revenues and expenditures. Also included is background information on immigration policies and practices and data on where immigrants come from, what they do in America, and how they will change the nation's social fabric in the decades to come.

According to Paul C. Light's controversial new book, The New Public Service, this January's 4.8 percent federal pay increase will do little to compensate for what potential employees think is currently missing from federal careers. Talented Americans are not saying "show me the money" but "show me the job." And federal jobs just do not show well.

All job offers being equal, Light argues that the pay increase would matter. But all offers are not equal. Light's research on what graduates of the top public policy and administration graduate programs want indicates that the federal government is usually so far behind its private and nonprofit competitors that pay never comes into play.

Light argues that the federal government is losing the talent war on three fronts. First, its hiring system for recruiting talent, top to bottom, underwhelms at almost every task it undertakes. Second, its annual performance appraisal system so inflated that federal employees are not only all above average, they are well on their way to outstanding. Third and most importantly, the federal government is so clogged with needless layers and convoluted career paths that it cannot deliver the kind of challenging work that talented Americans expect.

None of these problems would matter, Light argues, if the government-centered public service was still looking for work. Unfortunately, as Light's book demonstrates, federal careers were designed for a workforce that has not punched since the 1960s, and certainly not for one that grew up in an era of corporate downsizing and mergers. The government-centered public service is mostly a thing of the past, replaced by a multisectored public service in which employees switch jobs and sectors with ease.

Light concludes his book by offering the federal government a simple choice: It can either ignore the new public service and troll further and further down the class lists for new recruits, while hoping that a tiny pay increase will help, or it can start building the kind of careers that talented Americans want

Examines use of informal insurance arrangements in households of low-income countries. Relationship between household consumption and income; Ways in dealing economic hardships; Systems of reciprocal transfers; Role of public policy in reducing economic vulnerability; Overview on microcredit, insurance and employment guarantee schemes.

This article reflects on a need for social and behavioral science expertise in public health departments in the U.S. for the prevention of sexually transmitted diseases (STD). In the developed world, the U.S. has the highest rates of STD, higher than for some developing countries. As a result of sexual behaviors, which are shaped by social and environmental factors in communities, individuals are at risk for STD. A landmark report by the Institute of Medicine in 1997 concluded that the outbreak of STD is influenced by the lack of awareness among the general public, lack of skills and training among health professionals and the absence of an effective national system for the prevention of STD.

Poverty has been shown to negatively influence child health and development along a number of dimensions. For example, poverty-net of a variety of potentially confounding factors-is associated with increased neonatal and post-neonatal mortality rates, greater risk of injuries resulting from accidents or physical abuse/neglect, higher risk for asthma, and lower developmental scores in a range of tests at multiple ages.

Despite the extensive literature available that addresses the relationship between poverty and child health and development, as yet there is no consensus on how poverty should be operationalized to reflect its dynamic nature. Perhaps more important is the lack of agreement on the set of controls that should be included in the modeling of this relationship in order to determine the "true" or net effect of poverty, independent of its cofactors. In this paper, we suggest a general model that should be adhered to when investigating the effects of poverty on children. We propose a standard set of controls and various measures of poverty that should be incorporated in any study, when possible.

Public policies for urban development have traditionally emphasized investment in physical infrastructure, the development of large-scale commercial facilities, the construction of new housing, and the renewal of existing neighborhoods. Most efforts to revitalize central cities by building new facilities for visitors have focused on suburban commuters and tourists. At the same time, many housing initiatives in central cities have concentrated on low-income communities because outlying suburban areas have attracted traditional middle-income households.

This article argues that emerging demographic and cultural trends - combined with changes in the structure of business organizations and technological advances - provide new opportunities for cities to retain and attract middle-class households. Using gay and lesbian populations as an example, it focuses on the role that nontraditional households can play in urban redevelopment. In light of the rise of nontraditional households and the growth of self-employment and small businesses, cities should adopt policies that make them attractive places in which to live and work.

Discusses the importance of case discussion teaching method in training professionals on public policy. Analysis and action cycle; Experience with issues of risk and uncertainty; Work with enactments to generate learning from parallel processes; Hazards of case teaching.

The purpose of this study was to assess the relationship between syphilis and human immunodeficiency virus (HIV) infection in injection drug users. Methods. A 6-year prospective study of 790 injection drug users receiving methadone maintenance treatment in the Bronx, NY, was conducted. Results. Sixteen percent (4/25) of HIV-seroconverting patients, 4.8% (16/335) of prevalent HIV-seropositive patients, and 3.5% (15/430) of persistently HIV-seronegative patients were diagnosed with syphilis. Incidence rates for early syphilis (cases per 1000 person-years) were 15.9 for HIV-seroconverting patients, 8.9 for prevalent HIV-seropositive patients, and 2.9 for persistently HIV-seronegative patients. Early syphilis incidence was higher among women than men (8.4 vs 3.2 cases per 1000 person-years). Independent risks for early syphilis included multiple sex partners, HIV seroconversion, paid sex, and young age. All HIV seroconverters with syphilis were female. Conclusions. Diagnosis of syphilis in drug-using women reflects high-risk sexual activity and is associated with acquiring HIV infection. Interventions to reduce the risk of sexually acquired infections are urgently needed among female drug users.

This report examines the high cost of City health insurance. The approach includes both an historical review of the City's program and comparative analysis of the practices of other large public and private employers. The report recommends structural reforms that would yield nearly $600 million in recurring savings and still provide employees and retirees with benefits better than most of their counterparts in government and business.

Presents the text of the presidential address given at the Fall 1994 meeting of the Association for Public Policy Analysis and Management by Ellen Schall. Reflection and learning from experience; Why reflective, swamp learning should be taken seriously; Development of new ways to investigate and frame theories for public management in the swamp.

Understanding more about the psychological state of persons notified of human immunodeficiency virus (HIV) infection is critical for designing notification and counseling programs that will have the most positive effect. Methods. The subjects were blood donors who had been notified of HIV infection by the New York Blood Center. A nurse elicited a medical history, performed a limited medical examination, and asked the subjects to complete a questionnaire that included questions about drug use, sexual behavior, and psychological characteristics. The subjects completed another questionnaire approximately 2 weeks later. Results. The average depressive symptom scores for both men and women were substantially higher than scores typically found in representative population samples. More than a quarter of the men and more than a third of the women reported seeking psychological or psychiatric services in the first few weeks following notification. Conclusions. Anticipating and meeting individuals' psychological needs may be necessary if HIV screening programs are to address effectively the needs of persons infected with HIV.

To learn more about how people who did not volunteer for testing react to information about HIV infection, we assessed short-term behavior changes in HIV-positive blood donors. Methods. Blood donors who were notified at the New York Blood Center that they were HTV positive were asked to participate in a study. A nurse elicited a medical history, performed a limited medical examination, and asked participants to complete a questionnaire that included questions about drug use, sexual behavior, and psychological characteristics. Participants were asked to return in 2 weeks to complete another questionnaire. Results. Many fewer men and women reported engaging in unsafe sexual behaviors in the 2 weeks preceding the follow-up visit than had reported such behaviors prior to notification. These changes were greater than those other investigators have reported, but about 40% of the participants still reported unsafe sexual activity at the follow-up interview. Conclusions. To make nonvolunteer screening programs for HIV infection more effective in reducing the spread of HTV infection, we need to learn more about how to help people change their high-risk behaviors.

This article addresses the importance of economic and demographic assumptions in framing the public policy process. It examines functions of such assumptions as an important aspect of government and as a new challenge for public managers. Using Social Security as a case study, the article suggests that recent fore- casts have been inaccurate for four basic reasons: (I) the social and economic environment, (2) technique, (3) assumption drag, and (4) politics. Nevertheless, the assumptions have been crucial at several key legislative turning points in recent Social Security reforms. The article reviews the impact of political pressure in three specific instances and suggests an emerging pattern in the use and misuse of assumptions. The article concludes with suggestions on how to address the importance of assumptions in the public policy process.

It is generally thought that across-the-board tax limits, white encouraging fiscal restraint, create hardships for jurisdictions with above average and uncontrollable needs. Because of the recent imposition of most limits, the conclusion is difficult to confirm empirically. This article provides a test of the conclusion based on a study of New York State city school districts where limits long in effect were suspended between 1970 and 1978 because of unusual local behavior and legislative action. Because some, but not all, districts took advantage of legislatively granted authority to tax beyond their limit, art empirical investigation can be used to explain this behavior. The results of the analysis, which show that low ability to pay, low inter-governmental grants, and high needs account for much of the behavior of districts that exceed limits, are helpful in designing flexible tax limits.

Investigates the impact of social science research on school finance policy in the U.S. Formulation of social science research to public policy; Perspectives in evaluating the policy impact of social science research; Strengths of the perspectives.

The article focuses on the impact on local treasury of mobile home developments. The impact on the local public treasury of the parks in which most newly constructed mobile homes are located is as important to the discussion of the mobile home as a vehicle for enhancing the nation's housing services as is the analysis of private mobile home market operations. This is so because an adverse impact on the local treasury may cause local governments to resist zoning land for mobile home use. Furthermore, an analysis of the net benefits of mobile homes should include an estimate of their social overhead as well as their private net benefits. This note reports a hypothetical case study of the impact on the public treasury of a 600-unit mobile home park in an urban-fringe community of 16,400 population near Detroit, Michigan. A case study in other states with similar local finance structures would result in similar findings. In Michigan, mobile home parks yield revenues to local governments through various means.