New Perspectives on Transforming States' Health and Human Services: Practical Commentaries on the First Year of the Work Support Strategies Initiative

Millions of low-income working families in America today are struggling to make ends meet. While working hard, often in low-wage jobs, many of these families are living close to the edge of hardship and have little or no resources to fall back on in case of emergencies. Public benefit programs can make a huge difference in the well-being of these working families, providing help with food, child care, and health insurance expenses. These programs help families address immediate needs and weather short-term crises, such as repairing a car needed to get to work or dealing with an unexpected health problem. They can make it possible for families to hold onto their jobs in these emergencies, stabilizing employment and keeping families from falling further into poverty. Yet many families that are eligible for public benefit programs do not participate. Although the recession and its aftermath led to unprecedented increases in receipt of nutrition assistance through the federal Supplemental Nutrition Assistance Program (SNAP), the latest data (from 2010) show that only 65 percent of the eligible working poor are participating. Similarly, of all children eligible for public health insurance coverage through Medicaid or the Children's Health Insurance Program, only 86 percent are participating. The participation rate for public health insurance for parents is only 66 percent. And, these participation rates vary widely across states.The Work Support Strategies, or WSS, Initiative is motivated by the value public benefit programs can provide to working families and the belief that the states and localities administering these programs can improve how eligible families access and retain these benefits. In the first year of the demonstration, nine states took on the challenge of streamlining, integrating, and improving the provision of work support benefits through their SNAP, Medicaid, and child care programs (and, in some states, additional programs such as heating assistance and cash welfare). While most states hope their efforts will also reduce burden on caseworkers and administrative costs in these systems, all are motivated to improve the lives of the families they serve

Differences in risk factors for children with special health care needs (CSHCN) receiving needed specialty care by socioeconomic status

<p>Abstract</p> <p>Background</p> <p>The purpose of this study is to identify factors affecting CSHCN's receiving needed specialty care among different socioeconomic levels. Previous literature has shown that Socioeconomic Status (SES) is a significant factor in CHSHCN receiving access to healthcare. Other literature has shown that factors of insurance, family size, race/ethnicity and sex also have effects on these children's receipt of care. However, this literature does not address whether other factors such as maternal education, geographic location, age, insurance type, severity of condition, or race/ethnicity have different effects on receiving needed specialty care for children in each SES level.</p> <p>Methods</p> <p>Data were obtained from the National Survey of Children with Special Health Care Needs, 2000–2002. The study analyzed the survey which studies whether CHSCN who needed specialty care received it. The analysis included demographic characteristics, geographical location of household, severity of condition, and social factors. Multiple logistic regression models were constructed for SES levels defined by federal poverty level: < 199%; 200–299%; ≥ 300%.</p> <p>Results</p> <p>For the poorest children (,199% FPL) being uninsured had a strong negative effect on receiving all needed specialty care. Being Hispanic was a protective factor. Having more than one adult in the household had a positive impact on receipt of needed specialty care but a larger number of children in the family had a negative impact. For the middle income group of children (200–299% of FPL severity of condition had a strong negative association with receipt of needed specialty care.</p> <p>Children in highest income group (> 300% FPL) were positively impacted by living in the Midwest and were negatively impacted by the mother having only some college compared to a four-year degree.</p> <p>Conclusion</p> <p>Factors affecting CSHCN receiving all needed specialty care differed among socioeconomic groups. These differences should be addressed in policy and practice. Future research should explore the CSHCN population by income groups to better serve this population</p

Welfare Recipiency, Job Separation Outcomes, and Postseparation Earnings: Insight from Linked Personnel and State Administrative Data

This paper uses a unique personnel data set and state administrative data to follow welfare and nonwelfare hires who separate from similar jobs with the same firm. Welfare hires are more likely to separate from their job and are more likely to be on welfare after separation compared with similarly low-skilled nonwelfare hires. Those not returning to welfare, however, are no more or less likely to have moved on to a lower- or higher-paying job than nonwelfare hires

Frequency of employer changes and their financial return: gender differences amongst German university graduates

Gender differences in the frequency of employer changes and their financial return were examined in a sample of Bavarian university graduates. The search and matching theories were used to develop hypotheses which were then tested against each other. The results show that in the first few years after graduation women change employer more frequently than men. In large part this can be explained by gender differences in labor market structures, in particular the fact that a woman's first job is less likely to be in a large company, in an executive position or on a permanent contract and women tend to be less satisfied with their first job. After controlling for variance in these factors the coefficient changes sign, indicating that under similar circumstances men change employer more often. Furthermore, both men and women benefit financially from changing employer. The absolute return is higher for men, but as men tend to have a higher starting salary there is no gender difference in the relative return and hence no effect on the gender gap. The results are also discussed in the light of the specifics of the structure of the German labor market.Diese Studie nutzt eine Stichprobe bayerischer Hochschulabsolventen, um Geschlechtsunterschiede sowohl in der Häufigkeit als auch in den finanziellen Erträgen von Arbeitgeberwechseln zu untersuchen. Die Such- und Matchingtheorien werden genutzt, um Hypothesen zu entwickeln, die anschließend gegeneinander getestet werden. Die Ergebnisse zeigen, dass Frauen ihren Arbeitgeber in den ersten Jahren nach dem Abschluss häufiger wechseln als Männer. Das kann zu einem großen Teil durch unterschiedliche Arbeitsmarktstrukturen erklärt werden, vor allem durch die Tatsache, dass Frauen in ihrer ersten Beschäftigung seltener in Großbetrieben, in Führungspositionen und mit unbefristeten Verträgen arbeiten und weniger zufrieden mit ihrer Arbeit sind. Sobald auf all diese Faktoren kontrolliert wird, ändert der Koeffizient sein Vorzeichen, d. h. unter gleichen Umständen wechseln Männer den Arbeitgeber häufiger. Weiterhin profitieren sowohl Männer als auch Frauen finanziell von Arbeitgeberwechseln. Männer erhalten höhere absolute Erträge, aber aufgrund ihrer höheren Einstiegseinkommen existiert bei den relativen Erträgen kein Unterschied zwischen Männern und Frauen und somit auch kein Einfluss auf die Gender Pay Gap. Die Ergebnisse werden vor dem Hintergrund der Besonderheiten des deutsche

Gender Segregation and Gender Wage Differences During the Early Labour Market Career

Using German linked employer-employee data this paper investigates the gender wage gap at the time of entering the labour market and its development during workers' early career. The analysis contributes to the existing research on gender wage differentials among young workers by providing evidence on the impact of women's disproportionate concentration in lower-paying industries, occupations, establishments and job-cells, i.e. occupations within establishments. The estimation results reveal that all types of segregation and particularly job-cell segregation are significant determinants of the gender wage gap, while skill endowments and differences in work histories are found to be of minor importance. At the time of labour market entry women's wage disadvantages can almost entirely be explained by the fact that they start their working career in lower-paying occupations and establishments. With progressing labour market experience, however, gender segregation becomes less important and cannot fully account for a slight widening of the wage differential among young men and women. Therefore, part of the early career wage gap remains unexplained.Diese Studie untersucht auf Basis von Linked-Employer-Employee Daten die Entwicklung geschlechtsspezifischer Lohnunterschiede während der frühen Karrierejahre. Die Analyse zeigt, dass die Verteilung von Männern und Frauen auf unterschiedliche Branchen, Berufe und Betriebe einen erheblichen Beitrag zur Erklärung der Lohnnachteile von Frauen leistet. Zu Beginn der beruflichen Karriere existiert zwischen Männern und Frauen, die innerhalb des gleichen Betriebes den gleichen Beruf ausüben, nahezu kein Lohnunterschied. Mit zunehmender Arbeitsmarkterfahrung geht ein Wachstum des geschlechtsspezifischen Lohndifferentials einher, welches weder durch Segregation noch durch Unterschiede in der Arbeitsmarkthistorie erklärt werden kann

Impoverished Women With Children and No Welfare Benefits: The Urgency of Researching Failures of the Temporary Assistance for Needy Families Program

In the United States, the numbers of impoverished women with children and no cash safety net are increasing and constitute an emerging population. Many have exhausted cash benefits from Temporary Assistance for Needy Families, the work-based welfare program that replaced Aid to Families With Dependent Children in 1996. We examine empirical evidence about poverty and use of welfare programs in the United States, jobs for women on welfare, the consequences of leaving welfare, health disparities disproportionate to those of the general population, and outcomes for children of needy families. It is important that public health researchers investigate the experiences of the families for whom Temporary Assistance for Needy Families has failed

A randomized controlled trial to improve health among women receiving welfare in the U.S.: The relationship between employment outcomes and the economic recession

The high prevalence of health conditions among U.S. women receiving Temporary Assistance for Needy Families (TANF, or `welfare') impedes the ability of many in this group to move from `welfare-to-work', and the economic recession has likely exacerbated this problem. Despite this, few interventions have been developed to improve employment outcomes by addressing the health needs of women receiving TANF, and little is known about the impact of economic downturns on the employment trajectory of this group. Using data from a recent randomized controlled trial (RCT) that tested the efficacy of a public health nursing (PHN) intervention to address the chronic health condition needs of 432 American women receiving TANF, we examine the effect of the intervention and of recession exposure on employment. We further explore whether intervention effects were modified by select sociodemographic and health characteristics. Both marginal and more robust intervention effects were noted for employment-entry outcomes (any employment, p=0.05 and time-to-employment, p=0.01). There were significant effects for recession exposure on employment-entry (any employment, p=0.002 and time-to-employment, p<0.001). Neither the intervention nor recession exposure influenced longer-term employment outcomes (employment rate or maximum continuous employment). Intervention effects were not modified by age, education, prior TANF receipt, functional status, or recession exposure, suggesting the intervention was equally effective in improving employment-entry across a fairly heterogeneous group both before and after the recession onset. These findings advance our understanding of the health and employment dynamics among this group of disadvantaged women under variable macroeconomic conditions, and have implications for guiding health and TANF-related policy