Navigating health care: brokerage and access for undocumented Latino immigrants under the 2010 Affordable Care Act

ABSTRACT

Brokerage is a prominent mechanism that explains access for Latino immigrants to many American institutions. However, few studies examine the dual nature of brokerage in answering questions on access to health care for undocumented Latino immigrants. The growing importance of Federally Qualified Health Centers (FQHCs) and ethnic navigators connecting immigrants to health care under the 2010 Affordable Care Act calls attention to the duality of brokers and its role in access. The study draws from 44 in-depth interviews with providers, clinic directors, navigators, and immigrant patients and two years of fieldwork in FQHCs in California’s San Francisco Bay Area (2011–2013). Results show that brokers enable access through coaching and myth-busting but they also hinder it through scrutiny and bureaucratic filtering. The widespread dependence on brokerage, I argue, leads to ersatz brokerage, such as when providers navigate the health-care system for the undocumented without the appropriate linguistic resources or coordination. Furthermore, the study shows that the duality in brokerage generates misinformation, churning, and alienation. Understanding the relational processes that both include and exclude vulnerable populations from needed services enhances theories of immigrant integration and can help design more efficient policies and address inequalities related to documentation status.     

我国外贸代理制度的法律冲突及其消解

我国《合同法》第402条和第403条引入的英美法上的代理制度,在逻辑上软化了我国《对外贸易法》中关于国营贸易经营权的强制性规定,破坏了仲裁条款的相对性原则,架空了行纪合同制度。所以,在实践中需要采用利益衡量的方法、体系解释的方法、目的解释的方法和历史解释的方法等来化解这些冲突与矛盾,从而符合立法本意。     

基于交易频率的农产品交易机制选择研究

我国农产品交易频率主要受农产品生产的自然资源依赖性、生产和消费的即时性、时空分布的非均衡性以及农产品的小规模经营特征的影响。因此,在农产品交易活动市场依赖度日趋提高的背景下,根据农产品交易频率特征,建立以农产品中介经纪组织和经纪人为主要载体的交易机制,是降低农产品交易频率的有效措施。     

(Net)Working out: social capital in a private health club

In Bowling Alone Robert Putnam considers the possibility that the growth of private health clubs and the rising rates of membership to such clubs might represent a counter-trend to his thesis on the decline in social capital. In this paper I explore this idea using ethnographic data and social network analysis. I show both that and how networks form in health clubs and I discuss the ways in which these networks constitute social capital for their members. In addition, however, I explore the 'dark side' of this form of social capital. I argue that high integration amongst some members of a fitness class can generate a power differential between those members and other, less integrated members who experience this negatively. Furthermore, with an eye on Burt's (2005 ) important thesis on brokerage and closure, I argue that brokerage between relatively closed clusters of agents can lead to inter-group rivalry and conflict, which, in turn, is experienced negatively by those involved.     

Brokerage in the Sacred Sphere: Religious Leaders as Community Problem Solvers in Rural Malawi1

Religious leaders in Sub‐Saharan Africa do not just deal with the spiritual needs of members but are also heavily engaged in dealing with social problems and material needs. Although true elsewhere, the realities of limited state infrastructure and an increasingly diverse religious landscape make it crucial for religious entrepreneurs to deal with material problems if they hope to gain adherents. This article applies the concepts of problem solving and brokerage ( Burt, 2005 ; Knoke, 1990 ) to a case study of religious leaders in Balaka, a small town of rural Malawi. I argue that religious leaders solve problems in three major areas—material infrastructure, activities and organization, and healthcare—and that they are able to do so at least partly because of their connections to various overlapping secular and religious networks. I focus both on the provision of material resources and the facilitation of effervescent experiences in order to advance a fuller understanding of the experience of poverty and the ways leaders in poor communities work to solve problems.     

复杂知识网络的结构特征对知识流动的影响

利用Jackson算法构建了知识网络的计算实验模型.该知识网络模型具备典型社会网络的五大特征.通过仿真试验探讨了单个虚拟的知识网络中具有不同属性的知识结点其知识水平演化的规律,两个具有不同知识水平的虚拟网络间建立知识合作联系的不同机制对落后网络和先进网络间知识扩散程度的不同影响,以及落后网络的网络密度和连接权重对网络间知识扩散程度的不同影响.     

我国旅游业的高额回扣问题及其对策研究

旅游业的高额回扣源自旅游商品的超高标价.导游薪金制度的不合理、旅行社恶性竞争、旅游购物商店管理混乱、旅游者消费心理不成熟等,是高额回扣未能根治的主要原因.因此,根治旅游高额回扣必须对旅游购物商店、旅行社以及导游人员进行全方位的有效管理.     

战略联盟——宁波地区证券经纪行业的选择方向

在新转轨的时代,证券经纪业务所面临的困境有目共睹。以宁波地区证券营业部为特定研究对象,运用波特五力模型分析行业内的竞争态势,并在此基础上寻找适合该地区证券经纪业务的战略模式,即战略联盟,该模式对国内其它地区的证券经纪行业能起到很好的借鉴作用。     

When homophilous ties matter: Social network brokerage and individuals’ innovative behavior

Occupying a brokerage network position provides the focal actor with structural opportunities to access non-redundant information and knowledge which may result in an enhanced innovative behavior. However, such a network position entails important challenges associated with knowledge articulation and behavioral constraints, which may hinder focal actors’ innovative outcomes. Drawing on the contingency perspective of social capital theory, in this study, we examine how socio-demographic similarity between a focal actor and his/her direct contacts may affect the relationship between brokerage and innovative behavior. Specifically, we focus on professional background and gender as salient socio-demographic categories that depict the type of knowledge possessed as well as informational, and behavioral differences among people. The results of an empirical study on 134 employees (the response rate was 88%) and 31 supervisors (the response rate was 97%) of an Italian consulting company show that having many homophilous ties, in terms of professional background and gender, strengthens the positive relationship between social network brokerage and individuals’ innovative behavior. These findings furnish important insights for the research on intra-organizational social networks and innovative behavior. At the end of the paper, we discuss its theoretical and practical implications as well as the potential limitations that open avenues for future research in the field.     

绩效与不足：合作运动对中国农业生产影响分析——以20世纪前半期乡村合作社为中心

传统农业改造之关键是新的现代性农业生产要素的引进,而新生产要素的分配、扩散对于仅能维持生存的个体农民而言是力所不及的,需要由相当的组织机构来承担。为挽救农村危机,20世纪前半期国民政府借助行政力量自上而下掀起了颇具声势的乡村合作运动。诸多合作社的组建,对于农村中诸如资金、技术及良种等现代性生产要素的引进有着促进作用,但同时合作社制度又为国家政权建设过程中基层社会形成的“经纪”体制所困扰,使其效用难以最大限度地发挥。