Theorizing Inequality: Comparative Policy Regimes,Gender, and Everyday Lives

Sociological explanations of inequality are incomplete unless they fully recognize the importance of social policy regimes, the policy logics embedded within them, and how policy arrangements work to stratify and shape daily lives. In this address, I develop my arguments by examining two overlapping struggles of everyday life in the contemporary United States: balancing work and family on the one hand, and securing health‐care services, both formal medical care and informal family care, on the other. Both struggles involve care deficits that are significantly more serious in the United States than in other high‐income countries, in part because our policy regime contributes to rather than counters the gendered roots of work–family conflict. Comparative studies hold a key to better understanding the link between policy regimes and everyday lives, as illustrated by the author's own comparative research in Finland and in the United States In terms of policies and policy logics that promote gender equity, paid parental leave for fathers has received much recent attention from social science scholars. Sociologists are challenged to become aware of comparative social policy scholarship and to approach inequalities and the related daily conflicts and struggles—such as over care deficits—by including this work in their analyses.     

Explaining the United States’ Penal Exceptionalism: Political,Economic, and Social Factors

In this review, I examine explanations for why the United States is a world leader in its use of imprisonment. I first outline cross‐national trends in incarceration and then evaluate the state of the literature and empirical evidence for why the United States is more punitive than other advanced industrialized nations. I argue a confluence of political, economic, and social factors distinct to the United States context are implicated in the punitive turn in the 1970s. Specifically, United States’ penal exceptionalism is the result of (1) a shift of criminal justice policy from the judicial to the legislative branch of government; (2) political responses to social and economic changes including deindustrialization and the upheaval of race relations in the 1960s; and (3) a weak welfare state. These changes stand in stark contrast to the dynamics of criminal justice policymaking among comparable nations. However, there is a need for more comparative research on the topic, as understanding the mechanism behind the stabilization or decrease of penal populations in other countries may better elucidate the reasons for America’s divergence from international trends.     

The transition from state care to adulthood: international examples of best practices

Around the world, the transition from adulthood is a difficult time for many youth. It is even more difficult for those who are transitioning to adulthood without the benefit of a support network full of family and friends. Youth leaving state care face a transition to independence and adulthood without many of the skills and supports most others take for granted. Preparedness is key to a successful transition, and youth leaving state care tend to be lacking it. In order for youth to truly be prepared for the transition process, they must have support in key areas of their lives: relationships, education, housing, life skills, identity, youth engagement, emotional healing, and adequate financial support. Without these supports, the dismal outcomes for youth transitioning to adulthood will remain unchanged. The United States, England, and Australia have successful programs targeting youth as they transition out of state care. These initiatives bring together and address the variety of needs of this unique population and aim to improve outcomes. While many of these programs and policies are in their infancy, they show promising results, and each contributes valuable experience to successfully working with youth through this tough transition.     

Young people and social action: youth participation in the United Kingdom and United States

This chapter provides two case studies of projects in the United Kingdom and United States using a social action approach to encourage youth participation and civic engagement. The authors provide a snapshot of U.K. and U.S. policy related to inclusionary practice in youth development work, along with testimony from youth participating in the two community development initiatives. As part of the positive youth development approach, youth inclusion is seen as a key to policy, programs, planning, and practice with young people. Educators, researchers, and practitioners using participatory methodologies have continued to move the youth development field forward. Social action provides a theory and practice that enhances community building, social cohesion, and positive youth development.     

Health care for older persons in Singapore: integrating state and community provisions with individual support

Health care policy in Singapore is similar to that in the United States and the United Kingdom, where a residualist strategy is used to pass health care costs to individuals and their families, the rationale being that this enables the state to concentrate on devolution of care to the community and ensure efficient and affordable service to all Singaporeans. The services include public restructured hospitals and outpatient poly-clinics as well as community services such as community hospitals and hospitals for the chronically ill, nursing homes, day care centers, and home help services. Availability does not translate into optimum usage because current and potential users and their families are not able to match their financial and social resources with the services. Instead, the state acts as the case manager and places parameters on what individuals can access.     

Health Care for Older Persons in Singapore

Abstract

Health care policy in Singapore is similar to that in the United States and the United Kingdom, where a residualist strategy is used to pass health care costs to individuals and their families, the rationale being that this enables the state to concentrate on devolution of care to the community and ensure efficient and affordable service to all Singaporeans. The services include public restructured hospitals and outpatient poly-clinics as well as community services such as community hospitals and hospitals for the chronically ill, nursing homes, day care centers, and home help services. Availability does not translate into optimum usage because current and potential users and their families are not able to match their financial and social resources with the services. Instead, the state acts as the case manager and places parameters on what individuals can access.     

Adapting dating violence prevention to francophone Switzerland: a story of intra-western cultural differences

Dating violence prevention programs, which originated in the United States, are beginning to be implemented elsewhere. This article presents the first adaptation of a violence prevention program for a European culture, Francophone Switzerland. A U.S. dating violence prevention program, Safe Dates (Foshee & Langwick, 1994), was reviewed in 19 youth and 4 professional focus groups. The most fundamental program concepts--"dating" and "violence"--are not the same in Switzerland and the United States. Swiss youth were not very focused on establishing monogamous romantic relationships, and there is no ready translation for "dating." Violence has not become the focus of a social movement in Switzerland to the same extent that it has in the United States, and distinctions among terms such as "dating violence" and "domestic violence" are not well known. Psychoeducational approaches are also less common in the Swiss context. As the movement to prevent violence extends worldwide, these issues need greater consideration.     

Caring for Persons with Serious Mental Illness

Abstract

This article places evidenced-based knowledge of practice within the social context of care and proposes five policy objectives and specific policy and program changes to address care needs of people with serious mental illness. In spite of demonstration programs that provide the basis for proposed policy initiatives throughout the United States, treatment provision for this population remains inadequate and their safety and well-being continues to be at risk. The authors suggest that treatment initiatives need to be tied to stable policies protecting the mentally ill from adverse social context changes. The authors conclude that policies are needed that will enhance housing assistance, independent social functioning, personal empowerment, and treatment engagement. In addition, efforts are needed to make better use of inpatient hospital care, to better understand the role of assisted treatment, and to better develop consistent long-term fiscal support for the seriously mentally ill. They offer specific policy recommendations for changes in HUD programs, Medicaid and Medicare funding, and treatment programming that address these needs.     

Transitioning youth: Policies and outcomes

The primary policies and outcome studies regarding youth transitioning from foster care and young adults who have aged out of foster care over the past quarter of a century are reviewed. Although several policies have increased services and funding for this population, overall, their outcomes have not significantly improved. In terms of educational achievement, employment, and well-being, many continue to fare poorly in young adulthood. Further policies and practice improvements may need to be implemented. The population of youth transitioning has far outpaced the funding available, state and program eligibility requirements may be eliminating the most vulnerable from services, in many states there is an inadequate provision of basic needs such as housing and healthcare, the expectations of self-sufficiency for this population now exceed societal norms, and the restrictions and placement instability associated with many older adolescents in care may be in contrast to their developmental needs. In order to more fully address the needs of youth transitioning from foster care, child welfare policies and practices may need to focus more attention on the relational and social development of youth while in foster care. Furthermore, during young adulthood, policies and practices may need to provide greater safety nets and resources to this population.     

Independent living services,adjudication status,and the social exclusion of foster youth aging out of care in the United States

Recent policy changes have increased the availability of independent living services (ILS) to foster youth aging out of care in the United States. Yet, it is possible that youth who are also involved in the juvenile justice system may have trouble accessing these services. This study uses a social exclusion framework to examine associations between independent living service receipt, adjudication status, and early adult outcomes for youth aging out of the U.S. foster care system. Outcomes and ILS receipt data for 7412 older youth from the National Youth in Transition Database (NYTD) were used for this study. Chi-square tests and logistic regression models were used to explore the relationships among adjudication status, ILS, social exclusion, and social connectedness at age 19. Findings indicated that postsecondary education support and education financial services at baseline were related to a higher likelihood of being socially connected and lower likelihood of being socially excluded at age 19. Being an adjudicated delinquent and receiving special education and career services were related to a lower likelihood of being socially connected. This suggests that ILS are well-suited for youth already doing well, but may not do enough for those who struggle the most during this period.     

Voices of former foster youth: Supportive relationships in the transition to adulthood

As the adolescent development literature has recognized the importance of social supports in the transition to adulthood, child welfare research, policies, and programs have turned their attention to the relational needs of youth emancipating from the foster care system. This study builds on the extant literature on social support among transitioning foster care youth; it goes beyond the sole identification of relational networks, to explore how youth actually utilize their network members, and the overall quality of their support system. This study collects data from twenty qualitative interviews with foster youth, ages 18–21. We analyze the data using consensual qualitative research methods in order to develop core themes around shared youth experiences. We found that while foster youth did identify a wide network of both formal and informal supports during their transition to adulthood, there were “holes” in the form of support, especially appraisal and instrumental support, provided by informal network members. Additionally, an unrealistic perception of supportive and permanent relationships may be contributing to poor outcomes in emerging adulthood. Implications for policy and practice are discussed.     

Coordinating co-production in complex network settings

This article draws together the concepts of network management and co-production with complexity sciences. So far, these approaches have rarely been connected in research literature. We suggest that this conceptual framework offers new insights for analyzing the challenges of co-production in complex network settings in the local public services. The aim of the article is to find out how complex network structures meet the co-production process in the context of social and health care services. The empirical part of the article presents a Finnish case study of a multiprofessional service network producing social and health care services for youth. Here, the clients, in this case children and young people with a need for social services, often need multiple services from different service providers simultaneously. Our research findings suggest that the outcomes of the service process are not only dependent on the client's needs, but rather on organizational and professional interests. Our research gives new insights for the discussion on co-production; when it is applied as an intended policy to improve and deliver public services, the complexity of interaction among the street-level workers and the detached professional frameworks should be kept in mind.     

Individualization and Prevention

SUMMARY

In 1905, Massachusetts General Hospital initiated the first medical social work program in the United States. Based on the writings of its leaders, this paper presents the early history of medical social work in the United States. Inspired by developments in European health care that emphasized the community context of disease, medical social work pioneers saw a need to individualize the patient while also promoting public health measures in the community, improving the patient's environment to eliminate the causes of disease. In addition, since they served patients because of their diseases rather than their poverty, medical social workers were among the first to provide social work services to the non-poor. In spite of their emphasis on environmental change, many of early medical social work leaders had an anti-institutional bias; they were suspicious of large-scale solutions for what they saw as fundamentally individual problems. Consequently, methods for promoting individual adaptation developed more rapidly than methods for promoting environmental change. Ironically, the medicalization of social problems in contemporary times has resulted in a focus on individual pathology rather than social and lifestyle causation in health, even as the rising cost and complexity of the system challenges health care consumers in the United States. Reaffirming the environmental emphasis of medical social work pioneers provides a way for today's health care social workers to incorporate environmental modification into their practice and promote the health of all citizens.     

Youth in Foster Care and Social Media: A Framework for Developing Privacy Guidelines

Although youth in foster care most likely use social media websites, there appears to be a lack of policy guidelines related to this use. When one considers youth in foster care, the state's mandate to provide safety, and foster parents' rights to exercise parenting responsibilities, the notion of privacy and the use of social media becomes complex. Critical Systems Heuristics will be introduced as a tool in developing policy recommendations. An application of this framework will be provided which can serve as a guide for an agency or workgroup tasked with developing policy guidelines for social media use by youth in foster care.     

Evaluation of a multi-site program designed to strengthen relational bonds for siblings separated by foster care

Sibling relationships in foster care settings have received increased attention in recent years. Despite growing evidence regarding the protective potential of sibling relationships for youth in care, some sibling groups continue to experience foster care related separation, and few programs exist to address the needs of these youth.This study describes and evaluates Camp To Belong, a multi-site program designed to provide short-term reunification to separated sibling groups through a week-long summer camp experience. Using a pre-test post-test survey design, this paper examines changes in youth ratings of sibling conflict and sibling support across camps located in six geographically distinct regions of the United States. The effects of youth age, number of prior camp exposures, and camp location were tested using multilevel modeling procedures.Findings suggest that participation in Camp To Belong may reduce sibling conflict, and improvements in sibling support are noted for youth who have had prior exposure to the camp’s programming. Camp-level variance in the sibling support outcome highlight the complex nature of relationships for siblings separated by foster care, and suggest the need for additional research. Lessons learned from this multi-site evaluation and future directions are discussed.     

Toward a Sociology of Knowledge of Land Surveys: The Influences of Societies and States

Although land surveys can be viewed as accomplishments of strong states, this paper shows that they are successful not because of state power, but because of two social factors, lay knowledge and the alignment of social interests. Land surveyance is a strategic research site because it is technologically and labor intensive, so it is difficult to complete. The paper uses historical methodologies of comparison and narrative to show that a national land survey was never completed in the case with the strong state, England/Great Britain/the United Kingdom, while such surveys were completed in the cases with the weak states, the United States and Italy. Where the surveys were completed, there was widespread social knowledge about them and support for surveyance.     

Measuring Social Return on Investment

Strategic decision making and evaluation in philanthropic giving and social investment requires good‐quality information about the social impacts of that investment. One way to meet this need is by calculating a social return on investment (SROI) measure, akin to the return on investment (ROI) approach used in business analysis. Despite much buzz in the field, SROI measurements are rarely used, in part because of the complexity of the calculations but also because of a number of thorny and often expensive organizational challenges associated with implementing an SROI process. This article explores these implementation challenges by comparing four social venture organizations in the health care field—two in the Netherlands and two in the United States—that have utilized some sort of SROI measurement. We summarize the SROI process and identify the specific organizational challenges in each case. Lessons learned from this analysis include the value of process versus product and the importance of fitting the type of measurement to the organizational context. We conclude with a summary of best practices for organizations and social investors who might try to make effective use of SROI measures.     

Certainty,Fairness, and Balance: State Resonance and Environmental Justice Policy Implementation1

Little research has examined how and why institutional context and framing dynamics shape the institutionalization of movement claims into the state’s formal policies, and what the implication of these processes might be for movements attempting to mobilize on the same conceptual terms after institutionalization. In this study, I explore the role institutional context and framing play in the institutionalization of movement claims in a case: the implementation of environmental justice policy in the California Environmental Protection Agency from 2002 to 2007. I ask: How and why were aspects of the environmental justice frame institutionalized into regulatory policy while others were not? I use ethnographic field methods and content analysis of archival data to answer this question and offer two contributions to previous research. First, I add to previous scholarship on the environmental justice movement by identifying the character of newer problems faced by movement actors as they engage in regulatory policy processes with opponents in the United States. Second, I extend social movement framing theory by developing the notion of “state resonance” to understand how and why a collective action frame is institutionalized and implemented in regulatory policy.     

Home is where the help is: community-based care in Denmark.

Policy regarding long-term care has been an issue of rising national concern. In this paper we examine the transition of Danish long-term care policy with special attention to Skaevinge, the first community in Denmark to integrate institutional and community-based services for the elderly. Recent studies on the variation between costs and services in Danish communities and the results of U.S. studies on community-based care suggest that successful implementation of integrated institutional and community-based long-term care is feasible in the United States. Lessons from Denmark highlight conditions that will facilitate success in this endeavor.     

Integrating creative art into a community-based mental health program for Asian American transition age youth

This paper advocates for the use of creative art as an adjunct in the delivery of mental health care for Asian American transition age youth in the United States. A case study of a participant in a community-based mental health program called Project FOCUS in Orange County, California details how art was used to assist a young woman to identify and achieve her personal goals, mitigate her emotional and behavioral problems, and reach a sense of overall well-being. The findings in this paper lay the groundwork for future research into how art can be systematically incorporated into community-based mental health programs to facilitate service utilization. Further, this study demonstrates that Asian American transition age youth face mental health challenges typical of their cohorts, despite being putative members of a “model minority.” The use of creative art transcends cultural and language barriers, and empowers Asian American transition age youth to explore their identity and express their emotions, which ultimately promotes their mental well-being.