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.

Identifying Robust, Parsimonious Neighborhood Indicators

Abstract: Identifying a few indicators that summarily tracked key dimensions of neighborhoods would be invaluable for neighborhood monitoring and measuring impacts of interventions. The goal of this article is to search empirically for such robust, parsimonious indicators. In five cities, the authors analyze the interrelationships among a broad set of census tract indicators related to mortgage market activity; home prices; jobs and firms; demographic, socioeconomic, and housing stock characteristics; crime; and public assistance and health. Through factor analysis, they identify four to six neighborhood dimensions among these indicators that are common across cities. Using regression, the authors identify a parsimonious number of indicators that are inexpensive, annually updated, and available for all U.S. communities yet robustly capture significant variation in these neighborhood dimensions. Home Mortgage Disclosure Act (HMDA) data on mortgage approval rates, loan amounts, and loan applications and Dunn and Brad...

Cross-National Differences in Employment and Economic Sufficiency

Abstract: Economic independence is an important indicator of the transition to adulthood. This article portrays the level of economic in dependence among young adults, ages eighteen to thirty-two, in seven industrialized countries. The cross-national variations the authors uncover help one understand how work, family, and comparative income packages affect economic self-sufficiency. In all countries, young women are less able than are young men to become economically independent through market work alone. The ability to support a family is affected more by government transfers than the ability to support oneself. The authors also find that family support through additional income, the provision of housing, and caring labor as well as decisions to have roommates are clearly important to the economic well-being of young adults. In closing, the authors suggest several avenues for future research.

The impacts of the State Children's Health Insurance Program on children who enroll: findings from ten states.

Abstract: The State Children's Health Insurance Program (SCHIP) was created in 1997 primarily to expand insurance coverage to more low-income children States had latitude over numerous aspects of their program design and ultimately all states expanded eligibility for public coverage under the new program (Kenney and Chang 2004) One of the yardsticks by which SCHIP is measured is the extent to which the program improves children's access to and receipt of care over and above what they would have experienced otherwise SCHIP is expected to lower the costs and other barriers associated with obtaining care for the children who enroll, particularly relative to being uninsured, which should in turn, increase their access to care Prior research has demonstrated that uninsured children experience more access problems and receive fewer services than children with public health insurance coverage (Rosenbach 1989; Monheit and Cunningham 1992; Stoddard, St Peter, and Newacheck 1994; Currie and Thomas 1995; Newacheck, Hughes, and Stoddard 1996; Moreno and Hoag 2001; Dubay and Kenney 2001) However, the access and use gaps found between the uninsured and the insured may derive not only from differential access to health care, but may also reflect unmeasured differences between the two groups in health seeking behavior and attitudes toward health care A number of studies have attempted to address the potential bias introduced when comparing the uninsured and insured, by examining changes in access and use following enrollment in a public health insurance program (Lave et al 1998; Szilagyi et al 2000, 2004, 2006; Slifkin et al 2001; Damiano et al 2002; Dick et al 2004; Kempe et al 2005; McBroome, Damiano, and Willard 2005; Shone et al 2005) These studies have found improvements in access and use for children who enrolled in the program based on a longitudinal analysis of children's experiences before and after they have coverage Two of these studies examined the impacts of non-Medicaid programs that predated the enactment of the SCHIP program: Szilagyi et al (2000) reported on Child Health Plus in New York and Lave et al (1998) reported on the Children's Health Insurance Program in Pennsylvania while the other studies focused on SCHIP programs All of these studies found improvements in a number of different measures of health care access and use for children who enrolled in these programs These findings suggest that differences in service use found between the uninsured and the insured are not all driven by unmeasured differences in characteristics of the two groups, but instead reflect greater access to care afforded to children with health insurance coverage In this paper, the impacts of SCHIP on the children who are served by the program are examined using an approach that is a variant on that used by Lave et al (1998), Szilagyi et al (2000), Damiano and Williard (2002), and Dick et al (2004) The 10 states examined—California, Colorado, Florida, Illinois, Louisiana, Missouri, New Jersey, New York, North Carolina, and Texas—include a large proportion of all low-income uninsured children in the United States, wide geographic representation, and diverse approaches to program design These states account for over 60 percent of all SCHIP enrollees nationwide and represent all four census regions (Smith and Rousseau 2005) They reflect the three different SCHIP program structures (California, Colorado, Florida, New York, North Carolina, and Texas have separate non-Medicaid expansions,1 Louisiana and Missouri have Medicaid expansions, and Illinois and New Jersey have a combination program with Medicaid and non-Medicaid components) They also vary in terms of their reliance on managed care, their cost sharing structures, and benefit packages (Hill et al 2005) To estimate impacts, the experience of a sample of enrollees who have been on the program for at least 5 months is contrasted with the pre-SCHIP experience of a separate sample of recent enrollees, using data from 2002 The following section describes the data and methodological approach Subsequent sections present results and discuss the implications

The Impacts of State Health Reform Initiatives on Adults in New York and Massachusetts

Abstract: The 2010 national health reform legislation—The Patient Protection and Affordable Care Act (PPACA)—builds on state coverage initiatives, most notably on Massachusetts' 2006 landmark reform effort PPACA includes expansions of existing public programs, efforts to make private insurance more affordable, and individual and employer mandates This study looks at the impacts of state health reform initiatives in New York and Massachusetts on insurance coverage and health care access and use to expand our understanding of the likely impacts of national reform Understanding the impacts of coverage expansions on both insurance coverage and access to health care is critical to designing initiatives that lead to improvements in the health care available to the population and, thereby, population health—which is the ultimate goal of coverage expansion efforts (Hadley 2003; Institute of Medicine 2009; McWilliams 2009;) Prior studies of individual state health reform initiatives have seldom considered impacts on access to and use of health care, largely because of a lack of data This study takes advantage of the availability of state-level data in the National Health Interview Survey (NHIS) to examine the impacts of the health reform initiatives in New York and Massachusetts on coverage and access to and use of health care To our knowledge, this represents the first use of the NHIS, which is the nation's most comprehensive health survey, to study the effects of an individual state's health reform initiative on health care access and use