Medicaid Funding for Assisted Living Care: A Five-State Examination

Medicaid waiver programs financing assisted living care are examined in five states to gain insights about program implementation, accomplishments, and challenges. Documents, augmented with stakeholder interviews, are used to describe income eligibility, options for supplementing payments to facilities, risk adjustment payment levels, and participation. Needs determination and waiver-based payments are in place. Eligibility and funding levels are complicated by room and board allocations that are linked to the federal benefit rate for Supplemental Security Income. Provider participation may be diminishing. Many recipients have to accept shared occupancy as program payments are insufficient for single units.     

Occupational Mobility and Culture Maintenance: The Welsh in a Nineteenth Century Australian Gold Town

This article quantifies the concentration of Welsh male immigrants in a nineteenth- century Australian gold town within one occupational category (gold mining), and considers the extent to which that concentration was maintained and the relevance of this economic specialisation to culture maintenance. In addition, this study provides an analysis of intragenerational and intergenerational changes in socio-economic status amongst the Welsh, as indicated by occupational shifts, which gives a clearer picture than the images promulgated by contemporary Welsh leaders who strove to emphasize the industry and upward mobility of their fellow countrymen.     

The measurement of historical trends in fetal mortality in England and Wales

This paper critically discusses recent attempts to estimate long-term trends in the stillbirth rate for England and Wales. It assesses the available historical evidence for the level of late-fetal mortality, drawing especially on examples from Norway, Sweden, and Denmark. A theoretical fetal–infant life table for a high-mortality population is also outlined as a means of analysing the relationship between segments of the conception-to-first-birthday mortality curve. Finally, new estimates of the stillbirth rate for England and Wales are proposed, based on variations in the early neonatal and maternal mortality rates during the 1930s. These estimates are substantially lower than the earlier estimates and are more in keeping with the available evidence from northern Europe. The implications of the revised estimates for interpretations of historical changes in mortality patterns are also considered.     

Explaining the Gender Wealth Gap

To assess and explain the United States’ gender wealth gap, we use the Wisconsin Longitudinal Study to examine wealth accumulated by a single cohort over 50 years by gender, by marital status, and limited to the respondents who are their family’s best financial reporters. We find large gender wealth gaps between currently married men and women, and between never-married men and women. The never-married accumulate less wealth than the currently married, and there is a marital disruption cost to wealth accumulation. The status-attainment model shows the most power in explaining gender wealth gaps between these groups explaining about one-third to one-half of the gap, followed by the human-capital explanation. In other words, a lifetime of lower earnings for women translates into greatly reduced wealth accumulation. After controlling for the full model, we find that a gender wealth gap remains between married men and women that we speculate may be related to gender differences in investment strategies and selection effects.     

Age-parity-specific birth rates and birth probabilities from census or survey data on own children

The ‘own-children’ method is a census- or survey-based reverse-survival technique for estimating age-specific birth rates for years previous to enumeration. In this paper it is extended to estimate birth rates and birth probabilities by parity as well as by age. The refined method is tested for accuracy by comparing ‘own-children’ estimates of age-parity-specific birth probabilities for the United States in 1969 with parallel estimates obtained by the method used in Vital Statistics of the United States. The ‘own-children’ estimates give relatively lower values at ages 15-19 and higher values at ages above 40, but compare well in between. The discrepancies are probably due mainly to adoption of illegitimate children of young mothers by older women. The ‘own-children’ estimate of the total fertility rate is very close to the published vital statistics estimate.     

Demographic transition in sub-Saharan Africa: How big will the economic dividend be?

In mid-demographic-transition, many Asian countries enjoyed a large demographic ‘dividend’: extra economic growth owing to falling dependant/workforce ratios, or slower natural increase, or both. We estimate the dividend, 1985–2025, in sub-Saharan Africa and its populous countries. Dependency and natural increase peaked around 1985, 20 years after Asia. The UN projects an acceleration of the subsequent slow falls but disregards slowish declines in young-age mortality and thus, we argue, overestimates future fertility decline. Even if one accepts their projection, arithmetical and econometric evidence suggests an annual, if not total, dividend well below Asia's. The dividend arises more from falling dependency than reduced natural increase, and could be increased by accelerating the fertility decline (e.g., by reducing young-age mortality) or by employing a larger workforce productively. Any dividend from transition apart, low saving in much of Africa (unlike Asia) means that, given likely natural increase, current consumption per person is unsustainable because it depletes capital per person.     

Racial/Ethnic and Nativity Patterns of U.S. Adolescent and Young Adult Smoking

We document racial/ethnic and nativity differences in U.S. smoking patterns among adolescents and young adults using the 2006 Tobacco Use Supplement to the Current Population Survey (n = 44,202). Stratifying the sample by nativity status within five racial/ethnic groups (Asian American, Mexican–American, other Hispanic, non-Hispanic black, and non-Hispanic white), and further by sex and age, we compare self-reports of lifetime smoking across groups. U.S.-born non-Hispanic whites, particularly men, report smoking more than individuals in other racial/ethnic/nativity groups. Some groups of young women (e.g., foreign-born and U.S.-born Asian Americans, foreign-born and U.S.-born Mexican–Americans, and foreign-born blacks) report extremely low levels of smoking. Foreign-born females in all of the 25–34 year old racial/ethnic groups exhibit greater proportions of never smoking than their U.S.-born counterparts. Heavy/moderate and light/intermittent smoking is generally higher in the older age group among U.S.-born males and females, whereas smoking among the foreign-born of both sexes is low at younger ages and remains low at older ages. Taken together, these findings highlight the importance of considering both race/ethnicity and nativity in assessments of smoking patterns and in strategies to reduce overall U.S. smoking prevalence and smoking-attributable health disparities.     

The Educational Homogamy Gap Between Married and Cohabiting Couples in Latin America

The explosive expansion of non-marital cohabitation in Latin America since the 1970s has led to the narrowing of the gap in educational homogamy between married and cohabiting couples (what we call “homogamy gap”) as shown by our analysis of 29 census samples encompassing eight countries: Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Mexico, and Panama (N = 2,295,160 young couples). Most research on the homogamy gap is limited to a single decade and a small group of developed countries (the United States, Canada, and Europe). We take a historical and cross-national perspective and expand the research to a range of developing countries, where since early colonial times, traditional forms of cohabitation among the poor, uneducated sectors of society have coexisted with marriage, although to widely varying degrees from country to country. In recent decades, cohabitation is emerging in all sectors of society. We find that among married couples, educational homogamy continues to be higher than for those who cohabit, but in recent decades, the difference has narrowed substantially in all countries. We argue that assortative mating between cohabiting and married couples tends to be similar when the contexts in which they are formed are also increasingly similar.     

The Contribution of Job and Partner Satisfaction to the Homeostatic Defense of Subjective Wellbeing

Two studies investigate subjective wellbeing (SWB) homeostasis. The first investigates the contribution of job satisfaction (JS) and partner satisfaction (PS) to the homeostatic defense of SWB. The extant model of homeostasis does not include either variable. The second study investigates the relationship between Homeostatically Protected Mood (HPMood) and other factors involved in the homeostatic model. It has been proposed that HPMood is the basic, biologically determined, positive mood that saturates SWB and other related variables, and forms the basis of the SWB set-point. Thus, if HPMood is an individual difference and it perfuses other homeostatic variables, then HPMood should be responsible for much of the shared variance between such variables. Two comparative samples are involved. One is a group of 171 Hong Kong Chinese recruited through convenience sampling. The other is a group of 343 Australians recruited via a general population survey. Results indicate that both JS and PS predict significant variance in Global Life Satisfaction beyond the existing factors in the homeostatic model. It is also found that, after controlling for the effect of HPMood, the strength of correlations between SWB and other homeostatic variables is significantly diminished. The implications of these findings are discussed.     

Experiences of Sleep and Benzodiazepine Use among Older Women

Sleep disturbances are common among older women; however, little is known about sleep experiences among chronic benzodiazepine users. The experience of sleep, sleep troubles, and management of sleep problems were explored through semistructured interviews with 12 women aged 65–92 who had used a benzodiazepine for three months or longer to treat a sleep disturbance. Themes that emerged from an interpretive phenomenological analysis included multiple reasons for sleep disruptions (health problems, mental disturbances, and sleeping arrangements), opposing effects of benzodiazepines on sleep (helps or does not work), and several supplemental sleep strategies (modification of the environment, distraction, and consumption).