Suburban Poverty and Racial Segregation

Over the past thirty years, increasing numbers of low-income people live in suburbs in the United States, with an increased proportion of racial and ethnic minorities among them (Covington, Freeman, & Stoll, 2011; Frey, 2011; Howell & Timberlake, 2014; Puentes & Warren, 2006). In urban areas, increases in poverty rates have been marked by increases in racial and ethnic segregation among people living in poverty (Logan & Stults, 2010; Massey, 1990; Orfield & Luce, 2012). What is less clear from the research on suburban poverty is how much racial segregation exists. For example, some research indicates that there is more segregation among black people in the suburbs than in urban areas (Darden & Kamel, 2002) whereas other research finds that black people in the suburbs are less likely to live in segregated communities than black people in urban areas (Alba, Logan, & Stults, 2000). This paper presents findings from a new set analyses, using data from the U.S. Census Bureau’s American Community Survey, to first examine the distribution of poverty across different kinds of suburban communities and then the degree of racial and ethnic segregation within and across different kinds of suburban communities. The goal of the analyses is to better understand how policy solutions might best address racial and economic inequality in the suburbs

Exiting shelter: an epidemiological analysis of barriers and facilitators for families

This study examines the role of individual- and family-level factors in predicting the length of shelter stays for homeless families. Interviews were conducted with all families exiting one of six emergency family shelters in Worcester, Massachusetts, between November 2006, and November 2007. Analyses, using an ordinary least squares regression model, find that families with a positive alcohol or drug screen in the year prior stay 85 days longer than those without a positive screen; families leaving shelter with a housing subsidy stay 66 days longer than those leaving without a subsidy.Demographic factors, education, employment, health, and mental health are not found to predict shelter stay duration. Consistent with prior research, housing resources relate to families\u27 time in shelter; with the exception of a positive substance abuse screen, individual-level problems are not related to their time in shelter. Efforts to expand these resources at the local, state, and national levels are a high priority

Shared reading of children's interactive picture books

We report on a study of children and parents shared reading of interactive printed books. We investigated the differences between books with interactive features and books with expressive typography in order to evaluate which features within a book encouraged interaction between the reading participants and the book. 11 parent and child groups took part in the study that involved three observed reading sessions. From our observations we offer suggestions for the development of books and eBooks to encourage shared reading practices

Using Typologies to Frame Poverty and Service Delivery in Suburban America

Poverty in the suburbs is growing, but there is great diversity in the rates of growth of poverty as well as causes and consequences of the growth across different kinds of suburbs. Suburban typologies, systems to group different types of suburbs, are a useful tool for understanding the variation among suburbs and highlighting potential strategies for addressing poverty. This paper discusses why typologies of suburban communities are important, what factors have been considered in the development and use of typologies, what typologies have been developed to date, and lastly, how typologies can be used to inform strategies for addressing suburban poverty. Suburban typologies can assist in understanding the variation between suburbs in the overall level, duration, and causes of poverty as well as variation in resources, services, and opportunities available for addressing it (Allard & Roth, 2010; Kneebone & Berube, 2013). For example, suburbs experiencing a sharp increase in poverty coupled with large increases in population may have different social service needs than suburbs with sharp poverty increases and little or no growth in population. The typology research sheds light on those suburbs that are experiencing the most significant impacts from increases in poverty and can identify appropriate policy tools and strategies to help communities cope with poverty. Yet, typologies vary with respect to how suburbs are defined, which suburbs are included, and what factors are considered in their development. Not one consistent definition of suburb is used across the typologies that have been developed. Instead, different researchers classify different geographic areas as suburbs, in part, based on the availability of data. Typologies also differ in the sample of suburbs that are being classified. Some researchers focus on all suburban areas, whereas others focus more narrowly on subsets of suburbs, such as inner-ring suburbs or economically distressed suburbs. Finally, researchers use a range of factors and methodologies to develop these typologies including a number of different economic, demographic, and historical factors (Hanlon, 2010; Hanlon, Vicino, & Short, 2006; Mikelbank, 2004; Orfield & Luce, 2012). Their differences not withstanding, taken together, the suburban typologies that have been developed reveal a number of common findings related to the economic vitality and vulnerability of suburbs. Increasingly larger populations of suburban residents live in communities that do not resemble traditional perceptions of prosperous suburbs. Instead, they live in a diverse set of communities including those characterized by poor economic health with low average income and home values, less housing stability, large populations, diverse family structures and racial composition, and varying levels and composition of employment). Although poverty is increasing in suburbs throughout the country, it is growing fastest in distressed suburbs, which tend to be highly racially segregated and fiscally constrained. Moreover, suburbs closest to central cities are increasingly poor and increasingly non-white. The combination of population growth and economic decline in these communities serve as barriers for addressing the increase in poverty

Stratification and monitoring of natalizumab-associated progressive multifocal leukoencephalopathy risk: recommendations from an expert group

The use of natalizumab for highly active relapsing-remitting multiple sclerosis (MS) is influenced by the occurrence of progressive multifocal leukoencephalopathy (PML). Through measurement of the anti-JCV antibody index, and in combination with the presence or absence of other known risk factors, it may be possible to stratify patients with MS according to their risk of developing PML during treatment with natalizumab and detect early suspected PML using MRI including a diffusion-weighted imaging sequence. This paper describes a practical consensus guideline for treating neurologists, based on current evidence, for the introduction into routine clinical practice of anti-JCV antibody index testing of immunosuppressant-naïve patients with MS, either currently being treated with, or initiating, natalizumab, based on their anti-JCV antibody status. Recommendations for the frequency and type of MRI screening in patients with varying index-associated PML risks are also discussed. This consensus paper presents a simple and pragmatic algorithm to support the introduction of anti-JCV antibody index testing and MRI monitoring into standard PML safety protocols, in order to allow some JCV positive patients who wish to begin or continue natalizumab treatment to be managed with a more individualised analysis of their PML risk

Poverty and Service Delivery in Suburban America Framing Paper

In the United States today, contrary to popular belief, living in the suburbs is not synonymous with living the American dream. An unprecedented number of people in the suburbs are living on household incomes of less than $20,000, many on much less. Increasingly, individuals and their families need to rely on services and public benefits to meet their basic needs (Kneebone & Berube, 2013). Over the past 30 years, poverty in the suburbs has grown due to multiple factors, including job decentralization, shifts in the location of affordable and subsidized housing, and the relocation to the suburbs of lower income immigrants and minorities (Covington, Freeman, & Stoll, 2011; Frey, 2011a). The rate of growth in suburban poverty has been particularly high in the past decade, outpacing growth in both urban and rural areas. During the Great Recession (2007-2009), high rates of unemployment and underemployment and the home foreclosure crisis brought the number of people living in poverty in the suburbs to an all-time high. Today, suburban areas are home to about 40 percent of all poor people in the country, an increase from 25 percent in 1980. Furthermore, in the 100 largest metropolitan areas, more people are living in poverty in the suburbs than in urban areas (Frey, 2011b). Suburbs are now facing a range of challenges traditionally associated with cities, such as high rates of unemployment and underemployment, lower educational attainment, food insecurity, and lack of access to health care. The increase in the suburban poverty rate is straining social service providers and local governments at a time when resources are shrinking (Allard & Roth, 2010). The Office of the Assistant Secretary for Planning and Evaluation (ASPE) of the U.S. Department of Health and Human Services (HHS) seeks to better understand poverty and service delivery in suburban America, including how the dynamics of suburban poverty may differ from those in rural and urban communities and whether service models may need to be tailored to meet these differences. To that end, ASPE commissioned this framing paper to review and synthesize existing research, analyze the characteristics and service needs of those living in poverty in the suburbs, and identify information and research needed to more fully understand and guide efforts to address suburban poverty. To prepare this review, we used three types of information sources: existing literature, both published and unpublished; a select number of key informant interviews; and two sources of extant U.S. Census Bureau household survey data: the Annual Social and Economic Supplement to the Current Population Survey (CPS), which provides an annual count of the number of people living below 100 percent of the federal poverty level from 1959 to 2011, and the 2009-2011 American Community Survey (ACS) Weighted 3-Year Restricted-Use Files, a household survey of a nationally representative sample of individuals. These data provide information about all suburbs, including but not limited to, the 100 largest metropolitan areas (see Appendix 1). This paper will serve to frame the discussion during the Poverty and Service Delivery in Suburban America Roundtable, to be convened in 2014. The roundtable will bring together researchers, policy 5 experts, practitioners, and federal staff to discuss the issues raised in this paper and gaps in the research, formulate new research questions, consider the implications of the research for service delivery and public benefits, and assess opportunities for HHS and broader federal engagement

Poverty and Service Delivery in Suburban America Framing Paper

In the United States today, contrary to popular belief, living in the suburbs is not synonymous with living the American dream. An unprecedented number of people in the suburbs are living on household incomes of less than $20,000, many on much less. Increasingly, individuals and their families need to rely on services and public benefits to meet their basic needs (Kneebone & Berube, 2013). Over the past 30 years, poverty in the suburbs has grown due to multiple factors, including job decentralization, shifts in the location of affordable and subsidized housing, and the relocation to the suburbs of lower income immigrants and minorities (Covington, Freeman, & Stoll, 2011; Frey, 2011a). The rate of growth in suburban poverty has been particularly high in the past decade, outpacing growth in both urban and rural areas. During the Great Recession (2007-2009), high rates of unemployment and underemployment and the home foreclosure crisis brought the number of people living in poverty in the suburbs to an all-time high. Today, suburban areas are home to about 40 percent of all poor people in the country, an increase from 25 percent in 1980. Furthermore, in the 100 largest metropolitan areas, more people are living in poverty in the suburbs than in urban areas (Frey, 2011b). Suburbs are now facing a range of challenges traditionally associated with cities, such as high rates of unemployment and underemployment, lower educational attainment, food insecurity, and lack of access to health care. The increase in the suburban poverty rate is straining social service providers and local governments at a time when resources are shrinking (Allard & Roth, 2010). The Office of the Assistant Secretary for Planning and Evaluation (ASPE) of the U.S. Department of Health and Human Services (HHS) seeks to better understand poverty and service delivery in suburban America, including how the dynamics of suburban poverty may differ from those in rural and urban communities and whether service models may need to be tailored to meet these differences. To that end, ASPE commissioned this framing paper to review and synthesize existing research, analyze the characteristics and service needs of those living in poverty in the suburbs, and identify information and research needed to more fully understand and guide efforts to address suburban poverty. To prepare this review, we used three types of information sources: existing literature, both published and unpublished; a select number of key informant interviews; and two sources of extant U.S. Census Bureau household survey data: the Annual Social and Economic Supplement to the Current Population Survey (CPS), which provides an annual count of the number of people living below 100 percent of the federal poverty level from 1959 to 2011, and the 2009-2011 American Community Survey (ACS) Weighted 3-Year Restricted-Use Files, a household survey of a nationally representative sample of individuals. These data provide information about all suburbs, including but not limited to, the 100 largest metropolitan areas (see Appendix 1). This paper will serve to frame the discussion during the Poverty and Service Delivery in Suburban America Roundtable, to be convened in 2014. The roundtable will bring together researchers, policy 5 experts, practitioners, and federal staff to discuss the issues raised in this paper and gaps in the research, formulate new research questions, consider the implications of the research for service delivery and public benefits, and assess opportunities for HHS and broader federal engagement

Glucocorticoid receptor alters isovolumetric contraction and restrains cardiac fibrosis

Corticosteroids directly affect the heart and vasculature and are implicated in the pathogenesis of heart failure. Attention is focussed upon the role of the mineralocorticoid receptor (MR) in mediating pro-fibrotic and other adverse effects of corticosteroids upon the heart. In contrast, the role of the glucocorticoid receptor (GR) in the heart and vasculature is less well understood. We addressed this in mice with cardiomyocyte and vascular smooth muscle deletion of GR (SMGRKO mice). Survival of SMGRKO mice to weaning was reduced compared with that of littermate controls. Doppler measurements of blood flow across the mitral valve showed an elongated isovolumetric contraction time in surviving adult SMGRKO mice, indicating impairment of the initial left ventricular contractile phase. Although heart weight was elevated in both genders, only male SMGRKO mice showed evidence of pathological cardiomyocyte hypertrophy, associated with increased myosin heavy chain-β expression. Left ventricular fibrosis, evident in both genders, was associated with elevated levels of mRNA encoding MR as well as proteins involved in cardiac remodelling and fibrosis. However, MR antagonism with spironolactone from birth only modestly attenuated the increase in pro-fibrotic gene expression in SMGRKO mice, suggesting that elevated MR signalling is not the primary driver of cardiac fibrosis in SMGRKO mice, and cardiac fibrosis can be dissociated from MR activation. Thus, GR contributes to systolic function and restrains normal cardiac growth, the latter through gender-specific mechanisms. Our findings suggest the GR:MR balance is critical in corticosteroid signalling in specific cardiac cell types

Analysis of the peripapillary and macular regions using OCT angiography in patients with schizophrenia and bipolar disorder

Purpose: To measure RNFL and vasculature around the optic disc and in the macula in patients with schizophrenia (SZ) and bipolar disorder (BD) using optical coherence tomography angiography (OCTA). Methods: 24 eyes of patients with SZ and 16 eyes of patients with BD as well as 30 eyes of healthy subjects were examined with OCTA. The radiant peripapillary capillary (RPC) density and RNFL thickness were measured in the peripapillary area. Moreover, macular thickness and vessel density were measured in both superficial and deep layers. Results: Significantly decreased values of vessel density in the macular deep vascular complex were found in the eyes of patients with SZ, compared to BD and the control group. The macular thickness in the whole vascular complex and in the fovea was significantly lower in SZ and BD group than in the control group. The radiant peripapillary vascular density and RNFL thickness were similar across groups. Conclusions: The retinal microvascular dysfunction occurs in the macula in patients with SZ and BD, but not around optic disc. OCTA can become an essential additional diagnostic tool in detection of psychiatric disorders