Your tired and poor

Kevin Lewis

June 20, 2017

Contemporaneous Social Environment and the Architecture of Late-Life Gene Expression Profiles
Morgan Levine et al.
American Journal of Epidemiology, forthcoming


Environmental or social challenges can stimulate a cascade of coordinated physiological changes in stress response systems. Unfortunately, chronic activation of these adaptations, under conditions such as low socioeconomic status (SES), can have negative consequences for long-term health. While there is substantial evidence tying low SES to increased disease risk and reduced life expectancy, the underlying biology remains poorly understood. Using pilot data on 120 older adults from the Health and Retirement Study (2002-2010), we examined the associations between SES and gene expression levels in adulthood, with particular focus on a gene expression program known as the conserved transcriptional response to adversity. We also used a bioinformatics-based approach to assess the activity of specific gene regulation pathways involved in inflammation, antiviral responses, and stress-related neuro-endocrine signaling. Results showed that low SES was related to increased expression of conserved transcriptional response to adversity genes and distinct patterns of pro-inflammatory, antiviral, and stress signaling (e.g., Sympathetic Nervous System and Hypothalamic-Pituitary-Adrenal axis) transcription factor activation.

Double danger in the double wide: Dimensions of poverty, housing quality and tornado impacts
Jungmin Lim et al.
Regional Science and Urban Economics, July 2017, Pages 1-15


Tornadoes are the most frequent of the natural hazards in the United States, causing significant yearly human and economic losses. Given the potential destructive power of tornado events and their largely unpredictable nature, it is important to identify the major determinants of vulnerability. To date, only a limited number of studies have empirically investigated the determinants of tornado-induced deaths. Based on a conceptual framework where risk is considered to be a function of physically defined natural hazards and socially constructed vulnerability, we extend previous empirical studies by examining a wider range of potential socio-economic, governmental, and housing factors that determine tornado-induced fatalities. Using detailed county-level data for years 1980-2014, we find that counties with higher per capita income and per capita government spending on public safety and welfare have fewer deaths, whereas counties with greater income disparity are more vulnerable to tornadoes. We explore which aspects of poverty seem most associated with fatalities. Housing quality (measured by mobile homes as a proportion of housing units) is a critical factor in explaining tornado-induced fatalities.

Examining the Externalities of Welfare Reform: TANF and Crime
Scott Liebertz & Jaclyn Bunch
Justice Quarterly, forthcoming


This study explores the relationship between welfare policy variation in the United States following the introduction of Temporary Assistance for Needy Families (TANF) and its relationship with various types of crime. While early studies of the effects of welfare assistance on crime consistently found a negative association, more recent examinations have complicated these findings. Nearly all prior research focuses on Aid for Families with Dependent Children or early years of TANF. Examining a longer time-series and using propensity score weighting to model the tendencies of states to select into more stringent welfare regimes, we find a strong association between states with greater levels of welfare restrictiveness and higher rates of violent crime. There is mixed evidence that this relationship also exists with property crimes.

Within Year Labor Supply and the EITC: Employment Stability and the Role of Information
Riley Wilson
University of Maryland Working Paper, May 2017


The Earned Income Tax Credit (EITC) creates incentives for households to work at some point during the year, and a large existing literature suggests that the EITC expansions of the 1990s contributed to the increase in annual employment rates of less-educated single women, a group highly targeted by the program. However, the labor supply decisions of single women with a high school degree or less are characterized by high levels of within year turnover, suggesting that these women make employment decisions much more frequently than annually. At present it is unclear how EITC incentives impact these within year employment decisions. In this paper, I exploit the panel nature of the Current Population Survey to look at how less educated single women adjust labor force attachment and within year employment duration after an increase in EITC generosity. After an increase in EITC generosity, single women with a high school degree or less that were weakly attached to the labor force become less likely to exit in the following year and increase the annual number of weeks worked. The monthly surveys suggest that these same women also continue employment for more months, leading to longer employment duration and more employment stability. This highlights important potential welfare implications of job tenure and employment stability that are not captured at the annual level. Interestingly, employment decisions respond to increases in the EITC credit being received rather than being earned in the current year, which differ because the EITC is transferred as a tax credit with a one year lag. Further evidence suggests that this is not a response to relaxed liquidity constraints, but that this is consistent with a framework where potential recipients lacked information about the tax program, and adjusted employment decisions after learning that the EITC increased the returns to work.

Public housing agency preferences for the homeless as a policy lever: Examining county-level housing subsidy receipt and maltreatment rates
Emily Warren, Yonah Drazen & Marah Curtis
Children and Youth Services Review, July 2017, Pages 81-88


This study examines the relationship between county Public Housing Agency (PHA) practices that prioritize families experiencing homelessness and county-level child maltreatment rates. Using data from a survey of PHAs and the National Child Abuse and Neglect Data System (NCANDS) with a sample of 534 counties, we find that policies which give preference to homeless households for housing assistance are associated with reduced victimization and substantiation rates, while policies that reduce barriers to assistance eligibility are associated with reporting rates. Our findings suggest that beyond prioritizing homeless families for housing assistance as a means of ending homelessness, providing families with more expedient access to a valuable public subsidy may have important positive externalities, such as reduced CPS involvement. Additional partnerships between child welfare agencies and housing providers, particularly those that provide housing subsidies, may be worthy of additional investment and evaluation.

Mothers' Childhood Hardship Forecasts Adverse Pregnancy Outcomes: Role of Inflammatory, Lifestyle, and Psychosocial Pathways
Gregory Miller et al.
Brain, Behavior, and Immunity, forthcoming


Research suggests the health consequences of economic hardship can be transmitted across generations. Some of these disparities are thought to be passed to offspring during gestation. But this hypothesis has not been tested in contemporary American samples, and the mechanisms of transmission have not been characterized. Accordingly, this study had two goals: first, to determine if women exposed to economic hardship during childhood showed higher rates of adverse birth outcomes; and second, to evaluate the contribution of inflammation, psychosocial, lifestyle, and obstetric characteristics to this phenomenon. This prospective study enrolled 744 women with singleton pregnancies (59.1% White; 16.3% Black; 18.7% Latina; 5.9% Other). Childhood economic hardship was measured by self-report. Birth outcomes included length of gestation and incidence of preterm birth; birth weight percentile and small for gestational age; length of hospital stay and admission to Special Care Nursery. Analyses revealed that mothers' childhood economic hardship was independently associated with multiple adverse birth outcomes, even following adjustment for demographics, maternal education, and obstetrical confounders. Women raised in economically disadvantaged conditions had shorter gestation length and higher preterm delivery rates. Their babies had lower birth weights, were more likely to be small for gestational age, stayed in the hospital longer, and had more Special Care Nursery admissions. Mediation analyses suggested these associations arose through multiple pathways, and highlighted roles for inflammation, education, adiposity, and obstetric complications. Collectively, these findings suggest that childhood economic hardship predisposes women to adverse birth outcomes, and highlights likely behavioral and biological mechanisms.

Food Insecurity and Mental Health Status: A Global Analysis of 149 Countries
Andrew Jones
American Journal of Preventive Medicine, forthcoming

Introduction: This study sought to determine the association of individual-level food insecurity (FI) with mental health status across all global regions.

Methods: Cross-sectional data were analyzed in 2016 from the 2014 Gallup World Poll, a series of globally implemented, nationally representative surveys. FI was assessed using the Food Insecurity Experience Scale Survey Module for Individuals, an eight-question psychometric scale reporting individuals' experiences of FI. Individual-level composite indices of mental health, the Negative Experience Index and Positive Experience Index (0-100 scale), were calculated based on responses to five questions of respondents' recent negative and positive experiences, respectively, associated with depression and mental distress.

Results: The prevalence of any FI ranged from 18.3% in East Asia to 76.1% in Sub-Saharan Africa. In global analyses (149 countries) using adjusted multiple regression analyses, FI was associated in a dose-response fashion with poorer scores on the mental health indices (coefficient [95% CI]: Negative Experience Index: mild FI, 10.4 [9.5, 11.2]; moderate FI, 17.7 [16.4, 19.0]; severe FI, 24.5 [22.7, 26.3]; Positive Experience Index: mild FI, -8.3 [-9.3, -7.4]; moderate FI, -12.6 [-13.8, -11.3]; severe FI, -16.2 [-17.9, -14.5]). Within-region analyses (11 regions) consistently demonstrated the same trends.

Conclusions: FI is associated with poorer mental health and specific psychosocial stressors across global regions independent of SES. The numerous pathways via which FI may contribute to common mental disorders, and the broad social implications of FI linked to cultural norms and self-efficacy, may contribute to the cross-cultural consistency of the findings.

Scraping By: Income and Program Participation After the Loss of Extended Unemployment Benefits
Jesse Rothstein & Robert Valletta
NBER Working Paper, June 2017


Many Unemployment Insurance (UI) recipients do not find new jobs before exhausting their benefits, even when benefits are extended during recessions. Using SIPP panel data covering the 2001 and 2007-09 recessions and their aftermaths, we identify individuals whose jobless spells outlasted their UI benefits (exhaustees) and examine household income, program participation, and health-related outcomes during the six months following UI exhaustion. For the average exhaustee, the loss of UI benefits is only slightly offset by increased participation in other safety net programs (e.g., food stamps), and family poverty rates rise substantially. Self-reported disability also rises following UI exhaustion. These patterns do not vary dramatically across the UI extension episodes, household demographic groups, or broad income level prior to job loss. The results highlight the unique, important role of UI in the U.S. social safety net.

Who Is Screened Out? Application Costs and the Targeting of Disability Programs
Manasi Deshpande & Yue Li
NBER Working Paper, June 2017


The application process is critical to the targeting of disability programs because disability, relative to other tags, is difficult to observe and costly to verify. We study the effect of application costs on the targeting of disability programs using the closings of Social Security Administration field offices, which provide assistance with filing disability applications. Using administrative data from the Social Security Administration, we find that field office closings lead to large and persistent reductions in the number of disability recipients and reduce targeting efficiency based on current eligibility standards. The number of disability recipients declines by 13% in surrounding areas, with the largest effects for applicants with moderately severe conditions, low education levels, and low pre-application earnings. Evidence on channels suggests that most of the reduction in applications is attributable to increased congestion at neighboring offices rather than increased travel times or costs of information gathering.

HUD Housing Assistance Associated With Lower Uninsurance Rates And Unmet Medical Need
Alan Simon et al.
Health Affairs, June 2017, Pages 1016-1023


To investigate whether receiving US Department of Housing and Urban Development (HUD) housing assistance is associated with improved access to health care, we analyzed data on nondisabled adults ages 18-64 who responded to the 2004-12 National Health Interview Survey that were linked with administrative data from HUD for the period 2002-14. To account for potential selection bias, we compared access to care between respondents who were receiving HUD housing assistance at the time of the survey interview (current recipients) and those who received HUD assistance within twenty-four months of completing the survey interview (future recipients). Receiving assistance was associated with lower uninsurance rates: 31.8 percent of current recipients were uninsured, compared to 37.2 percent of future recipients. Rates of unmet need for health care due to cost were similarly lower for current recipients than for future recipients. No effect of receiving assistance was observed on having a usual source of care. These findings provide evidence that supports the effectiveness of housing assistance in improving health care access.

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.