Book Review: From Neighborhood to Nation: The Democratic Foundations of Civil Society,by Ken Thomson. Tufts University Press,Hanover, 2001

VOLUNTAS: International Journal of Voluntary and Nonprofit Organizations -     

Improving the contributions of technology assessment to the health care system of the U.S.A.

Summary Based on 14 case studies of highly effective therapies and the reasons they succeeded less frequently than they could, we propose a variety of steps to improve the health care system of the U.S.A. Whatever proposal emerges from current national debates until innovations are shown to be safe and effective, they should not be supported; when slightly better technologies are much more expensive than other good ones we need to consider appropriate choices carefully; simplified billing and bookkeping would reduce our costs; when a technology is rapidly introduced cautionnary measures may be needed; tracking immunization and repairing their omissions requires a new system; educational programs such as seen effective in hypertension should be applied in other areas such as vaccination; in organ transplantation the nation should consider “presumed consent”; our payment system sometimes creates perverse incentives and therefore needs review; and the preferences of the public in allocation of health resources need to be discovered once the public is informed about the issues. Research supported by Andrew W. Mellon Foundation.     

THE WELFARE IMPLICATIONS OF MORAL HAZARD AND ADVERSE SELECTION IN COMPETITIVE INSURANCE MARKETS

I model a competitive insurance market with both moral hazard and adverse selection, and analyze the effect on welfare when both problems are present simultaneously. An examination of the interaction between these two problems leads to two hypotheses. First, the nature of the equilibrium contracts is such that each problem partially offsets the welfare loss associated with the other. And second, the degree to which this occurs increases as agents become more heterogeneous. Simulation results overwhelmingly support both hypotheses.     

Classifying At‐Risk High School Youth: The Influence of Exposure to Community Violence and Protective Factors on Academic and Health Outcomes

Using cluster analysis, 789 predominately Latino and African American high school youth were classified into varying academic at‐risk profiles using self‐reported levels of academic confidence, motivation to attend school, perceived family support, connections with teachers and peers, and exposure to violence. Six clusters emerged, 5 of which were identified as “at‐risk.” The clusters were examined in relation to academic stress, health status, grades, and school retention. Exposure to violence was one distinguishing feature of youth identified as most vulnerable, vulnerable, and resilient; however, youth identified as resilient recorded better academic outcomes.     

Nonresponse weighting adjustment using estimated response probability

To reduce nonresponse bias in sample surveys, a method of nonresponse weighting adjustment is often used which consists of multiplying the sampling weight of the respondent by the inverse of the estimated response probability. The authors examine the asymptotic properties of this estimator. They prove that it is generally more efficient than an estimator which uses the true response probability, provided that the parameters which govern this probability are estimated by maximum likelihood. The authors discuss variance estimation methods that account for the effect of using the estimated response probability; they compare their performances in a small simulation study. They also discuss extensions to the regression estimator.     

Sex differences in nonverbal expressiveness: Emotional expression,personality, and impressions

Sex differences in expressiveness are well documented, but the reasons for and correlates of these important differences are not well studied. A comprehensive set of emotion-relevant personality measures was administered to 40 female and 39 male undergraduate participants, who were also videotaped in three situations: engaging in natural social interaction, describing a past emotional experience, and posing various emotions. Videotapes were judged by sets of naive observers as to emotion communicated and overall impression. Expressive females, who appeared friendly and dominant in social interaction, were found to have a hostile/aggressive personality (but this was not true of males). Expressive females also tended to look angry/disgusted when describing happy and sad experiences. The findings suggest that nonverbally skilled, charismatic women (but not men) may often possess a dominant/aggressive but self-controlled personality, in a new twist on the theory that sex differences in expressiveness result in part from the oppression of women in society.This research was supported in part by an intramural research grant from University of California, Riverside.     

Mitigating disaster losses through insurance

Losses from natural disasters have increased in recent years due to growth of population in hazard-prone areas and inadequate enforcement of building codes. This article first examines why homeowners have not voluntarily adopted cost-effective protective measures and have limited interest in purchasing insurance. It then proposes a disaster-management program which utilizes insurance coupled with well-enforced building codes to reduce future damage. Banks and financial institutions play a key role in this program by requiring inspections of homes as a condition for a mortgage. New forms of reinsurance coverage against catastrophic losses from natural disasters are necessary to protect insurers against potential insolvency from the next mega-disaster.     

Helping oneself by helping others: evaluation of a service credit banking demonstration

Between 1987 and 1990, the Robert Wood Johnson Foundation funded six service credit banking demonstration programs among the elderly in which participants delivered services in return for credits, entitling them to later service. This evaluation of the demonstrations found that these six sites successfully attracted elders for the delivery of household support services to a relatively old, frail population with potentially limited social networks. Evidence on the significance of the "credit" in attracting volunteers was mixed, but the programs have attracted new volunteers, and have not substituted for other volunteer activities. Program development has entailed considerable staff investment in volunteer support; programs are better understood as community membership organizations than as mechanical exchanges.     

The communal construction of the “outsider” in a Quaker community in Costa Rica

This paper attempts to capture the process of exclusion in a Quaker, rural farming community in the rain forest mountains of Costa Rica. The outsider is defined as a member of a close community, whose voice is not part of the communal dialogue. The silenced voice is investigated through the lives of four members — an authoritarian founding father in a community of the fraternal, an entrepreneur and his wife among the uncommercial, and an inarticulate man among the persuasive.