Commitment of Private and Public Agency Workers to Child Welfare: How Long Do They Plan to Stay?

ABSTRACT

Method: Child welfare professionals completing training to work in foster care were asked about reasons for taking their child welfare position, commitment to their agencies, and commitment to child welfare. Analyses compared responses from new public agency foster care workers (N = 100), public agency workers making lateral transfers to foster care (N = 64), and new private foster care workers (N = 105).

Results: Private agency foster care workers were less committed to their agencies and to child welfare and more likely to have taken the position because it was the only one available.

Conclusions: The practice by public child welfare of outsourcing foster care services to private agencies needs to be evaluated. This practice may not benefit children in care and may create organizational problems for agencies.     

Gender Differences in Determinants of Self-Rated Health Among African American in Omaha Nebraska: A Church-Based Study

Abstract

This study assessed the gender differences in determinants of fair/poor self-rated health among African American churchgoers in Omaha, Nebraska. Using data collected from 353 African American (245 women and 108 men) by the Center for Reducing Health Disparities at the University of Nebraska Medical Center in 2017, univariate and multivariate logistic regressions were performed to examine the gender differences in the relationships between fair/poor self-rated health and potential health determinants. Overall, 14.3% of women and 17.6% of men reported fair/poor self-rated health. There was a significant association between depression and poor/fair self-rated health among women (p?=?0.044) and men (p?=?0.001). For women, the fully controlled model confirmed the crude association between perceived poor/fair self-rated health and heart disease (OR = 3.10) and education (OR = 2.19). For men, the final model identified significant determinants of perceived fair/poor self-rated health such as depression (OR = 12.51) and diabetes (OR = 3.89). When assessing gender differences in determinants of self-rated health, similarities are higher than differences between the two groups. In both groups, the presence of depression was the strongest determinant of poor health. Future research should assess the immunological aspects of the association between psychological factors and perceived chronic diseases.     

Why Did Poverty Become Less Geographically Concentrated in the 1990s?*

Objective. After increasing sharply in the 1970s and 1980s, the number of high‐poverty neighborhoods in the United States unexpectedly and dramatically declined in the 1990s. This article examines the roles that residential and income mobility played in this decline. Methods. Using geocoded data from the Panel Study of Income Dynamics, this study analyzes changes during the 1990s and early 2000s in: (1) patterns of residential mobility between high‐poverty and lower‐poverty neighborhoods; and (2) patterns of income mobility for residents who remained in high‐poverty neighborhoods. Results. Both patterns of residential and income mobility changed in the 1990s and early 2000s. While patterns of residential migration to high‐poverty neighborhoods were largely unchanged over this period, patterns of residential migration from high‐poverty neighborhoods changed significantly, with poor individuals—especially poor blacks—becoming more likely to relocate from high‐poverty to lower‐poverty neighborhoods. Patterns of income mobility for residents who remained in high‐poverty neighborhoods also changed significantly, with nonpoor residents becoming less likely to become poor and poor residents becoming more likely to exit poverty. Conclusion. Poverty rates in high‐poverty neighborhoods fell primarily because of the net upward income mobility of residents who remained in these neighborhoods.     

Microfinance Participation and Women's Decision-Making Power in the Household in Bangladesh

ABSTRACT

This study draws from bargaining theory to examine whether microfinance, a range of financial instruments such as micro-loans to support micro-enterprises, affects women's participation in household decision-making operationalized by whether women play a role in household decisions about large purchases, small purchases, going out to meet friends and family, and health care among a nationally representative sample of 6,150 women between the ages of 15 and 49 years in Bangladesh. Bargaining theory suggests that decision-making in households is conflictual but conflict can be mitigated through bargaining. Central to bargaining power of women is control over resources, assuming that household decision-making involves making economic decisions. Logistic regression analysis was used to test the interaction effect of microfinance and control over resources on decision-making power in the household utilizing the nationally representative Bangladesh Demographic and Health Survey 2011. Results revealed that microfinance participants with control over resources reported higher odds of decision-making power (OR = 4.3, p < 0.05) when compared to microfinance participants without control over resources (OR = 1.22, p < 0.05) but less than women who did not participate in microfinance but had control over resources (OR = 5.2; p < 0.05). In conclusion, control over resources play an important role in bargaining that increases odds of having decision-making power in the household, even for women who do not participate in microfinance. The study findings contribute to both social work practice and research on low-income populations as it allows an understanding of the importance financial access and financial know-how while it sheds light on how precarious women's lives can be as they navigate income-generating financial systems that interfere with gender norms, which may have negative consequences. These findings are particularly important for practitioners working in the area of women's empowerment who would do well to emphasize the need for building financial capability so that women are able to garner control over their own and familial resources, whether or not they participate in empowerment programs like microfinance, which in turn gives women voice and agency. Meanwhile, future researchers are well positioned to examine the kinds of specific skills that best predict increases in women's decision-making power in the household as well how gender dynamics play into the decision-making process.     

Using Private Social Care Services in Finland: Free or Forced Choices for Older People?

ABSTRACT

Use of private social care services among older people is increasing in Finland. This study aims to understand why older people choose private care in a comprehensive tax-subsidized social care system and examines whether people choose private service as a free choice or a forced choice as well as what factors contribute toward making these choices. Data for this study (N = 1,436) were gathered in 2010 from people aged 75 and above living independently at home in two Finnish cities: Tampere and Jyväskylä. Data were analyzed with several quantitative tests: chi-squared tests, multinomial regression analysis, and qualitative content analysis (for the open-ended responses from the survey questionnaire). Findings reveal that people chose private services mostly because of the effortlessness involved in its use and of the need for additional services that are unavailable through municipality; for example, cleaning. Majority of the respondents performed a free choice to use private services. People who lived in a city center with a higher level of income and who needed more services were more likely to be constrained toward using private support. Major concern, due to diminishing public service provision, is about service accessibility of economically disadvantaged groups; therefore, more research is required to understand the effects of the growing care market in Finland.     

Gaps in social protection for health care and long‐term care in Europe: Are the elderly faced with financial ruin?

While public expenditure on health care and long‐term care (LTC) has been monitored for many years in European countries, far less attention has been paid to the financial consequences for older people of private out‐of‐pocket (OOP) expenditure necessary to access such care. Employing representative cross‐sectional data on the elderly populations of 11 European countries in 2004 from the Survey of Health, Ageing and Retirement in Europe (SHARE), we find that OOP payments for health care and LTC are very common among the elderly across European countries and such expenditures impact significantly on disposable income: up to 95 per cent of the elderly make OOP payments for health care and 5 per cent for LTC, resulting in income reductions of between 5 and 10 per cent, respectively. Failure to prevent financial ruin, as a consequence of excessive OOP payments, is evident in 0.7 per cent of elderly households utilizing health care and 0.5 per cent of elderly households utilizing LTC. Those particularly concerned are the poor, women and the very old.     

The prevalence and composition of asset poverty in Canada: 1999, 2005, and 2012

A household is considered asset poor if its assets (financial assets or net worth, taken separately) are insufficient to maintain well‐being at a low‐income threshold for 3 months. We provide the first national‐level estimates of asset poverty for Canada, using the 1999, 2005, and 2012 cycles of the Survey of Financial Security, and juxtapose these estimates with income poverty. The analysis provides new insight into economic insecurity by showing that asset poverty rates are consistently two to three times higher than income poverty rates. In addition to the prevalence of asset poverty across socio‐demographic groups, we analyzed how the composition of the poor change over time. Age and geography shape the risk for asset poverty in distinct ways. We found that while education appears to play a comparable role in shaping both income poverty and asset poverty, immigration places Canadians at a relatively higher risk of income poverty but not asset poverty. Key Practitioner Message: ? Practitioners ought to consider assets as well as income in assessing economic vulnerability; ? Asset poverty levels are 2–3 times higher than income poverty levels; ? Certain groups (e.g., immigrants) may be income poor but maintain sufficient assets.     

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.     

Health Policy in the Asian NIEs

This paper compares the health policies of Hong Kong, South Korea, Singapore and Taiwan with the purpose of drawing policy lessons. The study finds two distinct policy clusters: Hong Kong and Singapore on the one hand, and Korea and Taiwan on the other. With respect to provision of health care, the former rely largely on public hospitals for delivering inpatient care while the latter rely on private hospitals. In matters of financing, they are similar in that out‐of‐pocket is a major source of financing in all four countries. However, they are also different because Korea and Taiwan have universal health insurance while the city states do not. The study concludes that public provision of hospital care, as in Hong Kong and Singapore, yields more favourable outcomes than many mainstream economists would have us believe. Conversely, private provision in combination with social insurance, as found in Korea and Taiwan, severely undermines efforts to contain health care costs.     

Validation of multidimensional scale of perceived social support in middle-aged Korean women with diabetes

Purpose: The purpose of this study was to validate the Multidimensional Scale of Perceived Social Support (MSPSS) among middle-aged Korean women with type 2 diabetes. Methods: Data were collected from 123 middle-aged Korean women with diabetes. Construct and concurrent validity were examined using factor analysis. Results: Factor analysis extracted three factors: spouse, family, and friends. The MSPSS had relatively good concurrent validity (r = .66, p < .0001), construct validity, and strong reliability (Cronbach's alpha = .90). Conclusion: We concluded that the MSPSS is a simple and well-established instrument to measure social support in middle-aged Korean women with diabetes.     

The Choice Revolution: Privatization of Swedish Welfare Services in the 1990s

During the 1990s, the Swedish welfare state was declared by some to be in a “crisis”, due to both financial strain and loss of political support. Others have argued that the spending cuts and reforms undertaken during this period did slow down the previous increase in social spending, but left the system basically intact. The main argument put forward in this article is that the Swedish welfare state has been and is still undergoing a transforming process whereby it risks losing one of its main characteristics, namely the belief in and institutional support for social egalitarianism. During the 1990s, the public welfare service sector opened up to competing private actors. As a result, the share of private provision grew, both within the health‐care and primary education systems as well as within social service provision. This resulted in a socially segregating dynamic, prompted by the introduction of “consumer choice”. As will be shown in the article, the gradual privatization and market‐orientation of the welfare services undermine previous Swedish notions of a “people's home”, where uniform, high‐quality services are provided by the state to all citizens, regardless of income, social background or cultural orientation.     

Comparing income poverty gap and deprivation on social acceptance: A mediation model with interpersonal communication and social support

In many developed countries or regions, wide income disparities increase the difficulty in reducing poverty. In their day‐to‐day lives, poor people often feel less accepted by the society. The failures in communicating with social groups and receiving social support lead to negative consequences on individual well‐being and higher level of social exclusion. Based on the debate upon alternative approaches to conceptualizing and operationalizing poverty, this study attempts to verify a mediation model with data from a household survey (N = 1,202) in Hong Kong. The results of structural equation modelling reveal that deprivation is a more powerful indicator than income poverty for specifying the negative relations of poverty with interpersonal communication, social support, and social acceptance; the negative impact of deprivation on social acceptance can be reduced by two significant mediators of interpersonal communication and social support. The results are discussed in terms of directions for future research and policy and welfare intervention.     

Fostering educational prosperity: A randomized controlled trial of home tutoring in foster care

The educational gap between children in out-of-home care and their non-placed peers is well-documented. However, tutoring stands out as a promising intervention to raise children's educational attainment in out-of-home care. This study randomized 105 children in foster care (62% girls, aged 7–15 years [M = 10.3, SD = 2.0]) to the home tutoring program Foster Caregivers as Tutors (FCT) or regular public school services (treatment as usual [TAU]). In the FCT group, the foster caregivers tutored the children for 2.5 h/week for 40 weeks. The program effect is measured in learning and developmental outcomes, including reading and math ability, learning skills, IQ, executive function, and psychosocial function. Follow-up was 17.5 months after baseline. The results show a significant effect over time in both groups on IQ (effect size [ES] = 0.40, P < 0.001), verbal comprehension (ES = 0.29 P = 0.02) and perceptual reasoning (ES = 0.60, P < 0.001) measured by WISC IV. Neither the FCT nor TAU provided any significant academic recovery in reading and math nor progression in executive function, learning skills or psychosocial function. These findings, implications for practice and future efforts to support the schooling of children in out-of-home care are discussed.     

Protective legislation: The “third pillar” of the welfare state

Welfare states are built upon three central social policy pillars: (1) income programs, including an assortment of income maintenance and security benefits; (2) social services, comprising a diverse constellation of provisions, which furnish care such as health care and education, and “in kind” benefits; and (3) protective legislation, encompassing a dense web of proactive and preventative laws, rights, and entitlements, such as health and safety legislation, minimum wage laws, child protection acts, rent controls, and laws governing evictions and foreclosures. Despite its centrality to the welfare state and to our well‐being, this third pillar has received considerably less attention in comparative social policy research. The dominant welfare state typologies have focused almost exclusively upon income measures and, more recently, on social services, to construct their welfare state categories or “worlds” of welfare while largely neglecting this crucial third pillar. A greater focus on protective welfare legislation can help sharpen the distinctions among welfare states within and across the welfare worlds, which is particularly valuable in light of the ongoing erosion of the other two pillars over the past few decades.     

The education of children in care and children in need: Who falls behind and when?

We seek to explain the development of the educational gap between children in “out‐of‐home care” (CLA), children deemed in social need (CIN), and other pupils. A cohort of 642,805 pupils aged 16 in 2013 was used to chart the educational progress of the full cohort, the CLA (n = 6,236), the CIN in 2012 or 2013 but not CLA (n = 20,384), and a sample individually matched with the CLA (n = 11,084). At age 7, attainment of the CLA and CIN was approximately 1 standard deviation lower than the cohort average and predicted attainment at 16. At this point, the persistent “CIN” (those with earlier and persistent needs) had the lowest attainment relative to others, and this declined further during secondary school. Those entering care before or during primary school had very low attainment at age 7, but their relative attainment did not decline. Attainment of CLA and CIN at age 16 likely reflects early environment, special educational needs, and poor relationships with secondary school. Policy, research, and intervention should focus on CIN as well as CLA, do so before entry to care, and take account of the onset of, and probable reasons for, educational difficulties.     

Laws and policies to support the wellbeing of children: an international comparative analysis

Nicklett EJ, Perron BE. Laws and policies to support the wellbeing of children: an international comparative analysis Int J Soc Welfare 2010: 3–7 © 2009 The Author(s), Journal compilation © 2009 Blackwell Publishing Ltd and the International Journal of Social Welfare. The international community has raised concerns regarding the extent to which countries have implemented laws and policies to support the rights and wellbeing of children. This study evaluates the progress of least‐developed countries (LDCs) and middle‐income countries (MICs) in developing such legislation. Surveys were sent to 131 UNICEF country offices. Items included efforts to promote family preservation and family ties, family‐based care over institutionalization, and child participation in placement decisions. A total of 68 surveys were returned, reflecting a 52 percent response rate (LDC, n= 25; MIC, n= 43). Legislation that addressed abuse and neglect of children, maternity leave, removal of children from the family, family care, adoption, and guardianship was widespread. Chi‐square tests indicated that MICs had a substantially higher number of laws and policies related to child allowances, school feeding programs, maternity leave, and day care.     

Cash-Flow and Savings Practices of Low-Income Households: Evidence From a Follow-Up Study of IDA Participants

ABSTRACT

Understanding how low-income households manage their finances is critical to designing effective antipoverty interventions. This study used data from a 2008 follow-up survey of 326 low-income households in Hawaii who participated in an Individual Development Account (IDA) intervention from 1999 to 2005. Self-reported cash flow (five items) and savings (four items) practices were explored using latent class analysis. Three latent classes were produced: Class 3 managed cash flows and saved (n = 166; 51%); Class 2 managed cash flows but did not save (n = 73; 22%); and Class 1 struggled to manage cash flows and save (n = 89; 27%). Using ordinal regression, psychological sense of mastery was positively and significantly (p < .01) related to being in a higher class membership (b = .14; OR = 1.15). IDA participation had no association with latent classification. The key finding is the heterogeneity among low-income financial management practices and the importance of providing individualized services. Future longitudinal research is needed to understand how IDA participation affects financial practices in the short term and long term.     

The effects of income transfers on poverty reduction in people with disabilities in South Korea

Using a nationally representative sample dataset from the 2016 Korean Welfare Panel Study, we examined the anti‐poverty effects of income transfers in people with disabilities. Our findings indicate that in households with a person with a disability, income transfers decreased by 55.9% and 84.8% of the pre‐transfer poverty rate and poverty gap, respectively. Before income transfers, households with a person with a disability were 1.94 times more likely to be poor compared to those without a person with a disability. When income transfers were offered, the chance of being poor in the disability group was only 1.11 times higher than that in the non‐disability group. Findings from the aggregated data suggest that means‐tested income transfers were more effective in reducing poverty levels than social insurance or private income transfers. At the individual level, the provision of means‐tested programs was also more likely to decrease the likelihood of experiencing poverty than social insurance and private income transfers.     

The Effects of South Korean Social Workers' Professional Resources on their Understanding of a Patient's Right to End‐of‐Life Care Decisions in Long‐term Care Facilities

The aims of this study were to examine South Korean social workers' understanding of a patient's right to end‐of‐life care decisions (EOLCD) in long‐term care facilities and to explore the effectiveness of their professional resources in their understanding of this issue. A survey was conducted of 297 social workers from multiple long‐term care facilities in South Korea using structured questionnaires and face‐to‐face interviews. A multiple regression model was used, controlling for gender and religion. The participants' professional resources were measured by years of work, license type, number of beds, knowledge of advanced directives, experience in the EOLCD process, and training. The results demonstrated that South Korean social workers' understanding of a patient's right to EOLCD was moderate (mean 3.46), and their general (β = 0.576, P < 0.001) and medical knowledge (β = 0.117, P < 0.001) of advance directives, experience in the EOLCD process (β = 0.222, P < 0.001), and training (β = 0.028, P < 0.001) positively and significantly increased their understanding of patient rights (R² = 0.449, P < 0.001). The findings suggested that the development of academically supported and legally enforced standards and regulations for an EOLCD practice manual for long‐term‐care social workers would be beneficial.     

Material hardship and depression among low‐income households in South Korea: Differences by household type

With the recent trend of growing poverty in South Korea, low‐income households, particularly elderly‐ and single‐headed households, are at high risk of experiencing material hardship and depression. However, less is known about the association between material hardship and depression by household type in Korea. Using data (N = 2,913) from the Korean Welfare Panel Study and employing several methodological approaches to address the omitted variables bias, this study examined: (i) the association between material hardship and depression among low‐income households, and (ii) whether the association differed by household type. We found that experiencing material hardship was associated with a higher likelihood of being depressed. In addition, we also found that the association between material hardship and depression differed by household type. The magnitude of the association was most pronounced in single‐ and elderly‐headed households. Policy implications to improve well‐being among low‐income households were discussed.