Bureau's Current Population Survey Research Articles

Regional and social disparities in cessation behavior and motivation to quit among U.S. adult current smokers, Tobacco Use Supplement to the U.S. Census Bureau's Current Population Survey 2014-15 and 2018-19.

Variation in smoking cessation behaviors and motivators across the United States may contribute to health disparities. This study investigates regional differences over time in two key cessation motivators (quit interest and doctor's advice to quit) and two cessation behaviors (past-year quit attempts and recent successful cessation) across diverse demographic factors. Data were analyzed from two releases of the Tobacco Use Supplement to the U.S. Census Bureau's Current Population Survey (TUS-CPS) for the years 2014-15 and 2018-19. The analysis included sex, age, race and ethnicity, education, marital status, employment status, and household income. Findings from 2018 to 2019 TUS-CPS revealed that quit interest was highest in the Northeast and lowest in the Midwest, while doctor's advice to quit was most prevalent in the Northeast and least in the West. Past-year quit attempts were most common in the Northeast and least in the South. Recent successful cessation (defined as quitting for 6 to 12 months) was highest in the Northeast and Midwest, with the South showing the lowest rates. Compared to the 2014-15 survey, 14 demographic groups (7 in the Midwest, 6 in the South, and 1 in the West) showed decreases in both quit interest and actions to quit. Notably, the Asian non-Hispanic group in the Northeast experienced a significant decrease in quit interest (-17.9%) but an increase in recent successful cessation (+369.2%). Overall, the study indicates that while quit interest was highest in the West, the South exhibited the lowest rates of quit attempts and successful cessation. Significant differences were also noted between age groups. These findings highlight the need for further research into cessation behaviors at more granular levels to inform policies aimed at reducing smoking-related health disparities among populations facing the greatest challenges in cessation.

Employer-Sponsored Health Insurance Premium Cost Growth and Its Association With Earnings Inequality Among US Families

Costs of employer-sponsored health care benefits have increased faster than workers' wages for several decades, with important implications for disparities in earnings and wage stagnation. To quantify how growth in employer-sponsored health insurance (ESI) premiums may have been associated with reduced annual wages, disparities in earnings by race and ethnicity and wage level, and wage stagnation among US families with ESI. In this economic evaluation, serial cross-sectional analyses were performed of US families receiving ESI from 1988 to 2019 based on data from the Consumer Expenditure Survey, Kaiser Employer Health Benefits Survey, US Census Bureau's Current Population Survey, and federal payroll taxation rates. Statistical analysis was conducted from February 2022 to July 2023. Percentage of annual compensation associated with health care premiums (after accounting for tax deductibility) and lost wages associated with growth in cost of premiums from 1989 to 2019 based on 1988 compensation. To assess disparities, analyses were stratified by race and ethnicity and wage level. In 1988, 44.7 million individuals (head of household: mean [SD] age, 43.3 [13.1] years; 30.1% were female; and 2.4% identified as Asian, 6.2% as Hispanic, 8.6% as non-Hispanic Black, and 82.8% as non-Hispanic White) were covered by ESI family plans; this number remained similar in 2019 at 44.8 million individuals (head of household: mean [SD] age, 47.1 [12.9] years; 41.3% were female; and 1.3% identified as Asian, 9.9% as Hispanic, 9.9% as non-Hispanic Black, and 78.9% as non-Hispanic White). In 1988, the mean (SD) household size was 3.3 (1.3) people, and in 2019, it was 3.4 (1.3) people. If ESI costs had remained at the same proportion of the 1988 average compensation package, then in 2019, the median US family with ESI could have earned $8774 (95% CI, $8354-$9195) more in annual wages. During all 32 years, health care premiums as a percentage of compensation were greater for non-Hispanic Black and Hispanic families than for non-Hispanic White families. By 2019, 13.8% (95% CI, 13.5%-14.1%) of compensation among non-Hispanic White families with ESI went to premium costs compared with 19.2% (95% CI, 18.8%-19.7%) among non-Hispanic Black families and 19.8% (19.3%-20.3%) among Hispanic families with ESI. In 2019, health care premiums as a percentage of compensation at the 95th percentile of earnings for families with ESI were 3.9% (95% CI, 3.8%-4.0%) compared with 28.5% (95% CI, 27.8%-29.2%) at the 20th percentile of earnings. From 1988 to 2019, the mean cumulative lost earnings associated with growth in health care premiums for the median US family with ESI was $125 340 (95% CI, $120 155-$130 525) in 2019 dollars, 4.7% of earnings over the 32-year period. This economic evaluation of US families receiving ESI suggests that 3 decades of increasing health care premiums were likely associated with reduced annual earnings and increased earnings inequality by race and ethnicity and wage level and were meaningfully associated with wage stagnation.

Disparities in Smokefree and Vapefree Home Rules and Smokefree Policy Attitudes Based on Housing Type and Cigarette Smoking Status, United States, 2019.

This study examined variations in cigarette smoking status, home smoking and vaping rules, and attitudes toward smoking rules among U.S. adults. We analyzed data from the 2019 U.S. Census Bureau's Current Population Survey Supplements (n = 40,296 adults) and calculated weighted prevalence estimates of adult cigarette smoking based on housing type. In 2019, multi-unit housing (MUH) residents who currently smoked were predominantly residents of privately rented housing (66.9%), followed by privately owned (17.6%) and public housing (15.5%). MUH residents who currently smoked had the highest proportions of allowing smoking (26.7%) or vaping (29.1%) anywhere inside their homes and were least likely to support rules allowing smoking inside all MUH apartments or living areas. In the adjusted models, MUH residents with a current smoking status were 92% less likely to have a complete smoking ban. More than one in four MUH residents with a current smoking status allowed all smoking inside the home and supported allowing smoking inside all MUH apartment or living areas, reinforcing how MUH residents may be at higher risk of experiencing secondhand smoke or aerosol exposure, or incursions within their places of residence. Our results can inform the development, implementation, and sustainment of strategies to reduce exposures from tobacco and nicotine products in all living environments.

Incidence of female suicide in New York City: how important are socioeconomic factors?

After a steady decline in the incidence of suicide in the last 3 decades of the twentieth century, suicide rates in the US and likewise in New York City (NYC) began to rise. A breakdown of the city's rates by gender reveals that since 2000, suicides among men had held steady while the rate among women had increased in every age group, in divergence from the national pattern of rising rates in both genders. This study considers a broad range of socioeconomic variables to identify those most strongly associated with suicide rates of women in NYC. Drawing on 4 decades of data from the Census Bureau's Current Population Survey, the NYC Department of Health and Mental Hygiene's Vital Statistics and the Federal Bureau of Investigation's Uniform Crime Reporting Program, we use an Autoregressive Distributed Lag (ARDL) model to estimate short and long run relationships between suicide rates in women aged 15-44 and a range of socioeconomic factors. We find a positive aggregate association between women's suicide rates and the unemployment rate, the White percentage of the city's population, the number of forcible rapes reported in the crime statistics, and a negative association between suicide and abortion rates. The results of the study suggest that labor market conditions, rather than societal factors such as marriage or fertility rates affect younger women's suicide rates in NYC. Second, sexual violence against women, found in micro studies to have severe long-term negative effects on victims' mental health is also positively associated with the aggregate suicide rate. Finally, higher abortion rates correspond with lower suicide rates at the city level, but the mechanisms behind this link are not as clear, since micro studies find little association between unwanted pregnancy termination and mental health.

National Trends in Emergency Department Visits by Adults With Mental Health Disorders

BackgroundAlthough mental health disorders (MHDs) affect as many as 1 in 4 adults in the U.S., the national trends in emergency department (ED) use for adults who have MHD comorbidities are unknown. ObjectiveTo evaluate the role of mental health disorder co-morbidities for adults who use the ED and how this utilization differs by insurance type. MethodsThis is a retrospective analysis of the National Emergency Department Survey (NEDS) dataset of adults 18 to 64 years of age that was conducted from 2006 to 2011. We defined individuals with MHD comorbidities by applying the MHD Clinical Classification Software groupings to any of the 1 to 15 diagnostic fields available in the NEDS. We further evaluated ED visits made for a primary diagnosis of MHD by applying the same aforementioned codes to the primary diagnosis. We constructed ED visit rates using the U.S. Census Bureau's Current Population Survey. We used descriptive statistics and tested for differences in trends in visits and visit rates by payer using an ordinary least squares regression. ResultsThe number of ED visits increased by 8.6% from 2006 to 2011. The number of ED visits made by adults primarily for MHDs and with MHD comorbidities increased by 20.5% and 53.3%, respectively (p < 0.0001); ED visits made adults without MHDs decreased by 1.1% (p = 0.72) for the same time period. When accounting for the population growth rate, ED visit rates made by adults with MHD comorbidities increased for all insurance types, but decreased for those without MHD comorbidities. ConclusionMHD comorbidities play a significant role in the increasing number of ED visits, regardless of insurance coverage. Additional studies are needed to understand the role of patients with MHDs and ED use.

Medicaid Underreporting in the CPS: Results from a Record Check Study

The use of survey data can be significantly hampered by the occurrence of measurement error, particularly that engendered by re- spondent misreporting. Previous studies have shown that public program participation tends to be substantially misreported and underestimated. Comparison with administrative records shows such a situation with the reporting of Medicaid enrollment in the U.S. Census Bureau's Current Population Survey (CPS); for 36.2 percent of enrollees, their coverage was not reported in the survey. While false positive reporting also occurs, it is, on a percentage basis, much less frequent. To understand and correct for the false negative reporting, and to develop improvements to surveys to mitigate the occurrence of misreporting, it is useful to understand the factors that relate to it. This research sought to establish the relationship between false negative Medicaid reporting and various factors associated with the coverage (such as recency and intensity), the enrollee (such as demographics and the use of services), and differences in coverage status between the respondent and the person for whom he or she was reporting. Results show that coverage patterns including shared coverage, recency, and intensity of coverage all strongly relate to false negative Medicaid

Impact of socioeconomic status on cancer incidence and stage at diagnosis: selected findings from the surveillance, epidemiology, and end results: National Longitudinal Mortality Study.

BackgroundPopulation-based cancer registry data from the Surveillance, Epidemiology, and End Results (SEER) Program at the National Cancer Institute (NCI) are mainly based on medical records and administrative information. Individual-level socioeconomic data are not routinely reported by cancer registries in the United States because they are not available in patient hospital records. The U.S. representative National Longitudinal Mortality Study (NLMS) data provide self-reported, detailed demographic and socioeconomic data from the Social and Economic Supplement to the Census Bureau's Current Population Survey (CPS). In 1999, the NCI initiated the SEER-NLMS study, linking the population-based SEER cancer registry data to NLMS data. The SEER-NLMS data provide a new unique research resource that is valuable for health disparity research on cancer burden. We describe the design, methods, and limitations of this data set. We also present findings on cancer-related health disparities according to individual-level socioeconomic status (SES) and demographic characteristics for all cancers combined and for cancers of the lung, breast, prostate, cervix, and melanoma.MethodsRecords of cancer patients diagnosed in 1973–2001 when residing 1 of 11 SEER registries were linked with 26 NLMS cohorts. The total number of SEER matched cancer patients that were also members of an NLMS cohort was 26,844. Of these 26,844 matched patients, 11,464 were included in the incidence analyses and 15,357 in the late-stage diagnosis analyses. Matched patients (used in the incidence analyses) and unmatched patients were compared by age group, sex, race, ethnicity, residence area, year of diagnosis, and cancer anatomic site. Cohort-based age-adjusted cancer incidence rates were computed. The impact of socioeconomic status on cancer incidence and stage of diagnosis was evaluated.ResultsMen and women with less than a high school education had elevated lung cancer rate ratios of 3.01 and 2.02, respectively, relative to their college educated counterparts. Those with family annual incomes less than $12,500 had incidence rates that were more than 1.7 times the lung cancer incidence rate of those with incomes $50,000 or higher. Lower income was also associated with a statistically significantly increased risk of distant-stage breast cancer among women and distant-stage prostate cancer among men.ConclusionsSocioeconomic patterns in incidence varied for specific cancers, while such patterns for stage were generally consistent across cancers, with late-stage diagnoses being associated with lower SES. These findings illustrate the potential for analyzing disparities in cancer outcomes according to a variety of individual-level socioeconomic, demographic, and health care characteristics, as well as by area measures available in the linked database.

Measuring Labor Earnings Inequality Using Public-Use March Current Population Survey Data: The Value of Including Variances and Cell Means When Imputing Topcoded Values

Using the Census Bureau's internal March Current Population Surveys (CPS) file, we construct and make available variances and cell means for all topcoded income values in the publicuse version of these data. We then provide a procedure that allows researchers with access only to the public-use March CPS data to take advantage of this added information when imputing its topcoded income values. As an example of its value we show how our new procedure improves on existing imputation methods in the labor earnings inequality literature.

Marriage, employment, and health insurance in adult survivors of childhood cancer

Adult survivors of childhood cancer are at risk for disease- and therapy-related morbidity, which can adversely impact marriage and employment status, the ability to obtain health insurance, and access to health care. Our aim was to identify factors associated with survivors' attainment of these outcomes. We surveyed 1,437 childhood cancer survivors who were >18 years old and >10 years past diagnosis. We compared our cohort's data to normative data in the Medical Expenditure Panel Survey and the U.S. Census Bureau's Current Population Surveys. Respondents were stratified by hematologic malignancies, central nervous system tumors, or other solid tumors and by whether they had received radiation therapy. Most respondents were survivors of hematologic malignancies (71%), white (91%), and working full-time (62%); 43% were married. Compared with age- and sex-adjusted national averages, only survivors of hematologic malignancies who received radiation were significantly less likely to be married (44 vs. 52%). Full-time employment among survivors was lower than national norms, except among survivors of hematologic malignancies who had not received radiation therapy. The rates of coverage of health insurance, especially public insurance, were higher in all diagnostic groups than in the general population. While difficulty obtaining health care was rarely reported, current unemployment and a lack of insurance were associated with difficulty in obtaining health care (P < 0.05 and P < 0.001, respectively). CONCLUSIONS/IMPLICATIONS FOR CANCER SURVIVORS: Subgroups of cancer survivors do experience long-term differences in functional outcomes that should be addressed early. Survivors who are unmarried, unemployed, and uninsured experience difficulty accessing health care needed to address long-term health concerns.

The Financial Value of a Higher Education

Five years have passed since the U.S. Census Bureau published synthetic estimates of work-life earnings by educational attainment. This paper updates those figures with the most recent data from the U.S. Census Bureau's annual Current Population Surveys, and adds net present value analysis of the financial benefit of a college degree to the individual and to the federal government. The added value of a bachelor's degree over a high school diploma or GED has increased to $1.2 million in 2005 from $910,000 in 1997-1999. Compared with the average out-of-pocket costs of a college education, this represents a return on investment in excess of 27%. The added value also corresponds to an additional $133,000 in cumulative federal income tax revenue. Accordingly, it would be financially worthwhile for the federal government to replace loans with grants in the financial aid packages of low income students if this yielded at least a 32% increase in the number of low income students graduating with bachelor's degrees.

Expanding the View: The Lives of Women With Severe Work Disabilities in Context

I want people to know to know that we are human. We live, we love, we hurt, we laugh, we cry ... we just want to be seen and heard as human beings. Shay (Study Participant) The Rehabilitation Act Amendments of 1992 have mandated priority in services to those with the most severe disabilities. When gender and ethnicity are combined, women with severe work disabilities (SWDs) constitute the largest percentage of those with the most severe disabilities (Jans & Stoddard, 1999). Statistics indicating low educational attainment, unemployment of underemployment, high incidence of abuse, low self-esteem, and increased isolation (e.g., CoRone & Cottone, 1992; Danek, 1992; Fulton & Sarbonie, 1994; Hanna & Rogovsky, 1991; Nosek, Howland, & Young, 1997) highlight the problems faced by women with SWDs, yet much of the extant research has been conducted with women with disabilities who were employed of pursuing an education (e.g., Nosek et al., 1994). Unquestionably, women with SWDs face substantial barriers to participation in social, educational, and work roles (Capella, 2002; Doren & Benz, 1998; Graham, Jordan, & Lamb, 1990). Statistical representation, however, does not tell the full story of their lives (Morris, 1992; Saleebey, 1997). An exclusive emphasis on problems may have hindered investigations into aspects of existence that have meaning on personal, familial, and cultural levels (Marsella & Leong, 1995). The lives and experiences of women with SWDs consist of more than problems associated with disability, ethnicity, and gender status (Wendell, 1996), but rarely have they been approached from a perspective that seeks to understand rather than to diagnose. This study was developed in response to the dearth of knowledge about the lives and views of women with SWDs. This study is significant in that qualitative approaches to investigation combined with a feminist standpoint methodology (Alcoff & Potter, 1993; Riger, 1992) and a strengths-based approach to interviewing (DeJong & Miller, 1995; Saleebey, 1997) gave five women with SWDs the opportunity to describe their lives, experiences, and decisions in an interpersonal context. Prolonged observation of the participants, in-depth interviews, and interactive viewing of videotaped interviews were used to identify emerging themes that can widen the view of women with SWDs so that more than merely a snapshot of problematic aspects of their lives is given. Theories and interventions can effectively address the needs of women with SWDs only if derived from the women's standpoint (Alcoff & Potter, 1993). Method Participants The present study used a theoretically driven sample (Lincoln & Guba, 1985) rather than one selected on the basis of how well participants represented a larger pool of women with disabilities. The sample consisted of five women with physical or psychiatric disabilities, or both, who met the U.S. Census Bureau's (2002) Current Population Survey criteria for severe work disability. None of the five women were employed at the time of the study because of long-term physical or mental illness that prevented performance of any kind of work nor had any of them worked at all in the previous year because of illness of disability; all five were under 65 years of age and were covered by Medicare or were receiving Social Security Insurance. Participants ranged in age from 30 to 63 years, were of European American descent, and lived with one or more severe disabilities. The five participants were referred to me by counseling professionals or through personal contacts; each participant chose her own pseudonym. Shay, age 30 and having a disability for 4 years, lived alone in a subsidized housing complex. Shay was diagnosed with multiple sclerosis 2 years after sustaining multiple injuries in a car accident. The severity of her disabilities required a paid care provider to assist with activities of daily living. …

Protecting Workers from Secondhand Smoke in North Carolina

Exposure to job-related secondhand smoke represents a significant, but entirely preventable occupational health risk to non-smoking workers. This article examines trends in smoke-free workplace policies in North Carolina. We also examine whether workers comply with such policies. Data from the Census Bureau's Current Population Survey were analyzed from 1992 through 2002. Trends for North Carolina workers are compared with workers nationally and trends are presented by age, race, gender, and type of worker. North Carolina ranks 35th in the proportion of its workforce reporting a smoke-free place of employment. The proportion of workers reporting such a policy doubled between 1992 and 2002. Females were more likely to reporta smoke-free work environment (72.0%, CI +/- 2.6) than males (61.2%, CI +/- 4.6%). Blue-collar (55.6%, CI +/- 5.5) and service workers (61.2%, CI +/- 8.4), especially males, were less likely to report a smoke-free worksite than white-collar workers (73.4%, CI +/- 2.6). Compliance with a smoke-free policy does not appear to be an issue, only 3.2% of workers statewide reported someone had violated their company's nonsmoking policy While some progress has been made in North Carolina to protect workers from secondhand smoke, significant disparities exist. Smoke-free policies can make a significant difference in reducing exposure to airborne toxins and their associated diseases, and these protective public health policies have not been shown to reduce business revenues. Much has been done to assure the health and safety of workers through public health policy However, opportunities to protect North Carolina workers from the health effects of secondhand smoke are limited by a preemptive state law.

Will the United States Ever Have Universal Health Care?

The profession of social work has long been linked with efforts for health reform. At dawn of 20th century, Jane Addams, Lillian Wald, and others advocated reforms to prevent spread of communicable diseases in urban areas and raised concern about high rates of infant mortality. During 1930s Frances Perkins, a settlement house worker, became secretary of labor and advocated compulsory universal health insurance. Social workers also played central roles in enactment of Medicare and Medicaid, and during 1990s, NASW developed its own legislative proposal for health care, which Senator Daniel Inouye (D-HI) introduced in 1992 (Moniz & Gorin, 2003). The 1999 Delegate Assembly enacted a policy statement committing NASW to a national health policy that ensures right to universal access to a continuum of health and mental health care (NASW, 2003, p. 172). The failure of efforts to reform health system during 1990s led to a period of disillusionment about nation's ability to expand coverage to uninsured population (Gorin, 1997). In recent years, however, interest in this issue has resurfaced. Since 2001, Institute of Medicine has released a series of in-depth studies on problem of health coverage in United States (http://www.iom.edu/project.asp?id=4660). The National Coalition on Health Care (NCHC), which consists of large businesses, labor unions, religious organizations, health providers, and others representing least 150 million Americans, has advocated fundamental reforms aimed at instituting universal coverage (NCHC, 2004, p. 2). Other groups, such as Universal Health Care Action Network and Physicians for a National Health Program have accelerated their efforts for reform and universal coverage. Despite this, serious problems remain with our health system, particularly in terms of access and coverage. Tens of millions of individuals lack health coverage for an entire year, and millions more have only partial or inadequate coverage. Despite efforts by Clinton administration to enact policies for universal health care, United States remains only industrialized nation that does not provide universal access to health care. Problems with health system have only grown worse during Bush administration. This National Health Line column examines current status of health coverage, considers proposals for expanding coverage, and concludes with a discussion of implications for social workers. HEALTH CARE COVERAGE IN THE UNITED STATES The precise number of individuals without health coverage is open to debate (Congressional Budget Office [CBO], 2003). The figures most often cited come from U.S. Census Bureau's Current Population Survey (CPS), which every March asks individuals about their insurance status during preceding year (CBO). By this measure, in 2003 (the most recent year for which we have figures), 45 million individuals went without health insurance for entire year (U.S. Census Bureau, 2004). However, some analysts believe that these figures exaggerate scope of problem (Institute of Medicine, 2001). Although CPS ostensibly captures information about individuals who were without coverage for an entire year, data from other surveys suggests that it really measures number of people who lack coverage at time of survey (CBO). According to CBO estimates, in 1998 between 21 and 31 million people were without coverage for entire year, whereas between 39 million and 42.6 million were without it at a particular point in time; between 56.8 million and 59 million individuals were without coverage at some time during year. By CPS measure 43.9 million people were without coverage in 1998, and 45 million were without it in 2003, so we can conclude that CBO estimates for 1998 are roughly comparable to 2003. In any event, however one measures it, the number of uninsured Americans is substantial and increasing (Institute of Medicine, 2001, p. …

Disparities in smoke-free workplace policies among food service workers.

Information is lacking on which groups of workers are protected from job-related environmental tobacco smoke. Data from the Census Bureau's Current Population Survey are analyzed for trends in smoke-free workplace policies among 38 major occupations. Data are also analyzed to determine the degree of compliance with such policies. Although over three fourths of white collar workers are covered by smoke-free policies, including 90% of teachers, just 43% of the country's 6.6 million food preparation and service occupations workers benefit from this level of protection. Compliance with workplace restrictions is not a significant human resources issue because only 3.8% of workers reported that someone violated a smoke-free policy in 1999, down from 4.9% in 1996. Protection for workers is increasing, but those in food preparation and service occupations are significantly less protected than others.

Do the majority of Asian-American and African-American smokers start as adults?

Background Identifying ethnic differences in the age of smoking onset from nationally representative data can lead to improved targeted prevention programs and policies to combat smoking in ethnic communities. Methods Analyzing data from the Tobacco Use Supplements of the U.S. Census Bureau's Current Population Surveys throughout the 1990s, differences in the age of regular smoking onset among Asians/Pacific Islanders (A/PI), African Americans (AA), Hispanics/Latinos (H/L) and non-Hispanic whites (WH) are reported. Data on people aged 26 to 50 years at the time of the survey interview ( n =130,356; mean age=38.4 years; 47.9% male; 1.9% A/PI, 7.8% AA, 5.2% H/L, and 85.1% WH) were examined. Results Results indicate significant ethnic disparities in when people start smoking, among A/PIs in particular, and AAs and H/Ls to a lesser degree, who initiate regular smoking at later ages than do WHs. The majority of A/PIs and AAs initiated smoking as young adults, with almost half (47.8%) of A/PIs who were ever regular smokers starting between ages 18 and 21, compared with 39.8% of AAs, 37.5% of H/Ls, and 36.7% of WHs. Conclusions These findings indicate significant ethnic disparities in relation to when people start smoking, with the majority of A/PIs and AAs initiating as young adults. The findings suggest that prevention strategies should begin at a young age and continue throughout young adulthood, especially among ethnic minority populations. Further consideration of the different influences on later initiation in ethnic minorities may lead to suggestions to improve current smoking-prevention programs aimed at adolescents and young adults.

Development of a Spanish-Language Version of the U.S. Household Food Security Survey Module

A survey module used to monitor the prevalence of household food insecurity and hunger in the United States was developed by a broadly based collaborative project with leadership from the USDA and the National Center for Health Statistics (NCHS). It has been administered annually since 1995 as a supplement to the Census Bureau's Current Population Survey (CPS) and is part of the National Health and Nutrition Examination Survey (NHANES) and other national surveys. Spanish is the second most common language in the United States, yet no standardized Spanish-language version of this instrument has yet been sanctioned by the relevant federal agencies. In the CPS, interviewers free-translate the questions while interviewing respondents who prefer to have the interview conducted in Spanish. National prevalence data indicate relatively high rates of food insecurity for Hispanic households, raising the question whether methodological artifacts may contribute to these rates. We analyzed eight Spanish-language versions of the instrument that have been used in published work for variability in wording and phrasing. We then conducted focus groups of low-income Spanish-speaking participants from Mexico, Central America, Puerto Rico and Cuba to refine a single Spanish-language instrument. We also employed professional translators to render the English instrument into "standard" Spanish; both instruments were then back-translated. The focus group-derived instrument uses simpler language and grammar; its back-translation integrity to the English version was slightly better than the professionally translated version. We provide the instrument for use and further testing by other investigators.

The Geographic Distribution of Home Computer Ownership in the Southeast: An Analysis of Racial and Economic Differences

Although empirical studies on the "digital divide" have examined differences in computer access at the national scale, statewide variations in personal computer (PC) ownership have not been assessed at the regional scale. The objective of this article is to examine the geographic distribution and extent of the racial and economic divides in home PC ownership across 10 states of the U.S. Southeast. Recent data from the Census Bureau's Current Population Survey are used to compare the proportion of households owning a PC in each state and the region as a whole. Our results indicate that White households are significantly more likely to own a PC than African American households in all 10 states. The extent of this racial divide is particularly large in rural states such as Alabama and Mississippi, where African American ownership rates are smaller than in other states. A significant difference in PC ownership also exists in all states between the highest- and lowest-income households, particularly in Tennessee and Georgia. Our analyses emphasize the importance of a state-level approach for understanding the nature of the digital divide.

Paying more and losing ground: how employer cost-shifting is eroding health coverage of working families.

This report describes the decline in employer-based health coverage between 1989 and 1996 and the underlying causes of that decline--including rapidly rising worker premiums and other economic variables. The analysis combines data from a variety of sources, including the U.S. Census Bureau's Current Population Survey, the National Medical Expenditures Survey for workers with employer coverage, and annual KPMG Peat Marwick Surveys. The authors employed regression analysis to determine the relative importance of economic factors on an individual's probability of having employer-based coverage--as either a worker or dependent. In addition to providing a basis for measuring the impact of various factors on the level of coverage of workers and dependents during the 1989 to 1996 period, these models also allowed projection of coverage levels in future years under alternative assumptions about premium growth, employee contribution shares, and other economic factors.

Changes in Homeownership and Households, 1993 to 1995: An Evaluation of Estimates from the Current Population Survey

Long-term changes in the number of households and the rate of homeownership serve as indicators oftrends in the housing sector and in economic and social well-being. The Census Bureau's CurrentPopulation Survey (CPS), the principal data source used to measure these trends, underwent majordesign changes in 1994. Users have questioned whether these changes affected the CPS's accuracy asa basis for measuring trends during the first half of the 1990s.This research note uses independent estimates from the American Housing Survey (AHS) to assessnonsampling errors introduced by the 1994 CPS changes. The results indicate that the CPS-basedHousing Vacancy Survey (HVS) significantly underestimates the 1993 to 1995 growth in the numberof households. Differences between homeownership trends estimated by the HVS and AHS are notsignificant.

Welfare and the family size decision of low-income, two-parent families

The effect of welfare on family size is estimated by means of an ordered probit analysis on low-income, two-parent families. A multiyear cross-sectional pooled data set derived from the US Census Bureau's Current Population Survey over the period 1979–1990 is analysed. Behavioural impacts from a range of economic variables are consistent in sign with theoretical predictions and are reasonable in magnitude. A $1000 increase in the amount of welfare per child can be expected to increase the number of children by 2.2% for such families.