High Concentrations Of Poverty Research Articles

Ejaz Ghani (ed.). The Poor Half Billion in South Asia: What is Holding Back Lagging Regions? New Delhi: Oxford University Press. 2010. Hardbound. 339 pages. Rs 795.00.

South Asia portrays an interesting paradox; it is the second fastest growing region in the world, yet the region has high concentration of poverty and is home to dismal social outcomes, conflicts and gender disparities. South Asia in fact is a land of two highly diverse regions; ‘Asia Shinning’ and ‘Asia Suffering’. The disparity between the two areas as lagging and leading regions is so sharp that these seem to be anchored in two different centuries. The richer region has experienced stupendous growth, due to its economic geography, globalisation and growth-promoting institutions while the limited growth potential of the poorer region has been further compounded by the weak capacity of the state to deliver social services. The question then is what should be done to address the gigantic task of poverty alleviation and take up the challenges posed by the concentration of poverty. What should be done and what the public policy can do? With a focus on this contrast as seen in Bangladesh, India, Pakistan, and Sri Lanka, the essays in this volume put into perspective the colossal task of poverty eradication and inclusive growth. The research studies included in this book not only provide fresh perspective on spatial disparities but also offer innovative, short-term as well as long-term, policy solutions to escape the poverty trap.

AGENTES DE IMPLEMENTAÇÃO: MEDIAÇÃO, DINÂMICAS E ESTRUTURAS RELACIONAIS

O presente trabalho aborda a implementação das políticas públicas no nível local, em áreas de alta concentração de pobreza, a partir do estudo da mediação estrutural e dinâmica estabelecida pelos agentes implementadores entre a população e o poder público. Analisamos como esses agentes de implementação realizam suas práticas a partir da construção de mecanismos relacionais, da sua estrutura de redes pessoais e da interface entre a ação pública e a sociedade, e suas consequências no acesso da população aos serviços públicos. Os resultados pretendem contribuir para a compreensão da implementação local no resultados das políticas públicas no arranjo federativo brasileiro. Os resultados empíricos usados para a reflexão da temática do trabalho foram gerados em estudos qualitativos, com base etnográfica, e de aná­lise de redes sociais desenvolvidos com Agentes Comunitários de Saúde em distintas regiões do Brasil, entre 2004 e 2005. Foram estudados ACS dos municípios de Sobral, São Paulo, Taboão da Serra e Santo André, a partir de acompanhamento etnográfico de suas ações e com levantamento das redes sociais dos agentes e da comunidade de implementação do Programa Saúde da Família. PALAVRAS-CHAVE Redes sociais, políticas públicas, implementação de políticas, gestão pública e saúde, Agentes Comunitários de Saúde. ABSTRACT This paper discusses the implementation of public policies at the local level in areas of high concentration of poverty by the study of mediation and structural dynamics established by the implementing agents in the population and government. We analyze how these agents perform their practical implementation and by the construction of relational mechanisms and their network structure and its consequences in people’s access to public services. The results are intended to contribute to the understanding of the explanatory role of location in the results of public policies in the Brazilian federal arrangement. The empirical results were generated in qualitative studies and analysis of social networks developed with Community Health Workers in different regions of Brazil between 2004 and 2005. We studied Agents from four Brazilian municipalities: Sobral, São Paulo, Taboão da Serra and Santo André. We did ethnographic research to understand their practices and also social network research, considering the networks from the agents and also from the implementation policy. KEYWORDS Social networks, public policy, implementation policy, health public policy, Community Health Workers.

Neighbourhood Effects in Canada:A Critique

A growing number of researchers and policy-makers concern themselves with the possible effects of living in areas with high concentrations of poverty. This paper provides an overview of such literature from a Canadian policy perspective. I draw three conclusions. First, household exposure to concentrated poverty is substantially less than in the United States. Second, much of the existing Canadian research on neighbourhood effects relies on regression analysis, which is prone to bias and misinterpretation. Third, the most persuasive research to date suggests that residential environment matters most to an individual's mental health and exposure to crime, but has little influence on self-sufficiency or child development. Smaller spheres of interaction, such as at the classroom or roommate level, appear to matter more.

Disparities in Geographic Access to Pediatric Subspecialty Care

To identify correlates of geographic access to pediatric medical subspecialists in the United States and identify characteristics of populations at risk for poor geographic access. Geographic access was operationalized as distance to care. Using data from the American Board of Pediatrics and the Claritas' Pop-Facts Database, the straight-line distance between each zip code in the United States and the nearest subspecialist was calculated for each pediatric subspecialty using zip code centroids. Using 16 specialty-specific, random-effects multiple regression models, zip code characteristics associated with being farther from a subspecialty provider were identified. Under-18 population, metropolitan status, and presence of a nearby teaching facility were associated with shorter distances to care across pediatric subspecialties. The proportion of the population below the federal poverty level was positively associated with greater distances to care. Zip codes in the Mountain and West North Central regions, likewise, were significantly farther from pediatric subspecialists, even when statistically controlling for other factors. Pediatric populations at risk for poor geographic access to pediatric subspecialty care include those who reside in zip codes with high concentrations of poverty, in rural and small metropolitan areas, and in the Mountain and West North Central regions. The extent to which these distances create barriers to receipt of care is not established.

Mapping Educational Inequality: Concentrations of Poverty among Poor and Minority Students in Public Schools

We examine high concentrations of poverty in public schools by comparing economic segregation in schools and in their corresponding attendance boundaries. To do this, we assign poverty rates from the 2000 census to maps of school attendance boundaries for 21 of the largest school districts and link this with data enumerating the number of poor children enrolled in each school. Results show that percentages of poor children in neighborhood schools is greater than in their corresponding catchment areas and this difference is greater when the majority of children living in a neighborhood are racial minorities. These patterns reflect the withdrawal of wealthier children from public schools and into private, charter and magnet schools. The result is that poor and minority children are much more concentrated in high-poverty public schools than they would be if all children attended their local schools.

Geographic aspects of poverty and health in Tanzania: does living in a poor area matter?

Previous studies have consistently found an inverse relationship between household-level poverty and health status. However, what is not well understood is whether and how the average economic status at the community level plays a role in the poverty-health relationship. The purpose of this study is to investigate the concentration of poverty at the community level in Tanzania and its association with the availability and quality of primary health care services, the utilization of services, and health outcomes among household categories defined by wealth scores. A principal component method has been applied to rank households separately by urban/rural location using reported levels of asset ownership and living conditions. The household wealth scores were also used to classify communities into three cluster-types based on the proportion of households belonging to the poorest wealth tercile. On average, all the wealth terciles living in low poverty concentration areas were found to have better health outcomes and service utilization rates than their counterparts living in high poverty concentration clusters. Consistent with the finding is that high poverty concentration areas were further away from facilities offering primary health care than low poverty concentration areas. Moreover, the facilities closest to the high poverty concentration areas had fewer doctors, medical equipment and drugs. Among the high poverty concentration clusters, the 10 communities with the best women's body mass index (BMI) measures were found to have access to facilities with a greater availability of equipment and drugs than the 10 communities with the worst BMI measures. Although this study does not directly measure quality, the characteristics that differentiate high poverty concentration clusters from low poverty concentration clusters point to quality as more important than physical access among the study population.

Psychosocial stress and social support as mediators of relationships between income, length of residence and depressive symptoms among African American women on Detroit's eastside

Patterns of mental health are clearly associated with life circumstances, including educational and economic opportunities, access to safe and supportive neighborhoods, socially structured exposures to stressors and to supportive relationships. In this article, we examine the social and economic correlates of depressive symptoms among African American women residing within a predominantly African American urban neighborhood in Detroit, USA, with relatively few economic resources. We identify distinct stressors associated with financial strain, neighborhood social disorder (concern about police responsiveness, safety stress), and experiences of discrimination. We test the extent to which each of these stressors mediates relationships between household income, length of residence in the neighborhood, social support and depressive symptoms. Our results suggest that for women in this racially segregated area with a high concentration of poverty, relationships between household income and symptoms of depression are partially mediated by financial stress and social support, but that stressors associated with neighborhood disorder and discrimination influence depressive symptoms independent of household income. Furthermore, we find that length of residence in the neighborhood is negatively associated with financial stress and positively associated with police stress and social support, with no significant net effect on symptoms of depression. We conclude that higher household income may help reduce symptoms of depression by reducing financial stress and strengthening social support even within neighborhoods with high concentrations of poverty. However, increased household income does not protect African American women residing in a high poverty community from distress associated with neighborhood disorder or experiences of discrimination.

Geographical variation in acute psychiatric admissions within New York City 1990–2000: growing inequalities in service use?

The paper analyses geographical variations in use of acute psychiatric inpatient services within New York City and how these have changed from 1990 to 2000. We review literature suggesting reasons for the variations observed. Data from the New York State Department of Health Statewide Planning Research and Cooperative System were combined with population census data to produce age standardized ratio indicators of admissions and of bed days, as measures of use of general hospitals for psychiatric conditions, by males aged 15–64, in Zip Code Areas of New York City, in 1990 and 2000. Geographical variations in hospital use were related to proximity to general hospitals with psychiatric beds and to socio-economic status of local populations (as recorded in the 1990 and 2000 population censuses). Areas close to psychiatric hospitals areas show high admission levels. Controlling for this, Zip Code Areas with higher concentrations of poverty, of African American residents or of persons living alone were associated with relatively high admission ratios. These relationships vary somewhat between diagnostic groups. Area inequalities in standardized admission ratios persisted and widened between 1990 and 2000, and the highest hospital admission ratios were increasingly concentrated where social and economic disadvantage was greatest. Various possible reasons for this trend are explored. We conclude that increasing intensity of poverty in disadvantaged areas is not likely to provide an explanation and that the trends are more likely to result from changes in hospital management and funding affecting access to hospital services.

Anomie in the metropolis: the city of American sociology and psychiatry.

American sociologists and psychiatrists have often characterized cities as sites of social disintegration conducive to insanity. Small-town rural life, by contrast, has been presented as ideally suited for fostering mental health. Early research in psychiatric epidemiology confirmed these views. After World War II, psychiatrists and sociologists collaborated in influential research projects on mental illness in the community. Although these studies were guided by theories of social stratification, which ignores location, cities remained problematic for psychiatrists because they contained high concentrations of poverty and social problems and, consequently, mental health problems.

Neighborhood house price indexes in Chicago: a Fourier repeat sales approach

House price indexes are estimated for 851 census tracts in the City of Chicago using a Fourier repeat sales estimator. Locally weighted regression allows price indexes to be estimated for submarkets with small numbers of sales. Annual appreciation rates are higher between 1990 and 1996 in neighborhoods close to the city center with large minority populations, high concentrations of poverty, and many vacant homes in 1990. Copyright 2003, Oxford University Press.

Neighbourhoods and Exclusion

Neighbourhoods and Exclusion

Nativity differences in neighborhood quality among New York city households

This article adds to the literature on locational attainment of immigrants by evaluating how immigrant households in New York City compare with native‐born households with respect to neighborhood characteristics. It also examines whether the relationship between immigrant status and neighborhood quality varies by race/ethnicity and place of birth.Overall, foreign‐born households are more likely than native‐born households to live in neighborhoods with less access to medical care, higher rates of tuberculosis, and higher concentrations of poverty. Multivariate analyses reveal that all but one of these disadvantages disappear for foreign‐born households as a group. However, island‐born Puerto Ricans and immigrants—especially Dominicans, Caribbeans and Africans, and Latin Americans—are more likely to reside in lower‐quality neighborhoods than native‐born white households. Equally important, native‐born blacks and Hispanics are also disproportionately disadvantaged relative to native‐born whites, suggesting that a racial hierarchy exists in the locational attainment of households in New York City.

Nonadherence to asthma treatment and failure of therapy

Adherence to clinical regimens is paramount in determining their effectiveness. Asthma is a chronic illness that requires consistent, anti-inflammatory therapy. A "high risk" profile for fatal or near-fatal asthma has emerged that includes suboptimal pharmacotherapy in conjunction with severe disease, psychologic dysfunction, black race or Hispanic-American ethnicity, and residence in an urban area with a high concentration of poverty. Collaboration between physicians and patients is necessary to allow individuals to make choices informed by medical facts and the physician's experience. Objective monitoring of adherence and pulmonary function and acceptance by the clinicians of the National Asthma Education and Prevention Program guidelines to control airway inflammation are essential in order to reduce the unacceptable rates of morbidity and mortality associated with asthma.

Role of Latina-Owned Beauty Parlors in a Latino Community

The United States is currently struggling with how to best address persistent poverty and the high rates of social problems associated with its existence in urban centers (Hoechstetter, 1996; Jennings, 1994). Moore and Pinderhughes (1993) characterized the debate on the as who is responsible for the condition of the poor - the individual or society? Is persistent poverty caused by behavioral pathology or the economic structure? (p. xii). The answers to these questions have profound implications for the development of strategies to eliminate persistent poverty. Unfortunately, the debate has taken a deficit perspective toward communities (Saleebey, 1992, 1996) and has ignored community assets in the search for revitalization strategies (Kretzmann & McKnight, 1993; McKnight & Kretzmann, 1991). A focus on community social problems has a long historical record in the United States (Halpern, 1995): The neighborhood has long been an important locus for efforts to address the causes and consequences of poverty in American society. Over the course of the past century neighborhood-based initiatives have been called on to reduce class conflict, counter feelings of anger and alienation, localize control of institutions, create jobs and reverse neighborhood decline, and address a variety of specific poverty-related problems. (p. 1) Thus, the revitalization of neighborhoods presents many challenges for social work and other professions in helping to promote policies and services that address the needs of communities in a manner that meaningfully involves their populations in the decision-making process. Much attention has been paid to the high-risk environment of inner-city children and their families (Kozol, 1995) and the need for government (local, state, and federal) and the private sector to collaborate to create positive change at the community level (Perez & Martinez, 1993). Any efforts to revitalize these communities must enhance local assets. This article examines the nature and extent of persistent poverty among one population of color - the Latino population. A case study of Latina-owned beauty parlors in a large New England city illustrates the multifaceted role Latino businesses can play in the social-economic network of the community. Implications for social work practice in Latino communities are presented. Literature Review Poverty There are an estimated 22 million Latinos in the United States (Castex, 1994). The median income for Latino families is $23,884, compared to $39,239 for non-Latino white families (Institute for Puerto Rican Policy, 1993). All Latino groups have incomes below the national median (Holmes, 1996); Puerto Rican families have the lowest income of any group ($20,654), followed by Mexican families ($23,018). Cuban families have the highest median income of any Latino group ($30,095). Puerto Rican families have the highest percentage of people living below the poverty rate (39.4 percent), followed by Mexican families (29.5 percent), Central or South American families (24.6 percent), other Latino families (20.6 percent), and Cuban families (18.0 percent). These rates are in sharp contrast with the poverty rate of 9.4 percent for non-Latino white families (Institute for Puerto Rican Policy, 1993). However, despite the high concentration of poverty among most Latino subgroups, they have not received sufficient national attention. Enchautegui (1994) identified five reasons for this inattention: (1) misperceived identity, (2) lack of widespread attention to the working-poor population, (3) geographical concentration, (4) lack of political participation, and (5) differences among Latino subgroups. The interplay among these factors has resulted in Latinos being considered invisible in national policy. The literature on Latino poverty can be categorized into three schools of thought (Borges-Mendez, 1993; Enchautegui, 1994; Hurtado, 1995; Institute for Puerto Rican Policy, 1996; Melendez, 1993; Moore & Pinderhughes, 1993; Morales & Bonilla, 1993; Perez & Cruz, 1994; Perez & Martinez, 1993; Segura, 1992; Torres, 1995): (1) Poverty is the result of an interplay between immigrant status and rapid demographic changes (high rates of female-headed households and fertility); (2) Latinos are an underclass (low formal educational achievement and lack of or inconsistent employment history); and (3) a lack of market-attractive skills exclude Latinos from high-wage jobs. …

The social context of syphilis persistence in the southeastern United States.

In light of the racial-ethnic and poverty composition of the United States population and the distribution of syphilis morbidity across population subgroups, it is important to determine how race-ethnicity and poverty jointly and independently affect transmission dynamics of syphilis and other sexually transmitted diseases. Populations of minority race ethnicity and populations of poverty are both marked by youthful age composition and relative scarcity of men, and both populations live in areas of high poverty concentration. Sexually transmitted disease morbidity, particularly syphilis morbidity, is concentrated in these populations, which are neither purely racial-ethnic groupings nor purely economic groupings. This social context creates potential sex partner pools of high risk and high sexually transmitted disease prevalence, which carry a higher probability of exposure to infection for each sex act. The combined effects of poverty, minority race-ethnicity, and geographic clustering apparently contribute to persisting syphilis morbidity, particularly in the southeastern United States.

Correlates of Marital Status among African American Mothers in Chicago Neighborhoods of Concentrated Poverty

The following theoretical frameworks have been used to explain declining marriage patterns of Blacks in poor neighborhoods in the US: 1) imbalanced sex ratios with decreased availability of marriage partners and few employment prospects for Black men; 2) the intergenerational continuity of family formation patterns; and 3) the social context of life in a poor ghetto. This analysis touches on all explanations. The aim is to explain differences between Black married and unmarried mothers and the determinants of a never married status. Data are obtained from the 1986 Urban Poverty and Family Life Survey on Black women in high poverty concentration areas of Chicago Illinois. The findings show never married mothers as younger and heavily reliant on welfare assistance. Over 75% of never marrieds and 22% of ever marrieds are aged 18-23 years. Ever married mothers tend to be from 2 parent families. The analysis supports prior evidence from the studies of Duncan et al. and Tienda and Steir that intergenerational links in welfare participation occur more frequently in poverty neighborhoods. Almost 25% of never marrieds live in public housing projects compared to 10% of ever married mothers; 14% of ever married and 35% of never married mothers have never been employed. 44% of ever married mothers are currently married and have spent more time in the labor force. Maternal income among ever married mothers is double that of never mothers ($634 versus $304 monthly). Legal marriage is considered unlikely to greatly affect the likelihood of a Black mother receiving child support. 9.6% of never marrieds versus 6.2% of ever married are cohabiting. Findings from logistic models show that AFDC receipts or maternal education are good predictors of never married status. The best predictors are respondents age respondents education and paternal presence in childhood (a father with a high school diploma). The logistic model including fertility factors shows that the best predictors are the three aforementioned factors and the number of children. Additional socioeconomic factors in the model show a decreased impact of respondents education due to a stronger impact of increased time on welfare and lower household income.

Single Mothers, the Underclass, and Social Policy

This article focuses on the question of whether mother-only families are part of an emerging urban underclass. An underclass is defined as a population exhibiting the following characteristics: weak labor force attachment, persistence of weak attachment, and residential isolation in neighborhoods with high concentrations of poverty and unemployment. We find that only a small minority of single mothers fit the description of an underclass: less than 5 percent. But a small and growing minority of black, never-married mothers meet all three criteria. We argue that welfare programs are necessary but that too heavy a reliance on welfare can facilitate the growth of an underclass. In contrast, universal programs such as child support assurance, child care, health care, children's allowances, and full employment would discourage such a trend and promote economic independence among single mothers.