From the West Indies to Africa: A universal generational decline in health among blacks in the United States

Research shows that foreign-born blacks have better health profiles than their U.S.-born counterparts. Less is known, however, regarding whether black immigrants’ favorable health outcomes persist across generations or whether these patterns differ across the diverse sending regions for black immigrants. In this study, we use data from the 1996–2014 waves of the March Current Population Survey (CPS) to investigate generational differences in self-rated health among blacks with West Indian, Haitian, Latin American, and African ancestry. We show that first-generation black immigrants have a lower probability of reporting fair/poor health than third/higher generation blacks. The health advantage of the first generation over the third/higher generation is slightly more prounced among the foreign-born who migrated to the United States after age 13. Second-generation immigrants with two foreign-born parents are generally less likely to report their health as fair/poor than the third/higher generation. However, we find no evidence that self-reported fair/poor health varies between second-generation immigrants with mixed nativity parents (only one foreign-born parent) and the third/higher generation. These general patterns hold across each of the ancestral subgroups in the study sample. In summary, our findings highlight a remarkable convergence in health across immigrant generations among blacks in the United States.     

Foreign-born health integration during the transition to adulthood: The case of weight

Nativity differences in youths’ health in the United States are striking—the children of foreign-born parents often have healthier outcomes than those of native-born parents. However, very little is known about how immigrant-native differences evolve within the same individuals over time, or about life cycle aspects of the health-related integration of youth with migration backgrounds. Using data from the National Longitudinal Study of Adolescent Health, I examine nativity differences in trajectories of weight gain during adolescence and early adulthood, as well as the degree to which temporal patterns are stratified by race/ethnicity and socioeconomic status. I examine whether nativity differences converge, diverge or remain stable over time, and whether patterns are socially stratified within and across nativity groups. I find that first-generation adolescents begin at a lower weight than their third generation peers and gain weight at a significantly slower pace, resulting in meaningful differences by early adulthood. More complex examination of the relationship between nativity and weight gain reveals additional differences by ethnicity: the foreign-born advantage over time does not extend as strongly to Hispanic adolescents. The findings demonstrate how the health-related integration of foreign-born youth is tied to race/ethnicity and socioeconomic circumstances, and suggest the need to examine the ways in which social circumstances and health change together.     

统筹城乡医疗保险制度模式比较分析

在当前统筹城乡发展的大背景下,许多地方开展了统筹城乡医疗保险制度的探索,形成了"社保部门主管""、卫生部门主管""、社保部门和卫生部门合作管理"三种模式。其中多数地区由社保部门主管,并在此模式下又表现出"五险合一统一经办管理"、"医保机构分设经办管理""、商业保险参与经办管理"三种形式。不同模式在主管部门、经办机构、统筹层次、覆盖范围、筹资标准、待遇水平及保障范围上各不相同,形成各自的特色。通过比较分析,提出统筹城乡医疗保险制度建设并不以经济发展水平为前提,应当统一管理体制,提高统筹层次,科学设计适应当地情况的城乡居民基本医疗保险制度,完善城乡医疗保险信息化管理系统和信息网络平台。     

关于健康社会政策的理论思考

为深入讨论我国全民健康和医疗卫生服务的问题,本文首先提出一系列问题:什么是卫生,什么是健康,健康服务的社会意义,传染病与慢性病,以人为本与医学伦理,基本医疗服务能"市场化"吗,"政府失灵"和"准市场",等等。在对这些问题进行阐述研究的基础上,本文分析了国际国内,都认为的医疗保险三模式:其一,"以国家一般税收作为筹资来源的模式"(英国);其二,"以缴纳社会保险费(税)作为筹资来源的模式"(德国);其三,"私人保险模式"(美国),并对三种模式进行比较,本文认为:中国的医改必须以人为本,只有全民医疗服务或全民医疗保险才符合这个大方向。     

G7国家医疗保险制度的变迁和发展及其启示

G7国家的医疗保险制度代表了当今世界主要的医疗保险模式,其变迁和发展反映了世界医疗保险制度的历史和未来。文章基于历史制度主义的理论对医疗保险制度的源起做一简要解读,并采用历史的研究方法,考察G7国家医疗保险制度自建立至今的变迁和发展,从中归纳出医疗保险制度变迁的主要内容和一些共同点。据此指出中国医疗保险制度建设应该注意的首要问题,供进一步思考。     

论职工补充医疗保险的发展与规范

随着我国城镇职工“低水平,广覆盖”的基本医疗保险模式的建立,职工更高层次的医疗保障,迫切需要职工补充医疗保险的辅助,这同时也是中国“入世”后企业参与竞争的重要砝码。企业脱困目标的实现和人民生活水平的提高,以及职工互助保险等相关保险经验的积累,使发展职工补充医疗保险成为可能。发展职工补充医疗保险,应尽快通过法律、法规明确其地位、性质;制定税收等相关政策,鼓励其发展;加强监管,规范其经营活动,使职工补充医疗保险能健康发展。     

河北省农业保险的现状与风险分散机制

针对2008年河北省出台的农业保险的政策以及河北省的农业保险的实际情况,通过分析现状发现存在开展农业保险的公司高度集中、赔付率比较高;农户保险意识淡薄、投保能力不足;政府扶持农业保险的效率低,配套措施未到位等问题。结合我国农业保险开展的实际和河北省的情况提出从农业保险立法、扶持的财政和税收政策的加强、多层次风险分散体系建立以及大力发展互助性质的农业保险互助社等措施来完善河北省农业保险的风险分散机制。     

三峡移民社区存在的问题及对策研究——以新农保为例

三峡移民在移民后,社区存在很多的问题,社会保险尤其是养老保险就是其中一个很重要的方面。新型农村社会养老保险即将全面普及,国家、地方政府、个人都应该采取适当的措施,使社会养老保险全面覆盖,使每个三峡移民“老有所养”。     

试析我国保险资金运用法律监管制度的完善

保险资金运用已成为保险经营中不可或缺的重要环节,资金运用的收益成为弥补承保亏损和追求高效益的主要渠道。为防止保险公司在资金运用上的盲目性和投机行为,保证保险公司有足够的偿付能力,维护保险利益人的利益,各国在法律上都规定了保险资金运用的监管,但我国法律对此规定存在缺陷,针对我国相关法律制度不足本文提出完善我国保险资金运用监管法律制度的立法设想,从外部和内部两方面互为补充构建完善的符合国情的监管法律制度。     

可持续发展意义下德国社会医疗保障的特色及原则

德国社会保障是一个覆盖面广泛的庞大体系,具有显性的公共产品属性。社会医疗保障是其构成主体之一,不是国家机构却承担了部分的国家责任与任务,由企业(私法主体)提供公共服务,呈现出德国法定医疗保险的独特性。福利性与互助性、可持续性与适应性是德国医保的两大鲜明特色,福利国家原则、互助原则等七大原则是制度保证。此文着力以德国的社会医疗保障历史发展为基点和线索来观察与分析德国社会医疗保障的特色、原则及价值取向。     

Age at migration,family instability,and timing of sexual onset

This study builds on and extends previous research on nativity variations in adolescent health and risk behavior by addressing three questions: (1) whether and how generational status and age at migration are associated with timing of sexual onset among U.S. adolescents; (2) whether and how family instability mediates associations between nativity and sexual debut; and (3) whether and how these associations vary by gender. We find that first- and second-generation immigrant youth initiate sexual activity later than native youth. Foreign-born youth who migrate after the start of adolescence exhibit the latest sexual onset; boys’ sexual behavior is particularly sensitive to age at migration. Parental union stability is protective for first- and second-generation youth, especially boys; however, instability in co-residence with parents accelerates sexual debut for foreign-born girls, and dilutes protections from parental marital stability. Use of a non-English language at home delays sexual onset for immigrant girls, but not boys.     

Risk factors for family time burdens providing and arranging health care for children with special health care needs: Lessons from nonproportional odds models

We identify need, enabling, and predisposing factors for high family time burdens associated with the health care of chronically-ill children, using data from the U.S. 2009–2010 National Survey of Children with Special Health Care Needs (NS-CSHCN), a population-based survey of 40,242 children with special health care needs (CSHCN). We estimate generalized ordered logistic multivariable regressions of time spent (1) providing health care for the child at home, (2) arranging/coordinating health care, and (3) combined time. Factors associated with higher time burdens included child’s functional limitations, severe or unstable health conditions, public health insurance, lack of a medical home, low family income, low adult education, and non-white race. Nonproportional odds models revealed associations between risk factors and time burden that were obscured by binary and standard ordered logistic models. Clinicians and policymakers can use this information to design interventions to alleviate this important family stressor.     

社会保障覆盖率对农村居民消费的影响研究

农村居民消费支出受社会保障覆盖率的影响,且随收入的增加而增加。提高社会保障覆盖率能减少农村居民消费支出对微观保障水平的依赖程度;养老保险覆盖率每提高1%,农村居民消费支出会增加3233元。微观保障水平的边际消费倾向为1.043,而初次分配收入的边际消费倾向则为0.520。但保障覆盖率对城镇居民消费支出影响较小,居民消费支出的提高,主要依赖于初次分配收入的增加。当前应以政府财政转移支付为依托,首先扩大农村养老保险覆盖率,然后再提高保障水平。     

论我国商业健康保险的发展

商业健康保险是我国医疗保障体系的重要组成部分,对我国目前所施行的城镇职工基本医疗保险制度起到了重要的补充作用。目前,我国商业健康保险的发展面临着良好的机遇,但在发展过程当中还存在一些问题亟待解决。因此,这就急需我们采取一些行之有效的措施,以促进我国商业健康保险的进一步发展。     

新型农村社会养老保险路径选择探讨

新型农村社会养老保险制度的建立和完善是经济社会发展的必然结果。随着农村老龄化的加速趋势,新型农村社会养老保险成为农民群体主要养老模式。完善新型农村社会养老保险制度需要提高参保率,有效扩大制度覆盖面,有效实现风险分散,提高养老金的替代率。整合新型农村社会养老保险、城镇居民社会养老保险和城镇职工社会养老保险,协调各方利益,实现社会公平和正义。     

浅议我国养老保险制度的改革与完善

随着人口老龄化的不断加剧,我国养老保险正面临资金缺口、支付危机等严重挑战。进一步扩大养老保险覆盖面,提高基金统筹层次从而增强调剂能力,全面做实个人账户解决隐性债务,推进养老保险基金投资运营以实现保值增值,是应对困境的有效途径。     

我国经济欠发达地区农村社会养老保险制度的构建

与发达地区相比,我国经济欠发达地区农村养老保险发展十分缓慢,覆盖面极其有限。实际上,经济欠发达地区的农民最需要社会养老保险,因为他们的基本生活需求没有保证,这些地区未富先老特征更为明显,传统的保障功能在弱化。然而,源于农民收入低,增长慢,支付保险费的能力弱;集体经济薄弱,无法为农民养老保险提供资金支持;地方财力单薄,难以全面提供以政府为主的养老基金融资;经济欠发达地区农民获得社会养老保险能力又最弱。为此,应将经济欠发达地区农村社会养老保险作为建设覆盖城乡居民社会保障体系的推进重点,变政府扶持为财政拨款,并向经济欠发达地区倾斜;大力进行宣传教育,让农民充分了解参加社会养老保险的必要性。     

车险赔付义务的法律调整及其保障措施

我国车险赔付在车险的险种规定、责任规定等方面存在一定的问题。应借鉴美国“从人主义”的汽车保险制度、英国“完全市场细分”的汽车保险制度、德国的汽车分级保险制度,从汽车保险行业标准、车险赔付机制、保险市场信息系统、保险监管系统建设等方面对我国车险赔付义务有效履行的保障措施进行调整。     

城乡基本养老保险对老年人主观福利的影响研究——基于CGSS数据的实证分析

该文基于2018年、2021年中国综合社会调查(CGSS)数据,采用Ordered probit、Ordered logit模型实证分析了城乡基本养老保险对老年人主观福利的影响,研究结果表明,参加城乡基本养老保险对提升老年人主观福利水平有显著的正向影响,并通过异质性分析得出,对年龄在80岁以下、自评健康较低、西部地区、子女数目在两个及以下、无配偶、收入较低的群体影响尤为显著。文章采用倾向得分匹配法和改变变量的方法验证了研究结果的稳健性。基于该文研究结果,建议政府持续推进城乡基本养老保险政策的实施和动态性调整,加大对弱势群体、西部地区的关注度和支持度,促进养老产业的良性发展,加强精神文明建设和医疗建设,深入探索医养结合的养老模式,全面提升老年人的主观福利。     

New options for national population surveys: The implications of internet and smartphone coverage

Challenges to survey data collection have increased the costs of social research via face-to-face surveys so much that it may become extremely difficult for social scientists to continue using these methods. A key drawback to less expensive Internet-based alternatives is the threat of biased results from coverage errors in survey data. The rise of Internet-enabled smartphones presents an opportunity to re-examine the issue of Internet coverage for surveys and its implications for coverage bias. Two questions (on Internet access and smartphone ownership) were added to the National Survey of Family Growth (NSFG), a U.S. national probability survey of women and men age 15–44, using a continuous sample design. We examine 16 quarters (4 years) of data, from September 2012 to August 2016.Overall, we estimate that 82.9% of the target NSFG population has Internet access, and 81.6% has a smartphone. Combined, this means that about 90.7% of U.S. residents age 15–44 have Internet access, via either traditional devices or a smartphone. We find some evidence of compensatory coverage when looking at key race/ethnicity and age subgroups. For instance, while Black teens (15–18) have the lowest estimated rate of Internet access (81.9%) and the lowest rate of smartphone usage (72.6%), an estimated 88.0% of this subgroup has some form of Internet access.We also examine the socio-demographic correlates of Internet and smartphone coverage, separately and combined, as indicators of technology access in this population. In addition, we look at the effect of differential coverage on key estimates produced by the NSFG, related to fertility, family formation, and sexual activity. While this does not address nonresponse or measurement biases that may differ for alternative modes, our paper has implications for possible coverage biases that may arise when switching to a Web-based mode of data collection, either for follow-up surveys or to replace the main face-to-face data collection.