Your tired, your poor...
Marilyn Essex et al.
Child Development, forthcoming
Abstract:
Fifteen-year-old adolescents (N = 109) in a longitudinal study of child development were recruited to examine differences in DNA methylation in relation to parent reports of adversity during the adolescents' infancy and preschool periods. Microarray technology applied to 28,000 cytosine-guanine dinucleotide sites within DNA derived from buccal epithelial cells showed differential methylation among adolescents whose parents reported high levels of stress during their children's early lives. Maternal stressors in infancy and paternal stressors in the preschool years were most strongly predictive of differential methylation, and the patterning of such epigenetic marks varied by children's gender. To the authors' knowledge, this is the first report of prospective associations between adversities in early childhood and the epigenetic conformation of adolescents' genomic DNA.
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Patricia Ketsche et al.
Health Affairs, September 2011, Pages 1637-1646
Abstract:
All health care spending from public and private sources, such as governments and businesses, is ultimately paid by individuals and families. We calculated the burden of US health care spending on families as a percentage of income and found that at the national level, lower-income families pay a larger share of their incomes toward health care than do higher-income families. Specifically, we found that payments made privately, such as those for health insurance or out-of-pocket spending for care, and publicly, through taxes and tax expenditures, consumed more than 20 percent of family income for families in the lowest-income quintile but no more than 16 percent for families in any other income quintile. Our analysis provides a framework for considering the equity of various initiatives under health reform. Although many effects remain to be seen, we find that, overall, the Affordable Care Act should reduce inequities in the burden of paying for national health care spending.
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Socioeconomic inequalities in death from past to present: An introduction
Tommy Bengtsson & Frans van Poppel
Explorations in Economic History, July 2011, Pages 343-356
Abstract:
In the early postwar period, improvements in life expectancy in many Western countries made health authorities, health scientists and politicians believe that social differences in mortality converged. The assumption was that inequality, when measured as death rates, was on steady decline, possibly even on the brink of disappearing. The question is then, how far back in time can social differences in mortality be traced? Can they be traced back to the agricultural society or are they a result of industrialization? Whether or not these differences are the result of the industrial revolution became a lively debated issue at the time and has continued to be discussed to date. While many scholars have taken a Malthusian view, that mortality in the past was largely determined by economic factors, others argue that mortality was determined by non-economic factors, leaving little room for a social gradient in mortality. Due to lack of coherent data covering long time periods, our knowledge has been based on bits and pieces of evidence from various locations and time periods. The evidence used is not only fragmentary but furthermore only partly comparable as different definitions of social class and mortality have been used. Here we present results from seven new studies of locations in Western and Southern Europe, the US and Canada for which individual-level longitudinal data exists during the industrialization period. Most of these studies cover also the first part of the twentieth century, a period for which such microdata hitherto has largely been lacking. Taken together, they have a wide geographic coverage and a very long time horizon. Based on these studies, we argue that social differences appeared both long before and long after the industrial breakthrough, in both cases implying that these differences are not directly related to industrialization. We also argue that the association between income and mortality observed today most likely is a recent phenomenon. Overall, a causal link between income and mortality is put into question.
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The Effects of Housing and Neighborhood Conditions on Child Mortality
Brian Jacob, Jens Ludwig & Douglas Miller
NBER Working Paper, August 2011
Abstract:
In this paper we estimate the causal effects on child mortality from moving into less distressed neighborhood environments. We match mortality data to information on every child in public housing that applied for a housing voucher in Chicago in 1997 (N=11,848). Families were randomly assigned to the voucher wait list, and only some families were offered vouchers. The odds ratio for the effects of being offered a housing voucher on overall mortality rates is equal to 1.11 for all children (95% CI 0.54 to 2.10), 1.50 for boys (95% CI 0.72 to 2.89) and 0.00 for girls - that is, the voucher offer is perfectly protective for mortality for girls (95% CI 0 to 0.79). Our paper also addresses a methodological issue that may arise in studies of low-probability outcomes - perfect prediction by key explanatory variables.
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Richard Miech et al.
American Sociological Review, forthcoming
Abstract:
This article examines how educational disparities in mortality emerge, grow, decline, and disappear across causes of death in the United States, and how these changes contribute to the enduring association between education and mortality over time. Focusing on adults age 40 to 64 years, we first examine the extent to which educational disparities in mortality persisted from 1989 to 2007. We then test the fundamental cause prediction that educational disparities in mortality persist, in part, by shifting to new health outcomes over time. We focus on the period from 1999 to 2007, when all causes of death were coded to the same classification system. Results indicate (1) substantial widening and narrowing of educational disparities in mortality across causes of death, (2) almost all causes of death with increasing mortality rates also had widening educational disparities, and (3) the total educational disparity in mortality would be about 25 percent smaller today if not for newly emergent and growing educational disparities since 1999. These results point to the theoretical and policy importance of identifying social forces that cause health disparities to widen over time.
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Rising Educational Gradients in Mortality: The Role of Behavioral Risk Factors
David Cutler et al.
Journal of Health Economics, forthcoming
Abstract:
The long-standing inverse relationship between education and mortality strengthened substantially at the end of the 20th century. This paper examines the reasons for this increase. We show that behavioral risk factors are not of primary importance. Smoking declined more for the better educated, but not enough to explain the trend. Obesity rose at similar rates across education groups, and control of blood pressure and cholesterol increased fairly uniformly as well. Rather, our results show that the mortality returns to risk factors, and conditional on risk factors, the return to education, have grown over time.
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Kirstin Wells & Jean-Claude Thill
Journal of Urban Affairs, forthcoming
Abstract:
Intrajurisdictional delivery of publicly provided services often results in observable service level differences that vary by spatial subunit (neighborhood). These variations are related to the sociodemographic characteristics of neighborhoods and have been hypothesized in prior literature to be the result of bias against or favoritism toward certain neighborhoods. Using path regression, this paper examines publicly provided bus service in four cities-Asheville, North Carolina; Charlotte, North Carolina; Mobile, Alabama; and Richmond, Virginia-to examine whether the socioeconomic character of a neighborhood is related to the share of municipal bus service it receives. With this analysis, we test an expanded version of Lineberry's underclass hypothesis. Specifically, do transit-dependent neighborhoods, or those with a high percentage of non-Caucasian, low-income, elderly, or student residents receive inferior bus service? Findings confirm prior research that both standard rules and bias are present in service delivery decisions.
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Modernization, weather variability, and vulnerability to famine
Simone D'Alessandro
Oxford Economic Papers, December 2011, Pages 625-647
Abstract:
This paper shows that under weather variability the transformation from a rural to an incomplete market economy can increase the vulnerability of peasants to famine. This can occur even if improvements in technology have raised agricultural productivity and made production less responsive to weather variability. Indeed, negative environmental shocks can produce a drop in wages that outweighs the increase in wages due to an equivalent positive environmental shock. Consequently, the amount of grain stored increases more slowly in good seasons than it decreases in bad ones. This paper gives new insights on the catastrophic effects produced by widespread droughts in India during the second half of the 19th century. Notwithstanding the introduction of new modes of production and the modernization of infrastructures, the interaction between environmental variability and new institutional arrangements might have contributed to increase the vulnerability of peasants to famine.
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Down from the Mountain: Skill Upgrading and Wages in Appalachia
Christopher Bollinger, James Ziliak & Kenneth Troske
Journal of Labor Economics, October 2011, Pages 819-857
Abstract:
The Appalachian region has experienced persistently higher poverty and lower earnings than the rest of the United States. We examine whether skill differentials or differences in the returns to those skills lie at the root of the Appalachian wage gap. Using census data, we decompose the Appalachian wage gap using both mean and full distribution methods. Our findings suggest that significant upgrading of skills within the region has prevented the gap from widening over the last 20 years. Additionally we find that urban areas within Appalachia have not experienced the rise in returns to skills as in non-Appalachian urban areas.
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Kevin Milligan & Mark Stabile
American Economic Journal: Economic Policy, August 2011, Pages 175-205
Abstract:
We exploit changes in child benefits in Canada to study the impact of family income on child and family well-being. Using variation in child benefits across province, time, and family type, we study outcomes spanning test scores, mental health, physical health, and deprivation measures. The findings suggest that child benefit programs had significant positive effects on test scores, maternal health, and mental health, among other measures. We find strong and interesting differences in the effects of benefits by child sex: benefits have stronger effects on educational outcomes and physical health for boys, and on mental health outcomes for girls.
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Why Don't the Poor Save More? Evidence from Health Savings Experiments
Pascaline Dupas & Jonathan Robinson
NBER Working Paper, July 2011
Abstract:
Using data from a field experiment in Kenya, we document that providing individuals with simple informal savings technologies can substantially increase investment in preventative health, reduce vulnerability to health shocks, and help people meet their savings goals. The two main barriers that keep people from saving on their own appear to be transfers to others and "unplanned expenditures" on luxury items. Providing people with a designated safe place to keep money was sufficient to overcome these barriers for the majority of individuals, through a mental accounting effect. Adding an earmarking feature reduced savings for the average individual due to the associated liquidity cost and did not help present-biased people save more. For such individuals, stronger incentives to start and continue making deposits are necessary to overcome self-control problems.
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Life Satisfaction, Self-Determination, and Consumption Adequacy at the Bottom-of-the-Pyramid
Kelly Martin & Ronald Paul Hill
Journal of Consumer Research, forthcoming
Abstract:
Concentration on consumption in material environments characterized by too much rather than too little creates important gaps in understanding of how much of the earth's population navigates the marketplace. This study investigates bottom-of-the-pyramid or impoverished consumers to better comprehend the relationship between societal poverty and individual life satisfaction as moderated by psychological need deprivation and described by self-determination theory. Data were gathered from more than 77,000 individuals in 51 of the world's poorest countries. Using hierarchical linear models, results show that relatedness and autonomy improve poverty's negative influence on life satisfaction, but only if basic life necessities are available, described as consumption adequacy. Findings illustrate that without consumption adequacy, psychological need fulfillment has little effect on the poverty-well-being relationship, emphasizing the hopelessness of individuals living in extreme poverty. Findings also suggest to researchers that impoverished consumers not only face different circumstances but actually respond to these circumstances in unique ways.
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Why Do NGOs Go Where They Go? Evidence from Kenya
Jennifer Brass
World Development, forthcoming
Abstract:
Using Kenya as a case study, this paper provides preliminary evidence of the factors influencing Nongovernmental organizations (NGOs) to choose their locations within a country. Interpreting the findings from a range of models evaluating 4,210 organizations in 70 districts, and drawing on in-country interviews with NGO leaders and workers, government officials, and politicians, it finds that sub-national NGO location corresponds to an area's objective level of need, as well as the convenience of the location for accessing beneficiaries, donors, and elite goods. Contrary to dominant theories of African political economy, political factors like patronage appear to have little or no significant influence.
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Childhood Health and Labor Market Inequality over the Life Course
Steven Haas, Maria Glymour & Lisa Berkman
Journal of Health and Social Behavior, September 2011, Pages 298-313
Abstract:
The authors use data from the Health and Retirement Study's Earnings Benefit File, which links Health and Retirement Study to Social Security Administration records, to estimate the impact of childhood health on earnings curves between the ages of 25 and 50 years. They also investigate the extent to which diminished educational attainment, earlier onset of chronic health conditions, and labor force participation mediate this relationship. Those who experience poor childhood health have substantially diminished labor market earnings over the work career. For men, earnings differentials grow larger over the early to middle career and then slow down and begin to converge as they near 50 years of age. For women, earnings differentials emerge later in the career and show no evidence of convergence. Part of the child health earnings differential is accounted for by selection into diminished educational attainment, the earlier onset of chronic disease in adulthood, and, particularly for men, labor force participation.
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Neighborhood Context and Social Disparities in Cumulative Biological Risk Factors
Katherine King, Jeffrey Morenoff & James House
Psychosomatic Medicine, September 2011, Pages 572-579
Objective: This study examines the role of neighborhood context in the accumulation of biological risk factors and racial/ethnic and socioeconomic disparities.
Methods: Data came from face-to-face interviews and blood sample collection on a probability sample of adults (n = 549) in the 2002 Chicago Community Adult Health Study. Following the approach of prior studies, we constructed an index of cumulative biological risk (CBR) by counting how many of eight biomarkers exceeded clinically defined criteria for "high risk": systolic and diastolic blood pressure, resting heart rate, hemoglobin A1c, C-reactive protein, waist size, and total and high-density lipoprotein cholesterol. Data are presented as incidence rate ratios (IRRs) based on generalized linear models with a Poisson link function and population-average estimates with robust standard errors.
Results: Non-Hispanic blacks (n = 200), Hispanics (n = 149), and people with low (n = 134) and moderate (n = 275) level of education had significantly higher numbers of biological risks than their respective reference groups (IRR = 1.48, 1.59, 1.62, and 1.48, respectively, with p < .01). Black-white (p < .001) and Hispanic-white (p < .003) disparities in CBR remained significant after adjusting for individual-level socioeconomic position and behavioral factors, whereas individual-level controls substantially diminished the low/high (p < .069) and moderate/high (p < .042) educational differences. Estimating "within-neighborhood" disparities to adjust for neighborhood context fully explained the black-white gap in CBR (p < .542) and reduced the Hispanic-white gap to borderline significance (p < .053). Neighborhood affluence predicted lower levels of CBR (IRR = 0.82, p < .027), but neighborhood disadvantage was not significantly associated with CBR (IRR = 1.00, p < .948).
Conclusions: Neighborhood environments seem to play a pivotal role in the accumulation of biological risk and disparities therein.
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Sheila Mammen et al.
Journal of Family and Economic Issues, September 2011, Pages 461-472
Abstract:
Differences between rural low-income mothers who were non-participants and participants in the Earned Income Tax Credit (EITC) were examined. About one-third (35%) of the 224 eligible mothers in a multi-state USDA study, Rural Families Speak, did not claim the tax credit. The EITC non-participants were more likely to be Hispanic, be less educated, have larger families, perceive their income as being inadequate, live in more rural counties, and possess little understanding of the EITC. Participating mothers were more likely to be single, food secure, and satisfied with life. Analysis of qualitative data revealed that the mothers had many misconceptions about the EITC. These findings assist in formulating policies and outreach efforts that may increase rural low-income families' EITC participation.
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Ben Lennox Kail & Marc Dixon
Sociological Quarterly, Summer 2011, Pages 376-399
Abstract:
Scholars have been slow to test welfare state theories on the extensive subnational variation in the United States during the recent period of retrenchment. We assess institutional politics theories, literature on race and social policy, and public opinion arguments relative to levels of support in states' Aid to Families Dependent Children programs from 1982 until its elimination in 1996. Pooled time-series results demonstrate that the determinants of spending during retrenchment are mostly similar to those driving development and expansion. Pro-spending actors and professionalized state institutions limit benefit curtailment, while jurisdictions with larger African-American populations have lower benefits. Additionally, liberal citizens positively impact support and strengthen the effects of state institutions, but this effect is attenuated in states with larger African-American populations.
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Aletha Huston et al.
Journal of Policy Analysis and Management, Fall 2011, Pages 729-754
Abstract:
New Hope, an employment-based poverty-reduction intervention for adults evaluated in a random-assignment experimental design, had positive impacts on children's achievement and social behavior two and five years after random assignment. The question addressed in this paper was the following: Did the positive effects of New Hope on younger children diminish or even reverse when children reached the challenges of adolescence (eight years after random assignment)? Small positive impacts on school progress, school motivation, positive social behavior, child well-being, and parent control endured, but impacts on school achievement and problem behavior were no longer evident. The most likely reasons for lasting impacts were that New Hope families were slightly less likely to be poor, and children had spent more time in center-based child care and structured activities. New Hope represents a model policy that could produce modest improvements in the lives of low-income adults and children.
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Civil wars beyond their borders: The human capital and health consequences of hosting refugees
Javier Baez
Journal of Development Economics, November 2011, Pages 391-408
Abstract:
In early 1994, Kagera - a region in northwestern Tanzania - was flooded by more than 500,000 refugees fleeing from the genocides of Burundi and Rwanda. I use this population shock and a series of topographic barriers that resulted in variation in refugee intensity to investigate the short- and long-run causal effects of hosting refugees on outcomes of local children. This strategy provides evidence of adverse impacts over one year after the shock: a worsening of children's anthropometrics (0.3 standard deviations), an increase in the incidence of infectious diseases (15-20 percentage points) and an increase in mortality for children under five (7 percentage points). I also find that intra- and inter-cohort variation in childhood exposure to the refugee crisis reduced height in early adulthood by 1.8 cm (1.2%), schooling by 0.2 years (7.1%) and literacy by 7 percentage points (8.6%). Designs using the distance to the border with Rwanda as an alternative identification strategy for refugee intensity support the findings. The estimates are robust across different samples, specifications and estimation methods and provide evidence of a previously undocumented indirect effect of civil wars on the well-being of children and subsequent economic growth in refugee-hosting communities.
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Dan Banik
Journal of Democracy, July 2011, Pages 90-104
Abstract:
With 37.2 percent of its 1.2 billion citizens officially estimated to be living in poverty, India has the unenviable record of being home to a third of the world's poor. And while the country has averted famines since independence, it has not been as successful at preventing chronic hunger. This article provides a broad overview of Indian democracy's struggle with development and discusses the type of progress democratic India has made over the years in fighting poverty and inequality. Thereafter, it specifically examines undernutrition and starvation deaths in Orissa, one of India's poorest states. It argues that instead of sustained commitment to long-term policies that aim to reduce vulnerability to hunger, the political-administrative response is typically short-term, ad hoc, populist, and clientelistic in character.
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Pamela Bennett & Andrew Cherlin
Social Science Quarterly, September 2011, Pages 735-760
Objectives: We investigate the neighborhood contexts in which low-income families negotiate welfare reform.
Methods: Using data from the Three-City Study and U.S. Census, we follow 1,059 low-income women from 1999 to 2005 tracking their neighborhood quality, employment, and welfare use. We evaluate whether improvements in residential contexts facilitate transitions to economic self-sufficiency, but also test the reverse possibility.
Results: Despite living in similar neighborhoods in 1999, women who left welfare experienced larger reductions in neighborhood disadvantage than women who remained on welfare. Likewise, women who left welfare with employment achieved larger increases in neighborhood quality than those who left welfare without work; the latter experiencing neighborhood change no different than those who stayed on welfare.
Conclusions: Neighborhood conditions are, at minimum, associated with welfare outcomes. Findings suggest that neighborhood quality increases after women leave welfare, though we cannot reject the possibility that better neighborhoods lead to better welfare outcomes.
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Said Shahtahmasebi et al.
Journal of Social Policy, October 2011, Pages 653-673
Abstract:
Disabled children are significantly more likely to grow up in poverty than their non-disabled peers. We used longitudinal data from Waves 3-7 (2001-2005) of the UK Families and Children Study to explore the relationship between the presence of a disabled child in the family and poverty transitions. When compared to other families, families supporting a disabled child are more likely to be exposed to persistent or recurrent poverty, less likely to escape from an episode of poverty and more likely to descend into poverty. However, statistically controlling for the effects of salient family characteristics either attenuates, eliminates or reverses these associations. That is, when compared to other families with similar levels of personal and social resources, families supporting a disabled child are no more likely to escape from or descend into poverty than other families. Results are discussed in relation to the need for social policy to invest in strengthening the broader capabilities of families of disabled children.