Showing papers by "Urban Institute published in 1998"
TL;DR: In this article, the authors proposed a social capital model of neighborhood change that measures social capital as a function of two constitutive elements: sociocultural milieu and institutional infrastructure.
Abstract: There is a growing consensus among urban analysts that inner‐city neighborhoods suffer from a lack of social capital. Because these areas do not have a strong social infrastructure in place to support successful revitalization efforts, urban policy recommendations now call for developing social capital in the worst‐off parts of our cities. However, this consensus has been reached without any empirical analysis of the effect of social capital on urban neighborhoods. Moreover, there have been few, if any, efforts to show how to measure social capital at a neighborhood level. This article proposes a social capital model of neighborhood change that measures social capital as a function of two constitutive elements: sociocultural milieu and institutional infrastructure. In addition, we present a theoretical model to show how social capital affects neighborhood stability and an empirical analysis that provides evidence of the positive effect social capital has on neighborhood stability.
252 citations
TL;DR: In this paper, the authors explore the role of tenant-based housing assistance in addressing the problem of concentrated inner-city poverty, and propose a growing number of assisted housing mobility initiatives across the country.
Abstract: Historically, federal housing policy has contributed to the concentration of poverty in urban America. Moving out of poverty is not the right answer for every low‐income family, but tenant‐based housing assistance (Section 8 certificates and vouchers) has tremendous potential to help families move to healthier neighborhoods. This article explores the role of tenant‐based housing assistance in addressing the problem of concentrated inner‐city poverty. The Section 8 program by itself does not ensure access to low‐poverty neighborhoods, particularly for minority families. Supplementing certificates and vouchers with housing counseling and search assistance can improve their performance; a growing number of assisted housing mobility initiatives are now in place across the country. The U.S. Department of Housing and Urban Development (HUD) should continue to fund these initiatives and increase their number over time. HUD should also strengthen incentives for all housing authorities to improve location...
147 citations
TL;DR: Although protective behaviors among teenagers have increased, significant proportions of teenagers--especially Black and Hispanic males--remain unprotected.
Abstract: OBJECTIVES: This study examines shifts in sexual experience and condom use among US teenaged males. METHODS: Results from the 1988 and 1995 National Surveys of Adolescent Males were compared. RESULTS: The proportion of never-married 15- to 19-year-old males who had had sex with a female declined from 60% to 55% (P = .06). The share of those sexually active using a condom at last intercourse rose from 57% to 67% (P < .01). Overall, the proportion of males who had sex without condoms last year declined from 37% to 27% (P < .001). CONCLUSIONS: Although protective behaviors among teenagers have increased, significant proportions of teenagers--especially Black and Hispanic males--remain unprotected.
141 citations
TL;DR: In this paper, the authors argue that building social capital, facilitating civic participation, and providing public voice are activities central to an analysis of the interaction of nonprofits and public policy in democratic civil society.
Abstract: This article reviews how research on nonprofit organizations has traditionally defined advocacy and its function in the public policy process as rights-based expression and association and suggests the usefulness of an expanded definition. Nonprofits participate in a variety of public decisions at different points in the policy cycle. The authors argue that building social capital, facilitating civic participation, and providing public voice are activities central to an analysis of the interaction of nonprofits and public policy in democratic civil society. The article also analyzes the IRS data sets and National Taxonomy of Exempt Entities (NTEE) classification system available to researchers from the National Center for Charitable Statistics (NCCS) to assess their strengths and weaknesses for measuring advocacy activities. By evaluating the problems in accurately describing, analyzing, and collecting data on nonprofit organizations that facilitate a public role in decision making, this article develops ...
110 citations
TL;DR: Welfare reform and changes in immigrants' eligibility may lead to significant reductions in Medicaid caseloads, even though many states are expanding Medicaid eligibility rules to accommodate changes under the new welfare programs.
Abstract: Welfare reform and changes in immigrants' eligibility may lead to significant reductions in Medicaid caseloads, even though many states are expanding Medicaid eligibility rules to accommodate changes under the new welfare programs. In 1996, for the first time in almost a decade, Medicaid participation of adults and children fell about 2 percent, and further reductions seem likely in 1997. The gradual restrictions on new immigrants also will affect future caseloads. Although new initiatives such as the State Children's Health Insurance Program (CHIP) should expand health coverage for children, the welfare reform and immigration changes will disproportionately lead to loss of insurance among adults.
105 citations
TL;DR: Turnips as discussed by the authors show that lack of income is a significant barrier to child support payments for 16 to 33 percent of young noncustodial fathers, whom they call turnips after the common saying that You can't get blood from a turnip.
Abstract: Journal of Policy Analysis and Management: Volume 17, Issue 1, pages 44?51, Winter 1998
Child support reforms have focused almost exclusively on punitive measures, driven by the stereotypical image of a deadbeat dad who can afford to pay child support but refuses to do so. This image fits some noncustodial fathers, but ignores the diverse nature of this population. We show that lack of income is a significant barrier to child support payments for 16 to 33 percent of young noncustodial fathers, whom we call turnips after the common saying that You can't get blood from a turnip. Furthermore, the characteristics of turnips are similar to those of custodial mothers who are long-term welfare recipients?both are disproportionately composed of young, poorly educated, never-married minorities with little work experience. These findings suggest that a new approach to child support enforcement is needed, one that offers these fathers flexible child support orders that both reflect their current economic circumstances and provide employment and training assistance to enable them to meet their child support obligations in the future.
100 citations
TL;DR: The United States has become increasingly diverse racially and ethnically. This growing diversity is nowhere more apparent than in public elementary and secondary schools as mentioned in this paper, where students of color made up over one-third of K-12 enrollments, up from less than one-quarter in 1976 (NCES, 1982, 1996).
Abstract: has become increasingly diverse racially and ethnically. This growing diversity is nowhere more apparent than in public elementary and secondary schools. In 1993, students of color made up over one-third of K-12 enrollments, up from less than one-quarter in 1976 (National Center for Education Statistics [NCES], 1982, 1996). While the number of teachers of color also increased during this time period, their proportional gains pale in comparison to the dramatic demographic shift in the student population. Specifically, the fraction of people of color in the teaching force rose from 10 percent in 1976 to 13 percent by 1993 (NCES, 1996). As these figures indicate, the racial/ethnic disparity between teachers and students already evident 20 years ago has grown with time. This gap, which has serious social and educational implications for the nation and its schools (Carnegie Forum on Education and the Economy, 1986; Hidalgo & Huling-Austin, 1993; Smith, 1989), is expected to grow even wider in the years ahead unless immediate steps are taken to actively recruit more people of color into teaching (DarlingHammond, 1990).
99 citations
TL;DR: More conservative sexual attitudes and increased exposure to AIDS education are key predictors of decreased sexual activity among adolescent males, however, broader societal factors, such as fear of AIDS and increased awareness of problems associated with teenage pregnancy and STDs, may underlie both attitudinal and behavioral changes.
Abstract: This study examined how attitudes about sex behavior and exposure to AIDS education have affected premarital sexual behavior among urban teenage (Black and non-Black) males aged 17-19 years in 1979 1988 and 1995 in the US. Data were obtained from a 1979 National Survey of Young Men and the 1988 and 1995 National Surveys of Adolescent Males. The weighted pooled data set included 2087 never-married males aged 17-19 years. The percentage of those who had experienced sexual intercourse (SI) rose from 66% to 76% and then declined to 68% in 1995. For Black male youths SI rates remained stable after 1988. The percentage with recent SI in the 4 weeks before the survey rose from 40% to 45% in 1979 and 1988 and then declined to 39% in 1995. The average number of female sexual partners (FSPs) was 4. The average number of FSPs declined among non-Blacks--from 3.8 in 1979 to 2.9 in 1995--and increased among Blacks--from 5.1 in 1979 to 6.9 in 1995. SI frequency during the prior year rose significantly from 14 encounters/year in 1979 to 21 in 1995. Among Black adolescents SI frequency rose from 13 encounters/year in 1988 to 24 in 1995. Approval of nonmarital sex without an intention to marry followed similar increases and declines as for SI. Attitudes about premarital sex were strongly correlated with recent sexual activity. Teenagers who had received education about STDs or AIDS were significantly less likely to report having had recent SI. Birth control education and race were unrelated to sex behavior. Blacks were more supportive of marriage for nonmarital pregnancy in 1979. Black attitudes toward premarital sex grew more conservative. Less sexual activity is attributed in part to prevalence of AIDS education (except for Blacks) and more conservative attitudes with unknown other factors.
87 citations
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TL;DR: In this article, the authors use the longitudinal Health and Retirement Survey to analyze the dynamic relationship between health and alternative labor force transitions, including labor force exit, job change and application for disability insurance.
Abstract: This paper addresses the interplay between health and labor market behavior in the later part of the working life. We use the longitudinal Health and Retirement Survey to analyze the dynamic relationship between health and alternative labor force transitions, including labor force exit, job change and application for disability insurance. Specifically, we examine how the timing of health shocks affects labor force behavior. Controlling for lagged values of health, poor contemporaneous health is strongly associated with labor force exit in general and with application for disability insurance in particular. At the same time, our evidence suggests that controlling for contemporaneous health, poor lagged health is associated with continued participation. Thus, it appears that not just poor health, but declines in health help explain retirement behavior. We conclude that modeling health in a dynamic, longitudinal framework offers important new insights into the effects of poor health on the labor force behavior of older workers.
84 citations
TL;DR: Many of the significant changes in young males' attitudes toward condoms do not explain the increase in consistent condom use among adolescent males that occurred between 1988 and 1995, however increasing male contraceptive responsibility and emphasizing the risks and consequences of contracting HIV appear to be viable routes for policymakers to explore.
Abstract: CONTEXT: Understanding whether and to what degree changes in young men's attitudes explain increases in condom use over time can be useful in developing more effective disease prevention strategies. METHODS: Data from the 1988 and the 1995 National Survey of Adolescent Males are used to determine changes in attitudes toward condoms, pregnancy prevention and HIV and AIDS. Two-limit tobit models are employed to investigate the association between these attitudes and condom-use behavior and to examine how this relationship may have changed over time. RESULTS: Between 1988 and 1995, young men's attitudes toward partner appreciation of condom use, condom-use embarrassment and pleasure reduction from condom use all changed in a direction suggestive of more consistent condom use. However, attitudes related to pregnancy prevention and AIDS avoidance changed in a direction suggestive of less-consistent condom use. Changes over time in the strength of the relationship between three attitude measures (masculinity, pleasure reduction and partner appreciation) and condom use also were predictive of lower levels of condom-use consistency. Only the strength of the relationship between condom-use embarrassment and consistent condom use changed in a direction corresponding to observed increases in rates of condom use among young men. CONCLUSIONS: Many of the significant changes in young males' attitudes toward condoms do not explain the increase in consistent condom use among adolescent males that occurred between 1988 and 1995. However increasing male contraceptive responsibility and emphasizing the risks and consequences of contracting HIV appear to be viable routes for policymakers to explore. Efforts particularly need to be targeted toward Hispanics.
TL;DR: This paper examines how public health agencies have begun to refocus on traditional services, largely in response to Medicaid managed care and an associated decline in clients in thirteen states.
Abstract: Public health systems are undergoing major changes. Historically, population-oriented services framed the responsibilities of the public health system. Yet over time, clinical services, particularly maternal and child health care, became an important component. More recently, many public health agencies have begun to refocus on traditional services, largely in response to Medicaid managed care and an associated decline in clients. This paper examines such transformations in thirteen states.
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01 Jan 1998TL;DR: The history of comprehensive service integration Defining Adolescence and Risk A New Conceptual Framework for Understanding Risk Integrated Services - Initiatives Big Brothers Big Sisters of Greater Miami Teen Connectors The Belafonte-Talcolcy Centre, Inc. Oasis Centre Chins Up Youth and Family Services Houston Communities in Schools I Have a Future Garfield Youth Services Centre for Family Life Service Integration and Other Cross-Cutting Issues Evaluating Programmes Offering Integrated Services and Actitivies to Youth Financing Integrated Services Programmes Summary and Conclusions as discussed by the authors
Abstract: The History of Comprehensive Service Integration Defining Adolescence and Risk A New Conceptual Framework for Understanding Risk Integrated Services - Initiatives Big Brothers Big Sisters of Greater Miami Teen Connectors The Belafonte-Talcolcy Centre, Inc. Oasis Centre Chins Up Youth and Family Services Houston Communities in Schools I Have a Future Garfield Youth Services Centre for Family Life Service Integration and Other Cross-Cutting Issues Evaluating Programmes Offering Integrated Services and Actitivies to Youth Financing Integrated Services Programmes Summary and Conclusions.
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TL;DR: This article comprehensively assessed the only two operational medical no-fault programs in the U.S., Virginia and Florida's late 1980s compensation programs for children with severe, birth-related neurological injuries, finding no fault was found to keep liability coverage affordable, to raise funding for compensation, to lower overhead cost, to speed claims resolution and to achieve similar physician and claimant satisfaction as the tort system.
Abstract: This article comprehensively assessed the only two operational medical no-fault programs in the U.S., Virginia and Florida's late 1980s compensation programs for children with severe, birth-related neurological injuries. It relied upon literature review; surveys of program administrators, affected parties, and observers; as well as information from Florida's unusual census of all closed malpractice claims, national liability premiums, and other data bases. No fault was found to keep liability coverage affordable, to raise funding for compensation, to lower overhead cost, to speed claims resolution, and to achieve similar physician and claimant satisfaction as the tort system. On the negative side, the programs were very small, even for their narrowly defined eligibility, so no fault was too small to broadly improve compensation or deterrence, while the survival of tort for uncovered obstetrical injuries continued to encourage physician defensiveness, also likely inhibiting them from referring injuries to no fault, lest they wind up in court instead. Better understanding of these details should allow no-fault proponents to achieve improvements, but achieving political feasibility remains a daunting challenge. (University of Cincinnati Law Review 1998 Fall; 67(1): 53-123).
TL;DR: HIPAA is less of a departure from traditional federal authority than it is an application of existing tools to meet evolving health policy goals, which could clarify future health policy debates about appropriate federal and state responsibilities.
Abstract: The Health Insurance Portability and Accountability Act (HIPAA) of 1996 has been praised and criticized for asserting federal authority to regulate health insurance We review the history of federalism and insurance regulation and find that HIPAA is less of a departure from traditional federal authority than it is an application of existing tools to meet evolving health policy goals This interpretation could clarify future health policy debates about appropriate federal and state responsibilities We also report on the insurance environments and the HIPAA implementation choices of thirteen states We conclude with criteria for judging the success of HIPAA and the evolving federal/state partnership in health insurance regulation
TL;DR: In this paper, tax avoidance activity increased after the passage of the Tax Reform Act of 1986, and that high-income, high-wealth and more sophisticated taxpayers were most likely to avoid tax.
Abstract: Previous theoretical analyses of the capital gains tax have suggested that investors have considerable opportunity to avoid the tax. Yet, past empirical work has found relatively little evidence of such activity. Using a previously unavailable panel data set with a very large sample of high-income individuals, this paper aims to bring the theory and evidence closer together by examining the behavior of individual taxpayers over time. Though confirming past findings that avoidance of tax on realized capital gains is not prevalent, we do observe that tax avoidance activity increased after the passage of the Tax Reform Act of 1986, and that high-income, high-wealth and more sophisticated taxpayers were most likely to avoid tax. However, the efficacy of tax avoidance strategies depends on being able to avoid tax for long periods, and we find that most tax avoidance is of relatively short duration. Thus, the effective tax rate on realized capital gains is very close to the statutory rate in all years and tax brackets.
TL;DR: The results indicate that while Medicaid patients enrolled in managed care programs may be more likely to receive adequate prenatal care, birth outcomes under managed care are not significantly different from those under FFS financing systems.
TL;DR: Interactions between the Medicare and Medicaid home care programs are examined using state-level expenditure data for 1995 and through case studies in five states: Connecticut, Louisiana, Minnesota, New Mexico, and New York.
Abstract: Congressional attempts to curtail spending growth in Medicare home health may affect Medicaid, given the number of Medicare enrollees who qualify for Medicaid-covered home care services. This DataWatch examines interactions between the Medicare and Medicaid home care programs using state-level expenditure data for 1995 and through case studies in five states: Connecticut, Louisiana, Minnesota, New Mexico, and New York.
Journal Article•
TL;DR: The contributions of nonprofit hospitals and health plans to healthcare markets and to analyze state policy options with regard to the conversion of nonprofits to for-profit status are described and a conceptual economic framework is developed.
Abstract: OBJECTIVE: To describe the contributions of nonprofit hospitals and health plans to healthcare markets and to analyze state policy options with regard to the conversion of nonprofits to for-profit status. DATA SOURCES/STUDY SETTING: Secondary national and state data from a variety of sources, 1980-present. STUDY DESIGN: Policy analysis. DATA COLLECTION/EXTRACTION METHODS: Development of a conceptual economic framework; analysis of empirical, legal, and theoretical literature; and review of statutes, rules, and court decisions. PRINCIPAL FINDINGS: Three main rationales support special status for nonprofits, especially hospitals: charity care, other community benefits, and consumer protection. The main social rationale for for-profits is their incentives for better efficiency. There are reasons to expect that nonprofit and for-profit goals differ; however, measured differences in community hospital cost, prices, and quality between nonprofit and for-profit hospitals are undetectable or inconclusive. Nonprofit hospitals do provide more uncompensated care than for-profit hospitals. Similarities between nonprofit and for-profit hospitals may exist because nonprofits may set norms that for-profits follow to some degree. States have substantial power and discretion in overseeing nonprofit conversions. Some have regularized oversight through new legislation that constrains, but does not eliminate, state officials' discretion. These statutes may be deferential to converting entities and their buyers or may be very restrictive of them. CONCLUSIONS: Overseeing the appropriate disposition of nonprofit assets in individual conversions is extremely important. States should also monitor local market conditions through community benefits assessments and other data collection, however, to accurately assess (and possibly redress) what is lost or gained from conversion. Local market conditions are likely more important in determining hospital behavior than ownership form. Potentially, a mix of for-profit and nonprofit hospitals in a given market may improve market performance due to constraints the two ownership types may exercise over one another. If nonprofits disappear, the states may need to maintain quality and access norms through regulation.
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TL;DR: In this article, the authors study the effects of an economic and political union by studying the trade flows of the three Baltic countries of Estonia, Latvia and Lithuania after the breakup of the Soviet Union.
Abstract: The objective of this paper is to provide evidence on the effects of an economic and political union by studying the trade flows of the three Baltic countries of Estonia, Latvia and Lithuania after the breakup of the Soviet Union. We specify and estimate a gravity model of exports for the Nordic countries which enables us to determine the size and direction of trade flows in the Baltic states had they not been affected by the political institutions of the Soviet Union.
TL;DR: The authors survey current research that addresses these concerns, reconciling the sometimes disparate results of papers examining job tenure and separations, exploring the consequences of involuntary job loss, and reviewing research on trends in part-time, temporary, and contingent employment.
Abstract: In recent years, the popular press has led us to believe that downsizing and mergers are throwing unprecedented numbers of Americans out of secure jobs. In this paper, we survey current research that addresses these concerns, reconciling the sometimes disparate results of papers examining job tenure and separations, exploring the consequences of involuntary job loss, and reviewing research on trends in part-time, temporary, and contingent employment. There is no evidence of a dramatic change in job security over the last two decades. The various studies do not point to consistent losses in job security for any particular demographic group.
TL;DR: The results suggest that efforts to increase condom use in general should also influence young men's use of condoms when their partner is using a female method.
Abstract: Objective: Protection from both sexually transmitted diseases and pregnancy is best obtained by the combined use of male condoms and effective female contraceptive methods. This research examines dual contraceptive method use among teenage men. Method: Analyzed data from the 1995 National Survey of Adolescent Males, a nationally representative survey of 15 to 19-year-old males. Used bivariate analyses and logistic regression to examine the correlates of combined use of condoms and female methods. Results: At last intercourse, 17% of sexually active males reported use of a condom and a female method of contraception. Condom use, alone and in combination with a female method, was positively associated with talking with the partner about contraception and condoms, believing that males have a responsibility for contraception, and being in an earlier stage of a relationship. Only high levels of worry about sexually transmitted diseases differentially influenced dual method use, increasing the likelihood of using a condom with a female method, but not using condoms alone. Conclusions: The results suggest that efforts to increase condom use in general should also influence young men's use of condoms when their partner is using a female method. Providing information to young males about the high prevalence and serious consequences of sexually transmitted diseases may increase dual method use among adolescents.
TL;DR: Different approaches to encouraging the development of orphan drugs while ensuring access by regulating their prices are presented, as well as access to orphan drugs as promoted by special coverage for population subgroups, disease categories, and/or specific drugs.
Abstract: Six countries--Canada, France, Japan, Sweden, the United Kingdom, and the United States--were studied to compare public policies affecting the development and marketing of pharmaceuticals for rare diseases (i.e., orphan drugs). Information was obtained from a variety of published and unpublished sources, including interviews with public policy and pharmaceutical experts in each country. This article presents different approaches to encouraging the development of orphan drugs while ensuring access by regulating their prices. Additionally, the article describes access to orphan drugs as promoted by special coverage for population subgroups, disease categories, and/or specific drugs. Not all efforts to increase access to orphan pharmaceuticals have been the result of government action, as illustrated by the proliferation of for-profit organizations that specialize in orphan drugs. The many policy options from other countries identified in this study are especially relevant, given increasing calls for reform of the U.S. Orphan Drug Act.
Journal Article•
TL;DR: Data from the Medicare Current Beneficiary Survey is used to shed light on responses that need to be monitored in light of the recently mandated policies and other SNF and HHA options that are being considered.
Abstract: Provisions in the 1997 Balanced Budget Act affecting Medicare skilled nursing facility (SNF) and home health agency (HHA) services heighten the importance of knowing more about beneficiary, market, and policy factors that impact use of post-acute care and the costs of such services. This study used data from the Medicare Current Beneficiary Survey and other sources to address these issues. Findings shed light on responses that need to be monitored in light of the recently mandated policies and other SNF and HHA options that are being considered. (Inquiry 1998 Spring; 35(1): 49-61).
01 Jan 1998
TL;DR: The authors examine recent trends in the supply and earnings of various mental health providers from 1989 to 1995, in the context of major changes in the financing and delivery of mental health care.
Abstract: The authors examine recent trends in the supply and earnings of various mental health providers from 1989 to 1995. The makeup of the mental health workforce is fundamentally different now than a decade ago. The number and earnings of psychiatrists have been relatively flat. The number of psychologists increased by 24%, with their earnings rising rapidly in the 1980s, and remaining level since 1990. The number of clinically trained social workers increased by 87% over the same period, and the number of advanced practice nurses certified in mental health specialties almost doubled, with the earnings of these master's-level providers increasing steadily over the period described. These trends are discussed in the context of major changes in the financing and delivery of mental health care.