Administrative Burdens and Economic Insecurity Among Black, Latino, and White Families

This study investigates how administrative burdens influence differential receipt of income transfers after a family member loses a job. Using the panel component of the Current Population Survey from 1990 through 2019, we find that administrative burdens have increased in the Temporary Assistance for Needy Families and Unemployment Insurance programs but declined for the Supplemental Nutrition Assistance Program. These administrative burden effects generally contribute to lower income replacement rates for Black and Latino families experiencing job loss relative to White families, though results are sensitive to adjustments for benefit underreporting. Moreover, states with higher shares of White residents have smaller administrative burden effects, on average. Reducing administrative burdens in income transfer programs would likely reduce racial-ethnic inequalities in economic insecurity

Disability and the Worlds of Welfare Capitalism

A higher proportion of working- age persons receive disability assistance in the Nordic countries and the Netherlands than in other European countries. Whereas current research emphasizes the connection between disability assistance and rates of labor force exit, to date there has been no exploration of how welfare state context influences individual self-reported disability. Using nationally representative data from 15 countries (n = 88, 478), I find that residents of generous welfare states are significantly more likely to report a disability net of self-reported health, sociodemographic, and labor force characteristics and, notably, that this association extends to younger and more educated workers. I argue that welfare state context may directly shape what it means to be disabled, which may have consequences for evaluations of welfare state performance and social exclusion

Economic opportunity, health behaviours, and health outcomes in the USA: a population-based cross-sectional study

Summary Background: Inequality of opportunity, defined as differences in the prospects for upward social mobility, might have important consequences for health. Diminished opportunity can lower the motivation to invest in future health by reducing economic returns to health investments and undermining hope. We estimated the association between county-level economic opportunity and individual-level health in young adults in the general US population. Methods: In this population-based cross-sectional study, we used individual-level data from the 2009–12 United States Behavioral Risk Factor Surveillance Surveys. Our primary outcomes were current self-reported overall health and the number of days of poor physical and mental health in the last month. Economic opportunity was measured by the county-averaged national income rank attained by individuals born to families in the lowest income quartile. We restricted our sample to adults aged 25–35 years old to match the data used to assign exposure. Multivariable ordinary least squares and probit models were used to estimate the association between the outcomes and economic opportunity. We adjusted for a range of demographic and socioeconomic characteristics, including age, sex, race, education, income, access to health care, area income inequality, segregation, and social capital. Findings: We assessed nearly 147 000 individuals between the ages of 25 years and 35 years surveyed from 2009 to 2012. In models adjusting for individual-level demographics and county-level socioeconomic characteristics, increases in county-level economic opportunity were associated with greater self-reported overall health. An interdecile increase in economic opportunity was associated with 0·76 fewer days of poor mental health (95% CI −1·26 to −0·25) and 0·53 fewer days of poor physical health (−0·96 to −0·09) in the last month. The results were robust to sensitivity analyses. Interpretation Economic opportunity is independently associated with self-reported health and health behaviours. Policies seeking to expand economic opportunities might have important spillover effects on health. Funding Robert Wood Johnson Foundation Health and Society Scholars Program

Estimated difference between log-transformed SSDI (a) denial rates and (b) approval rates comparing commuting zones with an FC opening to their synthetic control commuting zones without an FC by year.

The synthetic control was a weighted combination of commuting zones without an FC such that the weights minimized the difference in outcome and covariates between FC and non-FC commuting zones in the years preceding an FC opening. The average line to the right of the vertical line represents the effect of an FC opening for the 3 years after the opening, with 95% confidence intervals. (a) SSDI denial rates, (b) SSDI approval rates.</p

Number of FC openings and closings between 2006 and 2017.

Number of FC openings and closings between 2006 and 2017.</p

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An estimated 17.6% of blue-collar, manufacturing jobs were lost in the United States between 1970 and 2016. These jobs, often union-represented, provided relatively generous pay and benefits, creating a path to the middle class for individuals without a four-year college degree. Evidence suggests the closure of manufacturing facilities and resulting decline in economic opportunity increased demand for disability insurance (SSDI) among blue-collar workers. In recent years, the opening of Amazon Fulfillment Centers (FCs) has accelerated around the country, driving a wave of blue-collar job creation. We estimated the extent to which the opening of FCs affected SSDI application rates, including rates of approvals and denials, using a synthetic control group approach. We found that FC openings were associated with a 1.4% reduction in the SSDI application rate over the subsequent three years, translating to 5,528 fewer applications per year across commuting zones with an FC opening. Our findings are consistent with FC openings improving economic opportunities in local labor markets, though our confidence intervals were wide and included the null.</div

Commuting zone level descriptive statistics.

An estimated 17.6% of blue-collar, manufacturing jobs were lost in the United States between 1970 and 2016. These jobs, often union-represented, provided relatively generous pay and benefits, creating a path to the middle class for individuals without a four-year college degree. Evidence suggests the closure of manufacturing facilities and resulting decline in economic opportunity increased demand for disability insurance (SSDI) among blue-collar workers. In recent years, the opening of Amazon Fulfillment Centers (FCs) has accelerated around the country, driving a wave of blue-collar job creation. We estimated the extent to which the opening of FCs affected SSDI application rates, including rates of approvals and denials, using a synthetic control group approach. We found that FC openings were associated with a 1.4% reduction in the SSDI application rate over the subsequent three years, translating to 5,528 fewer applications per year across commuting zones with an FC opening. Our findings are consistent with FC openings improving economic opportunities in local labor markets, though our confidence intervals were wide and included the null.</div

Estimated difference between log-transformed SSDI application rates comparing commuting zones with an FC opening to their synthetic control commuting zones without an FC by year.

The synthetic control was a weighted combination of commuting zones without an FC such that the weights minimized the difference in outcome and covariates between FC and non-FC commuting zones in the years preceding an FC opening. The average line to the right of the vertical line represents the effect of an FC opening for the 3 years after the opening, with 95% confidence intervals.</p

Comparison of Late HIV Diagnosis as a Marker of Care for Aboriginal Versus Non-Aboriginal People Living with HIV in Ontario

BACKGROUND: Studies have found that Aboriginal people living with HIV/AIDS (APHAs) are more likely than non-APHAs to receive suboptimal HIV care, yet achieve similar clinical outcomes with proper care.OBJECTIVE: To compare the proportions of individuals diagnosed late with HIV between APHAs and non-APHAs within the Ontario HIV Treatment Network Cohort Study (OCS).METHODS: The analysis included OCS participants who completed the baseline visit by November 2009. Two definitions of the outcome of late HIV diagnosis were used: the proportion of participants with an AIDS-defining illness (ADI) before or within three months of HIV diagnosis; and the proportion of participants with a CD4+ count ud_less_than200 cells/mL at diagnosis. Logistic regression analysis was used to assess the association between Aboriginal ethnicity and late HIV diagnosis.RESULTS: APHAs were more likely to be female and have lower income, education and employment. No statistically significant differences were noted in the proportions receiving a late HIV diagnosis defined by ADI (Aboriginal 5.2% versus non-Aboriginal 6.3%; P=0.40). Multivariate logistic regression analysis revealed a significant association between Aboriginal ethnicity and late HIV diagnosis defined by CD4+ count after adjusting for age and HIV risk factor (OR 1.55; P=0.04).DISCUSSION: APHAs were more likely to have a CD4+ count ud_less_than200 cells/mL at diagnosis but had similar clinical outcomes from late diagnosis when defined by ADI. However, differences may be underestimated due to recruitment limitations and selection bias.CONCLUSION: Additional work is needed to address the socioeconomic and health care needs of APHAs.Peer Reviewe