Gender-based health interventions in the United States: An overview of the coalition for healthier community initiative

Health disparities by gender constitute an important yet often overlooked aspect of health around the globe. Within the United States, there is both a paucity of research as well as planned programs that take into account how socio-cultural roles and expectations for men and women may differentially affect symptoms, access to care, and treatment. Viewing women's health exclusively as a function of sex (i.e., biological) differences represents a narrow understanding that does not fully explain gaps in health disparities between men and women. In September 2010, the U.S. Department of Health and Human Services (DHHS) launched a national initiative entitled the Coalition for a Healthier Community (CHC) to employ a gender-based framework in several urban, suburban and rural communities across the nation. The Office on Women's Health (OWH) within the DHHS funded 10 coalitions to ultimately improve the health of women and girls utilizing a gender-based approach. This article provides an overview of the initiative and the focus of the special issue.     

An empirical critique of the Lucas critique

This study provides a quantitative review of the empirical literature on the Lucas critique. Although there is great dissonance concerning the Lucas critique, our meta-analysis revealed how the apparent applicability of the Lucas critique may be attributed to misspecification and the manner in which expectations are treated. When models with questionable specification are discounted, empirical support for the Lucas critique vanishes.     

Federal legislative support for independent living

This article details the federal legislative background, development, and outlook, and current activities by the states, in relation to establishing services to help adolescents in foster care prepare for independent living. The authors also specify directions that future legislation should take to expand assistance.     

Trends and needs in programming for independent living

This report, from a national survey, pictures what presently exists on this important part of the foster care continuum, and sets forth the specifics of policy and practice that should characterize preparation for independent living.     

New legal options to prepare adolescents for independent living

New legal alternatives are needed to assist older adolescents living apart from their families to make the gradual transition to self-sufficiency. At present, there are only two legal alternatives for such adolescents in most states: agency legal custody (foster family or group care) and emancipation. Two new alternatives are needed to allow mature young persons to practice limited independence and to receive some continued aid and supervision from child welfare agencies: independent-living arrangements and special programs for young adults formerly in agency custody.     

The current status and future of centers for independent living in Korea

In Korea the independent living movement has made great strides since the late 1990s. This paper describes the current status and future directions of Centers for Independent Living (CIL) in Korea. This paper discusses the following. First, the demographic and historical perspectives of disabilities are described for context. Second, the disability movement and the independent living movement are described. The current status and operations of CIL are then explored in detail. Finally, the current issues and future directions of CIL are discussed. To facilitate independence among disabled people several critical tasks must be addressed: the establishment of relevant laws, the development of various funding sources, unification of the two associations for CIL, the development of the capacity of CIL staff and the establishment of an international network for sharing information and experiences. Achieving the goals listed above will advance the Korean independent living movement and, therefore, the international independent living movement.     

Ready or not: assessing youths' preparedness for independent living

This article discusses the utility of the Ansell-Casey Life Skills Assessment (ACLSA) in assessing life skills necessary for living successfully in the community upon emancipation from out-of-home care. ACLSA, completed by youths and their caregivers, identifies skills that have been mastered and those yet to be learned. Assessment information can be used for goal setting, strength identification, and relationship building, as well as to direct program planning and training in self-sufficiency services.     

Readiness for independent living of adolescents in youth villages in Israel

Most Israeli children who spend their youth away from their birth parents live in youth villages. The majority of these children come from either the geographical or social periphery of Israel. Since the 1990s the youth villages have specialized in absorbing immigrants mainly from the former Soviet Union (FSU) and Ethiopia. The paper reports on a survey conducted among the professional staff in the youth villages. This study explores their perceptions of the readiness for independent living of adolescents on the verge of leaving youth villages and examines how readiness is associated with individual and familial characteristics. A structured questionnaire was mailed to youth villages asking professionals to anonymously complete the survey. The total sample include reports on 1256 adolescents who spent in the current setting on average 3.3 (SD = 1.8) years. For many of them this was the first out-of-home placement. Generally, workers have a favorable assessment of the youths' readiness for independent living. Still, they report that many of the youths do not have any of the necessary skills for independent living. Additionally, there are sub-groups that are more disadvantaged and at greater risk because they lack skills for a successful transition from care. The findings indicate that youth of Ethiopian origin are more disadvantaged with regard to skills related to school, the job market, finances, interpersonal relationships and normative behaviors, whereas youths from FSU present fewer skills pertaining to military service. The findings emphasize the important role Israeli youth villages have in supporting underprivileged adolescents in acquiring basic skills for adult life and suggest guidelines as to which sub-groups and in which area programs should be developed.     

Understanding the complex negotiations in fulfilling the right to independent living for disabled people

The independent living agenda has become dominated by a rights focus that has helped drive national-level shifts in setting norms and changing mind-sets. This paper is concerned with examining how rights are utilised by service providers in the process of facilitating independent living. Drawing on an empirical study of providers in Ireland, the paper identifies the strategies being used to put rights into practice. The findings show that in the process of creating a well-managed support arrangement for each individual, providers often take a delicate approach to using rights, and sometimes dilute their guiding principles when engaging in ongoing complex negotiations between individuals, families, staff and volunteers. The disabled people's movement can contribute to the shared learning required in enabling managers handle this process better, rather than solely rely on an abstract call for rights.     

The crisis of local authority funding and its implications for independent living for disabled people in the United Kingdom

The recent financial collapse of Northamptonshire County Council sets a worrying precedent for local authorities in the United Kingdom, and in particular for disabled people who depend on services provided by local authorities, such as Direct Payments for personal assistance, for their daily living needs. While the Northamptonshire situation has been blamed on financial incompetence, we argue that it has deeper roots in austerity policies implemented by Conservative-led governments since 2010 on a national level. We also argue that the placement of responsibility for funding personal assistance services in the hands of local authorities creates a deeply unjust ‘postcode lottery’ for disabled people, and we call for a national right to all services necessary for independent living, regardless of cost.     

Social support, disability and independent living of elderly persons in the United States

This article examines the effects of the availability of kin and disability on the ability of elderly persons to live alone in the United States. The first part of the article uses a sample of women aged 65 and over from the 1980 census to study the factors associated with both living in group housing and living alone. Disability and absence of a spouse or children are strongly associated with living in group housing, whereas lack of disability and lack of children are associated with living alone. In the second part, data from the Supplement on Aging to the 1984 National Health Interview Survey are used to investigate the source and amount of help received among those with difficulties in performing Activities of Daily Living (ADLs) or Instrumental Activities of Daily Living (IADLs). Those living alone or with nonrelatives are most likely to rely on paid help and this is more likely if they have few living children.     

Youth aging out of residential care in Israel: Readiness for independent living and need for help

Youth leaving state care are a vulnerable group. It is important to examine their status and needs before they leave care, so that policies and practices are designed to address their needs. The aim of this study is to assess readiness for independent living of youth on the verge of leaving residential care in Israel, and to identify the life domains in which they need further help. Further, the study examines personal and interpersonal resources that may predict levels of readiness and needs before leaving care.     

Transition strategies for youths with sensory impairments: Educational,vocational and independent living considerations

Students with sensory impairments comprise a heterogeneous group that is often underserved by rehabilitation and other social services. This underserved status has been attributed to poor interagency collaboration and eligibility issues, the low incidence nature of these disabilities, and the shortage of trained professionals to address the specialized needs of these individuals. This article examines important educational and vocational characteristics of this population to assist rehabilitation professionals in supporting more effective transitions into employment and other adult roles. Specific transition considerations include unique learning challenges, assessment issues, assistive technology, and accommodations. The article concludes with strategies for transition planning, community integration, and evaluating transition outcomes.     

Tracking residential outcomes of supported independent living programs for persons with serious mental illness

This study seeks to document patterns and reasons of leaving housing, and identify factors associated with different types of exits for a cohort of 452 residents with serious mental illness entering supported independent living (SIL) in Philadelphia, PA. The study cohort was tracked through an integrated administrative database comprised information on basic demographic and clinical characteristics, length of stay, homeless shelter use, and publicly funded behavioral health services use. A convenience sample of 46 SIL leavers and their support staff provided data on scenarios of leaving. The findings of this study suggest that departure from SIL is not a unitary phenomenon, but involving plausibly favorable as well as unfavorable circumstances. Multivariate analysis based on administrative tracking data suggests demographic and clinical factors, housing setting, and service use factors to have effects on leaving SIL and distinct types of exit examined in this study. Data procured from the convenience sample highlight the potential roles that program rules and resident–staff relationships play in affecting housing tenure. Implications of the findings for the development of permanent supportive housing for persons with serious mental illness are discussed.     

An overview of the principles of clinical psychopharmacotherapy

The complexities of psychopharmacotherapy can be simplified through a careful consideration of certain fundamental guiding principles. While each patient is truly a unique individual, the general biological, psychosocial, and education issues reviewed above can provide a framework which can then be modified to meet the particular needs of a given patient.     

State commitment to home and community-based services: effects on independent living for older unmarried women

This study examines the impact of state variation in commitment to the provision of home and community-based services on the living arrangement outcomes of older unmarried females with functionallimitations. We combine data from the 1990 U.S. Census of Population (PUMS) with state-level information on long-term care home and community- based service expenditures, nursing home bed availability, and Medicaid nursing home costs from a special report that compares state variation in long-term care systems. Using multilevel logistic regression modeling techniques, we find that the risk of institutionalization compared to community living arrangements is reduced as spending for home and community-based services at the state level increases. We discuss these findings in light of policy changes during the 1990s.