Food Assistance Programs and Outcomes in the Context of Welfare Reform*

Objective. Food assistance programs play an important role in meeting the basic needs of low‐income households. We consider how the Food Stamp Program (FSP), labor force participation, and food insecurity status affect outcomes of low‐income households under different program designs and economic conditions. Methods. Data from the Survey of Program Dynamics allow estimation of the effects of participation in FSP, labor market participation, and food insecurity on each other. To obtain estimates of behavioral relationships, we apply a simultaneous equation model and make a set of plausible assumptions about identification to implement the instrumental variable estimation. Results. Food insecurity has a positive effect on FSP participation, while labor force participation reduces FSP participation. Furthermore, FSP participation is more responsive to changes in the amount of program benefits than to changes in nonlabor income. Labor force participation has no direct effect on food insecurity; although not statistically significant, the effect of FSP participation on food insecurity is positive. A higher wage rate decreases FSP participation and increases participation in the labor force. Conclusion. The structural approach, which relies on particular identifying assumptions, allows us to explicity examine linkages among food program participation, labor force participation, and well‐being, measured in terms of food insecurity. The results provide evidence that among low‐income households, program parameters affect FSP participation, but no evidence that the food assistance reduces food insecurity.     

Explaining state AFDC and food stamp caseloads: has welfare reform discouraged food stamp participation?

State food stamp caseloads have declined dramatically since the adoption of the 1996 welfare reforms. It is likely that the movement of large numbers of individuals from the welfare rolls to the work force has contributed significantly to the decline in food stamp usage. This hypothesis is tested by examining the impact that the pre-reform AFDC program had on food stamp participation. Employing OLS regression, we find that state AFDC caseloads are positively related to food stamp caseloads. Thus, welfare reform may be eliminating eligible food stamp participants.     

Assessing mental health and service needs among refugees in Malaysia

Refugees in Malaysia often experience economic insecurity and poverty, poor health, poor mental wellbeing and limited legal rights. Using a survey with quantitative measures and open‐ended questions, we assessed socio‐demographic characteristics, mental health (RHS‐15), and service needs, including interest in group support services, among 86 Dari‐ and Arabic‐speaking refugees living in Kuala Lumpur. High levels of emotional distress were found, as nearly all participants scored positive for distress and average scores were 2.5 times above the cut‐off signifying distress. Distress scores did not vary based on most factors examined, although being married was associated with lower levels of distress. All but one participant expressed interest in participating in a support group. Barriers to potential participation included childcare, sickness and transportation. Additional mental health and social supports are needed among refugees residing in Malaysia. Key Practitioner Message: ? Emotional distress is high among Dari‐ and Arabic‐speaking refugees sampled in Malaysia; ? Participants expressed strong interest in accessing supportive mental health services, including group supports.     

The roles of food prices and food access in determining food purchases of low-income households

A growing literature suggests that limited access to full-service grocery stores may be linked to poor diets, obesity, and other diet-related diseases. Food prices are likely to be as much of a factor in low-income consumers’ food purchase decisions as food store access is, but few studies consider the roles of prices and food access simultaneously. We incorporate supermarket access into a utility-theoretic censored demand system for 13 food groups among households that receive the Supplemental Nutrition Assistance Program (SNAP) benefits in the U.S. The demand system is estimated with a Bayesian procedure which otherwise would have been cumbersome with the classical approach. Results suggest that prices are significant determinants of food purchases, but supermarket access has limited influence. Improving food choices, diet, and health may require addressing both accessibility and affordability.     

Care without coercion – mental health rights,personal recovery and trauma‐informed care

Australian mental health services continue to use involuntary measures in response to consumers' mental distress. Regardless of the intent behind these practices, the experience of being forced to receive treatment, be secluded or restrained is traumatic and can cause further distress and harm. Other parts of the health or social service system have shifted to approaches that emphasise agency, social context, prevention, and rights. Three frameworks currently used in mental health services – human rights, personal recovery, and trauma‐informed – are consistent with a shift away from the use of force. We applied these frameworks to the text of the National Standards for Mental Health Services 2010 to analyse the degree to which it reflects a shift. We also analysed the public text of speakers' notes from the Care Without Coercion Conference 2012 concerning lived experiences of force in mental health services. The analysis highlights force in many aspects of policy. The findings have implications for directions of change, including freedom from violence; support for decision making; access and choice about community and inpatient options; safety and risk management; and greater understanding of current policy frameworks through engagement with people with lived experience about the options and impact of support processes that exclude the use of force.     

Sex differences in psychological distress,behavioural and emotional problems,and substance use in young people in out‐of‐home care

The aim of the study was to examine sex differences in self‐reported psychological distress, behavioural and emotional problems, and substance use in young people living in out‐of‐home care (OoHC). One hundred seventy‐six young people aged 12–17 years (females 53.4%) in OoHC in metropolitan Melbourne, Australia, were interviewed. Participants completed self‐report measures: Kessler Psychological Distress Scale, Strengths and Difficulties Questionnaire, and the World Health Organization Alcohol, Smoking, and Substance Involvement Screening Test—Youth Version. Girls had more OoHC placement instability over the past year compared with boys (p = .019). Compared with boys, the girls had significantly higher levels of distress (p < .001) (p = .007), were more likely to have self‐reported emotional symptoms (p < .001) and peer relationship problems (p = .043) and were more likely to use sedatives (p = .004). Girls had more psychological distress, behavioural disturbance, and sedative abuse; placement instability might contribute to these problems. Greater integration across OoHC, mental health, and substance use sectors is required. Girls in OoHC may benefit from interventions targeting problems with peer relationship and substance use and supporting prosocial behaviour; such targets may reduce distress and emotional symptoms and possibly prevent longer term problems.     

The Buffering Role of Social Support on the Psychosocial Wellbeing of Orphans in Rwanda

Little is known about the buffering role of social support among orphans living in Africa. This study examined (1) how perceived social support (PSS) varied across orphan‐related characteristics (e.g., orphan status, such as single, maternal or paternal, and their living environments, such as in child‐headed households, on the street, in an orphanage or in a foster home) and (2) the relative importance of sources of PSS (relatives/community/adults and peers) and functional social support (emotional/informational/instrumental and social) and its association with emotional well‐being and mental distress. The participants included 430 orphaned Rwandan children and youth aged between 10 and 25 years (Mean age = 17.74), of whom (n = 179, 41.6%) were females and (n = 251, 58.4%) were males. Result showed that children living in an orphanage exhibited a higher level of PSS from all sources of social support than did children in other living environments. A higher level of PSS from relatives, communities and adults was associated with high level of emotional well‐being, and only adult support was associated with low level of mental distress. Furthermore, the functional PSS indicated that emotional support and companionship support were equally important in their association with higher levels of emotional well‐being and lower levels of mental distress. The findings highlight the importance of having different sources of social support and their functions in relation to psychosocial well‐being.     

The Buffering Role of Social Support on the Psychosocial Wellbeing of Orphans in Rwanda

Little is known about the buffering role of social support among orphans living in Africa. This study examined (1) how perceived social support (PSS) varied across orphan‐related characteristics (e.g., orphan status, such as single, maternal or paternal, and their living environments, such as in child‐headed households, on the street, in an orphanage or in a foster home) and (2) the relative importance of sources of PSS (relatives/community/adults and peers) and functional social support (emotional/informational/instrumental and social) and its association with emotional well‐being and mental distress. The participants included 430 orphaned Rwandan children and youth aged between 10 and 25 years (Mean age= 17.74), of whom (n =179, 41.6 percent) were females and (n = 251, 58.4 percent) were males. Result showed that children living in an orphanage exhibited a higher level of PSS from all sources of social support than did children in other living environments. A higher level of PSS from relatives, communities and adults was associated with high level of emotional well‐being, and only adult support was associated with low level of mental distress. Furthermore, the functional PSS indicated that emotional support and companionship support were equally important in their association with higher levels of emotional well‐being and lower levels of mental distress. The findings highlight the importance of having different sources of social support and their functions in relation to psychosocial well‐being.     

Romantic Relationships,Relationship Styles,Coping Strategies,and Psychological Distress among Chinese and Australian Young Adults

This study examined the association between relationship styles, coping strategies, and psychological distress among 144 Anglo‐Australian and 250 Hong Kong Chinese undergraduate students. The results indicated that relationship styles (secure, clingy, and fickle) influenced psychological distress through their association with coping strategies (avoidance and self‐punishment). Society of residence was a moderating factor for the association between clingy relationship style and psychological distress. Females also reported higher levels of psychological distress than males. Among participants who had experienced a romantic relationship break up, participants endorsing clingy relationship style and those whose partners initiated the break up expressed more hurt in comparison, whereas those who endorsed avoidance strategy reported less hurt. The results of the present study also suggested that psychosocial variables (relationship styles, coping strategies) were generally more important than demographic factors (e.g., age) in predicting mental health outcomes. However, relationship styles and coping strategies may operate differently under different contexts.     

Unemployment and psychological distress among young adults in the Nordic countries: A review of the literature

This article reviews Nordic research, published from 1995 and onwards, on the relationship between unemployment and mental health among young adults. Cross‐sectional, longitudinal and time‐series studies are included. Cross‐sectional studies show that the unemployed experience more mental health problems than the non‐unemployed. Leaving unemployment is associated with increased well‐being. Economic problems, feelings of shame and poor social support increase the likelihood of psychological distress. The longitudinal studies show that unemployment increases the risk of psychological distress and attempted suicide, after initial mental health status and confounding factors are accounted for. The relationship remains significant when time‐invariant characteristics of the individuals are controlled for. The time‐series studies found no relationship between unemployment and suicide, but levels of psychological distress were found to vary with changes in the labour market. This relationship remained significant after excluding the non‐employed, indicating that unemployment trends have effects beyond those directly associated with unemployment.     

Exploring intergenerational communication and stress in refugee families

More than half of the refugees who have resettled to the United States in recent years have been youth. Refugee youth have often witnessed or experienced violence and family separation prior to resettlement and face barriers to successful resettlement such as language and educational challenges. These factors elevate risk for mental and emotional distress, and protective factors like strong familial relationships are important to promoting mental well‐being. This study utilized focus groups with 36 refugees ages 18 to 25 from four ethnic groups to explore conceptualizations of and communication about mental and emotional distress within and outside of family systems. Youth reported a nuanced conceptualization of their premigration and postmigration stressors and their patterns of communication about distress in three domains: (a) exposure to traumatic stress prior to resettlement, (b) stressful experiences in resettlement, and (c) communication about mental health inside and outside of family groups.     

A qualitative evaluation of an innovative resilience‐building camp for young carers

Young carers are at increased risk of developing mental health and social problems. The objective was to pilot a camp‐based resilience‐building programme for young carers. Twelve young carers (12 to 14 years) recruited from Carers Queensland attended a 3‐day resilience‐building camp adapted from the Resourceful Adolescent Program. One month after the camp, carers participated in a semi‐structured telephone interview. Thematic analysis was used to analyse the data. Two key themes emerged. The first, coping self‐efficacy, included subthemes of affect regulation, interpersonal skills, and recognition of strengths and coping ability. The second key theme, social benefits, included opportunities for respite and social engagement. Overall, participants reported enjoying the camp and would recommend it to other young carers, yet they were able to provide some suggestions to improve future camps. Implementing an integrative resilience‐building program such as the Resourceful Adolescent Program in a camp format shows promise as a way of both engaging and benefiting young carers, as well as selective populations more generally.     

Depressive Symptoms and Economic Outcomes of Low-Income Women: A Review of the Social Causation, Social Selection, and Interactionist Hypotheses

We review research that connects depression and depressive symptoms to employment and economic factors for low-income women. Women who have low incomes and are unemployed or underemployed are vulnerable to mental health distress. The strain of balancing work and family life can be exacerbated by poor psychological health or nonsufficient economic resources. Research on the barriers that impede self-sufficiency can lead to policies that improve the economic and psychological health of low-income populations.
The discussion is framed by contrasting evidence for three theoretical perspectives: the social causation, social selection, and interactionist (bidirectional) hypotheses. The only causal relation reported is an effect of increased income on reduced depressive symptoms. Yet strong associations are found among psychological distress, earnings, employment stability, income, and job characteristics. The effects of programs to increase employment and the benefits of (and barriers to) depression treatment are also discussed. A bidirectional or interactionist perspective best conceptualizes the relationship between depression and economic factors. The reported negative effects of both poor mental well-being and low-quality employment suggest the need for stronger policies in the areas of mental health and work supports. We present policy recommendations addressing mental health treatment and outreach, employment placement, and workplace flexibility.     

Working Toward a Just,Equitable, and Local Food System: The Social Impact of Community‐Based Agriculture*

Objective. This article serves as a pilot study of three central aspects of sociological research concerning the impact of local agriculture on local communities: food equity, social integration, and natural human capital. Methods. Four CSA farmers, four partners in a direct‐market organic farm, and four community garden site coordinators working in the Intervale, a local agriculture project in Burlington, Vermont, were interviewed in person for this research. Additionally, the author collected observational data in the Intervale, at two local farmers' markets, and as a member of a local community garden. Result. Different modes of local agricultural production have distinctive effects on the local population with regard to equitable access to healthy food, social inclusion, and experiential knowledge of the natural world. Conclusions. Given class‐based disparities in local agricultural participation, local food projects should consider promoting programs designed for broader social inclusion, including subsidized farmer‐to‐family coupons.     

Individual Differences in Infants' Emotional Resonance to a Peer in Distress: Self–Other Awareness and Emotion Regulation

In this study, relations between emotional resonance responses to another's distress, emotion regulation, and self‐other discrimination were investigated in infants three‐, six‐, and nine‐months‐old. We measured the emotional reactions to the pain cry of a peer, along with the ability to regulate emotions and to discriminate between self and other body movements. We found evidence that infants do regulate their emotional resonance responses to another's distress. This relation is age specific, with younger infants using more primitive self‐soothing behaviors, while in older participants attentional based strategies relate to affect sharing reactions. Only nine‐month‐old infants have shown self‐other differentiation abilities, and these were significantly connected to their emotions in response to a peer's distress. These findings have implications for our understanding of early empathy development.     

Reactions to research participation in vulnerable subgroups

This paper describes the extent to which vulnerable individuals (defined by economic, social, psychological, physical health, and child maltreatment status) react to research participation. As part of an ongoing longitudinal study, participants (N=896) completed a lengthy and intrusive in-person interview and provided a small amount of blood through finger pricks. At the end of the interview, participants were asked eight questions about their reactions to the research experience. Vulnerable individuals in general agreed more strongly about having an emotional reaction, but were not less willing to continue to participate. In addition, psychologically vulnerable individuals more strongly agreed they would continue to participate, were treated with respect and dignity, and found their participation meaningful. Compared to whites, nonwhites reported stronger agreement about the meaningfulness of the research and the belief that their responses would be kept private. Like others, individuals vulnerable by virtue of their prisoner status or homelessness (past or current) agreed more strongly about having an emotional reaction to the interview, but otherwise did not differ in their reactions. These results suggest that researchers and institutional review boards should not be deterred from conducting research on sensitive topics with potentially vulnerable populations.     

Reactions to Research Participation in Vulnerable Subgroups

This paper describes the extent to which vulnerable individuals (defined by economic, social, psychological, physical health, and child maltreatment status) react to research participation. As part of an ongoing longitudinal study, participants (N = 896) completed a lengthy and intrusive in-person interview and provided a small amount of blood through finger pricks. At the end of the interview, participants were asked eight questions about their reactions to the research experience. Vulnerable individuals in general agreed more strongly about having an emotional reaction, but were not less willing to continue to participate. In addition, psychologically vulnerable individuals more strongly agreed they would continue to participate, were treated with respect and dignity, and found their participation meaningful. Compared to whites, nonwhites reported stronger agreement about the meaningfulness of the research and the belief that their responses would be kept private. Like others, individuals vulnerable by virtue of their prisoner status or homelessness (past or current) agreed more strongly about having an emotional reaction to the interview, but otherwise did not differ in their reactions. These results suggest that researchers and institutional review boards should not be deterred from conducting research on sensitive topics with potentially vulnerable populations.     

The association between psychosocial well‐being and living environments: a case of orphans in Rwanda

This study examined how various living environments (child‐headed households, orphanages, street children and foster homes), quality of care and demographic factors were associated with the psychosocial well‐being of orphans in Rwanda by using a sample of 430 participants. Results indicated that children in orphanages exhibited higher levels of emotional well‐being and lower levels of mental distress and risk‐taking behaviour than others. Decision‐making ability was the highest among child‐headed households, while it was the lowest among those in orphanages. Quality of care, such as meal availability and length of time spent in a particular living environment, along with demographic factors, such as age and sex, were also important predictors of psychosocial well‐being.     

Enriching our understanding of vulnerability through the experiences and perspectives of individuals living with mental illness

ABSTRACT

Vulnerability is a central concept in research ethics and typically serves to identify individuals or groups whose participation in research prompts specific concerns or warrants special consideration. While theoretical discussions on vulnerability have contributed valuable insights to discussions of mental health research and care, they have not been enriched thus far by stakeholder perspectives. This oversight has important consequences for the ways in which we frame vulnerability. It misses the far-reaching insights and experiential knowledge of mental health research participants whose experiences this ethics concept ultimately seeks to capture. In view of this gap, our study combines a pragmatist ethics framework and interpretive phenomenological analysis of qualitative interviews to explore user perspectives on the notion of vulnerability through the lived experiences of mental health research participants and patient-advocates. Importantly, these perspectives offer essential clues to address the difficulties of operationalizing concerns for vulnerability in concrete and practical ways. They help refine our understanding of this key ethics concept.     

Is Food Insecurity Associated with Depressive Symptoms in South Korea?

Emerging studies have suggested a possible link between food hardship and depression; however, empirical knowledge is limited. In South Korea, more public discussion has been conducted regarding the prevalence and consequences of food insecurity on mental health. To begin to address the knowledge gap, we applied family stress theory and investigated the association of food insecurity with depression in South Korea. We employed observational data from the Korea Welfare Panel Study, the first data to draw on food insecurity information from a nationally representative sample in Korea. Our sample consisted of 744 non‐elderly household heads. The independent variable “food insecurity” was measured using a six‐item scale adapted from the United States Department of Agriculture Food Security Scale. The dependent variable “depression” was measured using 11 questions from the Center for Epidemiologic Studies Depression Scale adapted for Koreans. After controlling for income, material hardship, and other factors, our ordinary least squares regression findings show that food insecurity significantly predicts depression. Our findings are consistent whether food insecurity is measured on a continuum or in categorical groups. More research and empirical evidence should be shared to provide legitimate grounds for policy interventions that address and prevent food insecurity and mental health issues.