The Effects of the State Children’s Health Insurance Program on Insurance Status and Health Care Utilization of Children

The State Children’s Health Insurance Program (SCHIP) of 1997 aimed to increase public insurance eligibility to children in families that were above the Medicaid income cutoff line, but were too poor to afford private coverage. This paper shows that SCHIP helped as many as 1.3 million children leave the ranks of the uninsured. However, almost 400,000 of these children came from families with two privately insured parents, and added approximately $300 million in health care expenses to federal and state budgets. This paper also presents estimates of health care consumption of children who switched to public insurance as a result of SCHIP.     

Does Health Insurance Premium Exemption Policy for Older People Increase Access to Health Care? Evidence from Ghana

Aging in Sub-Saharan Africa causes major challenges for policy makers in social protection. Our study focuses on Ghana, one of the few Sub-Saharan African countries that passed a National Policy on Aging in 2010. Ghana is also one of the first Sub-Saharan African countries that launched a National Health Insurance Scheme (NHIS; NHIS Act 650, 2003) with the aim to improve access to quality health care for all citizens, and as such can be considered as a means of poverty reduction. Our study assesses whether premium exemption policy under the NHIS that grants non-payments of annual health insurance premiums for older people increases access to health care. We assessed differences in enrollment coverage among four different age groups (18–49, 50–59, 60–69, and 70+). We found higher enrollment for the 70+ and 60–69 age groups. The likelihood of enrollment was 2.7 and 1.7 times higher for the 70+ and 60–69 age groups, respectively. Our results suggest the NHIS exemption policy increases insurance coverage of the aged and their utilization of health care services.     

What Explains Divorced Women's Poorer Health? The Mediating Role of Health Insurance and Access to Health Care in a Rural Iowan Sample

Economic restructuring in rural areas in recent decades has been accompanied by rising marital instability. To examine the implications of the increase in divorce for the health of rural women, we examine how marital status predicts adequacy of health insurance coverage and health care access, and whether these factors help to account for the documented association between divorce and later illness. Analyzing longitudinal data from a cohort of over 400 married and recently divorced rural Iowan women, we decompose the total effect of divorce on physical illness a decade later using structural equation modeling. Divorced women are less likely to report adequate health insurance in the years following divorce, inhibiting their access to medical care and threatening their physical health. Full‐time employment acts as a buffer against insurance loss for divorced women. The growth of marital instability in rural areas has had significant ramifications for women's health; the decline of adequate health insurance coverage following divorce explains a component of the association between divorced status and poorer long‐term health outcomes.     

Are There Differing Patterns of Health Care Access and Utilization Among Male Sexual Minorities in the United States?

Disparities in health care access and utilization among male sexual minorities in the United States were explored using data from the National Survey of Family Growth (N = 8,846). Bisexual men had a small disadvantage in health insurance coverage but no differences were found in health insurance or consistency of coverage between gay and heterosexual men. Gay men were more likely to have a usual place of care, but were not more likely to utilize services. The current study provides inconclusive evidence for systematic disparities in health care access and utilization among gay and bisexual men in the United States.     

Does Citizenship Status Matter in Canadian Agriculture? Workplace Health and Safety for Migrant and Immigrant Laborers

This article explores how precarious legal status circumscribes differential inclusion in the agricultural labor market and affects workers' lives through a comparative study of workplace health and safety among temporary migrant guest workers and immigrants in Canada. Original, multimethod research with South Asian immigrant and Mexican migrant farmworkers examines employment practices, working conditions, and health‐care access. We find that both groups engage in precarious work, with consequences for their health and safety, including immigrant workers with citizenship. Nevertheless, migrant guest workers are subject to more coercive forms of labor discipline and a narrower range of social protection than immigrants. We argue that while formal citizenship can mitigate some dimensions of precariousness for farmworkers racialized as non‐white, achieving a more just, safer food system will require broader policies to improve employer compliance and address legislative shortcomings that only weakly protect agricultural labor.     

Women and Children's Health Care in the Yimeng Mountain Area

The Yimeng Mountain area in the central and southern part of Shandong Province, is very poor.     

Worthy? Crowdfunding the Canadian Health Care and Education Sectors

Crowdfunding, the practice of asking for money from others using the Internet, is a major private means through which Canadians are funding their health care and education. Crowdfunding has proliferated in Canada during the 2010s and continues to grow, approaching the revenues of Canada's major traditional charities. Proponents describe it as an empowering practice from which anyone can benefit. If its gains are inequitably distributed, however, increasing reliance on this private funding mechanism, especially in core areas of welfare state provision, can further exacerbate inequalities of opportunity and income. This study asks why Canadians turn to health care and education crowdfunding and how equitably funds are raised using this novel method. Based on a mixed methods analysis of 319 campaigns conducted on two prominent crowdfunding platforms between 2012 and 2014, we find that crowdfunding users’ needs frequently correspond to known gaps in the contemporary social safety net, including in the area of cancer care, and that campaigns for older and visible minority Canadians face a disadvantage. We argue that health care and education crowdfunding is a response to the shortcomings of Canadian welfare state provision, but one that reproduces offline inequalities with potentially perilous consequences for democratic life and individual suffering.     

Protect the Health of Women and Children

CHINA has reached its present standard of maternal and child health by constant effort. Before the founding of New China in 1949, Chinese women's life expectancy was only 37.6 years. A girl born today can expect to live an average of 72 years. Hygienic practices barely existed for mother and children in the early 1950s, said a health worker who remembers that period. Maternal mortality was high as a result of traditional midwifery practices, which often caused childbed fever. Infant     

Older Workers’ Access to Employer-Sponsored Retiree Health Insurance, 2000–2006

Using a multivariate framework, we analyze trends in employer provision of retiree health insurance (RHI), eligibility for new retirees, and retiree contributions. Data come for the Medical Expenditure Panel Survey—Insurance Component (MEPS-IC). While RHI provision to existing retirees decreased, eligibility for new retirees declined even more. Contribution requirements increased between 2000 and 2006 for retirees not yet eligible for Medicare (less than 65 years of age), but remained stable for those who were eligible (65 years of age or older). These results suggest growing financial instability for retirees.     

Who Uses Formal,Early Child Care in California? A Comparative Study of Children from Immigrant and Nonimmigrant Families

The purpose of this study is to examine the predictors of formal, early child care usage and to study the differences between immigrant and nonimmigrant families in their use of formal (center-based, preschool, Head Start, and family child care) and informal child care arrangements (grandparent and nanny) among California’s children. Since the California Health Interview Survey (CHIS) had children from California’s immigrant and nonimmigrant families, the data for 897 preschool age children who attended child care for 10 h or more were retrieved from the CHIS 2005 Child Survey. This study found that immigrants are twice more likely (OR = 2.006; p < 0.005) to use formal child care than nonimmigrant families in California. The study concludes with implications for social work.     

A Comparison of Out-of-home Care for Children and Young People in Australia and Sweden: Worlds Apart?

Abstract

In this paper we present a comparative analysis of out-of-home care in Australia and Sweden. We compare the age structure of the out-of-home care population and the types of out-of-home care services provided to children and young people in both countries. Our analysis reveals that in Australia the out-of-home care service system is focused mainly on children who are deemed to be abused or neglected within their families, while in Sweden the majority of the out-of-home care population are teenagers who cannot live with their families for emotional or behavioural reasons. These population differences intersect with variations in the forms of service provision in both countries, with a much greater reliance on home-based care in Australia than in Sweden, while there is more extensive use of residential care in Sweden. We envisage that this paper will demonstrate how the age structure of the out-of-home care population, though rarely considered in international comparative child welfare research, reveals much about the assumptions on which State intervention with children and young people is based. We intend that this analysis will assist social workers to better understand and address the gaps in the quality and comprehensiveness of out-of-home care service provision to children and young people in both countries.     

What's in It for Me?

Abstract

Social service workers' values and religious beliefs often differ greatly from those of their clients. This paper will assist helping professionals to develop a deeper understanding of the motivations behind clients' religious behaviors by describing religious participation through the lens of rational choice theory. A working definition of rational choice is provided. A graphic construct explaining the interaction of demand and supply on religious participation is presented. This model shows how a feedback loop develops to increase religious involvement. A discussion follows regarding religious participation as viewed from a demand side and supply side perspective. The paper concludes with ideas of how the information applies to social service workers and researchers.     

Health Insurance and Risk of Divorce: Does Having Your Own Insurance Matter?

Most American adults under 65 obtain health insurance through their employers or their spouses' employers. The absence of a universal health care system in the United States puts Americans at considerable risk for losing their coverage when transitioning out of jobs or marriages. Scholars have found evidence of reduced job mobility among individuals who are dependent on their employers for health care coverage. In this study, the author found similar relationships between insurance and divorce. She applied the hazard model to married individuals in the longitudinal Survey of Income Program Participation (N = 17,388) and found lower divorce rates among people who were insured through their partners' plans without alternative sources of their own. Furthermore, she found gender differences in the relationship between health care coverage and divorce rates: Insurance‐dependent women had lower rates of divorce than men in similar situations. These findings draw attention to the importance of considering family processes when debating and evaluating health policies.     

“Adding Their Flavour to the Mix”: Involving Children and Young People in Care in Research Design

Abstract

Children and young people are often the subjects of research but are not usually thought of as codesigners of research projects contributing to the development of tools and resources so that research about them and their peers is more likely to be appropriate and effective. This paper describes and analyses the involvement of a group of 14 children and young people who have been in out-of-home care. They assisted in the design of a research project that sought their views on what makes a “good” foster carer. The impetus for this study arose from a desire to include children and young people as stakeholders in improving the foster care system and a long-held belief that they could and should be active partners in creating change. The study demonstrated how children and young people could be engaged creatively in individual and group conversations and activities in relation to potential research questions and research methods and tools. The paper concluded that capturing their views will ensure that research will be of benefit to other children and young people and to policy makers and practitioners working in the field.     

The Gender Pay Gap in the US: Does Sector Make a Difference?

Analyses of data from the 2000 US Census show that the gender pay gap differs by sector of employment and according to the part of the earnings distribution that is considered. The gender pay differential in the private sector in the US does not display either the glass ceiling or sticky floor effects that have been reported for many other countries. The government sector is, however, characterized by a distinct sticky floor effect in the female–male pay differential. Regardless of the sector of employment, females have lower hourly rates of pay than men across the entire earnings distribution.

An Ambiguous Concept: On the Meanings of Co-production for Health Care Users and User Organizations?

Neither on the level of interactions between organizations nor on the level of servicing users, co-production has a fixed meaning. It is argued that there are different meanings that unfold once one looks at the impact of narratives such as consumerism, managerialism, or participatory governance. Altogether with the traditions of state-welfare, they simultaneously influence the modes and meanings of co-production in personal services. Taking up the example of modern healthcare systems and its hallmarks in Germany, it is shown that, therefore, uncertainty and ambiguity is the normalcy rather than the exception when it comes to define co-production. Role-expectations such as the “expert–patient” or the “citizen–consumer” have a liberating potential, but may likewise marginalize issues such as trust and the need for protection. User organizations are well challenged beyond their role of helping users to cope as good as possible with given role models of co-production.     

Where Are the Children? Extent and Determinants of Preschoolers' Child Care Time

According to the 1988 National Health Interview Child Health Supplement, half of all children under age six attended nonparental child care on a regular basis. Close to a quarter of all children spent 40 or more hours per week in care. Average time in care was 30.5 hours for children in care. Statistical tests indicate that (a) the predictors of whether parents use any child care differ from the predictors of the number of hours care is used, and (b) estimates for children under three years of age differ from estimates for children from three to five years of age. The probability of attending care is related to a child's age, mother's education, race, family type, number and age of siblings, type of adults living in the household, income, poverty status, and region and size of the community in which a family resides. For children from three to five years of age, hours in care are associated with child's age, mother's education, race, family type, siblings, income, poverty status, and region. For children under three years of age, relatively few factors (mother's education, race, siblings, and region) predict the number of hours spent in child care.     

Pathways to Mental Health Services for Children and Youth in the Child Welfare System: A Focus on Social Workers’ Referral

Case abstraction was used to collect data from court reports to examine characteristics that predict referral to mental health services by court and child welfare social workers and whether referral to mental health services was a significant determinant of service utilization. Home placement and multiple types of abuse were significant predictors of a referral to mental health services by the court social worker and age and reported sexual abuse were significant in the utilization of services. Practice and policy implications are discussed.