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.     

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.     

Adaptive designs for IVPT data with mixed scaled average bioequivalence

In vitro permeation tests (IVPT) offer accurate and cost-effective development pathways for locally acting drugs, such as topical dermatological products. For assessment of bioequivalence, the FDA draft guidance on generic acyclovir 5% cream introduces a new experimental design, namely the single-dose, multiple-replicate per treatment group design, as IVPT pivotal study design. We examine the statistical properties of its hypothesis testing method—namely the mixed scaled average bioequivalence (MSABE). Meanwhile, some adaptive design features in clinical trials can help researchers make a decision earlier with fewer subjects or boost power, saving resources, while controlling the impact on family-wise error rate. Therefore, we incorporate MSABE in an adaptive design combining the group sequential design and sample size re-estimation. Simulation studies are conducted to study the passing rates of the proposed methods—both within and outside the average bioequivalence limits. We further consider modifications to the adaptive designs applied for IVPT BE trials, such as Bonferroni's adjustment and conditional power function. Finally, a case study with real data demonstrates the advantages of such adaptive methods.     

Students Who Strip: The Benefits of Alternate Identities for Managing Stigma

We apply interactionist theories that highlight the contextual nature of stigma and the relational quality of stigmatization to the case of college students who work as topless dancers. We explore how the “toll of stripping” might be mediated by having an alternate, positive identity like “student.” Our analysis demonstrates that students who strip are distinctive from other strippers in important ways that stem from their salient, positive identity as students. Although they often feel as if they live a “double life” because they hide their occupation from family and friends, they benefit from sharing their student goals and ambitions with club customers. “Student” is a socially acceptable identity to share in routine social interactions and helps student strippers frame dancing as a transient occupation, offering them an opportunity to maintain a positive sense of self while buffering them from some of the negative effects of stripping.     

Understanding predictive information criteria for Bayesian models

We review the Akaike, deviance, and Watanabe-Akaike information criteria from a Bayesian perspective, where the goal is to estimate expected out-of-sample-prediction error using a bias-corrected adjustment of within-sample error. We focus on the choices involved in setting up these measures, and we compare them in three simple examples, one theoretical and two applied. The contribution of this paper is to put all these information criteria into a Bayesian predictive context and to better understand, through small examples, how these methods can apply in practice.     

The Income and Health Effects of Tribal Casino Gaming on American Indians

The legalization of American Indian casino gaming in the late 1980s allows examination of the relationship between income and health in a quasi-experimental way. Revenue from gaming accrues to individual tribes and has been used both to supplement tribe members’ income and to finance tribal infrastructure. We assembled annual data from 1988–2003 on tribal gaming, health care access (from the Area Resource File), and individual health and socioeconomic characteristics data (from the Behavioral Risk Factors Surveillance System). We use this information within a structural, difference-in-differences framework to study the effect of casino gaming on tribal members’ income, health status, access to health care, and health-related behaviors. Our difference-in-differences framework relies on before-after comparisons among American Indians whose tribe has at some time operated a casino and with-without comparisons between American Indians whose tribe has and those whose tribe has not initiated gaming. Our results provide identified estimates of the positive effect of gaming on American Indian income and on several indicators of American Indian health, health-related behaviors, and access to health care.     

Celebrating Spring Festival with a Chinese Family

Bring gifts The nice thing about visiting Chinese families is that while k is polite to bring gifts, generic gifts are expected and even welcome. You don＇t have to go overboard, nor do you have to spen...     

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.     

On the significance of social control: Treatment‐entry pressures,self‐choice and alcohol and drug dependence criteria one year after treatment

Storbjörk J. On the significance of social control: treatment‐entry pressures, self‐choice and alcohol and drug dependence criteria one year after treatment This article explores how self‐choice and treatment‐entry pressures are associated with one‐year treatment outcome (dependence symptoms, 0–6, 12 months) among alcohol and drug misusers, respectively. Informal pressures (from family and friends), formal pressures (related to work, healthcare, social services, social allowances, child custody) and legal pressures (related to the police, criminal justice system, compulsory treatment) were analysed. A sample (N= 1,210) representative of the addiction treatment system of Stockholm County was interviewed when starting a new treatment episode and after one year. Regression analyses indicated that self‐choice and pressures are associated with outcome among alcohol misusers but not among drug misusers when controlling for background factors and severity. Self‐choice (without pressures) correlated with a good outcome (a lower number of dependence criteria). Pressures were generally associated with poorer outcome. Alcohol misusers who had experienced threats regarding child custody did better in comparison with those not experiencing such pressure. The difference in results by drug type and implications were discussed.