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

HDAC inhibitors increase NRF2-signaling in tumour cells and blunt the efficacy of co-adminstered cytotoxic agents

The NRF2 signalling cascade provides a primary response against electrophilic chemicals and oxidative stress. The activation of NRF2-signaling is anticipated to have adverse clinical consequences; NRF2 is activated in a number of cancers and, additionally, its pharmacological activation by one compound can reduce the toxicity or efficiency of a second agent administered concomitantly. In this work, we have analysed systematically the ability of 152 research, pre-clinical or clinically used drugs to induce an NRF2 response using the MCF7-AREc32 NRF2 reporter. Ten percent of the tested drugs induced an NRF2 response. The NRF2 activators were not restricted to classical cytotoxic alkylating agents but also included a number of emerging anticancer drugs, including an IGF1-R inhibitor (NVP-AEW541), a PIM-1 kinase inhibitor (Pim1 inhibitor 2), a PLK1 inhibitor (BI 2536) and most strikingly seven of nine tested HDAC inhibitors. These findings were further confirmed by demonstrating NRF2-dependent induction of endogenous AKR genes, biomarkers of NRF2 activity. The ability of HDAC inhibitors to stimulate NRF2-signalling did not diminish their own potency as antitumour agents. However, when used to pre-treat cells, they did reduce the efficacy of acrolein. Taken together, our data suggest that the ability of drugs to stimulate NRF2 activity is common and should be investigated as part of the drug-development process

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

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

Does Adolescent Family Structure Predict Military Enlistment? A Comparison of Post–High School Activities

This paper investigates the link between adolescent family structure and the likelihood of military enlistment in young adulthood, as compared to alternative post-high school activities. We use data from the National Longitudinal Study of Adolescent Health and multinomial logistic regression analyses to compare the odds of military enlistment with college attendance or labor force involvement. We find that alternative family structures predict enlistment relative to college attendance. Living in a single-parent household during adolescence increased odds of military enlistment, but the effect is accounted for by socioeconomic status and early feelings of social isolation. Living with a stepparent or with neither biological parent more than doubles the odds of enlistment, independent of socioeconomic status, characteristics of parent-child relationships, or feelings of social isolation. Although college attendance is widely promoted as a valued post-high school activity, military service may offer a route to independence and a greater sense of belonging

Novel multimorbidity clusters in people with eczema and asthma:a population-based cluster analysis

Eczema and asthma are allergic diseases and two of the commonest chronic conditions in high-income countries. Their co-existence with other allergic conditions is common, but little research exists on wider multimorbidity with these conditions. We set out to identify and compare clusters of multimorbidity in people with eczema or asthma and people without. Using routinely-collected primary care data from the U.K. Clinical Research Practice Datalink GOLD, we identified adults ever having eczema (or asthma), and comparison groups never having eczema (or asthma). We derived clusters of multimorbidity from hierarchical cluster analysis of Jaccard distances between pairs of diagnostic categories estimated from mixed-effects logistic regressions. We analysed 434,422 individuals with eczema (58% female, median age 47 years) and 1,333,281 individuals without (55% female, 47 years), and 517,712 individuals with asthma (53% female, 44 years) and 1,601,210 individuals without (53% female, 45 years). Age at first morbidity, sex and having eczema/asthma affected the scope of multimorbidity, with women, older age and eczema/asthma being associated with larger morbidity clusters. Injuries, digestive, nervous system and mental health disorders were more commonly seen in eczema and asthma than control clusters. People with eczema and asthma of all ages and both sexes may experience greater multimorbidity than people without eczema and asthma, including conditions not previously recognised as contributing to their disease burden. This work highlights areas where there is a critical need for research addressing the burden and drivers of multimorbidity in order to inform strategies to reduce poor health outcomes

Longitudinal stability of temperamental exuberance and social-emotional outcomes in early childhood

The goals of the current study were to investigate the stability of temperamental exuberance across infancy and toddlerhood and to examine the associations between exuberance and social-emotional outcomes in early childhood. The sample consisted of 291 4-month-olds followed at 9, 24, and 36 months and again at 5 years of age. Behavioral measures of exuberance were collected at 9, 24, and 36 months. At 36 months, frontal electroencephalogram (EEG) asymmetry was assessed. At 5 years, maternal reports of temperament and behavior problems were collected, as were observational measures of social behavior during an interaction with an unfamiliar peer in the laboratory. Latent profile analysis revealed a high, stable exuberance profile that was associated with greater ratings of 5-year externalizing behavior and surgency, as well as observed disruptive behavior and social competence with unfamiliar peers. These associations were particularly true for children who displayed left frontal EEG asymmetry. Multiple factors supported an approach bias for exuberant temperament but did not differentiate between adaptive and maladaptive social-emotional outcomes at 5 years of age