Demographic and Welfare State Predictors of Out-of-Pocket Health Expenditures: A Path Analytic Model

ABSTRACT

Out-of-pocket (OOP) payments are principal components of financing healthcare and have a significant effect on poverty in numerous developing countries. The present study seeks to ascertain the relation among demographic, welfare state, and OOP health expenditure indicators using a path analysis. National representative household budget data from the Turkish Statistical Institute for 2015 were used. To test the goodness of fit of the model, multiple fit indices were utilized. The model fit for redefined path analytic model data was good (X²/df = 70.20/9 = 7.8; RMSEA = 0.032; GFI = 1.00; AGFI = 0.99; CFI = 0.99). The results of the analysis revealed that demographic and welfare indicators are causally related to OOP health expenditures, and income was a mediating factor for this interrelationship. Designing of socially inclusive policies on the basis of the values of equity is essential to combat poverty due to OOP health expenditures in developing countries.     

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.     

Support in the Workplace: Buffering the Deleterious Effects of Work–Family Conflict on Child Welfare Workers’ Well-Being and Job Burnout

ABSTRACT

We examined the impact of work–family conflict (WFC) on worker well-being and job burnout, as well as the role of social support in the workplace as a potential buffer against the influence of WFC. Results of hierarchical multiple regression analyses in a cross-sectional sample of 361 public child welfare workers indicate that WFC was related to reduced well-being and increased job burnout, whereas supervisory support moderated the relationship between WFC and well-being. Findings from this study hold implications to workforce management practices aimed at improving worker well-being in human service and child welfare organizations. Human resource management policies designed to manage worker schedules should aim to facilitate workers’ ability to meet work and family demands through programs such as flexible work schedules and telecommuting. Recommendations for future research on WFC and worker well-being are discussed.     

Evaluating social assistance reforms under programme heterogeneity and alternative measures of success

This article presents an assessment of welfare reforms under a framework of programme heterogeneity and alternative measures of success. The study focused on a specific programme – Madrid's Ingreso Madrileño de Integración (Madrid Regional Government's Welfare Programme) – which comprises heterogeneous sub‐programmes. We tested whether work‐related sub‐programmes performed better than general activities aimed at improving life skills by analysing the effects on different types of outcomes. We also tried to identify which work‐related sub‐programme worked best. Our results show that intensive employment activities yield remarkably better results than general work‐related schemes or life‐skills activities. However, increasing work participation does not automatically lift participants out of material hardship. Key Practitioner Message: ● Strategies to reduce the dependence of low‐income households on government support by improving employment opportunities; ● Evaluation of alternative work‐related sub‐programmes in welfare policies; ● New evidence on approaches that consider heterogeneous sub‐programmes and different types of outcomes might inform and partially shape the future public policy agenda in the welfare reform debate.     

Remittance volatility and financial sector development in sub-Saharan African countries

In this study we examine the relationship between remittances, remittance volatility and financial sector development in sub-Saharan Africa using a two-step system GMM estimator over the period 2002–2014. Separately focussing on banking sector- and stock market development, our study distinguishes between the effect of remittances and remittance volatility on financial sector depth and financial sector efficiency. The results indicate remittances act as a substitute for the formal banking system in sub-Saharan African countries. We further provide evidence that remittance volatility is detrimental to both banking sector depth and efficiency. No evidence is found that remittance volatility is related to stock market development. A policy implication from our study is that sub-Saharan African countries should have measures in place to monitor the predictability of remittances while the cost of remittance transfer needs to be investigated.     

An empirical analysis of monetary and multidimensional poverty: evidence from a household survey in Pakistan

ABSTRACT

The present study computes multidimensional poverty and compares it with unidimensional estimates of poverty for the district of Mandi Bahuddin in the Punjab province of Pakistan for the years 2010 and 2014. By employing the Foster, Greer and Thorbecke (FGT) and Alkire-Foster Methods, the incidence, severity and depth of unidimensional and multidimensionality poverty was estimated. We found an increase in absolute and relative poverty levels in 2014 as compared to 2010. The multidimensional poverty in terms of household assets has also increased over time. However, the relative proportion of educational and health poverty towards MPI remains higher, thereby calling for a holistic approach to identify multidimensional poverty in the social sector. A comprehensive policy dossier needs to be framed for designing effective poverty alleviation and social welfare programmes in the Punjab, Pakistan.     

Introduction: social policy and economic development in late industrializers

This Supplement in the International Journal of Social Welfare presents the main findings of a United Nations Research Institute for Social Development research project on social policy in late industrializers, covering countries in East Asia, Latin America, Middle East and North Africa (MENA), and sub-Saharan Africa, as well as the Nordic countries. One of the findings from the research is that social policy has been used as an integral part of economic development in successful late-industrializing countries. In the MENA region and sub-Saharan Africa, however, social policy was tried for too short a period to be properly implemented and tested. East Asian and Latin American countries started with a narrow-based social policy, but social policy in East Asia was extended to foster social solidarity, bringing people into the mainstream of social change. Such findings suggest that social policy is multifunctional, not only in terms of social protection but also economic development and democratic governance.     

The Impeachment Trial: Reflections on Group Process

ABSTRACT

The recent Impeachment Trial of President Clinton was of interest to social workers because the outcome might have some bearing on future social welfare policy initiatives and also due to the nature of the process itself. There was a striking difference between the partisan, rancorous debate in the House and the more collegial, dignified trial in the Senate. This essay applies 10 principles of large-group theory, particularly when there is social conflict, to the impeachment proceedings in an effort to understand the marked differences in the process between the two legislative chambers.     

Financial hardship during unemployment in Norway: the impact of public and private income support

It is common to assume that long-term unemployment no longer causes financial hardship because of generous welfare benefits. It is further assumed that unemployment benefits have eroded the traditional role of the family in protecting its members against hazards. This panel study of long-term unemployed people in 1991-1992 demonstrates the inadequacy of unemployment benefits and the importance of family support in reducing the risk of financial hardship. Vulnerable household types, such as single people and families with limited economic resources, at the outset seem unable to bear the personal risk of unemployment that is built into the benefit scheme. Persons disadvantaged at the outset risk a downward spiral because of long-term unemployment. Especially during times of high unemployment, the compensation level is not optimal from a welfare point of view. Greater coverage and more generous unemployment benefits may help unemployed people to cope better financially and thus avoid applying for discretionary and highly stigmatized social assistance allowance.     

Employment status,material hardship,and mental health among low-income working-age adults in South Korea

The current study examines the associations between employment status and mental health and the mediating role of material hardship among low-income households in South Korea. This study uses regression models with a rich set of control variables and lagged dependent variable models with a nationally representative sample of 1113 low-income working-age household heads from the Korean Welfare Panel Study (KOWEPS). We find that the nonstandard employment and unemployment statuses are associated with a higher level of depression and a lower level of self-esteem, when compared to a standard employment status. These negative associations are partially mediated by an increased material hardship risk. Policy implications to improve employment conditions and mitigate material hardship are discussed.     

The first interview as a guide to treatment 1

Abstract

This article is based on an exploratory study that examines clinical workers’ reactions to assault by a client within an established treatment relationship. Findings indicate that client assaults experienced as traumatic result in psychological processes and stages of resolution similar to those experienced by other victims of assault. The primary difference is fewer long‐term personal effects. Professional effect is significant and influences workers’ relationships with clients and their views of themselves as clinical workers. Long‐term positive professional effects are noted, and interviewed workers provide insight and advice for all who work with violent clients.     

A Comparison of Child Fatalities by Physical Abuse Versus Neglect: Child,Family, Service,and Worker Characteristics

ABSTRACT

In the field of child welfare, attention has been given to risk factors for child maltreatment fatalities with little attention to the difference between children who die from abuse versus neglect. As part of a larger study, child welfare workers (n = 104) from 14 different states responded to an anonymous online survey that described the child, family, and case characteristics before death and worker characteristics/experiences before and after death. Results supported that prior to death, neglectful families presented with less risk than abusive families, in the areas of parent–child attachment, child behavior problems, and changes in household composition while reporting that they received more services. With regard to child welfare practice, workers did not report any differences in how they handled cases before death nor did they report differences in their posttraumatic stress symptoms at the time of the survey. These findings can be used as a springboard for future research that focuses on fatal maltreatment.     

Empowerment and globalisation in a Nordic social work education context

The Nordic countries have been experiencing paradigm shifts from a focus on problems, pathology and deficits to more strengths-based, capacity-building and inclusive approaches, especially in the field of child welfare. This article describes joint Nordic (Nordplus) Master level courses that have been introduced to promote a more inclusive and empowering way of working with children and families. The overall theme of the Nordplus project is democratisation of child welfare work. The project includes three separate courses: (i) Empowerment and family decision making in child welfare; (ii) Strengths and solution oriented child welfare work; (iii) Children, youth and participation. The project brought together masters students from the Nordic countries and professional academics from the Nordic countries, South Africa and Australia. This article describes and problematises the learning process and the outcomes of the project. An important aim of the project was to interrogate the relationship between the global and the local.     

劳工输出、跨国生产政治与剥削关系的形成——中国赴日劳工的案例研究

在全球化背景下，发展中国家向发达国家的劳工输出形塑了一种资方与劳方之间的剥削关系。基于中国赴日劳工的案例，本研究借助“跨国生产政治”的分析框架探讨这种剥削关系的形成机制。雇主和移工围绕加班工资展开博弈，而外劳制度对移工权利的限制及其赋予雇主的权力、不同国族移工的竞争以及跨国劳务中介的选择性庇护，使移工无论反抗还是消极服从，都可能面临加班福利缩减、加班机会丧失甚至工作丢失的困境。这种跨国生产体制具有“市场专制”性质，而外劳制度限制、资方对外劳制度缝隙的利用、全球过剩的劳动力市场、拆分型劳动力再生产体制共同体现了国际合同劳工面临的跨国生产政治，成为发达资本主义国家资本强制剥削再度出现的重要机制。     

Public income transfers and wealth accumulation at the bottom: Within and between country differences in Canada and the United States

Both Canada and the United States are considered liberal welfare states, yet exhibit notable differences in income poverty attributed to social policy. While a more generous welfare system lifts many above income poverty, models of household financial behaviour suggest that more income from the state should displace private savings via a substitution effect. Using nationally representative wealth surveys from Canada and the US from 1998/1999 to 2016 we extend knowledge on the relationship between the welfare state and private wealth accumulation. Specifically, we study household asset poverty defined as financial asset levels that fall below three-month adjusted income poverty threshold. Asset poverty rates varied over time in the two countries and were higher in the less generous US welfare state. Further, income transfer share was positively related to asset poverty in Canada but not in the US. Counterfactual estimates offered evidence of the substitution effect in Canada, where higher levels of transfers may crowd out private asset accumulation. Results invite further consideration of the concept of asset poverty and its relationship to welfare state characteristics.     

Assessing the Effects of an Asset-Building Program in Resource-Constrained Households: The Case of Sub-Saharan Africa

ABSTRACT

Using a survey that was administered individually to respondents at set locations, this study examines the effects of participation in an asset-building program in resource-constrained households in rural Ghana (n = 120 in the experimental group and n = 120 in the comparison group). Results suggest the program is effective in reaching the most economically vulnerable households. We also learned that program participation was related to ownership of social assets, as well as psychosocial and financial well-being. Program characteristics, including trust among members and time spent on program-related activities, were related to enhanced social and financial assets, respectively. A number of implications emerge from this study. Given that the program, although effective in reaching the most economically vulnerable households, did not produce significant outcomes in such households, attention may be devoted to understanding ways to enhance the welfare of vulnerable program participants. A targeted approach may be a viable option. With respect to policy, consideration could be given to incorporating microfinance models in poverty alleviation strategies. Continued research using more rigorous design is needed to explore the relationship between microfinance and the welfare of vulnerable participants.     

Building state capacity for welfare governance: The pathway and development of child welfare system and social work in China

ABSTRACT

China’s dramatic socioeconomic transformation after the reform and opening up, coincided with changes in state-family relationship, has resulted in a large number of children at risk of care. In the past three decades, child welfare has been highly concerned by the government and society, and the child welfare system has substantially developed in the direction of establishing a moderately universal system. In this process, the development of child welfare and social work has shown a mutually reinforcing trend. This includes the professionalisation of child welfare services, the professional training of child welfare workers and the advancement of child welfare policies. The governance of child welfare is an essential component of national social governance. Its future development should be oriented towards a developmental and holistic approach of governance, and social work as an important institutional actor plays a critical role in promoting good governance of child welfare and beyond.     

Can the minimum living standard guarantee scheme enable the poor to escape the poverty trap in rural China?

The rural Minimum Living Standard Guarantee (Dibao) Scheme is the most important social assistance programme in rural China. However, how the rural Dibao programme affects household expenditures and whether it can enable the poor to escape the poverty trap are questions that remain largely unexplored. This study used data from the 2012 Rural Household Survey in China to investigate the impact of the rural Dibao programme on household expenditures. We found that the programme significantly improved the well‐being of low‐income households. Particularly, the programme significantly increased household expenditures on housing, education and health; furthermore, the impact was greater for households with educated household heads. However, the programme did not significantly affect household expenditures on food, transportation or farming inputs. The results imply that participation in the rural Dibao programme induces household investment in human capital, which could help to break the inter‐generational transmission of poverty and raise long‐run welfare.     

On the Division of Household Responsibilities in the Family

One of the main purposes of the study carried out in 1981 in the city of Krasnodar by the Section on the Family of the Institute of Sociological Research of the Academy of Sciences of the USSR was to determine the nature of the relationship between employment and household duties and the main reasons why these two important spheres of human activity are frequently in conflict with each other.¹     

Predicting Material Hardship Among Former Welfare-to-Work Participants: An Income- and Resource-Packaging Model

ABSTRACT

Material hardship is of concern because it refers to physical deprivation related to meeting the basic needs of food, housing, utilities, and other items. This study tests a predictive income- and resource-packaging model of material hardship using survey data collected from 459 former welfare-to-work program participants. Logistic regression results show that receiving social support in the form of living rent-free decreased the odds for experiencing material hardship. The predictors of working in the informal economy, being sanctioned while on public assistance, having mental health issues, and having transportation problems all increased the odds for experiencing material hardship. The measures of formal employment income, Temporary Assistance for Needy Families income, work-first program participation, sharing living expenses, monetary social support, and assistance from nonprofit organizations were unrelated to predicting material hardship experiences. Policymakers interested in improving conditions for needy families should question the use of sanctions and carefully monitor material hardship among those sanctioned. Future programs and future research should consider the extent to which low-income women participate in the informal economy to make ends meet, rely on social networks to live rent-free, and struggle with poor health and transportation problems.