Inequality Roundup, Stories in the News

Today I want to post a roundup of some items in the news that piqued my interest, we have poverty measurement, disabilities, spending on children in the US, Medicaid and mortality, getting high schoolers to go to college, and health/income inequalities in the OECD: 

Official Poverty Measure Ignores Key Improvements in the Safety Net Since the 1960s” CBPP Off the Chart Blog “the official measure of poverty counts various means-tested cash assistance programs that have shrunk markedly in real per capita terms, while ignoring key forms of “non-cash” assistance that have expanded substantially.  The result is that using the official poverty measure to compare today’s poverty rate to that of decades ago yields a distorted picture that obscures more than it illuminates.” One interesting piece of this blog post is that the author displays the time series for both the official poverty measure and the NAS alternative measure. 

At ADA Anniversary, Disabled Workers Still Struggle More with Unemployment,” PBS News Hour (Short Video) “SEN. TOM HARKIN:I’m asking employers to do what they have already agreed to do, and that is to have a little bit more affirmative action, to seek out people who have disabilities who are qualified for the job…We’re not asking any business to hire anyone with a disability who’s not qualified. This is not charity.” People with disabilities have fared very badly in the economic downturn – a hugely neglected issue – the segment guests mentioned some promising case studies (ex. Walgreens), but I’d like to know if there’s some rigorous research on employment demonstrations that work.

 Federal Spending on Kids Slips for First Time in 3 DecadesUrban Institute, Kids Count Report. “Key findings suggest that the size and composition of expenditures on children have changed considerably, but children have not been a budget priority. In 2011, federal outlays on children fell for the first time since the early 1980s, dropping from $378 billion in 2010 to $376 billion. Over the next decade, outlays on children are projected to decline from 10 to 8 percent of the federal budget.” The federal stimulus was good for children, but now that most of that money is gone, who will pick up the slack?

Mortality and Access to Care among Adults after State Medicaid Expansions” Sommers et al. NEJM “Medicaid expansions were associated with a significant reduction in adjusted all-cause mortality (by 19.6 deaths per 100,000 adults, for a relative reduction of 6.1%; P=0.001). Mortality reductions were greatest among older adults, nonwhites, and residents of poorer counties.” This paper takes the gold medal for timeliness – the states are now weighing whether to take the federal money to expand Medicaid through the ACA. Check out a good summary at the Incidental Economist. With the Oregon Health Study, the case seems very convincing that Medicaid substantially improves health.

LATE INTERVENTIONS MATTER TOO: THE CASE OF COLLEGE COACHING IN NEW HAMPSHIRE Carrell & Sacerdote, “We present evidence from an ongoing field experiment in college coaching/ mentoring. The experiment is designed to ask whether coaching plus cash incentives provided to high school students late in their senior year have meaningful impacts on college going and persistence. For women and recent immigrants (male or female), we find large impacts on the decision to enroll in college and to remain in college. Intention to treat estimates are an increase in 12 percentage points in the college going rate (against a base rate of 50 percent) while treatment on the treated estimates are 24 percentage points. Offering cash bonuses alone without mentoring has no effect.” The informational hurdles for enrolling in the right college are huge – especially for people with no support system – some well-timed guidance can have a big effect.

Income-Related Inequalities in Health Service Utilisation in 19 OECD Countries, 2008-2009” OECD Report, “This Working Paper examines income-related inequalities in health care service utilisation in OECD countries. It extends a previous analysis (Van Doorslaer and Masseria, 2004) to 2008-2009 for 13 countries, and adds new results for 6 countries, for doctor and dentist visits, and cancer screening. Quintile distributions and concentration indices were used to assess inequalities. For doctor visits, horizontal equity was assessed, i.e. the extent to which adults in equal need of physician care appear to have equal rates of utilisation. The paper considers the evolution of inequalities over time by comparing results with the previous study, as data permit. Health system financing arrangements are examined to see how these might affect inequalities in health service use.” Another study showing how the poorest people in the United States fall substantially below the rest of the developed world in access, and the wealthiest quintile has comparable access to the poor in much of Europe.

 

About Brendan Saloner

I am a postdoctoral fellow at the University of Pennsylvania in the Robert Wood Johnson Health and Society Scholars Program. I completed a PhD in health policy at Harvard in 2012. My current research focuses on children's health, public programs, racial/ethnic disparities, and mental health. I am also interested in justice and health care.
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