Measuring Intergenerational Time Preference: Are Future Lives Valued Less?

Prior research has estimated intergenerational time preferences by asking respondents to choose between hypothetical life saving programs. From such choices, researchers have concluded that the public heavily discounts the lives of people in future generations. However, using a multiversion survey involving 401 respondents, I show that imputed intergenerational time preferences can be dramatically affected by the specific question that is asked. Different elicitation procedures can yield widely varying results by evoking or suppressing various relevant considerations (such as uncertainty). Many formats revealed no preference for current generations over future generations.     

Preferences for life saving programs: how the public discounts time and age

In surveys of 3,000 households, we have found that people attach less importance to saving lives in the future than to saving lives today, and less importance to saving older persons than to saving younger persons. For the median respondent, saving six people in 25 years is equivalent to saving one person today, while for a horizon of 100 years, 45 persons must be saved for every person saved today. The age of those saved also matters; however, respondents do not weight lives saved by number of life-years remaining: For the median respondent, saving one 20-year-old is equivalent to saving seven 60-year-olds.     

Saving Lives in the Present Versus Saving Lives in the Future—Is There a Framing Effect?

This study considers how to compare programs which are designed to save lives. "To estimate the discount rate for lives saved in the future a number of studies have been carried out on the trade-off between saving lives now and in the future. A telephone survey is administered to about 1,700 individuals [in Sweden] to test if the framing of the question affects the estimated trade-off. In one sample the question is framed as saving 100 lives today versus saving x future lives and in one sample the question is framed as saving 100 future lives versus saving y lives today. The result shows that the framing has a major impact on the trade-off."     

Government Program Usage and Political Voice*

Objectives. Despite the scope of U.S. social spending, we know little about cumulative program usage among individuals or how it may influence their political attitudes or behavior. This article examines program usage among citizens and probes the association of usage with program assessment and the likelihood of voting. Methods. We examine these issues using the 2005 Maxwell Poll, which uniquely asked respondents about both usage of 18 social programs as well as attitudes about such programs and rates of political involvement. Results. The data indicate that direct experience of social programs is fairly common and widespread across the population, but beneficiaries of programs differ in their assessments compared to nonbeneficiaries. Most significant, after controlling for various demographic factors, we find that the greater the number of universal programs citizens have used, the greater the likelihood that they vote; conversely, the greater the number of means‐tested programs they have used, the lower their likelihood of voting. Conclusion. Experiences of social programs may influence voter turnout and may help explain why young and less advantaged citizens vote less than older citizens. Trends in social provision may be fostering inequality of political voice, particularly among younger generations.     

Subjective Probability Weighting and the Discovered Preference Hypothesis

Numerous studies have convincingly shown that prospect theory can better describe risky choice behavior than the classical expected utility model because it makes the plausible assumption that risk aversion is driven not only by the degree of sensitivity toward outcomes, but also by the degree of sensitivity toward probabilities. This article presents the results of an experiment aimed at testing whether agents become more sensitive toward probabilities over time when they repeatedly face similar decisions, receive feedback on the consequences of their decisions, and are given ample incentives to reflect on their decisions, as predicted by Plott’s Discovered Preference Hypothesis (DPH). The results of a laboratory experiment with N = 62 participants support this hypothesis. The elicited subjective probability weighting function converges significantly toward linearity when respondents are asked to make repeated choices and are given direct feedback after each choice. Such convergence to linearity is absent in an experimental treatment where respondents are asked to make repeated choices but do not experience the resolution of risk directly after each choice, as predicted by the DPH. I thank Peter P. Wakker for useful comments and suggestions.     

Accumulated knowledge and experience in the treatment of substance abuse

This article summarizes the accumulated knowledge and experience of people engaged in the institutional treatment of substance abusers in Sweden. The views of the respondents were obtained by means of the Delphi method, which entails compiling several rounds of written dialogue between researcher and respondents. The study had three rounds. The arguments of experienced staff concerning the professionalization of substance abuse treatment are presented, with the main emphasis being on general trends. At the time of the study, the main dividing line, according to the respondents, lies between the 12-step program of Alcoholics Anonymous and psychotherapeutic programs. The majority of the respondents believe that knowledge of psychotherapy provides a better understanding of the treatment process. This finding is particularly evident among the staff of drug treatment institutions, two-thirds of whom are of the opinion that acquiring proficiency in psychotherapy is a way to professionalize treatment. An important aspect is the quality of the relationship between therapist and client. The majority of the respondents believe that it is possible to define the criteria for good treatment.     

Gender,risk and stereotypes

This paper reports results from an economic experiment where respondents are asked to make choices between risky outcomes for themselves and others. We investigate whether subjects’ own risk preferences and gender stereotypes are reflected in the predictions they make for the risk preferences of others and the way this occurs. When predicting other people’s risk preferences, the respondents tend to use a combination of their own risk preferences and stereotypes. Moreover, when making risky choices for others, the respondents generally use a combination of their own risk preferences and their average predicted risk preference of the targeted group.

Part III: A student learns casework

Abstract

When homeless and severely mentally ill individuals leave housing programs designed to help them achieve stability, their very lives become at risk. Despite the prevalence of this problem and its potentially life-threatening consequences, there is a complete dearth of case studies examining why clients in programs for the homeless and mentally ill suddenly depart from those programs, and how paranoid and other seemingly unreachable clients can significantly improve the quality of their lives. This single case study, utilizing a naturalistic methodology, provides a before and after picture of a client who precipitously left a housing program, then returned two years later in a state of severe physical and mental decompensation. The study focuses on understanding why the client left the program the first time and what could be done to prevent another premature discharge. The findings point to a lack of coordination of care and problems with stable human interaction on the part of those caring for Charles, and are critical to understanding how to engage successfully with homeless and severely mentally ill clients.     

Role of AKRSP on Gender Development: A Case Study in Pakistan

ABSTRACT

In Pakistan, nongovernmental agencies (NGOs) play an important role in program implementation. This study focuses on the contribution of one of these NGO social service programs that serves women in a rural area of Pakistan. To assess program satisfaction and effectiveness, 200 females were surveyed to measure their opinions and overall satisfaction with this particular NGO. The key findings of the study showed that the Aga Khan Rural Support Program (AKRSP) had a significant positive impact on the lives of these women through increasing social and decision-making skills while improving their income and living standards by providing employment opportunities and training. Future recommendations are made to continue to sponsor such programs that focus on a group-support for women while also providing supportive services that empower decision-making and economic standing.     

Correlates of Treatment Retention Among Persons with Serious Mental Illness Receiving Integrated Care in a Community Mental Health Setting

ABSTRACT

Knowledge about methods to retain community mental health (CMH) clients in integrated primary and behavioral health care (PBHC) programs is needed to address longstanding health disparities. A preexisting data set that contained the clinical records of 446 PBHC program participants was used to examine whether baseline sociodemographic, health, and psychosocial characteristics predicted retention in care at 6 months post-enrollment. Results indicated that less than half of PBHC participants (43.7%) were retained in care, and approximately 17% of the variance in retention was explained by the inclusion of seven predictors in the model (overall health, medications, laboratory data, primary care provider, disorder type, transportation, and living arrangement). Clients with thought disorders were almost twice as likely as those with mood disorders to be retained in care, and greater frequency of prescribed medications also increased the likelihood of treatment continuation (ORs = 1.99 and 1.20, respectively). Future research should identify factors that improve retention in integrated PBHC programs overall, and among persons with mood disorders, in particular.     

Using Promotores Programs to Improve Latino Health Outcomes: Implementation Challenges for Community-Based Nonprofit Organizations

ABSTRACT

Promotores are community lay health workers who provide outreach and services to Latinos. Little research on the promotores programs exists, and the focus of this article is to identify the challenges faced by community-based nonprofits when implementing promotores programs. To explore this type of program, telephone interviews were conducted with 10 promotores academic experts and nonprofit executives. The results suggest that implementation challenges fall into three major categories: the lack of standardized information on promotores programs, labor issues, and organizational costs. Future recommendations made in the article highlight promotores recruitment and retention strategies and the development of a clearinghouse of programmatic implementation information for community-based nonprofits.     

Threads across the world: sewing resilience into the fabric of children’s lives

Strengthening the ecological resilience factors in the lives of children that have been abused can help them to navigate the healing process. It is through group work that children can share their “resilience wisdom” with one another as a healing community. There is a dearth of research on cross-cultural resilience programs for children who have been abused. This article explores a group work program that was conducted for one year in Bolivia and Australia. The results from each group reveal the similarities and the differences in outcomes between children from different cultural backgrounds that participated in a resilience group work program.     

Explaining the Identifiable Victim Effect

It is widely believed that people are willing to expend greater resources to save the lives of identified victims than to save equal numbers of unidentified or statistical victims. There are many possible causes of this disparity which have not been enumerated previously or tested empirically. We discuss four possible causes of the identifiable victim effect and present the results of two studies which indicate that the most important cause of the disparity in treatment of identifiable and statistical lives is that, for identifiable victims, a high proportion of those at risk can be saved.     

Assessing Statewide Need for Older Adult Health Promotion Services: The Oklahoma Experience

ABSTRACT

The growing senior population and persistent poor health status of seniors in Oklahoma compels a fresh look at what health promotion services would be well received. Surveys were distributed to a list of registered voters aged 65 and older in Oklahoma with a total of 1,248 surveys returned (19.8%). Survey items asked about interests in services, classes, and activities, plus current barriers to accessing and/or engaging in such programs. To account for survey weighting, Rao-Scott Chi-Square Tests were performed to determine differences by demographic characteristics. We identified services, classes, and activities that were (and were not) of interest to seniors in Oklahoma with legal assistance (52.1%), exercise classes (46.6%), internet classes (40.7%), and indoor exercise activities (45.5%) receiving the highest level of interest. Barriers to interest in participating in programs included not wanting to go and not knowing availability of such services. The results of this survey provide useful data on health promotion gaps for seniors, interests and barriers to engaging in such activities, and guidance for statewide program development. Future program development needs to be focused on areas of interest for older adults, including legal assistance, exercise classes, and internet classes.     

Individuals' Estimates of the Risks of Death: Part II—New Evidence

Using new survey data, we test the hypothesis that individuals' perceptions of health and safety risks are unbiased. While we find that respondents' estimates of those risks are sensitive to the information they are given to anchor their responses, we find no evidence to support the widely held view that people tend to underestimate the frequency of relatively common risks. The slight tendency for respondents to overestimate the frequency of extremely unlikely events can plausibly be interpreted as truncation bias. Overall, the accuracy of our subjects' estimates varies in a manner that is fully consistent with simple conjectures about the health and safety information that is of greatest relevance to them in the conduct of their lives. The marked difference between the results of our survey and those of previous studies appears to be attributable to the practical implications of costly information and the common failure of investigators to account for the fact that rational individuals will choose to acquire less than full information about many uncertain events.     

Evaluating the Senior Companion Program: a mixed-method approach

This article reports on a mixed-method assessment of the Senior Companion Program (SCP), a federal program which provides volunteer opportunities with small stipends to low-income older adults, 60 years of age and older, who provide companionship and offer assistance to frail community elders. Through four standardized scales and open-ended questions regarding the impact of the SCP in their lives, 34 Senior Companion volunteers and 32 of their clients were interviewed. Informants reported relatively large social networks and low levels of depression and loneliness. Thematic analysis of the qualitative data revealed the benefits of the program for both volunteers and their clients. Themes emerging from the rich narratives included: companionship, independence, reduced anxiety, giving, and rewards. The article concludes with a suggested brief evaluation instrument that directors of SCP programs, and other similar programs, can use to collect data on the impact of their program--something that is required, but often difficult to do.     

Changes in Life Satisfaction Among Participants of Adult Day Care and Their Informal Caregivers

This paper examines changes in life satisfaction among participants of Adult Day Care (ADC) in Manitoba, Canada, and their informal caregivers (where applicable). ADC participants (N = 112) and their informal caregivers (N = 34) were interviewed at two points in time. Data analyses reveal that, during attendance at the program, the life satisfaction of both the participant and the informal caregiver tend to improve. Attempts to predict which participants are most likely to improve, remain stable, or deteriorate in life satisfaction were largely unsuccessful. A smaller group of participants in Winnipeg programs were matched on age, sex, functional disability and illness with two control groups. Analyses reveal improvements in life satisfaction among ADC participants appear to be program effects.     

Managing the Family: Productivity, Scheduling and the Male Veto

This paper argues that research, analysis and policy innovations focused on how households combine paid work with care responsibilities are driven to too great a degree by preconceptions of “the problem” that do not take sufficient account of how families themselves understand their work and care roles and the choices they are making. The evidence of 246 SOCCARE interviews across five European countries (Finland, France, Italy, Portugal and the UK) is that the variables that are conventionally accepted as having fundamental significance (family‐friendly policies and generous care services, flexible working hours, women's work–life preferences, family type, national labour markets, cultural differences) are less important than is often suggested. More important are time pressures and the idiosyncratic factors that constrain the work and care timetables that families are able to construct. We characterize these as “scheduling problems”. They occupied a large part of the accounts of their lives provided by our respondents and are a primary dimension within which their combinations of paid work and care responsibilities need to be understood. The difficulties our respondents faced in coordinating the work and care activities of their families bear a striking similarity to the problems described in the operations research literature on small businesses. Within the context of these scheduling problems a second important factor emerged: the preferences and behaviour of men who played a critical, though often passive, part in the construction of work and care timetables of the families. We characterize this effect as the “the male veto”.     

Welfare Attitudes of Singaporeans – Ambiguity in Shifting Socio‐political Dynamics

This article presents findings from a survey of 440 Singaporeans on their attitudes towards welfare and welfare recipients. Attitudes were generally favourable, but sentiments towards higher taxes to help the poor were ambivalent. Controlled for demographic characteristics, ‘poverty sympathizers’ and affiliates of opposition political parties held the most liberal views, but were not more willing to pay higher taxes. Instead, poor respondents on the one hand and highly educated respondents on the other hand were more willing to pay higher taxes. Knowledge accumulation and beliefs about causes of poverty were strong predictors of attitudes. Effects of personal values and self‐interest were less evident. Couched against the backdrop of an economy that has experienced rapid transformation and one of the widest income inequality in the developed world, the article discusses the critical juncture of social response and policy choices that Singapore finds itself.     

Factors Associated With Productive Engagement Among Older South Koreans

ABSTRACT

 Although positive relationships among health, types of activities, and productive aging have been documented in Western industrial nations, little attention has been paid to rapidly developing countries. This study examined unique factors using national South Korean data. Community-dwelling adults aged 55 years and older (n = 6,688) were drawn from Wave II of the Korean Longitudinal Study on Aging. Binary logistic regression analysis was conducted to identify the main and interaction effects related to labor force participation (LFP) and lifelong-learning participation (LLP). Whereas one third (34.4%) of the respondents were involved in LFP, LLP was extremely low (6.8%). Health and socioeconomic status were significant in conducting LFP and LLP. Depression and cognition contributed to LFP but not LLP. Older men who reported higher levels of depression were less likely to engage in LLP than were their female peers. For female respondents, the social activities of exercise and alumni meetings contributed to the likelihood of LLP. Given the lower socioeconomic characteristics and low participation in lifelong learning, it is essential to establish financial incentives to encourage activity participation and develop programs to promote productive aging in South Korea. Future studies should consider the impact of environments and social policy on productive engagement.