Kevin Lewis

November 26, 2012

Intergenerational Effects of Welfare Reform on Educational Attainment

Amalia Miller & Lei Zhang
Journal of Law and Economics, May 2012, Pages 437-476

This paper estimates the impact of the fundamental welfare reforms of the 1990s on the educational attainment of children in low-income families. Using administrative records and individual survey data spanning the early 1990s to the mid-2000s, we find large positive effects of welfare reform: income gaps in school enrollment and dropout rates narrow by more than 20 percent. Unlike the significant and growing relative gains in the years following state welfare reforms, we find no evidence of relative gains for low-income adolescents in the years preceding the reforms. These findings are robust under alternative definitions of the treatment and control groups and after controlling for contemporaneous economic and policy changes.


Long Run Impacts of Childhood Access to the Safety Net

Hilary Hoynes, Diane Whitmore Schanzenbach & Douglas Almond
NBER Working Paper, November 2012

A growing economics literature establishes a causal link between in utero shocks and health and human capital in adulthood. Most studies rely on extreme negative shocks such as famine and pandemics. We are the first to examine the impact of a positive and policy-driven change in economic resources available in utero and during childhood. In particular, we focus on the introduction of a key element of the U.S. safety net, the Food Stamp Program, which was rolled out across counties in the U.S. between 1961 and 1975. We use the Panel Study of Income Dynamics to assemble unique data linking family background and county of residence in early childhood to adult health and economic outcomes. The identification comes from variation across counties and over birth cohorts in exposure to the food stamp program. Our findings indicate that the food stamp program has effects decades after initial exposure. Specifically, access to food stamps in childhood leads to a significant reduction in the incidence of "metabolic syndrome" (obesity, high blood pressure, and diabetes) and, for women, an increase in economic self-sufficiency. Overall, our results suggest substantial internal and external benefits of the safety net that have not previously been quantified.


Competition as a Savings Incentive: A Field Experiment at a Homeless Shelter

Sera Linardi & Tomomi Tanaka
Journal of Economic Behavior & Organization, forthcoming

This paper describes a randomized field experiment testing the impact of a savings competition on the behavior of homeless individuals staying at a transitional shelter. When monetary prizes were offered for achieving the highest saving rates within a particular month, average savings increased by $80 (a 30% increase in savings rate) while income and attendance at case management meetings remained unchanged. However, repeating the competition in the following month had no effect because responsive savers selected out of the shelter after the first month. In summary, while a savings competition can increase savings in the short run, its effect may be limited to the intensive margin and may diminish with repetition.


Dealing with consumer default: Bankruptcy vs Garnishment

Satyajit Chatterjee & Grey Gordon
Journal of Monetary Economics, forthcoming

What are the positive and normative implications of eliminating bankruptcy protection for indebted individuals? Without bankruptcy protection, creditors can collect on defaulted debt to the extent permitted by wage garnishment laws. The elimination lowers the default premium on unsecured debt and permits low-net-worth individuals suffering bad earnings shocks to smooth consumption by borrowing. There is a large increase in consumer debt financed essentially by super-wealthy individuals, a modest drop in capital per worker, and a higher frequency of consumer default. Average welfare rises by 1 percent of consumption in perpetuity, with about 90 percent of households favoring the change.


The Extended Family and Children's Educational Success

Mads Meier Jæger
American Sociological Review, forthcoming

Research on family background and educational success focuses almost exclusively on two generations: parents and children. This study argues that the extended family contributes significantly to the total effect of family background on educational success. Analyses using the Wisconsin Longitudinal Study show that, net of family factors shared by siblings from the same immediate family, factors shared by first cousins account for a nontrivial part of the total variance in children's educational success. Results also show that grandparents', aunts', and uncles' socioeconomic characteristics have few direct effects on educational success. Furthermore, resources in the extended family compensate for lacking resources in low-SES families, which in turn promote children's educational success. The main conclusion is that the total effect of family background on educational success originates in the immediate family, the extended family, and in interactions between these two family environments.


Association of Neighborhood Characteristics with Bystander-Initiated CPR

Comilla Sasson et al.
New England Journal of Medicine, 25 October 2012, Pages 1607-1615

Background: For persons who have an out-of-hospital cardiac arrest, the probability of receiving bystander-initiated cardiopulmonary resuscitation (CPR) may be influenced by neighborhood characteristics.

Methods: We analyzed surveillance data prospectively submitted from 29 U.S. sites to the Cardiac Arrest Registry to Enhance Survival between October 1, 2005, and December 31, 2009. The neighborhood in which each cardiac arrest occurred was determined from census-tract data. We classified neighborhoods as high-income or low-income on the basis of a median household income threshold of $40,000 and as white or black if more than 80% of the census tract was predominantly of one race. Neighborhoods without a predominant racial composition were classified as integrated. We analyzed the relationship between the median income and racial composition of a neighborhood and the performance of bystander-initiated CPR.

Results: Among 14,225 patients with cardiac arrest, bystander-initiated CPR was provided to 4068 (28.6%). As compared with patients who had a cardiac arrest in high-income white neighborhoods, those in low-income black neighborhoods were less likely to receive bystander-initiated CPR (odds ratio, 0.49; 95% confidence interval [CI], 0.41 to 0.58). The same was true of patients with cardiac arrest in neighborhoods characterized as low-income white (odds ratio, 0.65; 95% CI, 0.51 to 0.82), low-income integrated (odds ratio, 0.62; 95% CI, 0.56 to 0.70), and high-income black (odds ratio, 0.77; 95% CI, 0.68 to 0.86). The odds ratio for bystander-initiated CPR in high-income integrated neighborhoods (1.03; 95% CI, 0.64 to 1.65) was similar to that for high-income white neighborhoods.

Conclusions: In a large cohort study, we found that patients who had an out-of-hospital cardiac arrest in low-income black neighborhoods were less likely to receive bystander-initiated CPR than those in high-income white neighborhoods.


The relationship between child care subsidies and children's cognitive development

Laura Hawkinson et al.
Early Childhood Research Quarterly, forthcoming

Child care subsidies help low-income families pay for child care while parents work or study. Few studies have examined the effects of child care subsidy use on child development, and no studies have done so controlling for prior cognitive skills. We use rich, longitudinal data from the ECLS-B data set to estimate the relationship between child care subsidy use and school readiness, using value-added regression models as well as parametric and non-parametric models with propensity score matching. Compared to a diverse group of subsidy non-recipients in various types of non-parental care as well as parental care only, we find that child care subsidy use during preschool is negatively associated with children's math skills at kindergarten entry. However, sensitivity analysis suggests that these findings could be easily overturned if unobserved factors affect selection into subsidy receipt.


Family Income and Early Achievement Across the Urban-Rural Continuum

Portia Miller, Elizabeth Votruba-Drzal & Claude Messan Setodji
Developmental Psychology, forthcoming

Rural and suburban children account for the majority of poor children in the United States. Yet, most research examining poverty's associations with child development is focused on urban samples. Using nationally representative data from the Early Childhood Longitudinal Study, Birth Cohort (N ≈ 6,600), this study examines whether the form and magnitude of income's relationship with early achievement differ across the urban-rural continuum. Results suggest that there are urbanicity-related differences in the functional form of the association between income and early achievement, with nonlinear associations in urban and suburban areas and a linear relationship in rural areas. The magnitude of the association between income and early reading and math skills also differs across the urban-rural continuum, such that income increases are related to the greatest improvements in early academic skills in large urban areas and only slight improvements in rural areas.


A Novel Look at Racial Health Disparities: The Interaction Between Social Disadvantage and Environmental Health

Margaret Hicken et al.
American Journal of Public Health, December 2012, Pages 2344-2351

Objectives: We explored the notion that social disadvantage increases vulnerability to the health effects of environmental hazards. Specifically, we examined (1) whether race modifies the association between blood lead and blood pressure and (2) whether socioeconomic status (SES) plays a role in this modifying effect.

Methods: Using the National Health and Nutrition Examination Survey (2001-2008) and linear regression, we estimated the association between blood lead and blood pressure. Using interactions among race, SES, and lead, we estimated this association by levels of social disadvantage.

Results: Black men and women showed a 2.8 (P < .001) and 4.0 (P < .001) millimeters mercury increase in SBP, respectively, for each doubling of blood lead. White adults showed no association. This lead-SBP association exhibited by Blacks was primarily isolated to Blacks of low SES. For example, poor but not nonpoor Black men showed a 4.8 millimeters mercury (P < .001) increase in SBP for each doubling of blood lead.

Conclusions: Our results suggest that social disadvantage exacerbates the deleterious health effects of lead. Our work provides evidence that social and environmental factors must be addressed together to eliminate health disparities.


When Claimant Characteristics and Prior Performance Predict Bureaucratic Error

Sangyub Ryu, Jeffrey Wenger & Vicky Wilkins
American Review of Public Administration, November 2012, Pages 695-714

The public administration literature has paid scant attention to bureaucratic errors as performance measures. This has largely been due to a lack of data. Unlike most programs, the unemployment insurance (UI) program has systematically collected performance data and has independently audited those data to determine error responsibility (employer, employee, and agency error). In the first comprehensive analysis of these data, we examine the probability that a bureaucrat makes an error involving nonpayment of UI benefits and theorize about the reasons for these errors. Our findings indicate that the previous UI office error rate is a good predictor of current error rates, demonstrating that poorly performing offices remain poor performers. In addition, local offices with high error rates account for a disproportionate percentage of the errors, indicating a need to examine agency management. Second, errors are more commonly made on cases involving White UI claimants and claimants with a college education. Finally, we find that claimants who have higher self-valuation, are less likely to experience agency errors. Taken together, these results point to systematic agency errors. Public managers and the unemployed would be better served if training efforts and performance targets were developed with these systematic error effects in mind.


Information and College Access: Evidence from a Randomized Field Experiment

Philip Oreopoulos & Ryan Dunn
NBER Working Paper, November 2012

High school students from disadvantaged high schools in Toronto were invited to take two surveys, about three weeks apart. Half of the students taking the first survey were also shown a 3 minute video about the benefits of post secondary education (PSE) and invited to try out a financial-aid calculator. Most students' perceived returns to PSE were high, even among those not expecting to continue. Those exposed to the video, especially those initially unsure about their own educational attainment, reported significantly higher expected returns, lower concerns about costs, and expressed greater likelihood of PSE attainment.


Testing an Asset-Building Approach for Young People: Early Access to Savings Predicts Later Savings

Terri Friedline, William Elliott & Gina Chowa
Economics of Education Review, forthcoming

A major hypothesis of asset-building is that early access to savings accounts leads to continued and improved educational and economic outcomes over time. This study asks whether or not young adults (ages 18 to 22) in 2007, particularly among lower income households, are significantly more likely to own savings accounts and to accumulate more savings when they have access to savings accounts at banking institutions as adolescents (ages 13 to 17) in 2002. We investigate this question using longitudinal data (low-to-moderate income sample [LMI; N = 530]; low-income sample [LI; N = 354]) from the Panel Study of Income Dynamics and its supplements. Results from propensity score weighting and bivariate probit estimates support this hypothesis. Asset-building policies that extend early access to savings accounts may improve savings outcomes for young people from lower income households, which hopefully affords them with the economic resources needed to lead productive and satisfying lives.


Examining the Distributional Effects of Military Service on Earnings: A Test of Initial Dominance

Christopher Bennett & Ričardas Zitikis
Journal of Business & Economic Statistics, forthcoming

Existing empirical evidence suggests that the effects of Vietnam veteran status on earnings in the decade-and-a-half following service may be concentrated in the lower tail of the earnings distribution. Motivated by this evidence, we develop a formal statistical procedure that is specifically designed to test for lower tail dominance in the distributions of earnings. When applied to the same data as in previous studies, the test reveals that the distribution of earnings for veterans is indeed dominated by the distribution of earnings for non-veterans up to $12,600 (in 1978 dollars), thereby indicating that there was higher social welfare and lower poverty experienced by non-veterans in the decade-and-a-half following military service.


The effect of the original introduction of Medicaid on welfare participation and female labor supply

Sandra Decker & Frederic Selck
Review of Economics of the Household, December 2012, Pages 541-556

This paper uses the fact that states introduced Medicaid programs at different times between 1966 and 1972 to estimate Medicaid's effect on Aid to Families with Dependent Children (AFDC) participation. Using state-level data, we find that the introduction of Medicaid accounted for approximately 10% of growth in AFDC caseloads from 1964 to 1974, a time period during which there was thought to be significant unexplained growth in caseloads. Analysis of individual-level data indicates that Medicaid's effect on AFDC participation occurred through its effect in increasing the number of eligibles who participated in the program, and not because of increases in eligibility or reductions in workforce participation.


Barack Obama's "Fight" to End Poverty: Rhetoric and Reality

Richard Fording & Joseph Smith
Social Science Quarterly, December 2012, Pages 1161-1184

Objectives: In this article we examine President Barack Obama's leadership on the issue of poverty. Our analysis seeks to address three specific objectives. First, we begin by examining the Obama administration's anti-poverty efforts and their relationship with recent trends in the U.S. poverty rate. Second, we examine President Obama's rhetorical leadership on the issue of poverty, both in absolute terms and compared to other recent presidents. Compared to other recent presidents, how often has Obama talked about issues related to poverty and poor people? Third, we discuss the implications of our results for theories of presidential leadership.

Methods: We rely on a series of analyses of aggregate poverty trends, as well as content analyses of presidential weekly radio addresses.

Results: Our analyses find that contrary to the claims of critics, although the poverty rate has risen during President Obama's first term in office, recent increases in poverty have actually been somewhat lower that what would be expected given the state of the economy. The evidence indicates that one important reason for this is the implementation of ARRA. We find considerable support for claims that President Obama has demonstrated relatively little rhetorical leadership on the issue of poverty, although the frequency with which he has emphasized issues related to poverty is not significantly different compared to past presidents.

Conclusion: President Obama has had some objective success in his anti-poverty efforts, but his leadership style on this issue can be characterized more as a "facilitator" rather than a "director" of change.


Why the Poor Vote in India: "If I Don't Vote, I Am Dead to the State"

Amit Ahuja & Pradeep Chhibber
Studies in Comparative International Development, December 2012, Pages 389-410

Our empirical research in India shows the poor and the non-poor report different motivations for voting. The poor say they turn out to vote because it is their right while the non-poor report they vote because they expect material benefits from the state, some kind of access to the state, or because voting is their civic duty. We attribute the different reasons for voting offered by the poor and non-poor to their different relationships with the state. Unlike the non-poor, the poor mostly report the state mistreats or ignores them yet makes every effort on Election Day to ensure they are treated equally. The recognition the state grants to the poor on Election Day leads them to view voting as a valued right, one that gives them a rare chance to associate with those who govern as equals. The evidence in this paper was drawn from 30 focus groups with a total of 445 participants and 150 open-ended interviews conducted across Maharashtra, Tamil Nadu, and Uttar Pradesh and three state and national-level surveys.


The Pawn Industry and Its Customers: The United States and Europe

Marieke Bos, Susan Carter & Paige Marta Skiba
Vanderbilt University Working Paper, September 2012

As humankind's oldest financial institution, pawnbroking has served the financial needs of low-income families for centuries. Recently, and especially in the last five years, an increasing number of consumers have relied on pawnbrokers to help them meet daily financial needs. Seven percent of all U.S. and four percent of all Swedish households have used pawn credit at one time or another. Despite the general public's increased interest in the pawn industry, evidenced by the popularity of reality television shows like "Pawn Stars" and "Hard Core Pawn," economists have paid surprisingly little attention to the pawnbroking industry and pawnshop borrowers. We start by reviewing the history of pawn credit and the sparse economic literature on pawnbroking, and then present unique U.S. transaction data and Swedish register data to, first, show aggregate trends, and, second, shed light on the social and financial background of pawnshop borrowers and their behavior within the pawnbroking industry in both countries. We find that the pawnbroking industry and pawnshop borrowers are unexpectedly similar in the United States and Sweden.


Status Configurations, Military Service and Higher Education

Lin Wang, Glen Elder & Naomi Spence
Social Forces, December 2012, Pages 397-422

The U.S. Armed Forces offer educational and training benefits as incentives for service. This study investigates the influence of status configurations on military enlistment and their link to greater educational opportunity. Three statuses (socioeconomic status of origin, cognitive ability and academic performance) have particular relevance for life course options. We hypothesize that young men with inconsistent statuses are more likely to enlist than men with consistent status profiles, and that military service improves access to college for certain configurations. Analyses of the National Longitudinal Study of Adolescent Health (Add Health) show (1. that several status configurations markedly increased the likelihood of military enlistment and (2. within status configurations, recruits were generally more likely to enroll in higher education than nonveterans, with associate degrees being more likely.


The Effects of Housing and Neighborhood Conditions On Child Mortality

Brian Jacob, Jens Ludwig & Douglas Miller
Journal of Health Economics, forthcoming

In this paper we estimate the causal effects on child mortality from moving into less distressed neighborhood environments. We match mortality data covering the period from 1997 to 2009 with information on every child in public housing that applied for a housing voucher in Chicago in 1997 (N = 11,680). 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 1.13 for all children (95% CI 0.73 to 1.70), 1.34 for boys (95% CI 0.85 to 2.05) and 0.21 for girls (95% CI 0.01 to 1.04).


Economic Adversity and Children's Sleep Problems: Multiple Indicators and Moderation of Effects

Mona El-Sheikh et al.
Health Psychology, forthcoming

Objective: Toward explicating relations between economic adversity and children's sleep, we examined associations between multiple indicators of socioeconomic status (SES)/adversity and children's objectively and subjectively derived sleep parameters; ethnicity was examined as potential moderator.

Methods: Participants were 276 third- and fourth-grade children and their families (133 girls; M age = 9.44 years; SD = .71): 66% European American (EA) and 34% African American (AA). Four SES indicators were used: income-to-needs ratio, perceived economic well-being, maternal education, and community poverty. Children wore actigraphs for 7 nights and completed a self-report measure to assess sleep problems.

Results: Objectively and subjectively assessed sleep parameters were related to different SES indicators, and overall worse sleep was evident for children from lower SES homes. Specifically, children from homes with lower income-to-needs ratios had higher levels of reported sleep/wake problems. Parental perceived economic well-being was associated with shorter sleep minutes and greater variability in sleep onset for children. Lower mother's education was associated with lower sleep efficiency. Children who attended Title 1 schools had shorter sleep minutes. Ethnicity was a significant moderator of effects in the link between some SES indicators and children's sleep. AA children's sleep was more negatively affected by income-to-needs ratio and mother's education than was the sleep of EA children.

Conclusions: The results advocate for the importance of specifying particular SES and sleep variables used because they may affect the ability to detect associations between sleep and economic adversity.


Sleep problems as a mediator of the association between parental education levels, perceived family economy and poor mental health in children

Tormod Bøe et al.
Journal of Psychosomatic Research, December 2012, Pages 430-436

Objective: The aim of this study was to investigate the association between familial socioeconomic status (SES) and children's sleep problems, and the role of sleep problems as a mediator between familial SES and childhood mental health problems.

Methods: Participants were 5781 11-13 year old children from the Bergen Child Study. Data were collected on family economy, parental education, and children's difficulties initiating and/or maintaining sleep (DIMS), time in bed (TIB) and self-reported mental health problems using the Strengths and Difficulties Questionnaire (SDQ).

Results: Sleep problems were significantly more common in children from lower SES families. Children from families with poor and average perceived family economy had significantly higher odds of reporting DIMS compared to children from families with very good economy (ORs = 3.5 and 1.7, respectively). The odds were reduced by 12-36% adjusting for poor parental health and single parenting, but remained significant. Children from families with a poor economy had increased odds of a short TIB, both in the crude model (OR = 1.9) and adjusted for parental characteristics (OR = 2.2). Maternal education level was significantly associated with short TIB. Path analysis was conducted to investigate the potential mediating role of DIMS in the relationship between SES and mental health. The significant direct association between perceived family economy and SDQ total problems score was partially mediated by a significant indirect effect of sleep problems.

Conclusion: Sleep problems are common among children from families with a lower SES and may be a potential mechanism through which low SES is translated into mental health problems.


Frontal EEG/ERP correlates of attentional processes, cortisol and motivational states in adolescents from lower and higher socioeconomic status

Amedeo D'Angiulli et al.
Frontiers in Human Neuroscience, November 2012

Event-related potentials (ERPs) and other electroencephalographic (EEG) evidence show that frontal brain areas of higher and lower socioeconomic status (SES) children are recruited differently during selective attention tasks. We assessed whether multiple variables related to self-regulation (perceived mental effort) emotional states (e.g., anxiety, stress, etc.) and motivational states (e.g., boredom, engagement, etc.) may co-occur or interact with frontal attentional processing probed in two matched-samples of fourteen lower-SES and higher-SES adolescents. ERP and EEG activation were measured during a task probing selective attention to sequences of tones. Pre- and post-task salivary cortisol and self-reported emotional states were also measured. At similar behavioural performance level, the higher-SES group showed a greater ERP differentiation between attended (relevant) and unattended (irrelevant) tones than the lower-SES group. EEG power analysis revealed a cross-over interaction, specifically, lower-SES adolescents showed significantly higher theta power when ignoring rather than attending to tones, whereas, higher-SES adolescents showed the opposite pattern. Significant theta asymmetry differences were also found at midfrontal electrodes indicating left hypo-activity in lower-SES adolescents. The attended vs. unattended difference in right midfrontal theta increased with individual SES rank, and (independently from SES) with lower cortisol task reactivity and higher boredom. Results suggest lower-SES children used additional compensatory resources to monitor/control response inhibition to distracters, perceiving also more mental effort, as compared to higher-SES counterparts. Nevertheless, stress, boredom and other task-related perceived states were unrelated to SES. Ruling out presumed confounds, this study confirms the midfrontal mechanisms responsible for the SES effects on selective attention reported previously and here reflect genuine cognitive differences.


Effects of Welfare and Maternal Work on Recommended Preventive Care Utilization Among Low-Income Children

Jane Holl et al.
American Journal of Public Health, December 2012, Pages 2274-2279

Objectives: We examined how maternal work and welfare receipt are associated with children receiving recommended pediatric preventive care services.

Methods: We identified American Academy of Pediatrics-recommended preventive care visits from medical records of children in the 1999-2004 Illinois Families Study: Child Well-Being. We used Illinois administrative data to identify whether mothers received welfare or worked during the period the visit was recommended, and we analyzed the child visit data using random-intercept logistic regressions that adjusted for child, maternal, and visit-specific characteristics.

Results: The 485 children (95%) meeting inclusion criteria made 41% of their recommended visits. Children were 60% more likely (adjusted odds ratios [AOR` = 1.60; 95% confidence interval [CI] = 1.27, 2.01) to make recommended visits when mothers received welfare but did not work compared with when mothers did not receive welfare and did not work. Children were 25% less likely (AOR = 0.75; 95% CI = 0.60, 0.94) to make preventive care visits during periods when mothers received welfare and worked compared with welfare only periods.

Conclusion: The Temporary Assistance for Needy Families maternal work requirement may be a barrier to receiving recommended preventive pediatric health care.


Longitudinal roles of precollege contexts in low-income youths' postsecondary persistence

Matthew Diemer & Cheng-Hsien Li
Developmental Psychology, November 2012, Pages 1686-1693

Low-income youths enroll at postsecondary institutions less frequently, drop out more often, are less likely to return after dropping out, and are less likely to attain a postsecondary degree than their more affluent peers. It is therefore important to understand how low-income youths develop the capacity to persist in the postsecondary setting. This article explores how contextual supports contribute to low-income (and predominantly racial/ethnic minority) youths' educational expectancies and postsecondary persistence. The authors examined these questions by applying structural equation modeling to a longitudinal panel of youths surveyed 3 times over a 5-year period, while controlling for academic achievement, age, and gender. The obtained structural model suggests meditating "chains" by which parents and peers foster educational expectancies and postsecondary persistence over time. This article suggests that precollegiate contexts and expectancies clearly matter in explaining how low-income youths progress through intermediate checkpoints - postsecondary persistence - on the path to degree completion.


Neighborhood socioeconomic status and coronary heart disease risk prediction in a nationally representative sample

C.E. Pollack et al.
Public Health, October 2012, Pages 827-835

Objectives: Test the association between coronary heart disease (CHD) risk scores and neighborhood socioeconomic status (NSES) in a US nationally-representative sample and describe whether the association varies by gender and race/ethnicity.

Study design: Cross-sectional study.

Methods: We use Health and Nutrition Examination Survey (NHANES) data from 1999 to 2004 linked with Census tract data. Multivariable regression models and propensity score adjusted models are employed to test the association between NSES and 10-year risk of CHD based on the Framingham Risk Score (FRS), adjusting for individual-level characteristics.

Results: An individual living in a neighborhood at the 75th percentile of NSES (high NSES) has, on average, a 10-year CHD risk that is 0.16 percentage points lower (95% Confidence Interval 0.16, 0.17) than a similar person residing in a neighborhood at the 25th percentile of NSES (low NSES). Race/ethnicity and gender were found to significantly modify the association between NSES and CHD risk: the association is larger in men than women and in whites than minorities. Propensity score models showed that findings on the main effects of NSES were robust to self-selection into neighborhoods. Similar results were observed between NSES and risk of cardiovascular disease events.

Conclusions: NSES is significantly associated with CHD risk, and the relationship varies by gender and race/ethnicity.


Financial Hardship and Self-Rated Health Among Low-Income Housing Residents

Reginald Tucker-Seeley et al.
Health Education & Behavior, forthcoming

Background: Self-rated health (SRH) has been shown to be predictive of morbidity and mortality. Evidence also shows that SRH is socioeconomically patterned, although this association differs depending on the indicator of socioeconomic status used. The purpose of this study was to determine the association between SRH and financial hardship among residents of low-income housing.

Methods: We analyzed cross-sectional data from the Health in Common Study (N = 828), an observational study to investigate social and physical determinants of cancer risk-related behaviors among residents of low-income housing in three cities in the Boston metropolitan area. Modified Poisson regression models were used to obtain the relative risk of low SRH (fair or poor), adjusting for demographic and socioeconomic characteristics.

Results: Unadjusted models revealed that the respondents reporting financial hardship were 53% more likely to report low SRH compared with those not reporting financial hardship. After controlling for demographic characteristics, socioeconomic characteristics, and psychological distress, the results showed that those reporting financial hardship were 44% more likely to report low SRH.

Conclusion: Our results suggest that financial hardship is a robust predictor of SRH; and over and above the influence of demographic and traditional socioeconomic indicators, and even psychological distress, financial hardship remains strongly associated with low SRH. Additional research needs to be conducted to further elucidate this pathway and to better understand the determinants of variability in financial hardship among low-income housing residents to ensure the most appropriate policy levers (e.g., housing-related policy, food-related policy) are chosen to improve health outcomes in this population.


Housing Transitions and Low Birth Weight Among Low-Income Women: Longitudinal Study of the Perinatal Consequences of Changing Public Housing Policy

Michael Kramer et al.
American Journal of Public Health, December 2012, Pages 2255-2261

Objectives: We assessed the longitudinal association between housing transitions and pregnancy outcomes in a sample of public housing residents.

Methods: A cohort of 2670 Black women residing in Atlanta, Georgia, housing projects with 1 birth occurring between 1994 and 2007 was created from maternally linked longitudinal birth files and followed for subsequent births. Traditional regression and marginal structural models adjusting for time-varying confounding estimated the risk of preterm low birth weight (LBW) or small for gestational age LBW by maternal housing transition patterns.

Results: Women moving from public to private housing as a result of housing project demolition were at elevated risk for preterm LBW (risk ratio = 1.74; 95% confidence interval =  1.00-3.04) compared with women not affected by project demolition. Other non-policy-related housing transition patterns were not associated with pregnancy outcomes.

Conclusions: Further longitudinal study of housing transitions among public housing residents is needed to better understand the relationship between housing, neighborhoods, housing policy, and perinatal outcomes.


Cash transfers and anemia among women of reproductive age

Norbert Schady
Economics Letters, December 2012, Pages 887-890

Iron deficiency anemia is the most prevalent nutritional deficiency in the world, affecting more than 2 billion people in developing countries. We show that a modest cash transfer substantially reduced anemia among women of reproductive age in rural Ecuador.


Neighborhood poverty, park use, and park-based physical activity in a Southern California city

Deborah Cohen et al.
Social Science & Medicine, December 2012, Pages 2317-2325

A rich literature indicates that individuals of lower socio-economic status engage in less leisure time physical activity than individuals of higher socio-economic status. However, the source of the difference is believed to be, in part, due to differential access to resources that support physical activity. However, it has not been shown as to whether equal access to parks can mitigate differences in leisure time physical activity. Using systematic direct observation, we quantified physical activity in neighborhood parks in a large Southern California city located in areas with high, medium, and a low percentage of households in poverty. We documented how neighborhood parks are managed and programmed and also interviewed both a sample of park users and a random sample of households within a mile radius of the parks. We found that parks are used less in high-poverty areas compared to medium- and low-poverty area parks, even after accounting for differences in size, staffing, and programming. The strongest correlates of park use were the number of part time staff, the number of supervised and organized programs, and knowing the park staff. Perceptions of safety were not relevant to park use among those interviewed in the park, however it had a small relationship with reported frequency of park use among local residents. Among park users, time spent watching electronic media was negatively correlated with the frequency of visiting the park. Future research should test whether increasing park staffing and programming will lead to increased park use in high-poverty neighborhoods.


The Effects of Economic Pressure on the Resilience and Strengths of Individuals Living in Extreme Poverty

David Okech et al.
Journal of Poverty, Fall 2012, Pages 429-446

Economic pressure has negative effects on families living in poverty that require much resilience and strength to cope. Although the strengths perspective upholds many human service values, literature on how it can be used to build resilience of these families is scarce. This exploratory study reports on the relationship between the constructs of economic pressure and resilience among N = 194 individuals living in extreme poverty. The authors found a significant relationship between economic pressure and resilience, with higher economic pressure being associated with less resilience. However, family income was not a significant factor between economic pressure and resilience. Discussion is directed toward practice, policy, and research in enhancing the resilience and strengths of families living in extreme poverty.

to your National Affairs subscriber account.

Already a subscriber? Activate your account.


Unlimited access to intelligent essays on the nation’s affairs.

Subscribe to National Affairs.