Mapping the uninsured using secondary data: an environmental justice application in Dallas

Over the last 5 years, environmental justice (EJ) researchers have been calling for incorporation of health outcomes more directly into spatial studies of socio-demographics and environmental hazards. To date, researchers have not incorporated insurance status (an access to health care variable) in their models although access to care likely has an important association with the probability of health effects due to environmental exposures. As such, insurance status represents an important variable within spatial EJ studies focused on health, and the lack of spatially explicit access to care data is a critical limitation in the field. As a solution, we offer a method of using uninsured appendicitis cases, acquired secondarily from state hospital admissions data, to estimate rates of uninsurance at the zip-code level. We apply the technique to explore relationships between cancer risk from hazardous air pollutants and estimated rates of uninsurance, a previously unexplored phenomenon. Then, we compare the uninsurance findings to those related to poverty to illustrate how uninsurance, as a variable, compares to a more traditional socio-economic predictor used in EJ studies. The relationship between cancer risk from hazardous air pollutants and uninsurance is weaker than the relationship between risk and poverty, but both are statistically significant. As such, we conclude with a discussion of the importance of considering insurance status in spatial studies of EJ focused on health.     

Failures in Child Protection: A Case Study

A case example is used to illustrate how powerful a child abuser may become; where a complex hostage-type relationship develops between family members and is then extended to include the child protection worker. One consequence of this is the increased risk of re-abuse of the children. To establish this relationship the abuser uses a number of techniques such as violence, intimidation, isolation and unpredictability. In the case presented, the three children were subjected to ongoing severe abuse, although the child protection agency had known the family for 10 years. The children often denied and hid the abuse, and the child protection workers were left largely unsupported by other professionals and often appeared to comply with the wishes of the abusing parents. © 1997 by John Wiley & Sons, Ltd.     

Organizational perspectives on digital labor market intermediaries

Dramatic changes in organizational forms and employee-employer relationships have coincided with a proliferation of labor market intermediaries. Often digital and internet-based, these new hiring technologies assist organizations in recruiting and screening potential job candidates. We identify three types of digital labor market intermediaries (dLMIs): connectors, curators, and comminglers. We examine the use of dLMIs through the lens of organizational theory, focusing on implications for organizational efficiency, power, and equity. dLMI use is patterned but variable across different organizations and has unintended outcomes that defy efficiency expectations. It poses new constraints for job seekers while allowing organizations and intra-organizational groups to negotiate institutional pressures and power imbalances. Finally, dLMI use appears to reproduce pre-existing inequalities among different types of employees.     

Welfare programs and the state economy

Welfare policy has been controversial and support is often drawn along political affiliation lines, the economic return of investment in welfare programs is frequently cited as a justification for new and expanded policies. To investigate the direct and indirect effects of welfare programs on economic performance, the authors develop a multilink approach, through employment and investment. The relationship is then tested with data from each of the United States from 1976 to 2006. Findings show welfare programs have no direct effect on a state's economy. Indirectly, welfare has a negative effect through investment, though the effect on employment is minimal.     

The Role of Non‐profit Organizations in the Mixed Economy of Welfare‐to‐Work in the UK and Australia

This article charts the development of welfare‐to‐work policies and compares and contrasts the traditions of delivery in the UK and Australia. We find that in the UK, employment services and social security benefit administration have been dominated by the central state, traditionally affording a key role to civil servants as direct delivery agents. However, in federal Australia, mixed economies of welfare‐to‐work operate in the different states, there is a far greater role for social services and non‐profit organizations are firmly established as key providers of frontline employment services. Since the late 1990s, UK welfare reforms have been gradually following the Australian lead in contracting non‐state actors as delivery agents. As this trend seems set to continue and intensify, we examine the Australian experience in order to reflect on the role of non‐profits in policy reform.     

Is Asian ethnicity an independent risk factor for severe perineal trauma in childbirth? A systematic review of the literature

ObjectiveTo undertake a systematic review of the literature to determine whether Asian ethnicity is an independent risk factor for severe perineal trauma in childbirth.MethodOvid Medline, CINAHL, and Cochrane databases published in English were used to identify appropriate research articles from 2000 to 2010, using relevant terms in a variety of combinations. All articles included in this systematic review were assessed using the Critical Appraisal Skills Programme (CASP) ‘making sense of evidence’ tools.FindingsAsian ethnicity does not appear to be a risk factor for severe perineal trauma for women living in Asia. In contrast, studies conducted in some Western countries have identified Asian ethnicity as a risk factor for severe perineal trauma. It is unknown why (in some situations) Asian women are more vulnerable to this birth complication. The lack of an international standard definition for the term Asian further undermines clarification of this issue. Nevertheless, there is an urgent need to explore why Asian women are reported to be significantly at risk for severe perineal trauma in some Western countries.ConclusionCurrent research on this topic is confusing and conflicting. Further research is urgently required to explore why Asian women are at risk for severe perineal trauma in some birth settings.     

Production Teams and Producing Racial Diversity in Workplace Relationships

Production teams have become a dominant form of work organization as labor markets have become increasingly diverse. This transition likely affects coworker networks—possibly undermining entrenched patterns of workplace segregation. Contact theory suggests that teams can foster network diversity when workers cooperate and share values emphasizing mutual respect. Yet variants of conflict theory, including the critical teams literature, contend that the benefits of teamwork may be eroded by associated factors, including peer discipline, work intensification, and job insecurity. This study uses 2006 General Social Survey data to assess whether and how teamwork affects the racial diversity of worker acquaintance networks, contrasting worker‐ and manager‐directed teams. We find a positive relationship between teams and diversity, but only when teams are worker directed. Despite countervailing tendencies highlighted in the literature, teams foster greater cooperation between workers, which in turn promotes cross‐racial friendships. African Americans tend to receive the greatest diversity payoffs from teams. These findings suggest that teamwork can undermine segregation, though only with certain implementations and with variation across groups.     

Developing a Research Agenda on Resident-to-Resident Aggression: Recommendations From a Consensus Conference

This article provides an overview of the development of a research agenda on resident-to-resident aggression (RRA) in long-term care facilities by an expert panel of researchers and practitioners. A 1-day consensus-building workshop using a modified Delphi approach was held to gain consensus on nomenclature and an operational definition for RRA, to identify RRA research priorities, and to develop a roadmap for future research on these priorities. Among the six identified terms in the literature, RRA was selected. The top five priorities were: (a) developing/assessing RRA environmental interventions; (b) identification of the environmental factors triggering RRA; (c) incidence/prevalence of RRA; (d) developing/assessing staff RRA education interventions; and (e) identification of RRA perpetrator and victim characteristics. Given the significant harm RRA poses for long-term care residents, this meeting is an important milestone, as it is the first organized effort to mobilize knowledge on this under-studied topic at the research, clinical, and policy levels.     

Staffing-Related Deficiency Citations in Nursing Homes

There is evidence that staffing characteristics influence quality of care in nursing homes. Federal and state surveyors conduct inspections of homes to assess their compliance with regulatory standards, including requirements related to staffing. Deficiency citations are issued when these standards are not met. This article examines the relationship between operational, facility, and market characteristics and organizational performance measured as staffing-related deficiency citations. Online Survey Certification of Automated Records (OSCAR) data from 2000 through 2007 were used with multinomial logistic regression analyses to identify factors associated with deficiency citations for staffing. Chain members and facilities with poor quality of care were more likely to receive deficiency citations for staffing. Greater bed count and competition between nursing homes were associated with a decreased likelihood of deficiency citations for staffing. Staffing-related deficiencies within nursing homes vary according to various operational, facility, and market characteristics.