Urban Institute

About: Urban Institute is a nonprofit organization based out in Washington D.C., District of Columbia, United States. It is known for research contribution in the topics: Medicaid & Population. The organization has 927 authors who have published 2330 publications receiving 86426 citations.

New Estimates of Lifetime Nursing Home Use: Have Patterns of Use Changed?

Abstract: Objectives. The elderly population at risk for costly nursing home care is increasing. It is important to understand patterns of lifetime nursing home use and their implications for public and private payers. We provide new lifetime nursing home use estimates, project future use, and discuss cost im

Primary care access for new patients on the eve of health care reform.

Abstract: This study uses a simulated patient approach to assess appointment availability and wait times for new primary care appointments in late 2012/early 2013 by insurance status and state. Although most primary care physicians are accepting new patients, access varies widely across states and insurance status. Outreach programs are needed, not only to help patients enroll but also to identify practices accepting new patients within each plan's network. Tracking new patient appointment availability over time can inform policies designed to strengthen primary care capacity and enhance the effectiveness of the coverage expansions with the Patient Protection and Affordable Care Act.

Moving Up, Moving Out, or Going Nowhere? A Study of the Employment Patterns of Young Women and the Implications for Welfare Mothers

Abstract: Conventional wisdom holds that women on welfare will be better off in the long run if they take a job, even if it means initially having less money to spend on their and their children's needs. Underlying this thinking is the belief that women who take low-paying jobs will eventually move up to higher paying jobs either with their current employer or by changing employers. This paper examines the employment transitions of young women focusing on the likelihood that women who turn to the welfare system for support will make the transition from low-paying to high-paying jobs. The data are drawn from the National Longitudinal Survey of Youth (NLSY). Based on the experiences of women who never received welfare, an estimated one-quarter of young women who received welfare could be firmly established in jobs paying more than $9.50 an hour by ages 26 and 27. An additional 40 percent would work steadily but in low-paying jobs, and more than one-third would work only sporadically. © 2001 by the Association for Public Policy Analysis and Management.

Poverty, Time, and Place: Variation in Excess Mortality Across Selected US Populations, 1980-1990

Abstract: STUDY OBJECTIVE: To describe variation in levels and causes of excess mortality and temporal mortality change among young and middle aged adults in a regionally diverse set of poor local populations in the USA. DESIGN: Using standard demographic techniques, death certificate and census data were analysed to make sex specific population level estimates of 1980 and 1990 death rates for residents of selected areas of concentrated poverty. For comparison, data for whites and blacks nationwide were analysed. SETTING: African American communities in Harlem, Central City Detroit, Chicago's south side, the Louisiana Delta, the Black Belt region of Alabama, and Eastern North Carolina. Non-Hispanic white communities in Cleveland, Detroit, Appalachian Kentucky, South Central Louisiana, Northeastern Alabama, and Western North Carolina. PARTICIPANTS: All black residents or all white residents of each specific community and in the nation, 1979-1981 and 1989-1991. MAIN RESULTS: Substantial variability exists in levels, trends, and causes of excess mortality in poor populations across localities. African American residents of urban/northern communities suffer extremely high and growing rates of excess mortality. Rural residents exhibit an important mortality advantage that widens over the decade. Homicide deaths contribute little to the rise in excess mortality, nor do AIDS deaths contribute outside of specific localities. Deaths attributable to circulatory disease are the leading cause of excess mortality in most locations. CONCLUSIONS: Important differences exist among persistently impoverished populations in the degree to which their poverty translates into excess mortality. Social epidemiological inquiry and health promotion initiatives should be attentive to local conditions. The severely disadvantageous mortality profiles experienced by urban African Americans relative to the rural poor and to national averages call for understanding.

New laws but few cases: understanding the challenges to the investigation and prosecution of human trafficking cases

Abstract: All fifty states and the federal government have passed laws to combat human trafficking, but we know little about their effectiveness. Using data from investigative case records and court files for 140 human trafficking cases in 12 U.S. counties and qualitative interviews with law enforcement, prosecutors, and victim service providers, we examined the characteristics of and challenges to investigation and prosecution of human trafficking cases under new state and federal laws. We found that few human trafficking cases are identified by local law enforcement, most cases forwarded to state prosecution are sex trafficking cases involving U.S. citizens, and state prosecutors overwhelmingly charge human trafficking offenders with other, lesser crimes. The legal, institutional, and attitudinal challenges that constrain prosecution of human trafficking are similar across study sites despite varying types of state antitrafficking legislation. Study results suggest prosecution of human trafficking cases is challenging. If new laws are to be effective, then local law enforcement and prosecutors should work collaboratively and adopt proactive human trafficking investigative strategies to identify both labor and sex trafficking cases. There is social benefit to holding traffickers accountable, but more emphasis should be placed on policies that identify and serve victims.