How Much Is Leisure Worth? Direct Measurement with Contingent Valuation

This paper uses a contingent value survey in a Rocky Mountain city to measure the national income accounting value of leisure activities. Such direct measurement avoids shortcomings of the previously used labor value approach and individually values various types of leisure, e.g., napping and socializing. The results of the study indicate promise for this measurement approach but also raise some issues that require further research. Included are suggestions for overcoming problems discovered with this method and for future research.The authors wish to thank two anonymous referees of this journal who provided insightful comments and suggestions which improved the paper significantly.     

Evaluating risk: global fees and episodic care

In 1999, two articles in The Physician Executive -- "Part I: Global Theory and the Nature of Risk (July-August)." and "Part II: Towards a Choice-Based Model of Managed Care (October-November)" -- outlined the flaws of orthodox managed care theory and highlighted the unique advantages of moving to a genuinely market-based model, which included the concept of direct contracting for integrated episodes of care. This follow-up focuses on comparing an episode contracting system to a traditional capitated program and outlines the features that make this approach much more attractive to physicians, payers, and most importantly patients.     

Social Work Education and Clinical Learning

In response to a growing diversity of opinion regarding educational models and essential content in clinical social work education, this paper offers a perspective concerning graduate clinical curricula. Part I, the foundational piece of the paper, discusses the definition of clinical social work, social work’s core orientation and values, and influential contextual issues. The interrelated core orientations guiding knowledge and skill development are identified as the person-in-situation perspective and the concept of relationship. Based on this foundation, Part II identifies elements of a contemporary biopsychosocial knowledge base and essential clinical skills. This paper is intended to stimulate dialogue about a topic of importance to the profession and the clients it serves.     

CULTIVATING SOCIETY'S CIVIC INTELLIGENCE: PATTERNS FOR A NEW 'WORLD BRAIN'

In spite of remarkable advances in science and technology, humankind is beset with a number of serious problems. These are not just problems that 'won't go away'; they are problems that are worsening considerably. These problems include the growing gap between rich and poor, between those who have too much and those who have too little, as well as a broad range of environmental issues that may have major consequences but, at the same time, are little understood. This essay explores the idea of 'civic intelligence'. What projects, perspectives, policy and technology might humankind develop that would help us collectively address these problems? This essay discusses six aspects of 'civic intelligence' (orientation, organization, engagement, intelligence, products and projects, and resources) as well as ways to make cultivating our 'civic intelligence' a practical - non-utopian - enterprise.     

The Impact of the Earned Income Tax Credit on Economic Well-Being: A Comparison Across Household Types

Using survey data from Earned Income Tax Credit (EITC) recipients in Madison County, New York, we evaluate the effectiveness of the EITC in improving the economic well-being of low-income households. In particular, we examine the impact of the EITC across household types. For tax years 2002 through 2004, we find that the EITC is responsible for significantly lowering the poverty rate of EITC recipients, from 57 to 49%. In fact, for households below the poverty line, the EITC fills 31% of the gap between their adjusted gross income and the poverty line. The EITC has the largest impact on single parent households, lowering their poverty rate by 11.2 percentage points and reducing their poverty gap by almost 35%. However, the EITC has negligible effects on the poorest households in the sample—childless singles. A majority (64%) of EITC recipients intends to use at least some of the refund on basic needs and almost half plan on using part of their refund for debt repayment. This suggests that the EITC helps the majority of recipients get by but does not increase their economic mobility. Somewhat surprisingly, single parent households in the sample are not that different from married parent households in terms of EITC amounts, poverty rates, use of credit, and participation in government programs, despite earning less.     

Voluntary Siting and Equity: The MRS Facility Experience in Native America

This article focuses on aspects of intragenerational and intergenerational equity in the context of a unique policy experiment: the effort of the U.S. government to site a monitored, retrievable storage (MRS) facility for high-level civilian nuclear waste. This process and its outcomes are examined from both normative and subjective perspectives. While the MRS siting process was designed to be equitable, its eventual focus on Native American communities raises profound questions about environmental justice, as well as procedural, outcome, and intergenerational equity in cross-cultural contexts. The diverse reactions among Native American tribes demonstrate that translating theoretical concepts of equity into practice is an extraordinarily complex exercise. The MRS siting process, instead of being a bold policy experiment that promoted equity, emerges substantially flawed after its implementation in the Native American context.     

CORRECTING FOR MEASUREMENT ERROR IN AN EXPOSURE-RESPONSE RELATIONSHIP BASED ON DICHOTOMISING A CONTINUOUS DEPENDENT VARIABLE

Random error in a continuous outcome variable does not affect its regression on a predictor. However, when a continuous outcome variable is dichotomised, random measurement error results in a flatter exposure-response relationship with a higher intercept. Although this consequence is similar to the effect of misclassification in a binary outcome variable, it cannot be corrected using techniques appropriate for binary data. Conditional distributions of the measurements of the continuous outcome variable can be corrected if the reliability coefficient of the measurements can be estimated. An unbiased estimate of the exposure-response relationship is then easily calculated. This procedure is demonstrated using data on the relationship between smoking and the development of airway obstruction.