Economics

The utility of social capital in studies on health determinants

The utility of social capital in studies on health determinants
Milbank Quarterly Volume 79, Number 3, pages 387-428.

Macinko, J. & Starfield, B.
01/01/2001

Social capital has become a popular subject in the literature on determinants of health. The concept of social capital has been used in the sociological, political science, and economic development literatures, as well as in the health inequalities literature. Analysis of its use in the health inequalities literature suggests that each theoretical tradition has conceptualized social capital differently. Health researchers have employed a wide range of social capital measures, borrowing from several theoretical traditions. Given the wide variation in these measures and an apparent lack of consistent theoretical or empirical justification for their use, conclusions about the likely role of "social capital" on population health may be overstated or even misleading. Elements of a research agenda are proposed to further elucidate the potential role of factors currently subsumed under the rubric of "social capital."

The Welfare State and Infant Mortality

The Welfare State and Infant Mortality
American Journal of Sociology. November, Vol. 106.

Conley, D. & Springer, K.
01/01/2001

This article seeks to understand the effects of welfare-state spending on infant mortality rates. Infant mortality was chosen for its importance as a social indicator and its putative sensitivity to state action over a short time span. Country fixed-effects models are used to determine that public health spending does have a significant impact in lowering infant mortality rates, net of other factors, such as economic development, and that this effect is cumulative over a five-year time span. A net effect of health spending is also found, even when controlling for the level of spending in the year after which the outcome is measured (to account for spurious effects or reverse causation). State spending affects infant mortality both through social mechanisms and through medical ones. This article also shows that the impact of state spending may vary by the institutional structure of the welfare state. Finally, this study tests for structural breaks in the relationship between health spending and infant mortality and finds none over this time period.

Thinking About Children in Time.

Thinking About Children in Time.
The Dynamics of Child Poverty in Industrialised Countries. Edited by Bradbury, D. and S. Jenkins, J. Micklewright. Cambridge University Press.

Aber, J.L. & Ellwood, D.T.
01/01/2001

A child poverty rate of ten percent could mean that every tenth child is always poor, or that all children are in poverty for one month in every ten. Knowing where reality lies between these extremes is vital to understanding the problem facing many countries of poverty among the young. This unique study goes beyond the standard analysis of child poverty based on poverty rates at one point in time and documents how much movement into and out of poverty by children there actually is, covering a range of industrialised countries - the USA, UK, Germany, Ireland, Spain, Hungary and Russia. Five main topics are addressed: conceptual and measurement issues associated with a dynamic view of child poverty; cross-national comparisons of child poverty rates and trends; cross-national comparisons of children's movements into and out of poverty; country-specific studies of child poverty dynamics; and the policy implications of taking a dynamic perspective.

Urban Health: Is the City Infected?

Urban Health: Is the City Infected?
Medicine and Humanity. London: King's Fund,

Rodwin, V.G.
01/01/2001

The city is, at once, a center for disease and poor health and also a place for hope, cures and good health. From the earliest times, the city has attracted the poor and been the target of the plague, as well as war. Likewise, the health care industry has always been part of the economic base of cities - from Lourdes, in France, to Rochester, Minnesota, to megacities around the world. With its highly disproportionate share of health resources, e.g., hospitals, physicians, nurses and social services, the big city is a center of excellence in medicine. Yet, as Richard Horton, editor of The Lancet once noted, "For all of its rational efficiency and benevolent intent, the city is likely to be the death of us." Are cities socially infected breeding grounds for disease? Or do they represent critical spatial entities for promotion of population health? I propose to begin with a global view of urban health and disease and the challenge this poses for public health today. Next, I examine some evidence for the hypothesis that population health in cities is relatively poor. Finally, I suggest that the more pertinent question is not whether the city is unhealthy or healthy but rather the extent to which we can alleviate the problems posed by inequalities of income and wealth - in the city as well as outside of it.

Wealth and Poverty in America: A Reader

Wealth and Poverty in America: A Reader
(Edited, with an Introduction) Oxford: Blackwell,

Conley, D.
01/01/2001

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.

Why Assets? Toward a New Framework on Social Stratification

Why Assets? Toward a New Framework on Social Stratification
Ford Foundation Volume, The Mechanisms and Benefits of Spreading Asset Ownership among the Poor. Russell Sage Foundation,

Conley, D.
01/01/2001

Over the past three decades, average household wealth in the United States has declined among all but the richest families, with a near 80 percent drop among the nation's poorest families. Although the national debate about inequality has focused on income, it is wealth - the private assets amassed and passed on within families -- that provides the extra economic cushion needed to move beyond mere day-to-day survival. Assets for the Poor is a full-scale investigation into the importance of family wealth and the need for policies to encourage asset-building among the poor.

Caseload Change: An Exploratory Study

Caseload Change: An Exploratory Study
Journal of Policy Analysis and Management, vol. 19, no. 3 (Summer 2000)

Mead, L.
07/01/2000

The national caseload of Aid to Families with Dependent Children (since 1996, Temporary Assistance to Needy Families) rose 34 percent between 1989 and 1994,then fell 50 percent through June 1999 (data from U.S. Administration for Children and Families). These are the sharpest changes in the history of the program. They sparked a heightened interest in caseload dynamics. The simple model I report here reveals more about the policy causes of change than prior studies.

Sibling Rivalry in Africa

Sibling Rivalry in Africa
American Economic Review (AEA, Papers and Proceedings) 90 (2), May 2000, 405 - 409.

Morduch, J.
05/01/2000

This article uses data on young teenagers to investigate how sibling composition affects schooling outcomes in South Africa and Tanzania. The results, while not estimated very precisely, establish additional evidence of positive associations between school completion and the number of sisters a child has (controlling for the total number of siblings), but the evidence from South Africa shows that they are not general findings. The estimates are conditional on the given family structure, and of course, family structure may not be fully exogenous to schooling choices.

Socioeconomic Status and Dissatisfaction Among HMO Enrollees

Socioeconomic Status and Dissatisfaction Among HMO Enrollees
Medical Care. 2000, Volume 38, pages 506-516.

Carlson, M., Blustein, J., Fiorentino, N.& Prestianni, F.
05/01/2000

Objectives. Member satisfaction is commonly used as an indicator of the quality of care delivered by health plans. Yet few contemporary studies have explored the extent to which individual patient characteristics influence dissatisfaction in HMOs. We sought to determine whether socioeconomic status is associated with enrollee dissatisfaction.

Methods. Data are from a cross-sectional, telephone survey of a probability sample of adults enrolled in New Jersey HMOs in 1998 (n = 7,983). Health plan ratings were elicited as part of the Consumer Assessment of Health Plans Study (CAHPS) survey, along with income, education, and race/ethnicity. Other factors known to influence satisfaction (age, gender, health status, extent of plan choice, and payment for plan) were also ascertained.

Results. Socioeconomically advantaged enrollees were more likely to give low ratings to their health plans. In a multivariate logistic regression model, those with incomes exceeding $100,000 had 1.65 times the odds of being dissatisfied compared with those with family incomes less than $25,000 (P <0.001); those with a college education had 2.53 times the odds of being dissatisfied than those who had not completed high school (P <0.001). However, among enrollees in their plans for >=5 years, those in the lowest income group were significantly more dissatisfied than higher-income enrollees.

Conclusions. Among New Jersey HMO enrollees, higher socioeconomic status (SES) is associated with greater dissatisfaction. Although based on cross-sectional data and thus preliminary, the evidence presented here also suggests that the SES-dissatisfaction relationship varies as a function of duration of enrollment. Further research using longitudinal data could shed additional light on the SES-dissatisfaction link.

A New White Flight? The Dynamics of Neighborhood Change in the 1980s

A New White Flight? The Dynamics of Neighborhood Change in the 1980s
in Nancy Foner, Ruben G. Rumbaut, and Steven J. Gold, eds., Immigration Research for a New Century: Multidisciplinary Perspectives. New York City: Russell Sage Foundation, pp. 423-441.

Ellen, I.G.
01/01/2000

The rapid rise in immigration over the past few decades has transformed the American social landscape, while the need to understand its impact on society has led to a burgeoning research literature. Predominantly non-European and of varied cultural, social, and economic backgrounds, the new immigrants present analytic challenges that cannot be wholly met by traditional immigration studies. Immigration Research for a New Century demonstrate show sociology, anthropology, history, political science, economics, and other disciplines intersect to answer questions about today's immigrants. In Part I, leading scholars examine the emergence of an interdisciplinary body of work that incorporates such topics as the social construction of race, the importance of ethnic self-help and economic niches, the influence of migrant-homeland ties, and the types of solidarity and conflict found among migrant populations. The authors also explore the social and national origins of immigration scholars themselves, many of whom came of age in an era of civil rights and ethnic reaffirmation, and may also be immigrants or children of immigrants. Together these essays demonstrate how social change, new patterns of immigration, and the scholars' personal backgrounds have altered the scope and emphases of the research literature,allowing scholars to ask new questions and to see old problems in new ways. Part II contains the work of a new generation of immigrant scholars, reflecting the scope of a field bolstered by different disciplinary styles. These essays explore the complex variety of the immigrant experience, ranging from itinerant farmworkers to Silicon Valley engineers. The demands of the American labor force, ethnic, racial, and gender stereotyping, and state regulation are all shown to play important roles in the economic adaptation of immigrants. The ways in which immigrants participate politically, their relationships among themselves, their attitudes toward naturalization and citizenship, and their own sense of cultural identity are also addressed. Immigration Research for a New Century examines the complex effects that immigration has had not only on American society but on scholarship itself, and offers the fresh insights of a new generation of immigration researchers.

Pages

Subscribe to Economics