Income inequality,welfare regimes and aggregate health: Review of reviews

Wide income inequality in a society has been associated with worse aggregate health. Regarding the relationship, often termed as ‘the Wilkinson Hypothesis’, a number of empirical findings and related systematic reviews have reached inconsistent conclusions. In addition, the Scandinavian welfare regime is expected to have better aggregate health indicators in comparison with the other welfare regimes. The expectation is largely based on the Wilkinson Hypothesis because the regime has relatively narrow income inequalities. Again, related empirical findings and systematic reviews have produced inconsistent conclusions. This article reports on two rounds of ‘review of reviews’ (RR) over six previous (systematic) review articles. The first round of RR found that the review articles reached divergent conclusions. The second round of RR over another set of three review articles also demonstrated that their conclusions did not reach a consensus. Neither the hypothesised Scandinavia's good health nor the Wilkinson Hypothesis was given solid empirical backing.     

More present than absent: Men who use domestic violence and their fathering

An earlier article referred to the “absent presence” of the perpetrator in the lives of children and their mothers who have lived with domestic violence. It identified the ways in which the shadow of the perpetrator continued and was evidenced in the “symptoms of abuse” that both women and children experienced in spite of his absence. The current article argues that fathers who use violence are actually more present than absent in the lives of children (and women), even following separation. A mixed method approach surveyed men in Men's Behaviour Change Programs (N = 101), and interviewed women who had experienced violence (N = 50). The studies reported that the majority of men in both the quantitative men's study (80%) and the qualitative women's study (77%) had substantial contact with children. The women's interviews highlight the problematic fathering that many of their children experienced, both before and after separation. They reported very high levels of child abuse and poor attitudes to both women and children. The article concludes that the family violence and child welfare systems are poorly configured to address fathers who use violence and continue to hold substantial parenting roles, including following separation.     

Child care subsidy and child maltreatment

This study examined the relationship between receipt of child care subsidies and child maltreatment investigations in a sample of low‐income mothers in Illinois. We expected that receiving child care subsidies would have a protective effect on child maltreatment risk and therefore decrease the likelihood of child protective services investigations. Using structural equation modelling, we tested the direct and indirect paths of the receipt of child care subsidies to physical abuse or neglect. We found only direct effects of receiving child care subsidies on both physical abuse and neglect investigations. The findings suggest an important protective role of child care subsidies in the lives of low‐income families.     

Adapting the Friends of the Children programme for child welfare system‐involved families

Research has shown the importance of long‐term, caring adults for children in foster care. This paper reviews the Friends of the Children (FOTC) long‐term mentoring programme and how it was adapted to serve children and families with child welfare system involvement. This study's two research questions are (1) How do Friends (FOTC's paid professional mentors) currently work with, and in turn, have an impact on, child welfare‐involved families? and (2) How can Friends better support child welfare system‐involved caregivers and families to promote family stability, permanence, and child well‐being? Data were collected from 21 caregivers (foster and biological), 24 FOTC Friends, five child welfare workers, and five teachers. Qualitative analyses of focus group, interview, and open‐ended survey data revealed a wide variety of ways Friends currently support children and families. In addition, several recommendations were made for strengthening programming. These findings provide valuable insights into providing long‐term mentoring to child welfare system‐involved children and families.     

New perspective on the benefits of the gene–environment independence in case–control studies

We study the benefit of exploiting the gene–environment independence (GEI) assumption for inferring the joint effect of genotype and environmental exposure on disease risk in a case–control study. By transforming the problem into a constrained maximum likelihood estimation problem we derive the asymptotic distribution of the maximum likelihood estimator (MLE) under the GEI assumption (MLE‐GEI) in a closed form. Our approach uncovers a transparent explanation of the efficiency gained by exploiting the GEI assumption in more general settings, thus bridging an important gap in the existing literature. Moreover, we propose an easy‐to‐implement numerical algorithm for estimating the model parameters in practice. Finally, we conduct simulation studies to compare the proposed method with the traditional prospective logistic regression method and the case‐only estimator. The Canadian Journal of Statistics 47: 473–486; 2019 © 2019 Statistical Society of Canada     

A generalized Bayesian nonlinear mixed‐effects regression model for zero‐inflated longitudinal count data in tuberculosis trials

In this paper, we investigate Bayesian generalized nonlinear mixed‐effects (NLME) regression models for zero‐inflated longitudinal count data. The methodology is motivated by and applied to colony forming unit (CFU) counts in extended bactericidal activity tuberculosis (TB) trials. Furthermore, for model comparisons, we present a generalized method for calculating the marginal likelihoods required to determine Bayes factors. A simulation study shows that the proposed zero‐inflated negative binomial regression model has good accuracy, precision, and credibility interval coverage. In contrast, conventional normal NLME regression models applied to log‐transformed count data, which handle zero counts as left censored values, may yield credibility intervals that undercover the true bactericidal activity of anti‐TB drugs. We therefore recommend that zero‐inflated NLME regression models should be fitted to CFU count on the original scale, as an alternative to conventional normal NLME regression models on the logarithmic scale.     

Focused estimation for noisy and small data sets: a Bayesian minimum expected loss estimator approach

Central to many inferential situations is the estimation of rational functions of parameters. The mainstream in statistics and econometrics estimates these quantities based on the plug‐in approach without consideration of the main objective of the inferential situation. We propose the Bayesian Minimum Expected Loss (MELO) approach focusing explicitly on the function of interest, and calculating its frequentist variability. Asymptotic properties of the MELO estimator are similar to the plug‐in approach. Nevertheless, simulation exercises show that our proposal is better in situations characterised by small sample sizes and/or noisy data sets. In addition, we observe in the applications that our approach gives lower standard errors than frequently used alternatives when data sets are not very informative.     

Agency and clientship in public encounters: co‐constructing ‘neediness’ and ‘worthiness’ in shelter placement meetings

This article seeks to develop our understanding of the agency of vulnerable groups who at first sight may not seem to have much agency in their lives. It explores the co‐constructed nature of agency in three Danish homeless shelters. Unlike earlier interview‐based studies, our research is based on naturalistic data drawn from 23 video‐recorded placement meetings. Using concepts from Goffman, we examine how versions of the neediness and worthiness of homeless people are negotiated verbally and bodily between staff and clients. We find that homeless people have to juggle two partly contradictory roles when they are given or take the roles of either a (active) citizen or a (passive) client. Clientship is actively negotiated by both parties and demonstrates the agency of homeless people: they can collaborate with (as clients) or challenge (as citizens) the staff’s attempts to formulate solutions to their troubles. We further examine how the professional ideology of client centredness affects the meeting between the two parties. However, we show that, like any discourse, client centredness has no intrinsic meaning and is played out by actors in very different ways. In work with the homeless, the discourse of client centredness is related to discourses of ‘neediness’, ‘worthiness’ and ‘value for money’ that define agency in different ways and make three different client positions available: the resolute client, the acquiescent client and the passive client.